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Neuroscience and NeuroAnatomy > 32 - Infectious Diseases of the CNS > Flashcards

32 - Infectious Diseases of the CNS Flashcards

1
Q

Bacterial Meningitis

A

Most common infection of the CNS

Organisms reach the leptomeninges via hematogenous spread or direct extension

Spinal tap yields cloudy CSF with many PMNs and bacteria may be seen

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2
Q

Bacterial Meningitis - Neonates

A

Group B Strep, E Coli

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3
Q

Bacterial Meningitis - Infants and Children

A

H-Flu

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4
Q

Bacterial Meningitis - Adolescents and young adults

A

N. Meningitidis

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5
Q

Bacterial Meningitis - Elderly

A

Strep Pneumo

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6
Q

Path - Large Thick-walled Vessels

A

Landmark for the leptomeningeal space

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7
Q

Acute meningitis

A

Hella PMNs in the leptomeningeal space

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8
Q

Brain Abscess

A

Second most common CNS infection

Local contiguous spread (sinusitis, otitis, mastoiditis)
Hematogenous (septic emboli from bacterial endocarditis, pulmonary infection, etc)

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9
Q

Stages of Cerebral Abscess Formation

A

Early cerebritis (1 - 3 days)
Late cerebritis (4 - 9 days)
Early capsule formation (10 - 13 days)
Late capsule cofmation (14 days and later)

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10
Q

Early Cerebritis

A

1 - 3 days

Acute inflammation & edema

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11
Q

Late Cerebritis

A

4 - 9 days
+Necrosis
+Macrophages

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12
Q

Early Capsule Formation

A

Fibrous capsule surrounds abscess (which has degenerated to pus)

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13
Q

Cerebral Fungal Infection

A

Often opportunistic in immunocompromised patients
Hematogenous spread from other organs

May produce leptomeningitis, vasculitis, granulomas, or cerebral abscess

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14
Q

Cerebral Fungal Infection - Common Organisms

A

Asbergillus
Mucormycosis
Candida
Cryptococcus

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15
Q

Aspergillus

A 
Opportunistic
Septate hyphae
Acute angle branches
Flowery body
Attacks vasculature
Perivascular inflammation
Massive hemorrhage
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16
Q

Mucormycosis

A

Opportunistic

Nonseptate hyphae

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17
Q

Candida

A

Opportunistic
Budding yeast
Pseudohyphae

18
Q

Cryptococcus

A 
Opportunistic or previously healthy
Budding yeast
Encapsulated
Typically stays in leptomeninges
Extends along virchow robin spaces (projections of leptomeninges cuffing perforating vessels
Polysaccharide capsule (highlighted with mucy carmen stain)
Slippery brain. "Sugar coated brain"
Edema/fluid restricted to leptomeninges and in virchow robin spaces.
19
Q

See something all over the brain?

A

Hematogenous spread!!!!

20
Q

Parasitic Infections - Protozoa

A 
Toxoplasma
Acanthamoeba
Naegieria
Plasmodium (malaria)
Trypanosoma
Trichinella
Toxocara
21
Q

Parasitic Infections - Metazoa

A 
Cysticercosis
Echinococcus
Sparganum
Paragonimus
Schistosoma
Strongyloides
Angiostrongylus
22
Q

Neurocysticercosis

A

Cysts in brain tissue containing organisms

Humans are the definitive host
Tapeworms shed ova that get ingested by pigs
We eat pigs
If we eat the ova from poop, the intermediate stage will invade muscle, eye and brain. HEMATOGENOUS spread

23
Q

CNS Viral Infections - Manifestations

A

“Aseptic” Meningitis
Encephalitis
Meningoencephalitis
Myelitis

24
Q

Stereotypical Tissue Reactions

A 
Inflammatory Cell Infiltrates
Microgliosis
Neuronophagia
Microglial nodules
Astrocytosis
Intracellular inclusion bodies
Neuronal cell degeneration
Cellular and tissue necrosis
25
Q

Rabies - Pathology buzzword

A

Negri bodies
Intraneuronal cytoplasmic inclusions
Brightly eosinophilic
Inside purkinje cells

26
Q

Rabies

A

Transmitted via bite
Virus proliferates at bite site
Transaxial migration into nervous system

Bat bites
Aggression, violence
Photophobia

Vampires come from here.

27
Q

Herpes Encephalitis

A

Neurotropic virus
Hemorrhagic inflammatory partially necrotic legions in medial temporal lobe

Inflammatory lesion, microglial nodules, perivascular lymphocytes

28
Q

Herpes Encephalitis - Path Buzzword

A

Cowdry bodies
intranuclear inclusions
Viral particles growing inside nucleus

29
Q

HIV-1 - Primary Complications

A

HIV encephalitis or AIDS dementia complex
HIV-associated myelopathy (vacuolar myelopathy)
HIV-associated neuropathy (distal sensory neuropathy)
HIV-associated myopathy

30
Q

HIV-1 - Secondary complications (due to immunodeficiency)

A

Opportunistic Infections

Cryptococcosis
Toxoplasmosis
Progressive Multifocal Leukoencephalopathy
Cytomegalovirus Infections

Primary CNS Lymphoma

31
Q

HIV Encephalitis

A

Lymphocytic Encephalitis

Multinucleated giant cells (infected monocytes with multiple nuclei)

32
Q

Toxoplasma

A

Large necrotic lesions
Can sit dormant for years, then flare up when immune system is compromised.
Well circumscribed mass
MRI - Ring-enhancing lesion

33
Q

Differential for Ring-Enhancing Lesion on MRI

A

Glioblastoma
Metastatic Carcinoma
Lymphoma
Toxoplasmosis

34
Q

Toxoplasma - Path Buzz Word

A 
Tissue Cysts (bradyzoites)
Cysts burst with tachyzoites (more active form)
35
Q

JC Virus

A

Progressive Multifocal Leukoencephalopathy

36
Q

JC Virus (PML) - Path Buzz Word

A

Oligodendrocyte infected, gets big and glassy

Astrocytes start to look like astrocytomas

37
Q

Cytomegalovirus Ventriculitis

A

Predilection for ependymal cells
Typically CMV leads to ventriculitis
Microscopically, cells are hugesies!

38
Q

Transmissible Spongiform Encephalopathies - Prion Diseases

A 
Creutzfeldt-Jakob Disease
Gerstmann-Straussier-Scheinker disease
Fetal familial insomnia
Kuru
New Varient CJT (Mad Cow)

Animal Prion Diseases:
Scrapie
Bovine spongiform encephalopathy
Others

39
Q

Creutzfeldt-Jakob Disease

A 
Worldwide incidence of approximately 1 per million
Peak incidence in seventh decade of life
Sporadic (85%)
Familial (15%)
Iatrogenic (Rare)
Rapid progressive dementia
Myoclonus
Ataxia
Usually Fatal
40
Q

Prion Hypothesis

A

PrP is a normal protein present EVERYWHURR
Exists in a healthy alpha helix-rich state
Exists rarely in an unhealthy beta pleated sheet state (more likely to layer like amyloid)
Sporadic cases of switchy switchy through mutation cause folks to be susceptible
Beta pleated sheet serves as a nidus for more to convert

41
Q

Kuru

A 
Rapid progressive disease
myoclonus
ataxia
seizures
death

To honor them, bitches ate the body
Women and children ate the brain
Eating the brain gives you kuru

42
Q

Spongiform encephalopathy - Histo/path

A

Holes in the gray matter. Give spongy appearance.
Holes are INTRACELLULAR spaces.

End stage = Residual astrocytosis with dying neurons around

Neuroscience and NeuroAnatomy (41 decks)

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