Meningitis/Encephalitis Flashcards
what is the most common cause of bacterial meningitis in adults, infants and young children?
S. pneumoniae
N. Meningitidis is a highly contagious cause of meningitis in which populations?
teens and young adults
What is a common cause of meningitis in the elderly?
L. monocytogenes
What are is a unique characteristic of fungal meningitis?
What is the common culprit?
It “smolders” over months to years
Cryptococcal (esp. in DM or immunocompromised)
What is the go-to treatment for meningitis?
IV vancomycin, ceftriaxone, steroids and maybe acyclovir if you aren’t sure if it’s viral or bacteria
What are the common causes of infectious encephalitis?
HSV 1 or 2
HIV
West Nile
Varicella
T. pallidum (the Syph)
What are some common pathogens that cause encephalitis in neonates?
HSV2
CMv
Rubella
L. Monocytogenes
T. Pallidum
T. Gondii
What are some common pathogens that cause encephalitis in infants and children?
Eastern equine encephalitis
Japanese encephalitis
Murray Valley encephalitis
Influenza
La Crosse
What are some common pathogens that cause encephalitis in the elderly?
eastern equine encephalitis
St. Louis encephalitis
West Nile
CJD
L. Monocytogenes
What is the common presentation of HSV 1 encephalitis?
rapidly progressive illness with fever, HA, impaired consciousness, Szs, and focal neuro deficits
In HSV1 encephalitis, where are the MRI and EEG changes seen?
What is the treatment?
Temporal lobe
Acyclovir
What syndrome can develop in up to 25% of pt’s who experience HSV1 encephalitis?
recurrent neuropsych sx, sometimes associated with autoantibodies (NMDA) with a secondary encephalitis
In a patient with rapidly progressive encephalopathy (<6wks) or psychiatric disturbance with possibly seizures and or fever, what should be considered?
autoimmune encephalitis
What are two causes of autoimmune encephalitis?
What is the treatment?
NMDA encephalitis
LGI1 encephalitis
steroids, IVIG, plasma exchange, rituximab, cyclophosphamide, or other immunusuppresants
Who is most affected by NMDA encephalitis and what are the symptoms (at least 4/6 present for less than 3 months)
abnormal psychiatric behavior or cognitive dysfunction
speech dysfunction
Szs
movement disorders
decreased Levels of consciousness
autonomic dysfunction or central hypoventilation
What are the diagnostic results for NMDA encephalitis?
abnormal EEG with EXTREME DELTA BRUSH
CSF with pleocytosis or oligoclonal bands and or NMDA receptor abs
NMDA encephalitis is commonly associated with what?
Teratomas
Who is comonly affected by LGI1 encephalitis and what are the main sx?
men
faciobrachial dystonic seizures that often do not respond to AEDs alone
sleep disturbances
temporal lobe abnormalities
frequent relapse
According to the AAN, do recurrent HA patients require imaging?
no, if there is no change, no Sz, no focal neuro deficits, etc.
