What is the most common cause of bacterial meningitis in infants?
In 2-18 yr-olds?
In those over 60?
infants = group B strep
2-18: Neisseria meninigitidis
adults: streptococcus pneumoniae
over 60: streptococcus pneuminae
How do most cases of bacterial meningitis reach the brain?
nasopharyngeal infection that invades bloodstream and crosses BBB to the subarachnoid space
What are the two major areas a bacterial meningitis can reach the CNS thorugh direct extension?
sinusiits and epidural abscesses
Bacterial meningitis is often preceded with what symptoms?
a short prodromal respiratory illness or sore throat
What should the differential been for the 19 yrold college student in the case?
arbovirus (west nile, eastern equine ancephalitis, rocky mountain spotted)
What is the parimary diagnostic for meningitis?
Where do most cases of neisseria meningitidis occur globally?
the major disease burden is in non-industrialized countries
What are some characteristics of neisseria meningitidis?
What is the classic risk setting for neisseria meningitidis?
dorms, military training camp
True or false: active infection occurs most often in carriers, not newly infected individuals.
false - more often in newly infected (partially why dorms are such an issue - noninfected coming in close contact with carriers)
What is the fatality rate for neisseria meningitidis? Long term complication risk?
20% long term complicaitons
What causes the petechiae seen in 50% of patients with neisseria meningitis?
the endotoxin shedding causes diffuse coagulation
What is the treatment fo rneisseria meningitis?
IV fluids and immediate antibiotics
in ages 2-50 vancomycin and ceftriazone
over 50: ampicillin, vancomycin and ceftrixone (covering for listeria)
Why is neisseria meningitis a reportable disease?
so public health departments can prophylactically treat close contacts
How do you prevent neisseria meningitis?
vaccine with the bivalent and tetravalent vaccines - age 11 to 12 and in at-risk adults
1. A 42 year-old male presents to your office with a fever and headache. He has nuccal rigidity and a fever of 101 degrees. He has an unremarkable past medical history. The most likely bacterial organism causing his illness is:
1. A 50 year-old female presents with a fever and seizure. She has a history of sinus infections. What test should be done before an LP?
Why is C. diff a particular concern for ceftriaxone even though it tpically isn't for beta lactams?
Beta lactams are typically excreted in the urine, but ceftriaxone is unique in that it's also excreted thoruhg the bile, meaning it's present in the GI tract and capable to eliminating normal GI flora
What agar will neisseria meningitidis grow on?