CNS

Question 1

What are the typical causal organisms of meningitis?

Answer 1

Pneumococcus (+ve)
Meningococcus (-ve)
Listeria (+ve)

Question 2

Describe the gram stain of pneumococcus

Answer 2

Streptococcus pneumoniae

Gram positive diplococci or short chains

Alpha haemolytic

Question 3

Describe the gram stain of meningococcus

Answer 3

Neiserria Meningitidis

Gram negative diplococci

Question 4

Describe the gram stain of listeria

Answer 4

Listeria monocytogenes

Gram positive rod

Question 5

What investigations should be done if suspected meningitis or encephalitis?

Answer 5

Blood cultures

Throat swab (bacterial and viral)

EDTA (Ethylenediaminetetraacetic acid) for bacterial PCR and CSF

Question 6

What is the common causative organism of encephalitis?

Answer 6

Herpes Simplex Virus

Question 7

What is the treatment of meningitis?

Answer 7

Ceftriaxone IV & dexamethasone (started just before or with first dose of antibiotics)

Add aciclovir IV if suspected encephalitis

Question 8

How does the treatment of meningitis change in the immunocompromised and the elderly?

Answer 8

Add amoxicillin IV 4 hourly if >60 or immunocompromised