This document discusses meningitis, an inflammation of the meninges that surround the brain and spinal cord. It can be caused by viruses or bacteria entering the blood and crossing the blood-brain barrier. Common symptoms include fever, headache, and neck stiffness. Diagnosis involves spinal taps, blood tests, and scans. Treatment is with antibiotics and supportive care. Vaccines can help prevent some forms of bacterial meningitis.

3.  Introduction
 Types
 Layers of meninges
 Epidemology
 Mechanism
 Mode of transmission
 Signs and symptoms
 Diagnosis
 Treatment
 Prevention
3

4.  Condition where the brain and
the spinal cord meninges
become inflamed
 Fluid of a person's spinal cord
and the fluid that surrounds the
brain
 Can be further classified as
aseptic, septic, or tuberculous.

5. •Due to virus
•Less severeVIRAL
MENINGITIS
•Severe
•Brain demage.Loss
of hearing
•Learning disability
BACTERIAL
MENINGITIS
5

6. 6
CNS
BRAIN
SPINAL
CORD
MENINGS

8. 8
3 MEMBRANES MENINGES

9. •fibrous
•Connective
tissue
DURA
MATTER
•delicate
•Serous
membrane
ARACHNOID
•Vascular
membranePIA MATTER
9

10. IT CAN BE CAUSED BY THREE
TYPES OF BACTERIA
Haemophilus
inluenza type
b
Streptococcus
pneumoniae
Neisseria
meningitidis

11. EPIDEMOLOGY
. 3 people per 100,000 anually in
western world
Meningitis belt 500
cases per 100,000
sub-saharan africa
Meningococcal
,people living
together

12. 12
Mechanism
 Blood brain barrier
Normally the brain is protected by the blood brain barrier
 Thick membrane that filters out impurities from blood
 Does not allow entry into the brain.
 In some persons with decreased immunity the infection
crosses the blood brain barrier.

13. 13
 The subarachnoid space
Once bacteria have entered the bloodstream, they enter
the subarachnoid space.
 Swelling of the meninges
This leads to activation of the immune system that leads
to swelling of the meninges
 To stop the spread of the infection.
 This swelling damages the brain and the nervous system.
 Cerebrospinal fluid
The organism may also affect the CSF.
 This adds to the injury and there is increased pressure on
the brain and on the skull.
 This is called raised intracranial pressure.

14. 14
 The immune response
With the inflammation, the immune system identifies the
bacteria by its cell wall
 The immune cells of the brain (astrocytes and microglia),
respond by releasing large amounts of cytokines
are hormone-like mediators that recruit other immune cells. This
stimulates other tissues to participate in an immune response.
The blood-brain barrier becomes more permeable, leading to
"vasogenic" cerebral edema (swelling of the brain due to fluid
leakage from blood vessels)
 The blood vessels are also inflamed leading to
cerebral vasculitis which leads to a decreased blood flow another
type of edema, "cytotoxic" edema.

15. MODE OF TRANSMISSION
 direct contact
 indirect contact
 droplets
 INCUBATION PERIOD
 5-10 days after breaking blood brain barrier, but
lethal in 24 hours and shorter especially in young
pt.
15
15

16. 1. Signs of infection
Fever
Chills
Malaise
2. Signs of increased intracranial pressure
Headache
Vomiting

17. 3. Signs of meningeal irritation
 Nuchal rigidity (stiff neck)
Opisthotonos (backward arching
of the body in muscle spasms)
Photophobia (sensitivity to light)
Diplopia (double vision)
Delirium, stupor, coma: indicates
a decreasing level of
consciousness, an agitated state
followed by a progressive decrease
in consciousness, and ultimately a
lack of any response.

18. Other symptoms may include:
- nausea
-discomfort looking into bright
lights
- Confusion
-sleepiness.

19. NEW BORN
SYMPTOMS
FEVER
HEADACHE
NECK
STIFNESS
SEIZERS

21. Assessment and stabilization
BACTERIA
FROM
SAMPLE
FLUID
SPINAL
TAP
NEEDLE
INSERTED
SPINAL
CANAL
FLUID
ACESSIBLE

22. BLOOD TEST
• MARKERS
• INFLAMMATION
C-REACTIVE
• PROTEIN
• BLOOD CULTURES
CEREBROSPINAL
FLUID
• LUMBAR
PUNCTATE

23. A CBC will indicate acute infection. Bacterial antigen testing
may also be done.
A Gram’s stain will determine the presence of bacteria. A full
culture should be done with sensitivity.
 Radiography skull and spine x-rays used to identify sinus
infections, fracture, or osteomyellitis; chest x-rays may be used
to identify respiratory infections, abscesses, lesions, or
granulomas.
CT scan will usually be normal in uncomplicated cases of
meningitis, but can show diffuse enhancement in some types or
show hydrocephalus.
Electroencephalogram may be performed to show slow wave
activity.

24. Bacteria
penetrate the blood-brain barrier, endotoxin
and inflammatory mediators initiate a CSF
inflammatory response
causing leakage of protein and fluid out of
the cerebral vasculature.
the processes delineated in septicemia
occur in brain blood vessels, causing
cerebral edema and cerebral vascular
thrombosis.

25. Both the increased pressure and thrombosis
may lead to a reduction in cerebral perfusion, and
consequently cerebral infarction
Brain death

26. 12 to 18 month
4th dose
3DOSES OF Hib
6MONTH AGE
VACCINES

27. Treatment:
 ceftriaxone, one of the third-generation
cefalosporin antibiotics recommended for the
initial treatment of bacterial meningitis.
 High-flow oxygen should be administered as soon
as possible, along with intravenous fluids if
hypotension or shock are present
 Mechanical ventilation may be needed if the level
of consciousness is very low, or if there is evidence
of respiratory failure

28. Prevention
 A quadrivalent vaccine -Meningococcus
vaccines exist against groups A, C, W135 and
Y
 Pneumococcal polysaccharide vaccine
 Prophylaxis
meningococcal meningitis, prophylactic
treatment of close contacts with antibiotics
(e.g. rifampicin, ciprofloxacin or ceftriaxone)
can reduce their risk of contracting the
condition, but does not protect against future