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Flashcards in CNS infections Deck (23):
1

What is the major causative virus for viral meningitis?

Enterovirus e.g. ECHO virus

2

Management of viral meningitis

Supportive, as disease is usually self-limiting

3

Diagnosis of viral meningitis

Viral stool culture
Throat swab
CSF PCR

4

Presentation of viral encephalitis

Headache; fever; focal neurology e.g. speech, memory symptoms; stupor; coma

5

Essential features of the history in suspected viral encephalitis

Recent travel (e.g. Japansese encephalitis)
Occupational exposure e.g. rabies virus

6

Treatment of herpes simplex and varicella zoster encephalitis

High dose aciclovir

7

Which area of the brain does viral encephalitis tend to affect?

Temporal lobe

8

Main causative organisms of bacterial meningitis in teenagers/adults

Strep pneumonia (pneumococcus)
Neisseria meningitides (meningococcus)

9

Risk factors for bacterial meningitis

Decreased cell-mediated immunity;
Skull trauma e.g. cribriform plate fracure;
Post-neurosurgery;
CSF shunt

10

Symptoms of meningococcal meningitis are due to the effects of...

Endotoxin

11

Listeria monocytogenes is more common in what groups of patients?

Neonatal; older patients; immunosuppressed

12

Antibiotic for listeria

IV ampicillin/amoxicillin

13

Main four clinical features of bacterial meningitis

Headache
Fever
Neck stiffness
Change in mental state

14

Meningococcal meningitis may be associated with...

Purpuric (non-blanching) rash

15

When should performing an LP be avoided?

If there is a possibility of increased ICP

16

Key findings of LP in bacterial meningitis:
a) cells
b) gram stain
c) protein
d) glucose

a) 10^1 - 10^4. Polymorphs
b) Positive
c) elevated
d) lowered

17

Indications for CT prior to lumbar puncture

Immunocompromised state
History of CNS disease
New onset seizue
Papilloedema
Abnormal level of consciousness
Focal neurology

18

Initial "blind" antibiotic therapy

IV cefotaxime 2g bd. + amoxicllin if 50 years

19

Role of steroids in bacterial meningitis

Give to all suspected of having bacterial meningitis with the first dose of antibiotic. Reduces unfavourable outcomes particularly in pneumococcal meningitis

20

Antibiotic for meningococcal meningitis (after CSF/blood cultures)

Benzylpenicillin or ampicillin

21

Management of tuberculosis meningitis

Isoniazid + rifampicin

22

Most common cause of meningitis in neonates

Group B strep

23

When is contact prophylaxis needed and what is given?

In meningococcal meningitis. Oral ciprofloxacin