This document discusses several topics related to central nervous system infections, including skull osteomyelitis, epidural abscess of the brain, subdural empyema, brain abscess, and spinal infection. It provides information on pathogens, pathogenesis, clinical features, diagnosis, and treatment for each condition. Key points include that skull osteomyelitis is usually caused by S. aureus or S. epidermidis and can result from direct inoculation or hematogenous spread. Brain abscesses often originate from a contiguous infectious source but can also be hematogenous, and treatment involves antibiotics, surgical drainage, or a combination. Spinal epidural abscess is most commonly located in the thoracic region and caused by S. aureus
This document discusses central nervous system infections, including various types like meningitis, encephalitis, and brain abscess. It describes the etiology, pathogenesis, epidemiology, clinical presentation, diagnosis and lumbar puncture procedure for acute bacterial meningitis. The main causes are viral, bacterial, fungal or parasitic. Clinical features include headache, vomiting, fever and signs of meningeal irritation. Diagnosis involves blood and CSF tests as well as imaging like CT or MRI. Lumbar puncture allows examination of CSF and is an important diagnostic and therapeutic tool, requiring proper patient positioning, preparation, analgesia and technique.
This document provides an overview of bacterial meningitis, including protective factors, routes of infection, presentation based on age, general management and treatment, complications, and prevention. Key points include: the blood-brain barrier protects the CNS from infection; common causative organisms and routes of entry vary by age; symptoms in young children are often nonspecific; general management focuses on supportive care, antibiotics, and treating increased ICP; complications can include subdural effusions, hydrocephalus, and seizures; and prevention involves vaccination and chemoprophylaxis.
This document summarizes various central nervous system infections, including bacterial/pyogenic meningitis, tuberculous meningitis, and intracranial tuberculomas. Key imaging findings are described, such as meningeal enhancement on CT/MRI for meningitis and ring enhancement on CT/MRI for brain abscesses. Complications like hydrocephalus, infarctions, and ventriculitis are also discussed. MR spectroscopy findings that can help differentiate tuberculomas from other lesions are mentioned.
This document discusses CNS infections including acquired pyogenic infections like meningitis, abscesses, ventriculitis, and empyema. It describes the etiology, pathology, imaging findings, and differential diagnosis for these conditions. Specific pathogens covered include tuberculosis and neurocysticercosis. For meningitis, abscesses and ventriculitis, the document outlines the imaging appearance on CT, MRI, and diffusion weighted imaging over the course of the infection. It also provides details on the imaging features and evolution of tuberculomas and neurocysticercal cysts.
This document discusses common central nervous system (CNS) infections including meningitis, encephalitis, and brain abscess. It provides information on the causative organisms, pathogenesis, signs and symptoms, and laboratory diagnosis of bacterial, viral, fungal and parasitic meningitis. It also discusses meningitis cases, the anatomy of the meninges, and complications of meningitis. Encephalitis and brain abscess are also summarized, including their causes, pathogenesis, clinical features and diagnostic workup.
The document discusses various central nervous system infections, how they can be classified, their routes of entry and imaging appearances. It covers congenital infections including TORCH infections, acquired pyogenic infections such as meningitis, abscesses and ventriculitis. It also discusses viral, parasitic and fungal infections of the CNS. For each type of infection, the causative pathogens, locations, presentations and characteristic imaging findings are outlined.
The document discusses central nervous system (CNS) infections, including viral and bacterial meningitis and viral encephalitis. It describes the anatomy of the CNS and how it is protected. It then explains how the CNS can be infected by various agents like viruses, bacteria, fungi, protozoa, and helminths. It provides details on the clinical presentation, diagnosis, and treatment of acute bacterial meningitis, acute viral meningitis, and viral encephalitis.
1. The document discusses various central nervous system infections including meningitis, encephalitis, and cerebral abscess. It defines these conditions and discusses their etiology, clinical features, diagnosis, management, complications and prognosis.
2. Specific types of meningitis discussed in detail include pyogenic meningitis, tuberculous meningitis, and meningococcal meningitis. Case scenarios are also presented to test the reader's knowledge.
3. Encephalitis is defined as inflammation of the brain tissue, usually caused by viruses. The causes, presentation, and management of encephalitis are summarized.
This document discusses central nervous system infections, including various types like meningitis, encephalitis, and brain abscess. It describes the etiology, pathogenesis, epidemiology, clinical presentation, diagnosis and lumbar puncture procedure for acute bacterial meningitis. The main causes are viral, bacterial, fungal or parasitic. Clinical features include headache, vomiting, fever and signs of meningeal irritation. Diagnosis involves blood and CSF tests as well as imaging like CT or MRI. Lumbar puncture allows examination of CSF and is an important diagnostic and therapeutic tool, requiring proper patient positioning, preparation, analgesia and technique.
This document provides an overview of bacterial meningitis, including protective factors, routes of infection, presentation based on age, general management and treatment, complications, and prevention. Key points include: the blood-brain barrier protects the CNS from infection; common causative organisms and routes of entry vary by age; symptoms in young children are often nonspecific; general management focuses on supportive care, antibiotics, and treating increased ICP; complications can include subdural effusions, hydrocephalus, and seizures; and prevention involves vaccination and chemoprophylaxis.
This document summarizes various central nervous system infections, including bacterial/pyogenic meningitis, tuberculous meningitis, and intracranial tuberculomas. Key imaging findings are described, such as meningeal enhancement on CT/MRI for meningitis and ring enhancement on CT/MRI for brain abscesses. Complications like hydrocephalus, infarctions, and ventriculitis are also discussed. MR spectroscopy findings that can help differentiate tuberculomas from other lesions are mentioned.
This document discusses CNS infections including acquired pyogenic infections like meningitis, abscesses, ventriculitis, and empyema. It describes the etiology, pathology, imaging findings, and differential diagnosis for these conditions. Specific pathogens covered include tuberculosis and neurocysticercosis. For meningitis, abscesses and ventriculitis, the document outlines the imaging appearance on CT, MRI, and diffusion weighted imaging over the course of the infection. It also provides details on the imaging features and evolution of tuberculomas and neurocysticercal cysts.
This document discusses common central nervous system (CNS) infections including meningitis, encephalitis, and brain abscess. It provides information on the causative organisms, pathogenesis, signs and symptoms, and laboratory diagnosis of bacterial, viral, fungal and parasitic meningitis. It also discusses meningitis cases, the anatomy of the meninges, and complications of meningitis. Encephalitis and brain abscess are also summarized, including their causes, pathogenesis, clinical features and diagnostic workup.
The document discusses various central nervous system infections, how they can be classified, their routes of entry and imaging appearances. It covers congenital infections including TORCH infections, acquired pyogenic infections such as meningitis, abscesses and ventriculitis. It also discusses viral, parasitic and fungal infections of the CNS. For each type of infection, the causative pathogens, locations, presentations and characteristic imaging findings are outlined.
The document discusses central nervous system (CNS) infections, including viral and bacterial meningitis and viral encephalitis. It describes the anatomy of the CNS and how it is protected. It then explains how the CNS can be infected by various agents like viruses, bacteria, fungi, protozoa, and helminths. It provides details on the clinical presentation, diagnosis, and treatment of acute bacterial meningitis, acute viral meningitis, and viral encephalitis.
1. The document discusses various central nervous system infections including meningitis, encephalitis, and cerebral abscess. It defines these conditions and discusses their etiology, clinical features, diagnosis, management, complications and prognosis.
2. Specific types of meningitis discussed in detail include pyogenic meningitis, tuberculous meningitis, and meningococcal meningitis. Case scenarios are also presented to test the reader's knowledge.
3. Encephalitis is defined as inflammation of the brain tissue, usually caused by viruses. The causes, presentation, and management of encephalitis are summarized.
This document discusses various central nervous system infections that can be seen on CT and MRI imaging. It covers different types of infections including bacterial, viral, fungal and parasitic. It describes the routes of spread and typical presentations of these infections. Specific pathogens are discussed along with the imaging appearance of associated conditions like meningitis, encephalitis, brain abscesses and more. Common findings on CT and MRI are presented with examples of imaging findings for infections caused by organisms like herpes simplex virus, tuberculosis, HIV and fungi such as Cryptococcus.
Brain abscess is a focal infection within the brain parenchyma, typically surrounded by a capsule. It has an incidence of 0.3-1.3 per 100,000 people per year. Common causes include direct spread from a contiguous infection like sinusitis, hematogenous spread from infections elsewhere in the body, and head trauma. Clinical presentation is usually gradual onset of nonspecific symptoms like headache, fever, and focal neurological deficits. Diagnosis involves neuroimaging like MRI or CT scan showing a brain lesion, and microbiological evaluation of aspirated pus. Treatment consists of high dose intravenous antibiotics plus surgical drainage of the abscess. Prognosis depends on causative organism and ability to control infection, with a mortality rate of
This document discusses central nervous system (CNS) infections, including:
- Viral infections are more common than bacterial, which are more common than fungal/parasitic. Rickettsiae and Mycoplasma can also cause CNS infections.
- There are three main types - meningitis, encephalitis, and meningioencephalitis.
- Meningitis can be caused by bacteria, viruses, fungi or parasites. Presentation depends on age. Encephalitis has multiple viral and non-viral causes. Meningioencephalitis involves both meninges and brain tissue.
Complications, diagnosis, and management are discussed for each type of infection.
This document discusses acute CNS infections such as acute pyogenic meningitis, meningoencephalitis, and tuberculous meningitis (TBM). It covers the etiology, pathogenesis, clinical features, diagnosis, and treatment of these conditions. Common causes of acute pyogenic meningitis in children include Group B streptococcus, pneumococcus, meningococcus, and HIB. Meningoencephalitis can be caused by enteroviruses, arboviruses, or herpes viruses. TBM most often affects children ages 6 months to 4 years and has distinct prodromal, abrupt, and coma stages. Lumbar puncture and CSF analysis are important for diagnosing these infections
Imaging features in CNS infections - congenital, pyogenic and viral. TORCH infections, Brain abcess, meningitis, HSE vs JE, cerebellitis, ANE, approach to viral infections
Short presentation version cns infections Lecturetest
This document provides an overview of various infections that can affect the central nervous system, including bacteria, viruses, parasites, and fungi. It discusses specific conditions like bacterial meningitis, neurosyphilis, herpes simplex encephalitis, poliomyelitis, rabies, and more. For each, it covers topics like causes, clinical manifestations, diagnosis, treatment and prognosis.
Acute infections of the nervous system like bacterial meningitis can be life-threatening if not recognized and treated early. The document discusses various acute infections including bacterial meningitis, viral meningitis, encephalitis, and fungal infections. It provides details on the clinical presentation, diagnosis, and management of bacterial meningitis, which is often characterized by the classic triad of fever, headache, and neck stiffness, and requires prompt lumbar puncture and antibiotic treatment to identify the pathogen and prevent complications.
Imaging evaluation of spectrum of infective pathologies of CNS including encephalitis,meningitis,abscesses,congenital pathologies and hiv associated conditions etc.
This document discusses acute central nervous system infections in children. It provides details on a 2-year-old boy presenting with fever, vomiting, refusal of feeds, crying and fits. It then defines and discusses terms like meningitis, encephalitis and myelitis. The document reviews the history of understanding and treating these conditions. It discusses common causative organisms, pathogenesis, symptoms, diagnostic workup including lumbar puncture, and treatment approaches for conditions like meningitis and encephalitis.
This document discusses brain abscess, cranial subdural empyema, and epidural abscess. It covers the epidemiology, etiology, pathogenesis, clinical findings, diagnosis, and management of these conditions. Brain abscesses are typically caused by bacteria spreading from contiguous sites of infection or through the bloodstream. Clinical findings depend on the location and size of the abscess. Diagnosis involves neuroimaging and culture of aspirated contents. Treatment involves antibiotics and sometimes surgery. Outcomes depend on early diagnosis and treatment.
Bacterial infections of the central nervous system can cause meningitis, encephalitis, brain abscesses, and CSF shunt infections. Bacterial meningitis is the most common type and occurs when bacteria invade the subarachnoid space and CSF. The incidence is 3-5 per 100,000 people annually in the US. Bacterial meningitis and other CNS infections can cause significant morbidity and mortality if not treated promptly. A lumbar puncture is required to diagnose meningitis by examining the CSF for white blood cell count, differential count, Gram stain, and culture. Proper collection and rapid transport of CSF specimens to the laboratory is critical for accurate diagnosis. [END SUMMARY]
A 4 year old boy presented to the emergency room after having a seizure. Possible diagnoses include viral infections like herpes simplex encephalitis, which can cause seizures and disturbances in consciousness. Other potential causes are bacterial or parasitic infections like tuberculosis or toxoplasmosis. It is important to obtain a thorough history, including any recent illnesses, and perform diagnostic tests like a lumbar puncture and CSF analysis to determine the cause and guide treatment.
This document provides information about brain abscesses:
1. Brain abscesses usually begin as a focal intracranial infection that evolves into a collection of pus surrounded by a capsule. Common causative agents are streptococci, staphylococci, and various gram-negative bacteria.
2. Brain abscesses most often occur in the first four decades of life and are more common in males. Location is commonly the corticomedullary junction. Presentation includes headache, fever, seizures, and altered mental status.
3. Treatment involves surgical drainage, excision, and long-term antibiotics. Differential diagnosis includes tuberculomas, which appear as round or lobulated masses
This document provides an overview of various central nervous system infections and their imaging appearances. It describes how acute bacterial meningitis, viral meningitis and encephalitis, herpes simplex virus encephalitis, cytomegalovirus encephalitis, Japanese encephalitis, HIV infection of the CNS, JC virus infection, acute disseminated encephalomyelitis, varicella zoster virus vasculopathy, subdural and epidural empyemas, brain abscesses, cerebritis, tuberculous meningitis, neurocysticercosis, fungal infections, and hydatid cysts appear on CT and MRI scans. For each condition, it
neurosurgery.Cns infection.(dr.ali o. sadoon)student
Brain death is defined as the total and irreversible loss of function of the cerebral hemispheres and brainstem. To diagnose brain death, reversible causes of coma must first be excluded. Tests are then performed to check for the absence of motor responses and reflexes in the cranial nerve distribution, as well as the absence of respiration without life support. Brain death means life support is no longer useful as the patient has passed, and is a prerequisite for organ donation. In adults, the main causes are head trauma and subarachnoid hemorrhage, while in children abuse is more common than accidents.
Central nervous system infections can cause meningitis or encephalitis. Bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type b. It presents with fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture showing pleocytosis and low glucose in CSF. Treatment involves antibiotics, corticosteroids, and supportive care to prevent increased intracranial pressure complications.
This document discusses fungal diseases of the central nervous system (CNS). It begins by introducing different types of fungi, including yeasts, filamentous fungi, and dimorphic fungi. It notes that only a small group of fungi are pathogenic and able to cause CNS infections, which are rare but more common in immunocompromised patients. It then discusses various predisposing factors and clinical presentations of fungal CNS infections before examining specific conditions like meningitis, intracranial mass lesions, and skull-base syndromes in more detail. Diagnosis involves imaging, cerebrospinal fluid analysis, and sometimes biopsy. Treatment depends on the suspected fungal organism.
Slideshow is from the University of Michigan Medical
School's M1 Infectious Disease / Microbiology sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1IDM
The document discusses CNS infections including acute bacterial meningitis and encephalitis. It covers etiology, clinical manifestations, investigations and management. For acute bacterial meningitis, common causes are S. pneumoniae, N. meningitidis and H. influenzae. Signs include fever, neck stiffness, and altered mental status. Lumbar puncture shows neutrophil pleocytosis, elevated proteins and low glucose. Treatment involves antibiotics like ampicillin and dexamethasone to prevent hearing loss from H. influenzae. Encephalitis can be caused by viruses like herpes simplex, arboviruses and measles. Symptoms include fever, headache and seizures. Investigations include CSF analysis and neuroimaging.
This document provides an overview of meningitis and encephalitis. It discusses the different types of bacterial, viral and fungal meningitis including their causes, symptoms, diagnosis and treatment. Key points include that bacterial meningitis can be caused by organisms like pneumococcus, meningococcus and haemophilus influenza. Viral meningitis causes aseptic meningitis while encephalitis involves brain inflammation. Diagnosis involves lumbar puncture and CSF analysis. Treatment depends on the identified organism and may involve antibiotics, antivirals or antifungals.
Brain abscesses occur when bacteria or other microorganisms infect the brain tissue. They are usually caused by infections that have spread from other areas of the body, such as the ears, sinuses, or lungs. Common symptoms include headache, fever, nausea, and seizures. Diagnosis involves CT or MRI scans of the brain. Treatment consists of intravenous antibiotics for 6-8 weeks along with surgical drainage or resection of the abscess when possible.
Complications of csom Dr.sithanandha Kumar,29.02.2016ophthalmgmcri
Complications of chronic suppurative otitis media (CSOM) can include both intracranial and extracranial complications. Intracranial complications include meningitis, lateral sinus thrombosis, brain abscess, otitic hydrocephalus, and extradural/subdural abscesses. Extracranial complications involve spread of infection to nearby structures like the mastoid bone, petrous bone, facial nerve, and labyrinth. Prompt diagnosis and treatment of complications is important to prevent morbidity.
This document discusses various central nervous system infections that can be seen on CT and MRI imaging. It covers different types of infections including bacterial, viral, fungal and parasitic. It describes the routes of spread and typical presentations of these infections. Specific pathogens are discussed along with the imaging appearance of associated conditions like meningitis, encephalitis, brain abscesses and more. Common findings on CT and MRI are presented with examples of imaging findings for infections caused by organisms like herpes simplex virus, tuberculosis, HIV and fungi such as Cryptococcus.
Brain abscess is a focal infection within the brain parenchyma, typically surrounded by a capsule. It has an incidence of 0.3-1.3 per 100,000 people per year. Common causes include direct spread from a contiguous infection like sinusitis, hematogenous spread from infections elsewhere in the body, and head trauma. Clinical presentation is usually gradual onset of nonspecific symptoms like headache, fever, and focal neurological deficits. Diagnosis involves neuroimaging like MRI or CT scan showing a brain lesion, and microbiological evaluation of aspirated pus. Treatment consists of high dose intravenous antibiotics plus surgical drainage of the abscess. Prognosis depends on causative organism and ability to control infection, with a mortality rate of
This document discusses central nervous system (CNS) infections, including:
- Viral infections are more common than bacterial, which are more common than fungal/parasitic. Rickettsiae and Mycoplasma can also cause CNS infections.
- There are three main types - meningitis, encephalitis, and meningioencephalitis.
- Meningitis can be caused by bacteria, viruses, fungi or parasites. Presentation depends on age. Encephalitis has multiple viral and non-viral causes. Meningioencephalitis involves both meninges and brain tissue.
Complications, diagnosis, and management are discussed for each type of infection.
This document discusses acute CNS infections such as acute pyogenic meningitis, meningoencephalitis, and tuberculous meningitis (TBM). It covers the etiology, pathogenesis, clinical features, diagnosis, and treatment of these conditions. Common causes of acute pyogenic meningitis in children include Group B streptococcus, pneumococcus, meningococcus, and HIB. Meningoencephalitis can be caused by enteroviruses, arboviruses, or herpes viruses. TBM most often affects children ages 6 months to 4 years and has distinct prodromal, abrupt, and coma stages. Lumbar puncture and CSF analysis are important for diagnosing these infections
Imaging features in CNS infections - congenital, pyogenic and viral. TORCH infections, Brain abcess, meningitis, HSE vs JE, cerebellitis, ANE, approach to viral infections
Short presentation version cns infections Lecturetest
This document provides an overview of various infections that can affect the central nervous system, including bacteria, viruses, parasites, and fungi. It discusses specific conditions like bacterial meningitis, neurosyphilis, herpes simplex encephalitis, poliomyelitis, rabies, and more. For each, it covers topics like causes, clinical manifestations, diagnosis, treatment and prognosis.
Acute infections of the nervous system like bacterial meningitis can be life-threatening if not recognized and treated early. The document discusses various acute infections including bacterial meningitis, viral meningitis, encephalitis, and fungal infections. It provides details on the clinical presentation, diagnosis, and management of bacterial meningitis, which is often characterized by the classic triad of fever, headache, and neck stiffness, and requires prompt lumbar puncture and antibiotic treatment to identify the pathogen and prevent complications.
Imaging evaluation of spectrum of infective pathologies of CNS including encephalitis,meningitis,abscesses,congenital pathologies and hiv associated conditions etc.
This document discusses acute central nervous system infections in children. It provides details on a 2-year-old boy presenting with fever, vomiting, refusal of feeds, crying and fits. It then defines and discusses terms like meningitis, encephalitis and myelitis. The document reviews the history of understanding and treating these conditions. It discusses common causative organisms, pathogenesis, symptoms, diagnostic workup including lumbar puncture, and treatment approaches for conditions like meningitis and encephalitis.
This document discusses brain abscess, cranial subdural empyema, and epidural abscess. It covers the epidemiology, etiology, pathogenesis, clinical findings, diagnosis, and management of these conditions. Brain abscesses are typically caused by bacteria spreading from contiguous sites of infection or through the bloodstream. Clinical findings depend on the location and size of the abscess. Diagnosis involves neuroimaging and culture of aspirated contents. Treatment involves antibiotics and sometimes surgery. Outcomes depend on early diagnosis and treatment.
Bacterial infections of the central nervous system can cause meningitis, encephalitis, brain abscesses, and CSF shunt infections. Bacterial meningitis is the most common type and occurs when bacteria invade the subarachnoid space and CSF. The incidence is 3-5 per 100,000 people annually in the US. Bacterial meningitis and other CNS infections can cause significant morbidity and mortality if not treated promptly. A lumbar puncture is required to diagnose meningitis by examining the CSF for white blood cell count, differential count, Gram stain, and culture. Proper collection and rapid transport of CSF specimens to the laboratory is critical for accurate diagnosis. [END SUMMARY]
A 4 year old boy presented to the emergency room after having a seizure. Possible diagnoses include viral infections like herpes simplex encephalitis, which can cause seizures and disturbances in consciousness. Other potential causes are bacterial or parasitic infections like tuberculosis or toxoplasmosis. It is important to obtain a thorough history, including any recent illnesses, and perform diagnostic tests like a lumbar puncture and CSF analysis to determine the cause and guide treatment.
This document provides information about brain abscesses:
1. Brain abscesses usually begin as a focal intracranial infection that evolves into a collection of pus surrounded by a capsule. Common causative agents are streptococci, staphylococci, and various gram-negative bacteria.
2. Brain abscesses most often occur in the first four decades of life and are more common in males. Location is commonly the corticomedullary junction. Presentation includes headache, fever, seizures, and altered mental status.
3. Treatment involves surgical drainage, excision, and long-term antibiotics. Differential diagnosis includes tuberculomas, which appear as round or lobulated masses
This document provides an overview of various central nervous system infections and their imaging appearances. It describes how acute bacterial meningitis, viral meningitis and encephalitis, herpes simplex virus encephalitis, cytomegalovirus encephalitis, Japanese encephalitis, HIV infection of the CNS, JC virus infection, acute disseminated encephalomyelitis, varicella zoster virus vasculopathy, subdural and epidural empyemas, brain abscesses, cerebritis, tuberculous meningitis, neurocysticercosis, fungal infections, and hydatid cysts appear on CT and MRI scans. For each condition, it
neurosurgery.Cns infection.(dr.ali o. sadoon)student
Brain death is defined as the total and irreversible loss of function of the cerebral hemispheres and brainstem. To diagnose brain death, reversible causes of coma must first be excluded. Tests are then performed to check for the absence of motor responses and reflexes in the cranial nerve distribution, as well as the absence of respiration without life support. Brain death means life support is no longer useful as the patient has passed, and is a prerequisite for organ donation. In adults, the main causes are head trauma and subarachnoid hemorrhage, while in children abuse is more common than accidents.
Central nervous system infections can cause meningitis or encephalitis. Bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type b. It presents with fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture showing pleocytosis and low glucose in CSF. Treatment involves antibiotics, corticosteroids, and supportive care to prevent increased intracranial pressure complications.
This document discusses fungal diseases of the central nervous system (CNS). It begins by introducing different types of fungi, including yeasts, filamentous fungi, and dimorphic fungi. It notes that only a small group of fungi are pathogenic and able to cause CNS infections, which are rare but more common in immunocompromised patients. It then discusses various predisposing factors and clinical presentations of fungal CNS infections before examining specific conditions like meningitis, intracranial mass lesions, and skull-base syndromes in more detail. Diagnosis involves imaging, cerebrospinal fluid analysis, and sometimes biopsy. Treatment depends on the suspected fungal organism.
Slideshow is from the University of Michigan Medical
School's M1 Infectious Disease / Microbiology sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1IDM
The document discusses CNS infections including acute bacterial meningitis and encephalitis. It covers etiology, clinical manifestations, investigations and management. For acute bacterial meningitis, common causes are S. pneumoniae, N. meningitidis and H. influenzae. Signs include fever, neck stiffness, and altered mental status. Lumbar puncture shows neutrophil pleocytosis, elevated proteins and low glucose. Treatment involves antibiotics like ampicillin and dexamethasone to prevent hearing loss from H. influenzae. Encephalitis can be caused by viruses like herpes simplex, arboviruses and measles. Symptoms include fever, headache and seizures. Investigations include CSF analysis and neuroimaging.
This document provides an overview of meningitis and encephalitis. It discusses the different types of bacterial, viral and fungal meningitis including their causes, symptoms, diagnosis and treatment. Key points include that bacterial meningitis can be caused by organisms like pneumococcus, meningococcus and haemophilus influenza. Viral meningitis causes aseptic meningitis while encephalitis involves brain inflammation. Diagnosis involves lumbar puncture and CSF analysis. Treatment depends on the identified organism and may involve antibiotics, antivirals or antifungals.
Brain abscesses occur when bacteria or other microorganisms infect the brain tissue. They are usually caused by infections that have spread from other areas of the body, such as the ears, sinuses, or lungs. Common symptoms include headache, fever, nausea, and seizures. Diagnosis involves CT or MRI scans of the brain. Treatment consists of intravenous antibiotics for 6-8 weeks along with surgical drainage or resection of the abscess when possible.
Complications of csom Dr.sithanandha Kumar,29.02.2016ophthalmgmcri
Complications of chronic suppurative otitis media (CSOM) can include both intracranial and extracranial complications. Intracranial complications include meningitis, lateral sinus thrombosis, brain abscess, otitic hydrocephalus, and extradural/subdural abscesses. Extracranial complications involve spread of infection to nearby structures like the mastoid bone, petrous bone, facial nerve, and labyrinth. Prompt diagnosis and treatment of complications is important to prevent morbidity.
Complications of csom dr.sithanandha kumar,29.02.2016ophthalmgmcri
Complications of chronic suppurative otitis media (CSOM) can include both intracranial and extracranial complications. Intracranial complications include meningitis, lateral sinus thrombosis, brain abscess, otitic hydrocephalus, and extradural/subdural abscesses. Extracranial complications involve spread of infection to nearby structures like the mastoid bone, petrous bone, facial nerve, and labyrinth. Prompt diagnosis and treatment of complications is important to prevent morbidity.
This document provides information on brain abscesses, including their history, epidemiology, pathogenesis, clinical presentation, investigations, management, and surgical treatment. Some key points:
- Brain abscesses are focal intracranial infections that start as cerebritis and evolve into a collection of pus surrounded by a capsule. The most common causes are spread from a contiguous infection or hematogenous dissemination.
- Clinical features are often non-specific but may include headache, fever, focal neurological deficits, and altered mental status. Investigations like CT and MRI are used to identify location, size, and stage of the abscess.
- Treatment involves antibiotics along with surgical evacuation for abscesses over 2.5cm
This document discusses meningitis and encephalitis. It defines meningitis as an infection of the meninges and encephalitis as an inflammation of the brain parenchyma. It outlines the different types of meningitis and common causative organisms. It describes the clinical features, investigations, complications, prognosis and treatment for both conditions. The goals of physical therapy for patients with these inflammatory central nervous system disorders are also mentioned.
Neurocysticercosis is a disease caused by the larval form of the pork tapeworm Taenia solium infecting the brain and central nervous system in humans. There are two types of cysts - Cysticercus cellulosae and Cysticercus racemose, which can lodge in different areas and cause different symptoms. Neurocysticercosis has a variety of clinical presentations depending on the location, size, and number of cysts as well as the host's immune response. Treatment approaches for neurocysticercosis are controversial, with some evidence that antiparasitic treatment may cause more harm than benefit compared to simply managing seizures with antiepileptic drugs alone.
Meningitis is a severe CNS pathology and early and appropriate intervention is needed to prevent adverse outcome including mortality and long term complications. This presentation focuses on the different types of meningitis and the appropriate management options
This document provides an overview of central nervous system infections, focusing on acute bacterial meningitis. It describes the typical causes, pathogenesis, clinical manifestations, diagnosis, complications and treatment of bacterial meningitis. Key points include that the most common causes are Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. Bacteria reach the subarachnoid space via the bloodstream or direct invasion. Typical symptoms are fever, headache, vomiting and signs of meningeal irritation. Diagnosis involves CSF analysis showing cloudy appearance, high pressure, neutrophil pleocytosis, elevated proteins and low glucose. Complications can include subdural effusions, hydrocephalus and brain damage.
This document provides an overview of central nervous system infections, focusing on acute bacterial meningitis. It describes the typical causes, pathogenesis, clinical manifestations, diagnosis, complications and treatment of bacterial meningitis. Key points include that the most common causes are Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. Bacteria reach the subarachnoid space via the bloodstream or direct invasion. Typical symptoms are fever, headache, vomiting and signs of meningeal irritation. Diagnosis involves CSF analysis showing cloudy appearance, high pressure, neutrophil pleocytosis, elevated proteins and low glucose. Complications can include subdural effusions, hydrocephalus and brain damage.
There are 4 stages of brain abscess evolution: early and late cerebritis, early capsule formation, and late capsule. Common causes include hematogenous spread, direct extension from infections like otitis or sinusitis, and trauma. Presentation includes headache, fever, seizures, and neurological deficits. Imaging shows evolving appearance on CT and MRI from ill-defined lesion to encapsulated mass. Treatment involves surgical drainage with antibiotics and steroids.
The document discusses infections of the central nervous system (CNS), including meningitis. It lists the main causes of CNS infections as bacterial, viral, fungal, and protozoal. It then provides examples of specific infections for each category. The document focuses on meningitis, describing the introduction, clinical features, complications, types (pyogenic bacterial, tubercular, and viral), investigations, management, and physiotherapy assessment and management goals.
CNS infections ..Fitsum.ppt neurology lecture of infectionAbdulkadirHasan
This document provides information on central nervous system (CNS) infections including definitions, etiologies, clinical presentations, diagnostic testing, treatment, and prophylaxis. It discusses various types of meningitis (bacterial, viral, fungal), encephalitis, and brain abscesses. Common causative organisms, signs and symptoms, cerebrospinal fluid analysis findings, and appropriate antimicrobial therapies are outlined for different CNS infections. Complications are also reviewed along with their management.
This document provides an overview of neurocysticercosis (NCC), which is an infection of the central nervous system caused by the larvae of the pork tapeworm Taenia solium. NCC is endemic in many parts of the world and is the leading cause of adult-onset epilepsy. It discusses the pathogenesis, classification, clinical presentations, diagnostic criteria and differential diagnosis, and treatment options for NCC. Key points include that NCC presents with a variety of neurological symptoms depending on the location and stage of the cysticerci, imaging such as CT and MRI are important for diagnosis, and albendazole is the drug of choice for antiparasitic treatment along with corticosteroids.
Repeat CT scans or MRIs are recommended every 1-2 weeks during antimicrobial therapy to monitor response. Scans should continue every 4-6 weeks for 3-6 months after completion of therapy to ensure resolution and check for recurrence. Earlier follow up scans may be needed if clinical deterioration occurs which could indicate treatment failure or recurrence.
A 60-year-old woman presented with new onset seizures after developing a fever and headache. Examination revealed neck stiffness and altered mental status. Imaging showed a temporal lobe lesion and CSF analysis found elevated white blood cells and normal glucose/protein. This suggests acute bacterial meningitis. The document discusses meningitis causes, presentations, evaluations, and treatments. Initial antibiotic choices for community-acquired meningitis include vancomycin plus ceftriaxone.
This document provides an overview of endocarditis. It defines endocarditis as a microbial infection of the endocardial surface of the heart, most commonly affecting heart valves. A characteristic pathological lesion is a vegetation composed of platelets, fibrin, microorganisms, and inflammatory cells. The document discusses the pathogenesis, epidemiology, clinical presentations, diagnosis, complications including septic thrombophlebitis and mycotic aneurysms, treatment with antibiotics and surgery, and mortality rates associated with different causative organisms.
Endocarditis fisiopatologia diagnóstico y tratamientojosue946853
This document provides an overview of endocarditis. It defines endocarditis as a microbial infection of the endocardial surface of the heart, most commonly affecting heart valves. A characteristic pathological lesion is a vegetation composed of platelets, fibrin, microorganisms, and inflammatory cells. The document discusses the pathogenesis, epidemiology, clinical presentations, diagnosis, complications including septic thrombophlebitis and mycotic aneurysms, treatment with antibiotics and surgery, and mortality rates associated with different causative organisms.
Endocarditis is an infection of the inner lining of the heart. It commonly affects the heart valves, forming vegetations. It is classified as acute/subacute or chronic based on presentation and progression. The pathology is vegetations composed of platelets, fibrin, microorganisms and inflammatory cells. It is diagnosed using Duke criteria including blood cultures, echocardiogram findings and clinical features. Complications include heart failure, emboli and death. Treatment involves long-term antibiotics targeting the causative organism along with possible surgery. Prevention includes antibiotic prophylaxis for at-risk patients during invasive procedures.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
13. SUBDURAL EMPYEMA
Collection of pus in the subdural space
Widely spreading more than Epidural and Brain
abscess
Pathogenesis
contiguous spread ex Air sinus infection, ear infection,
Mastoiditis, Epidural abscess
After surgery/ device insertion beneath Dura
Infection of pre-existing subdural blood: septicemia
15. SUBDURAL EMPYEMA
Clinical feature
More severe than Epidural abscess
Rapidly progressive
Lacks significant barriers ex compartmentalization, septation
Status epilepticus may occur
Diagnosis
CT/MRI c contrast
Enhancing collection in subdural space
Severe brain edema
20. BRAIN ABSCESS
• A focal intracranial infection that is initiated as an area of
cerebritis and evolves into a collection of pus surrounded
by a vascularized capsule
21. EPIDEMIOLOGY
Higher incidence in developing countries
Men more common than women
Differences in age are based on the primary site of infection
Otitic focus : < 20 years or > 40 years
Paranasal sinuses : 30 - 40 years.
22. RISK FACTORS
pulmonary abnormalities
congenital cyanotic heart disease
bacterial endocarditis
penetrating head trauma
AIDS
24. PATHOGENESIS
o Contiguous source of infection
o Usually single brain abscess
o Infections in the middle ear , mastoid cells , or paranasal sinuses
• Otitis media : temporal lobe or cerebellum
• Paranasal sinusitis : frontal lobe
• Sphenoid sinusitis : temporal lobe or sella turcica
• Dental infections (molar teeth) : frontal lobe
25. PATHOGENESIS
Hematogenous (10-15%)
• Multiple , multiloculated abscesses , grey-white matter
junction(site of greatest blood flow)
• The most common sources : lung
• Chronic pyogenic lung diseases : lung abscess
• Bronchiectasis
• Empyema
• Cystic fibrosis
26. PATHOGENESIS
• Hematogenous dissemination
• Other : wound & skin infections , osteomyelitis , pelvic
infections , and intra-abdominal infections
• Cyanotic heart disease (TOF ,TGA) : common cause in
pediatrics
• Bacterial endocarditis
28. MICROBIOLOGY
• Bacteria is the most common
• Streptococcus spp.
• Enteric gram-negative bacilli
• Proteus spp. , Escherichia coli, Klebsiella spp. , Pseudomonas aeruginosa
and Enterobacter spp.
• Staphylococcus aureus
• Anaerobes
• Bacteroides spp. and Prevotella spp
29.
30. MICROBIOLOGY
• Fungus
• most common : Candida spp.
• Risk factor
• The use of broad-spectrum antimicrobial agents
• Corticosteroids
• Diabetes mellitus
33. PATHOPHYSIOLOGY
1.Early cerebritis (Day 0-3)
Histopathology
- Central zone of necrosis
- local inflammatory response
- Marked peri-lesion edema
- Poor demarcation from adjacent
brain
CT
- Poor marginated area of
hypodensity
- Minimal if any enhancement with IV
contrast
34. PATHOPHYSIOLOGY
2. Late cerebritis
Day 4-9
Histopathology
- Pus
- Enlargement of necrotic
center
- Maximal cerebral edema
- Reticulin network as precu
rsor to capsule
35. 2. LATE CEREBRITIS(CON’T)
CT
- Hypodensity area still
may show poor margination
- Patchy enhancement duri
ng early part of phase
- Rim-enhancement begins late
r in phase
- Central hypodense areas fil
ls in with contrast on delayed
scans
36. 3. Early capsule formation
Day 10-14
Histopathology
- Continue formation of pus
- Development of collagen capsule
- Cerebral edema surrounding
capsule
CT
- Well-defined rim enhancing
- mass; an outer hypodens rim
(double rim sign)
37. 4. Late capsule formation
Day >14
Histopathology
5 distinct zone
(a) Necrotic center filled with pus
(b) Peripheral zone of inflammatory cell
and fibroblasts
(c) Dense collagen capsule
(d) Layer of neovascularity with residual
cerebritis
(e) Zone of edema and reactive gliosis
40. CLINICAL FEATURES
• Signs & symptom : related to size, location ,virulence of the
organism
• Classical triad <50% :
• headache
• fever
• focal neurological deficit
• Sudden worsening of the headache & new onset of
meningismus, may signify rupture of the abscess into the
ventricular space
41.
42. INVESTIGATION
BLOODWORK
- Peripheral WBC: may be normal or only mildly elevated in
60-70% of cases (usually > 10,000)
- Blood cultures: usually negative
- ESR: may be normal
- C-reactive protein (CRP): infection anywhere in body can
raise the level. Patients with brain tumor and other
inflammatory condition (e.g. dental abscess) may have and
elevated CRP level. Sensitivity is 90%, specificity is 77%
43. INVESTIGATION
Lumbar puncture
No characteristic finding diagnostic of abscess
Open pressure is usually increase,WBC count and protein
may be elevated
Organism can rarely identified from CSF by LP
Risk of transtentorial herniation,especially with large
lesions
Due to the risk and the low yield of useful
information,avoid LP if not already done
44. INVESTIGATION
• Imaging
• MRI : gold standard
• CT with contrast : Rim enhancing lesion, smooth & thin wall
with surrounding edema
45.
46. TREATMENT
Medical
Abscess < 3 cm
Multiple small abscesses
Difficult area
Early cerebritis phase
High surgical risk
ATB 6-8 wk
Empirical tx :
Vancomycin
Cloxacillin+
Ceftriazone+
Metronidazole
Supportive treatment
Dexamethasone
Anticonvulsant
47.
48. SURGICAL MANAGEMENT
• Needle aspiration after burr-hole
• Indication
Well encapsulated > 3 cm
Nearly to ventricle
• No response to antibiotics
• Preferable
49. SURGICAL MANAGEMENT
• Complete excision after craniotomy
• Indication
• Multiloculated abscess
• Traumatic brain abscess (to remove bone fragment
or foreign body)
• Encapsulated fungal brain abscess
• Gas-forming lesion
50.
51. CLINICAL COMPLICATIONS
Abscess rupture transforms localized infection
-Meningitis
-Ventriculitis
Elevated ICP may cause uncal hernia and subsequently death
Seizure
52. OUTCOME
Mortality ranged form 40-60%
With improvement in antibiotics, surgery, and the improved
ability to diagnose and follow response with CT and/or MRI,
mortality rate has been reduced to 10%
But morbidity remains high with permanent neurologic
deficit or seizures in up to 50% of cases
A worse prognosis is associated with poor neurologic
function, intraventricular rupture of abscess
56. SPINAL EPIDURAL ABSCESS
Posteriorly, the epidural space contains fat, small arteries,
and the venous plexus
Anteriorly, the epidural space is a potential space with the
dura tightly adherent to the vertebral bodies and ligaments
Most spinal epidural abscesses occur in the thoracic area,
which is anatomically the longest of the spinal regions
57. PATHOGENESIS
Hematogenous : bacterial endocarditis, infected indwelling
catheters, urinary tract infection, peritoneal and
retroperitoneal infections, and others. Symptoms progress
rapidly
Direct extension : from vertebral osteomyelitis, Psoas
abscess , Epidural injections or catheters.
Slow progression of symptoms
58.
59. PATHOGENSIS
Staphylococcus aureus
Staphylococcus and Pseudomonas species, Escherichia coli,
Brucella, and Mycobacterium tuberculosis.
MRSA : history of MRSA abscesses, spinal surgery, or
implanted devices
Fungal infections : Immunosuppressed patients
61. CLINICAL FEATURES
Four phases
I. localized spinal pain
II. radicular pain and paresthesias
III. muscular weakness, sensory loss, and sphincter
dysfunction
IV. paralysis
Fever 30%
Headache & neck pain
62. INVESTIGATION
Imaging
MRI is the procedure of choice
CT myelography : intraspinal extramedullary mass
LP is relatively contraindicated : risk of introducing purulent
material into the subarachnoid space
The decline of fulminant osteomyelitis of the skull from a routine event to a rare occurrence has largely paralleled the emergence of potent antibiotics.
Today, osteomyelitis of the skull usually presents as a chronic process that occasionally complicates craniotomies and scalp injuries
non-neoplastic complication of acute sinusitis characterised by subperiosteal abscess and osteomyelitis
opacified frontal sinus with stranding and swelling of the overlying scalp. Bone algorithm will often demonstrate a defect in the anterior wall of the sinus.
ESR provides a useful marker to monitor the efficacy of therapy using serial determinations
CRP levels rise and fall rapidly after surgery, thus making it a good indicator of acute infections, recovery, and relapse
osteopenia, subtle erosion of inner and outer tables, and gross lytic destruction
Inflammation of cortical blood vessels, leading to thrombosis and stroke Cerebritis
LP frequently fails to yield the offending organism and risks herniation due to mass effect
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shows signs of meningitis but examination revealsno pathological changes in the meninges.
headache,neck stiffness
Posteriorly, the epidural space contains fat, small arteries, and the venous plexus
Anteriorly, the epidural space is a potential space dura adherent to vertebral bodies and ligaments
due to inflammation and fibrosis of the arachnoid villi or inflammatory reaction to the meninges and subsequent occlusion of the foramina of Luschka and Magendie
Noncommunicating hydrocephalus may be a consequence of intraventricular cysts.