Viral meningitis is a common problem, with an estimated 2,500-4,000 cases per year in the UK. It is caused by a variety of viruses, most commonly enteroviruses. While often considered self-limiting, viral meningitis can cause significant short-term symptoms like headaches and longer-term issues like fatigue, as well as incurring high healthcare costs. More research is needed to better understand pathogenesis, improve diagnosis, identify treatment options, and evaluate long-term outcomes.
This document summarizes various types of viral meningitis. The most common causes are enteroviruses, which account for over 75% of cases. Symptoms include headache, photophobia, and neck stiffness. Cerebrospinal fluid analysis typically shows lymphocytic pleocytosis. Treatment is supportive, with analgesics and antipyretics. Recovery is usually full. Rare causes include herpes simplex virus 2, arboviruses, mumps virus, and Epstein-Barr virus. Mollaret's meningitis is a recurrent form of aseptic meningitis believed to be caused by herpes virus. Chronic meningitis lasting over 4 weeks can be infectious or non-infectious.
This document discusses acute encephalitis in India. It defines acute encephalitis and acute encephalitis syndrome. Japanese encephalitis virus is a major cause of AES in India, transmitted via Culex mosquitoes between pigs, birds and humans. The document outlines the epidemiology, clinical features, diagnosis and management of AES. It emphasizes the importance of vaccination and vector control in prevention and control of AES in India.
This document provides an overview of acute viral encephalitis. It defines encephalitis and meningoencephalitis, and discusses the causes, pathogenesis, clinical manifestations, diagnosis and management of viral encephalitis. The most common causes are viruses like herpes simplex virus, varicella zoster virus, enteroviruses, and arboviruses. Diagnosis involves CSF analysis, imaging, and PCR. Management involves supportive care, antiviral drugs like acyclovir, and controlling raised intracranial pressure. Prognosis depends on factors like age, severity of symptoms, and time to treatment initiation. Rehabilitation is often needed due to potential neurological sequelae. Early diagnosis and treatment are emphasized to
Malaria is a protozoal disease transmitted through the bites of infected female Anopheles mosquitoes. In 2016, there were an estimated 216 million cases of malaria worldwide, with the majority occurring in Africa. Symptoms vary depending on the Plasmodium species and include fever, chills, and flu-like illness. Diagnosis is typically made through blood smears, antigen testing, or PCR. Treatment involves antimalarial medications such as chloroquine or artemisinin-based combination therapies depending on the species and severity of illness. Prevention strategies include mosquito control measures and chemoprophylaxis for travelers. Drug and insecticide resistance present ongoing challenges to malaria elimination efforts.
Varicella zoster virus causes both chickenpox and shingles. It is one of eight herpesviruses that infect humans. Chickenpox results from initial exposure to the virus and presents as a mild childhood illness characterized by a rash. The virus can remain dormant in nerves after chickenpox and reactivate later in life to cause shingles, a painful dermatomal rash. Complications are more common in adults, immunocompromised individuals, and neonates exposed maternally. Treatment focuses on antiviral medication for severe or complicated cases. Vaccination provides effective prevention against chickenpox.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Hepatitis D is caused by the Hepatitis D virus (HDV) and requires co-infection with Hepatitis B. HDV is found worldwide but prevalence is highest in Italy, the Middle East, Central Asia, West Africa, and South America. HDV transmission occurs through the same routes as HBV, except it is not sexually transmitted. Infection depends on HBV replication as HBV provides the envelope for HDV. HDV infection is diagnosed through an HDV antibody test.
Cryptococcal meningitis is caused by the fungus Cryptococcus infecting the brain and spinal cord. It commonly affects people with weakened immune systems. Symptoms include headache, fever, neck stiffness, nausea and altered mental status. Diagnosis involves examining cerebrospinal fluid for cryptococcal antigen or viewing yeast cells with India ink stain. Treatment involves antifungal medications like amphotericin B and fluconazole given over several weeks to months depending on severity and patient's immune status.
This document summarizes various types of viral meningitis. The most common causes are enteroviruses, which account for over 75% of cases. Symptoms include headache, photophobia, and neck stiffness. Cerebrospinal fluid analysis typically shows lymphocytic pleocytosis. Treatment is supportive, with analgesics and antipyretics. Recovery is usually full. Rare causes include herpes simplex virus 2, arboviruses, mumps virus, and Epstein-Barr virus. Mollaret's meningitis is a recurrent form of aseptic meningitis believed to be caused by herpes virus. Chronic meningitis lasting over 4 weeks can be infectious or non-infectious.
This document discusses acute encephalitis in India. It defines acute encephalitis and acute encephalitis syndrome. Japanese encephalitis virus is a major cause of AES in India, transmitted via Culex mosquitoes between pigs, birds and humans. The document outlines the epidemiology, clinical features, diagnosis and management of AES. It emphasizes the importance of vaccination and vector control in prevention and control of AES in India.
This document provides an overview of acute viral encephalitis. It defines encephalitis and meningoencephalitis, and discusses the causes, pathogenesis, clinical manifestations, diagnosis and management of viral encephalitis. The most common causes are viruses like herpes simplex virus, varicella zoster virus, enteroviruses, and arboviruses. Diagnosis involves CSF analysis, imaging, and PCR. Management involves supportive care, antiviral drugs like acyclovir, and controlling raised intracranial pressure. Prognosis depends on factors like age, severity of symptoms, and time to treatment initiation. Rehabilitation is often needed due to potential neurological sequelae. Early diagnosis and treatment are emphasized to
Malaria is a protozoal disease transmitted through the bites of infected female Anopheles mosquitoes. In 2016, there were an estimated 216 million cases of malaria worldwide, with the majority occurring in Africa. Symptoms vary depending on the Plasmodium species and include fever, chills, and flu-like illness. Diagnosis is typically made through blood smears, antigen testing, or PCR. Treatment involves antimalarial medications such as chloroquine or artemisinin-based combination therapies depending on the species and severity of illness. Prevention strategies include mosquito control measures and chemoprophylaxis for travelers. Drug and insecticide resistance present ongoing challenges to malaria elimination efforts.
Varicella zoster virus causes both chickenpox and shingles. It is one of eight herpesviruses that infect humans. Chickenpox results from initial exposure to the virus and presents as a mild childhood illness characterized by a rash. The virus can remain dormant in nerves after chickenpox and reactivate later in life to cause shingles, a painful dermatomal rash. Complications are more common in adults, immunocompromised individuals, and neonates exposed maternally. Treatment focuses on antiviral medication for severe or complicated cases. Vaccination provides effective prevention against chickenpox.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Hepatitis D is caused by the Hepatitis D virus (HDV) and requires co-infection with Hepatitis B. HDV is found worldwide but prevalence is highest in Italy, the Middle East, Central Asia, West Africa, and South America. HDV transmission occurs through the same routes as HBV, except it is not sexually transmitted. Infection depends on HBV replication as HBV provides the envelope for HDV. HDV infection is diagnosed through an HDV antibody test.
Cryptococcal meningitis is caused by the fungus Cryptococcus infecting the brain and spinal cord. It commonly affects people with weakened immune systems. Symptoms include headache, fever, neck stiffness, nausea and altered mental status. Diagnosis involves examining cerebrospinal fluid for cryptococcal antigen or viewing yeast cells with India ink stain. Treatment involves antifungal medications like amphotericin B and fluconazole given over several weeks to months depending on severity and patient's immune status.
This document provides an overview of diphtheria including its introduction, history, epidemiology in India and worldwide, clinical features, diagnosis, treatment, immunization, and control. It notes that diphtheria is caused by Corynebacterium diphtheriae and presents as respiratory or cutaneous infection. While immunization has reduced cases in developed countries, it remains endemic in India and other developing areas due to lack of widespread vaccination. Treatment involves antitoxin and antibiotics. Control relies on maintaining high immunization coverage with DPT vaccine along with identifying and treating cases and carriers.
meningococcal meningitis is a very serious and fatal disease if not treated in time. the case fatality rate can go upto 50% in untreated cases .there are many strains which are responsible for its occurrence .it tend to occur both in endemic as well as in epidemic form. a qudrivalent vaccine is available for protection. recipient of this vaccine are to be given chemo prophylaxis .recently a vaccine against type b strain has been made avialable in canada for use in routine immunization
Hepatitis C is a major global public health problem, infecting around 180 million people worldwide. It is a leading cause of liver disease and liver transplants. The hepatitis C virus is a RNA virus that primarily infects liver cells. Around 70-85% of infections become chronic, and 20-40% of chronic infections can lead to severe liver disease like cirrhosis or liver cancer over time. The most common modes of transmission are through blood exposure, though sexual transmission risk is low. There is no vaccine, but effective antiviral treatment exists.
This document discusses pertussis (whooping cough), including its etiology, epidemiology, pathophysiology, clinical features, diagnosis, complications, treatment, and prevention. Pertussis is caused by the bacterium Bordetella pertussis and is highly contagious, especially in children ages 1-5 years old. It presents in stages including catarrhal, paroxysmal, and convalescent stages. Diagnosis is usually clinical based on paroxysmal coughing fits. Complications can include respiratory issues, seizures, and intracranial bleeding. Treatment involves erythromycin or similar antibiotics and supportive care. Prevention is through vaccination and prophylactic antibiotics for close contacts when
Pneumonia is an inflammatory lung condition caused by infection, usually bacterial or viral. It is characterized by consolidation of the lungs due to inflammatory exudate, bacteria, and white blood cells filling the alveoli. Pneumonia can be classified as lobar or bronchopneumonia based on location in the lungs and as community-acquired or hospital-acquired based on where infection was contracted. Treatment involves use of antibiotics to eradicate the infecting organism as well as supportive care like oxygen supplementation. Antibiotic selection is based on suspected pathogen, patient age and health status, and severity of illness.
Among the major rickettsial diseases reported in India are scrub typhus, murine or flea-borne typhus, and Indian tick typhus. Scrub typhus is caused by Rickettsia tsutsugamushi and transmitted through the bite of trombiculid mites. It is considered an important cause of fever in India due to its prevalence and potential for serious complications if not treated promptly. Common symptoms include fever, headache, and an eschar at the site of mite bite in approximately 50% of cases. Diagnosis relies on PCR, serological tests like IFA, and the Weil-Felix test.
The document discusses bacterial meningitis, providing information on the anatomy of the meninges, causes of meningitis including bacterial, viral and fungal infections. It describes the typical presentation of bacterial meningitis including symptoms like headache, fever and neck stiffness. Complications are outlined such as subdural effusions, ependymitis and hydrocephalus. Causative organisms and their prevalence are summarized for different age groups.
Bacterial meningitis is a serious infection of the membranes surrounding the brain and spinal cord. It is usually caused by bacteria such as Streptococcus pneumoniae or Neisseria meningitidis. Symptoms include sudden onset of fever, headache, and neck stiffness. Without prompt treatment, bacterial meningitis can cause death or permanent disability. Diagnosis involves examination of cerebrospinal fluid obtained through lumbar puncture. Empirical antibiotic therapy with drugs such as ceftriaxone and vancomycin is started immediately while diagnostic tests are pending. Vaccination is the most effective way to prevent certain types of bacterial meningitis.
This document discusses the pharmacotherapy of acute bronchitis. It begins by defining acute bronchitis as a cough lasting less than 3 weeks, which is usually viral in origin. The goals of therapy are to rule out serious illness, minimize symptoms, and limit unnecessary antibiotic use. Treatment is primarily supportive and includes analgesics, antitussives, and bronchodilators only for those with wheezing. Antibiotics are not routinely recommended as they do not impact illness duration or severity. Education of patients about the typical self-limiting course of acute bronchitis is important.
For more information:
http://www.7activemedical.com/
info@7activemedical.com
http://www.7activestudio.com
info@7activestudio.com
http://www.sciencetuts.com/
Contact: +91- 9700061777,
040-64501777 / 65864777
7 Active Technology Solutions Pvt.Ltd. is an educational 3D digital content provider for K-12. We also customise the content as per your requirement for companies platform providers colleges etc . 7 Active driving force "The Joy of Happy Learning" -- is what makes difference from other digital content providers. We consider Student needs, Lecturer needs and College needs in designing the 3D & 2D Animated Video Lectures. We are carrying a huge 3D Digital Library ready to use.
VIRAL MENINGITIS
Viral meningitis is an infection usually affecting children under 5 years of age.
The virus causing the infection usually infects the meninges, which are the protective tissue coverings of the brain and spinal cord.
The meninges is made up of 3 distinct layers :
1. The Pia mater – which is the layer directly in contact with
the brain and spinal cord.
2. Arachnoid mater – which consists of spider web-like
extensions.
3. The Dura mater – which is the outermost and toughest
layer of the meninges.
Cerebrospinal fluid or CSF,which also protects the brain and spinal cord,flows between the meninges and the surface of the brain.
The most common causes of viral meningitis are :
1. The Mumps virus
2. The Measles virus
3. Enteroviruses
4. The Herpes virus
5. Japanese Encephalitis virus
The most common mechanism of transmission include :
1. Sneezing or Coughing
2. Faecal contamination
3. Bite from an infected insect (such as a mosquito)
After entering the body, the virus makes multiple copies of itself,and enters the bloodstream, eventually reaching the brain. Here, it crosses the blood brain barrier,to enter the CSF, ultimatley infecting the cells of the meninges.This causes an inflammation of the meninges,because of the body’s attempts to fight the infection.
Symptoms of viral meningitis in an infant or young child include :
1. Fever
2. Irritability
3. Loss of appetite
4. Decreased consciousness
Symptoms of viral meningitis in an older child or adult
include :
1. Fever
2. Headache
3. Neck stiffness
4. Photosensitivity
5. Decreased consciousness
6. Nausea or vomitting
In general,the symptoms of viral meningitis are less severe than what’s seen with bacterial meningitis.
Treatment for viral meningitis include :
1. Use of Acetaminophen/NSAIDs (for the fever & headache).
2. Acyclovir (if the meningitis is caused by the Herpes virus)
Besides supportive therapy, there is no specific
treatment for viral meningitis, which usually runs it
course within 2 weeks, if there are no complications.
This document summarizes the key steps in diagnosing pulmonary tuberculosis (TB), including:
1) Screening high-risk individuals with the Mantoux tuberculin skin test.
2) Obtaining a thorough medical history and physical exam to identify symptoms and risk factors.
3) Performing a chest x-ray, which can show abnormalities suggestive of TB but is not definitive.
4) Examining sputum samples under a microscope for acid-fast bacilli, which is rapid but not highly sensitive, and culturing samples, which is more sensitive but takes longer.
3) Integrating clinical, radiological and laboratory findings to make a presumptive or confirmed diagnosis of TB
This patient presented with fever, gait instability, and slurred speech. Investigations revealed cryptococcal meningitis. As a kidney transplant recipient on immunosuppressants, he was at risk for opportunistic infections. Examination found dysarthria and ataxia. Imaging and CSF analysis confirmed cryptococcal infection in the central nervous system. He received liposomal amphotericin B and was discharged on fluconazole to complete treatment for this fungal meningitis.
Hepatitis C is a global problem caused by the hepatitis C virus (HCV). HCV is a blood-borne virus that infects approximately 200 million people worldwide. Laboratory testing plays an important role in diagnosing HCV, evaluating patients for treatment, monitoring patients during treatment, and following up after treatment. There are 6 major genotypes of HCV with genotypes 1 and 4 being more difficult to treat and less responsive to interferon-based therapy.
Snakebite is a significant public health issue in India, causing approximately 50,000 deaths per year. The document discusses snakebite as an occupational hazard, particularly for agricultural workers. It provides details on the types of poisonous snakes found in India, the symptoms and complications of snakebites, and the current treatment protocol. The protocol involves first aid, diagnosis, and treatment with antivenom immunotherapy. Improving access to timely medical care and antivenom could help reduce the high snakebite mortality in India.
Meningitis refers to inflammation of the membranes (meninges) surrounding the brain and spinal cord. It is generally caused by viral or bacterial infections, though chemical meningitis can occur from injection of irritants into the subarachnoid space. The main types are acute pyogenic (bacterial), aseptic (usually viral), and chronic (often tuberculous or fungal). Common causative agents include bacteria like Neisseria meningitidis, Streptococcus pneumoniae, and viruses such as enterovirus. Bacteria typically enter the CSF through the blood or direct implantation. This causes an inflammatory response and increased CSF pressure that can lead to complications like hydrocephalus or brain damage if left untreated
The document discusses influenza, also known as seasonal flu. It is an acute respiratory infection caused by influenza viruses that causes symptoms like fever, cough, and muscle pain. Influenza occurs seasonally as well as sporadically, and can sometimes cause pandemics every 10-40 years when the virus undergoes major antigenic changes. Influenza viruses are classified into types A, B, and C. Type A is responsible for epidemics and pandemics. The document outlines the epidemiology, transmission, clinical features, diagnosis, treatment and prevention of influenza. Vaccination is recommended for high-risk groups to reduce complications.
This document provides information on meningococcal infection. It begins by defining meningococcal infection and describing its causative agent, Neisseria meningitidis. It then covers the epidemiology, pathogenesis, clinical forms, clinical manifestations, diagnosis and treatment of meningococcal infection. Key points include that it is transmitted via air droplets and can cause meningitis, meningococcemia, or both. Clinical features depend on the form but may include fever, rash, headache and vomiting. Diagnosis involves examining cerebrospinal fluid which shows pleocytosis. Meningococcal infection is a serious public health issue worldwide.
Non-Gonococcal urethritis. main causative organisms are Chlamydiae, Mycoplasma, Ureaplasma. various other bacteria and viruses can cause this. this powerpoint is made in systemic manner and will be helpful for Postgraduate students.
This case involves a 25-year-old woman who presented to the emergency department with shortness of breath and an expanding rash. She has a history of asthma and allergies to aspirin and shellfish. On exam, she was tachypnic, hypertensive, and had periorbital edema and scattered wheals. Her symptoms and history are concerning for anaphylaxis.
Meningitis is an inflammation of the membranes covering the brain and spinal cord caused by bacterial or viral infections. The two most common types of bacterial meningitis are caused by Neisseria meningitidis (meningococcal meningitis) and Streptococcus pneumoniae (pneumococcal meningitis). Viruses from the enterovirus group are the most common cause of viral meningitis. Symptoms of meningitis include fever, headache, stiff neck, and sensitivity to light. While bacterial meningitis requires intravenous antibiotics, viral meningitis is usually treated with supportive care. Handwashing is the best way to prevent transmission between people through contact with nose and throat secretions.
VIRAL MENINGITIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE CHINKIPO...Prof Dr Bashir Ahmed Dar
Meningitis is an infection of the protective membranes (meninges) surrounding the brain and spinal cord. It is usually caused by bacteria, viruses, or fungi. The disease is contagious and can spread through respiratory and fecal-oral routes. Common symptoms include headache, fever, and neck stiffness. Bacterial meningitis requires prompt treatment with antibiotics to prevent serious complications like brain damage.
This document provides an overview of diphtheria including its introduction, history, epidemiology in India and worldwide, clinical features, diagnosis, treatment, immunization, and control. It notes that diphtheria is caused by Corynebacterium diphtheriae and presents as respiratory or cutaneous infection. While immunization has reduced cases in developed countries, it remains endemic in India and other developing areas due to lack of widespread vaccination. Treatment involves antitoxin and antibiotics. Control relies on maintaining high immunization coverage with DPT vaccine along with identifying and treating cases and carriers.
meningococcal meningitis is a very serious and fatal disease if not treated in time. the case fatality rate can go upto 50% in untreated cases .there are many strains which are responsible for its occurrence .it tend to occur both in endemic as well as in epidemic form. a qudrivalent vaccine is available for protection. recipient of this vaccine are to be given chemo prophylaxis .recently a vaccine against type b strain has been made avialable in canada for use in routine immunization
Hepatitis C is a major global public health problem, infecting around 180 million people worldwide. It is a leading cause of liver disease and liver transplants. The hepatitis C virus is a RNA virus that primarily infects liver cells. Around 70-85% of infections become chronic, and 20-40% of chronic infections can lead to severe liver disease like cirrhosis or liver cancer over time. The most common modes of transmission are through blood exposure, though sexual transmission risk is low. There is no vaccine, but effective antiviral treatment exists.
This document discusses pertussis (whooping cough), including its etiology, epidemiology, pathophysiology, clinical features, diagnosis, complications, treatment, and prevention. Pertussis is caused by the bacterium Bordetella pertussis and is highly contagious, especially in children ages 1-5 years old. It presents in stages including catarrhal, paroxysmal, and convalescent stages. Diagnosis is usually clinical based on paroxysmal coughing fits. Complications can include respiratory issues, seizures, and intracranial bleeding. Treatment involves erythromycin or similar antibiotics and supportive care. Prevention is through vaccination and prophylactic antibiotics for close contacts when
Pneumonia is an inflammatory lung condition caused by infection, usually bacterial or viral. It is characterized by consolidation of the lungs due to inflammatory exudate, bacteria, and white blood cells filling the alveoli. Pneumonia can be classified as lobar or bronchopneumonia based on location in the lungs and as community-acquired or hospital-acquired based on where infection was contracted. Treatment involves use of antibiotics to eradicate the infecting organism as well as supportive care like oxygen supplementation. Antibiotic selection is based on suspected pathogen, patient age and health status, and severity of illness.
Among the major rickettsial diseases reported in India are scrub typhus, murine or flea-borne typhus, and Indian tick typhus. Scrub typhus is caused by Rickettsia tsutsugamushi and transmitted through the bite of trombiculid mites. It is considered an important cause of fever in India due to its prevalence and potential for serious complications if not treated promptly. Common symptoms include fever, headache, and an eschar at the site of mite bite in approximately 50% of cases. Diagnosis relies on PCR, serological tests like IFA, and the Weil-Felix test.
The document discusses bacterial meningitis, providing information on the anatomy of the meninges, causes of meningitis including bacterial, viral and fungal infections. It describes the typical presentation of bacterial meningitis including symptoms like headache, fever and neck stiffness. Complications are outlined such as subdural effusions, ependymitis and hydrocephalus. Causative organisms and their prevalence are summarized for different age groups.
Bacterial meningitis is a serious infection of the membranes surrounding the brain and spinal cord. It is usually caused by bacteria such as Streptococcus pneumoniae or Neisseria meningitidis. Symptoms include sudden onset of fever, headache, and neck stiffness. Without prompt treatment, bacterial meningitis can cause death or permanent disability. Diagnosis involves examination of cerebrospinal fluid obtained through lumbar puncture. Empirical antibiotic therapy with drugs such as ceftriaxone and vancomycin is started immediately while diagnostic tests are pending. Vaccination is the most effective way to prevent certain types of bacterial meningitis.
This document discusses the pharmacotherapy of acute bronchitis. It begins by defining acute bronchitis as a cough lasting less than 3 weeks, which is usually viral in origin. The goals of therapy are to rule out serious illness, minimize symptoms, and limit unnecessary antibiotic use. Treatment is primarily supportive and includes analgesics, antitussives, and bronchodilators only for those with wheezing. Antibiotics are not routinely recommended as they do not impact illness duration or severity. Education of patients about the typical self-limiting course of acute bronchitis is important.
For more information:
http://www.7activemedical.com/
info@7activemedical.com
http://www.7activestudio.com
info@7activestudio.com
http://www.sciencetuts.com/
Contact: +91- 9700061777,
040-64501777 / 65864777
7 Active Technology Solutions Pvt.Ltd. is an educational 3D digital content provider for K-12. We also customise the content as per your requirement for companies platform providers colleges etc . 7 Active driving force "The Joy of Happy Learning" -- is what makes difference from other digital content providers. We consider Student needs, Lecturer needs and College needs in designing the 3D & 2D Animated Video Lectures. We are carrying a huge 3D Digital Library ready to use.
VIRAL MENINGITIS
Viral meningitis is an infection usually affecting children under 5 years of age.
The virus causing the infection usually infects the meninges, which are the protective tissue coverings of the brain and spinal cord.
The meninges is made up of 3 distinct layers :
1. The Pia mater – which is the layer directly in contact with
the brain and spinal cord.
2. Arachnoid mater – which consists of spider web-like
extensions.
3. The Dura mater – which is the outermost and toughest
layer of the meninges.
Cerebrospinal fluid or CSF,which also protects the brain and spinal cord,flows between the meninges and the surface of the brain.
The most common causes of viral meningitis are :
1. The Mumps virus
2. The Measles virus
3. Enteroviruses
4. The Herpes virus
5. Japanese Encephalitis virus
The most common mechanism of transmission include :
1. Sneezing or Coughing
2. Faecal contamination
3. Bite from an infected insect (such as a mosquito)
After entering the body, the virus makes multiple copies of itself,and enters the bloodstream, eventually reaching the brain. Here, it crosses the blood brain barrier,to enter the CSF, ultimatley infecting the cells of the meninges.This causes an inflammation of the meninges,because of the body’s attempts to fight the infection.
Symptoms of viral meningitis in an infant or young child include :
1. Fever
2. Irritability
3. Loss of appetite
4. Decreased consciousness
Symptoms of viral meningitis in an older child or adult
include :
1. Fever
2. Headache
3. Neck stiffness
4. Photosensitivity
5. Decreased consciousness
6. Nausea or vomitting
In general,the symptoms of viral meningitis are less severe than what’s seen with bacterial meningitis.
Treatment for viral meningitis include :
1. Use of Acetaminophen/NSAIDs (for the fever & headache).
2. Acyclovir (if the meningitis is caused by the Herpes virus)
Besides supportive therapy, there is no specific
treatment for viral meningitis, which usually runs it
course within 2 weeks, if there are no complications.
This document summarizes the key steps in diagnosing pulmonary tuberculosis (TB), including:
1) Screening high-risk individuals with the Mantoux tuberculin skin test.
2) Obtaining a thorough medical history and physical exam to identify symptoms and risk factors.
3) Performing a chest x-ray, which can show abnormalities suggestive of TB but is not definitive.
4) Examining sputum samples under a microscope for acid-fast bacilli, which is rapid but not highly sensitive, and culturing samples, which is more sensitive but takes longer.
3) Integrating clinical, radiological and laboratory findings to make a presumptive or confirmed diagnosis of TB
This patient presented with fever, gait instability, and slurred speech. Investigations revealed cryptococcal meningitis. As a kidney transplant recipient on immunosuppressants, he was at risk for opportunistic infections. Examination found dysarthria and ataxia. Imaging and CSF analysis confirmed cryptococcal infection in the central nervous system. He received liposomal amphotericin B and was discharged on fluconazole to complete treatment for this fungal meningitis.
Hepatitis C is a global problem caused by the hepatitis C virus (HCV). HCV is a blood-borne virus that infects approximately 200 million people worldwide. Laboratory testing plays an important role in diagnosing HCV, evaluating patients for treatment, monitoring patients during treatment, and following up after treatment. There are 6 major genotypes of HCV with genotypes 1 and 4 being more difficult to treat and less responsive to interferon-based therapy.
Snakebite is a significant public health issue in India, causing approximately 50,000 deaths per year. The document discusses snakebite as an occupational hazard, particularly for agricultural workers. It provides details on the types of poisonous snakes found in India, the symptoms and complications of snakebites, and the current treatment protocol. The protocol involves first aid, diagnosis, and treatment with antivenom immunotherapy. Improving access to timely medical care and antivenom could help reduce the high snakebite mortality in India.
Meningitis refers to inflammation of the membranes (meninges) surrounding the brain and spinal cord. It is generally caused by viral or bacterial infections, though chemical meningitis can occur from injection of irritants into the subarachnoid space. The main types are acute pyogenic (bacterial), aseptic (usually viral), and chronic (often tuberculous or fungal). Common causative agents include bacteria like Neisseria meningitidis, Streptococcus pneumoniae, and viruses such as enterovirus. Bacteria typically enter the CSF through the blood or direct implantation. This causes an inflammatory response and increased CSF pressure that can lead to complications like hydrocephalus or brain damage if left untreated
The document discusses influenza, also known as seasonal flu. It is an acute respiratory infection caused by influenza viruses that causes symptoms like fever, cough, and muscle pain. Influenza occurs seasonally as well as sporadically, and can sometimes cause pandemics every 10-40 years when the virus undergoes major antigenic changes. Influenza viruses are classified into types A, B, and C. Type A is responsible for epidemics and pandemics. The document outlines the epidemiology, transmission, clinical features, diagnosis, treatment and prevention of influenza. Vaccination is recommended for high-risk groups to reduce complications.
This document provides information on meningococcal infection. It begins by defining meningococcal infection and describing its causative agent, Neisseria meningitidis. It then covers the epidemiology, pathogenesis, clinical forms, clinical manifestations, diagnosis and treatment of meningococcal infection. Key points include that it is transmitted via air droplets and can cause meningitis, meningococcemia, or both. Clinical features depend on the form but may include fever, rash, headache and vomiting. Diagnosis involves examining cerebrospinal fluid which shows pleocytosis. Meningococcal infection is a serious public health issue worldwide.
Non-Gonococcal urethritis. main causative organisms are Chlamydiae, Mycoplasma, Ureaplasma. various other bacteria and viruses can cause this. this powerpoint is made in systemic manner and will be helpful for Postgraduate students.
This case involves a 25-year-old woman who presented to the emergency department with shortness of breath and an expanding rash. She has a history of asthma and allergies to aspirin and shellfish. On exam, she was tachypnic, hypertensive, and had periorbital edema and scattered wheals. Her symptoms and history are concerning for anaphylaxis.
Meningitis is an inflammation of the membranes covering the brain and spinal cord caused by bacterial or viral infections. The two most common types of bacterial meningitis are caused by Neisseria meningitidis (meningococcal meningitis) and Streptococcus pneumoniae (pneumococcal meningitis). Viruses from the enterovirus group are the most common cause of viral meningitis. Symptoms of meningitis include fever, headache, stiff neck, and sensitivity to light. While bacterial meningitis requires intravenous antibiotics, viral meningitis is usually treated with supportive care. Handwashing is the best way to prevent transmission between people through contact with nose and throat secretions.
VIRAL MENINGITIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE CHINKIPO...Prof Dr Bashir Ahmed Dar
Meningitis is an infection of the protective membranes (meninges) surrounding the brain and spinal cord. It is usually caused by bacteria, viruses, or fungi. The disease is contagious and can spread through respiratory and fecal-oral routes. Common symptoms include headache, fever, and neck stiffness. Bacterial meningitis requires prompt treatment with antibiotics to prevent serious complications like brain damage.
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord known as the meninges. It is usually caused by a viral or bacterial infection of the fluid surrounding the brain and spinal cord. Meningitis can be life-threatening and is considered a medical emergency due to the inflammation's proximity to the brain and spinal cord. The meninges have three layers - dura mater, arachnoid mater, and pia mater - with a subarachnoid space between the arachnoid and pia mater filled with cerebrospinal fluid. Meningitis can be caused by bacteria, viruses, fungi, parasites, or physical injuries. A lumbar puncture is required for diagnosis to examine
This document discusses informing the public about immunization through strategic communication. It suggests finding out what the public thinks through tracking opinions of health professionals and parents. It also suggests pre-testing communications and evaluating their effectiveness. The document examines perceptions of disease severity and vaccine safety over time. It explores what influences parents, including negative media reports and scientific papers questioning vaccine safety. Effective communication is shown to be important for program acceptance through an example from Romania's HPV vaccine program. Overall, the document emphasizes understanding audiences and testing communications to engage the public about immunization.
MRF funded research into barriers to treating acute bacterial meningitis (ABM) in Malawi. They found recognition barriers like misdiagnosis of other illnesses and not recognizing severity. Action barriers included prioritizing maternal health, negative views of healthcare, and financial/decision constraints. To address this, MRF is training health workers to use WHO triage systems to identify severely ill children for treatment or referral. They are also using radio, mobile apps, and transport bikes to raise awareness and improve access to care. The goal is to reduce delays, prioritize treatment, and improve outcomes for children with meningitis.
The document discusses the Meningitis Research Foundation's current and upcoming work including assessing the impact of meningitis on families, developing a comprehensive meningococcal genome library, estimating the true burden of meningococcal disease in England, and funding 17 current research projects totaling over £2.7 million. It also puts out a call for proposals on hot topics in meningococcal research like monitoring MenB vaccine implementation and developing improved second generation MenB vaccines.
Bacterial meningitis typically begins as a localized infection that spreads to the meninges, causing inflammation. Common symptoms include headache, fever, and neck stiffness. Examination of cerebrospinal fluid shows increased white blood cells and protein levels, along with low glucose. Treatment involves antibiotics and measures to prevent complications. The diagnosis and treatment depends on the specific causative organism and patient age.
Viral meningitis can be caused by echovirus. Echovirus is a common cause of viral meningitis and usually causes a mild illness. Symptoms include headache, fever, and neck stiffness, and most patients fully recover with supportive care and rest.
The document discusses issues related to meningococcal B (MenB) vaccines before and after implementation. It addresses questions such as whether vaccine components are immunogenic, if vaccines can be incorporated into routine schedules, vaccine tolerability, and how to assess effectiveness. Studies show MenB vaccines have immunogenic components and can be given according to routine schedules with minimal interference or reduction in immune response. The vaccines demonstrate a good safety profile in clinical trials with few serious adverse events potentially related to vaccination. Overall, the document evaluates key considerations for MenB vaccines prior to and following widespread use.
Este documento trata sobre meningitis y encefalitis asépticas, bacterianas y tuberculosas en pediatría. Describe las características clínicas, exámenes complementarios, diagnóstico y tratamiento de la meningitis aséptica, bacteriana y tuberculosa. Explica que la meningitis aséptica generalmente es de origen viral y suele tener una evolución benigna, mientras que las meningitis bacterianas son más graves y requieren tratamiento antibiótico urgente.
Meningococcal meningitis is an inflammation of the membranes covering the brain and spinal cord caused by the Neisseria meningitidis bacterium. Symptoms include intense headache, fever, stiff neck, and confusion or coma. Infants may only show irritability, tiredness, or poor feeding. Diagnosis is made through spinal fluid tests and treatment requires immediate antibiotics and hospitalization. Vaccines can prevent certain strains of the disease.
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 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.
The document discusses meningitis vaccines and changes to immunization programs. It summarizes the epidemiology of different meningitis strains like MenB, MenC, MenW, and MenY in various countries. It describes the vaccines available for different strains and how they are used. Future vaccines for MenB are discussed, including investigational vaccines in development by Pfizer and Novartis that use novel antigens discovered through reverse vaccinology. Forthcoming changes to immunization schedules are also mentioned.
A 30-year-old male presented with bilateral pyramidal signs and pseudobulbar palsy. MRI showed hyperintense lesions in the crus cerebri and basis pontis, involving the corticospinal tract, more on the left side. This represents demyelination and edema along the corticospinal tract fibers, mainly located in the midbrain/thalamus with extension to the posterior limb of the internal capsule, basis pontis, and medulla. The diagnosis is neuro-Behcet disease.
Medcrave Group - Association analysis of the polymorphismMedCrave
This study analyzed the association between human leukocyte antigen (HLA) alleles (HLA-A, HLA-B, HLA-E) and Behcet's disease in a Japanese cohort. Sequencing-based typing was performed on 382 Behcet's disease patients and 382 healthy controls. The results showed that HLA-B*51 is strongly associated with Behcet's disease in the Japanese cohort. HLA-A*26 was also significantly associated, while HLA-E*01:01 was not observed to have any significant association. Analysis of linkage disequilibrium structures between the Japanese and Han Chinese cohorts found differences in the HLA-A and HLA-E regions that could explain differences in susceptibility between
This document discusses the cerebrospinal fluid (CSF) and its examination. It covers the formation and composition of CSF, characteristics of normal CSF, and the clinical application of CSF examination. Key tests discussed include measurements of CSF pressure, turbidity, coagulation formation, xanthochromia, and microscopic examination. Specific conditions like pyogenic bacterial meningitis, viral meningitis, and tuberculous meningitis are examined in terms of their appearance and typical CSF findings.
Meningitis is an infection of the meninges, the membranes covering the brain and spinal cord. It used to occur mainly in infants but a vaccine has reduced infant cases, so it now occurs primarily in adults. Viral meningitis is usually less severe and people typically recover fully, while bacterial meningitis can cause more serious complications like seizures, increased intracranial pressure, and residual neurological deficits if not treated promptly.
Meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord. It is usually caused by microorganisms like bacteria and viruses spreading into the cerebrospinal fluid through the blood. The main types are bacterial, viral, fungal, parasitic, and non-infectious meningitis. Bacterial meningitis causes vary by age group, with newborns commonly experiencing Group B Streptococcus and older adults experiencing Streptococcus pneumoniae and Neisseria meningitidis.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS#CNS INFECTIONS
This document summarizes a presentation on bacterial meningitis. It discusses the clinical presentation, mortality and risks, diagnostic workup including CSF results, treatment including antibiotics and vaccination, and scripts for bacterial versus viral meningitis. Key points include that untreated bacterial meningitis has nearly 100% mortality, but with treatment mortality is around 25%. Presentation often includes fever, nuchal rigidity, and altered mental status. Diagnostic tests include lumbar puncture and analysis of CSF findings. Treatment involves antibiotics and dexamethasone to improve outcomes.
This document provides guidelines for the diagnosis and management of acute bacterial meningitis. It outlines the definition, incidence, transmission, types, signs and symptoms, investigations, treatment guidelines, and prevention including vaccination. Bacterial meningitis is most common in infants aged 1 month to 5 years. Presenting signs can include fever, headache, neck stiffness, vomiting, and altered mental status. Investigations should include lumbar puncture for cerebrospinal fluid analysis if no contraindications are present. Treatment involves prompt administration of antibiotics, and prevention focuses on vaccination programs and prophylactic antibiotics for close contacts after a confirmed case.
This document discusses central nervous system infections, specifically meningitis and encephalitis. It defines meningitis as inflammation of the meninges and encephalitis as infection of the brain parenchyma. The causes of meningitis include various viral and bacterial pathogens. Viral meningitis is usually less severe and caused by enteroviruses. Bacterial meningitis requires prompt treatment with antibiotics to prevent complications. Symptoms, signs, investigations, and treatment are described for both conditions.
Clinical Approach To Aseptic Meningitis and Encephalitis
Virology Rotation (R2) , Clinical Microbiology Residency
King Fahd Hospital of The University
23/4/2019
Meningitis is an inflammation of the meninges that can cause significant morbidity and mortality, especially in children. The most common causes are bacterial and include Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis. Symptoms vary by age but may include fever, headache, nausea, and neck stiffness. Lumbar puncture and CSF analysis are important for diagnosis. Empiric antibiotic therapy should cover the most common pathogens. Complications can include neurological deficits, hearing loss, seizures, and hydrocephalus. Prevention through immunization against preventable causes such as Hib, meningococcus, and pneumococcus can reduce the burden of disease.
1) The document discusses the approach to a case of suspected meningitis. It covers the types, causes, clinical presentation, investigations including lumbar puncture and CSF analysis, management algorithm, and overview of different types of meningitis.
2) The approach involves obtaining blood cultures and administering empirical antibiotics and dexamethasone prior to lumbar puncture based on suspicion of meningitis. Lumbar puncture is performed if no contraindications exist.
3) Treatment involves early administration of antibiotics, with antibiotic choice guided by CSF gram stain and culture results. Corticosteroids are also recommended to reduce inflammation and complications.
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 of the meninges, which cover the brain and spinal cord. It can be caused by viruses, bacteria, or fungi. Bacterial meningitis requires urgent treatment with antibiotics to prevent death. Common symptoms include headache, fever, and neck stiffness. Diagnosis involves lumbar puncture and analyzing cerebrospinal fluid. Treatment depends on the cause but antibiotics are given for bacterial meningitis. Vaccines can prevent some types of bacterial meningitis.
Meningitis is an inflammation of the meninges, which are the protective membranes that cover the brain and spinal cord. Bacteria can reach the meninges through the bloodstream, direct contact from a site of infection like the sinuses or ears, or iatrogenically through procedures like lumbar puncture. Symptoms include fever, headache, neck stiffness, and altered mental status. Diagnosis involves analyzing cerebrospinal fluid obtained via lumbar puncture for signs of infection like increased white blood cells. The most common causes of bacterial meningitis are Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae.
Slideshow is from the University of Michigan Medical
School's M1 Infectious Disease / Microbiology sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M1IDM
The document discusses meningitis, including:
1. It defines meningitis as inflammation of the meninges covering the brain and spinal cord. Meningitis can be caused by viruses, bacteria, fungi or other microorganisms.
2. It classifies meningitis based on etiology, including bacterial, viral, fungal and parasitic meningitis. The most common bacterial causes are S. pneumoniae, N. meningitidis and H. influenzae.
3. It notes that while viral meningitis is more common, bacterial meningitis requires urgent treatment due to high mortality and morbidity. Prompt diagnosis and treatment are critical for improving prognosis.
This document discusses various neurological complications of HIV/AIDS, including:
- Primary complications like HIV-Dementia and neuropathy. Secondary complications include opportunistic infections like cerebral toxoplasmosis, tuberculosis meningitis, and cryptococcal meningitis.
- HIV enters the central nervous system early in infection and can progress to HIV encephalitis, manifesting as cognitive, motor, and behavioral dysfunction.
- Highly active antiretroviral therapy can arrest disease progression and even reverse some neurological disability. Neurologists should be competent in antiretroviral prescribing.
- Cerebral toxoplasmosis is the most common central nervous system lesion in AIDS. It presents as multiple ring-
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. Bacterial meningitis is usually caused by bacteria entering the brain and spinal cord directly or through the blood. The most common symptoms are headache, fever, and neck stiffness. Complications can include seizures, brain damage, and hearing loss. Diagnosis involves examination of cerebrospinal fluid obtained through lumbar puncture. Treatment involves administration of broad-spectrum antibiotics until the specific bacterium is identified, then targeted antibiotics are given. Prompt treatment is important to reduce risk of serious complications or death from bacterial meningitis.
Does CD4 Cell Count Influence CT features of Intracranial Opportunistic Infec...hajikareem00
The document examines the relationship between CD4 cell count and computed tomography (CT) scan findings of intracranial opportunistic infections in HIV/AIDS patients. It found that 87.5% of patients were in the late stage of disease with CD4 counts below 200 cells/μl. Common opportunistic infections seen on CT scans were Toxoplasmosis and Cryptococcosis. There was no significant correlation observed between Cryptococcosis and the site of intracranial lesions. Both Toxoplasmosis and Cryptococcosis serology were strongly associated with late stage disease.
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 discusses meningitis and encephalitis in children. It begins by defining meningoencephalitis, meningitis, and encephalitis. It then discusses the various etiologies of encephalitis and encephalopathies in children, which can be caused by viruses, bacteria, fungi, parasites, and other pathogens. It provides details on specific viral meningoencephalitides like Japanese encephalitis and herpes simplex encephalitis. It also discusses acute bacterial meningitis and tubercular meningitis in children, including their presentations, investigations, and management.
This document discusses the neurologic manifestations of HIV/AIDS in India. Some key points include:
- Opportunistic infections like cryptococcal meningitis and tuberculosis account for the majority (around 70%) of neurologic events seen in HIV patients in India.
- Conditions like progressive multifocal leukoencephalopathy and myelopathy are relatively rare compared to Western countries.
- Common neurologic manifestations include meningitis, mass lesions in the brain, and various neuropathies.
- The pattern of neurologic involvement tends to change as the CD4 count declines, with more severe complications occurring at very low CD4 levels.
A 4 year old boy presented to the emergency room after having a seizure. Possible diagnoses include viral infections like herpes simplex encephalitis, which can cause seizures and disturbances in consciousness. Other potential causes are bacterial or parasitic infections like tuberculosis or toxoplasmosis. It is important to obtain a thorough history, including any recent illnesses, and perform diagnostic tests like a lumbar puncture and CSF analysis to determine the cause and guide treatment.
Bacterial meningitis is an inflammation of the meninges caused by bacterial infection. The most common causative bacteria are Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. Symptoms include fever, headache, neck stiffness, and rash. Complications can include seizures, brain damage, hearing loss, and hydrocephalus. Diagnosis is made through examination of cerebrospinal fluid which shows increased white blood cells, decreased glucose, and increased protein levels. Prompt treatment with antibiotics is required to prevent serious complications.
Similar to Viral Meningitis: A real pain in the neck by Dr Fiona McGill (20)
The document discusses the Global Meningitis Genome Partnership (GMGP), which aims to address inequities in genomic surveillance capacity for meningitis pathogens between high-income and low-income countries. It outlines what has been achieved so far, including establishing standardized metadata for sequencing and epidemiological data. The GMGP is working to incorporate genome surveillance into regional surveillance strategies, initially focusing on Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus agalactiae in Africa. Open data sharing is encouraged according to clear governance policies. Standardizing metadata and curating sequencing data in a central library are discussed to facilitate consistent analysis and data visualization for public health benefit
- There was a significant reduction in cases of invasive bacterial infections like pneumococcal disease, H. influenzae, and meningococcal disease in 2020 coinciding with COVID-19 containment measures across many countries. Vaccination coverage rates have decreased dramatically in Brazil representing a potential risk of rebound in infectious disease rates. Maintaining disease surveillance is important to inform authorities on current disease burden and carriage rates even though some diseases were reduced during the pandemic.
This document discusses optimal schedules for controlling pneumococcal infection in countries with high and low carriage. It notes that the African Meningitis Belt has seen sub-optimal pneumococcal conjugate vaccine (PCV) coverage due to geopolitical factors and vulnerable populations. Outbreaks in Ghana pre- and post-PCV introduction show that herd protection may be inadequate. Research is needed to better understand pneumococcal biology and prevention. Improving PCV access and coverage, including schedules with boosters and catch-up campaigns targeting 5-29 year olds, may help prevent outbreaks. Strengthening surveillance systems allows rapid response.
Professor Muhamed-Kheir TAHA MD, PhD, HDR presented on lessons and impacts for meningitis in the COVID-19 era. Data showed cumulative cases of invasive meningococcal disease (IMD) from 2014-2020 in France as well as distribution of IMD cases from 2011-2020. Vaccine use in France declined during the COVID-19 pandemic in 2020, with reduced doses of the 5-month and 12-month vaccines. Distribution of IMD cases by age group from 2011-2021 showed an immunity gap in childhood due to the pandemic. Conclusions were that reduced pathogen circulation may decrease herd immunity, social distancing was associated with lower vaccine uptake, and countries need plans to promote
Progress is being made on developing a combined MenABCWY vaccine. Studies are underway evaluating the immunogenicity and safety of combining different meningococcal vaccines that target serogroups A, C, W, Y. Combining the vaccines could simplify immunization schedules, reduce costs by needing fewer doses, and increase vaccination uptake by reducing the number of required injections. However, a combined vaccine may also increase reactogenicity and interfere with the immune response to other concomitant vaccines. Ongoing studies are evaluating different potential MenABCWY vaccine combinations to determine the optimal formulation.
This document discusses pneumococcal genomics, vaccines, and antibiotic resistance. It examines how pneumococcal carriage and disease changes following vaccination as non-vaccine serotypes increase. The author analyzed carriage samples from Native American communities before and after vaccination, finding 35 sequence clusters but vaccination did not change overall carriage prevalence. The document explores how the accessory genome varies between locations and how negative frequency dependent selection structures pneumococcal populations. Models are developed to predict which sequence clusters may increase or decrease following vaccination based on accessory genome content and frequency dependent fitness. Comparisons are made between predicted and actual changes in sequence cluster prevalence post-vaccination.
Cryptococcal meningitis is responsible for 15% of AIDS-related deaths globally. A strategic framework is needed to end cryptococcal meningitis deaths by 2030 by addressing gaps in screening, diagnosis, and access to critical antifungal medicines. Key targets include expanding access to CD4 and cryptococcal antigen tests, improving availability of lumbar puncture and antifungal drugs, and increasing research to develop better diagnostics and treatments.
This document summarizes changes in invasive meningococcal disease (IMD) cases in Germany during the COVID-19 pandemic. It finds that overall IMD cases decreased during the first pandemic period (PP) in 2020 compared to pre-pandemic levels, with the largest declines in children ages 1-4 and 5-9. However, IMD cases increased again after restrictions eased. The decrease in IMD cases during increased restrictions correlates with decreased mobility based on Google mobility indices.
1) The PSERENADE project analyzed surveillance data from over 50 sites in 34 countries to assess the impact of PCV10 and PCV13 introduction on pneumococcal meningitis incidence globally in children under 5 years old and adults 18 years and older.
2) For both age groups, PCV10 and PCV13 significantly reduced meningitis caused by serotypes covered by the vaccines, with almost elimination in children under 5 years old within 5 years. Herd protection was observed in adults as well.
3) PCV13 significantly reduced meningitis from additional serotypes it covers compared to PCV10, though serotype 19A increased with PCV10 and serotype 3 trends were unclear
This study examined sequelae in 49 pediatric patients with invasive meningococcal disease (IMD) in Chile between 2009-2019. The researchers found that 59% of patients experienced sequelae at hospital discharge, with neurological disorders being the most common at 59.2%. Risk factors for sequelae included age under 1 year old, shock, and meningeal signs at admission. Sequelae were also associated with a clinical diagnosis of meningitis with meningococcemia. The study concludes that multidisciplinary follow-up is needed to reduce the long-term impacts of IMD in children.
National Center for Immunization & Respiratory Diseases
Rapid Diagnostic Tests for Bacterial Meningitis Pathogens: where we are now and what’s next.
Xin Wang Chief, Bacterial Meningitis Laboratory Director WHO Collaborating Center for Meningitis MVPDB/DBD/NCIRD/CDC Meningitis Research Foundation Conference Nov 1-3, 2021
The document discusses the current state of rapid diagnostic tests for bacterial meningitis pathogens and outlines a vision for their future development and deployment. It describes existing tests and their limitations. Potential new platforms are identified that could meet targets outlined in a target product profile. Advanced technologies like sequencing and CRISPR/Cas are also discussed
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae that can lead to serious health complications if left untreated. There is an urgent need for a gonorrhea vaccine due to increasing antibiotic resistance and the potential for the disease to become untreatable. However, vaccine development faces several difficulties as N. gonorrhoeae is highly variable, able to avoid the immune system, and past vaccine trials have shown no efficacy. Continued research is focused on identifying conserved antigens that could induce a protective immune response through vaccination.
Dr. Sami Gottlieb of the World Health Organization discussed the potential for meningococcal B (MenB) vaccines to help prevent gonococcal infection on a global scale. MenB vaccines have shown preliminary efficacy against gonorrhea in clinical trials and epidemiological data. WHO is working to define priority populations for gonorrhea vaccines and assess how existing MenB programs could be leveraged. Effectiveness may depend on disease epidemiology, vaccine characteristics, target populations, and integration with current immunization systems. Ongoing trials of MenB vaccines against gonorrhea will provide critical data to inform introduction decisions.
Gavi has supported the rollout of the Meningococcal A Conjugate Vaccine (MenAfrivac) in 26 African countries since 2010 through routine immunization and preventive campaigns for those aged 1-29. No cases of meningococcal A have been identified in the African meningitis belt since 2018. In 2018, non-A outbreaks prompted Gavi to authorize support for multivalent meningococcal conjugate vaccines contingent on regulatory approval, review processes, and cost targets being met. The estimated cost per death averted for the risk-based multivalent meningococcal conjugate vaccine program would be $6,300 to $13,400.
While pneumococcal disease primarily burdens infants in their first year of life, relying on herd effects from PCV schedules could help protect others indirectly and reduce costs. However, caution is needed, as indirect protection depends on direct protection of main transmitters, and key questions remain around who transmits, the duration of protection from boosters, and lessons from cRCTs comparing 2-dose and 3-dose schedules in Malawi and Gambia. Programmatic concerns like booster dose coverage, incomplete dosing, travel/border effects, and lack of surveillance also warrant consideration.
The document discusses Nepal's introduction of the PCV 10 vaccine using a 2+1 schedule of administration at 6 weeks, 10 weeks, and 9 months. A trial found this schedule to be equally effective as a 3+0 schedule. Surveillance data showed declines in invasive pneumococcal disease cases and pneumonia with consolidation following vaccine introduction. Pneumococcal carriage among children with clinical pneumonia under 2 years old declined significantly, but no decrease was seen in older children. Short term impact was observed using the 2+1 schedule, but continued surveillance is needed to assess long term vaccine impact.
The document discusses optimal vaccination schedules for pneumococcal disease in countries with high and low disease carriage. It summarizes studies comparing 1+1 and 2+1 vaccination schedules for PCV10 and PCV13 vaccines. The studies found immunogenicity was equivalent or higher for many serotypes with 1+1 schedules. The UK switched to a 1+1 schedule in 2020 and ongoing surveillance will monitor its impact on invasive pneumococcal disease cases. Future studies will evaluate the impact of the schedule change and potential for disease rebound over time.
Viral Meningitis: A real pain in the neck by Dr Fiona McGill
1. Viral Meningitis: a real pain in
the neck!
A current review of viral meningitis.
Dr Fiona McGill
Clinical Research Fellow, Liverpool Brain Infections Group
Specialist Registrar in Infectious Diseases and Medical
Microbiology
2. Outline
• Background
• How big is the problem.
• What causes viral meningitis.
• What happens to people who have viral
meningitis
– In the short term - symptoms
– In the longer term - consequences
• What are the outstanding unanswered
questions.
3. Meningitis
• What do people think of when they think of meningitis?
– “Panic, really serious illness”
– “rash, glass test, projectile vomiting, sore neck, dislike of bright
light, scary bananas”
– “Aaaaaaaaaaaaaagh!”
– “inflammation of the stuff round the brain, membrane? I don't know”
– “Affects small children, every parent’s nightmare, nearly always fatal”
– “Headaches, rashes that don’t disappear, aversion to bright
lights, vomiting and nausea”
– “that's not good. Then the test u r supposed to do with the glass for
blotchy skin, high temperature, difficulty breathing, vomiting possibly”
– “'serious' and mainly of kids/young people, the glass test”
– “It is extremely dangerous, can kill”
– “Scary, serious, unpredictable, rash”
– “serious illness, rash, glass test”
4. Meningitis
• What do people think of when they think of meningitis?
– “Panic, really serious illness”
– “rash, glass test, projectile vomiting, sore neck, dislike of bright
light, scary bananas”
– “Aaaaaaaaaaaaaagh!”
– “inflammation of the stuff round the brain, membrane? I don't know”
– “Affects small children, every parent’s nightmare, nearly always fatal”
– “Headaches, rashes that don’t disappear, aversion to bright
lights, vomiting and nausea”
– “that's not good. Then the test u r supposed to do with the glass for
blotchy skin, high temperature, difficulty breathing, vomiting possibly”
– “'serious' and mainly of kids/young people, the glass test”
– “It is extremely dangerous, can kill”
– “Scary, serious, unpredictable, rash”
– “serious illness, rash, glass test”
5.
6. What is meningitis?
• Meningitis
– Inflammation of the meninges
• What are meninges?
– Lining of the brain.
7. What is meningitis?
• Often caused by infection
– Bacteria
– Viruses
– Fungi, parasites, tuberculosis, HIV.......
8. What is a virus?
Viruses Bacteria
• Very small (10nm-300nm) • Larger – can be seen with a
• Live inside cells normal microscope
(1000nm)
• Difficult to grow in a lab
• Most grow easily given the
right conditions
• Can live out with cells
9. Viral Meningitis
• How big is the problem?
– 2009-2010 data
• HES 3434 cases
• HPA 260 notified cases
– Finnish study
• 7.6/100,000 (adults)
– 50% of all meningitis related hospital admissions
• c. 2500 – 4000 cases a year in the UK
10. Viral Meningitis - causes
• Lots!
• Enteroviruses
– Same family as poliovirus
– Gut bug
– Can be fatal in very young children
– Spread by poor hygeine
– Outbreaks
– Seasonal
11. • Herpesviruses
– Herpes simplex virus type 2
• Spread sexually – often asymptomatically
• Very few have current/history of genital disease
• Amount of people infected worldwide with HSV-2 is
increasing
• Can recur (most don’t!)
• Can occur with a first infection, or several years after
infection
12. • Varicella Zoster virus
– Chickenpox/Shingles
– Often occurs without rash
– Can occur at time of first infection or as a
reactivation
13. • Arboviruses
– Arthropod Borne Viruses
– Not present in UK but are in Europe/USA
– Think of in travellers
– Toscana Virus, West Nile Virus, Tick Borne
Encephalitis
14. • HIV
– Causes an “aseptic” meningitis
– Normally at time of first infection
– Can occur later in disease
– If missed may mean patient not diagnosed until
have advanced disease or ‘AIDS’
– 30% of patients diagnosed with HIV could have
been diagnosed earlier
15. • Others
– Mumps
– Other herpes viruses
• EBV, CMV, HSV-1, HHV-6/7
– Parechoviruses (normally in young children only)
• Many remain without a specific bug
19. Demographics
Age and Gender Distribution between different aetiologies
Median Age %age female n
Control 37 67.4 92
ASM 32.5 62.7 102
SBM 59.5 35.7 28
Encephalitis 47.5 60 10
Median Age %age female N
Enterovirus 30 65.1 43
HSV-2 43 78 9
VZV 40 60 5
Unknown 32.5 58 38
ASM
20. Clinical Features
• Common
– Headache
– Fever
– Photophobia
– Neck Stiffness
– Nausea and vomiting
• Less common
– Rash
– Myalgia
– Very few have concurrent (or previous) genital lesions
21. Clinical Features of Different Viruses
Headache Photophobia Neck Stiffness Fever N and/or V
Enterovirus Ihekwaba et 100% 82% 77% 37.8+/-0.8 91%
al (n=22)
Meningitis 100% 91% 77% 67% 47%
NW (n=43)
VZV Ihekwaba et 76% 25% 38% 37.3+/-1.0 50%
al (n=8)
Meningitis 100% 60% 20% 60% 80%
NW (n=5)
HSV-2 Ihekwaba et 100% 63% 100% 37.8+/-0.6 100%
al (n=8)
Meningitis 100% 67% 56% 44% 56%
NW (n=9)
Ihekwaba UK, Kudesia G, McKendrick M. Clinical Features of viral Meningitis in Adults: significant
differences in Cerebrospinal Fluid Findings among Herpes Simplex Virus, Varicella Zoster Virus and
Enterovirus Infections. CID 2008:47. 783-789.
23. What are the longer term outcomes for
people with viral meningitis?
•Viral meningitis is often quoted as being a
benign self-limiting illness
•Doesn’t tend to maim or kill
•However
• individual consequences
• fatigue
• cost implications1
• psychosocial
• evidence of poor neuropsychological
outcomes2
• recurrences
1) Khetsuriani et al, Viral Meningitis associated hospitalisations in the US, 1988-1999. Neuroepidemiology. 2003; 22: 345-352
2)Schmidt et al, Neuropsychological sequelae of bacterial and viral meningitis. Brain (2006):129:333-345
24. Individual impact
• 2500-4000 individuals
– Significant impact at the individual level
– I am nowhere near being back to normal and anticipate it being months until I am.
– Since being home I have found it hard to concentrate, had memory loss, muffled ears, sleep
apnoea, racing heart, shooting pains down my legs, loss of co-ordination, sore and stiff neck
and back, speech problems, shakes, photophobia on occasion, tics and twitches and felt
depressed.
– It lasted for only a week but I can honestly say that was the worst seven days of my life. I
wouldn't wish meningitis on my worst enemy.
– I had never felt so unwell.
– it was the scariest thing I have ever had to experience
– I now have really bad headaches and my back is always sore with shooting pains through it.
25. Economic sequelae
• Healthcare costs
• Loss of earnings
• Young, fit people
• Indirect costs
• Carers etc…
• 1.3 billion USD over a 5 year period
Khetsuriani et al, Viral Meningitis associated hospitalisations in the US, 1988-1999.
Neuroepidemiology. 2003; 22: 345-352
26. Neuropsychological sequelae
Domain BM (%) VM (%) Control (%) P value
Attention 39 42.6 20.0 Ns
Executive 63.6 48.3 25.0 Ns
Function
Short term 58.6 39.5 15.4 <0.01
memory
Verbal learning 31 25.0 10.0 Ns
Schmidt et al, Neuropsychological sequelae of bacterial and viral meningitis. Brain
(2006):129:333-345
28. Recurrences
Herpes viruses – latency and reactivation
• Herpes viruses are characterised by the ability to
establish latency
– Remains present in the host
– No active replication
– Always retain ability to reactivate
• Reactivation
– Triggers
– Associated with immune status
– More frequently with HSV than VZV (normally only
once)
– Normally asymptomatic
29. Recurrences
Recurrent genital HSV-2
• Genital recurrences common
– Asymptomatic and symptomatic
– Asymptomatic more common
– Infection with HSV-2 globally is rising
– Infection with HSV-2 significantly increases risk of
HIV infection
– Antivirals reduces clinical disease and detectable
genital shedding but don’t reduce transmission or
HIV acquisition
30. Recurrences
Recurrent HSV-2 meningitis
Finnish study
665 patients with lymphocytic meningitis
37 had recurrent meningitis (5.6%)
28 had HSV-2 in CSF (76%)
27-30% of pts with HSV-2 in CSF had previous
episodes of meningitis
3 patients had recurrent genital herpes (8%)
Prevalence of RLM 2.7/100000
Prevalence of HSV-2 ass RLM 2.2/100000
Kallio-Laine et al. Recurrent Lymphocytic Meningitis Positive for Herpes Simplex Virus Type 2.
EID. 15(7) :1119-1122
31. Recurrences – does prevention work?
101 patients with HSV-2 meningitis
Randomised to Valaciclovir or placebo
Treated for one year and followed up for a further year
Recurrent meningitis commoner in patients who took valaciclovir than in
those who were on placebo
?Dose not right
?unable to completely eradicate/prevent virus once it has established latency
33. Research questions
• Pathogenesis
• Diagnostics
• Treatment options
• Longer term outcomes
– Recurrences
– Economics
34. Pathogenesis
• Current work is very patchy
– Based on work on polio
• Why do some people get recurrent disease?
– Immune defects
35. Diagnostics
• The polymerase chain reaction has greatly
improved things
• Still significant number of people not getting a
diagnosis
– Requires education
– New approach
• Gene expression profiling
36. New approaches to diagnostics
• Gene expression profiling
– gene expression
A - TB meningitis
B - Cerebral Malaria
C – Bacterial meningitis
Griffiths, M, Hemingway C
Newton, C Levin, M;
unpublished
37. Treatment options
No proven, licensed treatments for any of the common causes of
viral meningitis
– ?Aciclovir
• Enterovirus
– Pleconaril • HIV
• Reduced symptoms by a – Antiretrovirals
day or so • Others
• Potential for interactions – Supportive
deemed too high for clinical – ?steroids
benefit, never licensed
– ?immunoglobulin
– ?immunoglobulin
• Herpes viruses
38. HSV-2 meningitis - to treat or not to treat
• US Study (2009)
– Retrospective review of HSV-2 in CSF
– 19 cases of meningitis, 74% female, only 2 had history of prior
genital herpes, one had concurrent herpes
– Treatment variable
– None to 21 days of IV Aciclovir and everything in between.
• Need for a properly conducted trial
39. Longer term outcomes
• How much does viral meningitis cost the NHS
in the UK?
• Are there neuropsychological consequences?
40.
41. How common is it?
Patients admitted with suspected meningitis who have
a lumbar puncture (spinal tap)
1. Control patients
Symptoms of meningitis, normal lumbar puncture
findings.
2. Meningitis
Viral, bacterial, other....
42. Adults ≥16
Admitted to hospital with suspected
meningitis
Lumbar Puncture
Aseptic Suspected
Control meningitis Bacterial
(ASM) Meningitis
(SBM)
Viral Others
meningitis TB
43. How common is it?
• C.30 hospitals in the North of England
44. What happens to people with viral
meningitis?
• Follow-up with questionnaires for a year after
admission
– Headaches
– Quality of life
– Brain functioning
– Economics
45. Suspected
Aseptic Bacterial
Control meningitis Meningitis
5 x questionnaires at 6, 12, 24 and 48 weeks
46. Improving diagnosis
• Looking at genes expressed in the
host/patient
• Are their differences between
controls and meningitis?
• Are they different between patients who have
viruses and those who have bacteria?
• Are they different between different viruses?
• Blood and spinal fluid
c/o M.Griffiths
47. Pathogenesis
• HSV is so prevalent why do some people
develop meningitis and others don’t?
– Examine differences in DNA from pts with
meningitis and those without
– Both patient and viral/bacterial DNA
– Compare differences in pathogen DNA from
different sites e.g. CSF and genital
48. Thanks
• You – for listening
• MRF
• LBIG and Prof Solomon etc…..
• Doctors and Nurses at all the sites involved in
my study
• All the patients in the study
Any questions?