HIGH YIELDS III Flashcards
role of vancomycin?
in community acquired meningitis?
vanco covers S pneumoniae resistant to ceftriaxone, not MRSA
role of vancomycin?
in nosocomial meningitidis?
covers MRSA, MRSE
recommended quinolones?
moxifloxacin
gatifloxacin
not ciprofloxacin
are steroids like a dexamethasone recommended for suspected strep pneumoniae
yes
this accounts for about 35-50% of cases of encephalitis in which a cause is determine?
HSV
clinical manifestations for HSV encephalitis?
atypical manifestations?
> 90% decreased MS, fever
80% headache, focal neurologic findings,
usually <1 week of symptoms
***chronic, relapsing, MRI negative cases, recurrent brainstem encephalitis, hypomania, kluver bucy syndrome, intractable emesis
MRI abnormality cases found for HSV encephalitis?
90%
CSF PCR for HSV?
is sensitivity, specificity good?
both, upper 90% and false negatives can occur if LP is done <72 hours after onset of symptoms
HSV encephalitis tx?
Acyclovir 10 mg/kg IV q 8 hours x 14-21 days
culex mosquito
all areas of US
severe disease more common in immunocompromised and elderly
1 in 150 infections
acute flaccid paralysis is characteristic, polio like presentation
West Nile virus (WNV)
WNV IgG (acute and convalescent), IgM in serum
how is VZV diagnosed?
Diagnosis:
skin lesions + for VZV
CSF IgM + for VZV
what is this disease?
subacute
fever, headache for days or weeks disease
- photophobia, neck stiffness present in < 25%
CSF WBCs may be very low or even zero
In one series with HIV/AIDS, CSF showed 0 WBCs in 31% and 1-10 WBCs in 23%
CSF protein usually slightly increased, glucose normal or slightly decreased
Cryptococcal Meningitis
what is this disease?
molds with 90 degree branching
rhino orbital cerebral mucormycosis
ketone reductase
-DKA
mucormycosis (zygomycosis)
what is this disease?
agent of toxoplasmosis
immunocompromised
reactivation
AIDS:focal
transplants: nonfocal
malignancy: both
extrapyramidal sx
toxoplasma gondii
name this disease?
multiple lesions which enhance
toxoplasma encephalitis
