第五章第十三节流行性脑脊髓膜炎.pptVIP

meningococcal meningitis Clinical Manifestation Fulminant Type 脑膜脑炎型 脑实质损害 脑疝 枕骨大孔疝 天幕裂孔疝 Mixed type meningococcal meningitis meningococcal meningitis Clinical Manifestation 轻型 fever, joint pain and symptoms of an upper respiratory infection. 少量出血点 Children and Old man meningococcal meningitis Lab 血常规 WBC↑↑↑，NE↑↑ CSF 混浊，WBC1000X106/L，多核为主 Pr↑, Glu↓ Cl-↓ 颅压↑ meningococcal meningitis 腰穿 meningococcal meningitis Lab 细菌学 涂片 meningococcal meningitis Lab Bacteriology 培养 meningococcal meningitis Lab Immunology Antigene Antibody Others CSF-Β2mg LLT meningococcal meningitis 并发症及后遗症 Diagnosis and different diagnosis Diagnosis 季节，突发高热，头痛，呕吐 瘀斑，脑膜刺激症 血、脑脊液检查，细菌培养 Different diagnosis 其他细菌 病毒脑，结脑，梅脑 败血症休克型 meningococcal meningitis meningococcal meningitis Treatment 普通型 一般治疗 病原治疗 对症治疗 暴发型 休克型：纠正休克 脑膜脑炎型：减轻脑水肿，防脑疝 meningococcal meningitis Prevention 传染源 传播途径 易感人群 菌苗注射 SMZco Meningococcal Meningitis 流行性脑脊髓膜炎 meningococcal meningitis Introduction 亚撒哈拉非洲被称为 Meningitis Belt. 不论是发达国家，还是发展中国家， 80% 的细菌性脑膜炎由3种致病菌引起: 乙型流感嗜血杆菌, 肺炎链球菌 and Neisseria meningitidis meningococcal meningitis Introduction meningitidis, the 病原微生物 of meningococcal meningitis, was first 分离 from 脑脊液 and described in 1887 by Weichselbaum meningococcal meningitis Introduction 感染涉及： 脑膜炎、菌血症、呼吸道、关节、心包、眼、 泌尿生殖系等 主要临床表现： Fever Headache 呕吐 颈强直 弥散性斑丘疹 Joint pain 畏光 meningococcal meningitis Bacteria The Neisseria family is made up of more than 10 species. Only 2 of them are of clinical importance 淋病奈瑟菌, responsible for gonorrhea, N. meningitidis, responsible for meningococcal disease. meningococcal meningitis Bacteria G- ， ‘双球菌’ ， φ0.6~1.0μm Can be found in blood, CSF, 紫癜 meningococcal meningitis Bacteria meningococcal meningitis Bacteria 专性需氧菌 巧克力色血琼脂平板 5%-10% CO2 PH 7.4-7.6 meningococcal meningitis Bacteria A, B, C, D, E29, H, I, K, L, W135, X, Y Z A占90%以上 meningococcal meningitis Distribution of 主要的 N. meningitidis serogroups (A, B, C), 1996–1997 Source : Can. Commun. Di