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17 Cards in this Set
- Front
- Back
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Bacterial Meningitis: <3 months
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(1) GNRs like E. coli; (2) Group B Strep; (3) Listeria
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Bacterial Meningitis: 3mo-18yrs
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(1) N. meningitidis; (2) S. pneumoniae; (3) H. influenzae
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Bacterial Meningitis: 18-60yrs
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(1) S. pneumoniae; (2) N. meningitidis; (3) Staph
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Bacterial Meningitis: >60yrs
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(1) S. pneumoniae; (2) GNRs; (3) Listeria
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Treatment of Bacterial Meningitis
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(1) GNR: ceftriaxone or cefotaxime; (2) GBS: amp+gent for newborn, PCN G for infants; (3) Listeria: amp+gent; (4) H.flu: ceftriaxone or cefotaxime; (5) Meningococcus: PCN G; (6) Pneumococcus: Vanc+Cefotaxime
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Use of Dexamethasone for Meningitis
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Can reduce hearing loss and death after meningitis for both children and adults. Give 0.6mg/kg/day divided q6h; consider in children >2mo, must start dose within 24hrs of initial antibiotics
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Triad of Meningitis
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Fever, HA, nuchal rigidity
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Causes of Viral Meningitis
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(1) Enterovirus [echo, coxsackie] in 85-90%; (2) Mumps; (3) Arboviruses; (4) West Nile Virus; (5) Herpes virus; (6) HIV; (7) CMV
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Encephalitis
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(1) New onset bizarre behavior; (2) HSV PCR, WNV titer, Arbovirus panel; (3) Treat as HSV with acyclovir
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Mycoplasma
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(1) Transmitted by respiratory droplets; (2) Cold agglutinins seen in 50%; (3) 4-fold rise in acute and convalescent titers
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Subacute bacterial meningitis (aka TB meningitis)
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Headache, fever, lethargy often present for over 4-8wks; only 10-20% have active pulmonary disease
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Neurosyphilis
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Treatment: Kids: PCN G 300,000 U/kg/d IV q 4-6 hrs
Adults: PCN G 4 million units IV q 4 hrs for 10-14 days |
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Lyme Disease
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Usually transmitted in early summer via Tick vector - 15% have neurologic signs; 7th nerve is most common; Treat with Ceftriaxone or PCN
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Neurocysticercosis
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Treat ONLY when infection is active with Albendazole/Praziquantel +steroid
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Cryptococcus
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Most common CNS fungus, often seen in immunocompromised
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Spinal epidural abscess
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Usually is Staph; Treat with Nafacillin+Cefotaxime+Metronidazole
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Subdural abscess
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Pus between dura and arachnoid ; 50% associated with sinus infection! 50% present with seizures
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