Neurological Infections: Meningitis Flashcards
Adult Infectious Agents
- Neisseria meningitidis
- Streptococcus Pneumonia
- Listeria monocytogens (especially immunosuppressed people)
- Haemophilus influenza (not common now due to vaccine)
Neonatal Infectious Agents
- Streptoccus agalatiae
- Listeria monocytogens
- E. Coli
Viral Infections
- Enterovirus: Coxackie virus, Echo virus, Polio
- HSV-1 & 2 (2 more likely)
- HIV
- West Nile
Fungal Infection
o Cryptococcus neoformans (contaminated soil with bird excrement)
o Coccidioides immitis → Californian fever
o Histoplasma capsulatum (contaminated soil with bird excrement
Others Causative Agents
- TB 2. Neurosphyllus 3. Lyme Disease
Risk Factors for Bacterial Meningitis
- Source of infection
- Haematological Source: cut somewhere, skin infection, sepsis
- Parameningeal: sinusitis, otitis media, throat infection
- Direct: Trauma
- Iatrogenic: shunts
- Immunosuppression: Aspleina, corticosteroid use, HIV, organ transplant recepient
- Age: Too old, Too young
Clinical Triad of Meningitis
Neck stiffness, fever and altered mental
Karnigis Sign
Resistance to knee extension with hip and knee flexed→ pain in back. Very specific (95) but not sensitive
Brudzinski’s sign
Flexion of the neck causes involuntary flexion of knees and hips. Very specific (95) but not sensitive
Empirical Treatment
- Dexamethasone 10mg with first dose of antibiotics.
- Ceftriaxone
- For Listeria cover give benpen
- If suspecting pneumococcal and sensitivity from LP not back give Vancomycin
Neisseria meningitidis
- Benzylpenicillin for 3 to 5 days
- Alternative: Ceftriaxone
Streptococcus pneumoniae (penicillin sensitve)
- Benzylpenicillin IV for 10 to 14 days
- Alternative: Ciprofloxacin
Haemophilus influenzae type b
- Ceftriaxone for 7 days
Listeria monocytogenes
- Benpen for 3 weeks extending to 6 weeks if immunocompramised
- Alternative: if allergic, use trimethoprim + sulfamethoxazole
Streptococcus agalactiae (group B streptococcus)
- Benpen for 14 to 21 days. Most common cause in new borns.
