Meningitis/Encephalitis Flashcards
Survive Neuro (38 cards)
Define meningitis
infection/inflammation of meninges, subarachnoid space, including brainstem and spinal cord
Define encephalitis
diffuse infection of brain parenchyma
Infection of the spinal cord
Myelitis
Give 2 mechanisms by which the Blood-Brain Barrier protects the brain
- Tight junctions
2. Decreased permeability
What are the main routes of microbial infection to the meninges?
- Haematogenous
- Via the peripheral nerves
- Trauma
- Local extension (traveling between connected areas)
List the mechanisms of nervous system damage
- Inflammation
- Neural glia injury
- Immune-mediated damage
- Via toxins
Which condition is indicated by the symptoms below?
- Fever
- Headache
- Nuchal rigidity
- Photophobia
- Phonophobia
Meningitis
List some possible symptoms of meningitis besides the basic ones
Adults: petechiae on trunk/extremities
Infants: tense/bulging fontanel, high fever, extreme shivering, vomiting/refusing food, diarrhea, difficult to wake, blotchy skin (pale or turning blue), irritable on being picked up, either stiff body with jerky movements or floppy and lifeless, cold hands and feet, irritability from joint pain
Pain on flexion of the hip and knee
Kernig’s sign
an indication of meningitis
Pain in neck and flexion of knees on passive flexion of the neck
Brudzinski’s sign
an indication of meningitis
What is the condition described?
Infection of brain parenchyma and inflammation of meninges
Meningoencephalitis
What is the condition described?
Infection/inflammation of brain parenchyma, meninges, and spinal cord
Encephalomyelitis
What condition is indicated by the following?
Fever, headache, nuchal rigidty, focal neurological deficits
Encephalitis
note that photophobia, and phonophobia are NOT necessarily present
Diagnostics tests for encephalitis and meningitis
CSF analysis (lumbar puncture)
Microscopy (staining)
Culture (bacterial, fungal, blood)
Antigen testing
latex beads coated with a specific antigen/antibody that binds a complementary other.
Positive: grainy look of clumped beads
Negative: white emulsion
Latex Agglutination Test
CSF analysis:
↑↑↑ WBC (neutrophils) ↑↑ protein ↑↑ opening pressure ↓ glucose turbid CSF Gram stain yields results
Pyogenic (Bacterial) Meningitis/Encephalitis
CSF analysis:
↑↑ WBC (lymphocytes) ↑ protein ↑ opening pressure Normal glucose Clear CSF Gram stain yields NO results
Aseptic Meningitis/Encephalitis
CSF analysis:
↑ WBC (lymphocytes) Normal protein (Opening pressure may be contraindicated due to papilloedema) Normal glucose Clear CSF Gram stain yields NO results
Viral Encephalitis
CSF analysis:
↑ WBC (lymphocytes) ↑↑ protein Normal opening pressure ↓ glucose Slightly turgid CSF w/COBWEB CLOT No gram stain Acid fast stain positive
Chronic tuberculosis
List some characteristics of aseptic meningitis
In-tact mental status; Fever, headache, nuchal rigidity; Altered sensorium; NON BLANCHING RASH Possible preceding upper respiratory tract infection
List some causal organisms of aseptic meningitis
Eneteroviruses (poliovirus, coxsackie virus, ECHO virus);
HSV
What is the likely causal organism for the following:
not immunised recent travel outside the US (likely sub-Saharan Africa) mild gastritis/stomach ache flaccid paralysis hyporeflexia aseptic meningitis symptoms and labs
Polio virus
Name the condition described:
not immunised
progressive weakness with pain and ↓ muscle mass
possibly travel outside the US in the past (whether recent or distant)
Postpolio Syndrome
Salk vaccine
For: Poliovirus
Type: killed (sulking emo with skull tee)
Route: IV
Advantages: no risk of vaccine-relate disease; safe for immuno-compromised patients; effective
Disadvantages: requires booster (secretory antibody made); painful; virus can still spread from GI tract
