jean robert
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A 5 y.o. XY has been irritable for the past 2 days. He has temperature of 39.1 C. A lumbar puncture is performed , and the CSF shows numerous neutrophils, a slightly increased protein level, and decreased glucose concentration. A gram stain of the CSF is most likely to show
a) No organism
b) Gram (+) cocci
c) Gram (– )diplococci
d) Short gram (+) rods
e) Gram (-) bacilli
Edited by jean robert on 01/02/08 - 07:56 PM
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| angel23
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c)gram - diplococci
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| Tiff
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b - Strep Pneumo
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| angel23
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newborns is strep B gp...
1 mth to 18yrs is neisseria meningitidis
18yrs n above is strep pneumoniae
so ans is c)refer goljan
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| arlete
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B
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| new_n_lost
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angel23 wrote:
newborns is strep B gp...
1 mth to 18yrs is neisseria meningitidis
18yrs n above is strep pneumoniae
so ans is c)refer goljan
pg 579 table 25-4
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| Tiff
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Interesting. 
According to the First Aid....
Newborn (0-6 months) = Group B Strep
Children (6 months - 6 years) = Strep Pneumo
6 years to 60 years = N. Meningitides
60 years + = Strep Pneumo
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| Tiff
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Is it a First Aid misprint? Which is a more reliable source? 
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| new_n_lost
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I will rather stick with Pappi than a book with known errors and major mistypes.
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| SILVER
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well it could be a mistype in goljan as well--his recent edition was known for its share of errors.
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| new_n_lost
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silver wrote:
well it could be a mistype in goljan as well--his recent edition was known for its share of errors.
Hmm true but he was courteous enuf to review the book and then post his corrections unlike FA who are known for mistakes year after year.
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| Tiff
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Thanks. guess I gotta be careful with First Aid.
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| jean robert
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Correct answer E
He has acute bacterial meningitis .In his age group, the most common organism is Haemophilus influenzae
-Strep. is more likely to be seen in an Adult.
- N.meningitidis is seen in young adults.
-L. monocytogenes appear sporadically or in epidemics from food poisoning.
- E. coli most often seen in neonates
Robbins Review of pathology. pp296 Question #49 1st edition
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| new_n_lost
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jean robert wrote:
Correct answer E
He has acute bacterial meningitis .In his age group, the most common organism is Haemophilus influenzae
-Strep. is more likely to be seen in an Adult.
- N.meningitidis is seen in young adults.
-L. monocytogenes appear sporadically or in epidemics from food poisoning.
- E. coli most often seen in neonates
Robbins Review of pathology. pp296 Question #49 1st edition
Not Fair Foul Foul Foul  I need a plenty shot cos there is not that mentions H.Inf. as the major pathogen in the Meningeal infections.
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| new_n_lost
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The relative frequency of the various causes of community-acquired bacterial meningitis has changed over the decades. When all cases occurring after the neonatal period are taken into account, the leading cause 20 to 30 years ago was H. influenzae (45 percent), followed by Streptococcus pneumoniae (18 percent) and Neisseria meningitidis (14 percent). By 10 years ago, considerable change had occurred as a result of the immunization of infants with H. influenzae type b protein–polysaccharide conjugate vaccines, reducing the total number of annual cases of H. influenzae type b disease in the United States by 55 percent and the number of cases of H. influenzae meningitis by 94 percent.3 As a consequence, S. pneumoniae became the leading species (47 percent), followed by N. meningitidis (25 percent) and Listeria monocytogenes (8 percent) — a distribution quite similar to that currently seen in the Netherlands. Another change has been an increase in the percentage of adults with bacterial meningitis at large urban hospitals in whom the origin of the disease is nosocomial — about 40 percent, for example, at Massachusetts General Hospital in Boston.
http://content.nejm.org/cgi/content/full/351/18/1...
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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| SILVER
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how can it be hemophilus? ever since the vaccine came, cases of hemophilus meningitis are rarely seen.
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| Tiff
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Wow. I'm really suprised.  especially with a Robbins with a relatively recent copyright.
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| SmokyWaters
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recent copyright doesnt mean the content is recent... it takes a year for the book to be written and then published.. what you see today in books is almost 2-5 years old...
FA is right about this part
I dont consider pappi to be right about this :P
gram positive cocci until age of 6
and then neiseria...
in adolescents is the commonest pathogen
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