Purulent Meningitis in Children Jiang Li Department of Neurology Children's Hospital Chongqing University of Medical Sciences
Purulent Meningitis in Children Jiang Li Department of Neurology Children’s Hospital Chongqing University of Medical Sciences
Purulent Meningitis Acute infection of central nervous system(CNS) 90% of cases occur in the age of 1mo-5yr The inflammation of meninges caused by various bacteria. Common features in clinical practices include: fever, increased intracranial pressure, meningeal irritation One of the most potentially serious infections, associated with high mortality(about 10%)and morbidity
Acute infection of central nervous system(CNS). 90% of cases occur in the age of 1mo-5yr. The inflammation of meninges caused by various bacteria.Common features in clinical practices include: fever, increased intracranial pressure, meningeal irritation. One of the most potentially serious infections, associated with high mortality (about 10%) and morbidity. Purulent Meningitis
1. Etiology 1.1 Pathogens: Main pathogens: Neissria meningitidis, streptoccus pneumoniae, Haemophilus influenzae. (2/3 of purulent meningitis are caused by these pathogens) Pathogens in special populations(neonate <3mo infants, malnutrition, immunodeficiency) gramnegative enteric bacilli, group B streptococci, staphlococcus aureus
1.Etiology 1.1 Pathogens: Main pathogens: Neissria meningitidis, streptoccus pneumoniae, Haemophilus influenzae. (2/3 of purulent meningitis are caused by these pathogens) Pathogens in special populations (neonate & <3mo infants , malnutrition, immunodeficiency): gramnegative enteric bacilli, group B streptococci, staphlococcus aureus
1.2 Major risk factors for meningitis Immature immunologic function and attenuated immunologic response to pathogens Low level of immunoglobulin defects of complement and properdin system Immature or impaired blood-brain-barrier(BBB) Immature BBB function maturation at about 1yr Impaired BBB: Congenial or acquired defects across mucocutaneous barrier
1.2 Major risk factors for meningitis Immature immunologic function and attenuated immunologic response to pathogens • Low level of immunoglobulin, defects of complement and properdin system Immature or impaired blood-brain-barrier (BBB) • Immature BBB function: maturation at about 1yr • Impaired BBB: Congenial or acquired defects across mucocutaneous barrier
1.3 Access of bacteria invasion Typical access---hematogenous dissemination o Bacteria colonizing the mucous membranes of the nasopharynx→> invasion into local tissue→ bacteremia -> hematogenous seeding to the subarachnoid space Mode of transmission: Person to person contact through respiratory tract secretions or droplets
1.3 Access of bacteria invasion Typical access---hematogenous dissemination • Bacteria colonizing the mucous membranes of the nasopharynx →invasion into local tissue → bacteremia → hematogenous seeding to the subarachnoid space • Mode of transmission: Person to person contact through respiratory tract secretions or droplets