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Medical bacteriology: First half > Infections of the CNS > Flashcards

Infections of the CNS Flashcards

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USMLE® Step 1 flashcards
1
Q

Infection of the membranes around the brain

A

Meningitis
Meninges
Subarachoroid space

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2
Q

Encephalitis

A

Infection of the substance of the brain

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3
Q

Brain abscesses

A

Localised lesion within the brain

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4
Q

3 most common causes of bacterial meningitis

A

Steptococcus pneumoniae
Neisseria meningitidis
Haemophilus influenzae

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5
Q

Causes of viral meningitis

A

ECHO
Coxsackie
Herpes simplex

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6
Q

Causes of bacterial meningitis

A
  • Cryptococcus neoformans
  • Mycobacterium tuberculosis
  • Naegleria fowleri
  • Coagulase negative staphylococci
  • Treponema pallidum
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7
Q

Neonatal meningitis

A

Symptoms often not obvious
Group B streptococci may be found in the female genital tract - increased infection in premature babies or protracted labour
If these is contracted in the first week of life mortality is 60%
After one week mortality is 20%
Treatment with penicillin or gentamycin
Mothers carrying this are treated with benzylpenicillin
Can be due to listeria monocytogenes = gram positive bacilli
Can cause septicaemia

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8
Q

Streptococcus pneumoniae meningitis

A 
Gram positive diplococci and is encapsulated 
Often in children less than 2 years old
High mortality associated with it 20-30%
Lanceolate
Sore throat and photophobia
Gentamycin and ampicillin
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9
Q

Neisseria meningitidis

A 
Gram negative dipococcus
Associated with polynuclear leukocytes (neutrophils)
Oxidase positive
Needs 5-10% CO2 to grow
Intracellular
20% carry this in the oropharynx
Encapsulated and the ABC W5 Y
C has decreased
Petichial skin rash
Skin of septicaemia
Rifampicin used to treat
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10
Q

Haemophilus influenzae

A 
Pleomorphic gram negative bacteria
Encapsulated
Pathogen of the respiratory tract
3-4 months to 3-4 years
Fastidious
X and V
Pittman B type
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11
Q

Mycobacterium tuberculosis

A 
Rare and fast onset
It DOES NOT gram stain
Grows very slowly in the lab
Fever
Severe headache
Neck stiffness
Photophobia
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12
Q

Diagnosis

A

Lumbar puncture to obtain CSF
Macroscopic examination for turbidity and bloodstaining
Microscopy for total and differential count
Microscopy for gram or india ink stain
Bacterial meningitis - high protein, low glucose, turbid
TB is opalescent

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13
Q

Treatment of streptococcal meningitis

A

Unknown - empirical treatment based
Healthy child - cefotaxine
Cefotaxine used for streptococcus pneumoniae but for those resistant vancomycin is used

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14
Q

Treatment of meningococcal meningitis

A

Penicillin or cephalosporin treatment of choice for meningococcal meningitis can be used in combination with cholamphenicol

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15
Q

Treatment of haemophilus influenza meningitis

A

Haemophilus influenzae usually produces b-lactamases so cefotaxine is used
Rifampicin has been used to treat those that come into contact with it

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16
Q

Treatment for Mycobacterium tuberculosis

A

Isoniazid and rifampicin

17
Q

Vaccines

A

2013 vaccine belonging to belonging to group B

Hib vaccine for infants 2,3 and 4 year olds

18
Q

Brain abscess

A

Focal supprative lesion in the brain parenchyma

19
Q

Cause of brain abscess

A

Often occur after surgery
May be due to osteomyelitis or ear infection
Usually polymicrobial with anaerobic bacteria
Staph aureus is the most common

Contigious suppurative focus
Haemotogous spread
After trauma
Crytogenic

20
Q

Lumbar puncture and brain abscesses

A

Can be fatal

Can lead to raised intracranial pressire

21
Q

Rare causes of brain abscesses

A 
Actinomycetes
Nocardia
M Tb
T. pallidum
B. burgoferi
Aspergillus
22
Q

Symptoms of a brain abscess

A 
Fever
Headache
Focal neurological deficit
Nausea
Vomiting 
Papilloedemia
23
Q

Treatment of brain abscesses

A

Drainage and antibiotics
Gram negative and Ziehl Neelson stain
Benzylpenicillin, metronidazole and cefotaxine

24
Q

Subdural empyema

A

Infection enclosed between outer meningeal layers (dura and arachoid layers)
Polymicrobial
Anaerobes
Infection usually spread from the sinus
Headache, fever, confusion, seizure and coma
Drainage and antimicrobials

25
Q

Ventriculoperitoneal shunt

A

Devices that are used to release high intracranial pressure caused by hydrocephalus

26
Q

How does a ventriculoperitoneal stunt work?

A

Plastic deura leads fluid from a ventricle of the brain through a one way to the peritoneal cavity

27
Q

Cause of ventriculoperitoneal stunt infection

A

Coagulase negative staphylococci by biofilm infection

Replaced the shunt

Medical bacteriology: First half (14 decks)

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