Meningitis Flashcards
What is the normal number of polymorphs in CSF?
0
Which bacteria causes meningitis in pregnant women?
L. monocytogenes
What is the protein and glucose in bacterial meningitis?
High >1g/dl
Low
What is the empircal abx therapy for bacterial meningitis?
Cetriaxone
Penicillin
In which seasons are viral meningitis most common?
Autumn and summer
Is it normal to have blood in the CSF?
Maybe in the first tube
If in all the tubes - think subarachnoid
When do you give antibiotics in relation to the CT?
Before
What is the most common cause so of encephalitis?
Herpes simplex virus
Which viruses cause viral meningitis?
Enteroviruses - Echo, polio, coxsackie
Which bacteria causes neonatal meningitis?
S. agalacticae
E. coli
What are some cause of aseptic meningitis?
Partially treated bacterial meningitis (when CSF is taken post abx)
Drugs (cotrimoxazole/NSAIDs)
Syphilis (particularly secondary)
Post ictal
How does meningitis present?
Headache, photophobia and neck stiffness
Fever, nausea and vomiting
Rash
(Clear conscious state)
What are the aetiology of bacterial meningitis?
Pneumococcus (most common)
Meningicoccus
L. monocytogenes
S. agalacticae
E. coli
TB
[H influenzae type b]
What is the duration and administration of abx therapy?
3 days minimum
10 days for meningococcal
IV
What does Listeria monocytogenes meningits differ in presentation?
Tends to target brainstem - eye signs, brainstem signs
How does TB meningitis kill people?
Respiratory depression due to invasion of local vessels
Strokes
What is Kernig’s sign?
Raise the leg and there is limitation of hip flexion that is improved by flexing the knee
Why is ancyclovir specific to viral infected cells?
Because a HSV enzyme phosphorylates the first step of activation
What is added to abx in the treatment of bacterial meningitis?
Steroids - dexamethasone
What is the phenotype of meningococcus?
Gram -ve
Intracellular
What is the protein and glucose in viral meningitis?
Both are normal
Where do the bacteria travel to the brain from?
Back of the throat
Secondary to a pneumonia, endocarditis
Cranial osteomyelitis
When is the empirical abx therapy for meningitis altered? How is it changed?
When Pneumococcus is suspected
- GPC seen, otitis media, CSF leak
Switch penicillin to vancomycin, (keep cefrtiaxone)
Add rifampicin if penicllin resistance is confirmed
What is the normal level of lymphocytes in the CSF?
2
How is TB meningitis treated?
Isoniazid
Rifampicin
Pyrazinamide
Ethambutol
