Encephalitis + Brain Abscess

Question 1

inflammation of the brain itself

Answer 1

encephalitis

Question 2

inflammation or swelling of the meninges surrounding the brain and spinal cord

Answer 2

meningitis

Question 3

how may encephalitis start off as?

Answer 3

bacterial meningitis

Question 4

what is the most common cause of encephalitis in the US?

Answer 4

west nile virus

Question 5

what is the most likely etiology of encephalitis that is most fatal if not treated?

Answer 5

Herpes Virus

Question 6

a patient presents with an acute onset of fever, headache, confusion, and sometimes seizures. what are they likely experiencing?

Answer 6

encephalitis

Question 7

what 3 symptoms would a child present with if they have encephalitis?

Answer 7

irritability
poor appetitie
fever

Question 8

how would the neurological exam of a patient with encephalitis present?

Answer 8

drowsy/confused

Question 9

what diagnostic and result would help us diagnose encephalitis?

Answer 9

lumbar puncture + CSF culture
viral etiology

Question 10

a patient presents with fever, AMS, seizures. their CSF shows mildly elevated WBCs + protein, but normal glucose. what is their likely diagnosis?

Answer 10

HSV-1 encephalitis

Question 11

imaging shows parenchymal inflammaiton and edema, especially in the temporal lobes. what is the diagnosis?

Answer 11

HSV-1 encephalitis

Question 12

what is the treatment for HSV-1 encephalitis?

Answer 12

acyclovir
supportive care

Question 13

a patient presents with transient symptoms/asymptomatic with a mild fever. CSF show IgG and IgM. what is the diagnosis?

Answer 13

west nile virus

Question 14

collection of pus within the brain tissue; the tissue is infected

Answer 14

brain abscess

Question 15

what are the 2 pathogenesis of a brain abscess?

Answer 15

direct spread
hematogenous spread

Question 16

bacteria comes from a contagious site, typically causing a single brain abscess

Answer 16

direct spread

Question 17

what vessel is hematogenous spread that leads to multiple brain abscesses associated with?

Answer 17

the middle cerebral artery

Question 18

a brain abscess will have the organism ____ if the source of infection is from paranasal sinuses, teeth, ear, or lungs.

Answer 18

streptococcus

Question 19

a brain abscess will have the organism pseudomonas a. if the source of infection is from:

Answer 19

urinary tract

Question 20

a brain abscess will have the organism staph aureus if the source of infection is from: (2)

Answer 20

penetrating head trauma
neurosurgery

Question 21

what are the 2 main sources of brain abscesses?

Answer 21

strep viridans
staph aureus

Question 22

what causes the symptoms in a brain abscess?

Answer 22

mass effect

Question 23

a patient presents with AMS, seizures, headache, drowsiness, N/V, and papilledema. what is their likely diagnosis?

Answer 23

brain abscess

Question 24

how long after symptom onset do patients typically seek care for a brain abscess?

Answer 24

within 2 weeks

Question 25

what is the main diagnostic used for a brain abscess?

Answer 25

brain CT/MRI

Question 26

what can be both diagnostic and therapeutic for a brain abscess?

Answer 26

surgical drainage + gram stain/culture

Question 27

what size brain abscesses can be treated medically, without surgical drainage?

Answer 27

less than 2cm

Question 28

what is the treatment for a brain abscess that’s less than 2cm? (3)

Answer 28

empiric broad spectrum antibiotics
IV dexamethasone/mannitol
brain CT/MRI q 2 weeks

Question 29

how would treatment for a brain abscess be administered?

Answer 29

IV for 6-8 weeks, then
oral for 2-3 months