Meningitis : types, causes, symptoms , treatment
Epidemiology / / August 12, 2017
Meningitis is a bacterial infection of the membranes of the brain and spinal cord, in which brain cells themselves are not affected, since the inflammatory process develops from the outside of the meninges.Meningitis is divided into viral (serous) and bacterial.
most common causes of meningitis are viral infections usually occurring without treatment.However, bacterial meningitis and infections are extremely serious, and can lead to death or brain damage, even with proper treatment.
Viral meningitis is more common than bacterial meningitis and milder.Outbreaks of viral meningitis usually occur in late summer and early autumn.It most commonly affects children and adults up to 30 years.
following types of meningitis:
- Aseptic meningitis
- cryptococcal meningitis
- Gram-negative meningitis
- Meningococcal meningitis
- Pneumococcal meningitis
- Staphylococcal meningitis
- TB meningitis
Causes and meningitis risk factors
normally, the brain is naturally
Meningitis can also be caused by the following reasons:
- Chemical irritation
- Drug allergy
- Infections occurring near the brain, for example,ears or nose
- Complications of brain surgery, head and neck
- Bypass on the occasion of hydrocephalus
- Sickle cell anemia
- Receiving drugs that suppress
immune system - Accommodation in adverse living conditions (barracks, barracks, close facilities)
- Boils on the neck or face
Many types of viruses can cause meningitis:
- Enteroviruses.Most viral meningitis is associated with enteroviruses, which cause intestinal diseases, such as E. coli, Salmonella, Pseudomonas aeruginosa.
- Staphylococci.The development of staphylococcal meningitis contribute to chronic pneumonia, abscesses, osteomyelitis of the cranial bones and spine, sepsis.
- Herpes.Viral meningitis can be caused by a herpes virus, the same virus T, which can cause genital herpes and herpes.However, people with herpes or herpes genitalia do not are at greater risk of this type of meningitis virus.
- Tuberculosis.The primary source of infection - develop TB in the lungs or intrathoracic lymph nodes.
- Mumps and HIV.The viruses that cause mumps and HIV can cause aseptic meningitis.
- West Nile Virus.Recently, West Nile virus that spreads through mosquito bites, has become a cause of viral meningitis.
- Fungal infections and candida.
Symptoms of meningitis in children and adults
Common symptoms of meningitis usually appear very quickly, and may include:
- Fever and chills, especially in children and infants;
- Mental disorders, a change of consciousness, hallucinations;
- Nausea and vomiting;
- Sensitivity to light (photophobia), patients usually lie, turned to the wall and his head covered with a blanket;
- Strong, intense, arching headache that is worse when driving or walking by a loud sound and bright light »
- Stiff neck (meningismus) - restriction or impossibility of bending head;
- Symptom Kernig - inability to extension legs, pre-bent at the knee and hip joints;
- Symptoms Brudzinskogo:
- when the passive reduction of the head to the chest in the position of the patient lying on the back there is an involuntary flexion of the legs at the knee and hip joints
- with pressure on the area of the pubic symphysis occurs involuntary leg flexion in the knee and hipjoints
- when checking Kernig symptom occurs involuntary flexion of the other leg in the same joints.
- skin pallor and cyanosis of nasolabial triangle;
- Flexing and pulsating fontanelle in infants;
- Lowering of attention;
- Violations sucking or irritability in infants, they are restless, often scream and abruptly excited from any touch
- Decreased appetite, but without giving up liquids;
- Rapid breathing and shortness of breath;
- rapid pulse;
- Lowering blood pressure;
- Unusual posture in children, such as posture "setter dog" when the head is thrown back, and his legs bent at the knees and pulled up to the stomach;
- Symptom "hanging" Lesage, when at underarms holding the baby, he pulls up his legs to his stomach and holding them in this position;
- Improved tactile sensitivity, when even a light touch to the patient causing increased pain;
- The appearance of the rash;
- Convulsions in young children.
usually meningitis not recognize after a physical examination of the patient, when detected:
- Increased heart rate
- Mental changes
critical importance for the diagnosis of meningitis is the study of cerebrospinal fluidwhich is obtained by lumbar puncture.Laboratory analysis of cerebrospinal fluid usually comprises determining the amount and structure of cells, proteins and glucose, fixed bacterioscopy drops cerebrospinal fluid Gram stained.
addition can be made:
- Bacteriological and immunological studies
- chest radiograph
cells - Computed tomography of the head
- Inspection fundus
Treatment of meningitis
When symptoms of meningitis you or your child immediately call emergency medical care.Early treatment is the key to a good result.
Treatment of patients with meningitis should be administered in a hospital, and started as soon as possible.First of all, the choice of treatment depends on the type of meningitis.
Acute bacterial as well as viral meningitis requires prompt treatment with intravenous infusion of drugs, to ensure recovery and reduce the risk of complications.Antibiotics are used to treat bacterial meningitis.Their choice depends on the type of bacteria causing disease.Initially, it may be recommended broad-spectrum antibiotic until the exact cause of meningitis is identified.At present, for the treatment of meningitis in adults and children use penicillin, ceftriaxone and cefotaxime.If they do not give a positive effect, the patients are administered vancomycin and carbapenems.They have serious side effects and are only used in cases where there is a real risk of developing life-threatening complications.
for the treatment of viral meningitis antibiotics are not used.In the case of this type of disease prescribe antiviral drugs.
Noncommunicable meningitis, caused by an allergic reaction or autoimmune diseases can be treated with cortisone drugs group.
Other treatments include drugs for the treatment of symptoms such as brain swelling, shock, convulsions, drop in temperature, and pain syndromes.
In severe cases of meningitis, the patient is prescribed antibiotics endolyumbalnoe in which drugs go directly into the spinal canal.
Early diagnosis and treatment of bacterial meningitis is essential to prevent neurological damage.Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no long-term complications.
after suffering a recurrence of meningitis do not occur, but there are exceptions.
- Brain damage
- Accumulation of fluid between the skull and brain (subdural effusion)
- Hearing Loss
- Violation of
- Epileptic seizures
- the cerebral circulation
- Increased intracranialblood pressure
cryptococcal meningitis - a fungal infection of the meninges.
cryptococcal meningitis, caused by the fungus Cryptococcus neoformans.This fungus found in the soil worldwide.
reasons cryptococcal meningitis
Cryptococcal meningitis most often affects people with weakened immune systems.
For cryptococcal meningitis risk factors include:
- Cirrhosis Diabetes
- organ transplants
Symptoms cryptococcal meningitis
Unlikefrom bacterial meningitis, meningitis this form develops more slowly over several days to several weeks.Symptoms may include:
- Nausea and vomiting
- Sensitivity to light (photophobia)
treatment of cryptococcal meningitis
Forthe treatment of this form of meningitis used antifungal agents.Intravenous therapy with amphotericin B is the most common treatment.It is often combined with oral drugs such as 5-flucytosine, fluconazole, which at high doses may also be effective against this infection, and can be used in the further course of treatment.
Complications cryptococcal meningitis
- Brain damage
- Hearing Loss
- Amphotericin B can have side effects, and sometimes causes and kidney damage.
Syphilitic aseptic meningitis
Syphilitic aseptic meningitis is a complication of syphilis undertreated.It is manifested by inflammation of the tissue covering the brain and spinal cord.
Causes Risk Factors syphilitic aseptic meningitis
Syphilis - an infectious disease, sexually transmitted, caused by Treponema pallidum Treponema.Syphilis has three main stages:
- Primary syphilis
- Secondary syphilis
- Tertiary syphilis
Syphilitic aseptic meningitis is a form meningovascular neurosyphilis, which is a progressive, life-threatening complication of syphilis.This disease is similar to meningitis caused by other conditions.
Risks of syphilitic aseptic meningitis include previous infection with syphilis or other sexually transmitted diseases such as gonorrhea.
symptoms of syphilitic aseptic meningitis
- Blurred and decreased vision
- mental changes, including confusion, decreased alertness and irritability
- Nausea and vomiting
- Pain in the neck
- Sensitivityto light (photophobia)
- sensitivity to loud noises
- Drowsiness, lethargy, difficult awakening
- Pain in shoulders or muscles
Diagnosis and treatment syphilitic aseptic meningitis
addition to the main diagnostic activitiesperformed in cases of suspected meningitis, it is advisable to carry out cerebral angiography and blood tests (RPR, RW Wasserman reaction) to detect syphilis.
The goal of treatment is to cure the infection and stop worsening symptoms.Treatment of infection helps prevent new nerve damage and may reduce symptoms, but it does not heal from the existing damage.
Typically prescribed penicillin and other antibiotics, e.g., tetracycline or erythromycin for a long time.
periodically performed a lumbar puncture to remove a sample of cerebrospinal fluid for testing to determine whether the treatment has a positive result.
forecast syphilitic aseptic meningitis
Late stage syphilis can cause nerve damage or heart problems, which can lead to disability and death.
Proper treatment and follow-up of primary syphilis infections reduces the risk of this type of meningitis.
All pregnant women should be screened for syphilis.
Meningitis in viral forms of influenza
Meningitis in viral forms of influenza caused by the bacteria Haemophilus influenza, it can occur after an upper respiratory infection when the infection spreads from the lungs and respiratory tract into the blood and then to the brain.
Risk factors include:
- Visiting children's institutions during the epidemic influenza
- Ear infection (otitis media)
- Advanced age
- Upper respiratory tract infection
- Weakened immune system
Symptoms of meningitis in viral forms of influenza
Symptoms usually appear rapidly, and may include:
- Fever and chills
disorders - Nausea and vomiting
- Sensitivity to light (photophobia)
- Severe headache
- Stiff neckmuscles (meningismus)
- Bulging fontanelle in infants
consciousness - Reduce the sucking reflex and irritability in
newborns - Rapid breathing
- Unusual pose with arched back his head and neck
Treatment of meningitis in viral forms of influenza
Taking antibiotics when this form of meningitis should be initiated as soon as possible.Ceftriaxone is one of the most commonly used antibiotics, but sometimes can be used and ampicillin.
Corticosteroids may be prescribed to combat inflammation, especially in children.
unvaccinated people who are in close contact with the patient, should immediately start taking antibiotics to prevent infection.
forecast meningitis viral forms of influenza
This is a dangerous infection can be fatal.The sooner treatment is started, the better the chances of recovery.Young children and adults over age 50 have the highest risk of death.
Meningococcal meningitis - an infection that causes swelling and inflammation of the membrane covering the surface of the brain and spinal cord.
Meningococcal meningitis is caused by the bacteria Neisseria meningitides, also known as meningococcus.
In most cases, meningococcal meningitis occur in children and adolescents.Infection occurs most often in the winter or spring.This can lead to local epidemics at boarding schools, college dormitories, or military bases.
Risk factors for this type of disease are recent upper respiratory tract infection.