Infections Flashcards
Vaccines against what organisms have decreased incidence of mengitis in youth?
H influenzae
strep pneumo
neiserria meningitidits
CSF findings bacterial meningitis
high WBC (leukocyte predominance)
elevated protein
low glucose
bacterial composition of most brain abscesses
polymicrobial
usually mixture of aerobic and anaerobic organisms
how do brain abcesses appear on CT/MRI and how to differentiate from neoplasm
mass lesion often surrounded by “ring enhancement” and signs of central necrosis.
use SPECT
neck/back pain with focal neurologic signs, often “sensory level”
may or may not present with fever
spinal epidural abscess
etiology of most spinal epidural abcesses
instrumentation (epidural or spinal anesthesia)…so common organism would be staph
or from spread from vertebral osteomyelitis/diskitis
how to treat spinal epidural abscess…and when it causes cauda equina syndrome?
IV antibiotics
neurosurgical drainage
may need surgical decompression of spinal cord if cauda equina syndrome occurs
three nervous system manifestations of TB
tuberculous meningitis
intracranial tuberculoma
Pott’s disease (spinal cord invasion)
How to differentiate tuberculous mengitis from bacterial mengitis on clinical presentation
unlike bacterial meningitis, TB meningitis typically…
- affects basal meninges at base of brain and therefore can present with CN palsies, hydrocephalus, brain infarcts from inflammation
- is usually more subacute/insidious and chronic in onset…can have long prodrome before you get neck stiffness
TB meningitis vs bacterial mengitis on CSF
TB meningitis - lymphocytic predomoinance, very low glucose
bacterial - neutrophilic predominance, low glucose
early and late neurological manifestations of Lyme disease
several weeks after bite (disseminated stage) - neck stiffness, myalgias, facial nerve palsy
several months after bite - polyradiculopathy, polyneuropathy, ENCEPHALOPATHY
which viruses can cause meningitis
enteroviruses (coxsackie)
arboviruses (west nile)
viral vs bacterial meningitis on CSF
viral - lymphocytic predominance, elevated protein, GLUCOSE NORMAL
bacterial - neutrophilic predominance, elevated protein, LOW GLUCOSE
what areas of brain does HSV encephalhitis attack typically
base of brain, specifically medial temporal lobe and orbitofrontal regions of cortex
how does HSV encephalitis present
headache, fever, AMS, seizures, focal neurologic
SPECIAL CHARACTERISITICS: complex partial seizures originating in medial temporal lobe, olfactory hallucinations, memory disturbances
