Common Causes of Meningitis

Question 1

name the common causes of meningitis in newborns (0-6 mos)

Answer 1

• group B streptococci
• E. coli
• Listeria

Question 2

name the common causes of meningitis in children (6 mos-6 yr)

Answer 2

• S. pneumoniae
• N. meningitidis
• H. influenzae type B
• Enteroviruses

Question 3

name the common causes of meningitis in 6-60 yo

Answer 3

• S. pneumoniae
• N. meningitidis (#1 in teens)
• Enteroviruses
• HSV

Question 4

name the common causes of meningitis in 60+ yo

Answer 4

• S. pneumoniae
• Listeria
• gram - rods

Question 5

meningitis–treatment

Answer 5

• give ceftriaxone and vancomycin empirically
  
  • add ampicillin in Listeria is suspected

Question 6

viral causes of meningitis

Answer 6

• enteroviruses (especially coxsackievirus)
• HSV-2 (HSV-1 = encephalitis)
• HIV
• West Nile virus (also causes encephalitis)
• VZV

Question 7

what is the common cause of meningitis in HIV patients?

Answer 7

• Cryptococcus spp.

Question 8

incidence of H. influenzae meningitis

Answer 8

• incidence has decreased greatly with introduction of the conjugate H. influenzae vaccine in last 10-15 years
  
  • today, cases are usually seen in unimmunized children

Question 9

CSF findings in bacterial meningitis:

opening pressure

cell type

protein

sugar

Answer 9

• opening pressure increases
• cell type increases PMNs
• proteins increase
• sugar decreases

Question 10

CSF findings in fungal/TB meningitis:

opening pressure

cell type

protein

sugar

Answer 10

• opening pressure increases
• cell type increases lymphocytes
• proteins increase
• surgar decreases

Question 11

CSF findings in viral meningitis:

opening pressure

cell type

protein

sugar

Answer 11

• opening pressure is normal or increased
• cell type increases lymphocytes
• proteins are normal or increased
• sugar is normal

Question 12

name the most common infections causing brain abscesses

Answer 12

• viridans streptococci
• Staphylococcus aureus
• if dental infection or extracion precedes abscess, oral anaerobes commonly involves

Question 13

brain abscesses:

multiple abscesses vs. single lesions

Answer 13

• multiple abscesses are usually from bacteremia
• single lesions from contiguous sites:
  
  • otitis media and mastoiditis –> temporal lobe and cerebellum
  • sinusitis or dental infection –> frontal lobe

Question 14

which organism is reactivated with AIDS?

Answer 14

Toxoplasma