Case Study - Meningitis
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Questions and Answers

What was the primary pathogen identified in Malorie's case of bacterial meningitis?

  • Streptococcus pneumoniae
  • Escherichia coli
  • Haemophilus influenzae
  • Neisseria meningitidis (correct)

    • Which of the following symptoms is NOT typically associated with meningitis?

  • Severe headache
  • Fever
  • Stiff neck
  • Rash (correct)

    • What laboratory finding is indicative of a bacterial infection in cerebrospinal fluid analysis?

  • Clear appearance
  • High glucose levels
  • Low WBC count
  • Elevated protein levels (correct)

    • Which bacterial species is the second most common cause of bacterial meningitis?

    <p>Neisseria meningitidis</p> Signup and view all the answers

    What underlying issue contributed to Malorie's recurrent infections with Neisseria meningitidis?

    <p>Complement deficiency</p> Signup and view all the answers

    Match the bacterial meningitis pathogens with their classification:

    <p>Streptococcus pneumoniae = Gram-positive coccus Neisseria meningitidis = Gram-negative diplococcus Haemophilus influenzae = Gram-negative bacillus Listeria monocytogenes = Gram-positive bacillus</p> Signup and view all the answers

    Match the symptoms of meningitis with their descriptions:

    <p>Fever = Elevated body temperature due to infection Stiff neck = Inability to flex the neck due to muscle spasm Headache = Severe pain experienced in the head region Cloudy CSF = Indication of infection or inflammation in the cerebrospinal fluid</p> Signup and view all the answers

    Match the complement system components with their roles:

    <p>C3b = Opsonization of pathogens C5a = Chemical signaling for inflammation C9 = Formation of the Membrane Attack Complex C1 = Initiation of the classical pathway</p> Signup and view all the answers

    Match the CSF findings with their implications:

    <p>High WBC count = Indicates infection or inflammation Low glucose levels = Suggests bacterial infection over viral Elevated protein levels = Commonly found in infectious diseases Cloudy appearance = Suggests the presence of pathogens or cells</p> Signup and view all the answers

    Match the bacterial species with their common association in meningitis cases:

    <p>Escherichia coli = Common in neonatal meningitis Streptococcus agalactiae = Associated with maternal transmission Mycobacterium tuberculosis = Can cause chronic meningitis Neisseria meningitidis = Known for outbreaks in crowded places</p> Signup and view all the answers

    What is a primary characteristic of Streptococcus pneumoniae?

    <p>It has a prominent polysaccharide capsule.</p> Signup and view all the answers

    Which of the following is a virulence factor of Neisseria meningitidis?

    <p>Endotoxin</p> Signup and view all the answers

    What method is used to identify Streptococcus pneumoniae capsular strains?

    <p>Quellung test</p> Signup and view all the answers

    What symptoms are characteristic of bacterial meningitis?

    <p>Headache and stiff neck</p> Signup and view all the answers

    Which agar is used to culture Neisseria meningitidis?

    <p>Chocolate agar</p> Signup and view all the answers

    What is the primary route of transmission for Haemophilus influenzae?

    <p>Direct contact</p> Signup and view all the answers

    Which organism is known to cause meningitis and is an acid-fast bacilli?

    <p>Mycobacterium tuberculosis</p> Signup and view all the answers

    What complication is associated with Neisseria meningitidis?

    <p>Meningococcemia</p> Signup and view all the answers

    Match the bacterial meningitis pathogens with their characteristics:

    <p>Streptococcus pneumoniae = Gram-positive diplococci with a capsule Neisseria meningitidis = Gram-negative diplococci with fimbriae Haemophilus influenzae = Gram-negative pleomorphic rods Listeria monocytogenes = Can cross the placenta and infect babies</p> Signup and view all the answers

    Match the virulence factors with their respective pathogens:

    <p>Streptococcus pneumoniae = Capsule Neisseria meningitidis = Endotoxin (LPS) Haemophilus influenzae = Direct contact transmission Mycobacterium tuberculosis = Can cause meningitis in endemic areas</p> Signup and view all the answers

    Match the pathogens with their common associations in meningitis cases:

    <p>Escherichia coli = Found in newborns due to unsanitary handling Streptococcus agalactiae = Infects babies during delivery Neisseria meningitidis = Can lead to meningococcemia Listeria monocytogenes = Warned against in pregnant women</p> Signup and view all the answers

    Match the bacterial species with their transmission routes:

    <p>Streptococcus pneumoniae = Person to person spread Neisseria meningitidis = Outbreaks in crowded places Haemophilus influenzae = Direct contact Listeria monocytogenes = Consumption of unpasteurized products</p> Signup and view all the answers

    Match the symptoms with their related conditions:

    <p>Cloudy CSF = Hallmark symptom of bacterial meningitis Petechiae = Associated with meningococcemia Severe headaches = Common symptom of meningitis Fever = General symptom of infection</p> Signup and view all the answers

    Match the type of meningitis with their typical demographics:

    <p>Streptococcus pneumoniae = Most common in all age groups Neisseria meningitidis = Common in adolescents and young adults Haemophilus influenzae = Primarily affects unvaccinated children Listeria monocytogenes = Affects newborns and the elderly</p> Signup and view all the answers

    Match the diagnostic methods with their specific purposes:

    <p>Quelling test = Identifies capsular strains of S.pneumoniae Spinal tap = Determines CSF cloudiness Blood culture = Detects systemic infection PCR testing = Identifies bacterial DNA in CSF</p> Signup and view all the answers

    Match the bacterial pathogens with their Gram stain characteristics:

    <p>Streptococcus pneumoniae = Gram-positive Neisseria meningitidis = Gram-negative Haemophilus influenzae = Gram-negative Escherichia coli = Gram-negative</p> Signup and view all the answers

    Study Notes

    Meningitis Case Study

    • Malorie, a 20-year-old college student, was diagnosed with bacterial meningitis caused by Neisseria meningitidis.
    • Malorie's symptoms included severe headache, fever, and stiff neck which are typical of meningitis.
    • Her cerebrospinal fluid (CSF) analysis revealed a cloudy white appearance, high white blood cell count (especially neutrophils), low glucose levels, and elevated protein levels.
    • A gram stain of her CSF showed gram-negative diplococci, which confirmed Neisseria meningitidis as the causative agent.
    • Malorie's history of recurrent meningococcus infections suggests a complement deficiency, a condition that weakens the immune system's ability to fight off infections.
    • Bacterial meningitis is a serious disease that can lead to complications including death.

    Common Causes of Bacterial Meningitis

    • The most common causes of bacterial meningitis are:
      • Streptococcus pneumoniae
      • Neisseria meningitidis
      • Haemophilus influenzae

    Other Bacterial Meningitis Pathogens

    • Other bacteria that can cause meningitis include:
      • Escherichia coli
      • Streptococcus agalactiae
      • Listeria monocytogenes
      • Mycobacterium tuberculosis

    Bacterial Meningitis

    • Malorie presented with classic symptoms of bacterial meningitis: severe headache, fever, and stiff neck.
    • Her cerebrospinal fluid (CSF) analysis revealed:
      • Cloudy white appearance
      • High white blood cell (WBC) count, particularly neutrophils
      • Low glucose levels
      • Elevated protein levels
    • Gram stain of CSF showed gram-negative diplococci, confirmed by cultures on Chocolate Agar and Thayer-Martin Agar.
    • Malorie was diagnosed with bacterial meningitis caused by Neisseria meningitidis.
      • Neisseria meningitidis is a gram-negative diplococcus responsible for meningococcal disease.
      • It is the second most common cause of bacterial meningitis.
    • Malorie has recurrent meningococcal infections due to a complement deficiency, highlighting the importance of the complement system in immunity.

    Common Causes of Bacterial Meningitis

    • The most common causes of bacterial meningitis are:
      • Streptococcus pneumoniae
      • Neisseria meningitidis
      • Haemophilus influenzae
    • Other bacterial pathogens that can cause meningitis include:
      • Escherichia coli
      • Streptococcus agalactiae
      • Listeria monocytogenes
      • Mycobacterium tuberculosis

    Bacterial Meningitis

    • Inflammation of the meninges, the three membrane layers surrounding the brain
    • Caused by bacteria entering the bloodstream, usually through the oral or nasal pharynx
    • Symptoms include headache, fever, nausea, vomiting, and stiff neck
    • Diagnosis involves analyzing cerebrospinal fluid (CSF) via a spinal tap (lumbar puncture)
    • Cloudy CSF with high levels of white blood cells, particularly neutrophils, indicate bacterial meningitis

    Streptococcus pneumoniae

    • Leading cause of bacterial meningitis in all age groups
    • Gram-positive, lancet-shaped diplococci that can form short chains
    • Possesses a prominent polysaccharide capsule, a virulence factor
    • Identification involves the Quellung test, which determines the capsular strain
    • About 5-50% of people carry pneumococci as normal flora in the nasopharynx
    • Transmission is typically endogenous (from within the body) and rarely spread person-to-person
    • Gram stain of a specimen reveals gram-positive diplococci
    • Culture on blood agar plates exhibits alpha hemolysis
    • Differentiated from viridans streptococci by sensitivity to optochin

    Neisseria meningitidis

    • Gram-negative diplococci
    • Possesses several virulence factors: a prominent polysaccharide capsule, fimbriae, IgA protease, and endotoxin
    • 3-30% of adults carry it as normal flora
    • Transmission occurs through aerosolized droplets, easily spreading person-to-person, leading to outbreaks
    • Can cause meningococcemia, characterized by internal bleeding (petechiae), necrosis, and potentially fatal outcomes
    • Diagnosis involves Gram staining of CSF, blood, or nasopharyngeal samples, revealing gram-negative diplococci
    • Culture on chocolate agar or Thayer-Martin agar (selective media)
    • Vaccines are available for serotypes A, B, and C

    Haemophilus influenzae

    • Tiny, gram-negative, pleomorphic rods
    • Normal colonist in the nasopharynx
    • Transmission occurs through direct contact but is not associated with epidemics
    • Causes meningitis, epiglottitis, otitis media, sinusitis, pneumonia, and bronchitis
    • The Hib vaccine (a subunit vaccine) for Haemophilus influenzae type b has significantly reduced cases in children

    Other Causes of Bacterial Meningitis

    • Escherichia coli (Gram-negative rod)
    • Streptococcus agalactiae (Group B Strep, Gram-positive cocci)
    • Listeria monocytogenes (Gram-positive rod)
    • Mycobacterium tuberculosis (Acid-fast bacilli, AFB)
    • Neonatal meningitis is commonly caused by E. coli, Streptococcus agalactiae, or Listeria monocytogenes infections
    • The elderly and immunocompromised are susceptible to meningitis caused by Listeria monocytogenes
    • Tubercular meningitis is fatal if untreated, with a 30-50% mortality rate even with treatment

    Bacterial Meningitis

    • Inflammation of the meninges, the protective membranes surrounding the brain and spinal cord.
    • Caused by bacteria entering the bloodstream, typically through the nose or mouth.
    • Bacteria cross the blood-brain barrier and multiply in the cerebrospinal fluid (CSF), causing inflammation.
    • Cloudy CSF during a spinal tap is a significant indicator of bacterial meningitis.
    • Increased white blood cells, particularly neutrophils, cause the cloudiness.

    Causes of Bacterial Meningitis

    • Streptococcus pneumoniae (Pneumococcus):

      • Leading cause of bacterial meningitis across all age groups.
      • Gram-positive, lancet-shaped bacteria found in pairs or short chains.
      • Possesses a capsule, a key virulence factor.
      • Quelling test identifies different capsular strains of S. pneumoniae.

    • Neisseria meningitidis (Meningococcus):

      • Second most common cause.
      • Gram-negative diplococci.
      • Virulence factors include a capsule, fimbriae, IgA protease, and endotoxin (LPS).
      • Serotypes A, B, and C are the most frequent causes, spread from person to person.
      • Meningococcemia: a serious complication causing skin hemorrhages, tissue death, and potential limb loss.

    • Haemophilus influenzae (H.flu):

      • Third most common cause.
      • Tiny, gram-negative, pleomorphic rods.
      • Mostly caused by the type B serotype, spread via direct contact.
      • H.influenzae type B vaccine significantly reduced cases.

    Less Common Causes

    • Escherichia coli:

      • Primarily affects newborns, often related to unsanitary conditions.

    • Streptococcus agalactiae (Group B Strep):

      • Can infect babies during childbirth if the mother is not tested or treated.

    • Listeria monocytogenes:

      • Can cross the placenta and infect babies during development.
      • Pregnant women are advised to avoid unpasteurized dairy products.

    • Mycobacterium tuberculosis:

      • Can cause meningitis in areas where tuberculosis is prevalent.
      • Spreads to the brain and causes meningitis.
      • Untreated tubercular meningitis can be fatal, with a high mortality rate even with treatment.

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    Description

    Explore the case of Malorie, a 20-year-old college student diagnosed with bacterial meningitis caused by Neisseria meningitidis. This quiz covers her symptoms, lab findings, and common causes of the infection. Learn about the serious implications of bacterial meningitis and its impact on health.

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