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Flashcards in Neuro Infections Deck (28):
1

What is Acute Encephalitis

Infection of the brain parenchyma

2

What does pyogenic meningitis show over the surface of the brain

A thick layer of suppurative exudate covering the leptomeninges

3

What does pyogenic meningitis show microscopically?

Neutrophils in the subarachnoid space

4

How do you diagnose viral meningitis?

Viral stool culture
Throat swab
CSF PCR

5

What is the treatment for viral meningitis?

Supportive as self limiting

6

What viruses can cause Viral Encephalitis?

Herpes simplex
Varicella Zoster
CMV
HIV
Measles

7

What is the treatment for Herpes Simplex and Varicella Zoster?

High dose IV Aciclovir

8

What are clinical features of Encephalitis?

Insidous onset
Meningismus
Stupor, coma
Seizures
Partial paralysis
Confusion, psychosis
Speach/memory issues

9

What are ivestigations for Encephalitis?

LP
EEG
MRI

10

What is found on MRI with Encephalitis?

Inflamed portion of temporal lobe involving uncus and adjacent parahippocampal gyrus, in brightest white

11

What are causes for bacterial meningitis in Neonates?

Listeria
Group B Strep
E.Coli

12

What are causes for bacterial meningitis in Children?

H. Influenza

13

What are causes for bacterial meningitis in ages 10 to 21?

meningicoccal

14

What are causes for bacterial meningitis in over 21's?

Pneumococcal > meningicoccal?

15

What are causes for bacterial meningitis in the elderly?

Pneumococcal > listeria

16

What are risk factors for bacterial meningitis?

Decreased CMI (listeria)
S/P neurosurgery/ open head trauma (Staph + gram -ve rods)
Fracture of cribiform plate (Pneumococcal)

17

What is listeria and what do you use to treat it?

Gram +ve bacilli
IV Ampicillin/Amoxicillin

18

Describe Cryptococcal meningitis?

Fungal
High in HIV
Serum and CSF Cryptococcal antigen
IV AmphotericinB/Flucytosine
Fluconazole

19

What are clinical signs of Bacterial Meningitis?

Fever
Stiff neck
Alteration in consciousness

20

What are signs and symptoms of bacterial meningitis?

Headache
Vomiting
Pyrexia
Neck Stiffness
Photophobia
Lethargy
Confusion
Rash

21

What are differential diagnosis of meningitis?

Encephalitis
Cerebral abscess
Severe sepsis from other source
Subarachnoid haemorrhage
Cerebral tumour

22

What is Aseptic meningitis?

Non-pyogenic bacterial meningitis

23

What is the spinal fluid like in Aseptic Meningitis?

Low number of WBC
Minimally elevated protein
Normal glucose

24

What should be done in all patients with papiloedema or focal neurological signs?

An urgent CT scan

25

What are warning signs?

Depressive conscious level GCS

26

What is tje empirical therapy for bacterial meningitiss?

1. IV Ceftriaxone 2g bd
add IV Ampicillin/Amoxicillin of listeria suspected
2. Penicillin allergy? - chloramphenicol IV with IV Vancomycin
If listeria suspected then give trimoxazole

27

What should be givenalongside the first dose or before the first dose of antibiotics in bacterial meningitis?

Steroids unless post-surgical meningitis

28

What can be given as contact prophylaxis?

600mg Rifampicin
500mg Ciprofloxacin
250mg ceftriaxone