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Bacterial Meningitides Flashcards

(51 cards)

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1
Q

Current m/c cause of bacterial meningitis

A

Strep pneumoniae

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2
Q

Cause of decrease in meningitis

A

Vaccines and screening for group B strep

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3
Q

Common problem w/ dx of meningitis

A

Difficulty culturing, presenting as “aseptic”

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4
Q

Community acquired meningitis causative agents

A

Strep pneumoniae, h. Flu, n. Meningitis

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5
Q

Hospital acquired meningitis causative agents

A

Gram negative rods, s. Aureus, other strep and staph

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6
Q

Cerebrospinal fluid is a perfect environment for bacterial because…

A

It’s sterile, no competition

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7
Q

Pathogenesis of meningitis

A

Mucosal colonization —> bloodstream —> BBB —> release of cytokines —> WBC into CSF —> inc. permeability of BBB —> exudation of serum —> edema, inc. intracranial pressure, altered blood flow

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8
Q

Most cases of bacterial meningitis are caused by

A

A localized infection elsewhere in the host

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9
Q

3 pathways for gaining access into the CNS

A
  1. Invasion of bloodstream and seeding of the CNS (M/c)
  2. Retrograde neuronal pathway (Naegleria)
  3. Direct contiguous spread (infections, malformations, trauma)
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10
Q

What causes swelling and decreased blood flow to brain?

A

“Leaky” blood vessels allow fluid, WBCs, and other immune components to cross the BBB

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11
Q

Classic triad of meningitis

A

Fever, HA, Neck stiffness

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12
Q

Dx of meningitis

A

Serum glucose compared to CSF glucose —> should be lower because bacteria are using the glucose for energy
CSF culture from lumbar puncture

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13
Q

Tx of meningitis

A

Prompt initiation of empiric therapy
Steroid to decrease swelling
Intrathecal abx for hospital acquired infections

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14
Q

Predisposing factors for neonatal meningitis

A

Immaturity of host defense, and organ systems
Low birth weight
Complications during birth

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15
Q

Signs of neonatal meningitis

A

Bulging Fontanelle
High pitched cry (intense amount of pain)
Hypotonia
Paradoxically irritability (quiet when stationary, crying when held)

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16
Q

Other signs and Sxs of neonatal meningitis

A

Hyperthermia —> very high fever
CNS manifestations
GI disturbances
Resp Abn

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17
Q

If hypothermia in neonate w/ meningitis

A

Advanced infection, body is unable to regulate anything

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18
Q

Predominant Agents of neonatal meningitis

A

Strep agalactiae
E. Coli
Listeria monocytogenes

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19
Q

Prevention of neonatal meningitis

A

Prenatal screening for group B strep during 35-37 weeks gestation

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20
Q

What do you do if the mother is positive for group B strep

A

If delivering vaginally, routine abx prophylaxis unless labor has begun

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21
Q

Prognosis of neonatal meningitis

22
Q

S. Agalactiae

Study These Flashcards
A 
AKA group B strep
Most common cause of NEONATAL meningitis
Prevention is difficult
Colonizes vagina and rectum
Infections in adults are rare if immunocompetent
23
Q

S. Agalactiae characteristics/morphology

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A

Gram positive cocci

Gray-white colonies w/ narrow zone of b-hemolysis

24
Q

S. Agalactiae virulence factors

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A 
Capsular polysaccharide
Hyaluronidase
Collage are
Hemolysis 
Sorta non-specific
Not well equipped to be pathogen
25
Early onset neonatal group B strep
Maternal OB complications are common Sxs during first 5 days Bacteremia, pneumonia, meningitis Better prognosis than late disease
26
Late onset meningitis
Maternal OB complications are uncommon | Sxs 7 days —> 3 months of age
27
Major clinical manifestations: bone/joint infections, bacteremia w/ meningitis
Late onset neonatal meningitis
28
Dx of s. Agalactiae
Detection of CAMP factor (People LOVE asking questions about this, but it is a HORRIBLE test) Enhanced hemolytic pattern Nothing else will exhibit this But definitive dx requires isolation from blood/CSF
29
E.coli as a causative agent of meningitis
Will start as GI infection and enter blood stream —> CSF | Gram negative enteric bacillus
30
most common cause of bacterial meningitis
S. Pneumoniae
31
What might follow pneumococcal pneumonia
Acute purulent meningitis
32
H. Influenzae morphology
Non-motile, gram negative coccobacillus
33
Usual pattern of h. Inf infection
Mild antecedent infection (prior URI or otitis media) followed by deterioration, signs and Sxs of meningitis
34
Seasonality of community acquired meningitis
All winter except L. Monocytogenes is summer
35
L. Monocytogenes morphology
Gram positive motile coccobacillus
36
Virulence of l. Monocytogenes
Mesophiles and can survive in the cold Facultative intracellular pathogen LPS-like surface component Listeriolysin O
37
LPS- like surface component of L. Mono
Antiphagocytic | Responsible for induction of complement dependent hemolytic antibodies
38
Listeriolysin O
Assoc L. Mono Disrupts the phagolysosome membrane Inhibits antigen processing Induces apoptosis
39
Pathogenesis of listeriosis
Ingest raw food...FINISH LATER
40
Clinical manifestations of listeriosis
Sepsis, meningitis
41
Dx of listeriosis
Finish later
42
Meningococcal meningitis | Causative agent
Neisseria meningitidis
43
N. Meningitidis morphology
Gram negative kidney bean shaped diplococcus | Encapsulated
44
Most important serogroups of n. Meningitidis
A, B, C, Y, W135
45
Epidemiology of meningococcus
Humans are the only reservoir, nasopharyx colonized | Infection requires close contact
46
Characteristics of meningococcemia
Skin rash Petechiae and pink macules Wide spread eruption DIC and shock can occur
47
Characteristics of meningococcal meningitis
Finish later, tumbler test
48
Dx of meningococcal meningitis
Gram stain of CSF, finish later
49
Tx of meningococcal meningitis
Penicillin G DOC
50
Prevention of meningococcal meningitis
Quadrivalent vaccine for serogroups A, C, Y, W135
51
Precaution w/ meningococcal meningitis vaccines
Administer serogroup B vaccine on one arm and the quadrivalent on the other

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