Nervous System Infections

Meningitis does not spare either adults or children: symptoms, causes and treatment

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meningitis in the child Meningitis is an inflammatory disease of the membranes of the brain and / or spinal cord. It should not be confused with the inflammation of the brain( encephalitis), in which the brain substance itself is involved in the process.

A distinctive feature of meningitis is the presence of so-called "meningeal symptoms".

This is a rather formidable condition which, in the absence of proper treatment and unfavorable circumstances, can lead to serious complications, for example deafness, blindness, paralysis, etc.

Contents

  • Causes and predisposing factors
  • How is meningitis transmitted?
  • Meningococcal form
  • disease Pneumococcal meningitis
  • Viruses are not asleep
  • TB meningitis
  • clinical picture
  • diagnosis and therapy
  • Consequences and outlook
  • stop on the outskirts of the brain

causes and predisposing factors

cause of meningitis in almost all cases are the infectious agents. These can be:

  • bacteria, for example: meningococcus, staphylococcus, salmonella, Klebsiella, hemophilic rod, Pseudomonas aeruginosa;
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  • viruses: Coxsackie, polio, ECHO, etc.;
  • mycobacterium tuberculosis;
  • intracellular parasites: toxoplasma, etc.

signs and causes of meningitis

How is meningitis transmitted?

The listed infectious agents can penetrate into the meninges in many ways. Most often they are recorded there with a blood flow( as a consequence of bacteremia or viremia), less often - through the lymphatic network.

One of the frequent routes of infection is direct contact with the infectious focus in diseases of the ENT organs( purulent otitis media, frontalitis, pansinusitis), thrombosis of cerebral vessels, severe head or spinal injuries.

Predisposing factors play a significant role in initiating the development of the disease: climate change, concomitant diseases of the immune system, toxins that damage the walls of the vessels, and poor condition of some internal organs, such as the kidneys, liver or adrenal glands.

The cause of aseptic meningitis( which has arisen without infection) can be metastasis of malignant tumors, connective tissue diseases, neuroleukemia, allergic reactions.

how is the infection transmitted

Depending on the affected shell, meningitis is divided into:

  1. Pakhi meningitis - in which the dura mater is damaged
  2. Lepto meningitis is an inflammation of the arachnoid and mild membranes. In clinical practice, meningitis usually means leptomeningitis. Here, arachnoiditis is recognized, an inflammation of the arachnoid membrane.
  3. Pan meningitis - involvement in the process of all meninges.

The nature of the change in the cerebrospinal fluid makes it possible to distinguish two main types of meningitis: serous and purulent. When serous in the cerebrospinal fluid( spinal fluid), a large number of lymphocytes is found, the liquid itself is transparent, opalescent, and there is little protein in it.

With purulent neutrophils and protein predominate, which causes the cerebrospinal fluid to become turbid, with a yellowish tinge. Usually the cause of purulent meningitis is bacteria, and serous viruses, tubercle bacillus.

The course of meningitis varies quite strongly depending on which causative agent this condition was caused to. Below are the main views.

Meningococcal disease

Meningococcal meningitis Meningococcal meningitis is the most common form. The source of meningococcus can be only another person, the route of transmission is airborne.

In most cases, when ingested, meningococcus does not lead to any noticeable manifestations. In some people, it can cause nasopharyngitis, less often - actually meningitis and very rarely - meningococcemia( generalized form).

Characteristic manifestations for this type of meningitis are: rapid development of the disease, chills, sharp headaches, fever up to 40 degrees, hyperesthesia( hypersensitivity to noise, bright light and other irritants), skin rash, lips, meningic symptoms.

Pneumococcal meningitis

Usually pneumococcus affects children of an early age. Getting into the meninges from already existing infectious foci( pneumonia, sinusitis, etc.), it causes a severe form of meningitis, accompanied by fever, seizures, paresis and paralysis, loss of consciousness, pallor, dyspnea, etc.

Viruses do not snooze

Viral meningitis in most cases is caused by viruses of the family of picornaviruses( Coxsackie viruses and ECHO).The source of the virus can act as a patient, and a virus carrier, which has no manifestations of meningitis.

To another person the virus gets fecal-oral or airborne, and the ability to transmit from one person to another in these viruses is very high.

After the virus enters the incubation stage( from 2 to 12 days), after which the body temperature rises, frequent vomiting, headache occurs. There may be reddening of the mucous membranes, face. On the second-third day, meningic symptoms develop. Viral meningitis, as a rule, proceeds relatively easily, but there may be relapses.

meningeal symptom complex

Tuberculous meningitis

Tuberculous meningitis is always a secondary form of tuberculosis( that is, initially there was a focus of the tuberculosis process in the body from which the "Koch's stick" got into the brain's shell).

It usually lasts a long and hard time. Somewhat more often develops in children. Unlike the above forms, the tuberculosis process develops not acutely, but within two to three weeks, during which there is lethargy, high fever, asthenic syndrome, headaches.

In the absence of treatment, signs of meningitis appear: vomiting, meningic symptoms, irritability, photophobia.

The clinical picture of

The course of meningitis, as noted above, may differ depending on its cause, but there are also persistent symptoms common to all types of diseases that are noted in both adult patients and children. These include:

  1. Brain symptoms .The most characteristic symptom is a sharp, bursting headache. Then there is nausea, repeated vomiting, from which it does not get any easier, cramps, impaired consciousness up to the coma.
  2. The presence of of the meningic symptoms of should be determined by the physician. The most noticeable of them are: stiff neck( when the chin is brought to the patient's chest, the examiner experiences resistance to the neck muscles), the upper, middle and lower symptoms of Brudzinsky, the Kernig symptom and others.
  3. Intoxication of .Intoxication with bacterial toxins and products of inflammation leads to muscle pain, increased heart rate and respiratory depression, severe weakness and fatigue.

General cerebral symptoms of meningitis

In children under one year of age, meningitis is manifested by anxiety, unceasing monotonous crying;with the progression of the disease there are convulsions, regurgitation, meningeal symptoms develop to the second or third day.

A characteristic meningic symptom for children of this age is the "suspension symptom".Checking his doctor takes the child under the armpits and lifts, paying attention to his legs. A healthy child will move them, as if seeking support, and with inflammation of the meninges the legs will bend to the stomach.

Also for children is characterized by sickness accompanied by drowsiness, arrhythmias, weight loss, bulging of a large fontanel.

Diagnosis and therapy

lumbar puncture Due to the characteristic manifestations, the inflammatory process in the meninges can be suspected already at the stage of physical examination. It will be indicated by the three groups of symptoms described above.

For confirmation of the diagnosis, all patients have to undergo a lumbar puncture to examine the cerebrospinal fluid, as in all cases there will be changes.

Virological, bacteriological and other methods for determining infectious agents are carried out.

Treatment of meningitis in all cases should be comprehensive. Therapy includes the fight against an infectious agent, pathogenetic treatment and the elimination of symptoms.

The fight against infection( etiotropic therapy) implies the fastest possible start of antibacterial or antiviral drugs. Antibiotic therapy begins with broad-spectrum antibiotics, until a specific pathogen is identified, after which the antibiotic is selected based on its effectiveness against this pathogen.

If meningitis is purulent, in almost all cases it is meningococcal, staphylococcal or pneumococcal, and these Penicillin pathogens are succumbing to penicillin antibiotics. The correct solution will be to start with an intramuscular injection of Penicillin in an amount of 260-300 thousand units of action per kg of body weight per day.

Among other drugs suitable for starting etiotropic therapy, you can name cephalosporins 3-4 generations, carbapenems, beta-lactams and others.

Pathogenetic treatment means detoxification, infusion therapy, the administration of diuretics and steroidal anti-inflammatory drugs. Diuretics( diuretics), such as Furosemide, Mannitol are necessary for removing toxins from the blood, and the steroids of Carbamazepine help to slow down the development of the inflammatory process.

Symptomatic therapy is reduced to taking antiemetics( Metoclopramide, Promethazine), fighting with convulsive syndrome( Carbamazepine and others).

This part of the treatment is certainly very important: vomiting in a person in serious condition can cause aspiration pneumonia and dehydration;cramps should also be kept under control whenever possible.

Consequences and prognosis of

headache In most cases, the prognosis in patients with meningitis is favorable. Only those situations where the treatment was started untimely or the patient has severe accompanying pathologies can present a danger. However, with severe bacterial( purulent) forms, a fatal outcome may follow.

Consequences of meningitis develop when the inflammation has passed from the brain envelopes to its substance. Then, for a long time, visual impairment, convulsions may persist, children may have a mental retardation.

But much more often there is a complete recovery and no consequences remain.

Stopping on the approach to the brain

Prevention of the disease is as follows:

  1. If a person has had contact with a patient with meningitis, should carefully monitor their health for the next two weeks. All manifestations of infection should be cautious: fever, headaches, rash, cramps, increased anxiety and crying in children, impaired consciousness.
  2. To prevent infection from other foci of , inflammatory diseases of should be treated in a timely manner in other organs. Especially often meningitis is complicated by ENT diseases.
  3. Vaccination( inoculation) of from of meningococcal infection .It is not in the standard plan of vaccinations and it is made only to those who are in the zone of increased danger of infection with meningococcus.
  4. Compliance with hygiene regulations .Fulfilling this requirement, we significantly reduce the possibility of entry into our body of pathogenic microorganisms.
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