CNS infections Flashcards
what can untreated infection in the CNS lead to?
brain herniation–» death
spinal cord compression–»paralysis
acute encephalitis=?
infection of the parenchyma
neutrophils on subarachnoid space is typical of?
bacterial meningitis
common cause of viral meningits?
enterovirus e.g ECHO virus
how to diagnose viral meningitis?
viral stool culture
throat swab
CSF PCR
what can cause viral encephalitis
herpes simplex- diagnose this fast and give high dose acciclovir
varicella zoster- history of shingles..give high does aciclovir
occupation related- rabies
travel related
autoimmune
clinical features of encephalitis?
usually insidious onset (sometimes sudden) stupor, coma seizures partial paralysis confusion physocosis speech and memory symptoms
what invetsogations would you do for encephalitis?
lumbar puncture
MRI
EEG
common cause of bacterial meningitis in the eldderly?
pneumococcal> listeria
most common of cause bacterial meningitis in neonates?
listeria, group B strep, E.coli
common cause of bacterial meningitis in children
H.influenzae
common cause of bacterial meningitis in people ages 10-21?
meningococcal
,most common cause of bacterial meningitis in those 21>
pneumococcal > meningococcal
what bug causes meningococcal meningitis?
N.meningitidis
normally found in the throat of healthy carriers
symptoms are due to endotoxin
where is strep.peumoniae usually found?
nasopharynx
people most likely to get this are diabetics
people in hospital
alcoholics
children
how do you normally treat bacterial meningitis?
ceftriaxone
how do you treat meningitis caused by listeria?
IV ampicillin/amoxicillin
what are the clinical signs of bacterial meningitis?
fever stiff neck alteration of consciousness headache vomiting photophobia lethary rash confusion
what would these findings from a lumbar puncture indicate/
WBC> 2000
neutrophils >1180
protein> 220mg/dl
glucose
bacterial meningitis
always treat with antibiotics before lumbar puncture
dont wait!!
signs of aseptic meningitis?
low WBC
not as high protein
normal glucose
as well as antibiotic what should also be given to all patients with bacterial meningitis?
STEROID
a fungal meningitis mainly seen in HIV disease
cryptococcal
