Méningites Flashcards

bactéries

1
Q

Cocci -

A

Neisseria meningitidis

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2
Q

Cocci +

A
  • NN = strepto B
  • adulte = strepto pneumoniae
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3
Q

Bacille -

A
  • NN = E coli
  • jeune enfant non vacciné = Haemophilus influenzae
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4
Q

Bacille +

A

NN et ID = listéria monocytogenes

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5
Q

Méningites du NN

A
  • E coli
  • Listéria monocytogenes
  • strepto B
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6
Q

Streptocoque B

A
  • cocci +
  • espèce agalactiae
  • hémolysine complète B
  • 25-40% infection néonatales
  • commensal voies génito-urinaire : infection lors de l’accouchement
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7
Q

Traitement Streptocoque B

A
  • B-lactamines : amox - céphalosporines
  • Macrolides possible si allergie
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8
Q

Streptocoque A

A
  • pyrogenes
  • angine
  • fasciite nécrosante
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9
Q

Escherichia coli

A
  • bacille -
  • Ag K1 = 80% méningites : gène capsule
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10
Q

Traitement Escherichia coli

A
  • R amox
  • C3G + gentamicine
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11
Q

Listéria monocytogenes

A
  • bacille +
  • rare : NN ou ID = opportuniste
  • risque TMF : augmente avec le temps et inversement proportionnel avec gravité
  • bactérie des frigos : contamination par aliments crus
  • multiplication dans macrophages
  • LCR claire
  • pas de recherche de Ag
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12
Q

Traitement Listéria monocytogenes

A
  • R C2G - C3G - clindamycine
  • amox associé à gentamicine pour action plus rapide
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13
Q

Traitement probabiliste devant tableau de méningite

A

amox + C3G +/- gentamicine pour accélérer effets

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14
Q

Méningites chez l’enfant et l’adulte

A
  • Neisseria meningitidis
  • streptocoque pneumoniae
  • Haemophilus influenzae (rare car vaccin)
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15
Q

Neisseria meningitidis

A
  • gram -
  • capsulé
  • multiplication intra et extra cellulaire
  • portage oro-pharyngé
  • pas agglutinable = pas de méningite
  • purpura fulminant = choc méningocoquique
  • prise ATB trop tôt = aggrave thrombose responsable de la maladie
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16
Q

Diagnostic de méningite à méningocoque

A
  • LRC eau de riz
  • hémoc - ORL
  • det sérogroupe après culture
17
Q

Traitement méningite Neisseria meningitidis

A
  • curatif = péni G, amox, C3G
  • prophylaxie sujet contact : rifampicine, spiramycine
  • vaccin
18
Q

Streptocoque pneumoniae

A
  • cocci +
  • capsulé
  • hémolyse a incomplète
  • capsule
  • terrain prédisposition
  • R ATB
19
Q

Traitement streptocoque pneumoniae

A
  • curatif : S diminué au B lactamine = faire CMI péni G, amox, C3G
  • vancomycine en fin de traitement
  • vaccin
20
Q

Haemophilus influenzae

A
  • rare car vaccination
  • portage sain respi possible
  • foyer ORL à rechercher si méningite
21
Q

Traitement haemophilus influenzae

A
  • C3G
  • Augmentin pour infection ORL