[Microbiology] Atlas of Infections of the Central Nervous System

Atlas of Infections of the Central Nervous System, Infections of the Central Nervous System, Textbook of Diagnostic Microbiology 4th edition 2011, Connie R. Mahon, Donald C. Lehman and George Manuselis, tuyenlab.net, atlas for medical

Fig 1. Components of the central nervous system (CNS) and flow pattern of
cerebrospinal fluid (CSF).

Fig 2. Direct smear of the cerebrospinal fluid (CSF)
from a high-school student showing clusters of gramnegative diplococci consistent with Neisseria meningitidis within polymorphonuclear leukocytes. Note the increased
cellularity of the smear in this cytocentrifuge preparation.
Gram stain; high-power view.

Fig 3. Direct smear of acute bacterial meningitis in
an adult showing the lancet-shaped, gram-positive diplococci
characteristic of Streptococcus pneumoniae. The
polysaccharide capsule produces a prominent “halo” around
organisms. Gram stain; noncytocentrifuge preparation;
high-power view.

Fig 4. Direct smear of posttraumatic, acute bacterial
meningitis showing numerous intracellular and extracellular
gram-negative bacilli with the prominent capsules
characteristic of Klebsiella pneumoniae. Gram stain;
cytocentrifuge preparation; high-power view.

Fig 5. Direct smear of cerebrospinal fluid (CSF) from
a newborn delivered to a woman with amnionitis secondary
to premature rupture of the membranes. Numerous short,
gram-negative bacilli in chains consistent with a Bacteroides
sp. are seen. The organism could easily be confused with
a Streptococcus sp. if the Gram stain was improperly
decolorized. Gram stain; noncytocentrifuge preparation;
high-power view.

Fig 6. Cytocentrifuge preparation of cerebrospinal
fluid (CSF) in a case of “aseptic” meningitis. Lymphocytes are
present, and in this case the background is bloody. No
organisms are seen; Wright stain.

Fig 7. Cytocentrifuge preparation of cerebrospinal
fluid (CSF) in meningitis resulting from tularemia. Reactive
lymphocytes with “monocytoid” features are the only clue
that this is not a viral infection. No organisms are seen.
Cultures were positive; Wright stain.

Fig 8. Cytocentrifuge preparation of cerebrospinal
fluid (CSF) showing a single yeast with narrow-based
budding and prominent surrounding capsule characteristic of
Cryptococcus neoformans. Cryptococcal meningitis in
partially immunocompetent hosts may show only rare
organisms mixed with an inflammatory background of
lymphocytes, monocytes, and eosinophils. Wright stain;
high-power view.

Fig 9. In contrast, cryptococcal meningitis in
immunosuppressed hosts may show numerous organisms and
scarce or absent inflammation. Notice the variation in size,
variable Gram staining, and narrow-based budding. The
organisms are evenly spaced because of their abundant
polysaccharide capsules. Gram stain; cytocentrifuge
preparation; medium-power view.

Fig 10. Touch preparation of brain tissue showing
typical “floret” of Toxoplasma gondii trophozoites. The
organisms are not typically seen in preparations of
cerebrospinal fluid. Wright stain; high-power view.

Fig 11. Direct smear of aspirated brain abscess
contents. Clusters of intracellular gram-positive cocci in
groups are consistent with microaerophilic streptococci.
Gram stain; noncytocentrifuge preparation; high-power
view.

Fig 12. Lumbar puncture. The cerebrospinal fluid is
obtained by inserting a long, sterile, hollow needle into the
spinal subarachnoid space in the lumbar region.

Fig 13. This photomicrograph shows a magnified
view of brain tissue within which is a centrally located
Acanthamoeba sp. cyst.

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