Micro Lecture 25 Notes p.611-630

Meningitis: I.V. antibiotics within 15 minutes of reporting to a doctor. What constitutes "reporting to a doctor?" In waiting room 2 hours? Problem: irreversible hearing loss.

Blood/ brain barrier: keeps out antibiotics (like penicillin) except, breached by infectious agent. Sodium vs. potassium forms (K⁺ painful I.V.; condition children not to see doctors)

Meninges (dura, arachnoid, pia mater) can become inflamed. "That's where she lives"; CNS. 1/3 = asymptomatic carriers of meningococci. One man's pathogen= another man's commensal?

Could terrorists spread? Critical issue: don't want to kill yourself (most people). Lincoln, "A man could kill me, so long as he's willing to die also".

Meningococci vs. gonococci: distinguish by ability to ferment maltose. "Get microbiology out of the incubator." Diagnosis must be quick! Save patient, stop epidemic!

Viral (aseptic) meningitis= hopeless, but not nearly so serious. Antibiotics until certain infection not bacterial.

Tetanospasmin, "...does begin to wear off within a (hideous) week". Don't want tetanus!

Botulinum toxin: most poisonous natural substance. Mayor Daley "utterly diluted..." Cosmetic treatments (get rid of wrinkles?!) Antitoxins 1X only (serum sickness).

Rabies: also hideous way to go. What are your chances of dying in agony?

Polio eradication: text, "by the end of 2000." Rotary, latest, "2005".

Mad cow disease. Report yesterday: mouse recovered from prion. How? Eliminate normal protein in transgenic. Cost British billions (why not transmitted by terrorists?) How much is a human life worth? 1/3rd of medical expenditures in last 2 months of life.

Clintons' initiatives failed. 70 year old, 3 terminal diseases, "cure them all."Reason, "I'm out of pocket very little".

Trypanosomiasis: Variant surface glycoproteins frustrate immune assault. Essay: Louise Pearce's mission. Missionary's question, "Why treat if patient only to be reinfected?" Answer, "For a few months of good life."

Pictures on back:

http://www.nlm.nih.gov/medlineplus/ency/article/000680.htm#visualContent

This is a gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenza, one of the most common causes of childhood meningitis (prior to the widespread use of the H. influenza vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenza (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4 and 12 months.

The most common causes of meningitis are viral infections that usually resolve without treatment. However, bacterial infections of the meninges are extremely serious illnesses, and may result in death or brain damage even if treated. Meningitis is also caused by fungi, chemical irritation or drug allergies, and tumors.