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Meningitis | MICB - Microbiology, Quizzes of Microbiology

Class: MICB - Microbiology; Subject: Microbiology; University: Samuel Merritt College; Term: Forever 1989;

Typology: Quizzes

2012/2013

Uploaded on 08/11/2013

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TERM 1
Meningitis
DEFINITION 1
infection of the cerebral spinal fluid (CSF) results in
inflammation of the meningesseverity of meningitis varies
greatly virulence of the infecting microorganism immune
status of the patient
TERM 2
Symptoms of meningitis
DEFINITION 2
Early Stiff neck (nuchal rigidity) Severe headache worst
headache of life Chills & feverLater Mental confusion,
stupor, & coma
TERM 3
Types of meningitis
DEFINITION 3
Acute bacterial - most severe rapid onset - a few hours to
1 or 2 days Acute aseptic not able to culture bacteria or
fungi caused by a virus milder symptoms & often self-
limitedChronic - slow onset insidious onset of symptoms -
weeks usually caused by fungi
TERM 4
Causes of meningitis
DEFINITION 4
Bacteria - Red are normal flor a Streptococcu s pneumoniae
Neisseria meningitidis* Ha emophilus influenzae* Streptococcus
agalactiae Listeria monoc ytogenesFungi Cryptococcus
neoformans Coccidioides immitisViru ses - Enteroviru ses (most
common viral cause)
TERM 5
Epidemiology / Pathology of Bacterial
Meningitis
DEFINITION 5
Nasopharyngeal colonization acquisition of a new
microorganism (i.e. exogenous origin) local infection or
colonization without overt disease Local invasion
microorganisms breach mucosal barrier enter bloodstream
(bacteremia & septicemia)
pf3
pf4
pf5

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Meningitis

infection of the cerebral spinal fluid (CSF) results in inflammation of the meningesseverity of meningitis varies greatly virulence of the infecting microorganism immune status of the patient TERM 2

Symptoms of meningitis

DEFINITION 2 Early Stiff neck (nuchal rigidity) Severe headache worst headache of life Chills & fever Later Mental confusion, stupor, & coma TERM 3

Types of meningitis

DEFINITION 3 Acute bacterial - most severe rapid onset - a few hours to 1 or 2 days Acute aseptic not able to culture bacteria or fungi caused by a virus milder symptoms & often self- limited Chronic - slow onset insidious onset of symptoms - weeks usually caused by fungi TERM 4

Causes of meningitis

DEFINITION 4 Bacteria - Red are normal flora Streptococcus pneumoniae Neisseria meningitidis* Haemophilus influenzae* Streptococcus agalactiae Listeria monocytogenes Fungi Cryptococcus neoformans Coccidioides immitis Viruses - Enteroviruses (most common viral cause) TERM 5

Epidemiology / Pathology of Bacterial

Meningitis

DEFINITION 5 Nasopharyngeal colonization acquisition of a new microorganism (i.e. exogenous origin) local infection or colonization without overt disease Local invasion microorganisms breach mucosal barrier enter bloodstream (bacteremia & septicemia)

Epidemiology / Pathology of Bacterial

Meningitis -CNS invasion

Central nervous system invasion - mechanism not known immune defense mechanisms in CNS are inadequate low level of antibodies & complement needed to combat encapsulated microorganisms most microorganisms that cause meningitis have a capsuleAntibodies andComplement cantget into CNS-but phagocytic cells canWhich is why you get inflamation TERM 7

Properties of polysaccharide capsule in

meningitis

DEFINITION 7 enhances virulence by its antiphagocytic activity defines serological group of microorganism antigen detected in spinal fluid of patient antigen used in vaccine(s) TERM 8

Meningitis is a medical emergency

DEFINITION 8 rapid diagnosis is criticalbegin antibiotic treatment immediately aimed at most likely pathogen use antibiotics that achieve MBC in CSF mortality rate is ~15 - 25% even with antibiotic treatmentcomplications often occurhearing defects & mental retardation TERM 9

Diagnosis of meningitis

DEFINITION 9 clinical symptoms After symptoms are noticed , then do a lumbar puncture lumbar puncture CSF analysis Gram stain, culture & bacterial antigen tests blood culture TERM 10

CSF analysis

DEFINITION 10 Etiology healthy bacterial Pressure normal increasedCells low increased (PMNs) Protein normal increasedGlucose normal decreased

Haemophilus influenzae - Prevention

prevention capsular polysaccharide-protein conjugate vaccine (for type b only) rifampin chemoprophylaxis for close contacts TERM 17

Neisseria meningitidis - I dentification

DEFINITION 17 facultative Gram-negative diplococcus oxidase positiveferments glucose & maltose (N. gonorrhoeae ferments glucose only) normal habitat is human upper respiratory tract / nasopharynx ~5 - 35% of individuals colonized TERM 18

Transmission of N. meningitidis

DEFINITION 18 exchange of respiratory and throat secretions i.e. coughing, kissing, etc. (not just breathing respired air) usually in close contacts same household day-care centers military barracks prisons college dormitories - highest rate of disease complement deficiency (C5-C9) at increased risk TERM 19

Virulence factors of N. meningitidis

DEFINITION 19 pili - helps to adhere polysaccharide capsule (13 serogroups) endotoxin IgA protease TERM 20

N. meningitidis epidemiology of

infection

DEFINITION 20 ~ 13 serogroups based on capsular polysaccharideserogroups A, B, C, & W-135 cause vast majority of typed casesserogroup B causes most (~ 25

- 50%) of theseSerogroups A, C, Y, W-135 are vaccine preventable

N. meningitidis vaccine(s)

capsular polysaccharide vaccine (MPSV4) not very effective in individuals < 18 years old recommended vaccine for > 55 years-old capsular polysaccharide-protein conjugate vaccine(s) (MCV4 licensed in 2005 & MenACWY-CRM licensed in 2010) for 2- 55 year-olds effective in children, adolescents, & adults All vaccines contain serogroups A, C, Y, & W- none provide protection against serogroup B B capsular polysaccharide similar to polysialic acid containing glycoproteins present in brain (tolerance & cross-reactivity) TERM 22

Recommendations for Meningococcal

Vaccine(s

DEFINITION 22 General Population (MCV4 or MenACWY-CRM) all 11- years old or at entry into high school Groups at Risk College freshman living in dormitories Military recruits Travelers to hyperendemic/epidemic regions Individuals with complement deficiencies Microbiologists at increased risk TERM 23

Chemoprophylaxis & Treatment of

Meningococcal Disease

DEFINITION 23 Chemoprophylaxis Rifampin PO Children & adults or Ciprofloxacin PO Adults**** or Ceftriaxone IV Children <15 & adults * may affect reliability of oral contraceptivesnot recommended for pregnant women, teratogenic in lab animals* not recommended for individuals < 18 or for pregnant and lactating women, cartilage damage in immature lab animals TERM 24

Bordetella pertusis Gram-negative short rod

(coccobacillus)

DEFINITION 24 whooping cough / pertusishabitat human upper respiratory tracttransmission respiratory droplets very contagious ~90% of unvaccinated children living with someone with pertusis & ~50-80% of unvaccinated children who attend school/daycare with someone with pertusis will become infected TERM 25

Bordetella pertusis - Virulence factors

DEFINITION 25 pili capsule endotoxin exotoxin

Pertusis -Facts

half of infants who get pertusis are infected by their parentsCA requires pertusis booster immunization all 7th graders prior to entering schoolIf you have young children or are around them frequently Get the booster!