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29 Cards in this Set
- Front
- Back
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What are the most common causes of CNS infections w/ fever?
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Viral > Bacterial > Fungal > Parasites
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What are some symptoms to be aware of when making a CNS infection diagnosis?
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Headache, nausea, vomitting, anorexia, restlessness, altered conciousness, irritability
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What are some classic findings on the physical of a CNS infected patient?
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fever, photophobia, bulging fontanel, neck pain, nuchal rigidity, obtundation, stupor, coma, seisures
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What is necessary for diagnosis of diffuse CNS infections?
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examination of CSF
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What are the expected CSF findings of a bacterial CNS infection?
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high pressure (CSF), high WBC, High protein, Low glucose
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What is the expected CSF finding for a viral CNS infection?
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Normal or slighly increase pressure (>80) , under 1000 WBC, slighly increased protein, normal glucose
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A pateints CSF has a dramatically increase protein level (3000 mg/dl), What is the likely cause?
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Tuberculosis
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What are the top 3 bacterial causes of menigitis in the neonate?
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Group B strep, E coli, Listeria
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What are the top 3 baceterial causes of meningitis in children?
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Strep pneumo, Neisseria, H. flu. b
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What are the top 3 baceterial causes of meningitis in the immunosuppressed?
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Psuedomona, Staph, Salmonella, Listeria
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A child returns from crowded conditions at camp. What bacterial agent is likely the causative agent in his meningitis?
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Neisseria meningitidis
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What conditions might predisposed one to meningitis?
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Asplenia or splenic dysfunction, congenital or acquired CSF leak
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How can a sinus infection cause meningitis?
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Enter CSF through the choroid plexus
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What are some of the clinical manifestations of a CNS infection?
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shock, purpura, DIC, coma, fever, stiff neck
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What is Kernig sign? Brudzinski's sing?
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Kernig - pain caused when knee is flexed when hip is flexed.
Brudzinski - lift head and watch for hips to flex |
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What type of WBC will be seen in CSF of a patient with a bacterial CNS infection?
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neutrophil
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Name some spinal tap contraindications?
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3rd or 6th cranial nerve palsy
Hypertension/bradycardia/respiratory (Cushing’s triad) BULGING FONTANEL IS NOT A CONTRAINDICATION skin infection over LP site |
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What is the differential for a likely CNS infection?
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Brain Abscess, subdural empyema, malignancy
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What is the treatment for neonatal meningitis?
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Ampicillin and AG or 3rd Gen. Cephalosporin
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What is the treatment for strep pneumo CNS infection?
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Vancomycin and 3rd Gen. Cephalosporin
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What is the treatment for immunocomprimized CNS infection?
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Ceftazidime and AG
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Should you delay treatment to get a LP?
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Never
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Which type of meningitis has the highest mortality?
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pneumococcal meningitis
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Which of the meningitis infections can be vaccinated against?
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Neisseria, strep pneumo, Hflu
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What can you use for prophylaxis against Neisseria or Hflu?
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Rifampin
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What class of viruses are most common in CNS infections?
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Enteroviruses (also Arboviruses and Herpes)
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What is the typical onset for viral meningitis?
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usually acutely after a nonspecific febrile illness (GI usually)
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A pateint is showing signs of temporal lobe involvement, which virus do you suspect?
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HSV
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What can you use to treat viral meningitis?
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Acylclovir
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