Infectious Diseases

Question 1

Meningitis

Answer 1

Acute inflammation of the meningeal tissues of the brain and spinal cord

Question 2

How is Meningitis spread?

Answer 2

Spread by:

• Droplet
• Contaminated saliva
• Respiratory secretions

*some people are only carriers

Question 3

Meningitis: Etiology

Answer 3

Infection (lungs or bloodstream) or penetrating wounds

Question 4

Meningitis: major organisms

Answer 4

Streptococcus pneumoniae
Neisseria meningitidis

Enteroviruses

Question 5

Meninges layers

Answer 5

OUTER
dura mater
arachnoid mater (CSF)
pia mater
INNER

Question 6

Meningitis is an infection of which layers

Answer 6

Pia mater
Subarachnoid space
Ventricular system
CSF

Question 7

Meningitis occurs when?

Answer 7

Fall or Winter

-People are inside in close quarters

Question 8

Meningitis usually follows which infections?

Answer 8

• Otitis
• Sinusitis
• Pneumonia in immunocompromised

Question 9

What ages does it effect?

Answer 9

Younger (college students)
Older >40
Prisoner

Question 10

How does it reach the brain?

Answer 10

Inhaled, attaches to NASOPHARANX, into mucus and then blood stream, finally reaching the BBB and passing through

Question 11

Meningitis Pathogenesis

Answer 11

1. Infection of arachnoid mater and CSF
2. Inflammatory response and pus secretion
3. Increase in CSF production
4. Increase in Intracranial pressure (ICP)

Question 12

Classic Meningitis Triad

Answer 12

1. Fever
2. Headache
3. Stiff neck

Question 13

Meningitis: S/S

Answer 13

N/V
Photophobia
Altered mental state
-Drowsiness  to coma
-Seizures

Meningococcus

• skin rash
• petechiae

Question 14

Meningitis: two tests to see if meninges are irritated

Answer 14

1. Positive Kernig sign
   - resistance to leg extension at hip (watch video)
2. Positive Brudzinski sign
   - Neck flexion (forward) causes hip/knee flexion

Question 15

Bacterial Vs Viral Meningitis

Answer 15

Acute Bacterial Meningitis

• Most common
• High fatality rate
• Long term effects (hearing loss, seizures, brain damage)
• Petechial rash

Acute Viral Meningitis

• Milder form
• No long term effects

Question 16

Bacterial Meningitis: Treatment

Answer 16

Aggressive Antibiotic Therapy

• IV, often multiple drugs
• Ceftriaxone (Rocephin), Vancomycin
• Acyclovir

Steroid Therapy

Prophylaxis: Vaccines
-Available for Meningococcus, pneumococcus, H. influenzae

Question 17

Encephalitis

Answer 17

Acute inflammation of the brain tissue

Etiology: Viral

• West Nile encephalitis
• Measles, chicken pox, mumps
• Herpes simplex virus 1 (HSV)

Question 18

Encephalitis: S/S

Answer 18

Signs appear on day 2 or 3

Range from mild changes in mental status to coma

Other symptoms

• Fever
• Headache
• N/V
• Other CNS changes (seizures)

Question 19

Encephalitis: Pharm

Answer 19

Viral Infection

• Acyclovir (Zovira) for HSV infection
• Reduces mortality
• Does not reduce neurological complications

Seizure disorders
-Antiseizure meds

Question 20

Brain Abscess

Answer 20

Accumulation of pus within the brain tissue

Question 21

Brain Abscess: Etiology

Answer 21

• Local or systemic infection

- Most common (ear, tooth, mastoid, or sinus tract)

Question 22

Brain Abscess: Organisms

Answer 22

Streptococci or Staphylococcus aureus

Question 23

Brain Abscess: S/S

Answer 23

Similar to those of meningitis and encephalitis

• Headache
• Fever
• N/V

Question 24

Brain Abscess: Signs of increased ICP

Answer 24

Drowsiness
Confusion
Seizures

Focal symptoms may reflect area of abscess:
-Example) temporal lobe = visual fields