neurological infections Flashcards
what is meningitis?
inflammation of the membranes and the fluid space surrounding the brain and spinal cord
what type of infections cause meningitis?
bacterial and viral
what is septic meningitis?
meningitis caused by bacteria
what type of bacteria causes bacterial meningitis?
- streptococcus pneumoniae
- neisseria meningitidis
what type of illness causes aseptic meningitis?
viral infection, lymphoma, leukemia, brain abscess
what can also cause meningitis?
tuberculosis
how is streptococcus pneumoniae spread?
coughing or sneezing while in close contact with others who breathe in the bacteria (airborne)
how is neisseria meningitides spread?
by sharing respiratory or throat secretions (droplet)
how is HIB spread?
airborne
how common is HIB meningitis?
not common at all, the vaccines have wiped it out of the US
what is the clinical presentation of meningitis?
- fever
- neck stiffness
- positive Kernig and Brudzinski sign
- photophobia
- rash
- seizures
- HA
- irritability
what does the rash look like in meningitis?
DIC, petechial, purpuric
what is a kernigs sign?
lifting the leg, if they have pain it is positive
what is brudzinskis sign?
lifting the neck and if they have pain it is positive
how to diagnose meningitis?
LP for culture CBC with diff CSF blood and urine cultures rapid antigen testing
complications of meningitis?
- brainstem herniation
- DIC
- Septic shock
- Hearing deficits
what antibiotics are given for meningitis?
ciprofloxacin
ceftriaxone
how are antibx given to patients?
as soon as possible before LP culture
prompt and uninterrupted
what do you give prior to antibiotics in bacterial meningitis?
dexamethasone to inhibit the cytokine cascade
why is it so important to give antibiotics and steroids as soon as possible?
early admin prevents longterm effects
what do we give to the family if someone is infected in their family?
prophylactic antibiotics
what is Reyes syndrome?
encephalopathy with hepatic, metabolic, and neurologic failure
what is Reyes syndrome preceded by?
a viral infection
what causes Reyes syndrome?
overuse of aspirin
what can Reyes syndrome cause?
liver failure
neuromuscular detioration
metabolic increased requirements
how is the blood sugar effected by Reyes syndrome?
it declines
what happens in relation to ammonia with Reyes syndrome?
increased ammonia
what will a patient with high ammonia look like?
jaundice, confused, change in LOC
what neurological effects does Reyes syndrome have?
increased cerebral edema
decreased LOC
seizures
how to dx reyes syndrome?
liver biopsy
scans
ammonia level
AST/ALT/SGPT
how to treat Reyes syndrome?
glucose
anticonvulsants
monitor coagulation status
what is Guillain barre syndrome?
ascending paralysis starting at the feet and works its way up
what is Guillain barre preceded by?
respiratory or GI infection
how long does Guillian barre last?
plateaus for 2-3 weeks and recovery takes 6-12 months
treatment for guillian barre?
supportive
what is the biggest concern with guiilian barre?
weakened respiratory drive may require intubation
diagnosis of guillian barre?
EMG
nerve conduction study
what is the tx for guillian barre?
plasmapheresis
IVIG
what is the goal of plasmapheresis for guillian barre?
antibodies slow destruction of myelin sheath
what is plasmapheresis?
removes patients own blood and removes the plasma from it containing the antibodies, returns the cells
what is IVIG?
given like blood products
it is antibodies to help with increasing immune system and helps to build up the myelin sheath
