Bacterial, viral, protoozal and fungal infections of the CNS Prof. Isidro Ferrer, Institut Neuropatologia, Servei Anatomia Patològica, IDIBELL-Hospital Universitari de Bellvitge, Universitat de Barcelona, CIBERNED, Hospitalet de LLobregat; Spain
Ramon Casas, original for the poster Andrew Wyeth, Cristina s world (poliomyelitis)
Meningococcal meningitis B C A Purulent meningitis (A) and ventriculitis (B) with inflammatory infiltrates in the subarachnoid space (C) mainly composed of neutrophils (D) D
Meningococcal meningitis; meningeal vasculitis
Purulent meningitis and infarction of the MCA Purulent meningitis with associated purulent vasculitis of the middle cerebral artery (MCA) and massive infarction of the territory of the MCA
Focal acute septic encephalitis secondary to purulent otitis Haemorrhagic necrosis and perivascular inflammatory infiltrates
Whipple disease, cerebral involvement Multiple necrotic lesions in the basal ganglia, hippocampus and temporal lobe. Necrotic areas are filled with macrophages with PAS positive granular inclusions composed of cellular debris and bacteria
Whipple disease Multiple necrotic lesions in the basal ganglia. Necrotic areas are filled with macrophages with PAS positive granular inclusions
Cerebral abscess Vascularization of the capsule
Tuberculous meningitis Tuberculous meningitis and cerebral infarction due to vasculitis and occlusion of the meningeal blood vessels. Inflammatory infiltrates contain giant cells of Langhans (arrows)
Cerebral tuberculoma Langhans cell Poor vascular network in the capsule
Actinomycotic abscess Sulphur granule
Nocardiosis Nocardia asteroides in a cerebral abscess
Chronic hypertrophic meningitis A B Dense infiltrate of lymphocytes in the meninges (A) and hypertrophy of cortical blood vessels (B)
Viral encephalitis A B C Perivascular infiltrates of lymphocytes (A), microglial nodules and neuronophagia (B, C)
Herpetic necrotizing encephalitis: HSV-1 B C A Encephalitis mainly involves the orbitary cortex and temporal lobes (A). Perivascular infiltrates of lymphocytes (B); and intranuclear inclusions and cytoplasmic deposits immunostained with anti-herpes virus antibodies
Herpetic encephalitis Involvement of the temporal pole, temporal lobe, insula and hippocampus (arrows)
Herpetic necrotizing encephalitis: HSV-1 Involvement of the temporal lobes. Intranuclear inclusions and cytoplasmic deposits immunostained with anti-herpes virus antibodies
Cytomegalovirus A B Periventricular involvement (A, B). Large intranuclear inclusions in the periventricular glia (C). Large intranuclear inclusions, often multiple, in the retina (D) C D
Acute anterior poliomyelitis B D A C E Distribution of lesions in the spinal cord (A); subacute stage with macrophages filed with neutral lipids (B and C); chronic stage: loss of motor neurons in the anterior horn and aberrant remaining motor neurons (D, E): post-polio
Human immunodeficiency virus-1: HIV-1 retrovirus HIV-1 encephalitis with infiltration of lymphocytes, microglial nodules, and small foci of demyelination
Paediatric HIV-1 infection A B C D E Brain calcifications in the cortex and basal ganglia (A, C). Generalized encephalitis with microglial nodules (D) and rare multinucleated cells (E)
Progressive multifocal leukoencepaholopathy, polyomavirus virus JC B A C D Multiple foci of demyelination in the cerebrum (A, B, arrows), aberrant astrocyte (C), and positive glial cells to specific JCV probe by in situ hybridization (D)
Progressive multifocal leukoencepaholopathy, polyomavirus virus JC Multiple confluent demyelinating lesions in the white matter of the cerebrum, cerebelllum and brain stem
Progressive multifocal leukoencepaholopathy, polyomavirus virus JC Foci of demyelination in the white matter of the cerebellum and pons (A). Bizarre glial cells with nuclear inclusions (B, C). Positive in situ hybridation for JCV (D) A C B D
Subacute sclerosing panencephalitis, measles virus B A C Reduced cortical thickness and myelin pallor (A). Intranuclear and cytoplasmic inclusions composed of packed tubules (B, C)
Toxoplasmosis B A Bilateral mass lesions with necrosis (A). Toxoplasma gondii in the vicinity of the lesions (B)
Multiple necrotic lesions caused by embolism of Aspergillus PAM staining. Fungi in the lumen of the vessels, in the vessel walls and in the cerebral parenchyma
Multiple necrotic foci due to Monosporium infection Methenamine silver staining PAM
Candidiasis
Cerebral mucormycosis A B Mucor sp, HE (A), PAM staining (B)
Cryptococcosis Clear cyst lesions in the striatum. Cryptoccocal yeasts in the cysts with no inflammation
Cryptococcosis Cryptococcus clear yeasts in cystic lesions
Cysticercosis, larvae of Taenia solium Several cysts located in the ventricle, cerebral parenchyma and cerebellum