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P2 NEURO > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

What is meningitis?

A

Inflammation of the meninges

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2
Q

What are the causes of meningitis? (3)

A
  • Bacterial
  • Viral
  • Fungal
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3
Q

What bacteria commonly cause meningitis in newborns? (3)

A
  • Group B strep
  • E.Coli
  • Listeria monocytogenes
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4
Q

What bacteria commonly cause meningitis in children & teens? (2)

A
  • Neisseria meningitidis

- Strep pneumoniae

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5
Q

What bacteria commonly cause meningitis in adults & the elderly? (2)

A
  • Strep pneumoniae

- Listeria monocytogenes

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6
Q

What are the symptoms of meningitis? (5)

A
  • Meningism: acute headache, fever, neck stiffness
  • Photophobia
  • Phonophobia
  • Altered consciousness
  • Nausea + vomiting
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7
Q

What are the signs of meningitis? (3)

A
  • Non-blanching petechial rash
  • Kernnig’s sign
  • Brudzinski’s sign
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8
Q

How would you manage meningitis? (7)

A
  • IM benzylpenicillin 1200mg + admit pt
  • Stabilise: A, B, C
  • Assess GCS
  • Blood cultures w/in the hour
  • Broad spec ab = cephalosporins (ceftriaxone, cefotaxime)
  • Steroids (IV dexamethasone)
  • Prophylaxis to close contacts of pt
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9
Q

If you suspect fungal meningitis, what test would you do?

A

Test blood for beta-D-glucan

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10
Q

What prophylaxis do you give to the patient’s close contacts? (3)

A
  • Ceftriaxone
  • Rifampin
  • Ciprofloxacin
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11
Q

When would you do a lumbar puncture in meningitis?

A

If pt has no shock/ raised ICP/ convulsions

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12
Q

Where should you do a lumbar puncture?

A

L3/4

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13
Q

When would you do an MRI in meningitis?

A

If focal neurological signs, papilloedema, continuous/ uncontrolled seizures, GCS = 12

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14
Q

What would the CSF results be for bacterial meningitis? (4)

A
  • Raised opening pressure due to cerebral oedema
  • High neutrophils
  • Low glucose
  • High protein
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15
Q

What would the CSF results be for viral meningitis? (4)

A
  • Normal opening pressure
  • High lymphocytes
  • Normal glucose
  • Normal proteins
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16
Q

What would the CSF results be for fungal meningitis?

A

Elevated opening pressure

17
Q

What viruses cause meningitis? (5)

A
  • Enterococcus (coxsackie)
  • HIV
  • Herpes simplex
  • Mumps
  • Varicella zoster
18
Q

What fungi cause meningitis? (2)

A
  • Cryptococcal

- Coccidioides

19
Q

What is encephalitis?

A

Inflammation of the brain parenchyma

20
Q

What are the causes of encephalitis? (6)

A
  • Viral
  • Bacterial
  • Fungal
  • Parasitic
  • Non-infective (autoimmune & paraneoplastic)
  • Other causes: tropical - rabies; tick-borne encephalitis
21
Q

What is the most common viral cause of encephalitis?

A

HSV (herpes zoster virus)

22
Q

What should you ask a pt suspected of encephalitis?

A

History of travel/ animal bite

23
Q

What are the investigations for encephalitis? (3)

A
  • Contrast-enhanced CT head/ MRI head (do before LP)
  • LP (CSF, viral PCR)
  • Other tests (blood tests, urine tests, swabs)
24
Q

What are the treatments for encephalitis? (3)

A
  • IV acyclovir if HSV/VZV
  • Supportive therapy
  • Symptomatic treatment
25
Q

What would be the CSF results for encephalitis? (3)

A
  • Moderately increased lymphocytes
  • Moderately increased protein
  • Reduced glucose
26
Q

What are the early symptoms of encephalitis? (2)

A
  • Flu-like symptoms (headaches, fever, confusion, N&V)

- (+/- meningism)

27
Q

What are the late symptoms of encephalitis? (2)

A
  • Decreased GCS/ coma

- Seizures

28
Q

How does the initial infection of herpes zoster present?

A

As chickenpox

29
Q

How does the reactivation of herpes zoster present?

A

As shingles

30
Q

What are the risk factors for herpes reactivation? (3)

A
  • Old age
  • Poor immune system
  • Chickenpox < 18 months age
31
Q

How does herpes present?

A

Dermatomal distribution of rash + pain

32
Q

How do you treat herpes?

A

Oral acyclovir

P2 NEURO (13 decks)

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