CNS infections Flashcards
what is meningitis
infection of the meninges
common bacteria in meningitis for neonates
listeria, group B strep, E.Coli
common bacteria in meningitis for infants and young children
H.Influenzae
common bacteria in meningitis for older children and adults
nisseiria meningitidis, strep pneumo
common bacteria in meningitis for +65
strep pneumo, listeria
common bacteria causing meningitis in immunocompromised patients
listeria monocytogenes
what bacteria can cause meningitis in a patient who fracture their cribiform plate
strep pneumo
what is the most common cause of meningitis
VIRAL
what is the most common cause of meningitis in immunocompetent adults in the UK
enterovirus
what is a definitive sign of acute bacterial meningitis
neutrophils in the subarachnoid space
which type of meningitis causes cerebral oedema
bacterial
what happens in viral meningitis
lymphocytic inflammatory CSF reaction
NO pus formation or adhesions
classic triad for meningitis
headache, neck stiffness and fever
what are some other common symptoms for meningtis
photophobia
vomiting
what is a general presentation of a patient with acute bacterial meningitis
sudden onset with rigors and high fever
non-blanching rash with meningococcal septicaemiaclinic
clinical presentation of meningoencephalitis
headache, fever and neck stiffness + features of encephalitis
investigation for meningitis
lumbar puncture
CSF in bacterial meningits
cloudy, high protein, low glucose, NEUTROPHILS
CSF in viral meningitis
clear, LYMPHOCYTES
management of viral meningitis
supportive
usually lasts 4-10 days
management of bacterial meningitis in adults
ceftriaxone + dexamethasone
what can be used as an alternative to ceftriaxone
chloramphenicol
what is added in the management of bacterial meningitis in adults if the patient is >60 or immunocompromised
amoxicillin
management of bacterial meningitis in <3 month olds
cefotaxime + amoxicillin
management of bacterial meningitis in >3 month olds
dose cefotaxime + once daily ceftriaxone 6 hours later
management of listeria
IV ampicillin/amoxicillin
management in contact prophylaxis of meningitis
single dose ciprofloxacin orally or ceftriaxone IM
name some complications of meningitis
purulence
invasion
cerebral oedema
hydrocephalus
what is encephalitis
acute inflammation of the brain parenchyma
what is usually the cause of encephalitis
VIRAL - HSV, VSV, enteroviruses and adenovirus
what might limbic encephalitis be associated with
underlying malignancy or autoimmunity
clinical presentation of encephalitis
FEVER
flu-like illness
seizures
focal neurological deficits
behavioural changes
what is limbic encephalitis
antibody-mediated encephalitis
investigations for encephalitis and their findings
CSF - elevated lymphocytes
MRI - bilateral medial temporal lobe involvement
EEG
management of suspected HSV or VZV encephalitis
IV acyclovir
management of limbic encephalitis
treat cause e.g. tumour, immunosuppressive agent
