Meningitis: etiology, symptomatic complex, types of diagnostic research methods. Meningitis: symptoms, signs, causes and treatment

Meningitis is a disease that develops due to the penetration of bacterial or viral microflora through the encephalitic barrier. This usually occurs against the background of decreased immunity, with the spread of infectious agents by hematogenous or lymphogenous routes. The condition is life-threatening. If large parts of the structural nerve fibers are damaged, respiratory and cardiac arrest may occur.

People die from meningitis

Mothers often warn their children that running without a hat in winter can easily cause meningitis. And then they won’t save you, and if they do, there is a risk of remaining mentally retarded for the rest of your life. Unfortunately, there is some truth in this - people die from meningitis. And not just children.

The causative agent of meningitis

It is known that meningitis can be caused by both bacteria and viruses. Explain which pathogen is the most dangerous? The development of the most severe and dangerous form of the disease - purulent meningitis - is provoked by bacteria. The most common causative agents of meningitis are meningococcus, pneumococcus and Haemophilus influenzae. These microorganisms can not only leave a person disabled for life, but even kill the patient.

How do you get meningitis? How meningitis is contracted depends on the form of the infection. Bacterial meningitis is transmitted only from person to person. Infection with meningitis is possible if you are in close contact with a sick person, drink from the same mug, or use shared utensils, towels, hygiene products. And here by airborne droplets meningitis is not transmitted because the microorganisms that cause it live in external environment very briefly. For example, it is enough to ventilate the room so that the meningococci that settle on the furniture die.

Viral meningitis: how is it transmitted?

Parents often scare their children, saying that if you don’t wear a hat in the cold, you will certainly get meningitis. Is it so? If there is no pathogen in the body, then the disease has nowhere to come from. Therefore, such a statement is a fallacy. However, I still don’t recommend walking without a hat in winter - this way you can significantly weaken your immunity and disarm your body from many different infections.

None of this is true about a viral infection. How is viral meningitis transmitted? By airborne droplets.

Causes of meningitis

People from young to old suffer from purulent meningitis: in our practice, the youngest patient was not even a month old, and the oldest was over 80 years old.

Statistics say that most often patients catch meningitis in the spring.

Why is it at this time that the immune system cannot resist a dangerous infection? The fact is that it is during this period that the causes of meningitis become more pronounced.

Every day, millions of different pathogens enter our body, including meningitis pathogens. The immune system immediately sends defenders to intercept - special cells that capture, swallow and digest harmful viruses and microbes. Usually the immune system easily and quickly copes with the enemy, so that we don’t even notice it. But in the spring the body is greatly weakened by a lack of vitamins and sun, cold, various infections. Especially many patients are admitted to infectious diseases hospitals during the decline of the influenza epidemic, which most often occurs at the end of winter - beginning of spring. Our immune system has to contain the powerful attack of viruses, and there is no longer any strength left to fight bacteria.

Brain meningitis disease

Why can’t other infections reach the brain, but meningococcus, pneumococcus and Haemophilus influenzae manage to do so and develop the disease meningitis?

The fact is that nature protected our brain not only with bone (cranium) from the outside, but also with a special blood-brain barrier (BBB) from the inside. This is the unique structure of the walls of the vessels located in the head. They allow only nutrients to reach the nervous tissue. But the passage to the brain is closed for infectious agents circulating in the blood. Even your own immune cells cannot pass through the BBB, let alone foreign bacteria. To penetrate the “fortress,” the bacteria that cause brain meningitis act very cunningly: they cover themselves with a special coating. As a result, the defender cells absorb the infection, but cannot digest it. Such a “Trojan horse” (bacteria inside immune cell) not only travels unhindered throughout the body, but also produces a special substance that helps it overcome the blood-brain barrier. Although, in the end, only a few bacteria reach the brain.

Signs of meningitis

Behind the blood-brain barrier there is a real paradise for pathogenic microbes: nutrients, plenty and there is no one who could defend themselves - no antibodies, no protective cells. Once behind the BBB, bacteria grow and multiply, as in an incubator. Therefore, signs of meningitis begin to appear quite quickly after infection.

Meningitis infection

Is it enough to strengthen your immune system and get proper treatment for the flu to avoid getting meningitis? There is a second way for bacteria to enter the “forbidden zone” - during traumatic brain injuries, when the integrity of the bone is compromised. Recently, road accidents are happening more and more often, and along with them the number of sick people is growing. purulent infection meningitis. The fact is that with fractures of the base of the skull, the membranes of the brain directly communicate with the airways of the nasopharynx, and as soon as the pathogen appears in the body, it penetrates the nervous tissue and multiplies very quickly.

What are the signs of meningitis?

The disease develops rapidly - literally in a few hours.

What signs of meningitis should you look out for? Bacteria, getting behind the BBB, take away all the nutrients from the membranes of the brain and release toxins that affect surrounding tissues and paralyze cells. If the infection is not stopped in time, necrosis occurs: the membranes of the brain die and pus forms. The death of the patient occurs due to cerebral edema: no longer able to fit into the cranium, the brain is wedged into the foramen magnum. In this case, paralysis occurs: breathing and heartbeat are disrupted, and vital centers are affected.

How does meningitis manifest?

Is it possible to recognize the disease in time and provide help to the person? Yes, if you know how meningitis manifests itself.

Purulent meningitis develops very rapidly, with vivid symptoms. The disease begins with a severe headache, vomiting that does not bring relief, and intoxication. The temperature rises above 40 °C, shortness of breath appears, severe weakness, sometimes a rash appears on the skin. The patient cannot even sit, let alone move. With purulent meningitis, consciousness is quickly disturbed: a person becomes agitated, aggressive, commits actions unusual for him, cannot perform some usual actions, or completely loses consciousness. In the most severe cases, seizures occur ( a clear sign severe brain damage). In this case, minutes count: than before man taken to a doctor, the more hope for salvation.

The first symptoms of meningitis

Symptoms of meningitis in general outline described above. There is a very simple way to detect meningitis when a person is conscious - if during a flu epidemic there is a huge influx of patients in the clinic and there is simply no time left for a thorough examination, ask the patient to tilt his head and press his chin to his chest. A person with bacterial meningitis will never be able to do this: his head hurts so much that he holds it like a crystal, afraid to move again. And when bending over, the pain increases sharply. These are the first symptoms of meningitis.

Course of meningitis

The course of meningitis of bacterial etiology is usually rapid.

What to do if you suspect purulent meningitis? Call " ambulance" Delay may cost the patient's life. Sometimes purulent meningitis develops so rapidly that the patient himself cannot even reach the telephone. The problem is aggravated by the fact that it is very difficult to determine why a person fainted and when it happened. Most often, people lose consciousness due to cardiovascular diseases or disorders cerebral circulation. Therefore, first, the emergency team takes the patient to the vascular center, where computed tomography and magnetic resonance imaging are performed. If no violations are found, the patient is immediately sent to an infectious diseases hospital. However, all these trips can take up valuable time. You need to know that in case of cardiovascular diseases high temperature can not be. Therefore, if a patient has a fever, you need to immediately send him to infectious disease specialists. Relatives must understand that under no circumstances should they leave a person with a fever or impaired consciousness at home and hope that everything will go away on its own. Another formidable confession
k - hemorrhagic rash. This is a very bad symptom. Hemorrhagic rash is a manifestation of the most severe form meningococcal infection- meningococcal sepsis, which affects all organs without exception human body. Such a patient should be taken to the hospital without delay.

The most important questions about the treatment of bacterial meningitis

Purulent meningitis is not a disease for which you can rest at home. Not only the effectiveness of treatment, but even the patient’s life depends on how quickly a patient sees a doctor.

Diagnosis of meningitis

Diagnosing meningitis is usually not difficult for an experienced doctor. If the patient is conscious, tests are taken. And sometimes a person is brought in in a state where there is no time for testing: first you need to restore your heartbeat, breathing, and bring you out of shock. This is done by a special resuscitation team.

Tests for meningitis

Despite the availability of ultra-modern computed tomographs, the presence of bacteria can only be determined by examining the cerebrospinal fluid. Therefore, for meningitis, a special procedure is performed, the so-called lumbar puncture, when a special needle is inserted into the patient’s back and CSF (cerebrospinal fluid) is taken for examination. This is the only 100% accurate procedure and test for meningitis, which allows you to quickly identify the presence of purulent meningitis (unlike viruses, bacteria are immediately visible under a microscope) and even determine the type of microorganism that caused it (using classical (culture) and express methods (agglutination, hybridization)).

How safe is a lumbar puncture? Lumbar puncture is performed under local anesthesia, the patient does not feel anything. The puncture is made in the lumbar region. At the puncture site there is no spinal cord or structures on which it rests spinal column. Therefore, you don’t have to worry about the needle damaging anything. There are also no complications after puncture.

What happens after an infection is discovered? It is very important to begin intensive treatment at the first suspicion of purulent meningitis, even before receiving test results. The patient is immediately admitted to the hospital and given intensive antibiotic treatment. Drugs that remove excess liquid from serous membranes and reducing intracranial pressure, neurometabolites that improve brain metabolism, as well as vitamins (if the patient does not have allergies). The patient is allowed to go home no earlier than a month later (and sometimes even later, depending on the condition). Then the patient must remain at home for another 2 weeks. And only then will the person gradually recovering be able to return to the usual rhythm of life. After recovery, the patient must be regularly monitored by doctors for another 2 years and undergo rehabilitation treatment. He is prohibited physical exercise and playing sports.

How to treat meningitis

Is it possible to treat yourself? In no case! Before treating meningitis, it is necessary to determine the sensitivity of the pathogen to antibiotics. Purulent meningitis must be treated only in infectious diseases hospitals with strong antibacterial drugs, since patients are very fond of making their own diagnoses and prescribing treatment. This often leads to disastrous consequences.

Treatment of meningitis

Treatment of meningitis is carried out in a hospital after laboratory examinations. Only a doctor can prescribe the drug, dose and duration of the course, depending on the pathogen, the time of contacting the doctor, concomitant diseases, characteristics of the patient’s body.

Antibiotics for meningitis

Antibiotics for meningitis can only be used as prescribed by a doctor. Bacteria quickly evolve and adapt to their environment. During treatment with antibiotics, it is necessary to drink the full course to kill all microbes. If the course is interrupted (and many people do this when they suddenly feel better), the bacteria not only survive, but also acquire resistance (immunity) to this medicine.

Just 20 years ago, penicillin was one of the most effective drugs. Today it has almost no effect. This is what uncontrolled use of antibiotics leads to! And at the same time, almost any of them can be freely purchased at the pharmacy. Over the past 7 years, not a single new antibacterial drug has been created in the world, since these studies are very expensive.

Meningitis is now treated with the latest effective 3rd generation antibiotics. If bacteria become resistant to them, a catastrophe will occur - there will simply be nothing left to treat patients with and medicine will return to the level of the 1920s, when meningitis could “mow down” entire neighborhoods. Already today, infectious disease specialists are faced with the fact that even the most modern drugs do not work, and the patient cannot be saved.

Purulent meningitis: consequences and complications

Complications of meningitis appear if the patient seeks treatment too late. medical assistance, and the infection managed to damage not only the meninges, but also the structure of the brain itself. The worst complication with purulent meningitis is, of course, death. But even if the patient was saved, he may still have paresis, paralysis, and hearing impairment. In rare cases, a person remains disabled for life. The most common complication of meningitis is cerebrasthenic syndrome, when a person reacts sharply to changes in weather and climate.

Are mental disorders possible? It is not true that after meningitis you will definitely become mentally retarded. After treatment, patients graduate from 2 institutes. Most of our patients who come to us are very in serious condition, graduated, found Good work. Mental disorders can occur extremely rarely and only if the patient seeks help too late.

Is it possible to get meningitis again? After a patient has had purulent meningitis, he develops lifelong immunity. But only to one specific bacterium. Therefore, you can become infected with meningitis several times. However, this is extremely rare. Only patients with traumatic brain injuries who have post-traumatic liquorrhea (leakage of cerebrospinal fluid into the nasal passages through a crack at the base of the skull) become ill again.

Prevention of meningitis

Prevention of meningitis is not only possible, but also recommended by all doctors. First of all, it is necessary to get vaccinated on time. Vaccination against hemophilus influenzae infection is included in the calendar. It is given to children at 3, 4.5 and 6 months. Booster vaccinations are also given at 18 months. Vaccinations against pneumococcus and meningococcus can now only be done in private clinics, since they appeared quite recently. However, these vaccines are planned to be introduced into the market soon. National calendar preventive vaccinations.

You also definitely need to monitor your health, avoid chronic foci of infection, treat your teeth on time, see a doctor, and not try to rest at home. It is very important to follow basic sanitary rules: each family member should have their own hygiene items, their own mugs, spoons, plates. Well, most importantly, wash your hands as often as possible.

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In neurologist's offices and clinics, you rarely hear about such a diagnosis. It seems that the destiny of neurology is osteochondrosis, radicular syndromes or hypertensive encephalopathy.

But there are heavy, and sometimes even fatal diseases central nervous system– meningitis and encephalitis.

Previously, it was believed that a person who had suffered this disease either died or remained insane. In fact, this judgment is fundamentally incorrect. What is this, meningitis? Let's try to understand the main issues of this vast and very interesting topic.

What is meningitis and its causes?

Meningitis is an inflammatory disease of the central nervous system, namely its meninges. Since there are both hard and soft membranes, there can be pachymeningitis and leptomeningitis, respectively. Severe diseases are among the most painful in all of neurology and, perhaps, in the entire clinic of internal diseases.

The severity of the condition is due to the excellent sensory innervation of the meninges. They perceive pain well, which is the main symptom of any meningitis.

The causes of the disease, of course, are microorganisms and viruses. The most famous are the following:

Meningococcal purulent meningitis caused by diplococci of the genus Neisseria. It is a “classic” with the full development of symptoms, the appearance of a hemorrhagic rash and all sorts of complications, among which gangrene of the extremities occurs. Currently, it is rare, occurring mainly in the form of outbreaks in organized institutions, especially children's;
. A significant proportion of cases occur in the meningeal form, without damage to the medulla and focal neurological symptoms;
Tuberculosis bacillus. Causes severe, sluggish tuberculous meningitis, which develops in weakened people who have been suffering from tuberculosis for a long time. To do this, you definitely need a primary focus of the tuberculosis process in the body.

In addition to these reasons, inflammation of the meninges can be caused by conditionally pathogenic flora or even fungi. The lower a person’s immunity, the higher this risk. In patients with HIV infection in the AIDS stage, meningitis can be caused by the most harmless bacteria, and the course of this disease will be severe.

Types of meningitis and features

As with any inflammation, meningitis can cause pus to form; such inflammation is called purulent. Moreover, during autopsies of patients who died from meningitis, the cerebral hemispheres are covered with a “purulent cap.” This is most noticeable in the meningococcal process.

Serous meningitis occurs much more easily, in which no pronounced protein production occurs in the cerebrospinal fluid, and the cerebrospinal fluid retains its transparency. An example is the meningeal form of tick-borne encephalitis. As a rule, the clinical course of such serous forms is easier than purulent ones.

But against the background of a serous process that proceeds unfavorably, secondary suppuration may develop. This process is called “secondary purulent meningitis.” It can appear, for example, as a complication of an open head injury.

In this case, a post-traumatic inflammatory process develops. If inflammation of the membranes complicates the course of purulent otitis media, then such meningitis is called otogenic, etc.

The disease can be classified according to the area affected. Inflammation at the base of the brain is called basal, with inflammation of the membranes covering cerebral hemispheres, convexital meningitis develops. There is meningitis that affects the lining of the spinal cord (spinal meningitis).

The course of the disease can range from fulminant (meningococcal sepsis) to chronic (tuberculosis process).

The disease can also be classified by sensitivity to antibiotics, by changes in cerebrospinal fluid and many other signs.

Why is meningitis dangerous? - Consequences of the disease

Of course, a purulent process is more dangerous than a serous one. Therefore, most often complications can be analyzed using the example of epidemic cerebrospinal meningitis caused by meningococcal infection. The most common conditions that develop are:

septic shock;
edema - swelling of the brain with subsequent dislocation of its substance, the development of various variants of herniation, is the most common cause of death in the first day of the development of the disease;
transfer of infection from the membranes to the substance of the cerebral cortex, with the addition of focal symptoms - the development of meningoencephalitis;
A serious complication is occlusive hydrocephalus. At the same time, adhesions, which are located in abundance in the cerebrospinal fluid tract after purulent process, are capable of blocking these pathways to a greater or lesser extent. As a result, a rapidly progressive syndrome of intracranial hypertension develops.

Any purulent meningitis, the consequences of which cannot be predicted in advance, must be treated in the neuroinfection department of an infectious diseases hospital or in the intensive care unit.

Signs of meningitis in adults during the first hours and days may not be specific enough: when there is no headache yet, the following symptoms may bother you:

increase in temperature, with chills, to high numbers;
the appearance of skin hyperesthesia - the patient finds it unpleasant to touch the skin (senestophobia);
Photophobia and phonophobia also arise - a person wants to retire to a dark, quiet room and, if possible, go to bed.

Of course, many diseases can have such signs, such as influenza, or even migraines (except fever). But the next day, meningitis develops in all its characteristic clinical picture.

The leading symptom of inflammation of the membranes is general cerebral symptoms. And the main symptom is a diffuse, diffuse, constant headache high intensity. Many patients even noted the hour of onset of the illness, and not just the day. And this hour was marked by the appearance of such a headache, which turned out to be the strongest in my life.

Combined with fever, such pain exhausts a person. It cannot be relieved by any analgesics, since its mechanism is completely different - the membranes are irritated by local inflammation, and overproduction of cerebrospinal fluid occurs.

This aggravates the situation: increased pressure of cerebrospinal fluid on the inflamed membranes leads to an even greater increase in headaches, as well as to the appearance of cerebral or central vomiting. This vomiting occurs without any connection with the stomach, food intake, and has nothing to do with the gastrointestinal tract at all: its cause lies in irritation of the brain structures by increased cerebrospinal fluid pressure.

The sign of this vomiting is complete suddenness. Suddenly, without any previous nausea, the patient vomits in a “fountain”, a powerful stream, wherever necessary.

After a few seconds, a person may realize that next time he needs to remove all the surrounding things away, otherwise they will be spoiled. Vomiting does not bring relief. In addition, with meningitis, an extremely painful symptom of shaking of the membranes occurs.

Its weak copy is the famous or lumbar lumbago - lumbago. Each time a nerve root is shaken, a sharp pain occurs in the lower back, from which the person groans and freezes. So, the same pain, only it constantly “explodes” in the head of a patient with meningitis. He loses sleep and appetite.

Every rise of the head, attempt to change position, get up, sit up in bed, brings severe torment. Any deep breath and straining intensify the headaches so much that they force you to give up the idea of emptying your bowels, and at this stage infectious intoxication is aggravated by constipation.

In addition, pain occurs in all tendons of the body, which, together with large muscles, contract due to painful impulses of the membranes.

Therefore, a characteristic posture of a patient with meningitis arises: it is aimed at “compensating” for the pain that arises: the patient lies on his side, his head is extended (thrown back), and his legs are pulled up to his stomach.

The classic symptom of meningitis, which makes it possible to distinguish it from all other conditions, is the zygomatic ankylosing spondylitis symptom: when tapping the cheekbone with a neurological hammer, a pronounced outbreak of headache occurs in the entire head, and not at the site of tapping. This symptom is a clear example of the effect of a concussion of the inflamed meninges.

Besides, sharp pain causes pressure on the eyeballs. The above symptoms may be accompanied by a painful grimace from the patient, confirming the pain reaction.

The symptoms of meningitis in adults described by us characterize both purulent and serous forms of the disease. In the event that foci of a rash that tends to merge appear on a person’s skin, a case of meningococcal meningitis is likely.

Further leaving the patient without urgent help from a neurologist and infectious disease specialist causes progression of symptoms.

An increase in intracranial pressure and infectious-toxic symptoms lead to a gradual loss of consciousness, infectious - toxic shock and the development of cerebral edema. There is a slow development of coma and oculomotor disorders (for example, strabismus) against the background of severe stupor and depression of consciousness.

Brain damage due to meningitis, photo

Meningitis is an interesting disease: a mandatory and absolutely necessary diagnostic method - lumbar puncture, almost always, in addition to the necessary and important information for the doctor (transparency and color of the cerebrospinal fluid, its flow out in drops or streams), brings the first and significant relief: the headache is sharply reduced. Therefore, treatment of meningitis in adults begins with a lumbar puncture.

It is carried out in a hospital, lying down; after the puncture, you are not allowed to get up for 24 hours. Further tactics depend on the composition of the cerebrospinal fluid. Thus, treatment of purulent meningitis begins with the introduction of bacteriostatic antibiotics, and treatment of tuberculous meningitis begins with tuberculostatics and the use of reserve drugs.

At the same time, anti-inflammatory therapy is carried out: intravenous administration of a solution of dexamethasone or other corticosteroid hormones can relieve pain during serous meningitis and reduce its intensity during a purulent process.

As a rule, with proper antibacterial and pathogenetic therapy, on the first or second day the intensity of the headache decreases, the temperature normalizes, vomiting stops, and appetite appears.

Forecast

With meningitis, the prognosis is quite difficult to determine. The later the time has passed since the development of the first symptoms, the easier it is to give some kind of prognosis. And on the first day it is completely unclear. For meningitis, the prognosis depends on:

Urgency of seeking medical help;
Level of development of fever and signs of intoxication;
The appearance of a hemorrhagic rash;
Severity of general cerebral symptoms (headache, vomiting);
The appearance of focal symptoms, signs of depression of consciousness;
Results of bacteriological and general research cerebrospinal fluid and the patient’s reaction to puncture;
First reaction to treatment;
Time frame for normalization of temperature and regression of symptoms.
The presence of concomitant pathology, aggravating factors (age, cardiac, renal and liver failure, polyvalent drug allergy).

Long-term results for quality of life are favorable. Sometimes subsequent treatment with nootropic drugs, vitamins, and absorbent agents is required. To prevent the increase in intracranial pressure and treat adhesions, electrophoresis with lidase through the eyeballs and administration of diacarb may be required.

If there are initial symptoms of meningitis, patients are provided with a protective regime and dietary nutrition. Upon receipt of the results of the cerebrospinal fluid analysis, adequate antimicrobial therapy is started. Treatment of bacterial meningitis is carried out with the latest generation of antibiotics registered in the Russian Federation. They are selected individually depending on the type of infectious agent and its sensitivity to antibacterial drugs. In the presence of viral meningitis, antiviral drugs are prescribed.

If, due to the presence of contraindications, it is not possible to perform a lumbar puncture in the presence of 1 sign of meningitis, empirical therapy is carried out with drugs to which most microorganisms that cause infectious diseases of the central nervous system are sensitive. Delay in treating meningitis can have fatal consequences. If you start adequate therapy in the presence of the first signs of meningitis, the prognosis is more favorable. After stabilizing the patient’s condition, neurologists perform a cerebrospinal puncture, determine the serotype of microorganisms that caused the inflammatory process, their sensitivity to antibiotics, and change the treatment regimen. All severe cases of meningitis are discussed at a meeting of the expert council with the participation of professors and doctors of the highest category.

The first signs of meningitis

The initial signs of meningitis depend on the type of pathogen, the age of the patient, his condition immune system, severity of the disease and the presence of concomitant pathology. If a patient is diagnosed with meningitis, signs of the disease are determined during a neurological examination. At the onset of the disease in young children, specific symptoms of meningitis may not be detected. All children with febrile fever in combination with the appearance of rashes that do not disappear with pressure, convulsions, and behavioral changes are treated differential diagnosis with bacterial diseases of the central nervous system. In adult patients, the initial symptoms of meningitis are more pronounced. If meningitis develops against the background viral disease, the first signs of the disease may be hidden by manifestations of the underlying pathology.

In order to identify the first signs of meningitis, doctors at the Yusupov Hospital, when examining a patient, specify:

factors preceding the disease;
dynamics of symptom development;
allergic reactions in past;
level of consciousness;
behavioral characteristics (depression, agitation, refusal to eat).

Record the heart rate, the nature of the pulse in the peripheral arteries, arterial pressure, body temperature. Examine the skin, since the first symptoms of meningitis may be rashes and changes in skin color. Then the tone of the occipital muscles, Kernig’s sign, and the presence of focal neurological symptoms are determined.

Bacterial purulent meningitis can be suspected in the presence of diffuse headache, aggravated by loud sounds, bright light, vomiting that is not associated with food intake and does not bring relief, refusal to eat, tearfulness and irritability in infants. The first signs of meningitis may be pain in the legs, decreased temperature of the hands and feet, and discoloration skin(bluish tint to the tips of the nose, ears, fingers, marbling of the skin).

When viral meningitis develops, the symptoms of the disease develop acutely. Body temperature rises to high levels, general malaise and intoxication syndrome appear. Muscle pain, nausea and vomiting, diarrhea and abdominal pain may occur. The patient refuses to eat and complains of a runny nose, sore throat or cough. In infants, tension or bulging of the fontanel is observed. With viral meningitis, minor disturbances of consciousness are often observed. Patients may be lethargic, drowsy, or restless and agitated.

Viral meningitis is accompanied by pronounced meningeal syndrome. It may be one of the first symptoms of the disease or appear on the second day. Patients are bothered by a constant painful headache, which is poorly relieved by taking analgesics. Vomiting often recurs, skin sensitivity increases (hyperesthesia), and painful perception of external stimuli (sharp sounds, noise, bright light) appears. The patient takes a characteristic position in bed - lies on his side with his head thrown back, hands pressed to his chest and knees brought to his stomach.

Symptoms of meningitis

Meningitis is manifested by symptoms of intoxication:

headache;
hyperthermia;
pale skin;
pain in muscles and joints;
shortness of breath;
rapid pulse;
cyanosis of the nasolabial triangle.

In severe cases of the disease, patients' blood pressure decreases. People with meningitis feel thirsty and therefore drink a lot. Refusal to drink is regarded as an unfavorable prognostic sign.

The first symptoms of meningitis in children have their own characteristics. Infants are very excited, restless, often cry out, and are sharply excited by touch. They experience diarrhea, drowsiness, and repeated regurgitation. In young children, one of the first signs of meningitis is frequent seizures. Adult patients cover their heads with a blanket and lie facing the wall.

From the first days of the disease, the following initial symptoms of meningitis are observed:

stiff neck – difficulty bending the head;
Kernig's symptom - the patient cannot straighten his legs, bent at the knee and hip joints;
Lesage's symptom - when the child is held under the arms, he throws his head back and pulls his legs towards his stomach.

In young children, the first symptoms of meningitis are not pronounced, so doctors examine the large fontanel. It is bulging, charged and pulsating. The cessation of pulsation of the fontanel is an unfavorable prognostic sign.

For meningitis, Brudzinski's symptoms are determined. The upper symptom is characterized by involuntary bending of the legs when the head is tilted to the chest. The average symptom is manifested by involuntary bending of the patient's legs when pressing on the pubic symphysis. The lower symptom is determined as follows: when checking the Kernig symptom on one side, the other leg, bending at the knee and hip joints, is pulled towards the stomach.

Patients suffering from meningitis often take a forced “coot dog” or “cocked gun” position: the patient lies on his side, brings his bent legs to his stomach and throws his head back. Patients with meningitis may have pain symptoms:

Bekhterev's symptom - contraction of facial muscles when tapping on the zygomatic arch;
Mendel's symptom - severe pain when pressing on the area of the external ear canal;
Pulatov's symptom - pain when tapping on the skull;
pain when pressing on the exit points of the cranial nerves.

When peripheral nerves are damaged in patients with meningitis, visual acuity decreases, double vision, nystagmus (involuntary oscillatory movements) appear eyeballs high frequency), ptosis (drooping upper eyelid), strabismus, paresis of facial muscles, hearing loss.

From the first or second day of the disease, against the background of fever and headache, a red rash appears on the skin, which disappears with pressure. Within a few hours it becomes hemorrhagic and looks like bruises. The rash begins on the feet, legs, rises to the thighs and buttocks, spreading higher and higher (up to the face). The rash is the necrosis of soft tissues against the background of incipient sepsis caused by meningococcus. Rashes in combination with fever are an indication for calling an ambulance and hospitalizing the patient at the Yusupov Hospital.

Diagnosis of meningitis

Doctors at the Yusupov Hospital confirm or refute the diagnosis of meningitis using a study of cerebrospinal fluid. A lumbar puncture is performed immediately after examining the patient. Normal cerebrospinal fluid is transparent, colorless, and flows out under a pressure of 130-180 mm during puncture. water Art. It detects from two to eight cells in one microliter. In serous meningitis, the cerebrospinal fluid is colorless, clear or opalescent. During cerebrospinal puncture, it flows out under a pressure of 200-300 mm. water Art. at a speed of 60-90 drops per minute. In the cerebrospinal fluid, from 200 to 800 cells are determined in 1 μl, 80-100% are lymphocytes. The amount of protein and glucose is increased. After the puncture, the patients' condition improves significantly.

With serous bacterial meningitis, the cerebrospinal fluid may be colorless or yellow color, opalescent. During puncture, it flows out in a stream under a pressure of 250-500 mm of water column. The number of cells increases to 800-1000 in 1 μl, they contain the same number of lymphocytes and neutrophils. Protein levels are increased and glucose concentrations are significantly decreased.

The liquor in purulent-bacterial meningitis is cloudy, whitish or greenish-brown. Due to the high viscosity and blockage of the liquor pathways, it often flows out in rare drops under high pressure. The number of cells in one milliliter of cerebrospinal fluid exceeds 1000; they consist mainly of neutrophils. Protein concentration varies from 600 to 16,000 mg/l, glucose levels are reduced.

To confirm the diagnosis of meningitis, doctors use bacteriological examination mucus from the nasopharynx and cerebrospinal fluid. During bacterioscopic examination of cerebrospinal fluid, smears are stained with Gram or methylene blue. To exclude fungal meningitis, the specimen containing cerebrospinal fluid is stained with ink. Laboratory technicians isolate a pure culture on media supplemented with normal horse serum or horse serum. cattle and identify it by biochemical activity and antigenic structure.

In case of viral meningitis, in preparations prepared with Gram staining and ink, it is impossible to identify the causative agent of the infection. Cultivation of bacteria and fungi also gives negative results. By culturing cellular material with standard laboratory cell lines, a pathogen serologically identical to the measles virus can be isolated. Rubella virus is isolated using the co-cultivation method.

To identify oligoclonal immunoglobulins, the method of agarose gel electrophoresis or isoelectric focusing of cerebrospinal fluid gamma globulins is used. Immunoglobulins appear in a number of viral infections. As a result of immunological studies, viral antigens or antibodies are detected in the cerebrospinal fluid, and the nucleic acid of the virus is detected using the polymerase chain reaction method. The enzyme immunoassay method detects pathogen antigens in feces, urine or saliva. Express methods allow you to quickly and easily early dates determine the presence of herpes simplex virus antigen in the cerebrospinal fluid and blood or viral DNA (by polymerase chain reaction).

Laboratory diagnosis of meningitis using modern methods Research can be done by calling the Yusupov Hospital. According to indications, doctors determine changes in brain tissue using computer or magnetic resonance imaging. If the first signs of meningitis are present, adequate antibiotic therapy is started immediately after diagnosis.

Bibliography

ICD-10 (International Classification of Diseases)
Yusupov Hospital
"Diagnostics". - Brief Medical Encyclopedia. - M.: Soviet Encyclopedia, 1989.
« Clinical assessment laboratory research results”//G. I. Nazarenko, A. A. Kishkun. Moscow, 2005
Clinical laboratory analytics. Fundamentals of clinical laboratory analysis V.V. Menshikov, 2002.

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“Don’t go without a hat - you’ll get meningitis!” Who among us did not have to listen to this kind of “horror stories” as a child? In fact, the mechanism of infection with this disease is much more complex and just wearing a warm hat cannot protect you from it. Let's say more: you can get meningitis even in the summer at sea, and massive outbreaks of this disease occur more often in tropical countries than in regions with a harsh climate.

Meningitis is an inflammation of the meninges, which is fatal in 10% of cases. The human brain and spinal cord consists of three membranes: soft, arachnoid and hard. If an inflammatory process begins in any of them (or all at once), they speak of meningitis. Inflammation of the dura mater of the brain is called pachymeningitis. Leptomeningitis affects the soft and arachnoid membranes, and panmeningitis is an inflammatory process in all three layers. But most often, doctors diagnose inflammation in the soft membranes of the brain.

Thus, everyone should know how and why meningitis occurs, whether it is contagious, whether it is possible to get it again, and who is most susceptible to inflammation of the meninges.

Types of meningitis

It is generally accepted that Hippocrates was the first to describe the symptoms of meningitis, and then medieval healers. So humanity has known about this disease for a very long time. But for many years, tuberculosis and consumption were mistakenly believed to be the cause of inflammation of the meninges, and before the discovery of antibiotics, 95 out of 100 patients died from meningitis. Nowadays, treating meningitis is also not easy, but thanks to modern knowledge, the survival rate is much higher than several centuries ago.

However, for therapy to be effective, you first need to understand what type of meningitis you will have to fight. And this disease is very “many-sided” in origin and nature, therefore international classification diseases (ICD 10), each type has its own code and definition, and specialists use different methods to systematize the disease.

According to the nature of inflammation, meningitis occurs:

purulent;
serous.

In the first case, the disease is caused by meningococcal bacteria, is very severe, and is caused by a primary septic process. The second type is of viral origin. This variety is considered not as dangerous as purulent and is less likely to cause complications.

By origin, meningitis is divided into:

primary (independent disease);
secondary (appears as a complication of sinusitis, otitis, respiratory infections, osteomyelitis of the skull bones, carious processes, boils on the face or neck, tonsillitis, sometimes occurs against the background of diseases such as tuberculosis, mumps, syphilis).

Classification by pathogen:

bacterial;
fungal;
viral;
protozoan;
mixed.

According to the nature of the flow:

lightning (fulminant);
spicy;
subacute;
chronic;
recurrent.

By localization of inflammation:

total;
basal (affects the deep parts of the brain);
spinal (affects the spinal cord);
convexital (affects the superficial brain).

According to severity:

mild;
moderately heavy;
heavy.

In addition, there is non-infectious meningitis. This is a type of aseptic meningitis, that is, a disease caused by any other cause other than bacteria, which usually causes acute meningitis - non-communicable diseases, drugs or vaccines. Overall, these causes of meningitis are uncommon. Most often, doctors diagnose cases of viral, bacterial, secondary purulent and fungal meningitis. Moreover, the bacterial (meningococcal) variety of the disease is more common among children under 5 years of age, and the fungal type is more common among pregnant women, patients after chemotherapy, and patients with acquired immunodeficiency. Bacterial, also known as purulent, meningitis can affect even babies under one year old, and viral (serous) meningitis usually appears in children after mumps or due to ECHO. Viral form not as scary for children as purulent, since it is easier to treat and less likely to cause complications.

Causes of infection

In many clinical cases, meningitis manifests itself as seasonal disease. But contrary to popular belief, hypothermia cannot be considered its main cause. Statistics indicate that more cases of infection occur in the warm season, as well as in countries with temperate climates. However, experts also record surges in the spread of the disease in the off-season. This is facilitated by several factors: increased humidity and decreased air temperature outside, seasonal hypovitaminosis, as well as more long stay in poorly ventilated areas. Not long ago, scientists noticed another cyclical pattern: every 10-15 years, an epidemic of meningitis occurs in the world. For example, in 2017, an epidemic of serous meningitis was recorded in Russia, the cause of which was the enterovirus ECHO30, which came from China.

People with weakened immune systems and children under 5 years of age are most susceptible to the disease (their immune system is still developing, and the blood-brain barrier is characterized by increased permeability). If we analyze the prevalence of the disease between the sexes, then more cases of inflammation in the brain are diagnosed among men (usually at the age of 20-30 years). Also at risk are pregnant women, patients with diabetes, ulcers digestive organs, AIDS, suffering chronic fatigue or people suffering from malnutrition. In the so-called “Third World” countries, the prevalence of meningitis is almost 40 times higher than the European average. It is also interesting that in Europe and Russia, diseases of bacterial etiology are approximately 3 times less common than viral ones. Doctors say the main reason for this is vaccination, which can help prevent the bacterial form of the disease. After vaccination, the body, when faced with a pathogen, will independently protect itself from it.

To protect yourself, first of all, you need to understand that meningitis is a contagious disease. Depending on the species, it can be transmitted in different ways:

airborne (through saliva particles during coughing and sneezing);
fecal-oral (through unwashed hands, fruits and vegetables, contaminated water);
hemocontact (through blood);
lymphogenous (through lymphatic fluid);
placental (from pregnant women to the fetus);
water (when swimming in open reservoirs or pools);
contact and household (through household items, dishes, toys);
through insect bites (mainly in African countries).

In children under 1 year of age, meningitis can be caused by the same reasons as in adults or have other causes. For example, be a consequence of birth trauma, prematurity, damage to the brain or spinal cord, sepsis, disease of the middle ear or nasopharynx. If a woman has meningitis during pregnancy, the risk of transmitting the infection to the fetus is very high, and this can lead to developmental disorders of the child. In most cases, meningitis during pregnancy ends in spontaneous abortion or intrauterine fetal death. But even if the fetus survives, doctors usually advise women to terminate their current pregnancy.

Variants of the course of meningitis

Meningitis is most dangerous for children under 5 years of age. Sadly, every 20 baby diagnosed with inflammation of the meninges dies. The most dangerous form of infantile meningitis is considered to be caused by streptococcal infection. Infection usually occurs during the baby's passage through the mother's birth canal. In this case, the disease develops at lightning speed and the child either dies within the first month of life or suffers serious developmental disorders. A complicated form of meningitis is no less dangerous for children. And already at the age of 1 to 5 years, children more often suffer from viral meningitis, which usually goes away more easily than bacterial meningitis.

The course of the disease consists of three periods: incubation, prodromal and the disease itself. The incubation period is the time from the moment the virus enters the body until the first symptoms of the disease appear. At this time, viruses or bacteria are contained in the body in small quantities, and therefore cause almost imperceptible harm. Depending on the type of disease incubation period can last from several minutes (rapid development) to several years (chronic inflammation). The duration of the incubation period also depends on the state of the patient’s immune system: the weaker it is, the faster the disease manifests itself. Most often, the incubation period lasts from 1 to 10 days. If the disease was diagnosed in the first two days after infection, then the chances of cure reach 95%.

The fulminant, or fulminant, form of meningitis is the most dangerous. With this form, all stages of the disease pass almost instantly, and death is possible within the first day. Acute meningitis also occurs according to an “accelerated” program: as a rule, 3 days are enough for the infection to reach its peak or even cause the death of the patient.

Purulent meningitis can enter the prodromal stage (the time when classic symptoms of the disease appear) within a few hours after bacteria enter the body. Acute bacterial inflammation progresses very quickly. If the disease was caused by Neisseria meningitidis, the patient may die within a few hours after infection. Against the background of this type of disease, bilateral hemorrhagic adrenal infarction (Waterhouse-Friderichsen syndrome) is possible. And the disease caused by the bacterium Haemophilus influenzae, or hemophilic meningitis, is more common in countries where vaccination against hemophilia is not carried out.

If we are talking about the acute period of the disease, then it usually develops from several days to several weeks, and chronic meningitis manifests itself no earlier than 4 weeks after infection. In addition, while most forms of inflammation in the brain occur rather quickly, chronic meningitis can drag on for even more than 25 years. In this case, the disease develops gradually, and it is almost impossible to determine when the infection entered the body.

Sometimes inflammation of the meninges returns even after successful treatment. Relapse can be caused by viruses, bacteria or non-infectious factors. The most common cause of recurrent disease is herpes simplex virus type 2 (Mollare meningitis). Bacterial meningitis can recur due to congenital or acquired defects of the base of the skull or spine.

Symptoms

The insidiousness of meningitis lies in its rapid development. Medicine knows of cases where death occurred just a few hours after the onset of the acute period of the disease. In the classic version, the incubation stage of meningitis in most cases lasts from 4 days to a week. If the disease is recognized in time, the patient has a chance of recovery. And for this you need to know the first symptoms of the disease. However, in most cases, the signs accompanying the onset of meningitis are not perceived by the patient as alarm signal, the disease is manifested by general infectious symptoms: the patient has a feeling of chills, fever, increased body temperature, in In some cases, skin rashes may appear.

The main symptom of meningitis is headache, which becomes more intense as the disease progresses. The nature of the pain is bursting, the pain can be very intense. In this case, the pain can be localized in the forehead and occipital region, radiating to the neck and spine. Bursting pain is associated with increased intracranial pressure as a result of the action of pathogen toxins. Pain syndrome worsens with head movements, as well as due to loud sounds and bright lights. Another sign important for differentiating the nature of a headache is rigidity (strong tension) of the neck muscles. Patients with meningitis (adults and children) do not lie in the usual position on their back. To ease the pain, they turn on their side, tuck their knees to their stomach and instinctively throw their head back.

Inflammation of the meninges in many cases is accompanied by nausea and severe vomiting. Moreover vomiting reflex does not stop even with a complete refusal of food. In addition, the patient’s body temperature rises (intermittently or stays consistently high at 39-40 degrees) and is not reduced by traditional antipyretics, severe weakness and sweating. The patient complains of intolerance to bright light, which worsens the headache. The presence of meningitis can also be suspected in cases where a bursting headache is accompanied by a disturbance of consciousness (a person answers questions slowly and with difficulty or does not respond to requests at all). Mental disorders, indicating inflammation of the membranes of the brain, can manifest as hallucinations, apathy or aggression. The patient may experience leg and/or arm cramps, muscle pain, and squint (if the inflammation has spread to the optic nerves).

In addition to the classic ones, they will help to recognize meningitis in young children. specific signs: Kernig's sign and upper Brudzinski's sign. In the first case, a child lying on his back with his legs raised will not be able to straighten them at the knee joints. The second symptom is also determined in the supine position. If a baby, raising his head, involuntarily bends his knees, this may also indicate inflammation in the meninges. To identify the disease in infants, the fontanel is examined: its swelling and tension are an alarming signal. Another sign of inflammation of the meninges in children is a rash, which is then replaced by specific bright burgundy spots that appear all over the baby’s body.

Diagnostics

An experienced doctor can suspect a patient has meningitis based on external clinical signs. But it is too early to make an accurate diagnosis based only on symptoms. Moreover, it is important not only to confirm or deny the presence of the disease, but also to determine its type and stage of development. To do this, the patient will have to undergo a comprehensive examination. In such cases, patients donate blood to general analysis(UAC), general urine test and smear from the pharynx mucosa. One of the main confirmatory tests is spinal cord puncture and laboratory diagnosis of cerebrospinal fluid (CSF). Since the brain and spinal cord are in constant contact, clouded cerebrospinal fluid is always considered as the main marker of meningitis.

If signs are observed during puncture high blood pressure cerebrospinal fluid (cerebrospinal fluid flows out in a stream or frequent drops), experts regard this as one of the laboratory signs of meningitis. In addition, the color of the cerebrospinal fluid in a sick person changes: it becomes cloudy white or yellowish-green. Not only a cerebrospinal fluid analysis, but also a blood test can also tell about the disease. If the disease is present, it is observed increased amount, lymphocytes or neutrophils. The patient's sugar and chloride levels also typically increase.

Differential diagnosis of the disease is based on a biochemical analysis of the cellular composition of the cerebrospinal fluid. To establish the causative agent of the disease, they resort to bacteriological and bacterioscopic examination of the cerebrospinal fluid to determine the causative agent of the disease. Using serodiagnosis, the presence of antigens and antibodies to different pathogens diseases.

Approximate test results for meningitis

Indicators	Liquor is normal	Viral meningitis	Bacterial	Purulent
Color/transparency	No color/transparent		Colorless/transparent or opalescent	Whitish or greenish-brown/cloudy
Pressure	130-180 mm water. Art.	200-300 mm water. Art.	250-500 mm water. Art.	Increased
Rate of cerebrospinal fluid flow during puncture (drops/min.)	40-60	60-90	Trickle	Rare viscous drops
Cytosis (cells/µl)	2-8	20-800	200-700 (sometimes 800-1000)	More than 1000
Lymphocytes	90-95%	80-100%	40-60%	0-60%
Neutrophils	3-5%	0-20%	20-40%	40-100%
Sedimentary reactions	–	+ (++)	+++ (++++)	+++ (++++)
Dissociation	No	Low cell-protein (protein-cell after 8-10 days)	Moderately high cytosis and protein (then protein-cell dissociation)	High cellular protein
	1,83-3,89	More than 3.89	Significantly reduced	Moderately reduced
Chlorides (mmol/l)	120-130	More than 130	Significantly reduced	Moderately reduced
Fibrin film	Not formed	In 3-5%	In 30-40%	Coarse, often in the form of sediment
Reaction to puncture	Causes headache and vomiting	Causes relief, turning point of the disease	Causes significant but short-term relief	Moderate short-term relief

The results of a blood test will reveal neutrophilia or lymphocytosis, indicating the nature of the disease, as well as the ESR indicator - erythrocyte sedimentation rate, which in high values indicates the presence of an inflammatory process. In addition to laboratory examination of the cerebrospinal fluid and blood, the doctor will definitely need the patient’s medical history, he will conduct a thorough neurological examination, and suggest a computer or magnetic resonance imaging scan. Using an MRI or CT scan, a specialist will be able to examine the condition of the meninges and find the source of inflammation. During a conversation with the patient, the doctor will ask how long ago the headaches began, and whether the patient has been bitten by ticks or mosquitoes (carriers of the pathogen, particularly in Africa and Central Asia).

If suspicions of meningitis were detected in a child, then before sending the baby for a puncture, he should be examined by an ENT specialist, neurologist, neurosurgeon and hematologist in order to exclude other possible reasons ailments.

Treatment

Any inflammatory processes in the body are very serious. And if the inflammation occurs in the brain, then there can be no talk of any self-medication at home. Neither traditional methods nor alternative medicine can replace the necessary drug therapy. Meningitis should only be treated by a doctor and only in a hospital. The sooner a patient seeks help from a specialist, the higher his chances of survival.

The doctor can draw up a comprehensive treatment program only after receiving the results of the patient’s examinations. Meanwhile, in the case of meningitis, when the clock is ticking, not a minute can be lost. Antibiotics are prescribed as an emergency treatment for all patients with suspected meningitis. wide range actions. At the beginning of treatment, the doctor may prescribe drugs from the group of penicillins, cephalosporins, and macrolides. This will neutralize the bacteria that cause purulent meningitis. For antibiotics to start working immediately, the medicine is usually administered intravenously (drip), and in very severe cases - directly into the cerebrospinal fluid. Treatment of serous meningitis is carried out with additional use antiviral drugs. In addition to specific antibacterial or antiviral therapy selected for sensitivity, patients are prescribed nootropic and vascular drugs - Nootropil, Piracetam or their analogues are taken to restore nerve cells and the condition of blood vessels. As anti-inflammatory drugs, doctors use hormone therapy patients with drugs such as Prednisolone, Dexamethasone, Methylprednisolone or Hydrocortisone.

Diuretic therapy is also used in the treatment regimen for meningitis. Diuretic medications are needed to relieve brain swelling.

Regardless of the form and stage of meningitis, children and adults are always prescribed vitamins and minerals. These substances are necessary to maintain immunity, which is always reduced during brain inflammation, as well as to restore the supply of nutrients necessary for the proper functioning of the patient’s systems and organs.

Prevention

The question of whether it is possible to become infected with meningitis interests many. But other problems are no less pressing: how to protect yourself from the disease and are there any vaccinations against brain inflammation? Meningitis is a contagious disease. But even if a child or adult is surrounded by a patient with inflammation of the meninges, one should not take this fact as a sentence of imminent infection. Meanwhile, protection should be taken care of in advance.

One of the most effective measures Prevention of bacterial meningitis is vaccination against pathogens. Nowadays, vaccines against meningitis come in three types: protein, polysaccharide and conjugate. Within each group of vaccines, there are drugs that are most suitable for different age categories. Which vaccine to choose for an adult or a child, and how often to vaccinate, should be determined by the attending physician.

Vaccination is, although not 100 percent, still a good guarantee that a healthy person will not become infected.

To protect yourself or your child from infection with viral meningitis, it is also important to follow the rules of hygiene and Sanitary Regulations, eat only clean fruits and vegetables, and wash your hands thoroughly with soap before each meal. The most common source of meningitis infection in the summer is polluted water bodies. To protect yourself from problems, it is important to avoid swimming and especially not to drink water from them.

An excellent way to prevent meningitis is to avoid contact with an infected person. But if this has already happened, you should undergo a course of chemoprophylaxis. It is also mandatory to disinfect the room where the patient was, and monitor contact persons. If contact with a carrier of infection is inevitable (for example, someone in the household gets sick), respirators or respirators must be used to prevent infection by airborne droplets. gauze bandages. Remember: the infection first enters the upper respiratory tract of a person, settling on the mucous membranes, and then spreads throughout the body. But infection by airborne droplets does not always occur, but only in cases of reduced immunity and impaired functionality of the blood-brain barrier, which protects the brain from harmful substances. To prevent infection, family members are prescribed a course of rifampicin and vaccination using a conjugate vaccine. By the way, many people are interested in whether it is possible to get meningitis again. As a rule, this does not happen, but the possibility cannot be completely ruled out.

If meningitis was diagnosed on time and treatment was successful, a person has a chance to live a long, fulfilling life. But for everything to be exactly like this, after completing treatment in a hospital, you will have to follow the doctor’s recommendations.

After suffering from meningitis, it is important to continue monitoring with a doctor: it is important to be examined by a neurologist every three months. And so on for at least 2 years. In addition, some restrictions are temporarily imposed on the regime and way of life. It is forbidden to fly on airplanes for at least 6 months after illness. Flight during this period is dangerous because intracranial pressure changes sharply during the flight, which can negatively affect the restoration of liquor dynamics after inflammation of the meninges. Also, doctors do not advise going to the seaside immediately after an illness, especially for children. The temporary ban also applies to sports: after illness, heavy physical activity should be avoided for about 2 years.

You will also have to reconsider your usual diet: give up fatty and fried foods in favor of boiled, stewed, baked or steamed. For meat, give preference to dietary varieties: poultry, and fish. It is useful to eat boiled porridge as a side dish, and heat-treat fruits and vegetables before eating. It is useful to eat low-fat dairy foods; the best drinks are, if not strong. The diet after meningitis completely excludes alcohol.

Physiotherapy during the rehabilitation period should consist of a course of massage, electrophoresis with the use of medications. To restore cognitive functions and coordination, they resort to magnetic and magnetic laser therapy, and use electrosleep. A course of physical therapy will help restore motor function. But for this you need to exercise under the supervision of a physical therapy specialist. To restore range of motion, strength and coordination, occupational therapy is used, and a cognitive program is necessary to restore memory, attention and logical thinking.

Possible complications

Inflammation of the meninges itself is a serious problem. But against the background of this disease, other, no less complex complications are possible.

One of the most common is cerebral edema. As a rule, a critical excess of cerebrospinal fluid accumulates already on the second day of the disease. A complication can be suspected based on several external signs. The patient suddenly loses consciousness, develops shortness of breath, and blood pressure readings either sharply decrease or increase. There are also jumps in heart rate: from severe bradycardia (slow) to tachycardia (rapid). If cerebral edema is not removed in time, death is possible, which usually occurs due to paralysis of the respiratory center.

The second common danger is infectious-toxic shock. It occurs as a result of poisoning of the body by decay products of pathogenic microorganisms. Against the background of this process, the patient’s body temperature usually drops, but intolerance to light and loud sounds increases, and shortness of breath appears. In many cases, infectious-toxic shock occurs along with cerebral edema. The result is coma and death within a few hours.

After suffering from meningitis, the body will need time to recover. Sometimes quite long. If the inflammatory process was caused by meningococcal infection, then there remains a high risk of damage to other organs or entire body systems. Prevent severe consequences Only timely seeking medical help will allow.

Meningitis can cause deafness, paralysis, epilepsy, hormonal disorders. In children, hydrocephalus, complete deafness or blindness, acute renal failure, developmental delays, cerebroasthenia. Often, inflammation of the membranes of the brain in children ends in death.

We answer your questions

Do they take you into the army after meningitis?

The question of whether people with meningitis are accepted into the army is of interest to many. Let us say right away that no one with an illness will be taken to the barracks directly, since any inflammation (especially the meninges) should be hospitalized. Workers diagnosed with meningitis are unconditionally given sick leave. If cases of the disease are recorded in a school or kindergarten, the educational institution is closed for quarantine. But what awaits the young man who suffered from meningitis several years ago? If there is documentary evidence of illness, the conscript automatically enters the reserve.

Meanwhile, the issue of compatibility between the army and meningitis is of interest not only to those who have had the disease, but also to healthy conscripts. Can you get meningitis in the army? Theoretically, such a risk exists, as, indeed, in boarding schools, schools, kindergartens, sanatoriums or children's camps. Therefore, to avoid an epidemic, vaccination is carried out. Conscripts should be vaccinated against meningitis approximately 75-80 days before conscription.

Can you die from meningitis?

Any inflammatory process in the body is already a potential danger of death. What then can we say about inflammation of the meninges? But if earlier the survival rate after meningitis was no more than 5-10%, then in our time this figure has increased to around 90. Of course, the risk of death always remains, but in most cases, patients who have suffered meningitis live a long, fulfilling life.

Take care of your health and be attentive to your body's signals. If you experience any unusual changes in your health, do not delay visiting your doctor. Be aware of the consequences of delaying treatment for meningitis.

Meningitis is an acute infection, which leads to inflammation of the membranes of the spinal cord and brain. The infection can be caused by fungi, viruses and various bacteria, for example: Haemophilus influenzae, enteroviruses, meningococcal infection, tuberculosis bacilli. Signs of meningitis can appear at any age, but, as a rule, people with weakened immune systems, premature babies, patients with head injuries, back injuries and central nervous system lesions become ill.

With adequate and, most importantly, timely treatment of meningitis, it is vital important organs and human systems are usually not affected. The exception is the so-called reactive meningitis, the consequences of which can be extremely severe. If treatment for meningitis is not started within the first 24 hours after the onset of severe symptoms, the patient may become deaf or blind. Often the disease leads to coma and even fatal outcome. As a rule, meningitis in children and adults forms immunity to the action of pathogens, but there are exceptions. However, cases of recurrent disease are extremely rare. According to experts, the infection occurs again in only 0.1% of people who have recovered from the disease.

What can meningitis be?

The disease can be primary or secondary. The first type of infection is diagnosed if the meninges are immediately affected during infection. Secondary meningitis in adults and children manifests itself against the background of the underlying disease (leptospirosis, otitis media, parotitis etc.), develops slowly, but ultimately also leads to damage to the meninges.

A distinctive feature of both types of infection is its acute nature. clinical course diseases. The disease develops over several days and requires immediate treatment to prevent serious complications. An exception to this rule is tuberculous meningitis, which may not manifest itself for several weeks or even months.

Causes of meningitis

The main causative agent of the disease is meningococcal infection. In most cases, it is transmitted by airborne droplets. The source of infection is a sick person, and you can catch the infection anywhere, from public transport to clinics. In children's groups, the pathogen can cause real epidemics of the disease. We also note that when a meningococcal infection enters the human body, purulent meningitis usually develops. We will talk about it in more detail in one of the following sections.

The second most common cause of the disease is various viruses. Most often, enterovirus infection leads to damage to the membranes of the brain, however, the disease can also develop in the presence of the herpes virus, measles, mumps or rubella.

Other factors that provoke meningitis in children and adults include:

boils on the neck or face;
frontal sinusitis;
sinusitis;
acute and chronic otitis media;
lung abscess;
osteomyelitis of the skull bones.

Reactive meningitis

Reactive meningitis is one of the most dangerous forms of infection. It is often called lightning because it is extremely transient. clinical picture. If medical assistance was provided too late, the patient falls into a coma and dies from multiple purulent foci in the brain area. If doctors began to treat reactive meningitis within the first 24 hours, the consequences will not be so serious, but they can also threaten a person’s life. Great value with reactive meningitis, timely diagnosis is carried out, which is carried out by taking a lumbar puncture.

Purulent meningitis in adults and children

Purulent meningitis is characterized by the development of cerebral, general infectious and meningeal syndromes, as well as lesions of the central nervous system and inflammatory processes in the cerebrospinal fluid. In 90% of reported cases, the causative agent of the disease was infection. If a child develops purulent meningitis, the symptoms initially resemble a common cold or flu, but within a few hours patients experience characteristic features meningeal infection:

very severe headache;
repeated vomiting;
confusion;
the appearance of a rash;
neck muscle tension
strabismus;
pain when trying to pull your head to your chest.

In addition to the above symptoms of meningitis, some other signs are also found in children: drowsiness, cramps, diarrhea, pulsation of the large fontanel.

Treatment of meningitis

Patients with meningitis are subject to immediate hospitalization. Don't try to treat meningitis folk remedies and do not delay calling an ambulance at all, since jokes with an infection can easily result in disability or death.

Antibiotics are the drugs of choice for treating meningitis. Let us note that in approximately 20% of cases it is not possible to identify the cause of the disease, so hospitals use broad-spectrum antibiotics in order to affect all possible pathogens. The course of antibiotic therapy lasts at least 10 days. This period increases in the presence of purulent foci in the skull area.

Currently, meningitis in adults and children is treated with penicillin, ceftriaxone and cefotaxime. If they do not give the expected effect, then patients are prescribed vancomycin and carbapenems. They have serious side effects and are used only in cases where there is a real risk of life-threatening complications.

If severe meningitis is observed, the patient is prescribed endolumbar administration of antibiotics, in which the drugs enter directly into the spinal canal.

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