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32 Cards in this Set
- Front
- Back
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Most common causes of Acute Bacterial Meningitis in: birth-4 weeks
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1. Group B Strep
2. E. coli 3. Listeria |
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Most common causes of Acute Bacterial Meningitis in: 4 weeks - 15 years
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1. S. pneumoniae
2. N. meningitidis 3. H. influenza Type B |
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Most common causes of Acute Bacterial Meningitis in: 15 years - 30 years
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1. N. meningitidis
2. S. pneumoniae |
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Most common causes of Acute Bacterial Meningitis in: 30 years - 50 years
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1. S. pneumoniae
2. N. meningitidis |
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Most common causes of Acute Bacterial Meningitis in: > 50 years
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1. S. pneumoniae
2. Listeria 3. Enteric GNR |
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Bacterial causes of meningitis
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pneumococcus
meningococcus h. influenzae enteric GNR Group B Strep Listeria |
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Aseptic causes of meningitis
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TB
Syphilis Viruses Fungi Parasites |
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Clinical Presentation of Meningitis
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fever, headache, nuchal rigidity, nausea/vomiting, drowsiness, confusion, seizures, cranial nerve palsies, papilledema
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Pathogenesis of Meningitis
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1. Upper resp tract colonization --> bacteremia
2. direct inoculation: congenital defects, trauma, surgery, parameningeal focus with rupture 3. retrograde access via neuron: Rabies/Herpes |
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Dx of Meningitis
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If Acutely Ill:
Blood culture, start abx (dont wait), THEN LP If Stable: LP, blood culture, start abx |
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Lab Tests for Meningitis on CSF
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Gram Stain
Culture India Ink Stain Latex Agglutination Counter Immuno Electrophoresis |
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What is India Ink Staining?
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use it to visualize the yeast Cryptococcus, gets black outline
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What is Latex Agglutination?
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Agglutination of latex particles coated with specific antibody in presence of polysaccharide antigen in CSF. Use it to detect capsular polysaccharides.
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Meningitis Predisposition:
Meningococcus |
outbreaks in close populations (military/college dorm)
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Meningitis Predisposition:
Pneumococcus |
recent head trauma (esp w/ nasal CSF leak)
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Meningitis Predisposition:
Group B Strep, E. coli, Listeria |
colonize vagina and infect neonate at birth
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Meningitis Predisposition:
S. Epidermis |
ventricular/peritoneal shunt
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Meningitis Predisposition:
Cryptococcus and Listeria |
Immunosuppression
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Meningitis Predisposition:
Gram Negative Rods |
Post-Neurosurgery
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Differential Diagnosis for Meningitis
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aseptic meningitis
brain abscess subdural/epidural empyema viral encephalitis |
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Meningitis Chemoprophylaxis
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Meningococci: Ciproflaxin/Rifampin
H. Influenzae: Rifampin |
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Meningitis Vaccines:
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meningococcus: vaccine w/ serotypes A, C, Y, W-135
pneumococcus: 23 serotype unconjugated vaccine or 7 serotype conjugated vaccine h. influenzae: capsular poly B conjugated vaccine |
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Causes of Brain Abscess
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oral flora: viridans, anerobes (bacteroides, fusobacterium, peptostreptococcus)
Listeria, Nocardia, Actinomyces |
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Brain Abscess Clinical Picture
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prolonged fever, headache, altered mental status, similar to other space occupying lesions
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Diagnosing Brain Abscess
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MRI (NO LP!)
blood culture culture/stain pus from abscess |
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Brain Abscess Therapy
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3G Cephalosporin plus metronidazole
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Viral Meningitis Causes:
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Enteroviruses (coxasackie, echoviruses)
HSV2 |
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Viral Meningitis Diagnosis:
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CSF tests for protein, sugar, cells
failure to find bacteria on stain/culture viral cultures rise in AB titer (retrospective) |
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Causes of Viral Encephalitis
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non-neonates: 70% unknown, HSV-1, Arboviruses
neonates: HSV-2 |
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Diagnosis of Herpes I Encephalitis
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PCR CSF, treat with acyclovir
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Post Infectious/Post-Vaccination Encephalitis
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varicella, MMR, H flu B
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Acute Flaccid Paralysis causes:
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Poliovirus, coxsackie, echo, west nile, guillain barre
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