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Purposeanddemand:Tofamiliarizethepathogenyofpurulentmeningitis.Tounderstandthemechanismandpathologychange.Tograsptheclinicalmanifestation,diagnosis,differentialdiagnosisandtreatment.Toself-studytheaccessoryexaminationofneuralsystem.
ContentsInductionEtiologypathogenesisManifestationsComplicationsLaboratoryfindingsDiagnosisdifferentialdiagnosisTreatmentprevention
IntroductionAcuteinfectionofcentralnervoussystem(CNS).75%ofcasesoccurintheageof2yr.Theinflammationofmeningescausedbyvariousbacteria.Commonfeaturesinclinicalpracticesinclude:fever,headache,vomit,convulsions,disturbanceofconsciousness,increasedintracranialpressure,meningealirritation.Oneofthemostpotentiallyseriousinfections,associatedwithhighmortality(about10%)andmorbidity.
Etiology1.Pathogens:Mainpathogens:Neissriameningitidis,streptoccuspneumoniae,Haemophilusinfluenzae.2/3ofpurulentmeningitisarecausedbythesepathogens
1.Pathogens(Pathogensinspecialpopulations)neonate＜3moinfants:EscherichiacoliStreptococcushaemolyticusgroupBStaphlococcusaureus＞3moinfants:HaemophilusinfluenzaegroupBStreptococcuspneumoniaeNeisseriameningitidis＞5yrchildren:NeisseriameningitidisStreptococcuspneumoniaeEtiology
Etiology2.MajorriskfactorsformeningitisImmatureimmunologicfunctionandattenuatedimmunologicresponsetopathogens?Lowlevelofimmunoglobulin,defectsofcomplementImmatureorimpairedblood-brain-barrier(BBB)?ImmatureBBBfunction:maturationatabout1yr?ImpairedBBB:Congenialoracquireddefectsacrossmucocutaneousbarrier
AccessofbacteriainvasionTypicalaccess---hematogenousdissemination?Bacteriacolonizingthemu
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