Infections of CNS - bacterial meningitis and miscellaneous bacterial infections Flashcards Preview

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Flashcards in Infections of CNS - bacterial meningitis and miscellaneous bacterial infections Deck (37):
1

how do bacteria reach the subarachnoid space?

- blood stream
- sinus
- ears

2

what causes edema in bacterial meningitis?

- toxins from bacteria or from leukocytes

3

bacterial meningitis presentation

- change in alertness
- headache
- fever
- stiff neck resistant to flexion

4

how diagnose bacterial meningitis?

LP

5

WBCs in bac meningitis

- usually 1000cells/cu mm or more and mostly PMNs
- early in disease WBC count can be low and can be mostly lymphocytes

6

protein and glucose in bac meningitis

high protein, low glucose

7

when start antibiotics in bac meningitis?

right away, it's an emergency, and LP will be good even if taken hours after starting antibiotics

8

most common pathogen in bac meningitis in neonates?

group B beta-hemolytic streptococci and enteric gram-negative bacilli are the most common pathogens, accounting for 60-70% of the cases of meningitis.

9

most common pathogen in bac meningitis in 2 month to ten year olds?

“Hemophilus influenzae, meningococci, or pneumococci.”

Excerpt From: “Disorders of the Nervous System.” iBooks.

10

what should we think about if there are unusual organisms?

immune deficiency

11

treatment for group B-beta hemolytic strep

penicillin

12

treatment for enteric gram negative bacilli

3rd gen cephalosporin

13

treatment for listeria

ampicillin or penicillin

14

treatment for H. influenza

penicillin

15

treatment for meningococcal meningitis

amp or chloremphenicol

16

ten complications of acute bacterial meningitis

- Cerebral edema (may lead to herniation)
- Vasculitis
Arteritis (stroke)
Cortical venous thrombosis (stroke, seizures)
Venous sinus thrombosis (increased intracranial pressure)
- Hydrocephalus
- Cranial nerve palsies
- Subdural effusion or empyema
- Disseminated intravascular clotting (purpura, cyanosis, pain, fever, and hypotension)
- Lactic acidosis
- Inappropriate ADH secretion (hyponatremia)
- Diabetes insipidus
- Residual findings
Cranial nerve palsies
Mental retardation
Seizures

17

causes of intracranial pressure in bac meningitis

- reduced resorption of CSF due to inflammation of the sinuses
- damage to arachnoid granulations
- in infants - subdural effusion
-

18

what causes DIC in bac meningitis?

vasculitis with intravascular deposition of fibrin

19

treatment of DIC in bac meningitis

- steroids in children
- possibly heparin

20

treatment of lactic acidosis in bac meningitis

- bicarb

21

presentation of bac meningitis in Lyme disease

- weeks after infection but often when rash is still present
- often accompanies damage to the facial nerve

22

array of presentations of neurosyphilis

- meningitis
- vasculitis and CNS infarction
- tertiary syphilis

23

two presentations of tertiary syphilis

- tabes dorsalis
- general paresis

24

symptoms of tabes dorsalis in tertiary syphilis

- inflammation of dorsal root ganglia
- loss of position and vibration sense
- loss of deep tendon reflex
- lightning pain to abdomen
- abdominal cramps and vomiting
- Argyll-Robertson pupil, small and irregular with no light reaction but with accommodation
- bladder dysfunction

25

symptoms of general paresis in tertiary syphilis

- infection of frontal lobes of cerebral cortex
- frontal lobe dementia
- pupillary changes, myoclonic jerks, tremor

26

what tests can be used to diagnose neurosyphilis?

- rapid plasma reagin (RPR)
- venereal disease research lab test (VDRL)
- fluorescent treponemal antibody test (FTA)

27

which test can confirm tertiary syphilis?

- only FTA

28

what spirochete is responsible for lyme disease?

borrelia burgdorferi

29

what is a common misdiagnosis in lyme disease parenchymal lesions?

- MS
- the lesions can occur with a fluctuating corset

30

which cranial nerve is most often affected by lyme disease?

VII

31

treatment of lyme disease

doxycyclin or amoxicillin, more successful earlier

32

rickettsial infection presents with

- non-specific meningoencephalitis
- headache, stiff neck, lethargy are often the first signs
- tick bite and associated rash

33

rickettsial infection treatment

tetracycline or chloramphenicol

34

4 common infant bacterial infections

E. coli
group B strep
staph
listeria

35

3 common child bacterial infections

H influenza
meningococcus
pneumococcus

36

2 common adult bacterial infections

meningococcus
pneumococcus

37

3 common elderly bacterial infections

H influenza
pneumococcus
listeria