Meningitis & Encephalitis Flashcards
Meningitis
inflammation of which spaces
- pia mater
- arachnoid
- CSF filled subarachnoid space
Meningitis
which age has majority of cases? why?
- adults
- vaccination
Meningitis
common bacterial organisms causing meningitis
5
- strep pneumoniae
- neisseria meningitidis
- Group B strep
- H. flu
- Listeria
Meningitis
sx in Bacterial Meningitis
6
- Fever
- HA
- Nuchal Rigidity
- AMS (altered mental status, confusion, lethargy)
- photophobia
- n/v
Meningitis
PE Findings
7
- Fever
- pos Kernig and Brudzinski
- Nuchal Rigidity
- Seizures
- Focal Neuro Deficits (CN VI, III, IV, VIII)
- Papilledema (rare)
- skin rashes
Meningitis
describe Kernig Sign
- flexing knee causes pain
Meningitis
describe Brudzinski sign
lifting head causes knee flexion w/ pain
Meningitis
describe CN III palsy
lateral, downward deviation
w/ ptosis
Meningitis
describe CN IV Palsy
upward deviation
Meningitis
CN VI palsy
medial deviation
Meningitis
essentials of dx
5 components
- fever, HA, v, delirium, seizures
- rash on skin/mucous membranes
- neck/back stiffness
- pos Kernig, Brudzinski
- purulent spinal fluid
Meningitis
dx
- Head CT before LP
- culture of cerebrospinal fluid
Meningitis
bacterial vs viral meningitis
bacterial more probable if:
* glucose < 34
* protein > 220
* WBC > 2000
* Neutrophil > 1180
Meningitis
what would gram positive diplococci in CSF suggest?
pneumococcal
Meningitis
what would gram negative diplococci in CSF suggest?
meningococceal
Meningitis
what would gram negative coccobacilli in CSF suggest?
H. flu
Meningitis
what do gram pos rods suggest?
listeria