CNS infection Flashcards
Listeria- bug? age? signs?
Gram positive Rod, >55yo, seizure or FND
Pneumococcus bug? treatment?
gram positive doplococci, Vanc plus 3rd gen ceph
Meningococcus bug? tx?
Gram negative diplococci, 3rd gen ceph
why and when steroids for meningitis? dose?
stabilized BBB, given before abx/10q6 for 4 days
at risk for pseudomonas meningitis?
skull fx, penetrating trauma, NSG, shunt
Neisseria meningitis prophylaxis?
roomate, next to infected for 8 hours, intimate partner
TB meningitis CSF glucose? cells?
very low/pleocytosis with mononuclear cells
WNV presentation, RF?, tx?
flaccid paralysis, immunocompromised, nothing
Brain Abscess bugs?
toxo, nocardia, listeria, aspergillus
immigrant with brain abscess?
neurocystericosis
brain abscess treatment?
Vanc cephalosporin anaeorobic coverage
when to give steroids with brain abscess?
mass effect , inc ICP
size threshold of brain abscess to treat medically?
<2.5 cm
Viral meningitis diagnosis?
CSF PCR but if repeat negative consider biopsy
TB meningitis CSf?
lymphocyte predominance, very low glucose
listeria CSf?
elevated WBC modestly and mostly lymphocytes, glucose is normal to decreased. Cultures positive within 3 days
viral meningitis with blood in CSf?
HSV
encephalitis with MRI showing b/l BG and thalamic hyperintensities
WNV
dosing of HSV meningitis?
acyclovir 10mg/kg/day
dexamethasone in bacterial meningitis dosing and timing?
before first abx, .15mg/kg every 6 hours for 4 days
HSV encephalitis CSF?
lymphtocytic pleocytosis, normal glucose, slightly elevated protein, RBC characteristic
MRI finding of HSV encephalitis?
hemorrhagic lesion of the temporal lobe
bugs that will cause post neurosurgical meningitis?
staph, pseudomonas, propionobacterium
characteristic speccific to propionobacterium growth?
indolent growth, can take up to 10 days to be positive on culture
bugs causing menignitis with a CSF leak?
S pneumo and H flu
listeria can be found in what?
soft cheeses and smoked meats
most common bugs of infected VP shunt?
initially skin flora like staph, later on more like strep and pseudomonas
when to use intraventricular abx for ventriculomeningitis?
refractory
when do the most of venticulomeningitis happen?
within 10 days after EVD placement
goal MIC for cephalosporin to be effective against pneumococcal meningitis? if does not reach that then use what?
MIC
what can you give if van does not sterilize CSF in pneumococcal meningitis?
intraventicular abx and can add rifampin
positive latex agglutination test in meningitis?
very specific for neisseria or strep
empiric meningitis coverage in severely immunocompromised?
vanc rocephin amp, ampho B, flucytosine
tuberculosis meningitis CSF?
high lymphs, very low glucose, high protein
meningitis that can present with seizures and focal neurologic deficits?
listeria
gram negative rods meningitis?
H flu
gram positive rods meningitis?
listeria
who to cover for pseudomonal meningitis?
shunt, penetrating trauma, NSG
