Meningitis

Question 1

Which form of meningitis (viral or bacterial) is more common in adults than children? why?

Answer 1

Bacterial. Due to the HIB vaccine

Question 2

What are the three types of edema relevant to meningitis pathogenesis

Answer 2

Cytotoxic edema (from IL-1 TNF subarachnoid space inflammation)

Interstitial edema (–>ICP incr resistance to CSF flow)

Vasogenic edema (increased BBB permeability)

Question 3

What three bacteria are most likely to infect neonatally?

Answer 3

Group B strep, E coli, Listeria monocytogenes

Question 4

Which bugs are most likely to infect 2-18 yr olds?

Answer 4

#1 N. meningitides
#2 S. pneumoniae

Question 5

Which bugs are most likely to infect 18-50?

Answer 5

#1 S.Pneumoniae
#2 N.meningitidis

Question 6

What is the common and diagnostic symptom>

Answer 6

change in mental status/decreased level of consciousness

Question 7

What underlying conditions predispose patients to bacterial meningitis?

Answer 7

otitis media, sinusitis, pneumonia, endocarditis, recent/remote head trauma, immunosuppression, alcoholism.

Question 8

What CSF parameters are evaluated to diagnose meningitis?

Answer 8

Opening pressure, cell count, protein, glucose, bacterial antigen detection (latex), gram stain and culture

Question 9

Aseptic Meningitis? Commonly caused by…? when? more or less severe than bacterial?

Answer 9

Meningitis with a lymphocytic predominant pleocytosis, bacterial stains and culture negative.

commonly caused by enteroviruses

summer-early fall

similar clinical presentation but less severe