What are the oragnisms that cause acute pyogenic meningitis in different age groups?
Neonates - Ecoli and GBS
Infants and Kids = Strep pneumoa
Young adults - mini epidemics = Neisseria meningitisi
Elderly - STrep pneumo and Listeria Monocytogenes
Clinical findings for acute purulent / pyogenic meningitis?
HA, photophosbia, irritability, clouding of consciousness, neck stiffness
CSF -- cloudy, increased neutrophils, increased protein, decreased glucose
What are the predisposing conditions for a brain abscess?
congenital heart disease (RL shunt)
chronic pulmonary sepsis with dental procesdures etc
Presentation for abrain abscess?
Pathology of brain abscess?
Focal deficits and increased ICP
Lesions are discrete and see central pus and debris surrounded by Hyperemic margin or fibrous collagen capsule
What are other bacterial infections of the brain?
Subdural Empyema = spread from skull or sinuses and can cause herniation or mass effect
Epidural Abscess - in association with osteomyeltis, can cause spinal cord compression
What can myocabacteria in the CNS cause?
what pathoogy would you see?
TB meningitis (BASILAR!) or a tuberculoma
see ganulomas with multinucleated histiocytes with Acid Fast Vacilli stain
see caseous necrosis
Waht are the different forms of neurosyphilis?
Meningovascular neurosyphillis = chronic meningitis with obliterative endarterities and perivascular plasma cell infiltrate (similar to TB with basilar meningitis + Vascular compromise like minit strokes
Parenchymatous - either general paresis of insane w/ brain atrophy and dementia OR Tabes Dorsalis which is damage to Dorsal Rooty sensory neurons of SC and loss of Deep Tendon Reflexes
What do you see with viral meningoencephalitis?
Parenchymal infection of the brain associated with meningeal inflammation
Perivascular and Parenchymal mononuclear infiltration
Neuronophagia and Microglial activation
sometimes see viral incluseions
What is the presentation of