MENINGITIS Flashcards
septic meningitis
high high WBC, high protein low glucose, neutrophils, bacterial infection , acute or chronic
aseptic meningitis
low wbcs in csf , lymphocytes, viral or fungal, no organisms in csf, mod high proteins and normal glucose
neonates
group b strep
e. coli
listeria monocytogenes
6 mo o 5 yrs
neisseria meningitidis
haemophilius influenzae - type b ( if not vaccinated )
60 yrs
Strepococcus pneumoniae
young adults
neisseria meningitidis
Transmission of GBS ( strep agalactiae)
from mom to baby
Virulences of GBS
polysaccharide capsule
early onset infections - GBS
I,II,III -serotypes
- symptoms during first 5 days of life
- increased risk with PROM and premature delivery
- presents with respiratory distress, fever, lethargy and hypotension
- pneumonia > bacteremia> meningitis
late onset infection - GBS
III
- seen in term infants, presents at day 7 - 3 months
- transmission ( baby to baby) or mother to baby
DX GBS and TX
blood or CSF cultures
- penicillin or ampicillin IV. screening at 35-36 weeks if + intrapartum prophylaxis
E. coli - transmission and virulence
- passage thru vaginal canal
- anti-phagocytic K1 capsular polysccharide
- other gram -: enterobacter, proteus, klebsiella
most common cause of meningitis in kids <6
streptococcus pneumoniae
Haemophilus influenzae - age group
vaccine prevents it but unimmunized children < 2 are at high risk
normal wbc / protein / glucose
0-5/ 15-45 / 45-85
clinical presentation of viral meningitis
acute febrile illness, headache, nucchal rigidity, sometimes maculoopapular rash. self limiting unless in kid <1
Poliovirus pathogenesis
colonizes the epithelial cells and lymphoid cells of the pharynx and also peyer’s patches ( in poop for 1-2 months post infection) . they migrate to regional lymph nodes , enter blood stream and go to secondary adn tertiary organ
poliovirus disease
- asymptomatic
- flu like
- aseptic meningitis
- paralytic - destruction of cells in spinal cord and brain stem motor neurons _> asymmetric flaccid paralysis with no sensory loss
vaccines for the polio virus
sabin - live attenuated organisms
salk - killed vaccine - now used
Group A coxsackievirus
vesicular lesions ( hand, foot mouth disease) and herpes-like vesicles in the buccal mucosa ( herpangina)
Group B coxsackievirus
associated with myocardial and pericardial infections
echovirus
- leading cause of viral meningitis
- rash maculopapular, petechial or vesicular
- disease is usually self limiting
- severity based on viral serotype, dose , pt status and age
naegleria fowleri - morph
protozoan parasite that has three developmental stages, cyst, flagellate and amoeboid forms. ( cysts occur under unfavorable conditions, other thrive in fresh warm water)
naegleria fowleri- transmission
lakes in southern states \, hot springs and polluted waters. accesses the host via nose and travels along the olfactory nerve to the brain.
infections in the summer months
clinical - n. fowleri
nasal congestion and loss of sense of smell. symptoms of meningoencephalitis occur 1-14 days after contact. Headache, fever, nausea, vomitting and stiff neck that prgress to seizures, loss of motor control and cognitive function. death within 3-6 days
dx by brain autopsy.
few cases treated with amphotericin B
leptospira interrogans
causes leptospirosis. found in rats, rodents, dogs, pigs and cattle. - mild infection of man and animals. organisms found in blood during the early stages or the disease but localize to the kidney and are excreted into the urine
morph of l. interrogans
long very thin spirochete with hooks at one or both ends. highly motile
- classified based on antigens- 150 different strains called seovars
- easy easy to grow
transmission or L. interrogans
transmitted by man from contact with water, food or soil contamination with urine from infected animals.
disease of L. interrogans
can be subclinical with mild flu like symptoms, to meningitis or severe with systemic disease . - WEIL’s DISEASE - sever form. jaundice, liver and kidney failure, vasculitis and myocarditis
TX : penicillin
