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Neurology > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

What are the main classifications of CNS infections

A 
Acute pyogenic meningitis (bacterial)
Acute aseptic meningitis (viral)
Acute focal suppurative infection (eg absess, subdural or extradural or extradural empyema)
Chronic bacterial (TB)
Encephalitis
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2
Q

What is the most cause of viral meningitis

A

enterovirus eg echo virus

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3
Q

what time of year does viral meningitis occur

A

late summer/autumn

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4
Q

How is viral meningitis diagnosed

A

viral stool culture

throat swab and csf for PCR

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5
Q

how is viral meningitis treated

A

supportive

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6
Q

What are the most common causes of viral enchephalitis

A

herpes simplex

herpes zoster

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7
Q

how is viral encephalitis treated

A

IV aciclovir

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8
Q

What are the typical clinical features of viral meningitis

A 
insidious onset
meningismus
stupor
coma
seizures
partial paralysis
confusion
psychosis
speech, memory problems
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9
Q

What investigations should be done in suspected viral encephalitis

A

lumbar puncture
EEG
MRI
if LP contraindicated do a CT

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10
Q

what commonly causes bacterial meningitis in neonates

A

Group B strep
Listeria
E.coli

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11
Q

what causes bacterial meningitis in children

A

h. influenza

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12
Q

What is the most common cause in 10-21 year olds of bacterial meningitis

A

meningococcal

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13
Q

What is more commonly the cause of bacterial meningitis in adults over 21

A

pneumococcal> meningococcal

listeria is seen in elderly

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14
Q

What are the possible sequelae of menigitis

A 
limb loss
deafness
blindness
cerebral palsy
quadriplegia
mental impairment
death
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15
Q

what causes of bacterial meningitis are seen in immunocompromised patients

A 
S.pneumonia, s.aureus
Listeria
TB
Mocardia asteroids
Cryptococcus neoformans (AIDS)
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16
Q

What causes the symptoms in meningococcal meningitis

A

Neisseria meningitis endotoxin

17
Q

How many types of h.influenzae are there and what type usually causes meningitis in young children

A

six

type b

18
Q

what does h.influenzae require for growth

A

blood factors

19
Q

What groups of people are more susceptible to pneumococcal menigitis

A 
hospitalized patients
CSF skull fractures
diabetics
alchoholics
young children
20
Q

What classification is listeria monocytogene

A

Gram positive bacilli

affects very young and old or immunocompromised

21
Q

What is the antibiotic of choice to treat listeria

A

IV ampicillin/amoxicillin

resistant to ceftriaxone

22
Q

What is cryptococcal meningitis

A

fungal - mainly in HIV
subtle presentation
aspetic CSF

23
Q

what is the treatment of cryptococcal meningitis

A

IV amphotericin/flucytosine

fluconazole

24
Q

what are the cardinal signs of bacterial meningitis

A 
fever
stiff neck
alteration in consciousness
headache
vomiting
photophobia
confusion 
rash
25
Q

what is aseptic meningitis

A

non pyogenic bacterial meningitis ie the spina fluid formula has ;
low WBC
minimally elevated protein
normal glucose

26
Q

What patients should undergo a CT prior to lumbar puncture

A 
immunocompromised
history of stroke, mass lesion or focal infection
new onset seizures 
papilloedema
abdnormal conscious levels
foca neuro deficit
27
Q

What is the empirical antibiotic therapy in adults with bacterial menigitis

A

IV ceftriazone 2g BD
Add IV Ampicillin/amocicillin 2g qds if listeria suspected
if allergic - chloramphenicol with vancomycin
if allergic and listeria - trimoxazole

28
Q

when can steroids be used in cns infections

A

give to patients with bacterial meningitis with or before first antibiotic dose

29
Q

when are steroids not given

A 
post surgical meningitis
immunocompromised
menigococcla
septic shock
allergy
30
Q

what can be given as contact prophylaxis in at risk individuals for bacterial meningitis

A

rifampicin
ciprofloxacin
ceftriaxone

31
Q

what vaccines are available to prevent meningitis

A

Neisseria meningitides (serotypes A and C0
H.influenzae
s.pneumoniae

Neurology (36 decks)

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