Chronic and Recurrent Meningitis Flashcards
Common categories of Chronic Meningitis
CAMMP C-Chemical meningitis A-autoimmmune inflammatory disorders M-malignancy M-meningeal infections P-parameningeal infections
Helpful diagnostic test to detect parameningeal infection
Contrast-enhanced CT or MRI to detect parenchymal, subdural, epidural or sinus infection.
Risk factors and systemic manifestations of Mycobacterium tuberculosis
Exposure history: previous tuberculosis illness, immunosuppressive, anti-TNF therapy, or AIDS, young children, fever, meningismus, night sweats, military TB, on X-ray or liver biopsy, stroke due to arthritis
Helpful diagnostic tests for SYPHILIS
CSF VDRL, serum VDRL (or RPR) Fluorescent treponemal antibody-absorbed (FTA) or MHA-TP serum VDRL may be negative in tertiary syphilis
CSF Formula Mycobacterium tuberculosis
Mononuclear cells except PMNs in early infection (commonly <500 WBC/uL)
Low CSF glucose
High protein
Risk factors and Systemic Manifestations for NOCARDIA
Associated brain abscess may be present
Risk factors and Systemic Infections for BRUCELLA
Intake of unpasteurized dairy products, exposure to goats, sheep, cows, fever, arthralgia, myalgia and vertebral osteomyelitis
Helpful diagnostic test or WHIPPLE’S Disease Tropheryma whipplei
Biopsy of small bowel or lymph node; CSF PCR for T. Whipplei
Brain and meningeal biopsy (with PAS stain and EM examination)
Risk factors and Systemic Manifestations
Diarrhea, weight loss, arthralgias, fever, dementia, ataxia, paresis, ophthalmoplegia, oculomasticatory myoclonus
Diagnostic test C. Neoformans and var gatti
India ink or fungal wet mount of CSF (budding yeast)
Blood and urine culture
Antigen detection in CSF
Risk factors and systemic manifestations of C. Neoformans
AIDS and immune suppression
Pigeon exposure for neoformans
Decaying wound exposure for var. gatti;
Skin and other organ involvement due to disseminated infection
Risk factor and systemic manifestations for Coccidiodes immitis
Exposure history- southwestern US
Increased virulence in dark skinned races
Risk factors and systemic manifestations CANDIDA sp.
IV drug abuse Post surgery Prolonged IV therapy Disseminated candidiasis Recent epidural infection
Risk Factors and Systemic Manifestations Sporothrix schenckii
Traumatic inoculation
IV Drug use
Ulcerated skin lesion
Risk factors and systemic manifestation of CYSTICERCOSIS
Usually with multiple cysts in basal meninges and hydrocephalus
Cerebral cysts and muscle calcification
