Meningitis Flashcards

1
Q

What is the normal number of polymorphs in CSF?

A

0

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2
Q

Which bacteria causes meningitis in pregnant women?

A

L. monocytogenes

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2
Q

What is the protein and glucose in bacterial meningitis?

A

High >1g/dl

Low

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3
Q

What is the empircal abx therapy for bacterial meningitis?

A

Cetriaxone

Penicillin

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4
Q

In which seasons are viral meningitis most common?

A

Autumn and summer

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5
Q

Is it normal to have blood in the CSF?

A

Maybe in the first tube

If in all the tubes - think subarachnoid

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5
Q

When do you give antibiotics in relation to the CT?

A

Before

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5
Q

What is the most common cause so of encephalitis?

A

Herpes simplex virus

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7
Q

Which viruses cause viral meningitis?

A

Enteroviruses - Echo, polio, coxsackie

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8
Q

Which bacteria causes neonatal meningitis?

A

S. agalacticae

E. coli

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8
Q

What are some cause of aseptic meningitis?

A

Partially treated bacterial meningitis (when CSF is taken post abx)

Drugs (cotrimoxazole/NSAIDs)

Syphilis (particularly secondary)

Post ictal

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10
Q

How does meningitis present?

A

Headache, photophobia and neck stiffness

Fever, nausea and vomiting

Rash

(Clear conscious state)

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11
Q

What are the aetiology of bacterial meningitis?

A

Pneumococcus (most common)

Meningicoccus

L. monocytogenes

S. agalacticae

E. coli

TB

[H influenzae type b]

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12
Q

What is the duration and administration of abx therapy?

A

3 days minimum

10 days for meningococcal

IV

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13
Q

What does Listeria monocytogenes meningits differ in presentation?

A

Tends to target brainstem - eye signs, brainstem signs

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15
Q

How does TB meningitis kill people?

A

Respiratory depression due to invasion of local vessels

Strokes

15
Q

What is Kernig’s sign?

A

Raise the leg and there is limitation of hip flexion that is improved by flexing the knee

16
Q

Why is ancyclovir specific to viral infected cells?

A

Because a HSV enzyme phosphorylates the first step of activation

17
Q

What is added to abx in the treatment of bacterial meningitis?

A

Steroids - dexamethasone

19
Q

What is the phenotype of meningococcus?

A

Gram -ve

Intracellular

20
Q

What is the protein and glucose in viral meningitis?

A

Both are normal

21
Q

Where do the bacteria travel to the brain from?

A

Back of the throat

Secondary to a pneumonia, endocarditis

Cranial osteomyelitis

22
Q

When is the empirical abx therapy for meningitis altered? How is it changed?

A

When Pneumococcus is suspected

  • GPC seen, otitis media, CSF leak

Switch penicillin to vancomycin, (keep cefrtiaxone)

Add rifampicin if penicllin resistance is confirmed

24
Q

What is the normal level of lymphocytes in the CSF?

A

2

25
Q

How is TB meningitis treated?

A

Isoniazid

Rifampicin

Pyrazinamide

Ethambutol

26
Q
A