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化脓性脑膜炎英文
Acuteinfectionofcentralnervoussystem(CNS).90%ofcasesoccurintheageof1mo-5yr.Theinflammationofmeningescausedbyvariousbacteria.Commonfeaturesinclinicalpracticesinclude:fever,increasedintracranialpressure,meningealirritation.?Oneofthemostpotentiallyseriousinfections,associatedwithhighmortality(about10%)andmorbidity.PurulentMeningitis
Etiology1.1Pathogens:Mainpathogens:Neissriameningitidis,streptoccuspneumoniae,Haemophilusinfluenzae.(2/3ofpurulentmeningitisarecausedbythesepathogens)Pathogensinspecialpopulations(neonate3moinfants,malnutrition,immunodeficiency):gramnegativeentericbacilli,groupBstreptococci,staphlococcusaureus
1.2MajorriskfactorsformeningitisImmatureimmunologicfunctionandattenuatedimmunologicresponsetopathogens?Lowlevelofimmunoglobulin,defectsofcomplementandproperdinsystem?Immatureorimpairedblood-brain-barrier(BBB)?ImmatureBBBfunction:maturationatabout1yr?ImpairedBBB:Congenialoracquireddefectsacrossmucocutaneousbarrier
1.3Accessofbacteriainvasion?Typicalaccess---hematogenousdissemination?Bacteriacolonizingthemucousmembranesofthenasopharynx?invasionintolocaltissue?bacteremia?hematogenousseedingtothesubarachnoidspace?Modeoftransmission:Persontopersoncontactthroughrespiratorytractsecretionsordroplets
Bacteriaspreadtothemeningesdirectly:throughanatomicdefectsintheskullorheadtraumaInvasionfromparameningealorgans:suchasparanasalsinusesormiddleearAccessofbacteriainvasion
2.PathologyStructureofmeninges
Characterizedbyleptomeningealandperivascularinfiltrationwithpolymorphonuclearleukocytesandaninflammatoryexudate.Exudatewhichmaybedistributedfromconvexityofbraintobasalregionofcranium.Exudateismorethic
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