Meningitis

Viral meningitis is an infection occuring mostly in children under age five it happens when certain
viruses invade the meninges which are the tissues that cover and protect the brain and spinal cord
the meninges are arranged in three layers the layer that actually touches the brain and spinal cord is
called the pia mater the spider web-like middle layer is called the arachnoid mater the outermost
and toughest layer is called the dura mater. Cerebrospinal fluid which also protects the brain and
spinal cord flows between the meninges and over the surface of the brain. The most common cause
of viral meningitis is a type of virus called enterovirus. Other viruses that can cause meningitis
include the mumps virus. the measles virus herpes viruses and a variety of viruses spread by blood
feeding insects such as mosquitoes and ticks. Viruses that cause meningitis may be spread through
the bite of an infected insect. However the two most common ways the viruses spread are through
fecal contamination which can happen when hands are not washed after using the toilet or changing
a diaper and through contact with the body fluids from an infected person such as through sneezing
or coughing once inside the body the viruses make copies of themselves and enter the bloodstream.
Viruses travel through the bloodstream to the brain where they cross the border between the
bloodstream and the brain into the cerebrospinal fluid the viruses spread throughout the
cerebrospinal fluid and infect the cells of the meninges. The meninges become inflamed as the
immune system begins to fight off the infection. Symptoms of viral meningitis in infants and young
childern include fever, irritability, loss of appetite and trouble awakening. Symptoms in older
childern and adults include fever , headache, stiff neck, sensitivity to light, sleepines, trouble
awakening, nausea, vomiting, loss of appetite. The symptoms of viral meningitis are similar to those
of bacterial meningitis but are usually less severe. Doctor may recommend acetaminophen or other
non-steroidal anti-inflammatory drugs for fever and headache for meningitis caused by a type of
herpes virus doctors may prescribe an antiviral medication such as acyclovir there is no treatment
for most viruses that cause meningitis though most people recover on their own within two weeks

Video 2 :

In 1987, tens of thousands of people gathered in saudi arabia for the annual hajj pilgrimage. But
what started out as a celebration led to a health crisis : just a few days after the pilgrimage, more
than 2,000 cases of meningitis broke out spreading across saudi arabia and the rest of the world. The
outbreak was so fierce that it was believed to have sparked a wave of deadly meningitis epidemics
that ultimately infected tens of thousands of people worlwide. Meningitis is the inflammation of the
meninges, three tissue layers responsible for protecting the brain and spinal cord. What makes
meningitis so dangerous compared to other diseases is the sheer speed with which it invades a
person’s body. In the worst cases, it causes death within a day. Fortunately, that’s rare for patients
who receive early medical treatment. The disease primarily comes in three forms : fungal, viral, and
bacterial- the last being the most deadly by far, and what we’ll focus on. People usually contract
bacterial meningitis by breathing in tiny particles of mucus and saliva that spray into the air when an
infected person sneezes or coughs. It can also be transmitted through kissing, or sharing cigarettes,
toothbrushes or utensils. Some people can be infected and carry the disease without showing
symptoms or getting sick, which helps the disease spread quickly to others. Once the bacteria enter
the nose, mouth, and throat, they cross the surrounding membranes and enter the bloodstream.
From there, bacteria have rapid access to the body’s tissues – including a membrane called the
blood-brain barrier. This is made of a tight mesh of cells which separate blood vessels from the
brain, and block everything except for a specific set of particles, including water molecules and
some gases. But in ways that scientists are still trying to understand, meningitis bacteria can trick the
barrier into letting them through. Inside the brain, the bacteria swiftly infect the meninges. This
triggers inflammation as the body’s immune response kicks into overdrive, bringing on fever and
intense headaches. As swelling in the meninges worsens, the neck begins to stiffen. Swelling in the
brain disrupts its normal function- causing symptoms like hearing loss and extreme light sensitivity.
As pressure increases in the cranium, it may also make the person confused- one of the hallmarks of
the disease. A few hours in, the rapidly multiplying bacteria start to release toxins, leading to
septicemia, also known as blood poisoning. This breaks down blood vessels, letting blood seep out
and form what starts out looking like a rash, and evolves into big discoloured blots beneath the skin .
at the same time, these toxins burn through oxygen in the blood, reducing the amount that gets to
major organs like the lungs and kidneys. That increases the chance of organ shut down and alongside
spreading septicemia, threatens death. That all sounds scary, but doctors are so good at trating
meningitis that a visit to the hospital can drasticaly reduce an adult’s risk of dying from it. The longer
it’s left untreated, though, the more likely it will lead to lasting damage. If declining oxygen levels
cause cell death in extreme parts of the body like fingers, toes, arms and legs the risk of amputation
goes up. And if bacterial toxins accumulate in the brain and trigger cell death, meningitis could also
cause long-term brain damage and memory loss. So fast treatment, or better yet, prevention, is
critical. That’s why most countries have vaccines that defend against the disease in its deadliest
forms. Those are usually given to the people who are most at risk-like young children, people with
weak immune systems, or people who gather in large groups where an outbreak of meningitis could
potentially happen. In addition to those gatherings, meningitis is most common in a region called the
meningitis belt that stretches across africa, though cases do happen all over the world. If you’re
concerned that you or someone you know may have meningitis, get to the doctor as soon as
possible, quick action could save your save your life.

Video ke 3 :

In the unit we’re going to talk about viruses that infect the brain so let’s start by defining the terms
that we’re going to need meningitis is inflammation of the pia the arachnoid and the dura which are
the meninges that surround the brain and sefa lightest is inflammation of the brain itself and
maninjau encephalitis is when you have both we’re going to talk about viral meningitis encephalitis
and meningitis and as a place to start let’s ask ourselves how do viruses get into the central nervous
system there’s two main ways that they can got into the CNS .the first is hematogenous spread
hematogenous means coming from the blood and so to get into the central nervous system from the
blood that means that the viruses have to get through the blood brain barrier which means that
either they have to directly infect and pass through the endothelium or they need to pass between
endothelial cells either by disrupting or loosening the tight junctions between an athelia cells or by
sneaking ride on cells such as immune cells that might be passing between the endothelial cells the
second way that viruses can get into the brain is through retrograde axonal transport and the way
this works so that viruses get into axone and follow them all the way back to the central nervous
system now because neurons can be so long they actually have transport mechanisms that carry
molecules along the axons in both directons kind of like mini railroads and viruses actually hitch a
ride on these transport mechanisms to travel into the CNS now once viruses get into the CNS now
once viruses get into the CNS what symptoms do they cause well both meningitis and encephalitis
can cause fever and headache and there’s definitely a lot of overlap between these two syndromes
but viral meningitis may or may not cause meningeal signs like neck stiffness and photophobia
whereas in encephalitis there should be some kind of brain dysfunction maybe altered conciousness’
confusion bizarre behavior seizures weakness there are a lot of possible manifestations so if
someone presents with the symptoms of either meningitis or encephalitis or both of course it might
not be viral but if it is viral how would you confirm the diagnosis first you might do a lumbar
puncture or LP now what do you do with this LP well first you look at the standard CSF parameters
which are cell count glucose and protein with a viral infection the white cell count is usually high
although usually not higher than a thousand white blood cells per microliter whereas with bacterial
meningitis it’s usually higher than that and the white cells you see are usually lymphocytes whereas
in bacterial meningitis normally you see neutrophils the glucose with a viral infection should be
normal whereas it’s usually low with bacteria and the protein can be either normal or moderately
elevated whereas it would be elevated in a bacterial infection now the second thing you can do with
the CSF is to actually test for specific viruses and the mainstay is to use PCR ti look for viral genomes
occasionally you might use serology to look for antibodies against a specific virus and rarely you’ll do
a viral culture to see if you can actually grow a certain virus so that’s what you do with an LP now
what else can you do to diagnose a viral infection

Well imaging of the brain can also help and that includes MRI with contrast which is usually
preferable to CT and EEG which measures electrical activity of the brain and you can see meningitis
and encephalitis with these and actually specific viruses can show distinct patterns on MRI and EEG
as we’ll talk about so that’s it for our general introduction to viral meningitis and encephalitis and
now we’re going to into more depth into some of the specific ideologies