CNS infections Flashcards

1
Q

def. of empyema

A

accumulation of pus within a space of cavity (ie epidural space = epidural empyema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

def. of abscess

A

localized collections of pus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

meningitis/leptomenigitis definition

A

inflammation of the pia and arachnoid in the subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

def. of encephalitis

A

inflammation of brain parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

def. of myelitis

A

inflammation of spinal cord parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

def. of radiculitis

A

inflamm. of nerve roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

def. of neuritis

A

inflamm. of peripheral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

def. of encephalomyeltitis

A

generalized inflammation of brain and spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

def. of ependymitis

A

inflamm. of ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

reactive leptomeningitis

A

response in the leptomeninges (subarachnoid space) due to infection in OTHER location (ie epiduarl, subdural spaces)… thus you have the changes in cell count, protein level, and pressure but will NOT find any organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CNS response to bacteria, fungi, and viruses

A
bacteria = purulent reactions with polymorphonuclear leukocytes and necrosis
fungi = granulomatous inflammation
viruses = lymphocytis response (and occasionally myelin breakdown via allergic response)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

E. Coli in meningitis (g stain and group effected)

A

neonates most vulnerable (G neg rods)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Neisseria Meningitides in meningitis

A

adolescents and young adults (COLLEGE DORMS!)

(G neg diplococci)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Strep. pneumoniae in meningitis

A

elderly, children, infants (G pos diplococci)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

group B strep (aka step. agalactiae) in meningitis

A

neonates (G pos cocci with Lancefield antigen B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Listeria monocytogenes in meningitis

A

elderly aka immunocompromised (G pos rods)

17
Q

What are the 3 main categories of meningitis?

A

1) acute pyogenic (usually bacterial)
2) acute lymphocytic aka aseptic meningitis (usually viral)
3) chronic (fungi, TB, and syphilis)

18
Q

Acute pyogenic meningitis characterisics

A

Purulent exudate in subarachnoid space and along vessels, includes neutrophils and bacteria

19
Q

acute lymphocytic meningitis

A

increase in lymphocytes (aka mononuclear cells aka B/T cells)

20
Q

Chronic meningitis causes

A

Caused by:
fungi (candidiasis, cryptococcosis)
tubercle bacillus (TB)
T. pallidum (syphilis)

21
Q

CSF changes characteristic of each of the 3 types of meningitis (pressure, glucose, and cells found)

A

Acute pyogenic = increased pressure, DECREASED glucose, and thousands of neutrophils ***CSF can actually appear cloudy, is normally clear

acute lymphocytic = normal/mild increase in pressure, NORMAL glucose, hundreds of mononuclear cells

chronic = increased pressure, sometimes decreased glucose, hundreds of mononuclear cells

22
Q

Most common form of virus causing encephalitis

A

herpes simplex virus 1.

acyclovir is the treatment!

unique among other viruses causing encephalitis because there are often RBCs in the CSF

23
Q

Rabies virus in CNS

A

enters peripheral nerve, goes retrograde to CNS

Negri bodies often found in hippocampal pyramidal neurons

24
Q

Varicella zoster virus (VZV) aka herpes zoster in CNS

A

causes chickenpox in primary infection and establishes a latent infection in DRG or trigeminal ganglia.

Manifests a 2nd infection in a dermatomal distribution

in immunosuppressed, can cause encephalitis or myelitis

25
Q

Cytomegalovirus in CNS

A

affects fetuses (part of TORCHES) or immunosuppressed. CMV is common opportunistic pathogen in AIDS patients*

26
Q

Fungal infection patterns in CNS (3 of em)

A

1) chronic meningitis
2) vasculitis
3) parenchymal invasion (most commonly via Candida and Cryptococus)

27
Q

Toxoplasma gondii in CNS

A
  • from cat shit
  • typically causes a ring-shaped lesion in brain
  • common in patients who are immunocompromised
28
Q

intracerebral abscesses (commonly bugs and their effects)

A

strep and staph are most common (fungi in immunocompromised)

resulst in a zone of fibrous tissue

seizures occur in 50% of cases

29
Q

what are the 3 types of tertiary neurosyphilis?

A

1) meningovasculitis - mimics a stroke (via occlusion)
2) General paresis - spirochetes found in brain tissue… mental changes, progressing to dementia, headache
3) Tabes Dorsalis - Loss of axons/myelin in dorsal roots with wallerian degeneration of dorsal columns
- causes “lightning pains”, sensory deficits, argyll-robertson pupils (react to accomodation but not to light)

30
Q

HIV-related CNS probs

A

50-70% develop AIDS-related cognitive-motor complex

primary: HIV-associated dementia & vacuolar myelopathy (swelling of myelin sheaths in dorsal and lateral columns thus MVP, CST probs)
secondary: CMV, cryptococcus, and toxoplasma infection & Progressive multifocal leukoencephalopaty (PML)

31
Q

progressive multifocal leukoencephalopathy (PML)

A
  • occurs in immunosuppressed
  • slowly progressing encephalitis due to altered virus
  • caused by JC polyomavirus
  • intellectual decline and dementia, death within 2-6months
  • inclusion bodies in oligodendroglia nuclei
32
Q

Subacute sclerosing panencephalitis

A

slowly (years) progressive encephalitis associated with altered measles virus

  • onset between 5-20 years old
  • personality changes, intellectual decline, seizures, limb spasticity
  • elevated IgG, antibody titer against measles elevated!*

perivascular cuffing by lymphocytes and plasma cells

death usually within several years