A.

CASE PATHOPHYSIOLOGY

PATHOPHYSIOLOGY
"The development of bacterial meningitis occurs following bacterial

invasion of the host and CNS, bacterial multiplication with subsequent inflammation of

the CNS, specifically the subarachnoid space and the ventricular space, pathophysiologic

alterations owing to progressive inflammation, and the resulting neuronal damage. The

critical first step in the acquisition of acute bacterial meningitis is nasopharyngeal

colonization of the host. Immunoglobulin’s (Igs) such as secretory IgA are found in high

concentrations within nasopharyngeal secretions and work to inhibit bacterial

colonization. However, the mucus barrier is deteriorated by IgA proteases secreted by the

bacteria, which then extend pili that allow adherence to the host cell surface receptors.

Bacterial pathogens attach themselves to nasopharyngeal epithelial cells and are

phagocytized into the host's bloodstream. After accessing the patient's bloodstream,

bacteria must overcome the host's defense mechanisms. Commonly, CNS bacterial

pathogens produce an extensive polysaccharide capsule resistant to neutrophil

phagocytosis and complement opsonization. H. influenzae,..."

 MENINGITIS

The most common organisms of bacterial meningitis in children and adults are
Streptococcus pneumoniae and Neisseria meningitidis.

The first step in the pathogenesis of meningitis is colonization of mucous membranes

(e.g. nasopharyngeal, respiratory tract, skin, etc.) of the host Various aspects of the
host’s defense system act to interfere with the steps involved in the pathogenesis of
meningitis in order to prevent the development of this infection.

Immunoglobulin’s (Igs) such as secretory IgA are found in high concentrations within
nasopharyngeal secretions and work to inhibit bacterial colonization.

Bacterial pathogens attach themselves to nasopharyngeal epithelial cells and are

phagocytized into the host's bloodstream. Commonly,

CNS bacterial pathogens produce an extensive polysaccharide capsule resistant to

neutrophil phagocytosis

Signs and Symptoms

A high fever
Vomiting or nausea with headache
Confusion, or difficulty concentrating — in the very young, this may appear as inability
to maintain eye contact
SeizuresLack of interest in drinking and eating
Skin rash in some cases, such as in viral or meningococcal meningitis