IPLab:Lab 9:Bacterial Meningitis: Difference between revisions - Pathology Education Instructional Resource

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This 45-year-old white female with a history of psychiatric illness sustained self-inflicted third degree burns over 49% of her body surface. After initially doing well under treatment, she developed severe respiratory distress and became comatose. Antemortem blood cultures were positive for Pseudomonas aeruginosa.

~~== Autopsy Findings ==~~

At autopsy the principal findings were in the lungs and brain. Bronchopneumonia was present in all lobes of both lungs. The brain weighed 1450 grams and the leptomeninges contained a thick yellow purulent exudate most prominent over the frontoparietal areas and at the base of the brain.

== Images ==

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IPLab9BacterialMeningitis8.jpg|This photomicrograph of brain tissue demonstrates diffuse edema.

</gallery>

== Virtual Microscopy ==

<peir-vm>IPLab9BacterialMeningitis</peir-vm>

== Study Questions ==

* <spoiler text="What is the most common etiologic agent that causes bacterial meningitis?">The specific etiologic agent varies with the age of the patient:

* in neonates: the organisms include Escherichia coli and the group B streptococci;

* in infants and children: S. pneumoniae and N. meningitidis pervade in immunized children (H. influenzae type b (Hib) vaccine is routine in the U.S.), while Haemophilus influenzae is more prominent in non-immunized children;

* in adolescents and in young adults: Neisseria meningitidis;

* in the elderly: Streptococcus pneumoniae and Listeria.</spoiler>

* <spoiler text="What organism caused meningitis in this case and why?">Burn patients are at high risk for developing Pseudomonas infections. In this case, the patient was debilitated due to the extensive severe burn and developed a Pseudomonas septicemia which then led to the Pseudomonas meningitis.</spoiler>

* <spoiler text="Why is there fibrin in these lesions?">Because of the acute inflammatory reaction, there is extravasation of fibrin as well as the recruitment of neutrophils.</spoiler>

== Additional Resources ==

=== Reference ===

* [http://emedicine.medscape.com/article/961497-overview eMedicine Medical Library: Pediatric Bacterial Meningitis]

* [http://emedicine.medscape.com/article/232915-overview eMedicine Medical Library: Meningitis]

* [http://emedicine.medscape.com/article/1278244-overview eMedicine Medical Library: Thermal Burns]

* [http://emedicine.medscape.com/article/226748-overview eMedicine Medical Library: Pseudomonas aeruginosa Infections]

* [http://www.merckmanuals.com/professional/neurologic_disorders/meningitis/acute_bacterial_meningitis.html Merck Manual: Acute Bacterial Meningitis]

* [http://www.merckmanuals.com/professional/injuries_poisoning/burns/burns.html Merck Manual: Burns]

=== Journal Articles ===

* Grände PO, Myhre EB, Nordström CH, Schliamser S. [http://www.ncbi.nlm.nih.gov/pubmed/11939916 Treatment of intracranial hypertension and aspects on lumbar dural puncture in severe bacterial meningitis]. ''Acta Anaesthesiol Scand'' 2002 Mar;46(3):264-70.

=== Images ===

* [{{SERVER}}/library/index.php?/tags/403-meningitis PEIR Digital Library: Meningitis Images]

* [http://library.med.utah.edu/WebPath/CNSHTML/CNSIDX.html#6 WebPath: CNS Infections]

[[Category: IPLab:Lab 9]]

@@ Line 2: / Line 2: @@
 This 45-year-old white female with a history of psychiatric illness sustained self-inflicted third degree burns over 49% of her body surface. After initially doing well under treatment, she developed severe respiratory distress and became comatose. Antemortem blood cultures were positive for Pseudomonas aeruginosa.
-== Autopsy Findings ==
+At autopsy the principal findings were in the lungs and brain. Bronchopneumonia was present in all lobes of both lungs. The brain weighed 1450 grams and the leptomeninges contained a thick yellow purulent exudate most prominent over the frontoparietal areas and at the base of the brain.
-At autopsy the principal findings were in the lungs and brain. Bronchopneumonia was present in all lobes of both lungs. The brain weighed 1450 grams and the leptomeninges contained a thick yellow purulent exudate most prominent over the frontoparietal areas and at the base of the brain.
 == Images ==
@@ Line 16: / Line 15: @@
 IPLab9BacterialMeningitis8.jpg|This photomicrograph of brain tissue demonstrates diffuse edema.
 </gallery>
+== Virtual Microscopy ==
+<peir-vm>IPLab9BacterialMeningitis</peir-vm>
+== Study Questions ==
+* <spoiler text="What is the most common etiologic agent that causes bacterial meningitis?">The specific etiologic agent varies with the age of the patient:
+* in neonates: the organisms include Escherichia coli and the group B streptococci;
+* in infants and children: S. pneumoniae and N. meningitidis pervade in immunized children (H. influenzae type b (Hib) vaccine is routine in the U.S.), while Haemophilus influenzae is more prominent in non-immunized children;
+* in adolescents and in young adults: Neisseria meningitidis;
+* in the elderly: Streptococcus pneumoniae and Listeria.</spoiler>
+* <spoiler text="What organism caused meningitis in this case and why?">Burn patients are at high risk for developing Pseudomonas infections. In this case, the patient was debilitated due to the extensive severe burn and developed a Pseudomonas septicemia which then led to the Pseudomonas meningitis.</spoiler>
+* <spoiler text="Why is there fibrin in these lesions?">Because of the acute inflammatory reaction, there is extravasation of fibrin as well as the recruitment of neutrophils.</spoiler>
+== Additional Resources ==
+=== Reference ===
+* [http://emedicine.medscape.com/article/961497-overview eMedicine Medical Library: Pediatric Bacterial Meningitis]
+* [http://emedicine.medscape.com/article/232915-overview eMedicine Medical Library: Meningitis]
+* [http://emedicine.medscape.com/article/1278244-overview eMedicine Medical Library: Thermal Burns]
+* [http://emedicine.medscape.com/article/226748-overview eMedicine Medical Library: Pseudomonas aeruginosa Infections]
+* [http://www.merckmanuals.com/professional/neurologic_disorders/meningitis/acute_bacterial_meningitis.html Merck Manual: Acute Bacterial Meningitis]
+* [http://www.merckmanuals.com/professional/injuries_poisoning/burns/burns.html Merck Manual: Burns]
+=== Journal Articles ===
+* Grände PO, Myhre EB, Nordström CH, Schliamser S. [http://www.ncbi.nlm.nih.gov/pubmed/11939916 Treatment of intracranial hypertension and aspects on lumbar dural puncture in severe bacterial meningitis].  ''Acta Anaesthesiol Scand'' 2002 Mar;46(3):264-70.
+=== Images ===
+* [{{SERVER}}/library/index.php?/tags/403-meningitis PEIR Digital Library: Meningitis Images]
+* [http://library.med.utah.edu/WebPath/CNSHTML/CNSIDX.html#6 WebPath: CNS Infections]
 {{IPLab 9}}
 [[Category: IPLab:Lab 9]]