eye an CNS

how important are CNS infections

critical emergency

what are the inner cover of the brain called

meninges made of dura mater, arachnoid, and Pia mater

what is the most common route of CNS infection

hematogenous: blood stream

what is the least common rout of CNS infection

nerves like rabies or HSV

what are the 3 portal of entries for CNS infection

hematog: blood

respiratory

ottic: ear

what are the major diseases of CNS

meningitis

encephalitis

abscess

what is meningitis

infection in subarachnoid space

purulent and asepticw

what is purulent meningitis

acute inflammatory response

large PMN, WBC, macrophages, and bacteria

pus

what is aseptic meningitis

increase lymphocytes and viruses

stiff neck

how do bacteria enter the CNS; how is the CNS weak enough for entry

disrupt tight junctions

transport within phagocytic cells

use endothelial vacuoles

what do you usually see in acute meningitis

fever, stiff neck, mental status, neuro issues

CSF has inflammatory cells

lower glucose CSF to serum level

increase protein level

what do you usually see in chronic meningitis

same as acute symptoms but also month or more

who are most affected by meningitis

kids under 5

what bacteria cause meningitis

H. influenza B but vaccine reduced it

Nisseria mening

strep pneumonia

what causes neonate meningitis

B strep

E. coli

L. moncytogenes

what bacteria causes acute meningitis for infants

B strep

S. pneumonia

L. monocytonges

H. influenza

what bacteria causes acute meningitis for kids

n. meningitis

S. pneumonia

H. influenza

what causes adult meningitis

staph aureus

s pneumococci

L. moncytogenes

what bacteria causes acute meningitis for teens

n. meningitis

what bacteria causes chronic meningitis

M. tb

neofrormes

nocardia

actinomyces

Treponema pallidum

brucella

salmonella

what is encephalitis

inflammation of brain parenchyma usually from virus caused by enterovirus, mumps, and HSV

what is it called if you have meningitis and encephalitis

meningoencephalitis

what time of year is encephalitis common

warmer months

what specimen is needed to diagnose CNS issues

lumbar puncture for CSF gets 5-10ml in 4 tubes

how are the CSF tubes used

tubes 1 and 2: micro and chem

tubes 3 and 4: cell count and diff

tubes 1 and 2 usually have more RBC

never refrigerate

what do you do with CSF larger than 1ml

centrifuge 15min

remove supernatant but leave .5ml for sediment

gram stain sediment

chocolate, BAP, and enrichment culture in 5-10% CO2 for 72hr

if there is a brain abscess, how do you culture

anaerobic culture

what is the appearance of CSF of acute meningitis

clear/turbid

what is the protein of CSF of acute meningitis

greatly increased

what is the glucose of CSF of acute meningitis

greatly reduced

what is the cell count of CSF of acute meningitis

greatly increased with PMN

what yeast causes meningitis

crytococcus neoformes

staph aureus can streak on BAP with satelliting. what is causing it

H. influenza

what is normal flora in eye

staph epidermis

lactobaccilus

proprion acnes

what is blepharitis

eyelid edges infection

what is conjunctivitis

conijunctiva infection

what is keratitis

cornea infection

what is keratoconjunctivitis

cornea and conjunctiva

what is endophthalmitis

aqueous or vitreous humor infection

what pathogens cause conjunctivitis

S. pneumonia

h. influenza

staph aerues

Chlamydia. trachomatis

n. gonneorrhea

S. pyogenes

adenovirus

what causes keratitis

s. aureus

s. pneumonia

p. aeruginosa

HSV

fungi

what causes endophtalmaitis

S. aueres

s. pneumonia

p. aeruginosa

other strep

yeast candida