Bacterial and fungal encephalitis

Question 1

Difference in presentation between encephalitis and brain abscess?

Answer 1

Brain abscess has insidious onset of meningism (acute onset in encephalitis)

Question 2

Cell count difference in blood results in bacterial, viral TB and cryptococcal meningitis

Answer 2

Bac- >200

all others 20-200

Question 3

cell type difference in blood results in bacterial, viral TB and cryptococcal meningitis

Answer 3

Bacterial has polymorphs, rest lymphocytes

Question 4

Glucose difference in blood results in bacterial, viral TB and cryptococcal meningitis

Answer 4

Reduced in all, but viral and cryptococcus could be normal

Question 5

protein difference in blood results in bacterial, viral TB and cryptococcal meningitis

Answer 5

All increased, but viral could be normal

Question 6

Neisseria meningitidis is normal flora where?

Answer 6

Nasopharynx

Question 7

2 things neisseria meningitidis can cause

Answer 7

Meningitis and septicaemia in various forms

Question 8

Rx of neisseria meningitidis?

Answer 8

Ceftriaxons and cefotaxime

Penicillin

Question 9

Chemoprophylaxis for contact for all forms of bacterial meningitis except? What would the treatment be in the others?

Answer 9

Strep pneumoniae

Rifampicin

Question 10

Vaccinations are available against which strains of neisseria meningitidis?

Answer 10

A, B, C, W135

Question 11

Which type of haemophilus influenza causes the most invasive disease?

Answer 11

B

Question 12

Rx haemophilus influenza?

Answer 12

Ceftriaxons and cefotaxime

Ampicillin

Question 13

Which type of bacterial meningitis is more common and severe in the elderly?

Answer 13

Strep. pneumoniae

Question 14

Rx strep pneumoniae?

Answer 14

Ceftriaxons and cefotaxime

Penicillin resistant is common in some areas

Question 15

What is raised in CSF in bacterial meningitis?

Answer 15

Neutrophils

Question 16

What is a treatment for streptococcal meningitis other than antibiotics?

Answer 16

Steroids- dexamethasone

Question 17

Interaction of dexamethasone?

Answer 17

Vancomycin- decreases levels in CSF so must also give rifampicin

Question 18

3 causative agents of bacterial meningitis?

Answer 18

Neisseria meningitidis
Haemophilus influenzae
Streptococcus pneumoniae

Question 19

3 causes of neonatal meningitis?

Answer 19

Group B beta haemolytic streptococci
E coli
Listeria monocytogenes

Question 20

Rx neonatal meningitis

Answer 20

cefotaxime

ampicillin and gentamicin

Question 21

Complications of meningitis (8)

Answer 21

Death
Sepsis
Raised ICP
Deafness
Delayed development
Seizures
Stroke
Hydrocephalus

Question 22

Are brain abscesses normally bacterial or viral?

Answer 22

Bacterial

Question 23

What is needed to confirm Dx of brain abscess?

Answer 23

Brain imaging

Question 24

Rx brain abscess?

Answer 24

Prolonged antibiotics

Drainage

Question 25

Rx cryptococcal meningitis?

Answer 25

amphotericin, flucytosine or fluconazole