CNS Infections Flashcards
(24 cards)
What pathogens are MC in adults, children, closed populations, immunosuppressed (including trauma and surgery), and neonates?
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What are the MC routes of CNS infections
- Vascular
- MC via arteries
- Venous
- periocular
- perinasal
- Direct Extension
- Middle ear infx
- Herpes in trigeminal ganglion
- Ascending neural
- Rabies in peripheral axons
Signs and symptoms of bacterial meningitis
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What is Kernig’s, Brudzinski’s, and Jolt accentuation?
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Causes of chronic meningitis
TFLS
CSF findings in acute bacterial and chronic meningitis?
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Causes of viral meningitis
VE-AMMS-H (VEAMMSH)
Treatment for meningitis
- Antibiotics
- Anti-Inflammatory
- Dexamethasone
How to counter effects of ICP
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Complications of meningitis
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Causes of viral encephalitis (where)
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Most important opportunistic iral infection in immunocompromised pt
CMV encephalitis
CMV Encephalitis
- TORCH infxs
- Path: Hemorrhagic necrotizing encephalitits
Poliomyelitis
- Viral Encephalitis**
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Oral/fecal route
- starts with gastrointeritis
- Spreads to spinal cord via blood
- anterior horn
- Flaccid paralysis**
- Severe cases: respiratory muscles
- Iron lung**
Rabies
- Single stranded RNA
- Ascending peripheral axons
- Negri bodies*
- Hippocampus*
- Purkinge cells*
- Brainstem*
- No inflammation
- Symptoms
- Irritability
- Seizures
- Contracture of pharyngeal muscles
- Delirium
- Tx
- Vaccine
- If virus reaches brain –> DEATH**
What part of the brain does herpes encephalitis affect?
Inferior and medial regions of temporal lobe
Progressive Multifocal Leukoencephalopathy (PML)
- Oligodendrocyte infxn
- Myelin destruction
- Immunosuppressed pts
- Symptoms
- Dementia
- Ataxia
- Abn speech and vision
Cryptococcal Infection
- Inhalation of pigeon** stools (fungus)
- Opportunistic infxn
- Chronic meningitis**/meningoencephalitis
- Fibrosis hydrocephaly
- Dx
- Cryptococcus in CSF
- Untreated = Fatal
Toxoplasmosis
- From Cats and Liter Boxes
- Opportunistic infxn
- Acute
- extensive brain necrosis
- Affects
- Basal ganglia
- Brain stem
- Chronic
- cystic leasions filled w/ necrotic material
Complications of meningitis
- Deaf and blind (Hellen Keller)
- SIADH
- Hydrocephalus
- Seizures
- Etc
- Where does the spinal cord end?
- Where do you do a LP?
- Ends at L2
- Between L3-L4 or L4-L5
LP indications
- Dx of CNS infnx
- Subarachnoid hemorrhage (SAH)
- Infusion of anesthetic, chemo, or contrast in spinal canal
- Tx of Idiopathic Intracranial Hypertension (aka. Psuedotumor cerebri)
- Dx of demyelinating or inflammatory CNS process
- MS
- Guillain-Barre
- Rule out ALS: nml CSF
Contraindications to LP
- Absolute
- Skin infnx over site
- Papilledema
- Focal neurological signs
- Relative:
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Complications of LP
- Headache
- Back pain
- Seeding of infxn
- Uncal or transtentorial herniation
