Meningitis Flashcards

1
Q

what are the CSF findings in tubercular meningitis?

A
  • raised protein
  • raised lymphocytes
  • polymorphonuclear cells
  • turbid appearance with fibrin web formation
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2
Q

what are the CSF findings in viral meningitis?

A
  • normal openng pressure
  • raised protein
  • normal glucose
  • lymphocytic predominance
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3
Q

what are the CSF findings in bacterial meningitis?

A
  • raised protein
  • low glucose
  • neutrophilic predominance
  • cultures +ve
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4
Q

what is meningism?

A
  • headache
  • photophobia
  • vomiting
  • myalgia
  • fever
  • neck stiffness
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5
Q

what is the antibiotic management of bacterial meningitis in hospital?

A

2g IV ceftriaxone BD

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6
Q

what additional antibiotic is given to young/old patients to cover listeria?

A

IV amoxicillin

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7
Q

what additional antibiotic is given if viral encephalitis is suspected?

A

IV aciclovir

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8
Q

what is the antibiotic management of bacterial meningitis in the community?

A

IM benzylpenicillin

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9
Q

what antibiotic is used in penicillin allergic patients?

A

chloramphenicol

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10
Q

what is the cause of meningitis with a non-blanching rash?

A

neisseria meningitidis

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11
Q

what are the common bacterial causes of meningitis?

A
  • streptococcus pneumoniae (gram +ve diplococci)
  • neisseria meningitidis (gram -ve diplococci)
  • haemophilus influenzea
  • listeria monocytogens - often seen in extremes of ages
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12
Q

what are the viral causes of meningitis?

A
  • enteroviruses - echoviruses, coxsackie viruses A&B, poliovirus
  • HSV2
  • HSV1
  • paramyxovirus - complications of mumps
  • measles and rubella virus
  • varicella zoster virus - complication of chicken pox
  • arboviruses
  • rabies virus
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13
Q

what is the most common cause of acute bacterial meningitis in young adults in the UK?

A

neisseria meningitidis

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14
Q

what are the fungal causes of meningitis?

A

crytococcus neoformans

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15
Q

what patient sub-group are more at risk of fungal meningitis?

A

immunosuppressed population

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16
Q

what are the parastic causes of meningitis?

A
  • ameoba - acanthamoeba (associated with keratitis and meningitis from contract lens fluid contamination)
  • toxoplasma gondii
17
Q

what are the non-infective causes of meningitis?

A
  • malignancy
  • chemical meningitis
  • drugs
  • sarcoidosis
  • systemic lupus erythematosus
  • behcets disease
18
Q

what is the management of cryptococcal meningitis?

A
  1. IV amphotericin B and oral flucyotsine for 2 weeks
  2. maintenance therapy with oral fluconazole for 8 weeks
  3. long-term low dose oral fluconazole
19
Q

how do you diagnose cryptococcal meningitis?

A
  • very high CSF opening pressure
  • cryptococcal antigen testing
  • india ink staining
20
Q

what investigations should be undertaken in meningitis?

A
  • blood tests - FBC, U&Es, clotting, glucose
  • arterial blood gas
  • blood cultures
  • CT head
  • lumbar puncture
21
Q

what are the possible complications from meningitis?

A
  • septic shock
  • DIC
  • coma
  • subdural effusions
  • SIADH
  • seizures
  • death
22
Q

what are some of the delayed complications from meningitis?

A
  • hearing loss
  • cranial nerve dysfunction
  • hydrocephalus
  • intellectual deficits
  • ataxia
  • blindness