Flashcards in infections of CNS - other types of meningitis Deck (22):
1
general difference in presentation of chronic meningitis
- less signs of inflammation and more signs of neurologic damage
- “cranial nerves, focal sensorimotor deficit, cognitive deterioration, etc”
2
two types of chronic meningitis
- infectious and non-infectious
3
types of infectious chronic meningitis
- tuberculosis
- cryptococcal
- atypical bacteria and spirochetes (syphilis and Lyme)
4
types of noninfectious chronic meningitis
- sarcoid
- carinoma
5
tuberculosis meningitis occurs mostly in...
- children
- immunocompromised
6
how does tuberculosis meningitis start?
- seeding of tuberculoma in brain or meninges, usually traveled in blood from a central lesion like the lung
7
tuberculosis meningitis possible findings
- headache, fever, malaise
- nuchal rigidity
- weight loss
- hydrocephalus, cranial nerve palsy, arteritis
8
WBCs in CSF in tuberculosis meningitis
- pleocytosis but usually fewer than 300/cu mm
9
protein and sugar in tuberculosis meningitis
protein high
sugar low
10
tuberculosis meningitis treatment if suspected
- Isoniazide (INH), streptomycin, rifampin and pyrazinamide are used in combination
- Ethambutol may be useful if given in high doses
- treat 6-9 months
11
labs for tuberculosis meningitis
- acid fast bacilli - not always accurate and can take a long time
- chest x-ray and skin test - but not always accurate
- PCR generally accurate
12
cryptococcal meningitis caused by
cryptococcus neoformans
13
presentation of crypt meningitis
- indolent, symptoms can go back years
- headache most common
- mental deterioration
- cranial nerve palsies and focal brainstem dysfunction
14
cryptococcus may grow on...
- india pink preparation
- but not uncommon for it to not show at all
15
treatment of crypt meningitis
- “systemic and intrathecal amphotericin B and 5-fluorcytosine”
16
CSF in crypt meningitis
- same as tuberculosis meningitis
- protein high, sugar low
- WBC count high but under 300/ cu mm
17
CSF in sarcoid meningitis
same as tuberculosis and cryptococcus
18
treatment of sarcoid meningitis
- immune suppressing drugs
- corticosteroids
19
CSF in carcinomatous meningitis
- very high protein
- possible cancer cells
20
carcinomatous meningitis presentation
- hydrocephaly and CN damage typical
21
possible tests to confirm carcinomatous meningitis
- biopsy
- flow cytometry for lymphoma looking for monoclonality
22