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Meningitis 2 Flashcards

1
Q

what is the definition of meningitis?

A

inflammation of the tissues that cover the brain and spinal cord

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2
Q

how do organisms cause meningitis infection?

A

breach blood – cerebrospinal fluid (CSF) barrier

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3
Q

what kind of organism is Strep pneumoniae?

A

gram positive cocci

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4
Q

what does Strep pneumoniae cause?

A

pneumonia and meningitis

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5
Q

how does Strep pneuminiae grow?

A

pairs of cocci - diplococci

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6
Q

how many serotypes of Strep pneumoniae are there?

A

92

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7
Q

how many serotypes of Strep pneumoniae are pathogenic?

A

25

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8
Q

in what ages does Strep pneumoniae cause meningitis?

A

<2 and old

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9
Q

how does Strep pneumoniae grow on blood agar?

A

alpha-haemolysis, green on colonies

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10
Q

what characteristic of Strep pneumoniae makes it pathogenic?

A

capsule

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11
Q

In which patients can Strep pneumoniae cause septicaemia?

A

patients without a spleen

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12
Q

what do the colonies of Strep pneumoniae look like?

A

collapsed in the middle

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13
Q

is Strep pneumoniae optochin sensitive or resistant?

A

sensitive

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14
Q

what kind of organism is Listeria monocytogenes?

A

gram positive bacillus

very short rod

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15
Q

what does Listeria monocytogenes normally cause?

A

food poisoning

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16
Q

who does Listeria monocytogenes usually infect?

A

pregnant women, neonates, elderly individuals, and immunocompromised individuals

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17
Q

if a Listeria monocytogenes infection is not treated, who is at high risk of meningitis?

A

neonates

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18
Q

how many Listeria monocytogenes infections result in meningitis?

A

30%

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19
Q

what kind of respiring organism is Listeria monocytogenes?

A

aerobic and facultatively anaerobic

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20
Q

what temperature can Listeria monocytogenes grow at?

A

1-45°C

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21
Q

where is Listeria monocytogenes typically found?

A

in soft cheese

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22
Q

what kind of haemolysis is Listeria monocytogenes?

A

Beta-hemolytic

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23
Q

how does Listeria monocytogenes grow on blood agar?

A

pearly appearance - see through halo around colonies

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24
Q

what antibiotics is Listeria monocytogenes resistant to?

A

cephalosporins and penicillin family

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25
Q

what is the most common cause of meningitis?

A

Neisseria meningitidis

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26
Q

what kind of meningitis does Neisseria meningitidis cause?

A

Meningococcal Meningitis

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27
Q

what is the incubation period of Meningococcal Meningitis?

A

1-3 days

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28
Q

what kind of organism is Neisseria meningitidis?

A

gram negative coccus

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29
Q

how does Neisseria meningitidis grow?

A

in pairs - clear pink

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30
Q

what factors affect Meningococcal disease?

A

serogroup, age, and prompt antibiotic treatment

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31
Q

is Neisseria meningitidis oxidase positive or negative?

A

Oxidase positive

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32
Q

how does Neisseria meningitidis grow on blood?

A

pearly looking colonies

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33
Q

what is Neisseria meningitidis resistant to?

A

vancomycin

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34
Q

what are the main symptoms of Neisseria meningitidis?

A

fever, headache, and stiff neck

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35
Q

what other symptoms are associated with Neisseria meningitidis?

A

nausea, vomiting, increased sensitivity to light, and confusion

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36
Q

what are symptoms of Neisseria meningitidis in infants?

A

inactivity, irritability, vomiting, or poor reflexes

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37
Q

tiredness, vomiting, cold hands and feet, chills, severe aches and pain, fast breathing, diarrhea, and a dark purple rash - what is the diagnosis?

A

Neisseria meningitidis sepsis

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38
Q

which bacterium causes epidemics in the sub saharan Africa- Meningitis belt?

A

Neisseria meningitidis

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39
Q

where is Neisseria meningitidis found?

A

normal microbiota of the upper respiratory tract

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40
Q

what is the peak season of Neisseria meningitidis in the UK?

A

January to March

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41
Q

what is the incubation period of Neisseria meningitidis?

A

1-3 days

42
Q

which serogroups of Neisseria meningitidis are the most common?

A

groups B, C, A, Y and W135

43
Q

B, C, A, Y and W135 are serogroups of which organism?

A

Neisseria meningitidis

44
Q

what type of meningitis does Haemophilus influenzae cause?

A

type b

45
Q

what does Haemophilus influenzae cause?

A

pneumonia, septic arthritis, sinusitis, otitis media, conjunctivitis, chronic bronchitis

46
Q

what kind of organism is Haemophilus influenzae?

A

Gram negative coccobacilli

47
Q

how many serotypes of Haemophilus influenzae type b are there?

A

6, determined a-f

48
Q

what is different about the different types of serotypes of Haemophilus influenzae type b?

A

different capsular polysaccharides

49
Q

where are the non-capsulated are commensals of Haemophilus influenzae type b found?

A

in the throat

50
Q

what agar does Haemophilus influenzae grow on?

A

chocolate - CO2

51
Q

what makes Haemophilus influenzae virulent?

A

capsule - impedes phagocytosis

52
Q

how is Haemophilus influenzae spread?

A

transmission droplet

53
Q

is Haemophilus influenzae oxidase positive or negative?

A

positive

54
Q

is Haemophilus influenzae catalase positive or negative?

A

positive

55
Q

how do you grow Haemophilus influenzae to diagnose it?

A 
grow on nutrient type agars
need X (haemin) and V (NAD) factors need the X and V together to grow
56
Q

what is the appearance of Haemophilus influenzae on chocolate agar?

A

pearly/shiny

57
Q

how can you view Cryptococcus neoformans?

A

gram/india ink

58
Q

who does Cryptococcus neoformans infect?

A

Immunocompromised patients

59
Q

why is viral meningitis under reported?

A

symptoms can be mild

60
Q

what are the symptoms of viral meningitis?

A

mild, flu like, headache

61
Q

what is the treatment for viral meningitis?

A

good nursing care

62
Q

what pathogens cause viral meningitis?

A

enteroviruses, herpes simplex, measles, polio, chickenpox

63
Q

if a meningitis sample has lots of neutrophils, what kind of meningitis is it likely to be?

A

bacterial

64
Q

if a meningitis sample has lots of lymphocytes, what kind of meningitis is it likely to be?

A

viral

65
Q

what series of tests should you do to diagnose meningitis?

A

Gram stain
Serology/ PCR/ Antigen tests
direct antibiotic sensitivity test (likely to be pure culture)
Repeat after culture

66
Q

what will a latex agglutination test of a sample determine?

A

antigens of common pathogens e.g.:

  • H. influenzae type b
  • S. pneumoniae
  • N. meningitidis
  • group B Streptococcus
67
Q

why would you take a blood culture when suspecting meningitis?

A

to check for septicaemia

68
Q

what should normal CSF values be like?

A

clear CSF
60-80% glucose
low protein
hardly any cell count (except in neonates)

69
Q

what are bacterial CSF values like?

A

cloudy CSF
raised protein (bacterial cells=protein)
low glucose (organisms use it)
lots of neutophils

70
Q

what test should you do on bacterial CSF?

A

agglutination tests to check if an organism is there

71
Q

what are viral CSF values like?

A 
CSF clear
raised protein (white cells are there)
glucose normal (viruses dont use it)
cell count - lymphocytes
cant see the organisms
72
Q

what test should you do on viral CSF?

A

PCR

73
Q

what is yeast CSF like? e.g. cryptococcus

A 
CSF cloudy
protein raised
glucose normal-low
lymphocytes up but not as much as others as different process
you can see the yeasts
74
Q

what test should you do on yeast CSF?

A

indian ink

75
Q

what do NICE guidelines 2010 say about treating meningitis?

A

if suspected - treat

if suspected meningococcal meningitis and rash - treat

76
Q

what do NICE guidelines 2010 say about lumbar punctures?

A

can be done up to 96 hours but dont let this delay treatment

77
Q

what is the recommended antibiotic treatment for Streptococcus pneumoniae?

A

Vancomycin plus a third-generation cephalosporin

78
Q

what is the recommended antibiotic treatment for Neisseria meningitidis?

A

Third-generation cephalosporin

79
Q

what is the recommended antibiotic treatment for Listeria monocytogenes?

A

Ampicillin or penicillin G

80
Q

what is the recommended antibiotic treatment for Haemophilus influenzae?

A

Third-generation cephalosporin

81
Q

what is the MenC vaccination?

A

meningococcal serogroup C conjugate

82
Q

who is the MenC vaccination for?

A

anybody under 25 years and anybody at increased risk of infection

83
Q

how many MenC vaccines are there in the UK?

A

3

84
Q

what meningitis does MenC not protect against?

A

meningococcal disease caused by other serogroups (A, B, W135, Y)

85
Q

which serogroup now causes the most meningococcal disease cases after MenC vaccine was introduced?

A

serogroup B

86
Q

in saudi arabia, which meningitis serogroup do they immunise against?

A

W135

87
Q

in africa, which meningitis serogroup do they immunise against?

A

A, C

88
Q

in the uk, which meningitis serogroup do they immunise against?

A

B, C

89
Q

in the usa, which meningitis serogroup do they immunise against?

A

C, B, and Y

90
Q

which vaccine is given to people in the meningitis belt?

A

MenAfriVac

91
Q

what ages is MenAfriVac given to?

A

1-29

92
Q

which meningitis serogroup causes 90% of meningitis?

A

A

93
Q

what other african meningitis vaccines are there?

A

MCV4
MPSV4
MenAfriVac

94
Q

when is MenB given to babies in the UK?

A

2 months
4 months
12 months

95
Q

what is Bexsero and how is it made?

A

MenB vaccine

Made from three majorproteins found on the surface of most meningococcal bacteria, combined with the outer membrane of one Men B strain

96
Q

what other meningitis vaccines are there in the UK and who are they given to?

A

MenACWY - teenagers and first time students

MenC - babies

97
Q

what is the conjugate vaccine for Hib?

A

polysaccharide capsule joined to DPT (diphtheria, pertussis, tetanus) vaccine

98
Q

how many serotype vaccinations are there for strep pneumoniae?

A

13 now

99
Q

which vaccination is given to people over the age of 65, or high risk under 65?

A

Polysaccharide pneumococcal vaccine

100
Q

which vaccination is given to children from 2 months - 2 years?

A

pneumococcal conjugate vaccine

X Infectious Diseases (9 decks)

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