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Flashcards in CNS infections Deck (85)
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1

what is meningitis inflammation of

all the meninges

2

why is time important in CNS infections

to save neural tissue
untreated infection may cause:
-brain herniation and death
-cord compression and necrosis (paralysis)

3

what is encephalitis

global infection of the brain parenchyma often caused by viruses

4

what is meningoencephalitis

inflammatory process (most often caused by viral infection), involving both the brain and meninges

5

what is encephalomyelitis

inflammation of the brain and spinal cord

6

what is neuritis

inflammation of one or more nerves

7

what are the types of menigitis

acute pyogenic (bacterial)
acute aseptic (viral)
acute focal suppurative infection (brain abscess, subdural and extradural empyema)
chronic bacterial infection (TB)

8

what is encephalopathy

any disease or disoder that affects the brain

9

what are the features of pyogenic meningitis

have a thich layer of suppurative exudate covering the leptomeninges over the surface of the brain
exudate in basal and convexity surface

10

what is seen microscopically in pyogenic meningitis

neutrophils in the subarachnoid space- lots of neutrophils in lumbar puncture= bacterial meningitis

11

do you get lots of neutrophils in CSF in a viral meningitis

no

12

what bacteria commonly cause bacterial meningitis

pneumococcus (strep pneumoniae)
meningococcus
haemophilus influenzae

listeria if >60 or immunocompressed

13

what is the treatment for bacterial meningitis

ceftriaxone IV
(if penicillin allergy chloramphenicol)
+
dexamethasone (IV) start with or just before abx

if listeria cover required add in amoxicillin IV (or co-trimoxazole if p allergic)

if recent travel ass in vancomycin IV for pneumococcal resistance

14

why should you make sure someone is allergic to penicillin before giving chloramphenicol

as v nasty drug - grey baby

15

what type of bacteria is strep pneumoniae

gram +ve cocci

16

what type of bacteria is listeria monocytogenes

gram +ve rod

17

what type of bacteria is haemophilis influenza

gram -ve bacillus

18

what causes viral meningitis

enteroviruses (echo virus)
herpes simplex (will have coldsores)
varicellar zoster virus


(in immunosuppressed EBV and CMV)

19

how is viral menigitis diagnosed

viral stool culture
throat swab
CSF PCR (will have only a few lymphocytes)

20

what is the treatment for viral meningitis

initially same as bacterial

supportive- e.g. vomiting give anti emetic

21

what should you not delay in suspected encephalitis

lumbar puncture (unless they have had seizures)

22

what Tx for viral encephalitis

IV aciclovir
LP after 14 days, HSV PCR weekly until negative

23

what are the clinical features of encephalitis

insidious onset
meningismus (features of meningitis without inflammation of the meninges)

cerebral cortex is diffusely involved:
mental changes
confusion
stupor
coma
seizures
partial paralysis
speech and memory symptoms
pychosis
focal or diffuse neurological changes

24

what are the clinical features of meningoencephalitis

features of encephalitis but with alos:
-headache
-fever
-neck stiffness

25

what viruses commonly causes viral encephalitis

herpes simplex

26

what investigations for encephalitis

LP, EEG, MRI

27

what are the symptoms of meningitis

headache
vomiting
pyrexia
neck stiffness
photophobia
lethargy
confusion
rash (non blanching)
muscle pain

28

what causes bacterial meningitis in neonates

listerior, group B strep, e coli

29

what causes bacterial meningitis in children

h influenza (vaccinate against this)

30

what causes bacterial meningitis in ages 10-21

neisseria meningitidis