Meningitis Flashcards
What is meningitis?
infection of meinges, CSF, and ventricles. can be bacterial or viral or fungal. bater - pyogenic and viral - aseptic.
What is encephalitis?
inflammation of brain
signs of encephalitis?
flu-like symptoms - fever or severe headache. confusion, seizures, sensory or motor impairment. usually viral so fewer meningal sings.
Bacterial meningitis pathogens?
Strept. pneum (+ diplococci)
H influ ( gram negative coccobacilli)
Staphylococcus (gram + cocci)
N. meningitidis (gram negative diplococci)
Recommended vaccines to prevent meningitis?
PCV 7 (children)
PPV 23
MCV4
MPSV4
incubation of N meningitis?
2-4 days, (1-10 day range)
Presentation of bacterial Meningitis?
triad: fever, headache, nuchal rigidity, stiff neck
Brudzinski and kernig sign
Possible causes of viral Encephalitis?
HSv, varicella, enterovirus, mosquito, tickborne viruses. rabies. measles, mumos.
CSF results in bacterial meningitis?
pleocytosis (WBC > 5 cell/mm3), elevated CSF pressure (also see in viral) WBC 1200, 90-95% neutrophils, reduced CSF glucose (
CSF results in viral meningitis?
pleocytosis (WBC > 5 cell/mm3), elevated CSF pressure, normal glucose, normal - elevated protein, lymphocytosis.
What is brudzinski sign?
passive neck flexion in supine patient causes flexion of knees and hips
What is kernig sign?
supine patient and flex hip 90 degrees, extension of knee from position elicits resistance or pain in lower back or posterior thigh.
signs of increased ICP?
papilledema, optic disk bulging, absence venous pulsations on funduscopic exam.
severe signs - vomiting, nausea, seizures, altered consciousness
What is common signal sign of N meningitidis?
purpura or petechial rash
Daignostic for encephalitis?
MRI or CT.
lumbar puncture
What strands of meningitis does the vaccination cover?
A, C, Y, W135.
does not cover serogroup B.
Prophylaxis during epidemic?
NO. limited help.
Prophylaxis during those in close contact with infected?
yes, single does oral cipro or IM ceftriaxone.
oral rifampin over 2 days.
Can vaccinations be used in outbreak?
yes
MCV4 is recommended for who?
those in outbreak and for all children during 11-12 yo. 13-18 if late. or booster if later.
Who gets a booster MCV 4?
16 yo for those who got it at 11-12. , college freshman, immune dx, outbreak in 11-55.
MPSV4 recommended for whom?
56+
Tx of bacterial meningitis?
supportive care and anti-infective agents.
empiric therapy based on stain, culture or CSF.
1) gram + diplococci (s. pneum) - ceftriaxone or cefotaxime + vancomycin + dexamethasone
2) gram - diplocci - N menginit - cefotaxime or ceftriaxone.
3) gram positive bacilli or coccobacilli (Staphyl) - ampicillin with or without gentamicin
4. ) gram negative bacilli (H influ) ceftazidime or cefepime with or without gentamicin
Tx viral meningitis?
acyclovir is an option
