Fungal and Parasitic Infections of the CNS

Question 1

Systemic fungi (all acquired by inhalation-potential to spread systemically) can cause CNS infection

Answer 1

histoplasma, blastomyces, paracoccidioides, coccidioides, cryptococcus

Question 2

Leading cause of fungal meningitis

Answer 2

cryptococcal meningitis

Question 3

Dimorphic fungi that causes systemic mycoses (molds in environment; yeast in tissues)

Answer 3

histoplasma capsulatum, blastomyces dermatitidis, paracoccidioides brasiliensis, coccidioides immitis

Question 4

Systemic mycoses agent that is not dimorphic and has a worldwide distribution

Answer 4

cryptococcus neoformans

Question 5

found throughout the western hemisphere-causes valley fever-found in San Joaquin Valley of California and in Southern Arizona

Answer 5

coccidioidomycosis

Question 6

occurs when you see drought-rain-drought pattern, large numbers of fungal elements present in blowing dust

Answer 6

coccidioidomycosis

Question 7

converts to spherules

Answer 7

coccidioidomycosis

Question 8

develops slowly with increasing headache, fever, stiff neck, and other neurological signs, if untreated is frequently fatal

Answer 8

coccidial meningitis

Question 9

encapsulated yeast, not dimorphic, identified by india ink

Answer 9

Crytpococcus neoformans

Question 10

abundant in soil contaminated with bird (mostly pigeon) droppings

Answer 10

cryptococcus neoformans

Question 11

cryptococcosis acute meningitis in

Answer 11

AIDS/immunosuppressed

Question 12

Fungal agents that are not causative agents of systemic mycoses

Answer 12

candida albicans, zygomycetes

Question 13

causes amoebic dysentery and can cause brain abscesses (and liver abscesses)

Answer 13

Entamoeba histolytica

Question 14

can cause sleeping sickness

Answer 14

Trypanosoma brucei (african trypanosome)

Question 15

causes complication of malaria-cerebral malaria

Answer 15

plasmodium falciparum

Question 16

opportunistic amoeba genera-very rare-normally reside in fresh water

Answer 16

acanthamoeba, naegleria, and balamuthia

Question 17

caused by Naegleria

Answer 17

Primary amebic meningoencephalitis (PAM)

Question 18

acquired during swimming in warm water-hot springs, heated pools, hot tubs- intranasal inoculation-majority of cases are fatal within one week

Answer 18

Primary amebic meningoencephalitis (PAM)

Question 19

symptoms of PAM

Answer 19

fever, headache, vomiting, confusion, and death

Question 20

Dx: PAM

Answer 20

observation of trophozoites in biopsy or cerebrospinal fluid

Question 21

Tx:

Answer 21

infection is usually fatal, some success following treatment with Amphotericin B

Question 22

caused by Acanthamoeba and Balamuthia

Answer 22

Granulomatous amoebic encephalitis (GAE)

Question 23

amoeba invade the brain, resulting in a slowly developing ulcerative lesion (slow progression than PAM)

Answer 23

Granulomatous amoebic encephalitis (GAE)

Question 24

GAE can be disseminated in

Answer 24

AIDS patients

Question 25

more common presentation of acanthamoeba infection

Answer 25

Acanthamoeba keratitis (chronic infection of cornea)

Question 26

corneal ulceration and ocular pain can accompany

Answer 26

Acanthamoeba keratitis

Question 27

Tx: Acanthamoeba keratitis

Answer 27

topical treatment, corneal transplantation/Eye enucleation

Question 28

toxoplasmosis is caused by

Answer 28

toxoplasma gondii

Question 29

sources of toxoplasma gondii

Answer 29

cat (oocysts in feces), food (livestock contaminated w/ cysts)

Question 30

majority of infected individuals in toxoplasma gondii are

Answer 30

asymptomatic

Question 31

congenitally acquired infection that can lead to miscarriage or stillbirth or blindness, mental retardation, neurological disorders

Answer 31

Congenital Toxoplasmosis

Question 32

causes encephalitis in the immunocompromised (HIV/AIDS)

Answer 32

toxoplasma gondii

Question 33

pregnant women are advised to avoid this task in order to reduce exposure to toxoplasma gondii

Answer 33

changing cat litter

Question 34

If it occurs in this trimester there is a greater chance of infection but it will be less severe or asymptomatic

Answer 34

toxoplasmosis-3rd trimester

Question 35

If it occurs in this trimester there is a slimmer chance of fetal infection, but with severe disease

Answer 35

toxoplasmosis-1st trimester

Question 36

toxoplasmosis symptomatic disease is

Answer 36

“flu-like”

Question 37

timmu system walls off bradyzoite filled cyst in this infection

Answer 37

toxoplasmosis

Question 38

toxoplasmosis encephalitis is due to

Answer 38

reactivation of existing infection (at time of severe immunosuppression)

Question 39

Dx: of toxoplasma gondii

Answer 39

serological testing-congenital may do PCR analysis of amniotic fluid

Question 40

Maternal testing of toxoplasma gondii

Answer 40

IgM or rising IgG titer indicates acute infection

Question 41

Children with toxoplasmosis should be treated for

Answer 41

the first year

Question 42

Visceral Lavarl migrans

Answer 42

granulomatous lesions in liver, spleen, lung, eye, brain

Question 43

Diagnoses of visceral larval migrans

Answer 43

eosinophilia, clinical presentation, serology, history (pets)

Question 44

Tx: of visceral larval migrans

Answer 44

steroids (no organisms to kill)

Question 45

Are eggs passed in the feces in individuals with visceral larval migrans?

Answer 45

No