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Encyclopedia > Meningitis
Meningitis
Classification & external resources
Meninges of the central nervous system: dura mater, arachnoid, and pia mater.
ICD-10 G00.-G03.
ICD-9 320-322
DiseasesDB 22543
MedlinePlus 000680
eMedicine med/2613  emerg/309 emerg/390
MeSH D008581

Meningitis is the inflammation of the protective membranes covering the central nervous system, known collectively as the meninges. Meningitis may develop in response to a number of causes, including infectious agents, physical injury, cancer, or certain drugs. While some forms of meningitis are mild and resolve on their own, meningitis is a potentially serious condition owing to the proximity of the inflammation to the brain and spinal cord. The potential for serious neurologic damage or even death necessitates prompt medical attention and evaluation. Infectious meningitis, the most common form, is typically treated with antibiotics and requires close observation. Image File history File links No higher resolution available. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... A diagram showing the CNS: 1. ... The meninges (singular meninx) are the system of membranes that envelop the central nervous system. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Staphylococcus aureus - Antibiotics test plate. ...

Contents

Signs and symptoms

Headache is the most common symptom of meningitis (87 percent) followed by nuchal rigidity ("neck stiffness", 83 percent). The classic triad of diagnostic signs consists of nuchal rigidity (being unable to flex the neck forward), fever and altered mental status. All three features are present in only 44% of all cases of infectious meningitis.[1] Other signs commonly associated with meningitis are photophobia (inability to tolerate bright light), phonophobia (inability to tolerate loud noises), irritability and delirium (in small children) and seizures (in 20-40% of cases). In infants (0-6 months), swelling of the fontanelle (soft spot) may be present. Meningism is the triad of nuchal rigidity, photophobia (intolerance of bright light) and headache. ... This article needs additional references or sources for verification. ... Photophobia (also light sensitivity) or fear of light, is a symptom of excessive sensitivity to light and the aversion to sunlight or well-lit places. ... The English suffix -phobia is technically used to describe irrational, disabling fear as a mental disorder, and commonly misused to describe hatred of a particular thing or subject. ... Irritability is an excessive response to stimuli. ... This article is about the mental state and medical condition. ... This article is about epileptic seizures. ... In human anatomy, a fontanelle (or fontanel) is one of two soft spots on a newborn humans skull. ...


Nuchal rigidity is typically assessed with the patient lying supine, and both hips and knees flexed. If pain is elicited when the knees are passively extended (Kernig's sign), this indicates nuchal rigidity and meningitis. In infants, forward flexion of the neck may cause involuntary knee and hip flexion (Brudzinski's sign). Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are uncertain.[2] The supine position is a position of the body; lying down with the face up, as opposed to the prone position, which is face down. ... Meningism is the triad of nuchal rigidity, photophobia (intolerance of bright light) and headache. ... Meningism is the triad of nuchal rigidity, photophobia (intolerance of bright light) and headache. ...


In "meningococcal" meningitis (i.e. meningitis caused by the bacteria Neisseria meningitidis), a rapidly-spreading petechial rash is typical, and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet. Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... Purpura is the appearance of purple discolorations on the skin caused by bleeding underneath the skin. ...


Diagnosis

Investigations

The suspicion of meningitis is generally based on the nature of the symptoms and findings on physical examination. Meningitis is a medical emergency, and referral to hospital is indicated. If meningitis is suspected based on clinical examination, early administration of antibiotics is recommended, as the condition may deteriorate rapidly. In the hospital setting, initial management consists of stabilization (e.g. securing the airway in a depressed level of consciousness, administration of intravenous fluids in hypotension or shock), followed by antibiotics if not already administered. In medicine, the physical examination or clinical examination is the process by which the physician investigates the body of a patient for signs of disease. ... {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... Staphylococcus aureus - Antibiotics test plate. ... The airways are those parts of the respiratory system through which air flows, to get from the external environment to the alveoli. ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... This article is about the medical condition. ...


Investigations include blood tests (electrolytes, liver and kidney function, inflammatory markers and a complete blood count) and usually X-ray examination of the chest. The most important test in identifying or ruling out meningitis is analysis of the cerebrospinal fluid (fluid that envelops the brain and the spinal cord) through lumbar puncture (LP). However, if the patient is at risk for a cerebral mass lesion or elevated intracranial pressure (recent head injury, a known immune system problem, localizing neurological signs, or evidence on examination of a raised ICP), a lumbar puncture may be contraindicated because of the possibility of fatal brain herniation. In such cases a CT or MRI scan is generally performed prior to the lumbar puncture to exclude this possibility. Otherwise, the CT or MRI should be performed after the LP, with MRI preferred over CT due to its superiority in demonstrating areas of cerebral edema, ischemia, and meningeal inflammation. Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Schematics of shorthand for complete blood count commonly used by physicians. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ... A patient undergoes a lumbar puncture at the hands of a neurologist. ... Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ... Herniation, a deadly side effect of very high intracranial pressure, occurs when the brain shifts across structures within the skull. ... negron305 Cat scan redirects here. ... “MRI” redirects here. ...


During the lumbar puncture procedure, the opening pressure is measured. A pressure of over 180 mmH2O is indicative of bacterial meningitis.


The cerebrospinal fluid (CSF) sample is examined for white blood cells (and which subtypes), red blood cells, protein content and glucose level. Gram staining of the sample may demonstrate bacteria in bacterial meningitis, but absence of bacteria does not exclude bacterial meningitis; microbiological culture of the sample may still yield a causative organism. The type of white blood cell predominantly present predicts whether meningitis is due to bacterial or viral infection. Other tests performed on the CSF sample include latex agglutination test, limulus lysates, or polymerase chain reaction (PCR) for bacterial or viral DNA. If the patient is immunocompromised, testing the CSF for toxoplasmosis, Epstein-Barr virus, cytomegalovirus, JC virus and fungal infection may be performed. Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ... “White Blood Cells” redirects here. ... “Red cell” redirects here. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Glucose (Glc), a monosaccharide (or simple sugar), is an important carbohydrate in biology. ... Gram-positive anthrax bacteria (purple rods) in cerebrospinal fluid sample. ... A microbiological culture is a way to determine the cause of infectious disease by letting the agent multiply (reproduce) in predetermined media. ... This article is about biological infectious particles. ... A latex fixation test (or latex agglutination test) is an agglutination technique used to detect antibodies, such as those produced in response to the rubella virus or the rheumatoid factor. ... “PCR” redirects here. ... In medicine, immune deficiency (or immunodeficiency) is a state where the immune system is incapable of defending the organism from infectious disease. ... The Epstein-Barr virus (EBV), also called Human herpesvirus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and is one of the most common viruses in humans. ... Species see text Cytomegalovirus (CMV) (from the Greek cyto-, cell, and -mega-, large) is a viral genus of the Herpesviruses group: in humans it is commonly known as human herpesvirus 5 (HHV-5). ... The JC virus (JCV) is a type of human polyomavirus (formerly known as papovavirus) and is genetically similar to BK virus and SV40. ... Divisions Chytridiomycota Zygomycota Ascomycota Basidiomycota The Fungi (singular: fungus) are a large group of organisms ranked as a kingdom within the Domain Eukaryota. ...

CSF finding in different conditions[3]
Condition Glucose Protein Cells
Acute bacterial meningitis Low high high, often > 300/mm³
Acute viral meningitis Normal normal or high mononuclear, < 300/mm³
Tuberculous meningitis Low high pleocytosis, mixed < 300/mm³
Fungal meningitis Low high < 300/mm³
Malignant meningitis Low high usually mononuclear
Subarachnoid haemorrhage Normal normal, or high Erythrocytes
An autopsy demonstrating signs of pneumococcal meningitis. The forceps (center) are retracting the dura mater (white). Underneath the dura mater are the leptomeninges, which are edematous and have multiple small hemorrhagic foci (red).
An autopsy demonstrating signs of pneumococcal meningitis. The forceps (center) are retracting the dura mater (white). Underneath the dura mater are the leptomeninges, which are edematous and have multiple small hemorrhagic foci (red).

In bacterial meningitis, the CSF glucose to serum glucose ratio is < 0.4. The Gram stain is positive in >60% of cases, and culture in >80%. Latex agglutination may be positive in meningitis due to Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli, Group B Streptococci. Limulus lysates may be positive in Gram-negative meningitis. A scanning electron microscope (SEM) image of a single human lymphocyte. ... Pleocytosis is a term used to describe a condition of increased white blood cell count in a bodily fluid, such as cerebrospinal fluid (CSF), indicative of an inflammatory, infectious, or malignant condition. ... Human red blood cells Red blood cells are the most common type of blood cell and are the vertebrate bodys principal means of delivering oxygen to body tissues via the blood. ... Image File history File links Size of this preview: 402 × 599 pixel Image in higher resolution (700 × 1043 pixel, file size: 123 KB, MIME type: image/jpeg) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Inflammation ... Image File history File links Size of this preview: 402 × 599 pixel Image in higher resolution (700 × 1043 pixel, file size: 123 KB, MIME type: image/jpeg) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Inflammation ... Post-mortem, postmortem and post mortem redirect here. ... Binomial name Streptococcus pneumoniae Streptococcus pneumoniae is a species of Streptococcus that is a major human pathogen. ... Plastic forceps are intended to be disposable Forceps are a handheld, hinged instrument used for grasping and holding objects. ... The dura mater (from the Latin hard mother), or pachymeninx, is the tough and inflexible outermost of the three layers of the meninges surrounding the brain. ... In medicine, leptomeninges is a term used to refer to the pia mater and arachnoid mater. ... This page is about the condition called edema. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Binomial name (Klein 1884) Chester 1901 Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus bacterium and a member of the genus Streptococcus. ... Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... E. coli redirects here. ...


Cultures are often negative if CSF is taken after the administration of antibiotics. In these patients, PCR can be helpful in arriving at a diagnosis. It has been suggested that CSF cortisol measurement may be helpful.[4] “PCR” redirects here. ... Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ...


Prediction rules

The Bacterial Meningitis Score predicts reliably whether a child (older than two months) may have infectious meningitis. In children with at least 1 risk factor (positive CSF Gram stain, CSF absolute neutrophil count ≥ 1000 cell/µL, CSF protein ≥ 80 mg/dL, peripheral blood absolute neutrophil count ≥ 10,000 cell/µL, history of seizure before or at presentation time) it had a sensitivity of 100%, specificity of 63.5%, and negative predictive value of 100%.[5] The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ... The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. ...


Causes

Most cases of meningitis are caused by microorganisms, such as viruses, bacteria, fungi, or parasites, that spread into the blood and into the cerebrospinal fluid (CSF).[6] Non-infectious causes include cancers, systemic lupus erythematosus and certain drugs. The most common cause of meningitis is viral, and often runs its course within a few days. Bacterial meningitis is the second most frequent type and can be serious and life-threatening. Numerous microorganisms may cause bacterial meningitis, but Neisseria meningitidis ("meningococcus") and Streptococcus pneumoniae ("pneumococcus") are the most common pathogens in patients without immune deficiency, with meningococcal disease being more common in children. Staphylococcus aureus may complicate neurosurgical operations, and Listeria monocytogenes is associated with poor nutritional state and alcoholicism. Haemophilus influenzae (type B) incidence has been much reduced by immunization in many countries. Mycobacterium tuberculosis (the causative agent of tuberculosis) rarely causes meningitis in Western countries but is common and feared in countries where tuberculosis is endemic. A microorganism or microbe is an organism that is so small that it is microscopic (invisible to the naked eye). ... Stop editing pages god ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... Divisions Chytridiomycota Zygomycota Ascomycota Basidiomycota The Fungi (singular: fungus) are a large group of organisms ranked as a kingdom within the Domain Eukaryota. ... A parasite is an organism that spends a significant portion of its life in or on the living tissue of a host organism and which causes harm to the host without immediately killing it. ... Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Many drugs are provided in tablet form. ... Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... Binomial name (Klein 1884) Chester 1901 Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus bacterium and a member of the genus Streptococcus. ... Binomial name Rosenbach 1884 Staphylococcus aureus , literally Golden Cluster Seed and also known as golden staph, is the most common cause of staph infections. ... Binomial name Murray (1926) Listeria monocytogenes is a Gram-positive bacterium, in the division Firmicutes, named for Joseph Lister. ... Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... Binomial name Zopf 1883 Mycobacterium tuberculosis is the bacterium that causes most cases of tuberculosis. ... Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ...


Treatment

Bacterial meningitis

Bacterial meningitis is a medical emergency and has a high mortality rate if untreated.[7] All suspected cases, however mild, need emergency medical attention. Empiric antibiotics must be started immediately, even before the results of the lumbar puncture and CSF analysis are known. Antibiotics started within 4 hours of lumbar puncture will not significantly affect lab results. Adjuvant treatment with corticosteroids reduces rates of mortality, severe hearing loss and neurological sequelae.[8] {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... A patient undergoes a lumbar puncture at the hands of a neurologist. ... Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ...

Age group Causes
Neonates Group B Streptococci, Escherichia coli, Listeria monocytogenes
Infants Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae
Children N. meningitidis, S. pneumoniae
Adults S. pneumoniae, N. meningitidis, Mycobacteria, Cryptococci

The choice of antibiotic depends on local advice. In most of the developed world, the most common organisms involved are Streptococcus pneumoniae and Neisseria meningitidis: first line treatment in the UK is a third-generation cephalosporin (such as ceftriaxone or cefotaxime). In those under 3 years of age, over 50 years of age, or immunocompromised, ampicillin should be added to cover Listeria monocytogenes. In the U.S. and other countries with high levels of penicillin resistance, the first line choice of antibiotics is vancomycin and a carbapenem (such as meropenem). In sub-Saharan Africa, oily chloramphenicol or ceftriaxone are often used because only a single dose is needed in most cases. A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... E. coli redirects here. ... Binomial name Murray (1926) Listeria monocytogenes is a Gram-positive bacterium, in the division Firmicutes, named for Joseph Lister. ... Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... Binomial name (Klein 1884) Chester 1901 Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus bacterium and a member of the genus Streptococcus. ... Binomial name (Klein 1884) Chester 1901 Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus bacterium and a member of the genus Streptococcus. ... Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... The cephalosporins, are a class of β-lactam antibiotics. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. ... Binomial name Murray (1926) Listeria monocytogenes is a Gram-positive bacterium, in the division Firmicutes, named for Joseph Lister. ... Crystal structure of a short peptide L-Lys-D-Ala-D-Ala (bacterial cell wall precursor, in green) bound to vancomycin (blue) through hydrogen bonds. ... Carbapenems are a class of beta-lactam antibiotics. ... Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. ... A political map showing national divisions in relation to the ecological break (Sub-Saharan Africa in green) A geographical map of Africa, showing the ecological break that defines the sub-Saharan area Sub-Saharan Africa is the term used to describe the area of the African continent which lies south... Chloramphenicol is a bacteriostatic antibiotic originally derived from the bacterium Streptomyces venezuelae, isolated by David Gottlieb, and introduced into clinical practice in 1949. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ...


Staphylococci and gram-negative bacilli are common infective agents in patients who have just had a neurosurgical procedure. Again, the choice of antibiotic depends on local patterns of infection: cefotaxime and ceftriaxone remain good choices in many situations, but ceftazidime is used when Pseudomonas aeruginosa is a problem, and intraventricular vancomycin is used for those patients with intraventricular shunts because of high rates of staphylococcal infection. In patients with intracerebral prosthetic material (metal plates, electrodes or implants, etc.) then sometimes chloramphenicol is the only antibiotic that will adequately cover infection by Staphylococcus aureus (cephalosporins and carbapenems are inadequate under these circumstances). Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Ceftazidime is an antibiotic which eliminates bacteria that cause many kinds of infections, including lung, skin, bone, joint, stomach, blood, gynecological, and urinary tract infections. ... Binomial name Pseudomonas aeruginosa (Schroeter 1872) Migula 1900 Synonyms Bacterium aeruginosum Schroeter 1872 Bacterium aeruginosum Cohn 1872 Micrococcus pyocyaneus Zopf 1884 Bacillus aeruginosus (Schroeter 1872) Trevisan 1885 Bacillus pyocyaneus (Zopf 1884) Flügge 1886 Pseudomonas pyocyanea (Zopf 1884) Migula 1895 Bacterium pyocyaneum (Zopf 1884) Lehmann and Neumann 1896 Pseudomonas polycolor... Crystal structure of a short peptide L-Lys-D-Ala-D-Ala (bacterial cell wall precursor, in green) bound to vancomycin (blue) through hydrogen bonds. ... Species S. aureus S. caprae S. epidermidis S. haemolyticus S. hominis S. lugdunensis S. pettenkoferi S. saprophyticus S. warneri S. xylosus Staphylococcus (in Greek staphyle means bunch of grapes and coccos means granule) is a genus of Gram-positive bacteria. ... Chloramphenicol is a bacteriostatic antibiotic originally derived from the bacterium Streptomyces venezuelae, isolated by David Gottlieb, and introduced into clinical practice in 1949. ... Binomial name Rosenbach 1884 Staphylococcus aureus , literally Golden Cluster Seed and also known as golden staph, is the most common cause of staph infections. ...


Once the results of the CSF analysis are known along with the Gram-stain and culture, empiric therapy may be switched to therapy targeted to the specific causative organism and its sensitivities. [citation needed]

Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... For the Japanese rock band, see Penicillin (band). ... Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Rifampicin (INN) or rifampin (USAN) is an antibiotic drug of the rifamycin group. ... Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro, Ciproxin and Ciprobay (and other brand names in other markets, e. ... Azithromycin is an azalide, a subclass of macrolide antibiotics. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Binomial name (Klein 1884) Chester 1901 Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus bacterium and a member of the genus Streptococcus. ... For the Japanese rock band, see Penicillin (band). ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Crystal structure of a short peptide L-Lys-D-Ala-D-Ala (bacterial cell wall precursor, in green) bound to vancomycin (blue) through hydrogen bonds. ... Binomial name Murray (1926) Listeria monocytogenes is a Gram-positive bacterium, in the division Firmicutes, named for Joseph Lister. ... Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. ... Gentamicin is an aminoglycoside antibiotic, and can treat many types of bacterial infections, particularly Gram-negative infection. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Binomial name Pseudomonas aeruginosa (Schroeter 1872) Migula 1900 Synonyms Bacterium aeruginosum Schroeter 1872 Bacterium aeruginosum Cohn 1872 Micrococcus pyocyaneus Zopf 1884 Bacillus aeruginosus (Schroeter 1872) Trevisan 1885 Bacillus pyocyaneus (Zopf 1884) Flügge 1886 Pseudomonas pyocyanea (Zopf 1884) Migula 1895 Bacterium pyocyaneum (Zopf 1884) Lehmann and Neumann 1896 Pseudomonas polycolor... Ceftazidime is an antibiotic which eliminates bacteria that cause many kinds of infections, including lung, skin, bone, joint, stomach, blood, gynecological, and urinary tract infections. ... Binomial name Rosenbach 1884 Staphylococcus aureus , literally Golden Cluster Seed and also known as golden staph, is the most common cause of staph infections. ... Nafcillin sodium is an beta-lactam antibiotic related to penicillin. ... Crystal structure of a short peptide L-Lys-D-Ala-D-Ala (bacterial cell wall precursor, in green) bound to vancomycin (blue) through hydrogen bonds. ... Streptococcus agalactiae is a gram-positive streptococcus characterized by the presence of group B Lancefield antigen. ... For the Japanese rock band, see Penicillin (band). ... Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. ... Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ...

Viral meningitis

Unlike bacteria, viruses cannot be killed by antibiotics. Patients with very mild viral meningitis may only have to spend a few hours in a hospital, while those who have a more serious infection may be hospitalised for many more days for supportive care. Patients with mild cases, which often cause only flu-like symptoms, may be treated with fluids, bed rest (preferably in a quiet, dark room), and analgesics for pain and fever. Serious cases, especially in the case of young children or neonates, may require the use of antiviral drugs, such as acyclovir. The physician may also prescribe anticonvulsants such as phenytoin to prevent seizures and corticosteroids to reduce brain inflammation. If inflammation is severe, pain medicine and sedatives may be prescribed to make the patient more comfortable. Aciclovir (INN) or aciclovir (USAN), marketed as Zovirax®, is one of the main antiviral drugs. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... This article is about epileptic seizures. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ...


Fungal meningitis

This form of meningitis is rare in otherwise healthy people, but is a higher risk in those who have AIDS, other forms of immunodeficiency (an immune system that does not respond adequately to infections) and immunosuppression (immune system malfunction as a result of medical treatment). In AIDS, Cryptococcus neoformans is the most common cause of fungal meningitis; it requires Indian ink staining of the CSF sample for identification of this capsulated yeast. Fungal meningitis is treated with long courses of highly dosed antifungals.[9] For other uses, see AIDS (disambiguation). ... In medicine, immune deficiency (or immunodeficiency) is a state where the immune system is incapable of defending the organism from infectious disease. ... Immunosuppression is the medical suppression of the immune system. ... Cryptococcus neoformans is an encapsulated yeastlike fungus that can live in both plants and animals. ... Indian ink (or India ink in American English) is a simple black ink once widely used for writing and printing, and now more commonly used for drawing, especially when inking comics. ... An antifungal drug is medication used to treat fungal infections such as athletes foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. ...


Complications

In children there are several potential disabilities which result from damage to the nervous system. These include sensorineural hearing loss, epilepsy, diffuse brain swelling, hydrocephalus, cerebral vein thrombosis, intra cerebral bleeding and cerebral palsy.[10] Acute neurological complications may lead to adverse consequences. In childhood acute bacterial meningitis deafness is the most common serious complication. Sensorineural hearing loss often develops during first few days of the illness as a result of inner ear dysfunction, but permanent deafness is rare and can be prevented by prompt treatment of meningitis.[11] Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the vestibulocochlear nerve (Cranial nerve VIII), the inner ear, or central processing centers of the brain. ... Cerebral edema is swelling of the brain which can occur as the result of a head injury, cardiac arrest or from the lack of proper altitude acclimatization. ... This article needs cleanup. ... This article or section is in need of attention from an expert on the subject. ... Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the vestibulocochlear nerve (Cranial nerve VIII), the inner ear, or central processing centers of the brain. ... Inner ear The inner ear is the bony labyrinth, a system of passages comprising two main functional parts: the organ of hearing, or cochlea and the vestibular apparatus, the organ of balance that consists of three semicircular canals and the vestibule. ...


Those that contract the disease during the neonatal period and those infected by S pneumoniae and gram negative bacilli are at greater risk of developing neurological, auditory, or intellectual impairments or functionally important behaviour or learning disorders which can manifest as poor school performance.[12] A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... Orders Bacillales Lactobacillales The term bacilli (singular bacillus) is used to refer to any rod-shaped bacteria. ...


In adults central nervous system complications include cerebrovascular disease, brain swelling, hydrocephalus, intracerebral bleeding; systemic complications are dominated by septic shock, adult respiratory distress syndrome and disseminated intravascular coagulation.[13] Those who have underlying predisposing conditions e.g. head injury may develop recurrent meningitis.[14] Case-fatality ratio is highest for gram-negative etiology and lowest for meningitis caused by H influenzae (also a gram negative bacili). Fatal outcome in patients over 60 years of age are more likely to be from systemic complications e.g. pneumonia, sepsis, cardio-respiratory failure; however in younger individuals it is usually associated with neurological complications.[14] Age more than 60, low glasgow coma scale at presentation and seizure within 24 hours increase the risk of death among community acquired meningitis.[15] A diagram showing the CNS: 1. ... Cerebrovascular disease is damage to the blood vessels in the brain, resulting in a stroke. ... Shock is a serious medical condition where the tissue perfusion is insufficient to meet the required supply of oxygen and nutrients. ... Disseminated intravascular coagulation (DIC) is a pathological process in the body where the blood starts to coagulate throughout the whole body. ... In epidemiology, case fatality (CF) refers the rate of death among people who already have a condition. ... Bacteria that are Gram-negative are not stained dark blue or violet by Gram staining, in contrast to Gram-positive bacteria. ... This article is about the medical term. ... Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... This article is about human pneumonia. ... Sepsis (in Greek Σήψις, putrefaction) is a serious medical condition, resulting from the immune response to a severe infection. ... The Glasgow Coma Scale is a neurological scale which seems to give a reliable, objective way of recording the conscious state of a person, for initial as well as continuing assessment. ... This article is about epileptic seizures. ...


Prevention

Immunization

All current vaccines target only bacterial meningitis.


Vaccinations against Haemophilus influenzae (Hib) have decreased early childhood meningitis significantly.[16] Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... Haemophilus influenzae type B vaccine (Hib vaccine) is a conjugate vaccine developed for the prevention of invasive disease caused by Haemophilus influenzae type B bacteria. ...


Vaccines against type A and C Neisseria meningitidis, the kind that causes most disease in preschool children and teenagers in the United States, have also been around for a while. Type A is also prevalent in sub-Sahara Africa and W135 outbreaks have affected those on the Hajj pilgrimage to Mecca. Binomial name Neisseria meningitidis Albrecht & Ghon, 1901 Neisseria meningitidis, also simply known as meningococcus is a gram-negative bacterium best known for its role in meningitis. ... A supplicating pilgrim at Masjid Al Haram, the mosque which was built around the Kaaba (the cubical building at center). ... This article is about the city in Saudi Arabia. ...


A vaccine called MeNZB for a specific strain of type B Neisseria meningitidis prevalent in New Zealand has completed trials and is being given to many people in the country under the age of 20. There is also a vaccine, MenBVac, for the specific strain of type B meningoccocal disease prevalent in Norway, and another specific vaccine for the strain prevalent in Cuba. MeNZB is a vaccine against a specific strain of group B meningococcus, currently being used to control an epidemic of meningococcal disease in New Zealand. ...


Pneumococcal polysaccharide vaccine against Streptococcus pneumoniae is recommended for all people 65 years of age or older. Pneumococcal conjugate vaccine is recommended for all newborns starting at 6 weeks - 2 months, according to American Association of Pediatrics (AAP) recommendations. Pneumococcal polysaccharide vaccine (PPV), also known as Pneumovax, is a vaccine used to prevent Streptococcus pneumoniae (pneumococcus) infections such as pneumonia and septicaemia. ... Binomial name (Klein 1884) Chester 1901 Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic diplococcus bacterium and a member of the genus Streptococcus. ... Pneumococcal polysaccharide vaccine (PPV), also known as Pneumovax, is a vaccine used to prevent Streptococcus pneumoniae (pneumococcus) infections such as pneumonia and septicaemia. ...


Prophylaxis

In cases of meningococcal meningitis, prophylactic treatment of close relatives with antibiotics (e.g. rifampicin, ciprofloxacin or ceftriaxone) may reduce the risk of further cases.[17] Rifampicin (INN) (IPA: ) or rifampin (USAN) is a bacteriocidal antibiotic drug of the rifamycin group. ... Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro, Ciproxin and Ciprobay (and other brand names in other markets, e. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ...


Epidemiology

Demography of meningococcal meningitis. Red: meningitis belt, orange: epidemic meningitis, grey: sporadic cases
Demography of meningococcal meningitis. Red: meningitis belt, orange: epidemic meningitis, grey: sporadic cases

Meningitis can affect anyone in any age group, from the newborn to the elderly. Image File history File links Size of this preview: 800 × 370 pixelsFull resolution (1357 × 628 pixel, file size: 29 KB, MIME type: image/png) ♦ Ceinture méningitique (Meningitis belt) ♦ Zones endémique (epidemic zones) ♦ Zones endémosporadique (sporadic cases) File historyClick on a date/time to view the file as... Image File history File links Size of this preview: 800 × 370 pixelsFull resolution (1357 × 628 pixel, file size: 29 KB, MIME type: image/png) ♦ Ceinture méningitique (Meningitis belt) ♦ Zones endémique (epidemic zones) ♦ Zones endémosporadique (sporadic cases) File historyClick on a date/time to view the file as... Neisseria is a genus of bacteria, included among the proteobacteria, a large group of gram-negative forms. ...


The "Meningitis Belt" is an area in sub-Saharan Africa which stretches from Senegal in the west to Ethiopia in the east in which large epidemics of meningococcal meningitis occur (this largely coincides with the Sahel region). It contains an estimated total population of 300 million people. The largest epidemic outbreak was in 1996, when over 250,000 cases occurred and 25,000 people died as a consequence of the disease. A political map showing national divisions in relation to the ecological break (Sub-Saharan Africa in green) A geographical map of Africa, showing the ecological break that defines the sub-Saharan area Sub-Saharan Africa is the term used to describe the area of the African continent which lies south... This article or section is in need of attention from an expert on the subject. ...


History

Meningitis may have been described in the Middle Ages, but it was first accurately identified by the Swiss Vieusseux (a scientific-literary association) during an outbreak in Geneva, Switzerland in 1805. The Middle Ages formed the middle period in a traditional schematic division of European history into three ages: the classical civilization of Antiquity, the Middle Ages, and modern times, beginning with the Renaissance. ... Giovan Pietro Vieusseux The Gabinetto Scientifico Letterario G.P. Vieusseux, founded in 1819 by Giovan Pietro Vieusseux, a merchant from Geneva, is a library in Florence, Italy. ... Geneva (pronunciation //; French: Genève //, German:   //, Italian: Ginevra //, Romansh: Genevra) is the second most populous city in Switzerland (after Zürich), and is the most populous city of Romandy (the French-speaking part of Switzerland). ...


In the 19th century, meningitis was a scourge of the Japanese imperial family, playing the largest role in the horrendous pre-maturity death rate the family endured. In the mid-1800s, only the Emperor Kōmei and two of his siblings reached maturity out of fifteen total children surviving birth. Kōmei's son, the Emperor Meiji, was one of two survivors out of Kōmei's six children, including an elder brother of Meiji who would have taken the throne had he lived to maturity. Five of Meiji's 15 children survived, including only his third son, Emperor Taishō, who was feeble-minded, perhaps as a result of having contracted meningitis himself. By Emperor Hirohito's generation the family was receiving modern medical attention. As the focal point of tradition in Japan, during the Tokugawa Shogunate the family was denied modern "Dutch" medical treatment then in use among the upper caste; despite extensive modernization during the Meiji Restoration the Emperor insisted on traditional medical care for his children. Emperor Akihito and Empress Michiko of Japan. ... Emperor Kōmei of Japan Emperor Kōmei ) (July 22, 1831 - January 30, 1867) was the 121st imperial ruler of Japan, according to the traditional order of succession. ... Emperor Meiji ) (November 3, 1852 — July 30, 1912) was the 122nd emperor of Japan according to the traditional order of succession, reigning from February 3, 1867 until his death. ... Emperor Taisho (大正天皇 Taishō Tennō) (August 31, 1879 – December 25, 1926), whose given name was Yoshihito (嘉仁), was the 123rd imperial ruler of Japan, according to the traditional order of succession, from 1912 until his death in 1926. ... Feeble-minded was a term used from the late 19th century through the early 20th century to loosely describe a variety of mental deficiencies, including what would now be considered mental retardation in its various types and grades, and learning disabilities such as dyslexia. ... Emperor Shōwa ) (April 29, 1901 – January 7, 1989) was the 124th emperor of Japan according to the traditional order of succession, reigning from December 25, 1926 until his death in 1989. ... The Tokugawa shogunate or Tokugawa bakufu (徳川幕府) (also known as the Edo bakufu) was a feudal military dictatorship of Japan established in 1603 by Tokugawa Ieyasu and ruled by the shoguns of the Tokugawa family until 1868. ... The Meiji Restoration ), also known as the Meiji Ishin, Revolution, or Renewal, was a chain of events that led to enormous changes in Japans political and social structure. ... Kampō (or Kanpō , 漢方) medicine is the Japanese study and adaptation of Chinese medicine. ...


See also

Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. ... Maurice Ralph Hilleman, (August 30, 1919 &#8211; April 11, 2005), was an American microbiologist who specialized in vaccinology and developed more than three dozen vaccines, more than any other scientist. ...

References

  1. ^ van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M (2004). "Clinical features and prognostic factors in adults with bacterial meningitis". N. Engl. J. Med. 351 (18): 1849-59. doi:10.1056/NEJMoa040845. PMID 15509818. 
  2. ^ Thomas KE, Hasbun R, Jekel J, Quagliarello VJ (2002). "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis". Clin. Infect. Dis. 35 (1): 46-52. PMID 12060874. 
  3. ^ Provan, Drew; Andrew Krentz (2005). Oxford Handbook of clinical and laboratory investigation. Oxford: Oxford university press. ISBN 0198566638. 
  4. ^ Holub M, Beran O, Dzupova O, et al. (2007). "Cortisol levels in cerebrospinal fluid correlate with severity and bacterial origin of meningitis". Critical Care 11: R41. doi:10.1186/cc5729. 
  5. ^ Nigrovic LE, Kuppermann N, Macias CG, et al (2007). "Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis". JAMA 297 (1): 52-60. doi:10.1001/jama.297.1.52. PMID 17200475. 
  6. ^ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology, 4th ed., McGraw Hill, 876–9. ISBN 0838585299. 
  7. ^ Beckham J, Tyler K (2006). "Initial Management of Acute Bacterial Meningitis in Adults: Summary of IDSA Guidelines". Rev Neurol Dis 3 (2): 57-60. PMID 16819421. 
  8. ^ van de Beek D, de Gans J, McIntyre P, Prasad K (2007). "Corticosteroids for acute bacterial meningitis". Cochrane database of systematic reviews (Online) (1): CD004405. doi:10.1002/14651858.CD004405.pub2. PMID 17253505. 
  9. ^ Gottfredsson M, Perfect JR (2000). "Fungal meningitis". Seminars in neurology 20 (3): 307-22. PMID 11051295. 
  10. ^ Vasallo, G; T R Martland (Jan 2004). "Neurological complications of pneumococcal meningitis". Developmental Medicine and Child Neurology Vol. 46: pg. 11. Retrieved on 2007-09-03. 
  11. ^ Richardson MP, Reid A, Tarlow MJ, Rudd PT (1997). "Hearing loss during bacterial meningitis". Arch. Dis. Child. 76 (2): 134-8. PMID 9068303. 
  12. ^ Grimwood K (2001). "Legacy of bacterial meningitis in infancy. Many children continue to suffer functionally important deficits". BMJ 323 (7312): 523-4. PMID 11546680. 
  13. ^ Pfister HW, Feiden W, Einhäupl KM (1993). "Spectrum of complications during bacterial meningitis in adults. Results of a prospective clinical study". Arch. Neurol. 50 (6): 575-81. PMID 8503793. 
  14. ^ a b Adriani KS, van de Beek D, Brouwer MC, Spanjaard L, de Gans J (2007). "Community-acquired recurrent bacterial meningitis in adults". Clin. Infect. Dis. 45 (5): e46-51. doi:10.1086/520682. PMID 17682979. 
  15. ^ Durand ML, Calderwood SB, Weber DJ, et al (1993). "Acute bacterial meningitis in adults. A review of 493 episodes". N. Engl. J. Med. 328 (1): 21-8. PMID 8416268. 
  16. ^ Peltola H (2000). "Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates". Clin. Microbiol. Rev. 13 (2): 302-17. PMID 10756001. Retrieved on 2007-09-03. 
  17. ^ Fraser A, Gafter-Gvili A, Paul M, Leibovici L (2006). "Antibiotics for preventing meningococcal infections". Cochrane database of systematic reviews (Online) (4): CD004785. doi:10.1002/14651858.CD004785.pub3. PMID 17054214. 

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 246th day of the year (247th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 246th day of the year (247th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links


  Results from FactBites:
 
MedlinePlus Medical Encyclopedia: Meningitis (715 words)
Meningitis is an infection that causes inflammation of the membranes covering the brain and spinal cord.
Meningitis is also caused by fungi, chemical irritation, drug allergies, and tumors.
Meningitis is an important cause of fever in newborn children.
Meningitis (2131 words)
Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord.
In some cases of bacterial meningitis, the bacteria spread directly to the meninges from a severe nearby infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis).
The symptoms of meningitis vary and depend both on the age of the child and on which bacterium or virus is causing the infection.
  More results at FactBites »

 
 

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