Miscellaneous Quiz / CNS Pathogens

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Can you name the CNS Pathogens?

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VF: Infective form: trophozoite
Dz: Pneumococcal meningitis
Prevention: 7-valent conjugate vaccine; 23-valent polysaccharide vaccine
Tx: Ampicillin + gentamicin
Tx/Prev: Empirical tx: antiviral (acyclovir) + antibacterial (ampicillin + cefotaxime)
Transmission: Ingestion (uncooked meat w/ cyst, oocyst from fecal contamination), transplacental, blood & organ tpx
VF: Infective form: trophozoite & flagellated forms -> purulent, hemorrhagic inflammatory rxn
Tx: Amphotericin B + Ketoconazole
Gram(+) cocci in chains, B-hemolytic, bile resistant
Group reservoir: human nasopharynx
Dz: Primary meningoencephalitis
Dx: From blood or CSF: microscopy, cx (blood agar), motility test
Gram (-) coccobacilli; capsule serovar b
Dx: Cysts and trophozoites in tissue
S/s: CNS (meningitis, encephalitis in immunocompromised patients)
Group s/s: Sudden onset: fever, stiff neck, severe HA (migraine-like); also n/v, photophobia, confusion, sleepiness, malaise…
Reservoir: normal flora
Pathogen causing parastitic infection not otherwise specified
Tx: Amphotericin B
Dz: toxoplasmosis
Reservoid: Soil enriched w/ brid droppings
Prevention: Hib conjugate vaccine
Pathogen causing parastitic infection in immunocompromised persons
Most common pathogens (3) for bacterial meningitis in children and adults
Most common pathogen (1) for bacterial meningitis in pregnant women, neonates, and immunocompromised patients
Free living amoebae
S/s: Non specific: fever, poor feeding, vomiting, irritability alternating w/ lethargy…
Most common pathogens (2) for bacterial meningitis in neonates
Intracellular parasite
Reservoir: Warm fresh water
Dx: Gram(-) coccobacilli + WBCs; Cx: Chocolate agar (X &V factors)
Group dx: CSF: high protein, low glucose, neutrophils
VF: pneumolysin
Group transmission: person to person via respiratory droplets
Prevention: MPSV4; MCV4
Gram (-) rods, Enterobacteriacea family, lactose (+)
S/s: Hemorrhagic skin rash (petechiae)
Group Dz: subacute to chronic meningitis
Group S/s: Slow onset, HA, visual disturbances, abnormal mental status, seizure
VF: Endotoxin (LPS); Capsule = poly-ribitol-phosphate (PRP)
VF: K1 capsule, pili, cytotoxins, endotoxin (LPS)
Dx: Gram(-) diplococci inside polymorphonuclear cells; Culture: Thayer-Martin agar
Transmission: Ingestion of contaminated food, transplacentally, or during delivery
Tx: Sulfadiazine + pyrimethamine (immunocompromised host); clindamycin & spiramycin (pregnant women)
Group dx: From CSF, blood or skin lesions (meningococcus)
Group Transmission: inhalation
Group Dx: CSF: blood, neutrophils, high protein, low glucose
Dx: Complement fixing antibodies in serum
Group tx/prev: Empirical tx: vancomycin + 3rd gen cephalosporin; Chemoprophylaxis: Rifampin
S/s: HA, altered mental status. Progresses slowly (several weeks)
Dz: Granulomatous amebic encephalitis
Dz: Listeriosis
Pathogens causing fungal infections in immunocompromised host
Group VF: Capsule, IgA protease, pili; Invasion into blood stream ->meninges -> inflammation
Opportunistic free-living amoebae
Transmission: From colonized mother (delivery, infected amniotic fluid); or nosocomial transmission
Reservoir: Cat = definitive host
Reservoir: normal flora GI tract -> secondary spread to vagina
Dz: Meningococcal meningitis, Meningococcemia (Waterhouse-Friderichsen syndrome)
Gram(+) cocci, in chain or pairs, lancet shaped, a-hemolytic
VF: Endotoxins (LPS, LOS): diffuse vascular damage
Tx/Prev: Amphotericin B + flucytosine
Reservoir: Soil; fresh, brackish, sea water; sewage, swimming pool. Contact lens equipment
Dx: Gram(+) cocci in pair + WBCs; Culture: blood agar -> α-hemolytic, optochin (S), bacitracin (R)
Dx: Serologic testing; biopsy (cyst, tachyzoites)
VF: Facultative intracellular pathogen, cell to cell spread
Dx: From CSF: capsulated yeasts, cx, capsular antigen detection
Dimorphic fungus: mold in environment, spherules filled w/ endospores in tissue
Dx: CSF: wet mount (motile trophozoites); Giemsa (trophozoites)
Group VF: Blood invasion from lungs -> brain
S/s: Self limited flu-like illness (immunocompetent host); toxoplasmic encephalitis (imminocompromised host); Maternal infxn (stillbirth, neurologic problems)
Reservoir: Asymptomatic carrier
Gram(-) diplococci (kidney-shaped); serogroups: A, B, C, Y, W 135
Dx: PCR (urine or CSF), Latex particle agglutination (urine), Cx (CSF, blood), CAMP test for GBS
VF: Capsule, peptidase, lytic enzymes
Reservoir: Soil-desert sand
Reservoir: Intestine of animals and humans
Small gram(+) rods, non-spore forming, growth at 1°C to 45°C, motile at 25°C
Pathogen causing parastitic infection in immunocompetent persons
VF: Infective form: cyst, oocyst; Intermediate host: other animal + humans; Oocyst -> tachyzoites -> invade macrophages -> spread to all organ systems: cyst
S/s: May follow respiratory or ear infections, head trauma...
S/s: Febrile gastroenteritis (immunocompetant pts); Bacteremia (fever, malaise, spread to placenta); Granulomatosis infantiseptica (stillbirth, abscesses or granulomas in neonates)
Transmission: Enter body via lower resp. tract, ulcerated or broken skin
S/s: Rapid onset, severe HA, fever, nausea, altered sense of smell. Progresses rapidly, death in a few days
Prevention: education for high-risk consumers
Transmission: Enter body via olfactory neuroepithelium
Encapsulated yeast
S/s: Often follows sinusitis or otittis media

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Created Oct 25, 2011ReportFavoriteNominate
Tags:cns, pathogen

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