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39 Cards in this Set
- Front
- Back
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What does meningies cover
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brain and spinal cord
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what are the three layers of the brain
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dura mater - 2 layers
arachnoid space and pia mater |
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what are differential diangoses for meningitis
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viral - 40% most enchephilitis
fungal in immunocompromised bacterial - most deadly chemical or drug induced collegan vascular disorders brain abcess SAH *anything r/t sepsis, headache or fever |
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what is inflammation of the brain and parenchyma
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enchephalitis
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what are the two most common causes of viral encephalitis
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HSV or Arbovirus from ticks/LD
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is enchephalitis bacterial or viral
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viral
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what are the most common bacteria for meningitis
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s pneumoniae - 30 - 50%
n meningitis 10 - 35% staph 5 - 15% listeria 5% GN bacilli 1-10% Hflu 1-3% Strep 5% |
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what are the triad of meningeal symptoms
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HA, Fever, Meningismus(nuchal ridgitity, HA and photophobia)
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other common symptoms in menengitis
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altered sensorium, kernig and brudzinski sign, vomiting, sz, and focal findings
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how is meningtitis contracted
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colonization by pathogens in the nasopharynx
skull fracture at cribiform plate systemic bacteremia Predisposing - immunosuppressed, HIV steriods asplenic |
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passive or active flexion of the neck will result in inability to touch the chin to chest
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nuchal ridgitity
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sign refers to spontaneous flexion of hips during attempted passive flexion of neck
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brudzinski
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sign refers to the inability or reluctance to allow full extension of the knee when the hip is flexed 90 degrees
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kernig
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what signs are common in N Meningitiditis
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skin - petechiae and palpable purpura
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what two lab tests should be ordered
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cbcd and culture gram stain
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what is the mortalitity rate when no therapy is given for bacteria meningitis
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100 percent
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what choice of agent should be used in empiric treatment of meningitis
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third generation ceph - cefotaxime and ceftriaxone
Vancomycin |
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what antibiotic do you give if suspect listeria
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ampicillin
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when do you suspect listeria
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over 50 years old, and immunocompromised
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strep pneumoniae meningitis treatment
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cephalosporin for two weeks with vancomycin, if steriods used add rifampin
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H Flu treatment regimen
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third generation cephalosporin for 5-7 days, if pharyngeal colonization persists after therapy, use rifampin
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N Meningitiditis treatment regimen
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best with PCN - will see petechial rash. therapy for 5 days, can use cephalosporins
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Listeria treatment regimen
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ampicillin is drug of choice, bactrim with PCN allergy
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treatment for gram negative rods
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third generation cephalosporins or aminoglycosides may be needed. check LP 2-4 days after therapy started to assess efficacy.
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how to prevent meningitis
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hflu vaccine and pneumococcal vaccine
menactra |
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what mengingitis infection is not covered under the vaccine
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type B meningococcus
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is there chemoprophalaxis for the prevention of hflu and pneumococcal
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not pneumococcal
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what medication do you give with exposure to meningitis
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rifampin or ciproflaxin to prevent spread and eradicate pharyngeal carriage
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is it supported to use steroids in adults
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no
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Arbovirus that causes encephalitis are members of three families
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togavirus, flaviviridae, and bunyaviridae
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who carries west nile virus
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migratory birds - hawks jays and crows
misquitos hard and soft ticks in mammals: pig, dog, horse, lemurs, pigs, camel, and cattle. |
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what is the incubation period for WNV
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5-15 days
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what are the mild cases of symptoms
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fever, HA, myalgia/athralgia, anorexia for 3-8 days
ST and GI complaints may progress to aseptic meningitis in comorbidites |
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clinical features of WNV
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Fever, HA, CHange in MS
confusion, vomiting, nuchal ridgitiy, rash, GI complaints, coma, lymphadenopathy, focal neur deficits |
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how is WNV mostly transferred
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misquitos
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prognosis of WNV
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complete recovery
fatalities occur in > 50 years those with deficits are children and elderly |
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how to test for WNV
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serum IgM if <10 days or paired IgG samples if 2-3 weeks or CSF
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treatment of WNV
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supportive
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what is the issue with serum IgM and IgG for WNV
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cross reactivity to the whole family of flaviviruses
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