MENINGITIS: TYPES, SYMPTOMS,CAUSES, TREATMENT AND MCQ WITH ANSWERS

INTRODUCTION:

1.) Meningitis refers to the inflammation of membranes enclosing the brain and the spinal cord.

2.) Meninges means the three membranes ( dura mater, arachnoid and pia mater) that line skull and vertebral canal and enclose the brain and spinal cord.

3.) The CSF (cerebro spinal fluid) provides both a cultural medium for the infecting organism and a rapid means of disseminating (spread widely) infection.

4.) Leptomeningitis, commonly called meningitis, is usually the result of infection, but chemical meningitis carcimatous meningitis by the infiltration of the subarachnoid space (it is the interval between the arachnoid membrane and the pia mater ) by cancer cell may occur.

CLASSIFICATION:

Infectious meningitis is broadly classified into three categories/types:-

A.] ACUTE PYOGENIC MENINGITIS: It us also called purulent meningitis. It is an acute infection of pia – arachnoid  and of the CSF enclosed in subarachnoid space.

CAUSATIVE AGENT : The causative agent varies with the age of patients.

a.) Escherichia coli ( E.coli ) infection us common in neonates (new born babies) with neutral tube defects.

b.) Haemophilus influenzae is commonly responsible fir infection in infants and children.

c.) Neisseria meningitidis causes meningitis in adolescent and young adults and is also responsible for epidemic meningitis.

d.) Streptococcus pneumoniae is responsible for infection at extreme if ages .

ROUTE OF INFECTION :

a.) Most commonly by the blood stream.

b.) From an adjacent focus of infection.

c.) By iatrogenic ( relating to illness caused by medical examination or treatment )such as introduction of microorganism at operation or during lumbar puncture.

SYMPTOMS AND SIGNS : Headache, photo phobia ( extreme sensitivity towards light ), irritability,clouding of consciousness, and neck stiffness. A spinal tap yield cloudy or frankly purulent (accumulation of pus ) CSF, under increased pressure, with as many as 90,000 neutrophills per mm cube, a raised protein level and a markedly reduced glucose content.

B.] ACUTE LYMPHOCYTIC MENINGITIS:

a.) Also called aseptic meningitis, especially common in children and young adults.

b.) Among the etiologic agents are the numerous viruses such as ENTEROVIRUSES, MUMPS, ECHO VIRUSES, COXSACKIE VIRUS, HIV, HERPES SIMPLEX VIRUS – 2 etc.

c.) Their is lymphocytic pleocytosis ( abnormal increase in lymphocyte in CSF ), protein elevation is only moderate and sugar level is nearly normal.

d.) The clinical manifestation of viral meningitis are much the same as in bacterial meningitis with features of acute onset meningeal symptom and fever.

C.] CHRONIC MENINGITIS:

Their are two types of chronic meningitis :-

a.) TUBERCULOUS MENINGITIS ( BACTERIAL ): Occurs in children and adult through haematogenous spread ( originating in or carried by the blood ) of infection from tuberculosis elsewhere in the body.

b.) CRYTOCOCCAL MENINGITIS ( FUNGAL ): It develops in patients who are debilitated (in a weakened and infirm state) or in immunocompromised person. Crytococcal meningitis is especially an important cause of meningitis in patients with AIDS,

TREATMENT: MENINGITIS CAN BE TESTED BY PERFORMING AN PROCEDURE CALLED SPINAL TAP.

  • Fungal Meningitis Treatment: Antifungal Drugs are used
  • Viral Meningitis Treatment: Antiviral Drugs are used
  • Bacterial Meningitis Treatment: Antibacterial Drugs are used

QUESTIONS….

QUES:1] Meningitis refers to ?

a.) Inflammation of the brain

b.) Blockage in nerves

c.) Both (a) and (b)

d.) None of these

QUES:2] Classic symptoms of meningitis usually include ?

a.) Fever, Headache, Stiff neck

b.) Backache, Hallucination, Indigestion

c.) Rash, Inner ear pain, Itching

d.) Dry skin, Dehydration, Cold sores

QUES:3] Which if the following people likely do develop bacterial meningitis?

a.) An obese women

b.) A new born baby

c.) A college student

d.) Any of the above

QUES:4] Which procedure is most likely used to do test for meningitis ?

a.) Throat culture

b.) Spinal tap

c.) Tuberculosis skin test

d.) None of the above

QUES:5] Which medicine can fight viral meningitis?

a.) Antibiotic medicines

b.) Anti- inflammatory medicines

c.) Hydrating fluids

d.) None of the above

QUES:6] Alcoholism is a risk fir bacterial meningitis ?

a.) True

b.) False

QUES:7] Tuberculous meningitis is which type of meningitis ?

a.) Fungal

b.) Viral

c.) Bacterial

d.) None if the above

QUES:8] Which of the following is an fungal meningitis  ?

a.) Tuberculous meningitis

b.) Crytococcal meningitis

c.) Both (a) and (b)

d.) None of the above

QUES:9] Haemophilus influenza is responsible for meningitis in which category of people ?

a.) Neonates

b.) Extremely aged people

c.) Infants and children

d.) None of the above

QUES:10] Inflammation of brain parenchyma refers to?

a.) Bacterial meningitis

b.) Myelitis

c.) Bacterial encephalitis

d.) None of the above

SOLUTION…

Sol.1] (a) Inflammation of the brain

Sol.2] (a) Fever, Headache, Stiff neck

Sol.3] (b) A new born baby

Sol.4] (b) Spinal tap

Sol.5] (d)

Sol.6] (a)

Sol.7] (c) Bacterial

Sol.8] (b) Crytococcal meningitis

Sol.9] (c) Infants and children

Sol.10] (c) Bacterial encephalitis

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REFERENCE:

1.] Robbin’s basic pathology.

2.] Textbook of pathology by Harsh Mohan.

 

 

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