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2a Neuro > Viral and Bacterial Meningitis > Flashcards

Viral and Bacterial Meningitis Flashcards

1
Q

Meningitis is inflammation of the meninges of the brain, notifiable to…

A

PHE

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2
Q

Name some viral causes of meningitis

A

Enteroviruses eg coxsackie
HSV-2 (herpes simplex virus)
VZV (varicella zoster virus)

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3
Q

Are viral or bacterial causes of meningitis more common?

A

Viral

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4
Q

Name some bacterial causes of meningitis

A

Strep. pneumoniae
Neisseria meningitidis

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5
Q

True or false:
Bacterial meningitis is more severe than viral meningitis

A

True

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6
Q

What are risk factors for meningitis?

A

Extremes of age
Immunocompromised
Non-vaccinated
Crowded environment

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7
Q

What bacteria commonly causes meningitis in neonates (1-3 months)

A

Group B alpha haem-strep
(Strep. agalactiae)

Also:
listeria, E. coli, S pneumoniae

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8
Q

Describe features of Neisseria Meningitidis

A

Gram negative
Diplococcus

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9
Q

What is a sign of Neisseria Meningitidis?

A

Non blanching purpuric rash

(meningococcal septicaemia causes DIC so very easily bleeds)

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10
Q

Describe the features of strep. pneumoniae

A

Gram positive
In pairs (diplococcus) or in short chains

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11
Q

What vaccine protects against strep pneumoniae?

A

PCV vaccine

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12
Q

How come group B strep is the most common cause of neonatal meningitis?

A

Group B strep colonises the maternal vagina

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13
Q

True or false: Group B strep is gram positive coccus in chains

A

True

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14
Q

What food is listeria monocytogenes found in?

A

Cheese

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15
Q

What group is affected most by listeria?

A

Extremes of age and pregnant ladies

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16
Q

What are symptoms of meningitis?

A

Headache
Neck stiffness
Fever
Photophobia
Rash
Altered consciousness
Seizures

17
Q

What are signs of meningitis?

A

Kernig (can’t extend knee when hip is flexed without pain)

Brudzinski (when neck flexed, knees and hips automatically flex

Pyrexia (fever)

18
Q

How do you diagnose meningitis?

A

Lumbar puncture and CSF analysis

19
Q

Should you lumbar puncture with raised intracranial pressure?

A

No, increased risk of herniation

20
Q

Where is a lumbar puncture taken?

A

L3-L4

21
Q

What colour will the CSF be from bacterial meningitis?

A

Cloudy yellow

22
Q

True or false:
The CSF from viral meningitis will be cloudy yellow

A

False
Will be clear and look normal

23
Q

What is the opening pressure in lumbar puncture of patient with bacterial meningitis?

A

High

24
Q

What is the opening pressure in lumbar puncture of patient with viral meningitis?

A

Normal

25
Q

True or false: there is more than 1g of protein per litre in lumbar puncture of bacterial and fungal meningitis

A

True (viruses may release a small amount of protein, they don’t use glucose)

26
Q

What happens to the white cell count in CSF of bacterial meningitis patient?

A

Neutrophilia

27
Q

Describe the CSF collected from bacterial meningitis

A

Cloudy, low glucose, high protein, neutrophilia

(Bacteria release proteins and use up glucose. Immune system releases neutrophils in response to bacteria)

28
Q

Describe the CSF collected from viral meningitis

A

Clear, normal glucose, mildly raised protein, high lymphocytes

(Viruses don’t use up glucose but may release small amount of protein. Immune system releases lymphocytes in response to viruses)

29
Q

What happens to the white cell count in CSF of viral meningitis patient?

A

lymphocytosis

(same as fungal or TB meningitis)

30
Q

How do you treat bacterial meningitis?

A

Ceftriaxone or Cefotaxime
with Dexamethasone (steroid)

31
Q

What antibiotic covers listeria?

A

Amoxicillin

32
Q

How do you treat meningitis caused by an enterovirus?

A

No treatment

33
Q

What antibiotic is used for meningitis caused by HSV or VZV?

A

Aciclovir

34
Q

What is given for prophylaxis for those who have been contact traced as having 7+ days of prolonged contact preceding a meningitis patient’s symptoms starting?

A

One off dose of ciprofloxacin

35
Q

If a patient present in the GP with a non-blanching rash and meningococcal septicaemia is suspected, what do they do?

A

Give IM benzylpenicillin and immediate hospital referral

36
Q

What is a complication of meningitis?

A

DIC due to meningococcal septicaemia

37
Q

What is Waterhouse Friedrichsen Syndrome?

A

Adrenal insufficiency caused by intra-adrenal haemorrhage as a result of meningococcal DIC

2a Neuro (42 decks)

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