CNS Infections

Question 1

Listeria is typically seen as a causative organism in bacterial meningitis for which 2 age groups?

Answer 1

Neonates and >65 y/o

Question 2

State 3 signs and symptoms commonly seen in bacterial meningitis

Answer 2

• Headache
• Neck stiffness
• Fever

Question 3

Seizures are more common in adults or children?

Answer 3

Children

Question 4

What would discourage you from taking a LP? (2)

Answer 4

• Signs of raised ICP

- Seizures

Question 5

What is the empirical antibiotic therapy for bacterial meningitis?

Answer 5

Ceftriaxone IV 2g BD, Dexamethosone IV 10mg QDS

Question 6

What other drug would be introduced if listeria was suspected?

Answer 6

Amoxicillin IV 2g 4hrly

Question 7

What organism is responsible for meningococcal meningitis and where can it commonly be found?

Answer 7

Neisseria meningitidis; in the throats of healthy carriers.

Question 8

In what instances would you continue Dexamethasone once the causative organism was identified?

Answer 8

Pneumococcus and penicillin/cephalosporin resistant pneumococcus strains of meningitis.

Question 9

What are the common causative organisms for viral meningitis and how is diagnosis made?

Answer 9

Enteroviruses; viral stool culture, throat swab and CSF PCR.

Question 10

Which groups should undergo CT prior to LP? (6)

Answer 10

• Immunocompromised
• Hx of CNS disease
• New onset seizure
• Papilloedema
• Abnormal conscious level
• Focal neurological deficit