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
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
3
Q
Meningitis definition
A
Inflammation of the meninges
4
Q
Encephalitis definition
A
Inflammation of the brain
5
Q
Sepsis definition
A
Whole body inflammation
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
7
Q
How can you confirm a diagnosis of meningitis?
A
- blood culture
- Lumbar puncture
- NAAT
8
Q
When is a lumbar puncture contra indicated?
A
- When GCS is less than 9
* Raised ICP
9
Q
What are the bacterial meningitis virulence factors?
A
- Anti-phagocytic polysaccharide capsule
- Endotoxin
- IgA protease
- Outer membrane proteins
- Pili
10
Q
normal CSF
A
- Clear
- 0-7 cells
- 12-40 protein
- 40-80 glucose
11
Q
CSF in bacterial meningitis infection
A
- Turbid
- Polymorphs
- increased proteins
- Reduced glucose
- Neutrophilia
12
Q
CSF in viral meningitis
A
- Clear
- Lymphocytes
- Slight increase in protein
- Normal glucose
- normal white cell count
13
Q
CSF in tuberculosis
A
- Clear
- Lymphocytes
- Increased proteins
- Reduced glucose
- normal white cell count
14
Q
Early onset neonatal meningitis
A
- Occurs >7 days
- Infected by heavily colonised mother
- Premature rupture of membranes
- Preterm delivery
- 60% fatality rate
15
Q
LAte onset neonatal meningitis
A
- Occurs <3 months
- Lack of maternal antibody
- Poor hygiene in nursery
- 20% fatality rate
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
