Bacterial Meningitis

Front 1

Signs of Acute Bacterial Meningitis
CSF

Back 1

Fever, headache, irritability, stiff neck, convulsions, drowsiness, coma
CSF: gram stain and/or bacteria culture usually positive UNLESS pt treated w/ antibiotics prior to eval

Front 2

Meningitis definition

Back 2

inflammation of the meninges of the brain or spinal cord, infection located within the subarachnoid space
CSF
Acute, Recurring, and Chronic

Front 3

Encephalitis definition

Back 3

inflammation of the brain

Front 4

Myelitis definition

Back 4

inflammation of the spinal cord

Front 5

Brain abscess definition

Back 5

focal intrcranial infection in the brain
Develops into a collection of pus surrounded by capsule

Front 6

Subdural empyema definition

Back 6

infection between dura mater and arachnoid

Front 7

Epidural abscess definition

Back 7

localized infection between the dura mater and the overlying skull or vertebral column

Front 8

Routes of Infection of the CNS

Back 8

Hemtogenous spread with most infectious agents From extracranial foci or by retrograde propagation of infected thrombi within emissary veins
Neurotropic spread in the case of some viruses (herpes simplex and rabies)
Spread of organisms through bone
Injury - traumatic inoculation of extradural bacteria
Surgury - shunts etc
congenital problems
Otitis - by extension
Sinusitis - by extension

Front 9

Haemophilus influenzae ID & route of transmission

Back 9

gram -, pleomorphic bacilli
spread via aerosol, some have polysacch capsule, req. factor X (hemin) & V (NAD/NADPH) on choco agar for growth

Front 10

Haemophilus influenzae disease

Back 10

meningitis: 1/3 survivors have deafness

Front 11

Haemophilus influenzae predisposing factors & menigitis spread

Back 11

pharyngitis, otitis media, usually hematogenous spread
Nasopharyngeal carriers = high incidence of meningitis, non-type B

Front 12

Haemophilus influenzae prophylaxis

Back 12

Immunize w/ Hib conjugate at 2 months old

Front 13

Haemophilus influenzae strains

Back 13

type B capsule = disease
nasopharyngeal = common non-B type, (high incid of menigitis)
encapsulated = more virulent (non-encapsulated now dominates c/o immu)

Front 14

Common bacterial meningitis species

Back 14

H. influenzae > N. meningitidis > S. pneumonia > S. agalactiae > L. monocytogenes > other/unknown

Front 15

Streptococcus pneumoniae ID

Back 15

Gram + diplococcus, α-hemolytic (green color), Optichin positive, pili

Front 16

Streptococcus pneumoniae virulence
& pathogenesis

Back 16

antiphagocytic capsule, pili (attachment), cross endothelial via receptor
#1 c/o meningitis in adults
complication of bacteremia, pneumonia, mastoiditis, endocarditis, sinusitis, OR head wound

Front 17

#1 c/o meningitis in adults

Back 17

Streptococcus pneumoniae

Front 18

Neisseria meningitidis ID

Back 18

Gram - diplococcus, oxidase positive, Opa (opaque protein - opaque if present)
Ferments glucose & maltose
Grow on blood or choco agar (not fastidious) (need Thayer-Martin Selective agar to exclude other species - grows only Neisseria)

Front 19

Neisseria meningitidis transmission
virulence/pathogenicity

Back 19

Respiratory transmission - overcrowing (winter/early spring epidemics, military)
Virulence: 1) Antiphagocytic capusle - invasive (13serotypes)
2) pili (mucosal attachment)
3) Opa (downregulated during invasive growth)
4) LOS (coat selves w/ host sialic acid attached to galactose on LOS)

Front 20

Neisseria meningitidis growth

Back 20

V-C-N inhibitor: (Vanco, colistin, nystatin) use to grow only N. meningitidis
V-C-N-T: (Same but w/ trimethoprim) for better recovery/growth of Neisseria

Front 21

Listeria monocytogenes

Back 21

Gram + motile rod, food borne
death in fetus & maternal in pregnant or immunocompromised

Front 22

Strep agalactiae classification
found where

Back 22

GBS, in vagina of some women

Front 23

Strep agalactiae disease

Back 23

mengitis, pneumonia, sepsis in newborn

Front 24

Aerobic Gram - bacilli

Back 24

E. coli (esp. K-1) - rod from perineal flor of mother
Klebsiella spp
serratia marcescens
pseudomonas aeruginosa
Salmonella

Front 25

Conditions predisposing to bacterial meningitis

Back 25

head trauma, neurosurgery, neonate, elderly, immunocompromised

Front 26

Staph causing meningitis
predisposing factors

Back 26

Staph aureus
staph epidermidis
factors: neurosurgery, CSF shunts, head trauma, sinusitis, pneumonia

Front 27

Chronic meningitis definition
frequency

Back 27

Neuro signs/symptoms persist and CSF abnormal for 4 weeks
rarer than acute meningitis

Front 28

Chronic meningitis causes

Back 28

m. tuberculosis, brucellosis, syphilis, Lyme disease

Front 29

Brain abcess definition
spread

Back 29

focal infxn of brain itself
spread from contiguous source (otitis media, mastoiditis, sinusitis, dental, trauma)
less commonly from distant site (hematogenous or heart or lung)

Front 30

Brain abcess etiology

Back 30

Aerobic/anaerobic/microaerophilic strep
Bacteroides
Aerobic cocci (staph aureus)
gram - RARE
Toxoplasma gondii (esp. in HIV +)

Front 31

Intracranial Epidural abcess definition

Back 31

lesion creating space btwn dura mater & skull (must peel dura from skull)

Front 32

Intracranial Subdural empyema definition

Back 32

infxn btwn dura mater & arachnoid mater

Front 33

Etiology/bugs of intracranial abcess/empyema

Back 33

staph aureus, anaerobes, gram -, H influenzae (extension of meningitis)
Paranasal sinus source in >50% cases
middle ear/mastoid in 10-20% cases
can follow truama, surgery, pre-existing subdural hematoma

Front 34

Spinal subdural empyema definition
epidural abcess spread/etiology

Back 34

actual space in spine (epidural space) - infxn spread unimpeded
source from osteomyelitis or paravertebral infxn, hematogenous spread

Front 35

Etiology/bugs of spinal abcess/empyema

Back 35

staph aureus, anaerobic or anaerobic strep, gram - bacilli
spread from distant source of sepsis