infections of the CNS Flashcards
Also septicaemia and shingles. (26 cards)
risk factors for bacterial meningitis
exposure in packed social areas - e.g. festivals, university barracks
baby picks up strep B vaginal commensal from mother at birth
common bacteria that cause meningitis
Neisseria meningitidis
Streptococcus pneumoniae
Group B Streptococcus
less common bacteria that cause meningitis
Haemophilus influenzae
Listeria monocytogenes
bacteria that may cause meningitis in the immunocompromised
Cryptococcus
TB
viruses that may cause meningitis
Herpes simplex virus
Varicella zoster virus
enteroviruses
classic triad of symptoms for meningitis
headache and stiff neck
photophobia
fever
signs of bacterial meningitis
purpuric rash
CSF cloudy with increased protein and decreased glucose
polymorph neutrophils in CSF
signs of viral meningitis
CSF clear with high glucose, low protein, and mononuclear white cells
risk factors for septicaemia
immunodeficiency major trauma burns neonates elderly
what percentage of cases of septicaemia start as an infection in the lungs?
50%
who must you call if a patient has Neisseria meningitidis?
Public Health England
signs of septicaemia
shock - cold hands and feet
evolving rash
metabolic acidosis
coagulation disorder
diagnosis of septicaemia
blood cultures
treatment of septicaemia
airway support
fluid resuscitation
IV abx - ceftriaxone (and also amoxicillin if over 60 or immunocompromised)
pathology of encephalitis
acute inflammation of brain parenchyma
risk factors for encephalitis
living in areas with vector - tick
travel
common causes of encephalitis
HSV, VZV, enterovirus
non-infective - autoimmune, paraneoplastic
symptoms of encephalitis
confusion decrease consciousness fever headache seizures preceding flu-like illness ±meningism
diagnosis of encephalitis
EEG characteristics: parodic shave and slow wave complexes
culture and PCR of CSF
MRI - inflamed areas of brain appear white
treatment of encephalitis if HSV or VZV
acyclovir
treatment of encephalitis
supportive
risk factors for shingles
prior varicella zoster infection
pathology of shingles
varicella zoster reactivation, dormant in dorsal root ganglion
appears to be contained within a dermatome
symptoms of shingles
pain in dermatomal distribution doesn't cross midline rash paraesthesia hyperasthesia
