Neuro infections Flashcards
what is meningitis
Inflammation of the meningies
What are the causes of meningitis,
Viral, Bacterial, fungal or parasite
meningioma, Drug Induced, Autoimmune (SLE)
specific bacterial causes of meningitis
Strep pneumonia (most common) Neisseria meningtitis (worse prognosis) Listeria monocytogene (pregnant women) Strep. agalactaie (newborns)
Which meningies are affected in meningitis
Pia and Arachnoid
specific viral causes of meningitis and how treat
EBV, Herpes simplex, mumps
=self lim treat with acyclovir
Presentation of meningitis
Triad:
Fever
Headache
Neck Stiffness
Photophobia
can develop into sepsis
loss of consciousness, focal seizures, coma
petechial rash = NON BLANCHING = meningococcal septicaemia
Signs in meningtis
pos Kernigs (pain on leg straightening when hip flexed - hamstriing stiffness) and Brudzinski signs (Back of head = neck flex = flex knees and hip)
rasied BP pulse temp
what is a complication of meningtis
meningococcal septicaemia
Rfs of meningitis
immuno comp IVDU pregnacny crowding (uni)_ diabetes
how does the bacterial get into meninges
direct spread (cranial injury, nasophaynx, congen defect = spina bifida) haematogenous spread - through BBB
what see on LP of meningitis
CSF has high proteins low glucose
DDx of meningtiis
migraine
subarachnoid haemmohrage
What else causes Kernig’s signs and Neck stiffness
subarachnoid haemorrhage
management for meningitis pre hospital
hosp
contacts
IM benzylpenicillin
hopsital = IV cefotaxime and amoxicillin (listeria)
contacts = rifampiccin (preg = CI)
men C vaccine
Investigations and Diagnosis for meningitis
Bloods ESR CRP
Definitive: lumbar Puncture, CSF MS&C
if gram +Ve, strep pneumoniae
gram -VE, neisseria meningitidis (notifiable)
CXR TB
LP is CI in raised ICP or petechial rash (=CONING RISK)
Head CT ^^
what is the causing agent of Encephalitis
Herpes simplex, commonest cause
other:
Herpes zoster, HIV Measles and Mumps
some bacterial causes of enceph
TB malaria,
Presentation of encephalitis
History of general unwell, flu like symptoms (chills malaise N&V)
day of presentation= altered GCS Fever Seizures Confusion memory loss hemiparesis
increased ICP = altered mental state
RF of enceph
immuno comp
elderly
children
What is encep
infection n inflam of the brain parenchyma
- cortex/brainstem/white matter/basal ganglia
cerebral function altered
Dx of enceph
MRI - areas of inflam and swelling
midline shift if Increased ICP
LP - increased lymphocyte count **
CSF profile and cultures
Tx of enceph
IV acyclovir - immediate
seizures - primidone
ddx of enceph
meningitis
stroke
brain tumour
