The inflammation is caused by a bacterial infection and can be lifethreatening. Protein leaks into the subarachnoid space from the blood, resulting in markedly increased csf protein levels. Neonatal meningitis is often caused by group b streptococcus and is associated with prematurity, gestational age, postnatal age, and geographic region. Treatment and outcome and initial therapy and prognosis of bacterial meningitis in adults and treatment of bacterial meningitis caused by. However, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. New understandings on the pathophysiology of bacterial. First, the introduction of conjugate vaccines in europe resulted in the virtual disappearance of. Pathophysiology and treatment of bacterial meningitis. Streptococcus pneumoniae, neisseria meningitidis, and haemophilus influenzae type b hib are the predominant causative pathogens in both adults and children the focus of this topic is on bacterial meningitis acquired in the community. The bacteria are found in the mouth, throat, or nose. No bacterial disease has undergone a more dramatic change in epidemiology during the past decade than acute bacterial meningitis. Bacterial meningitis can happen at any age, but infants are more susceptible. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed.
In vitro infection of human nasopharyngeal cells in organ culture with meningococci or h. Introduction bacterial meningitis is an inflammation of the leptomeninges, usually causing by bacterial infection. Pathophysiology and treatment of bacterial meningitis olaf hoffman and joerg r. See pathogenesis and pathophysiology of bacterial meningitis and bacterial meningitis in children older than one month. In brazil, the rate of bacterial meningitis is higher, at 45.
It can be treated with appropriate antibiotics that also prevents spread. Through the use of experimental animal models of infection, a great deal of information has been gleaned concerning the pathogenic and pathophysiologic mechanisms operable. The clinical features, treatment, prognosis, and prevention of bacterial meningitis in adults and children and issues related to chronic and recurrent meningitis are discussed separately. All patients with bacterial meningitis and many with viral meningitis will be treated in the hospital.
Bacterial meningitis is inflammation of the lining that surrounds and protects your brain and spinal cord. Bacterial meningitis remains a disease with associated unacceptable morbidity and mortality rates despite the availability of effective bactericidal antimicrobial therapy. Animal models have proven to be extremely valuable in the study of the pathogenesis and pathophysiology of bacterial meningitis, with the hopes of providing new information that may lead to an. Bacterial meningitis remains a very significant problem, having increased in frequency during the past several decades. Treatment is with antibiotics and corticosteroids given as soon as. In the past, hib was the most common cause of meningitis in children under five years of age. Bacterial, fungal, and parasitic infections of the central. The mainstay of treatment for bacterial meningitis is antibiotics. Through the use of experimental animal models of infection, a great deal of information. The meninges are the three membranes that along with the cerebrospinal fluid, enclose and protect the structures of the nervous system like the brain and the spinal cord. Streptococcus pneumoniae and neisseria meningitidis. Pathophysiology of bacterial meningitis international journal of. Although the occurrence of neonatal meningitis is uncommon, it remains a devastating infection with high mortality and high morbidity. Pathophysiology of bacterial meningitis semantic scholar.
Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. The subarachnoid space is bounded externally by the arachnoid membrane and internally by the pia, and dips into the brain along blood vessels in the perivascular virchowrobin spaces. Bacterial meningitis is an inflammation of the meninges, including the pia, arachnoid, and subarachnoid space, that occurs in response to infection with bacteria andor bacterial products. Despite the availability of bactericidal antibiotics with potent in vitro activity against the major meningeal pathogens, the morbidity and mor tality from bacterial.
In general, there are no medications to fight the germs that cause viral meningitis, so. Csf outflow resistance is elevated and inhibits csf flow from the subarachnoid space to the dural sinuses. Despite the availability of bactericidal antibiotics with potent in vitro activity against the major meningeal pathogens, the morbidity and mortality from bacterial meningitis remains unacceptably high. Clinical features and diagnosis and bacterial meningitis in the neonate. Dexamethasone halves the risk of poor outcome, but only in selected patient groups. This cascade leads to lipid peroxidation, mitochondrial damage and breakdown of the bloodbrain barrier, thus contributing to cell injury during neonatal meningitis. Through the use of experimental animal models of infection, a great deal of information has been gleaned concerning the pathogenic and pathophysiologic mechanisms operable in bacterial meningitis. The r ole of caspase casp1 in the pathophysiology of pneu mococcal meningitis has been the subject of recent experiments. In order to improve prognosis of the infection, early diagnosis and prompt treatment are crucial to.
Pathogenesis ofbacterial meningitis 119 torysituation indicates the ongoingneedto studythepathogenesis and pathophysiology of bacterial meningitis in an attempt to improve the response to conventional antimicrobial therapy 126, 148, 165, 166. Animalmodels experimental animal models have been employed exten. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. Bacterial meningitis remains a disease with associated unacceptable morbidity. Bacterial meningitis is the infection of the arachnoid membrane, subarachnoid space, and cerebrospinal fluid by bacteria.
Bacterial meningitis symptoms, diagnosis and treatment. Autolysis consists of selfdigestion of the cell wall by peptidoglycan hydrolyases termed autolysins. Meningitis, inflammation of the meninges, the membranes covering the brain and spinal cord. Neisseria meningitidis is remarkable for the diversity of interactions that the bacterium has with the human host, ranging from asymptomatic nasopharyngeal colonisation affecting virtually all members of the population. As such, it represents a unique human infectious disease, b. Pdf no bacterial disease has undergone a more dramatic change in epidemiology during the past decade than acute bacterial meningitis. Bacterial meningitis pathophysiology armando hasudungan. Cohen, professor, department of infectious diseases and micro biology, imperial college school of medicine, hammersmith hospital, london summary bacterial meningitis is the most common serious infection. Commonly from infection bacterial, viral, and fungal noninfectious reasons could be from cancer or drug interactions.
This bacterium is the most common cause of bacterial meningitis in infants, young children and adults in the united states. Pathogenesis and pathophysiology of bacterial meningitis. Bacterial meningitis also produces effects on blood vessels in the subarachnoid space with resulting vasculitis, vessel narrowing, thrombosis, and ischemia or infarction of the brain. Moore, specialist registrar in infectious diseases, and j. Various bacteria including the major meningeal pathogens e.
Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. Meningitis can be caused by various infectious agents, including viruses, fungi, and protozoans, but bacteria produce the most lifethreatening forms. Bacterial meningitis is a serious inflammation of the meninges caused by various bacteria. Findings typically include headache, fever, and nuchal rigidity. Surgical management is indicated where there is extremely increased intracranial pressure, infection. Through the use of experimental animal models of infection, a great deal of information has been gleaned concerning the pathogenic and pathophysiologic mechanisms. The pathogenesis of bacterial meningitis, including colonization of. Get a printable copy pdf file of the complete article 4. Pathogenesis of bacterial meningitis sciencedirect. Pathophysiology and treatment of bacterial meningitis ncbi. Meningitis is an infection of the meninges, the membrane covering the brain. New therapies based upon an understanding of the pathophysiology are needed.
The type of treatment depends on the germ that caused the meningitis. Bacterial meningitis occurs in about 3 people per 100,000 annually in western countries. Bacterial meningitis may present acutely symptoms evolving rapidly over 124 hours, sub acutely symptoms evolving over 17days, or chronically symptoms evolving over more than 1 week. Meningococci reach the brain from the bloodstream, implying that the patients immune response has prevented bacterial proliferation in the blood and not suffered overwhelming sepsis. It more commonly causes pneumonia or ear or sinus infections. Bacterial infections meningitis involves inflammation of the leptomeninges or pachymeninges covering the brain and spinal cord and may be caused by infectious or noninfectious agents. Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. They are spread from an infected person to another by. Most cases of bacterial meningitis originate from the host obtaining an infectious agent by nasopharyngeal colonization. Meningitis about bacterial meningitis infection cdc. Pathophysiology of neonatal acute bacterial meningitis.
Meningitis is an inflammation of the tissue that covers the brain and spinal cord that can be caused by several different types of, as well as viruses and fungibacteria. Descriptions of epidemic meningitis date back to 1805, although the causative bacterium neisseria meningitidis was not identified until 1887. Bacterial meningitis leads to a more permeable blood brain barrier due to increased inflammation. Neurological damage in meningitis may be caused by a mixture of direct bacterial toxicity, indirect inflammatory processes such as cytokine release, neutrophil activation, with resultant vasculitis, and cellular oedema. Emerging antibiotic resistance is an upcoming challenge. Diagnosis, initial management, and prevention of meningitis.
Changing epidemiology of acute bacterial meningitis. Bacterial meningitis is very serious because its onset is rapid and the infection is associated with a significant risk of death. The beginning of this millennium has witnessed the virtual disappearance of haemophilus invasive disease in some. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. Populationwide studies have shown that viral meningitis is more common, at 10. Pathophysiology of meningococcal meningitis and septicaemia. Fifty years after the advent of antibiotics for clinical use, bacterial meningitis remains an important cause of morbidity and mortality. Acute bacterial meningitis is rapidly progressive bacterial infection of the meninges and subarachnoid space. Bacterial meningitis is the most common serious infection of the central nervous system.
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