Bacterial and Fungal meningitis Flashcards
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S.aglactiae is one of the group ,,,,,, hemolytic streproccoi
Catalas ….. gram ……cocci
Virulence factor is ?
B BETA
catalse - gram +
Virulence factor ?
Polysaccaride capsule
Pathogenisis of diseases of S,aglactae?
It is commensal inermittenr in the vagina of some famels
Acuired by neonates from bith canal casuing :
Nenotatl sepsis
Neontalal menigits
Neonatal Pnemonia
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Predisponsig factors for streptococci infections in neonates?
P2rolonged
Prolonged labor >18 h
Premature labour
Ruptured membreane
Fever at time of labour
Laboratory diagnosis of the S,aglaticae
Samples from CSF and blood
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direct smear gram + cocci in chains
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Cultured in blood agar
B hemolytic complete hemolysis
Special tests for S.aglactiae ?
CAMP test with staphs
Hippurate hydrolysis test
CAMP test show
Special for S.aglagtiace
there is al ine of staphs then you put a prepdndicular line of the suspected organism
if S.alagticae an arrow of hemolysis formed towardsd the line of staphs
Hppurate hydolysis test
Special for s,aglactiae
Hydolsing hippurate converting its color into violet
How to prevent s.aglatiae infections
Screening women pregnant at 35-37 weeks for S.agalctiae by doing vaginal and Rectal cultures if + Pencillin G must be adminsterd at time of deleviery
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Women with Prorlonged labor and premature labor and fever during labor and invasice GBS s.aglacitae befors must also be given Pencillin G
Mention diseases caused by listera monocyogens
Spesis and meningitsi in new born , pregannt women , immunocomprised adults
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Febrile gastroenterirtis
Imp propertis of listeria :
Shor non spore forming gram …..bacilli
In ,,,,,,,And,,,,and,,,,and,,,, trasmitted to humans by contat with,,,,,,,,or theri ,,,,,
Human listrosis is cassued by ,,,,,,,as ,,,,,,,,,,,,,,,(,,,,,,orl,,,,,,,)
an unsual Tumbiling movment at ,,,, not,,,,
gram + bacilli
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Git of animals , plants . water and soil
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animals and theri feces
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listera monocytogens as zoontoic ( sproadic or small epidemic)
22 NOT 37
Type of movement of listera monocyotgens and at which temp appera?
Tumbling movment
at 22 not 37
Both streptococci and listrea casue b ehmolysis how to differentiate ?
by catalase !
Listera of narrow b hemolysis is catalase +
while Streptococci of wide beta hemolysis of catalase -
Cold enhcnement mean in listeria ?
Can relicate in refergated food
The most imp virulence factor for listeria ?
Facultative intracellular parasite
can live inside?
Epithelial
Macrohpages
parenchymal cells
Modes of transmisson of listeria monocytogene
=By unpastuirized milk ,raw meat and vegetables
=Neonate through Tansplacental or During labour
=Contact with domestsic farm animals and their feces
it is food borne dieseas\
Describe pathogenisis of listeria
It colonized in colon and then to Female genital tract from which can invade neonate transplacental if membranes ruptured or during birth
during birth the neonate acquire meningitis and the pathogen reach meninges through blood stream .
It depends on ? The ability to invade and facultative intraculluar survival
Mention virulence factor of listeria
-Facultative intracellular parasite !
Hemolysin (listerolysin O)
making it able to escape from vacuoles of phagmosomes and contiues repulicating insde cytoplasm of the cell.
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C/P of nenontal disease
Early onset disease if tranplacental may cause granulomatous infantiseptica That leads to abscess + granulomas in multiple organ then death
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late onset during leaving birth canal
may cause Meningitis or menigio encephalitis with speis 2-3 weeks
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addition : in immmunocomprised and elderly
Meningits endocarditis speis
Mention one of the leading causes of bacteral meningits in patients with cancer and renal transplants recepients ?
Listeria monocytogens
Listeria is
=intacelluar gram …. rods that occur singlt or in pairs resembling……..
=MOtiel tumbling movment to be differentiated from ,,,,,,
=small grey colonies iwth narrow zone of B hemolysis on blood agar so differentiaed from streptococci by ?
Gram + Diptheriodis
coynebactria
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Catalse test
Prevention of listeria
no immunization
limiting the eposure of pregnants to
Animals
unpasturized milk
raw meat and vegetables
Cryptococcal meningitis is caued by ?
Cryptococcus neformans
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Espeically in AIDS patients
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IT IS divded into 5 serological types ABCD AD according to ? capsular antigen
Mode of transmisson
Inhalation of the organism from the soil contaitng bird droppings no human to human transmission
Pathogenisis of cryptococcal menigits
The inhhlation of the cryptococcus neforamns leading to its phagocytosis in lungs being asymptomatic or Causing Lobar pnemonia then hematogenous spread to the CNS and meiniges Causing menigitis
The ability to produce melanin aids it to evade phagocytic killing
C/P crytpococcal neforamns infection
often asymotomatc but there is anothr word in case of AIDS
CASUING lobar nepmina and hematogenous spread to meingis casusing cryptococcal meninigits
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Subcuatnous nodules may be disseminated
Lab diagnosis ?
=INdian ink stained smear
=or sabourad dextorse agar with mucoid colonies
=Laboratory diagnosis by capsular antigen latex agglutination test in CSF as highly sensitie and specific test
Asperigllius is opportunistic fungus most common species is Aspergillus ,,,,,,,,,
It is ,,,,, and,,,,,,, found on ……and…… and gorws as molds on ………..
IT has,,,,,,,,,,,,,,,,,,,,hyphae and produces sopres on tips of long ………
Fumigatus
saprhopytic opportunistic
soil ,plant
as molds on decaying vegetables
Bracnhcing septatae
Condiophores
Aspergillus is inhaled then Hematogenous to CNS cAUSING ?
mENIGITS cerbtiris and abscess in brain
Aspergiulls can invade blood vessels casuing nercrosis + polymorph nuclear infiltration csauing mycotic aneyrsum and ruptured casing subarachanoid Hge
Subarachanoid Hge appear in ?
why?
Asperigillis due to affecting blood vessels casuing necrosis + Polymorphnucelar infilation casuing mycotic aneyrusms and rupture casuning Hge
Risk factors for aspergillus infecion ??
Immunocompression
Neutropenia nd corticosteriods
Organ transplant recepients
Oncological
Hematological
AIDS
Patients
Pathogenis of aspergilis
enter by inhalation then heamtogenous spread to brain and meninges OR
direct extenrsion from mastoid paranasl sinus and ears to CNS
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mYCO toxins has :
Ceullar killing effect killing astrocyte microglia and neurons
Antiphagoccytin
Mycotoxins of aspegillus cause?
Ceullar killing killing Astrocytes microglia and neuron
Antiphagocytic effect
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hemipareiss dyarthria
KOH show ? in aspergilis
Branching Septate hyphae
Calcflour stain is
Fluorecne micrpscopc test for aspergillis stainign chitin in cell wall of fungi
Isolation of aspetgillus cc ?
most media
romm temp
fluffy white to blue green colony
ANTIGEN DETECED IN ASPETILLUS
GALACTOMANAN
aSPERIGULLUS TREATMETN
Variconazloe
Resection to cerebral lesions
Mucor and Rhizpous specis
are saprohytics found
on Soil , air ,and decaying vegetables
in tropics
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The major clincal form is ?
Rhinocerebral mucormycosis
Mucor and Rhizpous specis
are saprohytics found
on Soil , air ,and decaying vegetables
in tropics
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The major clincal form is ?
Rhinocerebral mucormycosis
other less common formes ?
Cutanuous pulmnary disseaminated
gastrointestinal
occure in patinets with:
Metabolic acidoisa: DKA
HEMATOLOGICAL malignancies
Acute invasine infrection of Paranasla sinus , orbit and nasal cavity involoving facial structures extending to CNS brain and meninges ?
Rhinocerebral mucromycosis
Pathogenisi of Rhinocerebral mucormycosis describe
Inhalations of spores then heamtogenous spread to blood vessles of Nasal paranasal orbital and brain blood vessels the fungal aseptate hyphae invade casuing thrombosis and infarction !
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Preoribtal edema diplopia loss if vision
decreased mental function
KOH and calcoflour revelas white aspetate hyphae in?
Rhinocerebral mucormycosis
Isolatin of mucor and rhizopus growing rapidly on lab media producitng ?
Abundant cottony colonies
Isolatin of mucor and rhizopus growing rapidly on lab media producitng ?
Abundant cottony colonies
Treatment of mucor and rhizpus infextion
Amphotercin B
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