Exam 4 Meningitis Flashcards Preview

Q4 Clin Med III (GI) > Exam 4 Meningitis > Flashcards

Flashcards in Exam 4 Meningitis Deck (18):
1

Bacterial Meningitis is?

Neuro emergency
Inflamm of arachnoid mater and CSF in subarachnoidspace and cerebral ventricles

2

Bacterial Meningitis etiology:

Neonates thru delivery?

Nasopharynx?

Crowds?

Head trauma?

Neurosurg?

Neonate = E coli, Strep B

Nasopharynx = S pneumo from sinusitis/otitis media/mastoiditis

Crowds = Neisseria (military/college)

Head trauma = Staph

Neurosurg = Staph, G-

3

Bacterial Meningitis pathophys?

Inflamm damages BBB ->
↑ permeability ->
∆s protein/glucose transport ->
↑ edema/ICP and ↓ perfusion ->
Neuro damage

4

Bacterial Meningitis presentation?

Progressively (few days)
Acutely w/ sxs of sepsis (over hrs)

Fever/Nuchal Rigidity/∆d Mental Status
HA/Photophobia
Anorexia
N/V
Weakness
CN palsies
Seizures


Neonates -> poor eating, irritability

5

Meningococcemia presentation?

Petechiae and purpura

6

Bacterial Meningitis labs? (6)

Lumbar puncture
CBC w/ diff
BMP
ESR
CRP
Blood Cx x2 before ABX

7

Bacterial Meningitis imaging?

When should it be done?

CT

Before lumb puncture if 1+ of:
Immunocomp
Hx of CNS dz
New onset of seizures
Papilledema
Abn LOC
Focal neuro deficits

8

Bacterial Meningitis CSF findings? (4)

↑ WBC w/ neutro dominance
↑ protein
↓ glucose
↑ opening pressure

9

Bacterial Meningitis meds:

Newborn?

1 mo - 50 yo?

>50yo?

Immunocomp?

Empiric IV ABX + steroids immediately after LP

Newborn = Ampicillin + Cefotax

1 mo - 50 yo = Ceftri + Vanco + Dexameth

>50yo = Ceftri + Vanco + Amp + Dexameth

Immunocomp = Cefepime + Vanco + Amp + Dexameth

10

Purpose of Dexamethasone?

↓ hearing loss and neuro damage
↓ morbidity/mortality

11

How long for steroids?

4 days u/l S. pneumo, then longer

12

Meningitis vaccines?

S. pneumo
Neisseria
H flu

13

Aseptic Meningitis is?

Non-baterial
Clinical and lab evidence of meningitis with negative bacteria cultures

14

Aseptic Meningitis viral etiology?

Non-viral?

Enterovirus (Most C): Coxsackie, Echovirus
HSV, Zoster, EBV, mumps, West Nile, CMV

Mycobacteria
Cryptococcus (fungi)
T pallidum, B burgd (spirochete)
Direct invasion by CA
Meds (NSAID, ABX)

15

Aseptic Meningitis presentation?

Similar

16

Aseptic Meningitis diagnostics?

Same labs
CT

17

Aseptic Meningitis CSF findings?

↓WBC 50% lympho
Glucose = N
Protein = N or mild ↑
Gram stain = neg
Viral Cx = dx standard

18

Aseptic Meningitis tx?

Symptomatic only
Empiric ABX until bacteria r/o