Question

-Compare the clinical manifestations of bacterial meningitis in infants with those seen in older children and adolescents.

•Explain the pathophysiology of bacterial meningitis.

•Discuss Neisseria meningitides as a causative agent in bacterial meningitis.

Answer 1

- Clinical Manifestation of Bacterial Meningitis in infants includes:

- High grade fever

- very less eating or not eating well

- vomiting

- less active than usual and being very sleepy  

- more irritable

- Bulging of the fontanel or the soft spot of the head.

- severe headache

- sensitive to bright light

- neck stiffness

In older adults symtoms like high fever, vomiting , intense headache, giddiness, nuchal rigity, positive kernig's sign,positive brudzinski's sign, seizures and increased intracranial pressure, memory impairment and disorientation,lethargy and coma occurs.

• Pathophysiology of Bacterial Meningitis: Bacterial meningitis or meningococcal meningitis occurs as an oppurtunistic infection in AIDS patients . Once the the infection enters the blood stream, ir crosses the blood brain barrier and causes an inflammatory reaction in the meninges. The causative agent causes inflammation in the subarachnoid space and pia mater. Since , there is a little space for the expansion within tyhe cranial vault, thus increases the intracranial pressure. Cerebrospinal fluid flows in the subarachnoid space,where inflammatory cellular material from the affected meningial tissue enters and accumulate in the subarachnoid space , thereby increases the CSF cell count.
• Neisseria Meningitidis infection likely to occur in dense community groups, Neisseria meningitidis concentrates in nasopharynnx and is transmitted by secretion or aerosol contamination. Though the infection mainly increases during winter and early spring season. The main risk factors are smoking, tobacco use , and viral upper respiratory tract infections because it increases the chance of developing for droplet infection. Otitis media and mastoiditis increase the risk for bacterial meningitis because the bacteria can cross the epithelial membrane and enter the subarachnoid space. Immune deficiency persons are most likely to occur bacterial meningitis.