CNS infections Flashcards
what is kernigs sign
knees and hips flexed, then extend leg from knee and there is pain
what is brudzinskis sign
flexion of the neck causes hips and knees to flex
if there is petechial rash (meningitis) what is the infecn
meningococcal- neisseria meningitides
if there is skull fracture, ear disease or congenital CNS lesion what is the infection (meningitis)
pneumococcal- strep pneum
what is the clinical course of viral meningitis
benign self limiting which resolves 4-10 days. headache can last for a few months
what should be given in meningitis before transfer to hospital
benzylpenicillin 1200mg (adult dose) IV or IM. if allergic- cefotaxime
what antibiotics to be given meningitis
if 55 or immunocompromised give ampicillin (for Listeria)
what prophylaxis should be given to household contacts
rifampicin 600mg/12h, or ciprofloxacin
what are septicaemic signs that can predominate
incr cap refill, cold hands and feet, rash
what should you give before doing LP or not
dexamethasone
what is encephalitis
acute inflammation of brain parenchyma usually viral, fever and meningism usual
what are the features of encephalitis
personality and behavioural change, decr level of conciousness and coma, seizures common, focal neuro deficits
viral causes encephalitis
herpex simplex, varicella zoster, adenovirus, enterovirus, outside thre UK- flavivirus, rabies
what investigations in encephalitis
bloods, CT, MRI, LP, EEG
what does MRI show encephalitis
areas of inflammation and swelling. incr ICP and midline shift may lead to coning
