Meningitis & encephalitis Flashcards
whats the most common causes of viral encephalitis
HSV
Enteroviruses
how can meninigits present
Fever
Headache
Neck stiffness
Altered mental state
Seizures
Mengiococcal rash
what are signs of encephalitis on CSF
High protein & normal glucose
Mononuclear cells
what type of rash occurs in meningocococal meningits
how woudl you describe it
Petechial
Burst blood vessels under the skin
Looks “vasculitic”
non-blanching on tumbler test
what are the most common bactrerial causes of meningitis in adults & kids
adults -> strep. pneumoniae
kids -> niseeria meningitidis
what is the main type of abx that’s used to treat meninigtis
what type is it
CefoTAXime
cephalosporin
what treatment can be given for viral encephalitis
aciclovir
what are your meninges
a membrane that surrounds the brain & spinal cord
whats the main difference between meningitsi and encephalitis regarding symtpoms
meningitis
sever headache
neck stiffness
photophobia
drowsiness
N&V
encephalitis
behavioural changes
seizures
confusion
obvs both cause a fever
whats like the main symptom of encephalitis that doesn’t tend to occur in meningitis
behavioural changes
what virus is the main cause of encephalitis
HSV
what are some causes of encephalitis
HSV
Rabies
HIV
Autoimmune
Insects
what type of encephalitis do you get from insects
what is aseptic meningits
all causes of mengiits with a -ve CSF bacterial culture
often caused by viruses
what viruses can cause mengintiis
HSV
Enterovirus (most common)
enteroviruses are the most common cause of viral meningits
what are they and give an exampel
RNA (single stranded) viruses
e.g, coxsakie virus
what test do you do for petechiae which can be a sign of meningiococcal septicemia
Meningitis glass test
AKA Tumbler test
how is meningitis treated for…
- 3m -> 50yo
- <3m & >50yo
- prophylaxis for family members
- neonatal
- IV cefotaxime
- IV cefotaxime + amoxicillin
- ciprofloxacin
- Gent + amox
what bacteria can casue meningitis
Group B strep
Strep pneumonia
Nisseria
Listeria monocytogenes
H. influenzae
E.coli
what bacteria can cause meningitis that is often found in the bum or vagina
hence why it’s a common cause in neonates
what is it’s fancy name
Group.B strep (agalactiae)
ages & bacteria causes of meningitis
- <3m old
- 3m -> 6yo
- 3m -> 50yo
- >50y old
1.
Listeria monocytogenes
E. coli 0157
Group B strep
2.
H. influenzae
Strep pneumoniae
Nisseria
3.
Strep pneumoniae
Niseeria
4.
Listeria monocytogenes
Strep pneumonia
Nisseria
what causes meningitis in both neonates and those who are proper old
(extremmes of age)
Listeria monocyotgenes
what the main type of cause of meningitis
bacterial
what are hte 5 steps of the pathogenesis of meningitis
- attaches to mucosa
- transgression (penetration) of mucosal barrier
- survucal in blood stream
- entry into CSF
- meningitis
LP results for meningitis
- what does it looks like
- what happens to glucose
- what happens to protein
- what are the main types of immune cells present
1.
usually cloudy regardless of cause
Viral may look clear
Fibirn web if TB
2.
Viral only one causing it to go up
all other casues it’s down
3.
Pretty much always increased
May be normal in viral
4.
bacteria is only one with neutorphils as most common
other types it’s lymphocytes
if you can see a fibrin web from an LP sample, what might be the cause of the meningits
TB
what are the differences between bacterial and viral meningitis on an LP
Bacterial
Glucose is low
Protein is high
Neurophils most common
Viral
Glucose is high
Protein is high or normal
Lymphocytes most common
what is the main fungal cause of meningitis
where can you get it from
Cryptococcus neoformans
bird poo
what is the main risk factor for crytpococcal (fungal) meningitis
HIV
what demographic is most commonly affected by viral meningitis
children & young adults
how is viral meningits treated
usually just supportive cause it’s self-limiting
Enterovirus -> supposrtive, will be fine after 72hrs
HSV -> may need aciclovir
are seizures more common in meningitis or encephalitis
encephalitis
what investigations are doen for meningitis
LP -> microcopy & culture + PCR
Bloods
Sputum samples
Stool samples
what are the main causes of neonatal meningits & how can you get them
Listeria monocytogenes -> refrigerated food
Group B strep -> from vagina commensals
e.coli -> from poo
how can you prevent neonatal meningitis
test mum for any of the causes
if cultures +ve -> giev mum abx (e.g. amox)
what examination test can you do for meningits and how do you do it
Kernig sign
Lie pt flat, flex their knee and hip
check for pain when extending knee
what are the 4 classifications of meningits
Bacteiral
Viral
Fungal
Other
What falls under the ‘other’ class of meningits
Aseptic
Shunt-associated
what are the main clincial features of meningitis and what do you call it
Menigisim
Neck stiffness
Photophobia
Headache
N&V
Altered mental state
what are some differentials for meningitis
SAH
Sepsis
Brain/spinal canal tumorur
what CN palsies are associated with meningits & why
CN 5, 7 & 8
as they branch off the cerebo-pontine angle
if you get a pt with suspected meningitsi in GP land, what abx can you give ASAP
Benzyl penicllin
Probs won’t have cefotaxime eh
what do you have to consider prior to doing an LP
if there’s any raised ICP
along with abx, what other med do you always give for bacteral meningitis
Dexamethasone
what causes the following types of bacterial meningits:
- meningiococcal
- pneumococcal
- nisseria meningiotidis
- strep pneumoniae
what are the 2 types of menignits vaccine
MenACWY -> against A, C, W and Y
Meningits B vaccine -> obvs against B
If you suddenly get severe meningococcal mengintisi along with sepsis, what is this called
Fluminant meningioccoal septicemia
what adrenal problem can be caused by meningioccoal septicemia
what is it
Waterhouse Friedrichsn syndrome
Adrenal glands can’t work as they are bleeding (BVs rupture)
is meningiococcal meningitis a notifiable disease
yes it is
whats the most common cause of bacterial meningitis in adults
Strep pneumoniae -> pneumococal meningitis
what are some causes of aseptic meningits
HIV
Lymes
Leptospirosis
what type of enterovirus is the most common cause of viral meningits
Coxsackie B
is meiningits a complication of mumps
yes
