Meningitis is an inflammatory process in which the infection affects the membranes of the brain and spinal cord. This disease is typical for different ages: meningitis is most often detected in children and adolescents with weakened immune systems, but the disease also occurs in older people with chronic diseases and bacterial infections.
According to statistics, meningitis is one of the leading infectious diseases in terms of the number of deaths. The percentage risk of death is 10-20% out of 100, i.e. Every second patient with meningitis risks not living to see the recovery process. Therefore, modern medicine is trying to pay close attention to this problem, developing new diagnostic methods and effective treatment. Timely and adequate assistance from specialists speeds up the correction process and reduces the list of possible consequences for the body.
Based on the causes and conditions for the development of the disease, meningitis can be divided into groups:
- viral. This type of illness is of the mildest nature and does not threaten the patient’s life. The peak of incidence can be called the period of transition from summer to autumn;
- fungal. It affects people with weak immune systems, which are most common in older people. Caused by pathogenic microflora containing fungal infections;
- bacterial. Meningitis of this type has pronounced symptoms, is severe and can be fatal. Develops in early spring;
- tuberculosis is the most dangerous type. The pathology manifests itself as the generalization of tuberculosis in the body.
What is meningitis
Most likely, as a child, you often heard the phrase from your parents that if you walk without a hat in winter, you can get meningitis. But the development of meningitis has nothing to do with the presence of a cap on the head or its absence.
Hypothermia can serve as a trigger, but is not the root cause of the disease.
Most often, children under 5 years of age suffer from meningitis. The incidence rate in children is about 80%. Older children (under 14 years of age) are not so susceptible to the disease - only 10 cases out of 100,000 are diagnosed with this disease in adolescents.
Meningitis is an inflammatory process in the meninges of the spinal cord or brain. Transmitted by airborne droplets from an infected person or carrier of the infection. The most dangerous contacts with seriously ill people are in the first days of the disease.
Less commonly, domestic and wild animals are carriers of pathogens.
Types of pathology
- Viral meningitis - develops against the background of rubella, smallpox, measles, influenza;
- bacterial - occurs when infected with staphylococci, meningococci, Haemophilus influenzae, salmonella;
- fungal – a rare form of the disease, occurs with the active growth of fungi of the genus Candida against the background of weakened immunity, autoimmune, endocrine diseases;
- parasitic - an infectious disease occurs when infected with amoebas, toxoplasma.
According to the nature of the inflammation, meningitis can be purulent and serous, and can occur in acute or chronic form.
Most often, the disease is diagnosed in children under 4 years of age; the peak of the disease occurs at 3-8 months of the baby’s life. Even with timely medical care, the number of deaths is 5-30%; more than 30% of children have severe neurological disorders after recovery.
First aid
In the prehospital period the following is prescribed:
- Antibiotics (penicillin - 1,000,000 units and streptomycin - 0.5 g intramuscularly).
- Symptomatic treatment: to reduce headaches - analgesics (amidopyrine - 0.25 g orally, 50% analgin solution - 1 ml or 2% promedol solution - 1 ml intramuscularly), for the purpose of dehydration - intravenous infusions of 20-46 ml of 40% solution glucose or intramuscular injections of 10-20 ml of 25% magnesium sulfate solution.
Expert opinion
Zemlyanukhina Tatyana Vyacheslavovna
Ambulance and emergency paramedic at the Clinical Emergency Hospital #7 in Volgograd.
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Obviously, if symptoms of meningitis are detected, it is necessary to call an ambulance as soon as possible, and the listed measures will be taken by health workers. Parents themselves can reduce the symptoms of dehydration with the help of rehydron solution and give the child an antiemetic drug (for example, cerucal).
The first signs of meningitis in children
The incubation period is 2-10 days, the first signs of meningitis in children appear within 4-6 days after infection.
How does meningitis begin:
- a sharp increase in temperature, severe vomiting, signs of severe dehydration appear - symptoms are characteristic of serous meningitis;
- the child throws his head back strongly, arches his back:
- photophobia, intolerance to sharp sounds;
- the skin becomes pale, the nasolabial triangle turns blue;
- shortness of breath, increased heart rate;
- severe headache, discomfort increases with pressure on the upper lip, central part of the forehead, eyelids;
- severe thirst, refusal to eat;
- diarrhea, abdominal pain, bloating - such symptoms appear if pathogenic viruses enter the body with food or water;
- rash in the form of large spots.
If at least one of these signs appears, immediately call an ambulance, even if it is not meningitis; similar symptoms also occur with other serious and dangerous diseases.
Why do spots appear?
The appearance of spots on a child's skin is a very dangerous symptom of meningitis .
This phenomenon is called meningeal rash, and, as a rule, begins from the legs, gradually rising higher and higher. The main reason for the appearance of spots lies in the harmful effects of meningococci on the child’s body. As a rule, the appearance of a rash is characteristic of purulent meningitis, so it is necessary to begin treatment urgently, otherwise the consequences can be very dire.
How does the disease manifest in children under one year of age?
One of the main signs of meningitis in babies under one year of age is the bulging of a large fontanel.
How to recognize meningitis in children under one year of age:
- Lessage's symptom - if you lift the child's armpits, he will reflexively throw back his head and pull his legs towards his stomach;
- severe diarrhea, regurgitation;
- the child is excited, constantly cries, due to the increased sensitivity of the skin, any touch causes pain;
- high temperature that does not decrease after taking antipyretics;
- convulsions;
- decreased muscle tone;
- a rash appears on the mucous membranes;
- loss of consciousness is possible.
Meningitis is very dangerous for young children - the disease develops rapidly, the child’s condition worsens every minute, and severe dehydration aggravates the situation.
Treatment
If there is the slightest suspicion that a child is developing meningitis, you should immediately call an ambulance. This disease requires mandatory sending to a hospital, where doctors can fully monitor the patient’s condition and monitor medication intake. The patient may remain in the hospital for a month or even more until all risks are minimized.
To treat purulent meningitis, you will need to take a number of medications:
- anti-inflammatory – to reduce body temperature;
- broad spectrum antibiotics – against bacterial pathogens;
- antiviral – against a viral pathogen;
- anticonvulsants - to suppress seizures;
- glucocorticosteroids - to relieve inflammation.
Often patients require a reduction in intoxication. To do this, additional therapy with diuretics is necessary. During such treatment, it is important to monitor the amount of urine excreted and venous pressure.
If meningitis occurs as a result of the development of another disease, then it will also need to be given attention. It must be treated immediately, otherwise no result in the fight against inflammation will be achieved.
If the condition is severe, the child may require artificial ventilation.
Signs of the disease in children older than one year
To independently recognize a dangerous disease, you can carry out a simple preliminary diagnosis.
One of the main symptoms of the pathology is that the child cannot raise his head or reach his chin to his chest due to hypertonicity of the neck muscles.
If you try to tilt your head to your chest, the baby’s legs will involuntarily bend at the knees; if the meninges are inflamed, the child cannot fully straighten the previously bent leg at the knee and hip joint.
Signs of brain inflammation:
- when pressing on the cheek under the cheekbone, the shoulders involuntarily rise;
- while lying on your back, pull up one leg, the second limb will also rise involuntarily;
- when pressing on the pubic area, both legs impulsively bend;
- the child complains of a severe headache, tinnitus, hides under the blanket, bright lights and loud sounds are unpleasant to him;
- the elevated temperature lasts for several days, falls and rises again;
- a rash appears on the body in the form of bright red, burgundy single or group spots, the skin becomes very sensitive;
- the baby becomes delirious in his sleep, chills and convulsive symptoms appear.
After 5 years, the first signs of meningitis may be respiratory symptoms - redness of the throat, pain when swallowing.
Additionally, confusion is observed, the child cannot answer simple questions, is delirious, the whites of the eyes acquire a yellowish tint, the face swells, turns red, and muscle hypertonicity is observed.
Diagnostics
Diagnostic measures are mainly carried out in a hospital. The main diagnostic method is spinal cord puncture to study the composition of the cerebrospinal fluid. This analysis allows you to confirm the diagnosis, clarify the cause, pathogen, and recognize the type of disease - serous or purulent, bacterial or viral. Normally, cerebrospinal fluid is clear. White color indicates a purulent process.
Before the puncture, an MRI or CT scan is often prescribed. The purpose of the study is to exclude neoplasms and confirm the safety of taking a cerebrospinal fluid sample.
In some cases, in order to determine the pathogen, several microbiological studies are required: culture on a nutrient medium, Gram staining. In particular, they are carried out in order to distinguish meningococcal meningitis from pneumococcal meningitis. Such studies can take a long time, but they make it possible to accurately recognize the cause and prescribe precise treatment.
Additionally, a general blood test, urine test, bacterioscopy, and bacteriological examination are performed. CBC shows an increase in ESR and an increase in leukocytes. Blood and proteins are found in the urine.
The determining factor in terms of diagnosis is to clarify the nature of muscle rigidity. The most indicative is Brudzinski's symptom. It includes 4 manifestations. The head of the child lying on his back is pulled to the chest. If you stop holding it, it hangs in the air. At the same time, uncontrolled flexion of the legs occurs at the hip joints and knees.
Another sign is that when you press under the patient’s cheekbone, his arm bends at the elbow on the side of the pressure. Sometimes the wrist rises. Tapping on the cheekbone and pressing on the pubis causes involuntary compression of the knees. When bending the knee of one leg, the same movement is automatically repeated by the second.
Kerning's sign is also associated with neck rigidity. In a patient lying on his back, the body remains in an arched position, the back of the head lies on the surface, the neck, shoulders and part of the chest hang in the air. When turning on its side, the posture does not change.
In infants, a characteristic feature is Lessage's symptom. The doctor takes the baby by the armpits, supports the back of the head with the index fingers of both hands, and lifts him up. The child immediately takes a certain position. He automatically pulls his legs bent at the knees towards his tummy and remains in this position for a long time. The legs do not straighten or relax.
In older children, additional tests are performed. This is how the Flatau reflex is tested. At the moment when the doctor bends the patient’s neck, the latter’s pupils dilate. A sign of meningitis is Mondonesi syndrome - the patient closes his eyes and feels pain when the doctor presses lightly on them.
Meningitis in adolescence
In adolescents, meningitis often begins with meningococcal nasopharyngitis - the back wall of the pharynx becomes granular and acquires a bluish-purple tint, which distinguishes this dangerous pathology from the usual viral form of the disease.
Other characteristic features:
- heat,
- weakness,
- drowsiness,
- attacks of dizziness,
- unbearable headache,
- nose is stuffed,
- the voice becomes hoarse.
In many ways, meningitis is similar to the common cold; a cerebrospinal fluid analysis will help make an accurate diagnosis.
Main symptoms
The inflammatory process is characterized by rapid development, which is why the onset of symptoms is observed suddenly. If the disease is not treated in a timely manner, certain symptoms appear. In severe forms of the pathological percentage, the patient experiences convulsions. The disease is accompanied by fainting. When the optic nerve is damaged by an inflammatory process, adolescents develop strabismus. During the course of the disease, complete or partial loss of vision is diagnosed .
If the patient makes the slightest movements, this leads to vomiting. A symptom of the disease is pallor of the epithelial covers. In pathology, an increase in sensitivity to touch is noted. In some cases, a sharp decrease in blood pressure is observed. The disease is characterized by an unexpected loss of strength and severe weakness. With meningitis, pain develops in the muscles and joints.
With meningitis, patients experience increased intracranial pressure. This leads to severe headaches, against which delirium or loss of consciousness is diagnosed. When these symptoms appear, it is recommended to urgently treat the pathology in a hospital setting.
Prevention methods
The most effective method of prevention is vaccination against meningitis in children. Unfortunately, it is not included in the list of mandatory activities, so you will have to purchase the vaccine yourself. Some routine vaccinations also help reduce the risk of infection.
What vaccinations and vaccinations can protect against meningitis:
- Meningo ACW , meningococcal A , A + C , A + C + Y + W 135 immunity is developed within 14 days and lasts for 3-4 years. Many children do not tolerate these vaccines well, but the complications from the vaccine are not comparable to the consequences of meningitis. Vaccination is carried out at the age of 9 months to 2 years, depending on the type of vaccine and the epidemiological situation in the region.
- Haemophilus influenzae vaccine , immunization is carried out simultaneously with DTP vaccination, the drug Pentaxim is most often used.
- The vaccine against pneumococcal meningitis is routinely given to children who often suffer from bronchitis for a long time. Immunization can be carried out from 2 months to 5 years with the drug Prevenar 13; it must be administered 4 times. If your baby is not at risk, you will have to pay for the vaccine.
- Trivaccine against rubella, measles and mumps, vaccination against pneumococcus, chickenpox - these vaccinations do not directly protect the child from meningitis, but significantly reduce the risk of contracting a dangerous disease.
All children who have been in contact with a patient with meningitis are given chemoprophylaxis in the infectious diseases department - a short course of antibacterial therapy with broad-spectrum drugs. Children are under medical supervision for 10 days; their blood is taken daily for general and biochemical analysis.
To avoid infection, regularly strengthen your child’s immunity, take more walks, ventilate the room, and do wet cleaning more often.
Since many dangerous bacteria enter the body with dirty hands, from an early age teach your child to wash their hands frequently and thoroughly, and use antibacterial sprays and wipes when going for walks.
More about the nature of the disease
Meningitis is considered to be a childhood disease, since it is children who are most often susceptible to this disease due to their immature and relatively weak immunity, compared to adults.
During the course of the disease, the membrane of the brain or spinal cord becomes inflamed, which often affects the further development of the baby’s nervous system.
The causative agents of the disease can be both viruses and bacteria. There is even a classification of forms of meningitis according to the types of pathogens. Eg:
- meningococcal is caused by diplococcus and can be transmitted through the air; the form of its complications is characterized by the accumulation of purulent masses in the cavities of the skull;
- pneumococcal is a consequence of infection with pneumococcus and develops against the background of pneumonia, or simply becomes one of the varieties of its complications; it may result in cerebral edema;
- staphylococcal can develop in a child with weak immunity and in newborns who are not yet 3 months old;
- Hemophilus influenzae occurs through penetration of the gram-negative Pfeiffer bacillus into the child’s body; often this variety can manifest itself in children from 6 months of age to one and a half years;
- Escherichiosis becomes a consequence of damage by Escherichia coli in the generalized form of Escherichiosis; often meningitis in children under one year of age refers specifically to this type, which occurs very rapidly and, in most cases, leads to death;
- Salmonella is transmitted by the fecal-oral route, most often children under six months get sick with it, and the course is very severe;
- Listeria can affect the nervous system in a short time, and its symptoms do not differ from other forms.
There are many methods for classifying meningitis. There are divisions according to the affected area, that is, depending on which brain is affected, the spinal cord or the brain, according to the characteristics of inflammation, etc.
There is also a classification based on the depth of the lesion:
- pachymeningitis is a consequence of inflammation of the dura mater;
- leptomeningitis – soft and arachnoid membranes;
- arachnoiditis - only arachnoid, which happens in very rare cases;
- simultaneous inflammation of all membranes of the brain is called panmeningitis.
There are also serous, purulent and hemorrhagic forms of meningitis, depending on the nature of the cerebrospinal fluid.
Symptoms of the disease after reaching 5 years of age
Meningeal symptoms in children also undergo changes when they reach 5 years of age. Added to the previous manifestations:
- redness of the throat, problems swallowing;
- confusion of thoughts, the child has difficulty finding answers to the simplest questions;
- numbness of hands and feet;
- stomach ache;
- blurred vision, the whites of the eyes fade and take on a yellowish tint;
- muscle rigidity;
- redness and swelling of the face.
