final ppt meningitis english 2.pptx

8/18/2019 final ppt meningitis english 2.pptx

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By:

Febriana Ayu Permatasari

10700185

MENINGITIS


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Meningitis the infection in the meninges.

Meninges is the membrane that surrounds in the brain and

spinal cord.

Meningitis is a transmitted infections.

May cause damage to the control of movement, thought, andeven death.

INTRODUCTION


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Meningitis is an inflammatory reaction that affecting one or

all the layers of tissue membrane that envelope the brain and

spinal cord, it makes exudation of pus or serous, caused by

specific / non-specific bacteria or virus.

DEFINITION


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Why we have to learn about

meningitis?


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In19!" #he order of the 9th $ 1% at education hospital in Indonesia

In 19&-199'" (M) *ediatric +((" &%-% patients / year mortality 1-1, %-!% disability

Marx '%%'0 " Mortality" '%-!% neonatal0

-1% children0

*ermanent disability " '-%

#he biggest incident " 2eonates and age - months

In 3et season, the case increases '- times than in dry season

#he most 4acteria cause"

5 Influen6ae

2 Meningitidis

( *neumoniae

7erms gram negative neonates0

8*I8MI:7;


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Infection of the upper air3ay,

titis media,

mastoiditis,

(ickle cell anemia and other hemoglobinopatis,

2e3 neurosurgical procedure,head trauma, and

immunologic effect.

meningitis:


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urameter, the outer layer of the duramater attached to the inner surface of the

cranium and also formed periosteum, and sends vessels and fibrous expansioninto the bone itself.


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The Causes of Meningitis?

The 3 main bacteria that cause:

Haemophilus influenzae type b

Neisseria meningitiis!Meningococcal"

#treptococcus pneumoniae!pneumococcal"


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Why we coul be sic$?


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The %ifferences in susceptibility of iniviuals affecte:

1. #he )actors that inhibit coloni6ation

'. #he )actors that prevent of bacteremia

. )actors 3hich prevent infection in the

meninges and >()


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nfectious

diseases

The factor of host The factor of environment The factor of bacteria

#e&: '( )

'*W an )rematurityprolonge parturition

manipulation of labor

+inal trimester maternal infection

*actericial activity of leu$ocytes,

Complement eficiencies serum- .gM-

.g/

malignant iseases

raiation

.mmunosuppressant therapy

malnutrition

Many types

virulensi of bacteria

)opulation ensity an hygiene

sanitation

0ucation an socioeconomic

1ector transmission: og- rat- tics


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The ways .nfection of the meninges:2 Hematogenous

4 )ercontinuitatum

3 %irect implantation5 Transplacental an aspiration of amniotic flui

!Neonates"

)/T670N0#.#


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2 *acteria attache to the

mucosal epithelial cells of

the nasopharyn&!colonization"

4 )enetrate in the mucosal

3 Multiply in the bloostream

!bacteremia"5 7oing in to C#+

8 Multiply in the C#+

9 .t ma$es inflammation of the

meninges an the brain


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The )athogenic of bacteria

No The ways ofneurotropic

The body’s defense The strategic of pathogen

2 Colonization invation of mucosa

secretory .g/

/ctivity of cilia

Mucosal epithelial

The secretion of .g/ protease

Ciliostasis

/ttachment in the pili

4 #urviving in theintravascular

The complement /voiing by the alternativepathway with the polysacchariecapsule

3 Crossing the *** The enothelial of

brain

The attachment in the pili

5 #urviving in the C#+ The opsoni$ activityis wea$

The replications of bacteria


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The component of bacteria that ma$es inflammation:

The capsule:

The polysaccharie capsule: Hinfluenza *- #pneumoni- N

meningitiis

7ram !;": The cell wall !peptioglycan an tei$oat aci"

7ram !


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)/T6+.#.6'67.


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Causati!e agent

" The in!asion of the CN# through the $%oodstream

"

Migrate to su$arachnoid %a&er

" The in'ammator& response in piamatter( arahnoid( and

!entricu%ar C#F

"

E)udates are spread throughout the crania% ner!es and spina%

ner!es"

Damage neuro%ogist


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Meningitis based on the changes in the cerebrospinal fluid as follo3s"

1. 4acterial meningitis is caused by certain bacteria and a serious illness. #hese

patches 3ill develop into bruises that reduces the blood supply to other organs

in the body can be fatal and cause death.

'. #uberculosis Meningitis, symptoms may include" fever, irritability, obstipasi,

vomiting, found signs of meningeal stimulation such as a nuchal rigidity, body

temperature up and do3n, pulse very unstable / slo3, disturbance the brain?sneurons. #he cause by mycobacterium tuberculosis germ hominis variants.

. @iral meningitis is milder disease. #he symptoms are similar like flu, and

generally the patient can heal itself. )reAuency of viral meningitis usually

increases in the summer because at that time people are more often exposed to

virus introduction agent.

C*A##IFICATION


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%epening on:- /ge


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Neonates

#tarte by #epsis- fever-

wea$- lazy to rin$- vomiting-

%ecrease of consciousness-fontanella may

conve&-irregular breathing-

>aunice

3 mo


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Inspection of nuchal rigidity

*atient lying supine and passive movements performed in the form of flexion

and rotation of the head. 2uchal rigidity positive sign B0 3hen the obtained

stiffness and resistance to flexion movement of the head 3ith pain and muscle

spasm.

CernigDs signs

4rud6inskiDs sign I 4rud6inski 2eck04rud6inskiDs sign II 4rud6inski >ontra :ateral :eg0

P+#ICA* E,AMINATION


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Ph&sica%-neuro%ogica%e)amination


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:umbal puncture examination

:umbal puncture is usually performed to analy6e the number of

cells and cerebrospinal fluid proteins, provided that no increase

in intracranial pressure.

4lood tests

+adiological examination

eg " ># (>


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'umbal )uncture


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2 The increasing of T. sign

4 The infection in the area of ')

3 *loo clotting isorers

5 the eformity of Columna vertebral lumbal8 #evere respiratory isorers

The Contra


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The type The pressure ofLP

Colour Amount ofcells

PMN MN protein glucose

M bacteria @@ Turbi (2AAAml ;;; ; / little

increase

N,

M 1iral N Clear B2AAml ; ;;; N @ N

M T* variations anthochromia

variations ; ;; @ ,

The /nalysis of C#+ in the CN# infections


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C%i i % t f th i iti


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Stage 1 Nons!e"i#" sym!toms an$signsT%ere is no &oss o'"ons"iousnessNo neuro&ogi"a& $e#"it

#tage / *etharg& and $eha!ior0s disorderirritation in meningensMinor neuro%ogica% de1cits suchas crania% ner!e pa%sies

C%inica% stage of the meningitis T2

Stage ( Stu!or or "omaabnorma& mo)ementsei*uresse)ere neuro&ogi"a& $e#"its:

Eg : !aresis


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How to the %iagnose?


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D AGNOS S

Anamnesis Physical examinations Analysis of CSF

Sign Kernig

Sign Brudins!iSign "AS#$%#

Stiff nec!

%%B stand

O&istotonus

Decreased

consciousness

Pathological

reflexes '()

S&asticity

*emi&legia

A&hasia

Systemic disease

Sym&toms and

maningeal

stimulati+e signsSym&toms and

signs of focal

neurological deficit

, - dominance P.N

cells/ , &rotein/ 0

glucose/ 1acterial

culture '()

Golden standart

The other examinations

!!G" neuro#imaging

T+ERAP


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Meningitis 2acteria% 3/m4o: The third generations of cepha%osporin or a com$ination of

Ampici%%in 567-/77 mg 8977 mg ; times dai%& dose and Ch%oramphenico% 67mg ;


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Meningitis Tuberculous:


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Meningitis Virus

+est and symptomatic treatment. :iAuor cerebrospinal issued for the purposes of

diagnosis may reduce the symptoms of headache.

Symptomatic treatment

E (topping sei6ures"

o ia6epam %.'-%. mg/kg/dose I@ or %.! to %.& mg/kg/dose rectal suppository,

follo3ed by"

o *henytoin mg/kg/day I@ / * divided into doses or

o *henobarbital -F mg /kg/day IM/* divided into doses

E decreased the fever"

o


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#reatment in patients 3ith meningitis


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If the urinary incontinence do catheters.

Hhen incontinence of alvi do lavement.

>lose monitoring"

4lood pressure

4reathing

*ulse*roduction of urine

)aal hemostasis to kno3 there I> early

*hysiotherapy and rehabilitation.

COMP*ICATION#


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(erious complications are usually caused by an infection"

Meningococcal sepsis or meningococcemia

(yndrome 3ater house-)riderichsen septic shock

I>

4leeding

*urpura

(Iomplications post meningitis in neonates"

@entriculitis 3hich produces cysts, the area bounded by the accumulation of fluid and

pressure in the brain0

isorders that persist and vision, hearing and other nerve 3eakness

>erebral palsy, mental disability, impaired learning, decreased attention, hyperactivity

disorder and the sei6ures.

5emiparesis and Auadriparesis - arthritis / thrombosis.

COMP*ICATION#


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PRE=ENTION#+%emo!ro!%y&a,is 'or Meningo"o""a& -isease

Adults and children >12 y.o 1st line: Rifampicin 600mg every 12 hours

for 4 doses2nd line: Ciprofloxacin 500mg po

Children: 1-12 y.o Rifampicin syrup 10mg/g every 12 hoursfor 4 doses

Children 0 – 11 m.o Rifampicin syrup 5mg/g every 12 hours for

4 doses

Chemoproph&%a)is for +i$ Disease

Children and adults Rifampicin 20mg/g once daily for 4days up to max of 600mg/day

Infants under 1 y.o Rifampicin 10mg/g once daily for 4days


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ImmunizationHorld3ide mass immuni6ation against 5ib infections has

provided a dramatic reduction of the incidence ofmeningitis.

7ive 4>7 vaccination


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*rognosis depends on"

the severity of clinical disease

the specific etiology

age of the child

*rolonged the sick before getting the treatment

#he sensitivity of bacteria on given antibiotics

#he complications

If severe clinical disease 3ith evidence of the involvement of many parenchyma, poor prognosis, 3ith a possible deficit in the intellectual, motoric, psychiatric,epileptic, vision or hearing.

*atients 3ith loss of consciousness have a high risk of getting risk of death.

PRO.NO#I#


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Patient #tatus


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ANAMNE#I#• IDENTIT

– Name : Putri A&u – Age : > month – address : Pandean( .ondang – #e) : Fema%e – Entr& : / septem$er /756

F % ti t > i ht >< $ ht t


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Fema%e patient( > m4o( @eight >


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+istor& of seiBures 8-( the 1rst time ofseiBures

Trauma histor& 8-

Past medica% histor&


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8- sic< during pregnanc&

Pregnanc& +istor&


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No one ha!e histor& of seiBures in fami%&

Fami%& histor&


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Ph&sica% E)amination

A@areness : decreased of cr&ing

=ita% #ign

Pu%se : 596 );minute Respirator& Rate : > );minute

Temperature : >(6 c


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+ead and nec< : norma%( 8A-;I-;C-;D-( nucha%

rigidit& 8

Thora) : norma%A$domen : norma%

E)tremitas : norma%

2%ood test


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Pemeri.saan $ara% /eng.a! Se!tember 20153

+emog%o$in : G4 * 857(77 H 56(77 gr;d% Trom$osit : 5> ) 57u% * 8/57 - 667 Pemeri.saan $ara% /eng.a! 5 Se!tember 20153

+emog%o$in : 4 * 857(77 H 56(77 gr;d%

Trom$osit : 5// ) 57u% * 8/57 - 667

Pemeri.saan $ara% /eng.a! 7 Se!tember 20153

Creatinin : 74 mg;d* * 87(>7 H 5(57 mg;d* Ja%ium : 45 mmo%;* * 846 - 646 Pemeri.saan $ara% /eng.a! 8 Se!tember 20153

*eG ) 57u% * 8/57 - 667 Pemeri.saan $ara% /eng.a! 4 Se!tember 20153

*e


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Pemeri.saan $ara% /eng.a! 1 Se!tember 20153 *e ) 57 + 8/(77-5/(77 Trom$osit : 69 ) 57u% + 8/57 - 667 Pemeri.saan $ara% /eng.a! 18 Se!tember 20153

*e


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9 Sept 201 1! Sept 201 1 Sept 201 1" Sept 201

fever B0, the feceslendir B0temp " F.! %> pulse"11%x/mt

++ " 'x/mnt onciousness"hercrying 3as enoughtemp " ,F%> pulse" 1' x/mt++ " ' x/mnt

ontinous :I@) +:%%cc/'!hoursIn=. +anitidin x ampIn=. 2orages x amp

In=. pulse " 1'x/mt++ " 'x/mnt


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1# sept 201 1$ sept 201 19 sept 201 21 sept 201

@omiting !x sinceyesterday, the fever hasdo3ntemp " &,& %>

pulse" 1'!x/mt++ " ' x/mnt

pulse" 1&x/mt

++ " %x/mnt)ontanella 3as little convex


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22 sept 201 2% sept 201

#he feces 3as black, mucousB01x, feverB0,temp " &,F%>

pulse " 1%x/mt++ " 'x/mntLL4 " agak cekung


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final ppt meningitis english 2.pptx

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