MENINGITIS

Question 1

septic meningitis

Answer 1

high high WBC, high protein low glucose, neutrophils, bacterial infection , acute or chronic

Question 2

aseptic meningitis

Answer 2

low wbcs in csf , lymphocytes, viral or fungal, no organisms in csf, mod high proteins and normal glucose

Question 3

neonates

Answer 3

group b strep
e. coli
listeria monocytogenes

Question 4

6 mo o 5 yrs

Answer 4

neisseria meningitidis

haemophilius influenzae - type b ( if not vaccinated )

Question 5

60 yrs

Answer 5

Strepococcus pneumoniae

Question 6

young adults

Answer 6

neisseria meningitidis

Question 7

Transmission of GBS ( strep agalactiae)

Answer 7

from mom to baby

Question 8

Virulences of GBS

Answer 8

polysaccharide capsule

Question 9

early onset infections - GBS

Answer 9

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

Question 10

late onset infection - GBS

Answer 10

III

• seen in term infants, presents at day 7 - 3 months
• transmission ( baby to baby) or mother to baby

Question 11

DX GBS and TX

Answer 11

blood or CSF cultures

- penicillin or ampicillin IV. screening at 35-36 weeks if + intrapartum prophylaxis

Question 12

E. coli - transmission and virulence

Answer 12

• passage thru vaginal canal
• anti-phagocytic K1 capsular polysccharide
• other gram -: enterobacter, proteus, klebsiella

Question 13

most common cause of meningitis in kids <6

Answer 13

streptococcus pneumoniae

Question 14

Haemophilus influenzae - age group

Answer 14

vaccine prevents it but unimmunized children < 2 are at high risk

Question 15

normal wbc / protein / glucose

Answer 15

0-5/ 15-45 / 45-85

Question 16

clinical presentation of viral meningitis

Answer 16

acute febrile illness, headache, nucchal rigidity, sometimes maculoopapular rash. self limiting unless in kid <1

Question 17

Poliovirus pathogenesis

Answer 17

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

Question 18

poliovirus disease

Answer 18

• asymptomatic
• flu like
• aseptic meningitis
• paralytic - destruction of cells in spinal cord and brain stem motor neurons _> asymmetric flaccid paralysis with no sensory loss

Question 19

vaccines for the polio virus

Answer 19

sabin - live attenuated organisms

salk - killed vaccine - now used

Question 20

Group A coxsackievirus

Answer 20

vesicular lesions ( hand, foot mouth disease) and herpes-like vesicles in the buccal mucosa ( herpangina)

Question 21

Group B coxsackievirus

Answer 21

associated with myocardial and pericardial infections

Question 22

echovirus

Answer 22

• 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

Question 23

naegleria fowleri - morph

Answer 23

protozoan parasite that has three developmental stages, cyst, flagellate and amoeboid forms. ( cysts occur under unfavorable conditions, other thrive in fresh warm water)

Question 24

naegleria fowleri- transmission

Answer 24

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

Question 25

clinical - n. fowleri

Answer 25

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

Question 26

leptospira interrogans

Answer 26

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

Question 27

morph of l. interrogans

Answer 27

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

Question 28

transmission or L. interrogans

Answer 28

transmitted by man from contact with water, food or soil contamination with urine from infected animals.

Question 29

disease of L. interrogans

Answer 29

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