Pathogenesis of bacterial meningitis sciencedirect. Bamberger, md, university of missourikansas city school of medicine, kansas city, missouri a cute meningitis is a medical emer. Meningitis can be caused by various infectious agents, including viruses, fungi, and protozoans, but bacteria produce the most lifethreatening forms. Vsu student health center nursing staff what is meningitis. Inflammation of the meninges of the brain and the spinal cord, most often caused by a bacterial or viral infection and characterized by fever, vomiting, intense headache, and stiff neck. Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. Smoking, secondhand smoke and crowded living conditions also increase the risk for some kinds of. Pathophysiology for nurses at a glance pdf ammedicine. 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. Nov 07, 2017 urinary tract infection overview signs and symptoms, pathophysiology, causes and treatment duration. Etiology of meningitis list of high impact articles. Meningitis, inflammation of the meninges, the membranes covering the brain and spinal cord.
However, injuries, cancer, certain drugs, and other types of. The development of bacterial meningitis progresses through four interconnected phases. The mainstay of treatment for bacterial meningitis is antibiotics. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the cns is improving. Urinary tract infection overview signs and symptoms, pathophysiology, causes and treatment duration. Much of the damage from this infection is believed to result from cytokines released within the csf as. Infections of the central nervous system, 2nd ed, scheld mw, durack wr eds, lippincott raven, philadelphia 1997. Pathophysiology and treatment of bacterial meningitis. Ppt bacterial meningitis powerpoint presentation free. For acute bacterial meningitis, prompt treatment using intravenous antibiotics and cortisone medications can help ensure recovery and prevent complications like seizures and swelling of the brain.
Mar 08, 2020 eventually, inflammatory cells enter the csf and release cytokines that play a central role in the pathophysiology of meningeal inflammation. Acute bacterial meningitis merck manuals professional edition. Meningitis, pathophysiology search for similar articles you may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search. Summary recurrent bacterial meningitis is a rare phenomenon and generally poses a considerable diagnostic challenge to the clinician.
Department of neurology, chariteuniversitaetsmedizin berlin, germany, department of cell biology and neurobiology, chariteuniversitaetsmedizin berlin germany, department of neurology, lkh, klagenfurt, austria. Treatment is with antibiotics and corticosteroids given as soon as. Mycobacterium tuberculosis bacilli enter the host by droplet inhalation. Neisseria meningitidis is remarkable for the diversity of interactions that the bacterium has with the human host, ranging from asymptomatic nasopharyngeal colonisation affecting virtually all members of the population. Pathophysiology and treatment of bacterial meningitis hoffman olaf and weber joerg r. Throughout the modern era of bacteriology, haemophilus influenzae type b hib has been identified as 1 of the 3 most common causes of bacterial meningitis in adolescents. Infection of the fluid in the spinal cord and the fluid that surrounds the brain viral or bacterial etiology is important because of the seriousness of the illness and the treatment needed viral meningitis usually clears up in a week or two with no specific treatment common. Meningitis knowledge for medical students and physicians. Nov 08, 2017 meningitis describes inflammation of the meninges, the protective membranes that surround the brain and spinal cord.
The treatment for meningitis depends on the particular type or cause. Can people with meningitis pass the illness to others. Pathophysiology and treatment of meningoencephalitis a. In the absence of focal neurologic findings, the risk of herniation in cases of hib meningitis is low and one can safely proceed to lumbar puncture without imaging. Clinical features alone cannot determine whether meningitis. Before the development of effective immunizations, these 3 bacteria accounted for more than 80% of all cases of meningitis in. Naegleria fowleri is a free living ameba a singlecelled living organism that is too small to be seen without a microscope. Meningitis is a serious infection of the meninges in the brain or spinal cord that is most commonly viral or bacterial in origin, although fungal, parasitic, and noninfectious causes are also possible. Most cases of bacterial meningitis originate from the host obtaining an infectious agent by nasopharyngeal colonization. Much of our understanding of the pathophysiology of meningitis has been obtained using animal models of s.
In persons who develop tbm, bacilli seed to the meninges or brain parenchyma, resulting in the formation of small subpial or. Enteroviruses and herpes simplex virus are the leading causes of viral meningitis, while neisseria meningitidis and streptococcus pneumoniae are most commonly responsible for bacterial meningitis. Pathogenesis and pathophysiology of bacterial meningitis. Start studying unit 6 neural pathophysiology meningitis. The role of caspase casp1 in the pathophysiology of pneumococcal meningitis has been the subject of recent experiments. Meningococcal meningitis generally has a better prognosis than septicaemia.
In vitro infection of human nasopharyngeal cells in organ culture with meningococci or h. 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. 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. Summary the epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. Diagnosis, initial management, and prevention of meningitis.
Further information on the pathogenesis and pathophysiology of bacterial meningitis should lead to the development of more innovative treatment andor preventive strategies for this disorder. Fire up to beat the threat of bacterial meningitis. Unit 6 neural pathophysiology meningitis flashcards quizlet. The infectious diseases society of america has published clinical guidelines for the treatment of bacterial meningitis. This text has been written with the intention of making the sometimes complex subject of pathophysiology understandable and stimulating. Autolysis consists of selfdigestion of the cell wall by peptidoglycan hydrolyases termed autolysins. 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. Neonatal meningitis is a severe acute infectious disease of the central nervous system and an important cause of morbidity and mortality worldwide. Viral meningitis and the aseptic meningitis syndrome. Etiology of meningitis list of high impact articles ppts. Pathophysiology of neonatal acute bacterial meningitis. Primary amebic meningoencephalitis pam is a rare brain infection that is usually fatal and caused by naegleria fowleri. Explain the pathophysiology of bacterial meningitis bacterial meningitis is an acute inflammation of the meninges and the cfs.
Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. Ppt bacterial meningitis powerpoint presentation free to. Epidemiology, diagnosis, and antimicrobial treatment of. What is the pathophysiology of meningitis in meningococcemia. Eventually, inflammatory cells enter the csf and release cytokines that play a central role in the pathophysiology of meningeal inflammation.
Dec 07, 2017 tuberculous meningitis tbm develops in 2 steps. Fifty years after the advent of antibiotics for clinical use, bacterial meningitis remains an important cause of morbidity and mortality. The principles of management of meningitis and septicaemia are best understood by having a basic knowledge of their pathophysiology 40. The pathogens take advantage of the specific features of the immune system in the cns, replicate and induce inflammation. Enteroviruses and herpes simplex virus are the leading causes of viral meningitis, while neisseria meningitidis and streptococcus pneumoniae are the pathogens most commonly responsible.
Pdf pathophysiology of meningococcal meningitis and. A free powerpoint ppt presentation displayed as a flash slide show on id. Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant burden of disease in adults, with a mortality of up to 30%. As such, it represents a unique human infectious disease, b. Infection of leptomeninges arachnoid and pia maters and subarachnoid space may be bacterial purulent or viral aseptic may be due to infection somewhere else in the body that has spread into the blood and csf. Meningitis is a serious infection of the meninges in the brain or spinal cord that is most commonly viral or bacterial in origin. Meningitis definition of meningitis by the free dictionary. Meningitis occurs in people of all ages, but it is more common in children and people over 65. Pdf pathophysiology of meningococcal meningitis and septicaemia. Pathophysiology of meningococcal meningitis and septicaemia.
Acute bacterial meningitis msd manual professional edition. We evaluated the data on the pathogenesis, pathophysiology, and treatment of bacterial meningitis and considered in depth the information from animal models that may have potentially important applications in the treatment of human disease. 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. Emerging antibiotic resistance is an upcoming challenge. Acute bacterial meningitis neurologic disorders merck. You get it when a virus enters the body through the nose or mouth and travels. A better understanding of the pathophysiology has led to a number of experimental therapies, targeting various inflammatory mediators table 1. Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. 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.
Localized infection escalates within the lungs, with dissemination to the regional lymph nodes. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to ascertain public health. Casp1 plays a central role in the generation of mature il1. Understanding the pathophysiology of meningococcal infection and the principles of management. Treatment is with antibiotics and corticosteroids given as soon as possible.
The inflammatory reaction involves the meninges, the subarachnoid space and the brain parenchymal vessels and contributes to neuronal injury. Meningitis describes inflammation of the meninges, the protective membranes that surround the brain and spinal cord. Epidemiology, etiology, pathogenesis, and diagnosis of. Ultimately, a structured approach and early diagnosis of any underlying pathology are crucial to prevent further episodes and improve the overall outcome for the affected individual. Bacterial meningitis remains a disease with associated unacceptable morbidity and mortality rates despite the availability of effective bactericidal antimicrobial therapy. Various bacteria including the major meningeal pathogens e. Our understanding of the pathophysiology of meningococcal septic shock allows a rational approach to treatment to be developed and are described in detail by welch and nadel. Scheme depicting the pathogenesis and pathophysiology of bacterial meningitis 1 mucosal colonization and systemic invasion most cases of bacterial meningitis originate from the host obtaining an infectious agent by nasopharyngeal colonization.
The pathogenesis and pathophysiology of bacterial meningitis involve a complex interplay between virulence factors of the pathogens and the host immune response. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. The introduction of antimicrobial therapy has had a. Key advances in understanding the pathophysiology of meningitis include insight into the pivotal roles of cytokines eg, tumor necrosis factor alpha tnf. The other 2 are neisseria meningitidis and streptococcus pneumoniae. Diagnosis, initial management, and prevention of meningitis david m. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pathophysiology and treatment of meningoencephalitis a journal reading 1. Much of the damage from this infection is believed to result from cytokines released within the csf as the host mounts an inflammatory response. Acute bacterial meningitis is rapidly progressive bacterial infection of the meninges and subarachnoid space. Any delay in treatment results in increased morbidity and mortality, so antibiotics are often started empirically based on the age of the patient see table in etiology above.
Additionally, ventilator assistance, kidney dialysis or other supportive treatments may be needed. For more detailed information see references section. Increased inflammation in bacterial meningitis results a higher icp and thus a high opening pressure. 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. Additionally, people with weak immune systems are more at risk for meningitis. Provocation poliomyelitis and entry of poliovirus to the cns.
1106 1526 7 481 949 1242 1072 439 611 1137 771 373 1371 994 509 1328 494 299 1047 1556 293 1518 317 853 681 153 880 483 1255 534 84