Meningitis - Tutorial + Infect and Immune lecture on meningitis Flashcards
Why is the CNS vulnerable to meningits?
What is the main method of spread to obtain meniningitis?
Hematogenous spread most common (from trauma or surgery, or other surgery).
Where does the CSF sit in between?
What is meningitis?
Between the pia mater and arachnoid.
What are the 3 classifications of meningitis?
What is the typical presentation immune cells in csf? How is this diagnostic?
Classic triad: clinical features of meningitis
Classic triad=
- Very high fever (95% of cases)
- Neck stiffness
- Headache (photophobia also)
Explain the rash associated with meningitis and what bacteria causes it?
What about kernigs sign?
N. meningitis
Morphology of N. meningitis?
Gram stain?
Where do they live?
Gram negative diplococci.
Carriage with N. meningitis?
Explain how N. meningitis kills?
Sepsis associated with N. meningitis is worse than the meningitis.
Why is N. meningits deadly?
LPS: proinflammatory.
Immune evasion: Many capsule types and avoid complement activation.
Invasion of the epithelium (blood-brain barrier) and intracellular mechanisms.
Diagnosis of bacteria meningitis?
What results would you expect to see?
CSF lumbar puncture: best taken before antimicrobial given.
- WBC’s present (polymorphonucleocytes), decrease in glucose, increase in protein. (as opposed to viral increase in lymphocytes, normal glucose and slight increase in protein).
- Visible turbidity of CSF sample (which is normally clear).
- Gram stain (diplococci negative)
- Get a culture to figure out antimicrobial sensitivity (gold standard) .
- PCR is rapid but doesnt give susceptibility.
Treatment of meningitis?
Ceftriaxone and penicillin good bets for exam question.
- Support CVS: monitor blood pressure.
Can you vaccinate for meningitis?
What groups are at highest risk?
Pacifica and Maori at highest risk.
Is viral meningitis deadly?
Usually mild and self limiting.
Explain the pathogenesis of N. meningitis?
Most common cause of meningitis for Neonates vs <2mth vs adolescents vs adults vs elderly vs AIDS?
What strain of meningitis is still a problem? What year were there increases in cases? What age group is most vulnerable?
What are the leptomeninges?
The pia and the arachnoid together. This is what is infected in meningitis.
Signs and symptoms of meningococcal septicemia?
Pathogenesis here?
What type of hypersensitivy occurs in TB?
Explain what forms due to this (go into detail about each layer)? What are some of the different cells which are made?
T cell mediated reaction=Type 4 sensitivity reaction.
Makes a granuloma around the M. tuberculosis bacteria.
What is the condition?
Common outcome from viral meningitis, bacterial meningitis? What if treatment is delayed?
Explain the pathogenesis of septic shock and how this can lead to multiorgan failure?
- Release of cytokines/proinflammatory mediators
- …..
What is disseminated intravascular coagulation and how does it occur?
What bacteria that causes meningitis causes DIC?
What are the 3 types of haemorrhagic spots?
What happens to the adrenal glands during N. meningitis septicemia?
Adrenal glands are under stress as the body requires high amounts of corticosteroids and catecholamines during infection.
- Complicated but adrenal glands undergo bilateral haemorrhage and are turned into sacs of blood.
