Neurological Infections Flashcards
What are the main brain infections
Meningitis
Encephalitis
Brain abscess
What is meningitis
Infection/inflammarion of the lining of the brain
What are the symptoms of meningitis
Headache Fever Stiff neck Photophobia Rash Kernigs and brudzinskis sign
What is the kernigs and brudzinskis sign
When you flex the hip and knee and straighten it, it would be painful as you are stretching the meninges
What are the organism that can cause meningitis
Virus
Bacteria
Other infection
Which viruses can cause meningitis
Enterovirus
Mumps
Which bacteria can cause meningitis
Neiseria meningitis
Stepococcus penumonia
Group b streptococci (in neonates)
What are the other infections that can cause meningitis
Mycobacteria TB
Cryptococcus neoformans
Apart from infection what are the other causes of meningitis
Drug reactions
Autoimmune
Maligancy
What is encephalitis
Inflammation of the brain tissue itself
What are the symptoms of encephalitis
Fever Impaired GSF Confusion Seizures Focal neurology
What organism can cause encephalitis
Viruses: HSV1, EBV, CMV
Other: toxoplasm, syphyilis and listeria
What is a brain abscess
Pus within the brain parenchyma
What are the symptoms of brain abscess
Fever Headache Low GCS Focal neurology Seizure
Which organims if brain abscess usually due to
Bacterial infection
What are the 3 main routes of spread of bacterial infection to result in a brain abscess
- From ear, sinus or tooth
- Hameotogenous (blood)
- Direct spread e.g from trauma and brain fractures
What are the diagnostic approaches for neurological infections
- History
- Examination
- Blood test: cultures, labs, serology, blood pcr
- Imaging: CT and MRI
- Lumbar puncture for CSF sample
In a CSF what do we look at/for
Appearance
Cells
Protein
Glucose
What is the apperance of CSF for bacterial infection
Turbid, purulent
What is the apperance for a viral infection of CSF
Clear
What is the CSF appearance in TB
Clear or cloudy
What is the white blood cell count of CSF in bacterial infection
More than 100
What is the viral CSF cells
5-1000 lymph
What is the cell in tb in csf
5-1000 lymph
What is the protein count in bacterial csf
High
What is the protein count in viral csf
Normal or midly raised
What is the protein count in tb
High
What is the glucose levels in bacterial csf
Low
What is the glucose levels in viral csf
Normal/slightly low
What is the glucose levels in tb csf
Low
How do we differentiate between viral meningitis and encephalitis
By imaging
What is a contraindication of a lumbar puncture
Increased ICP due to a brain tumour/abscess so if you release the pressue it can cause brain herniation and brain can cone so the patient can die
What are the indication of a ct scan before a lumbar puncture
Focal neurologu
GCS less than 12
Papilloedema
Seizure
What are the contraindications of a lumbar puncture after a ct
Brain shift on imahing
Ongoing seizure
Coagulopathy
Infection at site of LP
What is the treatment for meningitis in adults
Iv cetrifaxone
Iv dexamethasone
What antibiotic do we give for someone with meningitis and as risk of penicillin resistant pneumo (travel)
Iv cetriaxone and add vancomycin
What antibiotic treatment do we give for risk of listeria (over 60+ years, immunocompromised)
Iv cetrifaxone
Amoxicilin
If somone is penicillin anaphylactic fo ceftrixaone what do we give
Iv chloramphenicol
What is the treatment for encephalitis
Aciclovir
Why is aciclovir given for encephalitis but not in meningitis
Aciclovir is a antiviral agent and encephalitis is caused by viruses of HSV1 or HS2 (herpes etc)
What do we do with close contacts for meningitis
Report to public health and give them ciprofloxacin prophylaxis
What is the antibiotic treatment for adults
Iv ceftriaxone and give dexamethasone
What is the most common cause of meningitis in adults
Stepoccous penumoniae
