CNS Infections

Question 1

Meningitis

Answer 1

Inflammation of the leptomeniniges

Question 2

Encephalitis

Answer 2

Infection of the brain parenchyma - neurons and glial cells

Question 3

Brain Abscess

Answer 3

Localized brain infection

Question 4

What is fungal meningitis associated with?

Answer 4

Immune-compromisded state

Question 5

What is aseptic meningitis associated with?

Answer 5

Viral meningitis

Question 6

Common cause of meningitis in neonates…

Answer 6

– Group B streptococci

– Aerobic Gram-negative bacilli (E. coli)

Question 7

Common cause of meningitis in infants less than 1 year…

Answer 7

– S. pneumoniae (Pneumococcus)

– Haemophilus influenzae – less common now due to vaccination

Question 8

Common cause of meningitis in teenagers…

Answer 8

– Neisseria meningitis
– H. influenzae
– S. pneumoniae

Question 9

Common cause of meningitis in adults…

Answer 9

– S. pneumoniae

– Neisseria meningitidis

Question 10

Common cause of meningitis in elderly…

Answer 10

– L. monocytogenes

– Pseudomonas aeruginosa (less common)

Question 11

What are the causative agents of chronic meningitis?

Answer 11

• TB
• Fungal - Cryptococcus/Histoplasma
• Syphilis
• Borrelia (rare)

Question 12

What cells are found with bacterial meningitis in the CSF?

Answer 12

Neutrophils

Question 13

What cells are found with viral meningitis in the CSF?

Answer 13

Lymphocytes

Question 14

What cells are found with TB meningitis in the CSF?

Answer 14

Lymphocytes

Question 15

What is the most common cerebral parasite?

Answer 15

Taenia solium - cysticercosis

Question 16

How can cysticercosis present?

Answer 16

Seizures

Question 17

What are the TORCH infections?

Answer 17

Toxoplasmosis
Others
Rubella
CMV
HSV

Question 18

What viruses prefer to attack motor neurons?

Answer 18

Polio Virus and Enterovirus

Question 19

What matter of the CNS is more involved with viral encephalitis?

Answer 19

Greater gray matter involvement

Question 20

Polio Encephalitis

Answer 20

Fecal-oral transmission with infection and destruction of anterior horn cells - LMN

Question 21

What are Negri bodies indicative of?

Answer 21

Rabies

Question 22

What area of the brain does Herpes encephalitis localize to?

Answer 22

Medial temporal lobes - edema, hemorrhage and necrosis

Question 23

Who are the people affected with CNS infections by CMV?

Answer 23

Neonates and AIDs patients

Question 24

What is the cause of progressive multifocal leukoencephalopathy?

Answer 24

Caused by JC virus - usually the immuno compromised

Question 25

What are the characteristics of progressive multifocal leukoencephalopathy?

Answer 25

– Loss of myelin (with axonal sparing)
– Bizarre astrocytes
– Oligodendroglial inclusions

Question 26

What is characteristic of HIV encephalitis?

Answer 26

Widespread microglial nodule encephalitis with multinucleated giant cells

Question 27

Vacuolar Myelopathy

Answer 27

– Spastic paraparesis with hyperreflexia and ataxia

– Vacuolation of spinal cord white matter