Nonviral CNS infections Flashcards
Whos is at the highest risk for bacterial infections of the CNS?
newborns at highest risk, then 3-8 months old
What bacterial pathogen has the highest mortality rate when it infects the CNS?
pneumococcus
For a fever to count it needs to be greater than…
101.3
What test is positive if a supine pt cannot extend their knee fully?
Kernig’s sign
If a pt is having ssx of sz, focal deficit, consciousness, papilledema, or herniation, what should I do?
start empiric abx and steroids
do CT or MRI
How should a pt be positioned in an LP if we want to make sure that opening pressure is accurate?
lateral recumbent with bell side of needle up
What is the empiric tx for 0-3 mo old with bacterial meningitis?
ceftriaxone and ampicillin
for pts with bacterial meningitis 3 mo to 50 yo, I will tx the pt with…
ceftriaxone and vancomycin
For a pt with bacterial meningitis greater than 50 yo, I will tx them with…
ceftriaxone, ampicillin, and vancomycin
For a pt with bacterial meningitis who is postsurgical, post head injury, or i/c, I will tx the pt with
ceftazidime and vancomycin
What should be given to infants and children, 2 mo old and older, prior to their first dose of abx for txing bacterial meningitis? Why?
dexamethasone, for its anti-inflammatory properties
reduces hearing loss
What am I going to tx meningococcal meningitis with?
rifampin
vaccines for kids as young as 9 mo
alcoholism, debilitation, malnutrition, URI or following trauma to skull base
these are all risk factors for …
pneumococcal meningitis
When is the peak incidence of haemophilus influenze meningitis?
2 yo
What are the 5 types of neurosyphilis?
- syphilitic - weeks to years sp inf. Argyll Robertson pupil
- meningovascular - psych abnl
- general paresis - 3- 30 y sp, chronic dementia, change in personality
- tabes dorsalis - vision loss, loss of reflexes, spastic gait
- gummas
What is Argyll Robertson Pupil?
a/w tertiary syphilis
accomodates but doesnt react to light
A subdural effusion is (serous/purulent) while a subdural empyema is (serous/purulent)
serous
purulent
What is the MCC of meningitis in pts with AIDS?
cryptococcus neoformans
What is the first line tx for fungal CNS infection? second line?
Amphotericin B
Fluconazole
What are the top three things affected in prion disease?
sleep
psych
movement abnl
What CSF protein am I looking for in CJD?
14-3-3 protein
What will I see on MRI of CJD?
cortical ribboning, putamen/caudate hyperintensities
What is the pathognomic EEG finding in CJD?
1-2 hz, triphasic sharp wave pattern
MC reason world wide for epilepsy?
Neurocysticercosis
ingestion of eggs of pork tapeworm
taenia solium
How do you tx neurocysticercosis?
albendazole or praziquantel
steroids
surgical excision
