CNS Infections

Migraine pain is due to vasodilation vasoconstriction( vasodilation, vasoconstriction ) whereas headache pain is due to vasoconstriction vasodilation( vasoconstriction, vasodilation )

Streptococcus Pneumoniae are gram positive negative( positive, negative ) cocci that are arranged in pairs in threes as single, unbound cocci( in pairs, in threes, as single, unbound cocci )

Neisseria Meningitidis are intracellular extracellular( intracellular, extracellular ) gram negative positive( negative, positive ) cocci bacilli( cocci, bacilli ).

Give steroids to all patients with suspected pyogenic meningitis aseptic meningitis encephalitis( pyogenic meningitis, aseptic meningitis, encephalitis ) before or with the first dose of antibiotics then every 6 hours for 4 days.

The contact prophylaxis regimen for those exposed to an individual with meningitis is 500mg ciprofloxacin ceftriaxone co-amoxiclav( ciprofloxacin, ceftriaxone, co-amoxiclav ) orally as a single dose for all adults and children over 12.

Typical CSF Findings:
Viral Meningitis - Protein levels normal high low( normal, high, low ), glucose level normal high low( normal, high, low )
Bacterial Meningitis - Protein levels high normal low( high, normal, low ), glucose level low high normal( low, high, normal )

The most common cause of viral meningitis is enteroviruses herpes simplex virus( enteroviruses, herpes simplex virus ) and this typically affects children. Herpes simplex virus Enteroviruses( Herpes simplex virus, Enteroviruses ) on the other hand is less common and typically causes viral meningitis in adolescents and adults.

Herpes Simplex Virus Enteroviruses( Herpes Simplex Virus, Enteroviruses ) is the most common cause of Encephalitis and has an overall worse better( worse, better ) prognosis than viral meningitis

Treatment of Viral Meningitis by causative organism:
Human Enterovirus: Supportive Treatment Only Aciclovir Ganciclovir( Supportive Treatment Only, Aciclovir, Ganciclovir )
Herpes Simplex/Zoster: Aciclovir Supportive Treatment Only Ganciclovir( Aciclovir, Supportive Treatment Only, Ganciclovir )
Cytomegalovirus: Ganciclovir Supportive Treatment Only Aciclovir( Ganciclovir, Supportive Treatment Only, Aciclovir )