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37 Cards in this Set
- Front
- Back
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What are the community acquired pathogens causing Meningitis in babies under 1 month? |
GEL (Group B strep, E.coli and Listeria monocytogenes) |
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What are the community acquired pathogens causing Meningitis in babies 1-23 months?
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Streptococcus pneumoniae |
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What are the community acquired pathogens causing Meningitis in people 2-50 years?
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S. pneumoniae and N. Meningitidis |
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What are the community acquired pathogens causing Meningitis in people over 50 years?
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S. Pneumoniae N. Meningitidis L. monocytogenes Aerobic gram negative bacilli |
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Bacterial Meningitis that has 10-20% Mortality, 12 different serogroups of which 5 predominate, transmitted through droplets respiratory secretions/ saliva. |
Neisseria meningitides |
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Which serogroup is most common in Neisseria meningitides? |
Serogroup B |
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What are the 5 serogroups that predominate in Neisseria Meningitides? |
A, B, C, W-135 and Y |
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What age group has the highest predominance in Neisseria meningitides? |
children under 20 (infants 1 yrs and pre teens) |
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What are the 3 risk factors for Neisseria meningitides? |
1. Terminal complement deficiencies 2. Functional or anatomic asplenia 3. Household exposure to an infected person |
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Incidence of IPD (strep pneumonia) has decreased with what two vaccines? |
PCV7 (in 2005) and PCV13 (in 2011) |
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What age group is most prevalent (mortality wise) in Streptococcus pneumonia (a bacterial meningitides)? |
children under the age of 5 |
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25% of survivors of this bacterial meningitis suffer sequelae (hearing loss, behavioural problems...) |
that caused by strep pneumonia |
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How is strep pneumonia transmitted? |
droplets |
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What are the risk factors for bacterial meningitis- strep pneumonia? |
· Functional or anatomic asplenia
· Multiple myeloma (Ig issue) · Hypogammaglobulinemia · Alcoholism · Chronic liver disease· Chronic kidney disease ·Malignancy · Diabetes mellitus· Cochlear implants. or CSF leak |
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Bacterial meningitis that accounts for less than 5% of meningitis cases. Occurs primarily in unimmunized or partly immunized children. Transmitted by droplets. |
Hemophilus influenza |
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This bacterial meningitis is acquired through consuming contaminated foods (think unpasturized milk and meats) |
Listeria monocytogenes |
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What are the risk factors for Listeria Monocytogenes? |
Neonates, adults over 60, alcoholics, malignancy, immunosupressed, liver disease, chronic renal disease, pregnant women and iron overload. |
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Which bacterial meningitis has greatest mortality rate (15-30%)? |
that caused by listeria monocytogenes. |
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Most common cause of meningitis in neonates. Isolated from vaginal or rectal cultures of 15-35% of asymptomatic pregnant women |
Streptococcus agalactiae |
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________ forms 85-95% of viral meningitis? |
Enteroviruses |
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What viruses cause meningitis? |
Enteroviruses (echoviruses, coxsackieviruses), Herpes simplex viruses and Arboviruses. |
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What other infectious syndromes mimic meningitis? |
Parameningeal foci of infection |
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What are the clinical manifestations of viral meningitis in adults? |
-Fever -Headache -Altered mental status -Neck stiffness -Brudzinskis sign -Kernig's sign |
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Known as nape of the neck sign. Passive flexion of the neck results in flexion of the hips and knees. |
Brudzinki's sign |
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Patient supine, with the thigh flexed on the abdomen and the knee flexed, leg is then passively extended. Infected patient will REIST LEG EXTENSION |
Kernig's sign |
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If patient presents with a rash, suspecting Meningits, which would it be? |
N. meningitidis (in 75% of cases) |
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Cranial nerve findings in meningitis suspected patient is suggestive of what bacteria? |
L. monoytogenes |
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What would you include as your clinical management for Meningitis patients? |
ABCs Level of consciousness- intubate? Circulation and blood pressure Blood cultures Lumbar punctures (but do CT before in certain patients!!) Empiric antibiotics |
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When you obtain the CSF, what lab tests will you run? |
cell count biochem (glucose & protein) Gram stain & culture Molecular tests (PCR) for VIRUSES Viral culture |
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What empiric antibiotics will you use to treat in neonates (0-1 months)? * hint remember the usual organisms!! |
Ampicillin IV + Cefotaxime IV (or aminoglycoside IV) |
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What empiric antibiotics will you use to treat in infants (1-3 months)? * hint remember the usual organisms!!
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Ampicillin IV + Vancomycin IV + Cefotaxime OR Ceftriaxone IV |
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What empiric antibiotics will you use to treat in kids more than 3 months up to 50 years (0-1 months)? * hint remember the usual organisms!!
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Cefotaxime or Ceftriaxone IV + Vancomycin IV |
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What empiric antibiotics will you use to treat in adults over 50 years? * hint remember the usual organisms!! |
Ampicillin IV + Vancomycin IV + Cefotaxime or Ceftriaxone IV |
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When would you use IV Dexamethasone to treat meningitis? |
Haemophilus influenzae in infants, children &adults --> decreases hearing loss
Streptococcus pneumoniae in adults (someexperts recommend in children) --> lowers mortality and avoids hearing loss. |
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Inflammatory process of the brain parenchyma |
Encephalitis |
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Clinical findings of encephalitis |
Altered mental status motor or sensory deficits altered behaviour/ personality changes speech or movement disorders Seizures |
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What are the causes of encephalitis? |
Usually infectious --> predom. VIRUSES but can less often be due to autoimmune disorders, paraneoplastic syndromes |
