
Contents
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Introduction Introduction
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Etiology Etiology
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Epidemiology Epidemiology
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Pathogenesis Pathogenesis
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Blood–Brain Barrier Bacterial Invasion Blood–Brain Barrier Bacterial Invasion
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Central Nervous System Inflammatory Response Central Nervous System Inflammatory Response
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Mediators of Inflammation Mediators of Inflammation
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Cytokines Cytokines
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Matrix Metalloproteinases Matrix Metalloproteinases
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Excitatory Amino Acids and Vasoactive Peptides Excitatory Amino Acids and Vasoactive Peptides
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Oxidative Stress Oxidative Stress
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Neuronal Damage Neuronal Damage
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Pathological Consequences Pathological Consequences
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Cerebral Edema Cerebral Edema
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Neuropathology Neuropathology
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Clinical Presentation Clinical Presentation
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Laboratory Laboratory
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CSF Examination CSF Examination
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Management Management
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Antimicrobial Therapy Antimicrobial Therapy
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Supportive Measures Supportive Measures
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Fluids and Electrolytes Fluids and Electrolytes
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Management of Raised Intracranial Pressure Management of Raised Intracranial Pressure
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Corticosteroid Therapy Corticosteroid Therapy
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Complications Complications
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Prognosis Prognosis
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Conclusions Conclusions
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Future Directions Future Directions
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References References
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144 Acute Bacterial Meningitis
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Published:August 2016
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Abstract
Bacterial meningitis is one of the severest infections in childhood. Neuronal damage in meningitis is largely due to the extensive inflammatory cascade induced by pathogenic bacteria. This chapter discusses the current understanding of the interaction of multitude of factors in the pathogenesis of bacterial meningitis. This includes the mechanisms involved in transcellular traversal of the bacteria, and induction and release of several inflammatory cytokines and chemokines. The management of a child with bacterial meningitis requires meticulous supportive care and timely, appropriate, and adequate antibiotic therapy. The chapter also reviews the current understanding of some important clinical aspects of care of a child with bacterial meningitis.
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