Learn and Grow Ahead

1. -Meningitis,
Thyroid, Leprosy
and Tuberculosis

2. • Meningitis is a relatively rare infection that affects the delicate
membranes -- called meninges -- that cover the brain and spinal
cord.
ETIOLOGY
• Meningitis is almost always caused by a bacterial or viral
infection that began elsewhere in the body, such as in the ears,
sinuses, or upper respiratory tract.
• Less common causes of meningitis include fungal infection,
autoimmune disorders, and medications.
MENINGITIS

3. Bacterial
meningitis
Viral
meningitis
Fungal
meningitis
Onset Rapid (within
24hrs)
1-7 days > 7 days
Severity Severe Mild to moderate Often mild
Predominant cells Neutrophils Lymphocytes Lymphocytes
Changes in
intracranial
pressure
Increased Normal Increase
CSF gram stain Positive Negative Negative
Glucose in CSF Decreased Normal Decreased

4. PATHOGENS ETIOLOGY
BACTERIA • Mycobacterium tuberculosis
•Treponema pallidium
•Salmonella species
•Streptococcus species
•Nocardia sp.
FUNGI •Crytococcus neoformans
•Histoplasma capsulatum
•Candida species
•Aspergillus fumigatus
VIRAL •HIV
•Cytomegalovirus
•Herpes simplex type 2
•Varicella zoster virus

5. HALLMARK SYMPTOMS OF MENINGITIS

6. Symptoms in newborns Complications
•High fever
•Constant crying
•Excessive sleepiness
•Inactivity
•Poor feeding
•Stiffness in baby’s body and neck
•Loss of hearing
•Impaired memory
•Learning disabilities
•Damaged brain
•Seizure
•Kidney failure
•Death

7. PATHOPHYSIOLOGY
Inhaled meningococcus
Travel to cerebral blood vessels and cross the blood
brain barrier
Attaches to nasopharynx epithelial cells
Infect the meninges
Cross the mucosal barrier and reaches the
blood circulation

10. • Tuberculosis is an infective disease commonly affecting lungs.
• It is caused by
 Mycobacterium tuberculosis
 Mycobacterium bovis
• It is an airborne disease, spreads through air in form of small
droplets.
• Transmitted by sneezing, coughing, singing or even talking
TUBERCULOSIS

11. ETIOLOGY
• Droplet infection (inhalation of oral droplets from infected
person)
• Intake of unpasteurized cow milk.
• Re-infection
• Disease conditions like DM, alcoholism, whooping cough, etc
• Socio economic factors like Malnutrition, heavy workload,
inadequate sleep, unhygiene, etc

12. TYPES OF TUBERCULOSIS
1 Pulmonary TB Commonly affects the lungs and hence called
pulmonary TB
2 Primary TB
pneumonia
•Seen shortly after 1st infection
•Characterized by rupturing of the granuloma (located at
the edge of pleural cavity) into the pleural space (space
between lungs and chest wall)
3 Cavitary TB •Destruction in lungs progresses and cavities or enlarged
spaces are formed by bacteria.
•Upper lobes of lungs are most affected.
4 Miliary TB Miliary (tiny nodules) appears all over lungs as depicted
inX-ray and is considered as disseminated TB
5 Laryngeal TB Highly infectious form of TB which infects larynx or
vocal cord.

13. Signs and symptoms Complications
•Coughing (lasts more than 2 weeks
with green, yellow or bloody sputum)
•Weight loss
•Fatigue
•Chest pain
•Night sweats
•Evening pyrexia/fever
•Shortness of breath
•Spinal pain
•Joint damage
•Meningitis
•Liver and kidney functional
impairment
•Blurred vision

14. PATHOGENESIS
Inhalation of organism into lungs
secondary
infection
Individual with
high resistance
Migrates to lymph nodes and
produce Type IV hypersensitivity
reaction
Local inflammation
Individual with
low resistance
Primary
infection
Cavitation(large open
areas in lungs and
erosion of blood
vessels)
Dissemination through lungs
and other organs

17. • It is a bacterial infection caused by water and food contaminated with
Salmonella Typhi is called typhoid or enteric fever
• Some non-typhoid salmonella like Paratyphoid strains A, B, C also
causes this infection.
ETIOLOGY
• Caused by contaminated food and water
• The bacteria are exposed to external environment and contaminate
surrounding water supply, hence contaminates the food.
TYPHOID

18. SIGNS
AND
SYMPTOMS
•Loss of appetite
•Headache
•Muscle pain
•Fever up to 104̊
F
•Lethargy
•Diarrhoea
COMPLICATIONS
•Abdominal - Hepatitis, Gall stone
•Genitourinary - Urine retention, Glomerulonephritis
•Cardiovascular – ECG changes, sudden death
•Respiratory – Pneumonia, Bronchitis
•Neurological- Meningitis, Seizures

19. PATHOPHYSIOLOGY OF TYPHOID
S. Typhi enters body
Absorbed by Peyer’s
patches
Reaches the blood and
produce septicemia
Bacteria reaches liver,
spleen, gall bladder, etc
Damages the
organ
Enteric hemorrhage,
Perforation,
Typhoid encephalitis
Reaches gall
bladder
Excreted in
faeces

22. • A chronic infectious disease caused by Mycobacterium leprae and
mainly affects the skin, peripheral nerves, mucosal surfaces of the
upper respiratory tract, and eyes is termed leprosy or Hansen’s
disease
ETIOLOGY
• Mycobacterium leprae OR Mycobacterium lepromatosis
• Transmitted through direct contact
• Incubation period: Tuberculoid- 5 yrs, Lepromatous form- 12 yrs
TYPES
BASIS OF CLINICAL MANIFESTATIONS AND SKIN SMEAR RESULTS
Paucibacillary leprosy Show -ve smear test at all sites
Multibacillary leprosy Show +ve smear test at all sites
LEPROSY

24. REDLEY AND JOPLING CLASSIFICATION
Intermediate leprosy Few flat lesions – heal by their own
Tuberculoid Large, painless lesion – left untreated, develop to
lepromatous
Borderline tuberculoid Lesions small and numerous – may remain in this
stage or return to tuberculoid
Borderline lepromatous Numerous painful lesions- contain papules, plaques
and nodules– may remain in this stage or
progresses
Lepromatus leprosy At first, small, diffuse and cutaneous lesions develop
and later it changes to larger and deeper form

25. Immunity
High
Low
Multibacillary
leprosy
Disease
spreads
uncontrollably
Paucibacillary
leprosy
Lesions heal
faster
PATHOPHYSIOLOGY OF LEPROSY

26. SIGNS AND SYMPTOMS COMPLICATIONS
•Discolored skin lesions
•Growth on the skin
•Thick and dry skin
•Severe pain
•Numbness on affected area
•Eye problems
•Muscle weakness
•Nose bleeds
•Disfigurement
•Hair loss
•Muscle weakness
•Glaucoma and Iritis
•Blindness
•Permanent nerve damage in arms
and legs
•Kidney failure