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Meningitis and Encephalitis
Meningitis ,[object Object]
Encephalitis ,[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology
[object Object],[object Object],[object Object],Etiology-meningitis
Viral Etiologies
Causes in Thailand  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology-encephalitis ,[object Object],[object Object],[object Object]
Viruses and Severity of Disease
Seasonal Distribution
Noninfectious meningitides
Pathophysiology ,[object Object],[object Object],[object Object],[object Object]
Bacterial Meningitis ,[object Object],[object Object],[object Object],[object Object]
 
Viral Meningitis and Encephalitis
Herpes Simplex Virus
Viral Meningitis and Encephalitis ,[object Object],[object Object],[object Object],[object Object]
Eastern Encephalitis Virus
Equine Death from Viral Encephalitis
Regions Reporting Japanese Encephalitis
 
Encephalitis morbidity and mortality, Thailand 1976-2005
อัตราป่วยของโรค  Encephalitis unspecified   ( ต่อ แสนประชากร )  จำแนกตามกลุ่มอายุ ปี พ . ศ .  2545 - 2549
อัตราป่วยของโรค  Japanese Encephalitis B  ( ต่อ แสนประชากร )  จำแนกตามกลุ่มอายุ ปี พ . ศ .  2545 - 2549
Japanese B Encephalitis morbidity and mortality, Thailand 1976-2005
History of Japanese Encephalitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Japanese Encephalitis ,[object Object],[object Object],[object Object],[object Object]
Encephalitis and Japanese Encephalitis situation by Province 2006
Rice Fields
Japanese Encephalitis Virus
คำแนะนำในการวินิจฉัยผู้ป่วยสมองอักเสบ  ,[object Object],[object Object],[object Object],[object Object],[object Object]
คำแนะนำในการวินิจฉัยผู้ป่วยสมองอักเสบ  ,[object Object],[object Object]
คำแนะนำในการวินิจฉัยผู้ป่วยสมองอักเสบ  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features ,[object Object],[object Object],[object Object]
Clinical Features ,[object Object],[object Object],[object Object]
Complication of Bacterial meningitis
Complication of Bacterial meningitis
Bacterial Meningitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Viral meningitis ,[object Object],[object Object]
Viral Encephalitis ,[object Object],[object Object],[object Object],[object Object],[object Object]
TB meningitis ,[object Object],[object Object],[object Object]
Fungal meningitis ,[object Object]
Diagnostic Strategies
Lumbar Puncture ,[object Object],[object Object],[object Object],Diagnostic Strategies
Indication for CT scan before LP in suspected Bacterial meningitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lumbar Puncture ,[object Object],[object Object],[object Object],[object Object],[object Object]
CSF Analysis
Opening pressure -  50-200 mmH 2 O - Lateral recumbent position and    sitting position  may increase    several fold. - Elevated in bacterial, TB, fungal. -  Falsely elevated in tense,    obese, marked muscle    contraction .
Collection of Fluid ,[object Object],[object Object],[object Object]
Turbidity  ,[object Object],[object Object]
Cell count and diff. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cell count and diff. ,[object Object],[object Object],[object Object]
Traumatic LP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gram’s stain ,[object Object],Pathogen Typical characteristics Staphylococcus G + cocci: single,double,tetrad,cluster Streptococcus pneumoniae G + cocci; paired diplococci Listeria monocytogenes G + rods: single or chain Neisseria meningitidis G – cocci: paired diplococci;kidney or coffee bean Haemophilus influenzae G – coccobacilli;pleomorphic Enterobacteriaceae G – rods  Pseudomonas aeruginosa G – rods
Xanthrochromia ,[object Object],[object Object],[object Object],[object Object]
Glucose ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Glucose ,[object Object],[object Object],[object Object],[object Object]
Protein ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
India Ink Preparation ,[object Object],[object Object]
Lactic Acid ,[object Object],[object Object],[object Object]
Antigen Detection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antigen Detection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Antigen Detection ,[object Object],[object Object]
Neuroimaging Technique ,[object Object],[object Object],[object Object]
TB or Crypto meningeal involvement
MRI  in  HSV
Sporadic Herpes Simplex Encephalitis Fulminant hemorrhagic and necrotizing meningoencephalitis
Additional Investigation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Differential Consideration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Differential Consideration ,[object Object],[object Object],[object Object],[object Object]
Differential Consideration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management Differential Consideration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prehospital care ,[object Object],[object Object]
Assessment and stabilization ,[object Object],[object Object],[object Object]
Definitive Therapy Assessment and stabilization ,[object Object],[object Object],[object Object]
Bacterial meningitis
Empirical ATB for Bacterial meningitis
ATB for bacterial meningitis from Gram’s stain or Culture
ระยะเวลาในการให้ยาปฏิชีวนะใน  Bacterial meningitis
Bacterial meningitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Viral meningitis ,[object Object],[object Object],[object Object]
Viral encephalitis  ,[object Object],[object Object],[object Object]
TB meningitis ,[object Object]
Fungal meningitis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Chemoprophylaxis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemoprophylaxis ,[object Object],[object Object],[object Object]
Immunoprophylaxis ,[object Object],[object Object]
Important ! ,[object Object],[object Object]
END Have Any question ?

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Meningitis