CNS Infections

Frontal Lobe
- Rheed malformation
o Excised : incomplete margins
o Benign
o Regular MRI
- Woke up severe headache
- Febrile
- Blood Cultures weren’t clear?
- Platelets slightly down
- Lumbar Pucnture :
o Total WCC : 3040
 2880 polymoph + rem lympahocytes
 protein ???
- Bacterial Meningitis
- Rx IV antibiotics
- Neisseria Meningitis
- Strep Pneum adults
- Haem Influenzae
o Ceftriaxone + Pencillin
70yo Mlae
- History confusion
- Not feeling well day
- Vesicular rash down left arm
- Viral Meningitis : herpes Zoster PCR
Case 1 from slide :

CNS INFETIONS
- Virus
- Bacteria
- Fungi
- Protozoa
- Helminths
- Non-Infectious can MIMIC infections
o Neiplastic
o Intracranial tumours and cysts
o Medications
o Collagen Vasuclar diseases
- Clinical Presentation : Acute, Subacute, Chronic
- Depends on pathogenesis, host and area involved
- MOST COMPLAINSTS : fever, headache, alt mental state/focus naeurological deficits
Meningitis
- Doesn’t like light cand can’t move head
- More than 6 WCC in CSF they have inflammation
- Usually sen in infancy and childhood but all throughout life
- Going up in incidence because meningitis serotype has changed
- Pathogenesis
- Zoster Virus rash
- Asplenia : spleen keeps encapsulated organisms
o Make sure these patients are adequately vaccinated
- Classic Symptosm : fever headache, stiff nekc
- Kneck Stifffnes : chin on chest
- Knee pain when extending and thigh flex
- Brudziski’s Neck Sign : legs bend up as well
- Lumbar Puncture Complciations
o Headache
o Traumatic Tap
o Brain stepm sign s: apathy, reduced reps – need to know what these are
- NEJM Lumbar Puncutre Video
- Exam Question : lumbar puncture layers pass through to reach nerve roots (from
NEJM video