Meningitis

Question 1

DIAGNOSTIC TESTING:
In a CSF sample, what results would you see?
——————

Antigen Detection Tests:
What’s one way to detect the bacterial DNA?

How do Latex Agglutination tests work?

Answer 1

• CLOUDY due to presence of ↑Protein, WBCs, and ↓Glucose
• PCR
• Specific Antibodies are bound to latex beads and mixed with the bacteria in the CSF sample - Antibodies bind to antigen on bacteria, causing agglutination (aggregation) of the latex beads

Question 2

CAUSES:
1. Neisseria Meningitidis - What’s the Gram stain? What shape is it? Does it do Haemolysis? Does it have Oxidase activity?

2. Haemophilus Influenzae Type B - What’s the Gram stain? What shape is it? Does it do Haemolysis? Does it have Oxidase activity?
3. Streptococcus Pneumoniae - What’s the Gram stain? What shape is it? Does it do Haemolysis? Does it have Oxidase activity?

In an Elderly patient with Meningitis, which of these bacteria is it most likely to be the cause?

Answer 2

1. Gram-Negative, Diplococci, No Haemolysis, Oxidase activity
2. Gram-Negative, Bacillus, No Haemolysis, No Oxidase activity
3. Gram-Positive, Diplococci, α-Haemolysis, No Oxidase activity
   - Streptococcus Pneumoniae

Question 3

PUBLIC HEALTH:
In terms of notifying public health, what is Meningitis? Why is this necessary?

What is the clinical definition of an Outbreak?

What are the 2 public health measures in place against Meningitis?
→ When can MenB vaccine be given?

Answer 3

• LEGALLY NOTIFIABLE as it’s spread between close contacts and can lead to an outbreak
• 2 confirmed cases with the same serotype within a Defined group (school, uni, workplace) within a 4-week period
• • Prophylaxis with Antibiotics to close contacts e.g. Rifampicin/Ciprofloxacin
  • Vaccination - MenB, C, and Hib part of childhood schedule
  → If born after May 2015