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30 Cards in this Set
- Front
- Back
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What is the difference between an encephalitis, meningitis, & myelitis?
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Encephalitis: inflammation of the brain.
Meningitis: inflammation of the meninges Myelitis: inflammation of the spinal cord |
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What are the hallmark features of encephalitis?
What is the most common etiology of encephalities? |
Alteration of conciousness/lethargy/coma
Seizures/Parkinson-like features Focal findings on the brain VIRUSES are the most common etiology of encephalities. |
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What are the hallmark features of meningitis?
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Meninge irritation: headache, stiff neck, photophobia, fever
NO focal findings usually seen |
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What is the difference between septic and aseptic meningitis?
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Septic --> usually a bacterial infection; high neutrophils (PMN's); low glucose, & high protein
Aseptic meningitis: usually viral, normal glucose, moderate protein |
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Distinguish between the clinical pictures of the various forms of myelitis?
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Transverse: simulates acute transection of the chord w rostral limb weakness, sensory level + early bowel + bladder involvement (m. weakness doesn't progress)
Ascending flaccid paralysis: ascending flaccid paralysis + RISING sensory loss + bowel/bladder involvement Poliomyelitis:involves anterior horn cells; musclular pain w/OUT sensory loss or bowel/bladder involvement. |
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What is the most common cause of encephalitis?
What areas of the brain are affected? What cells are commonly seen in the CSF? |
HSV-1 (HSV-2 causes a more benign meningitis
The frontal and temporal lobes --> necrotizes these areas of the brain RBC's, PMN's early, lymph's late SEIZURES are common |
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What is the treatement for encephalitis caused by HSV-1, and how do we diagnose it?
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Acyclovir; we diagnose by doing PCR of the CSF
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What disease is associated with Varicella zoster? What is the treatment?
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Aseptic meningitis; usually undiagnosed and self-limiting
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What can be typically seen in children post chicken-pox rash? What is typically seen in adults?
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Cerebellar ataxia (vertigo & slurred speech) OR Encephalitis in adults (mostly in the immunocompromised)
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What is the treatment for encephalitis caused by varicella-zoster?
How do we diagnose aseptic meningitis caused by VZV? |
Acyclovir
CSF PCR, but easier to diagnose if rash is present. |
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What disease do EBV usually cause?
What CNS infection can it also cause? |
Mononucleosis; it can also cause aseptic meningitis
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How do we Dx aseptic meningitis in EBV?
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-Elevated transaminases
-atypical lymphocytes in blood/CSF -IgG/IgM in serum + spenomegally and lymphadenopathy to diagnose acute EBV infection |
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What does HHV6 cause? What is the method of diagnosis?
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Roseola: a febrile childhood exanthum in infants and children
CSF but it can remain + for many years |
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What is the first symptom seen with a rabies infection?
What are the 2 forms of rabies? |
Prodrome: Parasthesias/pain at bite site
The 2 forms of rabies: -furious form:agitation, delirium, hydrophobia, myocarditis, loss of autonomic control (salivating, drooling) -paralytic "dumb" form: ascending flaccid paralysis, coma follows |
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How do we diagnose Rabies?
What is the pathogenesis of Rabies? |
PCR of saliva
The virus first replicates locally in would --> then enters peripheral nerve & travels to the CNS & once in the CNS, it cannot be treated. If unvaccinated, treat with local would care. |
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When you see a patient with loss of control of autonomics, what should pop into your head?
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RABIES! (salivation, drooling, foaming of the mouth).
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What are the symptoms of Lymphocytic Choriomeningitis?
What season are you more likely to see this disease? What is the progression of the disease? |
orchitis (inflammed testes) or late myocarditis/ increased CSF pressure and high levels of protein, occasionally low glucose
fall/winter predilection Fever, rash, occ LAD that improves ans recurrs with meningitis or encephalitis. FOUND IN MICE |
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What diseases are acquired through the paramyxaviridae family?
Describe the progression of mumps? Measles, and how does it differ in the immunocompromised? |
Measles, Mumps, Nipah, Hendra
Mumps: CNS symptoms, followed by paratotitis --> generally self-limiting Measles: acute or chronic measles cause encephalitis; if you have the vaccine, the rash is atypical (in the immunocompromised, there may not be a rash and may have concominant pneumonia) |
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How do we diagnose + treat measles and mumps?
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IgM ELISA + treat with Vitamin A
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Enteroviruses have a predilection for which season?
Which viruses are most common for enterovirus meningitis? |
Summer
Cocksackie + Echo viruses account for 90% of enteroviral meningitis |
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What are the symptoms of enteroviral meningitis?
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Pleurodynia (inflammation of the pleura), herpangina (sore throat), and rash are helpful in Dx --> POLIOMYELITIS may also result although its rare in the U.S.
CAN CAUSE CHRONIC ENCEPHALITIS IN THE IMMUNOCOMPROMISED. |
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Who is mostly affected by poliovirus?
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children + young adults
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Poliomyelitis is the largely erradicated in the US, but is still seen in _____________ & _________.
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Africa and Asia
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What serotype of adenovirus is mostly responsible for CNS infections?
What is the typical treatment for CNS infections? When is a chronic form seen? |
Serotype 7
Cidofovir Chronic form is found in those with hypogammaglobulinemia |
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What types of syndromes are seen with HIV infections?
What cells are affected by HIV related meningitis? |
aseptic meningitis/encephalitis/MS-like lesions/ascending flaccid paralysis/Bell's palsy/cognitive impairment or dementia
The microglia cells of the whate and grey matter...NOT neurons |
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What virus should you be thinking of when you see aseptic meningitis, dementia, or aseptic meningitis?
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HIV
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How do you diagnose arboviruses? What is the seasonal predilection of these viruses?
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ELISA
Summertime predilection |
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The LaCrosse virus is typically found _____________?
What are the symptoms? What is the typical sequelae? How is diagnosis made? |
East of the Mississippi River
symtoms vary from mild meningitis to HSV-like illnesses Neurological residua isn't uncommon 50% of people have seizures |
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Where is EEV found?
What are the typical symptoms seen with EEV? |
Eastern and gulf coast states
High CSF WBC count, Low Na+/ MRI positive in basal ganglia/thalamus and brainstem vascular congestion/edema/hemmorraghe |
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What is the likely cause of W. Nile Virus?
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Birds (mosquitos carry it, but also seen in blood transfusions/breast milk.
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