CNS Infections bugs

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Author:
manjinder
ID:
147268
Filename:
CNS Infections bugs
Updated:
2012-04-13 18:19:44
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Microbiology
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Description:
CNS bugs
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  1. Group B streptococcus (S. agalactiae)
    Neonates
    • #1 cause
    • gram + cocci in chains, b-hemolytic, bactracin resistant
    • normal flora of GI tract --> secondary spread to vagina
    • neonates meningitis from colonized mother (delivery, infected amniotic fluid), if mother is group B + treat her during delivery
    • fever, poor feeding, vomiting, irritability alterning w/ lethary
    • PCR, latex particle aggluination, cAMP test, CSF: high protien, low glucose, neutrophils
    • Rx: acyclovir, ampicillin + cefotaxime
  2. E. coli
    neonates
    • Gram - rods, enterobacteriacea family, lactose +
    • normal flora of GI tract --> secondary spread to vagina
    • (2nd most common) neonates meningitis from colonized mother (delivery, infected amniotic fluid), K1 capsule
    • fever, poor feeding, vomiting, irritability alterning w/ lethary
    • PCR, latex particle aggluination, CSF: high protien, low glucose, neutrophils
    • Rx: acyclovir, ampicillin + cefotaxime
  3. Streptococcus pneumoniae
    adults
    • Sudden onset, fever, stiff neck, severe headache
    • N/V, photophobia, confusion, sleepiness
    • CSF: high protien, low glucose, neutrophils
  4. Neisseria meningitidis
    adults
    • gram - diplococci inside polymorphonuclear cells, Capsule- A, B, C, Y, W 135, (B is the most common cause but isn't included in the vaccine) oxidase +
    • Differences from N. gonorrhoeae: capsule, vaccine, glucose and maltose fermentation
    • Meningococcal meningitis, meningococcemia (Waterhouse-Friderichsen syndrome- adrenal insufficiency death in 12 hrs)
    • People who are deficient in C5-9 complements get recurrence of N. meningitidis
    • capsule, IgA protease, pili; invasion into blood stream --> meninges --> inflammation, LPS (responsible for shock); diffuse vascular damage
    • Hemorrhagic skin rash (petechiae)
    • sudden onset of fever, stiff neck, severe headache, nausea, vomiting, photophobia, confusion, sleepiness
    • Thayer-Martin agar, CSF: high protein, low glucose, neutrophils
    • Rx: vancomycin + cefotaxime
    • Prevention : MPSV4; MCV4
  5. Haemophilus influenzae type-b
    adults
    • Sudden onset, fever, stiff neck, severe headache
    • N/V, photophobia, confusion, sleepiness
    • CSF: high protien, low glucose, neutrophils
  6. Listeria monocytogenes
    pregnant women, neonates, immunocompromised patients
    • small gram + rods, growth at 1 C to 45 C (can grow in cold food), motile at 25 C-actin jet motility in cells, facultative intracellular pathogen, cell to cell spread
    • ingestion of contaminated food, transplacentally or during delivery
    • found in unpasteurized milk products, soft cheeses, deli meats, hotdogs
    • When pregnant women get infected they become septic --> bacteria crosses the placenta and lead to granulomatosis infantisepticum (sepsis w/ high mortality; disseminated granulomas w/ central necrosis).
    • meningitis w/ septicemia occurs after birth.
    • Culure on bood agar, CSF: high protein, low glucose, neutrophils
    • Rx: Ampicillin + gentamicin
  7. Cryptococcus neoformans, coccidioides immitis
    immunocompromised patients
    • Cryptococcus #1 cause of meningitis in AIDS patients
    • subacute to chronic meningitis
    • slow onset of headache, visual disturbances, abnormal mental status, seizure
    • CSF: high protein, low glucose, lymphocytes
    • Amphotericin
  8. Nagleria fowleri
    immunocompetant persons
    • free-living warm fresh water amoebae
    • meningoencephalitis enter body via olfactory neuroepithelium
    • trophozoite and flagellated forms --> purulent, hemorrhagic inflammatory
    • Rapid onset, severe headache, fever nausea, altered sense of smell. Progresses rapidly, death in few days
    • CSF: wet mount (motile trophozoites), blood, neutrophils, high protein, low glucose
    • Rx: Amphotericin B (rarely successful)
  9. Acanthamoeba spp
    • Opportunistic free living amoebae
    • Granulomatousamebicencephalitis (GAE)
    • free-living amebae in contaminated contact lens solution (airborne cysts)
    • enter body by lower resp tract, ulcerated or broken skin
    • Headaches, altered mental status
    • Keratitis
    • cysts and trophozoites in tissue
  10. Toxoplasma gondii
    • intracellular protozoa
    • cats= definitive host (oocyst from fecal contamination), ingestion of uncooked meat (pork) w/ cyst, transplacental, blood and organ transplant
    • oocyst --> trophozoites --> invade macrophages --> spread to all organ systems and form cyst
    • selflimited flu-like illness in immunocompetent host, toxoplasmic encephalitis in immunocompromised host (ring-enhancing lesions), maternal infection causes still birth, neurologic problems (hydrocephaly), asymp child can develop blindness later in life (teen years)

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