CNS Infections

Question 1

What are 4 dental related CNS infections?

Answer 1

1-Abscess
2-Empyema - between dura and arachnoid
3-Meningitis - subarachnoid/CSF space
4-Encephalomyelitis

Question 2

What are the 2 main ways to cause CNS infection from oral illness?

Answer 2

1-Direct extension of acute oral infections (Caries/pulpitis, Periodontitis, Abscess, NUG)
2-Bacteremia

Question 3

Which CNS condition is the most common infection from secondary dental pathology? What are the typical symptoms of it?

Answer 3

CNS abscess

symptoms - results in changes in consciousness, focal neurologic signs (speech, visual field defects, paresis) vomiting and fever

*Oral pathology, procedures, immunocompromise, heart disease, skull fx, meningitis, sinus infection; all risk factors

Question 4

The liquefactive nature of a bacterial abscess in the brain is treated in what two ways?

Answer 4

1-Antibiotics

2-Surgery (>2.5cm)

Question 5

What organism is a branching filamentous bacteria that is gram positive, non-acid fast, is normal oral flora and aerobic/microaerophilic and causes CNS?

Answer 5

Actinomyces

Question 6

Which organism family is the most common neurosurgical organism in immunocompromised patients? What are three examples that we should remember from this family?

Answer 6

Mycoses

*Aspergillus, Zygomycetes, Candida,

Question 7

What organism is the most common pathogen of brain infection, presents with focal symptoms, and is treated by aggressive surgical excision as well as amphotericin B + flu cytosine?

Answer 7

Aspergillus

*Can be single/multiple abscess, granulomata, infarcted brain

Question 8

Which organism family presents as rapid facial swelling, is wide and ribbon like with 90 degree branching and is a risk factor is diabetics and immunosuppressed patients? What are 3 examples of this family?

Answer 8

Zygomycetes

*Mucor, Rhizomucor, Rhizopus

Question 9

Which organism rarely causes CNS infection, is treated through multimodal antifungals and can cause meningitis, encephalitis or abscess?

Answer 9

Candida

Question 10

What are 4 CNS infections not orally related?

Answer 10

1-Parasites
2-Spirochetes
3-Viruses
4-Prion disease

Question 11

What two parasitoses are caused by helminths and protozoa respectively?

Answer 11

Helminth- Neurocystercercosis (taenia solum)

Protozoa- Toxoplasmosis (toxoplasma gondii)

Question 12

What non-dental organism causes neurosyphilis (treponema palladium) lyme disease (barrel burgdorferi) and are uncommon neurosurgical specimens?

Answer 12

Spirochetes

Question 13

What are the two main issues causes by Herpes virus?

Answer 13

1-Herpetic gingivostomatitis (very common)

2-Herpes simplex encephaliits (rare)

Question 14

Which group of organisms are slow viruses thatcause abnormal protein folding such as in Creutzfeldt-Jakob disease?

Answer 14

Prions

Question 15

What general kind of symptoms are expressed when an individual has encephalomyelitis?

Answer 15

gross systemic symptoms

Question 16

Which general category of bacteria are most and least likely to cause CNS infections?

Answer 16

Gram Positive cocci - Most

Gram Positive Bacilli - least