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