Term
location of nervous system infections
(general) |
|
Definition
can be focal, multifocal, or diffuse
-brain, SC, nerve root, plexus, peripheral nerve, muscle |
|
|
Term
time course of nervous system infections |
|
Definition
subacute
typically present clinical manifestations like a mass lesion with a subacute course |
|
|
Term
classification of neurologic infections |
|
Definition
by site of infection
by organism |
|
|
Term
classification of neurologic infections
by site of infection |
|
Definition
meningeal
parenchymal (brain, spinal cord)
peripheral nerve
muscle |
|
|
Term
classification of neurologic infections
by organism |
|
Definition
bacterial
viral
fungal
parasitic |
|
|
Term
|
Definition
encephalitis
cerebritis
abscess
granuloma |
|
|
Term
bacterial meningitis
clinical features |
|
Definition
headache, abrupt onset (acute)
fever
stiff neck - meningeal signs
photophobia
nausea/vomiting |
|
|
Term
|
Definition
Brudsinski's = doc passively flexes pt head forward and pt involuntarily flexes one or both hips -more specific -may be only subtle hip flexion
Kernig's = pain on extension of the knee while hip is flexed (from stretching out meninges) |
|
|
Term
bacterial meningitis
macroscopic pathology |
|
Definition
*hallmark = meningeal inflammation*
-swollen brain -congested meninges -purulent exudate (pus) in subarachnoid space around ventricles
(meninges look like they have a bad cold) |
|
|
Term
bacterial meningitis
microscopic pathology |
|
Definition
lots on PMNs and necrotic debris in subarachnoid space and ventricles
(1 wk) PNMs replaced by macrophages and lymphocytes; fibroblast proliferation |
|
|
Term
bacterial meningitis
secondary pathology |
|
Definition
perivascular inflammation - inflammatory cells infiltrate meningeal and cortical blood vessels; may cause thrombosis, infarction
fibrous organization can obstruct CSF outflow, causing hydrocephalus |
|
|
Term
bacterial meningitis
pathophysiology - route of entry |
|
Definition
bacteria colonize mucosal surfaces of nasopharynx |
|
|
Term
bacterial meningitis
pathophysiology - transport to the nervous system |
|
Definition
bacteria get transported from nasal mucosa to blood vessels (in phagocytic vacuoles across epithelial cells)
spread to choroid plexus via bloodstream (mechanism unknown)
cross BBB into subarachnoid space |
|
|
Term
bacterial meningitis
pathophysiology - inflammatory response |
|
Definition
in subarachnoid space, bacteria trigger inflammatory cytokine release
cell wall and lipopolysachharide surface components of bacteria induce meningeal inflammation
cytokines upregulate blood vessel endothelial cell adhesion molecules - PMN infiltration into CSF
PNMs degranulate and release other inflammatory mediators and toxic oxygen metabolites |
|
|
Term
bacterial meningitis
pathophysiology - cellular damage |
|
Definition
damage directly from bacterial toxins and toxins released from PNMs
edema from cellular damage and increased vascular permeability from inflammatory products |
|
|
Term
bacterial meningitis
CSF findings |
|
Definition
++ WBC >1000; mostly NEUTROPHILS
+ protein >100
+ opening pressure 200-500
- glucose <40%serum glucose
often + gram stain
- glucose |
|
|
Term
bacterial meningitis
likely organisms
age 0-12 weeks |
|
Definition
group B strep
e. coli
listeria monocytogenes |
|
|
Term
bacterial meningitis
likely organisms
age 3m - 50y |
|
Definition
strep pneumo
neisseria meningitides
h. flu |
|
|
Term
bacterial meningitis
likely organisms
age >50 years |
|
Definition
strep pneumo
listeria
gram (-) bacilli |
|
|
Term
bacterial meningitis
likely organisms
head trauma, neurosurgery |
|
Definition
staph - from skin irritation
gram (-) bacilli
strep pneumo |
|
|
Term
bacterial meningitis
likely organisms
immunocompromised |
|
Definition
listeria
gram (-) bacilli
strep pneumo
h. flu |
|
|
Term
bacterial meningitis
treatment |
|
Definition
empiric antibiotics
steroids?
symptom management |
|
|
Term
bacterial meningitis
empirical antibiotic treatment |
|
Definition
3rd generation cephalosporin PLUS
vancomycin (to cover resistance)
if immune comp, ADD ampicillin (listeria) |
|
|
Term
bacterial meningitis
role of steroids in treatment |
|
Definition
administration of steroid (dexamethasone) either before antibiotics or concurrently MAY help improve efficacy of the antibiotics |
|
|
Term
bacterial meningitis
symptom management |
|
Definition
important to manage these symptoms as they arise:
-intracranial pressure -seizures -SIADH (hyponatremia) -systemic complications (aspiration pneumonia) |
|
|
Term
viral meningitis
clinical features |
|
Definition
acute but less aggressive than bacterial meningitis
headache, abrupt onset (acute); fever; stiff neck - meningeal signs; photophobia; nausea/vomiting |
|
|
Term
viral meningitis
pathology |
|
Definition
vascular congestion
scant infiltrate of lymphocytes (NOT neutrophils as with bact) in the meninges, perivascular spaces, choroid plexus
less intense inflammatory reaction than bacterial meningitis |
|
|
Term
viral meningitis
pathophysiology - route of entry |
|
Definition
enteroviruses traverse the intestinal lining cells to Peyer's patches in the lamina propria
viral replication --> minor viremia
numerous organ systems seeded, more replication --> major viremia |
|
|
Term
viral meningitis
pathophysiology - transport to nervous system |
|
Definition
CNS can be seeded either at time of minor or major viremia
viral transport thought to be passive (exact mechanism unknown) |
|
|
Term
viral meningitis
pathophysiology - mechanism of infectivity |
|
Definition
virus replicates in choroid plexus and spreads through CSF
more replication in ependymal and meningeal cells causes cell destruction |
|
|
Term
viral meningitis
pathophysiology - inflammatory response |
|
Definition
replication in ependymal and meningeal cells incites inflammatory response
mediated by lymphocytes and monocytes
focal destruction of ependymal lining, meningeal fibrosis, inflammation of choroid plexus
inflammatory response much less destructive than the neutrophilic response in bacterial meningitis |
|
|
Term
viral meningitis
CSF findings |
|
Definition
+ WBCs 10-200; most lymphocytes
mildly + protein <100
normal opening pressure <200
normal glucose >50% serum glucose
gram stain negative |
|
|
Term
CSF findings
bacterial vs. viral meningitis |
|
Definition
no clinical or CSF feature RELIABLY discriminates between bacterial and viral meningitis |
|
|
Term
viral meningitis
common viral causes |
|
Definition
non-polio enterviruses (coxsackie, echovirous)
poliovirus
mumps |
|
|
Term
viral meningitis
treatment |
|
Definition
no specific viral meningitis treatment
empiric antibiotics for bacterial meningitis continued from onset until CSF cultures have been negative for at least 24-48 hours
symptom management |
|
|
Term
fungal meningitis
clinical features |
|
Definition
similar to bacterial meningitis -fever, headache, mental status changes
more indolent course - progression over weeks to months or even years
more common in immunocompromised individuals |
|
|
Term
fungal meningitis
pathology |
|
Definition
moderate thickening and opacification of meninges
scant meningeal inflammation microscopically -lymphocytes, plasma cells, eosinophils, multinucleated giant cells |
|
|
Term
fungal meningitis
CSF findings |
|
Definition
+ WBCs <800
+ protein - up to 500
+ opening pressure
- glucose 10-40
organisms visualized under microscope |
|
|
Term
fungal meningitis
diagnoses |
|
Definition
LP with typical CSF findings
fungal cultures
fungal serology (especially for cryptococcal antigen) |
|
|
Term
fungal meningitis
common fungal causes |
|
Definition
cryptococcus (HIV, older)* histoplasma blastomyces coccidioides candida aspergillus mucormycosis (DB)* paracoccidioides |
|
|
Term
fungal meningitis
treatment |
|
Definition
amphotericin B
flucytosine during initial therapy -especially in AIDS patients
fluconazole maintenance therapy in AIDS patients |
|
|
Term
TB meningitis
clinical features |
|
Definition
several week prodrome of headache, malaise, personality change, low-grade fever
gradual increase in headache, more continuous, nausea, vomiting, stiff neck, confusion, cranial nerve abnormalities, papilledema
strokes may occur
seizures in 10%
progression to stupor and coma; death within 2 months if untreated |
|
|
Term
TB meningitis
macroscopic pathology |
|
Definition
gelatinous subarachnoid exudate (pus) -thickest in Sylvian fissures and at base of the brain (esp. brainstem and optic chiasm) |
|
|
Term
TB meningitis
microscopic pathology |
|
Definition
exduate: lymphocytes, mononuclear cells, epitheliod nodules, a few multinucleated giant cells and tubercles |
|
|
Term
TB meningitis
microscopic pathology: tubercles |
|
Definition
central area of caseous necrosis surrounded by epithelioid macrophage reaction and peripheral ring of lymphocytes |
|
|
Term
|
Definition
CSF
mycobacterial cultures and acid-fast stain (take a loooong time)
PCR |
|
|
Term
TB meningitis
CSF findings |
|
Definition
+ WBCs 100-300; most lymphocytes
+ protein 100-500
+ opening pressure
- glucose <45 (in 80% of patients) |
|
|
Term
|
Definition
isoniazid
PLUS 2 more: rifampin, ethambutol, pyrazinamide, streptomycin |
|
|
Term
viral encephalitis
clinical features |
|
Definition
diffuse inflammation of the brain parenchyma
acute onset, incubation period usually <1week (can be up to 3)
similar to meningitis: fever, headache, mental status change
*mental status changes* occur earlier
neck stiffness and meningeal signs less prominent
seizures may occur
prodromal viral syndrome (nausea, vomiting, myalgia) |
|
|
Term
viral encephalitis
common epidemic causes |
|
Definition
arborviruses
enteroviruses
most common in later spring, summer, early fall |
|
|
Term
viral encephalitis
sporadic causes |
|
Definition
herpes simplex virus (HSV) most common
70% mortality if left untreated 20% mortality with early treatment |
|
|
Term
viral encephalitis
pathophysiology - routes of entry |
|
Definition
arborviruses: injected directly into bloodstream by their vector (mosquito, tick)
enteroviruses: enter through intestines from fecal-oral contamination
(less commonly by respiratory droplets) |
|
|
Term
viral encephalitis
pathophysiology - transport to nervous system |
|
Definition
must penetrate host defenses to reach the bloodstream
typically seed one or more intermediate organ systems before reaching CNS (accounts from prodrome)l sites for viral replication
create high viral titers to overcome BBB and nervous system defenses |
|
|
Term
viral encephalitis
pathophysiology - mechanism of infectivity |
|
Definition
virus attaches to neuron membrane and deliver their genome
co-opt neuron's cellular machinery to replicate viral genome and make new viral particles |
|
|
Term
viral encephalitis
pathophysiology - immune response |
|
Definition
predominant immune response is cellular - helps limit the spread of virus but may compound the tissue damage and exacerbate symptoms |
|
|
Term
viral encephalitis
pathology |
|
Definition
neuronal cell bodies destroyed and engulfed by macrophages ("neuronophagia")
perivascular cuffing by lymphocytes, macrophages, plasma cells
microglial proliferation, form nodules and rod cells appear
inclusion bodies in nuclei or cytoplasm (only with some viruses) |
|
|
Term
viral encephalitis - HSV
pathophysiology - route of entry |
|
Definition
infects peripheral nerves or cranial nerves |
|
|
Term
viral encephalitis - HSV
pathophysiology - transport to nervous system |
|
Definition
neuronal spread
travels up infected peripheral or cranial nerve and across synapses to enter the CNS (often after a latent period of many years) |
|
|
Term
viral encephalitis - HSV
pathophysiology - mechanism of infectivity |
|
Definition
same as other viral encephalopathies
preferentially involves the temporal lobes |
|
|
Term
viral encephalitis
diagnosis |
|
Definition
CSF
antibody testing for arboviruses
PCR for HSV, west nile
MRI, EEG for HSV |
|
|
Term
viral encephalitis
CSF findings |
|
Definition
+ WBCs 50-550, lymphocytic predominance
moderate + protein
+ opening pressure
normal or moderate - glucose
RBCs in 20-40% of HSV |
|
|
Term
viral encephalitis
treatment |
|
Definition
arboviruses - no treatment
HSV - acyclovir
*all patients should be treat with acyclovir until it is clear that they do dont have HSV |
|
|
Term
subacute sclerosing panencephalitis (SSPE) |
|
Definition
rare, late complication of measles
defective virus maturation in neural cells
children infected in first 2 years of life at greatest risk
interval between initial infection and manisfestations 2-12 years
three stages |
|
|
Term
|
Definition
1: change in personality or behavior
2: myoclonus, seizures, spasticity, choreoathetosis, ataxia, chorioretinitis
3: optic atrophy, quadriparesis, autonomic instability, akinetic mutism, coma
-affect gray and white matter; can cause just about any neurologic manifestation |
|
|
Term
|
Definition
intranuclear inclusion bodies in neurons |
|
|
Term
bacterial abscess
clinical features |
|
Definition
focal, subacute process (progression over weeks)
-headache -focal deficits -altered thinking -fever in ~50% -nausea/vomiting in ~50% |
|
|
Term
bacterial abscess
pathophysiology - route of entry |
|
Definition
hematogenous spread from a distant site of infection (especially lungs or heart)
or can arise from a contiguous infectious site |
|
|
Term
bacterial abscess
pathophysiology - transport to nervous system |
|
Definition
hematogenous spread (usually leads to location within the white matter near the junction with gray matter) |
|
|
Term
bacterial abscess
pathophysiology - mechanism of infectivity |
|
Definition
begins as a microscopic focus of septic microvascular injury that grows into a localized region of encephalitis, eventually necrotizing and getting walled off by a fibrous capsule
expands toward ventricle (this side of wall is thinest), and can ultimately rupture its contents into the ventricle (cause a meningitis) |
|
|
Term
bacterial abscess
pathology |
|
Definition
4 stages
1. days 1-3: focal cerebritis 2. days 4-9: late cerbritis 3. days 10-13: early encapsulation 4. days 14+: late encapsulation |
|
|
Term
bacterial abscess
pathology - focal cerebritis |
|
Definition
days 1-3
ill-defined region on hyperemia surrounded by edema
early parenchymal necrosis, vascular congestion, petechial hemorrhage, microthromboses, perivascular fibrinous exudate, PMNs |
|
|
Term
bacterial abscess
pathology - late cerebritis |
|
Definition
day 4-9
adjacent foci of necrosis become confluent resulting in a necrotic, purulent center surrounded by a narrow irregular later of inflammatory granulation tissue containing PMNs, lymphocytes, macrophages |
|
|
Term
bacterial abscess
pathology - early encapsulation |
|
Definition
days 10 - 13
fibroblast proliferation, reactive astrocytosis, capillary formation
early abscess capsule consists of granulation tissue that includes lymphocytes, plasma cells, monocytes, macrophages, numerous newly formed blood vessels, and scattered fibroblasts |
|
|
Term
bacterial abscess
pathology - late encapsulation |
|
Definition
days 14 onward
more firm, well encapsulated abscess consisting of 5 layers: 1) necrotic center 2) granulation tissue with proliferating fibroblasts and capillaries 3) lymphocytes and plasma cells in granulation tissue 4) dense fibrous tissue with embedded astrocytes 5) gliosis and edema |
|
|
Term
bacterial abscess
diagnosis - cerebritis stage |
|
Definition
non-enhancing focal region of low density on CT
non-enhancing hypointensity on MRI |
|
|
Term
bacterial abscess
diagnosis - adscess/capsule stage |
|
Definition
ring-enhancing mass with surrounding edema (CT, MRI) |
|
|
Term
bacterial abscess
typical organisms |
|
Definition
alpha-hemolytic and non-hemolytic strep
staph aureus
enterobacter
anaerobes |
|
|
Term
bacterial abscess
treatment |
|
Definition
total excision or aspiration under stereotactic CT or MRI guidance in conjunction with systemic antibiotic treatment
aspiration is more common
antibiotics tailored to specific cultured organism OR 3rd gen cephalosporin plus metronidazole (anaerobes) for empiric treatment |
|
|
Term
NON-bacterial abscess
types of organisms |
|
Definition
FUNGI: mucormycosis, aspergillus, candida, crptococcus
PARASITES: entamoeba, toxoplasma |
|
|
Term
|
Definition
|
|
Term
normal CSF values
predominent cell type |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
normal CSF values
gram stain |
|
Definition
|
|
Term
normal CSF values
cultures |
|
Definition
|
|
Term
normal CSF values
CSF pressure |
|
Definition
|
|
Term
CSF meningitis pathologies
WBCs |
|
Definition
bact: >1000
viral: 10-200
fungal: 50-800
TB: 100-300 |
|
|
Term
CSF meningitis pathologies
predominant cell type |
|
Definition
bact: neutrophils
viral: lymphocytes
fungal: lymphocytes
TB: lymphocytes |
|
|
Term
CSF meningitis pathologies
protein |
|
Definition
bact: >100
viral: 15-100
fungal: 40-500
TB: 100-500 |
|
|
Term
CSF meningitis pathologies
glucose |
|
Definition
bact: <40% serum
viral: normal
fungal: 10-40
TB: <45 |
|
|
Term
CSF meningitis pathologies
gram stain |
|
Definition
bact: postive
viral: negative
fungal: positive
TB: negative |
|
|
Term
CSF meningitis pathologies
cultures |
|
Definition
bact: positive
viral: negative
fungal: positive
TB: positive (eventually) |
|
|
Term
CSF meningitis pathologies
CSF pressure |
|
Definition
bact: 200-500
viral: normal
fungal: mild elev
TB: elevated |
|
|
Term
*neurologic infections key points*
meningitis |
|
Definition
FEVER
HEADACHE
meningeal signs |
|
|
Term
*neurologic infections key points*
viral encephalitis |
|
Definition
headache
MENTAL STATUS CHANGES |
|
|
Term
*neurologic infections key points*
abscess |
|
Definition
|
|
Term
*neurologic infections key points*
PCR test |
|
Definition
can be used for:
TB, HSV, west nile |
|
|
Term
*neurologic infections key points*
biopsy |
|
Definition
|
|
Term
|
Definition
granuloma/tuberculoma
TB's version of an abscess
parenchymal involvement
spherical/multilobar lesions with a caseous center surrounded by a granulomatous reaction comprised of giant cells, lymphcytes, and fibrosis |
|
|
Term
syphilis
clinical features |
|
Definition
1o: chancre at site of inoculation
2o: asymptomatic; flu-like symptoms; rash; lymphadenopathy; mucosal lesions
latent - months to years
3o: on in 10-30% on untreated patients |
|
|
Term
syphilis
neurologic syndromes |
|
Definition
aseptic meningitis
meningovascular syphilis
general paresis
tabes dorsalis |
|
|
Term
syphilis
aseptic meningitis |
|
Definition
only in ~5% of people
occurs in 2o syphilis or in the first 2 years of latent syphilis
cranial nerve involvement is common |
|
|
Term
syphilis
meningovascular syphilis |
|
Definition
type of 3o syphilis; usually 1-10 years after innoculation
headache, apathy, irritability, insomnia, focal deficits
lymphocyte and plasma cell proliferation in meninges and around blood vessels
combo of meningitis and stroke manifestations |
|
|
Term
|
Definition
10-20 years after initial inoculation
dementia, psychiatric manifestations, seizures, myoclonus, abnormal pupils, dysarthria, UMN findings, incontinence, death
thickened fibrotic meninges, loss of cortical neurons, gliosis, marked proliferation of rod-shaped microglia
(like SSPE, can cause almost any brain manifestation) |
|
|
Term
|
Definition
15-20 years after inoculation
dramatic loss of proprioception/vibrational sense
lighting-like pains, ataxia
chronic inflammation of dorsal roots and ganglia, with degeneration of posterior columns |
|
|
Term
|
Definition
RPR, VDRL: non-specific serologic test; present in blood of almost all 2o patients, but reverts to normal in 25% of late stage patients
FTA, MHA-TP: specific antibody tests; present in almost all 2o patients, persists throughout life (even after treatment) |
|
|
Term
syphilis
protocol for diagnosing |
|
Definition
serum FTA test
-if negative = NOT neurosyphilis
-if positive = do LP |
|
|
Term
|
Definition
+ WBCs
+ protein
+ VDRL in spinal fluid
...ANY of the above are an indication for treat for presumed neurosyphilis |
|
|
Term
|
Definition
high-dose intravenous penicillin
(when at 3o stage; presence of neurologic syndromes) |
|
|
Term
lyme disease
neuro manifestations |
|
Definition
1o and 2o similar to syphilis (3o more controversial)
most common neurologic manifestation = subacute or chronic meningitis, oftern with cranial nerve involvement (especially one of both CN VII) |
|
|
Term
herpes varicella-zoster virus VZV /("shingles")
clinical presentation |
|
Definition
(primary infection is chicken pox)
sharp, burning pain in dermatomal distribution
followed by rash in same area 2-5 days later
post-herpetic neuralgia (pain lasting >4weeks) in 10%, but in 50% of patients over age 60 |
|
|
Term
|
Definition
after chicken pox, remains latent in dorsal root ganglion cells
re-activated years later and spreads along the nerve root
more common in elderly and immunocompromised |
|
|
Term
|
Definition
diagnosis is primarily clinical
may do cultures, microscopic examination, or antibody testing on vesicular scrapings from rash
VZV culture or PCR from spinal fluid |
|
|
Term
|
Definition
acyclovir, famciclovir, valacyclovir all REDUCE DURATION of rash and post-herpetic neuralgia is started within 72 hours
steroids may be helpful, but not definite |
|
|
Term
VZV
other neurologic manifestations from spread |
|
Definition
spread to spinal cord - myelitis
spread to motor branches of nerve roots - radicualr weakness
spread to neighboring cranial nerves
spread to blood vessels - stroke (V1 branch of CN V is not far from carotid arteries) |
|
|
Term
HIV
4 factors predisposing to neurologic involvement |
|
Definition
1. patients are at increased risk for many opportunistic infections and tumors that affect the nervous system
2. HIV itself has a predilection for both the CNS and PNS and may produce symptoms directly
3. antigenic cross-reactivity can cause the inflammatory reaction provoked by HIV infection results in neurologic damage
4. many of the meds to treat HIV can have neurotoxic effects |
|
|
Term
HIV
neurologic manifestations |
|
Definition
encephalopathy
opportunistic infections: toxo, crypto, EBV/CNS lymphoma, JC virus/PML, VZV, CMV/polyradiculopathy
vacuaolar myelopathy (HIV attacking spinal cord directly)
peripheral neuropathies |
|
|
Term
PML
progressive multifocal leukoencephalopathy |
|
Definition
disease of white matter caused by JC virus (an opportunistic papova-virus)
can produce mass lesions - may present with progressive, focal symptoms, subacute time course
MRI looks like MS
histo: giant astrocytes, oligodendrocytes with enlarged nuclei and viral inclusions |
|
|
Term
HIV
approach to mass lesions |
|
Definition
solitary lesion on MRI = biopsy
multiple lesions on MRI = check toxo titers (-) toxo titer = biopsy (+) toxo titer = treat empirically for toxo...biopsy if no clinical response after 10-14 days
if PML or CNS lymphoma...treat with HAART |
|
|
Term
|
Definition
parasite that has a predilection for the nervous system
most common parasitic infection of the CNS
"pork tapeworm" that causes neruo disease when humans replace pigs in the life cylce of the parasite via fecal-oral contamination (usually from produce washed in contaminated water) |
|
|
Term
cysticercosis
clinical features |
|
Definition
may or may not be symptomatic, but usually don't occur until long after the infection is established (1-35 years!)
seizures, headache
stroke, encephalitis
may present with ICP features if cyst obstructs CSF flow
may have focal deficits depending on location of individual cysts |
|
|
Term
cysticercosis
pathophysiology |
|
Definition
4 stages:
1-cysticercus provkes edema form surrounding brain parenchyma
2-thin walled cyst containing fluid and a live larva develops over several months
3-inflammatory reaction from surrounding brain damages cyst-->fills with caseous material; larva dies and cyst contents released
4-cyst itself degenerates and becomes calcified and inacive
cysts often resolve spontaneously after the inflammatory reaction begins |
|
|
Term
|
Definition
anywhere from one to several hundred cysts in CNS: parenchyma (esp. gray), meninges, ventricles
after arg dies, surrounded by neutrophils, lymphocytes, macrophages, foreign body cells, eosinophils
cyst becomes zone of granulation tissue --> dense collagenous capsule --> fibrotic/calcified |
|
|
Term
|
Definition
albendazole
AEDs if seizures develop
shun (and resection) if hydrocephalus |
|
|
Term
|
Definition
bacterial meningitis
fungal meningitis (esp cryptococcal) |
|
|
Term
|
Definition
arboviruses - encephalitis |
|
|
Term
|
Definition
|
|
Term
is it SAH or bacterial meningitis? |
|
Definition
both = qualitatively different and "worst headache of life"
CT will show SAH in 95% of patients within 48 hours
LP: if no WBC, NOT meningitis; RBC hallmark of SAH |
|
|
Term
major antibiotics used to treat nervous system infections |
|
Definition
ceftriaxone
acyclovir
isoniazid
amphotericin |
|
|
Term
|
Definition
3rd generation cephalosporin
bacterial meningitis
empiric treatment of abscess |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|