on 30.1.09 with 0 comments

  • Inflammation of leptomeninges (arachnoid and pia mater) including subarachnoid space and CSF

  • C/S are F, H/A, stiff neck, and behavior changes

  • CSF changes in meningitis

    • Bacterial

      • Neutrophilic pleocytosis (pleocytosis = increase in cells)

      • Elevated protein

      • Reduced sugar

    • Viral

      • Lymphocytic pleocytosis (may have PMN pleocytosis early on)

      • Protein less elevated than bacterial, sugar normal

  • Bacterial

    • Also called acute meningitis or purulent meningitis

    • Caused by

      • Neonates: E. coli, Streptococcus agalactaciae (Group B strep), and Listeria

      • Kids: H. influenzae (incidence decreased due to vaccine)

      • Young adults: N. meningitidis

      • Older adults: S. pneumoniae, Listeria

      • Open head trauma: staph, strep, other flora

    • Subdural empyema

      • Spread of infection from skull or sinus to subdural space

      • May be bacterial (often fungal)

      • Can produce mass effect

      • Thrombophlebitis of bridging veins may result in brain infarction

      • Resolution from dural side

  • Viral

    • Also called lymphocytic or aseptic meningitis

    • Can be caused by numerous viruses, but enteroviruses are very common causes in summertime (1/3 of cases have unknown cause)

    • Has to be treated symptomatically, since a/b don’t work

  • Chronic

    • Usually fungal or TB

    • Cryptococcus meningitis – form of fungal meningitis in AIDS and other immunocompromised patients

  • TB meningitis

    • Chronic meningitis usually localized to the base of the brain

    • If gets into brain (encephalitis) will form discrete tuberculomas in the brain matter

      • 25% of intracranial masses in South America and India

      • Adult lesions are supratentorial, kids’ lesions are infratentorial

Category: Pathology Notes



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