SlideShare uma empresa Scribd logo
1 de 17
Meningitis

Dr. Ashish V. Jawarkar
The Central nervous system
Consists of:
Brain
Spinal

cord
ventricles
CSF
Peripheral
nerves
Dr. Ashish V. Jawarkar
Meningitis
Inflammation of the membranes surrounding the

brain and spinal cord
Most common organisms




Haemophilus influenzae
Streptococcus pneumoniae
Neisseria meningitidis

Dr. Ashish V. Jawarkar
H. Influenzae
Morphology



Gram negative
Cocco-bacillary

Dr. Ashish V. Jawarkar
Growth requirements on culture
Factor X – haemin
Factor V – NAD – nicotineamide adenine

dinucleotide

Dr. Ashish V. Jawarkar
Sattelitism

Dr. Ashish V. Jawarkar
Types
Capsulated (type B) – cause meningitis,

conjunctivitis, bacteriemia, pneumonia, arthritis,
endocarditis


children

Non capsulated – infections of respiratory tract


adults

Dr. Ashish V. Jawarkar
Meningitis

Dr. Ashish V. Jawarkar
Lab diagnosis
Sample – CSF
Lumbar puncture
Gram stain – gram negative cocco bacilli
Latex particle agglutination test
Culture – blood agar or chocolate agar with added

factor X and V

Dr. Ashish V. Jawarkar
Treatment
Cefotaxime
Augmentin
Cotrimoxazole

Dr. Ashish V. Jawarkar
Neisseria
Two types



N. meningitidis (meningococci) - meningitis
N. gonorrhoe – Uro genital infections

Dr. Ashish V. Jawarkar
Meningococci
Morphology



Gram negative
diplococci

Dr. Ashish V. Jawarkar
Pathogenicity
Cerebrospinal meningitis



Acute fever with chills
Rash

Meningococcal septicemia



Shock
Multisystem failure

Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar
Lab diagnosis
Sample – CSF
Gram stain
Latex agglutination test
Culture
Nasal swab for detection of carriers

Dr. Ashish V. Jawarkar
Treatment
IV penicillin G
Third generation cephalosporin

Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar

Mais conteúdo relacionado

Mais procurados (19)

Pertussis
PertussisPertussis
Pertussis
 
Bacteremia
BacteremiaBacteremia
Bacteremia
 
Pertusis (Whooping cough) by Sunil Kumar Daha
Pertusis (Whooping cough) by Sunil Kumar DahaPertusis (Whooping cough) by Sunil Kumar Daha
Pertusis (Whooping cough) by Sunil Kumar Daha
 
Diphtheria and pertussis (whooping cough)
Diphtheria and pertussis (whooping cough)Diphtheria and pertussis (whooping cough)
Diphtheria and pertussis (whooping cough)
 
Diptheria
DiptheriaDiptheria
Diptheria
 
Pertusis
PertusisPertusis
Pertusis
 
bordetella
bordetellabordetella
bordetella
 
Diptheria (For Undergraduates)
Diptheria (For Undergraduates)Diptheria (For Undergraduates)
Diptheria (For Undergraduates)
 
Diphtheria
DiphtheriaDiphtheria
Diphtheria
 
Module 3 opportunistic infections and hiv related conditi
Module 3  opportunistic infections and hiv  related  conditiModule 3  opportunistic infections and hiv  related  conditi
Module 3 opportunistic infections and hiv related conditi
 
HIV INFECTION
HIV INFECTIONHIV INFECTION
HIV INFECTION
 
EPIDEMIOLOGY OF MENINGOCOCCAL MENINGITIS
EPIDEMIOLOGY OF MENINGOCOCCAL MENINGITISEPIDEMIOLOGY OF MENINGOCOCCAL MENINGITIS
EPIDEMIOLOGY OF MENINGOCOCCAL MENINGITIS
 
Bordetella pertussis depa
Bordetella pertussis depaBordetella pertussis depa
Bordetella pertussis depa
 
Bordetella pertussis
Bordetella pertussisBordetella pertussis
Bordetella pertussis
 
Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,di...
Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,di...Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,di...
Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,di...
 
Whooping cough
Whooping coughWhooping cough
Whooping cough
 
Enteric fever
Enteric feverEnteric fever
Enteric fever
 
EPIDEMIOLOGY OF DIPTHERIA
EPIDEMIOLOGY OF DIPTHERIAEPIDEMIOLOGY OF DIPTHERIA
EPIDEMIOLOGY OF DIPTHERIA
 
Bordetella
BordetellaBordetella
Bordetella
 

Semelhante a Causes and Diagnosis of Meningitis

Semelhante a Causes and Diagnosis of Meningitis (20)

respiratory infections - microbiology
respiratory infections - microbiologyrespiratory infections - microbiology
respiratory infections - microbiology
 
Meningitis
MeningitisMeningitis
Meningitis
 
Adeno virus
Adeno virusAdeno virus
Adeno virus
 
Meningitis
MeningitisMeningitis
Meningitis
 
Encephalitis
EncephalitisEncephalitis
Encephalitis
 
Sexually transmitted diseases
Sexually transmitted diseasesSexually transmitted diseases
Sexually transmitted diseases
 
Brain abscess and it course of treatment
Brain abscess and it course of treatmentBrain abscess and it course of treatment
Brain abscess and it course of treatment
 
Brain abscess
Brain abscessBrain abscess
Brain abscess
 
Bacterial meningitis
Bacterial meningitisBacterial meningitis
Bacterial meningitis
 
Respiratory Tract Infections
 Respiratory Tract Infections Respiratory Tract Infections
Respiratory Tract Infections
 
Bohomolets Microbiology Lecture #14
Bohomolets Microbiology Lecture #14Bohomolets Microbiology Lecture #14
Bohomolets Microbiology Lecture #14
 
CNS INFECTION
CNS INFECTIONCNS INFECTION
CNS INFECTION
 
Imaging in CNS Infections
Imaging in CNS InfectionsImaging in CNS Infections
Imaging in CNS Infections
 
Uveitis
UveitisUveitis
Uveitis
 
Streptococcus
StreptococcusStreptococcus
Streptococcus
 
Neuropathogen
NeuropathogenNeuropathogen
Neuropathogen
 
Meningitis
MeningitisMeningitis
Meningitis
 
Viral Haemorrhagic Fevers
Viral Haemorrhagic FeversViral Haemorrhagic Fevers
Viral Haemorrhagic Fevers
 
N Meningitidis(Kim)
N Meningitidis(Kim)N Meningitidis(Kim)
N Meningitidis(Kim)
 
Meningitis encephalitis slides Dr sarfaraz
Meningitis encephalitis slides Dr sarfarazMeningitis encephalitis slides Dr sarfaraz
Meningitis encephalitis slides Dr sarfaraz
 

Mais de Ashish Jawarkar

VIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUS
VIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUSVIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUS
VIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUSAshish Jawarkar
 
Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...
Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...
Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...Ashish Jawarkar
 
Immunity - concepts - antigen, antibody, ag-ab reactions, vaccines
Immunity - concepts - antigen, antibody, ag-ab reactions, vaccinesImmunity - concepts - antigen, antibody, ag-ab reactions, vaccines
Immunity - concepts - antigen, antibody, ag-ab reactions, vaccinesAshish Jawarkar
 
Spore forming bacteria - bacillus and clostridia
Spore forming bacteria - bacillus and clostridiaSpore forming bacteria - bacillus and clostridia
Spore forming bacteria - bacillus and clostridiaAshish Jawarkar
 
Mycology - all about fungi
Mycology - all about fungiMycology - all about fungi
Mycology - all about fungiAshish Jawarkar
 
URINARY TRACT INFECTION - MICROBIOLOGY
URINARY TRACT INFECTION - MICROBIOLOGYURINARY TRACT INFECTION - MICROBIOLOGY
URINARY TRACT INFECTION - MICROBIOLOGYAshish Jawarkar
 
needle stick and sharp injuries..protocols
needle stick and sharp injuries..protocolsneedle stick and sharp injuries..protocols
needle stick and sharp injuries..protocolsAshish Jawarkar
 
infection and control of aerosol transmissable diseases
infection and control of aerosol transmissable diseasesinfection and control of aerosol transmissable diseases
infection and control of aerosol transmissable diseasesAshish Jawarkar
 
control of microbial growth
control of microbial growthcontrol of microbial growth
control of microbial growthAshish Jawarkar
 
sterilization and disinfection
sterilization and disinfectionsterilization and disinfection
sterilization and disinfectionAshish Jawarkar
 

Mais de Ashish Jawarkar (20)

VIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUS
VIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUSVIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUS
VIRULOGY - HIV (AIDS) , POLIOMYELITIS VIRUS, RABIES VIRUS
 
Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...
Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...
Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiol...
 
Immunity - concepts - antigen, antibody, ag-ab reactions, vaccines
Immunity - concepts - antigen, antibody, ag-ab reactions, vaccinesImmunity - concepts - antigen, antibody, ag-ab reactions, vaccines
Immunity - concepts - antigen, antibody, ag-ab reactions, vaccines
 
Parasitology
ParasitologyParasitology
Parasitology
 
Spore forming bacteria - bacillus and clostridia
Spore forming bacteria - bacillus and clostridiaSpore forming bacteria - bacillus and clostridia
Spore forming bacteria - bacillus and clostridia
 
Mycology - all about fungi
Mycology - all about fungiMycology - all about fungi
Mycology - all about fungi
 
Spirochaetes
SpirochaetesSpirochaetes
Spirochaetes
 
Viruses
VirusesViruses
Viruses
 
URINARY TRACT INFECTION - MICROBIOLOGY
URINARY TRACT INFECTION - MICROBIOLOGYURINARY TRACT INFECTION - MICROBIOLOGY
URINARY TRACT INFECTION - MICROBIOLOGY
 
Mycobacteria
MycobacteriaMycobacteria
Mycobacteria
 
nosocomial infection
nosocomial infectionnosocomial infection
nosocomial infection
 
streptococci
streptococcistreptococci
streptococci
 
staphylococci
staphylococcistaphylococci
staphylococci
 
needle stick and sharp injuries..protocols
needle stick and sharp injuries..protocolsneedle stick and sharp injuries..protocols
needle stick and sharp injuries..protocols
 
Quiz 2
Quiz 2Quiz 2
Quiz 2
 
Quiz 1
Quiz 1Quiz 1
Quiz 1
 
infections and immunity
infections and immunityinfections and immunity
infections and immunity
 
infection and control of aerosol transmissable diseases
infection and control of aerosol transmissable diseasesinfection and control of aerosol transmissable diseases
infection and control of aerosol transmissable diseases
 
control of microbial growth
control of microbial growthcontrol of microbial growth
control of microbial growth
 
sterilization and disinfection
sterilization and disinfectionsterilization and disinfection
sterilization and disinfection
 

Último

Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...narwatsonia7
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...narwatsonia7
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋TANUJA PANDEY
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 

Último (20)

Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 

Causes and Diagnosis of Meningitis