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    Meningitis Case Discussion

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    Jason Mirasol
    This document discusses a case of acute bacterial meningitis. It lists the typical symptoms the patient is experiencing and risk factors for the condition. The most common causes of community-acquired bacterial meningitis are identified as Streptococcus pneumoniae, Neisseria meningitidis, group B streptococci, and Listeria monocytogenes. These bacteria are able to invade the central nervous system by colonizing the nasopharynx and avoiding immune defenses before multiplying rapidly in the cerebrospinal fluid. The prognosis depends on factors like the causative organism, age of the patient, presence of complications, and delay in treatment initiation.

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    Meningitis Case Discussion

    Uploaded by

    Jason Mirasol
    105 views12 pages
    This document discusses a case of acute bacterial meningitis. It lists the typical symptoms the patient is experiencing and risk factors for the condition. The most common causes of community-acquired bacterial meningitis are identified as Streptococcus pneumoniae, Neisseria meningitidis, group B streptococci, and Listeria monocytogenes. These bacteria are able to invade the central nervous system by colonizing the nasopharynx and avoiding immune defenses before multiplying rapidly in the cerebrospinal fluid. The prognosis depends on factors like the causative organism, age of the patient, presence of complications, and delay in treatment initiation.

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    a case of acute bacterial meningitis

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    This document discusses a case of acute bacterial meningitis. It lists the typical symptoms the patient is experiencing and risk factors for the condition. The most common causes of community-acquired bacterial meningitis are identified as Streptococcus pneumoniae, Neisseria meningitidis, group B streptococci, and Listeria monocytogenes. These bacteria are able to invade the central nervous system by colonizing the nasopharynx and avoiding immune defenses before multiplying rapidly in the cerebrospinal fluid. The prognosis depends on factors like the causative organism, age of the patient, presence of complications, and delay in treatment initiation.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    105 views12 pages

    Meningitis Case Discussion

    Uploaded by

    Jason Mirasol
    This document discusses a case of acute bacterial meningitis. It lists the typical symptoms the patient is experiencing and risk factors for the condition. The most common causes of community-acquired bacterial meningitis are identified as Streptococcus pneumoniae, Neisseria meningitidis, group B streptococci, and Listeria monocytogenes. These bacteria are able to invade the central nervous system by colonizing the nasopharynx and avoiding immune defenses before multiplying rapidly in the cerebrospinal fluid. The prognosis depends on factors like the causative organism, age of the patient, presence of complications, and delay in treatment initiation.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 12

    Working Diagnosis & Case Discussion

    ACUTE BACTERIAL MENINGITIS


    Symptoms of Acute bacterial meningitis
    Fever
    Headache Neck stiffness Photophobia

    CASE

    Nausea and vomiting


    Sleepiness Confusion Delirium

    Coma

    ACUTE BACTERIAL MENINGITIS


    Bacterial meningitis is an acute purulent infection within the sub-arachnoid space.

    Risk factors
    Extremes of age (< 5 or >60 years) Diabetes mellitus, renal or adrenal insufficiency, hypoparathyroidism, or cystic fibrosis Immunosuppression, which increases the risk of opportunistic infections and acute bacterial meningitis

    HIV infection, which predisposes to bacterial meningitis caused by encapsulated organisms, primarily Streptococcus pneumoniae, and opportunistic pathogens Crowding (such as that experienced by military recruits and college dorm residents), which increases the risk of outbreaks of meningococcal meningitis

    Splenectomy and sickle cell disease, which increase the risk of meningitis secondary to encapsulated organisms Alcoholism and cirrhosis Recent exposure to others with meningitis, with or without prophylaxis Contiguous infection (eg, sinusitis)

    Dural defect (eg, traumatic, surgical, or congenital) Thalassemia major Intravenous (IV) drug abuse Bacterial endocarditis Ventriculoperitoneal shunt Malignancy (increased risk of Listeria infection) Some cranial congenital deformities

    Epidemiology
    Bacterial meningitis is the most common form of suppurative CNS infection The organisms most often responsible for community-acquired bacterial meningitis are:
    Streptococcus pneumoniae (50%), Neisseria meningitidis (25%), group B streptococci (15%), Listeria monocytogenes (10%). Haemophilus influenzae (<10%)

    Etiology
    S. pneumoniae is the most common cause of meningitis in adults >20 years of age, accounting for nearly half the reported cases (1.1 per 100,000 persons per year). Otitis, mastoiditis, and sinusitis are predisposing and associated conditions for meningitis due to Streptococci sp., gramnegative anaerobes, S. aureus, Haemophilus sp., and Enterobacteriaceae.

    S.pneumoniae/ N.meningitidis

    Pathophysiology

    Colonize the nasopharynx Few WBCs, Igs and complement Fluid nature of CSF

    Transported to the bloodstream


    Reach the intraventricular choroid plexus

    Avoid phagocytosis by PMNs and complement

    Prevents opsonization of bacteria

    Mutiply rapidly within the CSF CSF protein

    Production of inflammatory cytokines and chemokines

    leukocytosis

    Meningeal inflammation

    Prognosis
    Mortality rate is 37% for meningitis caused by H. influenzae, N. meningitidis, or group B streptococci; 15% for that due to L. monocytogenes; and 20% for S. pneumoniae. In general, the risk of death from bacterial meningitis increases with
    decreased level of consciousness on admission, onset of seizures within 24 h of admission, signs of increased ICP, young age (infancy) and age >50, the presence of comorbid conditions including shock and/or the need for mechanical ventilation, delay in the initiation of treatment.

    Diagnosis: CSF analysis

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