Meningitis

Question 1

How dangerous is community aquired meningitis?

Answer 1

Considered medical emergency

Question 2

WHat is the treatment of community aquired meningitis

Answer 2

1. Corticosteroids, 0.12mg/kg before first dose of Ab.
2. 3.

Question 3

What is Waterhouse-Friedriscen syndrome?

Answer 3

Affecting 10-20% of children under 10 yo with meningococcal INFECTION -usually from dissaminating infection.
* large petechial hemorrhages
* septic shock
* adrenal failure
*DIC

Question 4

Surgical treatment in case of Waterhouse Friedrichsen syndrome?

Answer 4

If comatose not localizing pt:
EVD.
If EVD is refractory - consider decompressive hemicraniectomy.

Question 5

What neurosurgical treatable condition is not unkommon after Cryptococcal meningitis?

Answer 5

Acute hcph

Question 6

What are the most common agens to infect after neurosurgery?

Answer 6

• KNS
• Staff. Aureus
• Entero?
• Pseudomonas

Question 7

What ab is used for the treatment in neurosurgical postoperative infection?

Answer 7

• Vancomycin (to cover MRSA)
• Cefipime 2gx3
  In severe PC allergy - use:
  Aztreonam
  or
  Ciprofloxacine

Question 8

In ADULTS; which are the most common Community Acquired Meningitis causing bacteria for people with intact immune system?

Answer 8

• Neisseria Meningitis
• Streptococcus pneumoniae
• Hamophilus influenza type B

Question 9

What is Cryptococcal meningitis?

Answer 9

A Fungal infection spreading from the lungs.

Question 10

What specific subgroup of people are more ogften affected by cryptococcal meningitis?

Answer 10

Patients with that are immunocompromised. The subsaharan area has had great problems with AIDS.

Data from 2009 estimated that of the almost one million cases of cryptococcal meningitis that occurred worldwide annually, 700,000 occurred in sub-Saharan Africa and 600,000 per year died.[13] Cryptococcosis was rare before the 1970s which saw an increase in at-risk groups such as people with organ transplant or on immunosuppressant medications.

Question 14

What is the rec. for pt with rhinorrhea and meningitis within 2 weeks after craniospinal injury?

Answer 14

• Antibitotics to be continued 1 week after sterile CSF
• If persistent rhinorrhea, exploration and seal

Question 15

What needs to be looked for in recurrent meningitis?

Answer 15

A fitulae!

Question 16

What are the three most common causes of chronical meningitis?

Answer 16

• Tuberculosis
• Fungal infection
• Cystercosis, neurocystercosis

Question 17

What are differential diagnostics to infectious causes of chronic meningitis?

Answer 17

• Sarcoidosis
• Meningeal carcinomatosis