infection Flashcards
causes viral meningitis
entervirus eg coxsaxkie, echovirus // mumps, measles // HSV, CMV, HIV
RF viral meningitis
v young and old // immunocompromised // IVDU
meningitis neonates organism
group B!!! // listeria // E.coli
meningitis children <10
Haem influenze // neisseria menigitiditis // strep pneumo
most common meningitis in 10-60
neisseria menigitiditis // strep pneumo
meningitis cause 60+
eisseria menigitiditis // strep pneumo // listeria
meningitis cause immunosuppresed
listeria
symptoms meningitis
headache, fever, N+V, photophobia, drowsiness, confusion, seizures, neck stiffness, rash (meningococcal disease) // viral tends to be milder and less neuro symptoms eg seizures
LP bacterial meningitis
cloudy // low glucose // high protein // higher white cell count
LP viral meningitis
clearer appearance // normal glucose //normal or slight raised proteins // lower WCC
LP TB meningitis
cloudy + fibrin web // low flucose // high protein // lower WCC
contraindications to LP
signs of raised ICP: focal neuro signs, papilloedema, bulging fontanelle, DIC // severe sepsis or rash // bleeding risk
if LP cannot be taken within 1st hour what should be done
take blood cultures and give IV abx
what type of meningitis is LP contraindicated in
meningococcal sepsis
invx when LP contraindicated
blood cultures + PCR
invx for viral meningitis
PCR
invx TB meningitis
PCR or Ziehl-Neelson
what mx can be given for suspected bacteral meningitis in GP
IM pen V
antibotics for bacterial meningitis
<3 months = IV ceftriaxone + amox // <50 = IV ceftriaxome // >50 or immunocompromised = IV ceftriaxone + amox
anx if pen allergy meningitis
chloramphenicol (+ vanco)
mx for brain oedema meningitis
IV dex
when should mx for oedema in meningitis not be given
<3 months // septic shock // meningococcal sepsis
abx if viral meningitis
IV acyclovir if HSV suspected
when is prophylaxis for bacterial meningitis indicated
close contact within 7 days
prophlyactic mx for meningitis
oral cipro or rifampicin
complications from meningitis
sensorineural hearing loss // seizure // focal neuro deficit
what strain of meningococcus are Uk kids vaccinated against
A,B,C
when are meningitis vaccines given
2 months, 4 months, 12 months
what is encephalitis
swelling of brain itself (frontal temporal lobes involved)
causes encephalitis
HSV1 (CMV, HIV, measles)
symptoms encephalitis
fever, headache, speech and memoru problems, aphasia, seizures
invx encephalitis
CSF + PCR: lymphocytosis, elevated proteins // MRI // EEG: 2hz
mx encephalitis
IV acyclovir
which lobe does HSV encephalitis affect
temporal
how to brain abscess form
sepsis, extension from middle ear, endocarditis, trauma
symptoms brain abscess
headache, fever, focal neruopathy eg CNIII or CNIV, raised ICP
invx brain abscess
CT
where do spinal epidural abscesses form
superifical to dura mater
how does spinal epidural abscesses form
from discitis, bacteraemia, IVDU, spinal injury
RF spinal epidural abscesses
HIV, diabetes, alcohol, chemo, steroids
organism spinal epidural abscesses
staph A
symptoms spinal epidural abscesses
fever, back pain, focal neuro deficits
