Y Lecture 4: CNS Infections and Meningitis Flashcards

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1
Q

Which antibiotic should be used first line in meningitis?

A

Ceftriaxone

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2
Q

Is listeria meningitis is suspected, what antibiotic therapy should be used?

A

Ceftriaxone plus amoxicillin

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3
Q

Which pathogen is most likely to be the cause in myelitis?

A

Poliovirus

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4
Q

What is myelitis?

A

Inflammation of the spinal cord

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5
Q

Recall the 3 most likely causative organisms in acute meningitis, and the most susceptible demographic of patient to each

A

N. meningitidis = young
S. pneumoniae = elderly (so vaccine at 65 years)
H. influenzae = those who haven’t had HiB vaccine

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6
Q

What is the most commonn cause of meningitis in neonates?

A

Group B strep

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7
Q

What is the most likely causative organism in chronic meningitis?

A

TB

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8
Q

What is the most likely causative organism in aseptic meningitis?

A

Coxsackie virus

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9
Q

Describe the rash produced by meningococcal meningitis

A

Non-blanching purpuric rash

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10
Q

What is the most likely viral cause of encephalitis in the UK and worldwide?

A

UK: HSV
Worldwide: WNV

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11
Q

Recall 3 possible routes of infection that may cause a brain abscess

A

Direct expansion from - otitis media- mastoiditis- paranasal sinusitis

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12
Q

What is the most common type of spinal vertebral infection?

A

Pyogenic vertebral osteomyelitis

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13
Q

What is the most common cause of pyogenic vertebral osteomyelitis?

A

Infective endocarditis - staph/ strep can be ‘flicked off’ the valve

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14
Q

What is the first investigation to do in suspected meningitis?

A

Blood cultures

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15
Q

Recall the stains used in CSF analysis to look for a) bacteria b) TB and c) fungi

A

a) gram stain b) auramine stain c) India ink

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16
Q

If “alpha haemolytic diplococci” are found in CSF, what is the pathogen causing meningitis?

A

Streptococcus pneumoniae

17
Q

What is the normal range for CSF protein?

A

0.15-0.4

18
Q

What is the appearance of CSF in purulent vs aseptic vs TB meningitis?

A

Purulent: turbid

Aseptic/ TB: slightly turbid or clear

19
Q

What type of cell is elevated in the CSF in purulent vs aseptic vs TB meningitis?

A

Purulent: polymorphs

Aseptic/ TB: lymphocytes

20
Q

In which type of meningitis will gram stain antigen tests be positive?

A

Purulent meningitis

21
Q

Which type of meningitis produces the most protein in CSF?

A

TB meningitis

22
Q

What is the empirical therapy for meningitis?

A

Ceftriaxone 2g IV bd

Add amoxicillin if >50 or immunocompromised

23
Q

What are the causative organisms in a brain abscess?

A

o Causative Organisms (Strep > Staph > gram -ve > other):
 Streptococci (anaerobic and aerobic)
 Staphylococci
 Gram-negative organisms (mainly in neonates)
 TB, fungi, parasites, actinomyces and Nocardia species