Central Nervous System infections
Microbiology · Topic 6
Source: NMC CBME Curriculum 2024 · Volume I · Microbiology · Topic 6 · combined PDF page 211
Practice questions
- A patient with suspected CNS infection has negative targeted tests, and an uncommon pathogen remains possible. Which diagnostic feature of CSF mNGS is most relevant in this setting?
- In a systematic review of CNS infection case reports using mNGS, how many of the 27 viruses and 19 bacteria identified were reported as detectable by syndromic encephalitis/meningitis panels?
- Why might mNGS be useful when a CNS infection is caused by a bacterium that is difficult to grow?
- Which statement accurately describes the patients in the systematic review of CNS infection case reports using mNGS?
- A diagnostic meta-analysis of CSF presepsin for CNS infection reported pooled sensitivity of 87% and specificity of 67%. Which interpretation is most appropriate?
- Which conclusion best follows from the pooled specificity of 67% for CSF presepsin in the supplied diagnostic meta-analysis?
- Which statement accurately describes the evidence base for CSF presepsin in the supplied meta-analysis?
- A systematic review of linezolid for post-neurosurgical CNS infection included 36 studies. Which description of that evidence base is correct?
- In the systematic review of linezolid for post-neurosurgical CNS infection, which circumstance was most commonly reported as a reason for its use?
- Which safety concern was identified as the most common adverse-event type in the linezolid review of post-neurosurgical CNS infections?
- A meta-analysis comparing vancomycin and linezolid for CNS infections reported clinical cure rates of 84.7% and 79.7%, respectively, with a pooled odds ratio of 1.29 (95% CI 0.55–2.99; p = 0.56). What is the best interpretation?
- In the supplied vancomycin-versus-linezolid meta-analysis, which treatment had the higher pooled adverse drug reaction rate?
- A clinician is considering vancomycin or linezolid for a CNS infection. Which approach best reflects the supplied comparative meta-analysis?
- A patient in Vietnam develops a CNS infection after consuming raw pig products. Which pathogen is specifically associated with this exposure in the supplied regional review?
- Which transmission association is reported for Japanese encephalitis virus in the supplied review of CNS infection aetiologies in Vietnam?
- A work-up for CNS infection in Vietnam is unrevealing for commonly tested pathogens. Which group of organisms does the regional review suggest may merit consideration as possible contributors to unidentified cases?
- A regional review notes that the cause remains unknown in many CNS infection cases. Which interpretation best reflects its discussion of this uncertainty?
- A CAR T-cell recipient with preexisting carbapenem-resistant Klebsiella pneumoniae colonization develops recurrent fever and convulsions despite broad-spectrum coverage. Which finding in the supplied case report established a CNS pathogen diagnosis?
- In the reported carbapenem-resistant Klebsiella CNS infection after CAR T-cell therapy, which treatment approach was associated with microbiological clearance?
- The patient in the CAR T-cell-associated CRE CNS infection report achieved clinical and microbiological clearance of the infection. Which outcome was subsequently reported?
- According to the supplied review, which definition best describes difficult-to-treat resistant Pseudomonas aeruginosa?
- Why does the supplied review describe treatment of DTR Pseudomonas aeruginosa CNS infection as especially challenging?
- Which group of agents is specifically included among the therapeutic options discussed in the supplied review of DTR Pseudomonas CNS infection?
- Which spectrum of CNS pathology was reported in the systematic review of CNS infections identified in autopsies of sudden unexpected deaths in infancy?
- An infant autopsy identifies mild leptomeningeal inflammation in the setting of systemic infection. Which conclusion is most consistent with the supplied systematic review?