Meningitis vs. Encephalitis

[acciddropping]

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Several fungal CNS infection cause meningeoencphalitis so is there a good way to differentiate what causes meningitis vs encephalitis?

For example, in FA - for meningitis in HIV patients, they also included Toxo and JCV/ CMV
I thought that C. neoformen and HSV2 were the only two that cause meningitis and the rest caused the encephalitis or some kind of brain infection- Are these fine lines important or is that something examiners go after?

Thanks.

 

[NeuroLAX]

I never had to differentiate the two on UWorld. HSV2 also causes temporal encephalitis.

In his audio series Goljan likes to make a difference between the two highlighting the typical meningitis s/sx vs change in mental status for encephalitis.

 

[acciddropping]

I never had to differentiate the two on UWorld. HSV2 also causes temporal encephalitis.

In his audio series Goljan likes to make a difference between the two highlighting the typical meningitis s/sx vs change in mental status for encephalitis.

Where did you see that HSV2 causes temporal encephalitis? In the FA, it lists HSV2 under menigitis and then in parenthesis it says (HSV1 encephalitits) - I think I also saw a Q on HSV1 that causes encephalitits.

 

[macstjo]

10% caused by HSV-2, Wikipedia

 

[NeuroLAX]

Where did you see that HSV2 causes temporal encephalitis? In the FA, it lists HSV2 under menigitis and then in parenthesis it says (HSV1 encephalitits) - I think I also saw a Q on HSV1 that causes encephalitits.

I think I came across it in DIT. It looks like most cases are caused by HSV1. I doubt you'd have to differentiate HSV1 vs 2 encephalitis.

 

[Enzymes]

HSV2 is temporal encephalitis in INFANTS. Reason is that HSV2 is passed during vaginal delivery. HSV1 is temporal encephalitis in adults. But there are obviously rare exceptions.

 

[acciddropping]

HSV2 is temporal encephalitis in INFANTS. Reason is that HSV2 is passed during vaginal delivery. HSV1 is temporal encephalitis in adults. But there are obviously rare exceptions.

makes sense.. txks 🙂

 

[thehundredthone]

Several fungal CNS infection cause meningeoencphalitis so is there a good way to differentiate what causes meningitis vs encephalitis?

Not really. A lot of the organisms that cause meningitis can possibly go on to cause meningoencephalitis. Although usually viruses are more likely to cause encephalitis than meningitis, like NeuroLAX said, you won't have to differentiate the two from this perspective.

You will have to differentiate a case of meningitis from encephalitis though, and the main clinical feature to look out for is seizures/altered mental status in encephalitis (and nuchal rigidity in meningitis). Of course, the patient may have meningoencephalitis in which case both features may be present.