Neuroinfections Flashcards
(26 cards)
The most common causes of community-acquired bacterial meningitis in patients > 60 years are the gram-positive bacteria_____, and the gram-negative bacteria _______
- S. pneumoniae and L. monocytogenes
- H. influenzae and E. coli
Xantochromia is seen in two situations:
- Herpes simplex virus encephalitis
- SAH
What is the empiric treatment for suspected bacterial meningitis in adults and children >1 month?
- Vancomycin + ceftriaxone.If >50 years old, add ampicillin
What is the empiric treatment for suspected bacterial meningitis in adults and children < 1 month?
Ampicillin + cefotaxime
The most common causes of community-acquired bacterial meningitis in patients < 1 month are ______ and _______
Group B Streptococcus
Escherichia coli
The most common causes of community-acquired bacterial meningitis in teenager patients is:
Neisseria meningitidis
CNS infections key words:
- Photophobia, nuchal rigidity:
- Focal neurological deficits:
- Confusion, altered mental status:
- Meningitis
- Brain abscess
- Encephalitis
The presence of RBCs in CSF without a history of trauma is highly suggestive of:
HSV encephalitis
Hypodense ring-enhancing mass lesions in the CT scan of a patient with AIDS:
Toxoplasmosis
When should HAART be initiated in patients with HIV who present with an AIDS-defining illness secondary to lack of anti-retroviral therapy?
2 weeks after initiating treatment of the infection
What is the likely diagnosis in an HIV patient that presents with fever and altered mental status with encapsulated yeast visualized on CSF fungal stain?
Cryptococcal meningoencephalitis
Treatment of Cryptococcal meningitis consists of a joint therapy of ____________followed by maintenance therapy with ___________
Amphotericin B and flucytosine
Fluconazole
Indications for performing a head CT prior to LP in patients with suspected meningitis are summarized in the mnemonic “FAILS:”
- Focal neurological deficit
- Altered mental status
-Immunocompromised/ICP elevated - Lesion in the brain or skin near LP site
- new-onset Seizures.
What are the three most common causes of aseptic meningitis?
Coxsackievirus, echovirus (enteroviruses), HSV-2
What is the most common cause of viral encephalitis?
HSV-1
Waterhouse-Friderichsen syndrome classically follows after disseminated intravascular coagulation (DIC) in young children with________infection
N. meningitidis
People in close contact with an individual with Neisseria meningitidis infection are given prophylactic
rifampin, ciprofloxacin, or ceftriaxone
What is the most common sequelae of bacterial meningitis in children, and what is the appropriate management?
- Hearing loss due to inflammatory damage to CN VIII and the cochlea
- Dexamethasone
Nausea / vomiting, headache, and focal neuro deficits following otitis media is suggestive of
brain abscess
Brain abscesses larger than 2.5 cm or those with signs of increased ICP are managed with:
biopsy and surgical drainage
Which type of meningitis presents with decreased glucose and increased lymphocytes in the CSF?
Fungal / TB meningitis
What types of vaccines are the meningococcal vaccines?
Conjugate polysaccharide and recombinant (subunit)
In neonates with fever, poor feeding, jaundice, and irritability or lethargy, ____- should always be ruled out!
meningitis
What is the diagnosis in an AIDS patient with multiple ring-enhancing lesions in the basal ganglia and subcortical white matter on CT scan or MRI?
Cerebral toxoplasmosis
