Meningitis 2 Flashcards
1
Q
what is the definition of meningitis?
A
inflammation of the tissues that cover the brain and spinal cord
2
Q
how do organisms cause meningitis infection?
A
breach blood – cerebrospinal fluid (CSF) barrier
3
Q
what kind of organism is Strep pneumoniae?
A
gram positive cocci
4
Q
what does Strep pneumoniae cause?
A
pneumonia and meningitis
5
Q
how does Strep pneuminiae grow?
A
pairs of cocci - diplococci
6
Q
how many serotypes of Strep pneumoniae are there?
A
92
7
Q
how many serotypes of Strep pneumoniae are pathogenic?
A
25
8
Q
in what ages does Strep pneumoniae cause meningitis?
A
<2 and old
9
Q
how does Strep pneumoniae grow on blood agar?
A
alpha-haemolysis, green on colonies
10
Q
what characteristic of Strep pneumoniae makes it pathogenic?
A
capsule
11
Q
In which patients can Strep pneumoniae cause septicaemia?
A
patients without a spleen
12
Q
what do the colonies of Strep pneumoniae look like?
A
collapsed in the middle
13
Q
is Strep pneumoniae optochin sensitive or resistant?
A
sensitive
14
Q
what kind of organism is Listeria monocytogenes?
A
gram positive bacillus
very short rod
15
Q
what does Listeria monocytogenes normally cause?
A
food poisoning
16
Q
who does Listeria monocytogenes usually infect?
A
pregnant women, neonates, elderly individuals, and immunocompromised individuals
17
Q
if a Listeria monocytogenes infection is not treated, who is at high risk of meningitis?
A
neonates
18
Q
how many Listeria monocytogenes infections result in meningitis?
A
30%
19
Q
what kind of respiring organism is Listeria monocytogenes?
A
aerobic and facultatively anaerobic
20
Q
what temperature can Listeria monocytogenes grow at?
A
1-45°C
21
Q
where is Listeria monocytogenes typically found?
A
in soft cheese
22
Q
what kind of haemolysis is Listeria monocytogenes?
A
Beta-hemolytic
23
Q
how does Listeria monocytogenes grow on blood agar?
A
pearly appearance - see through halo around colonies
24
Q
what antibiotics is Listeria monocytogenes resistant to?
A
cephalosporins and penicillin family
25
what is the most common cause of meningitis?
Neisseria meningitidis
26
what kind of meningitis does Neisseria meningitidis cause?
Meningococcal Meningitis
27
what is the incubation period of Meningococcal Meningitis?
1-3 days
28
what kind of organism is Neisseria meningitidis?
gram negative coccus
29
how does Neisseria meningitidis grow?
in pairs - clear pink
30
what factors affect Meningococcal disease?
serogroup, age, and prompt antibiotic treatment
31
is Neisseria meningitidis oxidase positive or negative?
Oxidase positive
32
how does Neisseria meningitidis grow on blood?
pearly looking colonies
33
what is Neisseria meningitidis resistant to?
vancomycin
34
what are the main symptoms of Neisseria meningitidis?
fever, headache, and stiff neck
35
what other symptoms are associated with Neisseria meningitidis?
nausea, vomiting, increased sensitivity to light, and confusion
36
what are symptoms of Neisseria meningitidis in infants?
inactivity, irritability, vomiting, or poor reflexes
37
tiredness, vomiting, cold hands and feet, chills, severe aches and pain, fast breathing, diarrhea, and a dark purple rash - what is the diagnosis?
Neisseria meningitidis sepsis
38
which bacterium causes epidemics in the sub saharan Africa- Meningitis belt?
Neisseria meningitidis
39
where is Neisseria meningitidis found?
normal microbiota of the upper respiratory tract
40
what is the peak season of Neisseria meningitidis in the UK?
January to March
41
what is the incubation period of Neisseria meningitidis?
1-3 days
42
which serogroups of Neisseria meningitidis are the most common?
groups B, C, A, Y and W135
43
B, C, A, Y and W135 are serogroups of which organism?
Neisseria meningitidis
44
what type of meningitis does Haemophilus influenzae cause?
type b
45
what does Haemophilus influenzae cause?
pneumonia, septic arthritis, sinusitis, otitis media, conjunctivitis, chronic bronchitis
46
what kind of organism is Haemophilus influenzae?
Gram negative coccobacilli
47
how many serotypes of Haemophilus influenzae type b are there?
6, determined a-f
48
what is different about the different types of serotypes of Haemophilus influenzae type b?
different capsular polysaccharides
49
where are the non-capsulated are commensals of Haemophilus influenzae type b found?
in the throat
50
what agar does Haemophilus influenzae grow on?
chocolate - CO2
51
what makes Haemophilus influenzae virulent?
capsule - impedes phagocytosis
52
how is Haemophilus influenzae spread?
transmission droplet
53
is Haemophilus influenzae oxidase positive or negative?
positive
54
is Haemophilus influenzae catalase positive or negative?
positive
55
how do you grow Haemophilus influenzae to diagnose it?
```
grow on nutrient type agars
need X (haemin) and V (NAD) factors need the X and V together to grow
```
56
what is the appearance of Haemophilus influenzae on chocolate agar?
pearly/shiny
57
how can you view Cryptococcus neoformans?
gram/india ink
58
who does Cryptococcus neoformans infect?
Immunocompromised patients
59
why is viral meningitis under reported?
symptoms can be mild
60
what are the symptoms of viral meningitis?
mild, flu like, headache
61
what is the treatment for viral meningitis?
good nursing care
62
what pathogens cause viral meningitis?
enteroviruses, herpes simplex, measles, polio, chickenpox
63
if a meningitis sample has lots of neutrophils, what kind of meningitis is it likely to be?
bacterial
64
if a meningitis sample has lots of lymphocytes, what kind of meningitis is it likely to be?
viral
65
what series of tests should you do to diagnose meningitis?
Gram stain
Serology/ PCR/ Antigen tests
direct antibiotic sensitivity test (likely to be pure culture)
Repeat after culture
66
what will a latex agglutination test of a sample determine?
antigens of common pathogens e.g.:
- H. influenzae type b
- S. pneumoniae
- N. meningitidis
- group B Streptococcus
67
why would you take a blood culture when suspecting meningitis?
to check for septicaemia
68
what should normal CSF values be like?
clear CSF
60-80% glucose
low protein
hardly any cell count (except in neonates)
69
what are bacterial CSF values like?
cloudy CSF
raised protein (bacterial cells=protein)
low glucose (organisms use it)
lots of neutophils
70
what test should you do on bacterial CSF?
agglutination tests to check if an organism is there
71
what are viral CSF values like?
```
CSF clear
raised protein (white cells are there)
glucose normal (viruses dont use it)
cell count - lymphocytes
cant see the organisms
```
72
what test should you do on viral CSF?
PCR
73
what is yeast CSF like? e.g. cryptococcus
```
CSF cloudy
protein raised
glucose normal-low
lymphocytes up but not as much as others as different process
you can see the yeasts
```
74
what test should you do on yeast CSF?
indian ink
75
what do NICE guidelines 2010 say about treating meningitis?
if suspected - treat
if suspected meningococcal meningitis and rash - treat
76
what do NICE guidelines 2010 say about lumbar punctures?
can be done up to 96 hours but dont let this delay treatment
77
what is the recommended antibiotic treatment for Streptococcus pneumoniae?
Vancomycin plus a third-generation cephalosporin
78
what is the recommended antibiotic treatment for Neisseria meningitidis?
Third-generation cephalosporin
79
what is the recommended antibiotic treatment for Listeria monocytogenes?
Ampicillin or penicillin G
80
what is the recommended antibiotic treatment for Haemophilus influenzae?
Third-generation cephalosporin
81
what is the MenC vaccination?
meningococcal serogroup C conjugate
82
who is the MenC vaccination for?
anybody under 25 years and anybody at increased risk of infection
83
how many MenC vaccines are there in the UK?
3
84
what meningitis does MenC not protect against?
meningococcal disease caused by other serogroups (A, B, W135, Y)
85
which serogroup now causes the most meningococcal disease cases after MenC vaccine was introduced?
serogroup B
86
in saudi arabia, which meningitis serogroup do they immunise against?
W135
87
in africa, which meningitis serogroup do they immunise against?
A, C
88
in the uk, which meningitis serogroup do they immunise against?
B, C
89
in the usa, which meningitis serogroup do they immunise against?
C, B, and Y
90
which vaccine is given to people in the meningitis belt?
MenAfriVac
91
what ages is MenAfriVac given to?
1-29
92
which meningitis serogroup causes 90% of meningitis?
A
93
what other african meningitis vaccines are there?
MCV4
MPSV4
MenAfriVac
94
when is MenB given to babies in the UK?
2 months
4 months
12 months
95
what is Bexsero and how is it made?
MenB vaccine
Made from three major proteins found on the surface of most meningococcal bacteria, combined with the outer membrane of one Men B strain
96
what other meningitis vaccines are there in the UK and who are they given to?
MenACWY - teenagers and first time students
| MenC - babies
97
what is the conjugate vaccine for Hib?
polysaccharide capsule joined to DPT (diphtheria, pertussis, tetanus) vaccine
98
how many serotype vaccinations are there for strep pneumoniae?
13 now
99
which vaccination is given to people over the age of 65, or high risk under 65?
Polysaccharide pneumococcal vaccine
100
which vaccination is given to children from 2 months - 2 years?
pneumococcal conjugate vaccine
