It can be treated with appropriate antibiotics that also prevents spread. The pathogenesis of bacterial meningitis, including colonization of. Csf is usually hazy analysis of csf chemistries typically includes measurement of glucose and total protein concentrations. Encephalitis is an inflammation of the brain parenchyma, which may result in a more advanced and serious disease meningoencephalitis. Meningitis can be caused by a bacterial, fungal or viral infection.
In vitro infection of human nasopharyngeal cells in organ culture with meningococci or h. Meningitis is inflammation of the arachnoid and pia mater of the brain and spinal cord. Learn more about how you get meningitis, its symptoms, and how its treated at webmd. Meningitis is an infection of the membranes meninges surrounding the brain and spinal cord. Treatment of the subdural abscess consists of evacuation plus intravenous antibiotics. Your risk for bacterial meningitis is increased if you are. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. Treatment is with antibiotics and corticosteroids given as soon as possible. It is essential for clinicians to recognize the clinical signs and symptoms of meningitis and understand its management and prevention. Pathogenesis of bacterial meningitis is a complex process which may occur due to imbalance between the host immune response and virulence factors of pathogen causing infection. Meningitis is an infection of the meninges, the membrane covering the brain. A the inflammatory, coagulation, and fibrinolytic pathways are linked at many levels, leading to organ failure and eventually death. Unit 6 neural pathophysiology meningitis flashcards quizlet. Pathophysiology and treatment of bacterial meningitis olaf hoffman and joerg r.
New understandings on the pathophysiology of bacterial. Pathophysiology of meningitis and encephalitis meningitis and encephalitis are two similar infections of the central nervous system that often lead to fatality of the host organism. In general, meningitis caused by a virus is less serious than meningitis caused by bacteria. Meningitis is an inflammation of the tissue that covers the brain and spinal cord that can be caused by several different types of, as well as viruses and fungibacteria. Jul 16, 2019 meningitis is a clinical syndrome characterized by inflammation of the meninges. Pathophysiology of meningococcal meningitis and septicaemia. Most cases of bacterial meningitis originate from the host obtaining an infectious agent by nasopharyngeal colonization. Meningitis about bacterial meningitis infection cdc.
The role of caspase casp1 in the pathophysiology of pneumococcal meningitis has been the subject of recent experiments. Pathophysiology and treatment of bacterial meningitis. Bacterial meningitis may present acutely symptoms evolving rapidly over 124 hours, sub acutely symptoms evolving over 17days, or chronically symptoms evolving over more than 1 week. Despite the availability of bactericidal antibiotics with potent in vitro activity against the major meningeal pathogens, the morbidity and mor tality from bacterial. Bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention. Meningitis is caused by bacterial and viral organisms, although fungal and protozoal meningitis also occurs. Bacterial meningitis is the most common serious infection of the central nervous system. Children who develop bacterial meningitis must be treated swiftly to limit the risk of permanent neurological damage. The bacterium streptococcus pneumoniae is a common cause of meningitis in adults. The image below depicts acute bacterial meningitis. Cerebrospinal fluid is analyzed to determine the diagnosis and the type of meningitis. In order to improve prognosis of the infection, early diagnosis and prompt treatment are crucial to prevent mortality and the incidence of neurologic sequelae that cause longterm. Acute bacterial meningitis is rapidly progressive bacterial infection of the meninges and subarachnoid space. Meningitis is an acute bacterial infection of the meninges, which may affect the brain and lead to irreversible neurological damage and auditory impairment.
Cerebral spinal fluid csf is the fluid within the open spaces of the brain that protect and cushion the brain and. Meningitis, inflammation of the meninges, the membranes covering the brain and spinal cord. A head injury or head surgery may also spread the infection. Meningococcal disease what meningococcal disease is meningococcal disease is illness caused by the bacterium neisseria meningitidis, also known as meningococcal bacteria. Diagnosis, initial management, and prevention of meningitis. New therapies based upon an understanding of the pathophysiology are needed. In the past, hib was the most common cause of meningitis in children under five years of age. Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. Meningitis is a viral, bacterial, or fungal infection of the lining of the brain and spinal cord, the meninges. Meningococci reach the brain from the bloodstream, implying that the patients immune response has prevented bacterial proliferation in the blood and not suffered overwhelming sepsis. Neurological damage in meningitis may be caused by a mixture of direct bacterial toxicity, indirect inflammatory processes such as cytokine release, neutrophil activation, with resultant vasculitis, and cellular oedema. Fifty years after the advent of antibiotics for clinical use, bacterial meningitis remains an important cause of morbidity and mortality. As such, it represents a unique human infectious disease, b.
Neisseria meningitidis are bacteria that can cause meningococcal disease, a very severe form of meningitis andor blood infection. Bacterial meningitis is an inflammation of the meninges, including the pia, arachnoid, and subarachnoid space, that occurs in response to infection with bacteria andor bacterial products. Bacteria gains access to bloodstream, bacteria will have a capsule around it that helps it evade opsonization and complement it will mostly live or reside in the cerebral spinal fluid this is because it will have the most permeability through the bbb in order to get to the brain area. Pathogenesis and pathophysiology of bacterial meningitis. It is not known why one person gets meningitis when others exposed to the same germs do not get as sick, or dont get sick at all. Meningitis can occur when fluid surrounding the meninges becomes infected. Bacterial meningitis is a serious disease that can lead to paralysis, stroke, and even death. In bacterial meningitis research on genetic factors is lacking but may provide important pathophysiologic insights. In rare cases, however, the bacteria pass through the.
Essay on pathophysiology of meningitis and encephalitis. Many infectious agents, such as viruses, bacteria, and parasites, can cause inflammation of the central nervous system cns. Meningococcal meningitis generally has a better prognosis than septicaemia. About 15% of people carry these bacteria in their throats without getting sick. To establish accurate diagnosis and develop effective vaccines and drugs to overcome this disease, it is important to understand and. The meninges are the three membranes that cover the brain and spinal cord. Meningitis is usually caused by a bacterial or viral infection that invades the cerebral spinal fluid csf.
Meningitis can be the primary reason a patient is hospitalized or can develop during hospitalization. This axial nonenhanced computed tomography scan shows mild ventriculomegaly and sulcal effacement. Anyone experiencing symptoms of meningitis should see. Sep 12, 2018 staphylococcal meningitis affects the protective covering around your spinal cord and brain. Pathophysiology of bacterial meningitis international journal of.
Start studying unit 6 neural pathophysiology meningitis. Epidural and subdural abscesses are collections of pus. Emerging antibiotic resistance is an upcoming challenge. Bacterial meningitis is a complex disorder in which injury is caused, in part, by the causative organism and, in part, by the hosts own inflammatory response. Assessing whether a treatable cns infection is present in those. In persons who develop tbm, bacilli seed to the meninges or brain parenchyma, resulting in the formation of small subpial or. Even with appropriate treatment, morbidity and mortality can be substantial. Acute bacterial meningitis neurologic disorders msd. Ruling out meningitisencephalitis is a big headache it is okay to go out of order for diagnostics and treatment of suspected bacterial meningitis steroids before or with antibiotics pretend to know indications for when to ct a patient asepticfungal meningitis in special populations empirically treat encephalitis with acyclovir. Pneumococcal infections and meningococcal infections are the most common causes of bacterial meningitis.
Bacterial meningitis remains a disease with associated unacceptable morbidity and mortality rates despite the availability of effective bactericidal antimicrobial therapy. Some of the most common bacteria known to cause meningitis are described below. Both diseases occur when pathogens enter the blood stream and gain access into the central nervous system. Vision our collective vision is towards a world free of meningitis. Streptococcus pneumoniae and neisseria meningitidis.
Despite the availability of bactericidal antibiotics with potent in vitro activity against the major meningeal pathogens, the morbidity and mortality from bacterial meningitis remains unacceptably high. Meningitis can be caused by various infectious agents, including viruses, fungi, and protozoans, but bacteria produce the most lifethreatening forms. As a result, streptococcus pneumoniae and neisseria meningitidis are the major causes of bacterial meningitis in these regions. Following steps may explain the underlying process in a comprehensive way. The most common causes of meningitis are viral and bacterial infections. Bacterial meningitis is very serious because its onset is rapid and the infection is associated with a significant risk of death. Moore, specialist registrar in infectious diseases, and j. Feb 27, 2019 meningitis, especially which is caused by bacteria, is a life threatening condition and needs urgent treatment. Meningitis is an inflammation of the membranes that surround the brain and the spinal cord. Bacterial meningitis is very serious and can be deadly. The clinical features, treatment, prognosis, and prevention of bacterial meningitis in adults and children and issues related to chronic and recurrent meningitis are discussed separately.
Acute bacterial meningitis merck manuals professional edition. Findings typically include headache, fever, and nuchal rigidity. Nov 07, 2017 this feature is not available right now. No bacterial disease has undergone a more dramatic change in epidemiology during the past decade than acute bacterial meningitis. Determining the right treatment depends on identifying the infecting organism paediatric meningitis treatment of bacterial infection summary paediatric bacterial meningitis can be caused by a variety of different. Beyond the newborn period, the most common causes of bacterial meningitis are neisseria meningitidis, streptococcus pneumoniae, and haemophilus influenzae. However, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. Neonatal meningitis is often caused by group b streptococcus and is associated with prematurity, gestational age, postnatal age, and geographic region. Casp1 plays a central role in the generation of mature il1. B the coagulation and fibrinolytic pathways rely on the function of endothelial proteins and protein complexes. Meningitis can result from many causes, both infectious and noninfectious. Meningitis can be acute, with a quick onset of symptoms, it can be chronic, lasting a month or more, or it can be mild or aseptic.
Through the use of experimental animal models of infection, a great deal of information has been gleaned concerning the pathogenic and pathophysiologic mechanisms operable in. Animal models have proven to be extremely valuable in the study of the pathogenesis and pathophysiology of bacterial meningitis, with the hopes of providing new information that may lead to an. Mycobacterium tuberculosis bacilli enter the host by droplet inhalation. Much of the damage from this infection is believed to result from cytokines released within the csf as. Furthermore, a dramatic change in the epidemiology has resulted from these achievements such that the median age of onset of acute bacterial meningitis has increased from age 9 months to age 25 years in the united states 1. In bacterial meningitis, glucose transport from the blood into the csf is impaired. Acute bacterial meningitis neurologic disorders merck. The pathogenesis and pathophysiology of bacterial meningitis involve a complex interplay between virulence factors of the pathogens and the host immune response 48. Most children with viral meningitis recover completely.
The peripheral white blood cell count alone is not help. They are spread from an infected person to another by coughing, kissing, or sharing food or drinks. Sep 24, 2017 meningitis is an inflammation of the lining around the brain and spinal cord caused by bacteria or viruses bacterial meningitis is caused by bacteria. Localized infection escalates within the lungs, with dissemination to the regional lymph nodes. Much of our understanding of the pathophysiology of meningitis has been obtained using animal models of s. Pathophysiology of neonatal acute bacterial meningitis. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment.
Pdf no bacterial disease has undergone a more dramatic change in epidemiology during the past decade than acute bacterial meningitis. Sometimes funguses, cancers, head injuries or other factors can cause meningitis, but cases from these sources are rare. Introduction bacterial meningitis is an inflammation of the leptomeninges, usually causing by bacterial infection. If severe neurologic impairment is evident at the time of presentation or if the onset of illness is extremely rapid, mortality is 5090% and morbidity is even higher, even with immediate medical treatment.
There is also increased anaerobic glycolysis by leukocytes and brain cells. In general, meningitis due to bacteria bacterial meningitis is more severe than meningitis caused by viruses viral meningitis. Some children with meningitis may have longterm problems, but this depends on the cause of the infection and the age of the child. Bacterial exotoxins, cytokines, and icp stimulate nociceptors in the meninges cerebral tissue itself lacks nerve endings that generate pain sensation. Through the use of experimental animal models of infection, a great deal of information. The bacteria are found in the mouth, throat, or nose. Despite the effectiveness of antibiotics in clearing bacteria from the cerebrospinal fluid csf, bacterial meningitis in adults continued to cause. Early identification and treatment of patients with acute bacterial meningitis. Streptococcus pneumoniae and neisseria meningitidis are now the leading causes of bacterial meningitis. Since the hib vaccine is now given to all children as part of their routine immunizations, the number of hib infections and related meningitis cases has declined. Etiology of meningitis list of high impact articles ppts. Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. It can cause stroke, hearing loss, and brain damage.
Changing epidemiology of acute bacterial meningitis. Staphylococcal meningitis is defined as either hospital or. Transmission is by direct contact, including droplet spread. Infection of the subarachnoid space leads to cerebrospinal fluid csf inflammation, meningeal irritation, and the clinical triad of headache, fever, and meningismus. Bacterial meningitis is an inflammation of the meninges, in particular the arachnoid and the pia mater, associated with the invasion of bacteria into the subarachnoid space, principles known for more than 100 years flexner, 1907. Pathogenesis and pathophysiology of bacterial meningitis uptodate. It usually starts with bacteria that cause a coldlike infection. Pathogenesis of bacterial meningitis sciencedirect. Cohen, professor, department of infectious diseases and micro biology, imperial college school of medicine, hammersmith hospital, london summary bacterial meningitis is the most common serious infection. It can also spread from an ear, nose, throat, sinus, or brain infection. Dec 07, 2017 tuberculous meningitis tbm develops in 2 steps. Dexamethasone halves the risk of poor outcome, but only in selected patient groups. Michael scheld,12 uwe koedel,4 barnett nathan,3 and hanswalter pfister4 division of infectious diseases, departments oflinternal medicine, 2neurosurgery, and neurology, university of virginia school of medicine, charlottesville. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Pathophysiology and treatment of bacterial meningitis ncbi. This cascade leads to lipid peroxidation, mitochondrial damage and breakdown of the bloodbrain barrier, thus contributing to cell injury during neonatal meningitis. Bacterial meningitis is a lifethreatening condition that requires prompt recognition and treatment. Through the use of experimental animal models of infection, a great deal of information has been gleaned concerning the pathogenic and pathophysiologic mechanisms operable in bacterial meningitis. Treatment is with antibiotics and corticosteroids given as soon as.