What perpetuates the infectious process in bacterial meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Replicating bacteria, increasing numbers of inflammatory cells, cytokine-induced disruptions in membrane transport, and increased vascular and membrane permeability perpetuate the infectious process in bacterial meningitis. These processes account for the characteristic changes in CSF cell count, pH, lactate, protein, and glucose in patients with this disease.

Exudates extend throughout the CSF, particularly to the basal cisterns, resulting in the following:

  • Damage to cranial nerves (eg, cranial nerve VIII, with resultant hearing loss)

  • Obliteration of CSF pathways (causing obstructive hydrocephalus)

  • Induction of vasculitis and thrombophlebitis (causing local brain ischemia)

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