Clinical Reasoning Crossword: Meningoencephalitis
Introduction
Meningoencephalitis means the “inflammation” of the meninges and the brain (enkéfalos in the Greek language). The origin is usually an infection associated with a bacteria, a virus or a fungus, and in this sense we brought the term here.
A meningeal infection is not always associated with a cerebral involvement, but the opposite, a brain infection is more or less accompanied with some meningeal involvement, mainly in the skull base.
Objectives
We want to introduce here a Crossword based in three clinical entities that can involve the brain, some of them are more prone to a predominant cerebral involvement, but others to a meningeal preference.
The objective of this Crossword is to complete the cells with the “most probable answer” for every situation, without looking for a complete description of the clinical picture, but to fix some particular concepts of each disease based on the Illness Script Structure.
You can access the crossword HERE
These are the definitions that have to be included in every cell of the Crossword (choose the order):
- TIME: 1A)Subacute 1B) Acute 1C) Chronic *(when no previous suspiction)
2. KEY CLINICAL DATA
.2A) Confusion, nausea, vomiting, stiff neck, Visual deficit, Hearing loss
.2B) Rhombencephalitis, Focal neurological deficit, cranial nerve palsies
.2C) Fever, vomiting, headache, Focal neurological deficit, cranial nerve palsies
EPIDEMIOLOGY
.3A) Contaminated food in immunocompetent
.3B) Previous infection, known or unknown, High clinical suspicion
.3C) Previous exposure and immunodeficiency
CSF(Cerebrospinal Fluid characteristics)
4A) Pleocytosis, Lymphocytosis, Low Glucose (mild)
4B) Pleocytosis, Lymphocytosis, Low Glucose (mild)
4C) High WBC, High proteins, + VDRL test
(WBC: White Blood Cells) VDRL: Venereal Disease Research Laboratory test)
ANSWER TO THE CROSSWORD HERE
Author: Dr. Lorenzo Alonso Carrión
FORO OSLER
