Bacterial evasion mechanisms to host responses

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Bacterial evasion mechanisms to host responses
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Commonest Meningitis-Causing Bacteria according
to Patient Age
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Signs and symptoms of meningitis in
children          -fever, headache and neck
stiffness, these may be subtle, marked or
associated with Kernig and/or Brudzinskis signs
(present in 50 cases only) -vomiting
(35 cases)        -seizures (30 cases)
-cranial nerve palsies and focal cerebral signs
(10 20 cases) -petechiae are seen in
meningococcal disease with or without meningitis
(this sign should lead any health worker or
parents to rapidly consult a doctor or the
nearest casualty department).
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Laboratory methods of diagnosis. CSF Gram
staining CSF biochemistry (protein, glucose,
chlore) and culture which may take 24 to 48
hours, Latex agglutination test detects
antigens of common pathogens (H. influenzae type
b, S. pneumoniae, N. meningitidis, E. coli K1 and
group B Streptococcus) ? results are available
within 20 30 minutes, but the sensitivity
ranges from 50 to 90 and specificity can be
variable. Blood culture is of great help.
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Basic laboratory requirements for diagnosis.  
- Light microscopy - Gram stain and Ziehl
Nielsen stain - CSF chemistry and culture when
available, -Latex agglutination test is useful
- Other cheap and easily available tests are
needed (32-34).
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Recommended immediate antibiotic treatment for
meningococcal disease in France. Ceftriaxone
50 to 100mg/kg (maximum 1g) to be given I.V or
I.M. or Cefotaxime 50 mg/kg I.V or I.M
(maximum 1g) or Amoxicillin 25 mg/kg I.V
or 50 mg/kg I.M (maximum 1g) The dose is to be
repeated within two hours after the first
injection
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Complications of meningitis in infants and
children.- Hearing loss is the most encountered
sequelae it occurs in 30 cases of S.
pneumoniae meningitis, in 20 of H.
influenzae meningitis, in 10 of N.
meningitidis meningitis. Mental retardation,
seizures, delay in language acquisition, visual
impairment, behavioural problems and
hydrocephalus.