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MSII: Microbio Unit 3 > Viral CNS Infections (2) > Flashcards

Viral CNS Infections (2) Flashcards

1
Q

Three pathways of viral entry into the CNS?

A

Neural, olfactory, hematogenous

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2
Q

Define meningitis:

A

Inflammation of the lining of the brain

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3
Q

Causes of aspetic meningitis:

A

Viruses, fungi, TB

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4
Q

Of the viruses that cause aspetic meningitis, which is the most common cause?

A

Enterovirus

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5
Q

Define encephalitis:

A

Inflammation of the brain tissues

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6
Q

Define Meningoencephalitis:

A

Widespread infection of the meninges and brain

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7
Q

What are the hallmark symptoms of meningitis?

A

Neck stiffness, HA, photophobia

Can also see N/V, muscle pain rash abd pain, malaise, sore throat

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8
Q

How is a diagnosis of aseptic meningitis made?

A

Elevated WBC count in spinal fluid and sometime virus can be detected (via OCR)

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9
Q

Progonsis associated with aseptic meningitis?

A

Usually resolves without complication in 2 weeks. Encephalitis is a rare complication.

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10
Q

What is a hallmark sign of meningitis?

A

Brudzinski’s sign: neck is so stiff that knees flex when head is flexed

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11
Q

What is the major symptomatic difference between meningitis and encephalitis?

A

Meningitis: Mental status is normal

Encephalitis: Altered mental status

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12
Q

T/F: encephalitis can cause intracerebral hemorrhage

A

True

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13
Q

What are the symptoms of encephalitis?

A

Altered mental status (memory loss, flat affect, withdrawal, poor judgement, unresponsive), fever, HA, N/V, photophobia, stiff neck, seizures

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14
Q

How is encephalitis diagnosed?

A

Spinal tap–> blood, increased lymphocytes, PCR (gold standard)

EEG–> suggestive of seizures

Brain imaging–>can show foci or inflammation or hemorriage (to help r/o abscess and septic bacterial infection)

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15
Q

Treatment for encephalitis?

A

supportive care, antivirals, AEDs, anti- inflammatories

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16
Q

Prognosis of encephalitis?

A

Depends, can recover fully or can have severe complications

17
Q

What is Acute disseminated encephalomyelitis?

A

Post-infectious encephalitis that follows a viral infection by 1-2 weeks

Associated with measles, mumps, VZV, influenza, parainfluenza

18
Q

Which viruses have neuronal spread?

A

Herpes viruses (alphaherpesviruses)

Rabies

19
Q

Which viruses have fecal-oral spread?

A

Picornaviruses (enteroviruses)

20
Q

What viruses have insect vector spread?

A

Flavavirus

Togaviruses (alphaviruses)

21
Q

Which HSV primary infection is more likely to cause meningitis?

A

HSV2

22
Q

How do you treat HSV and VZV meningitis and encephalitis?

A

Acyclovir

23
Q

Why do herpes viruses spread via neuronal pathways?

A

Because they are neurotropic…they establish latency in the ganglia

24
Q

What are the symptoms of HSV1 encephalitis?

A

Altered mental status, focal cranial nerve deficites, hemiparesis, slurred speach, fever seizures

25
Q

What are the two findings that are diagnostic for HSV1 encephalitis?

A

1- PCR of CSF for HSV

2- MRI shows unilateral temporal lobe abnormalities

26
Q

How is rabies transmitted?

A

Bite of infected animal

It replicates in the muscle at the bite site and they infects peripheral nerves and travels to the brain

27
Q

How long is the incubation period of rabies?

A

Week to months….so it is easy to prevent after exposure

28
Q

When are enteroviruses more prevalent?

A

Summer months

29
Q

What additional symptom with patients have when they present with enterovirus caused encphalitis?

A

Diarrhea (because fecal oral transmission)

30
Q

Which picornaviruses us there a vaccine for?

A

Poliovirus

31
Q

Vector and host of arboviruses?

A

Vector: insects

Host: usually birds

Dead end hosts: Humans and horses

32
Q

Which togaviruses can cause encephalitis?

A

VEE, EEE, WEE

33
Q

What flaviviruses can cause encephalitis?

A

JE, West Nile, SLE, Russian spring-summer encephalitis virus, Powassan virus

34
Q

Describe flavivirus dissemination?

A

Mospquito bite–> infection at bite site and infasion of lymph node–> primary viremia (vascular endothelium, macrophages, liver, spleen)–> secondary viremia (encephalitis, hemorrhagic fever)

35
Q

People at a higher risk for west nile virus meningoencephalitis?

A

Cancer, diabetes, HTN, kidney disease

There is also a genetic predisposition (HLA)

36
Q

Prognosis with west nile virus meningoencephalitis?

A

recovery over weeks or months and some neuro effects may be perminant

37
Q

CSF findings with meningitis?

A

No increase in glucose

Mild increase in protein

Mild increase in WBC

MSII: Microbio Unit 3 (2 decks)

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