文档介绍：Purulent Meningitis
in Children
Jiang Li
Department of Neurology
Children’s Hospital
Chongqing University of Medical Sciences
Acute infection of central nervous S). 90% of cases occur in the age of 1mo-5yr.
The inflammation of meninges caused by various mon features in clinical practices include: fever, increased intracranial pressure, meningeal irritation.
One of the most potentially serious infections, associated with high mortality (about 10%) and morbidity.
Purulent Meningitis
Etiology
Pathogens:
Main pathogens: Neissria meningitidis, us pneumoniae, Haemophilus influenzae. (2/3 of purulent meningitis are caused by these pathogens)
Pathogens in special populations (neonate & <3mo infants , malnutrition, immunodeficiency): gramnegative enteric bacilli, group B i, us aureus
Major risk factors for meningitis
Immature immunologic function and attenuated
immunologic response to pathogens
Low level of immunoglobulin, defects of
complement and properdin system
Immature or impaired blood-brain-barrier (BBB)
Immature BBB function: maturation at about 1yr
Impaired BBB: Congenial or acquired defects
across mucocutaneous barrier
Access of bacteria invasion
Typical access---hematogenous dissemination
Bacteria colonizing the mucous membranes of
the nasopharynx invasion into local tissue
bacteremia hematogenous seeding to the
subarachnoid space
Mode of transmission: Person to person contact
through respiratory tract secretions or droplets
Bacteria spread to the meninges directly:
through anatomic defects in the skull or
head trauma
Invasion from ans:
such as paranasal sinuses or middle ear
Access of bacteria invasion
2. Pathology
Structure of meninges
Characterized by leptomeningeal and
perivascular infiltration with
polymorphonuclear leukocytes and an
inflammatory exudate.
Exudate which may be distributed from
convexity of brain to basal region of cranium.
Exudate is more thickness due to