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What is it?
Causes
What’s Happening
Symptoms
Treatments
Diagnosis
Research
What is it?
Inflammation of the meningesor
Swelling of the Cerebrospinal Fluid (CSF)
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Causes
• Bacterial• Pneumococcal Meningitus (S. Pneumonia)• Meningococcal Meningitis (N meningitidis)
• Very contagious (college, military, etc)
• Viral• Most common• Typically mild and non-lethal
• Fungal
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Symptoms
• Early symptoms are flu-like leading to delayed diagnosis• Severe headache• Sudden fever• Stiff neck• Nausea
• Later symptoms• Seizures• Stupor• Coma• Death
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What’s happening• Pathogen enters
bloodstream• Survives host immune
system• Invades Blood Brain Barrier
(BBB)• Science not sure how it
does this (PhD anyone?)• Replicate in subarachnoid
spacehttp://jid.oxfordjournals.org/content/186/Supplement_2/
S225.long
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Illustration found at http://www.daviddarling.info/encyclopedia
More details
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• The exposure of cells to pathogens can trigger increased production of Cytokines, TNF, and other inflammatory agents
http://jid.oxfordjournals.org/content/186/Supplement_2/S225.long
More details
• Inflammatory agents will degrade BBB allowing intake of leukocytes and other fluids.
• Increased pressure may physically press hind brain into brain stem causing death1
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Illustration found at: http://jid.oxfordjournals.org/content/186/Supplement_2/S225.lonJournal of Infectious Diseases Volume183, Issue12 Pp. 1749-17591 – Personal communication with Dr. David R. Boulware
More Details• Bacterial wall may
trigger iNOS to release NO leading to metabolic pathways that trigger greater inflammatory responses and glucose depletion. This leads to cell necropsy.
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Journal of Infectious Diseases Volume183, Issue12 Pp. 1749-1759Lymphokine Cytokine Res. 1992 Dec;11(6):293-8
Diagnosis
• Neurological exam• strength, coordination, speech, vision
• Lab screening of blood, urine, body secretions• Looking for antibodies, foreign proteins
• Throat culture for bacteria• Spinal tap
• Looking for blood, bacteria, WBC, low glucose• CT scan or MRI looking for swelling of meninges
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National Institute of Neurological Disorders and Stroke
Treatment
• All: EARLY TREATMENT ESSENTIAL• Corticosteroids to reduce swelling and potential
damage• Bacterial
• Antibiotics, intravenously in severe cases• Sinuses drained
• Viral• Bed rest, fluids, dark room
• Fungal• Anti-fungal medication
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Personal communication with Dr. David R. BoulwareNational Institute of Neurological Disorders and Stroke
Research
• CNS response to inflammation• Role of T-cell in suppression of infection in the brain• How the BBB is initially breached• Role of NOS isoforms in inflammatory response• Biochemical pathways of inflammatory response• Neuroprotective compounds that block post infection
damage that leads to loss of cognitive function and dementia
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National Institute of Neurological Disorders and StrokePersonal communication with Dr. David R. Boulware Journal of Infectious Diseases Volume183, Issue12 Pp. 1749-1759
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