Home Auditorium 8 Symptoms and first signs of meningitis: how does this disease manifest itself? Modern methods of treating meningitis of various etiologies

Symptoms and first signs of meningitis: how does this disease manifest itself? Modern methods of treating meningitis of various etiologies

There are no diseases in life that could be pleasant.

Diseases can be very dangerous and slightly less dangerous.

Acute meningitis is a very dangerous and serious disease that has four types of meningococci: A, B, C and D. The first two of them need constant attention during the epidemic.

Most common cause The reason why people get meningitis is called walking down the street in cold weather without a hat, and even worse with a wet head.

There is some truth in this, but only some. In most cases, meningitis is caused by bacteria and viruses that negatively affect the pia mater of the brain and cerebrospinal fluid.

To catch a disease, you simply need to come into contact with a person who is sick with a viral or infectious disease.

For children, the most popular source of meningitis is the introduction of enterovirus into the body through dirty food or water. The disease can also be acquired during childbirth, when the virus can enter by airborne droplets, through dirty water or through the mucous membrane. In addition, meningitis is often a complication of various headaches and injuries.

It is very important for people of all ages to avoid at least the basic causes that cause such a serious illness.

It is necessary to wash your hands before eating, maintain hygiene and prevent your head from freezing in bad weather.

Symptoms of acute meningitis

With meningitis, the symptoms are obvious and very unpleasant.

Having received the disease, a person begins to feel a headache. The temperature rises, the neck muscles stop moving, and the knee joint stops working.

Light and sound are perceived too harshly, which causes additional discomfort. Also, with meningitis, nausea and vomiting, a feeling of weakness and heart rhythm disturbances appear.

In the most unpleasant situations, a person can lose consciousness or even fall into a coma. A particularly acute reaction of the body to meningitis occurs if it is bacterial.

If a combination of these symptoms occurs, steps must be taken immediately to prevent the disease. Often a symptom of meningitis is upper respiratory tract disease. In this case timely treatment antibiotics can correct the disastrous state of affairs and normalize the situation with the disease.

Diagnostics

Nowadays, there are a number of ways to diagnose meningitis. The main ones include:

Biochemical blood test. This analysis allows us to understand the state of the patient’s immunity.
X-ray. The infection can occur in respiratory tract and in the nasal sinuses. Thanks to x-rays, it will be possible to understand the cause of the disease.
Urinalysis. Allows you to identify genitourinary system the presence of an infectious focus and helps to assess the functioning of the kidneys.
MRI. Allows you to examine the brain and nervous system for complications.
Puncture. As already mentioned, meningitis affects the cerebrospinal fluid. The puncture allows you to determine the degree of infection of the body and how advanced the inflammatory process is. The body's sensitivity to medications is also determined.
Biopsy. It is not necessary to diagnose using a biopsy, but it often allows you to understand the condition of the skin and the cause of skin inflammation.

Despite all the variety of methods for diagnosing the disease, the key factor is the speed of the patient himself. It is he who must react to his illness in time and immediately consult a doctor.

Prognosis and treatment

When making a prognosis for a cure for meningitis, doctors must correctly determine the type of disease.

The most dangerous type is meningococcal meningitis, which is the most common.

It is unpleasant to realize, but with this form of the disease there is a possibility of death.

Yes, today there are huge strides in the field of medical progress, but this cannot completely eliminate the possibility of death of the patient.

It is worth noting that overall the situation is still improving. In previous times, an average of 75% of patients died from meningococcal meningitis, but now this percentage has decreased by 4-5 times. In addition, the likelihood that after illness a person will have complications such as paralysis, epilepsy and dementia decreases.

There are also types such as viral and tuberculous meningitis. They are not as dangerous, so the prognosis is much better. You can recover without consequences in a few weeks. For serous meningitis healing is typical within a week.

Meningitis is treated with various types therapy. These include antibacterial, detoxification, anti-inflammatory hormonal and symptomatic therapy. In addition, when treating secondary meningitis elimination of the purulent focus is necessary.

Prevention

Three categories of people are more susceptible to the disease:

children under five years of age;
teenagers from 16 to 25 years old;
elderly people over 60 years of age.

It is especially important for them to follow basic rules of hygiene and a healthy lifestyle.

If it turns out that you have come into contact with a person suffering from meningitis, you must immediately go to the hospital.

You need to be under the supervision of a specialist for up to two weeks. In addition, if an infection is detected, it is necessary to immediately heal its source.

One of the most important helpers for people in the fight against meningitis is vaccination. This disease is very dangerous and it is not a fact that vaccination will save you from problems, but if you carry out a whole range of vaccinations against viruses, this will significantly increase the chances of avoiding the disease.

Meningitis is a complex disease, the symptoms of which are unpleasant and immediately visible. It is impossible to insure yourself against meningitis, but you can make every effort to reduce the likelihood of the disease. If the disease does occur, it is necessary to see a doctor in a timely manner, diagnose the problem and begin treatment.

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Meningitis is a disease characterized by inflammation of the lining of the brain, most often caused by infection of the cerebrospinal fluid.

Meningitis can develop due to various reasons: bacterial or viral infection, traumatic brain injury, cancer, certain medications.

The severity of the disease depends on the cause, and the treatment regimen is selected individually in each case. That's why it's so important to know everything about meningitis.

Bacterial meningitis

With meningitis, the inflammatory process is localized in the membranes of the brain.

Bacterial meningitis is severe. Although most patients recover, many experience complications such as brain damage, hearing loss or loss, and learning disabilities.

There are several germs that cause meningitis: meningococcus, group B streptococcus, pneumococcus, listeria, Haemophilus influenzae.

Reasons

The main causes of the disease (more precisely, the types of microbes that cause it):

Risk factors

Factors that increase the risk of developing bacterial meningitis:

Age
- Children younger age are more likely to get meningitis than people of all other ages. However, this does not mean that adults are not at risk.
Staying in a team
- Any infectious disease spreads quickly in large groups of people. Meningitis is no exception. Recruits are at greatest risk.
Certain Conditions
- There are some diseases, medications and surgical interventions, which can weaken the immune system or otherwise increase the risk of contracting meningitis.
Working in the laboratory with pathogens that cause meningitis.
Trips
- A number of African countries located near the Sahara are considered to be unfavorable areas for meningitis.

Distribution routes

A patient with bacterial meningitis may be contagious. Some pathogens are transmitted through droplets of saliva when sneezing, coughing, or kissing. But fortunately, all these bacteria are not as contagious as viruses, so the risk to people visiting the sick person is not as great.

U healthy people the microbe can be sown from the nasopharynx, but many carriers of meningococcus never get sick.

Signs and symptoms

Meningeal infection presents with fever, headache, and neck stiffness. To others persistent symptoms include:

Nausea
Vomit
Impaired consciousness

Symptoms of bacterial meningitis may develop immediately or may take several days to appear. Symptoms usually appear 3 to 7 days after infection.

Newborns (up to 1 month of age) are at greater risk of developing bacterial meningitis than older children. In children, the classic symptoms of meningitis such as fever, pain, and stiff neck may be absent or unrecognized. Young children may experience loss of appetite, poor response to stimuli, vomiting, poor appetite. In children, the doctor always checks the condition of the large fontanelle (bulging and tension is a sign of illness) and reflexes.

Later, such dangerous symptoms meningitis, as convulsions and coma.

Diagnostics

If meningitis is suspected, a blood test is always taken and spinal tap. The resulting samples are sent to a laboratory, where specialists do a culture to identify the bacteria and determine its sensitivity to antibiotics. It is necessary to know exactly the causative agent of the disease in order to select the right antibiotic from the very beginning and anticipate the course of the disease.

Treatment

Bacterial meningitis is highly treatable with antibiotics in the vast majority of cases. It is very important to start treatment as early as possible. The right antibiotics reduce the risk of death by up to 15%, although mortality may remain high among young children and the elderly.

Prevention

The best way to protect yourself and your children from bacterial meningitis is to stay up to date on all vaccinations. There are vaccines against pathogens that can cause meningitis:

Meningococcal vaccine
Pneumococcal vaccine
Hib vaccine against Haemophilus influenzae.

Also, people who have been in contact with people with meningitis, or relatives of the sick person, are sometimes prescribed prophylactic antibiotics.

It is very important to lead healthy image life, do not smoke, play sports and try not to contact sick people. The latter is especially important for children, the elderly and people with weakened immune systems.

Viral meningitis

Viral meningitis is much milder than bacterial meningitis. Sometimes it goes away on its own, without any treatment. However, viral meningitis can be extremely dangerous for older people and people with weak immunity.

Reasons

Most cases viral meningitis are complications. But it is worth noting that only a small number of people with enterovirus infection develop enteroviral meningitis.

Other viral infections which may be complicated by meningitis:

Herpes virus, .
Flu
Viruses that are spread by insects (arboviruses)

Risk factors

Anyone can get viral meningitis, but newborns and people with weak immune systems are most at risk. If a person comes into contact with a patient with viral meningitis, he may catch a viral infection and get sick, for example, with the flu, but this does not mean that meningitis will necessarily develop as a complication.

Risk factors for getting viral meningitis include:

Age
- Most often, viral meningitis develops in children under 5 years of age.
Weakened immune system
- There are diseases and medications that can weaken immune system. For example, chemotherapy or immunosuppressive therapy.

Spreading

The most common cause of viral meningitis is enterovirus infection.

Enterovirus spreads from person to person through the fecal-oral route, i.e. it is a disease of dirty hands. Enterovirus can also be transmitted by airborne droplets, through droplets of saliva released when coughing and sneezing.

Signs and symptoms

Meningeal infection causes sudden fever, headache, and neck stiffness. Other symptoms include:

Nausea
Vomit
Photophobia (painful sensitivity to light)
Impaired consciousness

Enterovirus is the most common cause of viral meningitis. Outbreaks of morbidity are typical in spring and autumn.

Anyone can get viral meningitis. The symptoms of viral meningitis are practically no different from those of bacterial meningitis.

Symptoms of viral meningitis may vary among patients of different age groups.

Symptoms characteristic of childhood

Fever
Irritability
Poor appetite
Drowsiness

Symptoms characteristic of adults

Symptoms of viral meningitis persist for 7–10 days, and then (in people with healthy immunity) disappear. Viruses that cause meningitis can also infect not only the membranes, but also the tissues of the brain and spinal cord.

Diagnostics

If an infectious disease specialist suspects meningitis, the patient will be prescribed:

nasopharyngeal swab,
blood, urine and stool tests,
blood culture for sterility,
spinal tap.

It is very important to identify the causative agent of meningitis, since the severity depends on the type of virus, possible complications and outcome of the disease.

Treatment

Infectious disease specialists try to select the right antiviral drugs for treating patients, for example, Acyclovir to combat herpes meningitis. Since antibiotics do not act on viruses, they are not prescribed. Most patients recover within 7–10 days.

Prevention

A special vaccine against viral meningitis has not yet been developed. Thus, the best way to protect yourself and your loved ones is to avoid contact with sick people. However, this can be difficult because viral infections do not always produce symptoms: a person may be sick and contagious and not know it.

Risk factors

Naegleria fowlera is found in all corners of the world. It can be found in:

rivers and lakes
geothermal springs
swimming pools (which are poorly cleaned)
water heaters, etc.

Spreading

Symptoms and signs

The first symptoms of PAM appear 1–7 days after infection. As with any other meningitis, headache, nausea, vomiting, fever, and stiff neck are noted. Later, disturbances of consciousness, hallucinations and convulsions appear. Once symptoms appear, the disease progresses rapidly and can be fatal within 1–12 days.

Diagnostics

Treatment

According to numerous studies, some drugs are quite effective against Naegleria fowleri. However, in practice this has not yet been clarified due to the high mortality rate.

Prevention

Since Naegleria Fowler enters the body through the nose while swimming, you should try not to swim in natural bodies of water where it can live.

Fungal meningitis

Reasons

Fungal meningitis is quite rare. Although theoretically no one is immune from this type of meningitis, people with immunodeficiencies are at greatest risk of getting the disease.

The main causative agent of fungal meningitis is cryptococcus. Cryptococcal meningitis is most common in Africa.

Spreading

Fungal meningitis is not contagious and cannot be transmitted from a sick person to a healthy person. Fungal meningitis develops after the fungus travels through the bloodstream from the primary lesion to the brain.

Also increased risk Fungal meningitis occurs in people with weak immunity (it is caused by HIV, AIDS, chemotherapy, taking immunosuppressants, hormones).

Risk factors

Some diseases medical procedures and medications may increase your risk of getting fungal meningitis. For example, premature babies are at risk for candidal meningitis.

Signs and symptoms

The following symptoms are typical for fungal meningitis:

Diagnostics

At the diagnostic stage, the patient undergoes a blood test, a lumbar puncture, and the cerebrospinal fluid is sent to the laboratory for analysis. Without identifying the causative agent of meningitis, proper treatment is impossible.

Treatment

Fungal meningitis is treated with long courses antifungal drugs, which are usually prescribed intravenously. Therefore, the patient must remain in the infectious diseases department for the entire period of treatment. The duration of treatment depends on the initial state of health, the reactivity of the immune system and the type of fungus.

Prevention

There is no specific prevention against fungal meningitis.

Non-infectious meningitis

Reasons

Possible causes of the development of non-infectious meningitis:

Malignant neoplasms
Systemic lupus erythematosus
Some medications
Head injuries
Brain surgery

Spreading

This type of meningitis is not spread from a sick person to a healthy person.

Signs and symptoms

Meningeal infection causes sudden fever, headache, and a stiff neck. To others general symptoms include:

Nausea
Vomit
Photophobia
Impaired consciousness

Diagnostics

If a person experiences severe headaches and has a fever and a stiff neck, then all doctors first think about meningitis. Then a series of studies are carried out to determine the nature of the disease (bacterial, viral, fungal). If a patient has mild symptoms, they most likely have nonbacterial meningitis.
But in any case, the patient undergoes a spinal tap, and the cerebrospinal fluid is sent to the laboratory for analysis. In the cerebrospinal fluid, the level of sugar, protein and the number of white blood cells are determined. Cerebrospinal fluid culture is also done to identify the pathogen and its sensitivity to medicines. The diagnosis of non-infectious meningitis is made when there is a large number of leukocytes in the cerebrospinal fluid, confirming inflammation, but there are no bacteria, viruses, or other possible pathogens.
If an infectious disease specialist suspects the presence of a cyst in the brain, the patient will be prescribed an MRI or CT scan.

Treatment

If the patient's condition is very serious, the doctor prescribes standard treatment without waiting for laboratory test results. The treatment regimen includes antibiotics, which the patient will receive until the bacterial nature of meningitis is ruled out. Otherwise, if the patient does have bacterial meningitis, without prescribing antibiotics, they may develop severe complications(psycho-neurological abnormalities) or even death. Also in standard scheme Treatments include Acyclovir in case the meningitis may be viral.
Once the cause of meningitis is identified, the doctor prescribes appropriate treatment. The patient must undergo symptomatic therapy.

Meningitis is very insidious inflammatory disease membranes of the spinal cord or brain, which sometimes develops at lightning speed and requires urgent medical intervention.

This disease always leaves behind a lot of consequences, ranging from migraine-like pain to serious disturbances in brain function.

Fortunately, if treatment is started early, meningitis can be defeated, and probably without consequences. Both children and adults suffer from this disease. Meningitis - symptoms in adults and consequences, read below.

This disease is common to a certain extent in all countries of the world, but is most often found in the countries of the African continent. In Russia, outbreaks of meningitis most often occur in winter or spring, from February to April. This seasonality is determined by sudden changes in weather conditions, as well as long stay people in closed and poorly ventilated areas.

Meningitis occurs due to the fact that the soft membranes of the brain in various ways harmful microorganisms penetrate. According to the etiology of the disease, that is, the reasons for its occurrence, several types of meningitis are distinguished:

viral;
bacterial;
protozoan;
fungal;
mixed.

Based on the names of the species, the occurrence of meningitis can be caused by fungi, viruses and pathogenic bacteria, among which are:

But the most common cause of this disease in adults is considered to be meningococcal infection, which is transmitted from an infected person by airborne droplets, although it can enter the body through head injuries or from developing infectious foci in the human body.

At the same time, you can catch meningitis anywhere – even on public transport, even in a clinic. This disease is characterized by a very severe course of the disease and often leads to the development of serious complications.

Other diseases can cause the development of meningitis:

boils in the neck area;
sinusitis;
otitis;
bone osteomyelitis;
lung abscess, etc.

The risk group primarily includes people with weakened immunity, head injuries, problems with the central nervous system, back diseases, premature babies, pregnant women, people with chronic diseases. Meningitis most often affects men or young children. The carrier meningococcal infection may be a healthy person.

Meningitis is a dangerous disease, so at the first signs of its development it is important to immediately visit a doctor. The patient expects immediate hospitalization.

Symptoms

The very first signs of the disease appear within 24 hours after infection. Meningitis is quite easy to detect at the most early stages, since it has very clear and characteristic symptoms that cannot be confused with signs of other diseases:

body temperature quickly rises to 40 degrees;
3 hours after the temperature rises, a rash covers the whole body;
persistent nausea and vomiting occur;
soreness eyeballs when pressed;
severe headaches;
severe dizziness;
the desire of the patient lying on his back to throw back his head;
rigidity neck muscles(difficulty tilting the head to the chest);
the patient draws in his stomach and draws in his legs, bending them at the joints;
throat and tonsils are red.

Already at this stage, it is important to call a doctor as quickly as possible, who will prescribe the necessary treatment. If you delay even a little, the disease develops further and the following signs appear:

loss of consciousness;
inappropriate behavior;
the person begins to delirium;
convulsions.

It is especially important to pay attention to the appearance of any of these symptoms if the person the day before suffered from sinusitis, pneumonia, or is suffering from tuberculosis.

The doctor will be able to make a final diagnosis and determine the type of meningitis only after conducting the necessary examination. Depending on the severity of the disease, a person may be placed either in a general ward or in intensive care.

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Meningitis is an acute infectious disease primarily affecting the soft meninges of the brain and spinal cord. Manifestations of the disease may vary depending on the stage and type of disease.

Symptoms of meningitis development

IN clinical picture diseases can be distinguished:

general infectious symptoms of the disease

malaise,
chills, hyperthermia or low-grade fever,
lymphadenitis,
skin exanthema,
changes in the blood

cerebral signs of meningitis:

headache,
"brain" vomiting,
convulsions,
disturbance of consciousness,
psychomotor agitation),

meningeal manifestations of the disease:

cephalgia,
vomit,
hyperesthesia skin,
photophobia)

and meningeal syndromes:

stiff neck,
Kernig's symptoms,
Brudzinsky, etc.)

Patients often experience astheno-neurotic phenomena: headaches, increased irritability, fatigue, decreased performance, sleep disturbance.

Mechanism of development of meningitis

The main mechanisms of development of the neuroinfectious process (direct impact on neural structures):

intoxication,

infectious-allergic and immunopathological reactions (appearance of sensitized lymphocytes, autoantibodies, etc.)

and secondary mechanisms for the development of meningitis symptoms: inflammation, edema, compression, disturbances of cerebral hemodynamics, metabolism, formation and circulation cerebrospinal fluid.

Diagnosis of meningitis

intoxication,

psychomotor,

meningeal,

asthenoneurotic.

Diagnostic symptoms of meningitis with a syndromic approach

Syndrome of general infectious intoxication. Symptoms of meningitis of this syndrome: hyperthermia, fever, sweating; sleep disturbance, appetite disturbance; muscle weakness, apathy.

Syndrome of increased intracranial pressure.Symptoms of meningitis of this syndrome: severe headache, of a diffuse, bursting nature. The presence of nausea, vomiting that does not bring relief; signs of hyperesthesia (cutaneous, light, sound), dizziness, the presence of changes in consciousness (psychomotor agitation, delirium, hallucinations, convulsions, in severe cases - depression of consciousness from stupor to coma) are also a manifestation of the syndrome of increased intracranial pressure. When examining the fundus, disc congestion is determined optic nerves. When performing a lumbar puncture, there is an increase in intracranial pressure.

Syndrome of edema and swelling of the brain.

Signs of meningitis in meningeal syndrome

Symptoms of the disease are caused by the syndrome high blood pressure, the presence of inflammation of the pia mater, irritation of the endings of the trigeminal nerve, parasympathetic and sympathetic fibers innervating the membranes of the brain and their vessels, irritation of receptors vagus nerve.

Meningeal symptoms of meningitis include:

rigidity of the long muscles of the trunk and limbs,

stiff neck as a symptom of meningitis,

reactive pain phenomena,

pain on palpation of the exit points of the branches of the trigeminal nerve,

percussion pain of the skull as a symptom of meningitis,

changes in heart rhythm,

bowel dysfunction as a symptom of meningitis.

The maximum degree of severity of meningeal syndrome during meningitis is the presence of a characteristic “pointing dog” pose (meningeal posture). A manifestation of meningeal syndrome is Kernig's symptom, determined by the presence of flexion contractures, which appears due to irritation of the pyramidal system. Other manifestations of meningeal syndrome during meningitis are Brudzinski's symptoms - upper, middle and lower. For upper symptom Brudzinski is characterized by involuntary flexion of the legs at the knees and hip joints in response to an attempt to bring the head to the chest in a lying position.

For the average – the same reaction of the legs when pressing on the pubic symphysis. When determining lower symptom Brudzinsky with meningitis, an attempt to straighten one leg leads to involuntary flexion of the second leg, which is brought to the stomach.

Symptoms of meningitis in encephalitic syndrome

Initially, a pseudoneurasthenic syndrome appears, manifested by irritability, emotional lability, disturbance of sleep rhythm, revival of all tendon and periosteal reflexes. These symptoms of meningitis are caused by the development pathological process in the meninges, changes in the composition of the cerebrospinal fluid, which has an effect on the cerebral cortex. In the same period of the disease, due to irritation of the cerebral cortex, a decrease in the threshold of perception occurs, which leads to the appearance of general hyperesthesia and convulsive syndrome.

Then the tendon and periosteal reflexes are inhibited. Symptomatic menintitis of this phase of development is characterized by:

deep disturbances of consciousness,

disorders of the cardiovascular system and breathing,

dysfunction of the cranial nerves,

the presence of paresis and paralysis.

Definition of pathological focal symptoms meningitis are the most typical. If there is a rapid reverse development of encephalitic manifestations, an encephalic reaction is determined.

Manifestations of meningitis in the syndrome of inflammatory changes in the cerebrospinal fluid

Symptoms of this form of disease are increased cytosis and changes in cellular composition, increasing the amount of protein. In meningitis, inflammatory dissociation is determined: 1 g of protein corresponds to 1000 cerebrospinal fluid cells. A clear predominance of protein content over cytosis indicates protein-cell dissociation, the opposite ratio indicates cell-protein dissociation. Subject to availability inflammatory process(meningitis, meningoencephalitis) note the predominance of cell-protein dissociation. With predominance destructive processes over inflammatory ones, protein-cell dissociation is recorded.

Symptoms of different stages of meningitis and types of disease

There are 3 stages of development of the syndrome of edema and swelling of the brain with meningitis.

I stage of edema with symptoms of meningitis

Stage I – stage of edema. Characterized by the following symptoms of meningitis:

syndrome of increased intracranial pressure,

disturbance of consciousness (in the beginning, the presence of stupor, lethargy, delirium, hallucinations, agitation; subsequently - deep stupor and coma;)

availability convulsive syndrome,

decreased reflexes;

tachypnea, subsequently – bradypnea,

symptoms of brady or tachyarrhythmia, hypotension).

Stage II of meningitis and its signs

Stage II – phase of brain dislocation. Characterized by a lack of consciousness, a reaction to pain, areflexia, the presence pathological breathing, brady or tachyarrhythmias.

Symptoms of stage III meningitis

Stage III – phase of brain herniation. With temporotentorial herniation, dislocation of the trunk is manifested by a progressive loss of consciousness, dysfunction of the third pair of cranial nerves (the presence of ptosis, anisocoria, strabismus), and the presence of hemiplegia. Transtentorial herniation is manifested by a deep disturbance of consciousness to the level of stupor, the presence of dilated pupils, “floating eyeballs,” and dyspnea. Dislocation at the level of the midbrain is characterized by symptoms of decerebrate rigidity, absence of photoreaction, absence of corneal reflexes, narrow pupils, disturbance of the rhythm and depth of breathing.

Terminal dislocation with symptoms of meningitis is determined by compression of the medulla oblongata by the cerebellar tonsils into the foramen magnum, characterized by areflexia, muscle atony, apnea, sharp dilation of the pupils, and absence of corneal reflexes.

Types of meningitis and their manifestations

Clinical meningitis can be systematized:

by type of development:

hyperacute or fulminant meningitis,
spicy,
subacute,
chronic meningitis,
recurrent

lungs,
moderate severity,
severe meningitis,
extremely severe forms

localizations:

basal meningitis,
convexital, etc.

Depending on the nature of the changes in the cerebrospinal fluid, purulent (in most cases bacterial) and serous (usually viral) meningitis are distinguished. The etiological classification provides for the identification of bacterial, viral, chlamydial, fungal, protozoal and other meningitis.

Features of treatment of meningitis

Treatment includes antibacterial therapy (cephalosporins, Erythromycin, Oleandomycin, Levomycetin succinate), detoxification measures and correction of water and electrolyte balance (Reopoliglyukin, Gemodez, Kvartasol), maintenance and correction of vital functions (with arterial hypertension- Clonidine, Gemiton, Arifon, Anaprilin, for respiratory failure - mechanical ventilation for the treatment of meningitis, for cardiovascular failure - Korglukon, Noradrenaline, for DIC syndrome - anticoagulants, for acidosis - Sodium Bicarbonate), drugs that relieve psychomotor agitation and convulsions ( Seduxen, Sonapax, sodium hydroxybutyrate), correcting microcirculation and metabolism nerve tissue for the treatment of meningitis (Nootropil, Piracetam, Encephabol, Phenibut), vasodilators for the treatment of meningitis (Xanthinol nicotinate, Trental, Nikoverin, Troxevasin, Actovegin, Cavinton, Redergin), antihypoxants for the treatment of meningitis (vitamins C, E and A), as well as means for correcting disorders of liquorodynamics for the treatment of meningitis (Lasix, Mannitol, Glycerin).

Pathogenetic and symptomatic treatment meningococcal infection

Detoxification treatment of meningitis (administration of plasma, Albumin, polyionic solutions), forced diuresis. Monitoring of diuresis is necessary.

Short course glucocorticoids for 1–2 days. Great value is given to the use of Dexamethasone, especially in case of damage auditory nerve. This drug in the treatment of meningitis, it can prevent severe hearing loss due to bacterial meningitis.

Anticonvulsant treatment meningitis (Phenobarbital, Diazepam. It is better not to administer GHB due to depression of the respiratory center and the possibility of respiratory arrest).

Prescription of antihistamines in the treatment of meningitis.

Prescription of vitamin therapy.

Dehydration therapy for meningitis

Dehydration treatment of meningitis includes the prescription of osmodiuretics, saluretics, oncodehydrants, and glycerin.

Mannitol is an emergency dehydration drug for the treatment of meningitis, an osmodiuretic. However, plasma osmolarity should be monitored when treating meningitis. When plasma osmolarity is above 290 mOsm/L, osmodiuretics are not used in the treatment of meningitis, since a rebound phenomenon is possible.

Lasix is the drug of choice for initial treatment of meningitis. Maintaining plasma osmolarity and its electrolyte composition is achieved by administering Mafusol, an isotonic sodium chloride solution, according to indications - hypertonic solutions.

Albumin is an oncodehydrant in the treatment of meningitis. Albumin does not cause rebound phenomenon. Administration of hypertonic solutions is contraindicated due to the risk of increased metabolic acidosis in the brain.

Other treatment options for meningitis

Decongestant therapy includes the administration of corticosteroids. Preference is given to prescribing Dexazone and Hydrocortisone. If cerebral hypotension develops, intravenous drip administration physiological solution, puncture of the ventricles of the brain is possible.

Metabolic and neurovegetative protection of the brain in the treatment of meningitis is aimed at relieving oxidative stress and replenishing energy deficiency in brain and meningeal tissue. For this purpose, Unithiol, vitamins E and C, and B vitamins are prescribed. Cavinton, Trental, Actovegin are prescribed to improve microcirculation.

For effective treatment meningitis requires immunocorrective therapy. Interferon preparations, Interferon inducers (Amiksin, Neovir), immunomodulators (Timogen, T-activin) are used.

Replenishing the body's energy costs and activating restoration processes is a prerequisite for the fight against protein-catabolite disorders. For this purpose, enteral and parenteral nutrition is used in the treatment of meningitis.

Physiotherapy for meningitis

Physical methods of treating patients with meningitis are aimed at:

improvement of cerebral hemodynamics and microcirculation (vasodilator and hypocoagulation methods),

enhancing the metabolism of nervous tissue (enzyme-stimulating methods),

correction of cerebral liquor fluid imbalance (diuretic and ion-correcting methods),

restoration of nervous system functions (tonic and sedative methods)

and correction of immune dysfunction (immunomodulatory methods).

Treatment of meningitis with antibiotics

If the pathogen is sensitive to well-penetrating cerebrospinal fluid antibiotics, the cerebrospinal fluid becomes sterile within 24 hours after the start of treatment for meningitis. This happens with bacterial meningitis caused by streptococci, N. meningitidis, H. influenzae.

If the treatment of meningitis is sufficiently effective, the protein content in the cerebrospinal fluid may still remain high, and the glucose level may remain low for two or more weeks. Other microorganisms, especially gram-negative bacilli, can be cultured from the cerebrospinal fluid for a longer period of time (up to 72 hours of treatment for meningitis).

If the pathogen is isolated longer, the antibiotic is replaced or administered endolumbarally. If meningitis is resistant to treatment, hidden parameningeal lesions are possible, which can cause long-term, persistent infection of the cerebrospinal fluid.

Stages of antibiotic therapy for meningitis

The choice of antibiotics for the treatment of meningitis depends on the etiology of the process and the permeability of the blood-brain barrier. Bacteriological methods make it possible to determine the pathogen within 48–72 hours from the moment the material is taken; the sensitivity of the pathogen culture to antibiotics is determined after another 24–36 hours.

Antibiotic therapy is carried out in 2 stages:

treatment of meningitis until the etiology is established;

treatment of meningitis after establishing the etiology.

Types of Antibiotics to Treat Meningitis

Antibacterial drugs that penetrate well through the blood-brain barrier (in the presence of inflammation): penicillins (Benzylpenicillin, Amoxicillin, Ampicillin), cephalosporins III generation, Cefuroxime, aminoglycosides for the treatment of meningitis (Kanamycin, Amikacin); fluoroquinolone drugs (Ciprofloxacin, Ofloxacin), glycopeptides for the treatment of meningitis (Vancomycin), monobactams for the treatment of meningitis (Aztreonam); carbapenems (Meropenem), Chloramphenicol, Rifampicin, Flucanazole, Ethambutol, Isoniazid.

Antibacterial drugs for the treatment of meningitis that poorly penetrate the blood-brain barrier: Streptomycin, Gentamicin, Azlocillin, Macrolides, Ketonazole, Lomefloxacin, Norfloxacin.

Antibacterial drugs for the treatment of meningitis that do not penetrate the blood-brain barrier at all: Clindamycin, Lincomycin, Amphotericin B.

In the presence of coccal flora, listeriosis, it is prescribed for the treatment of meningitis. penicillin series, cephalosporins, Chloramphenicol. Combinations of Ampicillin with Chloramphenicol and Amikacin are favorable for the treatment of meningitis.

The criterion for discontinuing antibiotics in the treatment of meningitis is:

persistent normal temperature bodies,

disappearance of meningeal syndrome,

sanitation of cerebrospinal fluid.

Treatment of complicated forms of meningitis with antibiotics

In the presence of immunodeficiency conditions, the following are recommended for the treatment of meningitis: third generation cephalosporins in combination with Ampicillin, or a combination of Ampicillin with Amikacin, or Meropenem or Vancomycin.

In the presence of angiogenic sepsis, combinations of Rifampicin with Gentamicin, third-generation cephalosporins with Amikacin or Meropenem, and Vancomycin with Amikacin are recommended for the treatment of meningitis.

In the presence of septic endocarditis, Ampicillin with Gentamicin, Vancomycin with Amikacin, third generation cephalosporins with Amikacin and Rifampicin are recommended for the treatment of meningitis.

For otogenic meningitis, third generation cephalosporins in combination with Vancomycin, Meropenem, Oxacillin with Tobramycin are recommended for treatment. In HIV-infected patients, combinations of third-generation cephalosporins with Vancomycin, Ampicillin with Gentamicin and Oxacillin are used.

In case of brain abscess, for the treatment of meningitis, combinations of third-generation cephalosporins with Vancomycin and Metronidazole, third-generation cephalosporins with fluoroquinolones and Metronidazole, Meropenem, Meropenem with Amikacin are recommended.

When the list of available antibacterial drugs is limited, combinations of Penicillin with Amikacin or Gentamicin are recommended as initial treatment for meningitis in adults.

In case of sepsis - Ampicillin with Oxacillin and Gentamicin. Most researchers recommend the use of third generation cephalosporins, Meropenem, as a starting antibacterial therapy.

If the etiology of meningococcal meningitis is established, then the administration of anti-meningococcal Y-globulin or anti-meningococcal plasma is recommended for the treatment of meningitis.

In the presence of staphylococcal etiology, anti-staphylococcal plasma and U-globulin are recommended for the treatment of meningitis.

Ways of infection with meningitis

Pathways for infectious agents of meningitis to enter the nervous system:

hematogenous [accumulation of bacteria (viruses) in neurons, infection of capillary endothelial cells and astrocytes and breakthrough of the blood-brain barrier],

lymphogenous (accompanied mainly by segmental disorders),

neural (by sequential destruction of lemmocytes or the use of retrograde axonal transport),

less often - in the presence of an entrance gate (recurrent meningitis and nasal liquorrhea).

After the infectious agent penetrates the subarachnoid space, meningitis agents are carried along with the cerebrospinal fluid and come into contact with cells sensitive to it. Within the nervous system, the pathogen can spread from cell to cell, through intercellular spaces, along axons, dendrites, or carried by leukocytes.

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 fatal, especially if it is caused by 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, insufficient ventilation in rooms with a large number 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 others 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, 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 spinal cord or brain correspond 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 trigeminal nerve area, the middle of the eyebrows or under the eye;
Kernig's sign (due to tension in the posterior thigh muscles, leg in knee joint does not unbend);
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;
Disruption of normal mental development children;
Purulent arthritis;
Blood clotting disorder;
Lethal outcome.

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 normal work other organs and systems, detoxification therapy is used.

To remove toxins from the body, use: “Atoxil”, “Enterosgel”.

For the same purposes it is assigned drinking plenty of fluids, especially with vitamin C - rosehip decoction, tea with raspberries and fruit juice.

3.5. Symptomatic treatment

At allergic reaction are appointed antihistamines: « », « ».

At high temperature, above 39°C anti-inflammatory drugs: “Diclofenac”, “Nurofen”, “”.

At increased irritability, for 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 a complete cure for 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 use 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 one 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 acute phase 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;

- Don't let things happen various diseases, especially infectious nature so that they do not become chronic;