CP26 - Bacterial and Fungal Meningitis

Question 1

which infection, meningitis or encephalitis will have a rash?

Answer 1

meningitis will have a rash

Question 2

which infection, meningitis or encephalitis will have altered conscious level?

Answer 2

encephalitis

Question 3

what are some symptoms for brain abscess?

Answer 3

insidious onset of fever, headache & neck stiffness, seizures, focal neurological signs

can also present with altered conscious level

Question 4

what is the usual causative agent for brain abscess?

Answer 4

bacterial maybe parasitic

Question 5

what is the normal range of glucose level in CSF?

Answer 5

2.5-4.0 mmol/L

Question 6

what is the normal range of protein level in CSF?

Answer 6

0.15-0.4 g/L

Question 7

what is cryptococcus ?

Answer 7

fungus

Question 8

who normally gets the fungal meningitis

Answer 8

usually occur usually in HIV patients

Question 9

what type of meningitis is neisseria meningitis

Answer 9

bacterial meningitis

Question 10

what sort of bacteria is neisseria?

Answer 10

gram -ve diplococci (often seen in pairs)

Question 11

where is the natural habitat for nesseria on the human body?

Answer 11

nasopharynx, increased in smokers

Question 12

how is the spread of nesseria done throughout the body

Answer 12

haemtogenous and then enter the CSF through crossing the blood brain barrier

Question 13

what are some of the presentation of nerisseria meningitis?

Answer 13

fulminant septicaemia

septicaemia with purpuric rash

pyogenic meningitis with no rash

Chronic meningococcal bacteraemia with arthralgia

Focal sepsis

Conjunctivitis, endophthalmitis

Question 14

what is fulminant septicaemia?

Answer 14

fulminant - sudden onset

septicaemia - widespread destruction of tissues due to uptake of toxins released from bacteria from blood - aka blood poisoning

Question 15

what is the treatment for nerisseria meningitis

Answer 15

medical emergency - rapid progression can cause death within hrs

ceftriaxone, cefotaxime
penicillin

rifampicin & ciprofloxacin available for chemoprohylaxis

vaccine available

Question 16

where does haemophilus influenzae grow?

Answer 16

in blood

Question 17

which type of haemophilus influenzae cause the most invasive disease?

Answer 17

type b

Question 18

what is the pathway which haemophilus influenzae can enter the human body

Answer 18

Throat carriage – invasion of submucosa – blood stream

Question 19

what are the treatment of meningitis induced by haemophilus influenzae

Answer 19

cefttriaxone, cefotaxime, ampicillin

chemoprohylaxis - rifampicin

vaccine available

Question 20

what sort of bacteria is Streptococcus pneumoniae?

Answer 20

gram +ve cocci, cells in pair, haemophilus

Question 21

what is the normal habitat for streptococcus pneumoniae

Answer 21

human respiratory tract

Question 22

what is the treatment for meningitis induced by streptococcus pneumoniae

Answer 22

ceftriaxone, ceftotaxime

vaccine available

Question 23

what must be used in conjunction the rest of the antibiotics used in streptococcus pneumoniae induced meningitis

Answer 23

steriods - Dexamethasone

Question 24

what agents causes neonatal meningitis?

Answer 24

Group B beta-haemolytic Streptococci
Escherichia coli
Listeria monocytogenes

Question 25

what is the treatment of neonatal meningitis?

Answer 25

cefotaxime, ampicillin and gentamicin

Question 26

what are some symptoms for TB meningitis?

Answer 26

insidious onset

Question 27

what usually cause brain abscess?

Answer 27

usually bacterial - from spread of adjacent area

Question 28

what is sort of pathogens are clostridium tetani

Answer 28

gram +ve spore forming bacillus, anaerobe

Question 29

what does clostridium tetani produce?

Answer 29

tetanospasmin - binds to ganglioside receptors and blocks release of inhibitory interneurones ie convulsive contraction of voluntary muscles

Question 30

what condition can tetanospasmin cause?

Answer 30

tetanus

Question 31

what are the symptoms involved in the tetanus?

Answer 31

tonic muscle spasms, trismus (spasm of the jaw muscles), opisthotonus (opisthen meaning “behind” in greek)

respiratory difficulties
cardiovascular instability

Question 32

what are the treatment of clostridium tetani induced meningitis ?

Answer 32

anti-toxin, penicillin or metronidazole