home Audience 1 Reasons for night meningitis. Eliminating the cause of meningitis. How does the inflammatory process develop?

Reasons for night meningitis. Eliminating the cause of meningitis. How does the inflammatory process develop?

- This inflammatory process, which occurs in the membranes of the brain and spinal cord. In this case, there is a distinction pachymeningitis (inflammation of the dura mater of the brain) and meningitis (inflammation of the soft and arachnoid membranes of the brain).

According to experts, cases of inflammation of the soft tissues are more often diagnosed meninges, which are usually referred to as “meningitis”. The causative agents of this disease are a variety of pathogenic microorganisms: viruses, protozoa, bacteria. Meningitis most often affects children and adolescents, as well as older people. Serous meningitis most often affects children of preschool age. Viral meningitis has milder symptoms and course than bacterial meningitis.

Types of meningitis

According to the nature of inflammation in the membranes, as well as changes in cerebrospinal fluid Meningitis is divided into two types: serous meningitis And purulent meningitis . In this case, the predominance in the cerebrospinal fluid is characteristic of serous meningitis, and the presence more neutrophils – for purulent meningitis.

Meningitis is also divided into primary And secondary . Primary meningitis occurs without the presence of infectious diseases in the patient’s body, and secondary meningitis manifests itself as a complication, such as general infection, and an infectious disease of a specific organ.

If you monitor the prevalence of the inflammatory process in the meninges, then meningitis is divided into a disease of a generalized and limited nature. So, basal meningitis arises from the base of the brain, convexital meningitis - on the surface of the cerebral hemispheres.

Depending on the speed of the start and further progression meningitis diseases are divided into fulminant , spicy (sluggish ), subacute , chronic .

According to etiology there are viral meningitis , bacterial , fungal , protozoal meningitis .

Clinical picture of meningitis

Diseases that have become chronic form (sarcomatosis , , toxoplasmosis , leptospirosis , , brucellosis etc.), can serve as a kind of impetus for the development of meningitis.

Infection of the meninges can occur by hematogenous, perineural, lymphogenous, or transplacental routes. But basically, the transmission of meningitis is carried out by airborne droplets or contact. At contact method infection, pathogens can enter the membranes of the brain due to the presence purulent infection the middle ear, paranasal sinuses, the presence of dental pathologies, etc. The mucous membrane of the nasopharynx, bronchi, and gastrointestinal tract acts as an entry point for infection during meningitis. Entering the body in this way, the pathogen spreads through the lymphogenous or hematogenous route to the membranes of the brain. Clinical manifestations of meningitis are accompanied by the presence of an inflammatory process in the meninges and adjacent brain tissue, microcirculation disorders in cerebral vessels. Due to too strong secretion of cerebrospinal fluid and its slow resorption, it may be impaired normal level and dropsy of the brain appears.

Manifestation pathological changes with purulent meningitis, which occurs acutely, does not depend on the pathogen. After the pathogen penetrates the membranes of the brain through lymph or blood, the inflammatory process affects the entire subarachnoid space of the brain and spinal cord. If the area of infection has a clear localization, then the purulent inflammatory process may be limited.

When infected, swelling of the membranes and substance of the brain occurs. Sometimes flattening of the cerebral convolutions occurs due to the presence of internal . In patients with serous viral meningitis, swelling of the membranes and substance of the brain is observed, while the cerebrospinal fluid spaces expand.

Symptoms of meningitis

Regardless of the etiology of the disease, the symptoms of meningitis are usually similar to different forms diseases.

Thus, the symptoms of meningitis are accompanied by general infectious signs: the patient has a feeling of chills, fever, elevated temperature body, the presence of signs of inflammation in the peripheral blood (increase, presence leukocytosis ). In some cases, skin rashes may appear. In the early stages of meningitis, the patient may experience a slow heart rate. Not during the development of meningitis this sign replaces . A person's breathing rhythm becomes disturbed and becomes more frequent.

Meningeal syndrome manifests itself as nausea and vomiting, fear of light, skin hyperesthesia, stiffness of the neck muscles and other signs. In this case, the symptoms of meningitis first manifest themselves as a headache, which becomes more intense as the disease progresses. The manifestation of a headache provokes irritation of pain receptors in the membranes of the brain and in the vessels due to the development of inflammation, exposure to the toxin and an increase in intracranial pressure. The nature of the pain is bursting, the pain can be very intense. In this case, the pain can be localized in the forehead and occipital region, spreading to the neck and spine, even sometimes affecting the limbs. Even at the very beginning of the disease, the patient may experience vomiting and nausea, although these phenomena are not related to food. Meningitis in children, and more in rare cases and in adult patients it can manifest itself as convulsions, the presence of delirium, and psychomotor agitation. But in the process of further development of the disease, these phenomena are replaced by a general stupor and. For more late stages diseases, these phenomena sometimes turn into coma.

Due to irritation of the membranes of the brain, reflex muscle tension is observed. Most often the patient has Kernig's sign and neck stiffness. If the patient's illness is severe, then other signs of meningitis appear. So, the patient throws his head back, draws in his stomach, straining the front abdominal wall. In this case, in a lying position, the legs will be pulled towards the stomach (the so-called meningeal position). In some cases, the patient exhibits zygomatic Bekhterev's symptom , severe pain in the eyeballs, which manifests itself after pressure or when moving the eyes. The patient reacts poorly to loud noise, loud sounds, and strong odors. Best in similar condition a person feels like lying in a dark room without moving and with his eyes closed.

Meningitis in infants is manifested by tension and protrusion of the fontanelle, as well as the presence of Lesage’s “suspension” symptom.

With meningitis, possible manifestations venous hyperemia, papilledema. If the disease is severe, then signs of meningitis may include dilated pupils, diplopia, . It is difficult for a person to swallow, and possible paralysis of the limbs, poor coordination of movements, and the presence of tremors. These symptoms of meningitis indicate damage to both the membranes and substance of the brain. This is possible on last stage diseases.

Bacterial meningitis usually begins acutely, with pronounced meningeal symptoms. Slower development is typical only for tuberculous meningitis . In most cases of bacterial meningitis, sugar levels are low and protein levels are high.

In older people, the course of meningitis may be atypical. Thus, headaches may be absent or appear slightly, but trembling of the arms, legs, and head is observed. There is drowsiness.

Diagnosis of meningitis

As a rule, the diagnosis of meningitis is made based on the presence of three signs of meningitis:

— presence of a general infectious syndrome;
— presence of meningeal (meningeal) syndrome;
- inflammatory changes in the cerebrospinal fluid.

However, meningitis cannot be diagnosed based on the presence of only one of these syndromes. For staging correct diagnosis The results of a number of virological and bacteriological research methods are important. Diagnosis of meningitis is also carried out by visual examination of cerebrospinal fluid. In this case, the specialist must take into account the general epidemiological situation and features clinical picture.

Patients who have signs of meningeal irritation should undergo a lumbar puncture. During this procedure, cerebrospinal fluid is collected for later testing using a thin needle inserted into the lower back. The current state is also determined , the presence of a large number of cells is determined ( pleocytosis ), as well as how much their composition has changed. Special tests are also used to determine the difference between bacterial and viral meningitis.

Treatment of meningitis

When treating meningitis, it is very important, first of all, to determine which pathogen provoked the development of the disease. However, this disease should be treated exclusively in a hospital setting. Viral meningitis, as a rule, is relatively mild, so the patient is strongly recommended to drink plenty of fluids in order to prevent dehydration of the body. Analgesics and antipyretic drugs are used to treat meningitis. Typically, a person recovers in about two weeks.

For bacterial meningitis, especially if it is provoked, treatment should be prescribed and carried out very urgently. If a patient is diagnosed with bacterial meningitis, then broad-spectrum antibiotics are generally used for treatment. The most commonly used drug for this form of the disease is . According to researchers, this remedy can destroy about 90% of meningitis pathogens. Also, immediate treatment with penicillin is prescribed to patients diagnosed with purulent meningitis.

Also used for the treatment of meningitis in children and adults. medicines, which can reduce intracranial pressure, drugs with antipyretic effects. Often, nootropic drugs are also prescribed in complex therapy, , drugs that stimulate the activity of cerebral blood flow.

It is important to consider that while adults who have recovered from meningitis do not always need constant further monitoring by doctors, then meningitis in children is a reason to regularly visit a doctor even after complete cure.

For patients who are at the recovery stage, it is important to avoid heavy stress, both physical and emotional nature, do not stay in direct sunlight for too long, do not drink a lot of fluids and try to consume as little salt as possible. Alcohol should be avoided altogether.

The doctors

Medicines

Prevention of meningitis

To date, vaccination against certain pathogens of meningitis (vaccine against pneumococcus, Haemophilus influenzae) has been successfully used. It is important to take into account that vaccination has a fairly noticeable effect in terms of protection against meningitis, but does not guarantee one hundred percent prevention of infection. However, even after contracting the disease, a person who has been vaccinated will suffer from meningitis in a much milder form. After vaccination valid for three years.

It is important to adhere to the basic rules of everyday hygiene as a method of preventing meningitis. Important Special attention pay attention to regular hand washing, personal items (lipstick, dishes, toothbrush etc.) do not give for use to strangers. If you have close contact with someone who has meningitis, it is important to contact your doctor immediately. A specialist may prescribe certain medications for preventive purposes.

Complications of meningitis

Due to bacterial meningitis the person may experience brain damage. So, the most severe complications of this disease are deafness, delay mental development with meningitis in children. If proper and timely treatment of meningitis is not started, the disease can cause death. In particular severe cases fatal outcome comes in a matter of hours.

List of sources

E. I. Gusev, G. S. Burd, A. N. Konovalov. Neurology and neurosurgery. - 2000.
Lobzin Yu.V., Pilipenko V.V., Gromyko Yu.N. Menigitis and encephalitis. St. Petersburg: Foliot, 2001.
Khaitov R.M., Ignatieva G.A., Sidorovich I.G. Immunology. - M.: Medicine, 2001.
Lobzina Yu.V., Kazantseva A.P. Guide to Infectious Diseases. - St. Petersburg: Comet, 1996.

Meningitis is a dangerous disease that is an inflammation of the membrane of the brain (usually) or the spinal cord. Meningitis has a short incubation period (up to 7 days) and can lead to death in just a few hours. Therefore, everyone needs to know the symptoms of this disease.

Meningitis in adults can be primary or secondary. Primary is an independent disease that is caused by meningococcal infection, and inflammation immediately begins in the lining of the brain. Secondary meningitis is a consequence of diseases such as osteomyelitis of the skull bones, sinusitis, neck and face, as well as other foci of inflammation.

Symptoms of meningitis

The very first signs of meningitis in adults resemble progressive colds and then the following symptoms appear:

chills and fever, which are most severe in young adults and adolescents;
vomiting and constant nausea;
increased sensitivity to the light. The patient often lies facing the wall or covers his head with a blanket;
spasm of the muscles of the back of the head, due to which the patient cannot turn his head or tilt it;
acute, often unbearable, which intensifies significantly with loud sounds, bright light or head movements;
Kerning's sign. It lies in the fact that the patient cannot straighten the leg, bent at the hip and knee joints.

Brudzinski's sign:

– if the patient’s head in a supine position is raised to the chest, the legs are bent at the hip and knee joints;

– if light pressure is applied to the pubic plexus, the legs bend at the hip and knee joints;

– when testing for Kernig’s sign, the second leg also bends.

Brudzinski's sign - if the patient's head in a supine position is raised to the chest, the legs are bent at the hip and knee joints

the patient may experience increased sensitivity of the skin, and even a light touch may be painful;
decreased appetite;
shortness of breath and rapid shallow breathing;
Possible skin rash.

Symptoms of the disease largely depend on the type of meningitis, of which there are seven.

Meningitis in adults - there are 7 types

Aseptic meningitis

It is a consequence of undertreatment or can lead to death. The main symptoms are:

– fever;

– mental disorders;

– vomiting and nausea;

– decreased vision;

– curvature of the neck;

– increased sensitivity to light;

– chills and fever.

Treatment is the same as for viral form diseases. If the disease does not proceed at lightning speed, then when timely treatment after 10-12 days recovery occurs. In the fulminant form, a person dies in less than a day from renal, respiratory or cardiovascular failure.

Pneumococcal meningitis

Pneumococcus very often causes bacterial meningitis in adults, it is in second place after meningococcus. This type of disease is extremely difficult for patients to tolerate, with a high percentage of deaths. There is an increased risk of developing pneumococcal meningitis in people who have recently suffered a head injury, who have had meningitis before, people who have had their spleen removed and have infectious lesions. heart valve. and other long-term chronic diseases increase the likelihood of pneumococcal infection.

The main features are:

– raising the temperature to 40 degrees;

– blueness of hands and feet;

The disease develops very quickly, the patient can fall into a coma and die without leaving it. Deaths are common because meningitis develops quickly and the bacteria are quite resistant to antibiotics.

Tuberculous meningitis

This is a form of the disease that develops slowly. They have mild symptoms common to meningitis, as well as the following signs:

– chills and fever, temperature persists long time, but increases very slowly;

– appetite decreases, general malaise and weakness appear;

– catarrhal, nasopharyngitis;

– asthenia, lethargy, weight loss.

Diagnosis requires skin tests, brain tissue tests, and a chest x-ray.

Despite its sluggish course, tuberculous meningitis can pose a threat to human life. The danger is that it is extremely difficult to diagnose it on your own, and the symptoms at the onset of the disease are not so significant for a person to see a doctor. Treatment lasts at least a year, the patient must take anti-tuberculosis drugs, sometimes steroids. Vaccination with BCG eliminates the possibility of contracting tuberculous meningitis.

Diagnosis of the disease

A doctor can diagnose meningitis or suspicion of it based on the following signs:

fever;
torticollis;
mental disorders.

After the listed symptoms have been detected, the patient is sent for a spinal puncture. This analysis allows you to evaluate the bacterial picture of the spinal cord, as well as the structure and number of cells. A lumbar puncture is done between the 3rd and 4th lumbar vertebrae, with the game being inserted into the space between the spinal cord and its membrane (subarachnoid space).

Depending on additional symptoms, encephalography, chest x-ray, fundus assessment, various immunological and bacteriological studies, as well as may also be prescribed. All these studies are needed in order to determine the type of meningitis a person has and prescribe treatment.

Important! You cannot treat meningitis on your own, since if the drugs are selected incorrectly, death is likely. Most people who died from did not see a doctor in time or tried to treat the disease on their own.

Treatment of meningitis

The specifics of treatment depend on the type of disease diagnosed. In the vast majority of cases, the patient is hospitalized. Until a lumbar puncture has been performed, the patient is prescribed general-spectrum antibiotics, and then more targeted treatment is prescribed.

Bacterial and purulent meningitis are treated with antibiotics of different spectrum of action. It is often necessary to change several drugs in order to identify the greatest sensitivity of bacteria to the drug. The selection of antibiotics also depends on the patient’s age and health status.

Viral meningitis is much more serious and causes severe nausea and headache. The patient is prescribed antiemetics and analgesics, with high temperature Paracetamol is prescribed.

How long the disease will last depends on the general condition of the body and the type of pathogen. On average, the treatment period lasts from 10 days to 3 weeks, if there are no complications.

Prevention of meningitis

Even now, in 2016, people are dying from meningitis due to the fact that the disease was not prevented in time. The most reliable way to protect yourself against most types of meningitis is through vaccinations. Most vaccinations are given during childhood, but adults and teenagers who have not previously been vaccinated may be vaccinated. First of all, these are vaccinations against rubella, chickenpox, mumps, etc. These diseases themselves are dangerous in adulthood, and can also become causative agents of meningitis. A vaccine with meningococcal bacteria has also been developed, which reliably protects against this type of meningitis. Is not compulsory vaccination, but it is recommended for children and people who are at risk of getting meningitis (for example, they travel frequently).

People who have implants and whose spleen has been removed should be vaccinated with pneumococcal conjugate vaccine (PCV).

In addition to vaccination, the following rules will help protect against the disease:

Avoid contact with a person who has meningitis. When caring for a patient, you need to wash your hands with soap and change clothes that have touched the patient. If a person is being treated at home, then he must be isolated from other family members until he recovers so that the disease is not transmitted to them;
avoid animals and insects that are carriers. Primarily these are rats, mosquitoes and ticks. Therefore, when going to the forest, you must use insect repellent. Deratization should be carried out regularly in houses;
meningitis primarily affects people with weakened immune systems, so it is important to eat well, take periodic vitamins and lead a healthy lifestyle. Hypothermia in winter can also end in disaster, as it causes a sharp decrease in immunity.

Meningitis- this is dangerous and serious illness, which is much easier to prevent than to cure.

Meningitis is an acute infectious disease that affects the soft membrane of the brain and spinal cord. Meningitis is accompanied by inflammatory changes in cerebrospinal fluid, liquor. Just a century ago, this diagnosis sounded like a death sentence. Today, although this is serious disease nervous system, it is almost always curable. Sometimes only minor changes in health status may indicate the presence of meningitis, but more often severe symptoms force the patient to immediately seek medical help.

In adults, this disease is less common than in children, but the symptoms are somewhat different from the manifestations of meningitis in childhood. We will talk about 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 functions:

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

Causes and classification of meningitis

Meningococcal infection may be the cause of inflammation of the meninges.

Since meningitis is an infectious disease, the causative agents can be:

bacteria: a wide variety, most often pneumococci, meningococci, tuberculosis bacillus;
viruses: enteroviruses, adenoviruses, influenza and parainfluenza viruses, measles, rubella, Epstein-Barr herpes, cytomegalovirus;
mushrooms: candida, cryptococcus;
protozoa: toxoplasma, malarial plasmodium, mycoplasma, chlamydia, helminths, etc.

Of course, the first two groups of pathogens cause the disease in 95% of cases. The entry points for infection are 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 infection occurs through a wound due to injuries to the brain or spinal cord.

Meningitis occurs:

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

Based on changes in the cerebrospinal fluid (CSF), 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 caused by bacteria.

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

fulminant (especially typical for meningococcus);
spicy;
subacute;
chronic;
recurrent.

According to severity, meningitis is divided into:

lungs;
moderate severity;
heavy;
extremely heavy.

Symptoms

The 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 diseases;
general cerebral;
meningeal.

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

These include: general malaise, feeling of heat 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, increased heart rate and breathing, increased lymph nodes, blood changes characteristic of infection ( increase in ESR, increase in the number of leukocytes).

General cerebral symptoms include headache, vomiting, confusion, generalized seizures, congestion in the fundus.

The headache with meningitis is bursting in nature, spreading to the entire head, the person experiences pressure on the eyes from the inside. The source of headaches is irritation of the meninges, increased intracranial pressure as a result of inflammation. A characteristic feature of headaches with meningitis is the occurrence of vomiting at the peak of pain without preceding nausea. Vomiting does not bring relief and may recur several times. This type of vomiting is called “brain vomiting.”

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

Seizures occur due to irritation of the meninges and increased intracranial pressure. Sometimes epileptic seizure develops suddenly, in the absence of other symptoms of meningitis.

General cerebral symptoms are also not specific to meningitis.

Meningeal symptoms– these are special clinical signs of damage to the meninges. One or two symptoms detected 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 confidently assume the presence of meningitis. And if the patient simultaneously with meningeal symptoms has both general infectious and cerebral symptoms, then the preliminary diagnosis can be considered established.

Meningitis is an inflammatory process that affects the meninges. Meningitis comes in several forms, each of which is life-threatening for the patient and requires immediate medical intervention. In most cases, inflammation of the meninges develops against the background of infectious pathogens entering the body. This pathological process, regardless of etiology, is characterized by the presence of general meningeal symptoms, general inflammatory signs, as well as inflammatory elements in the cerebrospinal fluid. When diagnosing meningitis, the clinical picture is analyzed, and a number of additional studies are carried out, the key among which is lumbar puncture; based on its results, the form of meningitis can be clarified and the optimal treatment tactics can be determined.

Classification of meningitis

Today there is no unified classification of meningitis; in clinical practice, inflammation of the meninges is divided simultaneously according to several criteria.

By etiology:

bacterial (staphylococci, mycobacterium tuberculosis, streptococci);
fungal (cryptococcus, fungi of the genus Candida);
protozoans (for toxoplasmosis, malaria);
viral (for herpes, measles, rubella, HIV, ECHO).

According to the nature of the inflammatory process:

serous (develops in infectious diseases);
purulent (if present) high level leukocytes in the cerebrospinal fluid).

By pathogenesis:

primary (the development of the inflammatory process in the meninges occurs independently, in the absence of general infectious lesion organism or local infection of any organ);
secondary (develop against the background of a local or general infectious disease).

According to the prevalence of the process:

limited;
generalized.

By process localization:

convexital;
diffuse;
local;
basal.

According to the rate of progression of the disease:

sharp (these include lightning);
subacute;
chronic;
recurrent.

The following forms are distinguished according to severity:

light;
average;
heavy;
extremely heavy.

Etiology and pathogenesis of meningitis

Etiological factors that trigger the development of meningitis can be:

bacterial pathogens (pneumococcus, staphylococcus, meningococcus, coli, streptococcus, mycobacterium tuberculosis);
mushrooms (cryptococci, candida);
viruses (rubella, measles, Coxsackie, HIV, ECHO, herpes).

In some cases, inflammation of the meninges develops as a result of complications of helminthiasis and the introduction of protozoan microorganisms into the body.

Ways of infection entering the body

Infectious agents can penetrate the meninges in various ways, but most often the primary focus of inflammation, and as a result, the entrance gate for infection, is localized in the nasopharynx. Next, the infection moves along with the bloodstream to the membranes of the brain. As a rule, the spread of infection throughout the body through the bloodstream is typical in the presence of chronic foci of infection (sinusitis, otitis media, cholecystitis, furunculosis, pneumonia, etc.).
There is also a contact route for the introduction of an infectious pathogen into the meninges. This variant of the development of meningitis can occur when the integrity of the skull bones is violated and pus penetrates into the cranial cavity as a result of osteomyelitis against the background purulent sinusitis, inflammation of the eyeball and orbit, as well as congenital defects development of the central nervous system, after lumbar punctures, with defects of the soft tissues of the head and with skin fistulas.
In rare cases, the infection may spread to the meninges through lymphatic vessels nasal cavity.

Patients of any age can suffer from this disease, but most often meningitis develops in children, the reason for this is the imperfection of the blood-brain barrier (a body function whose task is to protect the human nervous system from foreign substances) and insufficient development of the immune system.

An important role in the development of meningitis is played by predisposing factors, which include: infectious diseases, traumatic brain injuries, intrauterine pathologies of the fetus, vaccination, etc.

Upon penetration pathogenic microorganisms In the central nervous system, the soft membranes of the brain and spinal cord are damaged. In most cases, the pathological process extends to the soft and arachnoid membranes, but it is also possible to damage the dura mater, the roots of the cranial and spinal nerves and the upper parts of the brain.

The impact of the inflammatory process on the meninges can provoke many complications from most organs and systems, in particular adrenal, renal, respiratory and heart failure, and in some cases leads to death.

Clinical picture of meningitis

Regardless of the etiological factors and mechanisms of development of this pathology, the clinical picture of meningitis is characterized by standard manifestations: meningeal syndrome in combination with characteristic changes in the cerebrospinal fluid, as well as general infectious symptoms.

Meningeal syndrome develops as a result of irritation and inflammatory reactions in the meninges and is clinically manifested by a general cerebral symptom complex and meningeal symptoms themselves. General cerebral symptoms include dizziness, headache, fear of light and sound. The first manifestations of meningeal signs, as a rule, appear 2-3 days after the onset of the disease and are expressed in the following: rigidity of the neck muscles, symptoms of Brudzinsky, Kernig, Lesage, etc. The inability to passively flex the head (stiff neck muscles) is the first and constant sign of inflammation meninges.

In addition, there is a separate group of symptoms, which consists of characteristic pain sensations diagnosed during palpation and percussion of certain target points. With meningitis, patients feel pain if pressure is applied to them. eyeballs through closed eyelids, onto the anterior wall of the outer ear canal, when tapping the skull, etc.

The clinical picture of meningitis in young children is characterized by mild symptoms, therefore, when examining a child with a suspected inflammatory process in the brain and, in particular, meningitis, attention is paid to tension, bulging and pulsation of the large fontanel and a number of other symptoms.

An important element of the clinical picture of meningitis is the presence of characteristic changes in the cerebrospinal fluid. Inflammation of the meninges is indicated by cell-protein dissociation in the cerebrospinal fluid. During the study of purulent meningitis, the cerebrospinal fluid has a cloudy color, it is noted high blood pressure cerebrospinal fluid, and its content is determined a large number of protein cells.

In elderly patients, symptoms are atypical, which manifests itself in mild headaches or complete absence, drowsiness, tremors of the limbs and head, as well as mental disorders.

Diagnosis and differential diagnosis of meningitis

Main diagnostic method when examining meningitis, a lumbar puncture will be performed, since the examination of cerebrospinal fluid can detect meningitis even with minimal clinical manifestations. This study is performed only in a hospital setting and after preliminary diagnosis, which includes taking an anamnesis, palpation, percussion, identifying meningeal and cerebral signs, as well as excluding contraindications. In most cases, examination of the cerebrospinal fluid allows one to determine the etiology of the disease and prescribe appropriate treatment. The main task of differential diagnosis is to exclude other diseases with similar symptoms, in particular meningism. A distinctive feature of meningism is the absence of general infectious symptoms against the background of meningeal syndrome.

Treatment of meningitis

Meningitis is a direct indication for hospitalization of the patient. Therapeutic tactics are etiotropic in nature and are aimed at eliminating the primary source of infection. The effect of etiotropic treatment must be assessed by analyzing clinical data and the results of microscopic examination of the cerebrospinal fluid.

In the process of treating bacterial meningitis, both in children and adults, the main emphasis is on drug therapy done for appointment antibacterial drugs in large doses. The choice of antibiotic depends on the causative agent of the infection.

In case of viral origin of the inflammatory process, it is important to use antiviral drugs, in particular Viferon. And with fungal etiology, meningitis is treated with antimycotic drugs.

Along with therapeutic measures aimed at eliminating the cause of the disease, the use of detoxification and restorative therapy is very important.

To prevent seizures, it is recommended to use lytic mixtures(pipolfen, aminazine, novocaine). If the course of meningitis is complicated by cerebral edema or Waterhouse-Friderichsen syndrome, it is advisable to use corticosteroids (dexamethasone). Also, if necessary, carried out symptomatic treatment pain and hyperthermia.

Prognosis for meningitis

The prognosis of this disease depends on the cause of its development and the timeliness of therapeutic measures. Sometimes, after treatment for inflammation of the meninges, patients may be left with a headache, impaired hearing, vision, liquor hypertension, etc. If not diagnosed in time and treatment is not started, meningitis can be fatal.

Prevention of meningitis

To prevent this disease, it is necessary to lead a healthy lifestyle, harden yourself, promptly sanitize the foci of acute and chronic infection, and at the slightest suspicion of a disease, immediately contact a specialist.