Eng / Meningeal syndrome

Classification of meningitis

With the flow lightning fast

acute (up to 4 weeks)

protracted (up to 3 months

chronic (more than 3 months) -

recurrent -

complicated.

By severity

medium-heavy,

heavy

very heavy

Etiology of purulent meningitis

Bacterial

Meningococcal

pneumococcal

hemophilic

staphylococcal

streptococcal

escherichious

Klebsiella

proteinaceous

salmonella

Pseudomonas aeruginosa

Protozoa - amoebic meningoencephalitis

purulent meningitis

The incidence of bacterial meningitis averages about 3 cases per 100,000 population.

In more than 80% of cases, bacterial meningitis is caused by N.meningitidis, S.pneumoniae and H.influenzae.

In Russia, N.meningitidis is the cause of about 60% of cases of bacterial meningitis, S.pneumoniae - 30% and H.influenzae - 10%.

Pathogenesis of primary purulent bacterial meningitis

entry gates of infection - nasopharynx and bronchi

The release of microbial toxins leads to a "cytokine explosion"

Development of a systemic inflammatory response

Increasing the permeability of the blood-brain barrier

Entering the subarachnoid space of bacteria and their active reproduction

The production of pro-inflammatory cytokines and chemokines by the endothelium of the cerebral capillaries, which determine the severity and severity of inflammatory reactions in the CNS.

Distribution of the process to the substance of the brain with the development of:

Encephalitis, brain abscess, ventriculitis

Pathogenesis of primary purulent bacterial meningitis

violation of blood flow and metabolism of the brain

Apoptosis and death of neurons.

Hypernatremia due to hypersecretion of antidiuretic hormone.

Hypoglycemia, lactic acidosis

Violation of secretion, circulation and resorption of cerebrospinal fluid leads to an increase in ICH, cerebral edema.

Liquorodynamics in meningitis

increased intracranial pressure due to:

CSF hypersecretion (due to inflammation)

decrease in fluid outflow (difficulty in the absorption of cerebrospinal fluid due to

swelling of the meninges)