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MD1 Neuroscience > CNS Infections - Cellular Pathogens > Flashcards

CNS Infections - Cellular Pathogens Flashcards

(60 cards)

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1
Q

What is meningitis?

A

Inflammation of meninges

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2
Q

What is encephalitis?

A

Inflammation of brain

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3
Q

What is myelitis?

A

Inflammation of spinal cord

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4
Q

What is neuritis?

A

Inflammation of nerves

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5
Q

What is a brain abscess?

A

Pus in brain

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6
Q

What is a subdural empyema?

A

Pus in subdural space

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7
Q

What is an epidural abscess?

A

Pus in epidural space

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8
Q

Where are most cases of bacterial meningitis found?

A

96% in less developed countries

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9
Q

What is the mortality rate of bacterial meningitis globally?

A

50%

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10
Q

How many people have neurological sequalae after bacterial meningitis?

A

Half of survivors

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11
Q

Who is meningococcal disease most common in?

A

Children under age of 5

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12
Q

How does the likelihood of death from bacterial meningitis change over different age groups?

A

More likely as you get older

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13
Q

What are the causes of meningitis?

A 
Culture positive
- Bacteria
Culture negative
- Bacteria
- Viruses
- Other
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14
Q

What is aseptic meningitis?

A

Culture negative

  • Didn’t grow bacteria
  • Caused by something else
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15
Q

What is the most common cause of meningitis?

A

Viruses

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16
Q

What are the most common viral causes of meningitis?

A

Enteroviruses

  • Coxsackie
  • Echo
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17
Q

What are other infectious causes of meningitis?

A 
TB
Fungus
Parasites
Syphilis
Lyme
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18
Q

What are some non-infectious causes of meningitis?

A 
Malignancy
Drugs
- NSAIDs
- Antibiotics
- IV Ig
Inflammatory conditions
- Sarcoidosis
- Connective tissue disorders
- Lupus
- Vasculitis
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19
Q

Does viral meningitis usually need treatment? Why?

A

Doesn’t usually need treatment because

  • Self-limiting
  • Don’t get neurological sequelae
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20
Q

What are the most common causes of bacterial meningitis?

A

Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae

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21
Q

Who gets infected with the three most common causes of bacterial meningitis?

A

Infants
Children
Adults

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22
Q

What are the most common types of N meningitidis in Australia?

A

B and C

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23
Q

Which type of N meningitidis is the most common killer of people and especially children worldwide?

A

A

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24
Q

Which type of H influenzae is most common in Australia?

A

Type b

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25
Where are the three most common causes of bacterial meningitis usually found?
In nasopharynx
26
Which bacteria additionally cause bacterial meningitis in neonates and infants under the age of three months?
E coli and other Gram negative rods Group B Streptococcus Listeria monocytogenes
27
Where are the bacteria that especially infect neonates and young infants found?
In birth canal of mother
28
Which bacteria don't usually cause bacterial meningitis?
``` Streptococcus pyogenes (group A) Staphylococcus aureus ```
29
What are the host factors that predispose a person to bacterial meningitis?
``` Genetics Young age Recent respiratory infection Neuroanatomical defects Immunodeficiency ```
30
What are the pathogen factors that predispose a person to bacterial meningitis?
Polysaccharide capsule Infecting dose Competing commensals
31
What are the environmental factors that predispose a person to bacterial meningitis?
``` Overcrowding Smoke exposure Season Attendance at daycare Sharing food, drink, and dummies ```
32
What are the steps in the development of bacterial meningitis?
1. Colonisation of nasopharyngeal mucosa 2. Invasion of bloodstream > bacteraemia 3. Survival and multiplication > septicaemia 4. Crossing of BBB 5. Invasion of meninges and CNS 6. Increased permeability of BBB 7. Pleocytosis 8. Increased intracranial pressure 9. Release of pro-inflammatory cytokines 10. Neuronal injury
33
What causes neuronal injury in bacterial meningitis?
Immune response
34
What are the non-specific symptoms and signs of meningitis?
Fever Vomiting/nausea Headache
35
What are more specific signs of meningitis?
Stiff neck Altered mental state Photophobia Seizures
36
What is meningococcal disease often associated with?
Petechial or purpuric rash
37
How do you test if a rash is purpuric?
Put glass against rash > doesn't blanch
38
What are the normal values of CSF?
Pressure: 60% blood
39
Do normal CSF values change with age?
Yes
40
What does the CSF look like with viral meningitis?
Increased WCC Negative Gram stain Increased protein Normal glucose
41
What does the CSF look like with bacterial meningitis?
``` Raised pressure Cloudy Hugely increased WCC Positive Gram stain Increased protein Decreased glucose ```
42
What does the CSF look like with TB meningitis?
``` Raised pressure Cloudy Increased WCC ZN positive stain Increased protein Decreased glucose ```
43
When don't you perform a lumbar puncture?
``` Raised ICP Shock Spreading purpura After convulsions Coagulationk abnormalities Infection at site of lumbar puncture ```
44
What happens to the CSF sample if it isn't sent off to the lab immediately?
Cells start to lyse > WCC and glucose rapidly decrease
45
Can normal CSF results exclude meningitis?
No
46
Does pre-treatment with antibiotics change the WCC in CSF?
No
47
What is the treatment for bacterial meningitis?
``` Resuscitation/life support Fluids Antibiotics Steroids Contact prophylaxis ```
48
What are the antibiotics used for the treatment of bacterial meningitis?
``` IV 3rd generation cephalosporin - Eg: cefotaxime/ceftriaxone For neonates and infants under 3 months, add - IV penicillin - IV gentamicin ```
49
Why is the family of the patient also treated?
Because family at increased risk of infection, especially if bacteria N meningitidis
50
What antibiotic is given to contacts for prophylaxis?
Rifampicin
51
Which bacteria is associated with the worst complications?
Streptococcus pneumoniae
52
What is the most common neurological sequelae of bacterial meningitis?
Hearing loss
53
Why are steroids used in the treatment of bacterial meningitis?
Suppress immune response that causes damage
54
What is the state of consciousness in a person with meningitis?
Normal
55
What are the causes of encephalitis?
Almost always viral
56
What is the most common cause of viral encephalitis?
HSV
57
What are the symptoms of encephalitis?
Fever Headache Altered conscious state +/- convulsions
58
What is added to the treatment if encephalitis is suspected?
Acyclovir
59
Why is acyclovir added to treatment of bacterial meningitis if encephalitis is suspected?
People can have meningoencephalitis
60
Which types of bacteria that cause meningitis are we vaccinated against?
H influenzae type b S pneumoniae N meningitidis A - given to travellers only N meningitidis B - not on schedule, but available - very expensive N meningitidis C

MD1 Neuroscience (55 decks)

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