Nervous System Infections Flashcards
Types of infections of CNS
Meningitis
Encephalitis
Abscesses
Part of nervous system affected by pathogen in meningitis
Meninges
Membrane lining the Brain
Spinal cord
Which is worse, bacterial or viral meningitis
Bacterial
Primary causative agents of neonatal meningitis
Group B strep
E. coli
Listeria monocytogenes
More prevalent bacterial meningitis in children
Neisseria meningitides
More prevalent bacterial meningitis in adults and elderly
Strep pneumoniae
Can hémophilus influenzae cause bacterial meningitis
Yes
Can neisseria meningitis cause medical emergency by causing acute fulminant meningitis
Yes
Risk at group in N. Meningitides
2-18yo
Risk factors N. Meningitides
Overcrowded quarters living conditions
Symptoms and signs N. Meningitides
Stiff neck High fever Headache Altered mental status Nausea Vomiting Radiculaire pain Increased intracranial pressure signs Focal neuroglia deficits
Complications of N. Meningitides
Water house friderichsen syndrome
DIC
Coma
Rapid death
Diagnosis of N. Meningitides, strep pneumoniae , hemophilus influenzae
Physical -> Kernig and brudzinski signs
Lab -> CSF biopsy for bacterial and culture, high neutrophil, high protein , decreased glucose, skin biopsy if petechiae
Is strep pneumoniae as rapid and fulminant as N. Meningitides
No
Proportion of survivors that suffer neurological sequalae like deafness, persistent seizures, mental retardation
1/3or4
Risk group of hemophilus influenzae
Children under 5yo
Means of spread of hemophilus influenzae
Direct sinus
Hematogenous spread
Percentage of survivor that sustain permanent neurologic sequalae like deafness and mental retardation
15-35%
Group B strep that is leading cause of meningitis in neonates
Strep agalactiae
Transmission of Strep agalactiae
Vertical transmission during birth
Community
Nosocomial
Risk factors Strep agalactiae
Prematurity
Low birth weight
Preterm labor
Premature or prolonged rupture of membranes
Previous infants affected with Strep agalactiae
Intrapartum fever
History of maternal Strep agalactiae infection
Symptoms Strep agalactiae infection s
Non specific Meningitis in newborn
Diagnosis of Strep agalactiae in infants
If Fever above 38degrees -> LP to search since there’s no specific symptoms
Latex agglutination test
Transmission of E. coli
Vertical transmission
Risk factors E. coli
Prematurity
Low birth weight
Symptoms E. coli meningitis
Fever Irritability Failure to thrive Focal neurologic deficits Decreased feedings Vomiting Jaundice Seizures Apnea Neurologic sequalae
Diagnosis of E. coli meningitis
Blood culture Throat swab CBC PCR ESR C reactive protein Urinalysis CSF , latex agglutination
Patients at risk of listeria monocytogenes
Birth to 3 months Patients above 65yo Immunocompromised Pregnant women Alcoholics
Are brain abscess possible in listeria monocytogenes
Yes
Common source of listeria monocytogenes
Dairy products
Unpasteurized milk
Soft cheese
Neonatal infection with listeria monocytogenes transmission
Birth canal
Transplacental infection
Risk factors listeria monocytogenes
Prematurity
Birth weight
Symptoms listeria monocytogenes
Fever Nuchal rigidity Headache Irritability Poor feeding Lethargy Seizures
Prognosis of listeria monocytogenes, E. coli , GBS
Good but morbidity high
Is mortality higher in elderly or neonate
Yes
Person at risk of mycobacterium tuberculosis
Immunocompromised
HIV
Signs of mycobacterium tuberculosis
Same as in meningitis
Pathogens in fungal meningitis
Cryptococcus neoformans Candida albicans Histoplasm capsulatum Blastomycoses Coccidiodes immitis
Risk factors of fungal meningitis
Immunocompromised
Pigeon droppings
Smoking
Viral meningitis mild or severe
Mild and clear on its own
People at risk of severe viral meningitis
Viral meningitis
Viruses in viral meningitis
Non polio enteroviruses HSV EBV Varicella zoster Measles Influenza HIV West Nile virus Lymphocytic choriomeningitis
What is encephalitis
Inflammation due to infection on the brain parenchyma
Most common agents in encephalitis
Viruses HSV CMV Enteroviruses Mumps Varicella Rotavirus Flavivirus
Bacteria causes of encephalitis
Treponema pallidum
Tuberculosis
Protozoan in encephalitis
Amoeba
Diagnosis encephalitis
Travel history tick or mosquito bite exposure immunocompromised status organ transplant history MRI
Symptoms of neurosyphilis enceophalitis
Cranial nerve abnormalities meningismal signs psychiatric disturbances movement disorders hearing loss dementia stroke like syndrome seizures
Diagnosis of neurosyphilis encephalitis
Csf VDRl
fluorescent trepanomalmantibody absorption testing of CFS
Symptoms of HSV encephalitis
Fever headache memory loss AMS confusion
Sequelae of encephalitis in HSV
Delirium agitation
withdrawal
hallucinations
Diagnosis of HSV encephalitis
LP
imaging of the brain
PCR of CSF
Symptoms of west Nile encephalitis
Non-specific flu like symptoms
Diagnosis of west Nile encephalitis
Eliza detection
Treatment of west Nike encephalitis
No antiviral therapy
