Meningitis

Question 1

Which bug will cause ACUTE meningitis - die within 24 hrs of presenting with fever?

Answer 1

N.meningitidis

Question 2

Drugs for meningitis prophylaxis

Answer 2

Rifampin
Cipro
Ceftriaxone

Question 3

Presenting symptoms for meningitis + SIRS

Answer 3

Fever
Lethargy - somnolent
Headache
Low BP
High HR
Meningismus = stiff neck
Petechial rash + purpura = SIRS

Question 4

Drugs for meningitis

Answer 4

Ceftriaxone + vanco

START ASAP

Question 5

What do you expect to see for meningitis on LP

Answer 5

High opening pressure
High WBC
Low glucose
High CSF protein

Question 6

How does liver disease affect bacterial infection?

Answer 6

Delayed clearance of bacteremia

Question 7

What bug are you think about for meningitis post URI?

Answer 7

Strep pneumo

Question 8

What is an atypical cause of meningitis? Risk factors/presentation.

Answer 8

Listeria monocytogenes

• Ate soft cheese/bad dairy
• Elderly
• Immunocompromised

Question 9

Treat L.monocytogenes meningitis

Answer 9

Ampicillin

Question 10

What is aseptic meningitis?

Answer 10

Not caused by pyogenic bacteria

Aka due to viruses, non-pyogenic bacter, fungi, parasites

Question 11

What is the key difference between aseptic and bacterial meningitis?

Answer 11

Bacterial: HIGH CF WBC - mostly PMN
Aseptic: moderate CF WBC - mostly lymphocytes > PMN