Meningitis - treatment, prevention methods and prognosis. Meningitis: etiology, symptomatic complex, types of diagnostic methods
This is an inflammation of the membranes of the brain and spinal cord. With this disease, brain cells are not damaged, the inflammatory process is formed externally.
You can get meningitis at any age. Rather, the incidence does not depend on age, but on the condition of the body. For example, premature babies (since they are weakened) are most at risk of meningitis. Also, the group of people who are more susceptible to the disease includes people with various defects of the central nervous system, with head or back injuries.
Meningitis is dangerous disease, which even with adequate and proper treatment may cause consequences. Such consequences include headaches, dizziness, decreased visual acuity or hearing (even blindness and deafness), epileptic seizures etc. Such consequences can last for several years, or even last a lifetime.
Meningitis in children under one year of age can cause the following consequences: violation motor function(paralysis, paresis), mental retardation, decreased visual or hearing acuity, epilepsy, difficulties during study, behavioral disorders, etc. These complications do not develop in all children who have had meningitis, but according to statistics, such problems are observed in 25- 50% children.
Causes of meningitis
The causes of meningitis are viruses, bacteria and fungi. Meningitis affects people of all ages. Thus, the incidence is not due to age, but to the condition of the body. In particular, premature babies are most at risk from meningitis. Similarly, the group of people most susceptible to the disease includes people with various defects of the central nervous system, with injuries to the head or back. There are other factors that influence the incidence of meningitis.
Signs of meningitis
Meningitis in most cases has an acute and sudden onset. The initial symptoms of meningitis are very similar to those severe cold or flu:
- feeling of weakness;
- fever (temperature rises to 39 degrees or more);
- pain in joints and muscles;
- decreased appetite.
Symptoms of meningitis
Over a period from a couple of hours to several days against the background high temperature characteristic (specific) symptoms of meningitis appear. These include:
| Severe pain in the head. During meningitis, the nature of the headache is diffuse, that is, the pain is distributed throughout the head. Over time painful sensations increase and take on the character of bursting pain. After a certain period of time, the pain progresses to unbearable (from such pain an adult groans, and children can scream). Then the pain in most cases is accompanied by a feeling of nausea and vomiting. Usually, with meningitis, pain in the head increases if you change the position of the body, as well as under the influence of external irritants (loud sound, noise). |
| Meningococcal meningitis is characterized by the appearance of a rash. If meningitis manifests itself in a mild form, the rash may appear as small dotted dark cherry-colored rashes. On the third or fourth day from the moment of formation, the rash with meningococcal meningitis disappears. In more severe forms of meningitis, the rash appears as large spots and bruises. Rashes in severe meningitis disappear within ten days. |
| Confusion. |
| Repeated vomiting, after which there is no feeling of relief. |
| Meningeal symptoms: the muscles of the back of the head are very tense; Patients with meningitis, as a rule, prefer to lie on their side, with their knees pulled up to their stomach, their head thrown back, and if you change the position of the patient's head, tilting it towards the chest, or try to straighten your knees, severe pain appears. |
| In some cases, meningitis causes damage cranial nerves, which leads to strabismus. |
Detailed descriptions of symptoms
Symptoms of meningitis in children under one year old
In children under the age of one year, in addition to the symptoms already listed, there are also signs of meningitis such as:
- diarrhea (diarrhea);
- apathy;
- drowsiness;
- constant strong crying;
- refusal to eat;
- anxiety;
- convulsions;
- swelling and pulsation in the area of the large fontanel;
- vomiting and repeated regurgitation.
Diagnosis of meningitis
A great difficulty is diagnosing meningitis in patients who have received antibiotic therapy in quantities insufficient for recovery. The temperature drops to 37.5 - 38.5 C, meningeal symptoms regress, headache weakens, but meanwhile remains persistent, nausea often remains, and rarely vomiting.
After a few days, due to the spread of the process to the ventricles and brain matter, the patient’s condition rapidly deteriorates. General cerebral and focal neurological symptoms occur.
Mortality and frequency increase sharply residual effects in this group of patients. Viral meningitis begins to develop with symptoms characteristic of the corresponding infection, while meningitis develops later. In these cases, a two-wave course of the disease is observed. But meningitis from the first day can be the main manifestation of the disease.
The fever is moderate, meningeal symptoms are detected on the second-third or fifth-seventh day from the onset of the disease, sometimes later. Despite the strong headache and poor condition of patients, meningeal symptoms are manifested moderately, often not in full, disorder of consciousness is not typical.
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 the cause of the disease cannot be identified, which is why antibiotics are used in hospitals wide range actions in order to influence all likely 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 developing fatal dangerous complications. If severe meningitis is observed, the patient is prescribed endolumbar administration of antibiotics, in which the drugs enter directly into the spinal canal.
Instructions for the use of drugs for meningitis
Prevention of meningitis
To prevent meningitis, in some cases a vaccination is given. The vaccination is valid for 4 years. But there are no vaccinations against all types of meningitis. In addition, it is difficult to predict which pathogen will cause an outbreak next time.
Vaccines have not yet been created against many pathogens that can cause meningitis. Therefore, it is necessary to carry out nonspecific prevention of diseases in general, increase nonspecific immunity (hardening, vitaminization, etc.) and notice the symptoms of the disease in time and call a doctor.
Classification of meningitis
Reactive or fulminant meningitis
Reactive meningitis is a form of acute bacterial meningitis. This form is also called lightning, as it develops very intensively. Purulent infections meninges and cerebral edema lead to coma or death. The disease is caused by the following bacteria: group B streptococci, meningococci, pneumococci. It also occurs as a complication of various pathologies:
- pneumonia;
- otitis;
- sinusitis;
- endocarditis;
- glomerulonephritis.
Sometimes the first symptoms of reactive meningitis are:
- a sore throat;
- temperature increase;
- vomit;
- headache;
- hardening of the neck and neck muscles.
This form of meningitis for adults becomes fatal within a day after the disease, for children - faster.
In some cases, symptoms of nerve damage appear from the very beginning: paresis and paralysis, deafness. Even timely diagnosis and intensive therapy often cannot prevent serious complications of reactive meningitis: the concentration of sodium ions in the blood plasma decreases (hypoatremia), blood clotting is impaired, and septic shock occurs.
Reactive meningitis can be diagnosed using a lumbar puncture. Thus, it is distinguished from other diseases with similar symptoms. But the procedure takes a certain time, which patients often do not have. Timely treatment of this form of meningitis does not guarantee a favorable outcome: mortality is more than 10% of all cases.
Serous meningitis
Serous meningitis occurs with serous inflammation of the meninges. According to its etiology, it can be viral, bacterial (tuberculosis, syphilitic) and fungal. Spicy serous meningitis occurs under the influence of various viruses. Most often these are enteroviruses and viruses mumps(70-80% of all diseases). Influenza, herpes and other viruses can also be pathogens. Viral serous meningitis is manifested by meningeal symptoms and fever; Other organs may also be affected. The central and peripheral nervous systems are also affected.
Tuberculous meningitis
Tuberculous meningitis is more common among children and adolescents than among adults. It is a secondary disease that occurs as a complication of tuberculosis. Tuberculous meningitis begins with weakness, headache, weight loss, sweating, extreme fatigue and vomiting. Then symptoms such as stiffness of the neck muscles, decreased vision, and squint appear.
Modern medicine can guarantee a favorable outcome of tuberculous meningitis in 90-95% of cases, but only in case of timely and long-term complex treatment. If the diagnosis is made late, the disease can be fatal. Complications of tuberculous meningitis include epileptic seizures, hydrocephalus, endocrine disorders, etc.
Viral meningitis
Viral meningitis is an inflammatory process in the serous membranes of the brain or, in rare cases, the spinal cord, caused by a viral infection. Meningitis manifests itself in several forms (secondary purulent, serous, protozoal and meningococcal), but it is viral form The disease has the most positive prognosis for the patient and proceeds relatively favorably. In most cases, isolated cases of the disease are recorded; epidemic outbreaks are extremely rare. Most often, children suffer from viral meningitis.
Viral meningitis can be either an independent disease or a complication after an infectious disease. Such lab tests, such as cultivation and serological tests, make it possible to identify the exact causative agent of the disease in 30-70% of all cases. A study of the patient's cerebrospinal fluid proves that at least two-thirds of cases of viral meningitis are caused by enteroviruses.
Purulent meningitis
Purulent meningitis (inflammation of the soft meninges) is the most severe infectious disease in both children and adults. The disease can be caused by any bacterial agent, but in the vast majority of cases it is caused by meningococci and Haemophilus influenzae type b.
According to modern research, bacterial purulent meningitis in Russia is caused in 54% of cases by meningococci, in 39% by Haemophilus influenzae type b, in 5% by pneumococci, and only in 2% of cases by all other bacterial agents. The disease is especially common in children aged 2 months to 5 years.
The development of purulent meningitis at this age is facilitated by prematurity, artificial feeding, perinatal pathology or any other disease that increases the permeability of the blood-brain barrier.
The disease occurs as a result of bacterial pathogens entering from places of primary localization (nasopharynx, lungs, abscesses on the skin, etc.) through the blood into the soft meninges, in which they multiply and form purulent foci of inflammation. Purulent exudate is usually located on the basal surface of the brain, at the site of decussation optic nerves, as well as in the region of the medulla oblongata and spinal cord.
In severe cases, the process from the soft meninges spreads to the substance of the brain with the appearance of meningoencephalitis. If treatment is started late, inflammation of the cerebral ventricles may develop, leading to blockage of the cerebrospinal fluid ducts (aqueduct of Sylvius, foramina of Mozhandi, Luschka) with purulent exudate, resulting in hydrocephalus (hydrocephalus).
Meningococcal meningitis
Meningococcal infection - acute infection, characterized by significant clinical polymorphism and occurring in the form of nasopharyngitis, meningitis or meningococcal sepsis.
Meningococcal infection can be localized or generalized. Localized forms are meningococcal carriage, acute nasopharyngitis, isolated meningococcal pneumonia. Generalized forms include meningococcemia (acute and chronic), meningococcal meningitis, meningococcal meningoencephalitis, mixed form (meningococcemia + meningitis), meningococcal endocarditis, meningococcal arthritis (synovitis) or polyarthritis, meningococcal iridocyclitis.
Due to their occurrence, all types of meningitis can be divided into purulent and aseptic (non-purulent). There are acute and subacute purulent meningitis. The former are caused by bacteria (most often meningococcal infection), the latter develop over a long period of time as a result of tuberculosis and syphilis. Aseptic meningitis can also be divided into acute (caused by viruses) and subacute (as a consequence of various diseases).
Questions and answers on the topic "Meningitis"
Question:Hello, my 4 month old son was diagnosed with purulent meningitis today. He has been in intensive care for 3 days. He was a healthy boy and developed well. Tell me what the consequences may be after treatment? and how long will the treatment take?
Answer: Hello. Duration of treatment and possible consequences your child's meningitis depends on his general condition and the type of bacteria that caused the meningitis. Only the child’s attending physician can give more specific figures.
Question:I am 23 years old and suffered from serous meningitis 5 months ago. I still have a headache, I can’t drive a car, clouded consciousness, weak reactions, I can’t live as before, everything is not the same, everything is different. When will it end?
Question:Hello, my husband’s sister suspected meningitis and was admitted to the hospital for examination. My daughter had close contact with the patient for 10 months, what should we do now? I’m very worried?! Tell me, are all types of meningitis contagious?
Answer: Hello. Almost all types of meningitis can be contagious. Check with your husband's sister for the type of meningitis and contact your child's pediatrician.
Question:How long can a fever last for pneumococcal meningitis?
Answer: As a rule, with meningitis, a prolonged increase in temperature is observed - until the patient recovers. The duration of meningitis varies widely - from a week to a month.
Question:Hello! My brother was diagnosed with infectious meningitis and was admitted to the hospital. At first the doctor said that he would stay in the hospital for a month, but now only 2 weeks have passed and he is already being discharged! This is fine? And with such meningitis, what treatment is carried out - antibiotics? Please answer.
Answer: Hello. Infectious meningitis can be bacterial (in which case treatment with antibiotics) or viral (in which case antibiotics are not prescribed). Ask the doctor what treatment was prescribed for your brother and why he is already being discharged. Perhaps your brother is already on the mend?
Question:The child spent 2 weeks in the hospital with a diagnosis of mild serous meningitis. Now he is at home, but no one advises what is possible, what is not, what measures and for how long should be carried out so that there are no consequences of the disease.
Answer: Must be excluded physical exercise. Rational mode nutrition and daily routine. Specific medical recommendations To prevent complications of meningitis, your attending physician should give you advice from a neurologist.
Question:Hello! Please tell me how to restore hearing after meningitis. My brother suffered from meningitis after going on vacation to India. Lost my hearing. Doctors say it’s useless, but maybe something can be done?
Answer: The cause of hearing loss after meningitis is damage to the corresponding areas of the cerebral cortex or the pathways conducting auditory impulses. Treatment is possible only after a thorough diagnosis of brain functions and hearing aid in a specialized neurological clinic.
Group of diseases:
Meningitis is a dangerous disease that is an inflammation of the membrane of the brain (usually) or the spinal cord. Meningitis is short incubation period(up to 7 days) and can lead the patient to death in just a few hours. Therefore, everyone needs to know the symptoms of this disease.
Meningitis in adults can be primary or secondary. Primary is independent disease, which is caused by meningococcal infection, and inflammation immediately begins in the lining of the brain. Secondary meningitis is a consequence of diseases such as osteomyelitis of the skull bones, sinusitis, neck and face, as well as other foci of inflammation.
Symptoms of meningitis
The very first signs of meningitis in adults resemble progressive colds and then the following symptoms appear:
- chills and fever, which are most severe in young adults and adolescents;
- vomiting and constant nausea;
- increased sensitivity to the light. The patient often lies facing the wall or covers his head with a blanket;
- spasm of the muscles of the back of the head, due to which the patient cannot turn his head or tilt it;
- acute, often unbearable, which intensifies significantly with loud sounds, bright light or head movements;
- Kerning's sign. It lies in the fact that the patient cannot straighten the leg, bent at the hip and knee joints.
- Brudzinski's sign:
– if the patient’s head in a supine position is raised to the chest, the legs are bent at the hips and knee joints;
– if light pressure is applied to the pubic plexus, the legs bend at the hip and knee joints;
– when testing for Kernig’s sign, the second leg also bends.
Brudzinski's sign - if the patient's head in a supine position is raised to the chest, the legs are bent at the hip and knee joints - the patient may experience increased sensitivity skin, and even a light touch can be painful;
- decreased appetite;
- shortness of breath and rapid shallow breathing;
- Possible skin rash.
Symptoms of the disease largely depend on the type of meningitis, of which there are seven.
Meningitis in adults - there are 7 types
Aseptic meningitis
It is a consequence of undertreatment or can lead to death. The main symptoms are:
– fever;
– mental disorders;
– vomiting and nausea;
– decreased vision;
– curvature of the neck;
– drowsiness, headache, fever.
Revealed on late stage the disease often leads to disability or death.
Cryptococcal meningitis
Caused by a fungus that inhabits soil throughout the world. As a rule, it affects people who are weakened by a long-term or severe chronic disease or after an organ transplant. Its symptoms are:
– hallucinations;
– fever;
– vomiting and nausea;
– curvature of the neck;
– mental disorders and fear of light.
Treated successfully antifungal drugs, there may be complications leading to disability.
Viral meningitis due to influenza
It is caused by the Haemophilus bacterium, which enters the bloodstream from the upper respiratory tract and then into the brain. Like cryptococcal meningitis, this type of disease is dangerous for people with weakened immune systems and is often observed during influenza epidemics.
Symptoms appear almost immediately after infection:
- mental disorders;
– chills and fever;
– photophobia;
– impaired consciousness;
– convex fontanel in infants;
– frequent shallow breathing;
– disturbance of the sucking reflex in an infant;
– rigidity of the neck muscles, due to which a person cannot tilt his head;
- Strong headache.
Treatment with antibiotics must be started as early as possible so that the infection does not have time to cause irreversible damage to the brain. People who do not have appropriate vaccinations and who come into contact with a sick person should also take a course of antibiotics to avoid infection. The worst prognosis is usually in infants and people over 50 years of age.
Meningococcal meningitis
This is infectious meningitis, the disease is very contagious, mainly children and adolescents are susceptible to it. IN winter period The prevalence of the disease can take the form of an epidemic. The symptoms of this type of meningitis are quite characteristic and differ in hemorrhagic manifestations, and are also observed:
– pinpoint reddish spots resembling a rash;
– very severe headache;
– hematomas;
- rashes on mucous membranes, appearance reminiscent;
– increased sensitivity to light;
– chills and fever.
Treatment is the same as for a viral form of the disease. If the disease does not proceed at lightning speed, then when timely treatment after 10-12 days recovery occurs. In the fulminant form, a person dies in less than a day from renal, respiratory or cardiovascular failure.
Pneumococcal meningitis
Pneumococcus very often causes bacterial meningitis in adults, it is in second place after meningococcus. This type of disease is extremely difficult for patients to tolerate, with a high percentage of deaths. There is an increased risk of developing pneumococcal meningitis in people who have recently suffered a head injury, who have had meningitis before, people who have had their spleen removed and have infectious lesions. heart valve. and other long-term chronic diseases increase the likelihood of pneumococcal infection.
The main features are:
– raising the temperature to 40 degrees;
– blueness of hands and feet;
The disease develops very quickly, the patient can fall into a coma and die without leaving it. Deaths are common because meningitis develops quickly and the bacteria are quite resistant to antibiotics.
Tuberculous meningitis
This is a form of the disease that develops slowly. They have mild symptoms common to meningitis, as well as the following signs:
– chills and fever, temperature persists long time, but increases very slowly;
– appetite decreases, general malaise and weakness appear;
– catarrhal, nasopharyngitis;
– asthenia, lethargy, weight loss.
Diagnosis requires skin tests, brain tissue tests, and a chest x-ray.
Despite the sluggish progress, tuberculous meningitis may pose a threat to human life. The danger is that it is extremely difficult to diagnose it on your own, and the symptoms at the onset of the disease are not so significant for a person to see a doctor. Treatment lasts at least a year, the patient must take anti-tuberculosis drugs, sometimes steroids. BCG vaccination excludes the possibility of contracting tuberculous meningitis.
Diagnosis of the disease
A doctor can diagnose meningitis or suspicion of it based on the following signs:
- fever;
- torticollis;
- tachycardia;
- mental disorders.
After the listed symptoms have been detected, the patient is referred to spinal tap. This analysis allows you to evaluate the bacterial picture of the spinal cord, as well as the structure and number of cells. A lumbar puncture is done between the 3rd and 4th lumbar vertebrae, with the game being inserted into the space between spinal cord and its membrane (subarachnoid space).
Depending on additional symptoms, encephalography, chest x-ray, fundus assessment, various immunological and bacteriological research, and . All these studies are needed in order to determine the type of meningitis a person has and prescribe treatment.
Important! You cannot treat meningitis on your own, since if the drugs are selected incorrectly, death is likely. Most people who died from did not see a doctor in time or tried to treat the disease on their own.
Treatment of meningitis
The specifics of treatment depend on the type of disease diagnosed. In the vast majority of cases, the patient is hospitalized. Until a lumbar puncture has been performed, the patient is prescribed antibiotics general spectrum actions, and then prescribe more targeted treatment.
Bacterial and purulent meningitis are treated with antibiotics of different spectrum of action. It is often necessary to change several drugs in order to identify the greatest sensitivity of bacteria to the drug. The selection of antibiotics also depends on the patient’s age and health status.
Viral meningitis is much more serious and causes severe nausea and headaches. The patient is prescribed antiemetics and analgesics, and paracetamol is prescribed for high temperatures.
How long the disease will last depends on the general condition of the body and the type of pathogen. On average, the treatment period lasts from 10 days to 3 weeks, if there are no complications.
Prevention of meningitis
Even now, in 2016, people are dying from meningitis due to the fact that the disease was not prevented in time. The most reliable way to protect yourself against most types of meningitis is through vaccinations. Most vaccinations are given in childhood, but adults and teenagers who have not previously been vaccinated can still get vaccinated. First of all, these are vaccinations against rubella, chickenpox, mumps and . These diseases themselves are dangerous in adulthood, and can also become causative agents of meningitis. A vaccine with meningococcal bacteria has also been developed, which reliably protects against this type of meningitis. This is not a mandatory vaccination, but is recommended for children and people who are at risk of contracting meningitis (for example, frequent travelers).
People who have implants and whose spleen has been removed should be vaccinated with pneumococcal conjugate vaccine (PCV).
In addition to vaccination, the following rules will help protect against the disease:
- Avoid contact with a person who has meningitis. When caring for a patient, you need to wash your hands with soap and change clothes that have touched the patient. If a person is being treated at home, then he must be isolated from other family members until he recovers so that the disease is not transmitted to them;
- avoid animals and insects that are carriers of encephalitis. Primarily these are rats, mosquitoes and ticks. Therefore, when going to the forest, you must use insect repellent. Deratization should be carried out regularly in houses;
- meningitis primarily affects people with weakened immune systems, so it is important to eat well, take periodic vitamins and healthy image life. Hypothermia in winter can also end in disaster, as it causes a sharp decline immunity.
Meningitis- this is dangerous and serious illness, which is much easier to prevent than to cure.
Meningitis is a disease caused by microbes: viruses, bacteria, and rarely fungi. No one is immune from its occurrence, but children and adolescents are most susceptible to the disease, especially those who have congenital or acquired brain pathologies. Elderly people with weakened immune systems and chronic disorder blood supply to the brain, also quite often suffer from meningitis. The first signs of this disease should be known to everyone.
How does meningitis become infected?The virus can reach a person through airborne droplets, through water and food that has not undergone sufficient heat treatment, through insect bites, or by contact. Also, having been in the body for a long time, it can be activated and penetrate the lining of the brain from lymphocytes or nerve cells with suppressed immunity (these are herpes viruses, Epstein-Barr, cytomegalovirus). If the virus is given enough resistance protective systems body, meningitis will not develop.
Bacterial meningitis most often occurs when the pathogen spreads to the membranes of the brain from the ear cavity during purulent otitis, from the nose - with purulent rhinitis, from the sinuses. It can be brought in from the blood during sepsis, and also get directly onto the membrane during a penetrating injury to the cranial cavity or spine.
If you get it from a patient, it is almost impossible. The maximum you will get is an uncomplicated viral disease, which will look like ARVI, intestinal infection, herpetic rashes, as well as measles, chickenpox, mumps and other viral infections. You can get sick if your immune system is very weakened or if the pathogen is very aggressive. Therefore, if your child had contact with another child in the children's group, who was later diagnosed with it, you should know, but you should not panic because of this. You can limit yourself to only taking prophylactic medications “Arbidol”, “Anaferon” or “Groprinosin”. You can put interferon drops in your nose.
If meningitis develops as a complication of other purulent diseases, it is not contagious. That is, if you talked with a relative who developed otitis media, sinusitis (or other sinusitis), or pneumonia as a result of untreated or incorrectly treated sinusitis, you don’t have to worry about yourself. Only one bacterium, meningococcus, which causes infectious meningitis (also called epidemic meningitis), can be transmitted from one person to another. The source can be a person who is sick with meningococcal infection (it can manifest itself in the form of a runny nose and sore throat, maybe in the form of a rash or in the form of meningitis) or a carrier of this bacterium. He "spreads" germs through talking, coughing and sneezing. People who have had close contact with such a person become infected: relatives or children in a children's group. Among them there are outbreaks of meningitis. If you or your child have had contact with a person who has been diagnosed, urgently consult with an infectious disease specialist about prophylactic antibiotics - is this indicated in this case and when meningitis may appear in you.
First signs and symptoms of this disease
The initial symptoms of the disease may be a runny nose, malaise, weakness, and cough. A rash may appear: one that would be characteristic of chickenpox, herpes or shingles. If a rash of dark red, brown or black color appears that does not itch or hurt, and does not become paler when the skin underneath is stretched, call an ambulance immediately: this could be meningococcal meningitis, the first signs of which may appear much later.
The following are considered early:
The appearance of a severe headache, which is briefly relieved with painkillers, intensifies with a sharp turn of the head, bright light, loud sounds;
Increased body temperature (a mandatory sign of meningitis);
Nausea and vomiting that occur against the background of a headache are not accompanied by diarrhea.
Later they may appear: as a type of excitement and inadequacy or, conversely, in the form of a state when it is difficult to wake a person; convulsions, delirium, hallucinations. In babies, a large fontanel bulges, they become drowsy, refuse to eat and drink, do not want to be held, but lie with their heads thrown back.
Almost all forms of meningitis develop extremely quickly. The infection affects the soft and arachnoid membrane, the disease does not directly affect the brain matter. The main provocateurs of meningitis can be: mumps, and other infectious diseases.
The most commonly reported disease is meningococcal meningitis. The source of infection is sick people and bacteria carriers. In winter and spring, the number of cases of the disease increases significantly. The spread of the pathogen is affected by decreasing air temperature, increasing humidity and crowding of people. Outbreaks of morbidity occur every 10–15 years.
Meningitis occurs everywhere, but the number of cases in African countries is more than 40 times higher than the European average. Until the 20th century, the mortality rate from meningitis was about 90%, but thanks to the invention of antibiotics and other effective drugs it was significantly reduced.
A person of any age can get meningitis, but children under five years of age, premature babies, and people with weakened immune systems are at risk for this disease.
Causes
Any infectious agents that penetrate the soft meninges can cause meningitis. The main causative agents of meningitis, as a rule, are bacteria and viruses; less often they encounter infection with protozoa and yeast fungi. More often, a person becomes infected with meningococcus, tuberculosis bacillus and Afanasyev-Pfeiffer bacillus. Less common: pneumococci, staphylococci and Haemophilus influenzae streptococcus.
The causes of childhood meningitis are usually enteroviruses that enter the body with food, water and contaminated objects; they can also spread against the background of chickenpox and rubella.
Adult patients are characterized by a bacterial form of the disease caused by Neisseria meningitidis and Streptococcus pneumoniae. Microorganisms can inhabit the mucous membranes of the respiratory tract and not manifest themselves in any way, but when the body’s defenses are reduced, they penetrate the membranes of the brain, where they cause severe symptoms of the disease.
Group B streptococci often cause the disease in newborns; infection can occur during childbirth or in the postpartum period. Listeria can cause disease in infants, debilitated people and persons old age. In rare cases, the causative agent of meningitis is Klebsiella, or coli. This pathogen provokes the disease due to brain injuries and blood poisoning.
The main routes of transmission of meningitis are:
- airborne;
- fecal-oral;
- insect and rodent bites;
- transplacental.
Meningitis can occur as a complication of other infectious processes occurring in the body. Infectious agents penetrate the lining of the brain in different ways. The most common is hematogenous. It is also possible to spread the infection by lymphogenous route. If the source of inflammation comes into contact with the meninges, a contact route of transmission is likely. It is promoted by purulent otitis media, frontal sinusitis, brain abscess, and sinus thrombosis of the brain. Open injuries spine and head with the leakage of cerebrospinal fluid create a gateway for infection.
Classification
Classification of meningitis is carried out according to many characteristics.
Depending on the cause of its occurrence (etiology), there are:
- viral;
- bacterial;
- fungal;
- protozoan;
- mixed.
By origin, meningitis is divided into:
- primary (most neuroviral infections and purulent meningitis);
- secondary (syphilitic, tuberculous).
Depending on the features infectious process:
- serous (most often caused by viruses);
- purulent (caused by bacteria).
According to the nature of the course, meningitis is divided into:
- spicy;
- subacute;
- chronic;
- fulminant.
The localization of the lesion can be different; on this basis, the disease is classified into types:
- spinal (damage to the spinal cord);
- cerebral (brain damage);
- convexial (superficial);
- basal (damage to the base of the brain).
Primary meningitis is considered as a separate pathology in which the pathogen enters the body from environment and then develops in the tissue of the meninges. In the case of secondary infection, meningitis is a serious complication of another disease in the patient’s body from the source of which the infection has spread.
Symptoms
Meningitis is characterized by a predominantly acute course. The disease is diagnosed by three syndromes:
- General infectious disease.
- Meningeal (meningeal).
- Analysis of cerebral fluid.
The first symptoms of the disease may resemble a cold (general infectious):
- temperature rise to 38°C and above;
- muscle pain;
- chills;
- rapid breathing;
- , increase in ESR.
There are also specific signs of meningitis (meningeal):
- Headache. Localization pain syndrome often absent, usually diffuse. Over time, the pain becomes unbearable, bursting, and any movements and irritations intensify it even more. Confusion may occur.
- Nausea and vomiting, after which there is no relief.
- Skin rashes. Mild primary meningococcal meningitis may appear as a small, dark red rash that goes away after a few days. Long-lasting bruising and large red spots indicate a severe form of the disease.
- Stiff neck. When trying to bring your chin to chest, patients experience severe pain. The typical position for such patients is the lateral position with the head thrown back and the limbs bent, pressed against the chest and abdomen.
- Brudzinski's sign. When pressing on eyeballs or when the eye muscles move, the patient feels pain. There is also irritability from bright lights, strong smells and loud sounds.
- Kernig's sign. The patient takes a supine position, then bends his leg at a right angle at the knee and hip joint. Trying to straighten the knee causes the patient to experience pain in the lower back and hip.
- Bakhterev's symptom. By lightly tapping zygomatic bone pain occurs.
- Lessage's sign is characteristic of infants. When lifting a child by the armpits, he involuntarily bends his legs in hip joints and knees.
Diagnostics
If you suspect meningitis, you should contact medical care V as soon as possible. If a child experiences vomiting against a background of high body temperature, this is also a reason to conduct a diagnosis to rule out meningitis.
To clarify the diagnosis and determine the type of pathogen in the conditions medical institutions carry out the following activities:
- Lumbar puncture makes it possible to examine the cerebrospinal fluid for inflammatory processes. A study of cerebrospinal fluid provides answers to the question of the type of meningitis (purulent or serous) and the type of pathogen.
- Bacteriological examination of a smear from the nasopharyngeal mucosa.
- Blood, stool, and urine tests to determine general indicators.
- X-ray examination of the lungs to check for.
- MRI and CT scan in the first week of illness to exclude similar pathologies.
Meningitis is diagnosed by infectious disease specialists and neurologists.
Treatment
At the first symptoms of meningitis, the first priority is urgent hospitalization to begin treatment. Before the introduction of penicillin and sulfa drugs, the mortality rate from meningococcal meningitis ranged from 30 to 70%. Modern drugs help effectively resist the disease.
With symptoms of meningitis in a reactive form, the struggle to save a person can be calculated in hours. The patient may require intensive care or resuscitation measures. The course of treatment consists of etiological, pathogenetic and symptomatic therapy. The prescription of treatment tactics and medications depends on the type of pathogen that caused the disease.
At purulent meningitis antibiotics are shown that have the ability to penetrate in the required dosage through the barrier between the blood and central nervous system. The choice of drug will depend on the lumbar puncture findings, medical history and level of consciousness of the patient. After clarifying the pathogen and its sensitivity (which takes time) antibacterial therapy corrected.
The tuberculous type of meningitis requires the use of anti-tuberculosis antibiotics in the maximum permissible dosages. Treatment of viral meningitis requires the use of antiviral agents, interferon preparations, immunoglobulins, etc. Antibiotics in this case are used to treat complications.
All types of meningitis require the use of detoxification, dehydration, maintenance therapy and analgesics. Diuretics are given to prevent swelling of the brain. In severe cases, the use of anticonvulsants and corticosteroids may be required.
People who have had meningitis spend a long time under clinical care with a neuropsychiatrist, pediatrician, neurologist and therapist.
Complications
The consequences of the disease will depend on what microorganism it was caused by and on the general health of the person. The later treatment for meningitis is started, the higher the likelihood of severe complications.
One of the most dangerous conditions caused by meningitis is cerebral edema. This complication most often develops in adolescents and children after the first day after the onset of the disease. Further, due to paralysis of the respiratory center, breathing stops and the patient dies.
Infectious-toxic shock occurs due to pathogenic meningococci entering the bloodstream. This condition is commonly called meningococcemia. Death this complication can occur within three days. Young patients may develop simultaneously toxic shock and cerebral edema.
Sometimes the consequences of meningitis for many years are migraines, weather dependence and drowsiness, in other cases the following appear:
- memory impairment and absent-mindedness;
- hearing loss;
- loss of visual acuity;
- delay mental development in children;
- and psychopathy;
- strabismus.
After treatment for meningitis in childhood severe complications can remain for life, so the disease requires long-term therapy and careful monitoring after recovery.
Prevention
There is no single specific prevention of meningitis. It is difficult to prevent the development of the disease, since there are quite a few pathogens, and the prevention system for each of them is different. General rules are:
- timely isolation of patients;
- early diagnosis;
- compliance with hygiene rules;
- use of protective equipment when communicating with a patient;
- maintaining normal immune status.
The only one specific method Vaccination is considered to be able to protect against the most common and severe forms of the disease. Most often used for this purpose meningococcal vaccine, triple MMR vaccine and Haemophilus influenzae type B vaccine.
Forecast
The prognosis of the disease is individual and depends on many factors:
- type of pathogen;
- timing of treatment initiation;
- the general health of the patient;
- involvement of brain tissue.
The prognosis is ambiguous, sometimes the disease is reactive, and no emergency measures do not help save the patient; in other cases, complete recovery occurs without any consequences.
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Meningitis in adults and children: causes of its occurrence, signs and symptoms, diagnosis, and effective methods therapy
Meningitis is an acute infectious pathology, accompanied inflammatory process membranes of the spinal cord and brain. This disease develops as a result of exposure to the human body of such viruses and bacteria as tuberculosis bacilli, meningococcal infection, enteroviruses, Haemophilus influenzae and some others. TO obvious signs of this disease can be attributed to both high body temperature and severe headache, severe pain when trying to straighten the patient’s legs at the knees, a dark rash on the body, the inability to bend the head to the chest, as well as repeated vomiting.
In children under one year of age, as well as in newborns, this pathology is accompanied by excessive anxiety, bulging of the large fontanel, constant crying, the appearance of a rash, and refusal to eat. Both diagnosis and treatment of this pathology are the responsibilities of neurologists and infectious disease specialists. If any signs of this disease develop, the patient must be taken to the hospital as soon as possible. medical institution. Therapy for this disease is based on the use of antibiotics, hormonal and diuretics, as well as antipyretic medications.
Meningitis - what is this pathology?
Meningitis means inflammatory damage to the membranes of the spinal cord and brain. This disease is considered to be very serious and extremely dangerous, as sometimes it can cause the death of the patient. If you believe the statistics, then this disease is in tenth place among the causes of mortality from infectious diseases. For example, in a number of African countries, two hundred to three hundred cases of this pathology are recorded annually per one hundred thousand citizens. The mortality rate for this disease varies from ten to twenty percent.If we talk about European countries, then in most cases, residents of Ireland and Iceland suffer from this disease. Behind Lately noted sudden jump the number of people suffering from this pathology. Children especially often suffer from meningitis. If we talk about children under the age of fourteen, then in their case this pathology is observed in ten children out of one hundred thousand. Most often, this disease is characterized by extremely severe pathogenesis. The risk of death of a child is determined by his age. The younger the child, the greater the likelihood of death.
Meningitis in children and adults - what can it be?
Today, there are two forms of this disease: primary And secondary meningitis. Meningitis is called primary if, when the body is infected, the disease immediately affects the brain. Secondary meningitis tends to develop along with some other underlying pathology such as otitis media, mumps , leptospirosis and so on. In such cases, the membranes of the brain undergo a series of lesions not immediately, but over time. This pathology is characterized acute course. It only takes a few days to fully develop. The exception is tuberculous meningitis, which tends to develop over several weeks or months.Primary meningitis - what are the causes of its occurrence?
Meningitis is considered to be an infectious disease. The main causative agents of primary meningitis include:Viruses. Viral meningitis occurs against the background viral infection. Typically this is enterovirus infection. In addition, measles, mumps, chickenpox, and rubella can provoke the development of this pathology. This form of meningitis is often called serous.
Bacteria. The most common cause of the development of this pathology is considered to be meningococcal infection. Infection with this infection occurs through direct contact with its carriers. It is transmitted by airborne droplets. As a rule, it is observed among urban residents, who especially often use public transport. The presence of this infection in preschool institutions provokes outbreaks of meningitis. In addition to this form of meningitis, it is quite possible to develop purulent form. In addition to meningococcus cause this pathology may also be Hemophilus influenzae, pneumococcus, spirochetes, tubercle bacillus.
Secondary meningitis - what are the causes of its occurrence?
The most common reasons The development of this pathology is considered to be:- Lung abscess
- Furuncle of the face or neck
- Acute or chronic otitis media
- Osteomyelitis of the skull bones
Signs and symptoms of meningitis in adults and children
In almost all cases, this pathology immediately makes itself felt very acutely. Its first signs are very similar to the symptoms of an ordinary severe cold or flu:- General weakness
- Pain in muscles and joints
- Increase in body temperature more than thirty-nine degrees
- Lack of appetite
In just a few days, due to the very high body temperature, specific signs of this pathology also develop. These include:
- Severe headache. In this case, the pain is diffuse in nature, that is, the pain is felt in the entire head. Gradually it becomes so strong that it begins to burst. After a while it becomes completely unbearable. Adults groan because of such pain, but children scream and cry. Typically, such pain causes vomiting and nausea. In most cases, headaches in the presence of this pathology tend to intensify at moments when a person tries to change the position of his body, as well as when exposed to environmental irritants.
- A rash is always observed in this case. If on face light form of this disease, then small dark cherry-colored rashes appear on the patient’s body. In the case of meningococcal meningitis, it goes away already on the third or fourth day. If the form is severe, then large spots and bruises appear on the patient’s body. This rash disappears only after ten days.
- Confusion.
- Frequent vomiting, which does not bring relief to the patient.
- Meningeal signs: excessive tension in the neck muscles, severe pain when trying to straighten your knees or bend your head to your chest.
- Strabismus occurs only if the nerves of the skull are damaged.
- Repeated spitting up and vomiting
- Apathy, anxiety, drowsiness, refusal to eat, constant severe crying
- Pulsation and bulging of a large fontanel
Symptoms accompanying chronic tuberculous meningitis
We already said a little higher that this disease tends to develop over several weeks and even months. The first sign of this pathology is considered to be increasing pain in the head area, which only gets worse every day. In addition to headaches, the patient complains of poor general health, frequent vomiting, and confusion.Methods for diagnosing meningitis
To identify this pathology, we use following methods diagnostics:1. Fundus examination
2. Electroencephalography
3. Cerebrospinal fluid examination. This fluid is removed through a lumbar puncture. To determine certain changes characteristic of meningitis, both the amount of protein in a given liquid, as well as its transparency, color, as well as the presence of microflora and glucose are taken into account.
4. X-ray of the skull
5. Nuclear magnetic resonance and computed tomography
An accurate diagnosis of meningitis is made if three signs of this pathology are present:
1.
Signs of infection
2.
Presence of symptoms of this disease
3.
Presence of specific changes in the cerebrospinal fluid
Treatment of meningitis in adults and children
Therapy for this pathology cannot be delayed. If one or another symptom of this disease is present, the patient must be urgently taken to the hospital. Self-treatment in this case, it is strictly contraindicated, since without the help of doctors a person can simply die. The sooner it starts effective therapy, the greater the chance of survival.Prescribing antibiotic drugs
The main principle of treatment for this disease in both children and adults is considered to be the use of antibiotics. We draw the attention of readers to the fact that in more than twenty percent of cases it is not possible to identify the causative agent of this pathology from the blood. That is why in such cases doctors have to prescribe antibiotic drugs, as they say, at random. As a result, they are trying to choose an antibiotic that could fight several of the most common pathogens at once. In the fight against this pathology, the course of antibiotic therapy is at least ten days. It is very important that the patient receives antibiotics for at least another seven days after doctors manage to normalize his body temperature. If there are purulent foci in the cranial cavity, the course of treatment may be even longer.The following antibiotics are used in the fight against meningitis:
- Penicillin - this drug is prescribed especially often and all because most often this disease occurs due to exposure to pathogens such as: staphylococcus, meningococcus, streptococcus, pneumococcus. This drug administered intramuscularly in the amount of three hundred thousand units per kilogram of body weight per day. It is administered to newborns every three hours, but for adults, the intervals between injections should not exceed four hours.
- Cephalosporins such as Cefotaxime and Ceftriaxone. These antibiotics are used to combat meningitis pathogens that cannot be destroyed by penicillin. Ceftriaxone is prescribed to children at fifty to eighty milligrams per kilogram of body weight in two doses. For adults it is prescribed in the amount of two grams.
- It is quite possible to use Vancomycin, and Carbapenems, but only if the above antibiotic agents did not have the proper therapeutic effect.