Meningitis - treatment, prevention methods and prognosis. Meningitis: prevention is better than cure
Pneumococcus
Pneumococci long time may be on the mucous membrane oral cavity and upper respiratory tract and do not cause any symptoms. However, when the body’s defenses decrease, the infection becomes more active and spreads through the blood. The difference between pneumococcus is its high tropism ( preference) to brain tissue. Therefore, already on the second or third day after the disease, symptoms of damage to the central nervous system develop.
Pneumococcal meningitis can also develop as a complication of pneumococcal pneumonia. In this case, pneumococcus from the lungs reaches the meninges through the lymph flow. Meningitis has a high mortality rate.
Haemophilus influenzae
Haemophilus influenzae has a special capsule that protects it from the body's immune forces. Healthy body becomes infected by airborne droplets (when sneezing or coughing), and sometimes contact ( in case of non-compliance with hygiene rules). Once on the mucous membrane of the upper respiratory tract, Haemophilus influenzae reaches the meningeal membranes through the blood or lymph flow. Next, it is fixed in the soft and arachnoid membrane and begins to multiply intensively. Haemophilus influenzae blocks the villi of the arachnoid membrane, thereby preventing the outflow of cerebral fluid. In this case, fluid is produced, but does not drain away, and the syndrome of increased intracranial pressure develops.
In terms of frequency of occurrence, meningitis caused by Haemophilus influenzae is in third place after meningococcal and pneumococcal meningitis.
This route of infection is characteristic of all primary meningitis. Secondary meningitis is characterized by dissemination of the pathogen from the primary chronic source of infection.
The primary site of infection may be:
- inner ear with otitis;
- paranasal sinuses with sinusitis;
- lungs with tuberculosis;
- bones with osteomyelitis;
- injuries and wounds due to fractures;
- jaw and teeth during inflammatory processes in the jaw apparatus.
Otitis media is an inflammation of the middle ear, that is, the cavity located between the eardrum and the inner ear. Most often, the causative agent of otitis media is staphylococcus or streptococcus. Therefore, otogenic meningitis is most often staphylococcal or streptococcal. An infection from the middle ear can reach the meningeal membranes as in acute period illness, as well as chronic.
Routes of infection from the middle ear to the brain :
- with blood flow;
- through the inner ear, namely through its labyrinth;
- by contact in case of destruction in the bone.
Inflammation of one or more paranasal sinuses is called sinusitis. The sinuses are a kind of air corridor that connects the cranial cavity with the nasal cavity.
Types of paranasal sinuses and their inflammatory processes :
- maxillary sinus– its inflammation is called sinusitis;
- frontal sinus– its inflammation is called frontal sinusitis;
- lattice labyrinth - its inflammation is called ethmoiditis;
- sphenoid sinus- its inflammation is called sphenoiditis.
Pathways for infection to spread from the sinuses to the meningeal membranes :
- with blood flow;
- with lymph flow;
- by contact ( with bone destruction).
The most common causes of bacterial sinusitis are:
- Pneumococcus;
- hemophilus influenzae;
- Moraxella catharalis;
- Staphylococcus aureus;
- Streptococcus pyogenes.
Pulmonary tuberculosis is the main cause of secondary tuberculous meningitis. The causative agent of tuberculosis is Mycobacterium tuberculosis. Pulmonary tuberculosis is characterized by a primary tuberculosis complex, in which not only lung tissue is affected, but also nearby vessels.
Components of the primary tuberculosis complex:
- lung tissue ( as tuberculous pneumonia develops);
- lymphatic vessel ( tuberculous lymphangitis develops);
- lymph node ( tuberculous lymphadenitis develops).
Osteomyelitis
Osteomyelitis is a purulent disease that affects the bone and surrounding soft tissue. The main causative agents of osteomyelitis are staphylococci and streptococci, which enter the bone due to injury or through the bloodstream from other foci ( teeth, boils, middle ear).
Most often, the source of infection reaches the meninges through the bloodstream, but with osteomyelitis of the jaw or temporal bone it penetrates the brain by contact, due to bone destruction.
Inflammatory processes in the jaw apparatus
Inflammatory processes in the jaw apparatus affect both bone structures ( bone, periosteum), and soft tissues ( The lymph nodes). Due to the proximity of the bone structures of the jaw apparatus to the brain, the infection quickly spreads to the meninges.
Inflammatory processes of the jaw apparatus include:
- osteitis– damage to the bone base of the jaw;
- periostitis– damage to the periosteum;
- osteomyelitis– damage to both bone and bone marrow;
- abscesses and phlegmons in the jaw apparatus- limited accumulation of pus in soft tissues jaw apparatus ( for example, at the bottom of the mouth);
- purulent odontogenic lymphadenitis– damage to the lymph node of the jaw apparatus.
The causative agents of infection of the jaw apparatus are:
- viridans streptococcus;
- white and golden staphylococcus;
- peptococcus;
- peptostreptococcus;
- actinomycetes.
A special form of meningitis is rheumatic meningoencephalitis, which is characterized by damage to both the meninges and the brain itself. This form of meningitis is the result of rheumatic fever ( attack) and is mainly characteristic of children and adolescence. Sometimes it can be accompanied by a large hemorrhagic rash and is therefore also called rheumatic hemorrhagic meningoencephalitis. Unlike other forms of meningitis, where the patient's movements are limited, rheumatic meningitis is accompanied by severe psychomotor agitation.
Some forms of meningitis are a consequence of generalization of the initial infection. Thus, borreliosis meningitis is a manifestation of the second stage of tick-borne borreliosis ( or Lyme disease). It is characterized by the development of meningoencephalitis ( when both the membranes of the brain and the brain itself are damaged) in combination with neuritis and radiculitis. Syphilitic meningitis develops in the second or third stage of syphilis when treponema pallidum reaches the nervous system.
Meningitis can also be a consequence of various surgical procedures. For example, the gateway to infection may be postoperative wounds, venous catheters and other invasive medical equipment.
Candidal meningitis develops against the background of sharply reduced immunity or against the background of prolonged antibacterial treatment. Most often, people with HIV infection are susceptible to the development of candidal meningitis.
Signs of meningitis
The main signs of meningitis are:
- chills and fever;
- headache;
- stiff neck;
- photophobia and hyperacusis;
- drowsiness, lethargy, sometimes loss of consciousness;
- rash on the skin, mucous membranes;
- anxiety and psychomotor agitation;
- mental disorders.
Chills and fever
Fever is the dominant symptom of meningitis. It occurs in 96–98 percent of cases and is one of the very first symptoms of meningitis. The rise in temperature is due to the release of pyrogenic ( fever-causing) substances by bacteria and viruses when they enter the blood. In addition, the body itself produces pyrogenic substances. The most active is leukocyte pyrogen, which is produced by leukocytes at the site of inflammation. Thus, the increase in temperature occurs due to increased heat production both by the body itself and by the pyrogenic substances of the pathogenic microorganism. In this case, a reflex spasm of skin vessels occurs. Vasospasm entails a decrease in blood flow in the skin and, as a result, a drop in skin temperature. The patient feels the difference between internal warmth and cold skin as chills. Severe chills accompanied by trembling throughout the body. Muscle tremors are nothing more than the body’s attempt to warm up. Stunning chills and a rise in temperature to 39 - 40 degrees are often the first sign of illness.Headache
Severe diffuse progressive headache, often accompanied by vomiting, is also early sign diseases. Initially, the headache is diffuse and is caused by the phenomenon of general intoxication and elevated temperature. In the stage of damage to the meninges, the headache increases and is caused by cerebral edema.The cause of cerebral edema is:
- increased secretion cerebrospinal fluid due to irritation of the meninges;
- outflow disturbance cerebrospinal fluid up to the blockade;
- direct cytotoxic effect of toxins on brain cells, with their further swelling and destruction;
- increased vascular permeability and, as a result, penetration of fluid into the brain tissue.
In infants, there is bulging and tension of the large fontanelle, a pronounced venous network on the head, and in severe cases, divergence of the sutures of the skull. This symptomatology, on the one hand, is caused by the syndrome of increased intracranial pressure ( due to cerebral edema and increased secretion of cerebrospinal fluid), and on the other hand, the elasticity of the skull bones in children. At the same time, young children experience monotonous “brain” crying.
Stiff neck
Neck stiffness occurs in more than 80 percent of meningitis cases. The absence of this symptom can be observed in children. The patient's posture, characteristic of meningitis, is associated with muscle rigidity: the patient lies on his side with his head thrown back and his knees brought to the stomach. At the same time, it is difficult for him to bend or turn his head. Stiff neck is one of the early symptoms of meningitis and, along with headache and fever, forms the basis of meningeal syndrome, which is caused by irritation of the meninges.Photophobia and hyperacusis
Painful sensitivity to light ( photophobia) and to sound ( hyperacusis) are also common symptoms of meningitis. Like hypersensitivity, these symptoms are caused by irritation of receptors and nerve endings in the meninges. They are most pronounced in children and adolescents.However, sometimes the opposite symptoms may occur. Thus, if the auditory nerve is damaged, with the development of neuritis, hearing loss may occur. In addition to the auditory nerve, the optic nerve can also be affected, which, however, is extremely rare.
Drowsiness, lethargy, sometimes loss of consciousness
Drowsiness, lethargy and loss of consciousness are observed in 70 percent of cases and are more late symptoms meningitis. However, in fulminant forms they develop on days 2–3. Lethargy and apathy are caused by both general intoxication of the body and the development of cerebral edema. For bacterial meningitis ( pneumococcal, meningococcal) there is a sharp depression of consciousness up to coma. Newborn babies refuse to eat or often spit up.As brain swelling increases, the degree of confusion worsens. The patient is confused, disoriented in time and space. Massive cerebral edema can lead to compression of the brain stem and inhibition of vital centers, such as the respiratory and vascular. At the same time, against the background of lethargy and confusion, pressure drops, shortness of breath appears, which is replaced by noisy shallow breathing. Children are often drowsy and lethargic.
Vomit
With meningitis, one-time vomiting is rarely observed. As a rule, vomiting is often repeated, repeated and not accompanied by a feeling of nausea. The difference between vomiting during meningitis is that it is not associated with eating. Therefore, vomiting does not bring relief. Vomiting can be at the height of a headache, or it can be provoked by exposure to irritating factors - light, sound, touch.This symptomatology is caused by the syndrome of increased intracranial pressure, which is the main symptom of meningitis. However, sometimes the disease may be accompanied by low intracranial pressure syndrome ( cerebral hypotension). This is especially common in children early age. Their intracranial pressure is sharply reduced, to the point of collapse. The disease occurs with symptoms of dehydration: facial features become sharper, muscle tone is reduced, reflexes fade. Symptoms of muscle stiffness may then disappear.
Rash on the skin, mucous membranes
A hemorrhagic rash on the skin and mucous membranes is not a mandatory symptom of meningitis. According to various sources, it is observed in a quarter of all cases of bacterial meningitis. Most often it is observed with meningococcal meningitis, since meningococcus damages inner wall vessels. Skin rashes occur 15–20 hours after the onset of the disease. The rash is polymorphic - roseola, papular, rash in the form of petechiae or nodules are observed. Rashes always irregular shape, sometimes protrude above the skin level. The rash tends to coalesce and form massive hemorrhages that appear as purplish-blue spots.Hemorrhages are observed on the conjunctiva, oral mucosa and internal organs. Hemorrhage with further necrosis in the kidneys leads to the development of acute renal failure.
Convulsions
Seizures occur in one fifth of cases of meningitis in adults. In children, tonic-clonic convulsions are often the onset of the disease. How younger child, the higher the likelihood of developing seizures.They can occur like epileptic convulsions, or tremor of individual parts of the body or individual muscles may be observed. Most often, young children experience tremor of the hands, which later turns into a generalized seizure.
These cramps both generalized and local) are a consequence of irritation of the cortex and subcortical structures of the brain.
Anxiety and psychomotor agitation
As a rule, the patient's agitation is observed in a later stage of meningitis. But in some forms, for example, with rheumatic meningoencephalitis, this is a sign of the onset of the disease. Patients are restless, agitated, disoriented.With bacterial forms of meningitis, excitement appears on the 4th – 5th day. Often psychomotor agitation is replaced by loss of consciousness or transition to coma.
Meningitis in infants begins with anxiety and unmotivated crying. The child does not fall asleep, cries, and gets excited at the slightest touch.
Mental disorders
Mental disorders during meningitis belong to the so-called symptomatic psychoses. They can be observed both at the beginning of the disease and in a later period.Mental disorders are characterized by:
- excitement or, on the contrary, inhibition;
- rave;
- hallucinations ( visual and auditory);
In children, mental disorders are more often observed with tuberculous meningitis. They experience an anxious mood, fears, and vivid hallucinations. Tuberculous meningitis is also characterized by auditory hallucinations, disorders of consciousness of the oneiric type ( the patient experiences fantastic episodes), as well as a disorder of self-perception.
Features of the onset of the disease in children
In children in clinical picture meningitis in the first place are:- fever;
- convulsions;
- vomiting like a fountain;
- frequent regurgitation.
In infants, attention should be paid to skin. They may be pale, cyanotic ( blue) or pale grayish. A clear venous network is visible on the head, the fontanel is pulsating. The child may constantly cry, scream and tremble. However, with meningitis with hypotensive syndrome, the child is lethargic, apathetic, and constantly sleeps.
Symptoms of meningitis
The symptoms that appear with meningitis can be grouped into three main syndromes:
- intoxication syndrome;
- cranial syndrome;
- meningeal syndrome.
Intoxication syndrome
Intoxication syndrome is caused by septic damage to the body due to the spread and multiplication of infection in the blood. Patients complain of general weakness, fatigue, weakness. Body temperature rises to 37 - 38 degrees Celsius. A headache of aching nature appears periodically. Sometimes signs of ARVI come to the fore ( acute respiratory viral infection ): nasal congestion, cough, sore throat, aching joints. The skin becomes pale and cold. Appetite decreases. Due to the presence of foreign particles in the body, the immune system is activated and tries to destroy the infection. In the first days, a rash may appear on the skin in the form of small red dots, which are sometimes accompanied by itching. The rash disappears on its own within a couple of hours.In severe cases, when the body is unable to fight the infection, it attacks the blood vessels of the skin. The walls of the blood vessels become inflamed and clogged. This leads to ischemia of skin tissue, minor hemorrhages and skin necrosis. Compressed areas of the skin are especially vulnerable ( back and buttocks of a patient lying on his back).
Craniocerebral syndrome
Craniocerebral syndrome develops due to intoxication of the body with endotoxins. Infectious agents ( most often, meningococcus) spread throughout the body and enter the blood. Here they are susceptible to attack by blood cells. With increased destruction of infectious agents, their toxins enter the blood, which negatively affect its circulation through the vessels. Toxins cause intravascular coagulation and blood clots. The brain matter is especially affected. Blockage of brain vessels leads to metabolic disorders and accumulation of fluid in the intercellular space in brain tissue. As a result, hydrocephalus appears ( cerebral edema) with increased intracranial pressure. This causes sharp headaches in the temporal and frontal region, intense and painful. The pain is so unbearable that patients moan or scream. In medicine, this is called hydrocephalic cry. The headache is aggravated by any external irritant: sound, noise, bright light, touch.Due to swelling and increased pressure, various parts of the brain that are responsible for the functioning of organs and systems suffer. The thermoregulation center is affected, which leads to a sharp increase in body temperature to 38 - 40 degrees Celsius. This temperature cannot be lowered by any antipyretics. The same explains the profuse vomiting ( vomiting fountain), non-stop for a long time. It appears when the headache gets worse. Unlike vomiting during poisoning, it is not associated with food intake and does not bring relief, but only worsens the patient’s condition. In severe cases, the respiratory center is affected, leading to respiratory failure and death.
Hydrocephalus and impaired circulation of cerebral fluid causes seizures various parts of the body. Most often they are generalized in nature - the muscles of the limbs and torso contract.
Progressive cerebral edema and increasing intracranial pressure can lead to damage to the cerebral cortex with impaired consciousness. The patient cannot concentrate, is unable to perform tasks given to him, and sometimes hallucinations and delusions appear. Psychomotor agitation is often observed. The patient moves his arms and legs chaotically, his whole body twitches. Periods of excitement are followed by periods of calm with lethargy and drowsiness.
Sometimes the cranial nerves are affected by swelling of the brain. The oculomotor nerves that innervate the eye muscles are more vulnerable. With prolonged squeezing, strabismus and ptosis appear. When the facial nerve is damaged, the innervation of the facial muscles is disrupted. The patient cannot close his eyes and mouth tightly. Sometimes sagging of the cheek on the side of the affected nerve is visible. However, these disturbances are temporary and disappear after recovery.
Meningeal syndrome
The main characteristic syndrome of meningitis is meningeal syndrome. It is caused by impaired circulation of cerebrospinal fluid against the background of increased intracranial pressure and cerebral edema. The accumulated fluid and edematous brain tissue irritate the sensitive receptors of the vessels of the meninges and spinal nerve roots. Various pathological muscle contractions, abnormal movements and the inability to bend limbs appear.Symptoms of meningeal syndrome are:
- characteristic “cocked hammer” pose;
- stiff neck;
- Kernig's sign;
- Brudzinski's symptoms;
- Gillen's sign;
- reactive pain symptoms ( Bekhterev's symptom, palpation of nerve points, pressure on the ear canal);
- Lessage's sign ( for children).
Irritation of the sensitive receptors of the meninges causes involuntary muscle contraction. When exposed to external stimuli ( noise, light), the patient takes a characteristic position, similar to a cocked gun. The occipital muscles contract and the head falls back. The stomach is pulled in and the back is arched. The legs are bent at the knees towards the stomach and the arms towards the chest.
Stiff neck
Due to the increased tone of the neck extensors, stiffness of the neck muscles appears. When trying to turn the head or bend it towards the chest, pain appears, which forces the patient to throw his head back.
Any movement of the limbs that causes tension and irritation of the spinal membrane causes painful sensations. All meningeal symptoms are considered positive if the patient cannot perform a certain movement because it causes acute pain.
Kernig's sign
With Kernig's sign, in a supine position, you need to bend the leg at the hip and knee joint. Then try to straighten your knee. Due to the sharp resistance of the flexor muscles of the leg and severe pain, this is almost impossible.
Brudzinski's symptoms
Brudzinski's symptoms are aimed at trying to provoke the characteristic meningeal posture. If you ask the patient to bring the head to the chest, this will cause pain. He will reflexively bend his knees, thereby easing the tension on the spinal membrane and the pain will ease. If you press on the pubic area, the patient will involuntarily bend his legs at the hip and knee joints. When studying the Kernig sign on one leg, during an attempt to straighten the leg at the knee, the other leg involuntarily bends at the hip and knee joint.
Gillen's sign
If you squeeze the quadriceps muscle on one leg, you may see the same muscle on the other leg involuntarily contract and flex the leg.
Reactive pain symptoms
If you tap on the zygomatic arch with a finger or a neurological hammer, there is a contraction of the zygomatic muscles, increased headaches and an involuntary grimace of pain. In this way, a positive ankylosing spondylitis symptom is determined.
When pressing on the external auditory canal and on the exit points of the facial nerves ( brow ridges, chin, zygomatic arches) pain and a characteristic painful grimace also appear.
I>Lessage's symptom
In infants and small children, all these meningeal symptoms are mild. Increased intracranial pressure and cerebral edema can be detected by feeling the large fontanel. If it is enlarged, bulging and pulsating, then the baby’s intracranial pressure has increased significantly. Infants are characterized by Lessage's symptom.
If you take the baby under the armpits and lift him up, he involuntarily takes on the characteristic “cocked hammer” pose. He immediately throws his head back and bends his knees, pulling them towards his stomach.
In severe cases, when the pressure in the spinal canal increases and the membranes of the spinal cord become inflamed, the spinal nerves are affected. In this case, motor disturbances appear - paralysis and paresis on one or both sides. The patient cannot move his limbs, move around, or do any work.
Diagnosis of meningitis
If symptoms are pronounced, the patient should contact the ambulance service with further urgent hospitalization in an infectious diseases hospital. Meningitis is an infectious pathology and therefore it is necessary to consult an infectious disease specialist. If the course of the disease is sluggish, with a blurred picture, then the patient, due to headaches that bother him, may initially turn to a neurologist.
However, treatment of meningitis is carried out jointly by an infectious disease specialist and a neurologist.
Diagnosis of meningitis includes:
- interview and neurological examination at a doctor’s appointment;
- laboratory and instrumental examinations (blood test, spinal puncture, computed tomography).
Survey
To diagnose meningitis, your doctor needs the following information:- What diseases does the patient suffer from? Does he suffer from syphilis, rheumatism or tuberculosis?
- If this is an adult, was there any contact with children?
- Was the disease preceded by injury, surgery or other surgical procedures?
- Does the patient suffer from chronic pathologies, such as otitis media, sinusitis, sinusitis?
- Has he recently had pneumonia or pharyngitis?
- Which countries and regions has he visited recently?
- Was there a fever, and if so, for how long?
- Did he take any treatment? ( taken antibiotics or antiviral agents can erase the clinical picture)
- Does light and sounds irritate him?
- If there is a headache, where is it located? Namely, is it localized or spread throughout the skull?
- If there is vomiting, is it related to food intake?
Neurological examination
A neurological examination is aimed at identifying characteristic symptoms of meningitis, namely:- stiff neck and Brudzinski's symptom;
- Kernig's sign;
- Lessage's symptom in infants;
- symptoms of Mondonesi and Bekhterev;
- examination of cranial nerves.
The patient is in a supine position on the couch. When the doctor tries to bring the patient's head to the back of the head, a headache occurs and the patient throws his head back. At the same time, the patient’s legs reflexively bend ( Brudzinski's sign 1).
Kernig's sign
With the patient lying on his back, the leg is bent at the hip and knee joints at a right angle. Further extension of the leg at the knee with a bent hip is difficult due to tension in the thigh muscles.
Lessage's sign
If you take a child armpits and lift, then an involuntary pulling of the legs towards the stomach occurs.
Mondonesi and Bechterew's sign
Mondonesi's sign is light pressure on the eyeballs ( eyelids are closed). The manipulation causes headaches. Ankylosing spondylitis's symptom involves identifying painful points when tapping the zygomatic arch with a hammer.
Sensitivity is also examined during the neurological examination. With meningitis, hyperesthesia is observed - increased and painful sensitivity.
With complicated meningitis, symptoms of damage to the spinal cord and its roots are revealed in the form of motor disorders.
Examination of cranial nerves
The neurological examination also includes examination of the cranial nerves, which are also often affected by meningitis. The oculomotor, facial and vestibular nerves are most often affected. To examine a group of oculomotor nerves, the doctor examines the reaction of the pupil to light, the movement and position of the eyeballs. Normally, in response to light, the pupil narrows. This is not observed with paralysis of the oculomotor nerve.
To examine the facial nerve, the doctor checks facial sensitivity, corneal and pupillary reflexes. Sensitivity can be reduced, increased, or asymmetrical. Unilateral or bilateral hearing loss, staggering and nausea indicate damage to the auditory nerve.
The doctor's attention is also drawn to the patient's skin, namely the presence of a hemorrhagic rash.
Laboratory tests include:
- latex tests, PCR method.
A general blood test reveals signs of inflammation, namely:
- Leukocytosis. The increase in the number of leukocytes is more than 9 x10 9. With bacterial meningitis, 20 – 40 x 10 9 is observed, due to neutrophils.
- Leukopenia. Decrease in white blood cell count to less than 4 x 109. It is observed in some viral meningitis.
- Shift of the leukocyte formula to the left– an increase in the number of immature leukocytes, the appearance of myelocytes and metamyelocytes. This shift is especially pronounced in bacterial meningitis.
- Increased erythrocyte sedimentation rate– more than 10 mm per hour.
- a decrease in hemoglobin concentration of less than 120 grams per liter of blood;
- decrease in the total number of red blood cells less than 4 x 10 12.
- Thrombocytopenia. Decrease in platelet count less than 150 x 109. It is observed in meningococcal meningitis.
Changes in biochemical blood tests reflect abnormalities acid-base balance. As a rule, this manifests itself in a shift in the balance towards increasing acidity, that is, acidosis. At the same time, the concentration of creatinine increases ( above 100 – 115 µmol/liter), urea ( above 7.2 – 7.5 mmol/liter), the balance of potassium, sodium and chlorine is disturbed.
Latex tests, PCR method
To determine the exact causative agent of meningitis, latex agglutination or polymerase chain reaction methods are used ( PCR). Their essence is to identify pathogen antigens contained in the cerebrospinal fluid. In this case, not only the type of pathogen is determined, but also its type.
The latex agglutination method takes 10 to 20 minutes, and the agglutination reaction ( gluing) is carried out before our eyes. The disadvantage of this method is low sensitivity.
The PCR method has the highest sensitivity ( 98 – 99 percent), and its specificity reaches 100 percent.
Cerebrospinal puncture
Cerebrospinal puncture is mandatory in making the diagnosis of meningitis. It consists of introducing a special needle into the space between the soft and arachnoid membrane of the spinal cord at the level lumbar region. In this case, spinal fluid is collected for further study.Cerebrospinal puncture technique
The patient is in a position lying on his side with his legs bent and adducted to the stomach. By piercing the skin between the fifth and fourth lumbar vertebrae, a needle with a mandrel is inserted into the subarachnoid space. After the sensation of “sinking through,” the mandrin is removed, and a glass tube is brought to the needle pavilion to collect spinal fluid. As it flows out of the needle, pay attention to the pressure under which it flows. After the puncture, the patient needs rest.
The diagnosis of meningitis is based on inflammatory changes in the cerebrospinal fluid.
Instrumental examination includes
- electroencephalogram ( EEG);
- computed tomography ( CT).
Electroencephalography
EEG is one of the methods for studying the functioning of the brain by recording it electrical activity. This method is non-invasive, painless and easy to use. He is very sensitive to any slightest changes in the functioning of all brain structures. All types brain activity recorded using a special device ( electroencephalograph) to which the electrodes are connected.
EEG technique
The ends of the electrodes are attached to the scalp. All bioelectric signals received from the cerebral cortex and other brain structures are recorded in the form of a curve on a computer monitor or printed on paper. In this case, tests with hyperventilation are often used ( the patient is asked to breathe deeply) and photostimulation ( in a dark room where the study is being carried out, the patient is exposed to bright light).
Indications for the use of EEG are:
- epileptic seizures;
- seizures of unknown etiology;
- attacks of headaches, dizziness and neurological disorders unknown etiology;
- disturbances in sleep and wakefulness, nightmares, sleepwalking;
- injuries, tumors, inflammatory processes and circulatory disorders in the medulla.
CT scan
CT is a method of layer-by-layer examination of the structure of organs, in this case the brain. The method is based on circular transillumination of the organ with a beam of X-ray radiation with further computer processing. The information captured by X-rays is translated into graphic form in the form of black and white images.CT technique
The patient lies on the tomograph table, which moves towards the tomograph frame. Over a period of time, the X-ray tube moves in a circle, taking a series of images.
Symptoms detected by CT scan
A CT scan shows the structures of the brain, namely the gray and white matter of the brain, meninges, ventricles of the brain, cranial nerves and blood vessels. Thus, the main syndrome of meningitis is visualized - the syndrome of increased intracranial pressure and, as a consequence, cerebral edema. On CT, edematous tissue is characterized by reduced density, which can be local, diffuse or periventricular ( around the ventricles). With severe edema, dilation of the ventricles and displacement of brain structures are observed. With meningoencephalitis, heterogeneous areas of reduced density are found, often bordered by a zone of increased density. If meningoencephalitis occurs with damage to the cranial nerves, then signs of neuritis are visualized on CT.
Indications for use of CT
The CT method is necessary in the differential diagnosis of meningitis and volumetric processes in the brain. In this case, spinal puncture is initially contraindicated and is done only after a computed tomography scan. However, in terms of information content, CT is inferior to MRI ( magnetically resonance tomography
). MRI can detect inflammatory processes in both brain tissue and meninges.
Treatment of meningitis
Treatment of meningitis is complex, it includes etiotropic therapy ( aimed at eliminating the infection), pathogenetic ( used to eliminate the development of cerebral edema, increased intracranial pressure syndrome) and symptomatic ( aimed at eliminating individual symptoms of the disease).Eliminating the cause of meningitis
Eliminating the causes of bacterial ( meningococcal, staphylococcal, streptococcal) meningitis
| A drug | Mechanism of action | How to use |
| benzylpenicillin | has a bactericidal effect against streptococci, pneumococci and meningococci | 4,000,000 units each. intramuscularly every 6 hours. For children, the dose is calculated based on 200,000 - 300,000 units. per 1 kg of weight per day. The dose is divided into 4 doses |
| ceftriaxone | has a bactericidal effect against streptococci, pneumococci and Escherichia coli | adults: 2 grams intravenously every 12 hours. Children 50 mg per 1 kg of body weight per day in 2 divided doses |
| ceftazidime | effective against group B hemolytic streptococci, listeria and shigella | 2 grams every 8 hours |
| meropenem | effective against hemolytic streptococci and Haemophilus influenzae | 2 grams every 8 hours. Children: 40 mg per kg of body weight three times a day |
| chloramphenicol | effective against Escherichia coli, Shigella and Treponema pallidum | 50 – 100 mg per kg of body weight per day, the dose is divided into 3 doses ( interval every 8 hours) |
For meningococcal meningitis, penicillin therapy is appropriate; for streptococcal and staphylococcal meningitis - a combination of penicillins and sulfa drugs (ceftriaxone, ceftazidime); with meningitis caused by Haemophilus influenzae ( H.Influenzae) – a combination of chloramphenicol and sulfonamides.
Eliminating the causes of tuberculous meningitis
| A drug | Mechanism of action | How to use |
| isoniazid | has a bactericidal effect against the causative agent of tuberculosis | from 15 to 20 mg per kg of body weight per day. The dose is divided into three doses and taken half an hour before meals. |
| ftivazid | anti-tuberculosis drug | 40 mg per kg of patient weight per day |
| streptomycin | active against Mycobacterium tuberculosis, gonococci, Klebsiella, Brucella | 1 gram per day intramuscularly. When combined with other drugs ( for example, with ftivazid) streptomycin is administered every other day |
Average duration Treatment for tuberculous meningitis is 12–18 months.
Elimination of the causes of meningitis caused by malarial plasmodium or toxoplasma
Elimination of the causes of herpetic meningitis, as well as meningitis caused by the Epstein-Barr virus
Specific treatment for other types viral meningitis No. Basically, treatment for viral meningitis is pathogenetic and aimed at reducing intracranial pressure. Some clinicians use corticosteroids for viral meningitis, but data on their effectiveness are mixed.
Eliminating the causes of candidal meningitis
Symptomatic treatment
Symptomatic treatment consists in the use of diuretics, drugs that replenish fluid deficiency, vitamins, painkillers and antipyretics.| A drug | Mechanism of action | How to use |
| 20% mannitol solution | increases the pressure in the plasma, and thereby promotes the transfer of fluid from the tissue ( in this case from the brain) into the bloodstream. Reduces intracranial pressure | at the rate of 1.5 g per kg of weight, administered intravenously |
| furosemide | inhibits Na reabsorption in the tubules, thereby increasing diuresis | for cerebral edema, the drug is administered in a stream, in a single dose of 80–120 mg, most often combined with colloidal solutions; for moderate edema syndrome in the morning on an empty stomach, one to two tablets ( 40 – 80 mg) |
| dexamethasone | used to prevent complications, prevent hearing loss | initially 10 mg intravenously four times a day, then switch to intramuscular injections |
| hemodesis | has a detoxifying effect | 300 - 500 ml of solution, heated to 30 degrees, is administered intravenously at a rate of 40 drops per minute |
| vitamin B1 and B6 | improve metabolism in tissues | administered intramuscularly 1 ml daily |
| cytoflavin | has cytoprotective ( protects cells) action | 10 ml of solution is diluted in 200 ml of 5% glucose solution and administered intravenously, drip for 10 days |
| acetaminophen | has analgesic and antipyretic | one to two tablets ( 500 mg – 1g), every 6 hours. The maximum daily dose is 4 grams, which is equal to 8 tablets |
| calcium carbonate | In conditions of acidosis, corrects acid-base balance | 5% solution 500 ml is administered intravenously |
| cordiamine | stimulates metabolism in brain tissue | intramuscularly or intravenously, 2 ml one to three times a day |
Anticonvulsant therapy
If meningitis is accompanied by convulsions, psychomotor agitation, and anxiety, then anticonvulsant therapy is prescribed.Anticonvulsant therapy for meningitis
| A drug | Mechanism of action | How to use |
| diazepam | has a calming, anti-anxiety and anticonvulsant effect | for psychomotor agitation, 2 ml ( 10 mg) intramuscularly; for generalized attacks, 6 ml ( 30 mg) intravenously, then repeat after an hour. The maximum daily dose is 100 mg. |
| aminazine | has an inhibitory effect on the central nervous system | 2 ml intramuscularly |
| mixture of aminazine + diphenhydramine | has a calming effect, relieves stress | in case of severe psychomotor agitation, chlorpromazine is combined with diphenhydramine - 2 ml of chlorpromazine + 1 ml of diphenhydramine. To prevent hypotension, the mixture is combined with cordiamine. |
| phenobarbital | has anticonvulsant and sedative effect | 50 – 100 mg 2 times a day, orally. Maximum daily dose 500 mg |
From the very first minutes of the patient's admission to the hospital, it is necessary to carry out oxygen therapy. This method is based on inhaling a gas mixture with a high concentration of oxygen ( because the pure oxygen has a toxic effect). The method is indispensable, since cerebral edema during meningitis is accompanied by oxygen starvation ( brain hypoxia). With prolonged hypoxia, brain cells die. Therefore, as soon as the first signs of hypoxia appear ( tissue cyanosis is observed, breathing becomes shallow) it is necessary to carry out oxygen therapy. Depending on the severity of the patient's condition, it can be performed using an oxygen mask or by intubation.
In case of traumatic meningitis with the presence of purulent foci in the bones, in addition to intensive antibiotic therapy, surgical intervention with removal of the purulent focus. Surgical treatment is also indicated in the presence of purulent foci in the lungs.
Patient care
People who have had meningitis need special care, which is based on diet, proper daily routine and a balanced distribution of physical activity.Diet
When recovering from meningitis, you should eat in small portions, at least five to six times a day. The patient's diet should ensure a decrease in the level of intoxication in the body and normalization of metabolism, water-salt, protein and vitamin balance.
The menu should be balanced and include products containing easily digestible animal proteins, fats and carbohydrates.
These products include:
- lean meat - beef or pork tongue, veal, rabbit, chicken, turkey;
- lean fish– herring, balyk, tuna;
- eggs - boiled or soft-boiled, as well as steamed omelets, soufflé;
- dairy and fermented milk products – kefir, yogurt, cottage cheese, mild cheese, kumiss;
- milk fats – cream, butter, sour cream;
- low-fat broths and soups prepared on their basis;
- vegetables and fruits with a small content of coarse fiber - zucchini, tomatoes, cauliflower, cherries, cherries, plums;
- dried wheat bread, crackers, products made from rye flour, bran.
When caring for a patient after meningitis, the consumption of animal fats should be minimized, as they can provoke metabolic acidosis. It is also worth minimizing the consumption of easily digestible carbohydrates, which can cause intestinal fermentation processes, cause allergies and inflammatory processes.
The diet of a person who has had meningitis should not contain following products:
- fatty types meat - lamb, pork, goose, duck;
- cooked pork and fish products by smoking or salting;
- sweet drinks, desserts, creams, mousses, ice cream;
- fresh wheat bread, puff pastry, baked goods;
- whole milk;
- buckwheat, pearl barley, legumes;
- vegetables and fruits with coarse plant fiber - carrots, potatoes, cabbage, red and white currant, strawberry;
- dried fruits;
- spicy and fatty sauces and dressings for dishes based on mustard and horseradish.
In order to improve metabolism and speed up the removal of toxins from the body, the patient should consume about two and a half liters of fluid per day.
You can drink the following drinks:
- weakly brewed tea;
- tea with milk;
- rosehip decoction;
- table mineral water;
- jelly;
- fresh fruit compote;
- natural sweet and sour juices from fruits.
The main factors in recovery from meningitis are:
- bed rest;
- lack of stress;
- timely deep sleep;
- psychological comfort.
A foot massage helps improve your well-being and relaxation. Do this procedure You can do it yourself, or I use Kuznetsov’s applicator. You can purchase this product in pharmacies or specialty stores.
Distribution of physical activity
Return to active image life should be gradually, in accordance with the doctor’s recommendations. You need to start with daily walks fresh air, exercises in the morning. Complex physical activity should be avoided. You should also minimize your exposure to the sun.
Rehabilitation of patients after meningitis
After discharge from the infectious diseases hospital, the patient is sent to specialized rehabilitation centers and outpatient treatment at home. Rehabilitation therapy begins in the hospital during the early recovery of the patient. All activities must be in strict sequence at different stages of recovery. Rehabilitation should be comprehensive and include not only recovery procedures, but also visits to specialist doctors. All activities and loads must be adequate for the patient’s physical condition and gradually increase. Constant monitoring of the effectiveness of these rehabilitation measures and correction of methods if necessary is also necessary. Recovery is carried out in three stages - in the hospital ( during treatment),
in a sanatorium, in a clinic. The complex of all rehabilitation measures includes:
- therapeutic nutrition;
- physical therapy;
- physiotherapy ( myostimulation, electrophoresis, warming, massage, water procedures, etc.);
- drug correction;
- psychotherapy and psychorehabilitation;
- sanitary resort rehabilitation;
- vocational rehabilitation
- social rehabilitation.
With a mild form of meningitis, which was diagnosed in time and the correct course of treatment was started, there are practically no residual effects. However, such cases are rare in medical practice, especially if children suffer from meningitis.
Often, the primary symptoms of meningitis are ignored or mistaken for symptoms of other diseases ( colds, poisonings, intoxications). In this case, the disease progresses with damage to nerve structures, which recover very slowly after treatment or do not recover at all.
Residual effects
Possible residual effects after meningitis include:- headaches depending on meteorological conditions;
- paresis and paralysis;
- hydrocephalus with increased intracranial pressure;
- epileptic seizures;
- mental impairment;
- hearing impairment;
- disruption of the endocrine system and autonomic nervous system;
- damage to the cranial nerves.
Elimination of complications of meningitis
In case of paresis and paralysis, which lead to motor disorders, it is necessary to undergo a rehabilitation course with various types of massage, water procedures, therapeutic exercises, acupuncture. Consultations and observations of a neurologist are required.In fulminant forms of meningitis or undiagnosed forms, when the circulation of cerebrospinal fluid is disrupted and it accumulates in large quantities in the cavities of the brain, hydrocephalus with high intracranial pressure develops. This is especially common in children. Headaches persist, mental disorders and slowed mental development are noted. Convulsions and epileptic seizures appear periodically. The introduction of such children into public life undergoes some difficulties, so first of all they should undergo courses of psychotherapy and psychorehabilitation. They are under clinical observation and must regularly visit a neurologist, neurologist and psychiatrist.
Hearing impairment most often occurs in cases of infection and inflammation inner ear. To restore patients, they resort to physiotherapy ( electrophoresis, heating). In cases of deafness, patients need special training ( deaf language) and special hearing aids.
Due to malfunctions of the nervous system, all organs and systems suffer, especially the endocrine and immune systems. Such people are more susceptible to environmental factors. Therefore in rehabilitation period It is necessary to take measures to strengthen the immune system. They include vitamin therapy, heliotherapy ( solar treatments), sanatorium rehabilitation.
Lesions of the cranial nerves are often accompanied by strabismus, facial asymmetry, ptosis ( drooping eyelid). With adequate anti-infective and anti-inflammatory treatment, their risk is minimal and they resolve on their own.
Periods of incapacity for work
Depending on the severity of meningitis and the presence of complications, the period of incapacity for work varies from 2 to 3 weeks ( in mild serous forms of meningitis) up to 5 – 6 months or more. In some cases, an early start to work is possible, but with easier working conditions. With mild serous meningitis, residual effects are rare, and the period of disability ranges from three weeks to three months. For purulent meningitis with various residual effects ( hydrocephalus, epileptic seizures) the period of incapacity for work is about 5 – 6 months. Only in case of complete regression of symptoms can the recovering person return to work ahead of schedule, but with certain work restrictions. You should alternate physical and mental stress and dose them correctly. The worker must be exempt from night shifts and overtime for at least six months. If the symptoms of complications return, then the sick leave is extended for another couple of months.If within 4 months after discharge from the hospital the symptoms of complications do not subside and the disease becomes chronic, the patient is referred to medical and social examination to determine the disability group.
The main indications for referral to a medical and social examination are:
- persistent and severe complications that limit the patient’s life activity;
- slow recovery of functions, which causes a long period of disability;
- chronic forms of meningitis or constant relapses with disease progression;
- the presence of consequences of the disease due to which the patient cannot perform his work.
The main package of analyzes and consultations consists of:
- general and biochemical analysis blood;
- all results of bacteriological, serological and immunological studies during the period of acute meningitis;
- results of cerebrospinal fluid analysis over time;
- results of psychological and psychiatric research;
- results of consultations with an ophthalmologist, otorhinolaryngologist, neurologist and neurologist.
Disability determination system
Adults are assigned three different categories of disability, depending on the severity of the complications and the degree of disability.If, as a result of meningitis, the patient is limited in his ability to self-care due to blindness, decreased intelligence, paralysis of the legs and arms and other disorders, he is given the first disability group.
The second disability group is given to patients who cannot perform work in their specialty under normal production conditions. These patients have significantly impaired motor functions, some mental changes are observed, and epileptic seizures, deafness. This group also includes patients with chronic and recurrent forms of meningitis.
The third disability group includes persons with partial disabilities. These are patients with moderate impairments motor functions, moderate hydrocephalus, with maladaptation syndrome. The third group includes all cases in which a person has difficulties performing work in his specialty, and it is necessary to reduce his qualifications or reduce the amount of work. This includes cases with epileptic seizures and intellectual disabilities.
The third disability group is determined during retraining or learning a new profession and new employment.
Dispensary observation
After meningitis, clinical observation is required for at least 2 years, depending on the severity of the disease and complications. For mild forms of meningitis, observation by doctors in the clinic is once a month for the first three months, then once every three months for a year. With purulent meningitis, severe forms with complications, visits to doctors should be at least twice a month for the first three months. The following year, inspection is required every three months and every six months during the second year. Visits to specialists such as a neurologist, psychiatrist, therapist and infectious disease specialist are required. According to the testimony of specialists, dispensary observation may be extended.Prevention of meningitis
Prevention can be specific and nonspecific. Specific prevention includes vaccination. Vaccination
The main vaccines to prevent bacterial and viral meningitis are:- Meningococcal vaccine– provides protection against a number of bacteria that can cause meningitis. This vaccination is given to children 11-12 years old, and is also recommended for first-year students living in a dormitory, military recruits, tourists visiting places where there are epidemics of this disease;
- Haemophilus influenzae type B vaccine– intended for children aged from two months to five years;
- Pneumococcal vaccine– can be of two types: conjugative and polysaccharide. The first category of vaccine is intended for children under two years of age, as well as for at-risk children whose age does not exceed five years. The second type of vaccine is recommended for older people, as well as for middle-aged people whose immunity is weakened or there are certain chronic diseases;
- Vaccines against measles, measles rubella and mumps – are administered to children in order to prevent meningitis, which can develop against the background of these diseases;
- Vaccination against chickenpox.
Nonspecific prevention
Nonspecific prevention of meningitis is a series of measures aimed at increasing the body's immunity and preventing contacts with possible pathogens of the disease.What should I do?
To prevent meningitis you need to:- strengthen immunity;
- observe balanced diet nutrition;
- observe personal hygiene rules and precautions;
- carry out vaccination.
Hardening strengthens the body's immune system, increasing its resistance to negative factors. environment. Hardening activities should begin by taking air baths, for example, by exercising in a room with an open window. Subsequently, classes should be moved to the open air.
Water procedures represent effective method hardening, which should be resorted to if the body is healthy. You should start by dousing with water, the temperature of which is not lower than +30 degrees. Next, the temperature must be gradually reduced to +10 degrees. When drawing up a schedule and choosing the type of hardening manipulations, you should take into account the individual characteristics of the body and consult a doctor.
Helps increase the body's resistance to walking and playing various outdoor sports. If possible, you should choose places away from highways and roads, closer to green spaces. Exposure to the sun has a beneficial effect, as exposure to it promotes the production of vitamin D.
Diet
Eating a balanced, healthy diet is an important factor in preventing meningitis. In order to effectively resist bacteria and viruses, the body should receive sufficient amounts of protein, fats, carbohydrates, vitamins and minerals.
The diet should include the following elements:
- Plant and animal proteins– immunoglobulins synthesized from amino acids help the body resist infections. Protein is found in meat, poultry, eggs, sea fish, legumes;
- Polyunsaturated fats– increase the body's endurance. Included in nuts, fatty fish, flaxseed, olive and corn oils;
- Fiber and complex carbohydrates – essential for strengthening the immune system. Included in cabbage, pumpkin, dried fruits, wheat and oat bran, wholemeal products. Also with these products the body receives B vitamins;
- Vitamins A, E, C– are natural antioxidants, increase the body’s barrier resistance. Contained in citrus fruits, sweet peppers, carrots, fresh herbs, apples;
- Vitamins of group P– immune stimulants. Contains black currants, eggplant, blueberries, dark grapes, red wine;
- Zinc– increases the number of T-lymphocytes. Is in quail eggs, apples, citrus fruits, figs;
- Selenium– activates the formation of antibodies. Garlic, corn, pork, chicken and beef liver are rich in this element;
- Copper and iron– ensure good functioning of the blood supply system and are found in spinach, buckwheat, turkey meat, soybeans;
- Calcium, magnesium, potassium– elements necessary to strengthen the immune system. The sources of these substances are dairy products, olives, egg yolks, nuts, and dried fruits.
It is quite difficult to obtain the necessary complex of vitamins from the diet. Therefore, the body should be supported with vitamins of synthetic origin. Before using these drugs, you should consult a physician.
Hygiene rules and precautions
In order to prevent the likelihood of contracting bacterial meningitis, the following rules should be followed:
- for drinking and cooking, use bottled water, filtered or boiled;
- Vegetables and fruits should be doused with boiling water before consumption;
- before eating you need to wash your hands with soap;
- Avoid using other people's handkerchiefs, toothbrushes, towels and other personal items.
Some forms of meningitis are carried by insects.
Therefore, when going to a forest or park, you need to:
- use insect and tick repellents;
- dress in tight, closed clothing;
- wear a headdress.
To prevent meningitis, you should avoid swimming in lakes, ponds and other bodies of water with standing water. When planning to travel to countries where epidemics of viral or other types of meningitis are common, you should get the necessary vaccines. Also, when visiting exotic places, doctors recommend taking antifungal drugs. During tourist trips, it is imperative to refrain from contact with animals and insects.
In residential and office premises, the required level of cleanliness should be maintained and the destruction and prevention of rodents and insects should be systematically carried out.
If one of your family members gets meningitis, you need to isolate the patient, minimizing any kind of contact with him as much as possible. If communication with a person infected with meningitis is unavoidable, you should consult a doctor. The doctor will prescribe an antibiotic depending on the nature of the disease and the type of contact.
What not to do?
To prevent meningitis, you should not:- trigger otolaryngological diseases ( otitis, sinusitis, sinusitis);
- neglect preventive treatment in the presence of chronic diseases;
- ignore the vaccination schedule;
- do not comply with sanitary and hygienic standards at work and at home;
- eat dirty fruits and vegetables;
- do not observe precautions when interacting with a patient;
- ignore protection methods when visiting potentially dangerous places ( transport and other public places).
Meningitis - causes, symptoms, complications and what to do? - Video
Meningitis in medicine is an inflammatory process that occurs in the lining of the brain, which is located between cranium and directly by the brain. It is transient and can lead to death in a few hours. Moreover, the incubation period of meningitis can last from 4 to 7 days, so everyone should know the first signs of this dangerous disease.
We recommend reading:Classification of the disease
Meningitis has been fairly well studied and accurately classified. There are several types of this disease:
- According to the nature of the inflammatory process:
- purulent meningitis - the disease is caused by pathogenic bacteria (meningococcus), pus is formed, and has a very severe course;
- serous meningitis - caused by viruses (for example, enteroviruses, polio viruses, mumps and others), characterized by the absence of purulent contents in the area of inflammation and a less severe course than with the previous type.
- According to the origin of the inflammatory process:
- primary meningitis - diagnosed as an independent disease, when examining the source of infection in the patient’s body, it is not detected;
- secondary meningitis - there is a focus of infection in the body, against which the inflammatory disease in question develops.
- Due to the development of meningitis:
- Depending on how quickly the inflammation develops:
- fulminant (fulminant) meningitis – develops very rapidly, all stages of progression pass almost instantly, the patient’s death occurs on the first day of the disease;
- acute meningitis - the development is not rapid, but rapid - a maximum of 3 days to reach the peak of the disease and death of the patient;
- chronic - lasts a long time, symptoms develop “increasingly”, doctors cannot determine when meningitis began to develop.
- According to the localization of the inflammatory process:
- basal - the pathological process develops in the lower part of the brain;
- convexital - localization of the inflammatory process occurs on the anterior (convex) part of the brain;
- spinal – the pathology affects the spinal cord.
Reasons for development
The only reason for the development of the inflammatory process in the membranes of the brain is the penetration of infection into them. This can happen in different ways:
- airborne;
- oral-fecal – we're talking about about eating unwashed vegetables, fruits, berries;
- hematogenous - through the blood;
- lymphogenous - through lymph.
The causative agents of meningitis can be:
- pathogenic bacteria - tuberculosis and E. coli, staphylo/streptococci, Klebsiella;
- viruses of different origins - herpes, mumps virus;
- fungi - candida;
- protozoa – amoeba and/or toxoplasma.
Factors that can trigger the development of the inflammatory process in question are:
- decreased immunity due to chronic diseases or forced long-term use medicines;
- chronic malnutrition;
- chronic fatigue syndrome;
- diabetes;
- peptic ulcer of the duodenum and stomach;
- AIDS virus.
Symptoms of meningitis in adults
Meningitis is characterized by pronounced symptoms, but the fact is that many of the signs go unnoticed or are relieved by taking simple medications. And this not only “lubrifies” the symptoms, but also makes it impossible to seek medical help in a timely manner. Symptoms of meningitis that should be a signal to immediately seek professional help:
- Headache. This is generally considered the main sign of meningitis, but this pain syndrome will have distinctive features:
- constant headache;
- there is a feeling of expansion of the skull from the inside;
- the intensity of the pain syndrome increases when the head is tilted forward and backward, as well as when turning left and right;
- Headache with meningitis becomes stronger with loud sounds and too bright colors.
- Neck muscle tension. It's not about convulsive syndrome, a person simply cannot lie on his back in usual position, he will definitely tilt his head back, as otherwise he will experience severe pain.
- Digestive disorder. This means that one of the signs of the inflammatory process in the membranes of the brain in question is nausea and vomiting. Note: vomiting will be repeated, even if the patient completely refuses food.
- Hyperthermia. An increase in body temperature during meningitis is always accompanied by chills, general weakness and increased sweating.
- Photophobia. A patient with a developing inflammatory process in the lining of the brain is unable to look at a bright light - this immediately causes an acute headache.
- Impaired consciousness. We are talking about a decrease in the level of consciousness - the patient becomes lethargic, answers questions slowly, and at a certain moment completely stops responding to speech addressed to him.
- Mental disorder. A person may experience hallucinations, aggression, and apathy.
- Convulsive syndrome. The patient may experience convulsions of the lower and upper extremities; in rare cases, voluntary urination and defecation appear against the background of convulsions.
- Strabismus. If, as the inflammatory process progresses, the optic nerves are affected, then the patient begins to develop pronounced strabismus.
- Muscle pain.
Methods for diagnosing meningitis
Diagnosis of meningitis is a rather complex and time-consuming process. After all, it is important not only to establish a diagnosis, but also to find out the degree of development, the type of meningitis, its localization and the pathogen that caused the onset of the inflammatory process in the membranes of the brain . Methods for diagnosing meningitis include:
- Analysis of patient complaints:
- how long ago did symptoms of meningitis appear?
- whether tick bites have been noted in the recent past - some species of this insect are carriers of the causative agent of meningitis;
- whether the patient was in countries where there are mosquitoes that carry meningococcal infection (for example, countries of Central Asia).
- Examination of the patient according to his neurological condition:
- whether the patient is conscious and at what level it is - does it react to speech addressed to him, and if there is no reaction to a call, then check the reaction to painful stimulation;
- are there any signs of irritation of the meninges - these include tension in the neck muscles and headache with a feeling of fullness and photophobia;
- are there focal neurological symptoms– we are talking about symptoms of damage to specific areas of the brain: seizures of a convulsive nature with biting the tongue, weakness in the limbs, speech is impaired, there is facial asymmetry. Please note: such signs indicate the spread of the inflammatory process from the meninges directly to the brain (encephalitis).
- Laboratory examination of the patient’s blood - the analysis reveals signs of an inflammatory focus in the body: for example, the erythrocyte sedimentation rate will certainly increase.
- Lumbar puncture. The procedure is carried out only by a specialist and using a special long needle - it makes a puncture through the skin of the back at the lumbar level (subarachnoid space) and a little cerebrospinal fluid is taken for analysis (maximum 2 ml). It may contain pus or protein, which is a sign of an inflammatory process in the meninges.
Liquor is a fluid that provides metabolism and nutrition in the brain and spinal cord.
- or magnetic resonance imaging of the head - the doctor can examine the meninges layer by layer and identify signs of inflammation, which include expansion of the ventricles of the brain and narrowing of the subarachnoid fissures.
- Polymerase chain reaction. This is an analysis during which the cerebrospinal fluid or blood is examined, which allows specialists to identify the causative agent of the disease and select a truly effective treatment.
Principles of treatment of meningitis
Important:treatment of the inflammatory process in the meninges in question should be carried out only in a hospital - the disease develops rapidly and can lead to the death of the patient in a matter of hours. None traditional methods will not help cope with meningitis.
The doctor immediately prescribes medications, namely broad-spectrum antibacterial drugs (antibiotics) - for example, macrolides, cephalosporins, penicillins. This choice is due to the fact that the causative agent of the disease in question can only be identified by collecting and examining cerebrospinal fluid - this process is quite long, and assistance must be provided to the patient on an emergency basis. Antibiotics are administered intravenously, and in case of serious condition patient's health and directly into the cerebrospinal fluid. Duration of use antibacterial drugs is determined only on an individual basis, but even if the main signs of meningitis have disappeared and the patient’s body temperature has stabilized, the doctor will continue to administer antibiotic injections for several more days.
The next direction in the treatment of the inflammatory process in the meninges under consideration is the administration of steroids. Hormonal therapy in this case will help the body quickly cope with the infection and normalize the functioning of the pituitary gland.
Diuretics are also considered mandatory in the treatment of meningitis - they will relieve swelling, but doctors should take into account that all diuretics contribute to the rapid leaching of calcium from the body.
The patient undergoes a spinal tap. This procedure makes the patient's condition easier because the cerebrospinal fluid puts much less pressure on the brain.
Treatment of meningitis is always carried out against the background of vitamin therapy:
- firstly, it is necessary to support the body and help it resist infection;
- secondly, vitamins are needed to replenish the necessary macro/microelements that do not enter the body due to malnutrition.
Complications and consequences of meningitis
Meningitis is generally considered a life-threatening disease. Complications of this inflammatory process in the meninges are:
- Brain swelling. Most often, this type of complication develops on the second day of the disease. The patient suddenly loses consciousness (this occurs against the background of standard symptoms of meningitis), his blood pressure drops sharply, and after a while his blood pressure suddenly rises, a slow heartbeat is replaced by a rapid heartbeat (bradycardia turns into tachycardia), intense shortness of breath appears, and all the signs of pulmonary edema are clearly visible.
note: if medical assistance is not provided, then after a short time the meningitis symptoms completely disappear, the patient experiences involuntary urination and defecation and death occurs due to paralysis of the respiratory system.
- Infectious-toxic shock. This complication develops as a consequence of the breakdown and absorption into the cells and tissues of the body of a large number of waste products. pathogens. The patient's body temperature suddenly drops, the reaction to light and sounds (even not loud ones) becomes very sharp and negative, there is agitation and shortness of breath.
Note:Infectious-toxic shock often resolves against the background of cerebral edema. The patient's death occurs within a few hours.
The consequences of meningitis can include epilepsy, deafness, paralysis, paresis, hormonal dysfunction and hydrocephalus. In general, meningococcal infection can affect any organs and systems of the body, so recovery from inflammation of the meninges lasts a very long time, and in some cases, a lifetime. Only immediate seeking help from doctors will help reduce the risk of complications and consequences of meningitis.
In this material we will consider what such a dangerous disease as meningitis is, the types of meningitis and its causes. We will also talk about the first signs of the development of the disease, diagnostic methods, features of prevention and treatment.
General information
Before we look at the types of meningitis, symptoms, causes, treatment, let’s find out what the disease is as a whole. The disease is characterized by the development of inflammatory processes on the membranes of the brain. In this case, it is not the deep ones who suffer cellular structures. The upper layers of tissue, which are located under the bone structure of the skull, are exposed to pathological effects. There is also a type of meningitis that affects the spinal cord.
The disease can develop in primary and secondary forms. In the first case, pathological pathogens attack the lining of the brain directly. In the second, the disease makes itself felt against the background of other pathological processes in the body. Gradually, the damage reaches the brain. A prerequisite for the development of meningitis in a secondary form may be the presence of mumps, tuberculosis, leptospirosis, etc.
As a rule, meningitis occurs quickly. A significant deterioration in health occurs over several days. The only exception to the rule is tuberculous meningitis, which develops slowly.
Mechanism of disease development
The human brain is reliably protected from attacks by pathological pathogens by the immune system. Such a barrier protects the most important organ from the penetration of bacterial, viral and fungal infections. When the body is weakened, some of them are still able to find their way to the brain. Penetrating under its shell, infections receive temporary isolation from the effects of immune cells, which are deprived of the ability to “devour” pathogenic structures.
Types of meningitis
There are also separate types of meningitis, depending on the speed of development of inflammation. When pathological processes make themselves felt in the shortest possible time, such a course of the disease is called rapid. In this case, all stages of meningitis occur literally within 24 hours after infection of the membranes of the brain. In the acute course of the disease, death without proper treatment occurs within 3-4 days. Also distinguished chronic form meningitis. In the latter case, the symptoms appear progressively. It is not easy for doctors to determine the real cause of a patient’s deteriorating health.
What other types of meningitis are there? Based on the localization of the pathological process, they are classified:
- Basal - the membranes in the lower part of the brain become inflamed.
- Convexital - tissue damage is localized in the frontal zone of the brain.
- Spinal - pathology affects the spinal cord.
Symptoms
It is important to identify both the types of meningitis and the symptoms. Among the main signs of the development of the disease are:
- Headache - constant, severe discomfort, a feeling of increasing pressure under the skull, increased discomfort when tilting the head.
- Overstrain of muscle tissue in the back of the head - a person feels difficulty when trying to move to a lying position. A decrease in pain is observed with rest and if the head is tilted back.
- Problems in the functioning of the digestive system - the development of attacks of nausea and vomiting. Stomach cramps can be repeated many times, even if a person completely refuses food and drink for a long time.
- Hyperthermia - certain types of meningitis cause an increase in body temperature. The development of the process is accompanied by general malaise, chills, and significant sweating.
- Acute reactions to external stimuli - inflammation of the brain leads to discomfort in bright light, loud sounds, and other influences.
- Clouding of consciousness: a person experiences lethargy, inability to answer simple questions, slow reactions to phrases addressed to him.
- Mental disorder: all types of meningitis cause apathy or aggressive reactions. In some cases, hallucinations may occur.
- Cramps: With meningitis, involuntary contractions of muscle tissue are often observed. This often results in twitching of the limbs. Muscle pain gradually appears.
- The development of strabismus is a sign that appears if the inflamed tissues of the membranes of the brain begin to put pressure on the optic nerves.
Diagnostics
In order to make a correct diagnosis, doctors resort, first of all, to interviewing the patient. Experts will find out how long ago the signs characteristic of the disease appeared, whether there were insect bites, for example, ticks, which act as carriers of a wide variety of infections.
Diagnosis also involves assessing the neurological condition. Doctors assess how adequately the patient responds to speech addressed to him, and whether there are signs of clouding of consciousness. A person's sensitivity to sound and light stimuli is determined. Meningitis can also be identified by the presence of convulsive seizures and the appearance of facial asymmetry. All these signs tell doctors about malfunctions in the brain under the influence of inflammatory processes.
Laboratory tests that can be used to diagnose meningitis include:
- A general blood test makes it possible to identify signs of inflammation of the membranes of the brain, in which there is an increase in the erythrocyte sedimentation rate.
- Computed tomography allows you to assess the condition of the brain based on the images obtained.
- Lumbar puncture - a special needle is inserted into the cartilage tissue of the spine, with which a sample of cerebrospinal fluid is taken. The presence of an abundance of protein or purulent manifestations in its composition is a sign of the development of meningitis.
Therapy
We looked at what meningitis is, types, causes, symptoms of the disease. Now let's find out what the treatment is. When diagnosing meningitis, they resort to complex therapy, which consists of the following stages:
- Hospitalization of a person.
- Application pharmacological drugs.
- Detoxification of the body.
- Symptomatic treatment.
Hospitalization
Since all types of meningitis in adults and children are deadly, therapy should be performed exclusively in a hospital setting. This is required, first of all, to identify the nature of the causative agent of the disease. Depending on the type of infection, doctors determine a treatment strategy and prescribe appropriate medications. If necessary, in a hospital setting, actions can be taken to resuscitate the patient.
Antibacterial treatment
The purulent form of meningitis in children and adults requires the use of antibacterial pharmacological agents. Among these it should be noted:
- penicillins;
- ampicillins;
- cephalosporins;
- carbapenems.
In case of development of tuberculous meningitis, the following drugs are prescribed: Ethambutol, Isoniazid, Streptomycin. To enhance the bactericidal effect of these drugs, patients are prescribed Rifampicin and Pyrazinamide. In general, the course of taking antibacterial medications for meningitis should be at least 10-15 days, depending on the characteristics of the course of the disease.
Antiviral therapy
Treatment of serous meningitis involves the use of a regimen similar to therapy for acute respiratory diseases. Doctors resort to prescribing painkillers, drugs that reduce body temperature and slow down the activity of viral pathogens. Often, patients are prescribed a combination of drugs containing glucocorticosteroids and interferon. As additional measures barbiturates may be used vitamin complexes, nootropic drugs.
Treatment of fungal meningitis
Antifungal therapy is based on the use of the following pharmacological agents:
- "Flucytosine."
- "Amphotericin".
- "Fluconazole".
The active ingredients in these drugs effectively fight the growth of fungal spores, their spread, and provide good support to the body when it weakens.
Detoxification of the body
Why do they resort to detoxification of the body during the treatment of meningitis? Infectious pathogens release a whole host of toxins into the tissue. The latter poison healthy cells and weaken the immune system. All this leads to disruption of the functioning of organs and systems. To reduce Negative consequences For health, when fighting meningitis, the drugs “Enterosgel” and “Atoxil” are prescribed. These products help remove toxic substances from the body. Additionally, vitamin C may be prescribed, drinking plenty of fluids in the form of decoctions of raspberries and rose hips.
Symptomatic treatment
Meningitis can cause a wide variety of unpleasant symptoms. In order to eliminate certain negative conditions, the following medications are prescribed:
- Allergic reactions - "Claritin", "Suprastin".
- Increased body temperature - Paracetamol, Nurofen.
- Vomiting and nausea - “Cerucal”, “Motilium”.
- Emotional irritability - Tenoten, valerian.
- Swelling - “Furosemide”, “Diacarb”.
- Damage to cerebrospinal fluid - Cytoflavin.
Spinal cord meningitis
With this nature, the disease becomes inflamed. The disease progresses extremely seriously. There are numerous complications here. The types of spinal cord meningitis are still the same. The causative agents of the disease can be viral, fungal or bacterial pathogens. Basically, the disease develops in people who suffer from a decrease in the body's protective functions, for example, due to the presence of HIV infection.
Spinal cord meningitis is treated with antibiotics. Doctors necessarily prescribe the use of immunomodulatory drugs. Steroids and diuretics are sometimes used. Throughout the entire course of treatment, the patient should be at rest, adhering to strict bed rest.
Complications
The consequences of meningitis are the following:
- Disruption of the respiratory organs and cardiovascular system. As a result of cerebral edema, bradycardia and tachycardia, increased blood pressure, shortness of breath, and pneumonia may develop.
- Toxic shock - a complication resulting from the absorption by cells of a large amount of waste products of infectious pathogens of meningitis. The problem may cause partial loss of vision and hearing, hormonal dysfunction, paresis.
- Bedsores - treatment of meningitis requires bed rest. Sometimes patients fall into a coma or lose the ability to move. All this leads to the gradual formation of bedsores.
Prevention
We found out what types of meningitis can affect the body. Let's consider preventive actions, which should be resorted to in order to prevent a terrible disease. Among the preventive measures, it is worth noting the following:
- Compliance generally accepted rules hygiene.
- Drawing up a daily diet based on foods rich in vitamins and minerals.
- Avoid contact with people susceptible to viral, bacterial and fungal infections.
- Refusal to visit crowded places during periods of epidemics of respiratory diseases.
- Performing regular wet cleaning of the apartment.
- Hardening of the body (in the absence of contraindications).
- Avoiding hypothermia of the body.
- Avoiding factors that can lead to stress.
- Active lifestyle, playing sports.
- Timely treatment of infectious diseases before they reach the chronic stage.
- Quitting drugs, alcohol, smoking.
- Take pharmacological drugs only after consultation with a qualified doctor.
Finally
As you can see, meningitis is an extremely serious illness, the cure for which does not pose a threat to health and life only if it is diagnosed at early stages. In the absence of adequate treatment, the consequences of the disease lead to the development of irreversible pathological processes. Sometimes the elimination of complications of meningitis occurs throughout life. Therefore, at the first signs of the disease, it is necessary to urgently seek advice from a doctor.
Good day, dear readers!
In today's article we will look at a disease of the meninges, such as meningitis, as well as its first signs, symptoms, causes, types, diagnosis, prevention and treatment with traditional and folk remedies. So…
What is meningitis?
Meningitis– infectious inflammatory disease of the membranes of the spinal cord and/or brain.
The main symptoms of meningitis are headache, high body temperature, disturbances of consciousness, increased sensitivity to light and sound, and numbness of the neck.
The main causes of meningitis are fungi. Often, this disease becomes a complication of others, and often ends in death, especially if its cause is bacteria and fungi.
The basis of treatment for meningitis is antibacterial, antiviral or antifungal therapy, depending on the causative agent of the disease, and only in a hospital setting.
Meningitis in children and men is most common, especially the number of cases increases in the autumn-winter-spring period, from November to April. This is facilitated by factors such as temperature fluctuations, hypothermia, a limited amount of fresh fruits and vegetables, and insufficient ventilation in rooms with a large number of people.
Scientists also noticed a 10-15 year cyclical pattern of this disease, when the number of patients especially increases. Moreover, in countries with poor sanitary living conditions (Africa, Southeast Asia, Central and South America), the number of patients with meningitis is usually 40 times higher than in Europeans.
How is meningitis transmitted?
Like many other infectious diseases, meningitis can be transmitted in a fairly large number of ways, but the most common of them are:
- airborne droplets (through, sneezing);
- contact and household (non-compliance), through kisses;
- oral-fecal (eating unwashed foods, as well as eating with unwashed hands);
- hematogenous (through blood);
- lymphogenous (through lymph);
- placental route (infection occurs during childbirth);
- through ingestion of contaminated water (by swimming in polluted waters or drinking dirty water).
Incubation period of meningitis
The incubation period of meningitis, i.e. from the moment of infection to the first signs of the disease depends on the type of specific pathogen, but generally it ranges from 2 to 4 days. However, the incubation period can range from several hours to 18 days.
Meningitis - ICD
ICD-10: G0-G3;
ICD-9: 320-322.
How does meningitis manifest? All signs of this disease of the spinal cord or brain correspond to infectious manifestations. It is very important to pay attention to the first signs of meningitis so as not to miss precious time to stop the infection and prevent complications of this disease.
The first signs of meningitis
- A sharp rise in body temperature;
- Rigid neck (numbness of the neck muscles, difficulty turning and tilting the head);
- Lack of appetite;
- and frequent without relief;
- Sometimes a rash appears, pink or red, disappearing with pressure, which after a few hours appears in the form of bruises;
- (mainly in children);
- , malaise;
- Hallucinations, agitation, or lethargy may occur.
The main symptoms of meningitis are:
- Headache;
- – up to 40°С, ;
- Hyperesthesia (increased sensitivity to light, sound, touch);
- , disturbances of consciousness (even to the point of coma);
- Lack of appetite, nausea, vomiting;
- Diarrhea;
- Pressure in the eye area;
- Inflammation of the lymph glands;
- Pain when pressing on the area trigeminal nerve, middle of the eyebrows or under the eye;
- Kernig's sign (due to tension in the posterior thigh muscles, the leg does not straighten at the knee joint);
- Brudzinski's sign (legs and other parts of the body move reflexively when pressing on various parts of the body or when tilting the head);
- Bekhterev's symptom (tapping on the zygomatic arch causes contractions of the facial muscles);
- Pulatov's symptom (tapping the skull causes pain);
- Mendel's sign (pressure on the area of the external auditory canal causes pain);
- Lesage's symptoms (the large fontanel in small children is tense, bulges and pulsates, and if you take it under the armpits, the baby throws his head back, while his legs reflexively tuck into his tummy).
Nonspecific symptoms include:
- Decline visual function, double vision, strabismus, nystagmus, ptosis;
- Hearing loss;
- Paresis of facial muscles;
- Abdominal pain, ;
- Body cramps;
- Epileptic seizures;
- , bradycardia;
- Uveitis;
- Drowsiness;
- Increased irritability.
Complications of meningitis
Complications of meningitis may include:
- Hearing loss;
- Epilepsy;
- Hydrocephalus;
- Disturbance of normal mental development of children;
- Purulent arthritis;
- Blood clotting disorder;
- Death.
The first factor and main cause of meningitis is the entry into the body, into the blood, cerebrospinal fluid and brain of various infections.
The most common causative agents of meningitis are:
Viruses– enteroviruses, echoviruses (ECHO - Enteric Cytopathic Human Orphan), Coxsackie virus;
Basically, to relieve viral meningitis, a combination of the following drugs: “Interferon” + “Glucocorticosteroids”.
Additionally, barbiturates may be prescribed, nootropic drugs, protein diet containing a large amount, especially various antiviral drugs(depending on the type of virus).
3.3. Antifungal therapy
Treatment for fungal meningitis usually involves taking the following medications:
For cryptococcal and candidal meningitis (Cryptococcus neoformans and Candida spp): “Amphotericin B” + “5-Flucytosine”.
- The dose of Amphotericin B is 0.3 mg per 1 kg per day.
- The dose of Flucytosine is 150 mg per 1 kg per day.
Additionally, Fluconazole may be prescribed.
3.4. Detoxification therapy
To remove waste products of infection (toxins) from the body, which poison the body and further weaken the immune system and the normal functioning of other organs and systems, detoxification therapy is used.
To remove toxins from the body, use: “Atoxil”, “Enterosgel”.
For the same purposes, drinking plenty of fluids is prescribed, especially with vitamin C - rosehip decoction, tea with raspberries and fruit juice.
3.5. Symptomatic treatment
In case of an allergic reaction, antihistamines are prescribed: "", "".
At high temperatures, above 39°C, anti-inflammatory drugs: Diclofenac, Nurofen, "".
In case of increased irritability and anxiety, sedatives are prescribed: “Valerian”, “Tenoten”.
To reduce edema, including edema of the brain, diuretics (diuretics) are prescribed: Diacarb, Furosemide, Uroglyuk.
To improve the quality and functionality of cerebrospinal fluid, the following is prescribed: Cytoflavin.
Forecast
Timely consultation with a doctor, accurate diagnosis and correct treatment regimen increases the chances of complete cure from meningitis. It depends on the patient how quickly he will go to a medical facility and adhere to the treatment regimen.
However, even if the situation is extremely difficult, pray, the Lord is able to deliver and heal a person even in cases where other people cannot help him.
Important!
Before using folk remedies, be sure to consult your doctor!
When using folk remedies, keep the patient calm, dim the light, and protect him from loud sounds.
Poppy. Grind the poppy seed as thoroughly as possible, pour it into a thermos and fill it with hot milk, in the proportion of 1 teaspoon of poppy seed per 100 ml of milk (for children) or 1 tbsp. spoon of poppy seeds per 200 ml of milk. Leave the solution to infuse overnight. You need to take 1 tbsp of poppy infusion. spoon (children) or 70 g (adults) 3 times a day, 1 hour before meals.
Chamomile and mint. To drink, use tea from or, for example, one remedy in the morning, another in the evening. To prepare this medicinal drink you need 1 tbsp. Pour a spoonful of mint or chamomile into a glass of boiling water, cover the lid and let the product brew, then strain and drink a portion at a time.
Lavender. 2 teaspoons of medicinal lavender in dry, ground form, pour 400 ml of boiling water. Leave the product overnight to infuse and drink 1 glass, morning and evening. This product has analgesic, sedative, anticonvulsant and diuretic properties.
Herbal collection. Mix 20 g of the following ingredients - lavender flowers, peppermint leaves, rosemary leaves, primrose root and. Next, pour 20 g of the resulting mixture from plants with 1 glass of boiling water, cover with a lid and let the product brew. After the collection has cooled, strain it and you can start drinking the whole glass at a time, twice a day, morning and evening.
Needles. If the patient does not have an acute phase of meningitis, you can prepare a bath from fir needles; it is also useful to drink an infusion of pine needles, which help cleanse the blood.
Linden. 2 tbsp. spoons linden color pour 1 liter of boiling water, cover the product with a lid, let it brew for about 30 minutes and you can drink it instead of tea.
— During periods of seasonal outbreaks, avoid staying in places with large numbers of people, especially indoors;
— Do wet cleaning at least 2-3 times a week;
— Temper yourself (if there are no contraindications);
— Avoid stress and hypothermia;
- Move more, go in for sports;
— Do not let various diseases take their course, especially infectious nature so that they don't go into chronic form;
Meningitis is a dangerous disease that affects the meninges. From this article you will learn everything about what meningitis is, what the symptoms and treatment of the pathology are, how to recognize the signs of the disease and what are the reasons for the development of the disease.
What kind of disease
Meningitis is an inflammatory disease that affects the membranes of the brain and spinal cord. Treatment at home is never carried out, as this can be life-threatening for the patient. Even when the disease can be cured, serious consequences can develop over time or immediately after meningitis.
The main cause of the inflammatory process in the brain is considered to be the penetration of various microorganisms there. Although the pathology develops in both men and women, this diagnosis is more often found than in adults. Experts believe that this is due to the fact that the child has a high permeability of the blood-brain barrier or it has not yet fully formed.
Important! The risk of developing meningitis is greatest before the age of 4 years, especially in newborns between 3 and 8 months of age.
Even timely diagnosis and therapy effective methods does not always prevent the death of the patient. After recovery, at least another 30% of patients suffer from complications of meningitis.
Classification of pathology
There is a generally accepted classification of meningitis, which defines different features forms of pathology.
According to the characteristics of the course
According to the nature of the inflammation, meningitis occurs:
- purulent;
- serous.
Purulent meningitis is a pathology that is caused by a meningitis infection, or meningococcus. Has the most severe course. Purulent exudate accumulates inside.
Serous meningitis is a form of the disease caused by viral pathogens. The disease can be caused by the polio virus. Enteroviral, influenza and other forms of meningitis are also distinguished.
According to the mechanism of occurrence
Meningitis is also divided into primary and secondary. During primary inflammation, the infection penetrates directly into the meninges, and the entire body as a whole is not infected. With the secondary type of inflammation, other human organs and systems first suffer from infection, and then gradually the meninges are involved in the pathological process.
Due to development
Depending on the cause of meningitis, the following types of disease are distinguished:
- bacterial;
- fungal;
- viral;
- simplest;
- mixed.
Bacterial meningitis is considered the most dangerous, as it is more severe, causes more exacerbations and is more often fatal. Staphylococcal and syphilitic meningitis are considered the most difficult to treat.
Note! Meningococcal meningitis is also a bacterial form of the disease and is difficult to treat even in a hospital setting; its distinctive feature is the presence of a specific rash.
Fungal meningitis is caused by fungal microorganisms. A person becomes ill when an infection enters the brain. The causative agents may be Candida fungi or cryptococcal microorganisms.
Viral meningitis develops after the activation of viruses. In another way, this type of pathology is called aseptic. Symptoms are usually associated with the virus that turned out to be the causative agent of the disease. Meningeal symptoms in this form of pathology are usually mild. This infectious meningitis is provoked by the herpes virus, mumps and others.
Protozoal meningitis is one that is caused by protozoan microorganisms. This may be toxoplasma (protozoal form) or encephalitic (amoebic) meningitis.
In the mixed form, the disease is caused by several types of pathogens at once.
According to the rate of development of pathology
The following forms of meningitis are distinguished:
- lightning;
- spicy;
- chronic.
With fulminant, or reactive meningitis, the disease is characterized by rapid development. Symptoms increase very quickly. Unfortunately, even careful treatment by a doctor does not bring results, and the patient usually dies. This is due to the fact that everything clinical symptoms arise within one day and pass through all stages of pathology development in a short period.
In the acute course of the disease, all symptoms arise quickly, although not with lightning speed. The picture of the disease develops and usually lasts no more than three days.
In the chronic course of the disease, it can be difficult to clearly establish at what point the disease began. The pathology picture develops gradually, the symptoms intensify.
By process localization
Meningitis can also be divided into types depending on the location of the inflammatory process. It can be bilateral, or it can be localized only on one side.
If the pathology is located in the lower part of the brain, doctors call it basal. When inflammation is localized in the front, convexital meningitis is diagnosed. The spinal form of the pathology is diagnosed when the spinal cord is involved in the pathological process.
Other types of meningitis
Tuberculous meningitis is sometimes the first sign of infection with the tuberculosis bacillus. The symptoms are general, however, after some time characteristic signs appear that can be used to make a diagnosis.
Note! Previously, tuberculous meningitis was fatal, but now in 75-85% of cases it can be successfully treated.
Toxic meningitis begins when the meninges are affected by toxic substances. The cause of the pathology can be exposure to acetone, dichloroethane and other chemical compounds.
Post-traumatic meningitis develops after a traumatic brain injury. Symptoms appear approximately 2 weeks after the incident. Postoperative meningitis develops according to the same principle. The causative agent in this case is most often gram-positive cocci, especially streptococci and staphylococci.
Reasons for the development of the disease
It is important to understand why meningitis develops. To treat such a serious pathology, it is important to eliminate the negative impact of negative factors as soon as possible.
Get sick of this inflammatory pathology only possible if you have an infection. The main causative agent of the pathology is meningococcus. This infection is transmitted by airborne droplets, which means that with any contact, even distant contact, meningitis can be contagious.
Important! When the disease penetrates into a children's community, meningitis can acquire epidemic proportions.
Cerebral and spinal meningitis can develop due to the action of viruses, fungi and other microorganisms. Penetration of infection directly into the brain occurs through hematogenous and lymphogenous routes.
Risk factors
However, even when infected with viruses or bacteria, not everyone suffers from meningitis. First aid may be required in the presence of such conditions and circumstances that increase the risk of disease:
- decreased immune defense;
- chronic fatigue;
- poor diet;
- endocrine disorders;
- hormonal imbalances;
- stomach or duodenal ulcer;
- oncological diseases;
- long-term use of medications;
- traumatic brain injuries.
It is noted that in some patients meningitis developed shortly after the stroke. It is important to understand that sometimes even qualified doctors do not have time to differentiate between stroke and meningitis.
Sometimes the risk of developing the disease increases with frontal sinusitis and osteomyelitis localized on the face. With the odontogenic type of pathology, the cause may be a carious tooth or other problems in the jaws and teeth. Abscesses in the lungs, as well as all kinds of otitis media, increase the risk of meningitis.
Symptoms of the disease
To successfully treat meningitis, you must be able to recognize the first signs of the disease and call an ambulance in a timely manner. This is a very serious disease that cannot be delayed, as it could cost your life.
At first, general problems arise. Symptoms resembling signs of intoxication may occur:
- high body temperature;
- pale skin;
- joint and muscle pain;
- complaints of rapid heartbeat;
- dyspnea;
- reduction in blood pressure to critical levels;
- refusal of food;
- weight loss;
- strong thirst.
Important! The appearance of any negative symptoms during pregnancy should be a reason to immediately contact a specialist!
Many symptoms of meningitis can resemble other pathologies, which can make it difficult to make an immediate diagnosis. However, when meningeal symptoms are added to the clinical picture, it becomes easier to determine the disease.
Meningeal syndrome
The main symptom of meningitis is headache. However, it has certain features that make it possible to identify this dangerous disease.
Meningitis causes headaches in the following ways:
- constantly;
- there is a feeling of fullness;
- pain is stronger when bending forward, backward or when turning;
- a person reacts more strongly to bright lights and loud sounds.
There is a certain posture for meningitis. This is not due to a seizure, but to pain in the neck, which becomes easier when throwing the head back. This is why patients with this diagnosis maintain an unusual body position, as seen in the photo.
With this disease, disturbances in the functioning of the gastrointestinal tract occur. In particular, the digestive processes are damaged. Patients experience nausea and vomiting.
Note! Even with complete refusal from eating food, this symptom does not disappear, but brings severe suffering to the patient.
In addition to high fever, people with meningitis experience the following:
- fever;
- chills;
- lethargy;
- increased sweating.
In adulthood, almost all patients with meningitis report severe photophobia. In addition to all the symptoms, when the eyes are exposed to bright light, the headache increases significantly.
In more complex cases of the disease and in later stages of disease progression, the following symptoms may develop:
- the perception of the surrounding world changes;
- the patient becomes inhibited and responds slowly to calls;
- hallucinations may occur;
- there are cases where patients showed aggression;
- complete apathy;
- convulsions;
- voluntary urination.
After the incubation period passes, the intensive development of symptoms of the disease begins.
Symptoms in infants
Signs of pathology in adolescents will be somewhat different from those that develop in infants.
Before the age of one year, the following symptoms are possible:
- monotonous cry of a child;
- changes in body temperature;
- increased excitability;
- excessive sleepiness;
- refusal to feed;
- vomit;
- seizures;
- bulging fontanel;
- divergence of the seams of the skull.
To quickly identify meningitis, it is important to consult a doctor when the first symptoms appear.
Complications
If you do not get rid of the disease in a timely manner, serious complications may develop:
Cerebral edema is the most common complication of the disease. With its development, patients note disturbances of consciousness. Due to excessive compression of the brain, coma occurs. Convulsive seizures, hemiparesis, cardiac and respiratory arrest occur.
With hydrocephalus, there is a sudden sharp increase in intracranial pressure. This happens against the background of excessive filling of the brain with cerebrospinal fluid. Visually it can be noted physical increase head diameter and tension.
Subdural effusion occurs when fluid accumulates in spaces inside the brain. This usually happens in frontal lobes. Even with the use of antibiotics, the condition does not go away.
When the pathological process passes from the meninges to the ependyma of the ventricles, ventriculitis syndrome occurs.
Diagnostic measures
To put accurate diagnosis, the doctor will first listen to all the patient’s complaints and first identify the disease. It is important to determine:
- how long has the patient been bothered by unpleasant symptoms;
- Have you been recently bitten by ticks that carry meningitis?
- whether the patient has visited countries with an increased risk of contracting this pathology.
After this, the doctor will conduct a test to determine the degree of reaction, irritability, the presence of aggression, photophobia, and seizures. Some patients experience muscle weakness and facial asymmetry. When symptoms progress greatly, there is a high risk of encephalitis - inflammation of not only the membranes, but also the brain itself.
The following additional studies may be prescribed:
- clinical blood test to determine the inflammatory process in the body;
- lumbar puncture, in which a puncture is used to laboratory research part of the cerebrospinal fluid is taken;
- CT or MRI to visually assess the condition of the meninges and determine the size of the brain regions;
- PCR to determine the type of infection for more effective therapy.
Of all available methods, specifying meningitis - lumbar or spinal puncture. If there is a disease, even in appearance it will be cloudy and thick, and during the analysis process bacteria, proteins and increased lymphocytes will be found.
Principles of treatment
Everyone should know that for meningitis, treatment with folk remedies is strictly prohibited. In just one day without qualified assistance and without intensive care medicines the patient will die! Therefore, no traditional methods can be used!
The doctor writes out the prescription based on the examination results. It is important to identify the nature of the causative agent of the disease. The following medications may be recommended:
- broad-spectrum antibiotics (for example, Suprax);
- antiviral agents.
Since at first it is necessary to start therapy urgently, the doctor can prescribe medications without waiting for the results of laboratory tests.
Important! After 7 days, even if treatment has not yet been completed, it is necessary to change the antibiotic, as addiction may develop and it will no longer be so effective.
In addition to antibiotics, the following medications may be prescribed:
- diuretics to reduce swelling, including in the brain;
- steroids to normalize the functioning of the pituitary gland;
- vitamins to restore the body.
The operation is performed extremely rarely, mainly in cases of severe purulent meningitis to sanitize the affected areas of the brain. After such interventions, the rehabilitation period is usually longer than with drug treatment. However, in some cases, surgery can save a person's life.
Preventive measures
It is much better to take care of prevention in advance than to think about how to recover from such a serious disease. It is important to consider the following recommendations:
You can protect your child from meningitis only by constantly strengthening his immunity. For these purposes, it is better to use not chemical immunomodulators, but simple remedies, including lemon, sea buckthorn, raspberry jam and more.
For many years there has been debate as to whether you can get meningitis if you go outside with a wet head. If you remember what it is infection, then the disease will not appear simply from cold air. At the same time, such actions reduce immune defense, which can increase the risk of illness in case of contact with a sick person or another infection.
A balanced diet and periodic visits to the doctor will help you monitor your health and maintain it in good condition.
By following the basic rules of protection and getting vaccinated, you can protect your body from meningitis. This is much better than taking a serious risk not only with your health, but also with your life.
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