Which of the following pathophysiologic processes occurs in cases of bacterial meningitis?
A) Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia.
B) Trauma introduces skin-borne pathogens to the cerebrospinal fluid.
C) Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits.
D) Inflammation allows pathogens to cross into the cerebrospinal fluid.
Ans: D
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In the pathophysiologic process of bacterial meningitis, the bacterial organisms replicate and undergo lysis in the CSF, releasing endotoxins or cell wall fragments. These substances initiate the release of inflammatory mediators, which set off a complex sequence of events permitting pathogens, neutrophils, and albumin to move across the capillary wall into the CSF. Cerebral hypoxia does not result directly from meningitis, and the causative pathogens are not introduced from the skin nor is trauma an initiating event. Spinal cord compression is not an expected consequence of meningitis.
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