Microbiology*

Question 1

normal csf value for white cells
red cells
protein
glucose

Answer 1

<5mm3
<5mm3
150-450ml/L
60-70% of blood glucose

Question 2

who is viral meningitis common in

Answer 2

in children

Question 3

when is viral meningitis common

Answer 3

seasonal peak - summer/autumn

Question 4

what causes viral meningitis

Answer 4

enteroviruses (echoviruses, coxsachie viruses

Question 5

what can be given in meningitis to reduce long term neurological complications

Answer 5

steroids

Question 6

clinical presentation of viral meningitis

Answer 6

headache, fever, neck stiffness, photophobia

Question 7

LP for viral meningitis

what needs to be done after

Answer 7

white cell count raised - lymphocytes
protein normal or slightly raised
glucose normal

send for enterovirus PCR

Question 8

ix for viral meningitis

Answer 8

enterovirus PCR on throat swab

stool sample

Question 9

treatment for viral meningitis

Answer 9

supportive

Question 10

when does neonatal meningitis occur

Answer 10

within the first 4 weeks of life

Question 11

organisms for neonatal meningitis

Answer 11

group B strep
Coli
listeria monocytogenes

Question 12

Group b strep neonatal meningitis when does it occur
acquired from
ix
tx

Answer 12

within first few days of birth
mother - vaginal colonisation
culture blood and CSF
treat with benzylpenicilin and gent

Question 13

when is prevention for group b strep given with intrapartum antibiotics

Answer 13

pre term labour 
prolonged rupture of membranes
found incidentally to have GBS in vagina or urine
fever in labour/amnionitis 
GBS infection in previous baby

Question 14

treatment of Coli neonatal meningitis

Answer 14

cefotaxime and gent

amoxicillin if susceptible

Question 15

where is listeria monocytogenes found

what kind of infection is it

causes what

treatment

Answer 15

various foods - soft cheeses, pate

transplacental infection

causes stilbirth as well as neonatal sepsis/meningitis

amoxicillin and gentamicin

Question 16

how does a brain abscess occur

Answer 16

local spread - chronic ear infection, dental infection, post trauma, post neurosurgery, sinusitis

secondary to a remote infection such as endocarditis

Question 17

clinical features of a brain abscess

Answer 17

fever, headache and focal neurological signs

can have seizures

Question 18

organisms for brain abscess

Answer 18

streptococci
coliforms - proteus sp
anaerobes
staph aureus
actinomyces

Question 19

dx of brain abscess

Answer 19

CT with contrast

Question 20

treatment of brain abscess

Answer 20

drain if pus

IV 2g qds ceftriaxone and IV 500mg 8 hourly metro

Question 21

staph aureus brain abscess

Answer 21

Add IV flucoxacillin 2g qds

Question 22

PA or MRSA proven or suspected in brain abscess

Answer 22

IV vanc

Question 23

how long should antibiotics be given in brain abscess

Answer 23

4 weeks min

6 weeks in lecture