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Infectious Diseases Affecting the Nervous System

Infectious Diseases Affecting the Nervous System

Sample Answer 

Infectious Diseases Affecting the Nervous System

Introduction

The three primary functions of the nervous system (both central and peripheral) include motor, integrative, and sensory (Cowan, 2015). The sensory receptors execute the sensory function by producing the impulses that are transferred to the CNS (central nervous system), where integration and translation into thoughts/sensations occur. These drive the motor functions. The spinal cord and the brain are made of neurons (also called nerve fibers or nerve cells) that transmit and process information. Other important components of the nervous system include the meninges (a tough casing that encloses the soft tissues of the spinal cord/brain), the cerebrospinal fluid (which nourishes the spinal cord and the brain), nerves, and ganglia (Chretien, Wong, & Sharer, 2020). Even though the nervous system has a range of normal biota (such as herpes simplex), the entry of certain foreign microorganisms can sometimes result in diseases and infections. Therefore, this paper will specifically focus on some of the frequent or widespread infections/illnesses that affect the nervous system, including the causative agents, modes of transmission, symptoms, diagnostic techniques, and treatment/preventive measures.

Infections/Diseases that Affect the Nervous System

Meningitis

Meningitis, or inflammation/swelling of the meninges, is one of the few frequent illnesses of the nervous system. Several microorganisms (bacteria, viruses, and fungi) have been found to affect the meninges and, subsequently, cause inflammation. Usually, all these microorganisms produce a similar set of symptoms/signs. In most instances, bacteria have been found to cause the most severe and serious varieties of meningitis, even though their entry into the central nervous system is mostly facilitated by either the presence of respiratory viruses in the past or co-infection (Cowan, 2015).

General Symptoms. Regardless of the causative agent, meningitis is characterized by the following primary symptoms: vomiting, nausea, fever, stiff or painful neck, and headache. In most instances, the early indications of meningitis are mistaken for flu signs (Cowan, 2015). Sometimes, photophobia may be present, while rashes might appear in certain forms of meningitis. When examined under a microscope, meningitis might be characterized by elevated levels of leucocytes in the cerebrospinal fluid.

General Diagnosis and Treatment. The primary diagnostic test of meningitis involves performing a lumbar puncture to collect the cerebrospinal fluid (CSF) from the CNS. The CSF is usually taken to the laboratory and examined using culture or Gram staining techniques (Cowan, 2015). The common treatment measures for meningitis entail a string of antibacterial interventions. However, physicians sometimes might change the treatment modality after performing confirmatory or additional laboratory diagnoses. The next section highlights some of the different forms of meningitis, their causes, modes of transmission, pathogenesis, culture/diagnosis, as well as prevention/treatment.

Neisseria Meningitidis

Neisseria meningitidis (N. meningitidis) is one of the causative agents of epidemic meningitis. These gram-negative pairs of round cells (diplococci) are commonly referred to as meningococcus and cause the most severe and acute meningitis, accounting for nearly 15-20 percent of all cases. Most cases appear in young children below 11 years because healthy children below eleven cannot receive vaccination against the infection. Even though there are nearly twelve strains of Neisseria meningitidis, the common serotypes that cause a majority of severe infections are A, B, and C (CDC, 2011).

Pathogenesis, Virulence Factors, and Symptoms. N. meningitidis bacterium first enters the body through the upper respiratory tract and then shifts to the bloodstream. It then quickly crosses the meninges, producing symptoms of meningitis (Cowan, 2015). Some of the adverse complications of this type of infection arise from meningococcemia, which accompanies meningitis. Usually, the bacteria produce endotoxins – which are released into the bloodstream – that often stimulate particular leucocytes. Injury or rupture of the blood vessels due to the cytokines produced by leucocytes can result in the collapse of the vessels, petechiae (lesions), and hemorrhage (CDC, 2011).

Transmission and Epidemiology. The mode of transmission of the bacteria occurs when healthy people come in close contact with infected droplets or secretions. This is because meningococci cannot survive for longer periods when exposed to environmental conditions. The disease has a high incidence and epidemic rate in winter and early spring. Humans often serve as the continuous reservoir of the pathogen, harboring it in the nasopharynx. Studies have shown that the carriage state of the pathogen – which lasts between days and months – occurs in 3-30 percent of adults but can surpass 50 percent in institutional setups (Cowan, 2015).

Diagnosis/Culture. In the case of suspected bacterial meningitis, medical attention is often deemed necessary, with the differential diagnosis being the preferred model. Ruling out or confirming meningococcal meningitis is vital because it can be deadly if left untreated. Nasopharyngeal fluid, blood, and CSF samples are usually stained using the gram staining technique, then the slides are observed for gram-negative diplococci (Cowan, 2015). Cultivation of cultures is sometimes needed to distinguish the bacterial species from others, including Neisseria. The cultures are usually streaked on chocolate agar or MTM (Modified Thayer-Martin) media before incubating in high carbon dioxide environments.

Treatment/Prevention. The most effective preventive measure against meningococcus is developing natural immunity since the infection rate is just 1 percent in most populations. Usually, natural immunization happens when one is exposed to the meningococcus bacteria in early life developmental stages. However, if cases of the disease are confirmed, it is advisable to begin chemotherapy (which are given intravenously) as early as possible because the disease is fatal. The primary drugs used include chloramphenicol, aztreonam, and ceftriaxone. In the U.S., the major preventive measure used is vaccination, which starts at age 11 before a booster dose is offered later (Cowan, 2015). Today, there are also vaccines for high-risk populations, including elderly people aged 55 and above, as well as children aged 11 and below. Other protective measures apart from conjugated vaccine used include ceftriaxone, rifampin, as well as ciprofloxacin.

Streptococcus Pneumonia – Pneumococcal Meningitis

Streptococcus pneumoniae, which is also regularly known as S. pneumococcus or pneumococcus, is a spherical, gram-positive, and facultative anaerobic bacterium. Pneumococcus bacteria are non-motile diplococci (occur in pairs) and never form spores (Cowan, 2015). Usually, the bacterium is asymptomatic and colonizes the nasal cavity, sinuses, and respiratory tracts of carriers. But, in individuals with compromised or weakened immune systems, the bacteria become pathogenic and can move to other locations, including the nervous system, causing diseases (CDC, 2011). Pneumococcus is regarded as the primary cause of meningitis among the elderly and children.

Transmission, Pathogenesis, Virulence Factors, Symptoms, and Epidemiology. Pneumococcal bacteria often inhabit the back of the throat of children and adults like normal biota. The bacteria are usually transferred from one individual to another by direct contact with droplets from an infected individual’s nose, throat, and mouth. A majority of the pneumococcal bacteria that result in meningitis cross the meninges via the bloodstream, infecting the CSF (Chretien, Wong, & Sharer, 2020). This results in the inflammation of the meninges, causing pressure to build up around the brain, which can result in nerve damage. Susceptible individuals characteristically develop signs of the disease between 1-3 days after exposure, but in some cases, the symptoms take time to appear. Some common symptoms include headaches, stiffness in the neck, chest pain, weakness, high fever, confusion, cough, chills, agitation, rapid breathing, and irritability. As an encapsulated bacterium, there are approximately 93 serotypes of S. pneumoniae, with serotypes 5 and 1 being the most common in poor nations. It is estimated that for children aged five and below, the incidence rate is 7 per 100,000 (CDC, 2016).

Diagnosis/Culture. Diagnosis of pneumococcal meningitis is done by collecting the CSF of the infected person through a spinal tap. The CSF can then be used either for microscopy or for culture. Gram staining will specifically reveal the presence of S. pneumoniae as gram-positive, lancet-shaped chains of cocci or diplococci. For culture, the bacteria are incubated for 24-48 hours in chocolate agar or blood agar at 5 percent carbon dioxide to reveal the bacteria. Typically, the S. pneumoniae colonies are grayish, small in size, as well as mucoid. Other tests, like ‘the Bile Solubility’ experiment, can also be used to differentiate S. pneumoniae from other species of streptococcus (Reller et al., 2008).

Treatment/Prevention. Vaccination is the most effective way of preventing pneumococcal meningitis. The common vaccines used in the United States include Prevnar 23® or PPSV23 (pneumococcal polysaccharide vaccine) and Prevnar 13® or PCV13 (pneumococcal conjugate vaccine. Prophylaxis (which involves taking antibiotics after suspected exposure) and re-infection treatment are other recommended ways of preventing the occurrence of the disease. The common antibiotic drugs used are spiramycin, minocycline, ceftriaxone, ciprofloxacin, and rifampin (Molyneux & Njiram’madzi, 2015).

Poliomyelitis

Causative Agent, Symptoms, Pathogenesis, and Virulence Factors. Poliomyelitis, or polio, is caused by the poliovirus, which belongs to the genus Enterovirus and the family Picornaviridae. The poliovirus is nonsegmented and nonenveloped, with the exposed (naked) capsid having chemical resistance and stability against detergents, bile, and acid. This implies that the virus can withstand the stomach’s harsh acidic environment. After the virus is ingested, it attaches to the mucosal cell receptors in the intestine and oropharynx, whereby they multiply and increase in number. Some of these excess viruses leak into the bloodstream, while others are shed into feces and throat (Cowan, 2015).

Mild viremia is the most common symptom of polio infection. Others will likely develop nonspecific signs like myalgia, sore throat, nausea, headache, and fever. If the viremia symptoms continue, the virus often crosses from the bloodstream into the spinal cord before traveling to the brain. It can infiltrate the motor nuclei, cranial nerves, spinal ganglia, as well as motor neurons of the spinal cord. Once in the CNS, the poliovirus can either cause nonparalytic disease or paralytic disease. The former is characterized by the invasion and damage of the nervous tissue, resulting in meningeal inflammation, spasm, muscle pain, as well as vague hypersensitivity. The latter can result in some extent of acid paralysis as well as paralysis of the tissues and muscles of the bladder, pectoral girdle, diaphragm, intercostals, abdomen, back, and legs. Bulbar poliomyelitis, even though in rare cases, can also occur, with the body likely to lose control of the cardiorespiratory regulatory centers (Cowan, 2015). The paralyzed and unused muscles usually shrink (atrophy) because of slowed growth, resulting in serious deformities of the limbs and trunk, especially the feet, knees, hips, shoulder, and spine. The crippled limbs are usually very painful because of compromised motor function.

Transmission and Epidemiology. According to Cowan (2015), sporadic incidences of polio can occur at any time of the year, albeit the incidence rate is prominent during fall and summer. The virus is passed via mechanical vectors, hands, water, food, as well as materials contaminated with feces. The 20th century experienced a rapid decline in polio cases because of the vaccine’s development, meaning that it was eliminated in Western countries during this period. However, cases of polio are still being reported in developing nations. As of 2014, the disease is still endemic in Nigeria, Afghanistan, and Pakistan (Cowan, 2015).

Diagnosis, Prevention, and Treatment. Physicians often use symptoms to identify polio, such as abnormal reflexes, back stiffness, and difficulty in breathing and swallowing, as well as crippling. However, diagnostic tests using CSF, stool, and throat secretions can be taken for microscopic and culture tests to confirm the poliovirus.

The primary preventive mechanism of polio is immunization, which is conducted as early as possible, usually with the first dose administered just 2 months after birth. Soldiers and travelers are other candidates that often receive the poliovirus. Globally, the two common vaccines used are the OPV (oral poliovirus vaccine) and IPV (inactivated poliovirus vaccine).

Treatment of polio, on the other hand, entails alleviating the suffering and pain through palliative and supportive care. Painkillers like diazepam, aspirin, and acetaminophen are commonly used to treat chronic pain among polio patients. The use of nerve blockers, physical therapy, relaxation training, counseling, antidepressants, and hypnosis have also been discovered to boost the well-being and lifespan of patients (Stoelb et al., 2008).

Conclusion

Nervous system diseases are those infections that attack both the CNS and the PNS, including nerves, neurons, brain, meninges, spinal cord, and so on. Meningitis, including Neisseria meningitis and pneumococcal meningitis and poliomyelitis, are some of the most widespread nervous system illnesses. Whereas meningitis is caused by a broad spectrum of pathogens, primarily bacteria such as Streptococcus pneumoniae and Neisseria meningitidis, poliomyelitis is caused by the poliovirus. Antibiotics are commonly used to treat meningitis resulting from bacteria. Vaccination is the most widely preventive measure used to alleviate the incidence rates of the poliovirus.

References

CDC. (2011). Chapter 2: Epidemiology of meningitis caused by Neisseria meningitidis, Streptococcus pnemoniae, and Haemophilus influenza. In Laboratory methods for the diagnosis of meningitis: Laboratory methods for the diagnosis of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenza (2nd ed.). National Center for Immunization and Respiratory Diseases. Retrieved from https://www.cdc.gov/meningitis/lab-manual/chpt02-epi.html

Chretien, F., Wong, K. T., & Sharer, L. R. (2020). Infections of the central nervous system: Pathology and genetics. John Wiley & Sons.

Cowan, M. K. (2015). Microbiology Fundamentals: A clinical approach (2nd ed.). New York, NY: McGraw Hill Education.

Molyneux, E.,  & Njiram’madzi, J. (2015). Prevention and treatment of bacterial meningitis in resource-poor settings. The Pediatric Infectious Disease Journal, 34(4), 441-443.

Reller, L. B., et al. (2008). Laboratory diagnosis of invasive pneumococcal disease. Clinical Infectious Diseases, 46(6), 926-932.

Stoelb, B. L., et al. (2008). Pain in persons with postpolio syndrome: Frequency, intensity, and impact. Archives of Physical Medicine and Rehabilitation, 89(10), 1933-1940. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651567/

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Question 


Infectious Diseases Affecting the Nervous System

Topic. Human Disease of Your Choice

Infectious Diseases Affecting the Nervous System

Infectious Diseases Affecting the Nervous System

See chapters 16-21 in the textbook.

Choices are Nervous system caused by a microorganism such as Meningitis, streptococcus pneumonia, Zika virus, E Coli, poliomyelitis. Just a few of chapter 17.

The book name is Cowen Microbiology fundamental: clinical approach 3 edition

Requirements

  • APA Format, 6 pages, 6 citations, cover page, works cited page, no abstract needed

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