Flashcards in peds83 Deck (24):
why would you give steroids with antibiotics to treat meningitis?
before or with first dose of abx; effectively reduce hearing loss in HIB meningitis
complications of meningitis
hearing loss is most common (up to 25% of patients); global brain injury occurs in 5-10%; SIADH, seizures, hydrocephalus; brain abscess, CN palsy; learning disability; and focal neuro defects
CSF in acute bacterial infection
high protein, low glucose
CSF in viral meningitis
normal to high protein, normal glucose
tuberculosis meningitis- CSF
lymphocytes predom (as opposed to PMNs in bacterial); very high protein; very low glucose
CSF in fungal meningitis
lymphocytes predom; normal to high protein; low glucose
CSF in parameningeal focus (brain abscess)
polys or monos predom; high protein; low glucose; CSF culture neg
inflamm of the meninges with CSF lymphocyte pleocytosis; can be caused by virus (most common) or TB
classic finding on brain imaging for TB meningitis
acid fast stains in TB meningitis?
most common cause of aseptic meningitis
most common cause of viral meningitis
enteroviruses, mumps, lymphocytic choriomeningitis, herpes viruses (EBV, CMV, VZV)
viruses that commonly cause encephalitis and meningitis together
arboviruses (St louis, Western equine, Eastern equine, west nile virus), influenza, herpes virus
bacterial causes of ASEPTIC meningitis
mycobacterim tuberculosis; borrelia burgdorferi (lyme dz); treponema pallidum(syphilis)
fungal causes of aseptic meningitis
coccidioides immitis, crypto, histoplasmosis
parasitic causes of aseptic meningitis
taenia solium, toxoplasma gondii
management of viral meningitis
management of TB meningitis
four meds: rifampin, pyrazinamide, isoniazid, and streptomycin; corticosteroids are also commonly used
which cause of aseptic meningitis has the worst prognosis?
TB; it has a 20% mortality in kids
common viruses that cause the common cold
rhinovirus, parainfluenza, coronavirus, and RSV
URI sx for how long should prompt the physician to evaluate for bacterial superinfection?
greater than 10 days
when do sinuses develop?
ethmoid and maxillary present at birth; sphenoid develop between ages 3 and 5 yo; frontal between 7 and 10 yo
how is sinusitis classified?
acute, subacute, and chronic based on the duration of symptoms