CNS infections Flashcards by Omar Gazar

بسم الله الرحمن الرحيم
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modes of spread of infections to CNS

PHDL
Peripheral nerves
Hematogenous
Direct implanatitaon
Local extension

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Local extneison from ?

Air sinuses
Infeceted tooth
Otistis media
surgery

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Epidural and subdural abscess by?

staph + strept

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Direct local spread form ajacent sinusitis or ostero,yleits mays cause

Epidural abscess

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Infections from skull or air sinuses may spread to subdural space causing

Subdural empyema

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Thrombophlebitis in veins crossing the subdural spave causing ?

Venous occlusion and brain infarction

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Gross of CSF oa acute pyogenic menigitis

Increased CSF opened pressure
Turbid
Abundant neurtophlis and proteins decreased glucose

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Microscopic aucte pyogenic meningitis

Subarachnoid space filled with Pus Neutrophils And fibrin
With dialted congested BVs

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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 )

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Local complications of Menigits ?

=Increased ICT causing Dmage to C346 and dipliopia squint and Ptosis
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=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

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2 inflammation+ fibrosis + pressure

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Viral septic menigits CSF

Increased “ Lymphocytes”
ptoein normal or moderate elveation
normal glucose
increased pressure
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Gross and micro in viral menigits

Gross no cc
MIcro : Mild moderate infiltration of leptomenigies with lymphocytes
The Virus is commonly enterovirus

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Graulomatous menigitis =

Tubeclosus mengigtis
fungal meningitits

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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
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Base
Cisterna and CNs
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Leptomenigies

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CSF in tubeculosus mingitis

MonoNuclear cells increased
Protein elevation
Glucose moderately odecreases

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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
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direct implanation
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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
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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