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ELM2 - infection & immunity > lecture 7 - meningitis > Flashcards

lecture 7 - meningitis Flashcards

1
Q

What is meningitis?

A

A disease that results in swelling of the meninges and increased inter cranial pressure

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2
Q

Which types of pathogens can cause meningitis?

A

bacteria, viruses, fungi

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3
Q

What is the time frame of a chronic CNS infection?

A

> 4 weeks

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4
Q

What is encephalitis?

A

Inflammation of the brain due to an infection or allergic reaction

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5
Q

What are the key causes of non-infectious meningitis?

A

Lymphoma/leukaemia, subarachnoid haemorrhage, drug reactions, autoimmunity

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6
Q

What is meningoencephalitis?

A

Inflammation of the brain and meninges

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7
Q

What is the most common route of infection for infectious meningitis?

A

Haematogenous - via the bloodstream

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8
Q

What is the most common route of infection in meningitis?

A

haematogenous

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9
Q

What is the term for the presence of bacteria in the blood?

A

Bacteraemia

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10
Q

What is the term for the presence of viruses in the blood?

A

viraemia

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11
Q

What is the term for the presence of fungi in the blood?

A

fungaemia

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12
Q

What are the 4 possible routes of infection in the development of infectious meningitis?

A

Haematogenous spread, direct innoculation, contiguous spread, PNS->CNS

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13
Q

How does direct inoculation cause infectious meningitis?

A

Trauma, surgery, procedures can all allow pathogens to enter the brain

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14
Q

How does contiguous spread of infection cause meningitis?

A

Local infections, usually in the head, can spread to the meninges/brain

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15
Q

What type of pathogen typically causes infections spread via nerves from the PNS to CNS?

A

viruses

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16
Q

Are the meninges sterile or unsterile in health?

A

Sterile

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17
Q

What are the 3 layers of the meninges (outer to inner)?

A

Dura mater, arachnoid mater, pia mater

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18
Q

Which layer of the meninges contains CSF?

A

Arachnoid mater - central layer

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19
Q

What are the 3 classifications of infectious meningitis?

A

Acute, aseptic, chronic

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20
Q

What type of meningitis is pyogenic?

A

Acute bacterial meningitis

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21
Q

What immune cell can be found in large quantities in the CSF in acute bacterial meningitis?

A

neutrophils

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22
Q

What is the key characteristic of bacterial culture in aseptic meningits?

A

Negative for bacteria - indicating a viral aetiology

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23
Q

What cell type is found in large amounts in the CSF in cases of aseptic/viral meningitis?

A

Large numbers of lymphocytes

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24
Q

What types of bacteria typically cause chronic meningitis?

A

Tuberculosis, syphilis

25
Q

What cell type is found in large amounts in the CSF in cases of chronic meningitis?

A

Lymphocytes

26
Q

Which pathogen cause of meningitis has the lowest morbidity/mortality and is typically self-limiting?

A

Viruses (aseptic meningitis)

27
Q

What are the key respiratory commensal bacteria that cause meningitis?

A

neisseria meningitidis, strep. pneumoniae, haemophilus influenzae

28
Q

Which types of virus are associated with aseptic meningitis?

A

Enteroviruses, herpes, mumps, measles, influenza

29
Q

What disease is associated with increased risk of cryptococcus fungal meningitis?

A

HIV/AIDS (immunodeficiency increases susceptibility)

30
Q

Why are neonates vulnerable to meningitis?

A

They have an immature immune system

31
Q

What is the most common cause of bacterial meningitis in NZ?

A

Neisseria meningitidis

32
Q

What are the signs/symptoms of acute bacterial meningitis?

A

Fever, neck stiffness, photophobia, lethargy, myalgia, arthralgia, headache, seizures, mottles skin, rash, cold extremities

33
Q

What is the “classic triad” in meningitis?

A

A trio of common symptoms: fever, neck stiffness, headache

34
Q

What is the most common symptom of meningitis?

A

Fever

35
Q

What are the symptoms of acute bacterial meningitis in infants?

A

Lethargy, irritability, poor feeding, high pitched cry, bulging fontanelle

36
Q

What can bulging fontanelle be a sign of in infants?

A

Bacterial meningitis

37
Q

What is the process that causes the rash characteristic of bacterial meningitis?

A

The haemorrhage of capillaries under the skin leading to spots of redness/bruising

38
Q

Which bacteria typically causes a hemorrhagic rash in cases of meningitis?

A

N. meningitidis

39
Q

What is the name for the rash spots in early stage meningitis?

A

Petechiae

40
Q

What is the type of rash found in late stage meningitis?

A

Purpuric

41
Q

What is the key clinical sign of a meningitis rash?

A

Non-blanching (in cup test)

42
Q

What test is commonly used to identify meningitis rashes?

A

Cup/tumbler test - check for non-blanching rash

43
Q

What 2 signs are commonly used to assess lower limb presentations of meningitis?

A

Kernig’s sign, Brudzinski’s sign

44
Q

What is Kernig’s sign in meningitis?

A

Knee cannot be fully extended when hip flexed 90 degrees

45
Q

What is Brudzinski’s sign in meningitis?

A

Passive flexion of the neck causes flexion of both legs and thighs

46
Q

What are the prodromal symptoms of meningitis?

A

nausea, vomiting, fatigue, malaise, lethargy, cough, pharyngitis, headache, myalgia

47
Q

What are the complications of meningitis?

A

Death, amputation, hearing loss, blindness, epilepsy, cerebral palsy, cognitive issues

48
Q

What are the at risk groups for meningitis?

A

infants, elderly, students, immunosuppressed, trauma, surgery, asplenia, bacteraemia

49
Q

Is Neisseria meningitidis gram positive or negative?

A

negative

50
Q

How is Neisseria meningitidis transmitted?

A

Respiratory aerosol

51
Q

How is meningitis diagnosed?

A

Lumbar puncture for CSF then gram stain/culture/PCR to determine pathogen

52
Q

What is the normal appearance of CSF in lumbar puncture?

A

Clear, colourless

53
Q

What is the typical appearance of CSF from lumbar puncture in cases of meningitis?

A

turbid, yellow/orange/green from blood, green from pus

54
Q

What are the characteristic WBC, glucose and protein levels in CSF in bacterial meningitis?

A

High neutrophils, low glucose, high protein

55
Q

What are the characteristic WBC, glucose and protein levels in CSF in viral/aseptic meningitis?

A

High lymphocytes, normal glucose, high protein

56
Q

What technique can be used to identify meningitis causing viruses in CSF?

A

PCR

57
Q

What is the empiric antibiotic given for suspected/unclassified meningitis?

A

Ceftriaxone

58
Q

What is the role of steroids in meningitis treatment?

A

Reduce inflammation to decrease risk of complications

59
Q

What vaccine is part of the vaccine schedule for infants (Child vax programme) and at risk groups?

A

Meningococcal B

ELM2 - infection & immunity (22 decks)

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