# 44 CNS Infections

![](https://f001.backblazeb2.com/file/wikiFiles/X3VIjAi.jpg)

## Cryptococcus

![](https://f001.backblazeb2.com/file/wikiFiles/xq86Z8d.jpg)

* thick capsule evade immune system

![](https://f001.backblazeb2.com/file/wikiFiles/vJwlXyi.jpg)

* meningitis

![](https://f001.backblazeb2.com/file/wikiFiles/U3kgE8S.jpg)

* 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)

![](https://f001.backblazeb2.com/file/wikiFiles/PHJvhfc.jpg)

* different from bacterial (abrupt onset)
* important: raise ICP, risk of herniation

![](https://f001.backblazeb2.com/file/wikiFiles/U3kgE8S.jpg)

* 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

![](https://f001.backblazeb2.com/file/wikiFiles/k37Euim.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/BYRltcb.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/U3kgE8S.jpg)

* 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

![](https://f001.backblazeb2.com/file/wikiFiles/Q2cMsbR.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/UTA1OS6.jpg)

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

## PML

![](https://f001.backblazeb2.com/file/wikiFiles/Rcolq3t.jpg)


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