Meningeal meningitis. According to the mechanism of occurrence

Headache and high fever are not always the result of an acute respiratory illness, sometimes things are 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 is this disease - meningitis and what causes it? Meningitis is an acute inflammatory disease of the central nervous system (CNS). In modern neurology, this disease is, if not the most common, then at least in the leading positions.

Shell differences

In the course of the development of the disease, the outer membranes of the brain or spinal cord are damaged. It is noteworthy that the 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 triggered by various viruses, bacteria or fungi. Moreover, there is such a thing as secondary meningitis, which develops against the background of a 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 main 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 infection, etc.).

Types of meningitis

To the great regret of doctors, meningitis has several varieties. Thus, the classification of the disease consists of more than seven sub-items, which in turn significantly complicates the diagnosis and appointment 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;
by severity.

By etiology

The classification of the 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 hemophilia.

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

Pneumococcal infection refers to infectious diseases, 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 a cause of development, has strong allergic reactions to various things.
As it became clear from the name - the fungal type of the disease has a fungal structure. In particular, the disease is characterized by the least rapid progression compared to the infectious species. The development of the disease is provoked by fungi such as Candida and some others. Mushrooms are carried with the products of the digestive system of birds, unwashed fruits, and unpasteurized milk.

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

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 (meningococcus, golden streptococcus, enterobacteria, spirochetes, etc.), hence the name.

The viral nature of the disease is easier to tolerate by humans and has a better survival rate among patients than the bacterial form. The disease is provoked by various viruses, but 80% of cases were due to 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.

The nature of the inflammatory process

By the nature of inflammation, there is a complete and incomplete classification. Complete includes:

purulent;
hemorrhagic;
mixed.

Purulent meningitis is an infectious disease. The cause of the development of which is a 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 of purulent inflammation in the body, and the infection from there enters the brain.

What is the difference between diseases

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 susceptible to this disease.

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

With the flow

According to the nature of the process, there are:

spicy;
subacute;
recurrent;
chronic.

The acute type of the disease is manifested by lightning-fast development and rapid course. Symptoms appear almost all at once, 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, up to the onset of symptoms after several years (the so-called chronicity of symptoms).

The recurrent form of the disease is characterized by an undulating course. They note the deterioration, then the 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 spreading the infection with the help of blood or lymph, and accordingly, this infection can affect other organs.

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

According to the localization of the inflammatory process

According to localization, meningitis is:

convexital;
basal;
diffuse;
local.

Convexital means superficial. That is, the disease proceeds from the outside of the shell of the brain.
In turn, the basal type of the disease means in-depth inflammatory processes. This type of disease is the most dangerous and more difficult to tolerate.

The diffuse view is characterized by damage to the entire plane of the membrane of the brain, while the local one, 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 various causes can be distinguished for different types. However, regardless of the pathogen, there are general conditions that contribute to the development of the disease. So, the cause of the disease can be:

viruses or bacteria affecting the cerebrospinal fluid;
the presence in the body or the recent end of an infectious disease (flu, herpes, mumps, etc.);
using unwashed items after a potential carrier of the virus;
alcohol abuse;
surgery on the spinal cord or brain;
head injury;
bites of insects or rodents (the bite itself does not mean the fact of infection transmission, 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;
the presence of renal failure.

It is possible to transmit the disease to the child from the mother during childbirth

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

How is meningitis transmitted?

The causative agents of meningitis are different, and, accordingly, their transmission paths are different. Undoubtedly, this disease is contagious and can be transmitted from person to person by airborne droplets or through the blood.

There are two options:

Transmission of an 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 get infected not only from a person. Some rare forms of the disease can be picked up while swimming in water bodies. There is also the possibility of infection through the bite of an insect that can carry the disease.

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

Incubation period of meningitis

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

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

The period without fever and other unpleasant symptoms of the disease in this disease can be different. It is very difficult to track the pattern, since at the initial stage it is not clear what kind of infection struck the body (an exception may be a secondary type of disease).

infection under the microscope

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

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 (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 a high temperature and a headache, which has a growing character. Is there always a high temperature? Yes, this is the most important symptom. And usually, it rises for no apparent reason at all, and later the rest of the symptoms are connected.

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

meningeal symptoms - symptoms unique to meningitis

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

As for children, the manifestation of the disease in them is somewhat different. When it comes to, many of the symptoms are similar to those of adults.

Clinical picture in adults and children

As for infants, the symptoms of meningitis they may have are the following:

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

In addition, the development of strabismus, drooping of the upper eyelid is possible. The skin of the child may have a bluish tint.

In place of the fontanel, the 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 the pathogenic flora in the nose and in the pharyngeal cavity;
coagulogram;
HIV test;
liver puncture;
analysis for syphilis;
puncture of 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, an ophthalmologist, an endocrinologist and a neurologist.

In addition, before conducting this study, the doctor must conduct a patient survey to determine the presence of past diseases, the general condition, in order to make a conclusion and make the correct diagnosis.

Treatment of meningitis

Is meningitis treatable or not and can this disease be cured? Undoubtedly yes. This disease is curable. Which doctor treats this disease? Infectionist, despite the fact that the disease affects the nervous system. Since the disease is of an infectious nature, it means that such a specialist should treat it.

So, meningitis is treated only in a hospital, as the patient must be constantly under the supervision of a specialist.

Therapy is divided into:

antibacterial;
antiviral;
antifungal;
detox;
symptomatic.

Such differences are important, since you cannot treat a disease caused by a fungus with drugs from a virus, and vice versa. The exception, of course, are interchangeable drugs.

Antibacterial therapy

In the treatment of the bacterial form of meningitis, the patient is in any case shown to use. In addition, in the case of severe inflammatory processes, the use of corticosteroid drugs is indicated to reduce inflammation. And to reduce the convulsive effect, tranquilizers are shown.

The duration of treatment is from 10 to 14 days. Cancellation of antibiotic therapy is possible in case of normalization of body temperature, the disappearance of symptoms of intoxication of the body. In addition, to determine the patient's condition, he may be prescribed repeated blood and cerebrospinal fluid tests.

It should be understood 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 drugs so that treatment is not just for the sake of treatment.

Below is a table with the names of drugs capable and not able to overcome the BBB.

Comparative table of antibiotics capable and not able to overcome the BBB

In the case of the use of antibiotics, it is mandatory for the patient to prescribe medications to normalize the intestinal microflora in order to avoid his disorder. Young children are especially susceptible to this.

Antiviral therapy

Usually, the viral form of meningitis in a severe form 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 associated with the elimination of the symptoms associated with the disease.

In particular:

To eliminate vomiting - cerucal.
To reduce the general intoxication of the body - saline with prednesolone and vitamin C intravenously.
To eliminate headaches - lumbar puncture or diuretics.
to reduce the temperature - antipyretic drugs based on paracetamol.
to eliminate pain in the head - papaverine and a 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 types of disease is fungal meningitis. Previously, before the discovery of the drug Amphotericin B, the disease showed almost 100% mortality. After the start of the use of the above 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 normalizes.

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

Detox Therapy

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

This type of treatment consists in the introduction of an intravenous solution that reduces intoxication. In particular, such a solution includes - saline with the addition of vitamin C and prednezalon without fail.

Symptomatic treatment

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

Forecast

The consequences after suffering an illness can be very different, or they may not be at all. Since the membranes of the brain and spinal cord are affected during the development of the disease, the consequences are associated with neurological manifestations, in particular, the patient may retain:

Headache.
Hearing and vision impairment.
epileptic seizures.

A fatal outcome is not excluded at all, in the absence of proper therapy or timely assistance with purulent and bacterial meningitis, and in children with its viral forms.

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

Prevention

Hardening of the body.
Prophylactic use of immunostimulating drugs (especially in kindergartens).
Timely treatment of chronic diseases.
Hygiene.
Leading a healthy lifestyle.
Regular exercise.

So, meningitis is a serious disease and, in the absence of proper and timely treatment, it can even take the patient's life. Treatment can only take place in a hospital and under the supervision of a doctor, so in no case do not self-medicate, as this can be deadly. Take care of yourself and your loved ones, take care of yourself!

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, occurring against the background of another disease - otitis media, sinusitis , traumatic brain injury, etc.).

The clinical picture of meningitis is intense diffuse headache, nausea, vomiting, confusion or depression of consciousness up to coma, fever, malaise, tachycardia, myalgia and meningeal syndrome. Meningeal syndrome includes neck stiffness preventing passive head flexion, Kernig's sign (inability to fully extend the leg at the knee joint, previously bent at right angles at the hip and knee joints), upper Brudzinski's sign (flexion of the hip and lower leg when checking for neck stiffness), and lower Brudzinsky symptom (flexion of the hip and lower leg when checking for Kernig's symptom 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 elderly patients, meningitis may present with a combination of fever with confusion or progressive depression of consciousness.

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

In addition to meningitis, meningeal symptoms (“meningism”) can be detected with subarachnoid hemorrhage, intracranial hypertension, volumetric lesions of the posterior cranial fossa (hematoma or abscess of the cerebellum), 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 smooths out the clinical picture of meningitis. In immunocompromised patients, meningitis occurs either as a mild infection with headache and moderate fever, or as a rapidly growing coma.

History reference

Hippocrates

Some scholars believe that Hippocrates was aware of 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 the Scottish physician Robert Witt in a description of the death of a patient, although the relationship between meningitis, tuberculosis and its pathogen 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, the first 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 paper on 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 symptom of the disease was described in 1884 by the doctor of the Obukhov hospital V. M. Kernig. He pointed out that "a symptom of contracture of the knee joints" is an early sign of inflammation of the meninges. Vladimir Mikhailovich Bekhterev in 1899 described the shell zygomatic symptom (painful grimace when tapping with a hammer on the zygomatic arch). Later, the Polish physician Jozef Brudzinski described four meningeal symptoms.

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

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

In 1953, S. N. Davidenkov described a two-wave serous meningitis caused by ticks. The syndrome of acute serous meningitis, caused by infection with the tick-borne encephalitis virus, was distinguished 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, antibodies against meningitis pathogens were obtained by immunizing horses; 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, it was proposed to use steroids to improve the course of the disease in bacterial meningitis.

Types of meningitis

Bacterial meningitis usually occurs due to the penetration of pneumococcus bacteria, meningococcus, Haemophilus influenzae 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, sinusitis.
meningococcal meningitis usually proceeds quite hard; a hemorrhagic rash may occur in the form of spots (asterisks) of different sizes. Spots are localized on the legs, thighs and buttocks, mucous membranes and conjunctiva. The patient is disturbed by chills and high fever, intoxication is possible.
Pneumococcal meningitis occurs quite often and proceeds with the onset of pneumonia in about half of the patients. The disease is most severely tolerated by people with diabetes mellitus, alcoholism, cirrhosis of the liver. Symptoms are damage to consciousness and cranial nerves, gaze paresis, epileptic seizures. Pneumococcal meningitis can recur and is often fatal. Bacterial meningitis can lead to complications such as shock, endocarditis, purulent arthritis, bleeding disorders, pneumonia, 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. At the same time, meningeal symptoms are mild in patients. The disease most often proceeds without disturbances of consciousness.
Tuberculous meningitis is now often one of the first clinical symptoms of tuberculosis. Previously, this form of the disease was always fatal, but now, with adequate treatment, mortality is 15–25% of all cases of the disease. Tuberculous meningitis begins with fever, headache, vomiting. Meningeal symptoms appear, cranial nerves are affected.

Causes of meningitis

The most common causes of meningitis are bacteria or viruses that infect the meninges and cerebrospinal fluid. In children, the cause of meningitis is mainly enteroviruses that enter the body through food, water, and dirty objects. In adults, bacterial meningitis predominates, the causative agent of which is the bacterium Streptococcus pneumoniae. and Neisseria meningitidis. These bacteria do not cause meningitis in the throat and nose, but when they get into the blood, cerebrospinal fluid and soft tissues of the brain, they provoke inflammation.

Sometimes other types of bacteria are the cause of meningitis. Group B streptococcus often causes illness in newborns infected during or after childbirth. Listeria monocytogenes also predominantly affects infants and the elderly. 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 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 in this case.

For all varieties 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 the signs of meningitis are manifested in all categories of patients (women, men, children) in the same way. The difference can only be in the intensity of the symptoms and the rate of development of the disease.

General infectious signs

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

a significant increase in body temperature;
discoloration of the skin (pallor, sometimes cyanosis);
aching pain in the muscles;
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 symptoms of meningitis

The main symptom of meningitis is called meningeal syndrome. Its essence lies in the fact that if, having laid the patient on his back, try to tilt his head to the chest, the patient's legs will bend at the knees, and the tilt 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, meningitis headache is characterized by its 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 movements of the patient, exposure to light or sound stimuli. It is also characteristic that conventional painkillers, with such headaches, are powerless.

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

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

Also, extremely rarely, rashes on the patient's skin can be observed among the first symptoms of the disease. A rash with meningitis, with the course of the disease, can change its character and localization. So, for example, during the first days of the development of the disease, skin lesions appear on the limbs in the form of red spots.

In later stages, the meningitis rash looks like pinpoint hemorrhages on the mucous membranes and skin. In this case, the localization of integument lesions can extend to the entire surface of the patient's body, including the mucous tissues of the eyes, oral cavity, and genital organs.

At the first manifestations of the disease, whether it is general infectious or specific symptoms of meningitis, it is urgent to consult a doctor. The treatment of such a disease is a very time-consuming 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 the serious consequences of this disease.

Diagnosis of meningitis

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

lumbar puncture - a lumbar puncture is made, in 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, the treatment consists in the complex administration of significant doses of antibiotics, often intravenously. Corticosteroids aimed at reducing inflammation may also be used.

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 the 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. Predominantly, treatment focuses on the reduction of concomitant symptoms.

Prevention of meningitis in some of its forms is possible, for which a vaccine is given for a period of about 4 years, but it is currently impossible to completely protect against the disease. The doctor who is 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 about 10% of cases, mortality in viral meningitis, if the process does not turn into encephalitis, does not exceed 1%.

The most common and relatively harmless consequence after meningitis is asthenic syndrome: unreasonable 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 impairment;
paresis, paralysis;
blindness;
deafness (sensorineural hearing loss);
hydrocephalus;
convulsive syndrome;
ischemic stroke (up to 25% of all complications in adults).

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 suffering meningitis, the patient is observed by a neurologist for at least 2 years. In the first year, an inspection is required every 3 months, then 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 the gastrointestinal tract. Of the cooking methods, it is better to prefer cooking, including steaming, baking, stewing. Meat is recommended mainly low-fat varieties: rabbit meat, veal, chicken meat. Lean fish. For children, it is better to cook meat and fish in a chopped form: cutlets, soufflés, pates, it is not necessary for adults to grind. Well-boiled porridges are suitable as a side dish. Vegetables and fruits also need to be heat-treated: coarse fiber can irritate the mucous membrane that has become sensitive for a while. 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 classical massage and various hardware techniques. Electrophoresis of vitamins and some drugs allows you to either relax or, conversely, stimulate the desired muscle groups. With coordinating and cognitive (associated with memory and understanding) disorders, electrosleep, magnetotherapy, magnetic laser therapy are used to restore the functions of the central nervous system. Other methods are also used, which a competent physiotherapist should select for the treatment of the consequences of meningitis based on the condition of a particular patient.
Physiotherapy. This is also a separate and extensive area of meningitis recovery. The exercise therapy specialist helps the patient to restore the skills of movement, gradually and consistently training first the individual links of the motor act, then the “links” between them, moving on to more and more complex interactions. Modern rehabilitation centers use not only gymnastics, but also special feedback suits, robotic simulators and other methods that until recently seemed fantastic.
Ergotherapy. This is a set of methods that is aimed at the 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 the range of motion, strength, and coordination. On the other hand, as part of the rehabilitation system after meningitis, it helps to adapt the existing disabilities to the habits and lifestyle of the patient, teaches you to feel like a full-fledged person and enjoy life, regardless of physical limitations.
Cognitive Therapy- these are exercises aimed at restoring attention, memory, logical thinking.

Useful foods for meningitis

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

A meningitis diet should perform several functions:

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

Depending on the stage of the disease and the complexity of its course, various therapeutic diets should be used. For example, in the acute course of meningitis, diet No. 13 is used, in case of complicated meningitis - a zero diet, in case of 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 complete recovery - No. eleven.

Among the products you can use such as:

lean meat, steamed and mashed (veal, rabbit, chicken, turkey, aspic 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, sour-milk drinks, cottage cheese, acidophilus, kefir, yogurt, non-acidic sour cream in dishes, mild grated cheese);
easily digestible milk fats (cream, butter, sour cream);
foods with coarse fiber (mashed vegetables and fruits);
liquid (up to two and a half liters per day), which helps to 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 water;
low-fat broths;
natural sweet and sour fruit juices diluted with water;
dried wheat bread, lean buns, cookies, crackers, dry biscuit;
boiled or pureed cereals, boiled noodles and vermicelli, baked puddings, cutlets and zrazy from cereals or vermicelli.

You should limit the use of such products as:

animal fats that can cause metabolic acidosis (mutton, pork, goose, duck), smoked meats, canned food;
easily digestible carbohydrates (sweet drinks, jellies, mousses, honey, jam, etc.), which can cause intestinal fermentation processes, 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, rich 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 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);
spicy and fatty sauces, pepper, mustard, horseradish.

Folk remedies for meningitis

decoctions from the herb "camel hay", barley or mint water;
infusion of lavender flowers (three teaspoons for 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 grated poppy for one glass of hot milk, insist 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 consider with you such a disease of the meninges 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- an infectious inflammatory disease of the membranes of the spinal cord and / or brain.

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

The main causes of the development of meningitis are, and fungi. Often, this disease becomes a complication of others, and often ends in death, especially if it is caused by bacteria and fungi.

The basis of the treatment of 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, insufficient ventilation in rooms with a large number of people.

Scientists have also noticed a 10-15 year cycle 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 Europeans.

How is meningitis transmitted?

Like many other infectious diseases, meningitis can be transmitted in a wide variety of ways, but the most common are:

airborne droplets (through, sneezing);
contact-household (non-compliance), through kisses;
oral-fecal (eating unwashed foods, as well as eating with unwashed hands);
hematogenous (through the blood);
lymphogenous (through the lymph);
placental route (infection occurs during childbirth);
through the ingestion of polluted water (when bathing in polluted reservoirs 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 illness, depends on the type of specific pathogen, but in general, it is 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 itself? 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 the precious time to stop the infection and prevent the complications of this disease.

The first signs of meningitis

A sharp rise in body temperature;
Stiff neck (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 are possible.

The main symptoms of meningitis are:

Headache;
– up to 40°С, ;
Hyperesthesia (increased sensitivity to light, sound, touch);
, impaired consciousness (even to the point of coma);
Lack of appetite, nausea, vomiting;
Diarrhea;
Pressure in the eye area, ;
Inflammation of the lymph glands;
Pain with pressure on the area of the trigeminal nerve, the middle of the eyebrows or under the eye;
Kernig's symptom (due to the tension of the posterior thigh muscles, the leg in the knee joint does not unbend);
Brudzinsky's symptom (legs and other parts of the body reflexively move when pressure is applied to various parts of the body or when the head is tilted);
Bekhterev's symptom (tapping on the zygomatic arch causes contractions of the facial muscles);
Pulatov's symptom (tapping the skull causes pain in it);
Symptom of Mendel (pressure on the area of the external auditory canal causes pain);
Symptoms of Lesage (a large fontanel in young children is tense, bulges and pulsates, and if taken under the armpits, the baby throws his head back, while his legs are reflexively drawn up to the tummy).

Non-specific symptoms include:

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

Complications of meningitis

Complications of meningitis can include:

hearing loss;
Epilepsy;
Hydrocephalus;
Violation of the normal mental development of children;
Purulent arthritis;
Violation of blood clotting;
Fatal outcome.

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

The most common causative agents of meningitis are:

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

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

Additionally, barbiturates, nootropics, a high-protein diet, especially various antiviral drugs (depending on the type of virus), may be prescribed.

3.3. Antifungal therapy

Treatment for fungal meningitis usually includes the following medications:

With 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. Detox Therapy

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

To remove toxins from the body, apply: "Atoxil", "Enterosgel".

For the same purposes, a plentiful drink is prescribed, especially with vitamin C - a rosehip decoction, tea with raspberries and, fruit drink.

3.5. Symptomatic treatment

In case of an allergic reaction, antihistamines are prescribed: "", "".

At a strong temperature, above 39 ° C, anti-inflammatory drugs: Diclofenac, Nurofen, "".

With increased irritability, anxiety, sedatives are prescribed: Valerian, Tenoten.

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

To improve the quality and functionality of the cerebrospinal fluid, Cytoflavin is prescribed.

Forecast

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

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

Important! Before using folk remedies, be sure to consult your doctor!

During the use of folk remedies, provide the patient with calmness, subdued light, protect from loud sounds.

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

Chamomile and mint. As a 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 glass of boiling water over a spoonful of mint or chamomile, cover the lid and let the product brew, then strain and drink a portion at a time.

Lavender. 2 teaspoons of dry grated lavender, pour 400 ml of boiling water. Leave the product overnight to infuse and drink 1 glass, morning and evening. This remedy 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 of plants with 1 cup of boiling water, cover with a lid and let the product brew. After cooling the collection, strain it and you can start drinking, at one time the whole glass, twice a day, in the morning and in the evening.

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

Linden. 2 tbsp. spoons of lime blossom 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 a large number of people, especially indoors;

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

- Temper (if there are no contraindications);

- Avoid stress, hypothermia;

-Move more, go in for sports;

- Do not let various diseases take their course, especially those of an 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” in childhood. In fact, the mechanism of infection with this disease is much more complicated and only a warm hat cannot protect against it. Let's say more: you can get sick with 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. The human brain and spinal cord consists of three membranes: soft, arachnoid and hard. If in any of them (or immediately in all) an inflammatory process begins, they speak of meningitis. Inflammation in the dura mater 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 appears, whether it is contagious, whether it is possible to get sick with it again and who is most susceptible to inflammation of the meninges.

Types of meningitis

It is generally accepted that the first symptoms of meningitis were described by Hippocrates, and then by medieval healers. So this disease has been known to mankind 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. Treatment of meningitis is also difficult these days, but thanks to modern knowledge, the survival rate is much higher than a few centuries ago.

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

By the nature of inflammation, meningitis is:

purulent;
serous.

In the first case, the disease is caused by meningococcal bacteria, is very difficult, 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 rarely causes complications.

By origin, meningitis is divided into:

primary (independent disease);
secondary (appears as a complication of sinusitis, otitis media, respiratory infections, osteomyelitis of the bones of the skull, 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.

By the nature of the flow:

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

According to the localization of inflammation:

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

According to the severity of the flow:

mild degree;
medium heavy;
heavy.

In addition, there is non-infectious meningitis. This is a type of aseptic meningitis, that is, a disease caused by any other causes than the bacteria that usually cause acute meningitis - non-communicable diseases, drugs or vaccines. In general, these causes of meningitis are rare. 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 fungal - among pregnant women, patients after chemotherapy, as well as patients with acquired immunodeficiency. Bacterial, also purulent, meningitis can affect even babies up to a year old, and viral (serous) in children usually appears after mumps or due to ECHO. The viral form is not as scary for children as the purulent one, 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 of infection occur precisely in the warm season, as well as in countries with a temperate climate. However, experts also record spikes in the spread of the disease in the off-season. Several factors contribute to this at once: an increase in humidity and a decrease in air temperature outside, seasonal hypovitaminosis, as well as a longer stay in poorly ventilated rooms. Not so 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.

Most susceptible to the disease are people with weakened immune systems, children under 5 years of age (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 (more often at the age of 20-30 years). Also at risk are pregnant women, those with diabetes, ulcers of the digestive organs, AIDS, those suffering from chronic fatigue, or people suffering from malnutrition. In the countries of the so-called "Third World", the prevalence of meningitis is almost 40 times higher than the European average. It is also interesting that in Europe and Russia, a disease of bacterial etiology occurs about 3 times less often than a viral one. The main reason for this, doctors call vaccination, with which you can prevent the bacterial form of the disease. The body after vaccination, faced with the causative agent of the disease, 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 particles of saliva during coughing and sneezing);
fecal-oral (through unwashed hands, fruits and vegetables, contaminated water);
blood contact (through the blood);
lymphogenous (through lymphatic fluid);
placental (from pregnant women to the fetus);
water (when swimming in open water or pools);
contact-household (through household items, dishes, toys);
through insect bites (mainly in Africa).

In babies under 1 year old, meningitis can be caused by the same reasons as in adults or have other reasons. For example, be the result of a birth injury, prematurity, damage to the brain or spinal cord, sepsis, disease of the middle ear or nasopharynx. If a woman has had meningitis during pregnancy, the risk of transmission of the infection to the fetus is very high, and this can lead to impaired development of the child. In most cases, meningitis during pregnancy ends in spontaneous abortion or intrauterine fetal death. But even if the fetus survived, doctors usually advise women to terminate their current pregnancy.

Options for the course of meningitis

The most dangerous meningitis is for children under 5 years of age. It is unfortunate that every 20th baby diagnosed with "inflammation of the meninges" dies. The most dangerous form of infantile meningitis is considered to be a disease caused by streptococcal infection. Infection usually occurs during the passage of the baby through the birth canal of the mother. In this case, the disease develops at lightning speed and the child either dies during the first month of life, or suffers from serious developmental disorders. A complicated form of meningitis is no less dangerous for babies. And already at the age of 1 to 5 years, children are more likely to get viral meningitis, which is usually easier than bacterial.

The course of the disease consists of three periods: incubation, prodrome 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 a few minutes (rapid development) to several years (chronic inflammation). The duration of the incubation period also depends on the state of the patient's immune system: 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 a 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 already on the first day. Acute meningitis also proceeds according to the "accelerated" program: as a rule, the infection takes 3 days to reach its peak or even cause the death of the patient.

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

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, if most forms of inflammation in the brain proceed quite quickly, then 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 a recurrent disease is the herpes simplex virus type 2 (Mollare meningitis). Bacterial meningitis can recur due to congenital or acquired defects in the base of the skull or spine.

Symptoms

The insidiousness of meningitis is in its rapid development. Medicine knows cases when a fatal outcome occurred just a few hours after the onset of the acute period of the disease. In the classical 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 will have a chance for a cure. 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 alarm signal, the disease manifests itself as general infectious signs: the patient has a feeling of chills, fever, fever, and in some cases, skin rashes may appear.

The main symptom of meningitis is a 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, pain can be localized in the forehead and in the occipital region, giving to the neck and spine. Bursting pain is associated with an increase in intracranial pressure as a result of the action of pathogen toxins. The pain syndrome is aggravated by head movements, as well as due to loud sounds and bright lights. Another sign that is important for differentiating the nature of a headache is stiffness (strong tension) of the occipital muscles. Patients with meningitis (adults and children) do not lie in their usual position on their backs. To ease the pain, they turn on their side, pull their knees up to their stomachs, and instinctively tilt their heads back.

Inflammation of the meninges in many cases is accompanied by nausea and severe vomiting. Moreover, the gag reflex does not stop even with a complete refusal of food. In addition, the patient's body temperature rises (jumps or stays stably high at 39-40 degrees) and does not go astray with traditional antipyretics, severe weakness and sweating appear. The patient complains of intolerance to bright light, which exacerbates the headache. It is also possible to suspect the presence of meningitis in cases where a bursting headache is accompanied by a violation of consciousness (a person slowly and with difficulty answers questions or does not respond to requests at all). Mental disorders indicating inflammation of the membranes of the brain can be manifested by hallucinations, apathy or aggression. The patient may have cramps in the legs and / or hands, muscle pain, strabismus (if the inflammation has spread to the optic nerves).

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

Diagnostics

An experienced doctor can already suspect meningitis in a patient by external clinical signs. But it is too early to make an accurate diagnosis based on symptoms alone. Moreover, it is important not only to confirm or refute the presence of the disease, but also to determine its type, stage of development. For this, the patient will have to undergo a comprehensive examination. Patients in such cases donate blood for a general analysis (KLA), a general urinalysis and a smear from the pharyngeal mucosa. One of the main confirmatory tests is a spinal cord puncture and laboratory diagnosis of CSF (cerebrospinal fluid). Since the brain and spinal cord are in constant contact, cloudy cerebrospinal fluid is always considered as the main marker of meningitis.

If during the puncture there are signs of increased CSF pressure (cerebrospinal fluid flows out in a trickle or frequent drops), experts regard this as one of the laboratory signs of meningitis. In addition, in a sick person, the color of the cerebrospinal fluid changes: it becomes cloudy white or yellowish green. Not only a CSF 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. Also, the patient usually has elevated levels of sugar and chlorides.

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

Sample test results for meningitis

Indicators	Liquor is normal	Viral meningitis	Bacterial	Purulent
Color/Transparency	no color/transparent		Colorless/clear or opalescent	Whitish or greenish brown/cloudy
Pressure	130-180 mm w.c. Art.	200-300 mm w.c. Art.	250-500 mm w.c. Art.	Upgraded
CSF flow rate 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	Not	Low cellular-protein (protein-cellular after 8-10 days)	Moderately high cytosis and protein (then protein-cell dissociation)	High cellular protein
	1,83-3,89	Over 3.89	Significantly reduced	moderately reduced
Chlorides (mmol/l)	120-130	Over 130	Significantly reduced	moderately reduced
fibrin film	Not formed	At 3-5%	At 30-40%	Rough, often in the form of sediment
Response to puncture	Causes headache and vomiting	Causes relief, the turning point of the disease	Provides significant but short-term relief	Moderate short term relief

In the results of a blood test, neutrophilia or lymphocytosis will be detected, indicating the nature of the disease, as well as an ESR indicator - the erythrocyte sedimentation rate, which in high values indicates the presence of an inflammatory process. In addition to the laboratory study of cerebrospinal fluid and blood, the doctor will definitely need the patient's medical history, he will conduct a thorough neurological examination, and offer to undergo computed or magnetic resonance imaging. With the help of MRI or CT, a specialist will be able to examine the condition of the meninges and find the focus of inflammation. During a conversation with the patient, the doctor will ask how long the headaches began, whether the patient was bitten by ticks or mosquitoes (carriers of the pathogen, in particular in Africa and Central Asia).

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

Treatment

Any inflammatory processes in the body are very serious. And if inflammation occurs in the brain, then there can be no talk of any self-treatment at home. Neither folk 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 the patient seeks help from a specialist, the higher his chances of survival.

A 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 counts, there is not a minute to lose. As an emergency, all patients with suspected meningitis are given broad-spectrum antibiotics. At the beginning of treatment, the doctor may prescribe drugs from the group of penicillins, cephalosporins, macrolides. This will neutralize the bacteria that cause purulent meningitis. In order for antibiotics to take effect immediately, the medicine is usually administered intravenously (dropper), 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 selected for sensitivity, patients are prescribed nootropic and vascular drugs - Nootropil, Piracetam or their analogues are taken to restore nerve cells and the state of blood vessels. As anti-inflammatory drugs, doctors give hormone therapy to patients with drugs such as Prednisolone, Dexamethasone, Methylprednisolone, or Hydrocortisone.

Diuretic therapy is also used in the treatment regimen for meningitis. Diuretic drugs are needed to relieve cerebral edema.

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

Prevention

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

One of the most effective measures to prevent bacterial meningitis is vaccination against pathogens. There are three types of meningitis vaccines: protein-based, polysaccharide, and conjugated. In 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, how often to vaccinate - this should be determined by the attending physician.

Vaccination is, if not 100%, but still a good guarantee that a healthy person will not get infected.

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

An excellent prevention of meningitis is avoiding contact with an infected person. But if this has already happened, you should undergo a course of chemoprophylaxis. It is also mandatory to disinfect the premises where the patient was, and monitor contact persons. In the event that contact with the carrier of the infection is inevitable (for example, one of the household members falls ill), respirators or gauze bandages should be used to prevent infection by airborne droplets. Remember: first, the infection 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 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 either.

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

After suffering meningitis, it is important to continue monitoring with a doctor: it is important to undergo an examination by a neurologist every three months. And so for at least 2 years. In addition, some restrictions are temporarily imposed on the mode and way of life. At least 6 months after the illness, it is forbidden to fly on airplanes. The flight during this period is dangerous because intracranial pressure changes dramatically during the flight, which can adversely affect the recovery of liquorodynamics after inflammation of the meninges. Also, doctors do not advise immediately after the illness to go to the sea, especially for children. The temporary ban also applies to sports: after an illness for about 2 years, heavy physical exertion should be avoided.

You will also have to reconsider your usual diet: give up fatty and fried foods in favor of boiled, stewed, baked or steamed. From meat, give preference to dietary varieties: poultry, as well as fish. As a side dish, it is useful to eat boiled cereals, and heat-treat fruits and vegetables before eating. It is useful to eat low-fat dairy foods, drinks are best suited and, if - then weak. The diet after meningitis completely excludes alcohol.

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

Possible Complications

Inflammation of the meninges is already a serious problem in itself. 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 development of the disease. A complication can be suspected by several external signs. The patient suddenly loses consciousness, he has shortness of breath, blood pressure indicators either sharply decrease or increase. There are also jumps in the heart rate: from severe bradycardia (slow) to tachycardia (rapid). If cerebral edema is not removed in time, then 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 the body with decay products of pathogens. Against the background of this process, the patient's body temperature usually drops, but intolerance to light and loud sounds increases, 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 there is a high risk of damage to other organs or entire body systems. Only timely seeking medical help will prevent serious consequences.

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

We answer your questions

Do they take the army after meningitis

The question of whether they take meningitis into the army is of interest to many. Let's say right away that no one will be taken to the barracks directly with the disease, since with any inflammation (especially the meninges) one should lie in the hospital. Those working with a diagnosis of meningitis unconditionally open a sick leave. If cases of the disease are recorded at a school or kindergarten, then the educational institution is closed for quarantine. But what awaits a young man who had meningitis a few years ago? If there is documentary evidence of the fact of the disease, then the conscript automatically falls into the reserve.

Meanwhile, the question of the compatibility of the army and meningitis is of interest not only to those who have had the disease, but also to healthy conscripts. Is it possible to 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. Meningitis vaccinations for recruits should be done approximately 75-80 days prior to enlistment.

Can you die from meningitis?

Any inflammatory process in the body is already a potential danger of death. What then to 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 of death always remains, but in most cases, patients who have had meningitis live a long full life.

Take care of your health and be attentive to the signals of the body. In case of unusual changes in well-being, do not postpone a visit to the doctor. Be aware of the consequences of late treatment of meningitis.