DISEASE SUMMARY PAGE

Bacterial Meningitis and Meningoencephalitis in Great Apes

Summary Information

Diseases / List of Bacterial Diseases / Disease summary
Alternative Names  
Disease Agents
  • Streptococcus pneumoniae. (B336.39.w39)
  • Usually enteric bacteria, Streptococcus pneumoniae  or Haemophilus influenzae. (B23.50.w50)
  • May occur as extensions of e.g. ear infections or ethmoiditis. (B22.31.w31c)
  • Neisseria meningitidis strain 7796 serogroup B was isolated from the infected laryngeal air sac of a five-year-old hand-reared bonobo which was showing severe CNS signs. (P6.2.w13)
  • Staphylococcus sp. in a 3.5-year-old chimpanzee. (B644.2.w2)
Infectious Agent(s) --
Non-infectious Agent(s) --
Physical Agent(s) --
General Description
Clinical signs
  • Variable from lethargy to seizures. (B23.50.w50)
  • Usually fine-muscle fasciculations indicating irritation of the meninges. (B23.50.w50)
  • Initial cough and nasal discharge, then lethargy and vestibular signs, purulent conjunctivitis, head-holding, cervical rigidity, drooping lip, nystagmus, blindness, dysphagia, pyrexia, seizures. (B336.39.w39)
  • Raised temperature - 102 F or higher, sometimes over 104 F. (B23.50.w50)
  • In a 3.5-year-old chimpanzee, mild flu-like signs for two days, then depression, social isolation, dehydration, neck-ache (shoulders lifted up) and reluctance to move the head. (B644.2.w2)
  • Clinical pathology: 
    • Haematology: marked peripheral leucocytosis and neutrophilia with left shift. (B336.39.w39)
    • CSF (from lumbar puncture) increased protein and WBC. Contains bacteria; use Gram stain for initial decision regarding appropriate antibiotics. (B23.50.w50, B336.39.w39)
      • With Streptococcus pneumoniae, Gram-positive diplococci present in CSF. (B336.39.w39)
Further Information
  • Bacterial meningitis/meningoencephalitis has been seen in neonates of all the great ape species. (B22.31.w31c)
  • Some of the organisms involved are human pathogens, e.g. Neisseria meningitidis, isolated from a juvenile hand-reared bonobo with CNS signs, is normally found in the human pharynx. (P6.2.w13)
  • Staphylococcus sp. in a 3.5-year-old chimpanzee. (B644.2.w2)
Diagnosis
  • Haematology, examination of CSF including Gram-stained smear; culture. (B336.39.w39)
    • With Streptococcus pneumoniae, Gram-positive diplococci present in CSF. (B336.39.w39, J4.185.w9)
Treatment
  • Antibiotic treatment, initially based on the results of examination of a Gram-stained smear of CSF, and once available, based on bacterial culture and sensitivity testing.
  • Note: it is essential that the antibiotic chosen exceeds the minimum bactericidal concentration for the causative organism in the CSF. (B23.50.w50)
    • For beta-lactam antibiotics, in the presence of meningeal irritation, the concentration in the CSF is usually 5-10% of the serum concentration. (B23.50.w50)
    • Avoid use of Chloramphenicol as metabolism of this drug by neonates is inconsistent. (B23.50.w50)
  • Early Dexamethasone treatment may minimise obstructive hydrocephalus post infection. (B23.50.w50)
  • Supportive treatment: fluids, nutritional support, antipyretic agents (e.g. Acetaminophen (Paracetamol)) if the rectal temperature rises above 104 F, and anticonvulsive medication if required. (B23.50.w50)
Associated Techniques
Host taxa groups /species
Author Dr Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referees  

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