MENINGITIS

Meningitis is an inflammatory
process of the leptomeninges
and CSF

Space occupying lesions

CNS hemorrhage
Brain tumours
Brain abscess
Metastatic tumours

Classification
1. acute pyogenic (bacterial)

meningitis
2.acute aseptic (viral) meningitis
3.acute focal suppurative infection
(brain abscess,subdural and extradural
empyema)
4.chronic bacterial infection
(tuberculosis).

Acute pyogenic bacterial

meningitis
Most important
Can be fatal if untreated
Organisms:

E.coli ---------- neonates

Streptococci B ---------- neonantes
H. influenzae-------------adolescents
Neisseria meningitidis------------- young adults
Streptococcus pneumonia--------- elderly

Clinical signs
Signs of infection (fever,malaise,rigor.)
Signs of meningeal irritation:
1.headache
2.neck stiffness
3.photophobia
4.irritability
C.S.F by lumbar puncture shows :
a.cloudy purulent csf
b.abundant neutrophils > 90,000/mm3
c.high protein level and
d.reduced glucose level.

Morphology
Grossly , pyogenic meningitis shows a

thick layer of suppurative exudate covers

the leptomeninges over the surface of the
brain.
Exudate in basal surface--- H.INFLUENZAE
Exudate in covexity surface--- P.MENINGT
Microscopically :
neutrophils in the subarachnoid space

Complications
Antibiotic treatment------ full recovery
Delayed or untreated cases--- can be

fatal
Healing by fibrosis cause obliteration of
subarachenoid space--HYDROCEPHALUS
Brain abscess
Septic shock and skin rashes, why ?

Skin rashes

Is due to small skin bleed

All parts of the body are affeced
The rashes do not fade under pressure
Pathogenesis:
a. Septicemia
b. wide spread endothelial damage
c. activation of coagulation
d. thrombosis and platelets aggregation
e. reduction of platelets (cosumption )
f. BLEEDING 1.skin rashes
2.adrenal hemorrhage
Arenal hemorrhage is called Waterhouse-Friderichsen
Syndrome.It cause acute adrenal insufficiency and is uaually
fatal

Acute Aseptic (Viral )

Meningitis
Can follow any viral infection
Less danger
CSF shows :
1.lymphocytes
2. mild increase in protein
3. normal glucose level
Viral meningitis is usually self-limiting and
treated symptomatically.

Brain abscess
Causes :
1. complication of bacterial meningitis
2. bacterial endocarditis
3. pulmonary sepsis : peumoniaetc
4. other sepsis
Brain abscess cause a space occupying
lesion in the brain