Wk 4 Infectious Disease Flashcards
What is the definition of meningitis?
Acute inflammation of the meningeal tissues of the brain and spinal cord
Infectious meningitis potential etiologies (3)
Respiratory infection (PNA)
Bloodstream
Penetrating wound to CSF or brain
What are the two most common bacteria that cause meningitis?
Streptococcus pneumoniae
Neisseria meningitidis
What type of viruses are the most common that cause meningitis?
Enteroviruses
What else can cause infection meningitis?
Fungi, parasites, or toxins
The meninges are three layers that…
Protect the brain and spinal cord
What are the three layers of the meninges?
Pia mater
Arachnoid
Dura mater
What is the inner layer of the meninges?
Pia mater
What is the middle layer of the meninges?
Arachnoid
What is the outer layer of the meninges?
Dura mater
What layer of the meninges is filled with spinal fluid?
Arachnoid
Meningitis is primarily inflammation of the…
Pia mater and subarachnoid space
What time of the year does meningitis usually occur?
In the fall or winter
What type of infections does meningitis usually follow?
Otitis
Sinusitis
Immunocompromised state -PNA
How is meningitis spread?
Respiratory droplet and contact with contaminated saliva or respiratory secretions
Some patients can become __ of the meningococcal bacteria
carriers
What is the disease process of meningitis?
Bacteriums are inhaled and attach to the epithelial cells of the nasopharynx and then enter the bloodstream. They travel to the brain and cross the BBB to infect the meninges
Pneumococcal meningitis typically affects…
Younger persons, or those over 40
College students, military bases, prisons
How can pneumococcal meningitis be prevented?
Vaccine for high risk populations
Where does the infection of meningitis typically start?
Subarachnoid space and CSF
What does meningitis lead to?
Increased intracranial pressure
What is the classic triad of meningitis?
Fever
Headache
Stiff neck
The headache a patient with meningitis experiences if often described as a __ headache
throbbing
What are the additional s/s of meningitis?
N/V Photophobia Altered LOC Seizures Skin rash Petechiae
What s/s are specific to meningococcus?
Skin rash
Petechiae
What are two physical assessments that can be done to assess for meningitis?
Kernig sign
Brudzinski sign
What is a positive Kernig sign?
Resistance to leg extension
What is a positive Brudzinski sign?
Neck flexion causes hip/knee flexion
What type of meningitis is more fatal?
Bacterial, especially if treatment is not started quickly
What is the most common form of meningitis?
Bacterial
Bacterial meningitis can kill a patient within __
hours
You should never do what as a nurse concerning a patient with bacterial meningitis?
Withhold antibiotics
How do you differentiate between a petechiae rash and other types?
If you press against rash (with glass, or something clear) and it doesn’t fade then it is petechiae/purpura
What are 3 potential long-term effects of bacterial meningitis?
hearing loss
seizures
brain damage
Viral meningitis is a __ form…
milder, don’t even see leukocytosis
What are the long-term effects of viral meningitis?
Typically there are none
Severe bacterial meningitis can cause __ __, and patients can lose fingers/toes/limbs
Septic emboli
What are the two most common antibiotics given to treat bacterial meningitis?
Ceftriaxone
Vancomycin
What is the brand name of ceftriaxone?
Rocephin
When is vancomycin used to treat bacterial meningitis?
In patients who have MRSA
Why is acyclovir used in patients with bacterial meningitis?
Prophylactic for herpatic encephalitis, will be stopped once non-viral cause confirmed
What is the mainstay of treatment for bacterial meningitis?
Aggressive abx therapy
Steroids
What 3 vaccines are recommended to prevent meningitis?
Meningococcus
Pneumococcus
H. influenzae
What is the definition of encephalitis?
Acute inflammation of the brain
Encephalitis is almost always caused by a __
virus
What viruses can cause encephalitis?
West Nile Measles Chicken pox Mumps Herpes 1
What is herpatic encephalitis?
HSV 1 causing rapid encephalitis, even causing death
When do s/s appear with encephalitis?
2-3 days after infection
The s/s of encephalitis can range from…
mild to seizures, coma
What are the additional s/s of encephalitis?
Fever
Headache
N/V
What is the brand name for acyclovir?
Zovira
What is NOT a benefit of acyclovir for encephalitis?
Only works for HSV, doesn’t reduce other neurological complications
What are supportive therapies used in the treatment of encephalitis?
Fluids
Acetaminophen
Anti-emetics
Anti-seizure meds
Why is someone with encephalitis at risk for seizures?
Increased intracranial pressure
What is an accumulation of pus in the brain tissue?
Brain abscess
What causes a brain abscess?
Local infection (encephalitis) Systemic infection
Most brain abscesses come from an infection of the…
Ear, tooth, mastoid, or sinuses
What are the most common etiologies?
Streptococci or staph aureus
Brain abscess can cause a brain __ __ because of the increased pressure
midline shift
What might a surgeon do to treat a brain abscess?
Drain the exudate and instill antibiotics
What are the s/s of a brain abscess?
Headache
Fever
N/V
What s/s would lead to suspect increased ICP due to the brain abscess?
Drowsiness
Confusion
Seizures
Brain abscess: Focal symptoms may reflect the area that the abscess is in. Example-
Temporal lobe = visual field deficits
