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27 Cards in this Set

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List 3 causes of CNS infections:
(what is most common?)
1. Hematogenous spread***
2. Nearby CNS infection; sinuses, otitis media.
3. Trauma, congenital, anatomic defects.
Which age group has the highest prevalance of bacterial meningitis?
Neonates
Why do neonates get meningitis?
1. Inadequete BBB yet
2. Immune system
3. Vaginal canal passes it.
What 4 bugs cause neonatal meningitis?
1. Beta strep group B
2. E. coli/other gnb
3. Listeria monocytogenes
4. Chyseobacterium meningosepticum
What 3 bugs cause meningitis in kids under 5?
1. Haemophilus influenzae B
2. Strep pneumo
3. Neisseria meningitidis
What 2 bugs cause meningitis in adults/older kids?
1. Neisseria meningitidis
2. Strep pneumo
What is more common to cause meningitis in older kids?
Neisseria meningitidis - epidemic in crowded conditions.
What 3 organisms may cause meningitis in immunosuppressed patients?
1. Listeria monocytogenes
2. Pseudomonas aeruginosa
3. Nocardia
In what compromised patients would Listeria monocytog cause meningitis?
-Lymphomas
-those on Steroids
In what compromised patients would P aeruginosa/Nocardia cause meningitis?
Leukopenic
What type of CNS infection do Anaerobes tend to cause?
Brain abscess
How do anaerobic brain abscesses tend to develop?
(2 ways)
1. Spread from sinuses/otitis media.
2. Introduced by skull trauma
What 4 actions should be taken when processing CSF?
1. STAT STAT STAT
2. DON'T REFRIGERATE
3. IF MUST HOLD, 37'C
4. CALL DOC IMMEDIATELY IF POSITIVE DIRECT SMEAR/GROWTH
What should be kept in mind re: prescribing drugs for meningitis/abscesses?
Use drugs that cross the BBB.
e.g., Gentamicin.
What 2 infections are seen in bones and synovial fluid?
1. Osteomyelitis
2. Septic arthritis
What specimen should be obtained for osteomyelitis?
-Blood
What specimen should be obtained for septic arthritis?
-Synovial fluid
How does osteomyelitis develop?
-Hematogenous spread from another site - Staph aureus
-Contiguous from adjacent abscess/deep wound
What 3 bacteria cause Septic arthritis? What percentage?
1. Staph aureus - 70%
2. Neiss. gonorrhoeae
3. Haemophilus influenzae
In whom does GC cause gonococcal arthritis?
Adults under 30
In whom does H. influenzae cause arthritis?
Children
What should be set up for synovial fluids from adults or children?
Chocolate agar
What type of organism is usually obtained from pericardial fluid?
viral
What organisms usually are obtained from thoracentesis?
Pneumonia agents.
If the peritoneal fluid (ascites) is infiltrated, what is the usual cause?
-Perforated bowel
What condition may cause perforation of the bowels?
CAPD - continuous ambulatory peritoneal dialysis.
What bug usually causes an infection in CAPD?
Skin flora, just from the continuous open wound at dialyzing site.