neuroinfectious disease Flashcards
what are the 2 types of CNS infections
meningitis and encephalitis
what are 3 SC infections
• Spinal Meningitis
• Myelitis
• Epidural abscess
what are the 4 mode of entry for bacterial infections
-hematogenous spread
-extension from infected cranial structures
-penetrating cranial injuries
-surgical invasion
symptoms of meningitis and for infants
• Fever, chills
• Headache
• Neck pain & stiffness
• Generalized convulsions
• Drowsiness/confusion
Infants: bulging of fontanels (soft spots), vomiting, irritability
• Fever, chills
• Headache
• Neck pain & stiffness
• Generalized convulsions
• Drowsiness/confusion
• Infants: bulging of fontanels (soft spots), vomiting, irritability
these are symptoms of what
meningitis
what are the 2 meningeal sings and what do they do
kermit;s sign which is flexing pt hip to 90° then extending pateints knee causes pain
brudzinskis neck sign is flexing pt neck casues flexion of pateints hip and knees
what is the pathology of bacterial meningitis
-bacterial in CSF excite acute inflammatory reaction
- vessels may thrombose and causes brian infaraction
-exudate may block uptake of CSF causing hrodrcephalus
what is the diagnosis for CSF in bacterial meningitis
lumbar puncture in 3rd and 4th lumbar vertebrae
what is the characteristics of CSF in bacteria memigitis
-increased pressure e
-cloudy appearance
- increase WBC and protein
Gram negative enterobacteriae, Pseudomonas aeruginosa, staphylococci… these are common pathogens for what population
post neurosurgery
N. meningitidis, S. pneumoniae, Listeria monocytogenes… these are common pathogens for what kind of population
healthy adults
L. monoctogenes, gram negative enterobacteriae, P. aeruginosa, pneumococci…. these are common pathogens for what kind of population.
elderly
Neisseria meningitidis, Streptococcus pneumoniae, Hemopholius influenzae…. these are pathogens for what kind of population
infants and children
E. coli, Klebsiella, Enterobacter, Streptococcus agalactiae, Proteus group B Streptococci… these are common pathogens for what kind of population
newborns
t/f : acute meningitis a medical emergency
true
what is the treatment for bacterial meningitis
- antibiotics
- corticosteroids
treat for 10-21 days
- Tends to occur in epidemics, in roughly 10 year cycles
- Rapid onset over hours
- Meningococcemia can lead to petechial or hemorrhagic skin rash
- Mortality rate 10% (with treatment), 50% without Rx
what is this
Meningococcal Meningitis
what tends to occur in epidemics and has a rapid onset
Meningococcal Meningitis
f a pateint has a Fever, headache, meningeal irritation and CSF with lymphocytic predominance, normal glucose, and negative bacterial and fungal cultures
what is this
Viral (aseptic) Meningitis
what are the causes for Viral (aseptic) Meningitis
enterovirus most common and herpes simple virus
what drug is used to treT herpes simplx virus infection
Acyclovir
how do u treatment viral meningitis
treat as bacterial meningitis until Cx neg
- Fever, impaired consciousness, seizures, hemiparesis, ataxia, cranial nerve palsies.
- Usually accompanied by meningeal signs
** Seasonal incidence
** Enteroviruses, arbovirus
what is this
Acute Encephalitis
what is the symptoms of Acute Encephalitis and what is it accompanied by
fever
impaired consciousness
seizures
hemiparesis
ataxia
CN palsies
companies by meningeal sings
*** Most serious **of the viral encephalitides
* Usually caused by HSV type1
* Rapid evolution of fever, confusion, coma.
* Predominates in temporal and frontal lobes
* Treatment is with IV Acycloviror similar drugs
* Mortality rate of 50%
what is this
Herpes Simplex Encephalitis
what is Herpes Simplex Encephalitis causes by
HSV type 1
what lobes does Herpes Simplex Encephalitis predominate in
temporal and frontal
what is the treatment for Herpes Simplex Encephalitis
IV Acyclovir
what is the most serious of the viral encephalitides
Herpes Simplex Encephalitis
- Organism reaches brain via bloodstream during pulmonary infection.
* Basal meningitis+/-foci in brain - Many small tubercles on the surface of the
meninges - Hydrocephalus/stroke frequent
what meningitis is this
Tuberculous Meningitis
in Tuberculous Meningitis the organism reaches the ____ via bloodstream during a ____ infection
brain
pulmonary
Tuberculous Meningitis has a faster or slower evaluation of symptoms
slower
what is more frequently seen with Tuberculous Meningitis
CN palsies
how does the CSF presents with Tuberculous Meningitis
increase pressure
increase protein
mostly lymphocytes
what is the treatment for Tuberculous Meningitis
4 drug anti tuberculous regimen
- Purulent infection of the subdural space
- Usually a rises from disease of the sinuses or middle ear.
- Pus accumulates over **one **cerebral hemisphere
- leads to Meningeal veins thrombose causing infarction
- leads to cerebral symptoms
what is this
Subdural Empyema
Subdural Empyema is a purulent infection of the ___ space and usually arises from disease of the ____ or ___ ___ … pus accumulated over ___ cerebral hemisphere
subdural
sinuses or middle ear
one
what is the symptoms for Subdural Empyema
-HA
-fever
-focal seizures
-hemiparesis
-hemisensory loss
what is the treatment for Subdural Empyema
sx drain then antibiotics
• Infections of ear or sinuses may lead to thrombosis within the venous sinuses that drain the brain.
• Blockage leads to increased pressure, infarctions, focal findings
• Treat with antibiotics. Usually requires surgery on ear or sinus
waht is this
Intracranial Thrombophlebitis
brain abscess occurs when there is ___ of the brain tissue alone with ___ infections
necrosis
bacterial
brain abscess that are secondary to ear or sinus infections are what
single and near site of entry
what are the symptoms of brain abscess
HA
drowsiness
confusion
seizures
focal flinging
what is the treatment for brain abscess
aspiration and wide spectrum antibiotics
- Causative agent: Treponema pallidum
- Transmitted via sexual contact
what is this
Neurosyphili
what is early meningitis from Neurosyphilis
6-12 months after PRIMARY infection
what is Meningovascular syphilis
5-12 years after primary infection — stroke
what is Late, tertiary syphilis
tabes dorsalis , general paresis
- Caused by bacterium, Borrelia burgdorferi
- Transmitted by bite of infected blacklegged
ticks -
Symptoms:
– Initially: fever, headache, fatigue, rash (erythema migrans)
– Weeks – Months: meningitis, CN palsies, radiculopathy, neuropathy, cardiac disease
what disease is this
lyme disease
if a pateint has a disease transmitted y a bite of infected black legged tick and has symptoms of fever, HA , faitgue rash initially adn then lead to meningitis , CN palsies (facial n) , radicualophy , neuropathy and then cardiac disease what disease do we suspect she has
lyme disase
Cryptococcosis and Mucormycosis are what kind of infections
fungal infections of the CNS
which fungal infection of the CNS is more common in the US and is increasing in AIDS patients and subacute meningitis
Cryptococcosis
which fungal infection of the CNS is seen as a complication of DIABETES
Mucormycosis
is fungal infectiosn or bacterial infections of the CNS more common
bacterial
- Organism: Varicella-zoster virus (VZV)
- Reactivation of latent virus residing in sensory ganglion after primary chicken pox infection.
- Hits elderly, immunocompromised
- Radicular pain and vesicular eruption in dermatomal pattern–”shinglesb
what is this
herpes zoster
what PNS symptoms may u acquire form COVID 19
gillian barre syndrome or rhabdomyolysis
what is the most common prion disease that is rapidly progressive dementia , behavioral changes , ataxia , myoclonic jerks and blindness and is fatal within 1 years
Sporadic Creutzfeldt-Jakob disease:
is prion disease a virus
no just abnormal protein
HIV and AIDS can affect the ___ system at any level
nervous
what syndromes are a direct effect of HIV
aseptic meningitis , neuritis and myelitis
for HIV and AIDS opportunistic infections predominate as what happens
CD4 court drops
Most mass lesions of the brain in AIDS are
_____ or primary CNS ___
toxoplasmosis
lymphoma
what is Neurocysticercosis
parasite in uncock pork and is the #1 causes of sezuires world wide
what are symptoms for Neurocysticercosis
-seizure
-HA
-arachnoditis (hydrocephalus, mengitiis, stroke)
what is the treatment for Neurocysticercosis
antiparastitics
steroids
sx
