Mr. Entis (16 y/o)

RF: OMSK 1 year

S. pneumonia berkolonisasi di nasopharynx

Menembus epitel

Invasi langsungMembrane bound vacuoles

To bloodstream (having LPS, teichoic acid, peptidoglicans)

CSF

Cytokine Released (TNF, IL-6, IL-1, PAF)

Produce PMNNeutrophils recruitment to CSFIncrease permeability of BBBIncrease set point hypothalamusBacteria consume glucose in CSF

Leukocytes

PMN increaseESR increasedPMN in CSFPhagocytosis

Lysis bacteriaFluid & cells Extravasation

feverCSF glucose decreased

PR, HR, and RR increased

CSF purulentExudate produced

Obstruct CSF flowInterstitial edema

Increasing ICP

Obstruct cerebral vasculatureHeadacheMeningeal sign +Menekan ARAS

Decreasing consciousnessMenekan medulla oblongata

vomitMenekan pusat bicara dan motoric (Blurred speech)