CNS INFECTIONS

Question 1

inflammatory process of leptomeninges and CSF within the subarachnoid space

Answer 1

Meningitis

Question 2

combines this with inflammation of the brain parenchyma

Answer 2

Meningoencephalitis

Question 3

what are the types of CNS infections?

Answer 3

acute pyogenic meningitis
chronic meningoencephalitis
brain abscess
parenchymal infections

Question 4

name this Chronic Meningoencephalitis:

may be a part of systemic disease or isolated (seeding of brain from a silent, usually pulmonary, lesion)

Answer 4

Tuberculous Meningitis

Question 5

name this Chronic Meningoencephalitis:

the tertiary stage of syphilis

Answer 5

Neurosyphilis

Question 6

chronic meningitis w/ obliterative endarteritis & perivascular plasma cell infiltrate, what is this subtype of neurosyphilis

Answer 6

Meningeal Neurosyphilis

Question 7

invasion of brain by treponemal organisms w/ brain atrophy& resultant severe dementia, what is this subtype of neurosyphilis

Answer 7

Paretic Neurosyphilis

Question 8

damage to the dorsal root sensory nerves w/ impaired sensation & absence of deep tendon reflexes (similar to neuropathy), what is this subtype of neurosyphilis?

Answer 8

Tabes Dorsalis

Question 9

lesions w/central liquefactive necrosis, surrounded by fibrous collagen capsule & edema

Answer 9

Brain Abscess

Question 10

Caused by the poliovirus (which has since been controlled by immunization)

enterovirus attacks lower motor neurons

flaccid paralysis, muscle wasting, hyporeflexia

progressive weakness w/ decreased muscle bulk & pain

what is this parenchymal infection?

Answer 10

Poliomyelitis

Question 11

Viral encephalitis caused by JC virus

Focal, progressive neurologic symptoms

Occurs in immunosuppressed individuals

Most people have serologic evidence of exposure by the age of 14

Morphology: ill-defined white matter injury

what is this parenchymal infection?

Answer 11

Progressive Multifocal Leukoencephalopathy

Question 12

A rare, progressive clinical syndrome

Characterized by:
• Cognitive decline
• Limb spasticity
• Seizures

Typically occurs in children or young adults

The disease stems from a persistent, but nonproductive infection of the CNS by an
altered measles virus

Morphology:
Widespread gliosis and myelin degeneration
Viral inclusions
Variable inflammatory infiltrate of white and gray matter
Neurofibrillary tangles

Disease persists in non-vaccinated populations

what is this parenchymal infection?

Answer 12

Subacute Sclerosing Panencephalitis

Question 13

routes of entry?

Answer 13

○ Hematogenous spread
○ Direct implantation (traumatic, iatrogenic i.e. surgery)
○ Local extension (sinuses, cranial bones)
○ Peripheral nervous system (ex. Rabies, Herpes)

Question 14

name this causative organism for acute pyogenic meningitis for:

neonates

Answer 14

E. coli (maternal feces) & Group B Strep. (vaginal flora)

Question 15

name this causative organism for acute pyogenic meningitis for:

infants

Answer 15

H. influenza & Strep. pneumoniae

Question 16

name this causative organism for acute pyogenic meningitis for:

teens

Answer 16

Neisseria meningitidis (vaccine doesn’t cover all of the serotypes)

Question 17

name this causative organism for acute pyogenic meningitis for:

elderly

Answer 17

Strep. pneumoniae & Listeria monocytogenes (deli meats, cheeses)

Question 18

what disease

Clinical Findings
▪ Symptoms: headache, photophobia, irritability, clouding of consciousness, neck stiffness
▪ CSF: cloudy, purulent, increased pressure, increased neutrophils, *increased protein, and *decreased glucose (bc the bacteria ate it all)

Answer 18

Acute Pyogenic (Pus) Meningitis

Question 19

(can cause hydrocephalus) - large quantities of capsular
polysaccharide of causative organism produces particularly gelatinous exudate that encourages arachnoid fibrosis

this is a morphology for acute pyogenic meningitis?

Answer 19

Chronic adhesive arachnoiditis

Question 20

thick layer of suppurative exudate covers brainstem and

cerebellum and thickens the leptomeninges

Answer 20

Pyogenic meningitis

Question 21

name this disease:

Chronic bacterial infections; may be caused by M. tuberculosis, T. pallidum, and Borrelia

Answer 21

Chronic Meningoencephalitis

Question 22

what disease

Clinical Findings:
• Symptoms – headache, malaise, mental
confusion, vomiting
• CSF – mononuclear cells, increased protein, normal/decreased glucose

Answer 22

Tuberculous Meningitis of Chronic Meningoencephalitis

Question 23

well circumscribed intraparenchymal mass

Answer 23

Tuberculoma

Question 24

what are the subtypes of chronic meningoencephalitis?

Answer 24

tuberculous meningitis

neurosyphilis

Question 25

what are the subtypes of neurosyphilis?

Answer 25

Meningeal Neurosyphilis
Paretic Neurosyphilis
Tabes Dorsalis

Question 26

what are the predisposing conditions of brain abscess?q

Answer 26

Predisposing conditions
• acute bacterial endocarditis
• cyanotic congental heart disease
• right-to-left shunt
• chronic pulmonary sepsis

Question 27

clinical signs of poliomyelitis?

this is a syndrome of poliomyelitis that is progressive weakness w/ decreased muscle bulk and pain

Answer 27

flaccid paralysis, muscle wasting, hyporeflexia

Post-polio Syndrome

Question 28

name this disease:

Viral encephalitis caused by JC virus

kills oligodendrocytes and causes demyelination

Answer 28

Progressive Multifocal Leukoencephalopathy

Question 29

this disease is characterized by cognitive decline, limb spasticity, seizures

altered measles virus

Answer 29

subacute sclerosing panencephalitis