Bacterial meningitis By Dr. Osman Sadig
<ul><li>Commonest CNS infection </li></ul><ul><li>Causes:- </li></ul><ul><li>1- Gram negative bacteria in neonates </li></...
<ul><li>Meningococcal meningitis </li></ul><ul><li>Organism:- </li></ul><ul><li>Neisseria meningitides </li></ul><ul><li>-...
<ul><li>Occurrence:- </li></ul><ul><li>1- Sporadic (10-40%) </li></ul><ul><li>2-  Epidemic  ( A, B & C) </li></ul><ul><li>...
<ul><li>Prevalence:- </li></ul><ul><li>- More in young children. </li></ul><ul><li>- High in spleenectomized patients </li...
<ul><li>Pathology : -  - Congested pia - arachnoid matter . </li></ul><ul><li>-  Polymorph infiltration . </li></ul><ul><l...
<ul><li>Clinical picture of meningitis :- </li></ul><ul><li>- Incubation period= 1-5 days. </li></ul><ul><li>- Acute onset...
<ul><li>Acute meningococcemia :- </li></ul><ul><li>- Fever </li></ul><ul><li>- Rash </li></ul><ul><li>- Collapse </li></ul...
<ul><li>Diagnosis :- </li></ul><ul><li>- Suspected case </li></ul><ul><li>- Probable case </li></ul><ul><li>- Confirmed ca...
<ul><li>Complications:- </li></ul><ul><li>- Cranial nerve palsies e.g. occulomotor, facial, cochlear </li></ul><ul><li>- F...
<ul><li>Management :- </li></ul><ul><li>1-  Hospital based . ? Isolation </li></ul><ul><li>2-  Early antibiotic therapy : ...
<ul><li>5-  Acute meningococcemia : </li></ul><ul><li>- Urgency </li></ul><ul><li>- IV fluids </li></ul><ul><li>- Vasopres...
<ul><li>Prognosis:- </li></ul><ul><li>Unfavourable in : </li></ul><ul><li>- Extremes of age. </li></ul><ul><li>- Late pres...
<ul><li>Prevention :- </li></ul><ul><li>- Avoid over crowding </li></ul><ul><li>- Health education </li></ul><ul><li>- Vac...
Upcoming SlideShare
Loading in...5
×

Bacterial Meningitis

2,043

Published on

Published in: Health & Medicine, Technology
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
2,043
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
99
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Bacterial Meningitis

  1. 1. Bacterial meningitis By Dr. Osman Sadig
  2. 2. <ul><li>Commonest CNS infection </li></ul><ul><li>Causes:- </li></ul><ul><li>1- Gram negative bacteria in neonates </li></ul><ul><li>2- N. meningitides 3- H. influenzae </li></ul><ul><li>4- Strept. Pneuomoniae 4- Mycob. Tb </li></ul><ul><li>5- L. monocytogenes 5- Staph. Aureus </li></ul>
  3. 3. <ul><li>Meningococcal meningitis </li></ul><ul><li>Organism:- </li></ul><ul><li>Neisseria meningitides </li></ul><ul><li>- Gram negative , non motile, non sporing </li></ul><ul><li>diplococcus </li></ul><ul><li>- Contains capsular antigens ( A, B, C, X, Y, W135) </li></ul><ul><li>responsible for immune complex formation. </li></ul><ul><li>- Produces endotoxin responsible for circulatory </li></ul><ul><li>collapse & DIC. </li></ul>
  4. 4. <ul><li>Occurrence:- </li></ul><ul><li>1- Sporadic (10-40%) </li></ul><ul><li>2- Epidemic ( A, B & C) </li></ul><ul><li>Source of infection :- </li></ul><ul><li>1- Healthy carriers ( 1-50%) </li></ul><ul><li>2- Clinical cases. </li></ul><ul><li>Transmission :- </li></ul><ul><li>Droplet. </li></ul>
  5. 5. <ul><li>Prevalence:- </li></ul><ul><li>- More in young children. </li></ul><ul><li>- High in spleenectomized patients </li></ul><ul><li>Forms of infection :- </li></ul><ul><li>- Nasopharyngeal carriers. </li></ul><ul><li>- Meningitis ( mortality < 10%) </li></ul><ul><li>- Septicemia (meningococcemia) </li></ul><ul><li>1- Acute ( 50% mortality) </li></ul><ul><li>2- Chronic </li></ul>
  6. 6. <ul><li>Pathology : - - Congested pia - arachnoid matter . </li></ul><ul><li>- Polymorph infiltration . </li></ul><ul><li>- Adhesions causing: </li></ul><ul><li>- CSF obstruction, hydrocephalus & increased </li></ul><ul><li>intracranial pressure. </li></ul><ul><li>- Cranial nerves damage </li></ul><ul><li>- Obliterative endarteritis wz cerebral </li></ul><ul><li>infarction </li></ul><ul><li>- Brain edema . </li></ul>
  7. 7. <ul><li>Clinical picture of meningitis :- </li></ul><ul><li>- Incubation period= 1-5 days. </li></ul><ul><li>- Acute onset </li></ul><ul><li>- Main symptoms are headache, fever, vomiting and </li></ul><ul><li>photophobia. </li></ul><ul><li>- Neck retraction & stiffness. </li></ul><ul><li>- Kernig sign </li></ul><ul><li>- Brudzinski,s sign. </li></ul><ul><li>- Change in za level of consciousness </li></ul><ul><li>- Seizure. </li></ul>
  8. 8. <ul><li>Acute meningococcemia :- </li></ul><ul><li>- Fever </li></ul><ul><li>- Rash </li></ul><ul><li>- Collapse </li></ul><ul><li>- High mortality </li></ul><ul><li>- Diagnostic difficulty. </li></ul><ul><li>Investigations:- </li></ul><ul><li>- WBC & PL count </li></ul><ul><li>- CSF </li></ul><ul><li>- Blood culture </li></ul><ul><li>- Serology </li></ul>
  9. 9. <ul><li>Diagnosis :- </li></ul><ul><li>- Suspected case </li></ul><ul><li>- Probable case </li></ul><ul><li>- Confirmed case. </li></ul><ul><li>Differential diagnosis :- </li></ul><ul><li>- Other pyogenic meningitis </li></ul><ul><li>- Aseptic meningitis </li></ul><ul><li>- Cerebral malaria </li></ul><ul><li>- Subarachnoid haemorrhage </li></ul><ul><li>- Tuberculous meningitis </li></ul>
  10. 10. <ul><li>Complications:- </li></ul><ul><li>- Cranial nerve palsies e.g. occulomotor, facial, cochlear </li></ul><ul><li>- Focal neurological deficits. </li></ul><ul><li>- Epidural empyaema. </li></ul><ul><li>- Increased intracranial pressure. </li></ul><ul><li>- Seizures. </li></ul><ul><li>- DIC </li></ul><ul><li>-Coma </li></ul><ul><li>- Vasculitis, Gangrene. </li></ul><ul><li>- Arthritis </li></ul><ul><li>- Pericarditis </li></ul><ul><li>- Renal failure. </li></ul>
  11. 11. <ul><li>Management :- </li></ul><ul><li>1- Hospital based . ? Isolation </li></ul><ul><li>2- Early antibiotic therapy : </li></ul><ul><li>Benzyl penicillin, chloramphenicol, ceftriaxone </li></ul><ul><li>3- Supportive TR: </li></ul><ul><li>- Fluids & electrolytes - Nutrition </li></ul><ul><li>- Anti – convulsants - Analgesic antipyretics </li></ul><ul><li>- Dexamethazone. </li></ul><ul><li>4- Surgery : </li></ul><ul><li>- Epidural abscess </li></ul><ul><li>- Hydrocephalus </li></ul>
  12. 12. <ul><li>5- Acute meningococcemia : </li></ul><ul><li>- Urgency </li></ul><ul><li>- IV fluids </li></ul><ul><li>- Vasopressors </li></ul><ul><li>- IV hydrocortisone </li></ul><ul><li>- IV antibiotics. </li></ul><ul><li>6- Immune complex phenomenon : </li></ul><ul><li>- Steroid </li></ul>
  13. 13. <ul><li>Prognosis:- </li></ul><ul><li>Unfavourable in : </li></ul><ul><li>- Extremes of age. </li></ul><ul><li>- Late presentation. </li></ul><ul><li>- Delayed antibiotic therapy; </li></ul><ul><li>- Focal neurological signs </li></ul><ul><li>- Deep coma </li></ul><ul><li>- Acute meningococcemia </li></ul><ul><li>Mortality : </li></ul><ul><li>- < 10% in meningitis </li></ul><ul><li>- > 50% wz meningococcemia . </li></ul>
  14. 14. <ul><li>Prevention :- </li></ul><ul><li>- Avoid over crowding </li></ul><ul><li>- Health education </li></ul><ul><li>- Vaccination </li></ul><ul><li>- Chemoprophylaxis for close contacts within 24 hours </li></ul><ul><li>of diagnosis. </li></ul><ul><li>Immunity:- </li></ul><ul><li>Capsular poly saccharide Ag stimulates protective Abs </li></ul><ul><li>after clinical meningitis & following vaccination. </li></ul>
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×