CNS Infections Flashcards
Inflammed btwn pia and arachnoid meninges
Neck Rigidity
Kernigs Sign
Brudzinki Sign
Leptomeningitis
Low glucose in CSF
fever
neck rigidity
bacterial meningitis
newborn meningitis
E Coli (or Group B Strep)
Meningitis from 3 months-3 years old
H INfluenzae
- Main cause of meningitis later in life
- Might have hx of basilar skull fx
- Alcoholics and asplenics
strep pneumo
- Contracted in congested places (schools and barracks)
- Waterhouse Friderichsen Syndrome
N. Meningitides
- Cerebritis
- Astrogliosis
- Encapsulated by fibroblasts
- Can rupture into ventricles
cerebral abscess
- Increased CSF Protein
- Obliterative endarteritis
- Can induce cortex or brainstem infarcts
Neurosyphilis
- Loss of joint position sense and fine touch (dorsal column)
- Positive Romberg Sign
Tabes Dorsalis
Sluggish replication of T. pallidum spriochetes
- “Wind Blown appearance” of residual nerve cells
- gliosis
Leutic Dementia
- granulomatous response with giant cells and lymphocytes
- surrounds areas of caseous necrosis
- Commonly localized to base of brain
Tuberculous Meningitis
Tuberculosis of the spine
Pott Disease
- Oppurtunistic infection
- Soap Bubble abscesses
- Encapsulated fungi in Virchow Spaces
- India Ink shows clear halo
Cryptococcus meningitis
Name 6 other fungal causes of meningitis aside from cryptococcus (most common)
Coccidiomycosis-san joaquin valley Histoplasmosis-mississippi Blastomycosis Mucormycosis Aspergillosis Candidiasis-microabscesses
- Usually a benign meningitis
- Sudden febrile illness with headache
- Excess lymphocytes in CSF
- Increase in protein
- No change in glucose
Viral meningitis
- Inflammation of grey matter in spinal cord
- fever, malaise and headache
- develops into meningitis and paralysis
poliomyelitis
- Enters CNS thorugh retrograde axoplasmic flow
- Negri Bodies-eosinophilic cytoplasmic viral inclusion bodies
- Hydrophobia-difficulty swallowing
- Death without vaccine and Ig
Rabies
- Cowdry A intranuclear eopsinophilic inclusions surrounded by halo
- Commonly localizes to temporal region
HSV1 meningitis
- Crosses placenta and induces encephalitis in utero
- Periventricular necrosis and calcification –>obstructive hydrocephalus
- Eosinophilic viral inclusions
CMV
- JC Virus infects oligodendrocytes–>cytolysis and demyelination
- discrete foci of demyelination near grey-white junction
Progressive Multifocal Leukoencephalopathy
In and HIV+ patient, name the most common:
1) fungal meningitis
2) intracranial mass
3) neoplasma
1) Cryptococcus
2) toxoplasmosis
3) Primary CNS lymphoma
