Meningitis causes. Types of meningitis and their manifestations. Other purulent meningitis

Meningitis is considered an acute disease infectious nature, manifested by inflammation in the membranes of the brain or spinal cord. The disease can occur in a person of any age and gender. This suggests that it is important for people to be interested in how to treat meningitis at home.

The disease in question can be primary or secondary. Primary meningitis is considered initial and looks like inflammation of the membranes in the brain, while secondary meningitis appears due to the influence of infection on any internal organs person.

In addition, the disease can be bacterial, viral, fungal, protozoal and mixed. Based on its course, meningitis is divided into acute, subacute, chronic and fulminant forms. It is worth considering that the fulminant type leads to death within a few days, while the chronic type lasts for months.

The disease is transmitted by airborne droplets and quickly causes an epidemic. The most common causative agents of meningitis are meningococcal, pneumococcal and Haemophilus influenzae.

The viral form of the disease, which is caused by mumps or rubella, less often leads to severe complications. The fungal type is observed with low immunity. Tuberculous meningitis develops gradually and is characterized by increased intoxication.

Infectious process, occurring on the membrane of the brain, can spread to the brain tissue and nerve endings. This phenomenon threatens the patient with deafness, blindness and disability. Only timely and qualified treatment can save a person’s life.

First symptoms of the disease

Doctors who diagnose the disease note in their patients characteristic symptoms. Here are some of them:

1. Pain in the head that is not relieved by medications.
2. Constant screaming in children.
3. Intoxication, causing a rise in body temperature.
4. Severe vomiting caused by irritation of the meninges.
5. Excitement abruptly replaced by apathy.
6. Impaired consciousness, delirious state.
7. Fear of sound and bright light.
8. Strabismus.
9. A rash in the form of small dots all over the body, caused by the presence of meningococcal infection in the body.

In addition, there are several specific signs indicating that we are talking about the disease in question. They are as follows:

1. A man lying in bed throws his head back, bends his knees and puts his hands on his chest. This is the standard position for meningitis - meningeal.
2. The patient experiences stiffness of the muscles at the back of the head: he cannot bend his head forward, because severe pain appears.
3. If you tap a person on the cheekbones a little, he will grimace in pain.
4. During head movement and bending, the pupils may dilate significantly.

If a person notices similar symptoms in himself or a relative, he should immediately call ambulance or see a doctor. Delay can be life-threatening.

Diagnostic procedures

Doctors can make a diagnosis based on symptoms of irritation of the meninges, the presence of intoxication or pathological changes in the cerebrospinal fluid. First of all, the patient needs to perform a lumbar puncture, which helps not only to make an accurate diagnosis, but also to reduce intracranial pressure. It is necessary to remember that meningitis provokes cerebrospinal fluid pressure, so it is recommended to do the puncture very carefully. After all, if the cerebrospinal fluid expires very quickly, then the brain stem may be involved in the process, which can be fatal for the patient.

With meningitis, laboratory tests confirm a rapid increase in cells and protein in the cerebrospinal fluid. If we are talking about a purulent bacterial form of the disease, then an increased number of neutrophils and a decrease in glucose and chlorides may be observed in the cerebrospinal fluid. When viral meningitis is suspected, there are lymphocytes in the cerebrospinal fluid, and the levels of glucose and chlorides are off the charts.

When examining the composition of fluid from the spinal cord, a bacterial agent may be detected in it. To do this, bacterioscopy is performed - culture for reaction to antibiotics, or serodiagnosis - a method for detecting antibodies to viruses.

Which doctor should I contact with alarming symptoms?

Very often, a person faced with a problem does not know where to turn to start treating the disease. Initially, you should visit your local physician. If we are talking about a child, then the parents should take him to the pediatrician.

In the case when the disease proceeds without consequences and the patient seeks help in a timely manner, treatment can be done by a therapist or at home. If the disease is advanced and there is a risk of severe complications or death, then an infectious disease specialist or neurologist will come to the rescue.

Methods of treating the disease

We can say with confidence that the disease in question can be treated. But here it should be taken into account that this statement refers to a timely diagnosed form of the disease. When the disease is not treated for a long time, problems with the nervous system and other organs may arise. This suggests that meningitis is usually treated in an inpatient department of a hospital. But what therapy to choose depends on the reasons that led to the development of the disease.

The bacterial type of disease is usually treated with antibiotics, the viral type with antiviral medications, and the fungal type with antifungal medications. It is worth considering that antibiotics must have a wide spectrum of action, because it will not be possible to act on the meninges locally.

In addition, medications that combat the main manifestations of the disease are widely used. These may include medications that reduce fever, inflammation, and pain. This also includes diuretic therapy.

The duration of therapy can only be determined by the attending physician. He must take into account the stage of development of the disease when going to the hospital, the reasons for its development, indications of research and the general condition of the patient.

Self-treatment

Among the many questions regarding the disease is the clarification of such a point as treatment of meningitis at home. Here we can give one answer: it is recommended to treat the disease exclusively in a hospital setting.

On an outpatient basis, only rehabilitation of a patient who has suffered meningitis is allowed. This includes restoring health after fighting an illness. Such activities continue in individually taking into account the complexity of the therapy performed.

Before starting treatment at home, you need to get permission from your doctor. It is according to his recommendations that it will be possible to finally restore a sick person. In order to quickly get the patient back on his feet, the following conditions should be observed:

1. Strictly monitor bed rest.
2. Regularly darken the room in which the patient is located.
3. Nutrition should be balanced and drink plenty.
4. Do not forget about constantly taking a complex of vitamins.
5. Another mandatory item is the implementation of physiotherapeutic measures.

It is very important to monitor the person’s general condition: if any deterioration occurs, you should immediately call a doctor, because there is a risk of complications.

1. Taking a bath with chamomile and pine needles. Tinctures made from these gifts of nature make it possible to get rid of cramps, strengthen the heart and restore strength.
2. Cranberry tea is considered a natural antibiotic and is very useful for feverish conditions.
3. You need to mix coriander fruits, mint leaves and lemon balm. Pour all the ingredients with alcohol and water and leave to steep for 24 hours. The product should be used as a lotion on the temples and the back of the head for headaches.
4. The burnet root is crushed and after 20 days is poured with alcohol until a paste forms. The resulting mixture is rubbed into the skin several times a day.
5. Tincture of lavender flowers has diuretic, anticonvulsant and sedative effects.
6. Rose hips will enrich the body with all the necessary vitamins and relieve headaches. The berries are thrown into boiling water for 15 minutes, then placed in a closed jar for 24 hours and filtered. Take 100 milliliters 2 times a day.
7. Linden tea will improve sweating, relieve pain and have an antiseptic effect.
8. In spring, it is recommended to drink dandelion juice before meals.

All these tips are relevant only when the main therapy has ended and the disease is gradually receding. It should be remembered that no folk recipes will not replace medications.

What is disease prevention?

There are several methods to prevent this dangerous disease. One of them is timely vaccination against diseases that provoke inflammation in the meninges.

The second way is personal hygiene and limited contact with disease carriers. It is recommended to use special masks during mass epidemics.

In the event that it was not possible to prevent the disease, you should immediately go to the clinic for timely and adequate treatment.

In neurologist's offices and clinics, you rarely hear about such a diagnosis. It seems that the destiny of neurology is osteochondrosis, radicular syndromes or hypertensive encephalopathy.

But there are serious and sometimes fatal diseases of the central nervous system - meningitis and encephalitis.

Previously, it was believed that a person who had suffered this disease either died or remained insane. In fact, this judgment is fundamentally incorrect. What is this, meningitis? Let's try to understand the main issues of this vast and very interesting topic.

What is meningitis and its causes?

Meningitis is an inflammatory disease of the central nervous system, namely its meninges. Since there are both hard and soft membranes, there can be pachymeningitis and leptomeningitis, respectively. Severe diseases are among the most painful in all of neurology and, perhaps, in the entire clinic of internal diseases.

The severity of the condition is due to the excellent sensory innervation of the meninges. They perceive pain well, which is the main symptom of any meningitis.

The causes of the disease, of course, are microorganisms and viruses. The most famous are the following:

• Meningococcal purulent meningitis caused by diplococci of the genus Neisseria. It is a “classic” with the full development of symptoms, the appearance of a hemorrhagic rash and all sorts of complications, among which gangrene of the extremities occurs. Currently, it is rare, occurring mainly in the form of outbreaks in organized institutions, especially children's;
• . A significant proportion of cases occur in the meningeal form, without damage to the medulla and focal neurological symptoms;
• Tuberculosis bacillus. Causes severe, sluggish tuberculous meningitis, which develops in weakened people who have been suffering from tuberculosis for a long time. To do this, you definitely need a primary focus of the tuberculosis process in the body.

In addition to these reasons, inflammation of the meninges can be caused by conditionally pathogenic flora or even fungi. The lower a person’s immunity, the higher this risk. In patients with HIV infection in the AIDS stage, meningitis can be caused by the most harmless bacteria, and the course of this disease will be severe.

Types of meningitis and features

As with any inflammation, meningitis can cause pus to form; such inflammation is called purulent. Moreover, during autopsies of patients who died from meningitis, the cerebral hemispheres are covered with a “purulent cap.” This is most noticeable in the meningococcal process.

Serous meningitis occurs much more easily, in which no pronounced protein production occurs in the cerebrospinal fluid, and the cerebrospinal fluid retains its transparency. An example is the meningeal form tick-borne encephalitis. As a rule and clinical course Such serous forms are easier than purulent ones.

But against the background of a serous process that proceeds unfavorably, secondary suppuration may develop. This process is called “secondary purulent meningitis.” It can appear, for example, as a complication of an open head injury.

In this case, post-traumatic stress develops. inflammatory process. If inflammation of the membranes complicates the course of purulent otitis media, then such meningitis is called otogenic, etc.

The disease can be classified according to the area affected. Inflammation at the base of the brain is called basal, with inflammation of the membranes covering cerebral hemispheres, convexital meningitis develops. There is meningitis that affects the lining of the spinal cord (spinal meningitis).

The course of the disease can range from fulminant (meningococcal sepsis) to chronic (tuberculosis process).

The disease can also be classified by sensitivity to antibiotics, changes in the cerebrospinal fluid and many other signs.

Why is meningitis dangerous? - Consequences of the disease

Of course, a purulent process is more dangerous than a serous one. Therefore, most often complications can be analyzed using the example of epidemic cerebrospinal meningitis caused by meningococcal infection. The most common conditions that develop are:

• septic shock;
• edema - swelling of the brain with subsequent dislocation of its substance, the development of various variants of herniation, is the most common cause of death in the first day of the development of the disease;
• transfer of infection from the membranes to the substance of the cerebral cortex, with the addition of focal symptoms - the development of meningoencephalitis;
• A serious complication is occlusive hydrocephalus. At the same time, adhesions, which are located in abundance in the cerebrospinal fluid tract after purulent process, are capable of blocking these pathways to a greater or lesser extent. As a result, a rapidly progressive syndrome of intracranial hypertension develops.

Any purulent meningitis, the consequences of which cannot be predicted in advance, must be treated in the neuroinfection department of an infectious diseases hospital or in the intensive care unit.

Signs of meningitis in adults during the first hours and days may not be specific enough: when there is no headache yet, the following symptoms may bother you:

• increase in temperature, with chills, to high numbers;
• the appearance of skin hyperesthesia - the patient finds it unpleasant to touch the skin (senestophobia);
• Photophobia and phonophobia also arise - a person wants to retire to a dark, quiet room and, if possible, go to bed.

Of course, many diseases can have such signs, such as influenza, or even migraines (except fever). But the next day, meningitis develops in all its characteristic clinical picture.

The leading symptom of inflammation of the membranes is general cerebral symptoms. And the main symptom is diffuse, diffuse, constant headache high intensity. Many patients even noted the hour of onset of the illness, and not just the day. And this hour was marked by the appearance of such a headache, which turned out to be the most severe in my life.

Combined with fever, such pain exhausts a person. It cannot be relieved by any analgesics, since its mechanism is completely different - irritation of the membranes occurs local inflammation, overproduction of cerebrospinal fluid occurs.

This aggravates the situation: increased pressure of cerebrospinal fluid on the inflamed membranes leads to an even greater increase in headaches, as well as to the appearance of cerebral or central vomiting. This vomiting occurs without any connection with the stomach, food intake, and has nothing to do with the gastrointestinal tract at all: its cause lies in irritation of the brain structures by increased cerebrospinal fluid pressure.

The sign of this vomiting is complete suddenness. Suddenly, without any previous nausea, the patient vomits in a “fountain”, a powerful stream, wherever necessary.

After a few seconds, a person may realize that next time he needs to remove all the surrounding things away, otherwise they will be spoiled. Vomiting does not bring relief. In addition, with meningitis, an extremely painful symptom of shaking of the membranes occurs.

Its weak copy is the famous or lumbar lumbago - lumbago. Each time a nerve root is shaken, a sharp pain occurs in the lower back, from which the person groans and freezes. So, the same pain, only it constantly “explodes” in the head of a patient with meningitis. He loses sleep and appetite.

Every rise of the head, attempt to change position, get up, sit up in bed, brings severe torment. Any deep breath and straining intensify headaches so much that they force you to give up the idea of ​​emptying your bowels, and at this stage infectious intoxication is aggravated by constipation.

In addition, pain occurs in all tendons of the body, which, together with large muscles, contract due to painful impulses of the membranes.

Therefore there arises characteristic pose patient with meningitis: it is aimed at “compensating” for the resulting pain: the patient lies on his side, his head is extended (thrown back), and his legs are pulled up to his stomach.

The classic symptom of meningitis, which makes it possible to distinguish it from all other conditions, is the zygomatic ankylosing spondylitis symptom: when tapping the cheekbone with a neurological hammer, a pronounced outbreak of headache occurs in the entire head, and not at the site of tapping. This symptom is a shining example the effect of a concussion of the inflamed meninges.

In addition, sharp pain is caused by pressure on the eyeballs. The above symptoms may be accompanied by a painful grimace from the patient, confirming the pain reaction.

The symptoms of meningitis in adults described by us characterize both purulent and serous forms of the disease. In the event that foci of a rash that tends to merge appear on a person’s skin, a case of meningococcal meningitis is likely.

Further leaving the patient without urgent help neurologist and infectious disease specialist causes progression of symptoms.

Height intracranial pressure and infectious - toxic symptoms lead to a gradual loss of consciousness, infectious - toxic shock and the development of cerebral edema. There is a slow development of coma and oculomotor disorders (for example, strabismus) against the background of severe stupor and depression of consciousness.

Brain damage due to meningitis, photo

Meningitis is interesting disease: a mandatory and absolutely necessary diagnostic method - lumbar puncture, almost always, in addition to the necessary and important information for the doctor (transparency and color of the cerebrospinal fluid, its flow out in drops or streams), brings the first and significant relief: the headache is sharply reduced. Therefore, treatment of meningitis in adults begins with a lumbar puncture.

It is carried out in a hospital, lying down; after the puncture, you are not allowed to get up for 24 hours. Further tactics depend on the composition of the cerebrospinal fluid. Thus, treatment of purulent meningitis begins with the introduction of bacteriostatic antibiotics, and treatment of tuberculous meningitis begins with tuberculostatics and the use of reserve drugs.

At the same time, anti-inflammatory therapy is carried out: intravenous administration of a solution of dexamethasone or other corticosteroid hormones can relieve pain during serous meningitis and reduce its intensity during a purulent process.

As a rule, with proper antibacterial and pathogenetic therapy, on the first or second day the intensity of the headache decreases, the temperature normalizes, vomiting stops, and appetite appears.

Forecast

With meningitis, the prognosis is quite difficult to determine. The later the time has passed since the development of the first symptoms, the easier it is to give some kind of prognosis. And on the first day it is completely unclear. For meningitis, the prognosis depends on:

1. Urgency of seeking medical help;
2. Level of development of fever and signs of intoxication;
3. The appearance of a hemorrhagic rash;
4. Severity of general cerebral symptoms (headache, vomiting);
5. The appearance of focal symptoms, signs of depression of consciousness;
6. Results of bacteriological and general research cerebrospinal fluid and the patient’s reaction to puncture;
7. First reaction to treatment;
8. Time frame for normalization of temperature and regression of symptoms.
9. The presence of concomitant pathology, aggravating factors (age, cardiac, renal and liver failure, polyvalent drug allergy).

Long-term results for quality of life are favorable. Sometimes subsequent treatment with nootropic drugs, vitamins, and absorbent agents is required. To prevent the increase in intracranial pressure and treat adhesions, electrophoresis with lidase through the eyeballs and administration of diacarb may be required.

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

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

Shell differences

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

Where this disease comes from is a somewhat incorrect question, since there is no “meningitis virus” in nature. The disease can be caused 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 secondary form The disease is the most dangerous, since it is difficult for the body, already weakened by the underlying disease, to fight on two fronts.

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

Types of meningitis

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

So, what types of classification exist:

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

By etiology

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

• infectious;
• infectious-allergic;
• fungal;
• traumatic.

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

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

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

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

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

By origin

By origin, meningitis is:

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

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

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

According to the nature of the inflammatory process

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

• purulent;
• hemorrhagic;
• mixed.

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

In the first case, the infection enters the body through 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 ailments

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

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

With the flow

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

• spicy;
• subacute;
• recurrent;
• chronic.

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

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

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

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

According to the prevalence of the process, they distinguish

• generalized;
• limited.

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

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

By localization of the inflammatory process

According to localization, meningitis occurs:

• convexital;
• basal;
• diffuse;
• local.

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

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

Causes of meningitis

In order to understand what meningitis is and what causes it, it is necessary to understand the classification of the disease, since when different types Various reasons can be identified. However, regardless of the pathogen, there are general conditions that contribute to the development of the disease. So, the cause of the disease may be:

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

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

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

How is meningitis transmitted?

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

There are two options:

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

But how exactly is the infection transmitted?

• airborne;
• fecal-oral;
• sexual;
• cutaneous.

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

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

Incubation period of meningitis

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

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 for this disease may vary. It is very difficult to track the pattern, since initial stage It is not clear what kind of infection has affected the body (an exception may be a secondary type of disease).

Infection under a microscope

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

Dependence of the incubation period on the infectious agent

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

Symptoms of meningitis

The first signs of impending danger are high fever and headache, which is increasing in nature. Is there always a high temperature? Yes, this is the most main symptom. And usually, it rises without any visible reasons, and then the rest of the symptoms come into play.

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

meningeal symptoms- symptoms characteristic only of meningitis

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

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

Clinical picture in adults and children

Concerning infants, then the symptoms of meningitis may be as follows:

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

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

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

Diagnosis of meningitis

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

So, the list of diagnostic procedures:

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

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

Treatment of meningitis

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

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

Therapy is divided into:

• antibacterial;
• antiviral;
• antifungal;
• detoxification;
• symptomatic.

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

Antibacterial therapy

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

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

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

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

Comparative table of antibiotics that can and cannot cross the BBB

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

Antiviral therapy

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

In particular:

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

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

Antifungal therapy

One of the most dangerous types of disease is fungal meningitis. Previously, before the discovery of the drug Amphoterecin B, the disease showed almost 100% mortality. After starting to use the above-mentioned medicine, these statistics changed. Moreover, in the case of complex therapy Together with a drug such as fluconazole, survival rates have increased even more.

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

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

Detoxification therapy

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

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

Symptomatic treatment

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

Forecast

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

1. Headache.
2. Hearing and vision impairment.
3. Epileptic seizures.

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

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

Prevention

1. Hardening the body.
2. Preventive use of immunostimulating drugs (especially in kindergartens).
3. Timely treatment of chronic diseases.
4. Maintaining hygiene.
5. Maintaining healthy image life.
6. Regular exercise.

So, meningitis is serious illness 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 setting and under the supervision of a doctor, so do not self-medicate under any circumstances, as this can be fatal. Take care of yourself and your loved ones, get treated correctly!

A serious and quite severe neuroinfectious disease is meningitis - an inflammatory process in the soft and arachnoid membranes of the brain, leading to swelling of the brain structures and threatening the patient’s life.

The cause of such damage to the central nervous system can be bacterial agents, viruses, and less commonly protozoa. Sometimes meningitis in adult patients is provoked by autoimmune diseases, intracranial tumor processes or traumatic hemorrhage.

Meningitis is a dangerous and fleeting disease

Classification of meningitis

In accordance with the root cause of inflammation of the meninges, secondary and primary meningitis are distinguished. Secondary is often provoked by a head injury or occurs as a complication after neurosurgical manipulations; purulent ENT diseases (otitis media, sinusitis) can also be the cause. Primary meningitis is caused by the influence of a pathogenic pathogen directly on the structures of the nervous system (for example, meningococcal infection).

According to the predominant localization of the inflammatory process, meningitis can be:

• Convexital.
• Basal.
• Cerebrospinal.

According to the nature of the flow pathological process it can be classified:

• Fulminant meningitis.
• Spicy.
• Subacute.
• Chronic.

Meningitis can also vary in severity: mild, moderate, severe.

Main causes of the disease

There are two main types of meningitis causative agents: viruses and bacteria. Other etiological factors (mycoses, protozoa, rickettsia) are relatively rare.

Meningitis can be caused by a variety of pathogens

Among the viral pathogens biggest role played by Coxsackie and ECHO viruses. It is the viral etiology of the disease that is diagnosed in 60% of patients. A smaller part, about 30%, is due to inflammation of the meninges of a bacterial nature.

The main bacteria that cause meningitis in adults are pneumococcus, meningococcus, and Haemophilus influenzae. In children during the neonatal period, pathogens can also become coli, enterococci, klebsiella.

How does the inflammatory process develop?

The most common route of infection spread is hematogenous. The contact route is less common, for example, in the presence of purulent inflammation in the bones of the skull, paranasal sinuses, and middle ear.

The incubation period for inflammation of the meninges depends on etiological factor. So, with viral meningitis it can last from three to seven days, and with bacterial meningitis - from a day to a week. Tuberculous meningitis often has a longer incubation period, up to 10-14 days; sometimes this period is regarded as prodromal, when there are still no specific symptoms of damage and swelling of the membranes of the brain, but general weakness, malaise, and sleep disturbance are noted.

After penetration of a pathogenic agent into the subarachnoid space, inflammatory changes and swelling occur in the meninges, which are incapable of stretching. As a consequence, a displacement of the structures of the cerebellum and medulla oblongata occurs, which leads to cerebral edema and poses a threat to the patient’s life. This development of the disease is typical for severe meningitis with a fulminant onset. In the chronic course of the disease, cerebral edema is less pronounced, and accordingly, the symptoms of the disease may not be so bright.

Signs of meningitis

Regardless of the etiology of the disease, a description of its clinical picture consists of three main syndromes:

• Intoxicating
• Meningeal
• Characteristic changes in the cerebrospinal fluid.

Intoxication syndrome

This symptom complex includes signs characteristic of any other infectious pathology. Hyperthermia is noted; in case of acute bacterial inflammation it can reach 39 degrees and above; a chronic course (for example, exacerbation of the process of tuberculous etiology) is often accompanied by a slight rise in temperature to 37.5 degrees.

Other symptoms of meningitis are chills, excessive sweating, weakness, and loss of strength. In laboratory parameters of peripheral blood, a leukocyte shift to the left is noted, increased ESR, characteristic of an acute inflammatory process.

Meningeal syndrome

It includes cerebral manifestations and meningeal symptoms themselves. General cerebral - a consequence of swelling of the meninges and increased intracranial pressure. The main characteristics of the syndrome: severe diffuse headache, nausea, and possibly repeated vomiting. In severe cases of the disease, consciousness is impaired, from mild stupor to coma. In some cases, the disease may manifest itself as psychomotor agitation, hallucinations, and intellectual-mnestic disorders.

Checking Kernig's sign

Meningeal signs themselves are a distinctive feature of the pathology and allow the doctor to establish a primary diagnosis based on examination of the patient. These include symptoms of hyperesthesia - increased sensitivity to light, sound, and touch of the skin. The second group is pain phenomena (Kerer, Mendel, Pulatov) and so-called muscle contractures. The latter are most often used in medical practice for diagnostics, their main characteristics:

• The inability to fully bend the patient’s head in a supine position is due to stiffness of the neck muscles.
• Kernig's sign is tension in the muscles of the back of the thigh, as a result of which it is impossible to straighten the leg bent at the knee in a person lying on his back.
• The so-called meningitis pose is when, due to excessive tension of the long back muscles, maximum extension of the back occurs with the head thrown back and the legs brought to the stomach and bent at the knees.

The presence of meningeal signs means an inflammatory process and swelling of the meninges; if such symptoms are present, you should seek medical help as soon as possible.

Changes in cerebrospinal fluid

Carrying out a lumbar puncture, followed by laboratory diagnostics cerebrospinal fluid (CSF), allows not only to confirm the diagnosis of meningitis, but also to find out its etiology. Inflammatory processes and swelling of the meninges are manifested by a significant increase in cerebrospinal fluid pressure, with external inspection it can change transparency or color. This is especially characteristic of a bacterial process - the cerebrospinal fluid becomes cloudy and light yellow in color.

Spinal tap

Laboratory analysis shows a change in cellular composition towards its increase (pleocytosis). When the process is caused by bacteria, an increase in neutrophils is detected; in case of a viral infection, an increase in lymphocytes is detected. Further microbiological examination helps to identify the type of pathogen, and therefore its sensitivity to a particular antibiotic. When analyzing cerebrospinal fluid, they also give a description of the amount of sugar and protein it contains. Some clinics additionally carry out serological tests.

Other symptoms of meningitis include: skin manifestations. For example, with meningococcal infection, a stellate (hemorrhagic) rash appears on the extremities, abdomen, and less often on the head.

It should be remembered that the presence of high body temperature, which is combined with severe headache, nausea, vomiting, and the appearance of rashes on the body, may indicate a severe form of meningitis.

In this case, it is necessary to immediately seek medical help, since the fulminant course of such a disease can cause cerebral edema and threaten the patient’s life.

Complications of meningitis

IN acute period The most dangerous disease is cerebral edema and complications in the form of secondary encephalitis (damage directly to the brain tissue). Meningoencephalitis can manifest itself as focal and diffuse neurological symptoms, which sometimes persist for a long time after the patient has recovered, and in severe cases becomes a cause of disability.

Especially dangerous complication may result in the formation of a brain abscess, which more often occurs with secondary bacterial meningitis against the background of existing ENT pathology (sinusitis, otitis). It causes rapid perifocal swelling of the brain tissue and displacement of the midline structures, and therefore poses a threat to the patient’s life. In this case, along with conservative therapy, surgical treatment is performed.

Treatment

The sooner treatment for meningitis is started, the greater the patient’s chances of full recovery

Treatment of meningitis of any etiology is carried out only in a hospital setting. As a rule, primary forms of the disease (bacterial or viral) are treated in infectious diseases department, secondary - in a specialized department, depending on the main diagnosis (neurosurgery, ENT). In severe cases with rapidly progressive cerebral edema, the patient is in the intensive care unit.

Therapeutic regimen meningitis includes three main components: antibiotic therapy, symptomatic treatment and measures aimed at eliminating pathogenetic mechanisms (detoxification, combating cerebral edema, neuroprotection, correction of acidosis).

Since bacterial meningitis is inflammation and swelling of the meninges caused by a certain type of pathogen, antibacterial treatment is carried out with appropriate or broad-spectrum antibiotics. In addition, the antibacterial drug must penetrate well through the blood-brain barrier. The most commonly used are Cefotaxime, Ceftriaxone in combination with Ampicillin, and Benzylpenicillin.

Treatment for viral meningitis includes antiviral drugs– Tiloron, recombinant interferons, immunoglobulins. Anti-tuberculosis drugs are prescribed when it is confirmed tuberculous etiology diseases.

Rehabilitation

After discharge from the hospital, the patient is given recommendations for the period of treatment at home. Also, for two years, a person who has had meningitis has been registered with a neurologist at the dispensary.

Nootropic drug

For moderate and severe forms of meningitis, as well as after meningoencephalitis, tablet forms of medications are prescribed: neuroprotectors (piracetam, encephabol), multivitamin complexes (vitrum, duovit), adaptogens. When there are residual neurological effects (paresis, paralysis), exercise therapy, massage, and physiotherapy are recommended. Treatment by an ophthalmologist or ENT doctor is indicated for existing visual or hearing impairments, respectively.

Full rehabilitation after meningitis also includes nutritional correction. The diet must be complete, which means it must include a sufficient amount of easily digestible protein (chicken, rabbit, lean fish, cottage cheese, fermented milk drinks), fresh vegetables and fruits, vegetable oils rich in polyunsaturated fatty acids(olive, flaxseed).

For a period of about six months, severe physical exercise, work in night shift, on high.

Prevention

The main prevention of meningitis is strengthening the immune system, which is ensured by good nutrition, quality rest and regular physical activity. It is also necessary to promptly and under medical supervision treat purulent foci in the skull area, for example, otitis media or sinusitis, and undergo regular medical examination to identify foci of tuberculosis.

If there is an outbreak of meningitis in a kindergarten, the institution is closed for two weeks quarantine

If the sick child visited kindergarten, then a quarantine is declared in the group. In terms of timing, it corresponds to the incubation period of the disease. For viral meningitis, it is up to 7 days; for meningococcal infection, quarantine lasts up to 10 days. It should be taken into account that if the child visited preschool, then he can continue to go to the group during the entire quarantine period. At school, when meningitis is detected, quarantine is usually not declared. Parents of children should be informed about what meningitis is, what its symptoms are, the first signs and possible complications. If there is the slightest suspicion of meningitis (high fever, headache, vomiting, rash on the body), you should immediately contact a medical facility.

Meningitis is a disease characterized by an inflammatory process of the membranes of the brain and spinal cord of infectious etiology. Pronounced clinical signs of meningitis are neck rigidity (significant tension in the neck muscles, in which the patient’s head is thrown back, returning to a normal position is difficult), severe headache, body hyperthermia, disturbances of consciousness, hypersensitivity to sound and light stimuli. Meningitis manifests itself as a primary form of reaction to infection of the membranes or a secondary inflammatory process that occurs during complications of other diseases. Meningitis is a disease with a high percentage of deaths, disability of patients, incurable disorders and dysfunctions of the body.

What is meningitis?

Meningitis is serious disease, accompanied by inflammation of the membranes of the brain and/or spinal cord. The membranes cover the tissues of the brain and spinal canal. There are two types of shells: soft and hard. Depending on what type of infection is affected, the types of disease are distinguished according to the localization of the inflammatory process:

• leptomeningitis, the most common form in which the soft membranes are affected;
• pachymenigitis - inflammation of the dura mater, occurs in approximately 2 out of 100 cases of the disease;
• When all membranes of the brain are affected, panmeningitis is diagnosed.

As a rule, in the medical sense, when diagnosing meningitis, they mean inflammation of exclusively the soft membranes of the brain. Meningitis is one of the most dangerous diseases brain, causing complications, causing serious health problems, permanent disability, and developmental disorders. The percentage of deaths is high.

The description of the symptoms of meningitis was written by Hippocrates, and doctors wrote in the Middle Ages. For a long time, the cause of the development of the inflammatory process was considered to be tuberculosis or consumption, epidemics of which caused the death of millions of people.

Before the discovery of antibiotics, the mortality rate from meningitis was 95%. The discovery of penicillin made it possible to significantly reduce the statistics of fatal outcomes of the disease.
Today, modern synthetic drugs are available for the treatment of meningitis; vaccination against the most common pathogens is used to prevent most forms of the disease - pneumococcal bacteria, meningococcus and Haemophilus influenzae.

Prevalence of meningitis, seasonality of the disease, risk groups

The disease occurs throughout the world, but there is a strong correlation between the level of welfare of the state and the frequency of meningitis in the population. So, in African countries, South-East Asia In Central and South America, meningitis is diagnosed 40 times more often than in residents of European countries.

The statistical incidence rate of meningitis in Russia and European countries today is 3 cases per 100 thousand population for meningitis of bacterial etiology and 10 cases per 100 thousand population for the viral causative agent of meningitis. The tuberculous form of meningitis depends on the number of patients and the quality of care medical services on the treatment of the main disease in the country, with the second factor prevailing in importance over the first.

Seasonality and annual cyclicality of disease outbreaks are noted. The most typical period for meningitis is the six months from November to April, which is caused by fluctuations in air temperature, dietary restrictions and lack of vitamins, crowds of people in rooms with insufficient ventilation due to bad weather, etc. Scientists say that meningitis has an annual cycle : There is an increase in incidence once every 10-15 years. At risk due to the characteristics of the body and social reasons There are children aged from birth to 5 years and men 25-30 years old.

Ways of infection with meningitis

Primary meningitis, as a disease of infectious etiology, is caused by pathogenic microorganisms. Viruses and bacteria that cause meningitis are transmitted in various ways, the most common of which are:

• airborne: release of the pathogen with saliva, mucus during coughing and sneezing into the airspace;
• contact and household; in direct contact with a patient or carrier of infection, using the same household items (dishes, towels, hygiene items);
• oral-fecal when hygiene rules are not followed: eating with unwashed hands, eating unprocessed foods, dirty vegetables, fruits, herbs, etc.;
• hematogenous, transportation of the causative agent of meningitis of various etiologies (most often bacterial, but viral, protozoal and other forms are possible) through the blood, spread of infection inside the patient’s body from the existing inflammatory focus to the membranes of the brain;
• lymphogenous, when an infectious agent existing in the body spreads through the flow of lymphatic fluid;
• the placental route during intrauterine development and the passage of the pathogen through the placenta, as well as infection in the birth canal or when an infectious agent enters the amniotic fluid to the fetus;
• oral: when ingesting water contaminated with a pathogen (when swimming in ponds, public pools without a disinfection system, drinking dirty water) and so on.

Meningitis in adults

Group increased risk The disease consists of young men from 20 to 30 years old. The most common pathogens are meningococci, pneumococci, and Haemophilus influenzae; the tuberculous form of meningitis also occurs due to improper treatment of tuberculosis.

A common cause of the development of inflammation of the meninges at this age is considered to be a lack of medical culture: attitude towards various types of inflammatory diseases(carious processes, sinusitis, otitis, bronchitis, respiratory infections) as not worthy of proper attention and full-fledged therapy. Women are less susceptible to meningitis, but during pregnancy the risk of the disease increases due to the natural decrease in immunity during pregnancy. Prevention includes preliminary vaccination, timely sanitation, treatment of inflammatory diseases, and limiting contacts.

Meningitis in children

Photo: Africa Studio/Shutterstock.com

IN age period From birth to 5 years, meningitis poses a particularly serious danger to a child; the mortality rate is extremely high: every 20 children die from the disease. Complications of the disease at this age also have a serious impact on the child’s health.
The most severe form childhood meningitis develops when infected with streptococcus agalactiae (Streptococcus agalactiae) during passage through the birth canal. The disease progresses at lightning speed, causing severe consequences or the death of an infant.
For children 1-5 years old, viral forms of meningitis with a less pronounced clinical picture and consequences of the disease are most typical. Bacterial forms provoked by meningococcus, pneumococcus and Haemophilus influenzae are much more difficult to tolerate, so vaccination is recommended to protect against the disease.

Meningitis is an infectious disease, and its first signs indicate the presence of infection and damage to the nervous system. These signs of the disease include:

• sudden increase in body temperature, sometimes to critical levels;
• severe headaches;
• stiffness of the neck muscles (nuchal muscles), a feeling of numbness, difficulty moving the head, bending, turning;
• loss of appetite, nausea, frequent bouts of vomiting that do not bring relief, possible diarrhea (mainly in childhood);
• Pinkish or red rashes may appear. The rash disappears when pressed and after a few hours changes color to bluish;
• general weakness, malaise;
• Even in the first stages, especially with the rapid development of meningitis, manifestations of confusion, excessive lethargy or agitation, and hallucinatory phenomena are possible.

Main symptoms of meningitis

Meningitis is manifested by the following symptoms:

• Strong headache;
• hyperemia up to 40°C, fever, chills;
• hyperesthesia, hypersensitivity to various stimuli (light, sound, tactile);
• dizziness, confusion, hallucinations, disturbances of consciousness up to coma;
• lack of appetite, nausea, repeated vomiting;
• diarrhea;
• a feeling of pressure on the eyeballs, possible lacrimation, manifestations of conjunctivitis;
• soreness, enlargement lymph glands due to the inflammatory process;
• pain when palpating the area trigeminal nerve, between the eyebrows, under the eyes;
• presence of Kernig's sign (inability to straighten the legs in knee joints due to increased tension of the hip muscle groups);
• positive response to Brudzinski's symptom (reflex movements of the limbs when tilting the head, pressing);
• manifestations of ankylosing spondylitis (contractions of the facial muscles in response to tapping on the facial bow);
• Pulatov's symptom (pain when tapping on the scalp);
• Mendel's symptom (pressure on the area of ​​the external ear canal causes pain);
• Lesage symptoms in infants: pulsation, bulging of the membrane over the large fontanel; when lifting the child with a grip under the armpits, the head is thrown back, the legs are tucked towards the stomach.

Among nonspecific symptoms meningitis may include the following:

• decreased visual function, dystonia of the visual muscles, causing strabismus, nystagmus, ptosis, visual impairment in the form of double vision, etc.;
• hearing loss;
• paresis of facial muscles of the facial part of the head;
• catarrhal symptoms (sore throat, cough, runny nose);
• pain in the peritoneum, defecation disorders in the form of constipation;
• spasms of the limbs, body;
• epileptic seizures;
• violations heart rate, tachycardia, bradycardia;
• increased blood pressure values;
• uveitis;
• lethargy, pathological drowsiness;
• aggressiveness, increased irritability.

Complications of meningitis

Meningitis is a disease that is dangerous both in the process of damage to the membranes of the brain by its effects on the body, and in the possible accompanying complications of the disease.
Complications of meningitis include:

• hearing loss;
• development of epilepsy;
• endocarditis;
• purulent arthritis;
• bleeding disorders;
• retardation, mental development disorders of the child;
• emotional instability, hyperexcitability, rapid exhaustion of the nervous system;
• When the disease develops at an early age, a complication such as hydrocephalus is likely to occur.

Meningitis: causes and stages

Inflammation of the meninges can begin under the influence of various infectious agents. Depending on the type and variety of the causative agent of meningitis, the diagnosis is classified according to pathogenesis, which determines the methods of therapy and allows you to choose the desired treatment tactics.

Viral meningitis

Viral meningitis is considered the most favorable form in prognosis for the course of the disease and recovery. With the viral etiology of meningitis, as a rule, the degree of damage to the membranes of the brain is minimal, serious complications and death of the disease are caused by timely diagnosis and therapies are extremely rare.
Viral meningitis in the vast majority of cases occurs as a complication of infectious diseases with viral pathogens (mumps, measles, syphilis, acquired human immunodeficiency syndrome, etc.). Most common reasons and infectious agents that can provoke the development of viral meningitis are the following:

• enterovirus infection (Coxsackie virus, ECHO virus);
• infectious mononucleosis (Epstein-Barr virus);
• herpes infections (human herpes virus);
• cytomegalovirus;
• acute respiratory viral infections (influenza virus, adenovirus and others).

The paths of penetration of the pathogen into the membranes of the brain are different. Possible hemolytic pathway (through the blood), with lymph flow, and can also spread with the spinal cerebrospinal fluid. Unlike the bacterial form, viral pathogens cause an inflammatory process of a serous nature without the release of purulent exudate.
The viral form proceeds quite quickly: the acute stage takes an average of 2-3 days, giving way to significant relief and a stage of reverse development on the 5th day from the onset of the disease.

Bacterial stages of meningitis

Bacterial meningitis has a more pronounced clinical picture, differs in the severity of the disease, the addition of additional foci of inflammation, and serious complications. The highest percentage of deaths occurs with the bacterial form of meningitis.
During an inflammatory process of bacterial origin, purulent exudate is released on the surface of the membranes of the brain, obstructing the outflow of cerebrospinal fluid, which leads to an increase in intracranial pressure. A pronounced inflammatory process provokes febrile conditions and severe intoxication of the body.
This form often accompanied by disturbances of consciousness, confusion of thinking, hyperesthesia, hallucinations, and high psychomotor activity. If bacteria actively multiply, the patient may fall into a coma.
The most common causative agents of bacterial meningitis are:

• meningococcus;
• hemophilus influenzae;
• pneumococci;
• Staphylococcus aureus.

Bacterial meningitis can occur as a disease of primary or secondary etiology against the background of an ongoing inflammatory process or an untreated source of inflammation. Most often, the secondary form occurs as a complication of bacterial pneumonia, chronic tonsillitis, sinusitis, pyelonephritis, bone osteomyelitis, abscesses various localizations.
Boils and carbuncles are dangerous as sources of pathogenic microorganisms that can spread through the bloodstream and cause meningitis; you need to be especially careful about various inflammatory phenomena on the face, in the area of ​​the nasolabial triangle, inside and around the ears.
Therapy for bacterial meningitis is based on isolating the pathogen and treating it with antibacterial drugs (antibiotics) in significant doses. Without the use of antibiotics, in 95% of cases the disease is fatal.

Tuberculous meningitis

In the presence of foci of tuberculosis, mycobacterium can spread throughout the body by hematogenous or lymphogenous route and penetrate into the membranes of the brain. Most often, this complication is observed during an active tuberculosis process with foci in the respiratory organs, bones, kidneys, and reproductive system.
Despite the serous form of tuberculous meningitis, in which purulent exudate is not formed, just as with the viral etiology of the disease, meningitis that develops when the membranes of the brain are damaged by the tuberculosis bacillus is more severely tolerated than the viral form.
The basis of therapy for this form is complex treatment specific antibiotics active against mycobacterium tuberculosis.

Other causes of meningitis

Viral, bacterial forms and tuberculous meningitis are the most common etiological types diseases. In addition to viruses and bacteria, other pathogenic microorganisms and their combinations can become causative agents.
Thus, a fungal form of meningitis (torulosis, candidiasis), and a protozoal form (toxoplasma) are isolated. Meningitis can develop as a complication of processes and disorders of non-infectious etiology, for example, with metastasis malignant tumors, systemic diseases connective tissue and so on.

Classification of meningitis

In addition to distinguishing various forms of the disease according to etiology and causative agent, meningitis is classified depending on the nature of the inflammatory process, the localization of the source of inflammation and its prevalence, and the course of the disease.

Types of disease depending on the nature of the inflammatory process

Purulent meningitis is characterized by a severe course with severe neurological symptoms due to the formation of purulent exudate in the meninges. The most common form of bacterial infection. In the group of purulent meningitis, varieties are diagnosed depending on the causative agent of the disease:

• meningococcal meningitis;
• pneumococcal form;
• staphylococcal;
• streptococcal.

Serous meningitis occurs most often with a viral etiology of the disease, characterized by the absence of purulent inflammation and a milder course of the disease. To the group serous meningitis includes the following varieties:

• tuberculosis;
• syphilitic;
• flu;
• enterovirus;
• mumps (against the background of mumps or mumps) and others.

Classification according to the nature of the disease

Fulminant (fulminant) meningitis develops within a few hours and is especially common in infants. There is virtually no incubation period, and death can occur within 24 hours of infection.
The acute form of meningitis affects the body within a few days, characterized by acute clinical manifestations. Often ends in death or severe complications.
Chronic meningitis develops gradually, symptoms increase and become more pronounced.

Types of disease depending on the prevalence of the inflammatory process

Basal meningitis is characterized by localization of inflammation at the base of the brain. The convexital form affects the convex parts of the brain. With total meningitis, the inflammatory process covers the entire surface of the meninges. If the inflammation is concentrated at the base of the spinal cord, the spinal form of the disease is diagnosed.

Diagnosis of meningitis

Diagnosis of meningitis begins with a physical examination and history and may include some or all of the following:

• general blood analysis;
• blood chemistry;
• laboratory examination of cerebrospinal fluid;
• PCR analysis;
• serodiagnosis;
• magnetic resonance imaging (MRI);
• computed tomography (CT);
• electroencephalography (EEG);
• electromyography (EMG).

Treatment of meningitis

Treatment for meningitis should begin immediately. Treatment in any case is carried out in the infectious diseases department of the clinic; independent attempts or therapy in a day hospital are unacceptable, especially for sick children.
The disease can develop rapidly, and symptoms can suddenly increase. The condition of any patient can suddenly deteriorate, requiring emergency care (for example, with an increase in intracranial pressure, cerebral edema, respiratory and adrenal insufficiency, depression of consciousness, falling into a coma, etc.).
The optimal conditions for therapy are a separate ward in the infectious diseases department with specialists on duty around the clock, the ability to create conditions for desensitization: dim the lights, eliminate sources of loud sounds and patient anxiety.

Etiotropic therapy for meningitis

Causal therapy is treatment aimed at eliminating the cause of the infection.
For viral meningitis, therapy is based on antiviral drugs(recombinant interferons, inducers of endogenous interferon, immunomodulators, antiretroviral drugs, etc.), in case of bacterial origin of the disease, antibiotics active against a specific pathogen are prescribed (for example, antimeningococcal or antistaphylococcal gamma globulin), in case of meningitis of fungal etiology, treatment is carried out with antimycotic drugs etc.

Additional therapies

In combination with drugs that are active against the causative agent of the disease, symptomatic drugs are prescribed:

• decongestants (Furosemide, Mannitol);
• anticonvulsants (Seduxen, Relanium, Phenobarbital);
• detoxification methods of therapy (infusions of colloids, crystalloids, electrolytes);
• nootropic drugs.

Depending on the course and probable or developed complications, therapy may include correction of associated pathological conditions: respiratory, adrenal, cardiovascular insufficiency.
Not only recovery, but also the life of the patient depends on the time of initiation of therapy, both etiotropic and symptomatic. At the first sign ( sudden rise fever, severe headache, especially against the background of acute respiratory viral or other infectious diseases), you must urgently consult a doctor or call specialists from the ambulance service to your home. If symptoms appear in a child, examination and diagnosis should be carried out immediately, since with the rapid development of the disease in young children, literally minutes count.