Meningitis in newborns: causes, danger, symptoms and methods of prevention. Purulent meningitis in newborns

Meningitis in a newborn is a bacterial inflammatory disease. It manifests itself in the brain and carries a lot of negative consequences. The disease is very common among children in the first year of life and 50% of them do not survive. In this article we will look at how to prevent this insidious disease and whether it is possible to cure it.

After birth, 1 in 10 thousand babies is diagnosed with meningitis. This disease has several varieties, depending on which doctors prescribe treatment for the child:

Viral meningitis in children under one year of age is characterized by difficult diagnosis. The absence of symptoms can be life-threatening for the child. Typically, infection occurs due to exposure to the chickenpox virus or rubella measles virus.
Fungal meningitis occurs in children born prematurely or with risk factors for immunodeficiency pathology. A child can acquire this type of disease directly in the maternity hospital if hygiene rules are not followed.
Bacterial meningitis in infants occurs due to the penetration of pneumococcus or meningococcus into the baby's body.
Tuberculous meningitis among newborns has been quite common in recent years. This disease appears with characteristic symptoms: high fever, vomiting, loss of consciousness.

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He left. After some time, my daughter (6 years old) tells me:
- Mom, he is hopeless!

Each type of damage to the nerves of the brain in a child requires adequate treatment, since the lack of treatment is fraught with child death.

Watch a video about the symptoms of meningitis in infants.

Meningitis in a newborn: symptoms and diagnosis at home

Meningitis is an infection of the membranes of the newborn's brain, which creates a high level of inflammation. If the disease is not treated, dangerous consequences arise. You can determine brain dysfunction in a baby by knowing the following indicators:

body temperature rises sharply or drops without reason;
heavy breathing is observed (but not in all sick newborns);
muscle spasms and spasms appear in the cervical region;
facial expression changes, possibly bulging or sunken eyes;
vomiting, regular regurgitation, anxiety and headaches;
the baby’s body acquires a yellow tint, which is associated with the progression of .

Attention! The presence of meningitis in newborns can be determined by the bulging fontanel. Therefore, parents should be attentive, especially if the child was born weakened.

The child may also be bothered by soreness in the muscles of the cervical spine. It hurts him to turn his head, since meningitis often affects the nerve endings of the eyes, neck and face. Based on similar symptoms, the disease can be diagnosed in a newborn without medical help.

Treatment of neonatal meningitis with medication

Children's meningitis is a very dangerous phenomenon. Therefore, its treatment must begin strictly with the collection of tests to determine whether it is indeed bacterial meningitis. To neutralize pathogenic bacteria developing in the cerebrospinal fluid of a newborn's body, injections of antibacterial drugs are prescribed. For each child, the medicine is determined individually depending on age and possible intolerance to its components.

If a newborn periodically loses consciousness, he must be hospitalized, since treatment of the disease at home may be ineffective. In addition, meningitis caused by streptococcus carries a lot of complications, including death. With more favorable prognosis, treatment of headaches after meningitis is required.

Secrets of traditional treatment of meningitis in infants

We draw the attention of parents that it is permissible to treat meningitis in newborns with herbs only as an addition to drug medicine, and not instead of it. The use of traditional medicine recipes must be supervised by a doctor.

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Viral meningitis in a newborn (manifests itself after chickenpox or rubella) is treated with linden decoction. It should be given to the child three times a day, 0.5 cups. Make the tea warm and let the baby drink through a bottle with a nipple.

Bacterial meningitis should be treated with a decoction of dried lavender flowers. The child is given one glass of this drink in the morning before feeding and in the evening before bed, also through a bottle.

Attention! Folk remedies for abscess(meningitis) in infants not only help increase the chance of a successful recovery, but also increase the baby’s immunity.

Causes of purulent childhood meningitis

Purulent meningitis among children is spreading very rapidly. The causes of the disease are:

transmission of Coxsackie viruses by airborne droplets (coughing, sneezing);
by contact (if an infected person touches a newborn);
viral mumps epidemic;
penetration of E. coli into the body;
sepsis causes secondary purulent meningitis in infants.

In older children - from one to six years old - purulent meningitis may occur as a complication after otitis media and sinus diseases. Therefore, doctors recommend protecting your child from colds and contact with strangers until the immune system is stronger.

Today, medicine is not omnipotent in the fight against brain abscess in newborns. In this regard, some children die without coping with the disease.

What is the likelihood of consequences of meningitis? Significant risks

If the symptoms of the disease worsen and become permanent, there is a possibility that the infection has spread throughout the child’s body. Even with proper treatment, there is a risk of complications:

hydrocephalus appears in newborns;
complete or partial deafness develops;
possible development of strabismus;
characterized by delayed mental and physical development.

In more complex situations, the child remains disabled, and the likelihood of poor blood clotting increases.

How to avoid the consequences of meningitis is described in this video.

REFERENCE! Meningitis in infants occurs in 1 child out of 100; children under one year of age are most often affected. Half of the sick die.

The first signs in a baby up to one year old

During the incubation period of meningitis, infants develop symptoms:

headache, bursting pain;
body temperature rises;
the child feels sick and vomits;
the baby is weak, lethargic;
drowsiness;
the skin is unnaturally pale;
body aches;
bright light and loud sounds are poorly tolerated;
constant, high-pitched crying.

When the disease begins to develop, the temperature of the infant rises quickly. In 3-4 hours it rises to 40 degrees. With timely measures taken, the temperature drops on the third day.

Headache in the forehead, eyes, nose. At elevated temperatures, nausea and vomiting begin. The cause of vomiting is that the vomiting center of the brain swells. Vomiting is not associated with food; the child begins to vomit when he is turned over or the headaches intensify.

Symptoms of meningitis in an infant

The child refuses to eat, the respiratory rhythm is changed, and he suffers from convulsions. Consciousness is lost, the fontanel thickens. Fever, poor appetite and vomiting do not indicate that it is meningitis. Such signs are also characteristic of other diseases. An accurate diagnosis is made if there are the following symptoms of meningitis in infants:

The neck muscles become numb.
Buccal symptom.
Muscles are tense.
The baby lies on its side, head thrown back and knees bent to the stomach.

What to do if warning signs of the disease appear?

If a child under one year of age develops symptoms of meningitis, an ambulance is quickly called. Only a doctor knows what measures to take. You cannot act independently.

Why is self-medication dangerous?

Traditional methods of treatment are unacceptable. The disease is acute and passes with lightning speed. The baby’s immune system is not able to cope with the pathology on its own and will not bring a positive effect.

Self-medication with medications is also dangerous. There are medications that are incompatible with other medications. The dosage of the drug depends on the weight of the child; only the pediatrician can determine this accurately. The duration of taking medications is determined by the doctor.

IMPORTANT: Incorrectly chosen medications lead to gastrointestinal disorders. The child feels nauseous, has problems with bowel movements, and has a bloated stomach.

If traditional treatment is not started in a timely manner, the following may occur:

excess fluid accumulates in the brain;
intoxication of the body leads to toxic shock;
the brain swells;
hearing deteriorates.

Causes

The immediate cause of illness in children at any age is infectious agents. Common:

viruses;
fungi;
bacteria;
toxoplasma (protozoa).

At different ages, the development of the disease is influenced by different microbial agents. There is a pattern:

In newborns, the disease develops as a result of an intrauterine infection. It is transmitted to the fetus from the mother. The infection is herpes or toxoplasma.
In infants, meningitis can be a sign of congenital syphilis or HIV (combination with other infectious symptoms).

Risk group:

Important! The main cause of the disease is weak children's immunity.

Conclusion

To prevent complications, a full treatment course is completed. After all signs of meningitis in the infant have disappeared, treatment lasts another 2-3 weeks until complete recovery. Immunomodulators are taken and blood and urine tests are repeated. The risk of relapse is high.

Meningitis is a serious infectious disease characterized by inflammation of the membranes of the brain and spinal cord. It occurs both independently and against the background of other infectious diseases.

No one is immune from meningitis, but data shows that children under 5 years of age, young people aged 16 to 25 years and older people over 55 years of age are at risk. Meningitis is most severe in children and can lead to irreversible consequences, and in some cases, death. The disease affects the brain, so if not treated correctly, the person remains disabled. Most often, newborns suffer from severe consequences; in adults, meningitis is not so acute and is quickly treated.

Depending on the causes of meningitis, it can be bacterial, fungal or viral. The most complex form of the disease is bacterial meningitis. According to the type of inflammatory process, purulent and serous meningitis are distinguished. Serous meningitis is divided into two types: primary and secondary. The primary form of meningitis occurs due to low immunity and infection by various enteroviruses. The secondary form of the disease occurs after an infectious disease: measles, mumps, chickenpox and others.

Tuberculous meningitis is caused by the tuberculosis bacillus. Previously, this disease was not treated and the person died. Modern medicine can cure tuberculous meningitis, but only 15-25% of all cases are fatal. Cryptococcal meningitis is a form of fungal meningitis. The process of inflammation of the brain and spinal cord is caused by the fungus cryptococcus. Encephalitic meningitis - this type of disease begins when an encephalitis infection enters the body. It is transmitted through a tick bite or by drinking raw milk from an infected animal.

Causes of meningitis

The main cause of meningitis is viruses or bacteria that penetrate the soft membranes of the brain and spinal cord. In adults, bacterial meningitis is most often caused by streptococcus and meningococcus bacteria. If they are in the nasal cavity or throat, the disease does not develop, but in case of infection of the blood and cerebrospinal fluid, soft tissues of the brain, they provoke meningitis.

Other types of bacteria are also identified as causes of meningitis. This is group B streptococcus, which often affects newborns infected during or after childbirth. Listeria monocytogenes bacteria can cause meningitis in babies and older adults. After suffering an infectious disease, a person may develop meningitis, since his immunity is weakened and cannot resist bacteria. People with and are especially susceptible to this disease. Various head injuries can cause meningitis.

Ways of transmission of meningitis

A pressing question among patients is whether meningitis is transmitted by airborne droplets, like most infectious diseases. The answer to this question depends on the cause of the disease. So, if meningitis develops as a result of internal processes occurring in the brain, it is not contagious to others and is not transmitted. In the case when the disease is provoked by the penetration of a pathogenic microorganism into the membrane of the brain, meningitis is transmitted by airborne droplets.

It is characteristic that meningitis is transmitted from person to person not only in the traditional way when infected with infectious diseases. In addition to airborne droplets, you can become infected with meningitis through food or any contact with a carrier of the disease. In this case, the ways of contracting a disease such as meningitis are varied: sneezing, coughing, kissing, sharing dishes and household items, staying in the same room for a long time with a sick person.

You can prevent the transmission of meningitis to a healthy person by strictly adhering to the rules of prevention of infectious diseases and personal hygiene. This may include: wearing a medical mask in crowded places during outbreaks of the disease, avoiding prolonged exposure to public places. This also necessarily includes complete cessation of contact with the carrier of the infection for the period of his treatment.

However, if you still become infected with the disease, it is important to know that self-medication will not bring relief, but will only contribute to the development of complications. In order to quickly get rid of the disease meningitis, at the first symptoms of the disease, you need to consult a doctor. With qualified diagnosis and correct treatment, it will recede irrevocably.

Symptoms of meningitis

Symptoms of meningitis develop quickly and are easy to detect immediately. The temperature rises sharply to 40 degrees, pain in muscles and joints occurs, and general weakness and lethargy are observed. Among the characteristic symptoms of meningitis in adults are the formation of a rash, runny nose and sore throat, as with a cold, pneumonia, disorders of the gastrointestinal tract, and disruption of the salivary glands.

One of the most pronounced and common signs of meningitis is a severe headache that spreads throughout the entire area. The pain grows and cannot be tolerated. Then nausea and severe vomiting appear. The patient cannot tolerate sound and light stimuli.

Symptoms of meningitis appear in all patients to varying degrees. As a rule, they experience severe tension in the neck muscles. A person feels severe pain when tilting his head to his chest and straightening his legs at the knees. To relieve symptoms, the patient lies in a certain position. The person lies on his side, throwing his head back strongly, pressing his hands to his chest, and bending his legs at the knees and pressing them to his stomach.

The symptoms of meningitis in children are the same as in adults, but there may be additional signs of the disease. Among them are: diarrhea and regurgitation of food, drowsiness, apathy and weakness, constant crying and loss of appetite, swelling in the fontanel area. Meningitis develops rapidly; at the first signs, you should not hesitate and immediately go to the hospital. The incubation period of the disease ranges from 2 to 10 days. The symptoms of meningitis are very similar to ordinary meningitis. The speed of development of the disease depends on the child’s immunity level: the lower it is, the faster it affects the body.

One day after the first symptoms appear, the person’s condition becomes critical. The patient may become delirious, apathy, drowsiness, and irritability occur. Swelling of the tissues of the meninges begins, which impedes the flow of blood to organs and tissues, as in the case of a stroke. If help is untimely, the person falls into a coma and quickly dies.

Aseptic meningitis

Aseptic meningitis is an inflammation of the membranes of the brain and spinal cord, provoked in the human body, most often by a viral pathogen. This disease can develop in patients of all age categories.

Typically, a disease such as aseptic meningitis is diagnosed and treated fairly quickly. However, for timely diagnosis of the disease, it is necessary to know and understand the causes of the disease and the signs of its manifestation. This is exactly what this article will discuss.

Reasons for the development of the disease

The main cause of aseptic meningitis in the human body is the causative microorganism. In this case, the causative agent of the disease is a virus (enterovirus).

The virus enters the human body through the traditional, airborne or food route through contact with a carrier. Then, penetrating through the tissues of the gastrointestinal tract or upper respiratory tract and palatine tonsils into the blood, enteroviruses spread throughout the body. When the body’s defense reaction is weakened, pathogens transported by the circulatory system penetrate the membranes of the brain or spinal cord and provoke the development of the disease.

As mentioned above, enteroviruses are the cause of the disease in most cases. As for the reasons that, in addition to viral microorganisms, lead to aseptic meningitis, then, according to the nature of their origin, they can be divided into two categories: infectious and non-infectious.

As for non-infectious causes of the disease, these include previous injuries or diseases, as a result of which aseptic meningitis can develop. These include: infectious diseases, inflammatory processes, tumors, concussions and injuries, exposure to chemotherapy.

A feature of the aseptic type of disease is, in particular, that the bacteria and viruses that provoked the disease are extremely difficult to identify using conventional methods. This presents some difficulty, but is not an insurmountable task. Rather, on the contrary, it narrows the range of possible diseases for diagnosis.

Signs of aseptic meningitis

The symptoms of a disease such as aseptic meningitis appear quite clearly and are the first persistent signal that it is necessary to immediately consult a doctor. It is extremely important to remember that such a dangerous and fraught with consequences disease must be treated in the early stages. And for this you need to respond in a timely manner to the signs exhibited by the disease.

First of all, you should pay attention to general health indicators. Typically, they are subject to the following changes:

significant and rapid increase in temperature;
state of fever, chills;
throbbing headache.

More specific symptoms characteristic of other types of meningitis, with the aseptic form, appear rather weakly and develop at a slow pace. But, nevertheless, their presence can be traced.

The main symptom of the development of any form of meningitis is meningeal syndrome. It manifests itself when the patient, who is laid on his back, cannot tilt his head to his chest without bending his knees. Moreover, the bending of the legs occurs uncontrollably.

The danger of this type of disease lies precisely in the fact that specific signs of meningitis appear 4-5 days after the onset of the disease, which can lead to serious consequences. Therefore, in the presence of high temperature, mild meningeal syndrome, headache and fever, you should not wait for further symptomatic confirmation.

Bacterial meningitis

Bacterial meningitis is an infectious disease expressed in inflammation of the tissues of the spinal cord and brain, and provoked in the body by bacteria of the streptococcal group. The prevalence of this disease is quite insignificant, but the disease can easily be transmitted from person to person and cause epidemics among the population.

This type of disease has its own characteristics of occurrence (causes), symptoms and treatment methods that are different from other forms of meningitis. This is exactly what will be discussed in this article.

In addition to the genetic predisposition of some people to develop meningitis, there are also reasons why this disease can affect the body of each patient. These include the health status and age of the patient, as well as external pathogens.

Bacterial meningitis, like any other form of this disease, is provoked in the human body when a pathogenic microorganism penetrates into it. In the case of the form of the disease discussed in this article, the role of such a pathogen is played by harmful bacteria of the streptococcal group.

Bacterial meningitis, like any infectious disease, is transmitted by traditional, airborne or foodborne routes. This usually occurs upon contact with a carrier of the infection through a handshake, kiss, sneezing, or shared utensils and household items, which naturally suggests the need for strict adherence to personal hygiene rules.

The penetration of streptococcus bacteria into the body does not end the process of infection and development of the disease. Moreover, after transmission of infection has occurred, there are two options for the development of events: meningitis and its absence.

The fact is that for the development of the disease, appropriate conditions are needed. In the case of meningitis, this is: weakened immunity and a missed reaction of the body. Only with such additional factors do harmful bacteria that cause the disease penetrate into the blood and are transported to the brain. Therefore, if you have chronic diseases, bad habits, or undergo a course of therapies that negatively affect the immune system, the chance of getting meningitis increases significantly. This also explains the high susceptibility of younger patients to the disease.

Amoebic (encephalitic) meningitis

Amoebic or encephalitic meningitis is a dangerous inflammation of the membranes of the brain, which is provoked by small free-living amoebae, quite often for a long period of time, living in the human body.

This disease usually affects younger patients, putting children, adolescents and adults under 30 years of age at risk. Encephalitic meningitis has different causes of development, symptoms and signs of manifestation, as well as treatment methods and consequences from other forms of the disease. A detailed discussion of each of these factors will be provided in this article.

With a weakened protective reaction of the body, harmful microorganisms easily penetrate into the blood, and then, transported through the circulatory system, reach the central nervous system, namely, the lining of the brain. After this, amoebic meningitis begins to develop and the first signs of the disease appear.

Purulent meningitis

Purulent meningitis is an infectious inflammation of the membranes of the brain, accompanied by the formation and release of purulent masses. This disease can occur in patients belonging to any age category. Purulent meningitis often occurs in children.

In order to understand how to deal with this disease, you need to know and be able to identify its symptoms. The described form of the disease has its own characteristics of manifestation, causes of development and methods of treatment. These are the ones that will be discussed in this article.

The causes of a disease such as purulent meningitis are the penetration of pathogenic microorganisms into the membranes of the brain. The causative agents in this situation are usually harmful bacteria. These include streptococci, pneumococci, staphylococci, Pseudomonas aeruginosa and other pathogenic microorganisms. Most often, staphylococci are involved in the development of the disease, which is why this meningitis is often called staphylococcal.

As for how purulent meningitis is transmitted, there are several stages. The entry of the pathogenic microorganism into the human body most often occurs through the traditional airborne or food route.

Infection can occur through any contact with a carrier of the infection. Coughing or sneezing, shaking hands, or sharing common household items is enough to transmit harmful bacteria.

Then, penetrating through the tissues of the upper respiratory tract or stomach, harmful bacteria enter the blood. And the causative agent of meningitis reaches the membranes of the brain through the hematogenous route, transported by the circulatory system. Then, after entering the tissues of the membranes of the brain, the development of the disease begins.

A special characteristic of this disease is that its development, and indeed the penetration of bacteria into the blood itself, is possible only with a weakened immune system. Then the disease progresses quickly and without obstacles. This fact also explains why the disease so often affects children’s bodies, whose immunity is not yet fully developed.

Tuberculous meningitis

Tuberculous meningitis is an inflammation of the meninges that occurs as a secondary disease after tuberculosis. This form of the disease is quite rare and, in most cases, occurs in people with or who have recovered from tuberculosis.

The cause of a disease such as tuberculous meningitis is the spread of harmful pathogens from the source of inflammation in the respiratory system to the brain. As mentioned above, most often, this type of disease is secondary, against the background of the development of tuberculosis. The main causative agent of both diseases is acid-fast bacteria, or, in other words, tuberculosis microbacteria.

Tuberculous meningitis is transmitted, like tuberculosis itself, by airborne droplets or food through contact with a carrier of the infection. In the case of the spread of this disease, people, animals and even birds can be carriers of dangerous tuberculosis microbacteria.

It is also characteristic that when harmful microorganisms enter the body of a healthy person whose immune system is functioning properly, tuberculosis bacteria are almost always destroyed. Therefore, the conditions necessary for the full development of the disease include weakened immunity and a low rate of the body’s defense reaction. It is the poorly developed immune system that is the reason that tuberculous meningitis occurs in children.

First of all, when it enters the respiratory system, the disease is localized there. Then, penetrating into the blood, tuberculosis microbacteria are transported by the circulatory system to the meninges. It is from this moment that the development of a secondary disease called tuberculous meningitis begins.

Viral meningitis

Viral meningitis is an inflammation of the membranes of the brain and spinal cord, which is triggered by the entry of the disease-causing virus into the human body. This disease can affect quite large groups of patients, in terms of age categories, and is quite dangerous. Viral meningitis occurs most often in children.

This disease is one of the most curable forms of meningitis, but it also has its dangers. In order to clearly understand all the features and deterioration of this disease, you need to know the features of its manifestation, the reasons for its development, as well as the features of its course and treatment.

The main cause of this disease, as mentioned above, is a virus that causes a disease in the child’s body. This provocateur enters the child’s body, as with any other infectious disease, through airborne droplets or food through contact with a carrier of the infection.

A feature of the further development of the disease is that with normal functioning of the immune system, this virus may not provoke serious disruptions and may even be destroyed. This is why viral meningitis so often affects children. The child’s body’s immunity is not fully developed and cannot cope with the virus of this disease.

Thanks to these conditions, the causative agent of meningitis penetrates the blood and reaches the central nervous system through the blood vessels. After reaching the brain, the virus promotes the development of inflammation of its membranes.

Serous meningitis

Serous meningitis is an infectious disease characterized by the manifestation of a serous inflammatory process in the tissues of the membrane of the brain and spinal cord. Children of preschool and school age are most susceptible to this disease, which is why the question of how serous meningitis manifests itself in children is relevant for all parents.

This disease is dangerous and spreads extremely quickly from person to person. Therefore, every adult needs to know and understand what can provoke meningitis, what are the symptoms of its manifestation and characteristics of its course, as well as methods of treatment.

The cause of serous meningitis is the penetration of the microorganism that causes the disease into the human body. Such microorganisms can be viruses, bacteria or fungi. However, due to the fact that in more than 80% of cases, the disease is provoked by viruses, it is often called, especially when manifested in children, as serous viral meningitis.

Most often, this disease occurs due to enteroviruses entering the body. This also explains the fact that serous meningitis often occurs as a secondary disease as one of the viral diseases (measles, syphilis, AIDS, etc.).

It has been established that entry of enterovirus into a child’s body can occur in two main ways: airborne and waterborne. Airborne transmission of infection from a carrier to a healthy person is the traditional route for diseases of this kind. With any contact with a sick person (no matter with a child or an adult), the disease virus enters the child’s body: hugs, coughs, sneezing, kisses, shared dishes, household items (toys).

As for the water transmission route of the disease, in this case we are talking about the high content of harmful microorganisms in water bodies in summer. This explains the periodic epidemics of diseases in the warm season.

Entering a child’s body with a still weak immune system, the disease virus easily penetrates through the skin and mucous membranes into the blood. Then, transported by the blood circulation, the pathogen reaches the membrane of the brain. And after this, the development of serous meningitis begins.

Infectious meningitis

Infectious meningitis is a dangerous inflammatory disease that affects the tissues of the spinal cord and brain. As a primary infectious disease, meningitis is provoked by various microorganisms, which explains the diversity in the course of the disease, the expression of symptoms and treatment.

This type of disease can be easily transmitted from person to person and can affect patients of different ages and both sexes equally. Infectious meningitis has its own characteristics of occurrence (causes), symptoms and treatment methods that are different from other forms of meningitis. This is exactly what will be discussed in this article.

The main reason why a disease such as infectious meningitis develops in the human body is the penetration of the causative microorganism into it. Moreover, the role of such a pathogen in this case can be played by harmful viruses, bacteria or even fungus.

Infectious meningitis, like any disease of this type, is transmitted by traditional, airborne or foodborne routes. This usually occurs upon contact with a carrier of the infection through a handshake, kiss, sneezing, or shared utensils and household items, which naturally suggests the need for strict adherence to personal hygiene rules. In this regard, the ways of transmitting the infection of a disease called meningitis to another person are not much different from other diseases.

The peculiarity of the development of the disease is that the infection process is not limited to the mere fact of penetration of pathogenic microorganisms into the body. Moreover, with normal functioning of the body's defense system, meningitis may not occur.

Cryptococcal meningitis

Cryptococcal meningitis (cryptococcosis) is an inflammatory disease that affects the membranes of the brain and has a fungal nature of development. This disease has no age limits in affecting patients, therefore it is equally dangerous for all age groups of patients.

For timely diagnosis and treatment, as well as to prevent the development of the disease, it is worth knowing and understanding the causes, symptoms and characteristics of the disease. A description of all described parameters can be found in this article.

As mentioned above, cryptococcal meningitis has a fungal nature of development. And, therefore, like other infectious diseases, the cause of the occurrence of this disease in the patient’s body is the pathogenic microorganism. In this case, a fungus.

Penetration of the pathogenic microorganism into the tissue of the brain membrane occurs in a standard way for this disease. The fungus enters the surface of the tonsils and upper respiratory tract by airborne droplets or food. Then, subject to reduced functioning of the body’s defense systems, the pathogen enters the blood and, thanks to the well-functioning functioning of the circulatory system, moves to the brain tissue.

A distinctive feature of the occurrence of cryptococcosis is that, as an independent disease, it is extremely rare. All diseases of the nervous system of the body that have a fungal nature of development usually develop in people who have already suffered diseases that have weakened their immunity, including those with hemoblastosis, diabetes mellitus, AIDS, and malignant tumors. A disease such as cryptococcosis is a fairly common case after long-term therapy using antibacterial, corticosteroid, and immunosuppressive drugs.

Symptoms of disease development

Symptoms of a disease such as cryptococcosis are extremely difficult to identify. This is explained by the parallel or subsequent development of meningitis after another illness. Therefore, in order to monitor an additionally developing disease, it is recommended to periodically conduct diagnostics for inflammation of the meninges throughout the underlying disease.

Symptoms of a disease such as cryptococcal meningitis can be divided into two categories: general infectious and specific meningeal. At the same time, signs common to all infectious diseases can easily get lost against the background of the main illness, which cannot be said about specific ones.

General infectious signs of this type of meningitis are usually chronic. These include:

an increase in temperature by several levels (up to 37.8-38? C);
state of fever.

Against the background of constantly elevated, albeit slightly, body temperature, diseases of the respiratory tract, ears, and oral cavity may develop. Therefore, a prolonged change in body temperature should serve as a signal that meningitis is developing in the body. In combination with specific signs of the disease, one can obtain a strong basis for a preliminary diagnosis.

As for the specific symptoms of the disease, these include the usual signs of brain damage. Their list includes:

intense throbbing headache;
dizziness;
nausea and vomiting not associated with meals;
photophobia and sound sensitivity;
soreness of the neck muscles;

The main symptom indicating the development of meningitis in the patient’s body is meningeal syndrome. Its manifestation is that the patient’s legs will involuntarily bend at the knees if he tilts his head toward the chest when assuming a horizontal position.

Meningitis in infants

This disease is quite rare in newborns. The incidence of meningitis in infants ranges from 0.02% to 0.2%, depending on the weight of the newborn and his health status.

It is extremely important for the baby’s parents to know the causes of the disease, be able to recognize its symptoms and understand the features of treatment in order to know how to behave if a baby develops meningitis. All of the above issues will be described in this article.

Symptoms of meningitis in newborns

There is a set of signs of the development of the disease that can appear in both infants and adult patients. However, due to the fact that a newborn child cannot show or talk about what hurts, in this case it is worth paying attention to a larger range of factors. So, the symptoms of a disease such as meningitis in an infant will manifest themselves as follows:

significant increase in temperature;
state of fever, chills;
convulsions and twitching;
enlargement and pulsation of the fontanel;
diarrhea;
nausea and profuse vomiting;
decreased or complete lack of appetite;
a state of general weakness of the body.

Signs of meningitis in infants are also reflected in the child’s behavior. A newborn baby, due to a severe headache due to inflammation, is very excited, restless, and the state of irritation is replaced by drowsiness. An experienced parent will be able to notice that the complex of signs of the disease listed above can be inherent in any illness of an infectious nature. That is why, in order to accurately diagnose the disease, there are specific signs of the disease.

Meningeal syndrome

Meningeal syndrome is the main specific symptom that determines the presence of the inflammatory disease meningitis in the meninges. The peculiarity of its manifestation is that if you try to tilt the patient’s head towards the chest while he is in a horizontal position, his legs will bend uncontrollably at the knees. This test is suitable for both children and adults.

Lesage's symptoms

Due to the fact that in newborn children the symptoms of a disease such as meningitis are very mild, to confirm suspicions, an examination of the fontanelle (unfused bones of the skull) is carried out. When meningitis occurs, the area becomes inflamed and pulsates.

Lesage's sign is also called the pointing dog pose. Its essence lies in the fact that when a baby is held by the armpits, he involuntarily pulls his legs towards his stomach and throws his head back.

Causes

Infection of a newborn child usually occurs in a way that has become traditional for this type of disease. We are talking about the transmission of pathogens by airborne droplets from the carrier of the infection, which can be adults or small children.

Treatment of meningitis

It is quite easy to determine meningitis, but the diagnosis must be confirmed by a doctor. Since the disease develops rapidly, you cannot hesitate for a minute. Treatment of meningitis is carried out only under the supervision of doctors in the hospital, it cannot be treated at home. To confirm the disease, as well as determine the causative agent, the patient undergoes a spinal puncture. If you consult a doctor in a timely manner, meningitis can be treated well and does not cause complications. Treatments for meningitis include several drugs and vaccines to eliminate the pathogen:

The main treatment for meningitis is antibiotic therapy. At the first symptoms of the disease, broad-spectrum antibiotics from the group of penicillins, cephalosporins and macrolides are immediately used. Broad-spectrum medications are prescribed to immediately eliminate the pathogen. The results of a cerebrospinal fluid analysis will not be ready immediately, and it is almost impossible to determine the causative agent of meningitis in a blood test. Antibiotics are administered to the patient intravenously, and in severe forms of the disease, medications can be injected into the spinal canal. The duration of the course of antibacterial treatment is determined by the doctor, but the patient will receive medication for at least a week after his normal temperature has stabilized.
Diuretics can be used to treat meningitis. When using diuretics, fluid is simultaneously injected into the patient's body. Diuretics promote strong leaching of calcium from the body, so the patient is prescribed a vitamin complex.
For meningitis, detoxification therapy is used. It is necessary to reduce the symptoms of intoxication. The patient is given intravenous saline, glucose solution and other drugs.

The duration of treatment for meningitis varies and depends on the degree of development of the disease and the patient’s condition. In children, this disease can cause various complications; in adults, it is quickly treated without consequences. After completing therapy in the hospital, it is necessary to continue treatment at home and strengthen the immune system. The patient can recover health within one year, so it is not always possible to return to work or school.

Prevention of meningitis

Measures to prevent meningitis primarily include mandatory vaccination. Vaccination will help prevent the development of many diseases that lead to meningitis. Vaccinations should be given to children at an early age. Vaccines against bacterial and viral meningitis include vaccinations against Haemophilus influenzae type B, against infections that cause pneumonia and other diseases. Vaccination should be given to children between 2 months and 5 years of age, as well as children over 5 years of age who suffer from severe illnesses. Before the invention of the vaccine, bacteria were considered the most common cause of bacterial meningitis, but vaccination has been able to combat it.

The meningococcal vaccine can protect against the main bacteria that cause meningitis. It must be done for a child aged 11-12 years. This type of vaccination should be given to students living in dormitories, military recruits, patients with immune deficiencies, as well as tourists and workers traveling to countries where a meningitis epidemic may break out, for example, African countries. It is necessary to carry out mandatory vaccination against other infectious diseases: and others.

Other measures to prevent meningitis include maintaining personal hygiene and cleanliness:

avoiding contact with people with meningitis;
after contact with an infected person, it is necessary to receive a preventive course of medication;
wear a disposable medical mask during epidemics of influenza and other infectious diseases;
wash your hands before eating, after transport and public places, use antibacterial agents;
do not drink raw water, treat vegetables and fruits with boiling water, boil milk;
avoid swimming in stagnant bodies of water;
strengthen the child’s immunity from an early age.

Consequences of the disease

Meningitis is dangerous because untimely or incorrect treatment can lead to serious complications that will last for many years. Moreover, it does not matter at what age the disease was suffered. Consequences after meningitis occur in both adults and children.

In older patients, the list describing complications after meningitis includes: regular headaches, decreased hearing, significant visual impairment, epileptic seizures and many other deteriorations in the body's functioning that can haunt the patient from several months to several years.

As for the consequences of meningitis for children, in this case the situation is even more dangerous. If the disease occurs in the first years of a child’s life, the probability of death is very high. If the disease was successfully defeated, then it can cause mental retardation, disruption of the basic functions of the brain and the entire nervous system of the child’s body.

Moreover, the threat of death from the disease exists not only for children. To answer the question of whether it is possible to die from meningitis, let's talk about one of its most serious complications. We are talking about .

This complication is more common in younger patients, but is also common in adults. When this complication of the infectious disease meningitis occurs, the patient’s blood pressure and heart rate begin to change sharply, shortness of breath increases and pulmonary edema develops. The result of this process is paralysis of the respiratory tract. It is not difficult to guess what the consequences are after such a complication of meningitis - the death of the patient.

Another complication called infectious-toxic shock leads to the same consequences. Without contacting doctors at the first manifestations of the disease, complications of the disease cannot be dealt with.

If we talk about the general list, the consequences of meningitis affect the health of men, women and children. This indicates the urgent need for correct treatment and proper rehabilitation after illness.

The most common consequences of meningitis include: disruption of the nervous system, mental disorders, dropsy (excessive accumulation of fluid in the brain), hormonal dysfunction and others. This disease, even during treatment, can have a negative effect on the body. When the drugs are administered, blood pressure decreases significantly, the functioning of the urinary system deteriorates, and calcium is washed out of the bones.

It is important to know and always remember that timely diagnosis and correct treatment can save not only the patient’s health, but also his life. Therefore, in order to avoid consequences that pose a real threat to life, at the first symptoms of the disease, you need to consult a doctor.

Purulent meningitis in newborns - inflammation of the brain
membranes, a serious disease that occupies one of the first places among infectious
diseases of the central nervous system in young children. Incidence of purulent meningitis
is 1-5 per 10 thousand newborns.

It can be fatal or disabling
complications (hydrocephalus, blindness, deafness, spastic paresis and paralysis,
epilepsy, delayed psychomotor development up to mental retardation). Exodus
depends on timely initiation of intensive treatment. Etiology and pathogenesis.

According to etiology, meningitis is divided into viral, bacterial and
fungal. The route of infection is hematogenous. Child infection
can occur in utero, including during childbirth or postnatally.
Sources of infection are the mother's genitourinary tract, infection also
may occur from a patient or from a carrier of pathogenic microflora. Development
meningitis is usually preceded by hematogenous spread of infection.
Microorganisms overcome the blood-brain barrier and penetrate the central nervous system.
Predisposing factors include maternal urinary tract infections,
chorioamnionitis, long anhydrous period (over 2 hours), intrauterine
infection, prematurity, intrauterine malnutrition of the fetus and its
morphofunctional immaturity, asphyxia of the fetus and newborn, intracranial
birth trauma and related therapeutic measures, developmental defects
CNS and other situations where there is a decrease in immunological factors
protection. The penetration of bacterial infection into the child’s bloodstream is facilitated by
inflammatory changes in the mucous membrane of the nose and pharynx during acute respiratory
viral infection, which, according to our observations, often accompanies the onset
purulent meningitis.

The causative agents of meningitis are currently often
Streptococcus agalactiae (group B beta-hemolytic streptococcus) and
Escherichia coli. Meningococcal etiology of purulent meningitis in newborns in
nowadays it is rarely observed, which is apparently explained by the passage
through the mother's placenta to the fetus of immunoglobulin G containing antibodies to
meningococcus. Intrauterine meningitis, as a rule, clinically manifests itself in
the first 48-72 hours after birth, postnatal meningitis appears later.
According to our data, such children were admitted to the clinic on the 20-22nd day of life,
when there is a decrease in the level of immunoglobulin G obtained from the mother,
in the blood serum of a newborn. By this time, maternal immunoglobulin G
is catabolized and its level in the blood decreases by 2 times.

Postnatal meningitis can also develop in departments
resuscitation and intensive care and in departments for nursing premature babies.
Their main pathogens are Klebsiella spp., Staphylococcus aureus,
P. aeroginosae and fungi of the genus Candida. As our observations have shown, in the anamnesis
mothers noted such risk factors as threat of miscarriage,
urinary tract infection, presence of chronic foci of infection in pregnant women
(tonsillitis, sinusitis, adnexitis, vaginal thrush), as well as long-term
anhydrous interval during labor (from 7 to 28 hours).

Despite the diversity of pathogens of purulent meningitis in
newborns, the morphological changes in the central nervous system are similar. They are localized in
mainly in soft and arachnoid membranes. Exudate is removed by
phagocytosis of fibrin and necrotic cells by macrophages. Some people have it
undergoes organization, which is accompanied by the development of the adhesive process.
Impaired patency of the cerebrospinal fluid pathways can lead to the development of occlusive
hydrocephalus. Reparation may take 2-4 weeks or more.

Clinic and diagnostics

There are difficulties in diagnosing purulent meningitis at home,
and when the child is admitted to the hospital, since clear clinical manifestations
develop later, and initially nonspecific symptoms similar to
many infectious and inflammatory diseases (pallor, marbling,
skin cyanosis, conjugation jaundice, hyperesthesia, vomiting). Some children
There is an increase in temperature to subfebrile levels. Symptoms of the disease
develop gradually. The child's condition is progressively deteriorating. Temperature
rises to 38.5-39°C. On examination, the skin is pale, sometimes with a grayish
tint, acrocyanosis, marbling are often observed, sometimes pronounced in children
conjugation jaundice. Disorders of the respiratory system are noted -
decrease in respiratory rate, attacks of apnea, and from the cardiovascular
system is characterized by bradycardia. Patients also have hepato- and
splenomegaly.

In the neurological status of some newborns
signs of central nervous system depression are observed: lethargy, drowsiness, adynamia, decreased
physiological reflexes, muscle hypotonia. Others have symptoms
excitation of the central nervous system: motor restlessness, hyperesthesia, painful and
high-pitched scream, tremor of the chin and limbs, clonus of the feet. Violations with
sides of the cranial nerves may manifest as nystagmus, floating
movements of the eyeballs, strabismus, the “setting sun” symptom. Some
children experience regurgitation and repeated vomiting, sluggish sucking or breast refusal
and nipples. A sick child does not gain weight well. At a later date
head tilting back, meningeal symptoms (tension)
and bulging of the large fontanelle, stiffness of the muscles of the back of the neck).
A typical pose is for a child to lie on his side with his head thrown back, legs bent and
pressed to the stomach. Meningeal symptoms typical of older children (Kernig,
Brudzinsky), are not typical for newborns. Sometimes there is a positive
Lessage's symptom: the child is lifted up, grasped by the armpits, and in this
while his legs are in a flexed position. Polymorphic
convulsions, cranial nerve paresis, changes in muscle tone. The reason for the development
convulsions are caused by hypoxia, microcirculatory disorders, cerebral edema, and sometimes
hemorrhagic manifestations. In some cases there are
rapidly progressive increase in head circumference, separation of cranial sutures behind
account of intracranial hypertension.

Analysis of case histories of newborns with purulent meningitis,
who were in our clinic, revealed that all of them were admitted between the ages of 7 and
28 days of life (average age - 23 days). When referred to hospital, only 2
In children, purulent meningitis was suspected; in the rest, the guiding diagnosis was
ARVI, enterocolitis, conjugative jaundice, intrauterine infection, infection
urinary system, osteomyelitis. On admission, most newborns do not
There were clear and characteristic signs of meningitis. However, anamnestic
data and serious condition allowed us to believe that the disease began earlier,
which was confirmed by cerebrospinal fluid studies. Upon admission to
Most children had an increase in temperature to 38-39.6 ° C. Expressed
As a rule, there were no catarrhal symptoms. In some children in clinical
picture there were manifestations of local purulent infection (purulent conjunctivitis,
omphalitis, urinary tract infection).

In the blood test, most children showed inflammatory
changes in the form of an increase in the number of leukocytes (13-34.5x109/l) with a significant
an increase in the number of band neutrophils until the appearance of juvenile forms,
as well as an increase in ESR to 50 mm/hour.

Changes in urine tests (leukocyturia) were noted in three
children with a combination of purulent meningitis and pyelonephritis.

To confirm the diagnosis, a lumbar puncture should be performed.
carry out at the slightest suspicion of meningitis, in the early stages, without waiting
development of his expanded clinic. In cases where for some reason it is not
it is possible to perform a lumbar puncture, one should focus on the clinical
picture of the disease. During lumbar puncture for purulent meningitis in
In newborns, cerebrospinal fluid often leaks under pressure, is cloudy,
sometimes, with large cytosis, the color is yellow and thick. Contraindication to
Lumbar puncture is indicated by shock and disseminated intravascular coagulation.

In our observations, almost all admitted children
The diagnosis was made on the first day of hospital stay. Indication for
urgent lumbar puncture was the presence of febrile temperature
(above 38oC), symptoms of infectious toxicosis without a visible focus of bacterial
infections, less often - hyperesthesia. In the liquor there was an increase in the content
leukocytes with a predominance of neutrophils (more than 60%).

With purulent meningitis, the content of total protein in the cerebrospinal fluid
increases later than neutrophilic pleocytosis increases. Protein content
increases from the onset of the disease and can serve as an indicator of the duration
pathological process. In our studies, protein concentration varied
from 0.33 0/00 to 9 0/00. Increased protein content in the cerebrospinal fluid,
obtained during the first puncture, it was found in 10 patients that
indicated a certain duration of the disease. For purulent
meningitis is characterized by low levels of glucose in the cerebrospinal fluid.

In order to identify the pathogen and determine its
antibiotic sensitivity is tested microbiologically
cerebrospinal fluid. In our observations, clinical and laboratory data indicated
purulent nature of meningitis, while culture of cerebrospinal fluid and smear bacterioscopy in
In most cases, the pathogen was not identified. In two patients it was detected
beta-hemolytic streptococcus group B, one was cultured with Haemophilus influenzae
bacillus, and one more has pneumococcus.

Viral meningitis is characterized by serous inflammation
meninges with an increase in the content of lymphocytes in the cerebrospinal fluid. Serous
Meningitis has a milder course.

Instrumental methods include ultrasound
brain examination (neurosonography) and computed tomography,
which are carried out according to indications.

Neurosonography allows diagnosing ventriculitis,
expansion of the ventricular system, development of brain abscess, and also identify
severe concomitant intracranial hemorrhages, ischemic infarctions, defects
development.

Computed tomography is indicated to exclude an abscess
brain, subdural effusion, as well as to identify areas of thrombosis, infarction
and hemorrhages in the structures of the brain.

Complications

The most common early complications are swelling and
brain swelling and seizures.

Clinically, cerebral edema is manifested by increasing intracranial
hypertension. During this period, the characteristic position of a newborn is with
with his head thrown back, a monotonous, at times shrill,
a cry, sometimes turning into a groan. Possible bulging of a large fontanel, its
pulsation, divergence of cranial sutures. Brain edema may be clinically manifested
dysfunction of the oculomotor, facial, trigeminal and sublingual
nerves. Coma is clinically manifested by depression of all types of cerebral
activity: adynamia, areflexia and diffuse muscle hypotonia. Further
there is a disappearance of the reaction of the pupils to light, attacks of apnea become more frequent,
bradycardia develops.

With purulent meningitis, convulsive syndrome often develops.
Initially, the convulsions are clonic in nature, and as the edema progresses
brain are transformed into tonic.

A very dangerous complication of meningitis is
bacterial (septic) shock. Its development is associated with penetration into
bloodstream of a large number of bacterial endotoxins. Clinically
septic shock is manifested by sudden cyanosis of the extremities, catastrophic
decreased blood pressure, tachycardia, shortness of breath, weak moaning cry,
loss of consciousness, often in combination with disseminated syndrome
intravascular coagulation. Among the newborns we observed, two children
died. One girl was admitted on the 11th day of life and died within the first 6 hours
hospital stay from infectious-toxic shock, complicated
disseminated intravascular coagulation. Second girl aged
17 days died on the 2nd day after admission. She had intrauterine
generalized cytomegalovirus infection and purulent meningitis developed.
Severe consequences of purulent meningitis can include hydrocephalus, blindness,
deafness, spastic paresis and paralysis, mental retardation, epilepsy.

Differential diagnosis

Neurological symptoms similar to purulent meningitis
may be observed in the presence of intracranial hemorrhage in a newborn. U
These children also experience motor restlessness, chin tremor, and
limbs, nystagmus, strabismus, “setting sun” symptom. To exclude
purulent meningitis requires a spinal puncture. For
intraventricular hemorrhage is characterized by the presence in the cerebrospinal fluid of a large
the number of changed red blood cells, as well as an increased concentration of total protein
in the cerebrospinal fluid from the first days of the disease due to the penetration of plasma proteins and
erythrocyte lysis.

Often purulent meningitis occurs with vomiting, so it is necessary
carry out differential diagnosis with pyloric stenosis, in which
there is vomiting "fountain" without fever and inflammatory
changes in blood tests. Often, when examining the abdomen, a positive
hourglass symptom. The main methods for diagnosing pyloric stenosis are
esophagogastroduodenoscopy and ultrasound examination.

Symptoms of central nervous system excitation
(restlessness, tremor of the limbs and chin, hyperesthesia), similar to purulent
meningitis, can be observed with influenza and ARVI. In this case there is
meningism is a condition characterized by the presence of clinical and cerebral
symptoms without inflammatory changes in the cerebrospinal fluid. Meningism is not caused by
inflammation of the meninges, and their toxic irritation and increased
intracranial pressure. During a spinal tap, the fluid is clear and
colorless, flows out under high pressure, often in a stream, but the contents
cells, protein, and glucose are normal. Meningismus usually manifests itself in acute
period of illness and often precedes inflammation of the meninges, which
may develop within a few hours after its detection. If
meningeal symptoms of influenza and ARVI do not disappear, or, moreover, increase,
repeated diagnostic spinal punctures are necessary.

Purulent meningitis can occur in a child with sepsis, which
significantly aggravates the clinical picture of the disease.

Treatment

Newborns with purulent meningitis need comprehensive
treatment, including antibacterial, infusion therapy, replacement
immunoglobulin therapy for intravenous administration. If necessary
hormonal, anticonvulsant, dehydration therapy is carried out. So
Children require the most gentle regimen possible. In the acute period they are not recommended
breastfeed. They receive expressed breast milk, or, if not available,
His mother has it, formula from a bottle. When the sucking reflex is suppressed
Feeding the child through a tube is used.

Causal antibacterial therapy is the main
method of treating newborns with purulent meningitis. It is carried out taking into account
pathogen isolated from the cerebrospinal fluid and its sensitivity to
antibiotics. If the pathogen was not found, the effectiveness of the antibacterial
therapy is assessed based on clinical data and the results of repeated studies
cerebrospinal fluid no later than 48-72 hours from the start of treatment. If during this time there is no
obvious clinical and laboratory improvement occurs, a change is made
antibacterial treatment. In newborns with purulent meningitis, antibiotics
must be administered intravenously three or four times in the maximum permissible doses
through a subclavian catheter.

They use antibiotics that penetrate through
blood-brain barrier and have a wide spectrum of antimicrobial action.
A combined course of antibacterial therapy usually includes
third generation cephalosporins (ceftazidime, ceftriaxone) and aminoglycoside
(amikacin, netilmicin, gentamicin). To all the children we treated
Antibacterial therapy was prescribed immediately upon admission to the hospital and
included a cephalosporin. After receiving the result of a lumbar puncture in the diagram
combination antibiotic therapy, a second antibiotic was added
aminoglycoside series. If a second course of antibiotics is necessary, when not
it was possible to achieve improvement in the patient’s condition and normalization of indicators
cytosis in the cerebrospinal fluid, the children received a second course of antibiotic therapy
meropenem, vancomycin.

The issue of hormone therapy was resolved
individually, taking into account the severity of the condition. In severe cases of purulent meningitis
hormonal therapy in the acute period of the disease led to earlier
disappearance of fever and intoxication, improvement of the condition of the newborn.

For the treatment of hypertensive-hydrocephalic syndrome
dehydration was carried out using furosemide. Subsequently, after
elimination of symptoms of infectious toxicosis, in the presence of intracranial
for hypertension, acetazolamide was prescribed according to the regimen.

As our observations have shown, inclusion in
treatment regimen to increase the body's defenses of immunoglobulin for
intravenous administration, which is especially effective in the early stages of the disease.
Immediately after diagnosis, all patients began intravenous
administration of immunoglobulin. It was administered 2 to 5 times with mandatory laboratory tests.
control (determination of immunoglobulins G, M and A) before and after administration. More
frequent administration was required by children who showed slow positive dynamics
clinical and laboratory symptoms.

Viferon in suppositories containing recombinant human
leukocyte interferon alpha-2b, connected later, after improvement
clinical and laboratory parameters. It was administered at a dose of 150,000 IU 2 times a day,
The duration of the course was 10 days.

Simultaneously with the start of antibacterial therapy in children there was
Intensive infusion therapy was started through a subclavian catheter, including
yourself transfusion of solutions of glucose, rheopolyglucin, vitamins (C, B6,
cocarboxylase), furosemide, antihistamines for the purpose of detoxification,
improving microcirculation, correcting metabolic disorders.

Diazepam was used to relieve convulsive syndrome. WITH
Phenobarbital was prescribed for maintenance anticonvulsant therapy.
Drugs that improve cerebral circulation (vinpocetine,
cinnarizine, pentoxifylline).

The average stay of patients in the clinic was 26 days (from 14
up to 48 days).

Prognosis and long-term consequences

Purulent meningitis in newborns is a serious disease,
the mortality rate from which remains high.

As our research has shown, comprehensive intensive
therapy for purulent meningitis in newborns, started at the earliest stage
diseases, gives good results. Observation of children for 1-3 years,
who suffered purulent meningitis in the neonatal period, showed that the majority
of which, with early detection of the disease and adequate therapy, psychomotor
development corresponds to age. However, two children developed progressive
hydrocephalus, four had disturbances in muscle tone and
subcompensated hypertensive-hydrocephalic syndrome.

Currently, less than 15-20% of newborns with sepsis develop meningitis. Mortality from meningitis, according to literature, ranges from 20-25 to 33-48%.

There is no clear specificity of the microbiological picture; the flora transmitted to the newborn from the mother is characteristic.

Causes of meningitis in newborns

Ways of spread of infection:

most often hematogenous (as a consequence of bacteremia);
along the length - with infected defects of the soft tissues of the head;
along the perineural lymphatic pathways, often coming from the nasopharynx.

The inflammatory process during meningitis is most often localized in the soft and arachnoid membranes (leptomeningitis), less often in the dura mater (pachymeningitis). However, in newborns, all membranes of the brain are more affected. Through the perivascular spaces, the infection can spread to the substance of the brain, causing encephalitis, and to the ependyma of the ventricles (ventriculitis). Purulent meningitis is rare. The absence of an inflammatory response may be the result of a rapidly progressing infection, with an interval of only a few hours from the onset of clinical manifestations to death, or may reflect an inadequate response of the body to infection.

Consequences of meningitis in newborns

cerebral edema;
the development of vasculitis leads to prolongation of inflammation, the development of phlebitis, which may be accompanied by thrombosis and complete occlusion of blood vessels (usually veins); occlusion of several veins can lead to the development of a heart attack;
hemorrhages into the brain parenchyma;
hydrocephalus as a result of closure of the aqueduct or opening of the fourth ventricle with purulent exudate or through inflammatory disorders of CSF resorption through the arachnoid membrane;
subdural effusion, cortical atrophy, encephalomalacia, porencephaly, brain abscess, cysts.

Symptoms and signs of meningitis in newborns

early manifestations are nonspecific:
- deterioration in general health;
- fluctuations in body temperature;
- gray-pale skin;
- marbling of the skin;
- poor microcirculation;
physical inactivity, increased tactile sensitivity, hypotension;
reluctance to drink, vomiting;
cyanosis, tachycardia, shortness of breath, episodes of apnea;
tachycardia, bradycardia;
late manifestations:
- high-pitched scream;
- tense fontanel;
- opisthotonus;
- convulsions.

Initial signs are common to all neonatal infections; they are nonspecific and depend on birth weight and degree of maturity. In most cases, the signs are not characteristic of a central nervous system disease (episodes of apnea, eating disorders, jaundice, pallor, shock, hypoglycemia, metabolic acidosis). Clear signs of meningitis are observed only in 30% of cases. Neurological symptoms may include lethargy, irritability, seizures, and bulging fontanel. Meningitis as a manifestation of RNS usually develops in the first 24-48 hours of life.

Diagnosis of meningitis in newborns

Lumbar puncture for cerebrospinal fluid analysis. Complete blood count, levels of CRP, blood glucose, electrolytes; coagulogram, blood culture.

Diagnosis is based on microbiological methods (isolating a culture of microorganisms from cultures of CSF and blood). CSF cultures are positive in 70-85% of patients who have not previously received antibiotic therapy.

Negative cultures can be obtained during antibacterial therapy, brain abscess, infection caused by M. hominis, U. urealyticum, Bacteroidesfragilis, enteroviruses or herpes simplex virus. Infectious meningitis in newborns is characterized by an increase in protein content in the CSF and a decrease in glucose concentration. The number of leukocytes in the CSF is usually increased due to neutrophils (more than 70-90%).

Despite the wide variation in the cellular composition of the CSF, the generally accepted content of leukocytes in the CSF is >21 cells per 1 mm3 for culture-proven meningitis (sensitivity - 79%, specificity - 81%). Cytological and biochemical methods (changes in the cellular and biochemical composition of the CSF) are not always specific.

CSF glucose should be at least 55-105% of the blood glucose level in premature infants, and 44-128% in full-term infants. Protein concentration may be low (<0,3 г/л) или очень высокой (>10 g/l).

There is no clear opinion on the need for CSF examination in patients with RNS. The American Academy of Pediatrics recommends performing a spinal tap on newborns in the following situations:

positive blood culture;
clinical or laboratory data strongly suggest bacterial sepsis;
worsening during treatment with antimicrobial drugs.

If necessary, lumbar puncture can be delayed until the condition is stabilized, although there is a risk of delay in diagnosis and possibly inappropriate use of antibiotics. If a newborn with suspected sepsis or meningitis has abnormal CSF values, but blood and CSF cultures are negative, a repeat lumbar puncture should be performed to rule out anaerobic, mycoplasma, or fungal infection; It is also necessary to study the CSF for herpes, cytomegalovirus, and toxoplasmosis. Late analysis (delay greater than 2 hours) may significantly reduce the white blood cell count and glucose concentration in the CSF. The optimal time for delivery of material to the laboratory should not exceed 30 minutes.

Meningitis with normal indicators. Up to 30% of newborns with GBS meningitis may have normal CSF values. In addition, even microbiologically confirmed meningitis does not always lead to changes in the cellular composition in the CSF. Sometimes, in addition to increased CSF pressure, no other pathology in the CSF may be detected or the indicators may be “borderline”. In doubtful cases, for example, with “borderline” values of CSF parameters (leukocytes > 20 in 1 mm3 or protein > 1.0 g/l), in the presence of clinical symptoms, it is necessary to examine newborns for the presence of specific infections (syphilis, rubella, cytomegalovirus, herpes, AIDS virus).

Microscopy with Gram stain. Organisms in Gram-stained CSF smears are detected in 83% of neonates with GBS meningitis and in 78% of those with Gram-negative meningitis.

The likelihood of bacteria being visualized on a Gram stain correlates with the concentration of bacteria in the CSF. CSF culture is critical to diagnosis, regardless of other findings. A complete examination of the CSF is all the more necessary, since the pathogen isolated from the blood will not always match the CSF culture.

Ventricular puncture should be considered for meningitis that does not respond clinically or microbiologically to antibiotic therapy due to ventriculitis, especially if there is obstruction between the cerebral ventricles and between the ventricles and the spinal canal.

Treatment of meningitis in newborns

Antibiotics, anticonvulsants, possibly sedatives.

Mechanical ventilation for breathing problems. Observation of patients. Careful monitoring of the level of consciousness. Seizure attacks? A bulging, tense fontanel?

For the treatment of meningitis, the same antibiotics are chosen that are used for the treatment of RNS, since these diseases are caused by similar pathogens. Empirical therapy for meningitis usually includes a combination of ampicillin (or amoxicillin) in antimeningitis doses and aminoglycosides, or a third-generation cephalosporin, or a fourth-generation cephalosporin in combination with aminoglycosides; for infection caused by methicillin-resistant Staphylococcus aureus, vancomycin is used, for candidal meningitis - amphotericin B. If herpes is suspected, initial antibacterial therapy should be supplemented with acyclovir.

After isolation of the pathogen from the CSF and/or blood, antibacterial therapy is adjusted according to the sensitivity of the microflora.

The concentration of aminoglycosides may not reach sufficient levels in the CSF to suppress flora, so it seems understandable that some experts prefer third-generation cephalosporins. But third generation cephalosporins should not be used as monotherapy for the empirical treatment of meningitis due to the resistance of L. monocytogenes and enterococci to all cephalosporins. Doses of antibacterial drugs must be selected taking into account their permeability through the blood-brain barrier (you must read the instructions for the drug). Currently, most investigators do not recommend intrathecal or intraventricular antibiotics for neonatal meningitis.

48-72 hours after the start of antibiotic therapy, the CSF should be re-examined to monitor the effectiveness of treatment. Intravenous antibiotic therapy should be continued after CSF sterilization for at least 2 weeks. for GBS or Listeria, or 3 weeks if the causative agent is gram-negative bacteria. Consider longer duration if focal neurologic signs persist for more than 2 weeks, if CSF requires more than 72 hours to sterilize, or if obstructive ventriculitis, infarction, encephalomalacia, or abscess are present. In such circumstances, the duration of therapy can be determined by repeated lumbar punctures. In case of pathological CSF indicators (glucose concentration<1,38 ммоль/л, содержание белка >3 g/L or presence of polymorphonuclear cells >50%), without other explanation, continued antimicrobial therapy is suggested to prevent relapse. After completing the course of antibacterial therapy, a repeated examination of the brain using various neuroimaging methods is indicated. Currently, MRI is the best method for assessing the state of the brain in a newborn.

Care

Monitor vital signs carefully and regularly.

An accurate balance of injected and excreted fluid is important, as there is a risk of cerebral edema.

Prognosis of meningitis in newborns

Among children with meningitis caused by GBS, the mortality rate is about 25%. From 25 to 30% of surviving children have serious neurological complications, such as spastic quadriplegia, profound mental retardation, hemiparesis, deafness, and blindness. From 15 to 20% - mild to moderate neurological complications. Newborns with meningitis caused by gram-negative bacteria die in 20-30% of cases; in survivors, neurological complications occur in 35-50% of cases. These include hydrocephalus (30%), epilepsy (30%), developmental delay (30%), cerebral palsy (25%) and hearing loss (15%).