Neurological Infections Flashcards by selcan icli

What are the main brain infections

Meningitis
Encephalitis
Brain abscess

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What is meningitis

Infection/inflammarion of the lining of the brain

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What are the symptoms of meningitis

Headache
Fever
Stiff neck 
Photophobia
Rash 
Kernigs and brudzinskis sign

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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

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What are the organism that can cause meningitis

Virus
Bacteria
Other infection

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Which viruses can cause meningitis

Enterovirus

Mumps

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Which bacteria can cause meningitis

Neiseria meningitis
Stepococcus penumonia
Group b streptococci (in neonates)

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What are the other infections that can cause meningitis

Mycobacteria TB

Cryptococcus neoformans

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Apart from infection what are the other causes of meningitis

Drug reactions
Autoimmune
Maligancy

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What is encephalitis

Inflammation of the brain tissue itself

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What are the symptoms of encephalitis

Fever
Impaired GSF 
Confusion
Seizures
Focal neurology

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What organism can cause encephalitis

Viruses: HSV1, EBV, CMV
Other: toxoplasm, syphyilis and listeria

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What is a brain abscess

Pus within the brain parenchyma

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What are the symptoms of brain abscess

Fever
Headache
Low GCS
Focal neurology 
Seizure

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Which organims if brain abscess usually due to

Bacterial infection

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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

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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

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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