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ID - Awesome, mening
CSF findings
Question | Answer |
---|---|
High opening pressure | bacterial, increase intracranial pressure |
unilateral paralysis or muscle weakness, with decreased DTRs | West Nile Virus, summer or early fall bitten by a mosquito |
diplopia in meningitis | West Nile Virus - weakened extraocular muscles |
very high protein | TB meningitis |
low glucose | very specific for early bacterial meningitis CSF/serum < 0.4; can also be found in bacterial, viral and TB |
organisms that can cause aseptic meningitis | entero/echo viruses, OKT3 from graft vs host disease medication, NSAIDs, Bactrim, HSV |
blood in tap > than the usual 1000 RBCs to 1 WBC ratio | HSV |
Early PMNs | aseptic meningitis |
headache and olfactory hallucinations | HSV encephalitis |
What organisms do you need to cover for meningitis in a two-month-old? What antibiotics would you treat with? | Baby BEL. GBS, E. coli, Listeria. Treat with ceftriaxone and ampicillin. |
What organisms do you need to cover for meningitis in a teenager? What antibiotics would you treat with? | Teens are hypersensitive HSN. H. influenzae, Streptococcus pneumoniae, Neisseria meningitidis. Treat with ceftriaxone. |
What organisms do you need to cover for meningitis in an elderly person? What antibiotics would you use? | The elderly are senile and watching SNL. Streptococcus pneumoniae, Neisseria meningitidis, Listeria. Treat with vancomycin, ceftriaxone, ampicillin. |
What organisms do you need to cover for meningitis in a patient with head trauma or CNS infection? What antibiotics to treat? | MSG is neurotoxic. MRSA, Streptococcus pneumoniae, gram-negative Pseudomonas. Treated with vancomycin and cefepime. |