tailieunhanh - Medical Microbiology made memorable - part 4

Các nguyên nhân virus viêm màng não gia đình picornavirus Virus Virus Coxsackie Echo bại liệt Herpes Quai bị đơn Varicella zoster Epstein-Barr lymphocytic choriomeningitis Louping bệnh viêm não Nhật Bản E & W ngựa viêm não HIV | Viral causes of meningitis Bacterial causes of meningitis Virus family Virus Picornavirus Echo Coxsackie Polio Paramyxovirus Mumps Herpesvirus Herpes simplex Varicella zoster Epstein-Barr Arenavirus Lymphocytic choriomeningitis Togavirus Louping ill Japanese encephalitis E W equine encephalitis Retrovirus HIV Bacteria Typical patients Treatment Neisseria meningitidis Strep. pneumoniae Haemophilus influenzae Group B streptococci Coliforms . E. cob Listeria monocytogenes Mycobacterium tuberculosis Coagulase-negative staphylococci Staph. aureus Children and teenagers 2 years and elderly Unvaccinated children 5 years Neonates Penicillin Penicillin ceftriaxone Ceftriaxone Penicillin gentamicin Young middle-aged Isoniazid rifampicin pyrazinamide More common in non-Caucasians CSF shunt in situ Post-neurosurgery Shunt removal or intrathecal antibiotics Flucloxacillin or cephalosporin Infections are not restricted to these groups bSpecific treatment depends on susceptibilities of the isolate CSF findings in meningitis Cells pL Predominant cell type Glucose mmol L Protein g L Pressure Normal 100-200 mmHg 0-5 Lymphocytes Acute bacterial meningitis T 200-10 000 Neutrophils 11 Viral meningitis N or 1 100-1000 Lymphocytes N Tuberculous meningitis N or T 50-500 Lymphocytes 1 1-6 aThe ratio of CSF blood glucose is more important that the absolute level - normal CSF glucose is approximately 60 of blood glucose 39 M E D I C A L MICROBIOLOGY Encephalitis and other nervous system infections Infections occur in the brain encephalitis and brain abscess spinal cord myelitis nerves neuritis or polyneuritis or a combination of these. The nervous system is normally sterile and infections have to traverse either the blood-brain barrier or be directly inoculated Fig. . Unlike meningitis which often recovers without sequelae nervous tissue has poor repair mechanisms and tissue damage leads to long-term sequelae. Encephalitis brain abscess Encephalitis