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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?

A

Droplets

22
Q

What is the peak for meningococcal meningitis infections?

A

Winter/early sping

23
Q

What is the incubation time for meningococcal meningitis?

A

1-3 days

24
Q

What are the symptoms of meningococcal meningitis?

A
  • Headache
  • Sore throat
  • Drowsiness
  • Fever
  • Stiff neck
  • Hemorrhagic skin rash, which indicates septicemia
25
Q

What is the mortality rate of untreated meningococcal meningitis?

A

100%

26
Q

What is the mortality rate of treated meningococcal meningitis?

A

10-15%

27
Q

What are the different types of vaccines against meningococcal meningitis?

A
  • MPSV4

- MCV4 for 11-55 year olds

28
Q

How is meningococcal meningitis diagnosed?

A
  • Essential gram stain of CSF (organism should appear kidney shaped in pairs)
  • Culture
  • White cell count
29
Q

What does haemophilus mean?

A

Blood loving

30
Q

What is the “window of susceptibility” for haemophilus meningitis?

A

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
Q

What is the incubation period for haemophilus meningitis?

A

5-6 days

32
Q

What are the symptoms of haemophilus meningitis?

A
  • Hearing loss
  • Delayed language development
  • Mental retardation
  • Seizures
33
Q

When is the HiB vaccine administered?

A

Less than 2 months old

34
Q

What is the most common cause of bacterial meningitis?

A

Pneumococcal meningitis

35
Q

What is the gram status and morphology of pneumococcal meningitis?

A

Gram positive cocci in pairs

36
Q

What are the different types of vaccines against pneumococcal meningitis?

A
  • Heptavalent for 2-23 months and immunocompromised

- 23-valent for children over 5 years

37
Q

What are the symptoms of viral meningitis?

A
  • Headache
  • Fever
  • Light sensitivity
38
Q

Is complete recovery common with viral meningitis?

A

Yes

39
Q

How is viral meningitis diagnosed?

A

Viral genome detection (PCR) because it is hard to isolate the virus from CSF

40
Q

What is often the cause of viral meningitis?

A

Enteroviruses

41
Q

What is encephalitis?

A

Inflammation of the brain parenchyma

42
Q

What is usually the cause of encephalitis?

A

Viral, most commonly HSV

43
Q

What are the symptoms of encephalitis?

A
  • Cerebral dysfunction
  • Abnormal behaviour
  • Seizures
  • Nausea, vomiting, fever
44
Q

How do neonates acquire HSV encephalitis?

A

Passage down the birth canal of mother shedding HSV-2

45
Q

How do older children and adults acquire HSV encephalitis?

A

HSV-1 viral reactivation in nerves in the skull and the infection spreads back to temporal lobe

46
Q

What is the treatment for HSV encephalitis?

A

Antiviral therapy for 21 days

47
Q

What are the natural hosts of West Nile Virus?

A

Birds and culicine mosquitoes

48
Q

What are the incidental hosts of West Nile Virus?

A

Humans and horses

49
Q

How is West Nile Virus diagnosed?

A
  • WNV RNA detection

- IgM antibody in serum/CSF

50
Q

How can West Nile Virus be prevented?

A
  • No vaccine

- Mosquito control

MBIO 3010 (17 decks)

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