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SA Microbiology > L06: Musculoskeletal/Nervous System (Brown) > Flashcards

L06: Musculoskeletal/Nervous System (Brown) Flashcards

1
Q

Bone sites predisposed to infection

A
  • site of traumatic injury
  • areas of active growth with increased vascularity
  • sites with special vascular features (ie. Discontinuous epithelium in capillaries in vertebral end plates and metaphyses)
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2
Q

Primary cause of diskospondylitis

A

Hematogenous spread of systemic infection

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3
Q

Primary cause of vertebral osteomyelitis

A

Penetrating wound

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4
Q

Osteomyelitis

A

Inflammation of the medullar cavity of a bone

-can be caused by hematogenous spread or post-trauma

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5
Q

Bone infections assoc. with intervertebral disk infections

A
  • osteitis
  • osteomyelitis
  • periostitis
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6
Q

Bacterial agents assoc. with arthritis

A 
Strep
Borrelia burgdorferi
Staph pseudintermedius
Mycoplasma felis
Mycoplasma spumans
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7
Q

Bacterial agents assoc. with diskospondylitis

A
  • actinomyces sp.
  • Strep
  • Brucella canis
  • Staph pseud.
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8
Q

Bacterial agents assoc. with myositis

A
  • strep (dog)
  • obligate anaerobes
  • Pasteurella multocida (cat)
  • staph pseud.
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9
Q

Bacterial agent(s) assoc. with necrotizing fasciitis

A

Beta-hemolytic strep (dog)

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10
Q

Bacterial agent(s) assoc. with osteomyelitis

A

Actinomyces
Brucella canis
Staph pseudintermedius

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11
Q

Bacterial agent(s) assoc. with polymyositis

A

Leptospira sp.

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12
Q

Most common cause of bacterial bone infection

A

Staphylococcal species (46-74%), usually staph pseudintermedius

Others:
-strep, gram - aerobes, anaerobes

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13
Q

Common clinical features with anaerobic osteomyelitis

A
  • follows fractures, trauma, or bite wounds
  • putrid exudate or gas in soft tissues
  • “sterile” cultures despite signs of infection
  • multiple microorganisms in gram-stained specimens
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14
Q

Agents of mycotic bone infections

A

(Usually via hematogenous spread)

  • cryptococcus neoformans
  • coccidioides immitis
  • Aspergillus species
  • Penicillium species
  • Blastomyces dermatitidis
  • Histoplasma capsulatum
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15
Q

T/F: synovial fluid aspirate often negative in septic joint

A

T

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16
Q

Abx for septic joints

A
  • based on C/S
  • penicillins, cephalosporins, and aminoglycosides penetrate bone well
  • clindamycin penetrates bone and works well against grampos and anaerobic osteomyelitis
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17
Q

Fluroquinolones in tx of bone/joint infection

A
  • good bone penetration
  • not effective against gramnegs and mycoplasma under anaerobic conditions
  • avoid in immature animals - bad for growing cartilage
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18
Q

Components of central nervous system

A

Brain
Spinal cord
CSF
Meninges

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19
Q

Components of peripheral nervous system

A
  • Cranial and spinal nerves that innervate muscles/effector organs
  • somatic sensory and autonomic divisions
20
Q

Nervous system infections most commonly involve CNS or PNS?

A

CNS

21
Q

Normal flora of nervous system

A

NONE!

Can have latent infections of herpesvirus and distemper virus

22
Q

Natural anatomic antimicrobial defense mechanisms in nervous system

A
  • brain, spinal cord
  • meningeal layers
  • BBB (capillary endothelial cell tight junctions)
  • blood cerebrospinal barrier (protects pituitary and choroid plexus)
  • blood nerve barrier (protects PNS nerves from inflammatory rxns)
23
Q

Nervous system immune defenses

A
  • MHC expressed by astrocytes and microglial cells in CNS parenchyma
  • major function = immunosurveillance, NOT response
24
Q

Innate defenses of nervous system

A
  • Complement (recruits leukocytes, kills via membrane attack complex)
  • Microglia cells (act as macs)
  • Dendritic cells
  • Astrocytes (produce cytokine)
  • Nerve cells (produce IFN)
25
Q

Chars. Of infections of the nervous system

A
  • most involve brain or meninges
  • other sites may be co-involved or act as targeted site
  • spinal cord involvement rare due to dec. blood flow
  • microbial toxins can act even if pathogen not present
  • injury from direct cytotoxic effects, inflammatory response, or both
26
Q

Routes of infection to nervous system

A
  • hematogenous most common
  • retrograde movement within neurons
  • extension of infectious process from contiguous sites
  • secondary to FB near head or spine
  • iatrogenic infection (ie. Contaminated spinal needles)
  • CSF if patient with bacteremia
27
Q

Mechanism of CNS injury

A
  • vascular damage (usually due to septicemia and bacterial embolization of the CNS)
  • brain parenchyma or meninges (inflammatory response, myelin formation)
28
Q

CS of meninges lesion

A

Back rigidity, depressed mental state

29
Q

CS of cerebrum lesion

A

Circling, behavioral changes, seizures

30
Q

CS of brainstem lesion

A

Cranial nerve deficits, head tilt

31
Q

CS of cerebellum lesion

A

Ataxia, tremors

32
Q

CS of spinal cord lesion

A

Tetraplegia

33
Q

Chars. Of meningoencephalitis

A
  • meningitis + encephalitis

- CS of meningitis usually precede CS of encephalitis

34
Q

CS of meningitis

A
  • fever
  • hyperesthesia
  • neck rigidity
  • painful paraspinal muscle spasms

+/- depression, blindness, paresis, ataxia, opisthotonos, CN deficits, seizures, dementia, agitation, depressed consciousness

35
Q

Most reliable and accurate means of identifying meningitis or meningoencephalitis

A

Analysis of CSF

36
Q

Rabies causes what CNS CS?

A

Aggressive behavior, paralysis

37
Q

Pseudorabies virus causes what CNS CS in dogs?

A

Intense pruritus

Seizures

38
Q

Pseudorabies virus causes what CNS CS in cats?

A

Hyperexcitability
Paralysis
Paresis

39
Q

CNS CS of cryptococcus neoformans

A

Dogs: ataxia, head tilt, paresis, seizures

Cats: ataxia, paresis, CN deficits, seizures

*often the inflammation, not the pathogen itself causes the problems

40
Q

Canine viruses that cause nervous system CS

A

Adenovirus 1 (seizures)

Distemper (seizures, ataxia)

Herpesvirus (seizures, depression, back m. Spasm)

41
Q

Feline viruses that cause nervous system CS

A

Panleukopenia (ataxia)

FIV (aggressive or psychotic behavior, seizures)

FIP (ataxia, paresis, seizures)

FeLeuk (abn. Vocalization, hyperesthesia, paresis)

42
Q

Canine bacterial infections that cause CNS CS

A

Otitis (E. Coli, proteus, pseudomonas, staph, strep) –> vestibular dysfx

Ehrlichia canis: ataxia, cerebellar/vestibular dysfx, seizures

Clostridium botulinum –> flaccid paralysis, paresis

Clostridium tetani –> back m. Spasm, seizures, tremors

Rickettsia rickettsii –> ataxia, depression, vestibular dysfx, seizures

43
Q

Treatment of nervous system infection

A

Little benefit except for animals w/ probably immune-mediated, steroid-responsive inflammatory CNS diseases, or animals w/ meningoencephalitis caused by rickettsia and certain bacteria

-higher dosages of abx may be needed to maintain adequate conc. In the CNS

44
Q

What type of abx rec. for tx of CNS infection?**

A

BACTERICIDAL (not static)

Ampicillin, metronidazole, tetracyclines, TMS, fluoroquinolones, 3rd gen. Cephalosporins

45
Q

Natural defenses of MS system

A
  • circulatory immune system

- constant bone remodeling

SA Microbiology (10 decks)

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