Neurological Infections - CRASH! Medical Review Series

[@calebfredrickson9360]

That "CT" for HSV encephalitis is actually a T2 weighted MRI. MRI is the most sensitive and specific test for HSV encephalitis.

[@g-mannG]

😂

[@DrDinooshDeLivera]

with bilateral temporal lobe enhancement!

[@oatv]

Maybe this was a "recent" update, given that this video is about 5 years old, but (correct me if I'm wrong) the BEST test to diagnose either encephalitis or brain abcess is an MRI, not a CT scan!

[@micaelpompermayer9548]

Last semester I had Radiology and the latest "update" is, indeed, MRI.

[@xDomglmao]

@@micaelpompermayer9548 Thank you very much!

[@cate2552]

The slide for Encephalitis is incorrect: the treatment that you outlined would be for close contacts of individuals with bacterial meningitis. "For contacts of patients with H influenzae meningitis, the chemoprophylactic agent of choice is rifampin at a dosage of 10 mg/kg twice a day (maximum, 1200 mg/d) for 4 days. For contacts of patients with N meningitidis meningitis, rifampin is also used, but the duration of therapy is only 2 days. An alternative to rifampin for adult contacts of patients with meningococcal meningitis is a single 500-mg dose of ciprofloxacin"

[@neigeepierrot4694]

Cate LePree good catch good to know

[@xDomglmao]

Thx Cate!

[@myradelarosa1467]

Thank you so much Dr. Paul... i just have one correction..in treatment for TB Meningitis..aside from isoniazid, rifampicin....the 3rd one is pyrazinamide in quadruple Anti-Tb...not pyramethamine. Thank you!

[@Bnrar55]

And fourth being ethambutol...

[@isaacvidal2777]

Dexamethasone may be beneficial in S. pneumoniae or H. influenzae meningitis, if given 15-20 mins before antibiotics.

[@neigeepierrot4694]

Very informative also good job adding additional facts and details

[@James-2248]

Not even a med student, but I’m learning so much

[@silee526]

Thank you Dr. Bolin

[@kirubakaran09stanley]

Concise lecture ... Really easy to understand

[@DrDinooshDeLivera]

Thank you Dr Bolin, really great lectures!

[@jewelryinvegas]

An excellent video as usual Dr. Bolin and extremely helpful to me in my nurse practitioner courses. I do have a question about when to start the empiric antibiotics because you said initially that the antibiotics should be started immediately and then later mentioned that we should wait until we get the results of the CSF cultures. I believe that you were correct in your first statement that the empiric antibiotics should be started as soon as the LP is done without waiting for the results, and then begin specific antibiotics after we get the results. Which one is correct?

[@owensogbeiwi3526]

jewelryinvegas

[@21stcenturyoptimist]

You begin after LP.

[@isaacvidal2777]

Antibiotics may be given empirically up to 2 hours before and LP.

[@xDomglmao]

this might help (from meded [note: for USMLE purposes]): "LP first; if LP fails: 1. Blood cultures first (this is a MKSAP teaching point)

[@poohthetabby664]

Hello Dr Paul, you did mention that close contact people with Viral Encephalitis should be treated prophylactically with Ciprofloxacin or Rifampin which are antibiotics rather than Antivirals? Is there a reason behind that? I did'nt happen to find anything online on this so waiting for your response here. Btw love your channel :)

[@sbadrawi2011a]

He did mention that he does not know why and that "that's the way things are!" So, for test purposes go with the antibiotics.

[@doctorshakeel9442]

Bacteria can invade the pre existing viral encephalistis and is a high risk for Meningism.. So prophylactic Antibiotics should be given in such patients

[@claire5399]

Cipro . Yikes

[@MrHaloman3]

Thanks a ton.

[@Daniel-rk2qz]

If presumptive dx of toxo, do you still get brain bx?

[@sbadrawi2011a]

No. HIV + abscess = Toxoplasmosis (for test purposes). Treat Toxoplasmosis and if no improvement or symptoms worsen then we think about bx.

[@zimymyss233]

tb meningitis is common in India,neuro syphilis is common in India again cerebral malaria common in India, amoeboma. In the brain tuberculoma in the brain all are not rare in india

[@davidwarmflash5329]

Lyme disease, not Lyme's d. It's the name of a city.

[@dinooshd]

:D