Infections of NS/ Meningitis/encephalitis and brain abscesses Flashcards
what is meningitis?
Inflammation of the meninges
Symptoms of meningitis
Cerebral dysfunction- GCS<14 IN 69% of cases
Cranial nerve palsy
Seizures
Focal neurological deficits
Petechial skin rash (more likely in meningococcal meningitis but can also be found viral meningitis)
Meningism: stiff neck, photophobia and nausea and vomiting
Causes of meningitis
Inflammatory Drug induced Infective: Bacterial -Neisseria meningitis -Streotococcus pneumonia Viral Enteroviruses
Investigations for meningitis
- Blood cultures/gram staining
- LP
- Imaging If LP is indicative
Results from CSF results from bacterial meningitis
Cell count: increased with increased neutrophils
Glucose: reduced
Protein: high
Opening pressure: increased
Results from CSF from viral meningitis
Cell count: increased, especially lymphocytes
Glucose: normal
Opening pressure: normal
Protein: slightly increased
Encephalitis symptoms
- Headaches/fever
- Cerebral dysfunction
- Focal signs
- Flu like symptoms
- Seizures
Main 2 antibodies associated with encephalitis and symptoms
Anti VGKC
- Seizures
- Amnesia
- Altered mental state
Anti NMDA
- mental state
- flue like symptoms
- Can lead towards coma/ movement disorder
Investigations for encephalitis
- Blood cultures: looking for viral DNA
- LP
- EEG
- imaging
Herpes simplex encephalitis route of infection
Cold sores
Genital
Once infected the virus becomes latent in the sacral/trigeminal ganglion
Investigation and treatment for herpes simplex
Investigation:
CSF for viral DNA
Treatment: aciclovar
Symptoms for a brain abcess/ empyema
- Fever/headache
- Focal signs
- Signs of increased intracranial pressure
- Meningism
- Presence of underlying cause
What is a brain abcess?
Collection of pus
What is a subdural empyema
Collection of pus between the dura and arachnid
Causes of brain abscess/empyema
- Perforating trauma to the scalp
- Nearby infection
- Neurosurgery
- Blood borne infection
