Meningitis how it proceeds what pain and where. Meningitis in adults and children

Meningitis is an infectious disease characterized by inflammation of the soft membranes of the brain or spinal cord. Until the middle of the 20th century, meningitis in most cases ended in death or severe disability of the patient.

Meningitis can develop as an independent disease or as a complication of another infection

Modern medicine has the means to treat this pathology, therefore, with timely diagnosis and timely initiation of drug therapy, the risk of death and complications is minimized. In the event that on the first day after the onset of the disease, the patient did not receive the appropriate drugs, the course of the disease is significantly aggravated and unpleasant consequences of meningitis may remain.

General information

According to the mechanism of occurrence, meningitis is divided into primary and secondary. Primary meningitis is said to be when the disease begins directly with damage to the meninges. Secondary is the consequence of any other pathology, when the infection enters the nervous system from the primary focus in various ways. Tuberculous meningitis is a separate issue - its clinical symptoms increase slowly, over several weeks or months.

The most dangerous form of the disease is reactive meningitis due to the high rate of development and the transience of the clinical picture.

In a short period of time, purulent foci are formed on the surface of the brain, which lead to death. A favorable outcome is possible only if in the first hours after the onset of the onset of the disease, the correct diagnosis was made and appropriate treatment was started.

Purulent meningitis in adults and children is expressed in the development of cerebral and meningeal syndromes, which are accompanied by symptoms of infection and an inflammatory reaction of the cerebrospinal fluid. The first symptoms of purulent meningitis are similar to those of the flu, which, after a few hours, are complemented by severe headache, severe vomiting, impaired consciousness, tension in the neck muscles and pain when trying to pull the legs up to the stomach.

In the conditions of timely and adequate treatment, the prognosis is successful - in most cases, the disease is completely cured without leaving negative consequences behind. Serious consequences of meningitis develop if medical care was not provided on time or if the patient has a history of severe concomitant diseases. Complications are more common in children than in adults.

Undesirable consequences after suffering meningitis

On average, the consequences after meningitis are observed in 10-30% of patients who have had this disease, most of them are preschool children and adults over 60. Neurological complications after meningitis are divided into early and late.

The early ones include:

• Increased intracranial pressure.
• Epileptic seizures.
• Thrombosis of the venous or arterial network.
• Subdural effusion is an accumulation of fluid under the dura mater.
• Hydrocephalus (dropsy of the brain).
• Cranial nerve damage.

The main symptoms and consequences of meningitis

Late complications include:

• Residual effects of focal neurological deficit.
• Epilepsy.
• Dementia.
• Sensorineural hearing loss.

In addition to neurological symptoms, meningitis can be complicated by other systemic lesions, such as: sepsis, endocarditis, pneumonia, PE (pulmonary embolism), purulent arthritis.

Hydrocephalus

The negative consequence in the form of hydrocephalus is more common in children than in adults. In newborns who have had meningitis, hydrocephalus occurs in about 30% of cases. In most cases, the accumulation of cerebrospinal fluid is associated with impaired absorption of cerebrospinal fluid, less often with blockage of the ducts and the impossibility of normal outflow.

Epileptic seizures

Seizures are observed in 30-50% of patients with meningitis, with the majority being children. In most cases, the first seizures develop as early as 3-4 days from the onset of the disease, after which the risk of developing primary seizures decreases. Often, epileptic seizures are the first symptom of inflammation of the meninges, sometimes turning into status epilepticus (a condition in which seizures follow one another). When examining the brain using EEG (electroencephalogram), one can note the formation of epileptic foci or generalized epileptic activity.

Meningitis can be a background for the development of epilepsy

The main cause of epilepsy after meningitis is considered to be ischemia of brain tissue due to insufficient blood supply.

Less commonly, seizures are associated with high fever, low sodium levels, high intracranial pressure, or the toxic effects of inflammation products or toxins from bacteria.

Sensorineural hearing loss

Hearing impairment after meningitis is quite rare (5-10%). The first signs of hearing loss are observed already in the first days of the illness, while recovery takes about 2 weeks. In some cases, complete hearing recovery does not occur - such a complication is associated with serious irreversible damage to the cochlear apparatus of the ear and the vestibular cochlear nerve. Pneumococcal meningitis is more often complicated by hearing loss, especially with frequent epileptic seizures.

Meningitis is a serious illness that requires urgent hospitalization to prevent serious consequences. Suspicious symptoms should not be neglected - delay can cost life.

Meningitis - symptoms and treatment

What is meningitis? We will analyze the causes of occurrence, diagnosis and treatment methods in the article by Dr.P.Aleksandrov, an infectious disease specialist with 11 years of experience.

Definition of disease. Causes of the disease

Infectious meningitis - a combined group of acute, subacute and chronic infectious diseases caused by various types of pathogenic microorganisms (viruses, bacteria, fungi, protozoa), which, under conditions of specific resistance of the organism, cause damage to the membranes of the brain and spinal cord, manifested in a pronounced irritation syndrome of the meninges, severe intoxication syndrome and always proceeding with a potential threat to the patient's life.

Infectious meningitis can be either a primary pathology (developing as an independent nosological form), and secondary (developing as a complication of another disease).

Looking ahead, I would like to answer a popular question from readers and netizens: what is the risk of infection from a patient, and is it possible to be near a patient without a particular risk of developing meningitis? The answer is quite simple: in view of the fact that meningitis is a combined group of diseases caused by various infectious agents, the risk of infection will depend on the etiological cause of meningitis, but the likelihood of developing meningitis will depend on the capabilities of the human immune system. In other words, in order to know if there is a risk, you need to know which microorganism caused meningitis in the patient and what are the protective immune capacities of others.

Depending on the type of meningitis, the routes of infection and the mechanisms of occurrence of the disease differ. With regard to infectious meningitis, one can point to an extremely wide geographical distribution, with a tendency to increase the foci of the disease on the African continent (meningococcal meningitis), more frequent development of the disease in children and an increase in morbidity in the cold season (viral meningitis as a complication of ARVI). The transmission of infection often occurs by airborne droplets.

If you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Meningitis symptoms

Signs of involvement of the meninges in the pathological process (meningeal syndromes), which are divided into groups, are characteristic enough in meningitis (and in particular in the meningococcal process):

A specific manifestation that is similar to the symptoms of meningitis (meningeal syndrome), but is not such and has nothing to do with the pathogenesis of true meningitis, deserves a separate mention. meningism... Most often, it develops as a result of mechanical or intoxication effects on the meninges in the absence of an inflammatory process. It is stopped when the provoking effect is removed; in some cases, differential diagnosis is possible only when conducting special studies.

Pathogenesis of meningitis

The variety of pathogens and individual characteristics of individuals in the human population also determine the rather pronounced variability of the forms and manifestations of meningitis, the risk of infection for other people, therefore in this article we will focus on the most significant forms of diseases and their pathogens in the social plane.

Meningococcal meningitis- always acute (acute) disease. It is caused by Vekselbaum's meningococcus (a gram-negative bacterium, unstable in the environment, at a temperature of 50 degrees Celsius dies after 5 minutes, UFO and 70% alcohol kill almost instantly). The source of the spread of infection is a sick person (including meningococcal nasopharyngitis) and a carrier of bacteria, transmission occurs by airborne droplets.

The place of introduction (gate) is the mucous membrane of the nasopharynx. In the overwhelming majority of cases, the infectious process does not develop or local forms of the disease develop. When meningococcus overcomes local anti-infectious barriers, hematogenous spread of infection occurs and generalized meningococcal infection occurs, including the development of meningococcal meningitis, in the absence of adequate treatment, which ends in more than 50% of cases with death. In the pathogenesis of the disease, toxins that are released after the death of bacteria in the bloodstream, damage to the walls of blood vessels play a role, which leads to impaired hemodynamics, hemorrhages in organs and deep metabolic disorders. Hyper irritation of the meninges occurs, the development of purulent inflammation of the tissue and a rapid increase in intracranial pressure. Often, due to edema and swelling of the brain tissue, the brain is wedged into the foramen magnum and the patient dies from respiratory paralysis.

The latent period of the disease is from 2 to 10 days. The beginning is acute (even more correct - the most acute). In the first hours of the disease, there is a sharp increase in body temperature up to 38.5 degrees and higher, severe lethargy, weakness, pain in the periorbital region, decreased appetite, and a sharp headache. A characteristic sign of headache is a constant increase in its intensity, diffuse pain without clear localization, bursting or pressing in nature, causing true torment for the patient. At the height of the headache, vomiting gushes without preceding nausea, which does not bring any relief. Sometimes in patients with severe uncontrolled course, mainly in unconscious children, an uncontrollable cry is observed, accompanied by clasping the head with hands - the so-called. "Hydrocephalic cry" caused by a sharp increase in intracranial pressure. The appearance of patients is etched into the memory - sharpening of facial features (Laforte's symptom), meningeal posture for 2-3 days of the disease (while a "cop dog"). In some patients, hemorrhagic rashes on the body develop, resembling a stellate rash (which is an unfavorable sign). In the course of 2-3 days, the severity of symptoms increases, hallucinations, delirium may appear. The degree of impairment of consciousness can vary from doubtfulness to coma; if untreated, death can occur at any time.

Slowly developing pathology. It is mainly secondary, developing with an already existing tuberculous process of other organs. It has several periods of development, consistently developing over a long time:

1.prodromal (up to 10 days, characterized by mild symptoms of general malaise)

2.sensimotor irritation (from 8 to 15 days, the appearance of initial cerebral and weak meningeal manifestations)

3. paresis and paralysis (attracts attention from 3 weeks from the onset of the infectious process in the form of changes and loss of consciousness, disorders of swallowing, speech).

Initially, there is a moderate rise in body temperature without pronounced jumps and rises, quite tolerable headaches of low intensity, well-controlled by taking analgesics. In the future, the headaches intensify, nausea and vomiting are connected. An invariable sign of tuberculous meningitis is a rise in temperature, fever, and the numbers and duration can vary from subfebrile to hectic values. Gradually, from the end of the second week, symptoms of disorientation, stunnedness appear and slowly increase, ending in a deep "workload" of the patient, stupor and coma. Dysfunction of the pelvic organs, abdominal pain develop. Meningeal symptoms also gradually develop, and the truly classic symptoms (the "pointing dog" pose) develop only in advanced cases.

Herpetic meningitisit is most often caused by herpes simplex viruses of types 1 and 2, the chickenpox virus and develops against the background of a weakening of the body with ARVI or serious immunosuppression, incl. AIDS. It is divided into primary (when the process develops during primary infection with a virus) and secondary (reactivation of the infection against the background of a decrease in immunity). Always an acute disease, the primary manifestations depend on the previous premorbid background. More often, against the background of acute respiratory viral infections, herpetic eruptions of the perioral region and genitals, severe headache of a diffuse nature occurs, which intensifies over time, vomiting, which does not bring relief. All this can occur against the background of a moderate or high increase in body temperature, mild meningeal symptoms. Often, brain damage is added, in such cases, mental disorders (often aggression), hallucinations, disorientation, generalized convulsions occur on 3-4 days. With proper treatment, the prognosis is usually quite favorable; in the absence of adequate treatment in conditions of impaired immunological resistance, a lethal outcome or persistent residual phenomena are possible.

Classification and stages of development of meningitis

The following types of infectious meningitis are distinguished:

2. According to the predominant course of the inflammatory process:

• purulent (meningococcal, pneumococcal, caused by Haemophilus influenzae)
• serous (viral)

3. Downstream:

• sharp (as an option - lightning fast)
• subacute
• chronic

4) By localization, severity, clinical forms, etc.

Complications of meningitis

Complications observed in meningococcal meningitis (less often in other forms of meningitis) are early and late, associated with both a catastrophe of the nervous system and other parts of the body. The main ones are:

Diagnosis of meningitis

The primary diagnostic search includes an examination by an infectious disease doctor and a neurologist and, if a possible meningitis is suspected, a leading diagnostic study, a lumbar puncture, is carried out.

It involves the introduction of a hollow needle into the subarachnoid space of the spinal cord at the level of the lumbar spine. The purpose of this study is to clarify the type, properties and nature of changes in cerebrospinal fluid, to identify possible pathogens and ways of treating this type of meningitis.

Depending on the etiological agent that causes meningitis, the properties of the cerebrospinal fluid differ, we will give their main types and characteristics:

1. Bacterial meningitis (including meningococcal meningitis):

• high pressure liquor (over 200 mm water column)
• the outflowing liquid is yellow-green, viscous, with significant cellular-protein dissociation, flows out slowly
• high cell count (neutrophilic pleocytosis 1000 / μl and above)
• raising the level of protein 2-6 g / l and above
• drop in chloride and sugar levels

2. Serous meningitis (including viral):

• cSF pressure is normal or slightly increased
• the cerebrospinal fluid is transparent, the expiration on puncture 60-90 drops per minute
• the number of cellular elements in the cerebrospinal fluid (cytosis) less than 800 in μl
• protein concentration up to 1 g / l and below
• glucose within normal range

3. Tuberculous meningitis:

• moderate increase in CSF pressure
• transparent in appearance, sometimes opalescent film
• moderate number of cells (up to 200 / μl, mainly lymphocytes)
• protein increased to 8 g / l
• glucose and chlorides are reduced

In addition to determining the physicochemical properties of cerebrospinal fluid, methods are widely used today to isolate and establish the causative agent of the disease, which can play a decisive role in therapy and prognosis. The most significant are the cultivation of native cerebrospinal fluid on nutrient media (search for bacterial, fungal pathogens), PCR of the cerebrospinal fluid (polymerase chain reaction) in order to identify nucleic acids of the pathogen, ELISA (enzyme-linked immunosorbent assay) of cerebrospinal fluid, blood, urine, etc. the purpose of determining antigens and antibodies of possible causative agents of meningitis, microscopy of cerebrospinal fluid and nasopharyngeal mucus, clinical and biochemical blood tests. MRI of the brain is quite informative.

Etiotropic therapy (aimed at getting rid of the pathogen) depends on the specific situation (research conducted, doctor's experience, algorithms) and may include the appointment of antibacterial drugs, including anti-tuberculosis (with meningitis of a bacterial, tuberculous nature, unclear situation), antiviral funds (for herpetic meningitis, other viral pathogens), antifungal agents (for fungal infections). The advantage is given to intravenous administration of drugs under the control of the patient's condition and periodic control of cerebrospinal fluid (control lumbar puncture).

Pathogenetic and symptomatic therapy is aimed at interrupting the links of pathogenesis, improving the action of etiotropic drugs and improving the general condition of the patient. It can include the use of hormones, diuretics, antioxidants, vascular agents, glucose, etc.

Severe and life-threatening forms of meningitis should be kept in intensive care units under the constant supervision of medical personnel.

Forecast. Prevention

The prognosis for the development of meningitis depends on its pathogen. With bacterial meningitis (taking into account that in 60% of cases it is meningococcal meningitis), the prognosis is always (even in modern hospitals) very serious - mortality can reach 10-15%, and with the development of generalized forms of meningococcal infection - up to 27%. Even with a successful outcome, there is a high risk of residual (residual) phenomena, such as intellectual disabilities, paresis and paralysis, ischemic stroke, etc.

It is impossible to predict the development of certain disorders; it is only possible to minimize their appearance by a timely visit to a doctor and start treatment. With viral meningitis, the prognosis is more favorable; in general, the mortality rate is no more than 1% of all cases of the disease.

Prevention of meningitis includes specific and non-specific activities.

Non-specific - a healthy lifestyle, strengthening immunity, observing hygiene rules, using repellents, etc.

Specific prevention is aimed at developing immunity against certain pathogens of infectious meningitis, this is vaccination, for example, against meningococcal infection, pneumococcus, Haemophilus influenzae. The most effective vaccinations in children's groups, since children are most susceptible to the development of meningitis, and vaccination significantly reduces the level of their morbidity.

• Headache - constant, bursting in nature, may increase slightly with head movements and bending forward, as well as from bright light and loud sounds.
• Tension of the muscles in the back of the head, which makes the person lie with their head thrown back.
• Nausea, repeated vomiting.
• Photophobia is an unpleasant sensation in the head when looking at a light source.
• Increase in body temperature, accompanied by chills, general weakness, increased sweating.
• A decrease in the level of consciousness: a person becomes drowsy, answers questions more slowly, at a certain moment he may completely stop responding to speech addressed to him.
• Mental disorders: aggressiveness, hallucinations (frightening visions), apathy (lack of initiative) are possible.
• Convulsions: Seizures of involuntary muscle contractions in the limbs and body, sometimes with loss of consciousness and involuntary urination.
• Strabismus - when the oculomotor nerves are involved in the inflammatory process.
• Muscle pain.

Incubation period

Various, depends on the type of pathogen. For example, with serous meningitis caused by enterovirus, the incubation period most often lasts 7 days, with purulent meningococcal - 4 days.

Forms

• Depending on the nature of the inflammatory process, there are two main forms of meningitis:
  • serous - caused by viruses (for example, enteroviruses, polio viruses, mumps, Coxsackie viruses and ECHO). The inflammation proceeds without the formation of pus. In most cases, there is a less severe course than with a purulent form;
  • purulent - caused by bacteria (for example, meningococcus), the formation of pus is characteristic. The course is usually heavy.
• By origin, two forms of meningitis are distinguished:
  • primary meningitis - occurs as an independent disease, without a focus of infection in the body;
  • secondary meningitis - occurs a second time, against the background of an infection in the body, as its complication.
• For a reason, the following forms of meningitis are distinguished:
  • bacterial. Possible pathogens: staphylococci, streptococci, Escherichia coli, Klebsiella, meningococci;
  • viral. Possible pathogens: herpes virus, ECHO virus, mumps virus;
  • fungal. Possible pathogens - cryptococci, candida;
  • protozoa. Possible pathogens - amoeba, toxoplasma;
  • mixed - caused by a mixture of several pathogens.
• Depending on the rate of development of the process, several forms of meningitis are distinguished:
  • lightning (fulminant) - often leads to death in the first or second day, develops extremely rapidly;
  • acute - rapid development, within 2-3 days;
  • chronic - development is slow, it is difficult to determine how long ago the first signs of the disease appeared.
• Depending on the prevalence of the inflammatory process, two forms of meningitis are distinguished:
  • convexital - the inflammatory process is localized mainly on the convex (upper) part of the brain;
  • basal - the inflammatory process is localized mainly on the basal (lower) part of the brain;
  • spinal - the membranes of the spinal cord are affected.

Causes

• The cause of meningitis is the infection in the lining of the brain. This can occur by airborne droplets, fecal-oral (for example, when eating dirty fruits, vegetables), hematogenous (through the blood), lymphogenous (through the lymph) ways. The causative agents can be:
  • bacteria (eg staphylococcus, streptococcus, E. coli, Klebsiella, meningococcus, tubercle bacillus);
  • viruses (e.g. herpes virus, ECHO virus, mumps virus);
  • fungi (eg, cryptococci, candida);
  • protozoa (for example, amoeba, toxoplasma).
• Decreased immunity with:
  • malnutrition, starvation;
  • constant hypothermia;
  • chronic diseases (,);
  • congenital underdevelopment of immunity (various conditions characterized by abnormalities in the development of immunity);

Diagnostics

• Analysis of complaints and medical history:
  • how long ago any neurological disorders appeared (,);
  • whether there have been tick bites in the recent past (some of their species carry viruses that cause meningitis);
  • whether the patient was in countries where the transmission of viruses with mosquito bites is possible (countries in Africa, Central Asia).
• Neurological examination:
  • level of consciousness - an assessment of the patient's response to a hail, pain irritation (in the absence of a response to a hail);
  • the presence of symptoms of irritation of the meninges (headache, photophobia (painful sensations in the eyes when looking at any light source or when in a lighted room), tension of the occipital muscles of the neck with the head tilting back);
  • the presence of neurological focal symptoms (associated with damage to a specific area of \u200b\u200bthe head): weakness in the limbs, facial asymmetry, slurred speech, seizures (contractions of the muscles of the arms and legs, sometimes with biting the tongue) - can appear when inflammation passes from the membranes to the brain itself ( ).
• Blood test: detecting signs of inflammation (increased erythrocyte (red blood cell) sedimentation rate, fibrinogen, C-reactive protein).
• Lumbar puncture: using a special needle, the subarachnoid space of the spinal cord is punctured at the lumbar level (through the skin of the back) and 1-2 ml of cerebrospinal fluid (fluid that provides nutrition and metabolism in the brain and spinal cord) is taken. In the cerebrospinal fluid, signs of inflammation are revealed (an increase in the amount of protein, pus).
• CT (computed tomography) and MRI (magnetic resonance imaging) of the head: allow to study the structure of the brain in layers, to reveal indirect signs of inflammation of the membranes of the brain (narrowing of the subarachnoid fissures, expansion of the ventricles of the brain).
• PCR (polymerase chain reaction) of cerebrospinal fluid and blood: helps to detect the pathogen.
• Consultation is also possible.

Meningitis treatment

• Emergency hospitalization in a hospital: treatment cannot be carried out at home, as the patient's condition may deteriorate rapidly.
• Drug treatment:
  • antibiotic therapy, antiviral drugs;
  • antipyretic drugs (at a body temperature of more than 38.5 ° C);
  • hormone therapy (steroids);
  • intravenous administration of solutions to reduce intoxication of the body (poisoning with decomposition products of microorganisms);
  • diuretics (to reduce cerebral edema);
  • b vitamins, vitamin C - improve the body's resistance to infections.
• Lumbar puncture (collection of cerebrospinal fluid (CSF) with a special needle through a puncture of the spinal canal (the puncture is made between the vertebrae in the lumbar region)): helps to improve the condition of patients by reducing the pressure of the cerebrospinal fluid.

Complications and consequences

• Infectious toxic shock: a sharp drop in arterial (blood) pressure, increased heart rate, dysfunction of all organs. Its cause is the release of a huge amount of toxins by bacteria, which have a detrimental effect on the human body. This condition, in the absence of timely resuscitation care, is fatal.
• : weakness, recurrent headaches, lethargy.
• Hypertensive syndrome: increased cerebrospinal fluid pressure in the cranial cavity.
• Decreased hearing acuity.
• : a disease caused by the appearance of pathological foci of excitation in the cerebral cortex manifests itself in seizures.

Prevention of meningitis

• Avoid visiting crowded places (theaters, shops, etc.) during an epidemic of infections.
• Body hardening.
• In the autumn-winter period, take multivitamin preparations or vitamin C.
• Avoid hypothermia.
• The use of anti-meningococcal vaccine (vaccination against meningococcal infection).
• In contact with a patient with meningococcal infection, prophylaxis with antibiotics and anti-meningococcal immunoglobulins is carried out.
• Restricting tourist trips to countries where viral meningitis can be infected through mosquito bites.
• Vaccination (for example, against tick-borne meningoencephalitis).

Meningitis in adults is very difficult. Severe symptoms increase in a day from the onset of the disease. The disease is characterized by the development of an acute infectious process in the membranes of the brain, both spinal and cerebral.

Diseases are especially susceptible to people over 50 years old, and those with weakened immunity.

According to statistics, 20% of patients die from an extensive inflammatory process. Timely diagnosis of meningitis minimizes the risk of complications and speeds up the healing process.

What are the causes of meningitis and the symptoms of the disease in adults, let us consider in more detail.

The pathological process is associated with the penetration of the pathogen into the meninges. The main routes of infection transmission:

1. Airborne.
2. When eating foods that have undergone poor-quality heat treatment (fecal-oral).
3. Hematogenous (with blood flow).
4. Lymphogenous (with lymph flow).

By the nature of the causative agent, meningitis in an adult can be:

1. Viral.
2. Bacterial.
3. Fungal.

Along the course, meningitis is primary and secondary. In the first case, the disease is independent, that is, it is not a consequence of a purulent or infectious process in the body. Secondary develops after past diseases, as a result of the penetration of the pathogen into the membranes of the brain with sinusitis, frontal sinusitis, abscesses and furunculosis.

Localization of the process can take place in soft, arachnoid and hard shells. It happens that the infectious process affects all layers of the lining of the brain.

Symptoms and features of the course of the disease

Viral meningitis or bacterial meningitis can be identified by a number of symptoms. Sometimes, the patient tries to drown out important signs of the disease with drugs, which fundamentally complicates the diagnosis.

In no case, if the first signs of meningitis appear in adults, you can not self-medicate. It is better to play it safe once again and seek qualified help than to regret the lost time later.

The following manifestations characteristic of this disease should alert the patient or his loved ones:

• Violent pain in the head. With meningitis, it will be of a certain nature: the head hurts constantly and the patient cannot indicate a specific location. Turning the head or tilting the trunk makes the headache worse. There is a feeling of fullness. Photophobia and pain response to sound appear.
• The patient takes a forced position. Thus, it relieves pain in the head. The man lies on his side, imitating the pose of a "cop dog", the head is thrown back, the back is bent outward, the legs are brought to the stomach. The muscles of the back of the head are very tense, an attempt to pull the head up to the chest will be in vain.
• A rash on the body is one of the indicative symptoms of meningitis.
• Disruption of the digestive system. The sick person is tormented by nausea and vomiting. This is a sign of body intoxication due to an infectious process in the brain. Even if the person does not eat anything, vomiting will be repeated.
• High body temperature is also associated with an increasing infectious process. The temperature can rise to 40 * C, while the person is tormented by weakness, severe chills and sweating.
• The reaction to bright light causes an increase in the headache attack.
• Confusion of consciousness. The patient answers questions with a delay or does not react at all to the interlocutor. Weakness and aches, as well as the presence of infection in the lining of the brain, leads to mental disorders.
• Very often, a patient with meningitis develops a hallucinogenic syndrome, as well as bouts of aggression and apathy.
• Cramps in arms and legs. Sometimes cramps end with involuntary urination and bowel movements.
• With damage to the optic nerves, strabismus is observed.
• Violent pain in muscles and joints.

The danger of the disease lies in the increase in symptoms during the first day of the disease. Sometimes the process of infection develops in a few hours, which ends in the death of the patient.

Why meningitis is dangerous

Any type and form of meningitis is dangerous with consequences. The purulent process is more severe than the serous one. What is viral meningitis, what is bacterial, in the absence of timely diagnosis and treatment, leads to:

• Swelling of the brain. The brain swells, dislocation of the medulla occurs. Edema can develop on the first day after the onset of the disease. In this case, it is not possible to save the patient. Death occurs on the 1st day of illness.
• Septic shock. It occurs due to the ingress of pus into the bloodstream. In a matter of hours, sepsis develops, the probability of saving the patient is minimal;
• The development of meningoencephalitis. This process occurs as a result of the penetration of infection into the cerebral cortex.
• Progressive syndrome of intracranial hypertension (occlusive hydrocephalus). In the membranes of the brain, an adhesive process develops that blocks the cerebrospinal fluid pathways.

Not a single doctor undertakes to predict the course of the disease. It happens that a very severe form does not give complications, but it happens that a mild course leads to death. In any case, the treatment of meningitis in adults is carried out in a hospital setting.

How is an infectious disease diagnosed?

If meningitis is suspected, doctors use the following diagnostic measures:

• Examination of the cerebrospinal fluid (puncture). This research method is carried out only by a doctor and helps to identify the pathogen, the severity of the inflammatory process. Lumbar puncture gives a complete picture of the disease and helps to choose the right antibacterial drug, based on the sensitivity of the microorganism to the antibiotic;
• Blood biochemistry. With meningitis, the erythrocyte sedimentation rate (ESR) will certainly increase. In some cases, blood is tested for sterility;
• Study of the patient's urine. This analysis helps to identify impaired kidney function and the presence of an infection in the urinary system;
• Computed tomography and magnetic resonance imaging. This type of study helps to determine the degree of damage to the meninges;
• X-ray of the sinuses and lungs. Identifies foci of infection and the degree of damage to the respiratory system.

One of the reliable and mandatory measures is the collection of cerebrospinal fluid for research. It is the puncture that helps to identify the disease in the early stages of development.

How to treat meningitis

Therapeutic measures are carried out only in a hospital setting. You cannot take medicines before the arrival of an ambulance, and even more so, resort to the advice of traditional medicine. In no case should you apply warming compresses. This can radically aggravate the infectious process and provoke its lightning-fast development.

Upon admission to the infectious diseases department of the hospital, the patient is immediately prescribed antibiotics related to a number of macrolides, penicillins and cephalosporins. The wide spectrum of action of antibacterial drugs allows you to suppress the infectious process while the analysis is being prepared for the study of cerebrospinal fluid.

They resort to intravenous administration of drugs. If the patient's condition is extremely severe, antibiotics are injected directly into the spinal cord.

The frequency and duration of treatment with antibiotic therapy is determined by the doctor. Even if the main symptoms go away and the body temperature returns to normal, antibiotics continue to inject in a course.

In parallel, the patient is prescribed steroids. This group of drugs helps to stop the inflammatory process in the membranes of the brain.

Hormones are prescribed in order to normalize the work of the pituitary gland and suppress the infectious process.

The patient must be shown diuretics. This type of therapy is aimed at relieving swelling in the brain by removing retained fluid from the body. In parallel with diuretics, potassium-sparing drugs are prescribed.

Puncture is used to drain the cerebrospinal fluid. CSF collection helps to relieve pressure on the brain.

Meningitis is a complex inflammatory lesion of the meninges that is more common in children, although it can also develop in adults. Meningeal symptoms appear quite bright and intense. In addition, there are signs that are characteristic of this particular disease. Meningitis may develop slightly differently in children and adults.

So, the presented pathology is a viral or bacterial inflammatory lesion of the membranes surrounding the brain, which can develop in people with weakened immunity. All forms of the disease, except, are quite severe and can lead to serious consequences (impaired brain function, coma, loss of vision or hearing, death). Moreover, the highest risk of their onset is observed in elderly people.

As for the reasons for the development of the disease in a child or an adult, they may be as follows:

Watch the video in which the infectious disease doctor talks in detail about the disease:

These reasons can be considered the most common. If a person has a strong immune barrier, then it will prevent inflammation from developing. However, it is imperative to know the causes of the disease. Only in this case it is possible to provide effective preventive measures not only for yourself, but also for your loved ones.

Meningitis: common symptoms in an adult and a child

In order to recognize meningitis, it is necessary to consider its clinical manifestations. The following signs are common for a child and an adult:

1. Chills and fever, which is especially pronounced in children.
2. Changes in consciousness, disturbances in the mental sphere of a person, the appearance of hallucinations.
3. Nausea that is often accompanied by rampant vomiting.
4. Photophobia, too high sensitivity to loud sounds. Usually the patient turns to the wall and is completely covered with a blanket.
5. An adult or young child with meningitis usually feels like it is bursting in the skull. Moreover, unpleasant sensations only increase with any movement or exposure to various stimuli.
6. Hardening of the occipital muscles. In this case, the patient is not able to bend or turn his head.

Clinical forms of meningitis and their symptoms

1. Cyanosis in the area of \u200b\u200bthe nasolabial triangle.
2. Pallor of the skin.
3. Decreased attention.
4. A significant decrease in appetite.
5. Shortness of breath, rapid breathing and heart rate.

1. Decrease in blood pressure.
2. An unusual posture when the patient's head is thrown back, and the legs are pulled up to the stomach.
3. Among the meningeal signs, too high tactile sensitivity can also be distinguished. When touching a sick adult or child, he feels the strongest discomfort.
4. Skin rash.

These symptoms are considered common in adults and children. If the causes and general symptoms of the disease are determined, then the disease cannot be treated on its own. You need to immediately contact a doctor.

General infectious and cerebral signs of the disease

The above symptoms can be classified into several groups. The first of them is general infectious signs. The following symptoms of meningitis may belong to it:

• Feeling hot.
• General weakness and malaise.
• Pain in the muscles and joints.
• Runny nose, sneezing, redness of the throat.
• Increased body temperature.
• Swollen lymph nodes.

On the symptoms, causes, diagnosis, treatment and prevention of meningitis (detailed video in Russian, with doctors' comments):

In addition, general cerebral symptoms of meningitis in adults and children can also be distinguished:

• that cannot be appeased in any way.
• Congestion at the bottom of the eyeball.
• Headache that extends to the entire head and radiates into the eyes.
• Disorders of consciousness.
• Seizures caused by increased intracranial pressure.

These manifestations of meningitis are not considered specific, as they can talk about other pathologies.

Specific meningeal symptoms

There are special and adults who only talk about this disease. They make it possible to establish a diagnosis more accurately. So, you can name the following signs of pathology:

1. Kernig's symptom. It is the most famous sign of meningitis in both children and adults. The disease can manifest itself as follows: with passive bending of the leg in the hip and knee joint in a lying position, it is subsequently impossible to straighten it. The fact is that the leg muscles are straining too much. This symptom is specific.
2. Symptom of the "scaphoid" abdomen. In this case, the stomach is pulled inward on its own, the patient cannot control it. Some doctors consider this symptom to be part of a special meningeal position.
3. Ankylosing spondylitis. It consists in the fact that even with a light tapping on the cheekbone, the muscle of the face contracts and the patient has a kind of grimace on his face. The fact is that at the slightest touch, a child or an adult feels wild pain.

1. Mendel's symptom, manifested in a sharp increase in headache when pressing with a finger on the front wall of the ear.
2. Kerer's sign. When the doctor presses on the exit site of the trigeminal nerve, the patient also feels pain.
3. Hermann's symptom. With meningitis, passive tilt of the head in a child or an adult, if he lies on his back with straightened limbs, causes unauthorized extension of the big toe.
4. Gordon's sign. If you squeeze the muscles of the patient's leg with your hand, then he will have the extension of the big toe.
5. Guillain's sign. It is characterized by involuntary flexion of one leg in the event that the patient's hand is clamped on the lower leg of the other limb.
6. Laforte's symptom. It is characterized by the presence of pointed facial features in a child or an adult.
7. Flatau sign. If you carefully observe a patient with meningitis, then when you tilt your head, you can find dilated pupils.

For the methodology for determining meningeal symptoms, see the video:

1. Bogolepov's symptom. Regardless of whether the patient is conscious or impaired, a painful grimace will remain on his face when checking for Kernig and Guillain's signs.
2. Mandanese symptom. With meningitis, it manifests itself very clearly. If you press on the patient's eyeballs, then his face will be tense.
3. Bickel's sign. People who have meningitis cannot straighten their elbows, even with the help of a doctor.
4. Levinson's sign. A child or adult opens his mouth when tilting his head forward. This movement is spontaneous and does not depend on the will of the patient.
5. Brudzinsky's sign. If a buccal symptom is present, then it manifests itself as follows: after pressing on the cheek under the cheekbone in a child or an adult, the shoulder girdle rises from the same side. There is also an upper meningeal symptom in adults and children. In order to determine it, the patient will have to lie straight on his back and try to bend his head to the chest. With meningitis, he will automatically bend his legs at the knees, as well as the hip joint. In addition, the patient tries to pull the limbs towards the stomach. He performs the same actions when pressing on the pubis. This is the lower symptom of the manifestation of meningitis.

Since it is quite difficult to determine meningitis on your own (and valuable time is lost), it is necessary to urgently consult a doctor, even if only one of these signs is observed. Meningeal signs will help you more accurately identify the disease.

Meningitis symptoms depending on the patient's age

Now we need to figure out what signs of meningitis are characteristic of patients of different ages. For example, the first signs of meningitis in children under 1 year of age are similar to the manifestations of colds, so they are sometimes confused. The baby's mucous membranes of the mouth and nose dry up, signs of an inflammatory process appear. In most cases, the onset of meningitis in a child is not recognized in time until the pathology passes into the acute phase of development.

In addition, the newborn himself cannot say what exactly hurts him, where the maximum discomfort is felt. That is why meningitis in a child can be detected at the wrong time and in the first year of life he must be constantly under the supervision of doctors. Also, in the first months of life, an ultrasound scan of the brain is shown, which will help determine many other pathologies, if present.

Signs of meningitis in children under one year are as follows: high temperature, chills, fever, protrusion and pulsation of the fontanelle, irritability of the baby, violation of sucking, sharp excitement from any touch.

Symptoms of meningitis in children 2-3 years old:

• A sharp rise in temperature up to 40 degrees, and the heat is very persistent and it is difficult to bring it down with standard medications.
• Chills, drowsiness, lethargy.
• Pallor of the skin.
• Lack of response to an adult.
• Constant vomiting, after which it does not get better.
• Convulsions and spasms.

The symptoms of meningitis in children 3-4 years old are easier to recognize than in infants, because they can already be asked about their sensations. Even if the baby is not able to clearly answer, then he will be able to notice confusion, which already speaks of health problems.

How to protect a child from a dangerous virus will be suggested by folk doctors from the program "Life is healthy!" (start 32:55):

The first symptoms of meningitis in babies who are 5-6 years old can be determined not only by the previously indicated manifestations, but also by the state of the internal and external mucous membranes, by the ability to swallow food.

Signs of meningitis in children 7-10 years old are usually as follows:

1. Nausea with indomitable vomiting.
2. Very fast temperature rise to exorbitant values.
3. Confusion of consciousness, delusional state.
4. Numbness of the limbs or the appearance of seizures.
5. Sharp.
6. Grainy palatine surfaces, redness of the throat, clouding of the white of the eye.

Signs of meningitis in children of 11 years old, as well as in adolescents, practically do not differ from those described above.

Symptoms characteristic of different forms of the disease

We found out how meningitis manifests itself in children and adults. Consider the signs of pathology depending on its form:

• Cryptococcal meningitis. The cause of the disease is a fungal infection that can be found anywhere. In this case, the patient has the following symptoms: headache, hallucinations, fever, mental disorders, nausea and vomiting, photophobia, curvature of the neck.
• Aseptic meningitis. It develops as a result of poor treatment for syphilis. Aseptic meningitis is more common in adults. It is characterized by inflammation of the membranes of both the brain and spinal cord. Aseptic meningitis is characterized by the following symptoms: headache, fever, decreased vision and loss of acuity, neck pain, nausea and vomiting, confusion. In addition, this pathology is manifested by photophobia, an inadequate response to sounds.

• Infectious meningitis. It is triggered by the influenza virus or upper respiratory tract infections. The disease has the following symptoms: hardening of the occipital muscles, the patient manifests fever, sensitivity to stimuli (light and sound), rapid breathing and heartbeat.
• Meningococcal and enteroviral meningitis. It is characterized by a hemorrhagic rash, herpetic eruptions in the lips, mucous membranes of the mouth, bruises. Enteroviral meningitis is not considered a life-threatening disease, but if left untreated, it can lead to serious complications.

• Bacterial meningitis. This form of the disease is the most dangerous. Bacterial meningitis can even lead to death of the patient. It is provoked by any pathological bacterium that begins to multiply in conditions of reduced immunity. Bacterial meningitis is characterized by the following symptoms: a sharp rise in temperature, headache, dizziness, manifestation of mental disorders, an unusual posture characteristic of the patient (legs bent to the stomach and head thrown back).

• Tuberculous meningitis is considered quite common, the symptoms of which are as follows: chills, a slow rise in body temperature, tracheitis or catarrhal sore throat. In addition, the patient's asthenia slowly increases, appetite decreases, and general malaise appears.
• If the patient has suspicions of purulent meningitis, the symptoms of this pathology may be as follows: a sharp increase in body temperature, an inadequate response to light and sounds, weakness and lethargy, the presence of all meningeal symptoms.

As you can see, the symptoms and treatment of meningitis depend on its type. Therefore, the examination of the patient should be started as early as possible. Knowing how to recognize meningitis, you can without exaggeration save the life of yourself or another person.

Meningitis treatment

Therapy is carried out mainly in a hospital setting. At the same time, the patient is provided with complete rest, all possible stimuli are removed, which contribute to increased pain.

Various drugs are used for treatment: antibacterial, anti-inflammatory, immunomodulatory. In general, therapy helps, especially if you start it as early as possible. That is why it is impossible to delay the diagnosis and you should pay attention to the symptoms of meningitis in adults and especially in children.