Bacterial Meningitis

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Bacterial Meningitis

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General Diagnosis

General:

Spinal Tap; CSF fluid analysis

Lumbar Puncture (Spinal Tap)

Increase in proteins

Low glucose levels

Increase in WBCs

Presence of Bacteria

Culture

Physical Examinations

General Signs and Symptoms:

Painful, stiff neck with limited range

Headaches

High fever

Bruising

Skin Rash

Sensitivity to light

Atypical organisms

Atypical in response to antibiotics; Generally stains poorly due to lack of peptidoglycan or irregular cellular wall or absence of one

Mycobacterium tuberculosis

Treatment 9

Isoniazid and Rifampin;Pyrazinamide , Ethambutol ; BCG vaccine

Diagnosis 9

Doesn't stain well through Gram staining; Acid-Fast staining; CSF analysis

Acid-Fast staining

General Characteristics 9

aerobic, acid-fast, bacillary, nonmotile

infection via inhalation of infectious aerosols; colonizes lungs

Virulence Factors 9

Peptidoglycan layer linked with arabinose-galactose-mycolic acid, Wax D, free lipids, Cord Factor, Exported repetitive protein

Gram-negative organisms

Neisseria meningitidis

Treatment 6

 3rd generation cephalosporin such as ceftriaxone or cefotaxime; vaccination available

Diagnosis 6

fimbriae, polysaccharide capsule,  lipooligosaccharide, LPS A

Subtopic

General Characteristics 6

Gram (-), oxidase (+), aerobe ,non-motile diplococci, 4 virulent strains

microbiota of upper respiratory system, spread via respiratory droplets

Virulence Factors 6

Haemophilus influenzae

Treatment 5

 doxycycline; second generation cephalosporins 

Diagnosis 5

Culture testing; grows well in C02 enriched incubator on chocolate agar

General Characteristics 5

Gram(-), coccobacillary, facultatively anaerobic capnophilic, obligate parasites; normal residents of oral cavity, spread via direct contact, coughing, sneezing

Virulence Factors 5

phagocyte -resistant capsules (PRP), adhesion proteins, lipooligosaccharide, pilus, IgA protease, Outer MB protein

Escherichia coli

Treatment 4

Third-generation cephalosporins or fluoroquinolones

Diagnosis 4

Serological Testing to determine strain

General Characteristics 4

Gram (-), Aerobic or facultative anaerobe, fermentative, catalase (+)  rods

Urinary Tract; spread via consumption, commensal organisms, opportunistic infections, soil water, vegetation, -excretion from GI tract, animal reserve

Virulence Factors 4

O antigen, K antigen, H antigen, LPS, Capsule, Antigenic Phase Variation, Exotoxin , fimbriae, intracellular survival and multiplication, siderophores, hemolysins, resistance to serum killing, antimicrobial resistance, verotoxin,

Gram-positive organisms

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Listeria Monocytogenes

Neonatal Meningitis Risk

Treatment 2

Diagnosis 2

Clinical symptoms; culture confirmation; Spinal Tap;Mueller-Hinton agar specific can see hemolysis

General Characteristics 2

 Gram-positive, non-spore-forming, motile, facultatively anaerobic, rod-shaped, catalase-positive ,oxidase-negative, beta-hemolysis

Virulence Factors 2

has pseudo LPS mechanism; D-galactose residues bind to receptors on cell membrane, attachment to cadherin through internalin;Sigma beta factor

D-galactose residuese

Lipotechoic acids

Internalin A/B

beta-hemolysin

Streptococcus pneumoniae

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Treatment 1

penicillin; however MDR strains need amoxicillin or erythromycin in extreme cases or allergies

Diagnosis 1

Clinical symptoms; culture confirmation; Spinal Tap

K1 antigen

General Characteristics 1

Gram (+), catalase (-), facultative anaerobe, encapsulated, oval or lancet-shaped, paired or short chains, α-hemolysis

Virulence Factors 1

Capsule, adhesin, secretory IgA protease, pneumolysin, autolysin, hydrogen peroxide

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