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Flashcards in Infections of the Nervous System Deck (38)
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1

What is meningitis?

Inflammation and infection of meninges

2

What are the common symptoms of meningitis?

Headache
Fever
Neck stiffness
Altered mental state
Photophobia
Nausea/ vomiting
Seizures
Petechial skin rash

3

What are the bacterial causes of meningitis?

Meningococcus
Pneumococcus

4

What is the viral cause of meningitis?

Enterovirus

5

What is encephalitis?

Inflammation and infection of brain substances

6

What are the clinical symptoms of encephalitis?

Progressive headache
Meningism
Confusion
Abnormal behaviour
Memory disturbance
Depressed conscious level
Seizures

7

What are the investigations for meningitis?

Blood cultures
Lumbar puncture

8

What are the investigations for encephalitis?

Blood cultures
CT/MRI
Lumbar puncture
EEG

9

What are the antibodies associated with auto-immune encephalitis?

Anti-voltage gated potassium channel
Anti-NMDA

10

What are the CSF findings for bacterial meningitis?

Opening pressure increased
High cell count, mainly neutrophils
Glucose reduced or zero
High protein

11

What are the csf findings for viral meningitis or encephalitis?

Opening pressure normal or increased
Cell count high, mainly lymphocytes
Glucose normal
Protein slightly increased

12

What is the specific investigation for herpes simplex encephalitis?

Lab diagnosis by PCR of CSF for viral DNA

13

What is the treatment for herpes simplex encephalitis?

Aciclovir

14

Where is the herpes simplex virus found latent after primary infection?

Trigeminal and sacral ganglion

15

What is the significance of arbovirus encephalitides?

Relevant to travel history, common in sub/tropics

16

What is a brain abscess?

Localized area of pus within the brain

17

What are the clinical features of a brain abscess or empyema?

Fever
Headache
Seizures
Hemiparesis
Dysphasia
Signs of raised ICP (depressed conscious level, papilloedema)

18

What are the causes of brain abscess and empyema?

Penetrating head injury
Spread from adjacent infection
Blood borne infection (bacterial endocarditis)

19

What are the investigations for brain abscess or empyema?

CT/MRI
Investigate source
Blood cultures
Biopsy/ drainage of pus

20

What is the management of a brain abscess?

Surgical drainage
Penicillin or ceftriaxone to cover streps
Metronidazole for anaerobes

21

What are the common organisms responsible for brain abscess?

Strep anginosus
Strep intermedius
Strep constellatus
Prevotella
Bacteroides

22

What are the HIV indicator illnesses associated with the brain?

Cerebral toxoplasmosis
Aseptic meningitis/ encephalitis
Primary cerebral lymphoma
Cerebral abscess
Dementia
Cryptococcal meningitis

23

What are the diagnostics for HIV indicator illnesses?

India ink, cryptococcal antigen
Toxoplasmosis serology (IgG)
JC virus PCR
CMV PCR
HIV PCR

24

What are the investigations for Lyme disease?

Range of serological tests
CSF lymphocytosis
PCR of CSF
MRI brain/spine
Nerve condition studies

25

What is the treatment for Lyme disease?

Prolonged antibiotic treatment (IV ceftriaxone, oral doxycycline)

26

What are the symptoms of Lyme disease?

Fatigue
Myalgia
Headache
Neck stiffness
Fever, chills

27

What are the clinical findings for neurosyphilis?

CSF lymphocytes increased
Evidence of intrathecal antibody production

28

What is the treatment for neurosyphilis?

High dose penicillin

29

What part of the CNS does poliomyelitis infect?

Anterior horn cells of lower motor neurones

30

What are the clinical signs of poliomyelitis?

Asymmetric, flaccid paralysis in legs