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Peripheral Nervous system diseases
- Botulism
- Tetanus
- Leprosy
- Polio
- Herpese Simplex, Varicella
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Central Nervous System Infections
- Meningitis-meninges
- Encephalitits- brain tissue
- Myelitits- Spinal cord
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Clostridium botulinum
- G+ Rod, obligate anaerobe in soil
- Endospores on veggie roots ingested
- Secrete AB Exotoxin- NeurotoxinBlocks acetylcholine transmision in synapse
- Botulism is disease BOTOX is medical
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Botulism Effects
- Ab neurrotoxin blocks acetylcholine transmission
- Causes flaccid paralysis
- Respiratory failure and death
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Botulism Treatment
- Supportive care- ventilator
- antitoxin/ antibodies bind neurotoxin
- ANTIBIOTICS DO NOTHING
- There are several outbreaks yearly from peppers and onions
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Clostridium tetani
- G+ obligate anaerobe in soil
- Endospores grown in wounds and punctures
- Secrete AB exotoxing- tetanospasmin
- Blocks peripheral nerve relaxation pathways
- Symptom: muscle contraction and spasm
- Disease: spastic paraysis leaves body arched Spinal muscles stronger than abdominal
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Tetanus Symptoms
- Lockjaw- mouth cannot open
- Opisthotonos- extreme contraction
- Death from respiratory spasm
- 50 US cases a year, elderly
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Tetanus Treatment/Prevention
- Treated with antitoxin that binds antibodies to toxin
- Vaccine contains inactivated toxin
- Boosters needed every 10 years
- 50% of adult population has inadequate antibodies
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Mycobacterium leprae
- G+ acid fast rod identified in 1870
- Grows in peripheral nerves & skin cells
- Leprosy- Hansens disease
- Lepromatous- progressive form cool parts of body (nose hands)
- Tuberculoid- neural form- loss of sensation
- India, Brazil, Nepal, Mozambique, Angola, Myanmar
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Human Herpes Virus
- Varicella Virus
- Chicken pox is initial infection
- Shingles is reactivated virus
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CNS Portals of Entry
- Hematologous spread- most common
- Across blood brain barrier, from capillaries to CSF, between epithelial cells
- Skull or vertebra fracture Staph. sp.
- Through cibriform foramina- ameobas
- Along peripheral nerves- Rabies HSV
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CNS Pathogens
- Meningitis
- Encephalitis
- Vassculare Occlusion
- Granulomas
- Abscesses
- Cysts
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CNS pathogen Testing
- CT scan assess for tumors, abcesses and cysts
- Lumbar puncture for CSF test
- Gram, Capsule and acid fast
- Low glucose- suggests bacterai
- Neutrophils- sugests bacteria
- Lymphocytes- suggests virus
- Serology-syphillis, hiv, lyme
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Bacterial Meningitis
- Fevere, headache, stiff neck, nausea, vomitting
- Rapid progression to convulsions and coma
- Most common - Acute
- Haemophilus influenzae
- Streptococcus pneumoniae
- Neisseria meningitidis
- Uncommon: G- rods, Listeria Spp. M. tuberculosis
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Haemophilus influenza Type B
- G- aerobic w/ capsule
- Normal nasopharyngeal flora
- Meningitis in chilren younger than 4. 6% mortality
- Otis media, epigolttis and pneumonia
- HIB vaccine capsule antigenic conjugated with protein
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Neisseria Meningitidis
- Meningococcal meningitis
- G- aerobic cocci with capsule
- 10% people carry, College and military vaccinated
- From soar throat to deat in few hours
- Mortality-80% w/ out treatment, 12% w/ treatment
- Rapiid Endotoxin damage
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Streptococcus pneumoniae
- G+ diplococci pneumococcus
- 70% people carry
- ottis media and pneumonia
- Children under 4 most common
- 30% mortality meningitidis in kids. 80% elderly
- Vaccine: subunits from 7 strains- under 24mnths, continually ill elderly
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Cryptococcus neoformans
- Fungus with very thick capsule
- Identified by CSF indida ink stain
- Pigeon shit inhaled
- Mild lung infection
- Meningitis mortality up to 30%
- Treated: Amphotericin B
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Viral Meningitis
- Aseptic meningitis- no growth in culture
- Elevated lymphocytes in CSF
- Cannot be cultured by normal techniques
- Non-polio enterovirus meningitis mild self limited
- Herpes meningitis SEVERE
- hematologous, cranial nerves, acyclovir crucial
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Poliomyelitis
- Fecal diarrhea- oral spread of 3 enterovirus strains
- 1% infections hematologous spread
- Destroy spinal cord motor horns- gray matter
- Flaccid paralysis- limbs and respiratory
- 1984-"Infantile paralysis"
- 1979- last us wild case
- 2009-still; endemic in India, Pakistan, Nigeria and Afghanistan
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US Rabies
- Most us mammal pets are vaccinated
- Wild Mammals-never in squirrels
- Furious- animals restless and excitable
- Paralytic- animals are docile
- Vaccine-killed virus certain scientists vets, rangers
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Prions
- Ingestion, transplant inherited
- Years to decades to incubate-Chronic and fatal
- Sheep Scrapie- England scrap themselves to death
- Familal Fatal Insomnia- Italian Family
- Bovin spongiform encephalopathy- Mad cow disease
- Kuru-human- Pacific islands
- Creutzfeld Jacob disease
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African Trypanosmas Encephalitis
- Sleeping sickness
- Protozoa transmitted by tstse fly
- Gambiense- "milder chronice" human only host
- Rhodesiense- acute, lethal, cattle and human
- No effective medication due to rapidly evolving protein coat
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Rabies Diagnostic Test
- 1903- Direct observation of Negri body in neuron cell
- Rabies antibodies in serum and CSF
- Anitgen tesitng byu direct fluroescent of cerebellum and brain stem
- Polymerase Chain Reaction- RNA in saliva and neck nape skin biopsy of nerver aroudn hair root
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Rabies Encephalitis
- Virus travels 1cm a day along peripheral nerves in cns
- 1 month to 1 year until encephalitits
- Autonomic instability- fever sweating foaming saliva, delirium,
- hydrophobia (afraid to swallow
- 47 US cases since 1990 1 survivor
- Postexposure Prophylaxis- 40,000 per year
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Arbovirus Encephalitis
- WEE- severe residual nerological damage (birds, horses) Culex
- EEE- 30% mortality (birds, horses) Aedes & culiseta
- St. Louis- Urban 20% mortality (birds) culex
- California- small mammals- aedes
- West Nile- mild to severe 20% mortality (birds , mammals) Both
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