Meningeal meningitis. According to the mechanism of occurrence

Headache and high temperature are not always a consequence of acute respiratory disease, sometimes everything is much worse. Inflammatory processes that occur in the membranes of the brain, and in some cases in the membranes of the spinal cord, are called meningitis - symptoms, causes, classification, diagnostic and treatment options for which will be discussed in this article.

So, what kind of disease is meningitis and what causes it? Meningitis is an acute inflammatory disease of the central nervous system(CNS). In modern neuroscience this disease is, if not the most common, then at least in leading positions.

Shell differences

As the disease progresses, the outer membranes of the brain or spinal cord are damaged. It is noteworthy that inflammatory process does not penetrate the brain and does not spread to its cells.

Where this disease comes from is a somewhat incorrect question, since there is no “meningitis virus” in nature. The disease can be caused various viruses, bacteria or fungi. Moreover, there is such a thing as secondary meningitis, which develops against the background concomitant disease. Some doctors believe that the secondary form of the disease is the most dangerous, since it is difficult for the body, already weakened by the primary disease, to fight on two fronts.

The disease is dangerous as it can lead to death. The disease has no age preferences, although young children, due to objective reasons, are more likely to suffer from this disease (weak immunity, fewer resources to fight the infection, etc.).

Types of meningitis

Much to the regret of doctors, meningitis has several varieties. Thus, the classification of the disease consists of more than seven subparagraphs, which in turn significantly complicates the diagnosis and prescription of effective treatment.

So, what types of classification exist:

by etiology;
by origin;
by the nature of the inflammatory process;
with the flow;
by the prevalence of the process;
by localization;
according to severity.

By etiology

Classification of a disease by etiology implies the causes of the disease. So, the disease can be:

infectious;
infectious-allergic;
fungal;
traumatic.

Infectious meningitis is a bacterial disease with a mortality rate of 10%. The main pathogens are meningococci, pneumococci and haemophilus influenzae.

Hemophilus influenzae and meningococcal infections in most cases affect young children who are kept indoors in a micro group (kindergartens) for a long period of time. Meningococcal meningitis has fulminant development and a transient course.

Pneumococcal infection is an infectious disease, but can begin as a result of the spread of infection from purulent foci (wounds or abscesses). It is the most dangerous of the two types.

The infectious-allergic type of the disease, as the cause of development, has strong allergic reactions to various things.
As the name implies, the fungal type of disease has a fungal structure. In particular, the disease is characterized by the least rapid progression compared to infectious species. The development of the disease is provoked by fungi such as Candida and some others. Mushrooms are transmitted through the products of the digestive system of birds, unwashed fruits, and unpasteurized milk.

Traumatic meningitis can develop in people who have suffered any kind of trauma to the skull, when there is a chance of infection spreading from the nasal, auditory or other sinuses to the brain.

By origin

By origin, meningitis is:

Bacterial meningitis is a dangerous disease that, if not properly treated, is 100% likely to be fatal. The disease is caused by bacteria (meningococci, streptococcus aureus, enterobacteria, spirochetes, etc.), hence the name.

The viral nature of the disease is easier for humans to tolerate and has better survival rate among patients compared to the bacterial form. The disease is provoked by various viruses, but 80% of cases were caused by enterovirus infection(Coxsackie virus and ECHO).

The mixed form is also a dangerous type of disease because it can contain several types of illness, which complicates the treatment process.

According to the nature of the inflammatory process

There is a complete and incomplete classification based on the nature of inflammation. Full includes:

purulent;
hemorrhagic;
mixed.

Purulent meningitis - a disease infectious nature. The cause of which is meningococcal or pneumococcal infection. The disease can be primary or secondary.

In the first case, the infection enters the body by airborne droplets or as a result of existing mechanical damage to the skull. In the second case, the development of the disease is due to the presence of a focus in the body purulent inflammation, and the infection from there travels to the brain.

What is the difference between ailments

The least dangerous type of disease known. The disease does not cause the death of brain cells and does not lead to irreversible consequences. Children are more often susceptible to this disease.

Hemorrhagic meningitis is characterized by multiple hemorrhages into the pia mater (source - slovariki.org)

With the flow

Based on the nature of the process, the following are distinguished:

spicy;
subacute;
recurrent;
chronic.

The acute type of the disease manifests itself with lightning-fast development and rapid progression. Symptoms appear almost all at once and may increase gradually.

The subacute type is characterized by a slower (up to 5-6 weeks) development of the disease

The chronic type of the disease develops even more slowly, until symptoms appear after several years (the so-called chronicity of symptoms).

The recurrent form of the disease is characterized by a wave-like course. They note either deterioration or improvement of the patient’s condition
According to the prevalence of the process:

According to the prevalence of the process, they distinguish

generalized;
limited.

The generalized form is characterized by the possibility of infection spreading through tissue or lymph, and accordingly, this infection can affect other organs.

Limited, in turn, on the contrary, is limited to one area.

By localization of the inflammatory process

According to localization, meningitis occurs:

convexital;
basal;
diffuse;
local.

Convexital means superficial. That is, the disease occurs with outside membranes of the brain.
In turn, the basal type of disease means advanced inflammatory processes. This type of illness is the most dangerous and more difficult to tolerate.

The diffuse type is characterized by damage to the entire plane of the lining of the brain, while the local type, on the contrary, affects a specific area.

Causes of meningitis

In order to understand what meningitis is and what causes it, it is necessary to understand the classification of the disease, since when different types it is possible to highlight various reasons. However, regardless of the pathogen there are General terms, contributing to the development of the disease. So, the cause of the disease may be:

viruses or bacteria that infect the cerebrospinal fluid;
the presence in the body or the recent end of an infectious disease (flu, herpes, mumps, etc.);
using unwashed items after potentially transmitting the virus;
alcohol abuse;
spinal or brain surgery;
head injury;
insect or rodent bites (the bite itself does not mean the transmission of infection, but the formation of a purulent wound at the site of the bite can cause the infection that has developed in it to migrate);
hypothermia of the body;
taking corticosteroid drugs;
presence of renal failure.

The disease can be passed on to a child from the mother during childbirth.

In microgroups there is a greater likelihood of developing such an infection and transmitting it by airborne droplets

How is meningitis transmitted?

The causative agents of meningitis are different, and therefore their routes of transmission are different. Undoubtedly this disease contagious and can be transmitted from person to person through airborne droplets or blood.

There are two options:

Transmission of infection from a sick person to a healthy person.
Transmission of infection from a carrier of the virus (in most cases, the carrier does not even suspect that he has a dangerous disease in his body).

But how exactly is the infection transmitted?

airborne;
fecal-oral;
sexual;
cutaneous.

In addition, you can become infected not only from humans. Some rare forms of the disease can be contracted while swimming in ponds. There is also a possibility of infection through the bite of an insect that can carry the disease.

It should be understood that many sources have poor survival rates during external environment and die almost instantly when they get there. They are also not susceptible to boiling or exposure to sunlight.

Incubation period of meningitis

To understand how people get meningitis, it is necessary to take into account such a concept as incubation period.

Incubation period is the period of time from the moment the infection enters the body until the first symptoms appear.

Period without fever and others unpleasant symptoms The illness associated with this disease can be different. It is very difficult to track the pattern, since initial stage It is not clear what kind of infection has affected the body (an exception may be a secondary type of disease).

Infection under a microscope

On average, this period lasts from 2 to 10 days, but there are some peculiarities.

Dependence of the incubation period on the infectious agent

Entroviruses - 3-8 days (in especially serious cases, up to several hours).
Mumps - up to 3 weeks (on average 10-18 days).
Viral and have an incubation period of 2 to 4 days, but symptoms usually begin much earlier.

Symptoms of meningitis

The first signs of impending danger are high fever and headache, which is increasing in nature. Is there always a high temperature? Yes, this is the most important symptom. Moreover, usually, it rises for no apparent reason at all, and subsequently the rest of the symptoms appear.

In addition to the above-mentioned manifestations, the following symptoms are characteristic of all types of meningitis:

meningeal symptoms- symptoms characteristic only of meningitis

nausea;
general weakness of the body;
vomit;
increased sensitivity to light and loud sounds;
drowsiness;
loss of consciousness;
convulsive manifestations;
nervous overexcitability;
stiffness of the neck muscles (swelling of the fontanelle in infants);
rash;
delirium;
inhibited reaction;
hallucinations;
chills.

As for children, the manifestation of the disease in them is somewhat different. If we're talking about o, many symptoms are similar to those of adults.

Clinical picture in adults and children

As for infants, the symptoms of meningitis may include the following:

fever;
convulsive syndromes;
vomiting;
profuse regurgitation;
nervous excitability (the child constantly cries, does not want to sleep);
apathetic state, lethargy;
sudden screams.

In addition, it is possible to develop strabismus, omission upper eyelid. A child's skin may have a bluish tint.

At the site of the fontanelle, a venous network is clearly visible

Diagnosis of meningitis

In order to diagnose meningitis, a comprehensive diagnosis of the patient is carried out, which includes a large number of tests and hardware studies.

So, the list of diagnostic procedures:

blood and urine tests;
smear to determine pathogenic flora in the nose and throat cavity;
coagulogram;
HIV test;
liver puncture;
test for syphilis;
puncture cerebrospinal fluid;
computed tomography (CT);
head electroencephalogram (EEG);
magnetic resonance imaging (MRI);
nuclear magnetic resonance (NMR);
electrocardiogram (ECG);
X-ray of the skull;
examination by an ENT specialist, ophthalmologist, endocrinologist and neurologist.

In addition, before conducting this study, the doctor must interview the patient to determine the presence past diseases, general state in order to draw a conclusion and make a correct diagnosis.

Treatment of meningitis

Is meningitis curable or not and can this disease be cured? Undoubtedly yes. This disease is classified as curable. Which doctor treats this disease? Infectious disease specialist, despite the fact that the disease affects the nervous system. Since the disease is infectious in nature, it must be treated by a similar specialist.

So, meningitis can only be treated in a hospital setting, since the patient must be constantly under the supervision of a specialist.

Therapy is divided into:

antibacterial;
antiviral;
antifungal;
detoxification;
symptomatic.

Such distinctions are important because a disease caused by a fungus cannot be treated with drugs for the virus and vice versa. The exception, of course, is interchangeable drugs.

Antibacterial therapy

When treating the bacterial form of meningitis, the patient is in any case recommended to use it. In addition, in the case of serious inflammatory processes, the use of corticosteroid drugs is indicated to reduce inflammation. And to reduce the convulsive effect, tranquilizers are indicated.

The duration of treatment is from 10 to 14 days. Cancel antibacterial therapy possible if body temperature normalizes and symptoms of intoxication disappear. In addition, to determine the patient's condition, he may be prescribed repeated blood and cerebrospinal fluid tests.

It is worth understanding that not every antibiotic is able to overcome the blood-brain barrier (BBB), and since the main inflammatory processes occur precisely behind the BBB, it is worth taking a very responsible approach to the choice of medications so that treatment is not just for the sake of treatment.

Below is a table with the names of drugs that can and cannot overcome the BBB.

Comparative table of antibiotics that can and cannot cross the BBB

If antibiotics are used, mandatory the patient is prescribed medications to normalize the intestinal microflora in order to avoid intestinal upset. Young children are especially susceptible to this.

Antiviral therapy

Typically, the severe form of viral meningitis occurs in young children and pregnant women. Complications of the disease can even end in death for such patients. Therefore, hospitalization in this case is a mandatory measure.
Unlike the bacterial form of the disease, the viral form is not susceptible to antibiotics and its treatment is more related to the elimination of the symptoms accompanying the disease.

In particular:

To eliminate vomiting - cerucal.
To reduce general intoxication of the body - saline solution with prednesone and vitamin C intravenously.
To eliminate headaches - lumbar puncture or diuretics.
to reduce temperature - antipyretic drugs based on paracetamol.
to eliminate pain in the head - papaverine and similar medicine.

In addition, it is mandatory to carry out therapy to increase immunity (Interferon, etc.), antiviral therapy (Arbidol, etc.).

Antifungal therapy

One of the most dangerous species diseases - fungal meningitis. Previously, before the discovery of the drug Amphoterecin B, the disease showed almost 100% mortality. After starting to use the above-mentioned medicine this statistic has changed. Moreover, in the case of complex therapy along with a drug such as fluconazole, survival rates increased even more.

Treatment of this form of the disease is the most protracted and can last up to a year until the patient’s cerebrospinal fluid returns to normal.

The danger of the disease is that even after the end of therapy, a relapse is possible.

Detoxification therapy

Regardless of the type of meningitis, the patient will always experience intoxication of the body. Therefore, in any case, the doctor will prescribe detoxification therapy.

This type of treatment consists of administering an intravenous solution that reduces intoxication. In particular, this solution includes a saline solution with the mandatory addition of vitamin C and prednesalone.

Symptomatic treatment

This type of therapy is associated with the presence of a fairly wide range of symptoms in the patient, which cannot always be relieved with a standard set of drugs. That is why it is appointed symptomatic treatment. In addition, the sudden development of some unpleasant complication, in the form of severe vomiting or loss of consciousness, is possible. In such a situation, there is no time to wait for the doctor and listen to his recommendations. Medical staff in a hospital independently administer a medicine intended to eliminate a particular symptom.

Forecast

The consequences after suffering an illness can be very different, or there may be none at all. Since during the development of the disease the membranes of the brain and spinal cord are affected, the consequences are associated with neurological manifestations, in particular, the patient may retain:

Headache.
Hearing and vision impairment.
Epileptic seizures.

A fatal outcome cannot be ruled out in the absence of proper therapy or timely assistance for purulent and bacterial meningitis, and in children for its viral forms.

However, in general the prognosis is quite favorable, since modern level medicine allows you to qualitatively eliminate all possible consequences.

Prevention

Hardening the body.
Preventive use of immunostimulating drugs (especially in kindergartens).
Timely treatment of chronic diseases.
Maintaining hygiene.
Maintaining a healthy lifestyle.
Regular exercise.

So, meningitis is a serious disease and, in the absence of proper and timely treatment, can even take the patient’s life. Treatment can only take place in a hospital setting and under the supervision of a doctor, so do not self-medicate under any circumstances, as this can be fatal. Take care of yourself and your loved ones, get treated correctly!

Description of the disease

Meningitis– inflammation of the membranes of the brain and spinal cord, usually of infectious origin. Meningitis is classified according to etiology (bacterial, viral, fungal, etc.), the nature of the inflammatory process (purulent, serous), course (acute, subacute, chronic), origin (primary and secondary, arising against the background of another disease - otitis, sinusitis , traumatic brain injury, etc.).

The clinical picture of meningitis consists of intense diffuse headache, nausea, vomiting, confusion or depression of consciousness up to coma, fever, malaise, tachycardia, myalgia and meningeal syndrome. Meningeal syndrome includes stiffness of the neck muscles that prevents passive flexion of the head, Kernig's sign (the inability to fully extend the leg at the knee joint, previously bent at right angles in the hip and knee joints), the upper Brudzinski sign (flexion of the thigh and lower leg when checking the stiffness of the neck muscles), and lower symptom Brudzinsky (flexion of the hip and tibia when checking the Kernig sign on the other leg), general hyperesthesia (intolerance to bright light, loud sounds, touching the skin).

Meningeal symptoms can often be detected even in a coma, but in the first hours of the disease, as well as in children and the elderly, they are sometimes absent. In older patients, meningitis may present as a combination of fever with confusion or increasing depression of consciousness.

On the other hand, stiff neck muscles in the elderly may not be a consequence of meningitis, but cervical osteochondrosis or parkinsonism. In contrast to these conditions, with meningitis, only neck flexion is difficult, but not its rotation or extension. In young children, the symptom of Lessage suspension is determined (the child raises his armpits, draws his legs to his stomach and throws his head back). U infants it is possible to detect the bulging of a large fontanel and the cessation of its pulsation, caused by an increase in intracranial pressure.

In addition to meningitis, meningeal symptoms (“meningism”) can be detected with subarachnoid hemorrhage, intracranial hypertension, volumetric lesions of the posterior cranial fossa(cerebellar hematoma or abscess), intoxication, traumatic brain injury, neuroleptic malignant syndrome.

The development of meningitis is often preceded by an upper respiratory tract infection. Preliminary use of antibiotics often smoothes out the clinical picture of meningitis. In immunocompromised patients, meningitis occurs either as mild infection with headache and mild fever, or rapidly progressing coma.

Historical reference

Hippocrates

Some scientists believe that Hippocrates knew the existence of meningitis. Other doctors before the Renaissance, such as Avicenna, most likely knew about this disease. A case of tuberculous meningitis was reported in 1768 by Scottish physician Robert Witt in his death report, although the connection between meningitis, tuberculosis and its causative agent was not identified until the 19th century. Epidemic meningitis is a relatively recent phenomenon. The first documented epidemic occurred in Geneva in 1805. Over the following years, several epidemics occurred in Europe and the United States, with the first epidemic in Africa in 1840. African epidemics became more frequent in the 20th century, starting with epidemics in Nigeria and Ghana in 1905–1908.

The first article is about bacterial infection as the cause of meningitis was written by the Austrian bacteriologist Anton Weichselbaum, who described meningococcus in 1887. At the end of the 19th century, many clinical signs of meningitis were also described. In Russia, the most reliable sign of the disease was described in 1884 by the doctor of the Obukhov hospital V. M. Kernig. He indicated that the “symptom of knee joint contracture” is early sign inflammation meninges. Vladimir Mikhailovich Bekhterev in 1899 described the zygomatic membrane symptom (painful grimace when tapping the zygomatic arch with a hammer). Later, four meningeal symptoms were described by the Polish physician Jozef Brudzinski.

In the second half of the 20th century, the etiological connection of diseases with influenza A and B viruses, adenoviruses, as well as with an agent isolated in 1942, initially considered a virus, and then classified as a mycoplasma group bacteria, was established.

One of the first forms of viral meningitis is lymphocytic choriomeningitis. Armstrong and Lilly showed in an experiment on monkeys in 1934 that this form of meningitis is caused by an autonomous filtering virus. Soon, the Armstrong and Lilly virus was isolated from the cerebrospinal fluid of patients.

In 1953, S. N. Davidenkov described two-wave serous meningitis caused by ticks. Acute syndrome serous meningitis, caused by infection with the tick-borne encephalitis virus, was identified by the discoverer of the disease A.G. Panov, who described spring-summer taiga encephalitis in 1935.

Until the 20th century, mortality from meningitis reached 90%. In 1906, by immunizing horses, antibodies against meningitis pathogens were obtained; the development of the idea of immunization by the American scientist Simon Flexner made it possible to significantly reduce mortality from meningitis. In 1944 it was shown that penicillin could be used to treat this disease. At the end of the 20th century, the use of vaccines against Haemophilus influenzae led to a decrease in the number of diseases associated with this pathogen. In 2002, the use of steroids was proposed to improve the course of bacterial meningitis.

Types of meningitis

Bacterial meningitis usually occurs due to the penetration of pneumococcus, meningococcus, and Haemophilus influenzae bacteria into the central nervous system.
Haemophilus influenzae provokes the disease mainly in children under 6 years of age, less often in adults. It occurs against the background of diseases such as pneumonia, otitis media, diabetes mellitus, alcoholism, traumatic brain injury, and sinusitis.
Meningococcal meningitis usually proceeds quite severely; may occur hemorrhagic rash in the form of spots (stars) different sizes. The spots are localized on the legs, thighs and buttocks, mucous membranes and conjunctiva. The patient is bothered by chills and high fever, possible intoxication.
Pneumococcal meningitis occurs quite often and occurs with the occurrence of pneumonia in approximately half of patients. The disease is most severely experienced by people with diabetes, alcoholism, and cirrhosis of the liver. Symptoms include damage to consciousness and cranial nerves, gaze paresis, epileptic seizures. Pneumococcal meningitis can recur and often leads to death. Bacterial meningitis can lead to complications such as shock, endocarditis, purulent arthritis, bleeding disorders, pneumonia, and electrolyte disorders.
Viral meningitis begin with the symptoms of the infectious disease that caused them. Such meningitis occurs with moderate fever, severe headache and weakness. In this case, patients have mild meningeal symptoms. The disease most often occurs without disturbances of consciousness.
Tuberculous meningitis is now often one of the first clinical symptoms tuberculosis. Previously, this form of the disease was always fatal, but now, with adequate treatment, the mortality rate is 15–25% of all cases of the disease. Begins tuberculous meningitis with fever, headache, vomiting. Meningeal symptoms appear and cranial nerves are affected.

Causes of meningitis

The most common causes of meningitis are bacteria or viruses that affect the soft membranes of the brain and cerebrospinal fluid. In children, meningitis is caused mainly by enteroviruses that enter the body through food, water, and dirty objects. In adults, bacterial meningitis predominates, caused by the bacteria Streptococcus pneumoniae and Neisseria meningitidis. These bacteria do not cause meningitis when they are in the throat and nose, but when they enter the blood, cerebrospinal fluid and soft fabrics brain, provoke inflammation.

Sometimes meningitis is caused by other types of bacteria. Group B streptococcus often causes illness in newborns infected during or after birth. Listeria monocytogenes also primarily affects infants and older adults. Meningitis often develops as a complication of various diseases and head injuries. The disease can be transmitted during childbirth, by airborne droplets, through mucous membranes, dirty water, food, rodent and insect bites.

The first signs of meningitis

Due to the danger of the disease to the health and even the life of the patient, it is extremely important to know how to diagnose meningitis in order to be able to determine the development of the disease at home and consult a doctor. To do this, it is not enough to have a list of varieties of the disease; you need to understand what signs appear.

For all types of the disease, there are common first symptoms of meningitis. Moreover, they can also be divided into two categories: general infectious signs and specific signs of a disease such as meningitis.

It is worth noting that signs of meningitis appear equally in all categories of patients (women, men, children). The difference may lie only in the intensity of the symptoms shown and the speed of development of the disease.

General infectious signs

The list of general infectious symptoms that can be observed with meningitis includes the following signs:

significant increase in body temperature;
change in skin color (pallor, sometimes cyanosis);
aching muscle pain;
general weakness of the body;
decreased appetite.

With a complicated course of the disease, a noticeable decrease in blood pressure is also possible. The patient is in a depressed state and may refuse not only food, but also drink.

Specific signs of meningitis

The main symptom of meningitis is called meningeal syndrome. Its essence lies in the fact that if, after laying the patient on his back, try to tilt his head towards chest, the patient's legs will bend at the knees, and the bend itself will cause pain.

In addition to meningeal syndrome, there is a whole list of specific signs of a disease called meningitis.

These symptoms include:

headache;
constant dizziness;
painful reaction to bright light, loud sound;
nausea and vomiting.

Unlike other infectious diseases, headaches with meningitis are distinguished by their severity and intensity. This symptom is characteristic of any type of disease, as it occurs as a result of an increase in intracranial pressure under the influence of inflammation of the meninges.

Headache with meningitis manifests itself in the form of pulsating, bursting impulses, the intensity of which increases gradually. It can manifest itself both in a certain area and over the entire surface of the head. Over time, the intensity of pain impulses increases with the patient’s movements or exposure to light or sound stimuli. It is also characteristic that conventional painkillers are powerless for such headaches.

Signs of meningitis, such as dizziness and painful reactions to light and sound, usually appear within the first three days of the disease. This is due to a reduced sensitivity threshold of the brain receptors responsible for the perception of visual and auditory impulses, due to the development of inflammation of the meninges.

At the same time, symptoms of the disease such as nausea and vomiting appear. Vomiting with meningitis has nothing to do with eating habits. It is provoked by general weakness of the body, headache and irritation of all vital systems. This reaction of the body does not improve the condition, it only weakens it even more.

Also, extremely rarely, among the first symptoms of the disease, rashes on the skin sick. The rash during meningitis, as the disease progresses, can change its nature and location. For example, during the first days of the development of the disease, skin lesions appear on the extremities in the form of red spots.

For more late stages, the rash with meningitis looks like pinpoint hemorrhages on the mucous membranes and skin. In this case, the localization of lesions of the integument can spread to the entire surface of the patient’s body, including the mucous tissues of the eyes, mouth, and genitals.

At the first manifestations of the disease, be it general infectious or specific symptoms meningitis, you should immediately consult a doctor. Treatment of such a disease is a very labor-intensive and complex process, so the timeliness of seeking medical help in this case plays a huge role. Timely diagnosed meningitis will help to avoid infection of others and serious consequences of this disease.

Diagnosis of meningitis

Diagnosis of the disease in question involves the use of the following methods:

spinal puncture - a lumbar puncture is made, during which spinal fluid is removed for subsequent examination under a microscope for the presence of relevant microorganisms and cells;
blood cultures;
CT and MRI of the brain.

Treatment of meningitis

Bacterial meningitis requires mandatory hospitalization. In this case, treatment consists of complex administration of significant doses of antibiotics, often intravenously. Corticosteroids may also be used to reduce inflammation.

Tranquilizers may be used to prevent seizures. If a patient is diagnosed with viral meningitis, then the use of antibiotics in this case will not determine proper effectiveness. The disease in this variant often manifests itself in a moderate form, being cured as a result of protecting the body itself from the effects. Treatment is predominantly focused on reducing the accompanying symptoms.

Prevention of meningitis in some of its forms is possible, for which a vaccination is given for a period of about 4 years, but it is currently impossible to completely protect against the disease. The doctor needed for meningitis is a neurologist; in addition, you may need to consult a phthisiatrician and an ophthalmologist.

Complications after meningitis

Bacterial meningitis is lethal in approximately 10% of cases; the mortality rate for viral meningitis, if the process does not progress to encephalitis, does not exceed 1%.

The most common and relatively harmless consequence after meningitis is asthenic syndrome: causeless malaise, weakness, low mood. It can last from 3 to 12 months.

But, according to American doctors, serious neurological consequences of meningitis remain in almost 30% of cases, these are:

intellectual disabilities;
paresis, paralysis;
blindness;
deafness (sensorineural hearing loss);
hydrocephalus;
convulsive syndrome;
ischemic stroke (in adults it accounts for up to 25% of all complications).

It is impossible to predict in advance how severe the complications after meningitis will be and whether they can be eliminated.

Rehabilitation after meningitis

After meningitis, the patient is observed by a neurologist for at least 2 years. In the first year, an inspection is required once every 3 months, then once every six months. Recovery from meningitis is a complex, complex and multifaceted process.

Here are its components:

Diet. The task of nutrition after meningitis is to restore strength without irritating gastrointestinal tract. Of the cooking methods, it is better to prefer boiling, including steaming, baking, and stewing. Meat is recommended mainly low-fat varieties: rabbit, veal, chicken. Lean fish. For children, it is better to cook meat and fish in chopped form: cutlets, souffles, pates; adults do not need to chop it. Well-cooked porridge is suitable as a side dish. Vegetables and fruits also need to be heat treated: coarse fiber can irritate the mucous membrane that has become temporarily sensitive. Fruit purees, soups, stewed and baked vegetables are essential in the diet. Dairy products can serve as an additional source of protein. From drinks, compotes and jelly, weak tea are appropriate.
Physiotherapy. Includes both classic massage and various kinds hardware techniques. Electrophoresis of vitamins and some medications allows you to either relax or, conversely, stimulate the desired muscle groups. For coordination and cognitive (related to memory and understanding) disorders, electrosleep, magnetic therapy, magnetic laser therapy, and restoration of the functions of the central nervous system are used. Other methods are also used, which should be selected by a competent physiotherapist to treat the consequences of meningitis based on the condition of a particular patient.
Physiotherapy. This is also a separate and extensive area of recovery after meningitis. A physical therapy specialist helps the patient restore movement skills by gradually and consistently training individual parts first motor act, then “links” between them, moving on to more and more complex interactions. Modern rehabilitation centers use not only gymnastics, but also special suits with feedback, robotic simulators and other methods that until recently seemed fantastic.
Occupational therapy. This is a set of methods that is aimed at everyday adaptation of the patient. Any disease forces you to change your lifestyle, especially if the disease takes away part of your physical capabilities. Ergotherapy, on the one hand, helps to at least partially restore range of motion, strength, and coordination. On the other hand, as part of the rehabilitation system after meningitis, it helps to adapt existing limited opportunities tailored to the patient’s habits and lifestyle, teaches him to feel like a full-fledged person and enjoy life, regardless of physical limitations.
Cognitive therapy– these are exercises aimed at restoring attention, memory, and logical thinking.

Useful foods for meningitis

For meningitis, food should be taken in small portions at least six times a day (especially during the period when the temperature drops), weighing up to 400 g at a time.

A diet for meningitis should perform several functions:

removal of intoxication of the body, which occurs due to toxins of pathogens and protein breakdown products;
maintaining metabolism, water-salt, protein and vitamin balance in the body. Should be used in the diet easily digestible foods and dishes.

Depending on the stage of the disease and the complexity of its course, various therapeutic diets should be used. For example, when acute course meningitis, diet No. 13 is used, for complicated meningitis - a zero diet, for unconscious states of the patient - a tube diet, during the recovery period - diet No. 2 and No. 15, in case of exhaustion of the body as a result of the disease and after full recovery – № 11.

Among the products you can eat are:

lean meat, steamed and pureed (veal, rabbit, chicken, turkey, jellied meat, beef jelly, boiled tongue, lean ham, liver and meat pate);
boiled fish or steamed fish dishes;
soft-boiled eggs, steam omelettes or soufflés;
dairy products (kefir, fermented milk drinks, cottage cheese, acidophilus, kefir, yogurt, sour cream in dishes, mild grated cheese);
easily digestible milk fats (cream, butter, sour cream);
products with no coarse fiber(mashed vegetables and fruits);
liquid (up to two and a half liters per day), which helps improve metabolism and remove toxins from the body. You can drink weak tea with milk or lemon, a decoction of wheat bran or rose hips, fruit drinks, jelly, compotes, table mineral waters;
low-fat broths;
natural sweet and sour fruit juices, diluted with water;
dried wheat bread, savory buns, cookies, crackers, dry biscuits;
boiled or mashed porridge, boiled noodles and vermicelli, baked puddings, cutlets and zrazy from cereals or vermicelli.

You should limit your consumption of foods such as:

animal fats that can cause metabolic acidosis (lamb, pork, goose, duck), smoked meats, canned food;
easily digestible carbohydrates (sweet drinks, jellies, mousses, honey, jam, etc.), which can cause intestinal fermentation, allergic reactions and inflammatory processes;
sodium chloride ( table salt) up to 10 g per day, except in cases of diarrhea, vomiting or severe sweating.

Exclude products:

fresh wheat bread, butter products, puff pastry products, pancakes, pancakes, coarse rye bread;
fatty fish, salted, smoked and dried fish and canned fish;
whole milk and ice cream;
buckwheat and pearl barley porridge, legumes;
vegetables with coarse fiber (cucumbers, turnips, radishes, peppers, radishes);
marinated mushrooms;
hard berries and fruits with coarse grains (red currants, raspberries, gooseberries, dates, figs);
hot and fatty sauces, pepper, mustard, horseradish.

Folk remedies for meningitis

decoctions of camel hay, barley or mint water;
infusion of lavender flowers (three teaspoons per two cups of boiling water);
infusion of valerian root water, take half a glass twice a day for two weeks;
poppy seeds (one tablespoon of ground poppy seeds per one glass of hot milk, leave in a thermos for 12 hours) take 70 ml one hour before meals;
infusion of wormwood (three teaspoons of herb per 30 ml of boiling water, leave for two hours, well wrapped) take 50 ml 4 times a day half an hour before meals.

Good day, dear readers!

In today's article we will look at a disease of the meninges, such as meningitis, as well as its first signs, symptoms, causes, types, diagnosis, prevention and treatment with traditional and folk remedies. So…

What is meningitis?

Meningitis– infectious inflammatory disease of the membranes of the spinal cord and/or brain.

The main symptoms of meningitis are headache, high body temperature, disturbances of consciousness, increased sensitivity to light and sound, and numbness of the neck.

The main causes of meningitis are fungi. Often, this disease becomes a complication of others, and often ends in death, especially if its cause is bacteria and fungi.

The basis of treatment for meningitis is antibacterial, antiviral or antifungal therapy, depending on the causative agent of the disease, and only in a hospital setting.

Meningitis in children and men is most common, especially the number of cases increases in the autumn-winter-spring period, from November to April. This is facilitated by factors such as temperature fluctuations, hypothermia, a limited amount of fresh fruits and vegetables, and insufficient ventilation in rooms with a large number of people.

Scientists also noticed a 10-15 year cyclical pattern of this disease, when the number of patients especially increases. Moreover, in countries with poor sanitary living conditions (Africa, Southeast Asia, Central and South America), the number of patients with meningitis is usually 40 times higher than among European residents.

How is meningitis transmitted?

Like many others infectious diseases, meningitis can be transmitted in a fairly large number of ways, but the most common of them are:

airborne droplets (through, sneezing);
contact and household (non-compliance), through kisses;
oral-fecal (eating unwashed foods, as well as eating with unwashed hands);
hematogenous (through blood);
lymphogenous (through lymph);
placental route (infection occurs during childbirth);
through ingestion of contaminated water (by swimming in polluted waters or drinking dirty water).

Incubation period of meningitis

The incubation period of meningitis, i.e. from the moment of infection to the first signs of the disease depends on the type of specific pathogen, but generally it ranges from 2 to 4 days. However, the incubation period can range from several hours to 18 days.

Meningitis - ICD

ICD-10: G0-G3;
ICD-9: 320-322.

How does meningitis manifest? All signs of this disease of the spinal cord or brain correspond to infectious manifestations. It is very important to pay attention to the first signs of meningitis so as not to miss precious time to stop the infection and prevent complications of this disease.

The first signs of meningitis

A sharp rise in body temperature;
Rigidity occipital muscles(numbness of the neck muscles, difficulty turning and tilting the head);
Lack of appetite;
and frequent without relief;
Sometimes a rash appears, pink or red, disappearing with pressure, which after a few hours appears in the form of bruises;
(mainly in children);
, malaise;
Hallucinations, agitation, or lethargy may occur.

The main symptoms of meningitis are:

Headache;
– up to 40°С, ;
Hyperesthesia (increased sensitivity to light, sound, touch);
, disturbances of consciousness (even to the point of coma);
Lack of appetite, nausea, vomiting;
Diarrhea;
Pressure in the eye area;
Inflammation of the lymph glands;
Pain when pressing on the trigeminal nerve area, the middle of the eyebrows or under the eye;
Kernig's sign (due to tension posterior group thigh muscles, the leg does not extend at the knee joint);
Brudzinski's sign (legs and other parts of the body move reflexively when pressing on various parts of the body or when tilting the head);
Bekhterev's symptom (tapping on the zygomatic arch causes contractions of the facial muscles);
Pulatov's symptom (tapping the skull causes pain);
Mendel's sign (pressure on the area of the external ear canal causes pain);
Lesage's symptoms (the large fontanel in small children is tense, bulges and pulsates, and if you take it under the armpits, the baby throws his head back, while his legs reflexively tuck into his tummy).

Nonspecific symptoms include:

Decreased visual function, double vision, strabismus, nystagmus, ptosis;
Hearing loss;
Paresis of facial muscles;
Abdominal pain, ;
Body cramps;
Epileptic seizures;
, bradycardia;
Uveitis;
Drowsiness;
Increased irritability.

Complications of meningitis

Complications of meningitis may include:

Hearing loss;
Epilepsy;
Hydrocephalus;
Disruption of normal mental development children;
Purulent arthritis;
Blood clotting disorder;
Death.

The first factor and main cause of meningitis is the entry into the body, into the blood, cerebrospinal fluid and brain of various infections.

The most common causative agents of meningitis are:

Viruses– enteroviruses, echoviruses (ECHO - Enteric Cytopathic Human Orphan), Coxsackie virus;

Basically, to relieve viral meningitis, a combination of the following drugs is prescribed: Interferon + Glucocorticosteroids.

Additionally, barbiturates may be prescribed, nootropic drugs, a protein diet containing large amounts, especially various antiviral drugs (depending on the type of virus).

3.3. Antifungal therapy

Treatment for fungal meningitis usually involves taking the following medications:

For cryptococcal and candidal meningitis (Cryptococcus neoformans and Candida spp): “Amphotericin B” + “5-Flucytosine”.

The dose of Amphotericin B is 0.3 mg per 1 kg per day.
The dose of Flucytosine is 150 mg per 1 kg per day.

Additionally, Fluconazole may be prescribed.

3.4. Detoxification therapy

To remove waste products of infection (toxins) from the body, which poison the body and further weaken the immune system and the normal functioning of other organs and systems, detoxification therapy is used.

To remove toxins from the body, use: “Atoxil”, “Enterosgel”.

For the same purposes, drinking plenty of fluids is prescribed, especially with vitamin C - rosehip decoction, tea with raspberries and fruit juice.

3.5. Symptomatic treatment

At allergic reaction Antihistamines are prescribed: "", "".

At high temperatures, above 39°C, anti-inflammatory drugs: Diclofenac, Nurofen, "".

At increased irritability, for anxiety, sedatives are prescribed: “Valerian”, “Tenoten”.

To reduce edema, including edema of the brain, diuretics (diuretics) are prescribed: Diacarb, Furosemide, Uroglyuk.

To improve quality and functionality cerebrospinal fluid prescribed: "Cytoflavin".

Forecast

Timely consultation with a doctor, accurate diagnosis and the correct treatment regimen increases the chances of complete cure from meningitis. It depends on the patient how quickly he will go to a medical facility and adhere to the treatment regimen.

However, even if the situation is extremely difficult, pray, the Lord is able to deliver and heal a person even in cases where other people cannot help him.

Important! Before use folk remedies Be sure to consult your doctor!

When using folk remedies, keep the patient calm, dim the light, and protect him from loud sounds.

Poppy. Grind the poppy seed as thoroughly as possible, pour it into a thermos and fill it with hot milk, in the proportion of 1 teaspoon of poppy seed per 100 ml of milk (for children) or 1 tbsp. spoon of poppy seeds per 200 ml of milk. Leave the solution to infuse overnight. You need to take 1 tbsp of poppy infusion. spoon (children) or 70 g (adults) 3 times a day, 1 hour before meals.

Chamomile and mint. To drink, use tea from or, for example, one remedy in the morning, another in the evening. To prepare such a medicinal drink you need 1 tbsp. Pour a spoonful of mint or chamomile into a glass of boiling water, cover the lid and let the product brew, then strain and drink a portion at a time.

Lavender. 2 teaspoons of medicinal lavender in dry, ground form, pour 400 ml of boiling water. Leave the product overnight to infuse and drink 1 glass, morning and evening. This product has analgesic, sedative, anticonvulsant and diuretic properties.

Herbal collection. Mix 20 g of the following ingredients - lavender flowers, peppermint leaves, rosemary leaves, primrose root and. Next, pour 20 g of the resulting mixture from plants with 1 glass of boiling water, cover with a lid and let the product brew. After the collection has cooled, strain it and you can start drinking the whole glass at a time, twice a day, morning and evening.

Needles. If the patient does not have acute phase meningitis, you can prepare a bath from fir needles; it is also useful to drink an infusion of pine needles, which help cleanse the blood.

Linden. 2 tbsp. spoons linden color pour 1 liter of boiling water, cover the product with a lid, let it brew for about 30 minutes and you can drink it instead of tea.

— During periods of seasonal outbreaks, avoid staying in places with large numbers of people, especially indoors;

— Do wet cleaning at least 2-3 times a week;

— Temper yourself (if there are no contraindications);

— Avoid stress and hypothermia;

- Move more, go in for sports;

— Do not let various diseases take their course, especially infectious nature so that they do not become chronic;

“Don’t go without a hat - you’ll get meningitis!” Who among us did not have to listen to this kind of “horror stories” as a child? In fact, the mechanism of infection with this disease is much more complex and just wearing a warm hat cannot protect you from it. Let's say more: you can get meningitis even in the summer at sea, and massive outbreaks of this disease occur more often in tropical countries than in regions with a harsh climate.

Meningitis is an inflammation of the meninges, which is fatal in 10% of cases. Head and spinal cord The human body consists of three membranes: soft, arachnoid and hard. If an inflammatory process begins in any of them (or all at once), they speak of meningitis. Inflammation of the dura mater of the brain is called pachymeningitis. With leptomeningitis, the soft and arachnoid membranes are affected, and panmeningitis is an inflammatory process in all three layers. But most often, doctors diagnose inflammation in the soft membranes of the brain.

Thus, everyone should know how and why meningitis occurs, whether it is contagious, whether it is possible to get it again, and who is most susceptible to inflammation of the meninges.

Types of meningitis

It is generally accepted that Hippocrates was the first to describe the symptoms of meningitis, and then medieval healers. So humanity has known about this disease for a very long time. But for many years, tuberculosis and consumption were mistakenly believed to be the cause of inflammation of the meninges, and before the discovery of antibiotics, 95 out of 100 patients died from meningitis. Nowadays, treating meningitis is also not easy, but thanks to modern knowledge, the survival rate is much higher than several centuries ago.

However, for therapy to be effective, you first need to understand what type of meningitis you will have to fight. And this disease is very “many-sided” in origin and nature, therefore, in the international classification of diseases (ICD 10), each type is assigned its own code and definition, and specialists use different methods to systematize the disease.

According to the nature of inflammation, meningitis occurs:

purulent;
serous.

In the first case, the disease is caused by meningococcal bacteria, is very severe, and is caused by a primary septic process. The second type is of viral origin. This variety is considered not as dangerous as purulent and is less likely to cause complications.

By origin, meningitis is divided into:

primary (independent disease);
secondary (appears as a complication of sinusitis, otitis, respiratory infections, osteomyelitis of the skull bones, carious processes, boils on the face or neck, tonsillitis, sometimes occurs against the background of diseases such as tuberculosis, mumps, syphilis).

Classification by pathogen:

bacterial;
fungal;
viral;
protozoan;
mixed.

According to the nature of the flow:

lightning (fulminant);
spicy;
subacute;
chronic;
recurrent.

By localization of inflammation:

total;
basal (affects the deep parts of the brain);
spinal (affects the spinal cord);
convexital (affects the superficial brain).

According to severity:

mild;
moderately heavy;
heavy.

In addition, there is also non-infectious meningitis. This is a type of aseptic meningitis, that is, a disease caused by any other cause other than bacteria, which usually causes acute meningitis - non-communicable diseases, drugs or vaccines. Overall, these causes of meningitis are uncommon. Most often, doctors diagnose cases of viral, bacterial, secondary purulent and fungal meningitis. Moreover, the bacterial (meningococcal) variety of the disease is more common among children under 5 years of age, and the fungal type is more common among pregnant women, patients after chemotherapy, and patients with acquired immunodeficiency. Bacterial, also purulent, meningitis can affect even babies under one year old, and viral (serous) meningitis in children usually appears after mumps or because of ECNO. The viral form is not as dangerous for children as the purulent form, since it is easier to treat and less likely to cause complications.

Causes of infection

In many clinical cases, meningitis manifests itself as a seasonal disease. But contrary to popular belief, hypothermia cannot be considered its main cause. Statistics indicate that more cases infection occurs precisely in the warm season, as well as in countries with a temperate climate. However, experts also record surges in the spread of the disease in the off-season. This is facilitated by several factors: increased humidity and decreased air temperature outside, seasonal hypovitaminosis, as well as longer stays in poorly ventilated areas. Not long ago, scientists noticed another cyclical pattern: every 10-15 years, an epidemic of meningitis occurs in the world. For example, in 2017, an epidemic of serous meningitis was recorded in Russia, the cause of which was the enterovirus ECHO30, which came from China.

People with weakened immune systems and children under 5 years of age are most susceptible to the disease (their immune system is still developing, and the blood-brain barrier is characterized by increased permeability). If we analyze the prevalence of the disease between the sexes, then more cases of inflammation in the brain are diagnosed among men (usually at the age of 20-30 years). Also at risk are pregnant women, people with diabetes, gastrointestinal ulcers, AIDS, those suffering from chronic fatigue or people suffering from malnutrition. In the so-called “Third World” countries, the prevalence of meningitis is almost 40 times higher than the European average. It is also interesting that in Europe and Russia, diseases of bacterial etiology are approximately 3 times less common than viral ones. The main reason This is what doctors call vaccination, which can help prevent the bacterial form of the disease. After vaccination, the body, when faced with a pathogen, will independently protect itself from it.

To protect yourself, first of all, you need to understand that meningitis is a contagious disease. Depending on the species, it can be transmitted in different ways:

airborne (through saliva particles during coughing and sneezing);
fecal-oral (through unwashed hands, fruits and vegetables, contaminated water);
hemocontact (through blood);
lymphogenous (through lymphatic fluid);
placental (from pregnant women to the fetus);
water (when swimming in open reservoirs or pools);
contact and household (through household items, dishes, toys);
through insect bites (mainly in African countries).

In children under 1 year of age, meningitis can be caused by the same reasons as in adults or have other causes. For example, be a consequence of birth trauma, prematurity, damage to the brain or spinal cord, sepsis, disease of the middle ear or nasopharynx. If a woman has meningitis during pregnancy, the risk of transmitting the infection to the fetus is very high, and this can lead to developmental disorders of the child. In most cases, meningitis during pregnancy ends in spontaneous abortion or intrauterine fetal death. But even if the fetus survives, doctors usually advise women to terminate their current pregnancy.

Variants of the course of meningitis

Most dangerous meningitis is for children under 5 years old. Sadly, every 20 baby diagnosed with inflammation of the meninges dies. Most dangerous form Infantile meningitis is considered a disease caused by streptococcal infection. Infection usually occurs when the baby passes through birth canal mother. In this case, the disease develops at lightning speed and the child either dies within the first month of life or suffers serious developmental disorders. A complicated form of meningitis is no less dangerous for children. And already at the age of 1 to 5 years, children get sick more often viral meningitis, which usually goes away easier than bacterial.

The course of the disease consists of three periods: incubation, prodromal and the disease itself. The incubation period is the time from the moment the virus enters the body until the first symptoms of the disease appear. At this time, viruses or bacteria are contained in the body in small quantities, and therefore cause almost imperceptible harm. Depending on the type of disease, the incubation period can last from several minutes (rapid development) to several years (chronic inflammation). The length of the incubation period also depends on the condition immune system patient: the weaker it is, the faster the disease manifests itself. Most often, the incubation period lasts from 1 to 10 days. If the disease was diagnosed in the first two days after infection, then the chances of cure reach 95%.

The fulminant, or fulminant, form of meningitis is the most dangerous. With this form, all stages of the disease pass almost instantly, and death is possible within the first day. Acute meningitis also occurs according to an “accelerated” program: as a rule, 3 days are enough for the infection to reach its peak or even cause the death of the patient.

Purulent meningitis can enter the prodromal stage (the time when classic symptoms of the disease appear) within a few hours after bacteria enter the body. Acute bacterial inflammation progresses very quickly. If the disease was caused by Neisseria meningitidis, the patient may die within a few hours after infection. Against the background of this type of disease, bilateral hemorrhagic adrenal infarction (Waterhouse-Friderichsen syndrome) is possible. And the disease caused by the bacterium Haemophilus influenzae, or hemophilic meningitis, is more common in countries where vaccination against hemophilia is not carried out.

If we are talking about the acute period of the disease, then it usually develops from several days to several weeks, and chronic meningitis manifests itself no earlier than 4 weeks after infection. In addition, while most forms of inflammation in the brain occur rather quickly, chronic meningitis can drag on for even more than 25 years. In this case, the disease develops gradually, and it is almost impossible to determine when the infection entered the body.

Sometimes inflammation of the meninges even after successful treatment returns. Relapse can be caused by viruses, bacteria or non-infectious factors. The most common cause of recurrent disease is a virus. herpes simplex Type 2 (Mollare meningitis). Bacterial meningitis can recur due to congenital or acquired defects of the base of the skull or spine.

Symptoms

The insidiousness of meningitis lies in its rapid development. Medicine knows of cases where death occurred just a few hours after the onset. acute period diseases. In the classic version, the incubation stage of meningitis in most cases lasts from 4 days to a week. If the disease is recognized in time, the patient has a chance of recovery. And for this you need to know the first symptoms of the disease. However, in most cases, the signs accompanying the onset of meningitis are not perceived by the patient as an alarming signal; the disease manifests itself with general infectious symptoms: the patient experiences a feeling of chills, fever, elevated temperature body, in some cases, skin rashes may appear.

The main symptom of meningitis is headache, which becomes more intense as the disease progresses. The nature of the pain is bursting, the pain can be very intense. In this case, the pain can be localized in the forehead and occipital region, radiating to the neck and spine. Bursting pain is associated with increased intracranial pressure as a result of the action of pathogen toxins. The pain syndrome intensifies when moving the head, as well as due to loud sounds and bright lights. Another sign important for differentiating the nature of a headache is rigidity ( strong tension) occipital muscles. Patients with meningitis (adults and children) do not lie in the usual position on their back. To ease the pain, they turn on their side, tuck their knees to their stomach and instinctively throw their head back.

Inflammation of the membranes of the brain is in many cases accompanied by nausea and severe vomiting. Moreover vomiting reflex does not stop even with a complete refusal of food. In addition, the patient’s body temperature rises (intermittently or stays consistently high at 39-40 degrees) and is not reduced by traditional antipyretics, severe weakness and sweating. The patient complains of intolerance to bright light, which increases headache. The presence of meningitis can also be suspected in cases where a bursting headache is accompanied by a disturbance of consciousness (a person answers questions slowly and with difficulty or does not respond to requests at all). Mental disorders, indicating inflammation of the membranes of the brain, can manifest as hallucinations, apathy or aggression. The patient may experience leg and/or arm cramps, muscle pain, and squint (if the inflammation has spread to the optic nerves).

In addition to the classic ones, specific signs will help to recognize meningitis in young children: Kernig's sign and the upper Brudzinski's sign. In the first case, a child lying on his back with his legs raised will not be able to straighten them knee joints. The second symptom is also determined in the supine position. If a baby, raising his head, involuntarily bends his knees, this may also indicate inflammation in the meninges. To identify the disease in infants, the fontanel is examined: its swelling and tension are an alarming signal. Another sign of inflammation of the meninges in children is a rash, which is then replaced by specific bright burgundy spots that appear all over the baby’s body.

Diagnostics

Suspect the patient to have meningitis experienced doctor maybe already from the outside clinical signs. But put accurate diagnosis, based only on symptoms, it’s early. Moreover, it is important not only to confirm or deny the presence of the disease, but also to determine its type and stage of development. To do this, the patient will have to go through comprehensive examination. In such cases, patients donate blood for a general analysis (CBC), a general urinalysis and a smear from the pharynx mucosa. One of the main confirmatory tests is spinal cord puncture and laboratory diagnosis of cerebrospinal fluid (CSF). Since the brain and spinal cord are in constant contact, clouded cerebrospinal fluid is always considered as the main marker of meningitis.

If signs are observed during puncture high blood pressure cerebrospinal fluid (cerebrospinal fluid flows out in a stream or frequent drops), experts regard this as one of laboratory signs meningitis. In addition, the color of the cerebrospinal fluid in a sick person changes: it becomes cloudy white or yellowish-green. Not only a cerebrospinal fluid analysis, but also a blood test can also tell about the disease. In the presence of the disease, an increased number of lymphocytes or neutrophils is observed. The patient's sugar and chloride levels also typically increase.

Differential diagnosis of the disease is based on biochemical analysis cellular composition cerebrospinal fluid. To establish the causative agent of the disease, they resort to bacteriological and bacterioscopic examination of the cerebrospinal fluid to determine the causative agent of the disease. Using serodiagnosis, the presence of antigens and antibodies to various pathogens in the patient’s body is determined.

Approximate test results for meningitis

Indicators	Liquor is normal	Viral meningitis	Bacterial	Purulent
Color/transparency	No color/transparent		Colorless/transparent or opalescent	Whitish or greenish-brown/cloudy
Pressure	130-180 mm water. Art.	200-300 mm water. Art.	250-500 mm water. Art.	Increased
Rate of cerebrospinal fluid flow during puncture (drops/min.)	40-60	60-90	Trickle	Rare viscous drops
Cytosis (cells/µl)	2-8	20-800	200-700 (sometimes 800-1000)	More than 1000
Lymphocytes	90-95%	80-100%	40-60%	0-60%
Neutrophils	3-5%	0-20%	20-40%	40-100%
Sedimentary reactions	–	+ (++)	+++ (++++)	+++ (++++)
Dissociation	No	Low cell-protein (protein-cell after 8-10 days)	Moderately high cytosis and protein (then protein-cell dissociation)	High cellular protein
	1,83-3,89	More than 3.89	Significantly reduced	Moderately reduced
Chlorides (mmol/l)	120-130	More than 130	Significantly reduced	Moderately reduced
Fibrin film	Not formed	In 3-5%	In 30-40%	Coarse, often in the form of sediment
Reaction to puncture	Causes headache and vomiting	Causes relief, turning point of the disease	Causes significant but short-term relief	Moderate short-term relief

The results of a blood test will reveal neutrophilia or lymphocytosis, indicating the nature of the disease, as well as ESR indicator– erythrocyte sedimentation rate, which in high values indicates the presence of an inflammatory process. In addition to laboratory examination of cerebrospinal fluid and blood, the doctor will definitely need the patient’s medical history and will conduct a thorough neurological examination, will offer to undergo a computer or magnetic resonance imaging scan. Using an MRI or CT scan, a specialist will be able to examine the condition of the meninges and find the source of inflammation. During a conversation with the patient, the doctor will ask how long ago the headaches began, and whether the patient has been bitten by ticks or mosquitoes (carriers of the pathogen, particularly in Africa and Central Asia).

If suspicions of meningitis were detected in a child, then before sending the baby for a puncture, he should be examined by an ENT specialist, neurologist, neurosurgeon and hematologist in order to exclude other possible reasons ailments.

Treatment

Any inflammatory processes in the body are very serious. And if the inflammation occurs in the brain, then there can be no talk of any self-medication at home. Neither traditional methods nor alternative medicine can replace the necessary drug therapy. Meningitis should only be treated by a doctor and only in a hospital. The sooner a patient seeks help from a specialist, the higher his chances of survival.

The doctor can draw up a comprehensive treatment program only after receiving the results of the patient’s examinations. Meanwhile, in the case of meningitis, when the clock is ticking, not a minute can be lost. Antibiotics are prescribed as an emergency treatment for all patients with suspected meningitis. wide range actions. At the beginning of treatment, the doctor may prescribe drugs from the group of penicillins, cephalosporins, and macrolides. This will help neutralize bacteria that cause purulent meningitis. For antibiotics to start working immediately, the medicine is usually administered intravenously (drip), and in very severe cases, directly into the cerebrospinal fluid. Treatment of serous meningitis is carried out with the additional use of antiviral drugs. In addition to specific antibacterial or antiviral therapy, patients are prescribed nootropic and vascular drugs– Nootropil, Piracetam or their analogues are taken to restore nerve cells and the condition of blood vessels. As anti-inflammatory drugs, doctors provide hormonal therapy to patients with drugs such as Prednisolone, Dexamethasone, Methylprednisolone or Hydrocortisone.

Diuretic therapy is also used in the treatment regimen for meningitis. Diuretic medications are needed to relieve brain swelling.

Regardless of the form and stage of meningitis, children and adults are always prescribed vitamins and minerals. These substances are necessary to maintain immunity, which is always reduced during brain inflammation, as well as to restore the supply of nutrients necessary for the proper functioning of the patient’s systems and organs.

Prevention

The question of whether it is possible to become infected with meningitis interests many. But other problems are no less pressing: how to protect yourself from the disease and are there any vaccinations against brain inflammation? Meningitis is a contagious disease. But even if a child or adult is surrounded by a patient with inflammation of the meninges, one should not take this fact as a sentence of imminent infection. Meanwhile, protection should be taken care of in advance.

One of the most effective measures prevention bacterial meningitis is a vaccination against pathogens. Nowadays, vaccines against meningitis come in three types: protein, polysaccharide and conjugate. Within each group of vaccines, there are drugs that are most suitable for different age categories. Which vaccine to choose for an adult or a child, and how often to vaccinate, should be determined by the attending physician.

Vaccination is, although not 100 percent, still a good guarantee that healthy man won't get infected.

To protect yourself or your child from infection with viral meningitis, it is also important to follow the rules of hygiene and Sanitary Regulations, eat only clean fruits and vegetables, and wash your hands thoroughly with soap before each meal. The most common source of meningitis infection in the summer is polluted water bodies. To protect yourself from problems, it is important to avoid swimming and especially not to drink water from them.

An excellent prevention of meningitis is avoiding contact with infected person. But if this has already happened, you should undergo a course of chemoprophylaxis. It is also mandatory to disinfect the room where the patient was, and monitor contact persons. If contact with a carrier of infection is inevitable (for example, someone in the household gets sick), respirators or respirators must be used to prevent infection by airborne droplets. gauze bandages. Remember: the infection first enters the upper respiratory tract of a person, settling on the mucous membranes, and then spreads throughout the body. But infection by airborne droplets does not always occur, but only in cases of reduced immunity and impaired functionality of the blood-brain barrier, which protects the brain from harmful substances. To prevent infection, family members are prescribed a course of rifampicin and vaccination using a conjugate vaccine. By the way, many people are interested in whether it is possible to get meningitis again. As a rule, this does not happen, but the possibility cannot be completely ruled out.

If meningitis was diagnosed on time and treatment was successful, a person has a chance to live a long, full life. But for everything to be exactly like this, after completing treatment in a hospital, you will have to follow the doctor’s recommendations.

After suffering from meningitis, it is important to continue monitoring with a doctor: it is important to be examined by a neurologist every three months. And so on for at least 2 years. In addition, some restrictions are temporarily imposed on the regime and way of life. It is forbidden to fly on airplanes for at least 6 months after illness. Flying during this period is dangerous because during the flight the intracranial pressure, which can negatively affect the restoration of cerebrospinal fluid dynamics after inflammation of the meninges. Also, doctors do not advise going to the seaside immediately after an illness, especially for children. The temporary ban also applies to sports: after illness, heavy physical activity should be avoided for about 2 years.

You will also have to reconsider your usual diet: give up fatty and fried foods in favor of boiled, stewed, baked or steamed. For meat, give preference to dietary varieties: poultry, and fish. It is useful to eat boiled porridge as a side dish, and heat-treat fruits and vegetables before eating. It is useful to eat low-fat dairy foods; the best drinks are, if not strong. The diet after meningitis completely excludes alcohol.

Physiotherapy during the rehabilitation period should consist of a course of massage, electrophoresis using medicines. To restore cognitive functions and coordination, they resort to magnetic and magnetic laser therapy, and use electrosleep. Well physical therapy will help restore motor function. But for this you need to exercise under the supervision of a physical therapy specialist. To restore range of motion, strength and coordination, occupational therapy is used, and a cognitive program is necessary to restore memory, attention and logical thinking.

Possible complications

Inflammation of the meninges itself is a serious problem. But against the background of this disease, other, no less complex complications are possible.

One of the most common is cerebral edema. As a rule, a critical excess of cerebrospinal fluid accumulates already on the second day of the disease. A complication can be suspected based on several factors: external signs. The patient suddenly loses consciousness, he develops shortness of breath, indicators blood pressure sometimes they drop sharply, sometimes they increase. There are also jumps in heart rate: from severe bradycardia (slow) to tachycardia (rapid). If cerebral edema is not removed in time, death is possible, which usually occurs due to paralysis of the respiratory center.

The second common danger is infectious-toxic shock. It occurs as a result of poisoning of the body by decay products of pathogenic microorganisms. Against the background of this process, the patient’s body temperature usually drops, but intolerance to light and loud sounds increases, and shortness of breath appears. In many cases, infectious-toxic shock occurs along with cerebral edema. The result is coma and death within a few hours.

After suffering from meningitis, the body will need time to recover. Sometimes quite long. If the inflammatory process was caused by meningococcal infection, then it persists high risk damage to other organs or entire body systems. Prevent severe consequences Only timely seeking medical help will allow.

Meningitis can cause deafness, paralysis, epilepsy, hormonal disorders. In children, hydrocephalus, complete deafness or blindness, acute renal failure, developmental delays, cerebroasthenia. Often, inflammation of the membranes of the brain in children ends in death.

We answer your questions

Do they take you into the army after meningitis?

The question of whether people with meningitis are accepted into the army is of interest to many. Let us say right away that no one with an illness will be taken to the barracks directly, since any inflammation (especially the meninges) should be hospitalized. Workers diagnosed with meningitis are unconditionally given sick leave. If cases of the disease are recorded in a school or kindergarten, then Educational establishment closed for quarantine. But what awaits the young man who suffered from meningitis several years ago? If there is documentary evidence of illness, the conscript automatically enters the reserve.

Meanwhile, the issue of compatibility between the army and meningitis is of interest not only to those who have had the disease, but also to healthy conscripts. Can you get meningitis in the army? Theoretically, such a risk exists, as, indeed, in boarding schools, schools, kindergartens, sanatoriums or children's camps. Therefore, to avoid an epidemic, vaccination is carried out. Conscripts should be vaccinated against meningitis approximately 75-80 days before conscription.

Can you die from meningitis?

Any inflammatory process in the body is already potential danger of death. What then can we say about inflammation of the meninges? But if earlier the survival rate after meningitis was no more than 5-10%, then in our time this figure has increased to around 90. Of course, the risk fatal outcome always remains, but in most cases, patients who have had meningitis live long, fulfilling lives.

Take care of your health and be attentive to your body's signals. If you experience any unusual changes in your health, do not delay visiting your doctor. Be aware of the consequences of delaying treatment for meningitis.