Neuro - Infections Flashcards
risk factors for meningitis?
<5yrs >60yrs immunocompromised HIV cancer
what are the features of meningism?
headache
neck stiffness
photophobia
features of pyogenic meningitis?
meningism fever vomiting confused non blanching maculopapular rash
features of aseptic meningiis?
meningism
fever
nausea
late summer/autumn
what can cause aseptic meningitis?
enteroviruses
HIV
HSV
TB
what bacteria as associated with meningitis in neonates?
listeria
GBS
E coli
what bacteria as associated with meningitis in children?
h influenzae
what bacteria as associated with meningitis in 10-21yrs?
neisseria meningitis
what bacteria as associated with meningitis in >21?
strep pneumoniae
what bacteria as associated with meningitis in >65?
listeria
strep pneumoniae
what bacteria as associated with meningitis in those with head trauma?
staph aureus
staph epi
what bacteria as associated with meningitis in those who have had # cribiform plate?
strep pneumoniae
Ix for meningitis?
FBC, BM, U+Es, LFTs, coag throat swab (viral/bacterial) blood cultures LP CT (if concerned about raised ICP)
on CSF, what tests should be done for meningitis?
microbiology PCR glucose cell count lactate
in CSF, what is the pattern for bacterial meningitis?
bacteria +ve
protein ++
glucose <70%
in CSF, what is the pattern for viral meningitis?
bacteria -ve
protein (normal or high)
glucose normal
in CSF, what is the pattern for TB meningitis?
bacteria +
protein +++
glucose <60%
high lymphocytes
what is the Tx for meningitis? what can be added for cover?
IV ceftriaxone + dexamethasone
+ amox if >60 (for listeria)
+ vanc/rifamp (for penicillin resistant pneumoccas)
what is the pen allergic Tx for meningitis?
IV chlorampenicol + dexamethasone
+ co trimoxazole if >60 (for listeria)
what is the contact prophylaxis for meningitis? who gets it?
500mg cipro/60mg rifampicin
contact with infected individual in last 7 days
Tx for aspectic meningitis?
self limiting
supportive
what vaccines are available for meningitis?
HiB (kids) neisseria meningitis (18+) strep pneumoniae (babies/>65)
features of encephalitis?
insidious onset
meningism
speech and memory problems
what can cause encephalitis?
HSV
EBV
CMV
Ix for encephalitis?
FBC BM U+Es LFTs coag
throat swab
LP
MRI/CT (MRI preferred)
Tx for encephalitis?
acyclovir
complications of meningitis?
abscess
hydrocephalus
seizures
