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**Host and Defense > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

What are the 4 different types of Infections to the CNS?

A
  1. Abscess
  2. Empyema
  3. Meningitis
  4. Encephalomyelitis
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2
Q

Name two sites for CNS infections

A
  1. Brain

2. Spinal Cord

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3
Q

Describe the etiology of CNS infections

A
  • Bacterial
  • Fungal
  • Other
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4
Q

What are the two types of abscesses in a bacterial CNS infection?

A
  1. Cerebral

2. Spinal

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5
Q

What is the most common CNS infection secondary to dental pathology/procedure?

A

CNS abscess

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6
Q

List 4 symptoms of a CNS abscess

A
  1. Changes in consciousness
  2. Focal neurologic signs
  3. Vomiting
  4. Fever
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7
Q

Give 3 examples of Focal neurologic signs

A
  1. Speech defects
  2. Visual Field defects
  3. Paresis
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8
Q

What is Paresis?

A

a condition of muscular weakness caused by nerve damage or disease; partial paralysis.

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9
Q

What are the risk factors for a bacterial abscess in a CNS infection?

A
  1. Oral pathology
  2. Oral procedures
  3. Immunocompromised
  4. Chronic illness
  5. Chronic heart disease
  6. Skull Fracture
  7. Meningitis
  8. Sinus infections
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10
Q

What are 4 things involved in diagnosing a CNS abscess?

A
  1. Symptoms
  2. Physical exam
  3. Imaging
  4. Laboratories
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11
Q

What things are involved with the laboratory when diagnosing a CNS abscess?

A
  1. Peripheral blood
  2. CSF
  3. Cultures
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12
Q

What is the treatment for a CNS bacterial abscess?

A
  1. Antibiotics

2. Surgery (if > 2.5cm)

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13
Q

What is the pathology of a bacterial abscess?

A

Liquefactive

**which means:
necrosis (or colliquative necrosis) is a type of necrosis which results in a transformation of the tissue into a liquid viscous mass. Often it is associated with focal bacterial or fungal infections.

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14
Q

Name 4 dental sources of CNS infections

A
  1. Caries–pulpitis
  2. Apical periodontitis
  3. Phlegmon/Abscess formation external to the brain
  4. Necrotizing ulcerative gingivitis/periodontits
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15
Q

What is the dental procedure most commonly associated with CNS infection?

A

Extraction

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16
Q

What percent of Dental CNS infections have underlying intraoral pathology?

A

87%

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17
Q

What percent of Dental CNS infections with underlying intra-oral patholgy showed Dental symptoms before neurologic symtpoms?

A

40%

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18
Q

What percent of Dental CNS infections that have underlying intra-oral pathology present as ipsilateral?

A

70%

*diffuse/bilateral oral pathology is also common (like ginigivitis)

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19
Q

What percent of Dental CNS infections were preceded by dental procedures?

A

47%

*Most related to molar teeth

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20
Q

What type of patients are at risk for Mycoses infections in the CNS?

A

Immunocompromised

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21
Q

What are the most common fungi that are CNS infection causing?

A
  1. Pathogenic Molds
    • Aspergillus
    • Zygomycetes
  2. Candida spp.
  3. Cryptococcus Neoformans
  4. Dimorphic fungi
22
Q

What is the most common fungi that will cause a CNS infection?

A

Aspergillus fumigatus

23
Q

What is another name for Zygomycetes?

A

mucormycosis

24
Q

What are the risk factors for Zygomycetes?

A

Diabetes and immunosuppression

25
Q

What is the presentation of Zygomycetes?

A

Rapidly progressive facial swelling

26
Q

What are the different species of Zygomycocetes?

A
  1. Mucor
  2. Rhizomucor
  3. Rhizopus
27
Q

What is the morphology of Zygomycetes?

A
  • Wide/ribbon-like

- 90 degree branching

28
Q

T/F CNS infections caused by Candida are among the most common

A

False, they are uncommon

29
Q

What are the different forms of a CNS infection cause by candida?

A
  • Meningitis
  • Encephalitis
  • Abscess
30
Q

What is the treatment for Candidial infections of the CNS?

A

Multimodal antifungals

31
Q

What is the etiology of Candidial CNS infections?

A

Oral etiology is unproven

32
Q

T/F Candidial infectdions occur mostly in immunocompromised people

33
Q

Aside from bacteria and fungi, what are other causes of CNS infections?

A
  1. Parasites
  2. Spirochetes
  3. Viruses
  4. Prion Disease
34
Q

Name two parasites that can cause CNS infections

A
  1. Helminths

2. Protozoa

35
Q

Give an example of a CNS infection caused by a helminth and what organisms causes it

A
  1. Neurocystercerosis

- Taenia solum (pork tapeworm)

36
Q

Give an example of a CNS infection caused by Protozoa and the organism that causes it

A
  1. Toxoplasmosis

- Toxoplasma gondii

37
Q

What viruses can cause CNS infections?

A

Herpes virus

38
Q

Give two examples of CNS infections caused by herpes

A
  1. Herpetic gingivostomatitis

2. Herpes Simplex encephalitis

39
Q

Describe Herpetic gingivostomatitis

A
  • HSV1 or HSV2
  • Very common
    • Peak incidence 6 mos–5 years and 20 years
40
Q

Describe Herpes Simplex encephalitis

A

-Rare: around 3 cases/million people a year

41
Q

T/F Spirochetes are a frequent cause of CNS infections

A

False, they are uncommon neurosurgical specimens

42
Q

Give two examples of Spirochete caused infections that can cause CNS issues

A
  1. Neurosyphilis

2. Lyme Disease

43
Q

What spirochete organisms cause Neurosyphilis?

A

Treponema pallidum

44
Q

What spirochete organisms can cause lyme disease?

A
  • Borrelia burgdorferi

- Gumma–inflammatory pseudotumors

45
Q

What is also known as “slow viruses”?

A

Prion disease

46
Q

What are the 4 types of prion disesase?

A
  1. Creutzfeldt-Jakob disease (CJD)
  2. CJD new variant
  3. Gerstmann-Straussler syndrome (GSS)
  4. Kuru (extinct)
47
Q

Which type of Prion disease is sporadic/iatrogenic?

A

Creutzfeldt-Jakob disease (CJD)

48
Q

What is the etiology of CNS infections caused by Aspergillus?

A

Oral -> Sinus -> CNS

-Immunocompromised hosts

49
Q

What does the presentation of a CNS infection caused by Aspergillus look like?

A

Focal Symptoms

50
Q

What is the pathology of CNS infections caused by aspergillus?

A
  • Single/multiple abscess
  • Granulomata
  • Infarcted brain
51
Q

How would you treat a CNS infection caused by Aspergillus?

A
  • Aggressive surgical excision

- Amphotericin B + Flucytosine

52
Q

T/F Spirochetes can lead to a CNS infection via the dental/oral route

A

False,

*Dental/oral CNS infection not known

**Host and Defense (31 decks)

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