Viral CNS Infections Flashcards

1
Q

acute inflammation of brain parenchyma

A

encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acute inflammation in the subarachnoid space or leptomeninges

A

meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of meningitis outnumbers all other causes in the US?

A

viral (aseptic) meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the MCC of viral meningitis

A

enterovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the general prognosis of aseptic meningitis

A

usually self-limiting lasting 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the MCC of acute encephalitis?

A

HSV 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the targets in the CNS of each of these viruses?

polio

VZV

Rabies

HIV and HSV

A
  • motor neurons
  • peripheral sensory neurons
  • brainstem neurons
  • anything
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In general, what is the MC manifestation of viral CNS infection?

A

meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

hallmarks in pediatric viral meningitis include

A

more malaise and fever

tend not to have neck stiffness

neonates: hypotonia, irritability, poor feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are CSF findings in viral/aseptic meningitis?

A
  • WBC - pleocytosis, lymphocytes predominate
  • protein - nl to slightly elevated
  • glucose - normal
  • culture, gram stain, acid fast stain all normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In CSF we are finding increased lymphocytes and normal or decreased glucose. What are we thinking?

A

cryptococcus or another fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What will CSF look like with bacterial meningitis?

A
  • WBCs - PMNs predominate
  • glucose is low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tx for aseptic meningitis is usually supportive, but if it looks like meningoencephalitis, what should I do?

A

start empiric abx (for possible bacterial pathogens) and acyclovir (for HSV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What two viruses are known to cause septic shock in babies? What should we do because we know this?

A

enterovirus and HSV

abxs and acyclovir should be started ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MCC of sporadic lethal encephalitis?

A

Herpes simplex encephalitis (HSE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where will I see necrotizing inflammation from HSE?

A

inferior frontal and anterior temporal lobes

17
Q

What are the top five clinical features of HSE?

A
  • change in consciousness
  • fever
  • change in personality
  • headache
  • seizures
18
Q

What is the most important study in regards to meningitis/encephalitis?

A

PCR

19
Q

What is tx for HSE?

A

IV acyclovir started empirically when suspected

  • prolonged oral course following IV course
20
Q

When do most relapses of HSE occur?

A

within 3 months of completing initial tx

21
Q

What are some primary syndromes a/w HIV in the CNS?

A
  • AIDS dementia complex
  • HIV meningitis
  • HIV myelopathy (SC)
  • HIV sensory neuropathy
  • Primary CNS lymphoma
22
Q

My pt has non-AIDs PML, what should I be considering?

A

malignancy

CT disease

organ transplant

sarcoid

cirrhosis

medications

23
Q

fecal oral route

acute flaccid paralysis via infection of anterior horn cells (proximal worse than distal)

A

poliomyelitis