CNS infections 10.9 lec

Question 1

Bacterial meningitis in neonates

Answer 1

strep B and E coli via vaginal canal
poor feeding, diarrhea, irritability, nuchal rigidity
treat quickly, even if treat long term complications possible (mental retard, epilep, hydrocephalus, deafness, blindness)

Question 2

Bacterial meningitis in children

Answer 2

N meningitidis (meningococcus); H influenzae

Question 3

Bacterial meningitis in adults

Answer 3

Strep pneumo (50%), meningococcus

Question 4

herpes encephalitis

Answer 4

• need to recognize immediately
• acute phase - congestion and hemorrhagic necrosis in temporal lobes, may look normal at first few weeks later liquefactive necrosis –> cavitation and atrophy, slightly hypereosinophilic cytoplasm and may have eosinophilic inclusions and marginated chromatin
• chronic - in survivors, affected parts shrunken and cavitated; marked atrophy and yellow-born discoloration impact temporal lobes and insula

Question 5

Progressive Multifocal Leukoencephalopathy (PML)

Answer 5

• caused by JC virus
• usu asx in humans
• latent in kidney and B cells in tonsils of most adults and brains of some
• w/ impaired immunity (HIV & organ txp recipients, etc) –> reactiv w/in CNS or in peripheral tissue
• focal neuro deficits - dysarthria, limb weakness, visual disturbances, ataxia, personality change, occasionally seizures
• attacks oligodendrocytes

Question 6

cryptococcosis

Answer 6

• fairly common worldwide
• spherical budding yeast
• at one point an AIDS defining organism