Spectrum of Infectious diseases of the central nervous system

Congress:

ECR 2013

Poster Number:

C-2449

Type:

Educational Exhibit

Keywords:

Infection, Education, MR, CT, Neuroradiology brain, Pathology

Authors:

B. Alami, M. Jaffal, S. Bellakhdar, M. Maaroufi, I. Kamaoui, M. Boubou, N. Sqalli, S. Tizniti; Fes/MA

DOI:

10.1594/ecr2013/C-2449

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-2449

Fig. 2: Herpetic encephalitis: CT findings

Fig. 3: Herpetic encephalitis: MRI findings

Fig. 4: Herpetic encephalitis: MRI findings

Fig. 5: Herpetic encephalitis: MRI findings

Learning objectives

To offer a large overview about the different infectious processes involving central nervous system. To learn the different neuradiological patterns of this infectious processes.

Background

We report a retrospective study that evaluates 43 cases of Infections involving the central nervous system seen during three year- period from January 2009 to December 2011. Patients were admitted with variant clinical features: headache, vomiting, nausea, fever, seizures, neck stiffness, altered mental status and dementia. All our patients underwent brain CT scan and/or undergo brain MRI. All diagnoses were confirmed by biological and/or histopathological analysis and were confronted to clinical outcome of each patient.

Imaging findings OR Procedure details

The results that were obtained: (Fig.1) Herpetic encephalitis (n=10), tuberculosis (n=9), cystic echinoccosis (n=8), syphilis (n=7), neurobrucellosis (n=2), association tuberculosis and syphilis (n=1), Lyme disease (n=1), toxoplasmosis (n=1), cryptococcal infection (n=1), amebiasis (n=1), progressive multifocal leukoencephalopathy (n=1), Creutzfeld-Jakob disease (n=1). HERPETIC ENCEPHALITIS Clinical presentation Non-specific : fever, headaches, focal neurological deficits, seizures, and altered or decreased level of consciousness. Diagnosis is established with PCR of CSF, although the combination of clinical scenario, CSF demonstrating pleocytosis and elevated protein, and appropriate Imaging is usually highly suggestive...

Conclusion

Imaging abnormalities in Infections diseases of the central nervous system are variable and may mimic inflammatory or metabolic disorders. Combining the imaging findings with clinical history and biological tests is required for diagnosis of infectious diseases of the central nervous system.

References

1) M. Walid Al-Sous, Saeed Bohlega, M. Zuheir Al-Kawi, Jehad Alwatban, and Donald R. McLean. Neurobrucellosis: Clinical and Neuroimaging Correlation. AJNR Am J Neuroradiol 25:395–401, March 2004 2) Alice B. Smith and al, Central Nervous System Infections Associated with Human Immunodeficiency Virus Infection: Radiologic-Pathologic Correlation. November 2008 RadioGraphics, 28, 2033-2058. 3) Rajan Agarwal and al, Neuro-Lyme Disease: MR Imaging Findings. October 2009 Radiology, 253, 167-173 4) AG . OSBORN et al. Diagnostic imaging brain. 1ST ED. Salt lake city. Amirsys. 2004 5) MG Harisinghani et...