《儿科英文化脓性脑膜炎》由会员分享，可在线阅读，更多相关《儿科英文化脓性脑膜炎（49页珍藏版）》请在金锄头文库上搜索。
1、Bacterial meningitisBacterial meningitisIntroductionIntroductionn nBacterial meningitis is an inflammation of the Bacterial meningitis is an inflammation of the leptomenings, usually causing by bacterial leptomenings, usually causing by bacterial infection.infection.n nBacterial meningitis may prese
2、nt acutely Bacterial meningitis may present acutely (symptoms evolving rapidly over 1-24 hours), (symptoms evolving rapidly over 1-24 hours), subacutely (symptoms evolving over 1-7days), subacutely (symptoms evolving over 1-7days), or chronically (symptoms evolving over more or chronically (symptoms
3、 evolving over more than 1 week).than 1 week).IntroductionIntroductionn nAnnual incidence in the developed countries is Annual incidence in the developed countries is approximately 5-10 per 100000approximately 5-10 per 100000. . n n30000 infants and children develop bacterial 30000 infants and child
4、ren develop bacterial meningitis in United States each year. meningitis in United States each year. n nApproximately 90 per cent of cases occur in Approximately 90 per cent of cases occur in children during the first 5 years of life.children during the first 5 years of life.IntroductionIntroductionn
5、 nCases under age 2 years account for almost Cases under age 2 years account for almost 75% of all cases and incidence is the highest in 75% of all cases and incidence is the highest in early childhood at age 6-12 months than in early childhood at age 6-12 months than in any other period of life.any
6、 other period of life.n nThere are significant difference in the There are significant difference in the incidence of bacterial meningitis by season.incidence of bacterial meningitis by season.EtiologyEtiologyn nCausative organisms vary with patient age, with Causative organisms vary with patient ag
7、e, with three bacteria accounting for over three-three bacteria accounting for over three-quarters of all cases:quarters of all cases:n nNeisseria meningitidis (meningococcus)Neisseria meningitidis (meningococcus)n nHaemophilus influenzae (if very young and Haemophilus influenzae (if very young and
8、unvaccinated)unvaccinated)n nStreptococcus pneumoniae ( pneumococcus)Streptococcus pneumoniae ( pneumococcus)EtiologyEtiologyn nOther organisms Other organisms n nNeonates and infants at age 2-3 months Neonates and infants at age 2-3 months n nEscherichia coliEscherichia colin nB-haemolytic streptoc
9、occiB-haemolytic streptococcin nStaphylococcus aureusStaphylococcus aureusn nStaphylococcusStaphylococcus epidermidis epidermidisn nListeria monocytogenesListeria monocytogenesEtiologyEtiologyn nElderly and immunocompromisedElderly and immunocompromisedn nListeria monocytogenesListeria monocytogenes
10、n nGram negative bacteriaGram negative bacterian nHospital-acquired infectionsHospital-acquired infectionsn nKlebsiellaKlebsiellan nEscherichia coliEscherichia colin nPseudomonasPseudomonasn nStaphylococcus aureusStaphylococcus aureusEtiologyEtiologyn nThe most common organisms The most common organ
11、isms n nNeonates and infants under the age of 2monthsNeonates and infants under the age of 2monthsn nEscherichia coli Escherichia coli n nPseudomonas Pseudomonas n nGroup B StreptococcusGroup B Streptococcusn nStaphylococcus aureusStaphylococcus aureus EtiologyEtiologyn nChildren over 2 monthsChildr
12、en over 2 monthsn nHaemophilus influenzae type bHaemophilus influenzae type bn nNeisseria meningitidisNeisseria meningitidisn nStreptococcus pneumoniaeStreptococcus pneumoniaen nChildren over 12 yearsChildren over 12 yearsn nNeisseria meningitidisNeisseria meningitidisn nStreptococcus pneumoniaeStre
13、ptococcus pneumoniaeEtiologyEtiologyn nMajor routes of leptomening infectionMajor routes of leptomening infectionn nBacteria are mainly from blood.Bacteria are mainly from blood.n nUncommonly, meningitis occurs by direct Uncommonly, meningitis occurs by direct extension from nearly focus (mastoiditi
14、s, extension from nearly focus (mastoiditis, sinusitis) or by direct invasion (dermoid sinus sinusitis) or by direct invasion (dermoid sinus tract, head trauma, meningo-myelocele).tract, head trauma, meningo-myelocele).PathogenesisPathogenesisn nSusceptibility of Susceptibility of bacterial infectio
15、n on CNSbacterial infection on CNS in in the children the children n nImmaturity of immune systemsImmaturity of immune systemsn nNonspecific immuneNonspecific immunen nInsufficient barrierInsufficient barrier( (Blood-brain barrierBlood-brain barrier) )n nInsufficient complement activityInsufficient
16、complement activityn nInsufficient chemotaxis of neutrophilsInsufficient chemotaxis of neutrophilsn nInsufficient function of monocyte-macrophage systemInsufficient function of monocyte-macrophage systemn nBlood levels of diminished interferon (INF) -and Blood levels of diminished interferon (INF) -and interleukin -8 ( IL-8 ) interleukin -8 ( IL-8 ) PathogenesisPathogenesisn nSusceptibility of bacterial infection on CNS in Susceptibility of bacterial infection on CNS in the
