CNS Infections Flashcards
What are the Meningeal signs?
- Nuchal rigidity
- Kernig sign
- Brudzky’s sign
What is nuchal rigidity?
Pt supine, try to flex neck & meet resistance
What is Kernig sign?
Flex hip to 90° & extend the knee→ causes pain
What is Brudzky’s sign?
Pt supine, flex neck & pt pulls legs up (bend @ hips & knees)
What is a fever?
T >99.2° in AM or T>99.9° in PM
What are the Inc ICP signs?
- HA worse supine & in PM
- N/V
- Lethargic to coma
- Pailledema
- Lateral rectus pasly: estropia
- Blurred vision
- Cushings triad
What is Cushing’s Triad?
HTN, bradycardia & Resp irreg
What is the hx of Aseptic meningits (viral)?
- HA
- Neck pain & stiffness
- Acute or subacute onset
- Malaise
- N/V/D
- Hx of preceding URI
- Check hx of NSAID use
What are the PE findings of Aseptic meningitis (viral)?
- Fairly normal mental status or mildy lethargic or irritable
- Normal neuro exam
- nuchal rigidity
- photphobia
What are the CSF findings in Aseptic meningitis?
- Opening pressure mildly-mod inc
- Clear, colorless
- WBC count normal or inc
- Protein inc
- Glucose normal
- Culture neg
What are the PE findings of Bacterial meningitis?
- Acute or subacute
- Fever & HA
- Neck pain
- N/V
- Photophobia
- Altered mental status
- Seizures
When should a CT scan be performed prior to an LP in bacterial meningitis?
- Immunocompromised pt
- Focal neuro signs
- Altered mental status
- Papilledema
- Hx of recent head trauma
- Seizures
What are the CSF findings of bacterial meningitis?
- Elevated opening pressure
- Elevated WBC count w/ neutrophils
- Low glucose
- gram stain
When should empirical antimicrobial therapy be started in bacterial meningitis?
As soon as the dx is suspected
What are the PE findings of Viral encephalitis or meningoencephaltis?
- More profound mental status changes
- More freq seizures, CN ABN & focal neuro deficits
