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Chapter 70. Central Nervous System Infections

Student Questions

A 73-year-old patient with a documented allergy to sulfa agents (bronchoconstriction) should receive which antimicrobial(s) for Listeriosis treatment?

A. Ceftriaxone

B. Ampicillin

C. Gentamicin

D. Vancomycin plus gentamicin

Answer: B

Option A: Incorrect. Ceftriaxone may be used empirically in patients with meningitis, but does not have activity against Listeria.

Option B: Correct. Ampicillin is the drug of choice for Listeria infections. Since it is a penicillin, its use in patients with sulfa allergy is not contraindicated.

Option C: Incorrect. Gentamicin may be used empirically in patients with meningitis, but does not have activity against Listeria.

Option D: Incorrect. Vancomycin plus gentamicin may be used empirically in patients with meningitis, but does not have activity against Listeria.

Which patient would be assumed to be at the highest risk of Listeria meningitis?

A. 4-year-old attending daycare

B. 34-year-old woman with diabetes

C. 78-year-old chemotherapy patient

D. 19-year-old college sophomore

Answer: C

Option A: Incorrect. A 4-year old is not in the age range of those at risk (age > 3 months).

Option B: Incorrect. Pregnancy does not increase risk.

Option C: Correct. Advanced age and immunocompromised state place this patient at risk for Listeriosis.

Option D: Incorrect. Close living quarters commonly associated with college dormitories do not increase risk.

Meningococcal vaccine is recommended in which of the following patients?

A. 2-month-old infant

B. 67-year-old woman with diabetes

C. 5-year-old attending daycare

D. 12-year-old attending public school

Answer: D

Option A: Incorrect. Meningococcal vaccination is not recommended for this age.

Option B: Incorrect. Meningococcal vaccination is not recommended for this age.

Option C: Incorrect. Meningococcal vaccination is not recommended for this age.

Option D: Correct. Meningococcal vaccination is recommended for children aged 11–12 with a booster dose at age 16.

A 24-year-old woman is at 37 weeks gestation and tested positive for group B streptococcus with routine screening. She presents to the labor and delivery floor for ...

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