CNS Infections

Question 1

Common population with Neisseria meningitidis (Meningococcus)

Answer 1

Children and young adults in winter and spring

Question 2

Primary clue of pathogen N. meningitidis

Answer 2

Petechiae

Question 3

Treatment for N. meningitidis

Answer 3

Penicillin G 50,000 U/kg q4h

Question 4

Prophylaxis for N. meningitidis

Answer 4

Rifampin

Question 5

Population at risk for Streptococcus pneumoniae (Pneumococcus)

Answer 5

Very young (1-4months) and very old 
Secondary to primary infections involving the ear or paranasal sinuses

Question 6

Treatment for S. pneumoniae (empiric)

Answer 6

Ceftriaxone 2g q4h plus Vancomycin

Question 7

Population at risk for Haemophilus influenzae

Answer 7

Children 6 months - 3 years

Often a complication of primary infection of middle ear, paranasal sinuses or lungs)

Question 8

Treatment for H. influenzae infection

Answer 8

Cefotaxime or ceftriaxone

Question 9

Prophylaxis for H. influenzae

Answer 9

Rifampin

Question 10

When should Dexamethasone be given for CNS infections

Answer 10

BEFORE first dose of antibiotics (reduce inflammation/cytokine production in CSF)

Question 11

Population at risk for Listeria monocytogenes

Answer 11

Neonates, aged, immunosuppressed

Question 12

Treatment for Listera monocytogenes

Answer 12

Ampicillin +/- Aminoglycoside (3 weeks)

Question 13

Population at risk for viral meningitis

Answer 13

Children and young adults

Question 14

Population at risk for Herpes encephalitis

Answer 14

Neonates and sexually active adults

Question 15

Treatment for viral meningitis and herpes encephalitis

Answer 15

Acyclovir

Vidarabine or foscarnet (if resistance to acyclovir)

Question 16

Pathogens causing shunt infections

Answer 16

S. epidermidis

S. aureus

Question 17

Treatment for S. aureus (PCN-resistant)

Answer 17

Nafcillin 2g q4h

Question 18

Treatment for S. aureus (MCN-resistant)

Answer 18

Vancomycin 30-40 mg/kg/d

Question 19

Most common underlying condition of brain abscess

Answer 19

Otitis media and mastoiditis

Question 20

Most common pathogens in brain abscess

Answer 20

Polymicrobial—Streptococci, oral anaerobes (Actinomyces, Bacteriodes, Fusobacterium, Peptostreptococcus), S. aureus

Question 21

Empiric therapy for otitis media or mastoiditis brain abscess

Answer 21

Ceftriaxone + metronidazole

Question 22

Empiric therapy for paranasal sinusitis brain abscess

Answer 22

Ceftriaxone +/- metronidazole

Question 23

Empiric therapy for dental infection brain abscess

Answer 23

PCN +/- metronidazole

Question 24

Empiric therapy for trauma or neurosurgery brain abscess

Answer 24

Ceftriaxone

Vancomycin

Question 25

Empiric therapy for endocarditis brain abscess

Answer 25

Vancomycin

Question 26

Empiric therapy for congenital cardiac malformations

Answer 26

Ceftriaxone

Question 27

Empiric therapy for lung brain abscess

Answer 27

Ampicillin