In medicine, meningitis is an inflammatory process that takes place in the lining of the brain, which is located between the cranium and the brain itself. It is transient and can lead to death in a few hours. At the same time, the incubation period of meningitis can last from 4 to 7 days, so everyone should know the first signs of this dangerous disease.
Meningitis is well understood and well classified. There are several types of this disease:
By the nature of the inflammatory process:
- purulent meningitis - the disease is caused by pathogenic bacteria (meningococcus), pus is formed, has a very severe course;
- serous meningitis - caused by viruses (for example, enteroviruses, polio viruses, mumps and others), is characterized by the absence of purulent contents in the area of inflammation and a less severe course than in the previous form.
By the origin of the inflammatory process:
- primary meningitis - is diagnosed as an independent disease, when examining the focus of infection in the patient's body is not detected;
- secondary meningitis - the body has a focus of infection, against which the considered inflammatory disease develops.
Due to the development of meningitis:
- bacterial meningitis - pathogens are E. coli, meningococci, staphylococci, streptococci, Klebsiella;
- fungal meningitis - meningitis is caused by candida or cryptococcus;
- viral meningitis - the possible causative agents of the inflammatory process include mumps virus, herpes;
- the simplest - provoked the development of an inflammatory disease of amoeba or toxoplasma;
- mixed type of meningitis - several types of the pathogen are immediately present.
Depending on how quickly inflammation develops:
- lightning (fulminant) meningitis - develops very rapidly, all stages of progression pass almost instantly, the patient's death occurs on the first day of the disease;
- acute meningitis - the development is not rapid, but rapid - a maximum of 3 days to reach the peak of the disease and death of the patient;
- chronic - proceeds for a long time, symptoms develop "on the rise", doctors cannot determine when meningitis has developed.
According to the localization of the inflammatory process:
- basal - a pathological process develops in the lower part of the brain;
- convexital - localization of the inflammatory process occurs on the front (convex) part of the brain;
- spinal - pathology affects the spinal cord.
The only reason for the development of the inflammatory process in the membranes of the brain is the penetration of infection into them. This can happen in different ways:
- oral-fecal - we are talking about the use of unwashed vegetables, fruits, berries;
- hematogenous - through the blood;
- lymphogenous - through lymph.
And the causative agents of meningitis can be:
- pathogenic bacteria - tuberculosis and Escherichia coli, staphilo / streptococci, Klebsiella;
- viruses of different origin - herpes, mumps virus;
- fungi - candida;
- protozoa - amoeba and / or toxoplasma.
Factors that can trigger the development of the inflammatory process in question are:
- decreased immunity due to chronic diseases or forced long-term use of drugs;
- chronic malnutrition;
- chronic fatigue syndrome;
- peptic ulcer of the duodenum and stomach;
- AIDS virus.
Meningitis is characterized by pronounced symptoms, but the fact is that many of the signs go unnoticed, or are removed by taking the simplest medications.
And this not only "lubricates" the symptoms, but also makes it impossible to timely seek medical help.
Symptoms of meningitis, which should be a signal to immediately seek professional help:
Headache. This is generally considered the main sign of meningitis, but this pain syndrome will have distinctive features:
- headache constant;
- there is a feeling of bursting of the cranium from the inside;
- the intensity of the pain syndrome increases with tilting the head forward and backward, as well as when turning left-right;
- headache with meningitis becomes stronger with loud noises and too bright color.
Muscle tension in the neck. We are not talking about convulsive syndrome, just a person cannot lie on his back in his usual position, he will surely tilt his head back, because otherwise he experiences a severe pain syndrome.
Digestive upset. This means that one of the signs of the considered inflammatory process in the membranes of the brain is nausea and vomiting. Note: vomiting will be repeated, even if the patient completely refuses food.
Hyperthermia. An increase in body temperature with meningitis is always accompanied by chills, general weakness, and increased sweating.
Photophobia. A patient with a developing inflammatory process in the membrane of the brain is not able to look at bright light - this immediately causes an acute headache.
Impaired consciousness. We are talking about lowering the level of consciousness - the patient becomes lethargic, answers questions slowly, and at a certain moment completely stops responding to speech addressed to him.
Mental disorder. A person may have hallucinations, aggression, apathy.
Convulsive syndrome. The patient may experience cramps of the lower and upper extremities, in rare cases, against the background of cramps, arbitrary urination and the act of defecation appear.
Strabismus. If the optic nerves are affected during the progression of the inflammatory process, then the patient begins with a pronounced squint.
Diagnosing meningitis is a rather complicated and time-consuming process. After all, it is important not only to establish a diagnosis, but also to determine the degree of development, the type of meningitis, its localization and the pathogen that caused the onset of the inflammatory process in the membranes of the brain. Diagnostic methods for meningitis include:
- how long have symptoms of meningitis appeared;
- whether tick bites were noted in the recent past - some species of this insect are carriers of the causative agent of meningitis;
- whether there was a patient's stay in countries where mosquitoes carrying meningococcal infections are present (for example, countries in Central Asia).
Inspection of the patient for a neurological condition:
- whether the patient is conscious and at what level it is - does it respond to speech addressed to it, and if there is no reaction to the response, then check the reaction to pain irritation;
- if there are signs of irritation of the meninges - these include tension of the occipital muscles and headache with a feeling of fullness and photophobia;
- whether focal neurological symptoms are present - these are symptoms of damage to specific areas of the brain: seizures with a bite of the tongue, weakness in the limbs, speech is disturbed, there is an asymmetry of the face. Please note: such signs indicate the spread of the inflammatory process from the meninges directly to the brain (encephalitis).
Laboratory blood test of the patient - the analysis reveals signs of an inflammatory focus in the body: for example, the erythrocyte sedimentation rate will necessarily be increased.
Lumbar puncture. The procedure is carried out only by a specialist and using a special long needle - it makes a puncture through the back skin at the lumbar level (subarachnoid space) and a little cerebrospinal fluid is taken for analysis (maximum 2 ml). It may contain pus or protein, which is a sign of an inflammatory process in the meninges.
Liquor is a fluid that provides metabolism and nutrition in the brain and spinal cord.
- Computed tomography or magnetic resonance imaging of the head - the doctor can examine the meninges in layers and identify signs of inflammation, which include expansion of the ventricles of the brain and narrowing of the subarachnoid gaps.
- Polymerase chain reaction. This is an analysis in which cerebrospinal fluid or blood is examined, which allows specialists to determine the causative agent of the disease and choose a truly effective treatment.
Important: treatment of the considered inflammatory process in the meninges should be carried out only in a hospital - the disease develops rapidly and can lead to the death of the patient in a matter of hours. No folk methods can help cope with meningitis.
The doctor immediately prescribes medications, namely antibacterial drugs (antibiotics) of a wide spectrum of action - for example, macrolides, cephalosporins, penicillins. This choice is due to the fact that the causative agent of the disease in question can be established only by sampling and examining cerebrospinal fluid - this process is quite long, and the patient needs to be helped urgently.
Antibiotics are administered intravenously, and in the case of a serious health condition of the patient, and directly into the cerebrospinal fluid. The duration of the use of antibacterial drugs is determined only individually, but even if the main signs of meningitis have disappeared and the patient's body temperature has stabilized, the doctor will continue injecting antibiotics for several more days.
The next direction in the treatment of the considered inflammatory process in the meninges is the appointment of steroids. Hormone therapy in this case will help the body cope with the infection faster and normalize the pituitary gland.
Diuretics are also considered mandatory in the treatment of meningitis - they will relieve swelling, but doctors must consider that all diuretics contribute to the rapid leaching of calcium from the body.
Patients undergo spinal puncture. This procedure alleviates the patient's condition because cerebrospinal fluid exerts much less pressure on the brain.
Treatment of meningitis is always carried out against the background of vitamin therapy:
- firstly, it is necessary to support the body and help it resist infection;
- secondly, vitamins are needed to replenish the necessary macro / micronutrients that do not enter the body due to malnutrition.
Meningitis is generally considered a life-threatening disease. Complications of this inflammatory process in the meninges are:
Cerebral edema. Most often, this type of complication develops on the second day of the disease. The patient suddenly loses consciousness (this occurs against the background of standard symptoms of meningitis), he sharply decreases, and after a while pressure suddenly rises, a slow heartbeat changes to a rapid heart rate (bradycardia passes into tachycardia), intense shortness of breath appears, all signs of pulmonary edema are clearly visible.
Please note: if medical care is not provided, then after a short time the meningitis symptoms completely disappear, the patient experiences involuntary urination and an act of defecation and death due to paralysis of the respiratory system.
Infectious toxic shock. This complication develops as a result of the decay and absorption into the cells and tissues of the body of a large number of decay products of the vital activity of pathogens. The patient's body temperature suddenly drops, the reaction to light and sounds (not even loud) becomes very sharp and negative, there is excitement and shortness of breath.
Please note: infectious toxic shock often passes against the background of cerebral edema. The patient's death occurs within a few hours.
The consequences of transferred meningitis can be epilepsy, deafness, paralysis, paresis, hormonal dysfunction and hydrocephalus.
In general, any organs and systems of the body can be affected by a meningococcal infection, therefore, recovery after an inflammation of the meninges lasts a very long time, and in some cases, all of life.
Only immediate medical attention will help reduce the risk of complications and the consequences of meningitis.
Serous meningitis: what is it, causes, symptoms, diagnosis and treatment
Serous meningitis is a disease manifested by inflammation of the meninges, accompanied by the release of serous exudate with an admixture of blood cells and protein products.
Of all types of inflammation of the meninges, this proceeds more gently, without forming pus and tissue necrosis. More common in children under the age of six. Rarely in adults.
Causes of Serous Meningitis
The origin of the disease, the conditions and causes of occurrence are as follows:
- viruses (adenovirus, herpes, enterovirus, measles, polio, influenza).
- complications of infection (tuberculosis, syphilis).
- fungus (it happens with immunodeficiencies).
- previous pathological conditions of the central nervous system, leading to the formation of serous effusion (tumors and cysts).
- infected domestic mice and rats (lymphocytic choriomeningitis).
Infection occurs through contact-household (through wounds or the use of objects of the diseased), airborne (by sneezing or coughing), through water (pool).
According to ICD-10, the disease has the code A87.8, refers to the section "other viral meningitis." The section tells what it is, provides an etiological list:
Depending on the causative agent of serous meningitis:
Depending on the outbreak:
- primary (the beginning of development in the brain);
- secondary (the disease appears in other organs, then migrates through the blood-brain barrier).
Pathogenesis (the mechanism of the onset of serous meningitis in the human body)
An infection or virus, entering through the focus of penetration, passes into the bloodstream and spreads throughout the body. Immunity begins to attack a foreign object.
In the presence of immunological memory, the pathogen is suppressed quickly. If the parasite passes through the blood-brain barrier, inflammation begins with a vascular reaction.
Lymphocytes together with the liquid go beyond the vascular wall, which provokes the development of edema.
The virus multiplies, the immune system can not cope without medical treatment. The number of cerebrospinal fluid with serous meningitis increases, hypertension develops. Clinical manifestations begin. Shells of the brain thicken, which leads to complications.
Symptoms of Serous Meningitis
After completion of the incubation period, which lasts up to 20 days, sharp symptoms begin:
- headache, aggravated by noise and bright light, not amenable to relief by painkillers;
- double vision
- loss of consciousness;
- edema of fontanelles in newborns;
- frequent vomiting and nausea;
- with paralysis and paresis - difficulty or inability to breathe;
- critical temperature up to 40 degrees with sharp drops and rises, which is most difficult for a child's body;
- intoxication (arthralgia, weakness, myalgia).
In rare cases, there are symptoms of other diseases, which can complicate the diagnosis of meningitis infection:
- typical symptoms of SARS: cough with sputum discharge, sore throat;
- symptoms of inflammation of the cranial nerves: drooping eyelids, strabismus, diplopia.
Characteristic signs and postures with pathological changes in the meninges:
- typical posture with stiff muscles of the back of the neck - the patient lies on his side, his head is thrown back;
- Kernig symptom - tonus muscle tone is increased, the patient cannot straighten his leg from a bent state;
- Brudzinsky symptoms (a group of symptoms that arise due to irritation of the meninges):
- upper: when you try to reach your chest with your chin, your legs bend involuntarily;
- lower: when trying to straighten one leg, the second bends even more, reaching to the abdomen;
- symptom of Lesage. The baby is raised, holding the armpits, the head is held with the thumbs. If the child pulls his legs to his stomach, the study is positive.
Clinical manifestations of forms of meningitis
- The tuberculous form occurs with a disease of this type of various organs (lungs, kidneys). The incubation period lasts two weeks, after which dizziness, subfebrile condition, fatigue, sweating occur. Further, neurological signs appear (strabismus, decreased visual acuity). In the absence of therapy, complications develop (paresis, aphasia, coma) or a chronic process. Catarrhal phenomena are short-term, replaced by neurological.
With this form of the disease, a severe headache is observed with pressure on the eyeballs and ears. Vomiting is often repeated. Inflammation of the optic nerves develops.
Pressure decreases after lumbar puncture, symptoms in children are reduced.
The cerebrospinal fluid (cerebrospinal fluid) is transparent, the protein is slightly increased (globulins are present), lymphocytes from the first days of the disease predominate. Glucose appears. In half the cases, a fibrin film falls out. Antibodies in the blood appear a week after the onset of the disease, before which the test results may be negative.
- Acute lymphocytic choriomeningitis. Signs begin to occur a week after infection, are characterized by common symptoms of malaise and pharyngitis. The temperature rises sharply. With damage to the vessels of the ventricles, neurological symptoms begin.
- Fungal meningitis in AIDS. the lesion proceeds with an insignificant number of clinical manifestations. This form is a complication of immunodeficiencies (congenital and acquired, for example, in AIDS). It develops poorly, most of the typical symptoms in children are not detected. This makes diagnosis difficult.
- With mumps, inflammation in the central nervous system is observed a month after the onset of the virus. Symptoms of inflammation of the meninges are pronounced, severe vomiting, adynamia, drowsiness, paresthesia, cramps, and abdominal pain are observed. More often the disease develops in boys. According to this scheme, all viral forms of serous meningitis occur (Coxsackie viruses, Echovirus).
In the CSF (indicators of cerebrospinal fluid) in the first days there is a large number of polynuclear cells, which is replaced by pleocytosis. Immunological studies are carried out from the cerebrospinal fluid (complement fixation and agglutination delay), which allows the virus to be derived.
Mumps is characterized by dyspeptic symptoms, the doctor may make an erroneous diagnosis of food poisoning. After treatment, the clinical signs of serous meningitis are faster than cleansing the CSF.
- Parasitic type caused by toxoplasma. The carrier is cats. After the disease, an immunological memory is formed, a person does not get sick again. Neurological symptoms are mild. Pain in the head is localized in the back of the head. Cranial nerves are affected, cerebellar and neuroendocrine disorders occur. Toxoplasma form is divided into congenital and acquired. The first is most dangerous, since the baby has poorly developed immunity. It is characterized by dangerous complications: frequent seizures, eye damage, myoclonia, calcification of the brain substance. When taking CSF (cerebrospinal fluid), xanthochromia, pleocytosis with a predominance of lymphocytes is observed. A smear is made from cerebrospinal fluid. Looking through it under a microscope, the laboratory assistant detects toxoplasma. The diagnosis is confirmed by a subcutaneous allergy test and a compliment binding reaction.
- Enterovirus serous meningitis. It is transmitted fecal-oral, airborne, vertically (from mother to fetus through the placenta). Complications are found in the liver, cardiovascular and nervous system. More often, serous viral meningitis causes ARVI or intestinal disorders, inflammation in the central nervous system, it happens in children with weak immunity. When it passes through the blood-brain barrier, colds begin, then the person loses consciousness, hallucinations and convulsions appear. The fever is severe with bouts of headache. In children under one year of age, the symptoms are blurred, the nasolabial triangle is cyanotic, and the doctor may take the rash on the skin for measles. Therefore, it is difficult to diagnose the disease.
Enterovirus is manifested by myocarditis, liver necrosis, intravascular coagulation and enterocolitis. The disease resembles sepsis, but does not go away with the introduction of antibiotics.
When taking CSF for diagnosis, the patient becomes easier, since the pressure decreases when the cerebrospinal fluid exits. This condition serves as a signal to the doctor about CNS disorders.
Liquid during puncture follows a stream, it contains a large number of cells. At the beginning of the disease, neutrophilic white blood cells predominate, which leads specialists to two diagnoses: serous and purulent meningitis. Later, lymphocytes begin to prevail.
The prognosis is favorable, after the medication the fever disappears, the patient becomes better, the neurology goes away on the fifth day. An accurate diagnosis is made after a PCR study, when the enterovirus genome is detected.
- Aseptic meningitis is an inflammation of the meninges in the absence of an identified pathogen. It is caused by tumors, cysts, drugs, pathogens of enterovirus etiology and infection. Aseptic meningitis is dangerous, only a form with the presence of the pathogen is detected in the laboratory, the symptoms are blurred (similar to the flu) with fever, headache, intoxication. Typical neuralgic symptoms are absent. The temperature in some cases does not rise. Cerebrospinal fluid is normal, there is no protein, a small number of neutrophils are present. If a tumor is suspected, a CT scan or MRI scan is necessary.
Meningeal symptoms in adults are more accurately expressed than in children. This is due to the maturity of the nervous system.
The disease has an obvious clinical picture, a pediatrician may examine the presence of inflammation in the central nervous system when examining a child. The doctor needs to conduct a thorough analysis, the development of the epidemic is unacceptable.
The specialist gives directions to laboratory and other types of analyzes:
- general blood analysis. There is a slight leukocytosis and an increased erythrocyte sedimentation rate. By these indicators, the general condition of the patient is monitored;
- bacterial culture. Material is taken from the nose and throat. Determines the type of pathogen and reveals sensitivity to antimicrobials. This study cannot be dispensed with. With the erroneous use of antibiotics, the patient's condition worsens, and the pathogen acquires resistance to the selected drug;
- virus definitions: PCR, ELISA, RIF. It is necessary to take into account the state of immunity, with its deficiency, the results can be false negative.
- CSF puncture. In acute serous meningitis, it will be transparent with an admixture of protein. With the tuberculous form, the glucose content in the cerebrospinal fluid is increased. When taking punctate, the fluid flows with increased pressure. High lymphocyte counts are noted;
- staining of a part of the cerebrospinal fluid and examination under a microscope. Infections are detected;
- tuberculin test;
- additional examinations: EEG, ECHO-EG, MRI, CT.
Differential diagnosis is based on clinical symptoms and cerebrospinal fluid analysis. The main goal is to distinguish between two diseases: serous and purulent meningitis. Distinguish forms of serous inflammation of the meninges.
Serous Meningitis Treatment
Therapy is carried out in a hospital. Quarantine must be respected, contacting the patient only after putting on the mask. With a disease, the following is prescribed:
- antiviral drugs (Interferon, Acyclovir);
- antimicrobial agents. Sowing is done for a long time, which the patient does not have, therefore, a wide range of agents are used. Penicillin preparations are used;
- funds that restore the microflora of the gastrointestinal tract;
- antimycotics with fungal etiology. Fungal disease is caused by immunodeficiency, relapse is possible;
- anti-tuberculosis drugs;
- to raise immunity, immunoglobulins are prescribed intravenously;
- anti-inflammatory drugs;
- dehydration drugs are used to combat high blood pressure. They reduce hypertension through fluid withdrawal. Diuretics (Lasix) are introduced;
- antipyretic at high temperature;
- to stop seizures, sedatives are prescribed that are not addictive and are gently tolerated by children;
- Nootropics for the protection of nerve cells;
- vitamins intravenously (namely, vitamins of group B);
- polypeptides of the cerebral cortex are introduced after the end of therapy and are repeated every six months.
If aseptic meningitis is detected due to medication, all drugs should be discontinued immediately and symptomatic therapy should be given.
It is necessary to create the following conditions for a comfortable stay of the child in the hospital:
- dim light, preferably dense curtains;
- sharp sounds should not be;
- lack of stress (when crying, the child's nervous system is in a state of tension, his health worsens dramatically);
- diet with a lack of sweet, fatty, salty, hot.
With timely started therapy, they should not be. After treatment of the advanced form of serous meningitis, the following conditions appear:
- frequent headaches;
- sleep disturbances;
- memory impairment;
- loss of hearing or vision;
- lag in development and speech;
- epileptic seizures;
- weakness of the musculoskeletal system.
A favorable outcome with a timely diagnosis and treatment of serous meningitis. After the introduction of antibiotics, the temperature drops on the third day.
All symptoms in children completely disappear after ten days.
In some cases, after serous meningitis, memory is impaired, and symptoms of cephalgia appear (disappear after a few months).
If the doctor did not suspect a tuberculosis form and did not prescribe anti-TB drugs, the outcome is fatal. In case of his late therapy - there will be complications.
- Before traveling to water bodies, parents need to make sure that there are no outbreaks of various diseases anywhere.
- Wash hands before eating and during the day.
- To wash meat, process fruits and vegetables with boiling water or special means.
- Eat right, walk a lot, temper, observe sleep patterns.
- Treat all diseases to the end, fully observing all the recommendations of specialists.
Meningitis is an acute infectious disease associated with inflammation of the meninges, which may be bacterial or viral in nature.
In recent decades, the incidence of meningitis in adults and children has increased significantly. Meningitis in children is more common than in adulthood. At the same time, meningitis in children is more difficult. The smaller the child's age, the greater the likelihood of death.
Forms of meningitis
Due to the occurrence, meningitis is divided into infectious, infectious and allergic (serous, influenza, tuberculosis, herpetic meningitis), traumatic and fungal.
- panmingitis - when all the meninges are affected;
- pachymeningitis - when the dura mater is affected;
- leptomeningitis - when the soft and arachnoid meninges are affected.
By origin, meningitis can be primary and secondary.
If the infection immediately affects the meninges, then they talk about the development of primary meningitis.
In the case of secondary meningitis against the background of the underlying disease (leptospirosis, mumps, otitis media, frontal sinusitis, sinusitis, osteomyelitis of the bones of the skull, lung abscess, furunculosis), the infection spreads and the meninges are damaged.
Primary meningitis is neuroviral, purulent meningitis.
Secondary meningitis - tuberculosis, influenza, syphilitic.
The nature of the course distinguishes: acute, subacute, chronic and fulminant or reactive meningitis.
Reactive meningitis is the most dangerous form of this infection, as it develops within 24-48 hours.
By the nature of the cerebrospinal fluid, purulent meningitis, hemorrhagic, serous, mixed is distinguished.
According to the method of infection, meningitis can be:
Meningitis is caused by many pathogenic microorganisms, in particular:
- hemophilic bacillus type b;
- tuberculous mycobacteria;
- Escherichia coli;
- group B streptococcal bacteria;
Meningitis is transmitted by airborne droplets, but not everyone gets meningitis.
Acute onset is characteristic of meningitis in adults and children. The initial symptoms of meningitis are similar to the symptoms of flu or a severe cold. The patient's temperature rises (above 39 °), he feels weakness, pain in the joints and muscles, and there is no appetite.
Specific symptoms of meningitis appear in the next few hours or days.
The characteristic signs of meningitis are:
- headache, which is diffuse, that is, the whole head hurts. The pain gradually increases and becomes bursting. After a while, it becomes unbearable. Next, nausea and vomiting join the headache. An increase in headache with meningitis occurs when the body position changes, from noise, loud noises;
- a rash (a characteristic sign of meningitis meningococcal). In mild forms of meningitis, the rash looks like small point rashes of a dark cherry color. With meningococcal meningitis, the rash passes to 3-4 days of illness. In severe forms of meningitis, the rash looks like large spots and bruises and disappears within 10 days;
- repeated vomiting, which does not bring relief;
- confusion of consciousness;
- strabismus (cranial nerves can sometimes be affected against meningitis);
- meningial symptoms: neck muscle tension, severe pain when trying to straighten your knees or tilt your head to your chest.
With meningitis in children under the age of one year, in addition to the above signs of meningitis, there are:
- spitting up and vomiting;
- apathy, drowsiness, restlessness and constant strong crying;
- pulsation and bulging of a large fontanel.
Tuberculous meningitis, unlike other types of meningitis, develops over several weeks. The first symptom of meningitis of this type is a headache that grows every day and becomes unbearable, against which vomiting, deterioration in general condition and confusion occur.
Diagnosis of Meningitis
To make a diagnosis of meningitis, the following procedures are necessary:
- studies of cerebrospinal fluid, which is taken with the help of lumbar puncture for color and transparency, quantitative and qualitative composition of cells, the presence of microflora, the amount of glucose and protein, which make it possible to identify characteristic signs of meningitis;
- fundus examination;
- X-ray of the skull;
- nuclear magnetic resonance imaging and computed tomography of the brain.
If there is a combination of the following three signs of meningitis, the diagnosis of meningitis is made:
- signs of intoxication;
- specific symptoms of meningitis;
- characteristic changes in cerebrospinal fluid.
In the case of reactive meningitis, all time studies may not be found. The diagnosis is made after the detection of coccal bacteria in the cerebrospinal fluid.
Patients with meningitis are subject to urgent hospitalization. The sooner you start adequate treatment, the patient will have more chances for a full recovery. It is especially important to immediately begin intensive therapy with reactive meningitis, otherwise the disease will end in death.
Treatment of meningitis in adults and children is carried out in several directions:
The main treatment is antibiotic therapy. Usually antibiotics are used within 10 days. With purulent meningitis, antibiotic therapy should be more prolonged. Typically, with meningitis, penicillin-type antibiotics or cephalosporins are used if the meningitis-causing microbes are resistant to penicillins.
In the case of cerebral edema and for its prevention, diuretics are used.
Crystalloid and colloidal solutions are used for detoxification.
After treatment in the hospital, the patient continues treatment at home. The issue of disability and attendance at a kindergarten is decided on an individual basis.
Consequences of meningitis
As such, the effects of meningitis should not be. After an illness, a person returns to his usual state - the organs and systems of the body do not suffer.
But sometimes the consequences of meningitis can be quite serious. The patient may lose vision or hearing, developmental delay may occur.
Purulent meningitis can cause persistent paresis and paralysis, encephalitis and dropsy of the brain.
The worst consequences of meningitis are coma and death. But such complications are rare - in 1-2% of cases. As a rule, there is no recurrence of meningitis.
Prevention of Meningitis
The most effective preventative measure is vaccination of adults and children against meningitis pathogens. The vaccine is administered to children in parts: at the age of 3, 4, 5, 6 months, followed by revaccination at the age of one year.
Meningococcal vaccination is given to children at 2 years of age.
One of the important preventive measures is the timely and adequate treatment of diseases that can lead to the development of meningitis.
Meningitis: causes and prevention. Meningitis treatment in Moscow
Meningitis is an infectious inflammatory disease of the membranes of the brain or spinal cord of a bacterial, viral or fungal origin. Most often, this disease is manifested by headache, fever, impaired consciousness, increased sound and light sensitivity, numbness of the neck.
The causes of meningitis can be very different: in addition to viral, fungal and bacterial lesions, other infectious diseases can also cause the disease. Without timely treatment, meningitis can be fatal, especially if its occurrence is associated with fungi and bacteria.
An increased risk group among the adult population is made up of men aged 20-30, which is associated with their insufficiently serious attitude to various inflammatory diseases and the lack of proper treatment.
In addition, children under the age of five are included in a special risk group, since due to the imperfection of the immune system during this period they have an extremely high risk of death.
Prevention of childhood meningitis is vaccination.
Most often, cases of meningitis are diagnosed in the autumn-winter-spring period, which is due to temperature fluctuations, hypothermia, a limited amount of fortified foods and inadequate ventilation in rooms with large crowds.
The treatment of meningitis is based on the use of antibacterial, antiviral or antifungal therapy, which depends on the causative agent. Patients require urgent hospitalization in a hospital.
The Neurology Clinic of the Yusupov Hospital offers diagnostics and treatment of meningitis using advanced medical technologies. We guarantee maximum diagnostic accuracy, absolute examination safety and high treatment efficiency.
Routes of transmission of meningitis
Infection with meningitis, like many other infectious diseases, can occur in several ways:
- airborne droplets (through sneezing, coughing);
- contact-household way (through kisses, in case of non-observance of personal hygiene rules);
- by oral-fecal route (if unwashed foods are consumed, or a person eats with dirty hands);
- hematogenous (through blood);
- lymphogenous (through lymph);
- placental (during childbirth);
- by ingestion of contaminated water (when ingested or bathing in a contaminated body of water).
First signs of meningitis
The initial stage of the development of an infectious process in the spinal cord or brain is manifested by the following symptoms:
- a sharp rise in body temperature;
- stiff neck (numbness of the neck muscles, difficulty turning and tilting the head);
- lack of appetite;
- nausea and frequent vomiting, which does not bring relief;
- the appearance of a rash of red or pink;
- diarrhea (most often in children);
- general weakness, malaise;
- the appearance of hallucinations, agitation or lethargy.
The main symptoms of meningitis
The main symptoms of meningitis include:
- high body temperature, chills;
- hypersthesia (increased sensitivity to sound, light, touch);
- impaired consciousness, dizziness;
- nausea, vomiting, lack of appetite;
- conjunctivitis, sensation of pressure in the eyes;
- inflammation of the lymph glands;
- pain when pressing under the eyes, the middle of the eyebrows and the region of the trigeminal nerve;
- a number of specific symptoms: Kernig, Brudzinsky, Ankylosing spondylitis, Pulatov, Mendel, Lesage.
Nonspecific Symptoms of Meningitis
In patients with meningitis, visual function may decrease, strabismus, double vision, ptosis, nystagmus. They have hearing loss, paresis of facial muscles.
Patients often complain of the appearance of a sore throat, runny nose, cough, pain in the abdomen, constipation, cramps, increased blood pressure.
In some cases, epileptic seizures, bradycardia, tachycardia, drowsiness, uveitis and increased irritability may appear.
Dangerous complications of meningitis
Meningitis is a very serious disease, which may be accompanied by the development of the following complications:
- hearing loss;
- purulent arthritis;
- bleeding disorders;
- impaired mental development (in children);
- fatal outcome.
The causes of meningitis are primarily associated with the ingestion of various infectious agents into the body (cerebrospinal fluid, blood, brain).
Most often, meningitis is caused by:
- viruses - enteroviruses, echoviruses, Koksaki virus;
- bacteria - pneumococci, meningococci, group B streptococci, listeria monocytogenes, acne propionibacteria, type b hemophilic bacillus, Escherichia coli, tuberculous mycobacteria, diplococci;
- fungi - cryptococci, coccidioides immitis, Candida fungi;
- protozoa are amoebas.
In addition, the development of meningitis, as a rule, occurs against a background of weakened immunity, which does not cope with its main function and cannot protect the body from infections.
Weakened immunity may be due to several factors:
- past diseases, especially of an infectious nature: influenza, otitis media, pharyngitis, pneumonia, acute respiratory infections, and others;
- chronic pathologies: tuberculosis, HIV infection, syphilis, brucellosis, toxoplasmosis, sarcoidosis, cirrhosis, sinusitis, diabetes mellitus;
- diets, hypovitaminosis;
- various injuries (especially the head or back);
- hypothermia of the body;
- the use of alcoholic beverages and drugs;
- uncontrolled medication.
Meningitis: diagnosis at the Yusupov hospital
To diagnose meningitis in the Yusupov hospital, a comprehensive examination is prescribed. First of all, an experienced neurologist examines a patient using various tests and analyzes the symptoms.
Confirmation of the diagnosis requires the use of additional research methods:
- general blood test;
- biochemical blood test;
- cerebrospinal fluid studies;
- PCR (polymerase chain reaction);
- MRI (magnetic resonance imaging);
- CT (computed tomography);
- EEG (electroencephalography);
- EMG (electromyography).
The Neurology Center of the Yusupov Hospital is equipped with the latest diagnostic equipment, which allows to obtain the most reliable research results.
Meningitis: treatment at the Yusupov hospital
When choosing a treatment strategy for meningitis, specialists at the Yusupov hospital take into account the etiology of the disease, the condition and age of the patient. An individual therapy regimen is compiled for each patient.
Drug treatment that eliminates the cause of meningitis and relieves symptoms is carried out in the in-patient department of the Yusupov hospital. The patients are provided with comfortable wards, good nutrition and round-the-clock support of medical personnel.
The main method of treating meningitis in the Neurology Clinic of the Yusupov Hospital is antibiotic therapy with drugs with a wide spectrum of action aimed at the effective destruction of the infection, as well as with antiviral agents. In addition, symptomatic therapy is prescribed with anticonvulsants, drugs that normalize intracranial pressure, antipyretic and immunomodulating drugs.
Detoxification therapy helps to improve the well-being of the patient, to reduce intoxication of the body. Attention is paid to the regulation of water-electrolytic balance. Prevention after meningitis is done with steroids.
Given the timely start of treatment, after 3-4 days the condition of patients with meningitis improves significantly, and after 7-10 days the composition of the cerebrospinal fluid is normalized.
Prevention of meningitis consists in observing the following preventive measures:
- It is necessary to observe the rules of personal hygiene;
- exclude close contact with people infected with meningitis;
- to eat with a lot of vitamins and minerals;
- avoid staying in crowded places, especially during periods of outbreaks of seasonal viral diseases;
- do wet cleaning of the premises at least twice a week;
- conduct hardening procedures (in the absence of contraindications);
- avoid hypothermia, stress;
- move more, do sports;
- treat various diseases, especially infectious diseases, in order to prevent their transition to a chronic form;
- give up smoking, alcohol, drugs;
- taking medications with antibacterial and anti-inflammatory effects must be discussed with your doctor.
Diversified Medical Center in Moscow - Yusupov Hospital provides services in all areas of medicine.
An interdisciplinary approach is used to diagnose and treat meningitis, involving specialists from other fields of medicine.
By: Dr. Amy Lewis