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73 Cards in this Set
- Front
- Back
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MCC Newborns
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GBS, E. coli, L. monocytogenes, Klebsiella
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MCC Infants and children
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S. pneumo, N. meningitidis, H. flu
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MCC Adults
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S. pneumo, N. meningitidis
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A/w trauma/surgery
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S. aureus, S. epidermidis, S. pneumo, Pseudomonas
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Not a/w surgery/trauma
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microaerophilic or anaerobic strep, anaerobic gram-neg
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MCC acute purulent meningitis
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S. pneumo, N. meningitidis, H. flu
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Chronic granulmatous infxn
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M. tb, Coccidiodes, Crypto, Histo
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Parasistic infxn
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Toxoplasma, Trypanosoma, Acanthamoeba
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Nematodes
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Toxocara, Trichinella, Angiostrongylus
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Cestodes
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Taenia solium
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Chronic meningitis
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Tb, Fungi, Protozoa
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Aseptic meningitis
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Viral, syphillis, Borrelia, Trepenoma, Will's dz (Leptospira), Drugs, Tumors, SAH
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Diff b/t poliomyelitis and acute polyneuritis
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Polio - affects ant motor horn cells - asymmetric flaccid paralysis (polio, coxsackie)
Polyneuritis - symmetric flaccid paralysis (unknown, C. dipth, enteric, CMV, EBV) |
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Reye's syndrome sxs
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Viral illness, cerebral edema, hepatic dysfxn, hyperammonia
Influenza A, B, VZV, aspirin |
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Dx - Gold culture?
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Culture from CSF
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N. meningitdis - MC serogroup, Epidemic serogroup?
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MC - B, C, Y
Epidemic - A |
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N. meningitdis - Virulence
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Meningococcal Polysaccharide Capsule - inh opsonin
IgA Protease - inh ciliary activity LPS/LOS - aids immune invasion, similar to sphingolipids Endotoxemia |
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N. meningitdis
Tx Prophylaxis |
Tx - Penicillin, cefotaxime
Prophylaxis - rifampin |
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S. agalactiae - serotypes
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Children - 1a, 3, 5
Adults 1a, 5 |
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S. agalactiae - virulence
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GBS capsule (Sialic acid moiety) - binds factor H -- degrades C3b
Peptidase - inactivates C5a |
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Diff between early and late onset GBS infxn
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early - signs of infxn at birth
late - affects bones and joints |
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Adults infected w/ S. agalactiae
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1) Peripartum chorioamnionitis, bactermia
2) Pneumonia, skin/soft tissue |
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S. agalactiae - Dx
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CAMP test (GB - CAMP factor + Staph b-lysin - sphingomylinase) --> lysis of RBC
Resistant to bacitracin |
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S. pneumo - Virulence
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Capsule
a-hemolysis Autolysins 0 susceptible to peroxides |
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S. pneumo - Dx
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Bile solubility
Optochin sensitive |
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Listeria monocytogenes - characteristics
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+ catalase
Tubling motility in fluid B-hemolytic Intracellular --> CMI mediated |
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Listeria monocytogenes - Virulence
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Internalin
Listerolysin |
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Listeria monocytogenes - Tx
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Penicilin, ampicillin, TSX
Fulminant - gentamicin, ampicillin |
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H. flu - Virulence
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Capsule - Polyribitol phosphate, inh opsonization, phagocytosis
Pili/Adhesins Endotoxin - locally toxin not endotoxemia |
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H. flu - Tx
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cetriaxone, cefotaxime
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Mycobacterium leprae - Characteristics
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slow growth, lives in cells - macs and schwann cells/doesn't culture
Cell wall components - phenolic glycopid, Lipoarabinomannan |
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Mycobacterium leprae - pathogenesis
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inh lysosome/phagosome fusion
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Mycobacterium leprae - tuberculoid presentation
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Th1 response - IL2, IFNg, TNFb
hypopigmented macule Thickened peripheral nerve Numbness |
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Mycobacterium leprae - tuberculoid bx
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Histo - non-caseating epithelioid granuloma
S-100 + |
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Mycobacterium leprae - lepromatous
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Th2 response - IL4, IL5, IL10
lack of CMI, no mac activation Skin lesions, symmetric on face - leonine appearance |
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Mycobacterium leprae - lepromatous
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Arm nodules
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Tb meningitis - etiology
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hematogenous
rupture of subependymal tubercle in SA |
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Tb meningitis - clinical presentation
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Paresis of CN (ocular nerves MC)
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Tb - cell wall
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mycolic acid, N-glycolyl muramic acid, mycosides, sulfolipids, lipoarabinomannan
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Nocardia
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gram + branched hyphae
grows on blood/choco agar - dry, wrinkled, white - orange smells like wet dirt |
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MC nocardia in lung and brain infxns
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N. asteroids
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Nocardia - pathogenesis
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disruption of acidification of phagosome resists oxidative bursts
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Nocardia - tx
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Sulfonamide
Amikacin, impenem, cephalosporins For > 6 weeks |
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Clostridium botulinum - characteristics
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gram +, spore forming, anaerobic rod
Exotoxins - A, B, E, F |
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Clostridium botulinum - endospore germination
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lies - low O2, low pH, low Temp
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Clostridium botulinum - pathogenesis
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neurotoxin blocks transmission of nerve signals to muscle
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Viral meningitis etiologies
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dsDNA - VZV, EBV
(+) ssRNA - Enteroviruses (MCC) (-) ssRNA - Ca, Measles, Mumps, Lymphocytic choriomeningitis virus, HIV |
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Viral Encephalitis etiologies
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dsDNA - HSV (MCC), CMV
(+)ssRNA - west nile, St louis, E/W virus |
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Summer-fall infxns
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Coxsackie B, enteroviruses, Ca
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Winter - School
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Measles
Mumps Varicella |
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Winter - College
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EBV
Measles Mumps |
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Winter - Adults
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VZV
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Winter - other
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Lymphocytic choriomeningitis
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Immunocompromised
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Adenovirus, HIV
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EBV
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usu meningoencephalitis
focal neurologic features |
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Enteroviruses
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MCC of meningitis - coxsackie, echo, entero
FO route of infxn OUTBREAKS |
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California serogroup
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Lacross, Ca, Jamestown, Snowshoe
Arthropod transmission Acute phase - not recoverable Nonspecific febrile illness, aseptic meningitis, meningoencephalitis |
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Measles
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Acute - MC, occurs during convalescent stage
Chronic - Subacute sclerosing panencephalitis, > 7yrs after infxn |
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SSPE
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personality change
oor school performance myoclonic jerks spasticity, tremors, loss of coordination, ocular abnormalities (blindness) |
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Mumps
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meningitis or meningoencephalitis w/ parotitis
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Lymphocytic choriomeningitis
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Lasts 1-3 weeks
Biphasic (1) meningeal signs (2) headache |
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HIV
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initial presentation - mono-like
Can present as aseptic meningitis, less commonly encephalitis, or CN palsies |
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HSV
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MCC of viral encephalitis
1/3 < 20 yo; 1/2 > 50 yo |
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HSV 1
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sporadic
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HSV 2
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recurrent benign lymphocytic meningitis
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CMV
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immunocompromised
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West nile
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culex mosquito
neutrophil predominance tremors, parkinsonism, myoclonus poliomyelitis-like paralysis |
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St. louis
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Zoonotic, mosquito
<20 yo: 40% meningitis/50% encephalitis >60 yo: 90% encephalitis Seizures |
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Eastern/Western encephalitis virus
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Prodrome (malaise, fever, chills) --> Encephalitis sxs
Mortality > 1/3 West is the best(er) to have |
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Rabies
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Incubation 7 days - 6 yrs
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Furious rabies (80%)
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spasms, hyperactivity --> hallucinations, agitation, seizures, high body T
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Dumb rabies
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paresthesias, weakness, flaccid paralysis
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Polio
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Abortive - nonspecific febrile illness w/o CNS
Aseptic meningitis - meningeal irritation , rapid recover Paralytic - asymmetric paralysis |
