CNS Infxn Flashcards
Who are at risk for CNS infxn?
immunocompromised
young
old
How is the brain protected?
skull
dura
BBB
Who is at HIGHEST risk for CNS infxn?
infants b/c they do not have a fully developed BBB
How can bacteria be spread?
hematogenously
thin bone (sinus)
veins (facial infxn)
What is baceterial meningitis?
bacterial infxn of the arachnoid, subarachnoid, CSF
Bacterial meningitis - sx?
stiff neck
headache
fever
Bacterial meningitis - PE?
Kernigs
Burdzinski
*anything that stretches the dura
Why is there a stiff neck with bacterial meningitis?
they cannot move the neck b/c of dura inflammed
Who is at risk of getting bacterial meningitis?
YA who live in close areas (colleges students dorming)
Vacciniation for bacterial meningitis?
Neisseria menigitidis
H influ
Bacterial meningitis - dx?
CSF!!
Bacterial meningitis - CSF labs?
\+ neutrophils high CSF protein low glucose *bacteria eats glucose, poops proteins CSF culture
Bacterial meningitis - CSF culture? infants, children, adults?
infants- E coli, B strep
Children and adults: s. pneumonia, neisseria meningitisis, H influ (vaccine)
Bacterial meningitis - tx?
ASAP W/ BROAD ABX!!
Epidural abscess - cx?
surgical procedure
infxn from neighboring areas
Epidural abscess - leads to?
osteomyelitis
TCB of vertebral column
Subdural abscess/subdural empyema - cx?
spread of bacterial infxn from sinuses/middle ear
Spinal empymea - leads to?
compression of spinal cord - permenant damage
Intracranial subdural/epidural empyema - leads to?
increase in ICP
vomiting, diplopia, papilledema
Subdural abscess/empyema- tx?
1) surgical 2) abx IV
* b/c of compression, there is low blood circulation, so abx cannot get there
Brain abscess - cx?
bacterial spread from sinus/middle ear infxn
Brain abscess - sx?
headache
increased ICP - vomit, nausea, papilledema
seizures
mental status changes
Brain abscess - dx?
CT/MRI - DO NOT DO LP!! (CAN CX HEMORRHAGE)
Brain abscess - tx?
1) surgical 2) IV abx
CNS spirochete infection?
syphillis
lyme dz
CNS spirochete infxn - syphilis result?
Tabes dorsalis
CNS spirochete infxn -syphilis sx?
General paresis of the insane
tabes dorsalis
Tabes dorsalis?
result of untreated syphilis
infects the posterior dorsal column - affects vibration and propioception
pain of the sensory
General paresis of the insane?
behavior mood changes in syphilis infxted pts
encepahlitis
Lyme dz - bug?
tick borne illness d/t borrelia burgodferi
Lyme dz - leads to?
neurologic manifestions (neuropathy, meningitis)
How to tx syphilis?
PCN
CNS viral - cx?
vectors
GI tract
respiratory tract
animal bites
CNS viral pathophys?
immune response to viral infxn can lead to tissue damage
more damage from T cell and potent cytokines
Aseptic meningitis - sx?
HA
stiff neck
Aseptic meningitis - cx?
unknown
maybe theratpuetic drug
Aseptic meningitis vs bacterial meningitis - CSF labs?
CSF culture: negative
CSF: incr WBC/pleocytosis (same), elevated protein (same) but normal glucose
Encephalitis?
infxn of CNS neurons and glial cells
Viral encephalitis - cx?
secondary (common): viral infxn (pneumonia, enteritis)
primary (rare): rabies
Viral encephalitis - results?
confusion –> stupor –> seizures –> focal neurological defects –> coma –> death
Herpes simplex encephalitis - cx?
HSV I (cold sores) HSV II (herpes) primary infxn or viral reactivation in trigeminal ganglion that travels to the brain
Herpes simplex encephalitis - most common cx?
HSV I
Herpes simplex encephalitis - sx?
fever
confusion
seizures
coma
Herpes simplex encephalitis - what lobe is affected, role in sx?
frontal: personality changes, dementia, hallucination
temporal lobe
Herpes simplex encephalitis - cx in infants?
HSV II
to avoid: C section instead of vaginal birth (infants can get it easier b/c no BBB)
Herpes simplex encephalitis - CSF?
pleocytosis
increase protein
Herpes simplex encephalitis - dx?
PCR
CMV encephalitis?
rare in adults
CMV encephalitis - population?
immunocompromised (HIV pts)
HIV?
directly infects the CNS
CNS arthropod borne virus?
vectors
Prion dz?
abnormal form of neuron glycoprotein –> amyloid (neuron degeneration)
confined to gray matter –> spongiform encephalopathy
Prion dz - sx?
prominent personality changes dementia hallucination gait abnormalities seizures
Prion dz types?
Creutzfeldt Jakob (CJD)
Kuru
Bonvein Spoinform encephalopathy (mad cow)
Prion dz - dx?
brain bx postmortem - r/o other dz
CNS fungal infxn - popuatoin?
immunocomporomied
AIDs (loss of normla T cells)
low WBC
CNS fungal infxn - bugs?
candid
aspergillus mucormycosis
cryptococcus
Mycobacterial infxn?
TB meningitis
Mycobacterial infxn - sx?
HA
confusion
CN defects
Primary ameobic meningoencephalitis infxn?
rare
HIGH MORTALITY RATE
PAM - cx?
free-living ameoba (naegleria flowerir) - lives in freshwater and hot springs
PAM - population?
young men playing in American SW waters
CSF testing includes?
CBC and diff
protein
glucose
gram stain, C&S
