PHYS 799 Lecture Notes - Lecture 57: Venezuelan Equine Encephalitis Virus, Altered Level Of Consciousness, Aseptic Meningitis
12 Jun 2019
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Meningitis = meninges (headache, nuchal rigidity), encephalitis = brain (altered mental status, seizures, focal neuro deficits), myelitis = spinal cord (flaccid paralysis, sensory loss) Entry direct inoculation (e. g. trauma), systemic illness and entry thru bbb, direct infection of neural tissue and spread to brain, spread from contiguous sites (sinuses, eyes) Organisms can cross bbb by hijacking the cytokine response which allows leukocytes to cross. Lumbar puncture is gold standard culture for bacteria/gram stain, measure opening pressure, glucose, and protein (review week 8 for lp results) Aseptic meningitis = meningitis/meningoencephalitis where no bacteria are isolated from csf. Key things to ask for on history: bites, animal exposures, travel, medications. Etiologies: bacteria that do not grow on standard media, antibiotics prior to lp, viruses, fungi, parasites, non-infectious causes. Pre-treated bacterial meningitis will still have low glucose, high protein, neutrophils in csf. Viral will have normal glucose, high protein, lymphocytes in csf.
