infections of CNS - other types of meningitis Flashcards Preview

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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

drugs that can cause meningitis

- NSAIDs
- sulfa drugs
- chemotherapy and antiviral drugs in CSF