Meningitis - symptoms, causes, types and treatment of meningitis. Meningitis in adults - how to identify and stop a dangerous disease in time

Syphilism is one of the most common sexually transmitted diseases (STDs). The causative agent of the disease is the bacterium Treponema pallidum. Modern medicine can easily cope with this disease, but if the patient is not treated, he will face a slow and painful death with a wide range of symptoms.

According to 2014 data, 26 people per 100 thousand population of our country are sick with syphilis. The incidence of sexually transmitted diseases is decreasing at a slow pace, so the government is educating the population about STDs. Awareness about STD prevention helps to avoid serious problems with the health of both young people and adults.

Syphilitic infection symptoms

Once in the human body, the bacterium Treponema pallidum, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person is unaware of the infection, as he has no signs of illness. Even most tests cannot detect the disease at this stage. Eat high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of his actions.
The first signs of the disease appear at the end of the incubation period with the onset of primary syphilis. They can be located on the skin in the form of hard chancre, multiple chancre, syphilitic rash, baldness (cutaneous syphilides) and on the mucous membranes - chancre in the mouth, on the genitals, rashes on the mucous membranes (syphilides of the mucous membranes).

Symptoms of syphilitic infection in women

End asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). Where bacteria enter, it forms chancre. His appearance gives a countdown primary stage syphilis. Hard chancre is formed as an immune response to the introduction of Treponema pallidum. It is localized in the mouth, in the area of ​​the external and internal genital organs, and in the anus.

A chancre is a round inflammatory growth with a flat base. In the initial stages of its appearance there is practically no pain. Appears at sites of infection. If treatment is not carried out, then a syphilitic rash is added to the chancre on visible parts of the body and on mucous membranes.

Signs of syphilism in men

In men, as in women, the first noticeable sign of infection appears in the form of a chancre. Ulcers often form on the penis, at its base and on the head. However, it can also appear in the oral cavity, on the scrotum, and in the anus. The symptoms and course of the disease are practically no different in the male and female parts of the population. Further description of syphilism will be given without division by gender.

How does sifak manifest in women?

• The primary stage of sifak in women begins with the detection of hard chancre on the skin or mucous membranes. On initial stage it does not cause serious discomfort. Then a gradual inflammation of the chancre occurs, it takes on a red or bluish color, characteristic of a severe inflammatory process.
• During the first week after the first symptoms appear, women begin to experience inflammation of the lymph nodes and vessels near the chancre (regional scleradenitis). The lymph nodes become inflamed in the form of balls, forming significant edema and swelling around the chancre. If the sore is localized in the oral cavity, it threatens with inflammation of one tonsil and swelling of the throat, making it difficult to swallow and breathe. Symptoms cause significant distress when verbal communication and eating. Scleradenitis in the genital area makes walking and defecation difficult.

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The end of primary and the beginning of secondary syphilis is considered to be the appearance of a specific rash on the patient’s body. Modern methods diagnostics make it possible to detect syphilism immediately after the first symptoms appear. Most often used enzyme immunoassay(ELISA) and polymerase chain reaction (PCR). These tests are prescribed by a therapist in a clinic or a venereologist in a dermatovenereal dispensary. Average cost analysis costs 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. Earlier tests will not show anything other than a seronegative reaction, indicating the absence of Treponema pallidum in the body.

Symptoms of secondary syphilis

• The skin around the chancre becomes covered with spots and ulcers with a diameter of up to 15 mm. The rash can grow and unite into large areas on the skin and mucous surfaces, causing severe discomfort to the patient. There are three types of syphilitic rash.
  Roseola rash - pink or red spots with clear or blurred boundaries 5-50 mm in diameter. There are no cavities. Do not protrude above the skin.
  Papular rash - small conical growths pink color. May peel off at the top of the cone. This kind of cheese looks extremely unpleasant.
  Pustular rash - growths with purulent cavities.
• Along with the appearance of a rash, lesions may begin nervous system. Degradation of nervous tissue negatively affects vision, memory, attention, and coordination of movements. Unfortunately, treatment of the disease will not lead to the restoration of lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
• Signs of partial or complete baldness appear. Hair falls out, usually on the head. First, the quality of the hairline deteriorates: the hair splits, becomes thinner, and thins out. Then the hair thinning intensifies and large bald patches of skin appear. After recovery from syphilis, hair growth does not renew.

Stages of syphilis

Nowadays, every person infected with Treponema pallidum can quickly and efficiently receive adequate and effective treatment. Only a few go through all stages of syphilis. Without treatment, a person lives in terrible pain for 10 or even 20 years, after which he dies.
Below is brief description stages of syphilis.
Incubation stage

Stage of primary syphilis

Stage of secondary syphilis. It is divided into four stages of the disease. In the absence of adequate treatment, the order will be approximately as follows:

Stage of tertiary syphilis. It is divided into three stages of the disease. In the absence of adequate treatment, the order will be as follows:

Neurosyphilis begins towards the end of secondary syphilis. Usually manifests itself in the form of the following diagnoses:

• Asymptomatic neurosyphilis – in which there are no painful manifestations yet, but tests already show inflammation and infection of the cerebrospinal fluid. This stage of neurosyphilis usually begins a year and a half after infection.
• Gummy neurosyphilis - accompanied by the formation of gummas inside the brain and spinal cord. This is a painful symptom that feels like a large tumor, causes permanent pain, and causes an increase in pressure inside the patient’s skull.
• Syphilitic meningitis is a lesion of the membranes of the brain at the base and in the area of ​​the cranial vault. Accompanied by severe symptoms, including disturbances of attention, thinking, memory, emotional sphere person.
• Meningovascular form of neurosyphilis - destroys the blood vessels of the brain, accompanied by chronic meningitis. In the absence of therapy, it leads to headaches, personality changes, behavior changes, sleep is disturbed, and convulsions begin. This ultimately leads to strokes.
• Tabes dorsalis - a disorder nerve fibers spinal cord, their thinning and dysfunction. This leads to an irreversible impairment of the ability to move in space: the gait is bent, the patient may fall, losing the feeling of the ground under his feet. When you close your eyes, you lose orientation in space.
• Progressive paralysis - causes dysfunction of the central nervous system, accompanied by personality disorders, behavior dangerous to society, and all higher mental functions are degraded. A person turns into a madman and can easily end up in a psychiatric clinic if he is not diagnosed with syphilis. Ultimately, progressive paralysis leads to complete paralysis of the body.
• Optic nerve atrophy - degradation visual function. At first, the vision of only one eye deteriorates, but gradually the infection approaches the second optic nerve. Leads to complete blindness if left untreated. Changes in the visual apparatus are irreversible.
• Late visceral syphilis is degradation of tissues of internal organs. Mainly the cardiovascular system and liver are affected. Other organs are rarely affected. Patients complain of deterioration in health at the slightest exertion, they develop systolic murmurs in the heart due to dilatation of the aorta. When late visceral syphilis is localized in the heart, a heart attack can occur.
• Late syphilism of bones and joints - causes local expansion of bones and large joints. Accompanied by the formation of gumma on the bones.

Atypical syphilis

In addition to hard chancre, others, so-called, may also appear at the stage of primary syphilis. atypical chancre. That is why this variant of the development of the disease is called atypical syphilis. Atypical chancres are of the following types:

• Indurative edema.
  Looks like a change in color of the scrotum in men, the clitoris and labia in women. The color varies from scarlet to bluish in the center, turning pale at the edges of the swelling. Women are susceptible to this symptom more often than men. Usually the patient perceives indurative syphilitic edema as an infectious-inflammatory disease of a different kind, since a blood test at this stage of syphilis does not provide information about the true cause of the edema. It can be distinguished from another infection by the absence of an inflammatory process in the blood and the presence of inflammation of the lymph nodes.
• Chancre felon.
  It may appear in people caring for patients with syphilis: medical personnel, relatives. Affects the thumb, index finger and middle fingers hands. This is a very painful attack. The skin pulls away from the fingers, revealing large areas of bleeding, similar to second-degree burns. Also, felon is accompanied by swelling and inflammation of the fingers, preventing normal functioning person. Often appears together with chancre of the genital organs.
• Chancroid-amygdalitis.
  It manifests itself in the form of inflammation of one tonsil, and its surface is not disturbed and remains smooth. The oral cavity is subject to severe pain, and the swallowing process becomes difficult. The patient experiences a fever, as if he had a sore throat. The difference from a sore throat is that with amygdalitis, only one tonsil becomes inflamed.

Congenital syphilis

It is highly undesirable for a mother to suffer from illness during pregnancy. The fetus is exposed to Treponema pallidum, which leads to irreversible morphological consequences and disruption of intrauterine development.
Medicine knows three main symptoms:

• • Parenchymal keratitis is a pathology of the external epithelium of internal organs and eyeball. It manifests itself as severe redness and inflammation of the organ on the outside. Sometimes the inflammation penetrates a little deeper into the surface. After healing, scars remain and an eyesore may remain. The most a common consequence for the eye is a decrease in visual acuity. Keratitis is accompanied by blurred vision, acute pain, lacrimation.
  • Deafness from birth. The causative agent of syphilis actively destroys the nerve tissue of the fetus during pregnancy. One option may be a pathology of the auditory nerve, which leads to irreversible deafness.
  • Congenital dental anomalies. Occur due to underdevelopment of tooth tissue during fetal development. This pathology called Hutchinson's teeth. The teeth grow in the shape of a screwdriver with a rounded notch on the cutting edge, and are set sparsely. Sometimes teeth are not completely covered with enamel. Which leads to their early destruction and unflattering appearance.

A child who has had intrauterine syphilis has poor health, even if the mother has successfully completed treatment. If adequate treatment is not followed, the child will have severe deformities and remain disabled for life. If the mother is infected with syphilis, breast-feeding the child should be stopped immediately, as syphilis is transmitted through mother's milk.

If a woman who has previously had syphilis wants to become pregnant, she should be tested for Treponema pallidum (ELISA or PCR). After receiving confirmation of the absence of the disease, you can safely decide to become pregnant.

The causative agent of syphilis

Treponema pallidum is a bacterium that causes syphilis. German scientists in 1905 discovered the cause of one of the most common venereal diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists found the key to quickly curing syphilis, and the way was also opened for them to invent methods early diagnosis diseases.

Properties of the pathogen

The bacterium was called pale due to the fact that for a long time scientists could not examine it under a microscope. The transparent color of treponema is difficult to stain in other colors for subsequent research. For staining, the Romanovsky-Gizma and silver impregnation methods are used, which make it possible to detect bacteria under a dark-field microscope for subsequent study.
It was possible to discover that in favorable conditions(this must only be a human or animal organism) Treponema pallidum divides every 30 hours. The weak point of Treponema pallidum is that it lives and reproduces only at a temperature of 37 °C. This explains the effectiveness of archaic methods of treating syphilis, when, by artificially increasing the patient’s body temperature to 41 °C with the help of malaria, some relief of the symptoms of the underlying disease occurred.
The length of the bacterium is 8-20 microns with a thickness of 0.25-0.35 microns. Relatively long, its body forms curls in the form of a ball. At the same time, it constantly changes the shape and number of curls due to the ability of the Treponema pallidum cell to contract.

Incubation period

Entering the body through microdamages of the skin and mucous membranes, the causative agent of syphilis begins the incubation period. Dividing at a rate of about once every 30 hours, it accumulates at the site of infection. None visible symptoms not observed. After about a month, a hard chancre forms on the body in combination with inflammation of the lymph nodes next to it. This means the transition from incubation to the stage of primary syphilis. The strength of immunity varies from patient to patient, which makes the length of the initial period of infection vary widely. It can last from 1-2 weeks to six months.

How is syphilis transmitted?

The process of transmission of the pathogen occurs in most cases through sexual contact. Infection is guaranteed through traditional, anal and oral sexual contact, even with a patient in the incubation period. Hard chancre forms where bacteria enter.

When caring for patients, infection is likely through contact with the patient's clothing, his personal belongings, and his body. In this case, chancre-felon appears, affecting the fingers and toes. This is one of the most painful symptoms in the stage of primary syphilis. Then hard chancre of the genital organs may appear.
Syphilis can also be transmitted through blood. When transfusing contaminated blood, when repeatedly using a patient’s syringe, his razor, scissors, or utensils.

How to treat syphilis

Treatment should begin at the first signs of syphilis. This way the healing process will take place as quickly as possible. Since the 50s of the 20th century, antibiotics have been used in the treatment of syphilis. Penicillin-based drugs were used. Nowadays, drugs based on it are also used, since Treponema pallidum does not know how to adapt to this type of antibiotics. Sufficient doses of penicillin effectively fight the disease. To treat syphilis in patients with allergic reactions to penicillin, erythromycin or tetracycline is used.
If the course of the disease has progressed to neurosyphilis, then treatment becomes more complicated. Add pyrotherapy (artificial increase in body temperature) and intramuscular injection antibacterial drugs.

For tertiary syphilis, along with antibiotics, highly toxic bismuth-based drugs are used. Treatment occurs strictly in a hospital with multi-level supportive therapy.

If a patient is diagnosed with primary syphilis, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the last trimester.
If secondary syphilis is diagnosed, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the past year.

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing fixtures, dishes, bedding and underwear, clothing, etc.
Hospitalization for initial stages syphilis is not required, just enough outpatient treatment. Only in severe forms, starting from the secondary stage, the patient is admitted to the hospital. Treatment of syphilis by compulsory medical insurance policy is free and anonymous.

Coping with illness folk remedies highly not recommended. Only well-designed treatment can defeat Treponema pallidum. Otherwise, there is a high probability of the disease progressing to more severe stages.

Which doctor treats sifak disease?

Since sifak is a disease transmitted primarily through sexual contact, treatment is carried out by a venereologist. The patient can contact a general practitioner and receive a referral to a venereologist. The option of direct contact with a skin and venereal disease clinic is possible.

After examination and receipt of test results, the patient is treated either by a venereologist himself, specializing in all STDs, or the patient is referred to a highly specialized specialist - a syphilidologist.

There is a syphilidologist in everyone big city at skin and venereal dispensaries. He can select the maximum effective dosages medications and develop a treatment program that must be strictly followed. In case of complications in men (when the head of the penis is pinched), syphilis is treated together with a urologist.
In case of complications in women (chancre in the vagina, on the cervix), you need to go to a gynecologist.

How long to treat syphilis

The duration of treatment for the disease is determined solely by the doctor. Depending on the stage of the disease, complications and general condition of the body, healing may take from two weeks to six months.

It is very important to know that under no circumstances should you interrupt the course of treatment. If treatment is not completed, the patient will soon experience a relapse. Therefore, treatment must be taken extremely seriously.

Meningitis in medicine is an inflammatory process that occurs in the lining of the brain, which is located between the skull and the brain itself. It is transient and can lead to death in a few hours. Moreover, the incubation period of meningitis can last from 4 to 7 days, so everyone should know the first signs of this dangerous disease.

Classification of the disease

Meningitis has been fairly well studied and accurately classified. There are several types of this disease:

1. According to the nature of the inflammatory process:

• purulent meningitis - the disease is caused by pathogenic bacteria(meningococcus), pus is formed, and has a very severe course;
• serous meningitis - caused by viruses (for example, enteroviruses, polio viruses, mumps and others), characterized by the absence of purulent contents in the area of ​​inflammation and a less severe course than with the previous type.

1. According to the origin of the inflammatory process:

• primary meningitis - diagnosed as an independent disease, when examining the source of infection in the patient’s body, it is not detected;
• secondary meningitis - there is a focus of infection in the body, against which the inflammatory disease in question develops.

1. Due to the development of meningitis:

1. Depending on how quickly the inflammation develops:

• fulminant (fulminant) meningitis – develops very rapidly, all stages of progression pass almost instantly, the patient’s death occurs on the first day of the disease;
• acute meningitis - the development is not rapid, but rapid - a maximum of 3 days to reach the peak of the disease and death of the patient;
• chronic - lasts a long time, symptoms develop “increasingly”, doctors cannot determine when meningitis began to develop.

1. According to the localization of the inflammatory process:

• basal – pathological process develops in the lower part of the brain;
• convexital - localization of the inflammatory process occurs on the anterior (convex) part of the brain;
• spinal – the pathology affects the spinal cord.

Reasons for development

The only reason for the development of the inflammatory process in the membranes of the brain is the penetration of infection into them. This can happen in different ways:

• airborne;
• oral-fecal – we are talking about the consumption of unwashed vegetables, fruits, berries;
• hematogenous - through the blood;
• lymphogenous - through lymph.

The causative agents of meningitis can be:

• pathogenic bacteria - tuberculosis and E. coli, staphylo/streptococci, Klebsiella;
• viruses of different origins– herpes, virus mumps;
• fungi - candida;
• protozoa – amoeba and/or toxoplasma.

Factors that can provoke the development of the inflammatory process in question are:

• decreased immunity due to chronic diseases or forced long-term use of medications;
• chronic malnutrition;
• chronic fatigue syndrome;
• diabetes mellitus;
• peptic ulcer of the duodenum and stomach;
• human immunodeficiency virus.

Symptoms of meningitis in adults

Meningitis is different severe symptoms, but the fact is that many of the signs go unnoticed or are relieved by taking simple medications. And this not only “lubrifies” the symptoms, but also makes it impossible to seek medical help in a timely manner. Symptoms of meningitis, which should be a signal to immediately seek professional help:

1. Headache. This is generally considered the main sign of meningitis, but this pain syndrome will have distinctive features:

• constant headache;
• there is a feeling of expansion of the skull from the inside;
• the intensity of the pain syndrome increases when the head is tilted forward and backward, as well as when turning left and right;
• headache with meningitis becomes stronger with loud sounds and too bright color.

1. Neck muscle tension. It's not about convulsive syndrome, it’s just that a person cannot lie on his back in the usual position; he will definitely tilt his head back, as otherwise he experiences severe pain.
2. Digestive disorder. This means that one of the signs of the inflammatory process in the membranes of the brain in question is nausea and vomiting. Please note: vomiting will be repeated, even if the patient completely refuses food.
3. Hyperthermia. An increase in body temperature during meningitis is always accompanied by chills, general weakness and increased sweating.
4. Photophobia. A patient with a developing inflammatory process in the lining of the brain is unable to look at bright light– this immediately causes an acute headache.
5. Impaired consciousness. We are talking about a decrease in the level of consciousness - the patient becomes lethargic, answers questions slowly, and at a certain moment completely stops responding to speech addressed to him.
6. Mental disorder. A person may experience hallucinations, aggression, and apathy.
7. Convulsive syndrome. The patient may experience convulsions of the lower and upper extremities, in in rare cases against the background of convulsions, voluntary urination and defecation appear.
8. Strabismus. If, as the inflammatory process progresses, the optic nerves are affected, the patient begins to develop pronounced strabismus.
9. Muscle pain.

Methods for diagnosing meningitis

Diagnosis of meningitis is a rather complex and time-consuming process. After all, it is important not only to establish a diagnosis, but also to find out the degree of development, the type of meningitis, its localization and the pathogen that caused the onset of the inflammatory process in the membranes of the brain . Methods for diagnosing meningitis include:

1. Analysis of patient complaints:

• how long ago did symptoms of meningitis appear?
• whether tick bites have been noted in the recent past - some species of this insect are carriers of the causative agent of meningitis;
• whether the patient has been in countries where there are mosquito carriers meningococcal infection(for example, countries of Central Asia).

1. Examination of the patient according to his neurological condition:

• whether the patient is conscious and at what level it is - does it react to speech addressed to him, and if there is no reaction to a call, then check the reaction to painful stimulation;
• are there any signs of irritation of the meninges - these include tension in the neck muscles and headache with a feeling of fullness and photophobia;
• whether focal neurological symptoms are present - we are talking about symptoms of damage to specific areas of the brain: seizures of a convulsive nature with biting the tongue, weakness in the limbs, speech is impaired, there is facial asymmetry. Please note: such signs indicate the spread of the inflammatory process from the meninges directly to the brain (encephalitis).

1. Laboratory examination of the patient’s blood - the analysis reveals signs of an inflammatory focus in the body: for example, the erythrocyte sedimentation rate will certainly increase.
2. Lumbar puncture. The procedure is carried out only by a specialist and using a special long needle - it makes a puncture through the skin of the back at the lumbar level (subarachnoid space) and a little cerebrospinal fluid is taken for analysis (maximum 2 ml). It may contain pus or protein, which is a sign of an inflammatory process in the meninges.

Liquor is a fluid that provides metabolism and nutrition in the brain and spinal cord.

1. or magnetic resonance imaging of the head - the doctor can examine the meninges layer by layer and identify signs of inflammation, which include expansion of the ventricles of the brain and narrowing of the subarachnoid fissures.
2. Polymerase chain reaction. This is an analysis during which the cerebrospinal fluid or blood is examined, which allows specialists to identify the causative agent of the disease and select a truly effective treatment.

Principles of treatment of meningitis

Important:Treatment of the inflammatory process in the meninges in question should be carried out only in a hospital - the disease develops rapidly and can lead to the death of the patient in a matter of hours. No traditional methods will help cope with meningitis.

The doctor immediately prescribes medications, namely broad-spectrum antibacterial drugs (antibiotics) - for example, macrolides, cephalosporins, penicillins. This choice is due to the fact that the causative agent of the disease in question can only be identified by collecting and examining cerebrospinal fluid - this process is quite long, and assistance must be provided to the patient on an emergency basis. Antibiotics are administered intravenously, and in case of severe health conditions of the patient, directly into the cerebrospinal fluid. The duration of use of antibacterial drugs is determined only on an individual basis, but even if the main signs of meningitis have disappeared and the patient’s body temperature has stabilized, the doctor will continue to administer antibiotic injections for several more days.

The next direction in the treatment of the inflammatory process in the meninges under consideration is the administration of steroids. Hormonal therapy in this case will help the body cope with the infection faster and normalize the functioning of the pituitary gland.

Diuretics are also considered mandatory in the treatment of meningitis - they will relieve swelling, but doctors should take into account that all diuretics contribute to the rapid leaching of calcium from the body.

The patient undergoes a spinal tap. This procedure makes the patient's condition easier because the cerebrospinal fluid puts much less pressure on the brain.

Treatment of meningitis is always carried out against the background of vitamin therapy:

• firstly, it is necessary to support the body and help it resist infection;
• secondly, vitamins are needed to replenish the necessary macro/microelements that do not enter the body due to malnutrition.

Complications and consequences of meningitis

Meningitis is generally considered a life-threatening disease. Complications of this inflammatory process in the meninges are:

1. Brain swelling. Most often, this type of complication develops on the second day of the disease. The patient suddenly loses consciousness (this occurs against the background standard symptoms meningitis), his blood pressure drops sharply, and after a while his blood pressure suddenly rises, a slow heartbeat gives way to a rapid heartbeat (bradycardia turns into tachycardia), intense shortness of breath appears, and all the signs of pulmonary edema are clearly visible.

Please note: If medical care it doesn’t turn out, then through short time meningitis symptoms completely disappear, the patient experiences involuntary urination and the act of defecation and death occurs due to paralysis of the respiratory system.

1. Infectious-toxic shock. This complication develops as a consequence of decay and absorption into the cells and tissues of the body. large quantity decay products of pathogenic microorganisms. The patient's body temperature suddenly drops, the reaction to light and sounds (even not loud ones) becomes very sharp and negative, there is agitation and shortness of breath.

Please note:Infectious-toxic shock often resolves against the background of cerebral edema. The patient's death occurs within a few hours.

The consequences of meningitis can include epilepsy, deafness, paralysis, paresis, hormonal dysfunction and hydrocephalus. In general, meningococcal infection can affect any organs and systems of the body, so recovery from inflammation of the meninges lasts a very long time, and in some cases, a lifetime. Only immediate appeal seeking help from doctors will help reduce the risk of complications and consequences of meningitis.

Meningitis is an infectious disease, the course of which is characterized by extensive inflammation of the spinal cord and brain; its causative agents are various types of viruses and bacteria. Meningitis, the symptoms of which appear depending on the specific type of pathogen, occurs either suddenly or within a few days from the moment of infection.

General description

As we have already noted, with meningitis the brain, in particular its membranes, is subject to inflammation. That is, it is not the brain cells that are damaged during meningitis, but outer area brain, within which the inflammatory process is concentrated.

Meningitis in adults and children can occur in primary or secondary secondary form. Thus, primary meningitis occurs with a one-time lesion of the brain, secondary meningitis is formed against the background of a concomitant underlying disease, in which there is a spread of infection with subsequent damage to the meninges, relevant for meningitis. The main diseases in this case can be identified, etc.

In almost all cases, meningitis occurs quickly - as we have already noted, it develops over a period of several days. As an exception to the general variants of the course of the disease, tuberculous meningitis, which develops gradually, can be isolated.

The incidence of meningitis is observed in a wide variety of age categories, and age is not the determining criterion for susceptibility to this disease - here, as expected, the leading role is played by the condition of the body as a whole. For example, premature babies, due to a weakened state of the body, are most susceptible to meningitis.

In addition, the group of people who may develop meningitis includes patients with certain defects of the central nervous system, as well as with injuries to the back or head. Transmission of the disease is also possible during childbirth, through mucous membranes, contaminated food and water, through insect bites and by airborne droplets. In any case, there are many factors that can also determine predisposition to meningitis.

Types of meningitis

Depending on the etiology, that is, on the causes that provoked meningitis, this disease can be infectious, infectious-allergic, microbial, neuroviral, traumatic or fungal. Microbial meningitis, in turn, can manifest itself in the form of serous meningitis, tuberculous meningitis, influenza or herpetic meningitis.

Depending on the localization of the inflammatory process during meningitis, pachymeningitis is distinguished, which usually affects hard shell brain, leptomeningitis, in which the soft and arachnoid membranes of the brain are affected, as well as panmeningitis, in which all membranes of the brain are affected by the inflammatory process. If the inflammatory lesion is predominantly localized in the area of ​​the arachnoid membrane, then the disease is defined as arachnoiditis, which, due to its characteristic clinical features, belong to a separate group.

Basically, meningitis is divided into purulent meningitis and serous meningitis; we will consider the features of both types of forms below.

Depending on the origin, as we have already highlighted, meningitis can be primary (this includes most of the neuroviral forms of meningitis, as well as purulent meningitis) and secondary (syphilitic, tuberculous, serous meningitis).

Depending on the nature of the cerebrospinal fluid, meningitis can be hemorrhagic, purulent, serous or mixed. Based on the characteristics of the course, meningitis can be fulminant or acute, subacute or chronic.

The localization of the inflammatory process during meningitis determines such varieties of its forms as superficial meningitis (or convexital meningitis) and deep meningitis (or basal meningitis).

The following routes of infection of the meninges are determined for meningitis: possible forms: lymphogenous, contact, hematogenous, perineural meningitis, as well as meningitis that occurs against the background of traumatic brain injury.

Any type of meningitis is characterized by the occurrence meningeal syndrome, which manifests itself in increased intracranial pressure. As a result of this manifestation, this syndrome is characterized by the appearance of a bursting headache with a simultaneous feeling of pressure on the ears and eyes, it is also noted increased sensitivity in relation to exposure to sounds and light (which in turn is defined as hyperacusis and photophobia). Vomiting and fever appear, a rash and epileptic seizures may also appear.

Meningococcal meningitis

With this form of meningitis pathological changes affect the basal and convex surfaces of the brain. Fibrinous-purulent or purulent fluid formed in the area of ​​inflammation (exudate) densely covers the brain (similar to a cap), while infiltrates formed in the area along the vessels end up in the substance of the brain. As a result of this, edema begins to develop, the medulla begins to overflow with blood within its own vessels (i.e., hyperemia occurs).

Similar changes are also observed in the spinal cord.

Timely initiation of treatment can ensure the subsidence of the inflammatory process, after which the exudate is completely destroyed. If we talk about advanced cases of the course of this disease, as well as about cases with the prescription of irrational therapy when it is relevant, then the possibility of the development of a number of specific processes cannot be excluded, as a result of which, in turn, the processes of liquor dynamics, against the background of which it is already developing, may be disrupted.

Now let's move on directly to the symptoms that characterize this form of meningitis.

Most often it develops suddenly, which is accompanied by sharp increase fever and vomiting (it is repeated and does not bring adequate relief to the patient). Due to increased intracranial pressure, severe headache occurs. Against the background of the general condition, the patient develops characteristic pose, in which there is tension in the occipital muscles while the back is arched and the legs are bent to the stomach.

During the first days of the disease, many patients notice the appearance of a rash, which, meanwhile, disappears within one to two hours. In some cases, the posterior wall of the pharynx is also susceptible to hyperemia with simultaneous hyperplasia in its follicular area. Also, a number of patients are faced with the appearance, noted literally a few days before the onset of meningitis. Meningitis in infants in this form develops mainly gradually; in older children, a similar course is observed in rare cases.

Based on the severity of the disease, the patient may experience symptoms such as muscle cramps, blackouts or states of unconsciousness. In the case of an unfavorable course of meningitis, by the end of the first week, patients experience a comatose state, in which symptoms in the form of paralysis appear in the foreground facial nerve And eye muscles. Convulsions, which previously appeared periodically, gradually become more frequent and it is during one of the next manifestations that the patient dies.

If the course of meningitis in the form under consideration is determined to be favorable, then this, in turn, is accompanied by a decrease in temperature, and the patient develops previously lost appetite. Ultimately, a person with meningitis gradually moves into the recovery phase.

The total duration of meningitis in meningococcal form is about two to six weeks. Meanwhile, in practice, cases in which the course of the disease occurs at lightning speed are not excluded. In such a situation, the death of the patient occurs within literally a few hours from the onset of the disease.

With a prolonged course, after a short period of improvement, the patient’s temperature rises again, and it remains stable for a long time. This type of protracted form is either a hydrocephalic stage or a stage at which the patient develops meningococcal sepsis, which is accompanied by the entry of meningococcus into the blood (which is defined as meningococcemia).

The main feature of this course is the appearance of a hemorrhagic rash. In addition, there is an increase in temperature and a decrease in blood pressure, shortness of breath appears, and patients also experience tachycardia.

The most severe manifestation of meningitis in this form is bacterial shock. In this case, the disease develops acutely, with sudden increase fever and the appearance of a rash. The patient's pulse also quickens, breathing is uneven, and convulsions are often observed. Then the state becomes comatose. Often the death of a patient during such a course occurs without returning to consciousness.

There are also a number of the following symptoms with characteristic features inherent in them:

• Skin necrosis. The severe course of the disease against the background of meningococcal infection leads to the development of inflammation and inflammation in the vessels. As a result of this, extensive hemorrhage and, in fact, necrosis develop, which are especially pronounced in those areas in which there is compression. Subsequently, rejection occurs subcutaneous tissue and necrotic skin, resulting in ulcers. As a rule, they heal quite slowly; the depth and extent of skin damage often requires skin transplantation. Keloid scars in this case are also a common result course of the disease.
• . The acute stage of this form of meningitis is in some cases accompanied by damage to the cranial nerves, of which the abducens nerve is the most vulnerable due to the passage of a significant part of it along the base of the brain. If this nerve is damaged, paralysis of the lateral rectus eye muscles occurs. As a rule, strabismus disappears after a few weeks. But due to the spread of infection to the inner ear, partial deafness or complete loss of hearing is often observed.
• . A frequent manifestation of meningitis of the form in question is, which disappears fairly quickly with treatment. As for uveitis, it is much more serious complication, which can result in panophthalmitis and subsequent blindness. Meanwhile, antimicrobial therapy used today minimizes such severe consequences.

Purulent meningitis

Purulent (secondary) meningitis is accompanied by clouding, swelling and hyperemia of the meninges cerebral hemispheres(their convex surface). Purulent exudate fills the subarachnoid space.

The onset of the disease is accompanied by a sharp deterioration in the general condition of the patient, during which he experiences chills and his temperature also rises. Severe forms of the disease may be accompanied by loss of consciousness, convulsions, and delirium. A traditional symptom for the disease as a whole also appears in the form of repeated vomiting. At purulent meningitis Internal organs are affected, and joints are also affected.

Sharp severity is noted in the manifestation of symptoms such as stiffness of the neck muscles and Kernig and Brudzinsky symptoms. Kernig's sign determines the inability to extend a bent knee and hip joint legs. As for Brudzinski's symptom, its manifestations are reduced to bending the legs at the knees when trying to tilt the head forward in a lying position, to bending the legs in knee joints also causes pressure on the pubis.

Serous meningitis

Serous meningitis is characterized by the occurrence of inflammatory serous changes in the meninges. In particular, serous meningitis includes its viral forms. In about 80% of cases, enteroviruses, as well as the mumps virus, are identified as the causative agent of serous meningitis. Also common are influenza and adenoviral meningitis, herpetic and parainfluenza forms of this disease, including a number of other variants of its manifestation.

The source of the virus is predominantly house mice - the pathogen is found in their secretions (feces, urine, nasal mucus). Accordingly, human infection occurs as a result of consumption of products that have been subjected to similar contamination by secretions.

The disease is predominantly observed in children aged 2 to 7 years.

The clinical picture of the disease can be characterized by meningeal symptoms in combination with fever, manifested to a greater or lesser extent, and can often be combined with symptoms of generalized lesions in other organs.

Viral meningitis can be characterized by a two-phase course of the disease. Along with the main manifestations, there may be signs indicating damage to the peripheral and central nervous system.

The duration of the incubation period of the disease is about 6-13 days. A prodromal period is often observed, accompanied by manifestations in the form of weakness, weakness and catarrhal inflammation of the upper respiratory tract, simultaneously with a sudden increase in temperature to 40 degrees. Also, these symptoms can be supplemented by severe meningeal syndrome, which causes severe headache and vomiting.

In some cases, the examination determines the presence of congestion in the fundus of the eye. Patients complain of pain in the eyes. As for the vomiting noted above, it can be either repeated or repeated. As in previous variants of the development of meningitis, Kernig and Brudzinsky symptoms are noted, characteristic tension occipital region. Severe cases of manifestation of the disease are accompanied by a typical posture of the patient, in which his head is thrown back, his stomach is retracted, and his legs are bent at the knee joints.

Tuberculous meningitis

This form of meningitis is also predominantly observed in children, and especially in infants. Tuberculous meningitis appears much less frequently in adults. In about 80% of cases of the relevance of this disease, patients are identified with either residual effects of their previously suffered tuberculosis, or a form of active course of this disease in another area of ​​concentration at the time of detection of meningitis.

The causative agents of tuberculosis are a specific type of microbacteria that are common in water and soil, as well as among animals and people. In humans, it predominantly develops as a result of infection with a bovine or human species.

Tuberculous meningitis is characterized by three main stages of development:

• prodromal stage;
• irritation stage;
• terminal stage (accompanied by paresis and paralysis).

Prodromal stage the disease develops gradually. Initially, symptoms include headache and nausea, dizziness and fever. Vomiting, as one of the main signs of meningitis, can appear only occasionally. In addition to these symptoms, stool and urine retention may occur. As for the temperature, it is mostly low-grade; high levels are extremely rare at this stage of the disease.

After about 8-14 days from the beginning of the prodromal stage of the disease, the following stage develops - irritation stage. It is particularly characterized by a sharp increase in symptoms and an increase in temperature (up to 39 degrees). There is a headache in the occipital and frontal regions.

In addition, there is an increase in drowsiness, patients become lethargic, and consciousness is subject to depression. Constipation is characterized by the absence of bloating. Patients cannot tolerate light and noise; vegetative-vascular disorders are also relevant for them, manifesting themselves in the form of sudden red spots in the chest and face, which also quickly disappear.

By the 5-7th day of the disease at this stage, meningeal syndrome is also observed (Kernig and Brudzinsky symptoms, tension in the occipital muscles).

Severe symptoms are noted within the second stage of the stage under consideration; its manifestations depend on the specific localization of the tuberculous inflammatory process.

Inflammation of the meningeal membranes is accompanied by the occurrence typical symptoms diseases: headaches, stiffness of the muscles of the neck and nausea. The accumulation of serous exudate at the base of the brain can lead to irritation of the cranial nerves, which, in turn, manifests itself in blurred vision, strabismus, deafness, uneven pupil dilation and eyelid paralysis.

The development of hydrocephalus to varying degrees of severity leads to blocking of certain brain cerebrospinal connections, and it is hydrocephalus that is the main reason that provokes the symptom of loss of consciousness. If the spinal cord is blocked, the motor neurons become weak and paralysis in the lower extremities may occur.

The third stage of the disease in this form is thermal stage , characterized by the occurrence of paresis and paralysis. Manifestations of symptoms of this period are noted by 15-24 days of illness.

The clinical picture in this case has symptoms characteristic of encephalitis: tachycardia, temperature, Cheyne-Stokes respiration (i.e. periodic breathing, in it there is a gradual deepening and increase in rare and superficial respiratory movements when reaching a maximum at the 5-7th inhalation and a subsequent slowdown/weakening, turning to a pause). The temperature also rises (up to 40 degrees), and, as already noted, paralysis and paresis appear. The spinal form of the disease at stages 2-3 is often accompanied by extremely pronounced and severe girdling radicular pain, bedsores and flaccid paralysis.

Viral meningitis

The onset of the disease is acute, the main manifestations of which are general intoxication and fever. The first two days are characterized by the severity of the manifestations of meningeal syndrome (headache, vomiting, drowsiness, lethargy, anxiety/excitement).

There may also be complaints of runny nose, cough, sore throat and stomach pain. Examination reveals the same signs that characterize the disease as a whole (Kernig and Brudzinski syndrome, tension in the occipital region). Normalization of temperature occurs within 3-5 days; in some cases, a second wave of fever is possible. The duration of the incubation period is about 4 days.

Meningitis is a disease that develops due to the penetration of bacterial or viral microflora through the encephalitic barrier. This usually occurs against the background of decreased immunity, with the spread of infectious agents by hematogenous or lymphogenous routes. The condition is life-threatening. If large parts of the structural nerve fibers are damaged, respiratory and cardiac arrest may occur.

People die from meningitis

Mothers often warn their children that running without a hat in winter can easily cause meningitis. And then they won’t save you, and if they do, there’s a risk of remaining mentally retarded for the rest of your life. Unfortunately, there is some truth in this - people die from meningitis. And not just children.

The causative agent of meningitis

It is known that meningitis can be caused by both bacteria and viruses. Explain which pathogen is the most dangerous? Development of the most severe and dangerous shape diseases - purulent meningitis - are provoked by bacteria. The most common causative agents of meningitis are meningococcus, pneumococcus and Haemophilus influenzae. These microorganisms can not only leave a person disabled for life, but even kill the patient.

How do you get meningitis? How meningitis is contracted depends on the form of the infection. Bacterial meningitis is transmitted only from person to person. Infection with meningitis is possible if you have close contact with a patient, drink from the same mug, or use shared dishes, towels, and hygiene products. But by airborne droplets meningitis is not transmitted because the microorganisms that cause it live in external environment very briefly. For example, it is enough to ventilate the room so that the meningococci that settle on the furniture die.

Viral meningitis: how is it transmitted?

Parents often scare their children, saying that if you don’t wear a hat in the cold, you will certainly get meningitis. Is this true? If there is no pathogen in the body, then the disease has nowhere to come from. Therefore, such a statement is a fallacy. However, I still don’t recommend walking without a hat in winter - this way you can significantly weaken your immunity and disarm your body from many different infections.

None of this is true about viral infection. How is viral meningitis transmitted? By airborne droplets.

Causes of meningitis

People from young to old suffer from purulent meningitis: in our practice, the youngest patient was not even a month old, and the oldest was over 80 years old.

Statistics say that most often patients catch meningitis in the spring.

Why is it at this time that the immune system cannot resist a dangerous infection? The fact is that it is during this period that the causes of meningitis become more pronounced.

Every day, millions of different pathogens enter our body, including meningitis pathogens. The immune system immediately sends defenders to intercept - special cells that capture, swallow and digest harmful viruses and microbes. Usually the immune system easily and quickly copes with the enemy, so that we don’t even notice it. But in the spring the body is greatly weakened by a lack of vitamins and sun, cold, and various infections. Especially many patients are admitted to infectious diseases hospitals during the decline of the influenza epidemic, which most often occurs at the end of winter - beginning of spring. Our immune system has to contain the powerful attack of viruses, and there is no longer any strength left to fight bacteria.

Brain meningitis disease

Why are other infections unable to reach the brain, but meningococcus, pneumococcus and Haemophilus influenzae manage to do so and develop the disease meningitis?

The fact is that nature protected our brain not only with bone (skull) from the outside, but also with a special blood-brain barrier (BBB) ​​from the inside. This is the unique structure of the walls of the vessels located in the head. They allow only nutrients to reach the nervous tissue. But the passage to the brain is closed for infectious agents circulating in the blood. They can’t even pass through the BBB own cells immunity, let alone foreign bacteria. To penetrate the “fortress,” the bacteria that cause brain meningitis act very cunningly: they cover themselves with a special coating. As a result, the defender cells absorb the infection, but cannot digest it. Such a “Trojan horse” (a bacterium inside an immune cell) not only travels unhindered throughout the body, but also produces a special substance that helps it overcome the blood-brain barrier. Although, in the end, only a few bacteria reach the brain.

Signs of meningitis

Beyond the blood-brain barrier lies a veritable paradise for pathogenic microbes: nutrients, plenty and there is no one who could defend himself - no antibodies, no defender cells. Once behind the BBB, bacteria grow and multiply, as in an incubator. Therefore, signs of meningitis begin to appear quite quickly after infection.

Meningitis infection

Is it enough to strengthen your immune system and get proper treatment for the flu to avoid getting meningitis? There is a second way for bacteria to enter the “forbidden zone” - during traumatic brain injuries, when the integrity of the bone is compromised. IN lately Road accidents are becoming more common, and along with them, the number of people suffering from the purulent infection meningitis is growing. The fact is that with fractures of the base of the skull, the membranes of the brain directly communicate with the airways of the nasopharynx, and as soon as the pathogen appears in the body, it penetrates the nervous tissue and multiplies very quickly.

What are the signs of meningitis?

The disease develops rapidly - literally in a few hours.

What signs of meningitis should you look out for? Bacteria, getting behind the BBB, take away all the nutrients from the membranes of the brain and release toxins that affect surrounding tissues and paralyze cells. If the infection is not stopped in time, necrosis occurs: the membranes of the brain die and pus forms. The death of the patient occurs due to cerebral edema: no longer fitting into the cranium, the brain is wedged into the large foramen magnum. In this case, paralysis occurs: breathing and heartbeat are disrupted, and vital centers are affected.

How does meningitis manifest?

Is it possible to recognize the disease in time and provide help to the person? Yes, if you know how meningitis manifests itself.

Purulent meningitis develops very rapidly, with vivid symptoms. The disease begins with a severe headache, vomiting that does not bring relief, and intoxication. The temperature rises above 40 °C, shortness of breath, severe weakness appear, and sometimes a rash appears on the skin. The patient cannot even sit, let alone move. With purulent meningitis, consciousness is quickly disturbed: a person becomes agitated, aggressive, commits actions unusual for him, cannot perform some usual actions, or completely loses consciousness. In the most severe cases convulsions appear ( a clear sign severe brain damage). In this case, minutes count: the sooner a person is taken to a doctor, the greater the hope for salvation.

The first symptoms of meningitis

The symptoms of meningitis are generally described above. There is a very simple way to detect meningitis when a person is conscious - if during a flu epidemic there is a huge influx of patients in the clinic and there is simply no time left for a thorough examination, ask the patient to tilt his head and press his chin to his chest. A person with bacterial meningitis will never be able to do this: his head hurts so much that he holds it like a crystal, afraid to move again. And when bending over, the pain increases sharply. These are the first symptoms of meningitis.

Course of meningitis

Course of meningitis bacterial etiology usually rapid.

What to do if you suspect purulent meningitis? Call an ambulance. Delay may cost the patient's life. Sometimes purulent meningitis develops so rapidly that the patient himself cannot even reach the telephone. The problem is aggravated by the fact that it is very difficult to determine why a person fainted and when it happened. Most often, people lose consciousness due to cardiovascular diseases or disorders cerebral circulation. Therefore, first, the emergency team takes the patient to the vascular center, where computed tomography and magnetic resonance imaging are performed. If no violations are found, the patient is immediately sent to an infectious diseases hospital. However, all these trips can take up valuable time. You need to know that in case of cardiovascular diseases high temperature doesn't happen. Therefore, if a patient has a fever, you need to immediately send him to infectious disease specialists. Relatives must understand that under no circumstances should they leave a person with a fever or impaired consciousness at home and hope that everything will go away on its own. Another formidable confession
To - hemorrhagic rash. This is a very bad symptom. Hemorrhagic rash is a manifestation of the most severe form of meningococcal infection - meningococcal sepsis, which affects all organs of the human body without exception. Such a patient should be taken to the hospital without delay.

The most important questions about the treatment of bacterial meningitis

Purulent meningitis is not a disease for which you can rest at home. Not only the effectiveness of treatment, but even the patient’s life depends on how quickly a patient sees a doctor.

Diagnosis of meningitis

Diagnosing meningitis is usually not difficult for an experienced doctor. If the patient is conscious, tests are taken. And sometimes a person is brought in in a state where there is no time for testing: first you need to restore your heartbeat, breathing, and bring you out of shock. This is done by a special resuscitation team.

Tests for meningitis

Despite the availability of ultra-modern computed tomographs, the presence of bacteria can only be determined by examining the cerebrospinal fluid. Therefore, for meningitis, a special procedure is performed, the so-called lumbar puncture, when a special needle is inserted into the patient’s back and CSF (cerebrospinal fluid) is taken for examination. This is the only 100% accurate procedure and test for meningitis, which allows you to quickly identify the presence of purulent meningitis (unlike viruses, bacteria are immediately visible under a microscope) and even determine the type of microorganism that caused it (using classical (culture) and express methods (agglutination, hybridization)).

How safe is a lumbar puncture? Lumbar puncture is performed under local anesthesia; the patient does not feel anything. The puncture is made in the lumbar region. At the puncture site there is no spinal cord or structures on which it rests spinal column. Therefore, you don’t have to worry about the needle damaging anything. There are also no complications after puncture.

What happens after an infection is discovered? It is very important to begin intensive treatment at the first suspicion of purulent meningitis, even before receiving test results. The patient is immediately admitted to the hospital and given intensive antibiotic treatment. Also prescribed are drugs that remove excess fluid from the serous membranes and reduce intracranial pressure, neurometabolites that improve brain metabolism, as well as vitamins (if the patient does not have allergies). The patient is allowed to go home no earlier than a month later (and sometimes even later, depending on the condition). Then the patient must remain at home for another 2 weeks. And only then will the gradually recovering person be able to return to the usual rhythm of life. After recovery, the patient must be regularly monitored by doctors for another 2 years and undergo rehabilitation treatment. He is prohibited physical activity and playing sports.

How to treat meningitis

Is it possible to treat yourself? No way! Before treating meningitis, it is necessary to determine the sensitivity of the pathogen to antibiotics. Purulent meningitis must be treated only in infectious diseases hospitals with strong antibacterial drugs, since patients are very fond of making their own diagnoses and prescribing treatment. This often leads to disastrous consequences.

Treatment of meningitis

Treatment of meningitis is carried out in a hospital after laboratory examinations. Only a doctor can prescribe the drug, dose and duration of the course, depending on the pathogen, the time of contacting the doctor, concomitant diseases, characteristics of the patient’s body.

Antibiotics for meningitis

Antibiotics for meningitis can only be used as prescribed by a doctor. Bacteria quickly evolve and adapt to their environment. During treatment with antibiotics it is necessary to drink full course to kill all germs. If the course is interrupted (and many people do this when they suddenly feel better), the bacteria not only survive, but also acquire resistance (immunity) to this medicine.

Just 20 years ago, penicillin was one of the most effective drugs. Today it has almost no effect. This is what uncontrolled use of antibiotics leads to! And at the same time, almost any of them can be freely purchased at the pharmacy. Over the past 7 years, not a single new one has been created in the world. antibacterial drug, since these studies are very expensive.

Meningitis is now treated with the latest effective 3rd generation antibiotics. If bacteria become resistant to them, a catastrophe will occur - there will simply be nothing left to treat patients with and medicine will return to the level of the 1920s, when meningitis could “mow down” entire neighborhoods. Already today, infectious disease specialists are faced with the fact that even the most modern drugs do not work, and the patient cannot be saved.

Purulent meningitis: consequences and complications

Complications of meningitis appear if the patient seeks medical help too late, and the infection has managed to damage not only the meninges, but also the structure of the brain itself. The worst complication with purulent meningitis is, of course, death. But even if the patient was saved, he may still have paresis, paralysis, and hearing impairment. In rare cases, a person remains disabled for life. The most common complication meningitis is a cerebrasthenic syndrome, when a person reacts sharply to changes in weather and climate.

Are mental disorders possible? It is not true that after meningitis you will definitely become mentally retarded. After treatment, patients graduate from 2 institutes. Most of our patients who come to us are very in serious condition, graduated, found a good job. Mental disorders can occur extremely rarely and only if the patient seeks help too late.

Is it possible to get meningitis again? After a patient has had purulent meningitis, he develops lifelong immunity. But only to one specific bacterium. Therefore, you can become infected with meningitis several times. However, this is extremely rare. Only patients with traumatic brain injuries who have post-traumatic liquorrhea (leakage of cerebrospinal fluid into the nasal passages through a crack at the base of the skull) become ill again.

Prevention of meningitis

Prevention of meningitis is not only possible, but also recommended by all doctors. First of all, it is necessary to get vaccinated on time. Vaccination against hemophilus influenzae infection is included in the calendar. It is given to children at 3, 4.5 and 6 months. Booster vaccinations are also given at 18 months. Vaccinations against pneumococcus and meningococcus can now only be done in private clinics, since they appeared quite recently. However, these vaccines are planned to be introduced into the market soon. National calendar preventive vaccinations.

You also definitely need to monitor your health, avoid chronic foci of infection, treat your teeth on time, see a doctor, and not try to rest at home. It is very important to follow basic sanitary rules: each family member should have their own hygiene items, their own mugs, spoons, plates. Well, most importantly, wash your hands as often as possible.

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Meningitis is an inflammatory process in the soft and arachnoid membranes of the brain and spinal cord. This is a serious infectious disease caused by various pathogens.

Despite the large arsenal antibacterial agents, meningitis remains one of the most terrible infections, when such a diagnosis is made immediate hospitalization of the patient is necessary, because the consequences untimely treatment meningitis can be the most disastrous, and the percentage of deaths is also high.

What types of meningitis are there?

Meningitis is classified:

1. According to the pathogen that caused them: bacterial, viral, fungal, rickettsial, protozoal.
2. According to the nature of inflammation: serous, purulent, mixed.
3. By severity: mild, moderate, severe.
4. According to the speed of development: fulminant, acute, subacute, chronic.
5. According to the prevalence of the process: diffuse, limited.
6. According to the source of infection: primary, when meningitis develops without an obvious primary source of infection; secondary, when the infection penetrates from another identified focus (mainly purulent).

How does meningitis develop?

For inflammation of the meninges to develop, the pathogen must somehow get inside the skull. Most often, it gets there through the bloodstream during infectious diseases (dysentery, typhoid fever), as well as in the presence of any purulent focus in the body (abscess, endocarditis, infected wound or burn). The infection can also penetrate to the meninges through the regional lymph flow, along the nerve sheaths, or by contact in the presence of a purulent focus in the head area (purulent, periostitis, peritonsillar abscess, osteomyelitis, purulent skin lesions, especially in the forehead, scalp and nasolabial triangle) , as well as in case of traumatic injuries of the skull.

The causative agent of meningitis can be almost any infectious agent. Most often this is a virus of influenza, measles, mumps, herpes,. Among the bacteria, these are pneumococci, meningococci, tuberculosis bacillus. At certain conditions meningitis can be caused by fungi and protozoa.

It is obvious that the penetration of infection into the membranes of the brain and the development of inflammation in them is possible under a certain state of the immune system. It is likely that there are certain birth defects immunity, which predispose to the development of this disease.

When the pathogen enters the cranial cavity, it settles on the meninges, and an inflammatory reaction begins here - swelling, hypersecretion of cerebral cerebrospinal fluid, and disruption of its outflow. The membrane swells, intracranial pressure increases, irritation of the meninges and compression of the cranial and spinal nerves. arise clinical symptoms: menningeal, cerebral, and general intoxication of the body also progresses.

During the purulent process, there is an accumulation of pus in the intrathecal space, foci of softening in the cerebral cortex, and microabscesses. Purulent exudate can cover the entire brain, or be located only in the grooves. It is obvious that with this course of meningitis, even if recovery occurs, its consequences are irreversible.

Meningitis clinic

Despite the variety of causes, the clinical picture of meningitis is usually typical for all forms. Particularly similar in symptoms and usually does not cause difficulties in diagnosis acute form. The main symptoms of meningitis, the combination of which makes it possible to make a diagnosis:

The severity of these signs of meningitis depends on the severity of the process; some of them may be weakly expressed or not detected at all in sluggish and erased forms of the disease.

In young children (up to one year) The first signs of meningitis may be nonspecific. Hyperthermia, anxiety, constant monotonous crying, regurgitation, and convulsions are noted. Only on the 2-3rd day do meningeal symptoms and impaired consciousness appear.

Let's look at the most common forms of meningitis.

Epidemic meningococcal meningitis

60-70% of all bacterial meningitis is caused by meningococcus. Its danger is that such meningitis The course is very difficult; often, especially in children, it occurs at lightning speed, leading to death within a few hours. Infection occurs from a sick or latent carrier. Infection occurs through airborne droplets, which is why it is also called epidemic meningitis.

When infected, meningococcal nasopharyngitis first develops, which differs little from the usual symptoms: redness and swelling of the mucous membrane of the pharynx, pharynx, runny nose.

Infection with meningococcus will not always cause the development of meningitis. It all depends on individual defenses. If the body is not able to create a barrier for it at the stage of nasopharyngitis, the pathogen enters the brain through the bloodstream and after a few days (from 1 to 5) a clinical picture of purulent meningitis develops (acute onset, severe course).

It is meningococcal meningitis that causes the fulminant form in children: very acute course, with the development of meningococcal sepsis (high concentration of meningococcus in the blood - meningococcemia). Under the influence of toxins, microthrombi form, hemorrhages in all organs and the child dies. A terrible symptom of menigococcemia is a hemorrhagic rash on the skin.

With timely treatment high probability full recovery, since meningococcus is perfectly treated with regular old penicillin.

Other purulent meningitis

Staphylococcal, pneumococcal, caused by have a higher mortality rate And irreversible consequences, since most of these pathogens have developed resistance to existing antibiotics.

Untreated purulent meningitis leads to death in 50% of cases. The most severe form of meningitis is named reactive meningitis. This is a bacterial meningitis with a fulminant course, caused mainly by meningococci, streptococci, and pneumococci. It can be either primary or secondary. This form leads to death in 90% of cases. In adults, death occurs within 1-2 days, children die within a few hours.

Serous meningitis

Serous meningitis is mainly seasonal and epidemic in nature. Children get sick more often. Most often serous meningitis are caused by enterovirus and mumps virus.

Such meningitis is characterized by less pronounced meningeal symptoms and a relatively benign course.

Tuberculous meningitis

Recently, this form of meningitis has become much more common. Such meningitis is always secondary, complicating the course of the tuberculosis process in another organ (mainly the lungs). Develops subacutely as the disease progresses. There is a gradually increasing headache, general weakness, nausea, and increased body temperature.

Meningeal symptoms also appear gradually, after 7-10 days from the onset of the disease. Damage to the cranial nerves is characteristic, which is manifested by double vision, ptosis and strabismus.

Changes in the cerebrospinal fluid are often serous in nature; in 2/3 of cases, Mycobacterium tuberculosis is detected by microscopy.

Treatment of meningitis

Any suspicion of meningitis requires immediate hospitalization and immediate lumbar puncture to clarify the diagnosis.

Antibiotic therapy is the main method of treating meningitis. The choice of antibiotic depends on the type of pathogen. For purulent meningitis, treatment begins with high doses penicillin, which is administered intravenously. Combination with other antibiotics (gentamicin, cephalosporins, kanamycin) is possible. Upon receipt of the results of a bacteriological study of the cerebrospinal fluid, treatment is carried out with an antibiotic to which the isolated pathogen is sensitive.

For viral meningitis, treatment is mainly symptomatic, since there are no effective antiviral drugs.

Tuberculous meningitis is treated with specific anti-tuberculosis drugs.

Nonspecific treatment:

In addition to antibacterial therapy, the following are used to alleviate the condition:

• Diuretics for the treatment and prevention of cerebral edema.
• Glucocorticoid hormones.
• Plasma-substituting, saline solutions.
• Glucose solution intravenously.
• Cardiovascular drugs according to indications.

For secondary meningitis - treatment of the underlying disease. If meningitis is a complication of purulent inflammation of the ENT organs or the oral cavity, immediate surgical sanitation of the lesion (opening an abscess, draining the paranasal sinuses, middle ear cavity, etc.) is necessary.

Consequences of meningitis

There are many “horror stories” that after suffering from meningitis, consequences will inevitably remain for life. This is far from true.

If treatment is started on time, meningitis can go away without any unpleasant consequences, which is observed in most cases.

In a small percentage of cases may remain increased fatigue, headaches that will intensify with changes in atmospheric pressure, difficulties in remembering information, absent-mindedness, sleep disturbance. However, these symptoms usually gradually disappear over 5 years.

Even more rarely, when severe purulent forms of meningitis affect the very substance of the brain, visual impairment, hearing impairment, seizures, and significant mental retardation may remain.

Prevention of meningitis

No one is immune from meningitis. But meningitis has favorite ages:

• Children under 5 years old, and boys get sick 2-3 times more often than girls.
• Young people 16 – 25 years old.
• Elderly people over 60 years of age.

You need to know the basic rules that will help minimize the risk of infection, prevent the complicated course of other diseases, and also begin timely treatment of already developed meningitis. It must be remembered that meningitis is treatable and the earlier treatment is started, the more favorable the outcome.

Video: meningitis in children, “Dr. Komarovsky’s School”