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Flashcards in CNS Infections Deck (22)
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1
Q

What are some causes of a brain abscess?

A
  1. Contiguous spread
  2. Hematogenous seeding w/ bacteremia
  3. Trauma
  4. Cryptogenic
2
Q

What are the clinical manifestations of a brain abscess?

A

Presence of headache, seizures, nausea and vomiting, and focal neurologic signs
Uncommon: fever, nuchal rigidity

3
Q

What diagnostic tests are commonly performed for brain abscesses?

A

MRI & CT Scan commonly ordered, blood cultures for bacteremia
LP should NOT be performed (risk herniation)

4
Q

What are some features of a paraspinal abscess?

A

Usually due to bacteremia (staph aureus most common); requires surgical drainage to prevent cord compression; osteomyelitis of vertebral bodies

5
Q

What are the most common locations of a paraspinal abscess?

A

Posterior & thoracolumbar > cervical

6
Q

What are some infectious etiologies of chronic meningitis?

A

Tuberculosis, cryptococcus, lyme disease, syphilis, coccidioidomycosis, histoplasmosis

7
Q

What are features of the general paresis type neurosyphilis?

A

Personality, affect, reflexes, eye symptoms, sensorium, intellect, speech abnormalities

8
Q

What are features of the tabes dorsalis type neurosyphilis?

A

Ataxia, shooting pains, sphincter disturbance, peripheral neuropathy, cranial neuropathies

9
Q

What is neurocysticercosis?

A

Brain infection caused by infection with Taenia solum (tapeworm in pigs)

10
Q

What are some noninfectious etiologies of chronic meningitis?

A

Neoplasms, sarcoidosis, vasculitis, drug induced (NSAIDs)

11
Q

What are the differences between meningitis and encephalitis?

A

Meningitis - no altered mental status & infection of meninges
Encephalitis - altered mental status & infection of brain
CSF exam similar in both

12
Q

What are some etiologies of encephalitis?

A

Viral (HSV - common), bacterial pathogens, spirochetes, parasites, drugs, vasculitis, mycoplasma…

13
Q

What is acute disseminated encephalomyelitis (ADEM)?

A

Postinfectious encephalitis occurring 5-21 days after a viral illness; multifocal neurologic symptoms
Treatment: glucocorticoids –> complete recovery

14
Q

What type of organism often infects diabetics with uncontrolled sugar levels?

A

Mucor (Fungus)

15
Q

What type of brain abscess is related to frontal sinus disease and osteomyelitis?

A

Cranial epidural abscess

16
Q

Is a subdural abscess a medical emergency?

A

Yes. Headaches and seizures are common signs

17
Q

A patient’s blood work is positive for staph bacteremia and currently is running a 103 fever and reports of severe back pain limiting her walking. What is your first suspected diagnosis?

A

Paraspinal abscess

Surgical drain required

18
Q

What lab test would you do for a suspected case of lyme meningitis?

A

Synthesis index. Antibodies in the CSF will be greater than that in the serum.

19
Q

What does your CSF values look like with viral encephalitis?

A

Increased lymphocytes

Cell count 500 seen in HSV, CTFV, CEV

20
Q

HSV-1 is the most common etiology of Herpes Encephalitis. What is a unique symptom / sign in patients with this?

A

Seizures / status epilepticus –> temporal lobe affected often

21
Q

Your patient presents with acute hemorrhagic encephalitis. His friend says they had been swimming in the lake nearby. What do you diagnose?

A

Encephalitis due to naegleria fowleri

CSF: High PMN / low glucose
99% mortality

22
Q

How is Creutzfel Jakob Disease spread and what are some signs?

A

CJD is spread by cadaveric tissue.

You see myoclonus, cerebellar ataxia, and dementia.