CNS infections Flashcards
Non-infectious causes of meningitis
Meds, SLE, sarcoidosis, carcinomatosis
Most common cause of neonatal bacterial meningitis
Group B strep, E. coli, Listeria
Most common cause of meningitis in children >3 months
N. meningitidis, S. pneumo, H. influenza
Most common cause of meningitis in adults (18-59)
S. pneumo, N. meningitidis, H. influenza
Most common cause of meningitis in elderly (>50)
S. pneumo, N. meningitidis, Listeria
Most common cause of meningitis in immunocompromised pts
Listeria, GNRs, S pneumo
Maculopapular rash w/ petechiae and purpura indicates what cause of meningitis?
N. meningitidis
Vesicular lesions indicate what cause of meningitis
Varicella or HSV
CSF findings in bacterial meningitis
> 1000 WBCs (mostly PMN), low glucose (60)
Normal CSF findings
WBCs < 60
CSF findings in aseptic meningitis
60)
What should you do before a LP if signs of ICP?
CT scan (look for mass lesion)
Empiric treatment for meningitis in kids <3
Cefotaxime+ampicillin+vancomycin (and aminoglycoside if they are <4 wks)
Empiric treatment for meningitis in 3 months to 50 yrs
Ceftriaxone or cefotaxime+vancomycin
Empiric treatment for meningitis in pts >50
Ceftriaxone or cefotaxime + vanco+ampicillin
Empiric treatment for meningitis in pts with immunocompression
Ceftazidime+ampicillin+vancomycin
What should you vaccinate all pts >65 for?
S. pneumo (streptococcus)
What should you vaccinate asplenic pts for?
Streptococcus, meningococcus, and H. influenza (this one’s for you Dr. Haupt)
What should you vaccinate immunocompromised pts for?
Meningococcus
Tx for aseptic meningitis??
Supportive
Most common viral causes of encephalitis
Herpes (HSV1), arbovirus (Eastern equine encephalitis, West Nile Virus), Enterovirus
Non-viral infectious causes of encephalitis
Toxoplasmosis, aspergillosis
Non-infectious causes of encephalitis
Metabolic encephalopathies, T-cell lymphoma
Lab tests to work-up encephalitic pts
Electrolytes, CXR, urine and blood cultures, urine tox screen, LP for CSF
