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MBIO 3010 > Section 15 - CNS Infections > Flashcards

Section 15 - CNS Infections Flashcards

1
Q

What protects the CNS?

A
  • Brain is protected by skull

- Spinal cord is protected by vertebral column

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2
Q

How can a blood-borne invasion take place and what can it cause?

A
  • Across the BBB to cause encephalitis

- Across the CSF to cause meningitits

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3
Q

How can microbes cross the BBB?

A
  • Growing across and infecting the cells that comprise the barrier
  • Being passively transported across in intracellular vacuoles
  • Being carried across by infected WBC’s
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4
Q

What are the 2 categories of responses to CNS invasions?

A

1) Septic

2) Aseptic

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5
Q

What is the difference between septic and aseptic invasions?

A
  • Aseptic has clear CSF

- Septic is when the CSF becomes turbid/cloudy

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6
Q

What are some of the body’s responses to CNS invasion?

A
  • Increased protein and number of lymphocytes in septic and aseptic
  • Decreased glucose in septic and normal glucose in aseptic
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7
Q

What are some causes of septic infections?

A
  • Bacteria
  • Amoebae
  • Brain abscess
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8
Q

What are some causes of aseptic infections?

A
  • Viruses
  • Fungi
  • Partly treated bacterial meningitis
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9
Q

Why does a septic infection produce decreased glucose?

A

Because of increased bacterial metabolism

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10
Q

Between bacterial and viral meningitis, which is more common and which is more severe?

A
  • Bacterial is more severe

- Viral is more common

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11
Q

What was the most common cause of bacterial meningitis prior to the 1990s?

A

Hib

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12
Q

Which 2 organisms are responsible for most bacterial meningitis?

A
  • Neisseria meningtidis

- Streptococcus pneumoniae

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13
Q

What are some similarities and differences between Hib, Neisseria meningtidis, and streptococcus pneumoniae?

A
  • All 3 produce capsules and IgA protease

- Neisseria and Hib are gram negative so they produce endotoxins

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14
Q

What are the common causes of bacterial meningitis in neonates?

A
  • Gram negative bacilli
  • Strep. agalactiae
  • Listeria monocytogenes
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15
Q

What are the common causes of bacterial meningitis in infants (1-23 months)?

A
  • Strep agalactiae
  • E. coli
  • Strep pneumoniae
  • Neisseria meningtidis
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16
Q

What are the common causes of bacterial meningitis in children and adults?

A
  • Strep pneumoniae

- Neisseria meningtidis

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17
Q

What are the common causes of bacterial meningitis in adults over 65 years?

A
  • Strep pneumoniae
  • Neisseria meningtidis
  • Listeria monocytogenes
  • Aerobic gram-negative bacilli
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18
Q

What is an important virulence factor in neisseria meningtidis?

A

Pili for attachment to epithelium of nasopharynx

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19
Q

What protects the blood and meninges from invasion?

A

Presence of antibodies to capsular antigens

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20
Q

What makes an individual more susceptible to blood or meninges invasion?

A

C5-C9 complement deficiency

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21
Q

How is meningococcal meningitis transmitted?

22
Q

What is the peak for meningococcal meningitis infections?

A

Winter/early sping

23
Q

What is the incubation time for meningococcal meningitis?

24
Q

What are the symptoms of meningococcal meningitis?

A
  • Headache
  • Sore throat
  • Drowsiness
  • Fever
  • Stiff neck
  • Hemorrhagic skin rash, which indicates septicemia
25
What is the mortality rate of untreated meningococcal meningitis?
100%
26
What is the mortality rate of treated meningococcal meningitis?
10-15%
27
What are the different types of vaccines against meningococcal meningitis?
- MPSV4 | - MCV4 for 11-55 year olds
28
How is meningococcal meningitis diagnosed?
- Essential gram stain of CSF (organism should appear kidney shaped in pairs) - Culture - White cell count
29
What does haemophilus mean?
Blood loving
30
What is the "window of susceptibility" for haemophilus meningitis?
When a child is 3-4 months their mothers antibodies stop protecting them, so the window of susceptibility is between that point and when the child can produce their own antibodies
31
What is the incubation period for haemophilus meningitis?
5-6 days
32
What are the symptoms of haemophilus meningitis?
- Hearing loss - Delayed language development - Mental retardation - Seizures
33
When is the HiB vaccine administered?
Less than 2 months old
34
What is the most common cause of bacterial meningitis?
Pneumococcal meningitis
35
What is the gram status and morphology of pneumococcal meningitis?
Gram positive cocci in pairs
36
What are the different types of vaccines against pneumococcal meningitis?
- Heptavalent for 2-23 months and immunocompromised | - 23-valent for children over 5 years
37
What are the symptoms of viral meningitis?
- Headache - Fever - Light sensitivity
38
Is complete recovery common with viral meningitis?
Yes
39
How is viral meningitis diagnosed?
Viral genome detection (PCR) because it is hard to isolate the virus from CSF
40
What is often the cause of viral meningitis?
Enteroviruses
41
What is encephalitis?
Inflammation of the brain parenchyma
42
What is usually the cause of encephalitis?
Viral, most commonly HSV
43
What are the symptoms of encephalitis?
- Cerebral dysfunction - Abnormal behaviour - Seizures - Nausea, vomiting, fever
44
How do neonates acquire HSV encephalitis?
Passage down the birth canal of mother shedding HSV-2
45
How do older children and adults acquire HSV encephalitis?
HSV-1 viral reactivation in nerves in the skull and the infection spreads back to temporal lobe
46
What is the treatment for HSV encephalitis?
Antiviral therapy for 21 days
47
What are the natural hosts of West Nile Virus?
Birds and culicine mosquitoes
48
What are the incidental hosts of West Nile Virus?
Humans and horses
49
How is West Nile Virus diagnosed?
- WNV RNA detection | - IgM antibody in serum/CSF
50
How can West Nile Virus be prevented?
- No vaccine | - Mosquito control

MBIO 3010 (17 decks)

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