44 CNS Infections

Cryptococcus

  • thick capsule evade immune system

  • meningitis

  • Egyptian crypt for cryptococcus

  • coffins: Yeast are round and heavily encapsulated

  • repeating pattern on coffin: Cryptococcus capsule has a repeating polysaccharide capsular antigen. Main virulence factor for antiphagocytes

  • NH3 spray bottle: Urease positive

  • pigeons with droppings. Archaeologists coughing: Cryptococcus is inhaled from soil and/or pigeon droppings. Settles in lungs

  • cane: Immunocompromised (HIV)

  • different from bacterial (abrupt onset)

  • important: raise ICP, risk of herniation

  • archaeologists coughing: Pulmonary Crypto causes cough and dyspnea

  • Neck brace: Can cause cryptococcosis, a fungal meningitis. Most common cause of fungal meningitis

  • sweating: fever

  • frogs, pinecone, with flute: flucytosine/amphoterecin B joint treatment with maintenaince fluconazole

  • soap bubbles on lung: Diagnose with a microscopic exam of bronchopulmonary washing

  • red and silver stripes: Diagnosis of pulmonary Crypto can be aided by mucicarmine or methenamine silver stain

  • vase with bubbling tar: India Ink test can diagnose Crypto meningitis with lumbar puncture/CSF. Background dark, transparent organism

  • latex gloves next to repeating patterns: Latex agglutination test detects polysaccharide capsular antigens and causes their agglutination

  • soap bubbles on head: Causes "soap bubble" lesions in gray matter

PML

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