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Neuro > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

What are the causes of meningitis?

A

viruses, bacteria, other infectious causes and other non infectious causes

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2
Q

What is aseptic meningitis?

A

meningitis that is culture negative - either because it is non bacterial or the bacteria cannot be cultured

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3
Q

What are the usual aetiological agents of viral meningitis?

A

enteroviruses

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4
Q

Does viral meningitis require treatment?

A

no - it is usually self limiting

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5
Q

What are the 3 bacteria that are the commonest cause of bacterial meningitis?

A

strep pneumoniae, h. influenzae and neisseria meningitidis

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6
Q

What feature of the bacteria mean that they cause meningitis?

A

they evade the immune system because they are encapsulated and so can’t be fixed by complement and can’t be phagocytosed

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7
Q

Describe the pathogenesis of meningitis

A

Commensals invade the bloodstream where they multiply if they survive the host immune responses, they then cross the blood brain barrier and invade the meninges and CNS. Due to the immune response there is increased permeability of the blood brain barrier and an increase in ICP. Then the host immune response causes neurotoxic damage and neuronal injury.

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8
Q

What are the clinical features of meningitis in adults?

A

fever, vomiting, headaches, stiff neck, altered mental state, photophobia, headache and seizure

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9
Q

What are the clinical features of meningitis in children?

A

fever, nausea, vomiting, irritability, bulging fontanelle

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10
Q

What is the distinctive clinical feature of meningococcaemia?

A

purpuric rash

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11
Q

How is meningitis defined clinically?

A

by an abnormal CSF

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12
Q

What is the normal pressure of the CSF?

A

150mm

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13
Q

What is the normal white cell count of the CSF?

A

less than 5 X 10^6

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14
Q

What is the normal red cell count of the CSF?

A

0

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15
Q

What is the normal protein in the CSF?

A

less than 0.4g/L

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16
Q

What is the normal glucose in the CSF?

A

60% of the blood level

17
Q

What is the normal appearance of CSF?

A

clear

18
Q

What are the CSF results for viral meningitis?

A

slightly increased white cells and protein but otherwise normal

19
Q

What are the CSF results for bacterial meningitis?

A

increased pressure, cloudy, very high white cell count, gram stain positive, high protein count, low glucose

20
Q

What are the CSF results for TB meningitis?

A

increased pressure, cloudy, increased white cells, very high protein, very low glucose

21
Q

When is a lumbar puncture contraindicated?

A

raised ICP, shock, extensive purpuric rash, convulsions, coagulation abnormalitites, infection at lumbar puncture site, respiratory insufficiency

22
Q

Why does a CSF sample need to be sent to the lab immediately?

A

if left the cells will lyse and the cell count will rapidly decrease

23
Q

Do CSF test results definitively distinguish between different types of meningitis?

A

no - wide variety of results

24
Q

What is the treatment for bacterial meningitis?

A

resuscitation/life support, fluids, antibiotics, steroids

25
Q

What antibiotics are given for bacterial meningitis?

A

cephalosporin with additional gentamicin and penicillin if under 3 months

26
Q

What is encephalitis?

A

inflammation of the brain

27
Q

What is the most common cause of encephalitis?

A

HSV

28
Q

What is the treatment for encephalitis?

A

aciclovir

29
Q

How can you distinguish between meningitis and encephalitis clinically?

A

encephalitis involves an altered conscious state

30
Q

What is menigoencephalitis?

A

a combination of meningitis and encephalitis

31
Q

What vaccines are available for meningitis?

A

Hib, meningococcus C and B, pneumococcus

Neuro (43 decks)

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