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CNS Infections
Lect. 7
53
Pathology
Professional
01/25/2011

Additional Pathology Flashcards

 


 

Cards

Term

 

Meningitis infects what components of the brain? 

Definition

 

Leptomeninges (Pia matter and arachnoid matter) and CSF 

Term

 

bacteria --> PMNs --> pus 

Definition

 

 

Acute Pyogenic Meningitis 

Term

 

 

Meningoencephalitis 

Definition

 

 

Meningitis in leptomeninges and CNS parenchyma --> abscess formation

Term

 

 

Basilar Meningitis 

Definition

 

Infection affecting base of brain + cranial nerves and blood vessels 

Term

 

Granulomatous Meningitis 

Definition

 

Chronic basilar meningitis + pin head size granulomas 

Term

 

 

Carcinomatosis of the Meninges 

Definition

 

 

Involvement of the leptomeninges by malignant cells 

Term

 

Iatrogenic introduction of chemicals into subarachnoid space & irritant material spontaneously released from neoplasms 

Definition

 

Chemical Meningitis 

Term

 

What is the most common route of infective dissemination? 

Definition

 

Hematogenous 

Term

 

 

Rabies and Zoster reached the CNS via the...

Definition

 

 

Peripheral Nervous System 

Term

 

What is the prototype for all forms of pyogenic or bacterial meningitis?

Definition

 

Meningococcus 

Neisseria Meningitidis

Term

 

 

Group B Strep and E. Coli 

Definition

 

Most common in neonates 

Term

 

H. Influenzae and Strep Pneumoniae 

Definition

 

Most common infection in Infants 

Term

 

 

Most common infectious agent in Older adults?

Definition

 

 

S. Pneumoniae & Listeria monocytogenes 

Term

 

Gross morphology of Acute Meningitis 

Definition

  • surface --> milky/cloudy surface
  • PMNs in CSF --> pus
  • congested vessels
  • cerebral edema w/ or w/out herniation

 

Term

 

Microscopic examination of Acute Meningitis 

Definition
  • PMNs in subarachnoid space & ependymal lining (ependymitis)
  • Secondary vasculitis --> infarct or hemorrhage
  • infection of CNS parenchyma (cerebritis)
Term

 

-generalized septicemia

-fulminant septicemia

-Disseminated Intravascular Coagulopathy (DIC)

-Waterhouse-Friderichsen Syndrome

Definition

 

complication of Acute Meningitis 

Term

 

How does hydrocephalus happen in Acute Meningitis?

Definition

irritation of meninges --> fibrosis or reactive desmoplasia --> adhesive arachnoiditis --> occlusion of foraminae of Luschka and Magendie --> hydrocephalus 

Term

 

 

Abscess formation Mechanism 

 

Definition

 

cerebritis --> consolidation (large, round, semi-discrete mass w/ central necrosis) --> organization & repair (ingrowth of blood vessels, fibroblasts at edge) --> thick, fibrous capsule

Term

 

 

Subdural Empyema 

Definition

 

Extension of preexisting, primary infection: osteomyelitis of skull, sinusitis, mastoiditis or brain abscess into subdural space w/ pus 

Term

 

spread of abscess into adjacent areas of osteomyelitis/ sinusitis into epidural space of the spinal cord 

Definition
Term

 

-neurosyphilis

-tuberculosis

-fungal infections

-sarcoidosis 

Definition

 

Basilar of GRANULOMATOUS Meningitis 

Term

 

 

Non-necrotizing granuloma 

Definition

 

Sarcoid 

Term

 

 

Granuloma w/ caseous (cheese-like) necrosis 

Definition

 

Tuberculoma

from Mycobacterium Tuberculosis 

Term

 

 

Meningovascular Neurosyphilis 

Definition

 

-chronic infection inflammation

-subarachnoid space & leptomeninges

-vascular and cranial nerve involvement

Term

 

-degeneration of the dorsal columns

-ataxia

-Charcot joints (traumatic joint injury w/ deformation)

Definition

 

Tabes Dorsalis 

Term

 

Large granulomas w/ central core of 'rubber-like' necrosis 

Definition

 

Gumma granulomas 

(Neurosyphilis) 

Term

 

Gross morph of Neurosyphilis 

Definition

 

  • atrophic brain
  • narrowing of gyri
  • widening of the sulci
  • leptomeninges are thickened
  • granulomas at base of the brain/brainstem 

 

Term

 

 

What kind of cells are found in basilar/granulomatous meningitis?  

Definition

 

reactive gliosis

lymphocytes & plasma cells 

Microglia 

 

Term

 

Ventricles lining show areas of denudation & glial response w/ granular appearance

(in basilar/granulomatous meningitis)

Definition

 

 

Granular Ependymitis 

Term

-Borrelia Burgdorferi

-Ixodes tick

-Mild Menigoenchephalitis

-Facial Nerve Palsies

-Neuropathies 

Definition

 

 

Lyme Disease

(Neuroborreliosis)

Term

 

What is 'tropism"? 

Definition

 

Predilection of viral infection for specific cell tissues, such as CNS, and specific cell types: oligodendroglia

Term

 

Ability of virus to hide in the nervous system followed by re-emergence and subsequent infections

Definition

 

 

Latency 

Term

 

 

Intracytoplasmic neuronal inclusions in Purkinje cells fo the cerebellum and hippocampal formation of temporal lobes 

Definition

 

Rabies 

Term

 

 

Typical histopathological features of the Rickettsial Diseases 

Definition

-inflammatory round cell infiltrate

-predilection of injury of gray matter

-glial or microglial nodules 

Term

-children and young adults

-temporal lobes and orbital gyri of inferior frontal

-necrotic, hemorrhagic lesion

-Cowdry Type A inclusion

Definition

 

Herpes Simplex Type 1 (HSV 1)

Term

-meningoencephalitis in adults

-neonates born to mother w/ active lesions

-transmitted by birth canal no placenta

Definition

 

Herpes Simplex Virus Type 2 (HSV 2) 

Term

-chickenpox in childhood

-latent in NS and reactivated in adult

-painful vesicular eruption following dermatomes of sensory nerves

-Dorsal (sensory) root ganglia 

Definition

 

Varicella-Zoster Virus (Herpes Zoster; Shingles)

Term

- CNS infection fetus & immunosupressed

-Periventricular necrosis --> calcification

-Microencephaly & microcephaly

-Cowdry Type A inclusion

- ++ common in AIDS pts. 

Definition

 

Cytomegalovirus (CMV)

Term

-demyelinating dz

-JC Polyoma Virus

-tropism for oligodendroglia

-Cowdry Type A inclusion bodies

-bizarre astrocytes, like "tumor-cells", neoplasm?  

Definition

 

 

Progressive Multifocal Leukoencephalopathy PML

Term

-children & young adults

-acute episode of measles

-virus latency

-widespread demyelination & gliosis

-Cowdry Type A inclusion bodies 

Definition

 

 

Subacute Sclerosing Panencephalitis 

Term

 

-Poliovirus

-affects motor neurons of the anterior horn cells of the spinal cord & cranial nerve nuclei

-damage to entire motor unit 

 

Definition

 

 

Polyomyelitis 

Term

-Hyperexcitable NS

-hypersensitivity to sensory input

-exaggerated motor responses and convulsions

-Hypercontraction of the pharyngeal muscles leads to inability to swally food/water (hydrophobia)

Definition

 

 

RAbies 

Term

 

Inclusion bodies in Rabies?

Definition

 

Negri Bodies 

(eosinopholic w/in cytoplasm of neurons; esp. in Purkinje cells of the cerebellum & neurons of the hippocampal region of temporal lobe)

Term

-AIDS-Dementia

-mild atrophy & ventricular dilation

- minimal lymphocytic infiltrate

-glial/microglial nodules 

-multinucleated giant cells 

Definition

 

HIV Meningoencephalitis (Subacute Encephalitis)

Term

 

-cerebral palsy-like S/Os

-Calcifications of blood vessels in basal glanglia & cerebral white matter

-Delayed demyelination

-Multinucleated giant cells in parenchyma 

Definition

 

AIDS in children

Term

 

 

What is a frequent CNS neoplasm seen in HIV/AIDS

Definition

 

Primary Malignant Lymphoma of the CNS

Term

 

-multiple, ring-enhancing lesions w/ central necrosis

-rings of acute & chronic inflammation & macrophage activity

Definition

 

CNS Toxoplasmosis 

Term

-Acquired by swimming

-Naegleria species

-fulminating infection & rapid death

-chronic, granulomatous meningoencephalitis 

-organisms look like macrophages 

Definition

 

Amebic Meningoencephalitis 

Term

 

-larvae of the tapeworm Taenia solium

-multiple cysts w/in the brain

-South America 

Definition

 

Cysticercosis 

Term

 

 

Transmissible Spongiform Encephalopathies 

characterized by 

Definition

 

prion protein in gray matter --> neuron and processes affected --> destabilization of cell body cytoplasm & dendrites --> optically empty vacuoles --> microscopic spongiform change in neurons at all levels of gray matter

Term

 

 

Do prion proteins contain DNA or RNA? 

Definition

 

NO, but it is infectious and transmissible to other animals 

Term

 

The abnormal prion protein has a configuration change from the normal alpha-helix to ________,

which is resistant to ____________

Definition

 

beta-pleated, protease digestion 

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