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CNS infections Flashcards

1
Q

sites/types of bacterial infections

A
  • scalp, sinus, or ear infection - osteomyelitis - epidural abscess - leptomeningitis aka meningitis - brain abscess - encephalitis
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2
Q

pathology of acute bacterial meningitis shows

A

subarachnoid space filled with neutrophils, bacteria, necrotic debris

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3
Q

pathogenesis of bacterial meningitis

A

Direct extension or bacteremia

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4
Q

________ of a parameningeal cranial infection from the mastoid air cells, paranasal sinuses, skull, etc.

A

direct extension

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5
Q

a hematogenous dissemination of the bacteria

A

Bacteremia

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6
Q

clinical signs of acute bacterial meningitis

A

presents clinically with fever, headache, stiff neck, and mental status changes

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7
Q

meningeal inflammation means

A

stiff neck and headache

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8
Q

communicating hydrocephalus

A

the obstruction is within the subarachnoid space or arachnoid vili

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9
Q

non communicating hydrocephalus

A

the obstruction is within the ventricular system

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10
Q

type of bacterial infection in meningitis is ___ dependent

A

age

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11
Q

neonate bacterial meningitis infectious agents

A

Group B strep, Listeria, enteric bacilii

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12
Q

agents that cause bacterial meningitis in children

A

S. pneumonia, N. meningitidis, H. influenzae

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13
Q

agents that cause bacterial meningitis in adults

A

S. pneuomiae, N. meningitidis

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14
Q

onset of acute meningitis

A

hours to days

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15
Q

onset of subacute/chronic meningitis

A

weeks to months

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16
Q

Organisms associated with subacute/chronic meningitis include

A

mycobacteria (tuberculosis), fungi (cryptococcosis), and spirochetes (syphilis, Lyme disease)

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17
Q

idiopathic cause of meningitis

A

sarcoidosis

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18
Q

Granulomatous inflammation, mainly involving base of brain, causing brain infarcts from verse involvement

A

tuberculous meningitis

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19
Q

tuberculous meningitis can cause ____ mainly involving the base of the brain

A

granulamtous inflammation

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20
Q
A

multinucleate giant cells in the granuloma

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21
Q

stain of tuberculous meningitis

A

acid fast stain

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22
Q

common cause of brain infection in immunocompromised individuals

A

cryptococcosis

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23
Q

macroscopic findings of cryptococcosis

A

»Meninges thickened/opacified

»Slimy consistency

»Yellow-gray exudate in ventricles/perivascular spaces in immunocompromised.

»Subacute cases produce leptomeningeal fibrosis

  • multiple small cysts in brain
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24
Q

subactue cryptococcosis cases produce _______ fibrosis

A

leptomeningeal fibrosis

25
Q

50% cases show multiple _______ (“soap bubbles”) secondary to exuberant capsular material in brain (basal ganglia)

A

intraparenchymal cysts

26
Q

tuberculous meningitis can result in brain infarcts from vessel invovlement, leading to _____ damage and meningeal fibrosis. Meningeal fibrosis can cause ________.

A
  • cranial nerve damage
  • hydrocephalus
27
Q

microscopic findings on cryptococcosis

A
  • single budding yeast forms
  • surrounded by thick capsule, may shrink in tussue prep and leave “halo” around organisms
  • leptomeningeal inflammation: lymphocytes, plasma cells, gianet cells
28
Q

Types of neurosyphilis

A
  • subacute leptomeningitis
  • chronic leptomeningitis with associated vasculitis and vasculopathy (meningovascular syphilis)
  • chronic spinal arachnoiditis with degerneration of dorsal roots and the posterior columns of the spinal cord (tabes dorsalis)
  • chronic low grade encephalitis
  • congenital neurosyphilis
29
Q

what is this

A

brain abscess

30
Q

pathogenesis of brain abscess

A
  1. direct extension
  2. implantation following head trauma
  3. bacteremia from distant focus of infection
31
Q

direct extension from a parameningeal (cranial infection) can come from the _____ and cause a frontal lobe abscess

A

paranasal sinuses (sinusitis)

32
Q

direct extension from a parameningeal (cranial infection) can come from the __________ and cause temporal-lobe or cerebellar abscess

A

middle ear or mastoid air cells (otitis or mastoiditis)

33
Q

Direct extension may also cause an epidural abscess, subdural empyema, or ______

A

leptomeningitis

34
Q

bacteremia often creates how many brain abscesses?

A

multiple

35
Q

location of abscesses in brain

A

preferentially localizes to the gray-white junction

36
Q

focus of cerebritis after penetration of BBB by bacteria happens within ____ days

A

4-9 days

37
Q

formation of fibrous capsule happens day ____ in pathogenesis of a brain abscess

A

day 14

38
Q

a brain abscess typically presents as a _______

A

mass lesion

39
Q

in brain abscess, Patient may also have fever or _______.

A

leukocytosis

40
Q

clinical consequences of mass effect

A
  • headache, nausea, and vomiting from increased ICP
  • potential for herniation
41
Q

a brain abscess causes local brain destruction that may result in __________

A

neurological deficits

42
Q

A diffuse inflammation of brain

A

encephalitis

43
Q

A diffuse inflammation of brain and spinal cord

A

encephalomyeiltis

44
Q

most common cause of encephalitis

A

viruses

45
Q

common viruses that cause encephalitis

A
  • HSV 1 and other herpesviruses
  • arboviruses
  • HIV
  • rabies
  • enteroviruses
46
Q

Hematogenous Pathogenesis of CNS viral infection

A

from viremia after initial viral replication in GI tract (enteroviruses) or innoculation site (arboviruses)

47
Q

when viremia travels and infects leptomeningeal cells it causes

A

Stiff neck, headache, & fever;
lymphocytic leptomeningitis

48
Q

infectino of cells in the brain (viral encephalitis) causes

A

Headache, coma, seizures, & fever;
lymphocytic infiltrates & brain necrosis

49
Q

pathogenesis of viral infection can also be spread along axons by _________

A

retrograde spread

50
Q

HSV1 infection of oral cavity retrograde spread of virus goes to the ______ gangiion

A

trigeminal

51
Q

HSV 1 encephalitis primary involves the ____ and ____ lobes after infection

A

temporal and inferior frontal lobes

52
Q

initial infection of HSV1 occurs in ______ of cases and reactivation later occurs in ______ of cases

A

30%

70%

53
Q

viral trophism of poliovirus

A

anterior horn cells

54
Q

viral trophism of JC virus

A

oligodendrocytes - progressive multifocal leukoencephalopathy

55
Q

viral trophism of rabies virus

A

— hippocampus and cerebellum

56
Q

viral trophism of Varicella-Zoster virus

A

— dorsal root ganglia

57
Q

viral trophism of Lymphocytic choriomeningitis virus —

A

leptomeninges

58
Q
A

Neuro (27 decks)

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