Dr.Bashir Ahmed Dar Chinkipora Sopore Kashmir India,Associate Prof of medicine presently working in malaysia is a keen teacher, educator and takes pride in his clinical and research accomplishments. His interests include publishing articles related to health issues. email drbashir123@gmail.com

38. Neisseria meningitidis Bacteria http://www.waterscan.co.yu/viruses-and-bacteries.php?lng=sr

39. Hemophilus influenza (H flu) Strep pneumoniae

51. The white appearance of this calf brain is caused by neutrophils within the meninges – a condition known as meningitis. This is usually due to a bacterial infection.

52. This calf brain shows similar pathology. If a glass slide is pressed to the surface of the brain and stained it would show high numbers of neutrophils.

53. Bovine This brain shows irregular red spots which are areas of hemorrhage and necrosis caused by the bacteria, Histophilus somni .

54. Brain: Purulent meningitis

55. Brain: meningitis.

61. BRAIN ABCESS

65. Bacterial Meningitis: (Library Pictures) Abscess-Cerebral Gross:

66. Abscess-Cerebral MRI

68. Bacterial Meningitis: (Library Pictures) Meningial enhancement in a Bacterial meningitis - CT Scan Image

75. Signs & symptoms of Meningitis

78. Normal fundus

80. Meningococcemia - Petechiae

83. Meningococcemia - Purpura fulminans

90. Increased intracranial pressure Headache Vomiting Decreased Level of Consciousness Papilledema Herniation

104. Investigations & Diagnosis of Meningitis

118. Positioning INCORRECT CORRECT

158. CSF evaluation <50 25-500 25 – 500 Fungal <50 100-500 <500 TB Low to normal 100+ <1000 Viral Low 100-500 >1000K PMN’s Bacterial, acute >50 5-50 <5 , lymphs mainly Normal Glucose (mg/dL) Protein (mg/dL) WBC Condition

159. CSF Diagnosis Elevated (>100) Low (<50) Elevated (PMN’s early, lymphs late TB Meningitis Normal or slightly elevated Normal to low Elevated (PMN’s early, lymphs late) Aseptic Meningitis Elevated (>100) Low compared to serum (<20) >1000 PMN’s predominate Bacterial Meningitis 20-50 (½ serum level) 2/3 serum glucose <5 (lymphs 70%, PMN’s 3%) Normal Protein Glucose WBC

160. CSF Abnormalities In Bacterial Meningitis Positive in >60% Gram stain 100-500mg/dl Protein <0.4 CSF/serum glucose <2.2 mmol/l Glucose 1000-100 000 cells/mm3 White blood cells More than 180 mm H2O Opening pressure

161. CSF evaluation Normal 50-100 <500-1000 Viral <50 25-500 <500 Fungal <50 100-500 <500 TB Low to normal 100+ 1 – 10,000 Bacterial, part rx’d Low 100-500 >1000 PMN’s Bacterial, acute >50 5-45 <7, lymphs mainly Normal Glucose (mg/dL) Protein (mg/dL) WBC Condition

162. Summary of Typical CSF Findings +TB Negative Positive Negative Culture Increased +/- Increased Increased 5-40 Protein < 30% Normal <40% 66% CSF plasma: Glucose ratio Decreased Normal Decreased 60-80 Glucose Increased Predominate Late 5 Lymphocytes +/- increased Early Predominate 0 Polymorphs 25-500 <1000 >1000 0-5 Cells TB Viral Bacterial Normal