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192 Cards in this Set
- Front
- Back
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Viral encephalitis 90% of the tiem is
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West nile virus
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EEE locale
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Swamps
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EEE outcome
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High case fatality disease
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WEE locale
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Pastures and flooded areas
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Wee age
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<10
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WEE reservoir
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Birds/Horse and small mammall
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SLE locale
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Flava-Flave, duh, it's in the urban areas
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SLE age
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>40 or infant
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SLE reservoir
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only in people?
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SLE locale
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Midwest Urban
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WNV reservoir
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BIrds
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WNV keywords
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Kills birds, draught, viral encephalitis
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MAC-ELisa test
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Egm test for WNV
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WNV cross reacts w/ what viruses
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yellow, dengue, StLE
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Causes flacid paralysis syundrome
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WNV/Botulism in infants
unilateral polio |
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major sx of WNV
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Flacid paralysis
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WNV age
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>50
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Increases with draught
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WNV
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CAE reservoir
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Small mammal
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Day feeding mosquito
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CAE
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La Crosse serogroup
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CAE
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Squirrel/chipmunk
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Colorado Tick Fever
CTF (possibly WEE) |
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Saddle back fever pattern
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CTF
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REOvirus
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CTF
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CTF fever temporal pattern
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2-3 days fever
2-3days no fever 2-3 days fever |
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Flaccid asymmetric paralysis
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Poliovirus
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Polivirus pahtogeneisis
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enters via M cells in Gi to CNS
5'IRE gets into cells, kills host cells no latent period |
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5' IRE
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poliovirus
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Polio latency period
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none
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5 polio states
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1- inapparent infection
2- Abortive illness 3- Non paralytic polio 4- Paralytic poli 5- post- polio syndrome 30-40yrs post infection |
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Noparalytic polio sx
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stiff=neck and back
2-10 days w/ spontaneous resolution |
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Abortive polio sx
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Fever and maiaise, spontaneous recovery
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Paralytic poli
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Flacid paralysis, LMN damage, bulbar form\
Respiratory failure (iron lung) |
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Post polio syndrome
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30-40 yrs post infection
gradual clinical course of the bulbar form poliovirus Resp faiilure |
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Polio pathogenesis
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Kills neuron -bulbar form leads to respiratory failure/paralysis
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Early polio vaccine associations
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SV40- cancer causing virus found in polio vaccine
PML |
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SV40, or PML post shot
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Poliovirus vaccine
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Salk vaccine
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inactivated polio
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Enhanced potency vacine IPV
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Trivalent- need Ab for all 3 to givve immunity
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Sabin vaccine
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Live polio vaccine
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Rhabdovirus
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Rabies- bullet-shaped
ssRNA |
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REabies prodrome
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fever reffered to the area of the bite
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Excitatory phase of rabies
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anxiety, hydrophobia, coma, HTN and death
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negri bodies
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Rabies
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Rabies Tx
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Human Rabies immunoglobulin (HRIG)
Human diploid cell vaccine (HDCV) |
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Sporatid fatal encephalitis
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HSV1,2
Neonates, <20, >40 |
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Neonate Sporadic fatal encephalitis Sx general
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Lethargy, Irritablity, tremors, poor feeding, 4-11d post delivery
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neonate sporadic fatal encephalitis Sx specific
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Skin lesions- conjunctivits
focal encepalopathy Frontal and temproal head deformities |
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Tzanck smear
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Fluorescent Ab test for HSV1/2 encephalitis
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HSV encephalitis ages/agents
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HSV1- adult reactivation
HSV2 (sexual) neonates |
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HSV tx
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Acyclovir
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Sheep Prions
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Scrapie and Visna- give animals chronic pneumonia and they scrape their butts on rocks
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PRPsc
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prion responsible for progressive neruological diseases
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Mad cow
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oral consumption
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CJD sx
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Dimetnia w/ataxia and seizures
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CJD demographic
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Incubation ~15 months
Pt 60-70yrs |
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CJD transmission
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Corneal trasnplant, neurosurgery equip, pituitary derived GH
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papua New Guinea
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CJD/KUru
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Pt presents with dimentia/ ataxia/ seizures
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CJD mediated
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Sporadic CJD
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Horizontal transfer from infected individual
direct innoculation |
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New Variant CJD
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Human mad cow disease
Amyloid and halospongiform degeneration First starts at tonsils Young Pt BSE |
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Amyloid plaque
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NVCJD and KURU
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Cannibalistic feeding
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KURU
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Prion transmission (infectous protein)
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Blood
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Prion pathogenesis
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enter through M cells of GI and course to Lymphatics
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Prion identification
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western blot
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Lysis of oligodendrocytes
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PML
JC virus infected |
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PML pathogensis
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Immuno system compromised individuals with JC virus
(MS on immune depression drugs) |
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MS histology characterisitc
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Patchy lesions of white matter
young adults |
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PML sx
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mental/ neurological sx
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MS tx
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Natalizumab
for the slow relapsing form of MS |
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MS sx
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Relapsing, intermiitent course, chronic progression
neurological Sx of burning, pain, photophobia |
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HIV neurological charactgeristics
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With meatter disease, indirect destruction of nerve cells, viral proteins provoke the host response
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HIV CNS affects
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cognitive and motor issues
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Two causes of cyrptococcul meningio-encephalitis
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Neoformans and Gatti
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where is C Neoformans found?
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Bird poo
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Produce Laccase
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C Neoformans and Gatti
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C neoformans Course
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Start with skin move to lungs progress to CNS
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C. Neoformans identifiers
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Bird seed agaer
CBG- Yellow |
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C Neofrormans Trasmx
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inhale yeast cells
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C Gatti identifiers
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Bird seed agar
CBG- BlueI |
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Form melanin
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Gatti and neoformans
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Infects iummuno competent
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Crytptococcal meningoencephalitis- C Gatti
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C Gatti, Neoformans Cryptococcal meningioencephalitis Sx
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Pulmonary infection
flu then fever headache Stiff neck |
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Tigondii Morphology 3-
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Bradyzote- chronic disease
Tachyzote- acute and proliferative disease Zotocyst |
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Toxoplasmosis Sx
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Triad
1- Chorioretinism 2. Hydrocephalius 3. Intracranial calcifications |
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Toxoplasmosis infectious stage
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Cyst form
Zotocyst |
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Cats while pregnant will give you friggin
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toxoplasmosis
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Toxoplasmosis Tx
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Pyrmine-Thyamine
Sulfadizine |
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PAM agent
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primary acute miniingioencephalitis
Naegleria Fowleri |
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Naegleria fowleri morph
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1-cyst
2- Trophozite (flagellate) 3- Ameboid- sex form |
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PAM sx
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Sever brian infection
-fever, stiff neck seizure with necrosis Headache, CNS inflammation Confusion, Hallucinations |
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PAM course
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infect w/ flagellate trophozite
Sx in 1-14 days, rapidly fatal |
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PAM pahtogenesis
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enters nasal passage (Can change smell) transforms to ameboid form
travels up olfactory nerve to brian has sucker apparatus |
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Lobopodia
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Naegeleria Fowleri sucker apparatus
PAM |
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Naegleria Fowleri lab
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Wet mount
clearing on Eccoli Agar (eats bacteria) |
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PAM transmission
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Warm water- neti pots
can't get from drinking contaminated water |
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Granulomatous Ameoebic Meningitis
GAM |
Acanth Ameboe
A. Castellain, A. Culbertsoni |
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Acanthamoebae morphology
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Trophoxite (infectous form, spike pseudomembrane)
Cyst (wl layered wavy wall- resistant) |
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GAE sx
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Facial paralysis, Trouble swallowing, Seizures, paralysis, double vision
Rapid progression |
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GAM sx
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mental/neurological
Flu-like w/edema |
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GAM course
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inhale cyst
travels in blood to CNS Incubation is weeks Death in 7-12 days post manifestation |
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GAM transmission
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Resp tract or broken skin
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GAM mortality
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100%
infects chronically ill and immunosuppressed |
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Corneal Scrapings
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Acanth Amoebiasis
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Contact lenses with corneal damage
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Acanth Amoebiasis
often misdiagnosed as ocular herpes DO eye labs |
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GAE agent
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Balamuthia Mandrillaris
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Culture with primate hepatic cells or human brain
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GAE balmuthia mandarillaris
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GAE transmission
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Resp tract or broken skin
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GAE infectous forms
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Both tgrophoziete and Cyst are infectous,
Increased legionella infection w/ disease |
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E. Rostratum
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Tree fungus that grows at body temeperature
contaminated steroid injection from New England compounding center |
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Two causes of neonatal meningitis
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Strep agalactidae
Ecoli |
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meningits: maternal OB complications
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Strep Agalactidae
First five days (EARLY) sx: bacteremia, pneumonia, meningitis |
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Meningitis: no maternal OB complications
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Strep Agalctidae
7d-3mo (LATE) bone joint infection |
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Group B strep Virulence factors
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(normal vaginal flora) Neonatal meningitis
Capsular polysaccharide Hyaluronidase, collagenase |
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Leading cause of bacterimia w/ meningitis during delivery
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Strep Agalacticae Group B strep
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E coli neonatal meningitis
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Gram neg bacillis- K1 strain from moms rectum
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Leading cause of neonatal meningitis
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K1 strain of E Coli Gram neg bacillus
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Gram neg non motile pleiomorphic coccobacillus
vs Gram + motile coccobacillus |
HIB
vs Listeria (facultative) |
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Listeria virulence factor
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Listeosin O
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Coronary Artery Transplant
Renal Transplant Brain stem inflammation |
Listeria Monocytogenes
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Uncooked/undercooked/ raw food
w/ meningitis sx |
listeria
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Listeria pathogenesis
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T-cell mediated
undercooked food compromised host Macrophates and parenchymal cells |
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In-utero acquired inection
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listeria
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Lipopolysaccharide vs lipooligosaccharide
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LPS- Listerosin O
LOS- HIB cell envelope for attachment |
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Meningitis w/ epiglotitis and bacterimia
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HIB meningitis
non-typable strains |
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Post URI, Otitis media
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HIB meningitis
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Capsular antigen in CSF, Serum, Urine
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HIB meningitis
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Gram + lancet shaped
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Strep pneumoniae
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Strep pneumoniae VF
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anti phagocytic capsule
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Purulent meningits ofen phemonia or another infection
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Strep pneumoniae
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alpha hemolytic
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strep pneumoniae
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Recurrent meningitis
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strep pneumoniae
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Mot common cause of meningitis in the elderly
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Strep pneumoniae
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Strep pneumoniae meningites Prophylaxis
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23 valent vaccine (65+0
13 valent vaccine (children) |
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Fastidious gram negative diplococcus
kidney bean shaped |
Nisseria meningiditis
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Mild Nisseria Meningitis
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Trasnient bacterimia 1-2 days
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Sever Nisseria meningitis
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Acute meningiococcemia
Rash w/ DIC Waterhoasu Fredreson |
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Waterhaus
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Nisseria meningiditis- hemmorhagic adrenal infarction in children
from DIC of infection |
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"nonrewarding" CSF gram stain
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Nisseria Meningiditis
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Nisseria infection requirements
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b/c in nasopharynx has to be patient that is fatigued or has open wound (immunocompromised?)
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Brain Abscesses
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Bac Fragilis Parameningial infection
NEVER meningitis |
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obligate anaerobe
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Bac Faragilis
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Bac Fragilis VF
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Neuraminidase, hyaluronidase
LPS: hageman factor |
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Bac Frag days 1-14 events
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1-3: early cerebritis
4-9: late cerebritis 10-13: early capsule formation 14> late capsule formation- abscess |
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Bac frag parameningitis 3 phases
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1: Systemic infection- low grade fever
2: increased intracranial pressure- headache 3: Brain damage- ataxia, aplasia, LOC |
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Bac Frag Dx
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Lumbar puncture
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What causes the clinical manifestations of Bac Frag?
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Bran Abscess- never from bacterial meningitis
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Subdural empyema definition
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Pus B/t inner surface fo the dura and outer arachnoidl ayer
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Subdural empyema
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Polymicrobial parameningial infection
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Parameningeal infection
polymicrobial infectiou nn cause |
usually from paranasal sinusitis
or otitis media |
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paranasal sinusits/ bone erosion/ otitis media
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Polymicrobial parameningial infection
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Polymicrobial parameningeal infection symptoms
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All acute
HA fever impaired conscousness |
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Epidural Abscss definition
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Pus outsid eth dura w/in the spinal cord
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Epidural Abscess
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Staph A. Parameningieal infection
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Acute S. Aureaus parameningial infection
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Purulent necrosis of epidural fat
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Chronic S. Aureus parameningeal infection
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Dura is grey and thick, fat is replaced by granulation (fibrous?) tissue
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Pseudomonas A. parameiningeal infection pathology
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Malignant external otitis
infects adjacent tissues including the bone- spreads to parameninges |
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Staph Aureus prameningeal infection method
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Direct extension- perforatory wound
Metastasis through blood |
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S.A. paramenigeal infection Sx
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4 phases
1- back pain 2- nerve rood infection 3- progression of lesion 4- paralysis |
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malignant external otitis
Swollen parotid CN VI- XIIparalyis |
Psuedomonas A parameningeal infection
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Acid fast bacillus, obligate intracellular pathogen
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Leprosy mycobacterium
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Early leprosy
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Asymptomatic- poorly defined hypopigmented macule
anesthesia |
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TT leprosy
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Tuberculate: skin lesion granulomatous and hypopigmented
anestheisa of lesion |
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BB leprosy
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Borderlike skin lesions (looks like ringwork)
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LL leprosy
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Lepramatous- trauma causes infection hand/food deformities from necrosis
rasied skin lesion with marked anesthesia |
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Why leprosy affect extermitys?
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b/c grows at slightly colder temp than body temp, hence extremities
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3yr incubation, tropics
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leprosy
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G+ terminal spores vs
G+ sub-terminal spores |
Terminal- Tetani Tennis Racquet
Sub- Botulism |
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tetani VF
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Toxin
Plasmid mediated |
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Tetani Sx
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Spasms, Cramp, Lockjaw, Trismus (trigeminal N affected)
arms flexed respiratory and cardiac complications |
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Patients at risk of tetanus
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newborn- umbilical
IVDU- injections |
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Localized tetanus
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disease of extrematies
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Cephalic tetanus
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head wound only
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Tetanus death
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Resp or ccardiac failure
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Botulism VF
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Botulinum toxin- neurotoxic
bacteriophage produced |
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GI- nausea, dry mouth, Diarrhea
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Botulism, may lead to respiratory paralysis
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Infant w/ flaccid paralysis
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Botulism
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Symmetric neurological manifestations w/vomiting
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Botulism
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Botulism cardinal signs
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No fever, Symmetric n effects
Responsive pt no hypotension, no sensory deficit |
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Botulism diagnosis
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stool
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Home-canned food
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botulims
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12-36 incubation (post meal)
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botulism
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Botulism Tx
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Antitoxin- destroy the food.
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When do you give Tetanus IG?
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To a person with a wound that possibly hasn't been immunized. It is expensive and only provides proteciton for a few months
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When do you give tetanus toxoid
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to a person that has been immunized but not in a while, and just received a wound. the memory B cells will shout out Abs faster than the bacteria can proliferate.
Also, give to a person that hasn't been immunized so they can start building immunity (even when received a wound) |
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Non immunized pt with wound: Tetanus, what do youdo?
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Ig and Toxoid
Block immediate rxn and build immunity for after Ig wears off |
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Tetanus shot serum sickness
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with equine
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Active immunization after the exposure to an infectous disease should be done to prevent the disease only if
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the incubation period fo the disease excededs the time required to produce immunity
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Toxoids are inducers of active immunty because they:
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are immunogenic and antigenic
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Immunity induced by tetanus toxoid injection is
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antobody mediated and active
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passive antibody has the advantage over active immunization in that it
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provides immunity (Ab) more quickly
immediate vs few days |
