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Related Concept Videos

Viral Meningitis01:18

Viral Meningitis

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Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

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Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
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Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

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Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
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Encephalitis l: Introduction01:19

Encephalitis l: Introduction

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Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
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Atypical Pneumonia01:14

Atypical Pneumonia

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Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease...
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Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

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A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
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Infectious meningitis with atypical cerebrospinal fluid cells.

J C García-Moncó1, M G Beldarrain, I Zabalza

  • 1Department of Neurology, Hospital de Galdacano, 48960 Galdacano, Vizcaya, SpainDepartment of Pathology, Hospital de Galdacano, 48960 Galdacano, Vizcaya, Spain.

European Journal of Neurology
|November 29, 2013
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Distinguishing neoplastic from reactive cells in cerebrospinal fluid (CSF) is challenging. This study highlights that atypical lymphocytes in CSF can stem from infections like meningitis, not necessarily cancer, guiding appropriate treatment.

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Area of Science:

  • Neurology
  • Cytopathology
  • Infectious Diseases

Background:

  • Cytologic evaluation of cerebrospinal fluid (CSF) poses diagnostic challenges in differentiating neoplastic from reactive cells.
  • Non-neoplastic conditions can present with atypical cells in CSF, necessitating careful clinical consideration to prevent overtreatment.

Purpose of the Study:

  • To report cases of cytologically atypical lymphocytes in CSF due to infectious meningitis.
  • To emphasize the importance of distinguishing reactive cellular changes from neoplastic processes in CSF analysis.

Main Methods:

  • Case series involving three patients with infectious meningitis (Herpes zoster virus and neuroborreliosis).
  • Cytologic examination of CSF.
  • Further characterization using histochemical, immunocytochemical, and cellular genome analysis techniques.

Main Results:

  • Two patients diagnosed with Herpes zoster virus meningitis and one with neuroborreliosis presented with atypical lymphocytes in CSF.
  • Detailed analysis confirmed the pleocytosis in these patients was of reactive origin, not neoplastic.
  • Cytomorphology alone was insufficient for definitive diagnosis in these cases.

Conclusions:

  • Atypical lymphocytes in CSF can be indicative of infectious processes such as meningitis.
  • Advanced diagnostic techniques beyond basic cytomorphology are crucial for accurate differentiation between reactive and neoplastic cells.
  • Correctly identifying reactive cellular changes prevents unnecessary and aggressive therapies.