Test

Question 1

Bacterial Meningitis Symptoms

Answer 1

Neck stiffness
Photophobia
Nausea, vomiting, headache, fever
Irritability 
Altered mental status

Question 2

Meningitis Diagnosis

Answer 2

CSF TESTS

• Biochemistry (evidence of meningeal inflammation pleocytosis, protein, glucose and chloride levels)
• latex agglutination
• gram stain
• culture
• PCR

Blood test

• culture
• morphology, CPR, procalcitonin

Question 3

CSF In bacterial meningitis

Answer 3

Pleocytosis > 1000 cells/mm3
Granulocytosis 80-98%
Elevates protein > 100mg%
Decreased glucose <40mg %

Question 4

Empirical treatment for meningitis

Answer 4

3rd gen - Cephalosporin (cefotaxime or ceftriaxone) + vancomycin

Question 5

Chemoprophylaxis in meningitis

Answer 5

Rifampin
> 1 month :10mg/kg POq 12 h for 2 days
< 1 month : 5mg/kg POq for 2 days

Ceftriaxone
> 15 years : 250mg IM once
< 15years - 125 mg IM once

Ciproflxacin

> 18 years : 500mg PO once

Question 6

Encephalitis symptoms

Answer 6

• Start with flu like symptoms such as high temperature, headaches, nausea and vomiting, Joint pain
• after this, serious symptoms
  Changes in mental status
  Seizure
  Changes in personality
  Loss of consciousness
  Inability to speak

Question 7

Encephalitis treatment

Answer 7

Supportive care

• manage airways
• manage intracranial pressure
• control seizures
• rehabilitation therapies
• neuropsychiatric support

Medications

• acyclovir until HSV ruled out
• antibiotic until bacterial meningitis rule out
• corticosteroids/ IVIG/ PLEX (plasma exchange) if immunemediated encephalitis is suspected

Question 8

Encephalitis Diagnosis

Answer 8

CSF testing

• Cell count and glucose, protein
• culture
• PCR- EV, HSV, VZV
• anti neuronal antibodies panel

Blood testing

• culture
• anti neuronal antibodies panel
• CBC , CR

Other site testing

• surface swabs
• Throat rectal swabs
• respiratory specimen

Brain SCANS

• CT
• MRI
• EEG