Term
| What is the symptom that must be present to assume encephalitis |
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Definition
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Term
| What are the the most common organisms for children <2, 2-18 yr olds, and 19-59 yr olds? |
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Definition
Children <2: GBS
2-18yr olds: Nesseria Meningitidis
19-59 yr olds: Strep Pneumo |
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Term
| What organism is the most common cause of bacterial meningitis? |
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Definition
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Term
| What populations are typuically affected by listeria monocytogenes |
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Definition
Neonates, Elderly, or Immunosurpressed
Systemic Diseases or Organ Failure
(Diabetes, Malignancy, Alcoholism, Hepatic/Renal Disease, Collagen-Vascular) |
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Term
| What is the difference in the presentation of early vs late-onset GBS Meningitis |
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Definition
Early onset usuall presents with septicemia, respiratory distress, and meningitis in premature babies
Late onset presents like classic meningitis |
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Term
| What is the major risk factor for recurrent Nesseria meningitidis meningitis? |
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Definition
| Terminal Complement Deficiencies |
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Term
| What are the most common causes of bacterial meningitis |
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Definition
Streptococcus pneumoniae
Nesseria Meningitidis
Group B Strep
Listeria Monocytogenes
Haemophilus Influenzae |
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Term
| Which of the common bacteria meningitis agents presents with concurrent focal infections(pneumonia, Otitis media) |
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Definition
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Term
| What are the common bacteria organisms that cause meningitis after a neurosurgical procedure? |
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Definition
Gram Negative Aerobes
Staphylococci |
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Term
| What is the typical presentation of Bacterial meningitis |
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Definition
Fever, headache, stiff neck
Progression to Loss of consciousness and confusion |
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Term
| What are the symtoms and major signs of bacterial meningitis |
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Definition
Fever
Meningismus
Kernig's Sign: flex head in supine-Flexing knee and hip is positive
Brudzinski's sign: Supine position with flexed knee and hip and try to involuntarily extend both-Positive is resistance |
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Term
| What is the typical appearance of CSF fluid in bacterial meningitis and how does viral meningitis differ? |
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Definition
Cloudy
Low Glucose
High Protein
WBCs mostly PMNs
High Pressure
Viral: WBCs mostly lymphocytes,Normal glucose, less pressure
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Term
| What is the typical analysis when bacterial meningitis is suspected |
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Definition
CSF: Glucose, Protein, Pressure, Culture, Gram stain, WBC
Blood Culture
Radiologic
Bacteria Antigen Test only if gram stain is negative and patient is on Anti-biotics |
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Term
| How is the manifestation of viral meningitis different than bacterial meningitis? |
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Definition
| Viral has a slower onset with milder intensity |
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Term
| What are the major causes of viral meningitis/encephalitis and which will show more severe alteration in consciousness |
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Definition
Enteroviruses
Arboviruses
HSV type I: Mainly causes encephalitis; most severe. |
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Term
| In what type of presentation should you suspect cryptococcus meningitis |
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Definition
| Insidious onset of headache and fever in an immunosupressed patient(typically AIDS) |
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Term
| What testing usually needed to make a diagnosis of tuberculous meningitis |
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Definition
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Term
| What are the common causes of Chemical meningitis? |
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Definition
Trimethoprim/ Sulfamethoxazole
Spinal Anesthesia
Myelogram
NSAIDS |
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Term
| When should a LP be withheld until after head imaging |
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Definition
| If a focal lesion is suspected in the brain |
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Term
| What drugs are used as empiric therapy for bacterial meningitis and why? |
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Definition
3rd Gen Cephalosporin: For the common bugs
Vancomycin: For Strep pneumo resistance
Ampicillin: If young, old or immunosuppressed(listeria)
Dexamethasone: Reduce inflammation and scarring of the meninges |
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