Neuro Infections Flashcards
When during the year is the typical onset of viral meningitis?
Late summer/autumn
Which viruses are typically responsible for viral meningitis?
Enteroviruses most common e.g. ECHO
HSV and other microbes also
List investigations/diagnostic tools for viral meningitis
Viral stool culture
Throat swab
Lumbar puncture for CSF PCR
Outline treatment for viral meningitis
Supportive - paracetamol, fluids, rest, dark room
What is the main cause of viral encephalitis?
Herpes simplex
List investigations for viral encephalitis
Lumbar puncture
Electroencephalography (EEG)
MRI
CSF PCR
What is the main treatment for viral encephalitis?
IV aciclovir
Which organism is the main causes of bacterial meningitis in children?
H. influenzae
Which organism is the main cause of bacterial meningitis in 10-21 year olds?
Neisseria meningitides
List the main cause of bacterial meningitis in adults (>21)
Strep. pneumoniae
A fracture of the cribriform plate increases the risk of which bacterial meningitis?
Pneumococcal (Strep. pneumoniae)
Signs of bacterial meningitis are often absent in the very young, very old and immunocompromised. True/False?
True
List investigations for bacterial meningitis
Blood cultures
Throat swab (meningococci)
Lumbar puncture for CSF
A low ratio of blood sugar : CSF sugar is indicative of bacterial meningitis. True/False?
True
What is aseptic meningitis?
Aseptic meningitis means you suspect there is a bug but you can’t find it – low WBC, minimally elevated protein and normal glucose
A CT scan should delay treatment in bacterial meningitis. True/False?
False
An urgent CT scan should be requested but does not delay treatment
Strep pneumoniae looks like what under a microscope?
Gram positive diplococcus
Neisseria meningitidis looks like what under a microscope?
Gram negative intracellular
What causes meningitis in >60 years or immunocompromised or neonates?
Listeria (gram +ve bacillus)
What is Kernig’s sign in meningitis?
Painful knee extension while lying supine (inability to straighten the leg when the hip is flexed to 90 degrees)
> 2000 white cells in the lumbar puncture indicates what type of meningitis?
Bacterial
Cases of meningitis have to be reported to who?
Public health
What is the immediate treatment for meningitis?
Ceftriaxone IV (chloramphenicol for penicillin allergy) + dexamethasone IV
Elevated lymphocytes in a lumbar puncture indicated what type of encephalitis?
Viral
A single brain abscess can be caused by direct implantation OR secondary to what 2 conditions?
Chronic otitis media/mastoiditis
Multiple brain abscesses can be caused by what?
IV drug abuse, lung abscesses, congenital heart disease etc
