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28 Cards in this Set

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Type of edema?

Effect of released bacterial components such as cell wall and LPS as well as cytokines released from macrophages such as IL-1 and TNF lead to ince bloood brain permability because of shift from intravascular fluid mvmt to extravascular space
vasogenic edema
Type of edema?

Due to increased resistance to CSF outflow from subarachnoid space bc of inflammation leading to dec reabsorption of CSF
Interstial edema
type of edema?

Due to inflammation in subarachnoid space caused by cell death and swelling and release of cytokines IL-1 and TNF from macrophages
cytotoxic edema
Type of edema?

Effect of released bacterial components such as cell wall and LPS as well as cytokines released from macrophages such as IL-1 and TNF lead to inc blood brain barrier permability because of shift from intravascular fluid mvmt to extravascular space
vasogenic edema
Type of edema? Due to increased resistance to CSF outflow from subarachnoid space bc of inflammation leading to dec reabsorption of CSF
Interstial edema
type of edema?

Due to inflammation in subarachnoid space caused by cell death and swelling and release of cytokines IL-1 and TNF from macrophages
cytotoxic edema
What are pathogenic factors for mucosal colonization?
fimbriae
polysaccharide capsule
IgA protease production
What are pathogenic factors for intravascular survival?
polysaccharide capsule
what is the pathogenic factor for meningial invasion?
fimbriae, association with monocytes
What host factors are involved in resistance of mucosal colonization?
mucosal epithelium
secretory IgA
ciliary activity
#1 bug cause bacterial meningitis in < 1 mo
GBS
#1 bug cause bacterial meningitis in 1 to 23 mo
GBS
#1 bug cause bacterial meningitis in 23 mo to 18 yrs
N. meningitis
#1 bug cause bacterial meningitis in 18 yrs to 50 yrs
S. pneumoniae
#1 bug cause bacterial meningitis in > 50 yrs
S. pneumoniae
bugs cause bacterial meningitis in head trauma or neuro surgery
Staphylococcus aureus
Staphylococcus epidermidis
aerobic gram negative bacilli (including pseudomonas species)
bugs cause bacterial meningitis in Basilar skull fracture/CSF leak
S. pneumoniae
H. influenzae
Group A, β-hemolytic streptococci
What is an important clinical finding for Neonates/infant bacterial meninigitis?
a bulging fontanel
Underlying conditions which predispose to the development of bacterial meningitis
1. acute/chronic otitis media/mastoiditis
2. sinusitis
3. pneumonia
4. endocarditis
5. recent/remote head trauma (CSF leak)
6. immunosuppression (particularly defects in humoral immunity and/or splenic dysfunction); deficiency of terminal components of complement (N. meningitidis)
7. alcoholism
What is the best technique for detecting bacterial antigens in CSF and what organismis is it avaiable for?
Latex agglutination

available for:
S. pneumo
N. meningitis
H. influenza type B
E. coli
S. agalactiae (GBS)
Test done on all CSF from pt thought to have bacterial meningitis?
gram stain
Meningitis with a lymphocytic predominant pleocytosis in which bacterial stains and cultures are negative
Aseptic meningitis
most common cause of aseptic meninigitis
enteroviruses
when is aspetic meningitis most often seen?
in the late summer and early fall and is often associated with community epidemics
what are the early signs of bacterial meningitis?
Shock

coagulopathy
- disseminated intravascular coagulation

respiratory failure
-adult respiratory distress syndrome

cerebral edema
what are the late signs of bacterial meningitis?
behavioral/learning disabilities
hearing loss
seizures
hydrocephalus
what are measures of prevention for bacterial meningitis?
-Antibiotic prophylaxis for close contacts
- meningococcal vaccine
-HIB conjugate vaccine
-23 - valent pneumococcal vaccine, 7-valent pneumococcal conjugate vaccine
- management of GBS colonization in pregnancy
what are common sx of bacterial meningitis?
-Headache
-fever
-neck stiffness, photophobia
-nausea/vomiting
-change in mental status