CNS Flashcards
Meningitis
Most common cause of Bacterial Meningitis in neonates?
- Group B Strep (agalactiae)
- E. Coli
- Listeria monocytogenes
Most common cause of Bacterial Meningitis in adolescents?
Neisseria Meningitidis
Most common cause of Bacterial Meningitis in adults?
Strep. Pneumoniae
Most common cause of Bacterial Meningitis in adults over 60?
- S.pneumoniae
- N.meningitidis
- H. influenzae
Clinical Presentation of Bacterial Meningitis?
- Fever
- Nuchal Rigidity
- Altered Mental Status
- Headache
Complications with S. pneumoniae?
- Seizures
- Cerebral Infarction
Complications with N. meningitidis?
- Non-suppurative pharyngitis
- Petechiae/ Purpura
- Myalgia
- Septic Arthtitis
Which clinical presentations indicate CT scan prior to a lumbar puncture?
- Papilledema
- Altered mental status
- Focal neurologic deficit
- Immunocompromised state
- New-onset seizure (within 1 week)
- History of CNS disease or head trauma
CSF findings indicative of bacterial meningitis:
- Opening pressure >200 mm H2O
- WBC count1000-5000/microL
- > 80% neutrophils
- Protein >200mg/dL
- Glucose <40mg/dL
- CSF:serum glucose ratio ≤0.4
Physical Exam tests that indicate Bacterial Meningitis?
- Kernig’s sign- Unable to extend leg w/ a bent knee
- Brudzinski sign- Knees bend when head is flexed
Empiric treatment for Bacterial Meningitis?
- Vancomycin + 3rd gen Cephalosporin (Ceftriaxone)
* Add Dexamethasone for S. pneumo or unknown
What treatment should be added to the regimen in patients over 50 to cover Listeria?
Ampicilin
Empiric Treatment for Neonatal Meningitis?
Ampicillin + Cefotaxime/Amionglycoside
Empiric Treatment for patients with penetrating head trauma or recent neurosurgery?
Vancomycin + Ceftazidine/ Cefepine/ Meropenem
What prophylactic treatment is recommended for people exposed to N. Meningitidis?
- Rifampin
- Ciprofloxacin
- Ceftriaxone
Pathogens that cause Viral Meningitis?
- Enterovirus
- Herpes Simplex/ Varicella Zoster
- Lymphocytic choriomeningitis virus
- HIV
- Mumps
CSF analysis results that indicate viral meningitis?
- Incr. WBCs
- Mild Incr. Protein (<150)
- Normal Glucose
Treatment for Viral Meningitis caused by Herpes Simplex Virus?
Acyclovir
Patient presents with shaving half of their face or only combing one side of hair. What is the etiology?
Hemineglect syndrome
- Caused by lesion in the nondominant parietal lobe