Infectious Diseases of the Nervous System

Question 1

What are the symptoms of meningitis?

Answer 1

fever
headache
stiff neck
nausea
vomiting
photophobia

Question 2

What can cause meningitis?

Answer 2

bacteria (typically most severe)

viruses (typically less severe)

fungi (typically opportunistic, e.g., AIDS)

Question 3

What are the bacteria that can cause meningitis?

Answer 3

Neisseria meningitidis

• meningococcal meningitis
• encapsulated G- diplococcus

Streptococcus pneumoniae

• pneumococcal meningitis
• encapsulated G+ diplococcus

Haemophilus influenzae

• Haemophilus meningitis
• encapsulated G- pleomorphic bacillus

Question 4

What are the symptoms of the most serious form of meningitis? What is the differential symptom?

Answer 4

convulsions, shock, coma
clotting, cardiac failure

differential symptom = petechiae

Question 5

What used to be the most common type of meningitis in children? Why is it not anymore?

Answer 5

Haemophilus meningitis was the most common type in young children before 1992 when the Hib vaccine was introduced

Question 6

How do we prevent bacterial meningitis?

Answer 6

conjugate vaccines = capsule linked to protein antigen

• ActHIB 1992
• Prevnar 2000
• Menactra 2004

Question 7

What is neonatal meningitis?

Answer 7

Streptococcus agalactiae (group B strep)
 - 10-30% women colonized in vagina

vertical transmission during delivery
- meningitis, septicemia, & pneumonia

Question 8

How do we prevent neonatal meningitis?

Answer 8

pregnant women routinely screened at 35-37 weeks

i.v. beta-lactam administered before delivery

Question 9

Which differential symptom is associated with meningococcal meningitis?

Answer 9

petechiae

Question 10

Conjugate vaccines are used to prevent bacterial meningitis because the bacteria that cause meningitis are all:

Answer 10

encapsulated

Question 11

What are the symptoms of West Nile fever and encephalitis?

Answer 11

fever
headache
brain swelling
impaired function
paralysis

Question 12

What are the characteristics of west nile virus?

Answer 12

arthropod-borne virus (arbovirus)

mosquito vector

bird reservoir

Question 13

What are some other brain diseases and how are they spread?

Answer 13

zoonotic infections

toxoplasmosis
- meow!

rabies
- woof!

Creutzfeldt-Jakob disease (CJD)
- moo!

Question 14

What is tetanus and botulism?

Answer 14

paralytic diseases

Clostridium sp.

• soil bacteria
• G+ bacilli
• endospores
• anaerobic
• neurotoxins

Question 15

What are the characteristics of tetanus?

Answer 15

puncture wounds

neurotoxin = tetanospasmin

spastic paralysis

Question 16

How do you prevent tetanus?

Answer 16

wound cleaning
toxoid vaccine (DTaP)
10 yr boosters
passive immunization

Question 17

What are the characteristics of botulism?

Answer 17

caused by Clostridium botulinum
- foodborne transmission

neurotoxin = botulin

flaccid paralysis

floppy baby syndrome

Question 18

How do you prevent botulism?

Answer 18

food processing techniques & monitoring

passive immunization

Question 19

All the following are zoonotic infections except:

CJD
poliomyelitis
rabies
toxoplasmosis
West Nile encephalitis

Answer 19

poliomyelitis

Question 20

Tetanus and botulism have all the following in common except:

bacterial infection
neurotoxins
foodborne transmission
paralytic disease
endospores

Answer 20

foodborne transmission