Meningitis Overview and Risk Factors
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Questions and Answers

What condition may result from broken tight junctions in the retina?

  • Increased intracranial pressure
  • Persistent inflammation
  • Nephritis
  • Meningitis (correct)

What is a common route by which organisms can enter cerebrospinal fluid (CSF)?

  • Intravenous drug use
  • Contamination during lumbar puncture
  • Contagious spread from neighboring anatomical structures (correct)
  • Direct exposure to the outside environment

Which of the following is NOT a symptom associated with meningitis?

  • Nausea/vomiting
  • Confusion
  • Increased appetite (correct)
  • Photophobia

Which sign indicates a high suspicion of meningitis?

<p>Kerning's Sign (C)</p> Signup and view all the answers

What finding in CSF is suggestive of meningitis?

<p>Decreased glucose levels (D)</p> Signup and view all the answers

Which clinical manifestation is most closely associated with increased intracranial pressure?

<p>Seizures (A)</p> Signup and view all the answers

What is an important method for diagnosing potential meningitis?

<p>Lumbar puncture (D)</p> Signup and view all the answers

What immediate action is recommended if signs of meningitis are present?

<p>Treat with broad-spectrum antibiotics (B)</p> Signup and view all the answers

What condition should be ruled out if decreased glucose levels are found in the CSF?

<p>Fungal infection (A)</p> Signup and view all the answers

Which of the following may lead to a poor prognosis for a patient with suspected meningitis?

<p>Presence of neurologic deficit (B)</p> Signup and view all the answers

Which bacteria is the most common cause of bacterial meningitis?

<p>Streptococcus pneumoniae (A)</p> Signup and view all the answers

What role does the spleen play in preventing infections related to meningitis?

<p>It helps produce white blood cells and immunoglobulins. (D)</p> Signup and view all the answers

What is a key complication associated with cirrhosis in patients with alcohol use disorder?

<p>Diminished liver function (B)</p> Signup and view all the answers

What can be a consequence of using a ventriculoperitoneal (VP) shunt?

<p>Decreased risk of hydrocephalus (B)</p> Signup and view all the answers

Which virus is NOT commonly associated with viral meningitis?

<p>Bacillus anthracis (C)</p> Signup and view all the answers

What symptom is commonly associated with Acanthamoeba keratitis?

<p>Severe pain in the cornea (A)</p> Signup and view all the answers

What is the impact of IV drug use on the risk of acquiring infections?

<p>It contributes significantly to infection acquisition. (B)</p> Signup and view all the answers

What is a common method through which leptospirosis enters the body?

<p>Small wounds in contact with contaminated water (D)</p> Signup and view all the answers

What type of infection can Cryptococcus neoformans cause?

<p>Fungal meningitis (C)</p> Signup and view all the answers

What condition increases the risk of thrombosis in the meninges?

<p>Sickle cell anemia (C)</p> Signup and view all the answers

What diagnostic test is indicated for suspected viral meningitis?

<p>Multiplex and specific PCRs (B)</p> Signup and view all the answers

Which of the following best differentiates encephalitis from meningitis?

<p>Absence of meningeal symptoms (B)</p> Signup and view all the answers

In patients older than 50 years, which antibiotic combination is recommended for bacterial meningitis treatment?

<p>Vancomycin + Ampicillin + Cefotaxime (C)</p> Signup and view all the answers

Which imaging modality is best for detecting focal brain lesions?

<p>CT imaging (B)</p> Signup and view all the answers

What is a primary treatment for non-bacterial meningitis caused by fungal infection?

<p>Amphotericin B IV + Flucytosine PO (A)</p> Signup and view all the answers

What sign is commonly associated with increased intracranial pressure in meningitis?

<p>Papilledema (A)</p> Signup and view all the answers

What is the most common cause of encephalitis?

<p>Herpes Simplex Virus (HSV1) (A)</p> Signup and view all the answers

What change is observed in the CSF when using a contrast agent for imaging?

<p>Change in color due to the contrast (D)</p> Signup and view all the answers

Which condition presents with nausea and vomiting as common symptoms?

<p>Bacterial meningitis (B)</p> Signup and view all the answers

What type of virus is the leading cause of encephalitis?

<p>Virus (D)</p> Signup and view all the answers

What are the three major signs indicative of meningitis?

<p>Severe headache, fever, and stiff neck (D)</p> Signup and view all the answers

Which of the following is NOT a common risk factor for developing meningitis?

<p>Living in rural areas (B)</p> Signup and view all the answers

What is the most common cause of meningitis?

<p>Bacteria (B)</p> Signup and view all the answers

What condition must be ruled out before performing a lumbar puncture?

<p>Intracranial hypertension (B)</p> Signup and view all the answers

Which of the following signifies a potential sign of increased intracranial pressure?

<p>Projectile vomiting (D)</p> Signup and view all the answers

What role does vaccination play in the risk of meningitis?

<p>It reduces the risk significantly (B)</p> Signup and view all the answers

Which of the following age groups is at the highest risk for meningitis?

<p>Infants under 5 years and seniors over 65 (C)</p> Signup and view all the answers

Why are immunosuppressed individuals at higher risk for meningitis?

<p>They have weakened immune systems (D)</p> Signup and view all the answers

What is the definition of meningitis?

<p>Inflammation of the meninges (B)</p> Signup and view all the answers

What type of living conditions can increase the risk of meningitis?

<p>Crowded conditions (C)</p> Signup and view all the answers

Flashcards

Meningitis Definition

Inflammation of the meninges (dura mater, arachnoid, pia mater), lining the brain and spinal cord.

Meningitis Risk Factors

Factors increasing the chance of getting meningitis include chronic medical conditions, age extremes (under 5 or over 65), undervaccination, immunosuppression, crowded living, and exposure to endemic areas .

Meningitis Symptoms

Common signs include stiff neck, severe headache, fever, and potentially projectile vomiting and delirium (increased intracranial pressure).

Meningitis Causes (Common)

Bacteria and viruses are the most frequent causes of meningitis.

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Meningitis Risk (Immunocompromised)

Individuals with weakened immune systems, like transplant recipients or those with AIDS, have significantly higher risk of meningitis.

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Meningitis Diagnosis

Meningitis diagnosis often involves a lumbar puncture to collect cerebrospinal fluid for analysis.

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Meningitis Treatment

Treatment for meningitis varies based on the cause and can include antibiotics and antiviral medications. It's important to emphasize that this is a life-threatening disease.

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Meningitis - Important Considerations

Meningitis is a serious potentially life threatening condition.

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Meningitis signs of increased intracranial pressure

Signs of increased intracranial pressure, in addition to typical meningitis signs, include projectile vomiting and delirium.

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Meningitis Risk factor (Vaccines)

Under-vaccination significantly increases vulnerability to meningitis.

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Lyme disease vector

Ticks transmit Lyme disease, often from deer.

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Meningitis vector

Mosquitoes are a common vector for meningitis.

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Alcohol use disorder and Liver

Alcohol abuse can damage the liver, worsening existing conditions like cirrhosis.

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VP shunt function

A ventriculoperitoneal (VP) shunt reduces excess cerebrospinal fluid (CSF) production or flow obstructions (hydrocephalus).

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Bacterial endocarditis

Bacterial endocarditis is spread through the bloodstream (hematogenous).

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Meningitis most common causes

Bacterial infections are the most common causes, with Streptococcus pneumonia being the most frequent organism.

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Viral meningitis common cause

Enteroviruses are a frequent cause of viral meningitis.

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Fungal meningitis causes

Cryptococcus neoformans, Coccidioides, are possible fungal causes of meningitis.

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Hematogeous seeding

Bacteria enter the bloodstream from the nasopharynx, reach the brain and cause inflammation.

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Splenectomy affect on Meningitis

Removal of the spleen increases the risk of infection due to its role in immune function.

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Meningitis signs

Increased intracranial pressure, altered mental status, neurological deficit, seizures

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CSF glucose decrease

Sign of possible fungal infection.

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Meningitis transmission

Direct contagious spread of organisms entering CSF through neighboring anatomic structures (e.g., otitis media, sinusitis), foreign objects, surgical procedures. Also, retrograde transmission along neuronal pathways or hematogenous seeding (via blood).

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Tight junctions

Cellular barriers that can be broken, leading to inflammation and bacterial invasion.

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Kerning's sign

Inability to straighten the leg at 90 degrees, strongly indicating meningitis.

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CSF

Cerebrospinal fluid.

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Lumbar puncture

Procedure to collect CSF for diagnostic analysis.

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Poor prognosis

Unfavorable anticipated outcome due to delaying treatment in case of meningitis.

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Meningitis CSF Glucose

Cerebrospinal fluid (CSF) glucose levels are decreased in meningitis caused by severe white blood cell (WBC) elevation. This is a sign of bacterial meningitis.

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Meningitis CSF Culture

A CSF culture identifies the specific pathogen causing meningitis.

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Meningitis Diagnosis: Encephalitis vs. Abscess

Meningitis inflammation is primarily in the meninges, while encephalitis affects the brain tissue (parenchyma) and abscesses are localized lesions in the parenchyma.

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Meningitis Imaging: CT & MRI

CT and MRI scans are used to visualize inflammation and abnormalities in the brain and meninges.

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Meningitis Contrast Enhancement

Contrast dye in CT or MRI highlights inflamed meninges, appearing thicker and white.

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Meningitis Contrast Dye Contraindication

Gallodium, a common contrast dye, is contraindicated for patients taking metformin. Metformin must be stopped for at least 3 days before the scan.

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Meningitis Blood Culture

Blood culture helps identify the pathogen causing meningitis, especially in cases of bacteremia.

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Meningitis: Viral Treatment

Viral meningitis is treated with antiviral medications like acyclovir (IV).

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Meningitis: Fungal Treatment

Fungal meningitis is treated with antifungal drugs like amphotericin B (IV) and flucytosine (PO).

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Meningitis: Bacterial Treatment

Bacterial meningitis treatment includes antibiotics. The specific antibiotic regimen depends on age and potential risk factors.

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Study Notes

Meningitis Overview

  • Meningitis is an inflammation of the meninges (protective membranes surrounding the brain and spinal cord)
  • Millions of cases happen worldwide despite vaccinations, diagnoses, and treatments
  • Three main symptoms: stiff neck, severe headache, and fever. Increased intracranial pressure can cause projectile vomiting and delirium.
  • Life-threatening
  • Risk of death in patients who acquire meningitis.
  • Common causes: bacteria (most common), viruses, fungi, and parasites. Less common causes include autoimmune disorders triggered by corticosteroid use

Risk Factors

  • Chronic medical conditions (kidney failure, diabetes, adrenal insufficiency, cystic fibrosis)
  • Extremes of age (young children and those over 65)
  • Immunocompromised individuals
  • Undervaccinated people, especially children
  • Individuals who do not receive recommended vaccinations.
  • Lumbar puncture (spinal tap) is done for those not vaccinated.
  • Those with immunosuppressive conditions (e.g., AIDS, organ transplant recipients) have the highest risk
  • Living in crowded conditions (military barracks, college dorms), and travel to endemic areas

Bacterial Meningitis

  • Streptococcus pneumoniae (50-60%)
  • Group B Streptococcus
  • Neisseria meningitidis (14-37%)
  • Hemophilus influenzae (3-4%)
  • Listeria monocytogenes (4-11%)

Viral Meningitis

  • Enteroviruses (85%)
  • Herpes viruses
  • Other viruses (e.g., mumps, measles, HIV)

Fungal Meningitis

  • Cryptococcus neoformans
  • Coccidioides
  • Aspergillus
  • Candida
  • Mucormycosis (associated with prolonged corticosteroid use, especially in diabetics/transplant recipients)

Parasitic Meningitis

  • Naegleria fowleri
  • Acanthamoeba species (often linked to freshwater exposure)

Pathophysiology

  • Bacteria gain entry to the nasopharynx and bloodstream, cross the blood-brain barrier, and trigger inflammation and immune response. They may spread directly to the meninges.
  • Inflammation spreads through the cerebrospinal fluid.
  • Can be caused by medical devices/surgical procedures, otitis media/sinuses.
  • Direct spread or spread by neighboring structures that have infection.
  • Viruses and bacteria can spread via the blood or by traveling through nerves.

Symptoms

  • Fever
  • Neck pain/stiffness
  • Headache
  • Photophobia (sensitivity to light)
  • Dizziness
  • Confusion /delirium
  • Nausea and vomiting
  • Irritability
  • Altered mental state
  • Seizures
  • Neurologic deficits.

Diagnosis

  • CSF (cerebrospinal fluid) analysis is crucial
  • Appearance (Turbid/Clear), pressure, WBC count, protein, glucose

Treatment

  • Antibiotics (bacterial meningitis)
  • Antivirals (viral meningitis)
  • Antifungals (fungal meningitis)

Complications

  • Brain damage
  • Death

Meningitis vs. Encephalitis

  • Meningitis involves the meninges (membranes surrounding the brain and spinal cord)
  • Encephalitis directly involves inflammation of the brain tissue itself
  • Meningitis often has more prominent meningeal symptoms (like stiff neck)

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Description

This quiz provides an overview of meningitis, including its causes, symptoms, and risk factors. Learn about the importance of vaccinations and the potential complications associated with this life-threatening condition. Test your knowledge on the key aspects of meningitis and its impact on various populations.

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