Fungal Meningitis and clinical correlates from Dr. J

Question 1

How do we tx fungal meningitis?

Answer 1

Ampho B +/- flucytosine or voraconazole for BBB penetration

Question 2

MC cause of fungal meningitis?

Answer 2

Cryptococcus neoformans

Question 3

You find a broad-based budding yeasts in CSF, what organism?

Answer 3

Bastomyces

Question 4

You find hyphae going off in lots of directions from a central body at acute angles to each other in CSF, what organism?

Answer 4

Aspergillus

Question 5

You find sphere-shaped endospores in CSF, what organism?

Answer 5

Coccidioides

Question 6

Yeast w/ halos in India ink. What is it? Where does it come from?

Answer 6

Cryptococcus. Comes from pigeon poop. Don’t get AIDS and sleep under bridges.

Question 7

How do you tx RMSF?

Lyme dz?

Answer 7

Doxy- RMSF

Ceftriaxone- Lyme

Question 8

How do you tx syphilis?

Answer 8

Penicillin G IV

Question 9

How do you recognize and tx TB?

Answer 9

Acid-fast bacilli in CSF

Dexamethasone + TB drugs: (Isoniazid, Rifampin, Pyrazinamide, Ethambutol)

Question 10

Spinal epidural abscess, what is the causative agent?
What will the CSF analysis look like? How would you find the abscess otherwise?
How do you tx it?

Answer 10

S. aureus secondary to spine surgery, sinus, osteomyelitis, trauma, GU instruments
CSF- normal bc lesion is isolated
do MRI > CT myelogram
Drain it and give Steroids + Vanc