Meningitis

February 2, 2012

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Meningitis   - Is an inflammatory process that occurs in the membranes of the brain and spinal cord. In this case distinguish pachymeningitis   (inflammation of the dura) and meningitis   (inflammation of the soft and arachnoid meninges).

According to experts, more often diagnosed cases of inflammation of the meninges, which are referred to by the term "meningitis." The agents of this disease are a variety of pathogenic microorganisms such as: viruses, protozoa, bacteria. The most common meningitis ill children and adolescents, and the elderly. Hydromeningitis   most commonly affects children of school age. Viral meningitis   It has milder symptoms and course than bacterial meningitis.

Types of Meningitis

According to the nature of inflammation in the membranes, as well as changes in the cerebrospinal fluid of meningitis are divided into two types: hydromeningitis   and purulent meningitis . Thus predominance in the cerebrospinal fluid lymphocytes   characteristic of serous meningitis, and having more neutrophil   - For purulent meningitis.

Also meningitis divided into primary   and secondary . Meningitis occurs without the presence of the primary in the patient of infectious diseases, and appears as a secondary complications such as common infections, and infectious disease target organ.

If track incidence of inflammation in the meninges, the disease is meningitis divided into generalized and limited nature. So,   basal meningitis   It occurs on the base of the brain, convexital meningitis   - On the surface of the cerebral hemispheres.

Depending on the speed of the start and the further progression of the disease meningitis is divided into lightning . sharp   ( sluggish ) subacute . chronic .

According to the etiology distinguish viral meningitis . bacterial . fungal . protozoal meningitis .

The clinical picture of meningitis

Diseases that have moved into a chronic form ( sarcomatosis . sarcoidosis . syphilis . toxoplasmosis . leptospirosis . megakaryoblastoma . brucellosis   et al.), can serve as a kind of impetus to the development of meningitis.

Infection of the meninges may occur hematogenous, perineural, lymphogenous, chrezplatsentarnym ways .  But basically the transmission of meningitis carried by airborne droplets or by contact .  When the contact mode of infection pathogens can reach the lining of the brain due to the presence of purulent infection of the middle ear, sinus, presence of abnormalities of the teeth, etc. .  As a gateway for infection with meningitis appears nasal mucosa, bronchi, gastrointestinal tract .  Getting such a way into the body, the pathogen spreads through the lymphatic or hematogenous to the lining of the brain .  Clinical manifestations of meningitis are accompanied by the presence of edema and inflammation in the meninges and adjacent brain tissue, microcirculatory disorders in the cerebral vessels .  Because of too much cerebrospinal fluid secretion and its slow resorption may disrupt the normal level intracranial pressure   and brain edema occur.

The manifestation of pathological changes in purulent meningitis, which is acute, the pathogen is independent. After pathogen penetrates through the lining of the brain by the blood or lymph, inflammation affects all the subarachnoid space of the brain and spinal cord. If a zone has a clear localization of infection, the purulent inflammation may be limited.

When infection occurs swelling of the membranes and substance of the brain. Sometimes there is a flattening of the convolutions of the brain due to the presence of internal Hydrocephalus . Patients with serous viral meningitis observed swelling of the brain membranes and substances, while expanding liquor spaces.

Symptoms of meningitis

Regardless of what the etiology of the disease, the symptoms of meningitis generally similar in different forms of the disease.

So, the symptoms of meningitis lain obscheinfektsionnymi signs: the patient a feeling of chills, fever, fever, signs of inflammation in the peripheral blood (increase ESR , Choose leukocytosis ). In some cases, may cause skin rash. In the early stages of meningitis in a patient may experience slow heart rate. Not in the development of this feature is replaced by meningitis tachycardia . The man is disturbed and becomes more frequent breathing rhythm.

As a meningeal syndrome manifested nausea and vomiting, headache , Fear of light, hypersensitivity of the skin, the presence of the rigidity of the neck muscles, and other signs .  In this case, the first symptoms of meningitis appear headache that as the disease becomes more intense .  The manifestation of headache triggers stimulation of pain receptors in the meninges and blood vessels due to the development of inflammation, exposure to toxins and increase intracranial pressure .  The nature of pain - bursting, the pain can be very intense .  This pain may be localized in the forehead and in the occipital region, giving the neck and spine, sometimes even affecting the limb .  Even in the very beginning of the disease in the patient may appear nausea and vomiting, wherein the food these phenomena not related .  Meningitis in children, and in rarer cases in adults can appear seizures, presence of delirium, agitation .  But in the process of further developing the disease these phenomena are replaced by the general stupor and sleepiness . In the later stages of the disease, these phenomena sometimes go into a coma.

Because irritation of the meninges observed reflex muscle tension. In most cases the patient is present Kernig   and a stiff neck. If the patient's disease occurs in the severe form, the manifest other symptoms of meningitis. Thus, the patient's head tilts backward, pulls the stomach, straining the anterior abdominal wall. In the supine leg will be drawn to the stomach (called meningeal pose). In some cases, the patient manifested zygomatic symptom spondylitis , Great soreness of the eyeballs, which appears after pressing either by eye movements. The patient does not react to loud noise, loud noises, strong odors. The best thing in this state a person feels, lying in a dark room without moving and with closed eyes.

Meningitis in infants manifests stress and bulging fontanelle, as well as symptoms of "hanging" Lesage.

When meningitis are possible manifestations of venous congestion, edema of the optic nerve. If the disease is difficult, the signs of meningitis may be dilated pupils, diplopia, strabismus . Man is hard to swallow, may cause paresis and paralysis of limbs, poor coordination, and the presence of tremor. These symptoms point to the defeat of meningitis and shells, and the substance of the brain. This is possible at the final stage of the disease.

Bacterial meningitis usually begins acutely, while there are pronounced meningeal symptoms. Slower growth is characteristic only tuberculous meningitis . In most cases, bacterial meningitis sugar level is lowered, and the protein level is - increased.

Older people for meningitis may be atypical. So, may be absent or show little headaches, but there is trembling of the hands, feet, head. There drowsiness, apathy .

Diagnosis of meningitis

Usually, the diagnosis of "meningitis" set, guided by the presence of three symptoms of meningitis:

- Presence obscheinfektsionnogo syndrome;
- The presence of the shell (meningeal) syndrome;
- Inflammatory changes in the cerebrospinal fluid.

Thus it is impossible to diagnose meningitis, guided by the presence of only one of these syndromes. For the correct diagnosis of a number of important results of virological, bacteriological methods. Diagnosis of meningitis is also carried out by visual examination of cerebrospinal fluid. This specialist necessarily take into account the overall epidemiological situation, and clinical features.

Patients in whom there are signs of meningeal irritation, lumbar puncture should be performed. During this procedure, the cerebrospinal fluid for further studies taken using a fine needle, which is introduced at the bottom of the back. Determined by the current state CSF It determined by the large number of cells ( pleocytosis ), As well as the extent to change their composition. Used and special tests that can determine the difference between bacterial and viral meningitis.

Complications of meningitis

Because bacterial meningitis in human brain damage may occur. Thus, the most severe complications of the disease are epilepsy , Deafness, mental retardation in children with meningitis. If you do not start a proper and timely treatment for meningitis, the disease can cause death. In severe cases, death occurs within a few hours.

Treatment of meningitis

In the treatment of meningitis it is very important, first of all, to determine exactly what the pathogen trigger the development of disease. However, the disease should be treated only in a hospital. Viral meningitis usually occurs relatively easily, so it is strongly recommended that the patient drink plenty of fluids to prevent dehydration. For the treatment of meningitis used analgesics, antipyretics. Basically people recover in about two weeks.

In bacterial meningitis, particularly when it provoked meningococcus , Treatment should be administered and produce very urgently. If the patient diagnosed with bacterial meningitis, it is mainly used for the treatment of a wide profile antibiotics. The most commonly used drug for this form of the disease is penicillin . According to the researchers, this tool can destroy about 90% of causes of meningitis. Also, immediate treatment with penicillin is prescribed to patients with a diagnosis of purulent meningitis.

Also for the treatment of meningitis in children and adults used drugs that can reduce intracranial pressure means with antipyretic effect. Often in the treatment appointed as nootropics, antioxidants , Drugs that stimulate activity of the cerebral blood flow.

It is important to note that if the adults who recovered from meningitis do not always need constant supervision by future physicians, the meningitis in children - a reason to see your doctor regularly and after complete cure.

Patients staying at the stage of recovery, it is important to avoid heavy loads both physical and emotional, is not to be too long in direct sunlight, drink plenty of fluids and try to eat as little salt. Alcohol should be deleted altogether.

Prevention of meningitis

To date, vaccination has been used successfully against some causes of meningitis (pneumococcal vaccine, Haemophilus influenzae). It is important to bear in mind that vaccination gives a fairly significant effect in protecting against meningitis, however, does not guarantee one hundred percent infection warning. However, even he contracted the disease, a person who has been vaccinated, have been ill with meningitis in a much milder form. After inoculation vaccine   valid for three years.

It is also important as a method of prevention of meningitis adhere to the basic rules of everyday hygiene. It is important to pay special attention to regular hand-washing, personal items (lipstick, dishes, toothbrush, etc.) Are not to be used to give to other people. In the case of close contact with a patient with meningitis, it is important to immediately contact a doctor. The specialist may prescribe a particular drug for prevention.