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Pathophysiology of meningitis
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Recommended: Pathophysiology of meningitis
Meningitis by definition is the inflammation of the meninges, the three layered protective membrane that surrounds the central nervous system. The meninges are comprised of the Dura mater, the Arachnoid mater, and the innermost Pia mater. It is of utmost importance to determine if bacteria, virus, fungus, toxins, or parasites, caused the inflammation, and treat the microorganism quickly and efficiently to give the best prognosis. It is of utmost importance to determine the cause of inflammation (i.e. bacteria, virus, fungus, toxins). While viral or aseptic meningitis only need supportive treatment, bacterial meningitis is one of the ten most common causes of death by infectious disease killing approximately 135,000 people a year (Waghdhare, Kalantri, Joshi, & Kalantri, 2010).
Pathophysiology
In order to infect the meninges, pathogens must cross the blood brain barrier. According to Myers, Director of Infection Control at Scripps Mercy hospital (2000), pathogens enter through an open wound, surgical incision, or a mucus membrane. Systemic infections can also result in meningitis (Huether & McCance, 2012) with typical invasion occurring through the middle ear or during respiratory tract infections (Myers, 2000). Bacteria elude the body’s immune defenses with their capsule; viruses hide within the body’s own cells and invade the cerebrospinal fluid through the cerebral capillary system (Myers, 2000).
Once inside, the pathogens cause inflammation of blood vessels, infarcts (necrosis due to obstructed blood flow), edema, hydrocephalus caused by arachnoid villi obstruction (location that reabsorbs CSF) (Huether & McCance, 2012), and decreased cerebral blood flow (Myers 2000).
According to Huether and McCance, authors of Understandi...
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Dugdale, D., Jatin, V., & Zieve, D. (2012, 10 06). Kernig's sign of meningitis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/imagepages/19077.htm
Huether, S., & McCance, K. (2012). Understanding pathophysiology. (5th ed.). St. Louis, MO: Elsevier Mosby.
Nudelman, Y., & Tunkel, A. R. (2009). Bacterial meningitis. Drugs, 69(18), 2577-2596. doi:http://dx.doi.org/10.2165/11530590-000000000-00000
Van, d. B., Brouwer, M. C., Thwaites, G. E., & Tunkel, A. R. (2012). Advances in treatment of bacterial meningitis. The Lancet,380(9854), 1693-702. doi:http://dx.doi.org/10.1016/S0140-6736(12)61186-6
Waghdhare, S., Kalantri, A., Joshi, R., & Kalantri, S. (2010). Accuracy of physical signs for detecting meningitis: A hospital-based diagnostic accuracy study. Clinical Neurology and Neurosurgery, 112(9), 752-7. doi:http://dx.doi.org/10.1016/j.clineuro.2010.06.003
The thresholds used to calculate each mean were not highly variable between trials. The data recorded over each trial were highly consistent between one another, except for a slight deviation in the measurements recorded on the palm of the hand. During ascending trial three on the palm, the results deviated from the norm in reference two the two prior trails. On trial one and two, 0.05 was the only measurement that was not felt. On trial three, not only was 0.05 not felt, but 0.10 was also not felt, which deviated from the norm set forth in the two prior
Also contributing to the virulence of the bacteria are the exotoxins including invasive adenylate cyclase, tracheal cytotoxin, and lethal toxin. Invasive adenylate cyclase reduces local phagocytic activity as well as acting as a hemolysin. Tracheal toxin affects the ciliated respiratory epithelium by inhibiting the ciliary beating. This kills the cells and causes them to be eliminated from the mucosa. Tracheal toxin also stimulates the release of IL-1, which causes fever. Lastly, lethal toxin causes inflammation and local necrosis at infection sites.
The purpose statement from my articles ( Arnetz et al., Berry at al., and Khadjehturian,) all helped to comprehensively answer both my PICOT and Clinical questions.
Segal, E. A., Cimino, A. N., Gerdes, K. E., Harmon, J. K., & Wagaman, M. (2013). A
Wechsler, Henry, PhD, Jae Eun Lee, DrPH, Toben F. Nelson, MS, and Meichun Kuo, ScD.
There are five types of meningitis, each diagnosis classified according to their cause: viral, bacterial, fungal, parasitic, and non-infectious (developed as a result of HIV/AIDS, cancer, tuberculosis, and other diseases and conditions). The distinct symptoms that all five types of meningitis share are the symptoms originating from the inflamed meninges, which, as reported by the Mayo Clinic (2015), include headaches, fever, and stiffness of the neck as the most distinct few of the variety. As stated by the Centers for Disease Control and Prevention (2015), although meningitis is considered a relatively rare disease in the United States (with the usually nonfatal viral meningitis being the most commonly observed case), bacterial meningitis in particular is the epidemic type that is often times fatal and the most dangerous. It is contagious and it can be spread by respiratory fluids such as saliva and mucus (CDC, 2015). In some cases, it is possible for those who have recovered from this form of meningitis to suffer from acute complications that impact their
Meningitis, it’s an infection in the cerebral spinal fluid and inflammation of the meninges; the three outer layers of the brain. To be more specific, those three layers are called the Dura mater, Arachnoid mater, and the Pia mater. There are three main types of meningitis that will be discussed throughout this paper; viral, bacterial, and fungal. Each form is very similar but they all vary in terms of causative organisms, treatment and severity. Although meningitis is not very common, it can become very severe and always needs to be treated immediately.
Multiple Sclerosis (MS) is a complicated chronic deteriorating disease that has an effect on the central nervous system (CNS). This disease causes destruction of the myelin around the nerve fibers. “The exact etiology of Multiple Sclerosis is unknown; however, it is thought to be an immune mediated disease. MS is characterized by CNS inflammation, demyelination, and axonal loss” (Compston & Coles, 2008). Typically, it is described by early relapses and remissions of neurological signs of the CNS. This is known as relapsing-remitting MS (RRMS). MS can be identified by a variety of known risk factors. Multiple Sclerosis can be brought on by a mixture of inherited and environmental risk factors such as smoking or an exposure to a virus like Epstein Barr. The inflammatory process has an interesting role on the central nervous system.
Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
Bacterial meningitis is severe in most cases. Many people fully recover but for those who are less fortunate it may cause brain damage leading to learning disabilities and hearing loss. There are many different pathogens that cause bacterial meningitis. The most common here in the United States are Haemophilus influenzae, Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes, and Neisseria meningitidis. These bacteria can be transmitted through direct contact with the nose and throat secretions of an infected person. The main reservoirs for these bacteria are humans but can also be the environment, mainly from the soil.
Throughout history there have been very dangerous diseases that have been able to single handedly wipe out entire civilizations because there was nothing that we could do about it. Most of the time was because we did not quite understand what was actually happening. But thanks to all of the scientific advancements humans are able to live many more times than previous years. But that doesn’t meant that every human is healthy enough. This means that although we are less prone to die from some infectious diseases, we now have other risk for example not keeping up with a healthy diet is one of the many reasons why there are so many premature deaths. Now if you don’t get treated right away it can get worst the longer you get and sometimes it can also be fatal. One of those is Meningitis which is something very serious that if it doesn’t get treated it can lead to very serious complications in the long run or even death depending on the case. The reason why I chose this one was because when I was in high school I suffered from some...
U.S. National Library of Medicine, 26 Sept. 2011. Web. The Web. The Web. 19 Nov. 2013.
If the needle is not used, bacterial meningitis can also be diagnosed through blood cultures, especially in the cases where the patient has a negative culture of the cerebrospinal fluid (Fuglsang-Damgaard, Pedersen, & Schønheyder, 2009). Meningitis is an inflammation of the meninges - which is comprised of three thin anatomical layers that cover the brain and spinal cord. This infection occurs within the subarachnoid space, between the middle and innermost layers (Gray & Fedorkko, 1992). The three layers of the meninges consist of the outermost layer, which is made of tough, dense
Ed. David Zieve. U.S. National Library of Medicine, 26 Feb. 2014. Web. The Web.
I was surprised at the accuracy of the JUNG Typology Test and DISC Assessment. It