Infections Flashcards
HSV Encephalitis?
Necrotizing infection w/ RBCa and WBC, GTC, achey, temp, hyperreflex, Babinski, hypodense in TEMPORAL lobes
CSF: OP normal-ish, WBC up w/ Lymphos, RBCS UP, Glucose normal-ish, protein mild elevation
Cryptococcus Mening
Elevated OP, Elevated WBC w/ Lymphos, no RBC, little high glucose, high protein
HIGH ICP, nonlocalizing sixth => intermittent diplopia, communicating hydroceph (mild enlarged ventricles)
Tx = amphotericin B and flucytosine
Bacterial meningitis
CSF = low sugar, high PMNs, high protein
Can => hearing loss, or even visual loss!
TB meningitis
Basilar meningitis w/ multiple cranial neuropathies, raised ICP, hydrocephalus
LOW sugar! 100% lymphocytes, elevated protein
Guillan Barre
Tinling in all limbs, diffusely week, absent DTRs
CSF = high protein, no cells! Also seen in CIDP (chronic inflamm demyelinating polyneuropathy)
Ramsay Hunt
Herp Zoster of V3, w/ peripheral facial palsy (cant move side of face), and raised red lesions in EAC, red tympanic memrane
tx = acyclovir
EBV in HIV
If it looks like toxo but doesn’t respond to treatment, still mutliple mass lesions in brain, think CNS lymphoma from EBV :( PERIVENTRICULAR masses!
Lyme disease
bilateral facial weakness after being outdoors
Cryptococcus neoformans
Elevated opening pressure, lymphocytes, neg gram stain
dx w/ cryptoc antigen
Epidural abscess
Upper motor neuron signs (hyperreflex and extensor plantar response), can get it from a catheter
Cover staph aureus w/ cef/vanc
Neurocysticercosis
Most common cause of acquired epilepsy from t. solium, see calcified lesions throughout brain
Tx = albendazole
Neiserria Meningitidies
Petichiae, h/a, fever, obtund, tx contacts of pt w/ rifampin (or cipro)
Bells palsy
Gritty eye + facial drooling, if its not summer in the northeast, then not lyme. Maybe a herpes virus?
If seen in first 48 hous, give pred and antiviral
Congenital CMV
Hearing loss, spasticity, hyperintensities along ventricular margins on MRI
