Bacterial Meningitis -- Pneumococcus Flashcards
CSF Findings in bacterial meningitis?
Inc PMNs, Dec glucose, Inc protein
3 bacteria causing meningitis in birth to 3 months
GBS (agalactiae), G- enterics, Listeria
3 bacteria causing meningitis in 3 months to 2 years
Pneumococcus, Neisseria, Haemophilus
2 bacteria causing meningitis in 2 years to 18 months
Neisseria, Pneumoccocus
3 bacteria causing meningitis in immunocompromised host
Staphylococcus, G- enterics, Pseudomonas
MCC of bacterial meningitis in US?
Strep pneumoniae
How does pneumococcus colonize middle ear?
Cell wall cytotoxicity on ciliated cells of cochlea
How does pneumococcus colonize alveoli of LRT?
Choline surfactant prod. by alveoli
How does pneumococcus invade?
Alter vascular permeability or Direct invasion of endothelium
Pneumococcal virulence factor – interferes w/ phagocytosis by leukocytes by interference w/ binding of C3b to cell surface
Capsule
Pneumoccocal virulence factor – facilitates initial event in invasive disease of adherence to URT epithelium
Pili
Pneumococcal virulence factor – major pneumococcal adhesin that interacts with carbohydrates on pulmonary epithelial surface; necessary for crossing of BBB during dev. of meningitis
Choline-binding protein (CbpA; 8 choline-binding repeats)
Other important virulence factors of pneumococcus w/out their own card
Cell wall, pneumolysin, H2O2, Neuraminidase, IgA protease
Pneumococcal vaccine – multivalent w/ 23 non-conjugated capsule types, for pts. >65 and high risk groups, lasts 5-7 years, not effective in infants and young, protects against invasive dz
Pneumovax
Pneumococcal vaccine – Heptavalent (and 13-valent) conjugated capsule types, anamnestic response, effective in young
Prevnar
