infections of CNS - other types of meningitis Flashcards
1
Q
general difference in presentation of chronic meningitis
A
- less signs of inflammation and more signs of neurologic damage
- “cranial nerves, focal sensorimotor deficit, cognitive deterioration, etc”
2
Q
two types of chronic meningitis
A
- infectious and non-infectious
3
Q
types of infectious chronic meningitis
A
- tuberculosis
- cryptococcal
- atypical bacteria and spirochetes (syphilis and Lyme)
4
Q
types of noninfectious chronic meningitis
A
- sarcoid
- carinoma
5
Q
tuberculosis meningitis occurs mostly in…
A
- children
- immunocompromised
6
Q
how does tuberculosis meningitis start?
A
- seeding of tuberculoma in brain or meninges, usually traveled in blood from a central lesion like the lung
7
Q
tuberculosis meningitis possible findings
A
- headache, fever, malaise
- nuchal rigidity
- weight loss
- hydrocephalus, cranial nerve palsy, arteritis
8
Q
WBCs in CSF in tuberculosis meningitis
A
- pleocytosis but usually fewer than 300/cu mm
9
Q
protein and sugar in tuberculosis meningitis
A
protein high
sugar low
10
Q
tuberculosis meningitis treatment if suspected
A
- Isoniazide (INH), streptomycin, rifampin and pyrazinamide are used in combination
- Ethambutol may be useful if given in high doses
- treat 6-9 months
11
Q
labs for tuberculosis meningitis
A
- acid fast bacilli - not always accurate and can take a long time
- chest x-ray and skin test - but not always accurate
- PCR generally accurate
12
Q
cryptococcal meningitis caused by
A
cryptococcus neoformans
13
Q
presentation of crypt meningitis
A
- indolent, symptoms can go back years
- headache most common
- mental deterioration
- cranial nerve palsies and focal brainstem dysfunction
14
Q
cryptococcus may grow on…
A
- india pink preparation
- but not uncommon for it to not show at all
15
Q
treatment of crypt meningitis
A
- “systemic and intrathecal amphotericin B and 5-fluorcytosine”
