Meningitis - an inflammation of the membranes of the brain, is caused by bacterial, viral or fungal infection.
The causative agents of meningitis - ECHO viruses, Coxsackie viruses types A and B virus mumps, Epstein - Barr virus, Togaviridae, Bunya viruses arenaviruses, type 2 herpes virus, cytomegalovirus, adenoviruses (Typically 2, 6, 7, 12 and 32 serovars) streptococci Escherichia coli (E. coli), listeria; Haemophilus influenzae, gonococcus.
The disease is widespread.
In most cases, the pathogens are transmitted by airborne droplets (with saliva, coughing, sneezing) possible transmission path through the blood, insect bites; Listeria can infect the fetus in utero, or as it passes through the birth canal.
The incubation period for meningitis depends on the pathogen.
manifestations of meningitis
Onset of the disease possible with rhinitis, inflammation of the throat with a high body temperature (to 38 ° C). Penetration into the bloodstream pathogens attack accompanied by chills, headache and fever.
Meningitis develops acutely, with chills, fever, headache, nausea, vomiting.
In infants - and bulging fontanelle tension. Perhaps the appearance of a rash on the legs, torso and face. Edema and brain swelling may coma, convulsions, dyspnea. In severe depression replaced psychomotor agitation and delirium.
Diagnostics
- lumbar puncture
- bacteriological examination
- cranial tomography
- X-ray of the skull bones.
meningitis treatment at different ages
Patients hospitalization.
If you suspect meningitis lumbar puncture is required to carry out under the cover of antibacterial therapy (to identify the pathogen and defining its sensitivity wide Antibiotics spectrum).
In bacterial meningitis
- Antibiotics - treatment is initiated immediately after collection of material for bacteriological examination and determination of the sensitivity of microflora.
- Children up to 4 weeks. - a combination of ampicillin 300-400 mg / kg / day. and 3rd generation cephalosporins (cefotaxime 200 mg / kg / day. every 4-6 hours. ceftriaxone or 100 mg / kg / day. every 12-24 hours.) or ampicillin and aminoglycoside (tobramycin 7.5 mg / kg / day.. Every 6-8 hours, and preterm to 7 days - 2.5 mg / kg / day. every 12 hr.). The course of treatment - 2-3 weeks.
- Children from 4 to 12 weeks. - a combination of ampicillin and 3rd generation cephalosporin in the above doses. The course of treatment - 10 days.
- From 3 months. up to 18 - 3rd generation cephalosporin combination or ampicillin and chloramphenicol 75-100 mg / kg / day. The course of treatment - 10 days.
- From 18 to 50 years - a combination of penicillin from 1-8 up to 24 million units / day. every 4-6 hours. ampicillin or 12-18 g / day. every 4- 6 hours. cefotaxime and 12 g / day. every 4-6 hours. ceftriaxone or 4 g / day. every 12 hours. The course of treatment - 10 days.
- Older than 50 years old - a combination of ampicillin and 3rd generation cephalosporins (cefotaxime to 2 grams every 4 hours or ceftriaxone 2 g / d.). The course of treatment - 2-3 weeks.
In viral meningitis
- Vomiting - antiemetics such as promethazine 25 mg / m 3-4 hours.
- After the relief of nausea and vomiting, headache remover - inside analgesics, e.g., tablets containing paracetamol and codeine, for 1- 2 tablets every 3-4 hours. (Adults).
- At high body temperature - paracetamol: 650 mg for an adult orally or in suppositories every 4 h, 60 mg of children per year of life or 10-15 mg / kg..