Bacterial meningitis is a severe infectious disease of the central nervous system , an inflammation of the meninges , which is caused by the bacterial infection . Neisseria meningitides and Streptococcus pneumoniae are the pathogens in response for the most cases of this disease , though meningitis in patients older than 50 years may be caused by Listeria monocytogenes , and in patients that suffer from immunodeficiency or alcoholism Haemophilus influenzae (type b ) caused bacterial meningitis may occur . Bacterial meningitis is not a widespread disease , its general occurrence is about 3 to 10 cases for the every [banner_entry_middle]
100 000 people all over the world , particularly 2 .2 per 100 000 in the USA .  But the clinical course of the disease is grave and deceptive , and in an early stage of the disease patient may display only minor symptoms of cold that ‘s why early diagnostics of the bacterial meningitis is highly important and patients affected require adequate and timely treatment and attentive , careful nursing
In the case listed in the assignment patient displays the symptoms of the early stage bacterial meningitis . The disease had started in about 24 hours and manifested itself with mood changes (irritability headache and neck stiffness , drowsiness and nausea , accompanied by vomiting , photophobia , hyperthermia and moderate tachycardia . These pathologic changes in the organism of the patient are caused by the presence of the pathogenic microorganisms and by the intoxication with the metabolic wastes of the bacteria . These substances serve as pyrogens and stimulate the receptors of the appropriate white blood cells . These WBC start to release pyrogenic cytokines into the blood flow , and mentioned cytokines are transported to the anterior hypothalamus and trigger the mechanisms of thermoregulation in a way that leads to the elevation of the thermoregulatory set point . As a result of these changes and subsequent neurohumoral commands of the hypothalamus heat production and heat conservation in the organism are increased . Heat production is increased by the means of involuntary muscular contractions (so called chills , and recently produced heat is conserved because of the constriction of the peripheral blood vessels and of the appropriate behavioral changes . Tachycardia arises as a result of the sympathetic vegetative system activation by the cytokines and subsequent release of the additional portions of adrenaline into the blood flow . Headache is the results of elevated intracranial pressure which causes tension of the dura mater and irritation of nerve endings of the trigeminal nerve . The mechanism of ICP elevation , in a few words comprises the following steps : invasion of the bacterial cells into the central nervous system , their propagation in the liquor , production of proinflammatory cytokines , and increase of BBB (blood – brain barrier permeability and infiltration of inflammatory neutrophils (Tsao N . et al . 1999 ) This also increases liquor volume because of absorbance and circulation failure and , finally , results in elevation of ICP . Nausea and vomiting arise as the result of the nervus vagus endings irritation and the cause of photophobia is general hyperesthesia and aggravation of headache in the presence of bright light . Irritability and… [banner_entry_footer]
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