Meningitis, encephalitis

Question 1

Common causes of meningitis in newborns

Answer 1

• Group B strep
• Strep pneumonia
• Listeria
• E Coli

Question 2

Common causes of meningitis in babies and children

Answer 2

• Group B strep
• Strep pneumonia
• Neisseria meningitidis
• Hib

Question 3

Common causes of meningitis in teens

Answer 3

• Neisseria meningitidis

- Strep pneumonia

Question 4

Common causes of meningitis in elderly

Answer 4

• Neisseria meningitidis
• Group B Strep
• Strep pneumonia
• Listeria
• Hib

Question 5

Common causes of meningitis in immunocompromised

Answer 5

• Mycobacterium TB
• Listeria
• Fungal

Question 6

Contraindications to lumbar puncture

Answer 6

• Raised ICP
• Infection over needle site
• Clotting problems

Question 7

How to confirm raised ICP before performing a LP

Answer 7

CT head

Question 8

Signs of raised ICP

Answer 8

• intense headache, worse on lying flat
• papilloedema
• focal neurology
• decreased GCS
• seizures

Question 9

3 components of Cushing’s reflex

Answer 9

1. High BP
2. Bradycardia
3. Irregular breathing

Question 10

Why does raised ICP cause Cushing’s reflex

Answer 10

1. raised ICP activates sympathetic response –> artery constriction –> high BP
2. Baroreceptors detect high BP –> bradycardia
3. Raised ICP increases pressure on brainstem –> brainstem controls involuntary breathing –> irregular breathing

Question 11

How to tell difference between meningitis and encephalitis

Answer 11

• encephalitis has milder fever, headache
• encephalitis has seizures more often
• encephalitis has behaviour change (not meningitis)
• encephalitis has focal neuro deficits eg speech change

Question 12

What a/b is given for suspected meningitis

Answer 12

Ceftriaxone 2g stat

Question 13

What a/b is given for confirmed meningitis

Answer 13

Benzylpenicillin (in community)

or

Ceftriaxone

Question 14

What antiviral is given for encephalitis

Answer 14

Aciclovir