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Flashcards in CNS Infection IV Deck (30)
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1

symptoms of brain abscesses

– Rapid
– Headache, Changes in mental status, Generalized seizure

2

predisposing condition and organisms if brain abscess is at frontal site

-sinusitis and dental abscesses

-Streptococci, Bacteroides, S. aureus, Haemophilus spp.

3

predisposing condition and organisms if brain abscess is at temporal site

-otitis media and mastoiditis
-Streptococci, Bacteroides, Enterobacteriacea

4

predisposing condition and organisms if brain abscess is at frontal, temporal, and parietal site

-Trauma, Penetrating wound
-S. aureus, Clostridia

5

predisposing condition and organisms if brain abscess is at multiple site

-Infective endocarditis, Congenital Heart Disease, Lung abscess

-S. aureus, Streptococci (viridans), Fusibacteria, Nocardia

6

fungal brain abscesses

– Candida sp
– Aspergillus sp.
– Cryptococcus sp
– Histoplasma capsulatum
– Blastomyces dermatitidis

7

diagnosis of brain abscesses

– CT scan
– Hypodense centre
– Peripheral uniform ring
– Brain oedema

8

clinical presentation of subdural and epidural empyema

headache
fever (higher than 39oC)

9

etiology of subdural and epidural empyema

– Streptococci (25-45%)
– Staphylococci (10-15%)
– Enterobacteriacea (3-10%)
– Anaerobic bacteria (33%)
– Polymicrobial

10

predisposing factor for subdural empyema

sinusitis (male to female: 3 to 1)

11

how do you diagnose epidural empyema

MRI pachymeningeal enhancement, superficial area of diminished intensity

12

what are prions

infectious proteins that are resistant to formaldehyde, dry heat, boiling, ethanol, and ionizing radiation

13

disease of Prions

– Transmissible Spongiform Encephalopathies (TSE)
• Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker syndrome, familial fatal insomnia, Kuru

14

biology of prions

– Normal cellular glycoprotein: PrPc (↑ 􏰈 alpha helix, ↓ beta 􏰆􏰆􏰇􏰇helix)
– Infectious glycoprotein form: PrPsc (↓􏰈 alpha helix, ↑ 􏰆 beta helix)
– Aggregates in neurons (myeloid plaques)
– Spongy cerebrum (vacuoles in cortex & cerebellum)

15

are most cases of prions sporadic or familial

sporadic

16

how does on get prion diseases

eating undercooked beef

17

clinical feature of prions

– Nonspecific prodromal symptoms (1/3 CJD patients): fatigue, sleep disturbance, weight loss, headache, malaise, and ill-defined pain

– Most higher cortical function deficits.
• Progress over weeks-months: profound dementia (memory loss, impaired judgment, 􏰅􏰅intellectual function

18

how does one get Tania solium and what is a big symptom

uncooked pork
neurocystercosis

19

what does negleria and acanthamoba lead to?

• Negleria
– primary amebic meningoencephalitis (PAM)
• Acanthamoba
– Granulomatous Amebic Encephalitis (GAE)

20

what is the most common cause of brain abscess in immunocompromised people like AIDs patients

toxoplasmosis - toxoplasma gondii
multi ring lesions that involve the basal ganglia

21

how long after exposure does it take to see symptoms to nagleria and how long till death?

-1 day to 1 week week after exposure --> symptoms
-death at 7-14 days for 97% of those infected

22

what are symptoms of nagleria

• Headache
• Fever
• Nausea, vomiting
• Confusion
• Rapidly worsen over 3‐7 days

23

pathogenesis of nagleria

starts at the amoeba olfactory nerve --> migrates to olfactory bulbs --> feeds on nerve tissue --> necrosis and hemorrhaging --> migrates along nerve fibers --> enters the floor of the cranium via the cribriform plate and into the brain --> consume cells of the brain a amoebostome (a unique actin‐rich, sucking apparatus extended from its cell surface)

24

treatment of nagleria

– Amphotercin B (only shown effective in vitro)
– Combined Miconozole, Sulfadiazine and Tetracycline shows “some” benefit

25

who does acanthamoeba affect

people with compromised immune systems

26

symptoms of acanthamoeba

• headache, confusion
• nausea, vomiting, fever
• lethargy, stiff neck
• focal neurologic deficits
• signs of increased intracranial pressure

27

treatment of acathamoeba and how many survive

Combined Miconozole, 5‐ fluorocytocine “some” benefit

almost 100% dies

28

causes cerebral malaria

Plasmodium falciparum

29

symptoms of plasmodium falciparum

unarousable coma which leads to death if left untreated

30

used to treat neurocystercosis

Albendazole and praziquantel