Learning Objectives

1. Recognize infections of the nervous systems based on clinical

manifestations
2. Differentiate the various infections involving the nervous system
3. Describe the characteristics of the causative organisms of each
infection of the nervous system
4. Compare the important arbovirus diseases as to their etiology and
vector
5. Discuss the appropriate laboratory diagnosis and treatment of
each infection
6. Propose measures for the prevention and control of infections
involving the nervous system
Definition of Terms

 Encephalitis
 Encephalomyelitis
 Meningitis
 Meningoencephalitis
 Myelitis
Introduction
 Central nervous system (CNS) is impenetrable to infectious agents.
Microorganisms gain access to the CNS through the bloodstream
and the lymphatics and through trauma.
 Infections may present with non-specific manifestations of fever and
headaches.
 Other manifestations will include seizures, altered consciousness, or
localizing signs.
BACTERIAL MENINGITIS
Acute Bacterial Meningitis

 Bacterial meningitis is a suppurative infection of the meningitis and

subarachnoid space with associated inflammation of the CNS
 High risk, susceptible are children between six to twelve months of
age
 Cause: most common is E. coli; others are Streptococcus agalactiae
and Listeria monocytogenes, Haemophilus influenza type b,
Streptococcus pneumoniae.
 Manifestation include fever, headache, and nuchal rigidity with
associated nausea, vomiting, irritability and back pain. Other
manifestations may be observed.
BACTERIAL MENINGITIS
Neisseia meningitis

 General Properties
 Also known as Meningococcus, it is a gram-
negative, coffee bean-shaped diplococcus
that is transient flora of the nasopharynx. The
encapsulated part are virulent.
 Mode of Transmission: respiratory droplets,
respiratory aerosols
 Clinical Findings
 Laboratory Diagnosis
 Treatment and Prevention
BACTERIAL MENINGITIS
Listeria monocytogenes

 General Properties
 L. monocytogenes are short, motile, gram-positive bacilli that appear
individually, in pairs or in chains
 Mode of Transmission: ingestion of contaminated food products,
transplacental transmission.
 Clinical Findings
 Laboratory Diagnosis
 Treatment and Prevention
BACTERIAL MENINGITIS
Granumlomatous Meningitis

 Characterized by the formation of granulomas

 A chronic type commonly caused by Mycobacterium tuberculosis
and Cryptococcus neoformans.
 Characterized by remissions and relapses.
BACTERIAL MENINGITIS
Tuberculosis Meningitis

 Affects children
 Usually appears 3-6 months after initial infection, accompanies
military tuberculosis in half the cases.
 Headache, stiff neck, fever, fatigue and night sweats are typical
manifestations
 Diagnosis and Treatment
FUNGAL MENINGITIS

 Causes: Cryptococcus neoformans,

Cryptococcus gatti, Histoplasma
capsulatum, and Coccidiodes immitis
 Mode of Transmission: inhalation of
the fungus from the environment
 Clinical findings
 Diagnosis
 Treatment and Prevention
ACUTE VIRAL ASEPTIC MENINGITIS

 Introduction: Viral meningitis is self-limiting, serious disease causing

significant morbidity and mortality.
 Cause: Enteroviruses – Poliovirus and Coxsackie virus; Mumps virusl,
Herpes simplex virus, Epstein-Barr virus and Arboviruses.
 Manifestations: flu-like manifestations such as fever, malaise, sore
throat and myalgia followed by headache and stiff neck.
 Factors that increase the risk for viral encephalitis
 Complications: Inflammation in the brain can lead to coma or
death. Others can result to paralysis, lack of muscle coordination,
speech impairment, visual or hearing defect, memory problems
 Diagnosis and prevention
OTHER INFECTIONS OF THE NERVOUS SYSTEM

 Tetanus
 Botulism
 Leprosy (Hansen’s Disease)
 Poliomyelitis
 Rabies
OTHER INFECTIONS OF THE NERVOUS SYSTEM
Arboviral (Arthropod-Borne) Encephalitis

 Encephalitis caused by arbovirus infection

 Transmitted by mosquitoes

 Japanese B Encephalitis
 Common infection in the Far East
 Etiologic agent is Flavivirus.
 Vector is mosquito, common hosts are pigs and birds
 Initially presents flu-like symptoms, followed by encephalitis
 Prevention