Infectious diseases affecting the CNS Flashcards
What are the types of meningitis
- bacterial
- viral
- fungal
- parasitic
- noninfectious
Bacterial meningitis
-
- can be life-threatening
- requires immediate medical attention
- can be prevented with vaccines
- Meningococcus, pneumococcus, Hib
- can affect any age
Bacterial meningitis risk factors
- age
- community setting
- other medical conditions
- travel
How is bacterial meningitis transmitted
- not airborne
- exchange of respiratory and throat secretions
- contamined foods (listeria)
Bacterial meningitis: signs and symptoms
- sudden onset of feve, headache, stiff neck
- nausea, vomitting
- photophobia
- confusion
- in infants: slow, inactive, poor feeding, bulging fontanelle, abnormal reflexes
- later as progresses: seizure and coma
diagnosis of bacterial meningitis
- diagnosis via blood or csf testing
- treatment: antibiotics
- reduces risk of death
- prevention: vaccine
Kernig’s sign
Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.
complains of pain as well
tests for meningitis in kids
Brudzinski’s neck sign
- neck flexion causes knee flexion
- bacterial meningitis in kids
what is viral meningitis caused by
- enteroviruses
- mumps
- herpes
- arborvirus (inset born)
- LCMV (rodent born)
how is viral meningitis transmitted
- fecal contamination
- respiratory secretions
- in US more common in summmer and fall due to rodent population
- can affect any age
- most common in children under 5
viral meningitis signs and symptoms
- same as bacterial
- sudden onset of feve, headache, stiff neck
- nausea, vomitting
- photophobia
- confusion
- in infants: slow, inactive, poor feeding, bulging fontanelle, abnormal reflexes
- later as progresses: seizure and coma
viral meningitis treatment and prevention
- treatment: no specific treatment = self limiting
- prevention: handwashing, vaccines, avoid insect bites
fungal meningitis
- rare
- spread from blood to spinal cord
- more ccommon in people with impaired immune system
- most common cause: cryptococcus in africa
fungal meningitis transmission
- not contagious
- more susceptibale if immune system weak
- soil, environment with bird, bat guano
- steriod injections (multiple)
fungal meningitis: risk factors
- weak immune system
- premature infants, pregnant women
- african americans
- filipinoes
treatment for fungal meningitis
- antifungal meds
Parasitic meningitis
rare
fatal
noninfectious meningitis
- cancer
- lupus
- brain injury
- brain surgery
What is JC virus
- virus affects DNA transcription = polyomavirus
- only found in humans - many humans
- quiescent in kidenys, bone marrow, lymphatic system
- casues PML in immunosuppressed individuals
what is progressive multifocal leukoencephalopathy
- destruction of Glia esp. oliogodendrocytes = CNS demyelination
- occurs wih severe immunosuppression (HIV/AIDs, bone marrow transplantion, drugs that cause immunosuppression)
PML signs and symptoms
- correlates to the part of the brain thats damaged
- may develop seizure disorder
- diagnosis via MRI, blood, and CSF
- no known cure: remove immunosuppressants
if this is caused by HIV, antiretroviral therapy can help
Other JC virus disease
- JCV granule cell neuropathy: brain not affected but demyleination peripherally
- JCV encephalopathy
- JCV meningitis
Zika virus
- mosquito borne (vetor borne)
- symptoms can be mild: arthralgia, conjunctivitis, fever rash
- assoicated with prematurity and microcephaly
- prevention is key (bug spray/avoid stagnant water)
Creuzfeldt-Jakob Disease
- rare
- related to bovine spongiform encephalopathy
- some cases related to corneal transplants
- some can live a long time
HIV/AIDs
- human immunodeficiency virus
- aquired immunodeficiency deficiency syndrome
- overview: retrovirus, affects RNA and DNA production
- reduces WBC production
common infections in PWA (people with AIDs)
- PCP pneumonia (pneumocystis carinii)
- cryptococcus
- thrush: fungal infection of the mouth
- tuberculosis
- viral infections
- malignancies: kaposi sacroma, B-cell, lymphoma
What are some primary neurological disorders with PWA
- AIDs dementia/encephalopathy
- myelopathy
- neuropathy
- myopathy
What are secondary neurological infections in PWA
- cerebral toxoplasmosis
- primary CNS lymphoma
- progressive mutlifocal leukoencephalopathy
- cytomegalovirus
- crytococcal meningitis
AIDs dementia - early signs
- cognition: forgetfulness, easily distracted, loses train of though
- motor: impaired handwriting, ataxiaa, clumisness, slowed movement
- behavior: apathy( frontal lobe)
AIDs dementia complex
- cognition: global dementia
- motor: paraparesis or quadriparesis, urinary incontinence
- behavior: mutism
What can help with AIDS dementia
- exercise
- improves mood, cognition, muscle function, endurance, cardiovascular fitness, immune system, CD4 count
- can promote weight gain
Neglected parasitic infections: trichomaniasis:
- common STD,
- increase risk of premature,
- LBW baby
- pain/itching/fever
Neglected parasitic infection: toxoplasmosis:
- can cause neurological deficits or blindness in children
- carried in cat/dog feces
- adults typcially wont know they have it
Neglected parasitic infections: Toxocaraiasis:
- blindness, organ damage
- dog/cat feces
- in people < 20 years old
Neglected parasitic infections: Neurocystericosis:
- seizures, brain damage
- can be from a tape worm
Neglected parasitic infections: Chagas:
- arrhythmia,
- impaired swallowing,
- impaired digestion
Mpox
- causes skin lesions rash of nodules
- currenly most prevalent in Democratic Republic of Congo
- transmitted through close contact esp sexual contact
Mpox signs and symptoms
- incubation period 3-17 days
- symptoms usually start with in 21 days of exposure
- rash is most common
- other possible symtpoms: flu like
Mpox testing, treatment and prevention
- vaccine available
- treatment of symptoms
- safe sex
- universal precautions
- handwashing
- avoid large groups if you are sick
