L40- Nervous System and Special Senses Infections III Flashcards
Encephalitis:
- (1) definition
- (2) are the most common causes of primary form
- (3) = secondary cause
1- inflammation of brain parenchyma
2- Viral: HSV-1/2, Arbovirus, Enterovirus
3- ADEM (acute disseminated encephalomyelitis) occurs post-infection and results from an autoimmune attack on myelin
Encephalitis:
- (1) is the major criterion for Dx
- (2) are the other minor criterion
1- Altered Mental Status: impairment of consciousness, memory, mental status
2:
- fever w/in 72hrs of presentation
- seizure
- CSF w/ pleocytosis
- imaging with evidence of parenchymal inflammation
name the associated pathogen with the following unique sign seen in each encephalitis:
- (1) grouped vesicles in dermatomal pattern on skin
- (2) parotitis
- (3) flaccid paralysis
- (4) hydrophobia, aerophobia, pharyngeal spasms, hyperactivity
- (5) tremors in eyelids, tongue, lips, extremities
1- VZV 2- mumps 3- WNV 4- rabies 5- WNV, SLV (st. louis)
Meningitis, indicate if present or absent:
- (1) fever
- (2) HA, lethargy, n/v
- (3) photophobia, neck stiffness
- (4) seizures
- (5) CN palsies
- (6) altered mental status
1- yes 2- yes 3- yes 4- minimal 5- no 6- minimal
Encephalitis, indicate if present or absent:
- (1) fever
- (2) HA, lethargy, n/v
- (3) photophobia, neck stiffness
- (4) seizures
- (5) CN palsies
- (6) altered mental status
1- yes 2- yes 3- no 4- yes 5- yes 6- yes
name the associated pathogen with the following imaging seen in each encephalitis:
- hydrocephalus suggest encephalitis caused by (1)
- (2) involvement of temporal lobe
- (3) involvement of basal ganglia
1- non-viral cause (bacteria, fungal, parasite)
2- HSV
3- respiratory virus infection, Creutzfeldt-Jakob disease, arbovirus, Tb
(1) is the most common cause of encephalitis, ~10% of all cases:
- (2) describe mortality
- commonly affects (3) age group
1- HSV: 1 > 2
2- >50% if untreated
3- any age
describe the clinical presentation of HSV encephalitis- include affected brain regions
-HA, fever for up to 5 days
- personality / behavioral changes –> frontal lobe damage
- memory, speech problems –> temporal lobe damage
-seizures, hallucinations, altered levels of conciousness
Powassan encephalitis:
- (1) describe microbe
- (2) incubation period
- (3) Sxs
1- (rare- US, Canada) Arbovirus transmitted via ticks
2- 7-10 days after bite
3- HA, fever, nausea, confusion, partial paralysis, coma, seizures
describe the progression of infections that cause Brain Abscess — include affected area of brain parenchyma
Hematogenous Seeding
Contiguous Spread:
- subacute/chronic otitis media –> inferior temporal lobe, cerebellum
- frontal / ethmoid sinuses –> frontal lobe
- dental infections –> frontal lobe
Note- most are polymicrobial
brain abscess Sxs
- HA, 90%
- mental status changes, 67%
- hemiparesis, 61%
- fever, 57%
- papilledema, 56%
describe brain abscess Dx (importantly indicate what procedure is contraindicated) and Tx
Dx: CT / MRI
NO LUMBAR PUNCTURE => herniation
Tx: drainage
______ is the most common cause of acute viral myelitis
- Enterovirus: poliovirus
- Flavivirus
- some others
Poliovirus: family, genus, genome, structure
picornaviridae- enterovirus
- (+)ssRNA
- non-enveloped
list the different diseases caused by Poliovirus
1) abortive poliomyelitis: non-specific Sxs: fever, HA, sore throat, anorexia, vomiting, abdominal pain
2) non-paralytic poliomyelitis – aseptic meningitis
3) paralytic poliomyelitis (abortive –> paralysis), <2% of cases