Encephalitis + Brain Abscess Flashcards
inflammation of the brain itself
encephalitis
inflammation or swelling of the meninges surrounding the brain and spinal cord
meningitis
how may encephalitis start off as?
bacterial meningitis
what is the most common cause of encephalitis in the US?
west nile virus
what is the most likely etiology of encephalitis that is most fatal if not treated?
Herpes Virus
a patient presents with an acute onset of fever, headache, confusion, and sometimes seizures. what are they likely experiencing?
encephalitis
what 3 symptoms would a child present with if they have encephalitis?
irritability
poor appetitie
fever
how would the neurological exam of a patient with encephalitis present?
drowsy/confused
what diagnostic and result would help us diagnose encephalitis?
lumbar puncture + CSF culture
viral etiology
a patient presents with fever, AMS, seizures. their CSF shows mildly elevated WBCs + protein, but normal glucose. what is their likely diagnosis?
HSV-1 encephalitis
imaging shows parenchymal inflammaiton and edema, especially in the temporal lobes. what is the diagnosis?
HSV-1 encephalitis
what is the treatment for HSV-1 encephalitis?
acyclovir
supportive care
a patient presents with transient symptoms/asymptomatic with a mild fever. CSF show IgG and IgM. what is the diagnosis?
west nile virus
collection of pus within the brain tissue; the tissue is infected
brain abscess
what are the 2 pathogenesis of a brain abscess?
direct spread
hematogenous spread
bacteria comes from a contagious site, typically causing a single brain abscess
direct spread
what vessel is hematogenous spread that leads to multiple brain abscesses associated with?
the middle cerebral artery
a brain abscess will have the organism ____ if the source of infection is from paranasal sinuses, teeth, ear, or lungs.
streptococcus
a brain abscess will have the organism pseudomonas a. if the source of infection is from:
urinary tract
a brain abscess will have the organism staph aureus if the source of infection is from: (2)
penetrating head trauma
neurosurgery
what are the 2 main sources of brain abscesses?
strep viridans
staph aureus
what causes the symptoms in a brain abscess?
mass effect
a patient presents with AMS, seizures, headache, drowsiness, N/V, and papilledema. what is their likely diagnosis?
brain abscess
how long after symptom onset do patients typically seek care for a brain abscess?
within 2 weeks
what is the main diagnostic used for a brain abscess?
brain CT/MRI
what can be both diagnostic and therapeutic for a brain abscess?
surgical drainage + gram stain/culture
what size brain abscesses can be treated medically, without surgical drainage?
less than 2cm
what is the treatment for a brain abscess that’s less than 2cm? (3)
empiric broad spectrum antibiotics
IV dexamethasone/mannitol
brain CT/MRI q 2 weeks
how would treatment for a brain abscess be administered?
IV for 6-8 weeks, then
oral for 2-3 months
