Meningitis

Health And Medical Video: Agyhártyagyulladás (October 2018).

Anonim

Meningitis is an inflammatory process that occurs in the dorsal and brain membranes.

When timely treatment of the disease is completely curable. However, if you start the process and see your doctor late, even a lethal event (death) is possible.

The disease affects the entire age structure of the planet, but children and men who are most often exposed to this disease.

The spread of meningitis varies from country to country. So in some African countries, the incidence of this disease in some years is higher 30-60 times than in other states.

Causes of the disease

Meningitis may be caused by various microorganisms (bacterial viruses). The most common are meningococci (70% of all diagnosed meningitis), streptococci, staphylococci, pneumococci, klebsiella, hemophilous sticks, salmonella.

Meningococcus under a microscope looks like dual arranged round microorganisms of a rather small size. They enter the body by airborne droplets from a person in the body of which this bacterium is present. It can be as a healthy carrier, and patients with meningitis or nasopharynitis (an easy form of the disease that affects only the nose and throat).

The increase in incidence is due to winter and spring. This is due to low ambient air temperatures, sharp fluctuations of these figures, high humidity and a large number of people in closed and poorly ventilated areas. Against the background of reduced immunity, the infection is more easily transmitted between humans.

After meningococcus falls on the mucous membrane of the nasopharynx, only 10% of people have nasopharyngitis and another 5% of meningitis. The rest are carriers of this infection.

After meningococcus falls on the mucous membrane of the nasopharynx, it enters the bleeding that carries the microorganisms into the shells of the brain. There, the bacteria multiply and secrete the products of their life, which leads to the appearance of the first symptoms of the disease (primary-septic process). After the death of a part of the bacteria released toxin, which affects the vessels of the brain and other organs, which leads to a deepening of the clinical picture. In this regard, the effects of meningitis may be the worst.

Classification of meningitis

There are several meningitis classifications. By systematizing each of the points, the infectious disease physician exhibits the most accurate diagnosis and prescribes the appropriate treatment.

Classification by the nature of ignition:

  • Serous meningitis;
  • Purulent meningitis.

Classification for reasons:

  • Bacterial (meningococcal, staphylococcal, streptococcal, syphilitic, and others);
  • Viral (infectious) meningitis caused by influenza virus, rubella, mumps and others;
  • Fungal meningitis (candidiasis);
  • Protozoal (caused by mycoplasmas, toxoplasma);
  • Mixed meningitis (a combination of each of the above-mentioned pathogens).

Classification by origin:

  • Primary - the microorganism that caused the disease, immediately struck the shell of the brain;
  • Secondary - meningitis was preceded by another disease caused by one and the same causative agent.

Classification by the course of the disease:

  • Acute - symptoms develop quickly, the patient's condition is heavy;
  • Chronic course - the symptoms are weakly expressed, not dangerous to life in the course of timely treatment;
  • Fulminant (lightning) flow - the symptoms develop very quickly, the state is extremely severe, with frequent fatal cases, with the slightest delay in the treatment.

Symptoms of meningitis

Meningococcal meningitis develops quite quickly and dramatically. The first signs that are characteristic of the first day of the illness are:

  • A sharp jump in body temperature (up to 39-40 ºС);
  • Nausea and multiple vomiting do not relieve it;

  • dizziness;
  • Headache of varying degrees of severity (depending on the level of intracranial pressure);
  • Characteristic outside the patient: lies on the back, which is curved arc, head is thrown, legs bent in the knee joints (brought to the abdomen), stomach engraved;
  • Small rash on the body (can be detected within 1-3 hours);
  • Redness of the throat and tonsils.

In the absence of treatment from the first day to the second there are more severe signs of the disease: loss of consciousness; Delirium against the background of high body temperature and intoxication; Convulsions in different parts of the body.

In severe meningitis or in the absence of treatment after 5-7 days of illness occur: coma; Paralysis of different nerves (facial, oculomotor, nerves on the hands and feet); Court attacks merge into one another; Paralysis of the respiratory muscles against the background of the trial, which may end with death; The spread of blood infection with the development of meningococcemia (rash of reddish-brown color, increased heart rate, shortness of breath, lowering blood pressure).

In the event that the course of the disease is not severe and the treatment was prescribed in a timely manner, then at the beginning of the second week of the disease, the symptoms go down: there is a decrease in body temperature, appetite improves, the intensity of headaches decreases. After 1-5 weeks there is a complete recovery.

With the lightning (fulminant) form of meningitis, symptoms develop over a period of several hours to 1 day, leading to either irreversible changes in the body or death of the patient. Clinically, all of the symptoms described above develop in a very short time, and the patient dies, and does not come to the senses.

Diagnosis of meningitis

For the diagnosis of meningococcal and other forms of meningitis, the patient's examination and examination of the so-called membrane symptoms are first and foremost:

  • Brudzinsky's upper symptom: the doctor cant his head lying on the back of the patient to the chest, with his meningitis his legs bend in the knee joints;
  • The average symptom of Brudzinsky: when you click on the area of ​​the pubic bone, the same bending of the feet of the patient occurs;
  • Lower Brudzinsky's symptom: the doctor bends one leg of the patient in the knee and hip joint, while the other leg also bends to the patient with meningitis;
  • Kernig's Symptom: If you bend your leg in the hip and knee joint, it will be impossible to bend only in the knee.

With positive mucosal symptoms, a laboratory diagnosis of meningitis is performed, for the final confirmation of the diagnosis. To do this, take a cerebrospinal fluid (liquor), by puncture in the region of the lumbar spine, and wash off the nasopharynx. This material is sent to a laboratory where several studies are conducted:

Bacterioscopy of smears. Preparations are painted with special dyes and in a microscope, check and identify the pathogen. Bacteriological study. The animal's serum is added to the material of a sick person (as a nutrient), and pure cultures are harvested on special vegetable media. After that wait, when the colonies give growth and then do microscopy of the received microorganisms. Research using cultivation. Determine the presence of a viral pathogen (rubella, measles, flu). Serologic examination. Determination of the antibody titer for certain pathogens. PCR (Polymerase chain reaction). Determination of the genetic material (DNA or RNA) of the meningitis agent. Immunoenzyme analysis (IFA). The detection of the pathogen antigen in saliva, urine, stool, blood or liquor is detected.

Treatment for meningitis

For the treatment of meningitis of any form medication is used. In the first place, it should be aimed at the elimination of the pathogen. If it is a bacterium, antibiotics are used, if viruses, then antiviral drugs. Before you can prescribe an antibiotic, you need to check its sensitivity to this pathogen. Antibacterial drug should be taken as long as the body temperature is not normal, after which another 1 week.

When meningococcal meningitis, Penicillin antibiotics (penicillin, amoxicillin) are prescribed. This drug is administered intramuscularly, 300,000 OD per 1 kg of body weight per day. Multiplicity of injections - every 4 hours (for children every 3 hours).

In the presence of increased intracranial pressure and in the hypostasis of the brain prescribed diuretics. The most effective include furosemide (lasix). It is injected intravenously over 40-80 mg once a day.

In order to reduce the effects of intoxication and restore the water-salt balance, it is necessary to enter solutions. They are selected depending on the composition of the electrolytes in the blood. This may be an ordinary physiological solution, albumin, reopolyglucine, sodium carbonate.

Folk methods of treatment can not be used categorically, because they are practically not effective and the patient may die.

Complications of meningitis

The complications of the disease are quite diverse and often irreversible:

  • Uveitis and blindness;
  • strabismus;
  • Sores (necrosis on the skin);
  • Lack of development in children;
  • Paralysis and paresis;
  • death.

Prevention of meningitis

Prevention of this disease is divided into nonspecific and specific. Unspecific include: compliance with the rules of personal hygiene, retention from patients with meningitis. Specific prophylaxis includes vaccines against pathogens (from the hemophilic sticks, pneumococcus, neisseria, measles, rubella and mumps, and chicken pox).

Meningitis
Category Of Medical Issues: Diseases