Meningitis is an inflammation of the meninges that covers the brain and spinal cord. It can be caused by bacterial, viral, or fungal infections. The main symptoms include headache, fever, stiff neck, nausea, confusion, and seizures. A physical exam may reveal neck stiffness, rashes, and cranial nerve abnormalities. Prompt diagnosis and treatment are important as meningitis can progress rapidly and cause permanent damage or death if not treated. The most common causes are Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae.
Purulent meningitis is a serious infectious disease of the central nervous system that is most common in infants and children. The causative bacteria vary depending on the patient's age. Common bacteria include meningococci, hemophilus influenzae, and pneumococci. Purulent meningitis presents with nonspecific systemic symptoms along with signs of meningeal irritation and increased intracranial pressure. Diagnosis involves analysis of cerebrospinal fluid which shows neutrophilic pleocytosis, elevated proteins and low glucose. Complications can include subdural effusions, seizures, hydrocephalus and ventriculitis. Treatment involves initial broad-spectrum antibiotics targeting the common bacteria, followed by pathogen-directed therapy for
The document outlines key information about infections of the central nervous system, including various bacterial, viral, protozoal and fungal infections that can cause meningitis or encephalitis. It discusses the typical presentation, symptoms, diagnostic evaluation and treatment of different types of meningitis and how they vary depending on the causative pathogen and patient age.
This document provides an overview of meningitis, including its causes, symptoms, diagnosis, and management. It discusses the different types of meningitis such as bacterial, viral, fungal, and non-infectious meningitis. The most common causes of bacterial meningitis are Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, and Listeria monocytogenes. Viral meningitis is generally less severe but can still be fatal depending on factors like the virus and patient's immune status. Diagnosis involves blood tests, lumbar puncture of cerebrospinal fluid, and determining markers like C-reactive protein level. Prompt treatment with antibiotics
2. Meningitis diseses of the brain membrane.pptxabdinuh1997
The meninges, which cover the brain and spinal cord, become inflamed in meningitis. Bacterial meningitis is more severe and can cause death or brain damage if untreated. Viral meningitis is usually mild and self-limiting. A lumbar puncture collects cerebrospinal fluid which can be analyzed to distinguish between bacterial and viral meningitis and identify the specific cause. Common symptoms include headache, fever, and neck stiffness, while signs include Kernig's sign and Brudzinski's sign.
Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and other types of infections also can cause meningitis.
The document summarizes meningitis, including its classification, etiology, and most common bacterial pathogens based on age and risk factors. It discusses acute bacterial meningitis caused by various bacteria like Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Streptococcus agalactiae, and aerobic gram-negative bacilli. It also discusses aseptic meningitis and various infectious agents that can cause it like viruses, bacteria, fungi and parasites.
Purulent meningitis is a serious infectious disease of the central nervous system that is most common in infants and children. The causative bacteria vary depending on the patient's age. Common bacteria include meningococci, hemophilus influenzae, and pneumococci. Purulent meningitis presents with nonspecific systemic symptoms along with signs of meningeal irritation and increased intracranial pressure. Diagnosis involves analysis of cerebrospinal fluid which shows neutrophilic pleocytosis, elevated proteins and low glucose. Complications can include subdural effusions, seizures, hydrocephalus and ventriculitis. Treatment involves initial broad-spectrum antibiotics targeting the common bacteria, followed by pathogen-directed therapy for
The document outlines key information about infections of the central nervous system, including various bacterial, viral, protozoal and fungal infections that can cause meningitis or encephalitis. It discusses the typical presentation, symptoms, diagnostic evaluation and treatment of different types of meningitis and how they vary depending on the causative pathogen and patient age.
This document provides an overview of meningitis, including its causes, symptoms, diagnosis, and management. It discusses the different types of meningitis such as bacterial, viral, fungal, and non-infectious meningitis. The most common causes of bacterial meningitis are Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, and Listeria monocytogenes. Viral meningitis is generally less severe but can still be fatal depending on factors like the virus and patient's immune status. Diagnosis involves blood tests, lumbar puncture of cerebrospinal fluid, and determining markers like C-reactive protein level. Prompt treatment with antibiotics
2. Meningitis diseses of the brain membrane.pptxabdinuh1997
The meninges, which cover the brain and spinal cord, become inflamed in meningitis. Bacterial meningitis is more severe and can cause death or brain damage if untreated. Viral meningitis is usually mild and self-limiting. A lumbar puncture collects cerebrospinal fluid which can be analyzed to distinguish between bacterial and viral meningitis and identify the specific cause. Common symptoms include headache, fever, and neck stiffness, while signs include Kernig's sign and Brudzinski's sign.
Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and other types of infections also can cause meningitis.
The document summarizes meningitis, including its classification, etiology, and most common bacterial pathogens based on age and risk factors. It discusses acute bacterial meningitis caused by various bacteria like Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Streptococcus agalactiae, and aerobic gram-negative bacilli. It also discusses aseptic meningitis and various infectious agents that can cause it like viruses, bacteria, fungi and parasites.
Meningitis is always cerebrospinal infection. Meningitis is a rare infection that affects the delicate membranes -- called meninges -- that cover the brain and spinal cord.There are several types of this disease, including bacterial, viral, and fungal.
This document provides information about meningitis, including what it is, its causes, symptoms, and importance for public health. Meningitis is an inflammation of the meninges surrounding the brain and spinal cord. It can be caused by bacteria, viruses, fungi or other factors. Bacterial meningitis requires urgent antibiotic treatment and can be life-threatening. Common symptoms include fever, headache, neck stiffness, and rash. Public education is important for raising awareness of meningitis signs and encouraging timely medical care. Challenges for public health include educating the public and timely reporting, while opportunities include strengthening communication and partnerships.
This document summarizes meningitis in children, including the definition, causes, signs and symptoms, diagnosis, treatment, and prevention. Meningitis is an inflammation of the membranes surrounding the brain and spinal cord. It most commonly affects infants and children under 5 years old. Bacteria such as pneumococcus, meningococcus, and H. influenzae are common causes. Signs include fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture and culture of spinal fluid. Treatment involves antibiotics and supportive care. Vaccines can help prevent certain bacterial types. Complications may include neurological deficits if not treated promptly.
Bacterial meningitis can be severe and cause long term effects like hearing loss or learning disabilities, while viral meningitis is generally less severe and resolves without treatment. It is important to determine if meningitis is bacterial or viral and, if bacterial, to identify the specific bacteria causing the infection in order to guide treatment and preventative measures. Meningitis is diagnosed through spinal fluid analysis to check for signs of inflammation and look for bacteria. While some forms of bacterial meningitis can be transmitted between people, viruses that cause meningitis are not as contagious.
This document discusses group members and then provides information on meningitis. It defines cerebrospinal fluid and discusses the epidemiology and pathophysiology of meningitis. It outlines the clinical features of meningitis in neonates, infants, and children. It discusses the etiology of bacterial, viral, fungal and other types of meningitis. It describes the clinical manifestations, diagnosis, treatment and management of meningitis.
This document discusses acute community-acquired bacterial meningitis in adults. It begins by stating that the most common causes are Streptococcus pneumoniae and Neisseria meningitidis. It emphasizes that a lumbar puncture is needed to diagnose bacterial meningitis and identify the causative organism. While symptoms are not specific, prompt diagnosis and treatment are important as bacterial meningitis can have high rates of morbidity and mortality.
This document discusses meningitis and encephalitis. It defines meningitis as an infection of the meninges and encephalitis as an inflammation of the brain parenchyma. It outlines the different types of meningitis and common causative organisms. It describes the clinical features, investigations, complications, prognosis and treatment for both conditions. The goals of physical therapy for patients with these inflammatory central nervous system disorders are also mentioned.
Meningitis is an infection of the membranes (meninges) surrounding the brain and spinal cord. It can be caused by bacteria, viruses, or fungi. Bacterial meningitis is the most common and life-threatening type. Symptoms include fever, severe headache, nausea, and neck stiffness. Diagnosis involves spinal fluid analysis to identify the cause. Treatment focuses on antibiotics, steroids, and managing increased intracranial pressure. Complications may include hearing loss, learning difficulties, and seizures. Prevention involves vaccination and prompt treatment of infections.
The three membranes covering the brain and spinal cord are the dura mater, arachnoid mater, and pia mater. Meningitis is inflammation of these meninges and is most commonly caused by acute bacterial meningitis from Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type B. These bacteria enter the cerebrospinal fluid and cause an inflammatory response, potentially leading to complications like cerebral infarction, increased intracranial pressure, and hydrocephalus. Clinical manifestations of meningitis include nonspecific symptoms like fever and headache as well as signs of meningeal irritation like nuchal rigidity.
Albendazole or praziquantel
b) Inflammatory phase
Corticosteroids to reduce inflammation
c) Seizures
Antiepileptic drugs
Surgical
For cysts causing mass effect or hydrocephalus
Prevention
Improved sanitation, pork inspection, health education
This document provides an overview of central nervous system (CNS) infections including distinct clinical syndromes such as acute bacterial meningitis, viral meningitis, encephalitis, focal infections, and infectious thrombophlebitis. It discusses the epidemiology, etiology, risk factors, clinical manifestations, diagnosis, and treatment of various CNS infections with a focus on bacterial meningitis. Common causes of bacterial meningitis are outlined for different age groups and risk factors. The diagnosis involves CSF and blood analysis as well as imaging studies. Treatment depends on the suspected pathogen and involves antimicrobial therapy. Viral encephalitis is also overviewed including definition, clinical manifestations, diagnosis involving CSF analysis and imaging, and generally
This document provides an overview of meningitis beyond the neonatal period. It discusses the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, complications and prognosis of meningitis. The most common causative organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Clinical features may include fever, headache, vomiting, and signs of meningeal irritation. Diagnosis involves lumbar puncture and culture of CSF. Empiric antibiotic treatment is initiated while awaiting culture results. Complications can be early like seizures or late like hearing loss. Prognosis depends on causative organism, age of presentation, and presence of co-morbidities.
This document discusses central nervous system (CNS) infections such as meningitis and encephalitis. It defines the conditions and outlines their typical causes, signs and symptoms, diagnostic testing including lumbar puncture, and treatment considerations. The most common types of bacterial meningitis are caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Diagnosis involves imaging, blood and cerebrospinal fluid testing and analysis.
Infections and salivary gland disease in pediatric age: how to manage - Slide...WAidid
The slideset by Professor Susanna Esposito aims at explaining how to manage the salivary gland infections in pediatric age, from pathogenesis, to transmission, treatments and vaccination coverage, that should be urgently increased in Italy as well as in EU Countries.
This document discusses pyogenic meningitis (acute bacterial meningitis). It begins by defining pyogenic infections and describing the anatomy of the meninges. It then covers the epidemiology, causes, clinical features, diagnostic process, treatment, and potential sequelae of bacterial meningitis. Key points include that the most common causes are pneumococcus, meningococcus, and H. influenzae. Clinical features include headache, fever, neck stiffness, and signs of meningeal irritation. Diagnosis involves CSF analysis showing pleocytosis and low glucose. Treatment involves intravenous antibiotics and supportive care. Potential long term effects include deafness, epilepsy, or neurological deficits.
This week, cerebrospinal meningitis is on the news. This disease, which is majorly prevalent during the dry season has been reported to be ravaging five states in the North-West region of Nigeria including- Zamfara, Sokoto, Kebbi, Katsina and Niger States.
This document provides an overview of central nervous system (CNS) infections. It discusses the anatomy of the CNS and cerebrospinal fluid characteristics. The major causes of bacterial meningitis include Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. Fungal, mycobacterial, spirochetal and viral infections can also affect the CNS. Clinical presentation depends on the specific organism and may include symptoms like fever, headache, vomiting and altered mental status. Diagnosis involves CSF analysis and other tests. Timely treatment is important but infections can still cause long-term complications.
Microbial diseases can infect the nervous system through breaks in the skull or backbone, medical procedures, along peripheral nerves, or through the bloodstream. Bacteria like Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, Clostridium tetani, and Haemophilus influenzae can cause meningitis (inflammation of the meninges) or encephalitis (inflammation of the brain) by infecting the cerebrospinal fluid and nervous tissue. Vaccinations exist to help prevent certain types of bacterial meningitis caused by H. influenzae, N. meningitidis, S. pneumoniae, and C. tetani. Treatment involves antibiotics and supportive care
Infections of the central nervous and locomotor systemsSaeed Bajafar
Bacterial infections of the central nervous system like meningitis and encephalitis are caused by bacteria entering through breaks in the protective layers or through the bloodstream from infected areas elsewhere in the body. Common causes are Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, and Mycobacterium tuberculosis. Viral infections are generally milder and self-limiting. Tetanus infection occurs when Clostridium tetani spores enter wounds and release toxins causing painful muscle spasms. Bacterial infections of bones and joints like septic arthritis can result from injuries, bloodstream spread, or extension from nearby infected sites.
This document discusses meningitis, including the different types (bacterial, viral, fungal, parasitic), symptoms, diagnosis, and treatment. It provides details on the typical causes and presentation of bacterial meningitis in different age groups. Diagnosis involves examination of cerebrospinal fluid. Treatment depends on the identified organism but generally involves antibiotics, antifungals, or other drugs, along with measures to address complications.
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
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Meningitis is always cerebrospinal infection. Meningitis is a rare infection that affects the delicate membranes -- called meninges -- that cover the brain and spinal cord.There are several types of this disease, including bacterial, viral, and fungal.
This document provides information about meningitis, including what it is, its causes, symptoms, and importance for public health. Meningitis is an inflammation of the meninges surrounding the brain and spinal cord. It can be caused by bacteria, viruses, fungi or other factors. Bacterial meningitis requires urgent antibiotic treatment and can be life-threatening. Common symptoms include fever, headache, neck stiffness, and rash. Public education is important for raising awareness of meningitis signs and encouraging timely medical care. Challenges for public health include educating the public and timely reporting, while opportunities include strengthening communication and partnerships.
This document summarizes meningitis in children, including the definition, causes, signs and symptoms, diagnosis, treatment, and prevention. Meningitis is an inflammation of the membranes surrounding the brain and spinal cord. It most commonly affects infants and children under 5 years old. Bacteria such as pneumococcus, meningococcus, and H. influenzae are common causes. Signs include fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture and culture of spinal fluid. Treatment involves antibiotics and supportive care. Vaccines can help prevent certain bacterial types. Complications may include neurological deficits if not treated promptly.
Bacterial meningitis can be severe and cause long term effects like hearing loss or learning disabilities, while viral meningitis is generally less severe and resolves without treatment. It is important to determine if meningitis is bacterial or viral and, if bacterial, to identify the specific bacteria causing the infection in order to guide treatment and preventative measures. Meningitis is diagnosed through spinal fluid analysis to check for signs of inflammation and look for bacteria. While some forms of bacterial meningitis can be transmitted between people, viruses that cause meningitis are not as contagious.
This document discusses group members and then provides information on meningitis. It defines cerebrospinal fluid and discusses the epidemiology and pathophysiology of meningitis. It outlines the clinical features of meningitis in neonates, infants, and children. It discusses the etiology of bacterial, viral, fungal and other types of meningitis. It describes the clinical manifestations, diagnosis, treatment and management of meningitis.
This document discusses acute community-acquired bacterial meningitis in adults. It begins by stating that the most common causes are Streptococcus pneumoniae and Neisseria meningitidis. It emphasizes that a lumbar puncture is needed to diagnose bacterial meningitis and identify the causative organism. While symptoms are not specific, prompt diagnosis and treatment are important as bacterial meningitis can have high rates of morbidity and mortality.
This document discusses meningitis and encephalitis. It defines meningitis as an infection of the meninges and encephalitis as an inflammation of the brain parenchyma. It outlines the different types of meningitis and common causative organisms. It describes the clinical features, investigations, complications, prognosis and treatment for both conditions. The goals of physical therapy for patients with these inflammatory central nervous system disorders are also mentioned.
Meningitis is an infection of the membranes (meninges) surrounding the brain and spinal cord. It can be caused by bacteria, viruses, or fungi. Bacterial meningitis is the most common and life-threatening type. Symptoms include fever, severe headache, nausea, and neck stiffness. Diagnosis involves spinal fluid analysis to identify the cause. Treatment focuses on antibiotics, steroids, and managing increased intracranial pressure. Complications may include hearing loss, learning difficulties, and seizures. Prevention involves vaccination and prompt treatment of infections.
The three membranes covering the brain and spinal cord are the dura mater, arachnoid mater, and pia mater. Meningitis is inflammation of these meninges and is most commonly caused by acute bacterial meningitis from Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type B. These bacteria enter the cerebrospinal fluid and cause an inflammatory response, potentially leading to complications like cerebral infarction, increased intracranial pressure, and hydrocephalus. Clinical manifestations of meningitis include nonspecific symptoms like fever and headache as well as signs of meningeal irritation like nuchal rigidity.
Albendazole or praziquantel
b) Inflammatory phase
Corticosteroids to reduce inflammation
c) Seizures
Antiepileptic drugs
Surgical
For cysts causing mass effect or hydrocephalus
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Improved sanitation, pork inspection, health education
This document provides an overview of central nervous system (CNS) infections including distinct clinical syndromes such as acute bacterial meningitis, viral meningitis, encephalitis, focal infections, and infectious thrombophlebitis. It discusses the epidemiology, etiology, risk factors, clinical manifestations, diagnosis, and treatment of various CNS infections with a focus on bacterial meningitis. Common causes of bacterial meningitis are outlined for different age groups and risk factors. The diagnosis involves CSF and blood analysis as well as imaging studies. Treatment depends on the suspected pathogen and involves antimicrobial therapy. Viral encephalitis is also overviewed including definition, clinical manifestations, diagnosis involving CSF analysis and imaging, and generally
This document provides an overview of meningitis beyond the neonatal period. It discusses the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, complications and prognosis of meningitis. The most common causative organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Clinical features may include fever, headache, vomiting, and signs of meningeal irritation. Diagnosis involves lumbar puncture and culture of CSF. Empiric antibiotic treatment is initiated while awaiting culture results. Complications can be early like seizures or late like hearing loss. Prognosis depends on causative organism, age of presentation, and presence of co-morbidities.
This document discusses central nervous system (CNS) infections such as meningitis and encephalitis. It defines the conditions and outlines their typical causes, signs and symptoms, diagnostic testing including lumbar puncture, and treatment considerations. The most common types of bacterial meningitis are caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Diagnosis involves imaging, blood and cerebrospinal fluid testing and analysis.
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The slideset by Professor Susanna Esposito aims at explaining how to manage the salivary gland infections in pediatric age, from pathogenesis, to transmission, treatments and vaccination coverage, that should be urgently increased in Italy as well as in EU Countries.
This document discusses pyogenic meningitis (acute bacterial meningitis). It begins by defining pyogenic infections and describing the anatomy of the meninges. It then covers the epidemiology, causes, clinical features, diagnostic process, treatment, and potential sequelae of bacterial meningitis. Key points include that the most common causes are pneumococcus, meningococcus, and H. influenzae. Clinical features include headache, fever, neck stiffness, and signs of meningeal irritation. Diagnosis involves CSF analysis showing pleocytosis and low glucose. Treatment involves intravenous antibiotics and supportive care. Potential long term effects include deafness, epilepsy, or neurological deficits.
This week, cerebrospinal meningitis is on the news. This disease, which is majorly prevalent during the dry season has been reported to be ravaging five states in the North-West region of Nigeria including- Zamfara, Sokoto, Kebbi, Katsina and Niger States.
This document provides an overview of central nervous system (CNS) infections. It discusses the anatomy of the CNS and cerebrospinal fluid characteristics. The major causes of bacterial meningitis include Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. Fungal, mycobacterial, spirochetal and viral infections can also affect the CNS. Clinical presentation depends on the specific organism and may include symptoms like fever, headache, vomiting and altered mental status. Diagnosis involves CSF analysis and other tests. Timely treatment is important but infections can still cause long-term complications.
Microbial diseases can infect the nervous system through breaks in the skull or backbone, medical procedures, along peripheral nerves, or through the bloodstream. Bacteria like Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, Clostridium tetani, and Haemophilus influenzae can cause meningitis (inflammation of the meninges) or encephalitis (inflammation of the brain) by infecting the cerebrospinal fluid and nervous tissue. Vaccinations exist to help prevent certain types of bacterial meningitis caused by H. influenzae, N. meningitidis, S. pneumoniae, and C. tetani. Treatment involves antibiotics and supportive care
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Bacterial infections of the central nervous system like meningitis and encephalitis are caused by bacteria entering through breaks in the protective layers or through the bloodstream from infected areas elsewhere in the body. Common causes are Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, and Mycobacterium tuberculosis. Viral infections are generally milder and self-limiting. Tetanus infection occurs when Clostridium tetani spores enter wounds and release toxins causing painful muscle spasms. Bacterial infections of bones and joints like septic arthritis can result from injuries, bloodstream spread, or extension from nearby infected sites.
This document discusses meningitis, including the different types (bacterial, viral, fungal, parasitic), symptoms, diagnosis, and treatment. It provides details on the typical causes and presentation of bacterial meningitis in different age groups. Diagnosis involves examination of cerebrospinal fluid. Treatment depends on the identified organism but generally involves antibiotics, antifungals, or other drugs, along with measures to address complications.
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Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
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Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
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Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
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Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
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1. M E N I N G I T I S
P R E S E N T E D B Y
N U R U L H I D A Y U B I N T I I B R A H I M
N I K N O R L I Y A N A
2. OUTLINE
1. Introduction to meningitis
2. Risk factor
3. Anatomy and prognosis
4. Aetiology
5. History and physical examination
6. Clinical features
7. Complications
8. Differential diagnosis
9. Investigations
10. Management
3. INTRODUCTION
Meningitis is a disease caused by the inflammation of the meninges.
The inflammation is usually caused by an infection of the fluid surrounding the
brain and spinal cord.
It can be life-threatening because of the inflammation’s proximity to the brain
and spinal cord; therefore the condition is classified as a medical emergency.
If not treated, meningitis can lead to brain swelling and cause permanent
disability, coma, and even death.
Broadly classified as :
I. Acute meningitis
II. Chronic meningitis
WHAT IS MENINGITIS?
4. TERMS
Set of symptoms similar to those of meningitis but not caused by meningitis.
Meningism is caused by non-meningitic irritation of the meninges, usually associated
with acute febrile illness, especially in children and adolescents.
It therefore requires differentiating from other CNS problems with similar symptoms,
including meningitis and some types of intracranial hemorrhage.
The severity of clinical features varies with the causative organism.
M E N I N G I S M
5. RISK FACTORS
Risk factors that place people at higher risk for bacterial meningitis include
the following:
Adults older than 60 years of age
Children younger than 5 years of age
People with alcoholism
People with sickle cell anemia
People with cancer, especially those receiving chemotherapy
People who have received transplants and are taking drugs that suppress
the immune system
People with diabetes
Those recently exposed to meningitis at home
People living in close quarters (military barracks, dormitories)
IV drug users
People with shunts in place for hydrocephalus
6. ANATOMY OF MENINGES
The meninges is the system of the membranes which envelops
the CNS. It has 3 layers:
1. Dura mater
2. Arachnoid mater
3. Pia mater
Subarachnoid space – is the space which is filled with CSF
10. TRANSMISSION
H O W D O E S M E N I N G I T I S S P R E A D ?
An infectious agent can gain access to the CNS and cause meningeal disease via any of
the 3 following major pathways:
Direct contiguous spread (e.g. sinusitis, otitis media, congenital malformations, trauma,
or direct inoculation during intracranial manipulation)
1 . I N V A S I O N O F T H E B L O O D S T R E A M
Invasion of the bloodstream (i.e., bacteremia, viremia, fungemia, or parasitemia) and
subsequent hematogenous seeding of the CNS
2 . R E T R O G R A D E N E U R O N A L PAT H W AY
A retrograde neuronal (eg, olfactory and peripheral nerves) pathway (eg, Naegleria
fowleri or Gnathostoma spinigerum)
3 . D I R E C T C O N T I G U O U S S P R E A D
11. TRANSMISSION
H O W D O E S M E N I N G I T I S S P R E A D ?
3 . D I R E C T C O N T I G U O U S S P R E A D
Local extension from contiguous extracerebral infection (eg, otitis media,
mastoiditis, or sinusitis) is a common cause.
Possible pathways for the migration of pathogens from the middle ear to the
meninges include the following:
1. The bloodstream
2. Preformed tissue planes (eg, posterior fossa)
3. Temporal bone fractures
4. The oval or round window membranes of the labyrinths
14. PROGNOSIS
Patients with meningitis who present with an impaired level of
consciousness are at increased risk for neurologic sequelae or death.
A seizure during an episode of meningitis also is a risk factor for mortality
or neurologic sequelae, particularly if the seizure is prolonged or difficult
to control.
In bacterial meningitis, several risk factors are associated with death and
with neurologic disability. A risk score has been derived and validated in
adults with bacterial meningitis. This score includes the following
variables, which are associated with an adverse clinical outcome:
1. Older age
2. Increased heart rate
3. Lower Glasgow Coma Scale score
4. Cranial nerve palsies
5. CSF leukocyte count lower than 1000/μL
6. Gram-positive cocci on CSF Gram stain
15. PROGNOSIS
Advanced bacterial meningitis can lead to brain damage,
coma, and death.
In 50% of patients, several complications may develop in the
days to weeks following infection.
Long-term sequelae are seen in as many as 30% of survivors
and vary with etiologic agent, patient age, presenting
features, and hospital course. Patients usually have subtle CNS
changes.
16. AETIOLOGY
B A C T E R I A L
V I R A L
F U N G A L
P H Y S I C A L I N J U R Y
D R U G S R E A C T I O N
Severity/ treatment of illness differ depending on the cause. Thus, it is
important to know the specific cause of meningitis.
17. AETIOLOGY
B A C T E R I A L M E N I N G I T I S V I R A L M E N I N G I T I S
The most serious form of meningitis is
bacterial.
Even with treatment, bacterial meningitis
can be fatal some of the time.
If bacterial meningitis progresses rapidly,
in 24 hours or less, death may occur in
more than half of those who develop it,
even with proper medical treatment.
Determining how many people get viral
meningitis is difficult because it often
remains undiagnosed and is easily
confused with the flu.
The prognosis for viral meningitis is much
better than that for bacterial meningitis,
with most people recovering completely
with simple treatment of the symptoms.
18. AETIOLOGY
F U N G A L M E N I N G I T I S A S E P T I C M E N I N G I T I S
Fungal meningitis is a serious form of
meningitis that is normally limited to
people with impaired immune systems.
Aseptic meningitis is a term referring to
the broad category of meningitis that is
not caused by bacteria.
Approximately 50% of aseptic meningitis
is due to viral infections.
Other less common causes include drug
reactions or allergies, and inflammatory
diseases like lupus.
It occurs in individuals of all ages but is
more common in children
19. BACTERIAL CAUSES
Listeria monocytogenes ( >50 years old)
Group A β-hemolytic streptococcus
Group B β-hemolytic streptococcus
Mycoplasma pneumoniae
Gram –ve rods
C O M M O N O R G A N I S M S :
1. Streptococcus pneumoniae (α-hemolytic streptococcus)
2. Neisseria meningitidis
3. Haemophilus influenzae
O T H E R O R G A N I S M S :
V I R A L C A U S E S
Enteroviruses
Herpes simplex virus
20. ORGANISMS
R I S K O R P R E D I S P O S I N G F A C T O R S B A C T E R I A L P A T H O G E N
Age 3 months – 18 years
Neisseria meningitidis
Streptococcus penumoniae
Haemophilus influenza
Age 18 – 50 years
Streptococcus penumoniae
Neisseria meningitidis
Haemophilus influenza
Age > 50 years
Streptococcus penumoniae
Neisseria meningitidis
Listeria monocytogenes
Aerobic gram-negative bacilli
Immunocompromised state
Streptococcus penumoniae
Neisseria meningitidis
Listeria monocytogenes
Aerobic gram-negative bacilli
Intracranial manipulation, including neurosurgery
Staphylococcus aureus
Coagulase negative staphylococci
Aerobic gram-negative bacilli, including
Pseudomonas aeruginosa
Basilar skull fracture
Streptococcus penumoniae
Haemophilus influenza
Group A streptococci
21. NEISSERIA MENINGITIDIS
Also known as meningococcal meningitis
Gram negative aerobic cocci, capsule
10% of healthy people are healthy nasopharyngeal
carriers
Begin as throat infection, rash
Vaccination is recommended
22. NEISSERIA MENINGITIDIS
STREPTOCOCCUS PNEUMONIAE
Gram positive diplococci
70% of people are healthy nasopharyngeal carriers
Most common in children (1 month to 4 years)
Mortality: 30% in children, 80% in elderly
Prevented by vaccination
23. NEISSERIA MENINGITIDIS
HISTORY TAKING
~25% of those who develop meningitis have symptoms that develop
over 24 hours. The remainder generally become ill over one to seven
days.
~25% of patients have concomitant sinusitis or otitis that could
predispose to S pneumoniae meningitis.
Occasionally, if someone has been on antibiotics for another infection,
the symptoms can take longer to develop or may be less intense.
If someone is developing fungal meningitis (most commonly someone
who is HIV positive), the symptoms may take weeks to develop.
D U R AT I O N
24. NEISSERIA MENINGITIDIS
HISTORY TAKING
In contrast, patients with subacute bacterial meningitis and most
patients with viral meningitis present with neurologic symptoms
developing over 1 – 7 days.
Chronic symptoms lasting longer than 1 week suggest the presence of
meningitis caused by certain viruses or by tuberculosis, syphilis, fungi
(especially cryptococci), or carcinomatosis.
D U R AT I O N
26. NEISSERIA MENINGITIDIS
HISTORY TAKING
S Y M P T O M S I G N M E C H A N I S M
Chills, rigors Fever (T>38°) Endogenous cytokines (released during the
immune response to the invading
pathogens) affect the thermoregulatory
neurons of the hypothalamus, changing the
central regulation of body temperature.
Invading viruses or bacteria produce
exogenous substances (pyrogens) that can
also re-set the hypothalamic thermal set
point.
Nuchal rigidity (neck stiffness) Brudzinski sign and Kernig sign Flexion of the spine leads to stretching of
the meninges.
In meningitis, traction on the inflamed
meninges is painful, resulting in limited
range of motion through the spine
(especially in the cervical spine).
Altered mental status Decreased Glasgow Coma Scale (GCS) ↑ ICP → brain herniation → damage to
the reticular formation (structure in the
brainstem that governs consciousness)
27. NEISSERIA MENINGITIDIS
HISTORY TAKING
S Y M P T O M S I G N M E C H A N I S M
Focal neurological deficits, e.g. vision loss Examples: cranial nerve palsies,
hemiparesis, hypertonia, nystagmus
Cytotoxic edema and ↑ ICP lead to
neuronal damage.
Signs or symptoms depend on the affected
area (cerebrum, cerebellum, brainstem,
etc.)
Seizures Inflammation in the brain alters membrane
permeability, lowering the seizure
threshold. Exact seizure pathophysiology is
unknown.
Headache Jolt accentuation of headache: headache
worse when patient vigorously shakes head
Bacterial exotoxins, cytokines, and ↑ ICP
stimulate nociceptors in the meninges
(cerebral tissue itself lacks nerve endings
that generate pain sensation).
Photophobia Due to meningeal irritation. Mechanisms
unclear; pathways are thought to involve
the trigeminal nerve.
Nausea and vomiting ↑ ICP stimulates the area
postrema (vomiting centre), causing nausea
and vomiting.
Petechial rash Meningococcemia (due to N. meningitidis)
28. NEISSERIA MENINGITIDIS
HISTORY TAKING
O T H E R I M P O R TA N T H I S T O R Y
Contact with TB patient (TB meningitis)
Infection of middle ear, sinuses, lung or tooth and gum (brain abscess)
Contact with infected bodily secretions (meningitis, herpes encephalitis)
Sexual contact with a person infected with HIV (HIV encephalopathy)
Penetrating head trauma (brain abscess)
Neurosurgical complications (meningitis, brain abscess)
A chronic illness, such as cancer
A weakened immune system, such those with alcoholism, diabetes, HIV or people
who have had organ transplant.
A history of recent antibiotic use should be elicited. 40% of patients who present
with acute or subacute bacterial meningitis have previously been treated with oral
antibiotics (presumably because of misdiagnosis at the time of initial presentation).
29. NEISSERIA MENINGITIDIS
PHYSICAL EXAMINATION
G E N E R A L E X A M I N AT I O N
Non-toxic looking might suggestive of viral origin.
Sick, toxic looking might suggest bacterial origin.
Glasgow-coma scale
Kernig’s sign
Brudzinki’s sign
Look for other source of infections:
Cutaneous petachie/purpura rash meningococcus
Middle ear, sinus infection
Pneumonia pneumococcus
Papilledema (increase ICP)
Cranial nerves examination (III, IV, V, VI, and VII)
S P E C I F I C E X A M I N AT I O N
32. NEISSERIA MENINGITIDIS
CLINICAL FEATURES
C H R O N I C M E N I N G I T I S
Lymphadenopathy
Papilledema and tuberculomas during funduscopy
Meningismus
Cranial nerve palsies
Occurs most common shortly after primary infection in childhood or as part of
military TB.
The presentation of chronic tuberculous meningitis may be acute, but the classic
presentation is subacute and spans weeks. Patients generally have a prodrome
consisting of fever of varying degrees, malaise, and intermittent headaches.
T U B E R C U L O U S M E N I N G I T I S
33. NEISSERIA MENINGITIDIS
CLINICAL FEATURES
Cranial nerve palsies (III, IV, V, VI, and VII) often develop, suggesting basilar
meningeal involvement.
Clinical staging of tuberculous meningitis is based on neurologic status, as
follows:
Stage 1 - No change in mental function, with no deficits and no
hydrocephalus
Stage 2 - Confusion and evidence of neurologic deficit
Stage 3 - Stupor and lethargy
T U B E R C U L O U S M E N I N G I T I S
C L I N I C A L S TA G I N G O F T U B E R C U L O U S M E N I N G I T I S
35. NEISSERIA MENINGITIDIS
COMPLICATIONS
1 . H E A R I N G L O S S
2 . C E R E B R A L O E D E M A A N D I N C R E A S E D I C P
4 . B R A I N A B S C E S S
4 . S T R O K E
Infections / inflammation from subarachnoid space via cochlear aqueduct inner ear
Inflammatory response – damages cochlear (hair cells)
Cerebral edema may be vasogenic, from increased vascular permeability, cytotoxic from cerebral hypoxia, interstitial, from
increased CSF volume, or a combination of all. Increased intracranial pressure, in turn, causes decreased cerebral perfusion,
hypoxia/ischemia, and neuronal necrosis.
3 . D I S S E M I N AT E D I N T R A V A S C U L A R C O A G U L O PAT H Y ( D I C )
Bacterial products can damage the brain and blood vessels directly. Bacterial toxins cause neuronal apoptosis, and cell wall
lipopolysaccharide (endotoxin), released from bacteria, activates clotting causing disseminated intravascular coagulation (DIC).
36. NEISSERIA MENINGITIDIS
DIFFERENTIAL DIAGNOSIS
1 . S u b a r a c h n o i d h e m o r r h a g e
2 . T B m e n i n g i t i s
3 . S p a c e - o c c u p y i n g l e s i o n
4 . M e n i n g o e n c a p h a l i t i s
5 . E p i l e p s y
37. NEISSERIA MENINGITIDIS
INVESTIGATIONS
B L O O D T E S T S
1. Full blood count ( white cell count)
2. C-reactive protein
3. Blood culture and sensitivity
L U M B A R P U N C T U R E A N D C S F A N A LY S I S
For definitive diagnosis of meningitis, CSF needs to be collected for analysis.
C O N T R A I N D I C AT I O N S
Infected skin over needle entry site
Suspicion of increase ICP
Coagulopathy
Significant cardiorespiratory compromise
Immunocompromised
38. NEISSERIA MENINGITIDIS
INVESTIGATIONS
L U M B A R P U N C T U R E A N D C S F A N A LY S I S
T E S T B A C T E R I A L V I R A L F U N G A L T U B E R C U L A R
Opening pressure Elevated Normal Variable Variable
WBC count >1,000 / mm3 <100/mm3 Variable Variable
Cell differential Neutrophils Lymphocytes Lymphocytes Lymphocytes
Protein Mild to marked
elevation
Normal or mildly
elevated
Elevated Very high
CSF-to-serum
glucose ratio
Markedly decreased normal Low Low
I M A G I N G
If a patient has the following:
Focal neurologic findings (excluding cranial nerve palsies), new-onset seizures, severely immunocompromised
state, papilledema or presents with coma, perform a head computed tomography scan prior to doing a lumbar
puncture to rule out the presence of intracranial mass lesions because of the potential risk for herniation
39. NEISSERIA MENINGITIDIS
MANAGEMENT
S U P P O R T I V E T R E AT M E N T
Airway, breathing and circulation
Mechanical ventilation – level of consciousness is very low / evidence of respiratory failure
Intravenous fluid therapy – if hypotension or shock are present
Monitor vital signs and neurologic status regularly
Maintain adequate hydration and nutrition – tube feeding may be necessary
D E F I N I T I V E T R E AT M E N T ( P H A R M A C O T H E R PA P Y )
1. Antibiotic therapy
2. Anti-inflammatory therapy
3. Agents to decrease intracranial pressure (ICP)
4. Anti-convulsants
40. NEISSERIA MENINGITIDIS
MANAGEMENT
A N T I B I O T I C S ( A C U T E M E N I N G I T I S )
I N F E C T I O N
S U G G E S T E D T R E A T M E N T
C O M M E N T S
P R E F E R R E D A L T E R N A T I V E
Common organisms:
Streptococcus
pneumoniae
Neisseria meningitidis
Haemophilus influenzae
Ceftriaxone 2gm IV q12h
OR
Cefotaxime 2 – 4gm IV q8h
Dexamethasone 10mg IV q6h
is recommended to be
administered 15 to 20 minutes
before or at the time of first
dose of antibiotics, for up to 4
days or until there is no
evidence of pneumococcal
meningitis.
Antibiotic treatment must be
started immediately,
regardless of any
investigations undertaken. If
no organism isolated and
patient is responding,
continue antibiotics for 14
days.
41. NEISSERIA MENINGITIDIS
MANAGEMENT
A N T I B I O T I C S ( A C U T E M E N I N G I T I S )
I S O L A T E D C A U S A T I V E
O R G A N I S M
S U G G E S T E D T R E A T M E N T
C O M M E N T S
P R E F E R R E D A L T E R N A T I V E
HAEMOPHILUS INFUENZAE
(GRAM –VE BACILLI)
Ceftriaxone 2gm IV q12h
STREPTOCOCCUS PNEUMONIAE
(GRAM +VE COCCI)
Benzylpenicillin 4MU IV q4-
6h for 10-14 days.
For penicillin resistant strains
Vancomycin 1gm IV q12h
NEISSERIA MENINGITIDIS
(GRAM –VE COCCI)
Prophylaxis for household and
close contact of meningococcal
meningitis
Ceftriaxone 2gm IV q12h
Ciprofloxacin 500mg PO as
single dose;
Close contacts are defined as
those individuals who have
had contact with
oropharyngeal secretions
either through kissing or by
sharing toys, beverages, or
cigarettes.
42. NEISSERIA MENINGITIDIS
MANAGEMENT
A N T I B I O T I C S ( C H R O N I C M E N I N G I T I S )
I N F E C T I O N
S U G G E S T E D T R E A T M E N T
C O M M E N T S
P R E F E R R E D A L T E R N A T I V E
TUBERCULOUS MENINGITIS
Mycobacterium tuberculosis
Intensive 2 months S/EHRZ
and 10 months HR
Pyridoxine 10- 50mg PO q24h
needs to be prescribed
together with Isoniazid.
(Streptomycin should replace
Ethambutol in TB meningitis
as it crosses BBB better than
Ethambutol.)
Treatment is continued for 12
months.
CPG on management of
Tuberculosis, 3rd edition,
2012; 16, 22, 40-42, 56)
WHO Treatment of
Tuberculosis Guidelines, 4th
ed. 2009
43. NEISSERIA MENINGITIDIS
MANAGEMENT
A N T I - I N F L A M M AT O R Y T H E R A P Y
Dexamethasone 10 mg IV 6 hourly x 4 days
Mannitol 1 – 1.5 g/kg IV given over 15 minutes
I C P L O W E R I N G A G E N T
A N T I C O N V U L S A N T S
Diazepam, Lorazepam
Administered if patient has seizure
Action:
Mannitol is a hyperosmolar agent that makes the intravascular space hyperosmolar to the brain and permits movement of water
from brain tissue into the intravascular compartment
44. NEISSERIA MENINGITIDIS
PREVENTION AND PROPHYLAXIS
P R E C A U T I O N
Completion of recommended schedule of vaccination is an effective way of protecting individuals from certain
types of bacterial meningitis (E.g. meningococcus, pneumococcus and Hib)
F O L L O W U P
Repeat cerebrospinal fluid exam in patients in whom there is doubt about the success of therapy or the
accuracy of the initial diagnosis
Patients who respond promptly to therapy may no longer need repeat cerebrospinal fluid exams
Monitor for hydrocephalus and treat the condition appropriately - hydrocephalus usually manifests within the
first few weeks of infection and is treated with ventriculoperitoneal shunting
Monitor for neurologic sequelae and provide appropriate supportive therapy
Sequelae include hearing impairment, cranial nerve palsies and motor deficits
Supportive therapy should be individually tailored
Use of mask, gloves, and gowns prevents spread of disease as meningitis is a droplet infection
V A C C I N AT I O N