Chronic Bacterial Meningoencephalitis Flashcards
What are the 3 causative agents of this kind of infection?
TB, T. Pallidum (Syphilis), and the Borrelia species.
How does TB lead to meningitis?
It can be part of the systemic disease or it can be a silent seeding of the brain through the pulmonary lesions. It might involve the meninges or the brain, and often it might involve both.
What is the most common pattern of TB induced meningitis?
Diffuse meningoencephalitis.
What would a microscopic examination of the subarachnoid space show?
A gelatinous or fibrous exudate often at the base of the brain, obliterating the cisterns and encasing the cranial nerves.
What kind of cells would we find in TB induced meningitis? What about granulomas?
Macrophages, lymphocytes and plasma cells. Granulomas will be seen, with caseous necrosis and giant cells.
What would arteries running through the subarachnoid space show in TB induced meningitis?
Obliterative endarteritis with inflammatory infiltrates in their walls and marked intemal thickening.
What is a “tuberculoma?”
A single or multiple well circumscribed intraparenchymal mass, with a central core of caseous necrosis surrounded by a typical TB granulomatous rxn.
What is the most serious complication of TB induced meningitis?
Arachnoid fibrosis producing hydrocephalus and obliterative endarteritis producing atreial occlusion and infarction of the underlying brain.
Besides M. Tuberculae, what other mycobacterium are AIDS patients susceptible to to cause meningitis?
MAC, Mycobacterium Avium Intercellulaire.
How can Syphilis cause Meningitis?
It’s called Neurosyphilis and it is caused by the 3rd stage of untreated syphilis infection (only 10% of the infected).
How can Lyme disease cause Meningitis?
The disease is called Neuroborreliosis, when the spirochetes invade the brain.
Symptoms of Neuroborreliosis?
Highly variable, might include aseptic meningitis, facial nerve palsies and other polyneuropathies as well as encephalopathy.
