Micro I and II: CNS infections Flashcards
Common causes of viral meningitis
enteroviruses, arboviruses, (mumps, lymphocytic choriomeningitis virus from rodent excreta, HIV, esp. during initial infection)
What are the LP findings for bacterial meningitis?
PMN predominance, usually low glucose
What are Kerning and Brudzinski signs?
kerning: hip flexion, knee extension = back and neck pain
brudzinski: neck flexion = hip and knee flexion
Presentations of bacterial meningitis
profoundly ill appearance, often delierious, cranial nerve involvement, seizures
N. meningitidis and meningitis: features, prevention
often fatal within hours
vaccines available for all but the B strain
often accompanied by rash
Streptococcus pneumonie: features
usually adults
often associated with sinusitis, otitis media, or pneumonia
many predisposing factors,including splenectromy, HIV
When is L. monocytogenes common?
neonates, elderly, immunocompromised
characteristics of fungal meningitis
lymphocytic in CSF
subacute/chronic course
Types of fungal meningitis
crtytococcus neoformans: bird droppings. esp. in immunocompromised
coccidiodes inmitis: usually immunocompromised but possible in normal ppl
TB meningitis: features, treatment
classic subacute meningitis neutrophilic at first, then shift to lymphocytes high protein, low glusoce often see CSF blocks and hydrocephalus often in ppl w HIV many don't have pos ppd. treat with steroids
What spirochetes can cause meningits?
treponium pallidum: often during an early stage of syphilis, or at ten end of neurosyphilis
borrelia burgdoferi: Lyme diseases. Cranial nerve involvement common
When would I need to do CT before LP for meningitis?
focal signs, immunosuppression, papilledema. Don’t delay treatment for imaging.
Listeria is a potential pathogen. What should I add to the normal regimen? other special circumstances?
in addtion to 3rd gen cephalosporins, add ampicillin
also give aminoglycosides in kids less than 4 wks old
