Flashcards in Lecture 71: CNS Infections Deck (26):
Acute bacteria meningitis is a...presents originally as?
Medical emergency; a few days of headache, malaise, photosensitivity
Meningitis neck stiffness on...
Flexion (not lateral rotation)
CSF in meningitis
Elevated opening pressure, low glucose (0.6 of peripheral glucose), elevated protein, elevated WBC w/ PMNs
Adults get bacterial meningitis from (3)
Older adults get bacterial meningitis from (3)
S. pneumoniae, L. monocytogenes, gram (-) rods
Worse bacterial meningitis: name, bacteria, transmission, exposure prophylaxis, sign
Meningococcal meningitis caused by Neisseria; close contact; rifampin; petechial rash
What is a feared complication of meningococcal meningitis?
Waterhouse-Friderichsen Syndrome due to bleeding into adrenal gland --> adrenal failure, hypotension
Neonates get bacterial meningitis from (4)
Group B strep, E. coli, L. monocytogenes, gram (-) rods
Children get bacterial meningitis from (3)
S. pneumoniae, N. meningitidis, H. influenzae type B
Children and adults often get viral meningitsi from...
How does neonatal meningitis presentation differ?
Signs of meningeal irritation might be absence. Look for bulging fontanelles and fever
Describe tuberculous meningitis
Very purulent over base of brain (CN symptoms, CNS flow entrapment)
Growth of tubercles, which enlarge within the CNS parenchyma or remain encapsulated within the meninges,
CSF with tuberculous meningitis
High opening pressure, low glucose, very high protein, mixed cell types
Neurosyphilis can cause...discuss CSF
CN lesions, meningitis, gummas, "general paresis of the insane"; positive VDRL in spinal fluid = syphilis but neg DOES NOT rule out, negative CSF FTA rules out neurosyphilis
In encephalitis, you're more likely to have what? Less likely to have what?
Altered consciousness; headache
Encephalitis is more likely bacterial/viral
CSF fugal findings
Increased opening pressure, decreased glucose, increased proteins, increased lymphocytes (difficult to tell apart from viral meningitis)
CSF fungal infections are usually associated with...
Some fungal infections that can infect brain
Apergillosis, mucormycosis (ketoacidosis w/ red swollen eyes), cryptococcus neoformans, candidiasis
Common causes of encephalitis (3)
Enteroviruses (autumn), HSV, arbovirus (summer)
Acute viral encephalitis (4) and chronic (2)
Arbovirus, herpes encephalitis, poliomyelitis, rabies; HIV and subacute sclerosing panencephalitis (measles)
Characteristic findings of HSV encephalitis? Morbidity/mortality? Diagnosis (3)?
Hemorrhagic lesions of temporal lobes; high morbidity/mortality; PCR for HSV virus, RBCs in CSF, temporal lobe spikes on EEG
Where do you lose motor neurons in polio?
What is the histological sign of Rabies?
Negri bodies (eiosinophilic intracytoplasmic inclusions)