Most common pathogens for bacterial meningitis in neonates (3)
Group B strep
E coli
Listeria monocytogenes
Most common pathogen for bacterial meningitis in Children (2)
Streptococcus pneumoniae
Neisseria meningitidis
Most common pathogens for bacterial meningitis in adults (5)
Streptococcus pneumoniae
N. meningitidis
L. monocytogenes
staph
Gram negative bacilli
Patient with fever, headache, seizures. Died after a few days. This is the pathology. What is the diagnosis?
Bacterial meningitis
Note: PMNs exudates within leptomeninges
Fibrinoid necrosis of leptomeningeal and cortical arteries and veins
Thrombosis of leptomeningeal and cortical blood vessels
Role of corticosteroid use in bacterial meningitis
Reduces vasogenic edema, meningeal inflammation, and inflammatory response of meningitis.
Improves outcome and reduces mortality in infants, children and adults with bacterial meningitis.
Reduces incidence of neurologic sequelae (sensory neural hearing loss)
Most common sites for cerebral abcess (2)
Frontal and temporal lobes
Major stages in the formation of brain abcesses (4).
Early cerebritis
Late cerebritis
Early capsule formation
Late capsule formation
Patient with fever, severe left temporal headache, right hemiparesis. Prior history of mastoiditis.
Epidural abcess
Most common location of spinal epidural abcesses
Posterior to the cord in thoracic segment
Most common pathogen in spinal epidural abcesses
Staph aureus
Treatment for neuroborreliosis
Ceftriaxone
Syphilitic meningitis occurs in :
C) whithin 2 years of primary infection. Characterized by headache, nausea, vomiting, meningismus, ams, seizures, cranial neuropathies
Tabes dorsalis presents clinically:
Propioceptive loss, sensory ataxia, lancinating and lighnting-like pains, arreflexia.
Argyll Robertson Pupils: Poor consensual pupillary reflexes, but preserved constriction to accomodation.
Immigrant from Southeast asia, presents with loss of pain and temperature, hypopigmented and anhidrotic skin lesions. Preseved vibration and propioceptive sensation. Most likely diagnosis.
Leprosy: caused by Mycobacterium leprae
Male with maculopapular, petechial and eccymotic rash (involving palms and soles), with high fever, nausea, malaise, headaches, ams, seizures. Most likely diagnosis.
Rocky mountain spotted fever: treatment doxy.
Most common cause of arbovirus meningoencephalits
La Crosse (California) encephalitis
The most common agent believed to cause benign recurrent lymphocytic meningitis (Mollaret's meningitis)
HSV type 2
Predilection for inferior frontal and temporal lobes, behavioral dysfunction, personality change, aphasia, complex partial seizures, PLEDS. What is the bug involved?
HSV1
HSV-1 infection, is characterized by the following pathologic findings
Perivascular mononuclear infiltrates
Necrotizing inflammation
Foci of hemorrhage
Intranuclear viral inclussions
Most common cause of encephalitis world wide
Japanese encephalitis (flavivirus)
Most common virus in southern, western and midwestern US.
St Louis encephalitis virus
Which is the prominent and distinguishing feature of West Nile virus infection
Tremor
Other extrapyramidal symptoms: myoclonus and parkinsonism.
Fluctuations in mentation, behavior and consciousness, psychiatric disturbance, persistent fever, hydrophobia or aerophobia, hypersalivation, other autonomic features.
Subacute sclerosisng panencephalitis is related to infection with-----------
Measles: paramyxovirus
Risk factors associated with HIV dementia
low CD4 count (<200)
anemia,
high viral load,
history of hepatitis C injection
female gender
older age
24 year old man with persistent headaches (wakes up by headaches, vomiting, increased headaches with Valsalva).
MRI and pathology show the following.
