湘雅儿科精品课件-tuberculous meningitis

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1、结核性脑膜炎TuberculousMeningitis化脓性脑膜炎/急性细菌性脑膜炎PurulentMeningitis（AcuteBacterialMeningitis）中南大学儿科学教研室第十六章第三节Tuberculousmeningitisisaninfectionofthemembranescoveringthebrainandspinalcordwhichiscausedbythetuberculosisbacteria.Definition--------TuberculousMeningitisTuberculousmenin

2、gitisisatypeofsevereTB,itoccursmostfrequentlywithin6monthsaftertheonsetofinitialinfectionTuberculousmeningitisismostcommonlyfoundinyoungchildren(age6to24months)butmayoccurinallagegroupsDefinition--------TuberculousMeningitisPurulentmeningitisisaninfectionofthemembranescover

3、ingthebrainandspinalcordwhichiscausedbybacteria.Definition--------PurulentMeningitisPurulentmeningitisoccursmostfrequentlyinwinter&spring.Purulentmeningitisismostcommonlyfoundinyoungchildren(age6to12months).Manifestedbyfever,headache,vomiting,convulsion,changesinconsciousne

4、ss,meningesirritationsigns,purulentchangesofspinalfluid.Definition--------PurulentMeningitisMeningitisDiplococcus/脑膜炎双球菌StreptococcusPneumoniae/肺炎链球菌HaemophilusInfluenza/流感嗜血杆菌E.coli/大肠杆菌GroupBHaemolyticStreptococcus/B组溶血性链球菌StaphylococcusAureus/金黄色葡萄球菌EtiologyMycobacteriaT

5、ubercolusis结核杆菌tubercolouspurulentBlood-borneinfection(majorform)BacteriaBloodMeningesRoutesofinfectiontothemeningespassthroughB.B.B.Respiratorytractinfections(U.R.I)/pneumoniaSkinlesion:furuncle,impetigo,cellulitis,inflammationofumbilicusEnteritis:salmonellaeinfection,etc.

6、InfectionofAdjacenttissueRoutesofinfectiontothemeningesNoseinfection:Rhinitis,SinusitisEarinfection:Otitismedia,MastoiditisInjuryoftheskullorruptureofbrainabscess神经系统不成熟，血脑屏障不完善，免疫功能低下。结脑常常是全身性粟粒性结核病的一部分；化脑为致病菌通过血行即菌血症传播而引起。结核或化脓邻近病灶蔓延侵犯脑膜，如脊椎、颅骨或中耳、乳突病变等。PathogenesisandPat

7、hology全部脑组织表面、脑底、脑沟、脑裂、基底池和脊髓表面均可有不同程度的炎性渗出物覆盖软脑膜、蛛网膜均可受累血管病变脑实质炎症、脑水肿、颅内压增加PathogenesisandPathologyInfectionexudateusuallyassembleatthebaseofthebrain炎症渗出物易在脑底部积聚Infectionexudateusuallyassembleatthetopofthebrain炎症渗出物易在脑顶部积聚TuberculousMeningitisPurulentMeningitisClinicalMani

8、festation临床表现Commonmanifestations/一般症候群CNSmanifestations/CNS症候群“两颅、两脑、一脊髓”Clinical