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Path - Microbiology > CNS infections and meningitis > Flashcards

CNS infections and meningitis Flashcards

1
Q

List the 4 Four routes of entry in CNS infections

A

a) haematogenous spread
b) direct implantation
c) local extension
d) PNS into CNS

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2
Q

which areas do the following affect:

Meningitis
Encephalitis
Myelitis
Neurotoxin

A

Meningitis - meninges
Encephalitis - brain
Myelitis - spinal cord
Neurotoxin - CNS and PNS

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3
Q

Distinction between mengitis and encephalitis

A

Encephalitis - brain function disturbance:

confusion or disorientation
personality change
speech difficulty

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4
Q

List organisms that can cause meningitis?

A

in order of pop:

Neisseria meningitidis 
Streptococcus pneumoniae 
Haemophilus influenzae 
Listeria M
GROUP B STREP!
E.coli
				               		                		Cryptococcus neoformans

a lot of still causes can causes meningitis btw

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5
Q

List organisms that can cause Encephalitis?

A

RAAPT:

Rabies
Arboviruses
Ameoba
Prions
Trypanosoma

Toxoplasmosis

Bacterial encephalitis:
Listeria monocytogenes

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6
Q

List organisms that can cause disturbance of nerve transmission - Myelitis?

A

polio

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7
Q

List organisms that can cause

  1. rigid paralysis
  2. flaccid paralysis
A
  1. clostridium tetani

2. clostridium botulinum

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8
Q

what is Meningoencephalitis?

A

inflammation of meninges and brain parenchyma

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9
Q

list the meninges from top to bottom in brain?

A

DAP

dura
arachnoid
pia

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10
Q

In the UK, ~ 5% of _____ survivors have neurological sequelae, mainly sensorineural deafness??

A

meningitis

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11
Q

neurologiical damage in meningitis is caused by?

A

Direct bacterial toxicity.

cytokine release and oedema.

Shock, seizures, and cerebral hypoperfusion.

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12
Q

3 classes of meningitis and their causes?

A

a) Acute
usually bacterial meningitis

b) Chronic
	usually TB, spirochetes, cryptococcus

c) Aseptic
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13
Q

how is Neiserria meningitides transmitted?

A

Transmission is person-to-person, from asymptomatic carriers.

Through nasopharyngeal mucosa in a susceptible individual.

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14
Q

how long from exposure to infection in Neiserria meningitides?

A

Causes infections in less than 10 days

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15
Q

characterise the rash in meningitis?

which is most popular?

A

A nonblanching rash (petechial or purpuric) develops in 80% of children.

A maculopapular rash remains in 13% of children,

No rash occurs in 7%.

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16
Q

The clinical difference between septicemia and meningitis is important. why?

A

because patients who present with shock are treated

differently than patients who present primarily with increased intracranial pressure

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17
Q

what are the processes underlying septicaemia?

A

4 processes:

Capillary leak;

Coagulopathy; bleeding and thrombosis.

Metabolic derangement; particularly acidosis

Myocardial failure….multi-organ failure.

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18
Q

in which cause of meningitis is the following seen on CT:

enhancement in the basal cistern and
meninges, with dilatation
of the ventricles.

A

tuberculous meningitis

involves spinal cord too

19
Q

what is the most common infection of the CNS?

A

Aseptic meningitis

20
Q

which viruses are responsible for 80-90% cases in which a causative organism of aseptic meningitis is identified?

A

Coxsackievirus group B and echoviruses

21
Q

epidemiology of Aseptic meningitis?

A

children younger than 1 year

22
Q

Rx for aseptic meningitis?

A

is self-limited and resolves in 1-2 weeks

23
Q

the following cause CNS infections in which age group in particular?

Mumps
Measles
Varicella-zoster

A

kids/ infants

24
Q

how is Encephalitis transmitted?

A

person to person,

or through vectors:
Mosquitoes
Lice
Ticks

25
Q

all Encephalitis causes affects the young apart from?

A

St. Louis encephalitis

Rabies

26
Q

name a cause of Bacterial encephalitis?

A

Listeria monocytogenes

27
Q

name a cause of Amoebic encephalitis?

A

Naegleria fowleri

28
Q

toxoplasma is transmitted by which virus and routes?

A

Toxoplasma gondii

Via the oral, transplacental route or organ transplantation.

29
Q

Brain abscess can come from which conditions?

A

otitis media/mastoiditis/paranasal sinuses

endocarditis/haematogenously

30
Q

top 4 causative organisms in brain abscess?

A

Strep
Staph
Gram-negative organisms. (particularly in neonates)
Mycobacterium tuberculosis

31
Q

Name a common form of vertebral infection.

A

Pyogenic vertebral osteomyelitis

32
Q

name risk factors for spinal infections?

A 
Advanced age
Intravenous drug use
Long-term systemic steroids
Diabetes mellitus
Organ transplantation
Malnutrition
Cancer
33
Q

In the detection of parenchymal abnormalities such as abscesses and infarctions, which imaging modalities are best

A

MRI is superior to CT

34
Q

India ink stain is used to identify which organism?

A

cryptococcus neoformans

35
Q

what are the bacterial meningitis results like on csf?

A 
Turbid - purulent
low glucose
high cell count - polymorphs
higher protein
positive stain/antigen
36
Q

what are the viral meningitis results like on csf?

A

Clear or slightly turbid
15-500 lymphocytes
Negative stain
Normal glucose

37
Q

ddx for aseptic meningitis?

A

Viral meningitis, partially antibiotic treated bacterial meningitis, encephalitis, brain abscess, TB/fungal meningitis

38
Q

what are the tb meningitis results like on csf?

A 
Clear or slightly turbid
30-500 lymphocytes or polymorphs
Negative stain
high protein
low glucose
39
Q

how long do CSF analysis and CSF cultures take?

A

analysis 1-2 hours

culture At 24-48 hours

40
Q

treatment for meningitis ?

A

Ceftriaxone 2g iv bd

If >50yrs or immunocompromised add:
Amoxicillin 2g iv 4hourly

41
Q

treatment for meningo-encaphalitis?

A

Ceftriaxone 2g iv bd

Aciclovir 10mg/kg iv tds

If >50yrs or immunocompromised add:
Amoxicillin 2g iv 4hourly

42
Q

treatment for meningo-encaphalitis?

A

Ceftriaxone 2g iv bd

Aciclovir 10mg/kg iv tds

If >50yrs or immunocompromised add:
Amoxicillin 2g iv 4hourly

43
Q

in which causes of meningitis do we use Pen G 18-24 mu/d ?

A

Strep. pneumonia

Group B strep

Listeria (ampicillin 1st if possible)

44
Q

in which causes of meningitis do we use Cefotaxime?

A

H. influenza

gram negs

Path - Microbiology (27 decks)

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