VII- Bacterial Infections CNS Flashcards
anatomy/tissues of meningitis
meninges duh and CSF
anatomy/tissues of encephalitis
brain parenchyma
aseptic meningitis def
viral meningitis
-less severe and fatal than bacterial
morphology of strep pneumo
gram: pos, catalase neg
shape: oval/lancet
lab: alpha hemolytic (green) + susceptible to optochin and bile
morphology of N. meningitis
gram: neg,
shape: coffee/kidney bean
lab: oxidase, catalase, glucose, maltose pos - need CO2 for growth
strep pneumo virulence factors
- polysac capsule for dissemination
- pneumolysin for interfere macrophages
- IgA protease to prevent clearance
N. meningitis virulence factors
- polysac capsule to resist complement and phago
- endotoxin LOS for organ failure and DIC
- inflamm resp weakens BBB to cross within neutrophils
host factor risks
- pneumococcal- pneumonia or chronic otitis media
- meningococcal- recent URTI, complement deficiency, living in schools/military barracks
- immunocomp always
CSF changes bacterial
- presence of PNMs aka neutrophils
- dec glucose
- inc protein
- inc pressure
CSF changes viral
- mono/lymphocytes
- rare neutrophils/PNMs
- normal glucose
- normal/slight inc protein and pressure
pneumo meningitis treatment
initiate treatment before confirming bc medical emergency
-use age, underlying conditions, gram stain
VANCOMYCIN + CEPHALOSPORIN
neonates meningitis agents
- group B strep!!!
- E. Coli
- other gram neg enterics
- listeria monocytogenes
under 1 mo
infants meningitis agents
- Strep pneumo
- N. meningitides
under 2 years
children meningitis agents
- N. meningitides
- Strep pneumo
2-18 years
adults meningitis agents
- Strep pneumo
- N. meningitis
- Listeria monocytogenes
acute bacterial meningitis symptoms
- fever
- neck stiffness
- headache
- altered mental status
pneumococcal will have acute onset, high mortality, neurologic sequela
meningococcal disease
N. meningitis
abrupt onset fever
-normal meningeal symps
-hypotension from bacteremia
-rash
meningococcemia
bloodstream infection with or without meningitis
-fever + purpuric rash + hypotension + multiorgan failure
meningococcal meningitis treatment
initiate treatment before confirm with age, underlying condition, gram stain
PENICILLIN, prophylactic treat for close ppl
Strep agalactiae features
- gram pos cocci
- catalase neg
- beta hemolytic
- bacitracin resistant
risk factors GBS
- maternal intrapartum GBS for early onset dz in infants
- lack of maternal antibodies
- african american
- mo had previous kid with GBS
- obstetric problems
early onset GBS symptoms
- bacteremia
- pneumonia
- meningitis (fever, lethargy, irritability)
- permanent neurologic sequela (blind, deaf, mental retardation)
late onset has more meningitis and neuro complications
GBS treatment
PENICILLIN
-esp effective before delivery to prevent esarly onset
haemophilus influenzae type B
Hib
- gram neg coccobacilli
- requires hemin (X) and NAD (V) for growth of chocolate agar
- PRP capsule
Hib meningitis symptoms
- fever, stiff neck, headache
- some permanent neurologic sequelae (hearing loss)
Hib vaccine
conjugated with anti-PRP antibodies so highly immunogenic
-start at 2 mo old
Clostridium tetani
- gram pos rod
- anaerobic
- spore forming
- neurotoxin tetanospasmin (binds motor neurons)
tetanus symptoms
- spastic paralysis bc inhibitory neurotransmitters not released
- lock jaw/trismus
- diff swallowing
- abs rigid
- general muscle spasms esp back spasms
treating tetanus
passive immunization with immunoglobulin + active immunization with tetanus toxoid vaccine
Clostridium botulinum
- gram pos rod
- anaerobic
- spores (in meat, fish, veggies, canned foods)
- botulinum toxin (A-B blocks release of Ach)
botulism
- flaccid paralysis (ocular > laryngeal > respiratory > trunk > extremities)
- nausea
- dry mouth
- blurred vision, involuntary eye movement
Listeria monocytogenes
- gram pos rod
- motile
- consumption of milk, soft cheese, poultry
infection with Listeria monocytogenes
if in utero can result in stillbirth or premature delivery
mycobacterium tuberculosis prez
primary @ lungs but spread to CNS (meningitis, brain abscess, chronic dz)
Staph aureus prez
meningitis after bacteremia
brain abscesses