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Questions and Answers
What is the most common form of severe sporadic acute focal encephalitis?
What is the most common form of severe sporadic acute focal encephalitis?
- Meningococcemia
- Viral Meningitis
- HSV encephalitis (HSE) (correct)
- Bacterial Meningitis
How does HSV invasion to brain meninges occur?
How does HSV invasion to brain meninges occur?
- Via peripheral nerves (correct)
- Via skin lesions
- Via lymph nodes
- Via blood vessels
What is the main difference between bacterial meningitis and viral meningitis?
What is the main difference between bacterial meningitis and viral meningitis?
- Bacterial meningitis is more common than viral meningitis.
- Viral meningitis is almost never life-threatening, while bacterial meningitis is. (correct)
- Bacterial meningitis is caused by viruses, while viral meningitis is caused by bacteria.
- Viral meningitis has a higher mortality rate than bacterial meningitis.
What is used to detect HSV DNA in CSF samples?
What is used to detect HSV DNA in CSF samples?
What is the result of early and prolonged treatment with intravenous aciclovir?
What is the result of early and prolonged treatment with intravenous aciclovir?
What is characteristic of CSF in cases of meningitis?
What is characteristic of CSF in cases of meningitis?
What is the main difference between CSF and blood?
What is the main difference between CSF and blood?
What is the most common virus causing viral meningitis?
What is the most common virus causing viral meningitis?
What is the primary route of invasion for meningitis pathogens?
What is the primary route of invasion for meningitis pathogens?
Which type of meningitis is caused by Neisseria Meningitidis?
Which type of meningitis is caused by Neisseria Meningitidis?
What is the characteristic of the polysaccharide capsule of Neisseria Meningitidis?
What is the characteristic of the polysaccharide capsule of Neisseria Meningitidis?
How is Neisseria Meningitidis typically transmitted?
How is Neisseria Meningitidis typically transmitted?
What is the difference between bacterial and viral meningitis?
What is the difference between bacterial and viral meningitis?
What is meningococcemia?
What is meningococcemia?
What is the primary characteristic of aseptic meningitis?
What is the primary characteristic of aseptic meningitis?
What is the typical age range for bacterial meningitis?
What is the typical age range for bacterial meningitis?
What is the percentage of people who become chronic carriers of Neisseria meningitidis?
What is the percentage of people who become chronic carriers of Neisseria meningitidis?
What is the typical age group affected by meningitis caused by Neisseria meningitidis?
What is the typical age group affected by meningitis caused by Neisseria meningitidis?
What is the characteristic rash associated with meningococcemia?
What is the characteristic rash associated with meningococcemia?
What is the appropriate antibiotic therapy for prophylaxis of close contacts of meningococcal meningitis patients?
What is the appropriate antibiotic therapy for prophylaxis of close contacts of meningococcal meningitis patients?
What is the characteristic finding in the CSF of patients with meningococcal meningitis?
What is the characteristic finding in the CSF of patients with meningococcal meningitis?
What is the name of the bacterium that is a leading cause of meningitis in young children?
What is the name of the bacterium that is a leading cause of meningitis in young children?
What is the type of bacterium that includes Neisseria meningitidis and Haemophilus influenzae?
What is the type of bacterium that includes Neisseria meningitidis and Haemophilus influenzae?
What is the characteristic feature of meningococcemia?
What is the characteristic feature of meningococcemia?
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Study Notes
Meningitis
- Inflammation of meninges (tissues surrounding brain and spinal cord)
- Blood vessels and nerves are the main routes of invasion
Types of Meningitis
- Septic (Bacterial) meningitis
- Aseptic meningitis: caused by viruses, Mycobacteria, and Fungi
Pathogens that Cause Meningitis
- Bacteria (septic meningitis, less common, life-threatening):
- Neisseria meningitidis
- Haemophilus influenzae
- Streptococcus pneumonia
- Listeria monocytogenes
- Viruses (aseptic meningitis, more common, not life-threatening):
- Herpes simplex virus
- Enterovirus
- Varicella zoster virus
- Others: Mycobacteria, Spirochetes, Fungi
Viral Meningitis
- Presents with similar symptoms to bacterial meningitis (fever, headache, dislike of lights, and neck stiffness)
- Almost never life-threatening
Herpes Virus Infection of the Brain
- Herpes simplex virus (HSV) is usually present in skin or mucosal lesions
- Travels up axons using normal retrograde transport mechanisms to reach dorsal root ganglia, where it multiplies
- HSV encephalitis (HSE) is the most common form of severe sporadic acute focal encephalitis
- Diagnosis indicated by CT and MRI; HSV DNA can be detected in CSF sample using PCR
- CSF changes variably according to the invading microbes (bacteria or virus)
Diagnosis and Prevention of HSV Infection of the Brain
- Diagnosis: CSF is visibly clear; CSF shows high mononuclear leukocytes
- Prevention: no preventive measure; however, 70% mortality rate is greatly reduced by early and prolonged treatment with intravenous aciclovir
Bacterial Meningitis
- Less common than viral, but can occur at any age
- Can occur alongside blood sepsis, which is a life-threatening disease
- First symptoms are often non-specific (fever, vomiting, headache, then rash, neck stiffness, dislike of bright lights, and confusion)
Neisseria Meningitidis
- Gram-negative paired cocci
- Has prominent polysaccharide capsule with antiphagocytic action
- Causes meningitis and meningococcemia
- Mode of transmission: person-to-person spread by droplet infection
- Colonizes the membranes of the nasopharynx
- From the nasopharynx, the organism can enter the bloodstream and disseminate throughout the body
Diagnosis and Prevention of Meningococcal Meningitis
- Diagnosis: CSF is visibly turbid; CSF shows high polymorphonuclear leukocytes and proteins
- Methods of prevention: appropriate antibiotic therapy initiated immediately; culture and sensitivity of the infecting isolate should be done; prophylaxis of close contacts (family) with single dose ciprofloxacin; polysaccharide vaccine (poor protection in some cases)
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