Meningitis is a very life-threatening infectious disease that is accompanied by inflammation of the meninges. The brain in this disease is not involved in inflammation, but its membranes swell, causing a number of symptoms that can lead to death. The history of purulent meningitis is known for a long time, since it most often develops against the background of infections.
Causes and features of the development of purulent meningitis
First, it develops serous meningitis. With it, the membranes of the brain are impregnated with a lymphocytic infiltrate.
Diagnosis is established after studying under the microscope cerebrospinal fluid, the fence of which is carried out by performing a puncture of the CSF.
More than half of its cellular composition is represented by lymphocytes.
In the absence of treatment or its inadequacy, serous inflammation becomes purulent. In the cerebrospinal fluid with this meningitis the opposite picture is determined: the majority of the detected cells will be neutrophils.
The most common cause of meningitis is a viral infection, less often bacterial or fungal, then we should talk about the development of purulent bacterial meningitis. Mild non-infectious diseases most often do not cause the development of meningitis.
Allocate:
- Primary is a meningitis that has developed due to the direct entry of the pathogen into the membranes of the brain( pneumococci, meningococci, herpetic infection);
- Secondary - the occurrence of meningitis as a consequence of other diseases( frontal, otitis, osteomyelitis, sinusitis, caries, pneumonia, sepsis);serous secondary meningitis often develops as a complication of rubella, measles, chicken pox, mumps, leptospirosis and so on.
According to the developmental method, secondary meningitis can be otogenous( infection spread from the ear), odontogenic( caries-periodontitis, periostitis, osteomyelitis, brain membranes), hematogenous( spread by blood), and so on.
Absence in children is quite common. Be sure to consult a doctor to find out the cause of their appearance, as they can signal serious illnesses.
For example, one of them may be residual encephalopathy with intracranial hypertension. You can learn more about it from the article.
Pathogenesis of the disease
Meningitis develops when the pathogen penetrates the brain's blood-brain barrier. To prevent the development of the disease, it is necessary to know how purulent meningitis is transmitted.
The routes of transmission of infection can be different:
- Airborne droplets;
- Contact;
- Vertical( from mother to child during pregnancy, childbirth);
- Sexual;
- Parenteral( with accidental entry of the pathogen into the blood).
For the onset of the disease requires a simultaneous confluence of several circumstances: not only getting a microbe, but also reducing the overall and / or local immunity of a person, poor blood supply to his brain and so on.
More prone to meningitis:
- Premature babies;
- Children born with intrauterine infection or various pathologies of the brain( hypoxia and its complications, cerebral palsy, cysts).
In adults, meningitis is less often diagnosed, due to the development of antibodies to pathogens they have encountered earlier.
Chances of getting meningitis are higher in those who suffer:
- Immunodeficiency;
- Circulatory disturbances in the brain;
- Alcoholism;
- Atherosclerosis.
Secondary purulent meningitis occurs in almost the same degree often in all. It increases the likelihood for diseases of the paranasal sinuses, ear, skull bones, liquorrhea, penetrating wounds to the head.
The incubation period for meningococcal disease is 2-10 days.
Symptoms of purulent meningitis
At the beginning, meningitis manifests itself as symptoms similar to many other diseases. Having noticed them, you need to see a doctor as soon as possible to prevent formidable complications.
Meningitis itself develops later, the symptoms of which are quite specific.
The manifestation of viral meningitis is preceded by such symptoms: weakness, lethargy, coughing cold and other manifestations of ARVI, vomiting, diarrhea, rashes, as with measles, chickenpox, or rubella.
If meningitis develops as a complication of otitis, sinusitis, pneumonia, or osteomyelitis of the bones of the head, the patient may first note weakness, drowsiness, pain in the area of the affected sinuses( under the eyes or above the eyebrows), increase in the T body, nasal and ear discharge, painin the bones.
With pneumonia - shortness of breath, cough, weakness, chest pain.
Symptoms of meningitis in children under 3 years of age
- The child is difficult to wake up, in the dream it stretches to the head with handles;
- The large fontanel strains and protrudes above the cranial bones, it feels tense or sinks;
- Symptom of Lessuga, Meitus;
- The kid reacts inadequately to everything, can moan, cry monotonously, do not go to his hands;
- A characteristic posture: the child lies with his head to the side and his legs pinned back;
- Restless sleep;
- Convulsions;
- Rash.
In newborns, purulent meningitis lasts about a week and leads to death in the absence of adequate treatment.
Often before the development of meningitis proper, children have conjunctivitis, bronchitis, pneumonia - the primary focus of infection can be found in the oral cavity, bronchi, lungs, nasopharynx, bones.
Any of these symptoms should cause parents to think about meningitis and urgently call a doctor. The lightning course of meningitis, characteristic of newborns, is the greatest danger. Often the disease within 72 hours leads to the death of the child.
In the photo, affected by purulent meningitis, the brain envelope:
Symptoms of acute meningitis in adults
- The strong pain in the head that prevents sleep is relieved by analgesics only for a short while. Localization of pain - forehead of whiskey, sometimes the whole head completely. In some cases, pain in the lower back, back against the background of increased body temperature.
- Symptoms of intoxication: photophobia, weakness, discomfort when touching the skin, dizziness.
- Temperature rise. But with tuberculous meningitis, it can not exceed 38 degrees.
- Rigidity of the neck muscles( a person can not bend his head).
- Kerning Symptom - The diseased person is not able to fully extend his legs.
- The symptom of Brudzinsky is the patient's uncontrolled flexion of the hip and knee joints.
- Children with high fever often have seizures.
- Abruptly occurring, nausea, vomiting, after which no relief comes.
- In viral meningitis, a red rash appears in the form of spots of different diameters. When you press on them with glass, the stains disappear.
- If the patient has a meningococcal infection, then he has dark spots that do not disappear when the test is similar to glass.
- Inadequacy - a person who is ill can stop focusing, recognize faces, start hallucinating and fall into a coma.
- Inflammation of the membranes of the brain can sometimes lead to the defeat of joints and various organs( inflammation of the bladder, kidneys, stomach).
Pneumococcal meningitis can be as a consequence of some of the above listed diseases, and primary. It appears incomplete paralysis of the body( hemiparesis), seizures, frequent loss of consciousness.
Diagnosis of purulent meningitis
The main method of confirming the disease is a puncture of the CSF.In the cerebrospinal fluid, the glucose content will be reduced, the protein content will be increased, and the Non-Appelta, Pandi, and so on.will be positive.
The main symptom of purulent meningitis is a large number of neutrophils in the punctate.
Additional methods of investigation: head ultrasound, computer or magnetic resonance imaging. These methods will make it possible to diagnose "meningitis" two weeks after the onset of the disease. They need to be carried out for the differential diagnosis of meningitis from brain abscesses, tumors, strokes, encephalitis.
Secondary meningitis is also diagnosed on the basis of examination results from the ophthalmologist. Stagnant phenomena in the fundus are one of the symptoms of meningitis. A neurologist examination reveals the symptoms of Kerning and Brudzinsky.
Diagnosis of the disease in a child
For the confirmation of meningitis, children are also given spinal fluid puncture. Its transparency and color changes, the content of protein, neutrophils increases.
At late circulation, the punctate is found dense, it is often impossible to count cells, and the protein content can reach 10 g / l. A general blood test shows a large number of neutrophils, leukocytes, absence of eosinophils, leukocyte shift to the left.
Treatment of purulent meningitis
Meningitis therapy is performed in conditions of infectious disease in the polyclinic. After receiving the conclusion, a specific causative agent of the disease is established from the laboratory.
In accordance with this, shock doses of antibiotics( penicillin, cephalosporin series, aminoglycosides) that are able to penetrate the blood-brain barrier and protect the brain itself( pefloxacin, amikacin, cefazidime, cefazidime, ceftriaxone) are prescribed.
If the pathogen is pneumococcus, then immediately prescribe vancomycin in combination with cefepime or pefloxacin. In viral lesions, aciclovir, zovirax virolex, specific immunoglobulins are prescribed.
Usually a mild form of purulent meningitis is treated with sulfonamides and antibiotics of the tetracycline series. Meningitis caused by staphylococci requires complex antibiotic treatment for not more than a week.
To improve immunity, interferons, immunoglobulins are prescribed. Neutroprotectors, diuretics, anticonvulsants and corticosteroids - to eliminate puffiness of the meninges.
For the removal of intoxication, dehydration, for hypensensification, auxiliary and restorative drugs can also be administered: hemodez, glucose, neocomensane, albumin and others.
Ophthalmologists, otorhinolaryngologists, internists, pulmonologists are engaged in treatment of the disease. Symptomatic treatment may be needed by more narrow specialists( with lesions of internal organs, jaws, etc.).
Forecasts
The outcome of the disease depends on the timeliness of the beginning of treatment of the disease. Self-healing is impossible.
In connection with the transient development of meningitis, seek medical help immediately at the first symptoms and the slightest suspicion.
The complications or consequences of meningitis in adults and children include:
- Periodic headaches( meteosensitivity, overfatigue);
- Hydrocephalus( edema of the brain), epilepsy, paralysis;
- Skin necrosis;
- Diseases of the endocrine system;
- Memory impairment, ability to concentrate attention;
- Children may be late in development;
- Development of disorders of mental health, vision, speech, hearing, as well as by various internal organs, nerves paresis.
Generalized forms of meningococcal lesions can lead to brain edema, DIC syndrome, renal failure, infectious-toxic shock, sepsis, ependymatitis, cerebral hypotension and dural effusion.
It all depends on the severity of the meningitis, the success of its treatment, the duration of the course and the age of the patient. Some manage to transfer purulent meningitis and recover completely without feeling any echoes in the future. Timeliness of treatment plays a decisive role.
Meningitis has several varieties that differ in the causative agent of the disease. The main symptoms of reactive meningitis can be found in this article. Also, methods of its treatment are described here.
Is it possible to cure the arachnoid cyst of the brain folk remedies, read here.
And about what myoclonias are considered to be benign, you can find the link http: //gidmed.com/ bolezni-nevrologii /nevralgija/ chto-takoe-miokloniya.html.
Prevention of purulent meningitis
This type of disease develops often due to the emergence of foci of purulent inflammation of the body( furunculosis, tonsillitis, otitis, carbuncles, etc.).
It is necessary to try to sanitize these pockets( eliminate them), not to engage in self-treatment, especially when it comes to a small child.
Vaccine prophylaxis is also very effective now. Pneumococcal, meningococcal vaccines and antihemophilic vaccines are now available to everyone, nor save thousands of lives of our fellow citizens every year.
At the first symptoms( severe headache, fever, seizures, neurologic symptoms, neck muscle tension and others), you should immediately consult a therapist and neurologist to exclude this terrible diagnosis.
The video is a training film, which tells about meningitis and meningococcal infection itself: