Flashcards in 26 Bacterial and fungal meningitis Deck (21)
What are the CSF findings in bacterial meningitis?
Very high polymorph count.
i.e. mainly neutrophils, also basophils + eosinophils
What is the main cause of bacterial meningitis?
Where is carriage, and what %?
Nasopharynx. Below 20% are carriers, but increased above 20% amongst smokers and before outbreak.
How does N meningitidis survive intravascularly?
Capsule protects against complement based attack.
Acquires iron from transferrin.
What does N meningitidis usually cause alongside meningitis?
Fulminant septicaemia ± purpuric rash.
What is the treatment for N meningitidis meningitis?
Ceftriaxone, cefotaxime, penicillin.
What is the prophylaxis and vaccination for N meningitidis?
Rifampicin + ciprofloxacin.
Active against Group A+C+W135.
Which other bacteria cause meningitis besides N.meningitidis? (2)
Haemophilia influenzae (type b is most invasive, most are non-capsulate).
Streptococcus pneumoniae (most are capsulate).
Who gets meningitis caused by haemophilus influenzae?
What are the virulence factors that H influenzae has? (3)
Type b capsule.
What is the treatment for H influenzae meningitis? (3)
Ceftriaxone, cefotaxime, ampicillin.
(β-lactamase producing strains common).
Which meningitis causing organism is identifiable by the optochin test?
Who gets meningitis caused by Streptococcus pneumoniae?
Which type bacterial cause of meningitis has no chemoprophylaxis available?
Why are steroids used in meningitis? (2)
How do they alter antibacterial Rx?
Strep pneumoniae pathology partly due to immune system.
Dexamethasone decreases mortality.
If vancomycin used add rifampicin as dexamethasone decreases vanc levels in CSF.
What are the causative organisms of neonatal bacterial meningitis? (3)
Group B haemolytic Streptococci.
What is the treatment for neonatal meningitis?
Ampicillin and gentamicin.
Which fungus causes meningitis, and in who?
Late stage HIV patients.
Indian Ink stain of CSF.
How does cryptococcal meningitis present?
Insidious onset, lymphocytic.
Amphotericin, flucytosine or fluxconazole.
What causes a meningitis with a CSF cell count >200 consisting of mostly polymorphs and reduced glucose?
What causes a meningitis in which the CSF protein count may be normal?