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Things I Get Stuck On > Meningitis > Flashcards

Meningitis Flashcards

1
Q

Epidemiology of meningococcal meningitis

A

Children and young adults

<10% are >5 years

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2
Q

Epidemiology of meningococcal meningitis

A

Children and young adults

<10% are >5 years

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3
Q

What must you do in cases of meningococcal meningitis

A

Notify local health protection consultant

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4
Q

Clinical features of meningococcal meningitis

A 
Sepsis
Sudden onset
Purpuric rash
Unconsciousness
Fever
Sterile CSF
Waterhouse-Freidrichsen syndrome
Renal failure
Disseminated intravascular coagulation
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5
Q

Treatment of meningococcal meningitis

A

1st line is parenteral penicillin

2nd line high dose ceftriaxone then benzylpenicillin

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6
Q

Complications of meningococcal meningitis

A

50% die within first 24 hours and if it becomes chronic it is known as fulminant

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7
Q

Prognosis of meningococcal meningitis

A

Over 50% mortality, if they survive, sent home with rifampicin or ciprofloxacin

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8
Q

Prevention and prophylaxis of meningococcal meningitis

A

Men C and Men B vaccine

Rifampicin to r ciprofloxacin for all those who have been in contact with the sick

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9
Q

Pneumococcal meningitis epidemiology

A

Most frequent bacterial cause in adults

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10
Q

Clinical features of pneumococcal meningitis

A 
Predisposing pneumonia
Sinusitis
Endocarditis
Head trauma
Alcoholism
Splenectomy
Altered consciousness
Petechiae - uncommon
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11
Q

Treatment of pneumococcal meningitis

A

Early, high dose ceftriaxone

If uncomplicated then dexamethasone

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12
Q

Complications of pneumococcal meningitis

A 
Death
Hearing loss
Cranial nerve defects
Hemiparesis
Hydrocephalus
Siezures
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13
Q

Mortality of pneumococcal meningitis

A

30-50%

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14
Q

Prevention of pneumococcal meningitis

A

Pneumococcal vaccine (pneumovax or prevnar)

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15
Q

Epidemiology of Heamophilus influenzae type B meningitis

A

Young children

Often preceded by URTI with otitis media

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16
Q

Clinical features ofHeamophilus influenzae type B meningitis

A 
Fever
Lethargy
Drowsiness
Rarely petechiae
No nuchal rigidity
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17
Q

Treatment of Heamophilus influenzae type B meningitis

A

Cefotaxime

Dexamethasone if very serious

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18
Q

Prevention/prophylaxis of Heamophilus influenzae type B meningitis

A

Rifampicin for all those who have had close contact

Vaccinato

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19
Q

Listeria monocytogenes meningitis epidemiology

A

Neonates
Older people
Immunosuppressed

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20
Q

Listeria monocytogenes meningitis clinical features

A

Typical meningism

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21
Q

Listeria monocytogenes meningitis treatment

A

IV ampicillin

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22
Q

Mycobacterium tuberculosis meningitis epidemiology

A

Elderly men
Alcoholics
Post miliary tb

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23
Q

Mycobacterium tuberculosis meningitis clinical features

A

Often post miliary in children
Extrameningeal TB in 3/4 of adult
Subacutely presents with lethargy, chronic headache, mentation change, unconsciousness and meningitis

24
Q

Mycobacterium tuberculosis meningitis investigations

A

CSF studies
CXR
PCR
CT head

25
Q

Mycobacterium tuberculosis meningitis complications

A

Neurological

Lung scarring

26
Q

Mycobacterium tuberculosis meningitis prognosis

A

Poor in extremes of age, neurological deficits or resistant organisms

27
Q

Leptospirosis and Lyme disease meningitis clinical features

A 
"Aseptic meningitis"
Septicaemia with rigors
Myalgia
Vomiting
Conjunctival effusion
Meningism followed by rash
28
Q

Leptospirosis and Lyme disease meningitis treatment

A

IV cephalosporins or penicillin for 2-3 weeks

29
Q

Leptospirosis and Lyme disease meningitis complications

A

Hepato-renal damage

Cranial beiropathies

30
Q

Leptospirosis and Lyme disease meningitis prognosis

A

Good with early treatment

31
Q

Leptospirosis and Lyme disease meningitis prevention

A

Avoid tick bites

Early treatment of tick bites

32
Q

Viral meningitis causative viruses

A 
Enteroviruses (echovirus, cocksackievirus)
Mumps
HSV
VSV
Epstein Barr
33
Q

Clinical features of viral meningitis

A 
Non specific prodromal illness
Rapid headache onset
Photophobia
Low grade fever
Stiff neck
Lucid
Alert
Only later on so we get lethargy, confusion, siezures and focal neurological deficits
34
Q

Viral meningitis investigations

A

PCR of CSF
Throat swab
HIV testing

35
Q

Treatment of viral meningitis

A

If not recovered after 72 hours or very severe:
IV immunoglobulins
IV acyclovir for HSV

36
Q

Viral meningitis complications

A

Neurological disorders
Orchitis
Testicular atrophy

37
Q

Prognosis of viral meningitis

A

Most make a complete recovery

38
Q

Prevention of viral meningitis

A

MMR and good hand hygiene

39
Q

Cryptococcal neoformans meningitis epidemiology

A

Main cause of meningitis in HIV patients

Sometimes affects diabetics, lymphoma patients and immunosuppressed

40
Q

Cryptococcal neoformans meningitis investigations

A

Gram stain shows yeast cells

Serum cryptococcal antigen

41
Q

Cryptococcal neoformans meningitis presentation

A

Subacute onset with low grade fever, headache, nausea, photophobia, lethargy, confusion, abdo pain and meningism

42
Q

Treatment of Cryptococcal neoformans meningitis

A

Parenteral amphotericin

Add flucytosine if severe or replace entirely with high dose fluconazole

43
Q

Cryptococcal neoformans meningitis presentation

A

Long term fluconazole for at risk patients

44
Q

Neonatal meningitis causative organisms

A 
Group B strep
E.coli
Listeria monocytogenes
Enteroviruses
Parechoviruses
45
Q

Neonatal meningitis mortality

A

Early onset = 50%

Late onset = 10-20%

46
Q

Neonatal meningitis presentation

A

Non specific/ poorly localised symptoms
Low birth weight
Maternal diabetes mellitus

47
Q

Neonatal meningitis treatment

A

Group B strep = benzylpenicillin and amoxicillin
E.coli = cefotaxime
Listeria monocytogenes= ampicillin and gentamicin

48
Q

Neonatal meningitis complications

A

Neuro and development complications in 33%

49
Q

Prevention of neonatal meningitis

A

Mother’s with increased risk are given amoxicillin or co-amoxiclav during labour

50
Q

CSF findings in bacterial meningitis

A 
Turbid
Greatly increased cell count
Predominant cells are neutrophils
Glucose is reduced
Protein is greatly increased
51
Q

CSF findings in viral meningitis

A 
Clear to turbid
Moderate increase in cell count
Predominant cells are lymphocytes
Normal glucose
Moderate increase in protein
52
Q

CSF findings in TB meningitis

A 
Clear to turbid
Moderate increase in cells
Main cells are lymphocytes or a mix of cells
Reduced glucose
Greatly increased protein
53
Q

Ventricular atrial shunt meningitis main cause

A

Staph epidermis

54
Q

What is Kernigs sign?

A

Hamstring spasm preventing leg straightening

55
Q

CSF investigations

A 
Gram stain
Differential cell count
Antigen detection test
Bacterial culture
Mycobacteria or fungal culture
PCR for viruses
PCR for bacteria
Glucose
Protein

Things I Get Stuck On (13 decks)

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