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Questions and Answers
Which of the following conditions is characterized by inflammation of both the brain and the meninges?
Which of the following conditions is characterized by inflammation of both the brain and the meninges?
What is a significant difference between septic meningitis and aseptic meningitis in terms of CSF appearance?
What is a significant difference between septic meningitis and aseptic meningitis in terms of CSF appearance?
Which organism is associated with causing meningococcal meningitis?
Which organism is associated with causing meningococcal meningitis?
What is the primary transmission method for Neisseria meningitides?
What is the primary transmission method for Neisseria meningitides?
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Which of the following bacteria is known to commonly present in the normal flora of the throat and can cause bacterial meningitis?
Which of the following bacteria is known to commonly present in the normal flora of the throat and can cause bacterial meningitis?
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What is a critical factor in the pathogenesis of bacterial meningitis that differentiates it from viral meningitis?
What is a critical factor in the pathogenesis of bacterial meningitis that differentiates it from viral meningitis?
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Which of the following complications can occur as a result of untreated bacterial meningitis?
Which of the following complications can occur as a result of untreated bacterial meningitis?
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Which bacterial strain is primarily responsible for approximately 5% to 10% of bacterial meningitis cases in adults?
Which bacterial strain is primarily responsible for approximately 5% to 10% of bacterial meningitis cases in adults?
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What is a common symptom of Listeria meningitis?
What is a common symptom of Listeria meningitis?
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Which bacterium is responsible for causing tetanus?
Which bacterium is responsible for causing tetanus?
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What is true about polio infection?
What is true about polio infection?
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What type of meningitis is caused by a virus and is usually less severe than bacterial meningitis?
What type of meningitis is caused by a virus and is usually less severe than bacterial meningitis?
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Which of the following statements about botulism is correct?
Which of the following statements about botulism is correct?
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Which symptom is NOT associated with rabies infection?
Which symptom is NOT associated with rabies infection?
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What is the primary method of transmission of arboviral encephalitis?
What is the primary method of transmission of arboviral encephalitis?
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For which type of viral meningitis are mosquitoes considered potential vectors?
For which type of viral meningitis are mosquitoes considered potential vectors?
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Which type of encephalitis is characterized by a high mortality rate ranging from 3% to 30%?
Which type of encephalitis is characterized by a high mortality rate ranging from 3% to 30%?
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Study Notes
Nervous System Infections
- Infections can cross the blood-brain barrier during inflammation.
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Meningitis is inflammation of the meninges (the membranes surrounding the brain and spinal cord).
- Aseptic meningitis has clear cerebrospinal fluid (CSF) and is usually caused by viruses.
- Septic meningitis has turbid CSF and is usually caused by bacteria.
- Encephalitis is inflammation of the brain.
- Meningoencephalitis is inflammation of both the brain and the meninges.
- Neuromuscular junctions can also be targets for microbial infections or toxins.
Bacterial Infections
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Bacterial meningitis presents with nausea, vomiting, fever, headache, stiff neck, progressing to confusion, sleepiness, light sensitivity, potential convulsion, and coma.
- Early treatment is crucial to prevent neurological damage.
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Meningococcal meningitis is caused by Neisseria meningitides (gram-negative diplococcus).
- Asymptomatic carriers are common (20%).
- Transmission is person-to-person via respiratory droplets.
- Antibiotic therapy significantly reduces mortality (9-12% reduction).
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Haemophilus influenzae meningitis is caused by Haemophilus influenzae (gram-negative coccobacillus).
- Commonly a normal throat inhabitant.
- Vaccination has decreased incidence significantly in children.
- Causes 5-10% of bacterial meningitis in adults.
- Transmission is similar to N. meningitidis.
- Intravenous antibiotics are necessary.
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Pneumococcal meningitis is caused by Streptococcus pneumoniae (gram-positive diplococcus).
- Commonly carried in the throats of healthy individuals.
- A significant cause of otitis media and pneumonia.
- A conjugate vaccine exists.
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Listeria meningitis is caused by Listeria monocytogenes.
- Foodborne illness; can spread to the CNS.
- Affects the elderly and immunocompromised.
- Symptoms include fever, personality change, tremors, seizures.
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Tetanus is caused by Clostridium tetani neurotoxin (exotoxin).
- Characterized by prolonged muscle contractions and spasms.
- Spores are found in soil and animal feces.
- Infection occurs through wounds.
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Botulism is caused by Clostridium botulinum.
- Produces a potent neurotoxin (serotypes A-H).
- Occurs in various forms (foodborne, infant, wound, inhalation).
- Incidence is low, but mortality is high if not treated promptly.
Viral Infections
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Viral meningitis (aseptic meningitis) is relatively common and usually less severe than bacterial meningitis.
- It is spread via direct contact with infected feces or secretions. Mosquitoes can also transmit some viral meningitis.
- Symptoms include fever, headache, stiff neck, tiredness, rash, sore throat, vomiting.
- Resolves spontaneously due to immune response antibody production.
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Poliomyelitis is caused by the poliovirus.
- The virus replicates in the GI tract and sheds in feces.
- Person-to-person transmission through the oral-fecal route.
- Most infections are asymptomatic.
- In the United States, only inactivated polio vaccine (IPV) is routinely used.
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Rabies is a preventable zoonotic disease caused by the rabies virus.
- Typically causes acute encephalitis.
- Reservoirs include raccoons, skunks, foxes, coyotes and other animals and domesticated animals.
- Transmission occurs via saliva from an infected animal.
- Symptoms begin with fatigue, insomnia, muscle aches, headache, anxiety, nausea, vomiting, abdominal pain progressing to agitation.
- Pre- and post-exposure vaccination are key.
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Arboviral encephalitis is transmitted by vectors like mosquitoes and ticks.
- Multiple types exist (Eastern equine, Western equine, St. Louis, La Crosse, West Nile).
- Symptoms vary in severity.
- No readily available treatment or vaccines are available for most types.
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