Flashcards in CNS Infections Deck (42)
Why are infections in the cranial cavity so dangerous?
Infection leads to inflammation which in an enclosed space like the skull leads to compression herniation and necrosis.
If you have pyogenic meningitis in a non immunosuppressed patient caused by a gram +ve what is it likely to be?
If you have pyogenic meningitis in a non immunosuppressed patient caused by gram -ve rods what is it likely to be?
If you have pyogenic meningitis in an immunosuppressed patient caused by gram +ve rods what is it likely to be?
If you have a pyogenic meningitis in an immunosuppressed patient caused by gram -ve what is it likely to be?
Someone presents with pyogenic meningitis what is the treatment?
IV Ceftriaxone 2g
What organisms would IV Ceftriaxone be effective for?
If someone is Penicillin allergic what is the alternative to Ceftriaxone?
Chloramphenicol IV 25mg
When is Listeria considered a suspected cause of meningitis?
Immunosuppressed diabetes Alcohol
If Listeria is the suspected cause of the meningitis what is the treatment?
IV Amoxicillin 2g 4 hourly
If someone has recently travelled and presents with meningitis what is the treatment?
IV Vancomycin - increased risk of Penicillin resistance
For all cases of Pyogenic Meningitis what is the baseline length of treatment ?
A Purpuric non blanching rash is only present in one form of meningitis. Which organism is responsible?
What is the presentation of viral meningitis?
Headache Fever Neck Stiffness
When is a common time for people to contract Viral Meningitis ?
Late Summer Autumn
What are two common causes of viral meningitis ?
HSV - Most severe infection
What is the treatment for viral meningitis?
Usually supportive due to its self limiting nature.
What is used to diagnose viral meningitis ?
What are the clinical signs of encephalitis ?
Behavioural Changes - due to cerebral cortex involved
What signs can show up on MRI that might indicate a encephalitis?
Temporal lobe and adjacent parahippocampal gyrus are bright white on MRI
What gives the definitive diagnosis of encephalitis ?
What are the clinical signs of a CNS infection?
What nerves are at risk in a very purulent meningitis?
What routes can an infection take to cause a meningitis ?
Direct route - Invasion through bone into the cranial cavity e.g. mastoiditis from middle ear
Remote focus - Endocarditis Myocarditis blood
If there is a suspicion of a raised ICP what should be undertaken before a Lumbar Puncture ?
What region are you trying to hit in a lumbar puncture?
Sub Arachnoid Space
How may vials should be taken and where should they be sent to?
1 Haematology Cell Count and differentiation
2 Microbiology - Gram stain and culture
3 Chemistry - Glucose Protein
4 Haematology - Cell count
What is normal for a CSF sample?
Protein - 0.15 to 0.45
Glucose - 40 to 60% of blood
High Protein >220