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M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
M.meningitis
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M.meningitis

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  • 1. Microbiology MENINGOCOCCAL MENINGITIS
  • 2. • INTRODUCTION • STATISTICS • SYMPTOMS • LAB DIAGNOSIS • TREATMENT • PREVENTION • CONCLUSION • CASE STUDY • REFERENCES
  • 3. INTRODUCTION Meningococcal Meningitis • Inflammation of membrane covering brain and spinal cord • Caused by Neisseria meningitidis • Person to person transmission • Infect body parts - spread through bloodstream to nervous system • Incubation period: 2 to 10 days • Death and serious complication Figure 1: Neisseria meningitidis
  • 4. Figure 2 : Difference between normal & abnormal meninges
  • 5. STATISTICS • Highest case reported in area of sub-Saharan Africa • In 2009, 14 African country reported with 88199 suspected cases and 5352 deaths • Largest number since 1996 epidemic
  • 6. SYMPTOMS • Severe, persistent headache • Neck stiffness • Nausea or vomiting • Drowsiness/difficulty awakening • Confusion/mental changes • Purple, bruise-like areas • Rash, pinpoint red spots Figure 3: Purple spots
  • 7. LAB DIAGNOSIS 1. Imaging Test (X-rays & CT scans) • to create pictures of the head, including the skull, brain, eye sockets, and sinuses. • reveal swelling or inflammation 2. Blood culture • Check for the type of bacteria in blood sample • Type of media: BAP or CAP • Growth of germs observed • Gram stain- gram-ve diplococci
  • 8. (b)(a) Figure 4: (a) CT scan method (b) Image of brain
  • 9. Figure 5. N. meningitidis colonies on a BAP • Young colonies-round, smooth, moist, glistening, and convex • Some colonies appear to coalesce with other nearby colonies
  • 10. Figure 6. N. meningitidis in Gram staining method
  • 11. 3. WBC count • blood test to measure the number of white blood cells (WBCs) • Normal range: 4,500-10,000 WBC per microliter (mcL) • Affected patients : increased WBC (>10,000 mcL) 4. Lumbar puncture (Spinal tap) • insertion of a needle into an area in lower spine to drain cerebrospinal fluid (CSF) • 5-10mL collected • CSF - clear fluid (normal) - cloudy (bacteria present)
  • 12. Figure 7: (a) Lumbar puncture method (b) Cloudy CSF (a) (b)
  • 13. 5. CSF glucose, protein test
  • 14. TREATMENT • Doctor may recommend a broad-spectrum antibiotic until exact cause of the meningitis determine • Antibiotics: (a) Intravenous: ceftriaxone / penicillin (b) Oral: ciproflaxin / rifampin • If patient allergic to penicillin - chloramphenicol may be used • Steroid – used to prevent hearing loss • Surgery – to remove accumulated fluid around brain
  • 15. PREVENTION • All family and close contacts of infected person should receive antibiotic treatment • Wash your hands – before handling with foods and after using toilets • Cover your mouth - when you need to cough or sneeze • Vaccines: (a) Meningococcal polysaccharide vaccines - to control the disease (b) Vaccine that provide combined protection against A and C given to travelers. (c) Meningococcal B Immunisation for children-to achieve maximum immunity
  • 16. Figure 8: Hand washing steps
  • 17. CONCLUSION • Meningitis is a serious diseases- causing inflammation and swelling of meninges • 2 types: (a) bacterial meningitis-more severe, lead to death (b) viral meningitis- less severe, most people recover fully • Its present in saliva, commonly transmitted through close contact. • Vaccines available to treat and prevent the infection • Immediate treatment needed- to reduce the severity
  • 18. Patient’s Detail • A man – 21 year old • Construction site worker and he had travelled to China a few days before his illness. • Fever for one day • Patient’s BP was 109/50, pulse rate was 115 • Temperature was 38.1 C • Fully conscious and clinically stable • Headache, vomiting for three times and severe dizziness. • No rash was noted by him
  • 19. Physical Examination • Generalised maculo-papular rash and a patch of purpura on the dorsum of the right hand Figure 9:
  • 20. Cont… • Suboccipital lymph node was negative. • No neck rigidity. • Chest, cardiac and abdominal examination did not reveal any abnormality.
  • 21. Investigation • Showed white cell count of 29.1 with neutrophilia. • Raised CSF protein of 5.45 g/L. • Decreased CSF glucose of 0.1 mmol/L. • CSF was turbid with predominating polymorphs. • Gram Stain was negat ive but culture grew Neisseria meningitidis • Was sensitive to cefotaxime, ceftriaxone, chloramphenicol, ciprofloxacin, penicillin and rifampicin. • Blood culture grew the same pathogen.
  • 22. Treatment • Intravenous antibiotic including penicillin G and cefotaxime were administered • He recovered without any neurological sequelae.
  • 23. REFERENCES • Anonymous, (2013), introduction, viewed on 22nd January 2013, http://www.webmd.com/brain/meningococcal-meningitis- symptoms-causes-treatments-and-vaccines • Anonymous, (2012), introduction and symptoms, viewed on 22nd January 2013, http://www.nlm.nih.gov/medlineplus/ency/article/000608.htm • WHO, (2013), statistics, viewed on 22nd January 2013, http://www.who.int/mediacentre/factsheets/fs141/en/index.html • Anonymous, (2013), symptoms, viewed on 22nd January 2013, https://www.healthtap.com/#topics/meningococcal-disease • Anonymous, (2006), symptoms, viewed on 22nd January 2013, http://textbookofbacteriology.net/themicrobialworld/meningitis.html • Lee, G.P.C., Mark, Y.K., Kam, C.K.,(2001), Case report: meningococcal meningitis. Hong Kong Journal of Emergency Medicine. 8(2):108-110
  • 24. • Anonymous, (2007),prevention of meningitis, Viewed on 22nd January 2013, http://www.southerncross.co.nz/HealthResources • Anonymous, (2012),prevention, Viewed on 22nd January 2013, http://www. who.int/mediacentre/factsheets • Anonymous, (2012),test and diagnosis, Viewed on 22nd January 2013, http://www. mayoclinic.com/health/meningitis • Anonymous, (2008),treatment and prognosis, Viewed on 24th January 2013, http://www.path.org/vaccineresources/meningococcus • Anonymous, (2011),test and diagnosis, Viewed on 24th January 2013, http://www.bestpractice.bmj.com/best-practice/diagnosis/test • Anonymous, (2013),test and diagnosis, Viewed on 25th January 2013, http://www.meningitisfoundationofamerica.org Cont…

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