CNS Infections Flashcards

1
Q

what is encephalitis an infection of

A

brain parenchyma

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2
Q

what is the most common cause of encephalitis

A

herpes simplex

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3
Q

how does encephalitis present

A

insidious onset of:

  • confusion
  • seizures
  • speech/memory problems
  • partial paralysis
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4
Q

investigations of encephalitis

A

MRI, LP, EEG

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5
Q

treatment of encephalitis

A

IV Aciclovir

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6
Q

what is meningitis

A

inflammation of the meninges

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7
Q

what is meningococcal septicaemia? what is the presenting feature?

A

when the meningococcal bacteria has entered the bloodstream

  • NON BLANCHING RASH
  • indicates there has been disseminated intravascular coagulopathy (DIC) and subcutaneous haemorrhages
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8
Q

what causes viral meningitis

A

ECHO virus
coxasackie virus
herpes simplex

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9
Q

investigations of viral meningitis

A

viral stool culture + throat swab

CSF PCR

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10
Q

CSF results in viral meningitis

A

clear appearance
CSF protein + glucose normal
high numbers of lymphocytes

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11
Q

treatment of viral meningitis

A

supportive

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12
Q

most common cause of bacterial meningitis in neonates

A

Group B step

can also be caused by listeria / e.coli

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13
Q

what age group gets meningococcal meningitis

A

10-21 year olds

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14
Q

what causes bacterial meningitis in under 10s

A

H.influenzae

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15
Q

what causes bacterial meningitis in adults (>21)

A

Strep. Pneumoniae

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16
Q

what can cause bacterial meningitis in elderly (>65)

17
Q

what bacteria is suspected in patients who have had neurosurgery / open head trauma

A

staph aureus

staph epidermis

18
Q

what bacteria is suspected in immunocompromised

A

strep pneumonia
listera
meningococcal

19
Q

symptoms of bacterial meningitis

A
fever
neck stiffness
altered consciousness
vomiting 
photophobia
20
Q

CSF results bacterial meningitis

A

cloudy appearance
high protein
low glucose
high numbers of neutrophils

21
Q

what should be given in the community if meningococcal meningitis is suspected

A

IM Benzylpenicillin

22
Q

what is the empirical therapy for bacterial meningitis

A

IV ceftriaxone 2g BD

IV chloramphenicol + vancomycin if allergic

23
Q

what is added if listeria is suspected in bacterial meningitis treatment

A

IV amoxicillin

if allergic co-trimoxazole

24
Q

what else should be given in the management of bacterial meningitis

A

IV Dexamethasone

25
why is dexamethasone given in management of bacterial meningitis
reduce risk of neurological complications
26
neurological complications of meningitis
hearing loss seizures + epilepsy cognitive impairement memory loss
27
what is given for post exposure prophylaxis for bacterial meningitis to at risk individuals
ciprofloxacin
28
what is aseptic meningitis
non-pyogenic bacterial meningitis
29
CSF results aseptic meningitis
low WBC count normal glucose minimally elevated protein
30
what can cause aseptic meningitis
TB | cryptococcal meningitis
31
what is cryptococcal meningitis
fungal meningitis | - associated with HIV
32
treatment of cryptococcal meningitis
IV amphotericin + fluconazole
33
what virus causes progressive multifocal leucoencephalopathy
JC virus
34
multiple ring enhancing lesions
intra-cerebral toxoplasmosis
35
what patients require a CT before an LP
``` immunocompromised hx of stroke new onset seizures papilloedema altered conscious focal neurological deficit ```
36
what patients should never receive an LP
those with raised ICP