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Neuro Module > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

RFs of bacterial CNS infections

A

non-intact BBB, very young, elderly, immunocomp

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2
Q

Ways in which bacterial infections spread to CNS?

A
  • hematogenously (most common)
  • bone (where thin like mastoiditis, sinusitis, middle ear infx, abscessed tooth)
  • interconnecting veins (central facial infections)
  • axonal spread
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3
Q

Who is most likely to get bacterial meningitis?

A

groups of young adults living in crowded conditions

infants

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4
Q

Bacterial meningitis is an infection of ______, _____, and _______ by bacterial.

A

arachnoid, subarachnoid space, and CSF

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5
Q

Organisms that cause bacterial meningitis?

A

infants: E. coli, beta-hemolytic strep

children/adults: step pneumo (blood), Neisseria (UTI), H flu (ear infection)

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6
Q

Common symptoms of bacterial meningitis?

A

fever, severe HA, stiff neck

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7
Q

Positive PE tests in bacterial meningitis

A

Kernig’s (flex hip/knee)

Brudzinski’s (flex neck)

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8
Q

CSF analysis of bacterial meningitis

A
  • neutrophils with high WBC count
  • high proteins
  • low glucose
  • Gram stain
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9
Q

Bacterial meningitis tx

A

IMMEDIATE broad spectrum abx

vaccine: Neisseria meningitides and H-flu

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10
Q

Etiology of epidural abscess

A
  • infection in neighboring areas resulting in osteomyelitis or TB of vertebral column
  • infection post surgery (staph)
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11
Q

Etiology of subdural abscess

A
  • Infection spread via sinuses or middle ear to subdural space
  • staph aureus or strep
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12
Q

Progression of subdural abscess

A

spinal empyema -> compression of spinal cord -> paralysis/death

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13
Q

Etiology of brain abscess

A
  • extension from sinusitis, otitis, or meningitis

- hematogenous spread

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14
Q

Treatment of epidural, subdural, and brain abscesses

A

Surgical evacuation and IV abx

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15
Q

Dx imaging of choice for epidural, subdural, and brain abscesses

A

CT scan

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16
Q

2 types of CNS spirochete infections

A

Syphilis and Lyme Disease

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17
Q

What organism causes Lyme Disease?

A

Borrella Burgdoferi in ticks

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18
Q

Signs of syphilis CNS infection

A

Tabes dorsalis = inflamm/degen of posterior columns; impairs proprioception/vibration; causes shooting pain in legs and Robertson pupil paresthesias

General paresis of the insane = encephalitis due to spirochete invasion of brain; mental and personality changes

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19
Q

How are viral infections of CNS spread?

A

blood and peripheral nerves

20
Q

Etiology of viral meningitis?

A

unidentified virus; possibly enterovirus, HIV, chicken pox, herpes

Possible drug-induced

21
Q

CSF results of viral meningitis

A

high cell count
pleocytosis
high protein
normal glucose

22
Q

How is viral meningitis different from bacterial?

A
  • aseptic/viral has NO neuro deficits
  • viral has normal glucose; bacterial is low
  • bacterial organism can be identified via Gram stain
23
Q

definition of encephalitis

A

infection/inflamm of CNS neurons and glial cells

24
Q

Etiology of viral encephalitis

A
  • Generalized viral infection (pneumonia, enteritis)

- Primary CNS infection (rabies, West Nile)

25
Q

viral encephalitis management

A

acute and convalescent titers to measure antibodies

26
Q

What are 3 different types of viral encephalitis and what bug causes them?

A

Herpes Simplex (HSV I and II)
Cytomegalovirus (CMV)
HIV

27
Q

Who is affected by Herpes Simplex Encephalitis

A

HSV I: 2-3 yo

HSV II: neonates during vaginal delivery (not with C-section)

28
Q

What diseases can HIV cause in the CNS?

A

encephalitis, aseptic meningitis, AIDS-related dementia

29
Q

Which encephalitis is transmitted to fetus transplacentally?

A

cytomegalovirus encephalitis

30
Q

How is herpes simplex encephalitis treated?

A

Acyclovir

31
Q

How does the HSV I and II virus get to brain?

A

via the trigeminal ganglion

32
Q

What happens if HSV encephalitis gets into frontal/temporal lobes?

A

personality changes, bizarre behaviors, anosomia, dementia, gustatory (taste) hallucinations

33
Q

How is HSV encephalitis detected in CSF?

A

PCR

34
Q

Examples of arthropod borne CNS viruses

A

St. Louis encephalitis, Equine encephalitis, West Nile, tick-bourne encephalitis

35
Q

prion

A

abnormal form of neuron glycoprotein that is resistant to protease breakdown

36
Q

Examples of prion diseases

A

Creutzfeldt Jakob Disease (CJD): disease of humans and animals; gene mutation alters amino acid sequence (familial/sporadic) or iatrogenic (variant)

Kuru: Papua New Guinea tribe that ate dead people’s brains

Mad Cow disease: consumption of infected beef

Scrapie: prion disease in sheep

37
Q

Signs of prion disease

A

personality changes, mental changes, dementia, hallucinations, gait abnormalities

38
Q

MRI findings of prion disease

A

“spongey encephalopathy” from neuron loss and gliosis

39
Q

Prion disease tx

A

supportive therapy

40
Q

Fungi that can infect CNS

A

Candida, Aspergillus, Cryptococcus, Mucormycosis

41
Q

Mycobacteria that can infect CNS

A

TB

42
Q

Amoebic CNS infection from what?

A

Naegleria floweri in freshwater or hot springs

43
Q

blood in CSF =

A

intracranial bleed (i.e. subarachnoid hemorrhage)

44
Q

monocytes in CSF =

A

encephalitis (fungal or viral)

45
Q

elevated PMN in CSF =

A

bacterial meningitis

46
Q

low glucose in CSF =

A

bacterial or fungal/TB infection

47
Q

+G stain in CSF =

A

bacterial

Neuro Module (13 decks)

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