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CNS infections

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Illness
Symptoms
Labs
Agents: Viral
Agents: Bacterial
Agents: Parasitic
Allergic encephalitis       Rare complication of influenza, measles, mumps, immunization against these viruses      
Reye's syndrome   Kids: encephalopathy + liver degeneration; vomiting, lethargy, confusion, seizures, coma, death     Aspirin given to reduce fever implicated      
Guillain-Barre Syndrome   Acute rapidly progressing paralysis in limb, resp muscles, face, recovery w/in weeks usually     Autoimmune response (cross-reactive myelin antibodies) to influenze, EBV, CMV, vaccines      
Subacute Sclerosing Panencephalitis (SSPE)   Inflammatory lesions in brain --> fatal     Measles complication several years post-infxn      
Progressive Multifocal Leukoencephalopathy (PML)   Blindness, dementia, coma, death w/in 6 mo; primarily in immunocompromised PTs     Reactivation of JC (papova)virus --> infects oligodendrocytes + astrocytes      
African Sleeping Sickness   Chancre at site of bite, waves of fever, lymphadenopathy (Winterbottom's sign), cerebral edema, encephalopathy, mental deterioration, drowsiness, seizures, tremor, cachexia, coma, death   Thin smears blood/lymph aspirate w/Giemsa to ID       Trypanosomas gambiense + rhodesiense  
Primary Amoebic Meningoencephalitis   Severe meningitis: brain necrosis + hemorrhage via olfactory nerve, coma, death ~6 days (N.) or more slowly developing (A.)   CSF aspirate, wet mount: ID amoebae       Naegleria fowleri, Acanthamoeba castellani  
Cysticercosis   Pronounced cellular reaction to cysticerci in brain: epileptic seizures, death, vision problems   Eggs + proglottids in stool, X-ray/CT for CNS involvement, eye mass       Taenia solium  
Meningitis   Headache, fever, neck stiffness, vomiting, photophobia, altered mental status   CSF: Normal protein + glucose; WBC normal-elevated   Mumps virus, Enteroviruses (poliovirus, coxsackievirus, echovirus), Herpesviruses (esp HSV-2, HCMV)   N. meningitidis (esp w. altered mental status), H. influenzae, S. pneumonia, Listeria >50, (E. coli, TB, S. aureus, Strep agalactiae, P. aeruginosa)    
Encephalitis   Headache, fever, neck stiffness, vomiting, photophobia; may progress to lethargy, confusion, paralysis, seizure, coma, death     Rabies virus, Arboviruses (arthropod-borne), Measles virus, HSV-1, HSV-2, EBV, HIV      
Toxoplasmosis   Usually asymptomatic, fever, lymphadenopathy; Serious ds in newborns: still birth, mental retardation, calcification of brain tissue, hydrocephalus, death. Immunocompromised: fulminant encephalitis, retinochoroiditis, death   Serology: rise in AB titer over time       Toxoplasma gondii  


   


 

 

 
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Created by: eemolee27 on 2009-06-09




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