CNS infections III Flashcards
primary amebic meningoencephalitis. prognosis
fulminate: death in 1-2 wks
cerebral amebic abscesses. cause, location of leisons, causative agent
usually secondary to enteric infections–> hematogenous spread. grey-white junction, basal ganglia are common locations. often caused by entamoeba histolytica
symptoms of congenital toxoplasmosis
hydrocephalus, cerebral calcification , chorioretinitis, convulsions. often microencephalic.
locations of toxoplasmosis abscesses. gross/histologic features
basal ganglia and cerebral hemispheres; deep gray matter and cortical/subcortical junction. see bradyzoites and tachysoites. see necrosis. ring enhancing lesion.
affected locations of the 4 slow viruses that cause CNS infection
- JC: white matter
- prions: grey matter
3/4: measles and rubella: both grey and white matter
acute viral meningitis: what viruses cause this?
mumps, coxackie b, echovirus, poliovirus, herpes, lymphocytic choriomeningitis, Epstein-Barr.
stereotypic response to viral meningitis
diffuse/multifocal distribution
- predominant involvement of neurons
- hyperplasia and hypertrophy of micoglia-macrophages
- perivascular cuffs of mononuclear cells
what is the major inflammatory cell in viral meningitis/encephalitis?
lymphocyte. tissue rxn often disproportionately modest
microscopic characteristics of rabies
bullet-shaped virions
negri bodies: characteristic inclusions
esp. in hippocampal pyramidal neurons and Purkinje cells.
cytopathology of herpes encephalitis
increased neutrophils in CNF. hemorrhagic necrotizing encephalitis, esp. of frontal or temporal lobes
signs and symptoms of CMV CNS infection
retinitis, meningitis, cerebritis, ventriculitis, transverse meuloitis, radiculomyelitis.
gross and microscopic features of CMV infection
severe brain necrosis
owl’s eye (aka Cowdry type A) inclusions.
common CNS probs with HIV
toxoplasma, CMV, cryptococcus, primary CNS lymphoma. also directly infects macrophages (trojan horse). thus, can cause HIV encephalitis, HIV-associated leukoencephalopathy, and vacuolar myelopathy.
HIV encephalopathies
not much neuron involvement
multinucleated giant cells of macrophage origin in the deep white matter of frontal and temporal lobes and in the deep gray matter in perivascular locations.
vacuolar myelopathy
non-inflammatory vacuolation of myelinated fibers. looks like subacute combined degeneration of vitamin B12 deficiency
Kids with HIV encephalopathy
cerebral atrophy/ventricular dilation. micrencephaly, vascular mineralization of basal ganglia, severe leukoencephalopathy
progressive multifocal leukoencephalopathy. symptoms and path
associated with HIV
symtpoms: visual, memory, motor, and speech deficits
see focal demyelination, oligo inclusions, bizarre astrocytes (alzheimer type I). caused by JC virus
features of prion diseases
non0inflammatory spongy alteration of gray matter. non-Alzheimer amyloid plauqes, neuronal loss, reactive astrocytes.
