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Encephalitis meningitis Slide 1 Encephalitis meningitis Slide 2 Encephalitis meningitis Slide 3 Encephalitis meningitis Slide 4 Encephalitis meningitis Slide 5 Encephalitis meningitis Slide 6 Encephalitis meningitis Slide 7 Encephalitis meningitis Slide 8 Encephalitis meningitis Slide 9 Encephalitis meningitis Slide 10 Encephalitis meningitis Slide 11 Encephalitis meningitis Slide 12 Encephalitis meningitis Slide 13 Encephalitis meningitis Slide 14 Encephalitis meningitis Slide 15 Encephalitis meningitis Slide 16 Encephalitis meningitis Slide 17 Encephalitis meningitis Slide 18 Encephalitis meningitis Slide 19 Encephalitis meningitis Slide 20 Encephalitis meningitis Slide 21 Encephalitis meningitis Slide 22 Encephalitis meningitis Slide 23 Encephalitis meningitis Slide 24 Encephalitis meningitis Slide 25 Encephalitis meningitis Slide 26 Encephalitis meningitis Slide 27 Encephalitis meningitis Slide 28 Encephalitis meningitis Slide 29 Encephalitis meningitis Slide 30 Encephalitis meningitis Slide 31 Encephalitis meningitis Slide 32 Encephalitis meningitis Slide 33 Encephalitis meningitis Slide 34 Encephalitis meningitis Slide 35 Encephalitis meningitis Slide 36 Encephalitis meningitis Slide 37 Encephalitis meningitis Slide 38 Encephalitis meningitis Slide 39 Encephalitis meningitis Slide 40 Encephalitis meningitis Slide 41 Encephalitis meningitis Slide 42 Encephalitis meningitis Slide 43
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Encephalitis meningitis

  1. 1. RATHEESH R L
  2. 2.  Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.
  3. 3.  Bacterial  Aseptic  Viral  Parasitic  Non infectious
  4. 4.  In premature babies and newborns up to three months old-group B streptococci,Escherichia coli.  Listeria monocytogenes may affect the newborn  Older children- neisseria meningitidis streptococcus pneumoniae  under five- haemophilus influenzae type B  In adults, N. meningitides and S. pneumoniae together cause 80% of all cases of bacterial meningitis  L. monocytogenes in those over 50 years old
  5. 5.  Recent trauma to the skull  Individuals with a cerebral shunt or related device (such as an extra ventricular drain)- infection with staphylococci pseudomonas and gram negative bacilli  In a small proportion of people, an infection in the head and neck area such as otitis media or mastoiditis can lead to meningitis.  Recipients of cochlear implants for hearing loss are at increased risk of pneumococcal meningitis
  6. 6.  Tuberculous meningitis, meningitis due to infection with mycobacterium tubercle  Recurrent bacterial meningitis may be caused by persisting anatomical defects, either congenital or acquired.  Anatomical defects allow continuity between the external environment and the nervous system.  common cause of recurrent meningitis is skull fracture; particularly fractures that affect the base of the skull or extend towards the sinuses.
  7. 7.  Endocarditis ( Infection of the heart valves with the spread of small clusters of bacteria to the blood stream) may cause aseptic meningitis.  Aseptic meningitis also result from the infection with spirochetes.  Meningitis may be encountered in cerebral malaria ( malaria infecting the brain ).  Fungal meningitis Eg: due to cryptococeus Neo formans is typically seen in people with immune deficiency such as AIDS.  Amoebic meningitis due to the infection with Amoebae such as naegleria fowleria, is contacted from fresh water sources.
  8. 8. Viruses that can cause meningitis include  Entero viruses  Herpes Simplex virus type 2  varicella zoster virus ( known for causing chickenpox )  Mumps Virus  HIV.
  9. 9.  A parasitic cause is often assumed when there is predominance of Eosinophils in the CSF.  Most common parasites are angiostrongylus cantonensis and gnathostoma spinigerum.  Tuberculosis, Syphilis and Cryptococeosis are rare causes of Eosinophilic Meningitis
  10. 10.  Spread of cancer to the meninges ( Malignant Meningitis )  certain drugs ( mainly non steroidal anti inflammatory drugs, antibiotics and intravenous immunoglobulins )  Inflammatory conditions such as sarcoidosis and connective tissue disorders such as systemic lupus erythematosus.  Epidermoid cysts and dermoid cysts may cause Meningitis by releasing irritant matter into the subarachnoid space.
  11. 11.  In adults, a severe headache is the most common symptom of meningitis  Followed by nuchal rigidity The classic triad of diagnostic signs consists of  nuchal rigidity  sudden high fever  altered mental status.
  12. 12.  photophobia(intolerance to bright light)  phonophobia(intolerance to loud noises)  positive kerning’s sign  positive brudzinski’s sign  The rash consists of numerous small, irregular, purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and palms of the hands or soles of the feet
  13. 13.  is positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful
  14. 14.  Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.
  15. 15.  Increased intracranial pressure.  Residual neurological dysfunction.  Cranial nerve dysfunction often occurs with cranial nerves III, IV,VI, or VIII in bacterial meningitis.
  16. 16.  The optic nerve(CNII) is compressed by increased intracranial pressure. Papilledema is often present and blindness may occur  When the occulomotor(CN III) trochlear(CNIV) and abducens(CN VI) nerves are irritated, occular movements are affected. Ptosis, unequal pupils and diplopia are common  Irritation of the trigeminal nerve(CNV) is evidenced by sensory losses and loss of the corneal reflex  Irritation of the facial nerve(CNVII)results in facial paresis  Irritation of the vestibulocochlear nerve(CNVIII) causes tinnitus, vertigo, and deafness
  17. 17.  Acute cerebral edema may occur with bacterial meningitis, causing seizures, CNIII palsy, bradycardia, hypertensive coma and death  A non communicating hydrocephalus  The syndrome is manifested by petechiae, disseminated intravascular coagulation and adrenal hemorrhage  Disseminated intra vascular coagulation
  18. 18. TREATMENT OF BACTERIAL MENINGITIS Antibiotics  Ceftriaxone, one of the third generation cephalosporins antibiotics  Empiric antibiotics (treatment without exact diagnosis) must be started immediately  Empirical treatment consists of a third generation cephalosporin such as cefotaxime or ceftriaxone.
  19. 19. Steroids  Adjuvant treatment with corticosteroids(usually dexamenthasone) -to reduce rates of mortality, severe hearing loss and neurological damage in adults and adolescents.  mechanism is suppression of overactive inflammation.  Professional guidelines recommend the commencement of dexamenthazone or a similar corticosteroid just before the first dose of antibiotics is given and continued for four days.
  20. 20. TREATMENT OF VIRAL MENINGITIS  Requires supportive therapy only.  Herpes simplex virus and varicella zoster virus may respond to the treatment with antiviral drugs such as acyclovir.  Mild cases of viral meningitis can be treated at home with conservative measures such as fluid, bed rest and analgesics
  21. 21. TREATMENT OF FUNGAL MENINGITIS  Fungal meningitis such as cryptococcal meningitis is treated with long courses of highly dosed antifungals such as amphotericin B and flucytosine.  Frequent lumbar punctures
  22. 22.  Meningococcus vaccine  Routine vaccination against streptococcus pneumoniae with the pneumococcal conjugate vaccine  Childhood vaccination with Bacillus Calmette Guerin  In cases of meningococcal meningitis, prophylactic treatment of close contacts with antibiotics (e.g rifampicin, ciprofloxacin or ceftriaxone) can reduce their risk of contracting the condition  Hib vaccine provides long lasting immunity.
  23. 23. The specific measures for preventing or reducing your risk for viral meningitis includes:  Following good hygienic practices  Wash your hands thoroughly and often.  Cleaning contaminated surfaces, such as handles and door knobs  Cover your cough  Avoid kissing or sharing a drinking glass, eating utensil, lip stick or other items with sick people or with others when you are sick.  Receiving vaccinations included in the childhood vaccination schedule  Avoid bites from mosquitoes and other insects that carry diseases
  24. 24. ENCEPHALITIS
  25. 25.  Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.
  26. 26. Viral Exposure to viruses can occur through:  Breathing in respiratory droplets from an infected person  Contaminated food or drink  Mosquito, tick, and other insect bites  Skin contact
  27. 27. A number of viruses cause encephalitis. These include:  Measles  Mumps  Polio  Rabies  Rubella  Varicella (chickenpox) Other viruses that cause encephalitis include:  Adenovirus  Coxsackievirus  Cytomegalovirus  Eastern Equine Encephalitis Virus  Echovirus  West Nile virus
  28. 28. Bacterial and other  It can be caused by a bacterial infection, such as bacterial meningitis, spreading directly to the brain (primary encephalitis), or may be a complication of a current infectious disease syphilis (secondary encephalitis).  Certain parasitic or protozoal infestations, such as toxoplasmosis, malaria, or primary amoebic meningoencephalitis
  29. 29.  Cryptococcus neoformans cause fungal encephalitis in the immunocompromised.  Streptococci, Pneumococci, Staphylococci and certain gram negative bacilli cause ceribritis prior to the formation of a brain abscess.  Parasites such as roundworms, cysticercosis, and toxoplasmosis in AIDS patients and other people who have a weakened immune system  Another cause is granulomatous amoebic encephalitis.
  30. 30.  Age.  Weakened immune system.  Geographic regions.  Outdoor activities.  Season of the year.
  31. 31.  Fever that is not very high  Mild headache  Low energy and a poor appetite  unsteady gait  Confusion, disorientation  Drowsiness  Irritability or poor temper control  Light sensitivity  Stiff neck and back (occasionally)  Vomiting
  32. 32. Emergency symptoms:  Loss of consciousness, poor responsiveness, stupor, coma  Muscle weakness or paralysis  Seizures  Severe headache  Sudden change in mental functions:  "Flat" mood, lack of mood, or mood that is inappropriate for the situation  Impaired judgment  inability to make a decision  Less interest in daily activities  Memory loss (amnesia), impaired short-term or long-term memory
  33. 33.  CT scan or magnetic resonance imagining (MRI)  Electroencephalography  lumbar puncture  Blood culture  Brain biopsy
  34. 34. The most severe cases can result in:  Respiratory arrest  Coma  Death Other complications may persist for many months or be permanent:  Fatigue  Weakness  Mood disorders  Personality changes  Memory problems  Intellectual disabilities  Lack of muscle coordination  Paralysis  Hearing or vision defects  Speech impairments
  35. 35.  Antiviral medications, such as acyclovir (Zovirax) and foscarnet (Foscavir)  Antibiotics -- if the infection is caused by certain bacteria  Anti-seizure medications (such as phenytoin) -- to prevent seizures  Steroids (such as dexamethasone) -- to reduce brain swelling (in rare cases)  Sedatives -- to treat irritability or restlessness  Acetaminophen -- for fever and headache
  36. 36.  Physical therapy  Occupational therapy  Speech therapy  Psychotherapy
  37. 37.  Seek early treatment for any high fever or infections.  Wear long pants and long-sleeved shirts to avoid ticks and mosquitoes when in forests or grassy areas.  Use insect repellant in exposed areas of the body.  Avoid spending a long time outdoors during dusk when insects tend to bite.  National surveillance and control of mosquitoes through aerial spraying can keep insect populations under control.  Vaccinate children against viruses that can cause encephalitis (measles, mumps).
  38. 38.  Disturbed sensory perception related to decreased level of consciousness as evidenced by inaccurate interpretation of environment, signs of fear or anxiety, disorientation, restlessness  Acute pain related to headache and muscle and joint aches as evidenced by general discomfort of head, joints and muscles, apathy, grimacing on movement.
  39. 39.  Hyperthermia related to infection and abnormal temperature regulation by hypothalamus from increased ICP as evidenced by increased body temperature and chills.  Ineffective therapeutic regimen management related to lack of knowledge about the disease process as evidenced by asking doubts.
  40. 40.  Ineffective breathing pattern related to decreased loss of consciousness and respiratory fatigue as evidenced by altered respiratory rate  Altered cerebral tissue perfusion related to decreased blood flow due to cerebral edema as evidenced by altered level of consciousness  Risk for injury related to seizure episodes secondary to disease condition
  41. 41.  Risk for aspiration related to decreased level of consciousness and poor secretion control  Risk for seizure activity related to cerebral irritation  Risk for increased ICP related to presence of infectious exudates  Risk for deficient fluid volume related to increased metabolic rate and decreased oral intake
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