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Meningitis 2006 - Meningitis • Bacterial • Viral...

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Unformatted text preview: Meningitis • Bacterial • Viral ( aseptic) • TB • Fungal • Chemical • Parasitic • ? Carcinomatous Meningitis • Definition – Bacterial meningitis is an inflammatory response to bacterial infection of the pia- arachnoid and CSF of the subarachnoid space • Epidemiology – Incidence is between 3-5 per 100,000 – More than 2,000 deaths annually in the U.S. – Relative frequency of bacterial species varies with age. Meningitis • Epidemiology – Neonates (< 1 Month) • Gm (-) bacilli 50-60% • Grp B Strep 20-40% • Listeria sp. 2-10% • H. influenza 0-3% • S. pneumo 0-5% Meningitis • Epidemiology – Children (1 month to 15 years) • H. influenzae 40-60% – Declining dramatically in many geographic regions • N. meningitidis 25-40% • S. pneumo 10-20% Meningitis • Epidemiology – Adults (> 15 years) • S. pneumo 30-50% • N. Meningitidis 10-35% – Major cause in epidemics • Gm (-) Bacilli 1-10% – Elderly • S. aureus 5-15% • H. influenzae 1-3% – >60 include Listeria, E. coli, Pseudomonas Meningitis • Pathogenesis – Majority of cases are hematogenous in origin – Organisms have virulence factors that allow bypassing of normal defenses • Proteases • Polysaccharidases Meningitis • Pathology and Pathogenesis – Sequential steps allow the pathogen into the CSF • Nasopharyngeal colonization • Nasopharyngeal epithelial cell invasion • Bloodstream invasion • Bacteremia with intravascular survival • Crossing of the BBB and entry into the CSF • Survival and replication in the subarachnoid space Meningitis...
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Meningitis 2006 - Meningitis • Bacterial • Viral...

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