CNS Infections and Meningitis

Question 1

Bacterial pathogens causing meningitis

Answer 1

Classic - NHS + TB
Neonates - GEL
young people - NHS
Elderly - Group B strep, Listeria

Question 2

Viral pathogens causing meningitis

Answer 2

Enterovirus - coxsackie, echovirus
Mumps
HSV-2

Question 3

Fungal pathogens causing meningitis

Answer 3

Cryptococcus neoformans

Question 4

Types of meningitis

Answer 4

Acute - NHS - rapid onset
Chronic - TB weeks
Aseptic - viruses

Question 5

Meningitis Ix

Answer 5

1. CT head if LOC or focal
2. Blood cultures
3. LP

Question 6

CSF analysis table - appearance, glucose, cell type, protein, opening pressure

Answer 6

Question 7

Bacterial meningitis RFs

Answer 7

Complement deficiency, hyposplenism
Meningococcus - hypogammaglobulinaemia
Pneumococcus - pneumonia, head trauma

Question 8

Bacterial meningitis Mx

Answer 8

Resuscitate
IV ceftriaxone
IV corticosteroids (unless meningococcus)
Neonates/elderly - ampicillin - listeria
LOC/focal signs - acyclovir (viral enceph cover)

Question 9

Encephalitis most common pathogen

Answer 9

HSV 2

Question 10

Encephalitis Ix

Answer 10

1. CT
2. LP if no ICP
3. MRI - GS

Question 11

Encephalitis Mx

Answer 11

IV acyclovir

Question 12

Brain abscess causes

Answer 12

Strep, Staph
TB
Fungal
Parasitic

Question 13

Brain abscess Sx

Answer 13

SOL, swinging fever

Question 14

Brain abscess spread

Answer 14

Haematogenous spread (endocarditis)
Local extension (otitis media)