CNS Infections Flashcards
What is meningitis?
Inflammation of the meninges
What are the causes of meningitis? (3)
- Bacterial
- Viral
- Fungal
What bacteria commonly cause meningitis in newborns? (3)
- Group B strep
- E.Coli
- Listeria monocytogenes
What bacteria commonly cause meningitis in children & teens? (2)
- Neisseria meningitidis
- Strep pneumoniae
What bacteria commonly cause meningitis in adults & the elderly? (2)
- Strep pneumoniae
- Listeria monocytogenes
What are the symptoms of meningitis? (5)
- Meningism: acute headache, fever, neck stiffness
- Photophobia
- Phonophobia
- Altered consciousness
- Nausea + vomiting
What are the signs of meningitis? (3)
- Non-blanching petechial rash
- Kernnig’s sign
- Brudzinski’s sign
How would you manage meningitis? (7)
- 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
If you suspect fungal meningitis, what test would you do?
Test blood for beta-D-glucan
What prophylaxis do you give to the patient’s close contacts? (3)
- Ceftriaxone
- Rifampin
- Ciprofloxacin
When would you do a lumbar puncture in meningitis?
If pt has no shock/ raised ICP/ convulsions
Where should you do a lumbar puncture?
L3/4
When would you do an MRI in meningitis?
If focal neurological signs, papilloedema, continuous/ uncontrolled seizures, GCS = 12
What would the CSF results be for bacterial meningitis? (4)
- Raised opening pressure due to cerebral oedema
- High neutrophils
- Low glucose
- High protein
What would the CSF results be for viral meningitis? (4)
- Normal opening pressure
- High lymphocytes
- Normal glucose
- Normal proteins
What would the CSF results be for fungal meningitis?
Elevated opening pressure
What viruses cause meningitis? (5)
- Enterococcus (coxsackie)
- HIV
- Herpes simplex
- Mumps
- Varicella zoster
What fungi cause meningitis? (2)
- Cryptococcal
- Coccidioides
What is encephalitis?
Inflammation of the brain parenchyma
What are the causes of encephalitis? (6)
- Viral
- Bacterial
- Fungal
- Parasitic
- Non-infective (autoimmune & paraneoplastic)
- Other causes: tropical - rabies; tick-borne encephalitis
What is the most common viral cause of encephalitis?
HSV (herpes zoster virus)
What should you ask a pt suspected of encephalitis?
History of travel/ animal bite
What are the investigations for encephalitis? (3)
- Contrast-enhanced CT head/ MRI head (do before LP)
- LP (CSF, viral PCR)
- Other tests (blood tests, urine tests, swabs)
What are the treatments for encephalitis? (3)
- IV acyclovir if HSV/VZV
- Supportive therapy
- Symptomatic treatment
