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22 Cards in this Set
- Front
- Back
What are some common causes of chronic meningitis?
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-mycobacteria
-fungi -lyme disease -parasites |
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What are the most common causes of acute meningitis in neonates? list in order of prevalence
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1. Group B strep
2. E. coli 3. Listeria meningitides |
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What are the most common causes of acute meningitis in children >3 months? list in order of prevalence
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1. Neisseria meningitides
2. Strep pneumoniae 3. H influenzae |
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What are the most common causes of acute meningitis in adults (18-50)? list in order of prevalence
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1. Strep pneuominiae
2. N. meningitides 3. H. influenzae |
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What are the most common causes of acute meningitis in the elderly (>50)? list in order of prevalence
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1. Strep pneumoniae
2. N. meningitides 3. L. monocytogenes |
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What are the most common causes of acute meningitis in immunocompromised individuals? list in order of prevalence (3)
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1. L. monocytogenes
2. Gram negative bacilli 3. S. pneumoniae |
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What are some causes of aseptic meningitis? (4)
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-enteroviruses
-HSV -parasites -fungi |
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What are some common signs and symptoms of bacterial meningitis? List as many as you can
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-headache
-fever -n/v -still, painful neck -alteration in mental status -nuchal rigidity -maculopapular rash with petechiae cranial nerve palsies -kernig's and bradzinski's |
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What are the characteristic CSF findings for bacterial meningitis?
hint: glucose, protein, WBC etc... |
1. Elevated WBC (incr. PMNs)
2. Low Glucose 3. High protein 4. Gram stain positive in 75-80% |
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What are the characteristic CSF findings for asceptic meningitis?
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1. Elevated WBC (lymphocytes)
2. Protein is normal or slightly elevated 3. Glucose normal NB: CSF may be completely normal |
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What are the steps in mngt of bacterial meningitis?
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1. CT if focal neuro signs
2. Perform LP and send CSF for cell count, chemistry, gram stain and culture 3. Obtain blood Cx before Abx given 4. Administer empiric abx 5. Consider steroids (controversial) |
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What is the empiric Abx treatment for infants with suspected bacterial meningitis?
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Cefotaxime + ampicillin + vancomycin
(aminoglycoside if <4 wks) |
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What is the empiric Abx treatment for 3 yrs to 50yrs with suspected bacterial meningitis?
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Ceftriaxone or cefotaxime + vancomycin
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What is the empiric Abx treatment for > 50yrs with suspected bacterial meningitis?
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Ceftriaxone or cefotaxime + ampicillin + vancomycin
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What is the empiric Abx treatment for immunocompromised individuals with suspected bacterial meningitis?
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Ceftazidime + ampicillin + vancomycin
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For all close contacts of pts with meningococcus, what prophy should be used? (2 options)
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1. Rifampin
2. 1 dose of IM Ceftriaxone |
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Common causes of encephalitis?
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Usually viral in origin
-Herpes (HSV-1) -Arbovirus -Enterovirus |
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What is the most specific and sensitive test for diagnosing viral encephalitides?
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CSF PCR
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What is the characteristic finding on MRI of HSV encephalitis?
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Increased areas of T2 signal in the frontotemporal localization
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What would the EEG show with HSV-1 encephalitis?
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unilateral or bilateral temporal lobe discharges
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Treatment of HSV encephalitis? CMV encephalitis?
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1. HSV encephalitis --> acyclovir for 2-3 wks
2. CMV encephalitis --> ganciclovir |
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What are the most common non-bacterial causes of brain abscesses?
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AIDS:
- Toxoplasma gondii - fungi Neutropenic: - Candida spp - Aspergillus spp - Zygomycosis |