liveonearth (liveonearth) wrote,

Brain Infections (Neuro lecture week 10 Dr Thom)

*pearl: gut flora decr after age 50 causes decrease in immune function in elderly
*drT gives vit A protocol for chronic viral infx too

meningitis, encephalitis, myelitis
meningoencephalitis, meningomyelitis, encephalomyelitis
brain abscess

taenia solium
rock mtn spotted fever

strep penumoniae (children 1mo to 4 yrs and elders)
neisseria meningitidis (college students, diplococci)
haemophilus influenzae (infants, newborns, also E coli, strep agalactiaea)
groups B and A strep

WBC over 10000 in bact, under that in all other causes
RBC over 100 in encephalitis, under that in all other
glucose normal in viral, abscess, low in bact, chronic, N to low in encephalitis
prot under 200 in viral, over 200 in all other
gram stain + in bact only
ctyology + in neoplasm, fungal only
OP <170 in CSF, over 300 bact, 200 mm viral and neoplasm

devastating illness, rapid progression
how do you tell this from the flu?
a matter of severity and degree, difficult to deduce in children, babies
this very common in the Pacific NW
SX: classix sx of meningococal dz
early sx: skin pale blue, pale or dusky around lips, severe lag pain, cold hands or feet with high temp
babies: soft spot mb tense or bulge, can't wake up, if rash appears it is life threatening, moves fast
severe headache
altered LOC, drowsiness, confusion
phono and photophobia
stiff neck, siezure
high fever, vomiting
rapid breathing
trunk rash, petechiae, bad prognosis
joint/muscle/stomach pain
PE: tenting, check for dehydration, cool feet, higher up leg coolness = more dehydrated
DX: CBC, lumbar px, cat scan (funny image: cat scan and spinal tap)
ND TX: refer if you have any suspicion a meningitis mb bacterial, do not wait
TX when advanced (rash becomes severe): IV ABX and amputation of affected extremities
IV ABX started long before culture grows anything, hydration is also key
Sequellae: sensorineural hearing loss, cognitive impairment, gait problems, poor memory, death

less severe, may resolve without tx, hospital will send home
TX: hydrotherapy--induce fever, relaxation, COPs to activate immune system
vit A protocol: 500,000IU/day x3d, then 125,000 for 3d, then 60,000 until better
vit A OD sx: headache, nausea, liver pain, dry itchy skin, later: hair loss, dry mouth
tx for OD: drink ample H2O and open all emunctories, support liver (silybum, lipotropics), gall flush
Tx: antivirals: lomatium, ZACES, garlic
hydration, sleep
immune support products: EHB, echatin forte, bio veg, immunogen
toxic herbs: acon, bell, bry, gels, lobelia, physostima venenosum, rhus, veratrum (drop doses)
herbs: passiflora for convulsion
Tags: brain, microbes, nd4

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