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Flashcards in CNS infections Deck (85)
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61

what are the (treatable) causes of aseptic meningitis/ encephalitis

Infectious:
HSV 1 and 2
Syphilis
Listeria (occasionally)
Tuberculosis
Cryptococcus
Leptospirosis
Cerebral malaria
African tick typhus
Lyme disease

Non-Infectious:
Carcinomatous
Sarcoidosis
Vasculitis
Dural venous sinus thrombosis
Migraine
Drug
Co-trimoxazole
IVIG
NSAIDS

62

what are the contact prophylaxis regimes for meningitis

500 mg ciprofloxacin orally as a single dose for adults and children aged more than 12 years

600 mg rifampicin orally 12-hourly for four doses (adults and children over 12 years)

63

should you involve public health about meningitis

yes- all suspected cases

64

what vaccines protect against meningitis

travel vaccinations (neisseria)
HiB vaccine
pneumococcal vaccines

65

which space are samples obtained from in an LP

subarachnoid space

66

what are normal CSF WBC and RBC counts

white 0-5
red 0

67

what are the expected ratios for protein and glucose in CSF

glucose 0.6 (should be 2/3rds of blood glucose)
protein 150-450:1

68

proportionally more neutrophils (aka polymorphs) in CSF= ?

bacterial infection

69

proportionally more lymphocytes in CSF= ?

viral/ fungal infection

70

what is petechea

non blanching rash, meningitis

71

what are the rules for CTs and LPs

NEVER DO LP WITHOUT DOING CT AS MIGHT HAVE RAISED ICP- cause brain to herniate = coning (when cerebellum goes through foramen magnum)

unless
in suspected meningitis if patient has no focal deficit, is not immunocompromised, no skull #, has had no seizures,no Hx of CNS disease, no papilloedema, normal conscious level then do LP ASAP and start antibiotics

72

gram -ve cocci meningitis= ?

meningococcus meningitis (caused by neisseria)

73

what drug for chemoprophylaxis for bacterial meningitis

ciprofloxacin

74

what is the abx treatment for a brain abscess

IV ceftriaxone
IV metronidazole

add flucloxacillin in staph suspected
IV vancomycin if pen allergic/ MRSA suspected

for 4 weeks minimum

75

what other tests should be done in viral meningitisi

throat swap
stool sample
HIV test

76

what CNS infection causes oedema in the temporal loves

herpes simplex encephalitis

77

what test to confirm herpes simplex encephalitis

PCR from LP

78

what 3 tests do you prioritise in meningitis

LP
CT
blood culture

79

gram +ve diplococci meningitis= ?

pneumococcus

80

where can an brain abscess originate from

mastoiditis
sinusitis
orbital cellulitis

81

what organisms can cause brain abscesses

streptococci, bacteriodes, staphylococci, anaerobes, colliforms

82

why do you give ceftriaxone and not penicillin for meninigitis

as lasts longer in CSF

83

when do you delay an LP in meningitis

signs of severe sepsis
cardiac/ resp compromise
rapidly evolving rash
significant bleeding risk
signs suggesting shift of brain compartments (do CT)
- focal neuro signs
- papilloedema
- seizures that are continuous/ uncontrolled
- GCS = 12

84

buzzworrds: summer/ autumn time, GI symptoms

enterovirus viral meningitis

85

what is the key symptom in encephalitis

confusion