🧠 Nervous System🟢 BasicCentral Nervous System Infections

Pyogenic Meningitis: Pathology

Bacterial pus-forming inflammation of the meninges covering the brain and spinal cord, a serious infection with a typical cerebrospinal fluid picture.

Key points

Pyogenic meningitis is bacterial inflammation of the pia and arachnoid, with a layer of pus made of neutrophils spreading over the surface of the brain.
Common causes vary with age, including Streptococcus pneumoniae, Neisseria meningitidis and, in the newborn, Group B streptococcus and Escherichia coli.
The cerebrospinal fluid is cloudy with many neutrophils, a high protein and a low glucose, which separates it from viral and tuberculous meningitis.
Clinical features come from meningeal irritation: fever, headache, neck stiffness and dislike of light, with a non-blanching rash in meningococcal disease.
Complications include brain swelling, hydrocephalus, cranial nerve palsies, seizures and, if severe, death.

Memory trick

Pyogenic meningitis is neutrophil pus on the brain; CSF is cloudy with high protein, LOW glucose and many neutrophils (unlike viral or TB); fever, stiff neck, photophobia.

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