Encephalitis/Meningitis Flashcards
Clinical presentation of encephalitis
- Altered mental status
- Seizures
- CN palsies
- Exaggerated DTR
Physical exam findings for encephalitis
- Papilledema***
- Rash
- Autonomic/Hypothalamic disturbances
- loss of temperature, vasomotor control, SIADH
- Arthritis
What would temporal lobe envolvement on MRI in encephalitis case indicate?
Herpes simplex virus
Cushings Triad
- Bradycardia
- Respiratory depression
- Hypertension
Should CSF be refrigerated?
No. kills fastidious organisms like N. meningitidis
Lumbar puncture with CSF that is clear, cloudy, or straw-colored with high protein content and high lymphocytes?
viral
When you are concerned for encephalitis who do you call?
Infectious disease and Neurology!!!! STAT
What are 5 situations it is important to get CT before LP in encephalitis
- GCS of <12
- New seizures
- Focal neuro signs
- Papilledema
- Immunocompromised
What are 3 things you need to do with an encephalitis patient?
- Stabilize (intubate, monitor…)
- Acyclovir
- Isolation
How do you treat someone with increased intracranial pressure
- Elevate head 30-45 degrees
- Hyperventilate
- Consider mannitol or corticosteroids
What is the #1 cause of viral meningitis?
Enterovirus (coxsackie, herpes (HSV-1))
What organism is most likely to cause bacterial meningitis in: Neonates (<1 month)
Group B streptococcus
What organism is most likely to cause bacterial meningitis in babies/children?
Streptococcus pneumoniae
What organism is most likely to cause bacterial meningitis in Adults 65+ and immunocompromised patients?
Listeria monocytogenes
When are pregnant women screened for group B strept?
35-37 weeks
