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Most common pathogens for bacterial meningitis in neonates (3)
- Group B strep
- E coli
- Listeria monocytogenes
Most common pathogen for bacterial meningitis in Children (2)
- Streptococcus pneumoniae
- Neisseria meningitidis
Most common pathogens for bacterial meningitis in adults (5)
- Streptococcus pneumoniae
- N. meningitidis
- L. monocytogenes
- Gram negative bacilli
Patient with fever, headache, seizures. Died after a few days. This is the pathology. What is the diagnosis?
- Bacterial meningitis
- Note: PMNs exudates within leptomeninges
- Fibrinoid necrosis of leptomeningeal and cortical arteries and veins
- Thrombosis of leptomeningeal and cortical blood vessels
Role of corticosteroid use in bacterial meningitis
- Reduces vasogenic edema, meningeal inflammation, and inflammatory response of meningitis.
- Improves outcome and reduces mortality in infants, children and adults with bacterial meningitis.
- Reduces incidence of neurologic sequelae (sensory neural hearing loss)
Most common sites for cerebral abcess (2)
Frontal and temporal lobes
Major stages in the formation of brain abcesses (4).
- Early cerebritis
- Late cerebritis
- Early capsule formation
- Late capsule formation
Patient with fever, severe left temporal headache, right hemiparesis. Prior history of mastoiditis.
Most common location of spinal epidural abcesses
Posterior to the cord in thoracic segment
Most common pathogen in spinal epidural abcesses
Treatment for neuroborreliosis
Syphilitic meningitis occurs in :
A) Secondary syphilis
B) Terciary syphilis
C) Primary syphilis
A) whithin 2 years of primary infection. Characterized by headache, nausea, vomiting, meningismus, ams, seizures, cranial neuropathies
(this multiple choice question has been scrambled)
Tabes dorsalis presents clinically:
Propioceptive loss, sensory ataxia, lancinating and lighnting-like pains, arreflexia.
Argyll Robertson Pupils: Poor consensual pupillary reflexes, but preserved constriction to accomodation.
Immigrant from Southeast asia, presents with loss of pain and temperature, hypopigmented and anhidrotic skin lesions. Preseved vibration and propioceptive sensation. Most likely diagnosis.
Leprosy: caused by Mycobacterium leprae
Male with maculopapular, petechial and eccymotic rash (involving palms and soles), with high fever, nausea, malaise, headaches, ams, seizures. Most likely diagnosis.
Rocky mountain spotted fever: treatment doxy.
Most common cause of arbovirus meningoencephalits
La Crosse (California) encephalitis
The most common agent believed to cause benign recurrent lymphocytic meningitis (Mollaret's meningitis)
HSV type 2
Predilection for inferior frontal and temporal lobes, behavioral dysfunction, personality change, aphasia, complex partial seizures, PLEDS. What is the bug involved?
HSV-1 infection, is characterized by the following pathologic findings
- Perivascular mononuclear infiltrates
- Necrotizing inflammation
- Foci of hemorrhage
- Intranuclear viral inclussions
Most common cause of encephalitis world wide
Japanese encephalitis (flavivirus)
Most common virus in southern, western and midwestern US.
St Louis encephalitis virus
Which is the prominent and distinguishing feature of West Nile virus infection
- Other extrapyramidal symptoms: myoclonus and parkinsonism.
What is Ramsey Hunt syndrome?
Painful facial weakness acoompanied by vesicular eruption involving external auditory canal.
Features of congenital CMV infection
Variable: sensorineural hearing loss, developmental delay, microcephaly, microgyria, seizures, cerebral calcifications, choreoretinitis.
Clinical features of rabies
Fluctuations in mentation, behavior and consciousness, psychiatric disturbance, persistent fever, hydrophobia or aerophobia, hypersalivation, other autonomic features.
Subacute sclerosisng panencephalitis is related to infection with-----------
Risk factors associated with HIV dementia
- low CD4 count (<200)
- high viral load,
- history of hepatitis C injection
- female gender
- older age
24 year old man with persistent headaches (wakes up by headaches, vomiting, increased headaches with Valsalva).
MRI and pathology show the following.
What is the diagnosis?
Lhermitte Duclos syndrome