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TAS Infection And Immunity ✅ > Infections of the CNS ✅ > Flashcards

Infections of the CNS ✅ Flashcards

1
Q

What is the peak age of bacterial meningitis?

A

2 years

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2
Q

What has produced a decrease in cases of bacterial meningitis?

A

Vaccines

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3
Q

What bacteria causing meningitis can be vaccinated against?

A
  • N. meningitidis
  • S. pneumoniae
  • H. influenzae
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4
Q

What % of cases of meningitis are aseptic in countries with routine use of vaccines?

A

90%

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5
Q

What is the most common pathogen causing meningitis?

A

Enteroviruses

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6
Q

What are the most important organisms causing meningitis in neonates?

A
  • GBS

- E. coli

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7
Q

How does the incidence of encephalitis compare to meningitis?

A

Encephalitis is less common

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8
Q

What pathogens cause encephalitis?

A

Viruses, most commonly HSV

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9
Q

Where does infection usually start in bacterial meningitis?

A

The nasopharynx

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10
Q

How can infection in the nasopharynx lead to bacterial meningitis?

A

Nasopharyngeal infection is followed by bacteraemia and subsequent penetration of the blood brain barrier

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11
Q

What happens once bacteria have entered the CSF?

A

They continue to proliferate

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12
Q

What does the proliferation of bacteria in the CSF stimulate?

A

A pro-inflammatory cascade

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13
Q

Other than the CSF, where can the proliferation of bacteria cause a pro-inflammatory cascade in meningitis?

A

In the blood

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14
Q

What is produced when a pro-inflammatory cascade is stimulated in the blood due to the proliferation of bacteria?

A

Septicaemia

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15
Q

What does the pro-inflammatory cascade stimulated by proliferation of bacteria lead to in the CSF?

A

Upregulation of specific adhesion molecules and recruitment of leukocytes into the CSF

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16
Q

How does CNS damage occur in bacterial meningitis?

A
  • Directly due to meningeal irritation

- Indirectly due to circulatory collapse

17
Q

What is the result of meningeal damage in bacterial meningitis?

A

High rates of neurological sequelae

18
Q

How can death occur in bacterial meningitis?

A

Cerebral oedema

19
Q

How can cerebral oedema lead to death in bacterial meningitis?

A
  • Raised intracranial pressure

- Cerebral or cerebellar herniation

20
Q

How does the inflammatory response to viral meningitis compare to bacterial?

A

It is much less severe in viral meningitis

21
Q

How can organisms reach the brain in encephalitis?

A
  • Via the blood

- Via neuronal tract

22
Q

What is produced when organisms reach the brain via the blood in encephalitis?

A

Diffuse infection

23
Q

What is produced when organisms reach the brain via neuronal tracts in encephalitis?

A

Localised disease

24
Q

What produces immune mediated encephalitis?

A

Inflammatory lesions

25
Q

What produces inflammatory lesions in immune mediated encephalitis?

A
  • Host response to infection

- Presence of auto-antibodies

26
Q

What are the early complications of bacterial meningitis?

A
  • Seizures
  • SIADH
  • Subdural effusions
  • Focal neurological abnormalities
  • Hydrocephalus
  • Abscesses
  • Venous sinus thrombosis
27
Q

What % of children with bacterial meningitis can long-term sequelae?

A

20-30%

28
Q

What are the potential long-term sequelae of bacterial meningitis?

A
  • Sensorineural hearing loss
  • Epilepsy
  • Motor and cognitive impairment
  • Blindness
  • Learning/behavioural problems
29
Q

What is the fatality rate of meningitis in developed countries?

A

5-10%

30
Q

What is the prognosis of viral meningitis?

A

Full recovery is usual, although neuropsychological sequelae can occur

31
Q

What is the fatality rate of viral encephalitis?

A

3-4%

32
Q

What is the fatality rate of viral encephalitis neonates?

A

40-50%

TAS Infection And Immunity ✅ (14 decks)

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