home Audience 1 How is it treated after meningitis. Meningitis: etiology, symptomatic complex, types of diagnostic research methods

How is it treated after meningitis. Meningitis: etiology, symptomatic complex, types of diagnostic research methods

Headache and high fever are not always the result of an acute respiratory illness, sometimes things are much worse. Inflammatory processes that occur in the membranes of the brain, and in some cases in the membranes spinal cord are called - meningitis - symptoms, causes, classification, diagnostic and treatment options for which will be discussed in this article.

So, what is this disease - meningitis and what causes it? Meningitis - acute inflammatory disease central nervous system (CNS). In modern neurology this disease is, if not the most common, then at least in the leading positions.

Shell differences

In the course of the development of the disease, the outer membranes of the brain or spinal cord are damaged. It is noteworthy that the inflammatory process does not penetrate the brain and does not spread to its cells.

Where this disease comes from is a somewhat incorrect question, since there is no “meningitis virus” in nature. The disease may be caused various viruses, bacteria or fungi. Moreover, there is such a thing as secondary meningitis, which develops against the background of a concomitant disease. Some doctors believe that the secondary form of the disease is the most dangerous, since it is difficult for the body, already weakened by the main disease, to fight on two fronts.

The disease is dangerous, as it can lead to death. The disease has no age preferences, although young children, due to objective reasons, are more likely to suffer from this disease ( weak immunity, fewer resources to fight the infection, etc.).

Types of meningitis

To the great regret of doctors, meningitis has several varieties. Thus, the classification of the disease consists of more than seven sub-items, which in turn significantly complicates the diagnosis and appointment of effective treatment.

So, what types of classification exist:

by etiology;
by origin;
by the nature of the inflammatory process;
with the flow;
by the prevalence of the process;
by localization;
by severity.

By etiology

The classification of the disease by etiology implies the causes of the disease. So, the disease can be:

infectious;
infectious-allergic;
fungal;
traumatic.

Infectious meningitis is a bacterial disease with a mortality rate of 10%. The main pathogens are meningococci, pneumococci and hemophilia.

Haemophilus influenzae and meningococcal infection in most cases affects young children who are indoors in a micro group (kindergartens) for a long period of time. Meningococcal meningitis has a fulminant development and transient course.

Pneumococcal infection refers to infectious diseases, but can begin as a result of the spread of infection from purulent foci (wounds or abscesses). It is the most dangerous of the two types.

The infectious-allergic type of the disease, as a cause of development, has strong allergic reactions for various things.
As the name suggests - fungal type the disease has a fungal structure. In particular, the disease is characterized by the least rapid progression, compared with infectious species. The development of the disease is provoked by fungi such as Candida and some others. Mushrooms are carried with the products of the digestive system of birds, unwashed fruits, and unpasteurized milk.

Traumatic meningitis can develop in people who have received any trauma to the skull, when there is a possibility of infection from the nasal, auditory or other sinuses into the brain.

Origin

By origin, meningitis is:

Bacterial meningitis dangerous disease, which in the absence of proper treatment with a probability of 100% leads to a fatal outcome. The disease is caused by bacteria (meningococcus, golden streptococcus, enterobacteria, spirochetes, etc.), hence the name.

The viral nature of the disease is easier to tolerate by humans and has a better survival rate among patients than the bacterial form. The disease is provoked by various viruses, but 80% of cases were due to enterovirus infection(Coxsackievirus and ECHO).

The mixed form is also a dangerous type of disease, because it can contain several types of illness, which complicates the treatment process.

The nature of the inflammatory process

By the nature of inflammation, there is a complete and incomplete classification. Complete includes:

purulent;
hemorrhagic;
mixed.

Purulent meningitis is a disease infectious nature. The cause of the development of which is a meningococcal or pneumococcal infection. The disease can be primary or secondary.

In the first case, the infection enters the body by airborne droplets or as a result of existing mechanical damage skulls. In the second case, the development of the disease is due to the presence of a focus in the body. purulent inflammation, and the infection from there enters the brain.

What is the difference between diseases

The least dangerous type of disease known. The disease does not cause the death of brain cells and does not lead to irreversible consequences. This disease children are more often affected.

Hemorrhagic meningitis is characterized by multiple hemorrhages in the pia mater (source - slovariki.org)

With the flow

According to the nature of the process, there are:

spicy;
subacute;
recurrent;
chronic.

The acute type of the disease is manifested by lightning-fast development and rapid course. Symptoms appear almost all at once, may increase gradually.

The subacute type is characterized by a slower (up to 5-6 weeks) development of the disease.

The chronic type of the disease develops even more slowly, up to the onset of symptoms after several years (the so-called chronicity of symptoms).

The recurrent form of the disease is characterized by an undulating course. They note the deterioration, then the improvement of the patient's condition
According to the prevalence of the process:

According to the prevalence of the process, they distinguish

generalized;
limited.

The generalized form is characterized by the possibility of spreading the infection with the help of blood or lymph, and, accordingly, this infection may affect other organs.

Limited, in turn, on the contrary, is limited to one area.

According to the localization of the inflammatory process

According to localization, meningitis is:

convexital;
basal;
diffuse;
local.

Convexital means superficial. That is, the disease proceeds from the outside of the shell of the brain.
In turn, the basal type of the disease means in-depth inflammatory processes. This type of disease is the most dangerous and more difficult to tolerate.

The diffuse view is characterized by damage to the entire plane of the membrane of the brain, while the local one, on the contrary, affects a specific area.

Causes of meningitis

In order to understand what meningitis is and why it happens, it is necessary to understand the classification of the disease, since with different types various reasons can be identified. However, regardless of the pathogen, there are General terms contributing to the development of the disease. So, the cause of the disease can be:

viruses or bacteria affecting the cerebrospinal fluid;
the presence in the body or the recent end of an infectious disease (flu, herpes, mumps, etc.);
using unwashed items after a potential carrier of the virus;
alcohol abuse;
surgery on the spinal cord or brain;
head injury;
bites of insects or rodents (the bite itself does not mean the fact of infection transmission, but the formation of a purulent wound at the site of the bite can cause the infection that has developed in it to migrate);
hypothermia of the body;
taking corticosteroid drugs;
the presence of renal failure.

It is possible to transmit the disease to the child from the mother during childbirth

In microgroups, there is a greater likelihood of developing a similar infection and transmitting it by airborne droplets

How is meningitis transmitted?

The causative agents of meningitis are different, and, accordingly, their transmission paths are different. Undoubtedly, this disease is contagious and can be transmitted from person to person by airborne droplets or through the blood.

There are two options:

Transmission of an infection from a sick person to a healthy person.
Transmission of infection from a carrier of the virus (in most cases, the carrier does not even suspect that he has a dangerous disease in his body).

But how exactly is the infection transmitted?

airborne;
fecal-oral;
sexual;
cutaneous.

In addition, you can get infected not only from a person. Some rare forms of the disease can be picked up while swimming in water bodies. There is also the possibility of infection through the bite of an insect that can carry the disease.

It should be understood that many sources have poor survivability during external environment and almost instantly die when hit there. They are also not susceptible to boiling and exposure to sunlight.

Incubation period of meningitis

To understand how people get meningitis, it is necessary to take into account such a thing as the incubation period.

The incubation period is the period of time from the moment the infection enters the body until the first symptoms appear.

The period without fever and other unpleasant symptoms of the disease in this disease can be different. It is very difficult to track the pattern, because on initial stage it is not clear what kind of infection struck the body (an exception may be a secondary type of disease).

infection under the microscope

Average given period lasts from 2 to 10 days, but there are features.

Dependence of the incubation period on the infectious agent

Entroviruses - 3-8 days (in especially serious cases up to several hours).
Mumps - up to 3 weeks (average 10-18 days).
Viral and have an incubation period of 2 to 4 days, but symptoms usually begin much earlier.

Symptoms of meningitis

The first signs of impending danger are a high temperature and a headache, which has a growing character. Is there always a high temperature? Yes, this is the most main symptom. And usually, it rises without any visible reasons, and later the rest of the symptoms are connected.

In addition to the above-mentioned manifestations, the following symptoms are characteristic of all types of meningitis:

meningeal symptoms - symptoms unique to meningitis

nausea;
general weakness of the body;
vomit;
increased sensitivity to light and loud sounds;
drowsiness;
loss of consciousness;
convulsive manifestations;
nervous overexcitability;
stiff neck muscles (swelling of the fontanel in infants);
rash;
delirium;
delayed reaction;
hallucinations;
chills.

As for children, the manifestation of the disease in them is somewhat different. When it comes to, many of the symptoms are similar to those of adults.

Clinical picture in adults and children

As for infants, the symptoms of meningitis they may have are the following:

fever;
convulsive syndromes;
gushing vomiting;
profuse regurgitation;
nervous excitability (the child constantly cries, does not want to sleep);
apathetic state, lethargy;
sudden screams.

In addition, the development of strabismus, drooping of the upper eyelid is possible. Skin the child may have a bluish tint.

In place of the fontanel, the venous network is clearly visible

Diagnosis of meningitis

To diagnose meningitis, complex diagnostics patient, which includes a large number of analyzes and hardware research.

So, the list of diagnostic procedures:

blood and urine tests;
smear, to determine the pathogenic flora in the nose and in the pharyngeal cavity;
coagulogram;
HIV test;
liver puncture;
analysis for syphilis;
puncture cerebrospinal fluid;
computed tomography (CT);
head electroencephalogram (EEG);
magnetic resonance imaging (MRI);
nuclear magnetic resonance (NMR);
electrocardiogram (ECG);
x-ray of the skull;
examination by an ENT specialist, an ophthalmologist, an endocrinologist and a neurologist.

In addition, before carrying out this study the doctor must conduct a survey of the patient in order to determine the presence of past diseases, the general condition, in order to make a conclusion in the aggregate and make the correct diagnosis.

Treatment of meningitis

Is meningitis treatable or not and can this disease be cured? Undoubtedly yes. This disease is curable. Which doctor treats this disease? Infectionist, despite the fact that the disease affects the nervous system. Since the disease is of an infectious nature, it means that such a specialist should treat it.

So, meningitis is treated only in a hospital, as the patient must be constantly under the supervision of a specialist.

Therapy is divided into:

antibacterial;
antiviral;
antifungal;
detox;
symptomatic.

Such differences are important, since you cannot treat a disease caused by a fungus with drugs from a virus, and vice versa. The exception, of course, are interchangeable drugs.

Antibacterial therapy

In the treatment of the bacterial form of meningitis, the patient is in any case shown to use. In addition, in the case of severe inflammatory processes, the use of corticosteroid drugs is indicated to reduce inflammation. And to reduce the convulsive effect, tranquilizers are shown.

The duration of treatment is from 10 to 14 days. Cancellation of antibiotic therapy is possible in case of normalization of body temperature, the disappearance of symptoms of intoxication of the body. In addition, to determine the patient's condition, he may be prescribed repeated blood and cerebrospinal fluid tests.

It should be understood that not every antibiotic is able to overcome the blood-brain barrier (BBB), and since the main inflammatory processes occur precisely behind the BBB, it is worth taking a very responsible approach to the choice of drugs so that treatment is not just for the sake of treatment.

Below is a table with the names of drugs capable and not able to overcome the BBB.

Comparative table of antibiotics capable and not able to overcome the BBB

In the case of the use of antibiotics, it is mandatory for the patient to prescribe medications to normalize the intestinal microflora in order to avoid his disorder. Young children are especially susceptible to this.

Antiviral therapy

Usually, the viral form of meningitis in a severe form occurs in young children and pregnant women. Complications of the disease can even end in death for such patients. Therefore, hospitalization in this case is a mandatory measure.
Unlike the bacterial form of the disease, the viral form is not susceptible to antibiotics and its treatment is more associated with the elimination of the symptoms associated with the disease.

In particular:

To eliminate vomiting - cerucal.
To reduce the general intoxication of the body - saline with prednesolone and vitamin C intravenously.
To eliminate headaches - lumbar puncture or diuretics.
to reduce the temperature - antipyretic drugs based on paracetamol.
to eliminate pain in the head - papaverine and a similar medicine.

In addition, it is mandatory to carry out therapy to increase immunity (Interferon, etc.), antiviral therapy(Arbidol, etc.).

Antifungal therapy

One of the most dangerous species diseases - fungal meningitis. Previously, before the discovery of the drug Amphotericin B, the disease showed almost 100% mortality. After starting the use of the above medicine given statistics has changed. Moreover, in the case of complex therapy together with a drug like fluconazole, survival rates have increased even more.

Treatment of this form of the disease is the most protracted and can last up to a year, until the patient's cerebrospinal fluid normalizes.

The danger of the disease is that even after the end of therapy, a relapse is possible.

Detox Therapy

Regardless of the type of meningitis, the patient will always experience intoxication of the body. Therefore, in any case, the doctor will prescribe detox therapy.

This type of treatment consists in the introduction of an intravenous solution that reduces intoxication. In particular, such a solution includes - saline with the addition of vitamin C and prednezalon without fail.

Symptomatic treatment

This type of therapy is associated with the presence of a rather wide range of symptoms in the patient, which is not always possible to stop with a standard set of drugs. That is why it is appointed symptomatic treatment. In addition, the sudden development of some unpleasant complication is possible, in the form of severe vomiting or loss of consciousness. In such a situation, there is no time to wait for a doctor and listen to his recommendations. medical staff in a hospital, he independently injects a medicine designed to eliminate a particular symptom.

Forecast

The consequences after suffering an illness can be very different, or they may not be at all. Since the membranes of the brain and spinal cord are affected in the process of the development of the disease, the consequences are associated with neurological manifestations, in particular, the patient may retain:

Headache.
Hearing and vision impairment.
epileptic seizures.

A fatal outcome is not excluded at all, in the absence of proper therapy or timely assistance with purulent and bacterial meningitis, and in children with its viral forms.

However, in general, the prognosis is quite favorable, since the modern level of medicine makes it possible to qualitatively eliminate all possible consequences.

Prevention

Hardening of the body.
Prophylactic use of immunostimulating drugs (especially in kindergartens).
Timely treatment of chronic diseases.
Hygiene.
Doing healthy lifestyle life.
Regular exercise.

So, meningitis is a serious disease and in the absence of proper and timely treatment able to even take the patient's life. Treatment can only take place in a hospital and under the supervision of a doctor, so in no case do not self-medicate, as this can be deadly. Take care of yourself and your loved ones, take care of yourself!

Inflammation of the meninges (meminx) - serious illness requiring close attention and mandatory prevention. The consequences of the transferred illness can be irreversible and even lead to death. Especially dangerous is meningitis in children - a child can lose sight, hearing and remain disabled for life.

Effective treatment depends on several factors at once:

timely detection of signs of the disease and contacting a doctor;
accurate diagnosis and identification of causes;
the right strategy for therapy, recovery and prevention.

These aspects are of considerable complexity. A core symptom, such as a severe headache, may be mistakenly associated with other illnesses. And to determine the causative agent of meningitis, for example, the fungus with which the virus is transmitted, is often possible only by making very complex tests.

A disease called meningitis can affect anyone. There are cases when the meninges become inflamed without an external pathogen. For example, as a consequence of advanced sinusitis. Less often, phenomena are observed when the disease appears due to a genetic predisposition.

Most often, this virus is transmitted healthy person from the patient. But it should be noted the facts confirmed by statistics: bacteria, entering the body, do not always become active. If a person has good immunity, the virus is blocked.

The following groups of people are most susceptible to infection:

children under the age of five;
adolescents in puberty;
aged people.

The increased risk is long stay in a crowd or constant interaction with a large group of people:

accommodation in hostels;
daily work in a crowded cramped room;
frequent trips in crowded transport.

Those who are faced with the above circumstances need to be especially attentive to personal hygiene issues.

Disease classification

The treatment that a qualified doctor chooses depends entirely on the type of inflammation. The disease is classified according to three criteria:

cause of occurrence;
development speed;
flow form.

Inflammation of the meninges can be acute and chronic. In the first case, the disease proceeds rapidly, accompanied by vivid symptoms. In the second case pronounced signs no, or they look like a cold or poisoning.

From the point of view of origin, the disease is divided into primary and secondary. And according to etiology - fungal, bacterial or viral.

By the form in which the inflammatory process takes place, it is determined whether a person has serous or purulent meningitis. The second type is considered the most dangerous.

Causes of meningitis

Meningitis, as already noted, can be contracted, or you can get sick as a result of complications after other ailments, such as influenza or chronic sinusitis.

But most common causes meningitis turn out to be viruses. For example, enterovirus: usually it is the causative agent of gastroenteritis, but at the same time it is able to affect the meninges. Viral inflammation has, oddly enough, the most best forecast. With timely medical care, the patient gets better already on the 13-14th day.

One of the subspecies viral meningitis is herpes. With a weakened human immune system, this virus can provoke the onset chronic illness.

Viral meningitis is easy to get sick in a crowded place if you do not follow the rules of personal hygiene (for example, do not wash your hands). There have been cases of illness in children and adolescents who have been in summer camps.

Most often, meningitis in children appears if:

the baby was premature;
there were injuries during childbirth;
there were disturbances in the functioning of the nervous system.

The causes of meningitis in adults are more wide range. There are even such rare cases as a disease of the meninges after X-ray therapy or chemical intoxication.

A common cause of meningitis is alcoholism. Regular poisoning of the body with alcohol causes damage to the nerves of the brain, after which inflammation of the membranes begins. Treatment of pneumococcal meningitis in such situations is extremely difficult: cirrhosis of the liver prevents antibiotic therapy, and without it, there is practically no chance of a full recovery.

Signs of meningitis in adults and children

The most common symptoms of meningitis include:

With a bacterial or purulent form of the disease, the first signs of meningitis appear unexpectedly, and the disease develops very quickly. If treatment is not started immediately, the consequences will be disastrous for the patient.

Viral meningitis initially has symptoms resembling the usual respiratory disease: there is a "dull" headache, weakness, high fever, runny nose and possible cough. Further, meningococcal sepsis or nasopharyngitis develops, which causes intoxication of the body and inflammation of the meninges.

In order not to miss the onset of the disease, you should contact Special attention for two important symptom that help distinguish a cold from meningitis:

The headache extends to the back of the head. It is difficult for a person to tilt his head forward. The neck is often numb and difficult to turn to the side. In acute headache attacks, the eyeballs are so tense that it is almost impossible to move the eyes up, down, or sideways.
A characteristic rash appears on the body - red-violet spots. Usually in the armpits or on the legs, gradually spreading throughout the body. A meningitis rash can look like large or small stars. In children, it is found even on the palms and shoulder blades.

Symptoms of meningitis in children can vary depending on individual features child: some become lethargic and sleepy, others too restless. But common symptoms rash, headache and frequent regurgitation remain. At infants note a tense fontanel.

Signs of meningitis in adults can have several "waves". For example, when viral inflammation a person can feel sharp deterioration well-being, with nausea and pain in the back of the head. After taking painkillers and lying in bed for a couple of days, the adult experiences temporary relief and goes back to work.

After a while, the attack resumes, the body becomes covered with a rash, the temperature rises to 40 degrees. In these cases, you should not hesitate to contact a doctor. At the first signs, it is better to immediately undergo an examination and avoid consequences or complications.

What is the danger

Unfortunately, the statistics of mortality from meningitis is rather sad. Delayed treatment is not always able to prevent death or consequences in the form of mental retardation, loss of vision, hearing, or full motor activity.

Symptoms of meningitis are sometimes difficult to recognize in time. Sometimes there is no characteristic rash, according to which the diagnosis of meningitis becomes faster. In addition, people who tend to self-medicate make themselves erroneous diagnoses: they think they have caught the common flu, take painkillers uncontrollably and only temporarily push back serious problem.

The danger of the virus is that it can be very contagious. Meningococcus is quickly transmitted through unwashed hands or utensils. A sick person risks not only his health, but also the well-being of those around him.

Diagnosis of meningitis

A rash in meningitis greatly simplifies the diagnosis of the disease. However, there are times when this characteristic symptom No. Then use additional methods patient examinations:

Analyze nasal discharge. As a result of testing the fluid, the presence of a bacterium such as pneumococcus may be detected in the body.
Accurate diagnosis of meningitis is possible by taking a puncture. This is a rather unpleasant procedure. However, analysis of cerebrospinal fluid from lumbar of the spine allows you to quickly determine the type of meningitis and prescribe adequate treatment.
Testing the patient for symptoms of Kernig, Herman, Brudzinski, etc. For example, in the Kerning system, it is difficult for a patient with meningitis to extend the knee while the person is sitting, and the Brudzinski test tests the ability to pull the knees to the stomach while trying to pull the chin to the chest.

Disorders in the functioning of the joints - frequent consequences development of meningitis. But it can be difficult to determine them on your own, without the help of a doctor.

Medical treatment

Methods of therapy are selected in accordance with whether it is necessary to treat meningitis in children or in adults, at what stage of development the disease is, whether the process is acute or chronic. And also whether it was possible to detect meningitis in its incubation period.

Treatment also depends on the type of meningitis. For example:

Therapy for the meningococcal species includes penicillin, meglumine, mulfanomethoxine, and other drugs.
It is customary to treat the pneumococcal species with ampicillin, kanamycin sulfate and benzylpenicillin sodium salt.
Tuberculous meningitis usually requires isoniazid, ethambutol, streptomycin, pyrazinamide, and other drugs.

Treatment with antibacterial drugs is selected individually, as the doctor must take into account the age of the patient and his individual contraindications. For example, with a weak liver and problematic kidneys, strong antibiotics can cause even more Negative consequences.

Almost all patients are prescribed diuretics, as it is important to remove toxins from the body. General tonic and immune-supporting drugs are prescribed. Symptomatic treatment is selected to alleviate.

Unfortunately, there is no universal treatment regimen. Too many different factors affect right choice medicines. Therefore, it is strongly not recommended to self-medicate or use folk remedies. Only professional help help avoid the effects of inflammation.

Prevention of meningitis

It is difficult to argue with the opinion that the most effective treatment is something that could be minimized. Prevention of meningitis infection includes simple safety measures that are easy to follow:

Always wash your hands before eating.
Have personal utensils. Do not drink from the same mug with other people.
While in nature, protect yourself from insect bites (which can spread the infection).
Monitor the tone of your immunity: refuse bad habits, take care of proper nutrition and rest, replenish the vitamin reserve in demi-season periods.
Do not self-medicate. At the slightest suspicion of inflammation of the meninges, you need to call a doctor.

Good preventive measure can be vaccinated against meningitis. It can be done even for a child from 2 months. Vaccination is usually carried out among children up to 4-5 years.

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

die from meningitis

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

The causative agent of meningitis

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

How do you get meningitis? How meningitis is contracted depends on the form of the infection. Bacterial meningitis is transmitted only from person to person. Infection with meningitis is possible if you communicate closely with the patient, drink from the same mug, use common utensils, towels, hygiene products. But meningitis is not transmitted by airborne droplets, since the microorganisms that cause it live in the external environment for a very short time. For example, it is enough to ventilate the room so that the meningococci that have settled on the furniture die.

Viral meningitis: how is it transmitted

Parents often scare their children, they say, if you don’t put on a hat in the cold, you will certainly get meningitis. Is it so? If there is no pathogen in the body, then there is nowhere to take the disease. Therefore, such a statement is a fallacy. However, I still do not advise walking without a hat in winter - this way you can significantly weaken your immunity and disarm the body in front of many different infections.

All of this is not true of a viral infection. How is viral meningitis transmitted? Airborne.

Causes of meningitis

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

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

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

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

brain meningitis disease

Why can't other infections reach the brain, while meningococcus, pneumococcus, and Haemophilus influenzae succeed and develop meningitis?

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

Signs of meningitis

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

meningitis infection

Enough to strengthen the immune system and properly treated for the flu, so as not to get sick with meningitis? There is a second way for bacteria to enter the "forbidden zone" - with traumatic brain injuries, when the integrity of the bone is violated. In recent years, accidents have become more and more frequent, and with them the number of sick people is growing. purulent infection meningitis. The fact is that with fractures of the base of the skull, the membranes of the brain directly communicate with the airways of the nasopharynx, and as soon as the pathogen appears in the body, it penetrates into nervous tissue and reproduces very quickly.

What are the signs of meningitis?

The disease develops rapidly - in just a few hours.

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

How does meningitis manifest itself?

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

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

The first symptoms of meningitis

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

The course of meningitis

The course of meningitis of bacterial etiology is usually rapid.

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

The most important questions about treating bacterial meningitis

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

Diagnosis of meningitis

Diagnosis of meningitis is usually not difficult for an experienced physician. If the patient is conscious, tests are taken. And it happens that a person is brought in such a state when there is no time for tests: first you need to restore the heartbeat, breathing, get out of shock. This is done by a special resuscitation team.

Tests for meningitis

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

How safe is a lumbar puncture? Lumbar puncture is performed under local anesthesia the patient does not feel anything. A puncture is made in the lumbar region. At the puncture site there is neither the spinal cord nor the structures on which it rests spinal column. Therefore, you can not be afraid that the needle will damage something. Complications after the puncture also do not happen.

What happens after an infection is detected? It is very important to start intensive treatment at the first suspicion of purulent meningitis, even before the results of the analysis are available. The patient is immediately admitted to the hospital and intensively treated with antibiotics. Also prescribe drugs that remove excess liquid from serous membranes and reduce intracranial pressure, neurometabolites that improve brain metabolism, as well as vitamins (if the patient does not have allergies). The patient is allowed to go home no earlier than a month later (and sometimes even later, depending on the condition). Then the patient should lie at home for another 2 weeks. And only then gradually recovering will be able to return to the usual rhythm of life. After recovery, the patient should be regularly observed by doctors for another 2 years and undergo rehabilitation treatment. He is forbidden physical exercise and sports.

How to treat meningitis

Whether it is possible to be treated independently? In no case! Before treating meningitis, it is imperative to determine the sensitivity of the pathogen to antibiotics. Purulent meningitis should be treated only in infectious hospitals with strong antibacterial drugs, as patients are very fond of self-diagnosing and prescribing treatment. This often leads to disastrous consequences.

Treatment of meningitis

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

Antibiotics for meningitis

Antibiotics for meningitis can only be used as directed by a doctor. Bacteria are rapidly evolving and adapting to their environment. During antibiotic treatment, it is necessary to drink the full course to kill all germs. If the course is interrupted (and this is done by many when they suddenly feel better), the bacteria not only survive, but also acquire resistance (immunity) to this drug.

Even 20 years ago, penicillin was one of the most effective drugs. Today it hardly works. This is what the uncontrolled use of antibiotics leads to! And at the same time, almost any of them can be freely bought at a pharmacy. Over the past 7 years, not a single new one has been created in the world antibacterial drug because these studies are very costly.

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

Purulent meningitis: consequences and complications

Complications of meningitis appear if the patient applied too late for medical assistance, and the infection managed to damage not only the meninges, but also the very structure of the brain. The worst complication of purulent meningitis is, of course, death. But even if the patient was saved, he may have paresis, paralysis, hearing loss. IN rare cases a person is permanently disabled. Most common complication meningitis - cerebrosthenic syndrome, when a person reacts sharply to changes in weather, climate.

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

Can you get meningitis again? After the patient has been ill with purulent meningitis, he develops lifelong immunity. But only to one particular bacterium. Therefore, you can get infected with meningitis several times. However, this is a huge rarity. Only patients with craniocerebral injuries who have post-traumatic liquorrhea (liquor leakage into the nasal passages through a crack at the base of the skull) get sick again.

Prevention of meningitis

Prevention of meningitis is not only possible, but recommended by all doctors. First of all, you need to get vaccinated on time. Vaccination against hemophilic infection is included in the calendar. It is carried out for children at 3, 4.5 and 6 months. Also do revaccination at 18 months. Vaccinations against pneumococcus and meningococcus can now only be done in private clinics, as they have appeared quite recently. However, these vaccines are planned to be included in the National Immunization Schedule soon.

It is also necessary to monitor your health, not to start chronic foci of infection, treat your teeth on time, consult a doctor, and not try to lie down at home. It is very important to follow the basic sanitary regulations: each family member should have their own hygiene items, their own mugs, spoons, plates. And most importantly, wash your hands as often as possible.

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Almost all forms of meningitis develop extremely quickly. The infection affects the soft and arachnoid membranes, the substance of the brain is not directly affected by the disease. The main provocateurs of meningitis can be:, parotitis and other infectious diseases.

The most common is meningococcal meningitis. The source of infection are 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 a decrease in air temperature, an increase in humidity and crowding of people. Every 10-15 years there are outbreaks of the disease.

Meningitis is ubiquitous, but the number of cases in Africa is more than 40 times higher than the European average. Until the 20th century, mortality from meningitis was about 90%, but thanks to the invention of antibiotics and other effective drugs, it has been significantly reduced.

A person of any age can get sick with meningitis, but children under the age of five, premature babies, people with a weakened immune system are at risk for this disease.

Causes

Any infectious agents, when penetrating the pia mater, 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, tubercle bacillus and Afanasiev-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 do not manifest themselves in any way, but with a decrease in the body's defenses, they penetrate into the membranes of the brain, where they cause severe symptoms of the disease.

Group B streptococci often cause disease in newborns, infection can occur during childbirth or in postpartum period. Listeria can cause disease in infants, debilitated people and the elderly. In rare cases, the causative agent of meningitis is Klebsiella, or coli. This pathogen provokes a disease with brain injuries and blood poisoning.

The main routes of transmission of meningitis are:

airborne;
fecal-oral;
bites of insects and rodents;
transplacental.

Meningitis can occur as a complication of other infectious processes in the body. Infectious agents penetrate the brain membrane in different ways. The most common is hematogenous. It is also possible to spread the infection through the lymphogenous route. If the focus of inflammation is in contact with the meninges, a contact route of transmission is likely. It is promoted by otitis purulent nature, frontal sinusitis, brain abscess, and sinus cerebral thrombosis. open injuries the spine and head with the expiration of CSF create a gateway for infection.

Classification

Classification of meningitis is carried out according to many criteria.

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 characteristics of the infectious process:

serous (more 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 (surface);
basal (damage to the base of the brain).

Primary meningitis is considered as a separate pathology in which the pathogen enters the body from the environment and then develops in the tissues of the meninges. In the case of secondary infection, meningitis is a serious complication of another disease in the patient's body, from the focus of which the infection has spread.

Symptoms

Meningitis is predominantly characterized acute course. The disease is diagnosed according to three syndromes:

General infectious.
Shell (meningeal).
Analysis of cerebral fluid.

The first symptoms of the disease may resemble a cold (general infectious):

an increase in temperature to 38 ° C and above;
muscle pain;
chills;
rapid breathing;
, an increase in ESR.

There are also specific features meningitis (meningeal):

Headache. Localization pain syndrome often absent, usually diffuse. Over time, the pain becomes unbearable, bursting, any movements and irritations intensify it even more. Confusion may occur.
Nausea and vomiting, after which relief does not come.
Skin rashes. Primary meningococcal meningitis in mild form may present as a small, dark red rash that resolves after a few days. Long-term bruising and large red spots indicate a severe form of the disease.
Neck stiffness. When trying to bring the chin to the chest, patients experience severe pain. The typical posture for these patients is on the side with the head thrown back and the limbs bent, pressed against the chest and abdomen.
Brudzinski's symptom. When pressing on the eyeballs or when moving eye muscles the patient feels pain. There is also irritability from bright lights, strong odors, and loud noises.
Kernig's sign. The patient accepts lying position, then in the knee and hip joint, his leg is bent at a right angle. Trying to straighten the knee causes the patient pain in the lower back and hip.
Bakhterev's symptom. With light tapping on zygomatic bone pain occurs.
Lessage's symptom is characteristic of infants. When lifting the child by the armpits, he involuntarily bends his legs in hip joints and knees.

Diagnostics

If you suspect meningitis, you should seek medical attention at as soon as possible. If a child has vomiting against a background of high body temperature, this is also a reason to conduct a diagnosis to exclude meningitis.

To clarify the diagnosis and determine the type of pathogen in conditions medical institutions carry out the following activities:

Lumbar puncture makes it possible to examine the cerebrospinal fluid for inflammatory processes. The study of cerebrospinal fluid provides answers to the question about the type of meningitis (purulent or serous) and the type of pathogen.
Bacteriological examination of a smear from the mucous membrane of the nasopharynx.
Blood, feces, urine tests to determine general indicators.
X-ray examination of the lungs to check for.
MRI and computed tomography in the first week of illness to exclude similar pathologies.

Meningitis is diagnosed by infectious disease specialists and neuropathologists.

Treatment

At the first symptoms of meningitis, the first priority is urgent hospitalization to start treatment. Before the introduction of penicillin and sulfa drugs mortality from meningococcal meningitis ranged from 30 to 70%. Modern drugs help to effectively resist the disease.

With symptoms of meningitis in a reactive form, the struggle to save a person is calculated in hours. The patient may need intensive therapy or resuscitation. The course of treatment consists of etiological, pathogenetic and symptomatic therapy. The purpose of treatment tactics and drugs depends on the type of pathogen that caused the disease.

With purulent meningitis, antibiotics are indicated that have the ability to penetrate into the required dosage across the barrier between the circulatory and central nervous systems. The choice of drug will depend on the parameters of the lumbar puncture, history and level of consciousness of the patient. After clarifying the pathogen and its sensitivity (which takes time) antibiotic therapy correct.

The tuberculous type of meningitis requires the use of anti-tuberculous antibiotics as much as possible. allowable dosages. For the treatment of viral meningitis, the use of antiviral agents, interferon preparations, immunoglobulins, etc. is required. 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 cerebral edema. In severe cases, the use of anticonvulsants and corticosteroids may be required.

People who have had meningitis long time are registered with a psychoneurologist, pediatrician, neuropathologist and therapist.

Complications

The consequences of the disease will depend on what microorganism caused it, and on the general health of the person. The later treatment of meningitis is started, the higher the likelihood of severe complications.

One of the most dangerous states that are provoked 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 the ingress of meningococcal pathogens into the bloodstream. This condition is called meningococcemia. A lethal outcome from such a complication can occur within three days.. Young patients may develop concomitantly toxic shock and cerebral edema.

Sometimes migraines, meteorological dependence and drowsiness become a consequence of meningitis for many years, in other cases there are:

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

United specific prevention meningitis does not exist. 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. The general rules are:

timely isolation of patients;
early diagnosis;
compliance with hygiene rules;
use of protective equipment when communicating with the patient;
maintaining a normal immune status.

the only specific method able to protect against the most common and severe forms disease is considered vaccination. The most commonly used for this purpose is the meningococcal vaccine, triple MMR vaccine and the Haemophilus influenzae type B vaccine.

Forecast

The prognosis of the disease is individual and depends on many factors:

type of pathogen;
the timing of the start of treatment;
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 to save the patient, in other cases there is a complete recovery without any consequences.

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meningitis - acute infection, consisting in the defeat of the pia mater of the brain and spinal cord. Meningitis is accompanied by inflammatory changes in the cerebrospinal fluid, cerebrospinal fluid. Just a century ago, this diagnosis sounded like a sentence. Today, although this is a serious disease of the nervous system, it is almost always curable. Sometimes only minor changes in health may indicate the presence of meningitis, but more often formidable symptoms cause the patient to immediately seek medical attention.

In adults, this disease is less common than in children, but the symptoms are somewhat different from the manifestations of meningitis in childhood. Let's talk about the symptoms in adults in this article.

Functions of the pia mater

The pia mater is a thin layer connective tissue covering the entire surface of the brain and spinal cord. It has several main features:

contains blood vessels that feed the brain;
participates in the circulation of the cerebrospinal fluid that surrounds the brain;
protects brain tissue from infectious and toxic effects.

Causes and classification of meningitis

The cause of inflammation of the meninges can be a meningococcal infection.

Because meningitis is infectious disease, causative agents can be:

bacteria: the most diverse, more often pneumococci, meningococci, tubercle bacillus;
viruses: enteroviruses, adenoviruses, influenza and parainfluenza viruses, measles, rubella, Epstein-Barr herpes, cytomegalovirus;
mushrooms: candida, cryptococci;
protozoa: toxoplasma, malarial plasmodium, mycoplasmas, chlamydia, helminths, etc.

Of course, the first two groups of pathogens cause the disease in 95% of cases. The entrance gate for infection is most often the nasopharynx, bronchi and intestines. From these organs, viruses and bacteria enter the pia mater through the bloodstream. Much less often, meningitis develops when an infection enters through a wound with injuries to the brain or spinal cord.

Meningitis is:

primary: when there is no mention of a general infection or disease of any organ in the history of the disease;
secondary: if meningitis is the result (complication) of a disease.

According to the change in cerebrospinal fluid (cerebrospinal fluid), meningitis is divided into:

serous: if lymphocytes predominate in the cerebrospinal fluid;
purulent: if neutrophils predominate in the cerebrospinal fluid.

Serous meningitis is usually caused by viruses, while purulent meningitis is usually caused by bacteria.

According to the speed of development of the inflammatory process can be:

fulminant (especially characteristic of meningococcus);
sharp;
subacute;
chronic;
recurrent.

According to the severity of meningitis are divided into:

lungs;
moderate;
heavy;
extremely heavy.

Symptoms

Headache with meningitis is bursting in nature and is accompanied by nausea and vomiting.

All symptoms of meningitis can be divided into three groups:

general infectious;
cerebral;
meningeal.

General infectious symptoms non-specific, i.e. their presence does not indicate meningitis. These signs only indicate a possible infectious onset of the disease.

These include: general malaise, feeling hot or chills, muscle pain, joint pain, catarrhal phenomena in the form of a runny nose, redness of the throat, sneezing, etc., fever, rash, redness of the face, rapid heartbeat and breathing, increase lymph nodes, blood changes characteristic of an infection (increased ESR, an increase in the number of leukocytes).

Cerebral symptoms include headache, vomiting, disorder of consciousness, generalized seizures, congestion in the fundus.

Headache with meningitis is bursting in nature, spreads to the entire head, a person experiences pressure on the eyes from the inside. The source of headache is irritation of the meninges, increased intracranial pressure as a result of inflammation. characteristic feature headache in meningitis is the onset of vomiting at the peak of the pain without preceding nausea. Vomiting does not bring relief and may be repeated repeatedly. Such vomiting is called "brain".

The presence of mental disorders depends on the severity of meningitis. Consciousness may not be impaired in mild forms. In severe meningitis, quantitative (stupor, stupor, coma) and qualitative (hallucinations, delirium, psychomotor agitation, oneiroid) disorders of consciousness are observed.

Convulsive seizures occur due to irritation of the meninges and increased intracranial pressure. Sometimes epileptic seizure develops suddenly, against the background of the absence of other symptoms of meningitis.

Cerebral symptoms are also not specific to meningitis.

meningeal symptoms - these are special Clinical signs lesions of the meninges. One or two symptoms found separately do not confirm the diagnosis of meningitis, since they can also develop with other diseases of the nervous system (for example, with subarachnoid hemorrhage). However, the presence of a whole complex of such symptoms in one patient allows us to assume with sufficient certainty the presence of meningitis. And if a patient simultaneously with meningeal symptoms has both general infectious and cerebral symptoms, then a preliminary diagnosis can be considered established.