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Neurology > CNS infections > Flashcards

CNS infections Flashcards

1
Q

What is meningitis?

A

Inflammation of the leptomeninges

-arachnoid and pia mater

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2
Q

What are the risk factors for meningitis?

A 
Extremities of age
HIV
Diabetes
Previous splenectomy
Living in over crowded places
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3
Q

What are the causes of meningitis?

A

N.meningitidis
L.monocytogenes
Strep. pneumoniae

Viral

  • enterovirus
  • HSV
  • VZV
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4
Q

What are the symptoms of meningitis?

A

The triad

1) neck stiffness
2) headache
3) fever

  • photophobia
  • non blanching rash
  • malaise
  • N&V
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5
Q

What is found on examination in meningitis?

A

+ve kernigs sign
-patient supine and pain on knee extension

Brudzinski’s sign
-on neck flexion there is flexion of knees and hips

Signs of raised ICP

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6
Q

What investigations are needed?

A

Begin Sepsis 6
Observations
ABG
ECG

Bloods

  • blood cultures
  • FBC
  • CRP
  • U&Es
  • LFTs
  • Clotting
  • Glucose

Serum PCR for antigens

Lumbar puncture
-if no signs of raised ICP

Throat swabs for bacterial or viral cause

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7
Q

What are the LP findings of bacterial infection in CNS?

A 
Appearance= yellow/cloudy
Glucose= low
Proteins= raised
WCC= raised and plymorphs
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8
Q

What are the LP findings of viral infection in CNS?

A 
Appearance= clear
Glucose= high
Proteins= normal or slightly raised
WCC= slightly raised
Lymphocytes
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9
Q

What are the LP findings of fungal infection of the CNS?

A 
Appearance= clear
Glucose= low
Proteins= high
WCC= slightly high
Lymphocytes
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10
Q

What are the LP findings of TB infection of the CNS?

A 
Appearance= cloudy/fibrin
Glucose= slight decrease
Proteins= High
WCC= slightly raised
Lymphocytes
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11
Q

What is the management?

A 
Admit to hospital
A-E
Begin sepsis 6
?Pain relief for headache
Anti-emetics if nauseous 
Empirical abx
-<3 months of >50yrs then IV cefotaxime and amoxicillin
- 3months-50 yrs then IV cefotaxime

Once confirmed N.meningitidis= IV benpen or cefotaxime

Treat household contacts and close contacts with either rifampicin or ciprofloxacin

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12
Q

What are the acute complications of meningitis?

A

DIC
Adrenal haemorrhage
Hydrocephalus

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13
Q

What are the chronic complications of meningitis?

A 
Brain abscess
Hearing loss
Facial nerve palsy
Memory loss
Ataxia
Seizures
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14
Q

What is encephalitis?

A

Inflammation of the brain parenchyma

Often viral- HSV1= most common cause

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15
Q

What are the symptoms?

A 
Headache
Fever
Drowsiness 
Seizures
Vomiting
Psychiatric disturbances
Focal deficits e.g. aphasia
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16
Q

What investigations are needed?

A 
Observations
A-E examination
Bloods
-FBC
-U&Es
-LFTs
-CRP
-Clotting
-Lactate
-Glucose
-Blood cultures
ABG
Serum PCR
LP if no signs of raised ICP

?MRI to look for inflammation

17
Q

What is the management of encephalitis?

A

IV aciclovir

Commence as soon as any clinical suspicion

Neurology (17 decks)

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