meningitis/encephalitis

Question 1

meningitis organisms
Newborns 
Infants 
Toddler to 6 years old 
Teenagers and young adults 
Adults

Answer 1

Newborns – Group B Strep
Infants – E. coli
Toddler to 6 years old – Haemophilus influenzae
Teenagers and young adults – Neisseria meningitidis
Adults – Streptococcus pneumoniae (70% of all cases are caused by Strep pneumo)

Question 2

70% of all meningitis in adults are caused by what

Answer 2

strep pneumo

Question 3

1 of all meningitis in teens are caused by what

Answer 3

neiserria

Question 4

common organism in meningitis

• newborns
• infants

Answer 4

GBS

ecoli

Question 5

Fever
Headache
Vomiting
Stiff neck
Confusion

Answer 5

bacterial meningitis

Question 6

what special finding in a Neisseria infection

Answer 6

Petechial rash

Question 7

bacterial meningitis sx

Answer 7

Fever
Headache
Vomiting
Stiff neck
Confusion

Question 8

Lumbar puncture results for bacterial meningitis

• fluid appearance?
• pressure?
• WBC
• protein
• glucose

Answer 8

Cloudy fluid. Normal is clear and colorless
Elevated pressure
Elevated WBCs from about a normal of 5 up to 10,000 during infection
Protein is elevated. Normal is 15-60. During infection the range is 100-500
Glucose is decreased. Normal is about 60% of serum glucose. During infection it may be below 40
**Cultures and Gram stain

Question 9

meningitis symptoms plus altered mental status, papilledema, focal neuro deficits
- what to do next?

Answer 9

CT to rule of a space occupying lesion

Question 10

diagnostic test for meningitis

Answer 10

Cultures and Gram stain

Question 11

Vaccination for meningitis prevention

Answer 11

H. Flu
Neisseria meningitidis
Strep pneumonia

Question 12

Testing pregnant woman at ___ weeks for group B strep.

Answer 12

Testing pregnant woman at 35-37 weeks for group B strep. Treat GBS positive moms with penicillin during labor.

Question 13

meningitis tx for neonates and infants up to 3 months

Answer 13

Neonates: ampicillin and cefotaxime; or ampicillin/gentamicin/cefotaxime
infants up to 3 months receive same combo but higher doses of cefotaxime or ceftriaxone

Question 14

meningitis tx for immunocompetent children older than 3 months of age
and adults younger than 55 yrs of age

Answer 14

cefotaxime or ceftriaxone plus vancomycin

Question 15

meningitis tx

if it is hospital acquired, post-traumatic, post neurosurgery meningitis, or pt is immunocompromised

Answer 15

ampicillin plus ceftazidime plus vancomycin

Question 16

when is dexmathasone recommended

Answer 16

in adults with meningitis secondary to s pneumo and in kids older than 1 month of age with meningitis secondary to Hib

Question 17

common viruses in meningitis

Answer 17

enteroviruses(coxsackie virus, echovirus), herpes simplex

Question 18

presents with an acute confusional state, especially in kids and young adults

Answer 18

viral meningitis

Question 19

rash, pharyngitis, adenopathy, pleuritis, carditis, jaundice, organomegaly, diarrhea

Answer 19

particular causal agent in viral meningitis

Question 20

encephalitis features (3)

Answer 20

markedly altered consciousness, seizures, personality changes

Question 21

viral meningitis CSF

• pressure
• WBC
• protein, glucose, serum blood counts

Answer 21

pressure nml
WBC less than 1000
all nml

Question 22

herpes tx for viral meningitis

Answer 22

acyclovir

Question 23

mycobacterium TB
fungi(cryptococcus, cocidioides, histoplasma)
spirochetes(treponema pallidum, borrelia burgdorferi)

Answer 23

granulomatous meningitis

Question 24

granulomatous meningitis incidence in who

Answer 24

immunocompromised

Question 25

granulomatous meningitis non infectious causes

Answer 25

sarcoidosis and other granulomatous conditions

Question 26

granulomatous meningitis presentation

Answer 26

less acute; sx for wks to months

subtle mental status changes

Question 27

granulomatous meningitis CSF

Answer 27

high protein, low glucose, lymphocytosis

Question 28

granulomatous meningitis CT or MRI

Answer 28

marked enhancement of meninges, especially hydrocephalus