Infections Morphology Clinical Laboratory Findings Disease Pathogenesis Manifestation Microscopic Macroscopic Generally viral in origin Usually no abnormalities can be No distinctive Less fulminant, and CSF findings Echovirus found changes can be usually self-limiting Increased in pressure Acute Coxsackievirus Sometimes mild to moderate seen on the brain Clear color lymphocytic infiltration of the Sometimes, brain Nonparalytic poliomyelitis Increased numbers of Aseptic Leptomeninges appears Sometimes can be non-viral in Lymphocytes Meningitis edematous origin (drug-induced) Slightly increased NSAIDs protein Antibiotics Normal glucose level Smear and culture Nervous system tropism General characteristics General characteristics appear negative for Almost invariably Certain virus affects certain Perivascular and parenchymal bacteria with meningeal cells mononuclear infiltration inflammation Lymphocytes Others have preference Plasma cells towards particular area of the brain Macrophages Sometimes with the Temporal lobe/ limbic Gliosis with/out nodules involvement of the system Neurophagia spinal cord Herpes simplex Nuclear/cytoplasmic inclusion Capacity of latency bodies can be found Herpex Simplex Varicella-zoster may remain Herpex Simplex Encephalitis Encephalitis dormant at the dorsal root Large eosinophilic intranuclear Petechiae are seen ganglia inclusion on the Temporal It may also follow an immune Rabies lobe mediated disease pathway Negri bodies Rabies This has no evidence of Round to oval in shape Intense edematous Viral brain direct viral invasion Eosinophilic cytoplasmic Vascular Encephalitis For example Acute inclusion congestion Disseminated Encephalitis Found in Intrauterine infection Neurons in May lead to congenital Hippocampus malformation Pyramidal cells of May follow a slowly the Cerebellum degenerating disease CMV Postencephalitic Owl eyes Parkinsonism Intranuclear and cytoplasmic inclusion Measles Warthin Finkeldey Bodies in Subacute Sclerosing Panencephalitis (SSPE) JC Virus Progressive Multifocal Leucoencephalopathy (PML)
Infections Disease Pathogenesis Morphology Clinical Manifestation Laboratory Findings Microscopic Macroscopic Acute Aseptic Meningitis Generally viral in origin Echovirus Coxsackievirus Nonparalytic poliomyelitis Sometimes can be non-viral in origin (drug-induced) NSAIDs Antibiotics Usually no abnormalities can be found Sometimes mild to moderate lymphocytic infiltration of the Leptomeninges No distinctive changes can be seen on the brain Sometimes, brain appears edematous Less fulminant, and usually self-limiting CSF findings Increased in pressure Clear color Increased numbers of Lymphocytes Slightly increased protein Normal glucose level Smear and culture appear negative for bacteria Viral Encephalitis Nervous system tropism Certain virus affects certain cells Others have preference towards particular area of the brain Temporal lobe/ limbic system Herpes simplex Capacity of latency Varicella-zoster may remain dormant at the dorsal root ganglia It may also follow an immune mediated disease pathway This has no evidence of direct viral invasion For example Acute Disseminated Encephalitis Intrauterine infection May lead to congenital malformation May follow a slowly degenerating disease Postencephalitic Parkinsonism General characteristics Perivascular and parenchymal mononuclear infiltration Lymphocytes Plasma cells Macrophages Gliosis with/out nodules Neurophagia Nuclear/cytoplasmic inclusion bodies can be found Herpex Simplex Encephalitis Large eosinophilic intranuclear inclusion Rabies Negri bodies Round to oval in shape Eosinophilic cytoplasmic inclusion Found in Neurons in Hippocampus Pyramidal cells of the Cerebellum CMV Owl eyes Intranuclear and cytoplasmic inclusion Measles Warthin Finkeldey Bodies in Subacute Sclerosing Panencephalitis (SSPE) JC Virus Progressive Multifocal Leucoencephalopathy (PML) General characteristics Almost invariably with meningeal inflammation Sometimes with the involvement of the spinal cord Herpex Simplex Encephalitis Petechiae are seen on the Temporal lobe Rabies Intense edematous brain Vascular congestion
central-nervous-system-infections.docx