CNS Infections Flashcards
what is encephalitis an infection of
brain parenchyma
what is the most common cause of encephalitis
herpes simplex
how does encephalitis present
insidious onset of:
- confusion
- seizures
- speech/memory problems
- partial paralysis
investigations of encephalitis
MRI, LP, EEG
treatment of encephalitis
IV Aciclovir
what is meningitis
inflammation of the meninges
what is meningococcal septicaemia? what is the presenting feature?
when the meningococcal bacteria has entered the bloodstream
- NON BLANCHING RASH
- indicates there has been disseminated intravascular coagulopathy (DIC) and subcutaneous haemorrhages
what causes viral meningitis
ECHO virus
coxasackie virus
herpes simplex
investigations of viral meningitis
viral stool culture + throat swab
CSF PCR
CSF results in viral meningitis
clear appearance
CSF protein + glucose normal
high numbers of lymphocytes
treatment of viral meningitis
supportive
most common cause of bacterial meningitis in neonates
Group B step
can also be caused by listeria / e.coli
what age group gets meningococcal meningitis
10-21 year olds
what causes bacterial meningitis in under 10s
H.influenzae
what causes bacterial meningitis in adults (>21)
Strep. Pneumoniae
what can cause bacterial meningitis in elderly (>65)
Listeria
what bacteria is suspected in patients who have had neurosurgery / open head trauma
staph aureus
staph epidermis
what bacteria is suspected in immunocompromised
strep pneumonia
listera
meningococcal
symptoms of bacterial meningitis
fever neck stiffness altered consciousness vomiting photophobia
CSF results bacterial meningitis
cloudy appearance
high protein
low glucose
high numbers of neutrophils
what should be given in the community if meningococcal meningitis is suspected
IM Benzylpenicillin
what is the empirical therapy for bacterial meningitis
IV ceftriaxone 2g BD
IV chloramphenicol + vancomycin if allergic
what is added if listeria is suspected in bacterial meningitis treatment
IV amoxicillin
if allergic co-trimoxazole
what else should be given in the management of bacterial meningitis
IV Dexamethasone
why is dexamethasone given in management of bacterial meningitis
reduce risk of neurological complications
neurological complications of meningitis
hearing loss
seizures + epilepsy
cognitive impairement
memory loss
what is given for post exposure prophylaxis for bacterial meningitis to at risk individuals
ciprofloxacin
what is aseptic meningitis
non-pyogenic bacterial meningitis
CSF results aseptic meningitis
low WBC count
normal glucose
minimally elevated protein
what can cause aseptic meningitis
TB
cryptococcal meningitis
what is cryptococcal meningitis
fungal meningitis
- associated with HIV
treatment of cryptococcal meningitis
IV amphotericin + fluconazole
what virus causes progressive multifocal leucoencephalopathy
JC virus
multiple ring enhancing lesions
intra-cerebral toxoplasmosis
what patients require a CT before an LP
immunocompromised hx of stroke new onset seizures papilloedema altered conscious focal neurological deficit
what patients should never receive an LP
those with raised ICP
