Bacterial Meningitis Flashcards
Meninges
- membranes envelop ___
- 3 types of matter
- envelop CNS
- pia matter
- arachnoid matter
- dura matter
Meningitis
- infection of ___
- type of infection?
- meninges
- viral or bacterial
Blood Brain Barrier
- ___ passage from __ to ___
- __ cells stitched by ___
- tissue macrophages of CNS?
- what is not present?
- restricts passage from blood to CNS
- endothelial cells stitched by tight junctions
- microglia cells
- WBC + antibodies
Bacterial Meningitis Steps (10)
- ___ colonization
- ___ into blood
- ___ in blood
- crossing ___
- invasion of ___
- production of ____
- recruit ___
- edema, increased ___
- ____
- ___ death
- nasopharyngeal colonization
- invasion into blood
- multiplication in blood
- crossing BBB
- invasion of meninges
- production of pro-inflammatory cytokines
- recruit leukocytes
- edema, increased cranial pressure
- inflammation
- neuronal death
Bacterial Meningitis
- early signs ___?
- ___ damage
DANGEROUS
- nonspecific (fever, stiff neck, confusion)
- irreversible
3 Ways Traversing BBB
1) Transcellular
2) Paracellular
3) Trojan Horse
Bacterial Meningitis Diagnosis
- ___ CSF
- __ levels of glucose
- Lumbar puncture
- cloudy CSF
- low glucose
Nuchal Rigidity
neck flex
Brudzinski’s sign
stiff neck
neck flex –> knee flex
Kernig’s sign
stiff hamstring
can’t straighten leg
Treatment of Bacterial Meningitis
- IV antibiotics __ to culture?
- corticosteroids?
IMMEDIATE
- prior to culture
- reduces swelling in meninges
Capsule
- what is it?
- protect bacteria from ___?
- loose, unstructured network of polymers
- complement system
___ response to capsules –> antibodies from _ cells able to __ capsule
host
B cells
recognize
vaccine from capsules
- LT memory?
- conjugate vaccine?
- not LT (T-cell independent)
- T cells respond to proteins NOT sugars
- conjugate vaccine = polysaccharide conjugated to protein carrier
Types of Meningitis (5)
1) Neisseria Meningitidis
2) Streptococcus pneumoniae
3) Haemophilus influenzae type b
4) Listeria moncytogenes
5) Streptococcus agalactiae
Neisseria Meningitidis
- gram?
- human specific?
- colonizes?
- capsule? serotypes?
- gram NEGATIVE
- YES
- nose + throat
- polysaccharide capsule
- antigenic variants
Neisseria Meningitidis
- invasive ___ disease
- meningitis after bacteria ___?
- ___ –> septic shock
- blood ___
- invasive meningococcal disease
- bacteria enter blood
- endotoxin (LPS)
- blood clotting
Neisseria Meningitidis
- vaccine?
- __ capsule with _ serotypes
- vaccine?
- _ recombinant ___
- Meactra/Menevo
- conjugate, 4 (not group B)
- Bexsero
- 4 recombinant protein antigens
Neisseria Meningitidis
- serotypes (5)
A, B, C, W135, Y
Streptococcus pneumoniae
- gram?
- resides in?
- symptoms?
- capsule? serotypes?
- gram POSITIVE
- nasopharynx
- pneumonia + ear infections
- polysaccharide capsule
- many serotypes
Streptococcus pneumoniae
- vaccine?
- ___ capsule with _ serotypes
- vaccine?
- Prevnar 13
- conjugate capsule with 13 serotypes
- 23 variant polysaccharide vaccine
Haemophilus influenzae type b
- gram?
- capsule?
- ___ infection?
- gram NEGATIVE
- polysaccharide capsule
- upper respiratory
Haemophilus influenzae type b
- vaccine?
- Hib conjugate vaccine (childhood immunization)
Listeria moncytogenes
- gram?
- borne?
- capsule?
- ___ –> bacteremia –> meningitis
- who has high mortality?
- gram POSITIVE
- food-borne
- NO capsule
- gastroenteritis
- immunocompromised, fetus, pregnant mothers
Listeria moncytogenes
- grows at?
- invades ___? using ____ motility and __-__ spread
- 4 degrees Celsius
- invades intestinal epithelial cells
using actin based motility and cell-cell spread
Streptococcus agalactiae
- gram?
- capsule?
- who carries where?
- passed to?
- gram POSITIVE
- YES capsule
- women carry in urogenital tract
- passed to infants during birth
