November 20, 2012
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The incidence of meningococcal disease
The causative agent of the disease - Gram-negative diplococcus Neisseria meningitidis Which exhibits a high sensitivity to external factors. Beyond the human body it dies within 30 minutes. To date, scientists have isolated 13 serotypes of the pathogen.
Generally, meningococcal infection in civilized countries is rare: only 100 thousand of the population is fixed from 1 to 3 cases. This is most commonly diagnosed meningococcal infection in children (about 80% of the total number of cases of disease). The most common symptoms of the disease are recorded in children under three years of age. Particularly susceptible to the pathogen children under the age of one year. That is why prevention is so important disease. And at the slightest suspicion of its development is necessary to prompt access to a doctor to timely diagnosis and adequate treatment were made on time.
Increasing the number of cases, which characterizes the so-called epidemiological ups, fixed in the world every 10-20 years. Despite the fact that the disease affects people throughout the year, there is a certain tendency to the seasonality of the disease.
To catch the disease may be a carrier of bacteria from a sick person. Because the disease is transmitted by airborne droplets, a special danger to others are sick, who are marked catarrhal symptoms . Children can become infected in children's groups in close contact as possible from external contamination and human health.
The most common fatal disease in the development of fixed the first year of life. The fact that the children in this age group, usually develops hyperacute meningococcal sepsis , The consequence of which is toxic shock . Sometimes the infection is also provokes severe purulent meningitis Which is complicated by cerebral edema.
Symptoms of meningococcal infection
To meningococcemia characterized by abrupt onset: a jump in body temperature, which rises 38-39 ° C, severe pain in the joints and mice, chills, vomiting, and headaches. A typical symptom of this condition - purpura . As a rule, it appears in the first day of sickness or at the beginning of the second day.
At the most severe forms of the disease such a rash develops in a person just in the first hours after the onset of illness. Experts consider this a sign of the adverse terms of prognosis of the disease. The rash initially appears in small patches of light pink color on the legs and torso of man. Sometimes mistaken for a rash accept manifestations allergies . Later on the spot spots develop hemorrhage, which have irregular contours and forming a pale skin, similar to the mark of a starry sky. Such mimics rash mostly bottom and side areas of the trunk of the patient, it also appears on the thighs. A little later, the rash becomes darker in the center of hemorrhagic form necrosis . Gradually, the rash elements become larger, merge and affect large areas of the body. In this case it is advantageously extremities, fingers and toes. Sometimes necrosis progressed, resulting in becoming dry gangrene nose, ears, phalanges. If a rash appears on the eyelids, face, ears, similar to the forecast unfavorable. Under this condition the patient may manifest bleeding in the lining of the eye. If the disease is difficult, it is possible bleeding - Uterine, nasal, kidney, gastrointestinal.
In the process of the deterioration of a person can develop varying degrees of infectious-toxic shock.
With purulent meningitis once symptoms appear severe. The body temperature of the patient reaches 39-40 ° C, sometimes higher. Basically, the patient complains of very severe headache, which spreads to the forehead and neck. The pain increases sharply, it becomes quite unbearable. Man suffers from bouts of vomiting, nausea while he does not feel. If the patient is taking drugs, analgesics, they allow only a very small effect for a short time. In this state, the patient manifested hyperacusis, hypersensitivity, photophobia.
If purulent meningitis seen in a young child, it is, as opposed to staying in other disease states, does not want to hand to my mother, but remains in bed, taking the stood pose as headache becomes stronger with any movement. The most comfortable position in this state on its side, with the knees brought to the stomach and his head thrown back.
In an infant with purulent meningitis tense fontanelle, although very frequent vomiting it can sink in. In the first hours after the onset of the child is excited, he later becomes inhibited and sluggish. The kid may lose consciousness, suffer from periodic seizures manifested.
With the development of generalized forms of meningococcal infection sometimes accompanied by a manifestation of the main symptoms of the development of signs Arthritis and polyarthritis . Joints are generally affects one side of the body. Mainly occurs defeat of small joints, less likely to suffer major.
Less Meningococcal disease is manifested in the form of endocarditis . panoftalmita . iridocyclitis . pericarditis . pneumonia .
Complications
As complications of the disease can manifest loss of hearing nerve, which then becomes a cause hearing loss . In infants toddlers often manifest complications that are bacterial in nature. It hydrocephalus . ventriculitis . subarachnoid empyema . paresis . encephalopyosis . paralysis . If meningococcemia necrosis do not heal too long may their secondary infection.
Diagnostics
Due to lightning the disease, as well as too much risk of death is very important as soon as possible to diagnose the disease and to begin its treatment. The latter is particularly important in the case of a sick child.
Already at the stage of primary care doctors can identify the symptoms and promptly send the patient to the hospital.
Please note that for the diagnosis of meningococcal disease in the child's doctor has very little time. If in the early hours of the disease specific symptoms did not even show up already after 24 hours of the disease threatens the patient's life.
Suspicion of this disease in general practice can occur if a child marked the so-called reference signs: acute onset of the disease, fever , Purpura.
If there are suspicions, the patient should promptly conduct specific laboratory tests. In this case carried out as bacteriological and serology. Bacteriological analysis uses the cerebrospinal fluid, mucus from the nose and throat of the patient, blood.
To diagnose meningitis, lumbar puncture is performed.
When meningococcemia is important to differentiate between a rash from an allergic reaction. If meningococcal disease is variable rash disappears in a short period of time. Prodromal rash resembles a rash while also Measles . However, German measles rash occurs only after 4-5 days after the patient marks the beginning of catarrhal period.
With infectious mononucleosis rash also reminds measles . But before the onset of the disease in a patient observed symptoms sore throat , It has increased lymph nodes. Rash at scarlet fever It has clear differences with a rash when meningococcemia, but in this case manifested hemorrhagic component. The rash of scarlet fever affects the flexor surface of the limbs, mostly it develops in places of natural folds.
With hemorrhagic vasculitis the child has a rash appears on the skin of the buttocks, ankles symmetrically, most often develops after suffering acute respiratory disease .
Treatment
Initially, the patient is required to provide assistance to the doctor, who diagnosed meningococcal infection, or has suspicions news on its development. The patient was administered intravenously once chloramphenicol succinate and prednisolone . If the patient has symptoms of infectious-toxic shock, the therapy uses high doses of corticosteroids.
Patients with generalized forms of meningococcal disease is urgently hospitalized in the infectious department of the hospital. If the patient's condition serious, then held his admission to the intensive care unit. In an outpatient setting, you can treat only the localized form of the disease.
When nasopharyngitis, meningokokkonositelstvo also conducted antibacterial therapy.
If a child or an adult diagnosed with purulent meningitis, after first aid infusion therapy is performed using salt and colloidal solutions. Also in the complex treatment used drugs, antipyretics, Furosemide And, if used convulsions diazepam . Also, the doctor prescribes a comprehensive antibiotic therapy, individually selecting dose and species of drugs.
Furthermore, it is important to ensure that the patient abundant and frequent drinking, reception complex vitamins. It is important to introduce the vitamins belonging to the group B, ascorbic acid, kokarboksilazu. During treatment applied as oxygen therapy.
According to the observations of physicians, at hospital discharge, most patients still not entirely healthy, therefore, not all violations are reduced in the disease process functions. Those children who have been diagnosed with purulent meningitis, even after leaving for a few years, should regularly visit a neurologist. Most often, after meningococcal disease occurs in children tserebrastenicheskom syndrome , Which is characterized by a high level of fatigue, appetite and sleep disorders, low academic performance. If the child is small, he can show emotional instability, confusion and even signs of aggressiveness. The child with the syndrome need to provide a lightweight mode of the day, a good rest, limit contact with TV and office equipment, practice longer sleep, daily walks. During the recovery period after illness can be administered nootropics, multivitamin, cardiovascular drugs.
It should be noted that the signs of meningococcal can not in any case be treated at home without a doctor on call. Using traditional methods can only be for the first time to try to facilitate the general human condition. The patient needs complete rest, twilight in the room. The limbs draped wet cloths cold, cold can be applied to the head. It is recommended to drink a lot. If your child has seizures occur, it is possible to visit the doctor to wrap it in a sheet soaked in a solution of salt and vinegar, which dissolve in warm water. The sheet is well wrung out, and the child wrapped up in it for half an hour. On top of his need to wrap up warm with blankets.
Prevention
The main preventive measure to protect against infection, which triggers meningococcus, is a vaccination against the disease. If the child has previously received the vaccine, it ensures that even if the infection had not developed severe consequences. Vaccination is carried out in the event that in the groups of children there is a threat of an outbreak of disease. Immunity after vaccination develops from the fifth to the fourteenth day. Re-vaccination is carried out after 3 years.
Other common measures of prevention is to increase the body's defenses public methods, healthy and active lifestyle, timely treatment of infectious diseases.
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