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

What is meningitis?

A

Inflammation and infection of meninges

2
Q

What are the common symptoms of meningitis?

A
Headache 
Fever 
Neck stiffness 
Altered mental state 
Photophobia 
Nausea/ vomiting
Seizures 
Petechial skin rash
3
Q

What are the bacterial causes of meningitis?

A

Meningococcus

Pneumococcus

4
Q

What is the viral cause of meningitis?

A

Enterovirus

5
Q

What is encephalitis?

A

Inflammation and infection of brain substances

6
Q

What are the clinical symptoms of encephalitis?

A
Progressive headache 
Meningism 
Confusion 
Abnormal behaviour 
Memory disturbance 
Depressed conscious level 
Seizures
7
Q

What are the investigations for meningitis?

A

Blood cultures

Lumbar puncture

8
Q

What are the investigations for encephalitis?

A

Blood cultures
CT/MRI
Lumbar puncture
EEG

9
Q

What are the antibodies associated with auto-immune encephalitis?

A

Anti-voltage gated potassium channel

Anti-NMDA

10
Q

What are the CSF findings for bacterial meningitis?

A

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

11
Q

What are the csf findings for viral meningitis or encephalitis?

A

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

12
Q

What is the specific investigation for herpes simplex encephalitis?

A

Lab diagnosis by PCR of CSF for viral DNA

13
Q

What is the treatment for herpes simplex encephalitis?

A

Aciclovir

14
Q

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

A

Trigeminal and sacral ganglion

15
Q

What is the significance of arbovirus encephalitides?

A

Relevant to travel history, common in sub/tropics

16
Q

What is a brain abscess?

A

Localized area of pus within the brain

17
Q

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

A
Fever 
Headache 
Seizures 
Hemiparesis 
Dysphasia 
Signs of raised ICP (depressed conscious level, papilloedema)
18
Q

What are the causes of brain abscess and empyema?

A

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

19
Q

What are the investigations for brain abscess or empyema?

A

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

20
Q

What is the management of a brain abscess?

A

Surgical drainage
Penicillin or ceftriaxone to cover streps
Metronidazole for anaerobes

21
Q

What are the common organisms responsible for brain abscess?

A
Strep anginosus 
Strep intermedius 
Strep constellatus 
Prevotella 
Bacteroides
22
Q

What are the HIV indicator illnesses associated with the brain?

A
Cerebral toxoplasmosis 
Aseptic meningitis/ encephalitis 
Primary cerebral lymphoma 
Cerebral abscess 
Dementia 
Cryptococcal meningitis
23
Q

What are the diagnostics for HIV indicator illnesses?

A
India ink, cryptococcal antigen 
Toxoplasmosis serology (IgG) 
JC virus PCR 
CMV PCR 
HIV PCR
24
Q

What are the investigations for Lyme disease?

A
Range of serological tests 
CSF lymphocytosis 
PCR of CSF 
MRI brain/spine 
Nerve condition studies
25
Q

What is the treatment for Lyme disease?

A

Prolonged antibiotic treatment (IV ceftriaxone, oral doxycycline)

26
Q

What are the symptoms of Lyme disease?

A
Fatigue 
Myalgia 
Headache 
Neck stiffness 
Fever, chills
27
Q

What are the clinical findings for neurosyphilis?

A

CSF lymphocytes increased

Evidence of intrathecal antibody production

28
Q

What is the treatment for neurosyphilis?

A

High dose penicillin

29
Q

What part of the CNS does poliomyelitis infect?

A

Anterior horn cells of lower motor neurones

30
Q

What are the clinical signs of poliomyelitis?

A

Asymmetric, flaccid paralysis in legs

31
Q

What is the post-exposure treatment for rabies?

A

Wash wound
Give active rabies immunisation
Give human rabies immunoglobulin

32
Q

What is the infection associated with tetanus?

A

Clostridium tetani

anaerobic gram positive bacillus, spore forming

33
Q

What is the effect of tetanus?

A

Blocks inhibition of motor neurones causing rigidity and spasm

34
Q

What causes botulism?

A

Clostridium botulinum

35
Q

What is the clinical presentation of botulism?

A

Descending symmetrical flaccid paralysis
Respiratory failure
Autonomic dysfunction

36
Q

What are the investigations for botulism?

A

Nerve conduction studies

Culture from derided wound

37
Q

What is the treatment for botulism?

A

Anti-toxin
Penicillin/ metronidazole
Radical wound debridment

38
Q

What are the clinical features of sporadic Creutzfeldt-Jakob disease?

A

Early behavioural abnormalities
Rapidly progressive dementia
Myoclonus