MRCP Revision questions and answers
Causes of meningitis - Acute bacterial - Common in adults:
i) Meningococcus (neisseria meningitidis)
ii) Pneumococcus (strep. pneumoniae)
iii) Haemophilus influenzae
Common in neonates:
i) Group B streptococcus
ii) E. Coli
Rarities (with lymphocytic CSF):
i) Listeria monocytogenes
ii) Leptospirosis
iii) Syphilis
iv) Lyme disease (Borrelia burgdorferi)
Rarities (with polymorphs in CSF):
i) Mycobacterium tuberculosis (acute onset with CSF polymorphs)
ii) Staphylococcus aureus
Causes of meningitis - others - Chronic bacterial
= mycobacterium tuberculosis
Chronic fungal
, MRCP Revision questions and answers
= cryptococcosis (esp. immunosuppressed)
Acute viral
= Mumps
= Enteroviruses (e.g. polio)
= HSV (mainly type 2)
Miscellaneous
= Cysticercal meningitis (chronic, eosinophilic CSF)
= Amoebic meningitis (acute / chronic) - acquired from contaminated water,
access through cribiform plate
Meningitis - pathogen route of access - i) Haematogenous
ii) Skull fracture / direct penetration
iii) Via cribiform plate
iv) Via infected sinuses, mastoids or middle ear
v) Via peripheral nerves
Meningitis - risk factors - i) CSF shunts / dural defects
ii) Spinal procedures
iii) Splenectomy / SCD
Causes of meningitis - Acute bacterial - Common in adults:
i) Meningococcus (neisseria meningitidis)
ii) Pneumococcus (strep. pneumoniae)
iii) Haemophilus influenzae
Common in neonates:
i) Group B streptococcus
ii) E. Coli
Rarities (with lymphocytic CSF):
i) Listeria monocytogenes
ii) Leptospirosis
iii) Syphilis
iv) Lyme disease (Borrelia burgdorferi)
Rarities (with polymorphs in CSF):
i) Mycobacterium tuberculosis (acute onset with CSF polymorphs)
ii) Staphylococcus aureus
Causes of meningitis - others - Chronic bacterial
= mycobacterium tuberculosis
Chronic fungal
, MRCP Revision questions and answers
= cryptococcosis (esp. immunosuppressed)
Acute viral
= Mumps
= Enteroviruses (e.g. polio)
= HSV (mainly type 2)
Miscellaneous
= Cysticercal meningitis (chronic, eosinophilic CSF)
= Amoebic meningitis (acute / chronic) - acquired from contaminated water,
access through cribiform plate
Meningitis - pathogen route of access - i) Haematogenous
ii) Skull fracture / direct penetration
iii) Via cribiform plate
iv) Via infected sinuses, mastoids or middle ear
v) Via peripheral nerves
Meningitis - risk factors - i) CSF shunts / dural defects
ii) Spinal procedures
iii) Splenectomy / SCD
