Infections of the CNS Flashcards

1
Q

What are the clinical features of meningitis?

A
  • Headache, drowsiness, sore throat
  • Rapid onset of fever, stiff neck, photophobia
  • Level of consciousness progressively falls
  • Petechial or purpuric rash
  • Intravascular coagulation, endotoxaemia, shock, multi organ failure, raised intracranial pressure
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2
Q

Meningitis symptoms in babies

A
  • Tense/bulging soft spot on their head
  • Refusing to feed
  • Irritable when picked up, with a high pitched moaning or cry
  • A stiff body with jerky movements or else floppy and lifeless
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3
Q

Meningitis definition

A

Inflammation of the meninges

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4
Q

Encephalitis definition

A

Inflammation of the brain

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5
Q

Sepsis definition

A

Whole body inflammation

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6
Q

How can pathogens breach barriers

A
  • Growing across infecting cells comprising the barrier
  • Passive transfer in intracellular vacuoles
  • Carriage across in infected white blood cells
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7
Q

How can you confirm a diagnosis of meningitis?

A
  • blood culture
  • Lumbar puncture
  • NAAT
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8
Q

When is a lumbar puncture contra indicated?

A
  • When GCS is less than 9

* Raised ICP

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9
Q

What are the bacterial meningitis virulence factors?

A
  • Anti-phagocytic polysaccharide capsule
  • Endotoxin
  • IgA protease
  • Outer membrane proteins
  • Pili
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10
Q

normal CSF

A
  • Clear
  • 0-7 cells
  • 12-40 protein
  • 40-80 glucose
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11
Q

CSF in bacterial meningitis infection

A
  • Turbid
  • Polymorphs
  • increased proteins
  • Reduced glucose
  • Neutrophilia
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12
Q

CSF in viral meningitis

A
  • Clear
  • Lymphocytes
  • Slight increase in protein
  • Normal glucose
  • normal white cell count
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13
Q

CSF in tuberculosis

A
  • Clear
  • Lymphocytes
  • Increased proteins
  • Reduced glucose
  • normal white cell count
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14
Q

Early onset neonatal meningitis

A
  • Occurs >7 days
  • Infected by heavily colonised mother
  • Premature rupture of membranes
  • Preterm delivery
  • 60% fatality rate
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15
Q

LAte onset neonatal meningitis

A
  • Occurs <3 months
  • Lack of maternal antibody
  • Poor hygiene in nursery
  • 20% fatality rate
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16
Q

What are the complications of bacterial meningitis

A
  • Sepsis
  • Intellectual deficit
  • Deafness
  • Arthritis
  • Skin necrosis
17
Q

What are the signs of cerebral dysfunction?

A
  • Abnormal behaviour
  • Altered consciousness
  • Seizures
  • Nausa/vomiting
  • Fever
18
Q

What are the predisposing factors for a brain abscess?

A
  • Otitis
  • Mastoiditis
  • Sinustitis