基础医学北大病理学PPT课件急性化脓性脑膜炎.ppt

医学课件园 * 神经系统感染性疾病 I. Acute pyogenic meningitis 急性化脓性脑膜炎 病因 青少年: meningococcus 脑膜炎双球菌 发病机制 病人 带菌者 飞沫 呼吸道 上呼吸道 脑膜 血 Epidemic meningitis 流行性脑膜炎（流脑） 局部炎症 病变 Pyogenic inflammation of leptomeninges 软脑膜蛛网膜的化脓性炎 肉眼：脑脊膜血管高度扩张充血， 蛛网膜下腔充满脓性渗出物 光镜：嗜中性白细胞为主的炎细胞浸润 Acute pyogenic meningitis Here is another example of an acute meningitis from bacterial infection. The cerebrospinal fluid (CSF) in such cases typically has a low glucose, high protein, and many PMN's. A gram stain should be done to identify organisms. a gram stain reveals gram negative diplococci within a neutrophil, typical for Neisseria meningitidis. Gram stain and culture can be performed on cerebrospinal fluid obtained via lumbar puncture. A variety of bacteria can cause meningitis, but several are more common, and have an incidence more frequent at certain ages: 191 临床病理联系 颅内压增高 脑膜刺激症状 脑脊液变化 结局和后遗症 脑膜粘连 颅神经受损 Acute pyogenic meningitis 角弓反张 HP Acute purulent meningitis A 523 Acute purulent meningitis Polymorphonuclear leukocytes infiltrate the subarachnoid space. The cerebral cortex is edematous. * * * HP Acute purulent meningitis A 523 Acute purulent meningitis Polymorphonuclear leukocytes infiltrate the subarachnoid space. The cerebral cortex is edematous.