复旦大学：《传染病学 Infectious Disease》课程教学资源（MBBS）教学课件（英文）中枢神经系统感染 Central Nervous System Infection

山肾院 Central Nervous system Infection Lingyun Shao Department of Infectious Diseases Huashan Hospital, Fudan University

Central Nervous System Infection Lingyun Shao Department of Infectious Diseases Huashan Hospital, Fudan University

Definition Meningitis: an inflammation of the arachnoid membrane the Normal meninges pia mater, and the intervening dura mater arachnoid cerebrospinal fluid(CSF) a mater The inflammatory process extends throughout the ningi subarachnoid space around the brain and spinal cord and involves the ventricles

Definition Meningitis: an inflammation of the arachnoid membrane, the pia mater, and the intervening cerebrospinal fluid (CSF). The inflammatory process extends throughout the subarachnoid space around the brain and spinal cord and involves the ventricles

Anatomy Arachnoid Granulation Dural Sinus yenous Bloood) Sub arachnoid Space Choroid Plexus (Site of CSF Production) Lateral Ventricle 7 Fourth Ventricle Eye Spinal cord Papilledema Sub Arachnoid Space Sub Arachnoid ( Spinal C Space Optic Foramen Pituitary Gland

Anatomy

miNgles Dura mater(2 layers) Arachnoid Dura Pia mater tOMMY Subarachnoid Vein space Gray matter Virchow-Robin Spa

Meningies

山肾院 1. Bacterial Meningitis (Purulent Meningitis) 化脓性脑膜炎

1. Bacterial Meningitis (Purulent Meningitis) 化脓性脑膜炎

Definition Bacterial meningitis is usually an acute bacterial infection that evokes a polymorphonuclear response in CSF

Definition • Bacterial meningitis is usually an acute bacterial infection that evokes a polymorphonuclear response in CSF

山肾院 pidemiology Etiology

Epidemiology & Etiology

Causes of bacterial meningitis in adults B Community Nosocomial Streptococcus pneumoniae 38 8 Gram-negative bacilli Neisseria meningitidi 14 Listeria spp. 3 Streptococci 7 12 Listeriosis/Listeria Staphylococcus aureus 5 9 Haemophilus influenzae 4 Staphylococcal/ 9% Meningococcal/ Unspecified bacterium/ Meningocoque Bacterie non precise 6% 37% Streptococcal/ Pneumococcal/ Pneumocoque 21%

Causes of bacterial meningitis in adults

ETIOLOGY OF BACTERIAL MENINGITIS BY AGE 50 yrs S pneumoniae, N. meningitidis, L. monocytogenes gram-negative bacilli

50 yrs S.pneumoniae, N. meningitidis, L. monocytogenes, gram-negative bacilli ETIOLOGY OF BACTERIAL MENINGITIS BY AGE

ETIOLOGY OF BACTERIAL MENINGITIS BY PREDISPOSING CONDITION Immunocompromised state: S pneumoniae, N. meningitidis Listeria, aerobic gnr Basilar skull fracture: S pneumoniae, H influenzae, beta- hemolytic strep group a Head trauma or post-neurosurgery: S aureus, S epidermidis aerobic gnr CSF shunt: S epidermidis, S aureus, aerobic GNR, Propionibacterium acnes

ETIOLOGY OF BACTERIAL MENINGITIS BY PREDISPOSING CONDITION Immunocompromised state: S. pneumoniae, N. meningitidis, Listeria, aerobic GNR Basilar skull fracture: S. pneumoniae, H. influenzae, beta￾hemolytic strep group A Head trauma or post-neurosurgery: S. aureus, S. epidermidis, aerobic GNR CSF shunt: S. epidermidis, S. aureus, aerobic GNR, Propionibacterium acnes