CNS infections Flashcards
بسم الله الرحمن الرحيم
____________________
modes of spread of infections to CNS
PHDL
Peripheral nerves
Hematogenous
Direct implanatitaon
Local extension
Local extneison from ?
Air sinuses
Infeceted tooth
Otistis media
surgery
Epidural and subdural abscess by?
staph + strept
Direct local spread form ajacent sinusitis or ostero,yleits mays cause
Epidural abscess
Infections from skull or air sinuses may spread to subdural space causing
Subdural empyema
Thrombophlebitis in veins crossing the subdural spave causing ?
Venous occlusion and brain infarction
Gross of CSF oa acute pyogenic menigitis
Increased CSF opened pressure
Turbid
Abundant neurtophlis and proteins decreased glucose
Microscopic aucte pyogenic meningitis
Subarachnoid space filled with Pus Neutrophils And fibrin
With dialted congested BVs
Comlication of pyogenic menigits ?
Septicemia then
Infective endocarditis
Acute adrenal insufficieny
cause water house fridrichsan syndomre with( shock - fever - sever cutanupus heges coma and death )
Local complications of Menigits ?
=Increased ICT causing Dmage to C346 and dipliopia squint and Ptosis
_______________________
=Encephalitis
=Thromobosis of blood vessels infaction
=Meninginal fibrosis occluding foramina of Magendi and Luchka
Causing:
in child : hydocephalus
in adults : Increased ICP and Cranial nerves 346 damage diplopa ptosis and squint
__________________________
2 inflammation+ fibrosis + pressure
Viral septic menigits CSF
Increased “ Lymphocytes”
ptoein normal or moderate elveation
normal glucose
increased pressure
_____________________
Gross and micro in viral menigits
Gross no cc
MIcro : Mild moderate infiltration of leptomenigies with lymphocytes
The Virus is commonly enterovirus
Graulomatous menigitis =
Tubeclosus mengigtis
fungal meningitits
In tubeculosus menigits
Subarachnoid space is filled with ?
Mostly at the …. of the brain obliterating the ,,,,, and encases ,,,,,,,,
Discerte white granules scattered on ………….
Geltainous exudate or fibrinous exudate
________________
Base
Cisterna and CNs
_________________
Leptomenigies
CSF in tubeculosus mingitis
MonoNuclear cells increased
Protein elevation
Glucose moderately odecreases
CSF in tubeculosus mingitis
MonoNuclear cells increased
Protein elevation
Glucose moderately odecreases
Tubercloma= well circumscribe intraparynchymal mass assoicated with ?
TB menigits
Gross of Tuberculosis menigits
Tubeculoma
Well circumscribed
firm
avascular mass
Inside the mass : yellowish cramy caseation + Tuberecle bacilli
Gross of Tuberculosis menigits
Tubeculoma
Well circumscribed
firm
avascular mass
Inside the mass : yellowish creamy caseation + Tuberecle bacilli
Focal suppuarative infection in the brain or subdural space
Brain abscess
Focal suppuarative infection in the brain or subdural space
Brain abscess
by staph sterpt
penmococci
Ecoli
Brain abscess mode of infection
Hematogenous = systemic pyemia = acute bacetrial endocarditis
acute suppureative lung disease
then brain abscess
______
direct implanation
______
Local extension :- from suppurative mastoditis or acuute suppurative otitis media
Common sites of brain abscess
Frontal due to lung infection sinsitis and fraactures
Tempropairetal : due to middle ear disease
Mutliple small abscesss in pyemia
Compare between gross of acute and chronic brain abscess
Acute :
Shaggy irregular wall
Center of pus and liqufiication
Surrounded by area of congestion
__________________
Chronic :
Smooth fibrous wall
Surrounded by reactive gliosis
Clinical manficiations of Brain abscess:-
Progressive fatal defecits
INcreased ICT and progressive ………. that is fatal
Abscess rupture ?VeonM
________
CSF ? WBC?
PROTEIN?
Glucose ?
Herniation
___________
Ventricultis
Meningitis
Venous sinus thrombosis
_____________
WBC++
Protein ++
glucose normal
Viral Encephlaitis Microscopic
-Perivascular and parenchyma Mononuclear cell infiltration
__________________
-Microglia sharing in microglial nodules Neurophagia
HIV on CNS:
Direct effec on nervous system
HIV Patients usually develo
Opportunistic infectios or tumors as …..
Direct injury to brain causing?
Primary CNS lymphoma
_____________________
HIV1 aseptic menigits
HIV1 Meningoencephlatis
Progressive mutlifocal leukoencephlaopathy CAUSED BY? ?
JC VIRUS!
Papovirus
In immunosuppresed with poor prognosis
? Effect of PML
Irregular ill defined destruction of white matter
Virus causes demyleination due to attacking
Oligodendrocytes
Astrocytes
Herpes simplex Viral encephalitis type1 :
age?
Site :
causing?
Children and young adults
Inferior and medial regions of Temporal lobe +orbital gyri
Causing change in Memory mood behavior
_________
Herpes simplex viral encepalitsi type 2 :
aGE?
Menignits in adults
_____________
diffuce encephalitis in neonetas with vaginal birth in women with active HSV genital infections
Cowdry type A intranucelar viral inclusion bodies found in ?
Herpes simplex type 1 viral encephlaitis
HSV type 1 micro ?
Cowdry typue intranuclear viral inclusion bodies
prevascular ingiltration of mononuclear cells
Negri bodies ?
Rabies
representing intracytoplasic eosinophilic inculsions
Fungal encephalitis
cANDIA Albican
Mucro mycosis
aspergillus fumigates
cryptococcus neformans
Mode of fungal infection ?
Heamtogenous !
Direct extension
From siususe as mucormycosis in diabetics
Parastic diseases ?>
Toxo
cystticercosis
amebiasis
Hydatid cysT
_____________
oTHER INFECTION Neurosyphlis + prion accumulation of misfolded proteins resist denaturation by chemical and physical
الحمدلله رب العالمين
