Meningitis Flashcards
Most common causes of meningitis in a newborn
Group B strep
E. coli
Listeria
Most common causes of meningitis in a child
S. pneumoniae
N. meningitidis
H. influenzae B (in unvaccinated)
Enterovirus
Most common cause of meningitis in a teen
N. meningitidis (have purpura)
Most common causes of meningitis in adults
S. pneumoniae
N. meningitidis (have purpura)
Enterovirus
HSV (temporal lobe encephalopathy)
Most common causes of meningitis in elderly
S. pneumoniae
Gram negative rods
Listeria
Most common causes of meningitis in AIDS
Cryptococcus
CMV
Toxoplasmosis
JC virus
Meningitis treatment
Ceftriaxone + Vancomycin + Corticosteroids
*If Listeria add Ampicillin)
CSF findings in bacterial meningitis
Increased opening pressure
Increased neutrophils
Increased protein
Decreased sugar
CSF findings in fungal/TB meningitis
Increased opening pressure
Increased lymphocytes
Increased protein
Decreased sugar
CSF findings in viral meningitis
Normal opening pressure
Increased lymphocytes
Increased protein
Normal sugar
Rabies virus
Rhabdovirus
Bullet-shaped (linear-SS RNA, capsule)
Negri bodies found in Purkinje cells of cerebellum
Migrate retrograde up axons to CNS
Skunk, raccoon, and bat most common source
Prions
Prion protein (PrPc)=normal human protein
Converted to beta-pleated form (PrPsc)=transmissible
Encephalopathy, dementia, ataxia, and death
Sporatic=Creutzfeldt-Jabkob
Inherited=Gertmann=Straussler-Scheinker
Aquired=Kuru
Causes of bacterial meningioencephalitis
TB
Syphilis
Lyme disease
TB meningoencephalitis
Effects vessels/causes infarcts
Tuberculoma
Pott’s disease (TB osteomyelitis in spinal column)
Neurosyphilis (tertiary)
General paresis-cognition impairment
Meningovascular-base, infarcts, focal deficits
Tabes dorsalis-Loss of myelin in posterior columns
~Lightening pains w/ shuffling wide gait
HSV1 CNS infections
MCC of SPORADIC acute viral encephalopathy
Frontal/Temporal lobes=Mood/behavior change
Intra nuclear inclusions (Cowdry type A)
Other Herpes CNS infections
HSV2=neonates passing through birth canal
CMV = AIDS (intranuclear & cytoplasmic inclusions)
Varicella Zoster
HIV CNS infection
Microglia infected
Encephalitis/Leukoencephalopathy
MULTINUCLEATED GIANT MICROGLIAL CELLS
Progressive Multifocal Leukoencephalopathy (PML)
Caused by JC Virus (infects oligodendrocytes)
Immunocompromised
Aspergillus meningoencephalitis
Hemorrhagic infarcts (vasculitis) Immunocompromised
Cryptococcus meningioencephalitis
Lung infections spreads hematogenously to brain
Abcesses “SOAP BUBBLES”
Immunocompromised
Epidural/Subdural Empyema
Local extension of bacteria
~Sinusitis
~Otitis media
~Tooth pulled
