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Department of Infectious Diseases ( Shi Hong ) MENINGOCOCCAL MENINGITIS
Meningococcal meningitis Meningococcal meningitis Morbidity mortality rate Morbidity mortality ●   early diagnosis ●   modern  therapy ●   supportive  measure HIGH low
A case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],What was the most likely diagnosis
Definition ,[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Etiology ,[object Object],[object Object],[object Object],[object Object],What causes Meningococcal meningitis
Epidemiology ,[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Epidemiology ,[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Who is at risk?
Pathogenesis  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Pathogenesis  ,[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Pathogenesis ,[object Object],[object Object],Meningococcal meningitis endothelial cells endotoxin ▼ Petechia ▼ infectious  shock ▼ acidosis,  ▼ DIC  ▼ multiorgans  failure invade release
Pathogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Clinical manifestations What are the signs and symptoms petechia in the skin (Meningococcal meningitis)
Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],What are the signs and symptoms
Clinical manifestations Meningococcal meningitis Septic period ▲  an abrupt onset  ▲  chills  high fever ▲   Headache ▲  Petechias ▲  purpuras ▲ Splenomegaly Meningitic period ▲   intracranial   pressure  ▲   headache ▲   vomiting  ▲   restlessness ▲   Stiff neck   ▲   Kernig (+) ▲   brudziski (+) ▲   gradually disappears , ▲   recovers to normal . Prodromal period   Septic period Meningitic period Convalescent period
Clinical manifestations Meningococcal meningitis
Clinical manifestations Meningococcal meningitis
Laboratory examination ,[object Object],Meningococcal meningitis WBC>20×10 9 /L Polymorphonuclear leukocyte platelet count(DIC)
Laboratory examination ,[object Object],Meningococcal meningitis CSF
Laboratory examination ,[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis turbid >1000 ×10 6 /L
Laboratory examination ,[object Object],[object Object],Meningococcal meningitis Smear: skin lesions  spun sediment of CSF   Bacterial culture  of blood and CSF
Laboratory examination Meningococcal meningitis Figure :   Neisseria meningitidis  Gram-stain of a pure culture
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Differential diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],How to diagnose Meningococcal meningitis
A case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],What was the most likely diagnosis
Problems To analyze the case what’s the  most likely diagnosis? 1 what do we still do  for definitive diagnosis? 2 How  to  treat  this  young  patient? 3
Treatment 1 General treatment ① Isolation hospitalization:  ② Careful monitor nursing.  ③ Prevent complication. ④ Maintain the balances of fluid and electrolytes  2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],3 Other treatment   ●  High fever:  anti-pyretic (physical  chemical )  measures.  ●   Increased intracranial pressure: 20 % mannitol ( 0.5g/kg~2g/kg )
Treatment Meningococcal meningitis ⑴  Shock type  ① Etiology treatment:   . Penicillin G ②  Shock should be corrected promptly: a. Volume expanded. b. Metabolic acidosis corrected. c. Vasoactive drugs.  d. Adrenal corticosteroids.  e. Important organs protected   Fulminate type ⑵  Meningococcemia-meningitis type ①  Effective antibacterial drugs. Penicillin G. ② Alleviate cerebral edema  Mannitol and 50 per cent Glucose. ③  Adrenal corticosteroids:   Dexamethasone  ④  Treatment in respiratory failure: lobeline, coramine   ⑤ High fever and seizure:   Sedatives: wintermine  phenergan
Prognosis Meningococcal meningitis Fulminate meningo-coccemia early diagnosed  appropriately  treated in the extremes of age Good poor poor
Prevention Meningococcal meningitis Protect Protection of the susceptible population Protect Protection of the susceptible population Administer meningococcal vaccines, Chemoprophylaxis isolate for 3 days after the symptoms disappeared, generally no less 7 days after the onset observe Close contacts: observed medically for 7 days . Disrupt To go to the crowd places should be avoided during the epidemic
Multiple choice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Multiple choice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Summarization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Summarization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Summarization ,[object Object],Meningococcal meningitis
Thank You for your suggestion! E-mail:  [email_address] Qq: 673162735
Thank You !
Features of meningococcal meningitis in infants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis
Features of menigococcal meningitis in the old ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Meningococcal meningitis

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4 Meningococcal Meningitis

  • 1. Department of Infectious Diseases ( Shi Hong ) MENINGOCOCCAL MENINGITIS
  • 2. Meningococcal meningitis Meningococcal meningitis Morbidity mortality rate Morbidity mortality ● early diagnosis ● modern therapy ● supportive measure HIGH low
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  • 13. Clinical manifestations What are the signs and symptoms petechia in the skin (Meningococcal meningitis)
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  • 15. Clinical manifestations Meningococcal meningitis Septic period ▲ an abrupt onset ▲ chills high fever ▲ Headache ▲ Petechias ▲ purpuras ▲ Splenomegaly Meningitic period ▲ intracranial pressure ▲ headache ▲ vomiting ▲ restlessness ▲ Stiff neck ▲ Kernig (+) ▲ brudziski (+) ▲ gradually disappears , ▲ recovers to normal . Prodromal period Septic period Meningitic period Convalescent period
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  • 22. Laboratory examination Meningococcal meningitis Figure :  Neisseria meningitidis Gram-stain of a pure culture
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  • 26. Problems To analyze the case what’s the most likely diagnosis? 1 what do we still do for definitive diagnosis? 2 How to treat this young patient? 3
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  • 28. Treatment Meningococcal meningitis ⑴ Shock type ① Etiology treatment: . Penicillin G ② Shock should be corrected promptly: a. Volume expanded. b. Metabolic acidosis corrected. c. Vasoactive drugs. d. Adrenal corticosteroids. e. Important organs protected Fulminate type ⑵ Meningococcemia-meningitis type ① Effective antibacterial drugs. Penicillin G. ② Alleviate cerebral edema Mannitol and 50 per cent Glucose. ③ Adrenal corticosteroids: Dexamethasone ④ Treatment in respiratory failure: lobeline, coramine ⑤ High fever and seizure: Sedatives: wintermine phenergan
  • 29. Prognosis Meningococcal meningitis Fulminate meningo-coccemia early diagnosed appropriately treated in the extremes of age Good poor poor
  • 30. Prevention Meningococcal meningitis Protect Protection of the susceptible population Protect Protection of the susceptible population Administer meningococcal vaccines, Chemoprophylaxis isolate for 3 days after the symptoms disappeared, generally no less 7 days after the onset observe Close contacts: observed medically for 7 days . Disrupt To go to the crowd places should be avoided during the epidemic
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  • 36. Thank You for your suggestion! E-mail: [email_address] Qq: 673162735
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