Exam 3 - CNS Infxn's Flashcards
Acute meningitis
most common bacteria
- S. Pneumoniae
- H. influenzae (down since Hib vacc)
- N. meningitidis
Acute meningitis
less common bacteria
- Listeria
- Strep B
- Gram neg bacilli
- Staph
- Borrelia burgdorferi
- Treponema Pallidum
Acute meningitis
viral causes
- enteroviruses
- arboviruses
- HSV, CMV, VZV
Acute meningitis
bacterial path
-N. mening, H influenz fimbriae attah
to nasopharynx epithelium
-S. pneum, H. influenz, N. mening encapsulation
inhibits phagocytosis
-once in CSF, low complement and Ab levels
Acute meningitis
postpartum
-Strep B (agalact), Listeria, gram negs
Acute meningitis
1-3 mos
-Step B, Listeria, S. Pneum, H influenz,
N. mening
Acute meningitis
elderly, AIDS
-Listeria, gram negs
Acute meningitis
S. pneum
- # 1 in US; also highest mortality
- ass’d w/ otitis, pneumonia
Acute meningitis
H. influenz
-ass’d w/ otisis, pharyngitis
Acute meningtis
N. mening
- children, young adults
- nasopharyngeal acquisition
- chemoprophylaxis for close contacts
- ass’d rash
Acute meningitis
Listeria
- elderly, AIDS, neonates
- food-borne assoc’n
Acute meningitis
S. alagact
- aka Strep B
- neonates, chronic illness
- high mortality rate
Acute meningitis
gram neg
- E. coli, Klebsiella, Pseudomonas
- neonates, elderly, AIDS, nosocomial
Acute meningitis
bacterial clin/sx
-fever, headache, meningismus,
photophobia, confusion, CN palsy,
seizure
Acute meningitis
bacterial dx
-lumbar puncture, CSF analysis
-high intracranial pressure
-CSF leukocytosis (neutrophilic), high
protein, low glc
-gram stain, CSF culture
Acute meningitis
bacterial tx
- abx ASAP while awaiting lab
- tx empirically
Acute meningitis
bacterial prevention
-N. mening. vaccine
-however, this does not cover sero B (51%)
-rec’d for asplenics, complement deficiency,
travelers, military, children
-chemoprohpylaxis for close contacts
Acute meningitis
viral path
-breaching mucocilliary app, alv macrophages,
IgA
Acute meningitis
viral clin/sx
-fever, headache, meningismus, photophobia
-enteroviral may have rash, conjunctivitis
-HSV meningitis may have urinary retention,
paresthesias, weakness
Acute meningitis
viral dx
- lumbar puncture, CSF analysis
- high intracranial pressure
- CSF leukocytosis (lymphocytic)
- less pronounced protein, glc changes
Chronic meningitis
definition
sx persist at least 4 wks
Chronic meningitis
causative agents
-M. tuberculosis
-fungal (Cryptococcus, Histoplasma)
-Spirochetes (treponema pallidum,
Borrelia burgdorferi
Chronic meningitis
TB sx
- fever, meningismus, headache
- bx change, CN palsy,
Chronic meningitis
TB dx
- lymphocytic pleocytosis, low glc, up protein
- poor yield CSF culture
- PCR
