Meningitis Flashcards
(14 cards)
Differential diagnosis
A-Infectious
1-Bacterial:
*Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA)
*Streptococcus pneumoniae (pneumococcal)
*Group B Streptococcus (GBS) (neonates)
*Haemophilus influenzae type b (HIB)
*Neisseria meningitidis (meningococcal)
*Mycobacterium tuberculosis (tuberculous meningitis)
*Escherichia coli (especially in neonates)
*Listeria monocytogenes (common in immunocompromised or neonates)
بتوع الاطفال
GEL
Fungal
Hcc
1-Cryptococcus neoformans (common in immunocompromised individuals, especially HIV/AIDS)
2-Coccidioides spp. (especially in endemic areas)
3-Histoplasma capsulatum (common in immunocompromised pati
Parasitic
TNS
Naegleria fowleri (primary amoebic meningoencephalitis, PAME)
Toxoplasma gondii (in immunocompromised patients, often associated with HIV)
Strongyloides stercoralis (rare, but in immunocompromised
Non infectious
a) Autoimmune and Inflammatory Conditions:
1-Systemic lupus erythematosus (SLE) (lupus meningitis)
2-Sarcoidosis (neurosarcoidosis)
3-Behçet’s disease
4-Vasculitis (e.g., Giant cell arteritis)
5+Multiple sclerosis (MS) (inflammatory demyelination)
Non infectious
Drug-Induced Meningitis:
NSAIDs, antibiotics (e.g., trimethoprim-sulfamethoxazole, ampicillin), intrathecal chemotherapy, vaccines (rarely associated with aseptic meningitis)
Non infectious
Malignant Meningitis:
1-Leptomeningeal carcinomatosis (spread of cancer to the meninges, e.g., from breast, lung, or melanoma)
2-Lymphoma
3-Leukemia
Non infectious
Other Non-Infectious Conditions:
1-Subarachnoid hemorrhage (mimics meningitis symptoms, especially neck stiffness and headache)
2-Chemical meningitis (e.g., due to blood in the subarachnoid space)
3-Post-surgical meningitis (after neurosurgical procedures)
4- post lumbar puncture trauma (often causes transient symptoms of meningitis)
Compare between CSF findings in meningitis
1-Bacterial
Appearance: Turbid (cloudy), due to increased white blood cells (WBC)
WBC count: Very high (usually >1,000 cells/µL), predominantly neutrophils (polymorphonuclear cells)
Protein level: Elevated (100–500 mg/dL or higher)
Glucose level: Low (<40 mg/dL, often significantly reduced)
Lactate: Elevated
Gram stain: Often positive, revealing bacteria (e.g., Neisseria meningitidis, Streptococcus pneumoniae)
Compare between CSF findings in meningitis
2- Viral (Aseptic) Meningitis
Appearance: Clear or slightly cloudy
WBC count: Moderately elevated (100–1,000 cells/µL), predominantly lymphocytes
Protein level: Normal to slightly elevated (50–150 mg/dL)
Glucose level: Normal (40–70 mg/dL)
Lactate: Normal or mildly elevated
PCR tests: Positive for viral pathogens (e.g., Enteroviruses, HSV, VZV)
Compare between CSF findings in meningitis
- Tuberculous Meningitis
Appearance: Often turbid, with fibrin webs (due to exudate)
WBC count: Elevated (100–500 cells/µL), predominantly lymphocytes (may have mixed cells)
Protein level: Elevated (100–500 mg/dL)
Glucose level: Low (<40 mg/dL)
Lactate: Elevated
Acid-fast bacilli (AFB): Positive in CSF or positive culture for Mycobacterium tuberculosis
Ziehl-Neelsen stain: Positive for AFB (but may be negative early on)
Compare between CSF findings in meningitis
Fungal (Cryptococcal) Meningitis
Appearance: Clear but may be turbid
WBC count: Elevated (10–200 cells/µL), predominantly lymphocytes
Protein level: Elevated (50–250 mg/dL)
Glucose level: Low (<40 mg/dL)
Lactate: Elevated
India ink stain: Positive for Cryptococcus neoformans (capsule)
Cryptococcal antigen: Positive
الخلاصة في اسباب bacterial
في الاطفال GEL
1-Group B Streptococcus
2-E.coli
3-Listeria
في الكبار
1-Streptococcus pneumoniae (pneumococcal)
2-Neisseria meningitidis (meningococcal)
3-HIB
4-Staph &MRSA
5-TB
Causes of viral meningitis
*Enterovirus
*HSV
*HZV
*Ebv
*CMV
*HIV
*Mumps.
*Arbo virus
Normal ranges
Wbcs 0-5
Glucose 50-75
Ptn up to 40
Pressure up to 200
