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106 Cards in this Set
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How many pathogens cause bacterial meningitis?
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25
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Where can nearby infection cause bacterial meningitis from?[2]
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Middle ear
Sinuses |
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What route of spread is used for bacterial meningitis caused by an infection from a distant site?
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Hematogenous spread
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What conditions can cause direct introduction of bacteria into the CNS?[2]
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Surgery
Trauma |
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What are the most common pathogens to cause bacterial meningitis in Neonates?[4]
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Group B Strep
Coliforms Listeria monocytogenes Strep pneumoniae |
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What are the most common pathogens to cause bacterial meningitis in infants[3]
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N. meningidtis
Strep. pneumoniae H. Influenza |
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What are the most common pathogens to cause bacterial meningitis in children?[2]
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Strep pneumoniae
N. meningidits |
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What are the virulence factors for N. meniniditis?[4]
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Capsule
IgA protease Pili Endotoxin |
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What are the virulence factors for H. influenze?[4]
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Capsule
IgA protease Pili Endotoxin |
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What are the virulence factors for Strep. pneumoniae?[2]
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Capsule
IgA protease |
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What are the symptoms of bacterial meningitis in babies?[4]
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No obvious clinical signs
Failure to thrive Fever/hypothermia Diarrhea (occasionally) |
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What are the symptoms of bacterial meningitis in children and adults?[6]
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Fever
Emesis Loss of consciousness Rash (looks like a bruise) Recent upper respiratory tract infection Brudzinski's sign |
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Describe N. meningitiditis
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Exclusively Human Pathogen
Gram negative Diplococci |
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How is N. meningitiditis transmitted?
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Respiratory droplet
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What percentage of survivors of bacterial meningitis caused by N. meningitiditis develop neurological sequeleae?
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50%
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What condition increases the rate of transmission of N. meningitiditis?
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Overcrowding
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What time period of acute infection with N. meningitiditis is the patient at highest risk?
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24 hours
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Why are the first 24 hours critical in N. meningitiditis infection?
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Period before natural antibodies are formed
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What is the bacterial agent which causes meningococcal meningitis?
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N. meningitiditis
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What are the symptoms of meningococcal meningitis?[4]
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Rash
Sepsis Fever Sx associated with meningitis |
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What is the characteristic symptom of meningococcal meningitis?
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Rash
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What is required for diagnosis of meningococcal meningitis?
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Clinical signs
CSF tap + for N. meningitiditis |
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What treatment must be adminstered to patient with meningococcal meningitis?[2]
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Penecillin
Chephelosporin |
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What is the window of infection opportunity for H. influenzae?
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4 months to 3 years
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Describe H. influenzae?[2]
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Gram negative
Rod |
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What is the mode of transmission of H. influenzae?
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Respiratory droplets
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How does H.influenzae spread to the brain?
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Hematogenous spread
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What bacteria carries the greatest risk of permanent neurological damage after meningitis?
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H.influenzae
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What type of onset in bacterial meningitis caused by H. influenzae?
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Insidious
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Acute or insidious
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What is the treatment for bacterial meningitis caused by H. influenzae?
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Ampilicillin
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What virulence factor is present in some strains of H. influenzae which will counterindicate treatment of miningtis by ampicillin?
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β-lactamase
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What is the alternative treatment for H. influnzae infection when the stain consists of β-lactamase?[2]
What is the treatment if H. influenzae does not consist of β-lactamase |
Cephalosporin
Chloramphenicol Ampicillin |
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Why is H.influenzae declining in incidence?
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Vaccination with type B capsular polysaccharide
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Describe Listeria Moncytogenes[4]
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Gram positive
Non-Spore forming Aerobic Rods |
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What is the route of transmission for Listeria Monocytogenes?[4]
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Feco-Oral
Food-borne Zoonotic Vertical |
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What is the carrier rate for Listeria monocytogegens in humans?
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2% to 12%
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What is a consequence of vertical transmission of Listeria monocytogenes?
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Spontaneous abortion
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Where in the host does Listeria monocytogenes grow?
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Macrophages
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What is the attachment molecule for Listeria monocytogenes?
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Internalin
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What is internalin?
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Attachement molecule for Listeria monocytogenes
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What protein helps Listeria monocytogenes move into the cell?
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Listeriolysin
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What is listeriolysin?
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Protein which helps Listeria monocytogenes move into the cell
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How doe Listeria monocytogenes move to new cells?
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Using cellular actin
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What patients does Listeria monocytogenes tend to infect?
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Immunocompramised patients
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What molecule do internalins bind to?
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E-Cadherins
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What microbe are internalins associated with?
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Listeria monocytogenes
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What is observed in the CSF sample of a patient who is infected with Listeria monocytogenes?
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Beta-strep-like organism that is catalase positive and tumbles
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What is the treatment of Listeria monocytogenes infection?[2]
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Ampicillin
Gentamycin |
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What infection is treated with Ampicillin combined with Gentamycin?
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Listeria monocytogenes
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What Lancefield groups is Streptococcus agalectiae?
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Group B
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Where in the body is S. agalactiae normally found?
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Part of vaginal flora
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What is the mortality rate of neonates who develop infection with s agalactiae?
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60%
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What are the symptoms of S. agalactiae infection in neonates?[4]
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Lethargy
Fever Sepsis Respiratory distress |
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A neonate presents with lethargy, fever, sepsis, and respiratory distress. What is the causative agent?
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Group B Streptococcus (S. agalactiae)
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What would be observed in a culture of S. agalactiae?
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Gram positive cocci or coccobacilli in chains
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What is the most accurate way to test for S. agalatiae?
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Test for the Lacefield B antigen on the surface of the bacteria
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What is the treatment for Group B Streptococcus infection?
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Penicillin
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What is the treatment for S. agalactiae?
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Penicillin
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When should penicillin be administered to the neonate?
What is the causative agent? |
Lethargy
S. agalactiae |
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When is infection with Streptococcus pneumoniae most likely?[2]
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Children<2years
Elderly |
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What is the mortality rate of patients who are infected with S. pnemoniae and are treated?
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20% to 30%
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What is the percentage of patients who experience permanent neurological deficits following an infection with S. pneumoniae?
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15% to 20%
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What is the most common cause of bacterial meningitis in neonate?
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S. pneumoniae
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What is the preceding illness in the elderly who present with S. pneumoniae meningitis?
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Pneumonia
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What is the most common cause of bacterial meningitis?
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S. pnemoniae
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What preceding diseases can present before meningitis in infection with S. pneumoniae?[3]
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Pneumococcal pneumonia
Middle ear infection Sinusitis |
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T/F There is a vaccine for S. pneumoniae.
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True
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What is the first line of antibiotics used in the treatment of S. pnuemoniae infection?
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Penicillin
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What treatments are administered to a patient with S. pneumoniae that shows resistance to Penicillin?[2]
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Caphelasporins
Vancomyosin |
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What microbe causes "birth canal meningitis"?
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Entrobacteriaceae
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Who is at highest risk for CNS infection with enterobacteriaceae?
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Neonates
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What are the common organisms of the family Enterbacteriaceae which can cause a CNS infection?[2]
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Escheria coli
Klebsiella enterobacter |
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What strain of E. coli is prone to causing CNS infections?
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K1 strain
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How does Enterobacteriacea invade the CNS?
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Nasopharynx to the meninges
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When the Enterobacteriaceae invades the meninges from the nasopharynx by what route does it travel?
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Hematogenous
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Why is there a high rate of neonate infection of E.coli infection with the K1 strain?
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There is increased colonization of the K1 strain during pregnancy
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What are the symptoms of E. coli infection of the CNS in a neonate < 1 month?[5]
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Irritability
Lethargy Vomiting Lack of appetite Seizures |
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A neonate born less than a month ago presents with irritability, lethargy, vomiting, lack of appetite and seizures. What is the likely disease and organism?
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CNS infection with E. coli K1 strain
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What are the symptoms of E. coli infection of the CNS in an infant 4 to 18 months of age?[3]
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Neck rigidity
Tense fontanels Fever |
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A 11 month old infant presents with neck rigidity, tense fontanels and fever.
What is the likely disease and organism? |
CNS infection with E. coli K1 strain
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What are the symptoms of E. coli infection of the CNS in children and adults?[6]
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Headache
Vomiting Confusion Lethargy Seizures Fever |
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A 5 year old child presents with headache, vomiting, confusion, lethargy, seizures, and fever.
What is the likely disease and organism? |
CNS infection with E. coli K1 strain
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What antigen can be demonstrated to diagnosis an infection with E. coli?
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K1 antigen
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What is observed in a culture of E. coli?
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Gram negative Bacilli
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Describe E. coli?[3]
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Gram negative
Rod Facultative anaerobe |
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What type of metabolism does E.coli participate in?[2]
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Fermentive (anaerobic)
Respiratory (aerobic) |
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What is the treatment for E. coli infection?[2]
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Penicillin
Cephalosporin |
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What is the organism to cause the second most CNS infections in neonates after Group B Strep?
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Klebsiella enterobacter
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What are the symptoms of CNS infection with Klebsiella enterobacter?[6]
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Lethargy
Poor feeding Little cry Hypothermia Fever Sclerema |
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What is Sclerema?
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Induration (hardening) of subcutaneous fat
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Induration (hardening) of subcutaneous fat
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Sclerema
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What areas should be cultured for a suspected Klebsiella enterobacter infection?[4]
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Blood
Urine CSF Local infections |
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What WBC profile is seen in early Klebsiella enterobacter infection?[3]
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Thrombocytopenia
Leukopenina Neutropenia |
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What WBC profile is seen in late Klebsiella enterobacter infection?[3]
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Thrombocytopenia
Leukocytosis Neutrophilia |
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What is the result of a test for C-reactive protein in a patient with Klebsiella enterobacter infection?
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C-reactive protein is positive
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What treatment should be administered after confirmation of a Klebsiella enterobacter infection?[2]
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Ampicillin
Gentamicin |
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What drugs could substitute Gentmicin int he treatment of Klebsiella enterbacter infection?
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3rd generation cephalosporins
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Describe Klebsiella enterobacter. [3]
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Gram negative
Rod (with halo) Facultative anaerobe |
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How is Rickettsia rickettsii transmited?
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Tick bites
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T/F Rickettsia rickettsi can be spread human to human.
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False
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What is the key sign used in clinical judgment to diagnose Rickettsia rikettsii?
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Rash
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What are the symptoms of Ehrlichia chaffeensis infection?[5]
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Fever
Hypotension Confusion Renal Failure Hepatocellular injury |
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T/F Rash is common in infection with Ehrlichia chafeensis.
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False (No rash)
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What is the causative agent of Q fever?
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Coxiella burnetii
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What are teh symptoms of Q fever?[8]
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High fever
Malaise Headache confusion Chills n/v/d Abdominal pain Chest pain |
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What is the drug of choice for the treatment of Q fever
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Doxycycline
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