Flashcards in meningitis Deck (35)
what does neutrophils in the SAS suggest?
what is acute pyogenic meningitis ?
what is aseptic meningitis ?
what is acute encephalitis?
infection of the brain parenchyma
treatment of bacterial community acquired meningitis?
DECE - IV dexamethasone and ceftriaxone
if penicillin allergic, what is the treatment?
DECH - dexamethasone and chloramphenicol
what do you add as listeria cover?
IV ampicilin or amoxicillin (a is start of list)
who gets infected by listeria?
the very young and very old (start and end of list)
when is viral meningitis more common ?
late summer to autumn
which type of viruses would cause meningitis
enteroviruses (eg echovirus)
diagnosis od viral meningitis?
stool culture, throat swab, CSF PCR
treatment of viral meningitis?
supportive as self limiting
causitive orgs bacterial by age
explaining hot neck stiffness
infant - e coli
child - HI
young adult - Nesseria
old - strep pneumoniae
what prevents meningitis becoming an access?
what can cause infection in immunocompromised patient s?
what causes meningococcal ?
what are the symptoms in meningococcal meningitis due to?
most common cause of meningitis in children under 4 years old?
what antibiotic is used for listeria and which has no value ?
amoxicilin used, ceftriaxone has no value
previous TB on x ray, poor yield from CSF?
how do you treat tuberculous meningitis ?
rifampicin and Isoniazid (then add pyrazinimide and ethambutol)
3 clinical signs of bacterial meningitis ?
fever, stiff neck, alteration in consciousness
small, pleomorphic, gram negative rods?
what cells are usually seen in bacterial meningitis?
CSF glucose in bacterial?
less than 70% of blood glucose
CSF glucose in viral ?
cells in CSF in viral meningitis?
protein in viral/bacterial/tuberculous?
normal or slightly high in viral
high in bacterial
high or very high in tuberculous
why do you get high protein in bacterial ?
bacterial meningitis leads to a more permeable blood brain barrier, due to increased inflammation. Protein leaks into the SAS from the blood, so you get markedly increased CSF protein levels
what do you give if over 55 to cover listeria?
lumbar puncture, should it always be done?
yes, unless clear contraindication exists
if penicillin allergy, which antibiotic would you give in place of ceftriaxone?
DECH - chloramphenicol
Rapidly developing rash suggests
when would you do a CT scan of the head ?
immunocompromised, history of CNS disease, new onset seizure, papilloedema, focal neurological deficit