o Syphilitic meningitis -
MENINGITIS
Meningitis is an inflammation of the
meninges, the membranes that cover
the brain and spinal cord. Most cases
are caused by bacteria or viruses, but
some can be due to certain
medications or illnesses.
Bacterial meningitis is rare, but is
usually serious and can be life-
threatening if not treated right
away. Viral meningitis (also called
aseptic meningitis) is relatively
common and far less serious. It often
remains undiagnosed because its
symptoms can be similar to those of
the common flu.
Kids of any age can get meningitis, but
because it can be easily spread among
people living in close quarters, teens,
college students, and boarding-school
students are at higher risk for
infection.
If dealt with promptly, meningitis can
be treated successfully. So it's
important to get routine vaccinations,
know the signs of meningitis, and if
you suspect that your child has the
illness, seek medical care right away.
Types of Meningitis:
• Viral meningitis
o Enterovirus
o Arbovirus
o Measles
o Mumps
o Chickenpox
• Bacterial meningitis - the more
severe types
o Meningococcal Meningitis
o Pneumococcal meningitis
o Hib meningitis
o TB meningitis -
from tuberculosis
o E coli meningitis
from syphilis
o Group B Streptococcus (GBS)
meningitis
INCUBATION PERIOD
The incubation period depends on the
causative agent. For example the
incubation period of meningococcal
meningitis is 2-10 days while the
incubation for hemophilus meningitis is
much shorter ranging from 2-4 days.
However the range of incubation for
most organisms causing meningitis is 2
days to 2 weeks.
SIGNS AND SYMPTOMS
SIGNS:
The symptoms of meningitis,
especially chronic meningitis can
resemble symptoms of other diseases,
such as influenza. These symptoms can
include fever, headache, stiff neck,
irritability, and nausea and vomiting.
In acute meningitis and acute bacterial
meningitis, symptoms develop rapidly
and dramatically, within minutes to
hours. Fever can be very high and
the headache and stiff neck can be
intense. There may also
be sensitivity to light, and a purple or
red rash may appear.
Symptoms of viral meningitis generally
develop about three to seven days after
exposure to an enteroviruses virus or
other viruses that cause viral meningitis.
However, symptoms can develop more
quickly in some cases. Symptoms of
viral meningitis can also develop after a
person has had symptoms of
a cold or influenza, such as a runny
nose or diarrhea.
SYMPTOMS OF MENINGITIS:
• High fever
 • Severe headache EXAMS AND TESTS
• Nausea Physical examination will usually show:
• Vomiting
• Fast heart rate
• Photophobia
• Fever
• Sound sensitivity • Mental status changes
• Stiff neck • Stiff neck
• Pain on moving neck
For a patient who is suspected of having
• Stiff muscles
meningitis, it is important to perform a
• Alertness changes lumbar puncture ("spinal tap"), in which
o Lethargy spinal fluid (known as cerebrospinal
o Difficulty waking up fluid, or CSF) is collected for testing.
o Sleepiness Tests that may be done include:
o Lethargy
o Tiredness • Blood culture
o Confusion
• Chest x-ray
• CSF examination for cell count,
o Reduced alertness glucose, and protein
• Irritability • CT scan of the head
• Kernig's sign - inability to • Gram stain, other special stains,
and culture of CSF
straighten knees in front of body
• Confusion PATHOGNOMONIC SIGNS
• Convulsions
• Shock MENINGITIS
• Coma
Kernig’s sign (leg pain) Severe stiffness
MODE OF TRANSMISSION of the hamstrings causes an inability to
straighten the leg when the hip is flexed
Transmitted through respiratory to 90
secretions (e.g., coughing and
sneezing) and direct contact with
persons infected with the disease. Oral
contact with shared items such as
cigarettes or drinking glasses, or
intimate contact such as kissing could
put a person at risk for contracting
meningococcal disease. People
identified as close contacts of a patient
are at an increased risk for disease and
should receive antibiotics to prevent
meningitis. degrees.

PERIOD OF COMMUNICABILITY

A person can pass the infection to

others for as long as the bacteria are
present in discharges from the nose
and mouth. A person is no longer
infectious within 24 to 48 hours after
starting antibiotic treatment.
Brudzinski sign (neck pain). Severe
neck stiffness causes a patient's hips
and knees to flex when the neck is
flexed.
TREATMENT
Treatment with antibiotics should be
started as soon as possible.
Ceftriaxone is one of the most
commonly used antibiotics.
If the antibiotic is not working and the
health care provider suspects antibiotic
resistance, chloramphenicol with
ampicillin may be used. Sometimes
corticosteroids may be used, especially
in children.
Unvaccinated people who are in close
contact with someone who has H.
influenzae meningitis should be given
antibiotics to prevent infection. Such
people include:
• Household members
• Rommates in dormitories
• Those who come into close
contact with an infected person
ENCEPHALITIS
Encephalitis literally means an inflamma
tion
of the brain, but it usually refers to brain
inflammation caused by a virus.
o Dangerous infection of
the brain.
o Inflammation of the
arachnoid membrane and adjacent
subarachnoid space.
o inflammation of the brain
usually caused by a virus;
symptoms include headache and
neck pain and drowsiness and
nausea and fever (`phrenitis' is no
longer in scientific use).
INCUBATION PERIOD
1-2 weeks followed by abrupt onset of
encephalitis often with myalgia
SIGNS AND SYMPTOMS
Symptoms in milder cases of
encephalitis usually include:
• fever
• headache
• poor appetite
• loss of energy
• a general sick feeling
In more severe cases of encephalitis, a
person is more likely to experience high
fever and any of a number of symptoms
that relate to the central nervous
system, including:
• severe headache
• nausea and vomiting
• stiff neck
• confusion
• disorientation
• personality changes
• convulsions (seizures)
• problems with speech or hearing
• hallucinations
• memory loss
• drowsiness
 • coma

It's harder to detect some of these

symptoms in infants, but important
signs to look for include:

• vomiting
• a full or bulging soft spot
(fontanel)
• crying that doesn't stop or that
seems worse when an infant is
picked up or handled in some way
• body stiffness

MODE OF TRANSMISSION

• Transmitted to humans through the bite of

an infected mosquito, primarily Culexspecies.
Wading birds are the main animal reservoir
for the virus, but the presence of pigs greatly
amplifies the transmission of JEV.
• Humans are a dead-end host in the JEV
transmission cycle.

PERIOD OF COMMUNICABILITY

As long as there are infected

mosquitoes continuing to bite people.
Mosquitoes can also become infected
by feeding on a clinical case anytime
during illness.

LABORATORY

PATHOGNOMONIC SIGNS