Infectious Neuropath Flashcards
where does bacterial meningitis infection focus?
subarachnoid space
what happens to leptomeninges appearance in bacterial meningits?
cloudy/opaque appearance
what happens to blood vessels in subarachnoid space with bacterial meningitis?
swollen
what is the most common starting point for bacterial meningitis to spread from directly?
frontal sinuses
what is it called when bacterial meningitis occurs from blood?
bacteremia
name three neonate causes of bacterial meningitis
group B strep
e coli
listeria
name three child causes of bacterial meningitis
H flu
strep pneumo
n meningitis
name two adult bacterial meningitis causes
N meningitidis and strep pneumo
what is onset time for subacute meningitis?
weeks to months
what are symptoms of subacute meningitis?
fever headache meningismus and altered mental status
name three bugs to know for subacute meningitis
TB
cryptococcus
spirochetes
what are the spirochetes that can cause subacute meningitis?
syphilis and lyme disease
what is a non infectious cause of sub acute meningitis?
sarcoidosis
what portion of brain does TB involve?
base of brain
what does TB form in brain?
granulomas
what two things can reactivated TB lead to in brain?
tuberculoma and tuberculous meningitis
what is a tuberculoma?
huge mass…leads to mass effect and tissue destruction
what is tuberculous meningiis?
regular meningitis symptoms…cranial nerve issues, meningeal fibrosis and arteritis
what cells will you see in granulomas of TB in brain?
giant cells are common
what type of patient common to get cryptococcus meningitis?
immunocomp
what changes to meninges does cryptococcus meningitis cause?
meninges thickened and opicifiec with slimy consistency
what do you find in brain tissue of brain from cryptococcus meningitis?
sopa bubbles or cysts in intraparenchymal
what three ways can brain abscesses form?
direct extension from sinuses/middle ear
or
implantation from trauma
or bacteremia
what two locations are common for direct extension leading to brain abscess?
paranasal sinus and middle ear/mastoid cells
bacteremia leads to one or multiple brain abscesses?
multiple usually at white/gray matter jxn
what does brain abscess cause in brain?
mass effect
what is the mass effect in the brain?
headache nausea vomiting from ICP increase…risk of herniation
what is encephalitis?
diffuse inflammation of brain or brain and spinal cord
what is inflammation of brain and spinal cord called?
encephalomyeltlis
what is most common cause of encephalitis?
viruses
what viruses are common in encephalitis?
HSV1/2 Polio Coxsackivirus arboviruses HIV Rabies enteroviruses
what three pathology findings does encephalitis lead to?
necrosis or hemorrhagic necrosis of brain tissue
perivascular chronic inflammation
viral inclusions
what is perivascular inflammation in encephalitis?
area around brain vessels is chronically inflammed with lots of cells surrounding it
do you have stiff neck with meningitis or encephalitis?
meningitis
what are main symptoms of viral encephalitis?
headache, coma, seizures, fever, lymphocytic infiltrates, brain necrosis
what cells are active in encephalitis?
lymphocytes
name two routes that can cause viral encephalitis?
axonal spread and viremia
what viruses cause encephalitis by way of axon?
rabies
HSV1
what viruses cause encephalitis by way of hematogenous spread?
enteroviruses and arboviruses
HSV1 causes encephalitis where?
temporal and frontal lobes
poliovirus causes encephalitis where?
anterior horn cells
JC virus causes encephalitis where?
progressive multifocal leukoencephalopathy
rabies causes encephalitis where?
hippocampus and cerebellum
VZV causes encephalitis where?
dorsal root gangli
what is inclusion in neurons called with rabies virus?
Negri bodies
what are negri bodies?
eosinophilic cytoplasmic inclusions seen in neurons with rabies
what is cysticercosis?
parasitic cause of encephalitis
what is parasite that causes cysticercosis?
taenia solium
where do we get taenia solium?
pork tapeworm
what does cysticercosis cause in the CNS?
cyst formation
how do we get primary amebic meningoencephalitis?
swimming in fresh water with the amoebae…enters nasal cavity and then enters CNS through cribiform plate
how to treat amebic meningoencephalitis?
amphotericin B
what bug causes amebic meningoencephalitis?
Naegleria fowleri
