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Clinical Microbiology > CNS Infections > Flashcards

CNS Infections Flashcards

(44 cards)

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1
Q

Protozoal infections of the CNS is most commonly caused by…?

A

Toxoplasmosis

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2
Q

What type of microorganisms can cause acute meningitis?

A

Bacteria

Virus

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3
Q

What type fo microorganism can cause subacute meningitis?

A

Bacteria

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4
Q

What are the signs and symptoms of meningitis?

A 
Headache
Neck stiffness
Reduced GCS
Fever
Confusion
Rash (purpuric)
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5
Q

What underlying disorders can result in pnuemonoccocal infection of the meninges?

A 
Middle ear disease
Head injury
Neurosurgery
Alcohol
Immunosuppresion
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6
Q

What factors are. associated with an adverse outcome in patients with bacterial meningitis?

A 
Pneumococcal infections
Reduced GCS
CNS signs
Older age >60 years
CN palsy
Bleeding
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7
Q

What investigations and examinations should be conducted in suspected meningitis?

A 
Throat examination
Blood cultures
Throat culture
Viral gargle
FBC
U&Es
LFTs
CRP
Lumbar puncture
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8
Q

In suspected meningitis when should a CT be conducted before a lumbar puncture is done?

A 
CNS <12
CNS signs
Papilloedema
Immunocompromised
Seizure
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9
Q

In suspected meningitis, when is a lumbar puncture contraindicated?

A 
Brain shift
Rapid GCS reduction
Severe sepsis
Rapidly evolving rash
Infection at lumbar puncture site
Respiratory/cardiac compromise
Coagulopathy
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10
Q

Meningococcal and pneumococcal infections of the meninges should be treated with which antibiotics?

A

IV Ceftriaone

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11
Q

Listeria infections of the meninges should be treated with which antibiotics?

A

IV amoxicillin

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12
Q

What are the concerns with pre-hospital antibiotic therapy?

A

Microbe lysis pre-hospital leading to a cytokine storm
Exacerbation of sepsis
Lack of supportive measures

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13
Q

Viral meningitis is usually only diagnosed after exclusion of bacterial meningitis. How is this treated?

A

Supportive treatments

Aciclovir only if the patient is immunocompromised

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14
Q

What are the symptoms of viral encephalitis?

A

Confusion
Fever
Seizures

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15
Q

How is viral encephalitis treated?

A

IV acyclovir for 2-3 weeks

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16
Q

How is viral encephalitis investigated?

A

EEG
MRI
Lumbar puncture - lymphocytic CSF

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17
Q

Intra-cerebral TB may be unmasked during treatment for other TB infection. T/F?

A

True

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18
Q

Which cranial nerves are commonly affected by intracerebral TB?

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A

CN 3, 4, 6 and 9

19
Q

How is intracerebral TB treated?

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A

Steroids for one year

20
Q

What are the possible complications of HIV brain disease?

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A

Encephalitis
Dementia
Neurological-syphillis
Opportunistic infections such as TB, cryptococcus, toxoplasmosis and JVC

21
Q

What is progressive focal multifocal leucoencephalopathy?

Study These Flashcards
A

A progressive motor dysfunction which typically affects immunocompromised individuals.

22
Q

What organism causes intra-cerebral toxoplasmosis?

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A

Toxoplasma gondii

23
Q

What are the signs and symptoms of intra-cerebral toxoplasmosis?

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A

Headache
Seziures
Focal CNS signs

24
Q

How is intra-cerebral toxoplasmosis treated?

Study These Flashcards
A

Sulphadiazine

Pyrimethamine

25
How is crytococcal meningitis treated?
Amphotericin B | Flucytosine
26
Cryptococcal meningitis can cause a raised ICP. How can this be treated?
Shunt
27
What is the classic train of symptoms which defined meningitis?
Fever Nuchal rigidity Change in mental status
28
What type fo headache typically occurs in meningitis?
Severe and generalised meningitis
29
What. is the Brudzzinski sign?
Spontaneous flexion of the hips during attempted flexion of the neck. illustrates meningism; used to examine for neck stiffness/nuchal rigidity
30
What is the Kernig sign?
The inability or reluctance to allow full extension fo the knee, when the hip is flexed 90 degrees. Indicates meningitis
31
What three important contraindication may delay/defer perfuming a lumbar puncture?
Evidence of raised intracranial pressure (mass effect on CT, clinical. signs of impending herniation) Spinal epidural abscess Thrombocytopenia
32
What are the common causative organisms of meningitis in developed countries?
Strep.pneumoniae N.meningitidis H.influenzae Group B strep
33
What are the CSF findings that would be suggestive of bacterial meningitis?
High white blood cell count with a polymorph predominance High protein >200mg/dL Low glucose <40 mg/dL
34
What are the CSF findings typical of asceptic (viral) meningitis?
``` WBC elevated (but generally less than seen in bacterial meningitis) with lymphocyte predominance Slightly raised protein Normal glucose ```
35
What characterises Purpura fulminant (a possible complications of meningococcal septicaemia)?
Cutaneous haemorrhage and necrosis due to DIC
36
What is the long-term consequence of bacterial meningitis?
Sensorineural hearing loss
37
What are the four common causes of community acquired bacterial meningitis in adults in developed countries?
Streptococcus penumoniae Neisseria pneumoniae H. influenzae Group B streptococcus
38
Listeria monocytogenes is an important bacterial cause of meningoencephalitis in which patients?
Neonates Pregnancy Immunosuppressed Elderly
39
A small proportion of patients may be hypothermic with meningitis. T/F?
True
40
What is Brudzinski sign in meningitis?
Spontaneous flexion of the hips during attempted passive flexion of the neck used to examine for neck stiffness
41
What is Kernig's sign in meningitis?
The inability or reluctance to allow full extension of the knee when the hip is flexed to 90 degrees
42
What CSF findings are suggestive of bacterial meningitis?
High wight blood cell count with polymorph predominance High protein Low glucose
43
What CSF findings would you expect in viral meningitis?
WBC elevated (but not as much as in bacterial meningitis) with a lymphocyte predominance Slightly high protein Glucose normal
44
Purpura fulminans is a complication of meningococcal septicaemia What is it characterised by?
Cutaneous haemorrhage and necrosis due to DIC.

Clinical Microbiology (17 decks)

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