CNS Infections Flashcards by chioma Amako

Inflammation of meninges surrounding brain and Parenchyma

Meningoencephalitis

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Inflammation of meninges surrounding brain and spinal cord

Meningitis

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Diffused inflammation to the brain parenchyma

Encephalitis

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Focal infection of the brain parenchyma

Brain abscess

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Most cause of abscess

Staphylococcus Aureus

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Abnormal proteins with no nuclei acid

Prions e.g mad cow disease, yakob disease

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Polio is transmitted from fecal route what does this tell you about the structure of the virus?

It’s a naked virus- non enveloped virus

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Example of virus disease that enter through peripheral motor and sensory nerves

Rabies and Herpes

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What are the inflammatory cytokines?

IL-1, IL-6, IL-8, TNF-alpha, type 1 interferon-

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What cell produces the CSF?

Ependymal cells and are joined with Gap junction

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Tight junctions keep the brain barrier intact and are usually a target for CNS infections? T/F

True

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Tight junction in the Blood brain barrier is weak in neonates and infant hence 1/3 infants with bacteria developed Meningitis as compared to adults who do not develop meningitis. true or false?

True

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Mechanisms used by pathological agents to cross the BBB

Trojan horse” direct crossing”
Paracellular crossing

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Lecture question

Blood brain barrier

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Lecture question

Blood-CSF barrier

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Any kind of infection that is acquired outside of the hospital or healthcare facility is called?

Community acquired infection

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Some main organisms that can cause infections in the hospitals and are drug resistant

Staph aureus and Pseudomonas

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Classical Triad of Menigitis?

Fever (Meningeal irritation)
stiff neck( meningeal irritation)
headache (Brain swells edema)

Other symptoms: Seizure (complication), nausea vomiting, rash, sensitivity to bright light, stupors- coma, drowsiness.

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————— is the main cause of meningitis? 2nd cause is ————-

Viruses, Bacteria

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What is the most causal organism of community meningitis——————/ and which type?

Viruses; Enteroviruses

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Community acquired meningitis BACTERIA CAUSES

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Hospital Acquired Meningitis Bacteria

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Fungi and Parasite causal organisms in meningitis?

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Community acquired bacterial meningitis age related etiology

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Methods to confirm diagnosis for Meningitis

Safest place for a lumbar puncture (CSF)

L4 -L5

CSF analysis

Non bacterial menigitis from viral cause is referred to as —————- Bacterial Meningitis is referred to as ——————

Aseptic; Septic pyrogen

A not bacterial Aseptic viral meningitis will have

Increased lymphocytes Glucose level will be normal Protein moderately high Clear appearance Gram stain- no organisms

A bacterial Septic bacterial meningitis will have

Increased neutrophil counts Glucose level low Protein high Turbid appearance Gram stain- organisms may be seen

Symptoms and presentation of Viral Meningitis -Aseptic Meningitis

Bacterial and Fungi Chronic Meningitis

Symptoms and presentation of Bacteria Meningitis/ Pyrogenic Meningitis

How to differentiate Encephalitis from Aseptic Meningitis

Since Encephalitis affects the brain Parenchyma, FOCAL NEUROLOGIC DEFICIT will be presented

2 main signs of Meningeal Irritation —————-and —————

Kernig’s and Brudzinski

Summary of Meningitis Causal Organisms

Lecture questions

Aseptic Meningitis (Viral)

Class question

Enterovirus

Class lecture question

Staphylococcus Aureus

Class Questions

Chronic Meningitis Caused by Fungi - Cryptococcus neofroman

Class question

Streptococcus Pneumonia

Note: the main cause of meningitis in HIV patient is streptococcus it will be Crytococcus neoforman if additional parameters are listed. Students always make this mistake

Class question

Neisseria Meningitis

What Agar is used to differentiate lactose fermenter from Non-lactose fermented?

MacConkey’s Agar

Because of capsule, bacteria can evade getting phagocytosed. True or False?

True

Development of acute meningitis progresses through a series of stages

Name the bacteria based on its structure: Gram -ve diplococci, Capsule, Pili Exotoxin (LOS) lipoligosacharide

Neisseria Meningitidis

#1 cause of epidemic bacteria meningitis. Person to person spread

Neisseria Meningitides

Comprehensive information about Neisseria Meningitidis

Neisseria Meningitidis : Epidemiology, age, transmission, prevention

Complement deficiency (C5-C9) is an increased risk for Neisseria Meningitides. True or False

True

Who needs a Meningococcal Vaccine?

What are the two vaccines that provided protection to Neisseria Meningitidis

True or False Polysaccharide capsule B is what causes the meningitis in Hemophilus Influenzae B?

True … this is because the capsule contains PRP (Polyribitol phosphate)

Neisseria Meningitidis and Hemophilus Influenzae B both have Lipoligosaccharide and are both Gram -ve diploccocci. true or false?

True

Full picture of Hemophilus Influenzae B

We want to give conjugated vaccine for Hemophilus Influenza to get IgG rather than unconjugated that yields IgM

HIB conjugated vaccine is T-dependent (IgM and IgG) true or false

True

Most common cause of community acquired BACTERIA Meningitis is?

Streptococcus Pneumonia

True or False: Individuals with no Spleen gets overwhelmed by encapsulated bacteria because these bacteria cannot be phagocytosized and filtered anymore. Hence why immunicompromized and individuals with no spleen have to be vaccinated constantly

True

Structure, Virulence, virulence pathophysiology, Lab ID, Gram stain CSF, Blood Agat, Alpha hemolysis of Streptococcus Pneumoniae

Symptoms/signs, Epidemiology, Age, Transmission of Strep. pneumonia

Trigger clues, Prevention, Vaccination, Antibiotics for Strep. Pneumonia

What is the morphology of Strep. Pneumonia?

Gram positive diplococci - Capsuled

What bacteria meningitis infection is transmitted through ingestion of contaminated food from cattle feces exposure, transplacenta?

Listeria Monocytogene- a gram positive short bacilli

Structure, virulence, Patho physio, lab ID, CSF, antimicrobial of Listeria Monocytogenes

Trigger clues , symptoms, age, transmission, epidemiology, prevention

Neonate less than 28days with neonatal meningitis and sepsissquire the infection from their mothers’ genital tract and close contacts… true or false

True

What are the neonatal meningitis-sepsis symptoms and signs - don’t look for the classical meningitis triad

What are the causal organisms for neonatal meningitis + Sepsis

Describe E. coli

Describe Streptococcus agalactiae aka Group B Streptococci in relation to neonatal meningitis and Sepsis

Describe Listeria Monocytogene, a gram positive bacilli coccobacilli in relations to Neonatal meningitis and sepsis

What type meningitis presents with severe headache, fever, neck stiffness, nausea and vomiting, sensitivity to light BUT pt are completely awake and alert, no neurologic deficit, no seizures?

Viral meningitis/Aseptic Meningitis

Describe Aseptic Meningitis

Non enveloped virus makes it more resistant to drying, chlorination and gastric acid? True or false?

True

Polio destroys the anterior horn cells if the spinal cord causing lower motor neurons defect resulting in flaccid paralysis and respiratory defects

Describe Live Oral Polio Vaccine (OPV) aka SABIN

Itz a livs attenuated vaccine meaning it contains the live virus but in a weaker strain one of its disadvantages is that it can revert back to its original strain

Describe: Inactivated Polio Vaccine (IPV) US and western countries

AKA SALK- vaccine is dead

The most common cause of aseptic meningitis is?

Enterovirus, ECHO viruses and Coxsackie virus all belong to thr family?

Picornaviridae

Enterovirus, Coxsackie, ECHO and polio virus are ---------------- and have a ------------- genome

Which of the following lab diagnostic tests is useful in confirming a diagnosis of aseptic meningitis

Question

Acute Meningitis

Chronic Meningitis

Question

Aseptic Meningitis

Question

Acute Pyogenic Meningitis

Acute Meningitis

Aseptic Meningitis

Develops

Chronic Meningitis

Severe

Encephalitis

Sudden onset

Acite Pyogenic Meningitis

This type of meningitis is not seen in the US but in Africa and can cause neontal meningitis infection

Lymphocytic Choriomeningitis

Describe the Structure structure, virulence, pathphysio, treatment, of Cryptococcus Neoformans -causes chronic meningitis

Symptoms/Signs, tigger clues, Epidemiology, tranzmission of Crytococcus Neoformans

Nosocomical (healthcare spread) meningitis Etiology

VP SHUNTS TO RELEIVE HYDROCEPHALUS A 3-year-old girl with a history of hydrocephalus is brought to the neurologist by her parents with a severe headache and fever. The girl underwent a revision of ventricular- peritoneal shunt 1 month ago and the neurologist suspects that an infection has occurred. Which of the following organisms are most likely to cause infections in this case?

Enterococcus fecalis

Eosinophilic Meningtis caused by -----------

Parasite Larvae

Baylisascaris Procyonis a neutral larva migrans (NLM) is spread by? And who is susceptible?

Raccoon Round Worn; kids who play in sands. Eosinophil count goes up

Lecture question

Case of Neisseria. Ans: pneumococcalMeningitis (most common cause) Chose this over Meningococcemia because theres no petechial rash. If there was then it will be Meningococcemia even though they stem says army recruit.

Lecture question

Meningoccoccal Meningitis Note if the pt has a roommate or partner the partner will receive chemoprophylaxis: Rifampin and ciprofloxacin

Lecture

Streptocooccus Pneumoniae - #1 cause of Meningitis (headache of two-week duration) chronic cause. Note: in aids pt. Most common cause of bacteria infection is pneumococca. If chronic, choose Crytococcus, if no pneumococcus in option then you can think of listeria(next most common)

Class question

A-Aids Expozure to birds would have been second