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CS III/1 > Neurologic Infections > Flashcards

Neurologic Infections Flashcards

1
Q

Meningitis

A

Invasion of meninges by microorganism
Infection involves: Pia, arachnoid, subarachnoid/CSF (most)
Secondary involvement - blood vessels/brain parenchyma due to spasms

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2
Q

Viral Meningitis

A

Aseptic - unknown
Viral - enterovirus most common, self-limiting
Complication of systemic - mumps

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3
Q

Bacterial Meningitis

A

Brain not primary infection site - secondary infection

Sporadic/Epidemic - meningococcus***

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4
Q

SSX

A 
Chills, fever HA
Neck pain/stiffness
Altered mental state
Seizure
Petechial rash - meningococcus
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5
Q

Neonatal BM

A

GBS

E. coli

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6
Q

Children BM

A

H. influenzae - lower incidence with vaccine

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7
Q

Adult BM

A

Streptococcus pneumoniae
Neisseria meningitidis
Listeria monocytogenes (neonates also)

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8
Q

Why would no organism show on culture?

A

Antibiotics in CSF reduce growth on culture

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9
Q

Sequelae

A 
Focal neurologic deficits
Cranial nerve palsies
Seizures
Hydrocephalous
Myelopathy/radiculopathy
Death
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10
Q

DX of Meningitis

A

Confirmed by CSF analysis
Obtain LP BEFORE antibiotics
Other: high WBC, CT/MRI, sinus X-ray, blood culture

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11
Q

Cells, Protein, Glucose - Bacterial Purulent

A

High Polys (>1,000)
High protein
Low glucose (<20)
Gram stain, C/S, Ab titers

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12
Q

Cells, Protein, Glucose - Viral

A

High Monos
Normal to high protein
Normal to low glucose
Cultures, stains, Ab titers, PCR

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13
Q

Cells, protein glucose - fungal

A

High mixed cells (10-500)
Very high protein
Low Glucose (15-35)
Culture, india ink, Ag titer

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14
Q

Cells, protein glucose - TB

A 
High mixed cells (<500)
Extremely high protein
Low glucose (20-40)
Acid-fast, culture
Cloudy, ground glass clots
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15
Q

BM TX

A

Antibiotics - Cephs, Vanco

Supportive - hydration, ventilation, anticoag

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16
Q

TB Meningitis

A

Subacute/secondary
Rupture of tubercle into CSF
Present: HA, cognitive dysfunction, WL
DX - brain scan, CSF, biopsy

17
Q

CNS Abscess

A

Brain, spinal cord, epidural
Secondary to blood metastasis, direct extension, perforating wounds
Possible: Anaerobic/aseptic

18
Q

Myelitis

A

Spinal cord infection

19
Q

Leprosy

A

Chronic infection of skin/peripheral nerves
Granulomatous nerve deterioration
SX: anesthesia, motor loss, limb/joint deformities - cutaneous/peripheral
TX - dapsone, rifampin, clofazimine

20
Q

Encephalitis

A

Infection of parenchyma secondary to viral infection
W/spinal involvement - encephalo-myelitis
W/meningeal involvement - meningo-encephalitis (aseptic meningitis)
DX - virus isolation in CSF - most common HSV

21
Q

Poliomyelitis

A 
Enterovirus
1st acute infection - later flaccid paralysis (a-MN)
Occasional brain involvement
Respiratory/bulbar dysfunction
Post-polio syndrome 30-40 years later
22
Q

Herpes Simplex Encephalitis

A 
Most significant sporadic encephalitis
Endogenous reactivation of latent virus
Abrupt onset with fever, HA, malaise
Abnormal EEG/MRI
TX: Acyclovir, steroids, anticonvulsants
23
Q

Zika Virus

A

Mostly asymptomatic
Fever, flu-like
Prenatal microcephaly
Post-infectious Guillain-Barre - AIDP (acute inflammatory demyelinating polyneuropathy) - weakness in legs, slow progression to hands/head/respiratory

24
Q

AIDS

A

Secondary to HIV 1 infection
Neurotropic - prefers brain
HAART - highly active anti-retroviral therapy

25
Q

Progressive Multifocal Leucoencephalopathy

A

Slow progressive demyelinating disease
JC virus - destroys brain
Seen in immunodeficient - lymphoma, AIDS
Increased with Tysabri - MS drug

26
Q

Fungal Infections

A

Cryptococcosis - most common

Candida in IC patients

27
Q

Spirochete infections

A

Lyme Neuroborreliosis - erythema migrans, Bells palsy, meningoencephalitis, neuropathy
Neurosyphilis - meningoencephalitis, tabes dorsalis (dorsal column demyelination)

28
Q

Cerebral Cysticercosis

A

Encystment w/pork tapeworm
Multiple cysts of brain/meninges
TX - shunts, surgery, anticonvulsants, albendazole

29
Q

Prion disease

A

Protein w/out nuclei acid
Mad-cow, Jakob-Creutzfeldt
Dementia, motor signs, seizure, death

30
Q

Botulism

A

No direct CNS invasion

Paralysis of motor/ANS - prominent cranial nerve involvement

CS III/1 (14 decks)

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