infections Flashcards
what organism causes Lyme disease? how is the diagnosis made?
borrelia burgdorferi (spirochete) Antibodies in the serum and CSF.
how is neuro lyme disease treated?
2-4 weeks of IV ceftriaxone or penicillin G.
what organsisms cause mucormycosis?
mucor, rhizopus, rhizomucor (fungi)
what are risk factors for developing mucor?
immunocompromised states and iron chelation therapy with desferoximine.
In what disease does the pathology show white matter pallor, activated macrophages, multinucleated giant cells and vacuolar changes in the brain?
HIV associated Dementia
immunocompromised patients, exposure to bird droppings and positive india ink stain.
cryptococcus neoformans
what is the most sensitive test for cryptococcus?
CSF antigen testing
what is the treatment of cyrptococcus?
amphotericin plus flucytosine for 2-3 weeks, then switch to fluconozone.
most common opportunistic infection in patients with HIV, multiple ring enhancing lesions
Toxoplasmosis
what is the treatment for Toxoplasmosis?
sulfadiazine plus pyrimethamine plus folinic acid. Or can use Clindamycin
what medication is used for toxoplasmosis prophylaxis?
trimethoprine-sulfamethoxazole
multiple non-enhancing white matter lesions, myelin loss, giant astrocytes, oligodendrocytes with viral inclusions, “spagetti and meatball” appearance on electron microscopy.
PML
length dependent symmetric polyneuropathy in HIV
HIV neuropathy
ascending neuropathy occurring around the time of HIV seroconversion.
AIDP
multifocal neuropathy occurring late in HIV
mononeuritis multiplex
myositis occurring any time in HIV, MHC I expression on muscle cells.
auto immune myositis
muscle wasting in late stage HIV
AIDS cachexia
causes of meningitis in neurosurgical patients
pseudomonas, s. aureus, S. epidermidis, p. acnes.
empiric meningitis tx in older or immunocompromised patients .
Vanc, ceftriaxone, ampicillin (for listeria)
thickened nerves, multiple neuorpathies and weakly positive acid fast bacili
m. leprae (aka leprosy)
granulomatous inflammation, multinucleated giant cells, caseating necrosis
Tuberculous meningitis
in what stages of syphilis does syphilitic meningitis occur?
secondary syphilis
endarteritis obliterans and vasculitis
meningovascular syphilis
areflexia, lightening pains, sensory ataxia, loss of pain and temp sensation.
tabes dorsalis, tertiary syphilis.
abdominal symptoms, neurolgoci symptoms, adrenal insufficiency, cutaneous hypopigmentation.
Whippel’s diasease (t. whippelii)
schiff positive macrophage inclusions
whipples disease
what is the treatment for Whipple’s disease?
TMP-SMX
main difference between primary CNS lymphoma in immunocompromised and immunocompetent people.
EBV is usually causative in immuno compromised ppl.
EEG pattern in CJD
repetitive periodic pattern
