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Causes of Encephalitis
Causes of Encephalitis
VIRAL
MEASLES
Slow form encephalitis, occurs many yrs after child/adolescent’s measles infxn
MUMPS
RABIES Virus
Human bitten by rabid mammal, virus replicates locally for few days
Prodrome: non-specific Sx of fever, headache, sore throat, fatigue, nausea, sensitivy around wound site
Brainstem Encephalitis – CN dysfxn makes painful to swallow liquids (pharyngeal muscle contrxn)
“Hydrophobia” & “foaming of the mouth”
Rapid progression to death over 1-2 wks once symptoms develop, no recovery from active rabies
*Pathognomonic NEGRI BODIES (cytoplasmic collections of virions) in brain cells . Upon autopsy.
FLAVIVIRIDAE
MOSQUITO-vector (spread)
BUNYAVIRUS
California Encephalitis
TOGAVIRUS
FUNGAL CAUSES
CRYPTOCOCCUS NEOFORMANS
PARASITIC
TOXOPLASMA GONDII
ACANTHAMOEBA
Meningoencephalitis
Major Causes of Meningitis 12/31/2010
VIRAL
NEISSERIA MENINGITIDIS
High risk group: infants (6mos-2yrs) and Army recruits
Common cause in ADULTS in crowded living situations
Spreads via resp. secretions and can live asymptomatically in nasopharynx, bacteremia = meningitis
Petechial rash: classic sign of invasive meningococcal infxn
LISTERIA MONOCYTOGENES
3rd most common cause of NEONATAL MENINGITIS
neonates contract organism from asymptomatic mothers during delivery
Also causes Meningitis in ImmCo pts (AIDS, Transplants, Cancer)
STREPTOCOCCUS PNEUMONIAE
Most common cause of Adult Meningitis
Nuchal rigidity, stiff neck
3° SYPHILIS
A Sx of Neurosyphilis: Subacute Meningitis. Pts present with fever, stiff neck, headache
CSF lumbar puncture shows: predominance of lymphocytes and positive syphilis tests, (most Bact. Acute
meningitis – Hi neutrophil count)
MYCOBACTERIUM TUBERCULOSIS
Subacute Meningitis
CSF lumbar punct = predominance of lymphocytes (most Bact. Acute meningitis – high neutrophil count)
MUMPS
Meningitis may occur (more commonly than encephalitis)
STAPHYLOCOCCUS AUREUS
Disease can result from DIRECT organ invasion.
(Brain/Meninges) --> Meningitis, Brain abscess
POLIO VIRUS
1 of the 3 disease manifestations: ASEPTIC MENINGITIS (complete recovery in 1 week)
AIDS/HIV
Meningeal infxn results in Aseptic Meningitis
FUNGAL CAUSES
CRYPTOCOCCUS NEOFORMANS
MENINGITIS; mainly in ImmCo/ AIDS pts
Important! AIDS pts lack immune fxn so often don’t exhibit meningeal inflammation! Only sign may be fever,
vomiting, nausea. MUST Diagnose: lumbar puncture, test CSF
Pigeon poops, inhalation, yeast spreads
India Ink Stain yeast w/ surrounding halo (polysaccharide capsule)
PARASITIC
NAEGLERIA FOWLERI - Free-living amoeba: in freshwater & moist soils. Lots exposed, infxn rare
Infxn often occurs during summer, swimming in lakes, pools. Pts give history of swimming 1wk earlier
Penetrate thru nasal mucosa --> cribriform plate --> brain
Causes Meningoencephalitis (infxn of meninges and brain)
FOWL PLAY – 95% of pts die within 1 week.
ACANTHAMOEBA - Free-living amoeba: in freshwater & moist soils. Lots exposed, infxn rare
Chronic meningoencephalitis (granulomatous brain infxn) in ImmCo/AIDS pts