Bacterial meningitis pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Pathophysiology

Pathogenensis of bacterial meningitis is a complex process which may occur due to imbalance between the host immune response and virulence factors of pathogen causing infection. Following steps may explain the underlying process in a comprehensive way:

Transmission

• H. influenza type b and N. meningitides may be transmitted by close contact or prolong contact with patient suffering from meningitis
• It may also spread by exchanging throat and respiratory secretions (couging and kissing)
• Listeria monocytogenes may spread by eating contaminated food.
• Most people are carriers and do not develop the disease.

Colonization and evasion of host immune response

• Colonization of pathogenic organism involves evasion of host immune response mechanism.
• IgA protease produced by bacterial pathogen cleave mucosal IgA antibodies which prevent the bacteria from attachment to the mucosal surface.
• Once host immune response is evaded, bacteria attach themselves to the mucosa via fimbriae or pilli which facilitate colonization process.

Invasion and seeding

• Once colonized, the invasion of bacteria occurs via special adhesion proteins called adhesins.
• Adhesins may help bacteria to cross epithelial barrier intracellularly or intercellularly.

References

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