Description of the Disease

Meningitis is a clinical syndrome characterized by inflammation of the meninges, the three layers of membranes that enclose the brain and
spinal cord.

Before the era of antibiotics, the condition was universally fatal. Nevertheless, even with great innovations in healthcare, the condition still
carries a mortality rate of close to 25%

The disease can be caused by many different pathogens including bacteria, fungi or viruses, but the highest global burden is seen with bacterial
meningitis.

Despite breakthroughs in diagnosis, treatment, and vaccination, in 2015, there were 8.7 million reported cases of meningitis worldwide, with
379,000 subsequent deaths.

Anatomy and Physiology

The brain and spinal cord are covered by three layers of tissue called meninges. These layers are the

 Dura mater (outermost)- A tough outer membrane.

 Arachnoid membrane (middle)- A lacy, weblike middle membrane.
 Pia mater (innermost)- A delicate, fibrous inner layer that contains many of the blood vessels that feed the brain and spinal cord.

Tissues Covering the Brain

Anatomically, meningitis can be divided into inflammation of the dura (sometimes referred to as pachymeningitis), which is less common, and
leptomeningitis, which is more common and is defined as inflammation of the arachnoid tissue and subarachnoid space.

Bacteria
Colonization and
Penetration of
Nasopharyngeal muscosal
membranes by bacteria
Survival of Bacteria in Blood
and Transportation via
Circulation
Pathophysiology
Increased permeability of
Blood-brain Barrier
Release of Cytokines and
-Transedothelial Migration Prostaglandins
of Granulocytes and
Monocytes
Multiplication in
Leakage of Plasma Proteins
Subarachnoidal space
-Cerebral Edema
Invasion of the Central
-Increased ICP
Nervous System
-Impaired Circulation