This document discusses bacterial meningitis. It begins by describing the meninges and cerebrospinal fluid. Bacterial meningitis is defined as an inflammation of the meninges caused by bacterial infection. Risk factors include transmission through air droplets, being a young adult, having a compromised immune system, or being a college student or traveler. Signs and symptoms include neck stiffness, light sensitivity, headache, and rash. Pathogenesis involves bacterial invasion across defects in the skull or spread from other sites of infection. Diagnosis is made through lumbar puncture and analysis of cerebrospinal fluid, along with blood tests and culture of the bacteria. The case study describes a 19-year-old male student diagnosed with men

1. BACTERIAL
MENINGITIS
COMPILED & PRESENTED BY:
KESHIA CHITHRAY

2.  The brain and spinal cord are covered by connective tissue
layers called the meninges which form the blood-brain
barrier.
 1-the pia mater (closest to the CNS)
 2-the arachnoid mater
 3-the dura mater (farthest from the CNS)
 The meninges contain cerebrospinal fluid (CSF).
 Meningitis is an inflammation of the meninges
 Caused by infection with viruses, bacteria and micro
organisms
 Acute, subacute and chronic
WHAT IS BACTERIAL MENINGITIS?

3. WHAT IS BACTERIAL MENINGITIS?

4. WHAT IS BACTERIAL MENINGITIS?
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5. RISK FACTORS
 Transmission by air-droplets
 Meningitis is common in
children and young adults
 Immuno-compromised
individuals
 College students
 Travellers eg: Hajj
 Technologists
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6. SIGNS AND SYMPTOMS
 Head and neck stiffness
 Photophobia
 Phonophobia
 Children – irritability, drowsiness and rash
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7. SIGNS AND SYMPTOMS

8. SIGNS AND SYMPTOMS
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9. PATHOGENESIS
 Nasopharyngeal colonization
 Direct extension of bacteria.
 Para meningeal foci (sinusitis, mastoiditis, or brain abscess)
 Across skull defects/fracture
 From remote foci of infection
 Eg: endocarditis, pneumonia, UTI

10. PATHOGENESIS
 Diffuse bacterial infections
 Meningeal exudate of varying thickness
is found.
 Purulent material around veins and
venous sinuses, around the cerebellum,
and spinal cord
 Ventriculitis has been observed
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11. PATHOGENESIS

12. PATHOGENESIS
 Invasion of the ventricular wall.
 Subdural empyema may occur.
 Hydrocephalus occurs
 Obstructive hydrocephalus
 Communicating hydrocephalus

13. PATHOGENESIS
 Blood vessel walls infiltrated by inflammatory cells.
 Endothelial cell injury
 Vessel stenosis
 Secondary ischemia and infarction
 Ventricle dilatation associated with necrosis of cerebral
tissue due to the inflammatory process or to occlusion of
cerebral veins or arteries.

14. PATHOGENESIS
 Inflammatory process results in cerebral edema and
damage of the cerebral cortex.
 Conscious disturbance
 Convulsion
 Motor disturbance
 Sensory disturbance
 Meningeal irritation sign occurs because the spinal
nerve root is irritated.
 Cranial nerve damaged

16. CASE STUDY
Physical examination
 19 years old, student
 Purpuric rash on legs, wrist, trunk
 Supple neck

17. CASE STUDY
 19 year old male student with
normal health went to bed with a
fever/headache
 Fever of 40˚c
 Neck was supple
 Purpuric rash on legs, trunk and
wrists
 CSF glucose, protein and white
blood cell were increased.
 CSF sent to micro for gram, culture
 Blood culture grew the organism
 EDTA tube sent for FBC and diff.
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18. DIAGNOSIS
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 Lumbar puncture –
collection of CSF is
used for the diagnosis
of meningitis
 CSF analysis – The
CSF can be
diagnostic, and every
patient with meningitis
should have CSF
obtained unless the
procedure is
contraindicated

19. DIAGNOSIS
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20. DIAGNOSIS
Laboratory examination
Chemistry
 CSF glucose, protein, and
white blood cell was
increased
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21. DIAGNOSIS
Laboratory examination
Haematology
 Low platelet count –
indicates the intravascular
coagulation
 FBC – neutrophilia,WBC
count is elevated ,shift
toward immature forms
co.monroe.mi.us

22. DIAGNOSIS
Microbiology
Isolation:
 Growth on chocolate agar with 5 - 10% CO2
 Organism was cultured from blood – Gram Negative
Diplococci
Identification:
 Oxidase – Negative
 Catalase - Positive
 Nitrate Reduction – Positive
 Carbohydrate utilization tests - Glucose and Maltose
positive

23. DIAGNOSIS
Gram negative diplococci

24. DIAGNOSIS
 Gram stain - Neisseria
meningitidis
 The organism had
disseminated to the blood

25. CONCLUSION
 Patient was diagnosed with bacterial meningitis caused by
N. meningitidis
 Treatment - Penicillin, Chloramphenicol
 Prevention - Tetravalent vaccine

26. REFERENCES
 Mahon .C, Donald .L and Manuselis.G. (2007) Textbook of
Diagnostic Microbiology. 3rd Edition. Saunders-Elsevier, St.
Louis, Missouri.
 Centers for Disease Control and Prevention (2007).
www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcalg.htm
 Harmening, D.M. (2002). Clinical Haematology and
Fundamentals of Haemostasis. 4th edition. Philadelphia USA:
F.A Davis Company
 Hoffbrand, A.V., Pettit, J.E. and Moss, P.A.H. (2003). Essential
Haematology. 3rd edition. USA: Blackwell Science Ltd

27. Thank you for your attention!
Any questions?