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Terms in this set (21)
The presence or absence of normal brain function is the important distinguishing feature between encephalitis and meningitis
Patients with meningitis may be uncomfortable, lethargic, or distracted by headache BUT THEIR CEREBRAL FUNCTION REMAINS NORMAL
abnormalities in brain function are common, including altered mental status, motor or sensory deficits, altered behavior and personality changes, and speech or movement disorders.
Seizures and postictal states can be seen with meningitis alone and should not be construed as definitive evidence of encephalitis.
some patients may have both a parenchymal and meningeal process with clinical features of both.
The patient is usually labeled as having meningitis or encephalitis based upon which features predominate in the illness although meningoencephalitis is also a common term that recognizes the overlap.
Meningitis is among the ten most common infectious causes of death
Neurologic sequelae are common among survivors.
Inflammation of meninges (increased white blood cell count in cerebrospinal fluid) which may be due to infection (due to organism that does not grow on standard bacterial culture), chemical, autoimmune or other cause
Virus in 54.6%
Bacterial meningitis in 21.8%
streptococcal meningitis in 3.9%
staphylococcal meningitis in 3%
gram-negative meningitis in 2.5%
pneumococcal meningitis in 2.3%
Electron micrograph of a tight junction. Bacteria and viruses invade here.
Encephalitis causes swelling of the brain, hemorrhage in the superficial vessels.
The most common entry site is through the upper respiratory tract, or the lung.
community-acquired bacterial meningitis in adults in developed countries are:
Streptococcus pneumoniae, Neisseria meningitidis, and Listeria monocytogenes (primarily in patients over age 50 to 60 years or those who have deficiencies in cell-mediated immunity)
healthcare-associated bacterial meningitis
staphylococci and aerobic gram-negative bacilli
The most common viruses associated with childhood encephalitis include
Mumps, Measles and Varicella virus
Viruses are the most common cause of encephalitis, and the herpes viruses are most commonly implicated.
Human herpes virus 6 (the cause of roseola)
has been associated with a number of neurological complications.
The mechanism of entry of viruses for encephalitis is by two distinct routes:
Hematogenous spread or by Neuronal Retrograde dissemination, as in rabies.
CLINICAL FEATURES — Patients with bacterial meningitis are usually quite ill and often present soon after symptom onset. In a series of 301 adults, for example, the median duration of symptoms before admission was only 24 hours (range one hour to 14 days) .
The classic triad of acute bacterial meningitis consists of
fever, nuchal rigidity, and a change in mental status, although an appreciable number of patients do not have all three features
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