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CCR: Infectious diseases > Meningitis pt.1 > Flashcards

Meningitis pt.1 Flashcards

1
Q

What is meningitis?

A

Inflammation of the meninges

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2
Q

What are the meningies?

A

Three membranes that cover the brain and spinal cord and include (from most superficial to deepest):

  • Dura mater
  • Arachnoid mater
  • Pia mater
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3
Q

Where is the CSF found?

A

It is found in the subarachnoid space found between the pia and arachnoid mater

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4
Q

Aside from the arachnoid space, what other anatomical space can found in the CNS?

A

A potential space known as the subdural space and according to some authors, it contains a very thin layer of fluid

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5
Q

Where is the main site of meningitis infection?

A

The subarachnoid space with involvement of the CSF

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6
Q

According to the appearance of the CSF, how can one differentiate between possible etiologies of meningitis?

A
  • Transparent CSF suggests a viral meningitis

- Purulent (cloudy) CSF suggests a bacterial meningitis

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7
Q

What are the possible infectious etiologies of meningitis?

A

They include viral, bacterial, fungal, parasitic/protozoal

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8
Q

What are examples of parasitic/protozoal organisms that can cause meningitis?

A

They include:

  • Plasmodium
  • Toxoplasma
  • Amoeba (Naegleria fowleri)
  • Angiostrongylus
  • Hydatid
  • Cysticercosis (Taenia solium tapeworm)
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9
Q

What are examples of fungal organisms that can cause meningitis?

A

They include:

  • Cryptococcus
  • Histoplasma
  • Aspergillus
  • Candida
  • Mucormycosis
  • Coccidiosis
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10
Q

What is the most common etiological form of infectious meningitis?

A

Viral is the most common, followed by bacterial (still common), with fungal and parasitic/protozoal being rare

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11
Q

What are the most common bacteria causing bacterial meningitis?

A

They include:

  • Streptococcus pneumoniae
  • Group B Streptococcus
  • Neisseria meningitidis
  • Haemophilus influenzae
  • Listeria monocytogenes
  • Escherichia coli

H. Influenzae b, S. pneumoniae, N. meningitidis
cause together 75-80% of all bacterial meningitis

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12
Q

What is considered to be the most important bacterium causing meningitis?

A

Haemophilus influenzae

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13
Q

What type of bacteria is Haemophilus influenzae?

A

Gram negative facultative anaerobic capnophilic coccobacillary

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14
Q

What is a facultative anaerobic organism?

A

An organism that makes ATP by aerobic respiration if oxygen is present, but is capable of switching to fermentation if oxygen is absent

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15
Q

Is Haemophilus influenzae preventable?

A

Yes, vaccination is available

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16
Q

Which age group does Haemophilus influenzae affect?

A

Mostly children 6 months to 4 years old

17
Q

What type of bacteria is Neisseria Neisseria meningitidis?

A

Gram negative aerobic capsuled diplococci

18
Q

What is another name for Neisseria meningitidis?

A

Meningococcus

19
Q

What does capnophilic organisms?

A

Microorganisms that thrive in the presence of high concentrations of carbon dioxide (CO2)

20
Q

How common is the neisseria meningitidis bacterium in the population?

A
  • Widespread in general population

- Estimated to be found in the nasopharyngeal flora of 3% to 25% of healthy individuals

21
Q

Where is neisseria meningitidis bacterium found in carriers?

A

Mostly found in the naso-pharynx

22
Q

Which serogroup of neisseria meningitidis is most common in the United States and Europe?

A

Serogroup B in the USA and Serogroup C in Europe

23
Q

Who is neisseria meningitidis vaccine recommended to?

A
  • Universally recommended beginning at age 11 with boosters at 16 years
  • It is also recommended down to the age of 9 months for anyone at high risk for meningococcal
    disease (complement deficiency, asplenia, HIV infection)
    -
24
Q

What are the serogroups of neisseria meningitidis based on?

A

Serogroups are based on the

polysaccharide capsule

25
Q

Which neisseria meningitidis serotypes are the most clinically relevant?

A
  • The most important disease-producing serogroups are A, B, C, W-135, and Y
  • Group A causes widespread epidemics
26
Q

How N.meningitidis transmitted?

A

Transmission occurs by inhalation of aerosolized respiratory droplets

27
Q

What promotes transmission of N.meningitidis?

A
  • Close, prolonged contact
    such as occurs in families and closed populations promotes transmission.
  • The estimated attack rate among family members residing with an index case is 1000 times higher than
    in the general population; this fact is evidence of the contagious nature of meningococcal
    infection
  • Other factors that foster transmission are contact with a virulent strain and host susceptibility (lack of protective antibody)
28
Q

What are typical settings of large N. meningitidis outbreaks?

A

Typical settings of larger outbreaks are schools,
dormitories, and camps for military recruits. In these close living circumstances, N meningitidis
spreads readily among newly exposed individuals, but disease develops only in those who
lack group-specific antibody.

29
Q

What are problems with the current meningococcal vaccine?

A
  • Does not protect against serogroup B (failure of the group B polysaccharide to be immunogenic at all, recognized as self by the host), Group B causes up to one-third of all disease, so no vaccine that omits
    it is likely to be completely successful
  • The “hole” created by absence of a group B component could have epidemic potential
  • There is less experience with these protein-conjugate vaccines which is why the recommended starting age is 11. In practice the age is being slowly and cautiously dropped down
30
Q

How can disease arise in individuals in contact with N. meningitidis?

A

Disease may be endogenous (respiratory microbiota) or transmitted from a case
by respiratory droplets

31
Q

What is the current vaccine against N.meningitidis?

A

Meningococcal Conjugate Vaccine Quadrivalent (MCV4) which protects against serotypes A, C, Y, and W-135

32
Q

Which age group does N.meningitidis affect?

A

Most disease occurs in children 6 months to 5 years old ( 6 months and 2 years of age being the peak) with a second peak at 18 to 25 years of age

CCR: Infectious diseases (3 decks)

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