Meningitis - Causes, Symptoms and Treatment .MF .
Meningitis - an inflammatory disease of the brain membranes.
causes of meningitis
According to the etiology (cause of the) meningitis are contagious, infectious and allergic - neyrovirusnyh and microbial (serous meningitis, flu-like meningitis, tuberculosis, herpes), fungal meningitis, and trauma.
By location of the lesion is isolated panmeningity - affects all the meninges, pahimeningity - mainly affected dura, leptomeningity - affects the arachnoid and the pia mater.The primary lesion arachnoid - arachnoiditis - as a result of the clinical features highlighted in a separate group.
Meningitis is divided into serous and purulent.
By origin distinguish primary - this includes most neyrovirusnyh meningitis, purulent meningitis and secondary - the influenza, tuberculosis, syphilitic.
By the nature of the CSF - serous, purulent, haemorrhagic, mixed.
Adrift - lightning, acute, subacute, chronic.
Localization - convexital (surface) and basal (deep - at the base of the brain).
on ways of infection
Any meningitis occurs meningeal syndrome - increased intracranial pressure - arching headache with feeling of pressure in the ears and eyes, vomiting, light and sounds are annoying (photophobia and hyperacusis), high temperature, may epipristupy rash.Symptoms and treatment of meningitis varies.
purulent meningitis - heavy microbial inflammation of the meninges.It meningitis, called meningococcal disease, streptococci, staphylococci, pneumococci and other microbes - bacteria coliform, Pseudomonas aeruginosa ...
Risk Factors purulent meningitis: intoxication - smoking, alcohol, infections, stress, hypothermia, insolation - all that weakens the protective capabilitiesorganism.
disease Source - first-order carriers (not ill, but are germ), the second order (ill ARI, tonsillitis, pharyngitis).
are ill with meningitis at any age.
meningococcus hits the meninges of the nasopharynx by hematogenous.It convexital meningitis - severe inflammation, pus spreads, forming a "festering cloak."
Symptoms of purulent meningitis
purulent meningitis is the rapid start - fast temperature rises, growing headache, nausea, repeated vomiting, may develop epipristupa, symptoms of cranial nerves are affected all the internal organs - meningokokktsemiya - pericarditis, an ulcer, pyelitis, cystitis, affects the joints.The patient receives a characteristic pose with legs bent and his head thrown back.There are cold sores and purpura, roseolous rash on the skin and mucous membranes.At 2-3 day coma may develop.
rash with meningitis
optometrist examining patient - the fundus develop congestion.The leading role is a lumbar puncture - defined CSF pressure, increased neutrophils.
Neurologist sees meningeal signs - stiff neck (inability to bend his head and touch the sternum), Kernig symptom (inability to straighten a bent at the hip and knee leg joints), pain with pressure on the eyeballs, Brudzinskogo symptom (when you try to tilt your head forwardsupine leg bent at the knees, with pressure on the pubis legs bent at the knee joints).
necessary blood tests - found high leukocytosis and COE, leukocyte formula shift to the left.In severe cases, while reducing the body's defenses - leukopenia.
fulminant more often in newborns - baby cries, stunning chills, fever and dies (from hours to 3 days).In adults for acute, subacute.Proceeds 4-5 weeks with good yield.Subacute is more common in older people - the slow development of a long period of precursors.Older people may atypical course, there are only signs of nasopharyngitis or epipripadok.Perhaps a slight, moderate and severe course of meningitis.
characteristic posture of the patient with advanced meningitis.
head thrown back
View next photo is not recommended for children and people with a weak nervous system.
Photo Brain died from purulent meningitis - visible inflammatory changes and purulent raids - "festering cloak" - the brain's convolutions.
Complications purulent meningitis
possible complications: sepsis, hydrocephalus, hypothalamic syndrome, visual impairment, hearing loss, asthenic - neurotic syndrome, internal organ damage.
Treatment of purulent meningitis
The earlier the diagnosis and treatment is started, the more favorable the outcome.So do not delay the visit to a doctor and to self-medicate.
the appointment of treatment particularly important role is played by the exact definition of the pathogen.It depends on the specific treatment and outcome.
treat patients with purulent meningitis in infectious hospitals with massive doses of antibiotics (penicillins, aminoglycosides, cephalosporins), sulfa drugs, spend most powerful dehydration (hormones, diuretics), detoxification.Symptomatic treatment is prescribed therapist, optometrist, pulmonologist, ENT.
Clinical supervision after recovery and discharge from the Hospital for Infectious Diseases carries a neurologist.
Self unacceptable and will result in death.Folk remedies do not apply.
Prevention of purulent meningitis
as prevention focuses on sanitation foci of chronic infections - diseases of the nasal cavity and paranasal sinuses, ear, teeth.All contact with the patient is observed, disinfection room.
secondary purulent meningitis
secondary purulent meningitis is milder for no rough start, the temperature is not so high.There is a case of sepsis in the postoperative period, osteomyelitis, severe pneumonia.
limfotarny Acute meningitis
limfotarny Acute meningitis - serous meningitis, occurs in the form of epidemic outbreaks and sporadic cases.Carriers of the virus are mice (wild and domestic), who excrete the virus from nasal secretions, urine, feces and contaminate the surrounding human subjects.Upon infection - the beginning of acute gastro - intestinal disorders (nausea, vomiting, diarrhea, abdominal pain), normal or high temperature and development of meningeal syndrome.Possible loss of 3 and 6 pairs of cranial - cerebral nerves (oculomotor and outlet).
flow differs reverse development without residual effects.
The group of serous meningitis meningitis are caused by viruses poliomielitopodobnymi Coxsackie, ECHO.They differ in the summer-autumn season and more often affect children.The development of acute - fever, meningeal syndrome, gastro-intestinal disorders.Perhaps two-wave current.
development of serous meningitis is possible with mumps, influenza, herpes infections, fungal diseases, protozoa (malaria, toxoplasmosis).
When lumbar puncture cerebrospinal fluid clear, pressure is raised, there is a lymphocytic pleocytosis.From the cerebrospinal fluid and nasopharyngeal swabs can be isolated serous meningitis virus.Coxsackie virus could be isolated from feces.When looking for mumps meningitis pathogen in saliva.Cryptococcus causes a severe form of meningitis in patients with AIDS.When syphilis develops late syphilitic meningitis.
TB meningitis - serous meningitis.
Pathogen - tubercle bacillus (Mycobacterium) Koch.Carriers are almost all men.The mode of transmission - airborne.
Suffer all ages.Previously, there was a spring - autumn season, now growing incidence of tuberculosis and no seasonality, occurs year-round.On the increase in the incidence affect social conditions - unsanitary living conditions, malnutrition, unemployment, the growth of "undertreated" patients with tuberculosis.The contacts are everything.Meninges are affected in the presence of the body of tuberculosis focus in the lung, bone - joint system, kidneys, reproductive organs.
spread in the body: hematogenically liquor-by.
TB meningitis - basic process - 3-4th ventricle, Varol medulla.
symptoms develop gradually with a long period precursors - fatigue, weakness, sleep disturbances, loss of appetite, low-grade fever, night sweats, prolonged headache that can last 2-3 weeks.Then amplified headache, vomiting occurs, develops meningeal syndrome.Further, the condition worsens, it affects the cranial - cerebral nerves (usually the second, third, sixth, seventh pair).Thus there is ptosis (drooping of the century), strabismus, limitation of movement of the eyeballs, the eye can not be closed completely, the corner of the mouth droops, cheek unilateral air and "Sail" at breath.In the absence of specific treatment may be paralysis, respiratory disorders, swallowing, coma.
Current tubercular meningitis atypical longer than typical.
distinguish tuberculous meningitis with an acute course, with epileptichekim attack without meningeal signs, psevdoopuholevoe development, subarachnoid.
diagnosis extremely difficult.From forms of tuberculosis does not depend.It may be the first manifestation of tuberculosis.The differential diagnosis spend with other forms of meningitis, subarachnoid hemorrhage, a tumor.Detection of Mycobacterium particularly important for the proper and timely treatment.Without specific treatment the mortality rate is very high.Before the opening of Pasco in 1952 was 100% mortality from tuberculous meningitis after 3 - 4 weeks from the onset of the disease.
Complications biggest of all meningitis - paresis, paralysis, hydrocephalus, optic atrophy, vestibulopathy, hypothalamic and cerebellar disorders, hyperkinesis, tuberculoma.
Treatment long, in TB dispensaries.Specific treatment appoints phthisiatrician (PAS, ftivazid, tubazid, rifadin, isoniazid).The non - neurologist.Use hormone therapy, dehydration, detoxification, symptomatic treatment, antiholinesteraznye means, vitamin therapy and neuroprotective agents.Treatment long, up to a year - one and a half years.After hospital used the spa treatment on the South Coast.
Read more about this disease you can read in the article "tubercular meningitis."
conduct mass prevention of tuberculosis - primary BCG vaccination of newborns still in the hospital (the first time the vaccine was introduced newborn in 1921), the control of immunity - Mantoux test for the selection of patients for re-vaccination, fluorography examination of the entire population.It is necessary to complete the treatment of diseased and control monitoring of all, history of TB to prevent the TB epidemic.
In 1993, the WHO declared TB a national disaster, and on 24 of March - World TB Day.The seriousness of the problem of tuberculosis can be judged by the existence of WHO's special program, which allows to identify and heal the sick, which operates in 180 countries around the world.
Vaccination massively carried out (according to the calendar of vaccinations) prevent many diseases that can cause meningitis.Used vaccines against Hib, meningococcal disease, pneumococcal disease, measles, mumps, rubella, varicella, influenza.
Doctor's consultation on meningitis:
Question: when held with tuberculous meningitis lumbar puncture?
Answer: if the minimum phenomena meningism - shows immediate lumbar puncture.Found high CSF pressure, increased protein content, sugar level drops, chlorides are reduced.For sowing the tubercle bacillus analyzed three tubes in which a film is formed on standing, and it is possible to find the causative agent.Liquor taken twice a day for the diagnosis, 2-3 weeks after the treatment assigned to monitor specific designated doses, and then three times before discharge to monitor recovery.
question: how can you protect yourself in contact with a patient with meningitis?
Answer: in contact with the patient must use gauze bandage, wash your hands with soap and water, disinfected tableware, persons who are held in close contact chemoprophylaxis - rifampicin, ceftriaxone, immunoglobulin.
Question: Does a computer tomography for the diagnosis of meningitis?
answer is yes, do differential diagnosis requires the exclusion of serious brain diseases - subarachnoid hemorrhage, brain abscess, brain tumors.
Question: What is meningismus?
Answer: meningism - blurred manifestation of meningeal symptoms with infection, influenza, intoxication.Lasts 2 - 3 days and tested.Most events are meningism children.
neurologist Kobzev SV