Serous meningitis symptoms in adults treatment. Signs and treatment of serous meningitis in children

Serous meningitis is a rapidly developing inflammatory process that affects the lining of the brain. In 80% of cases, it is caused by viruses and bacteria. The disease is more susceptible to children aged 3-6 years. In medical practice, there are cases of the disease in schoolchildren and adults, but their number is extremely small.

Symptoms of serous meningitis in children

The first symptoms of serous meningitis appear as early as 1-2 days and are called "meningeal syndrome". These include:

• a rapid jump in body temperature up to 40 degrees;
• constant headache (aggravated by movement of the eyes, bright light and loud sounds);
• convulsions;
• increased irritability;
• weakness;
• pain in muscles and joints;
• problems in the gastrointestinal tract (nausea, vomiting, diarrhea, abdominal pain);
• cough;
• runny nose;
• sore throat;
• dry mouth;
• pallor of the nasal triangle;
• increased heart rate;
• the appearance of spots on the skin;
• impaired consciousness (slow reaction, stupor);
• problems caused by nerve damage (strabismus, difficulty swallowing);
• respiratory paralysis;
• in infants, the fontanel swells;
• I can't touch my chin to my chest.

Symptoms of serous meningitis can be expressed in varying degrees of intensity. After 3-5 days they pass. When they appear, you should immediately consult a doctor and begin treatment. Otherwise, the consequences of the disease can be serious and irreversible.

Causes of the disease

The causes of serous meningitis are distinguished by the nature of the occurrence:

• primary - an independent inflammatory process;
• secondary - a complication of an already existing infectious or bacterial disease.

The main causative agent are infections of the enterovirus group (Coxsackie, ECHO). The disease can also begin to develop as a result of viruses such as infectious mononucleosis, mumps, influenza, measles, herpes, adenovirus, arenavirus, Epstein-Barr virus (we recommend reading:).

In addition, the causative agents of the disease can be bacteria:

• Koch's stick (tuberculosis);
• syphilis;
• pale treponema.

Determination of the cause of serous meningitis is necessary for the appointment of antimicrobial therapy. It is worth remembering that timely treatment allows you to quickly cope with the disease and minimizes the risk of any complications.

Who is at risk?

Because serous meningitis is an infectious disease, it primarily affects people with weak immune systems. That is why the disease most often occurs in children aged 3-6 years, because the protective functions of their body have not yet been fully formed.

Serous meningitis can also affect adults and school-age children. This is possible only as a result of severe exhaustion of the body, chronic diseases, regular stress, malnutrition, severe hypothermia, lack of vitamins and minerals. Often meningitis occurs in people with cancer and immunodeficiencies.

The risk group also includes people living in conditions that do not meet the requirements of sanitary standards. Such premises are an excellent place for the reproduction of various infections.

Ways of infection

Infections that cause serous meningitis enter the body in a variety of ways. Sometimes there is infection of the child from the mother during pregnancy, with blood transfusions and bites of insects and dogs. Such cases are extremely rare. The most common ways are airborne, water and contact. Let's consider each of them in more detail.

Airborne

Airborne infection is transmitted when it is located and multiplies on the mucous membrane of the respiratory tract of a sick person. During coughing, sneezing, kissing or talking, the virus enters the air through saliva, quickly spreads and settles on the nasopharyngeal mucosa of people around.

Water

In recent years, serous meningitis in children has become seasonal. The number of sick people increases significantly in the summer. The fact is that enteroviruses that provoke the disease do not die in the water, so during the swimming season there is a high probability of infection through the dirty water of various reservoirs and pools.

Contact

Viruses constantly settle on objects surrounding an infected person. Upon contact with such things, an infection occurs in a healthy body. Failure to follow the basic rules of personal hygiene, unwashed vegetables, poor quality drinking water can cause infection that provokes the development of serous meningitis.

The first signs of the disease and the incubation period

The incubation period of the disease is 2-10 days. It depends on the human immune system. The first signs by which meningitis can be recognized include:

• Kernig's symptom - it is impossible to unbend the legs bent at a right angle;
• tripod symptom - it is impossible to sit straight (the body is tilted forward, and the head and arms are back);
• the upper symptom of Brudzinsky is automatic bending of the legs when the head is tilted forward;
• the average symptom of Brudzinsky - during pressure in the lower abdomen, the legs are involuntarily pulled up to the body;
• lower Brudzinsky syndrome - when you try to straighten one leg, the second will bend;
• symptom of ankylosing spondylitis - when you press the cheekbone, the muscles of the face contract;
• Pulatov's syndrome - painful sensations with a sharp touch of the skull.

Signs of damage to the cranial nerves can also be:

• heat;
• deterioration of vision and hearing;
• double vision;
• nystagmus - involuntary fluctuations of the eyes;
• ptosis - drooping of the upper eyelid;
• strabismus;
• disturbance of consciousness;
• increased agitation or drowsiness;
• hallucinations.

A dangerous sign is the appearance of a rash. It has the appearance of red or pink spots that disappear when pressed. They first appear on the legs and quickly spread throughout the body. After a few hours, the spots become bluish in color with a darker center.

When such a rash appears, you should immediately call an ambulance team, otherwise a fatal outcome is possible. These spots are the necrosis of tissues as a result of the onset of blood poisoning, provoked by meningococcus.

The mechanism of development of serous meningitis

The development of serous meningitis includes the following stages:

1. The infection enters the body and the inflammatory process begins. How long it takes depends only on the protective functions of the body. In this case, the active reproduction of the virus (incubation period) occurs.
2. As a result, there is a violation of hemodynamics and, as a result, an increase in cerebrospinal fluid (cerebrospinal fluid), which causes meningeal syndrome.
3. In the future, there is a thickening of the membranes of the brain, as a result of which serious complications can occur.

Ways to treat meningitis in children

Treatment of serous meningitis is carried out exclusively in a hospital under the supervision of specialists. This is necessary for constant monitoring and prevention of the development of severe complications. The course of therapy includes mandatory drug treatment and the creation of all conditions for a speedy recovery.

The therapy regimen is prescribed only after finding out the root cause of the disease (bacteria or virus):

1. Antibacterial drugs are used to treat meningitis caused by various kinds of bacteria. These include broad-spectrum antibiotics ("Ampicillin", "Bilmitsin", "Amoxicillin", etc.). Their feature is the addiction of bacilli to drugs, so it is not recommended to use them for more than a week. In this case, you just need to replace the medicine with another one.
2. With viral meningitis, antiviral drugs are prescribed (Acyclovir, Artepol, Interferon).
3. As the disease develops, a large amount of fluid accumulates in the head, which increases intracranial pressure. To remove fluid, diuretics are prescribed (Furosemide and Lasix). If there is no result, a lumbar puncture is done.

To reduce the number and intensity of seizures, sedatives are prescribed (Seduxen or Domosesdan). They are absolutely safe for children and are not addictive.

The following actions will also help to speed up recovery and alleviate the general condition of the child:

• creating subdued lighting (in patients, sensitivity to bright light is significantly increased);
• maintaining a calm psychological atmosphere (stress and nervous tension are contraindicated for the child);
• taking multivitamin preparations (to maintain the protective functions of the body);
• diet (it is not recommended to eat hot food, sweet, fatty, sour, salty).

Consequences of the disease

With timely access to a doctor, the consequences of viral meningitis are minimal or non-existent. At an advanced stage of the disease, as a result, there may be:

• regular headaches;
• sleep problems;
• memory impairment;
• poor perception of new information;
• convulsions;
• deterioration of hearing and vision (in rare cases, their complete loss is possible);
• developmental delay;
• speech disorder;
• epilepsy;
• violations in the work of the motor apparatus;
• weakening of the muscles of the limbs;
• paralysis.

Such consequences are possible only in the most severe cases. That is why, at the first signs of serous meningitis, it is necessary to immediately contact a specialist.

Only doctors can confirm the diagnosis and prescribe therapeutic measures. In such cases, it is impossible to self-medicate in any case, otherwise a fatal outcome is possible.

Prevention

To minimize the possible occurrence of viral meningitis, prevention is necessary, namely:

• swim only in permitted and verified places;
• observe personal hygiene and teach the child to do so;
• wash all fruits and vegetables thoroughly;
• drink boiled or purified water;
• use personal towels and cutlery;
• lead a healthy lifestyle;
• eat properly;
• temper;
• during epidemics, stay away from large crowds of people;
• follow the vaccination schedule.

Damage to the membranes of the spinal cord and brain, provoked by bacteria, viruses, fungi, is defined by official medicine as serous meningitis. At risk are mainly children of preschool age. This is exactly the period when the baby begins to attend kindergarten, where there may be potential carriers of the virus. In schoolchildren and adults, this pathology is detected quite rarely.

The disease is characterized by symptoms that accompany meningitis of a different etiology. These are high (above 38) temperature, headache, nausea and vomiting. Such symptoms make timely diagnosis difficult, since parents often confuse the condition with colds. But the consequences are unfavorable, so the manifestation of any signs should make you seek medical help.

Causes of the disease

The main pathogens that provoke serous meningitis are bacteria and viruses, less often fungi. But the main cause is an enterovirus. Often the disease is diagnosed as a complication after previous diseases:

• pneumonia;
• flu;
• measles;
• chickenpox;
• syphilis;
• tuberculosis;
• AIDS.

Infection often occurs from an infected person, even during a conversation with him. The greatest peak falls on the warm season, as many reservoirs are infected with harmful microorganisms.

A healthy immune system allows the body to withstand the onslaught of an infection. Weakened immunity, unhealthy diet, unhealthy lifestyle allow the virus to quietly penetrate and infect a weakened body. This explains the fact that serous meningitis in adults or children is the result of another disease. In a weakened body, an enterovirus quickly reaches the brain with blood flow, provoking an initial severe inflammatory process.

Disease classification

Modern medicine defines several types of serous meningitis. It depends on the type of pathogen or agent of the disease:

Depending on the severity of the course of the disease at the time of its detection, several more types are determined - primary or secondary degree.

Symptoms of the disease

After infection of the body, the disease can manifest itself in 2-6 days. This is the incubation period for pathology. The treatment is long, requiring a stay in the hospital. Recovery is possible in at least two weeks.

The disease manifests itself with meningeal specific signs:

• high body temperature;
• fever;
• headache;
• nausea, vomiting;
• pain in the eyes when looking at a bright light;
• ear pain even with slight noise;
• lack of appetite;
• Brudzinsky's or Kernig's symptom.

Meningeal signs are the presence of several symptoms at the same time. When Brudzinsky's symptoms are detected, the patient cannot turn his head, bend his neck. When you try to bend one leg, the other bends spontaneously. Determining the symptom of Kernig, the patient is invited to raise the leg vertically from a prone position. In the presence of a disease, he will not be able to do this. Often the condition is accompanied by loss of consciousness.

Diagnostics

Such a pathology as serous meningitis is diagnosed quite simply on the basis of the listed symptoms. But this is only enough for the doctor to draw up an anamnesis. The patient will have to undergo a complete laboratory and instrumental examination. Serological diagnosis involves:

• general blood analysis;
• bacteriological analysis;
• spinal puncture;
• Ultrasound, MRI of the brain.

Often, after spinal cord sampling, patients feel significant relief. This is further evidence that there is serous meningitis in children or adults. The relief is temporary, since after the fluid is taken, the intracranial pressure drops sharply. Treatment is complex and lengthy. It is necessary to do this, since the consequences are rather sad.

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Treatment

The appearance of these symptoms should cause concern, especially for parents. Do not wait for the arrival of the local pediatrician. The course of the disease is rapid, so it is better to call an ambulance team.

If at high temperature the patient cannot bend his legs, turn his head, serous meningitis can be suspected. In this situation, emergency hospitalization is required.

Lowering the temperature, giving antibiotics on your own is undesirable. This will give a temporary effect and complicate the diagnosis. Treatment of serous meningitis generally does not involve the use of antibacterial drugs. After a diagnostic examination, the doctor usually prescribes:

• antiviral drugs, more often interferon;
• immunoglobulin is prescribed to strengthen the immune system;
• to reduce intracranial pressure - diuretics (Furosemide, Lasix);
• antispasmodics (No-shpa, Drotaverine);
• droppers with prednisolone and ascorbic acid;
• colloid preparations are prescribed in the absence of cardiac pathologies;
• antipyretic only when the temperature is above 38 ° C;
• Seduxen, Domosezan to prevent seizures;
• vitamin therapy.

The patient was placed on bed rest for several days. It is desirable to exclude unnecessary movements. The etiology of the disease is not fully understood. Therefore, it is better to strictly follow all the prescriptions and recommendations of the doctor. This is the only way to quickly achieve a full recovery without sad consequences.

Consequences of serous meningitis

If the patient was provided with timely medical assistance, then the consequences of the disease are favorable. The fever disappears on the 3-4th day, complete recovery is possible in two weeks. If the appeal to a medical institution was untimely, treatment was carried out at home using improvised means, then cerebrospinal fluid-hypertension syndrome may be noted. This is increased intracranial pressure caused by the accumulation of CSF (spinal fluid) in the brain.

The situation is serious, provoking:

• loss of consciousness;
• inadequate mental and physical development;
• violations of the organs of hearing and vision, up to complete loss;
• kidney pathology;
• to whom;
• sudden infant death syndrome or death in adults.

Especially dangerous are the consequences caused by the tuberculosis pathogen. This form of the disease requires the use of anti-tuberculosis drugs. If this was not done, then the death of the patient may occur on the 22-25th day after the onset of the disease. Inadequate or incomplete treatment provokes a relapse.

Preventive actions

Treatment of any form of meningitis is not completed at the time of discharge from the hospital. A whole range of preventive measures will be recommended, some of which will have to be observed and implemented for 4 years. Prevention will not interfere with those who have been in contact with the patient.

The best prevention is considered to be a strong immune system, which is easy to maintain with a healthy diet, fortified complexes. Adults need to give up alcohol and smoking, children and their parents should ensure a healthy lifestyle. Tuberculosis vaccination may be recommended. This procedure should not be ignored. This ensures that there is no relapse.

• do not visit polluted water bodies;
• regularly do wet cleaning, ventilate the room;
• wash hands after the street and before eating;
• wash fruits and vegetables before eating;
• do not drink tap water;
• follow the rules of personal hygiene.

Nutrition principles

Not only ready-made vitamin complexes, but also recommendations from alternative medicine will help strengthen the immune system. Children need to be taught from an early age the dangers of unhealthy food. Therefore, it is necessary to exclude carbonated sweet drinks, spicy, fried, fatty foods, salt and sugar to a minimum, to refuse visits to fast foods. The menu of a person who has had meningitis should include:

• fresh vegetables and fruits;
• dairy products;
• hard cheeses;
• lean meats (boiled, steamed);
• sea ​​fish and seafood;
• nuts;
• buckwheat, cheese;
• dried fruits.

Serous meningitis is one of the severe diseases of the brain, characterized by inflammation of its membranes. Usually the cause is a viral infection or the reproduction of bacterial and fungal flora, but most of the recorded cases of this disease were still caused by viruses. Most often it is fixed in children of primary school and preschool age.

It usually begins with symptoms characteristic of purulent inflammation of the meninges - nausea and vomiting, headache. The main difference between this form of the disease and all the others is that inflammation develops abruptly, but it does not stand out as a violent clinic. Rather, it proceeds in a mild form, without disturbing the clarity of consciousness and passes without meningeal complications.

The diagnosis is established by the clinical manifestation and bacteriological analysis of the cerebrospinal fluid, PCR analysis.

Treatment is aimed at eliminating the pathogen and alleviating the general condition - the appointment of painkillers, antipyretics, antivirals. If, according to the treatment plan, the patient's condition does not stabilize, antibacterial drugs related to broad-spectrum antibiotics are additionally prescribed.

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ICD-10 code

A87.8 Other viral meningitis

Causes of serous meningitis

The causes of serous meningitis can be very diverse. The form is divided into primary and secondary. In primary inflammation, the disease state is an independent process. With a secondary manifestation, it occurs as a complicated course of an existing disease of an infectious or bacterial nature.

Symptoms of serous meningitis

Symptoms of serous meningitis at an early stage are similar to a cold - fatigue, irritability, passivity appear, the temperature rises, unpleasant sore sensations in the throat and nasopharynx. At the next stage, a temperature jump occurs - it rises to 40 degrees, the condition worsens, severe headache appears, accompanied by dyspeptic disorders, muscle spasms, delirium. Key manifestations of inflammation:

• positive reaction with the Brudzinsky test;
• "brain" vomiting;
• violation of the muscular activity of the limbs, difficulty swallowing;
• significant hyperthermia - 38-40 degrees.

On the 5-7th day from the onset of the disease, the symptoms may appear weaker, the fever decreases. This period is the most dangerous, because if treatment is interrupted at the first manifestation of recovery, meningitis may develop again. Relapse is especially dangerous, as it can be accompanied by severe persistent brain damage and pathologies of the nervous system. It is possible to confirm the nature of the pathogens using a virological and serological study of blood and cerebrospinal fluid.

The incubation period of serous meningitis lasts from the moment the pathogen enters the nasopharyngeal mucosa until the first signs of the disease appear. This can take a period of time from two to five days, but in many respects the terms depend on the nature of the pathogen and the resistance of the person's immunity. In the prodromal stage, the disease is manifested by a decrease in general tone, headaches, a slight increase in temperature, and the course is more like SARS. In the incubation stage, a person is already a carrier of the pathogen and releases it into the environment, therefore, when confirming the diagnosis, it is necessary to isolate everyone who has been in contact with the patient as soon as possible.

But very often, serous inflammation of the brain begins acutely - with a high temperature, vomiting, characteristic symptoms of inflammation of the meninges appear almost immediately:

• the appearance of stiffness of the neck muscles;
• positive reaction with the Kernig test;
• positive reaction in the Brudzinsky test.

The prognosis is mostly favorable, but in rare cases there are complications - impaired vision, hearing, persistent changes in the central nervous system. The first days after confirmation of the diagnosis, elevated levels of lymphocytes are noted. A few days later - moderate lymphocytosis.

How is meningitis serous transmitted?

Inflammation of the meninges or meningitis develops rapidly. The main reason is representatives of the group of enteroviruses. It is easy to become infected or become a carrier of the virus in the following situations:

• Contact infection. Bacteria and microorganisms enter the body with dirty food - fruits and vegetables with particles of dirt, when drinking unsuitable water for drinking, and neglecting the rules of personal hygiene.
• Airborne infection. Infectious agents enter the mucous membranes of the nasopharynx upon contact with an already sick person or with a carrier of the virus. Most often, pathogens are first released by patients into the environment, and then settle on the nasal mucosa and pharynx of a healthy person.
• Water route of infection. Perhaps when swimming in dirty water, when there is a high risk of swallowing contaminated water.

Especially dangerous is serous inflammation of the lining of the brain for children of the first year of life - during this period, exposure to infectious agents has such a detrimental effect on the children's brain and nervous system that it can cause mental retardation, partial impairment of visual and auditory functions.

Acute serous meningitis

It develops when enteroviruses enter the body, as well as viruses that cause parotitis, lymphocytic choriomeningitis, herpes simplex type 2, tick-borne encephalitis. With a viral etiology of this disease, a bacteriological examination of blood and cerebrospinal fluid will not give positive data, a manifestation of lymphocytic pleocytosis is diagnosed, the content is slightly higher than normal.

The clinical picture of the disease differs from the picture of the purulent form. The course of the disease is milder, manifested by headaches, soreness when moving the eyes, spasms in the muscles of the arms and legs (especially the flexors), Kernig's and Brudzinsky's symptoms are positive. In addition, the patient is worried about vomiting and nausea, pain in the epigastric region, against which physical exhaustion develops, photophobia develops. Persistent disturbances of consciousness, epileptic seizures, focal lesions of the brain and cranial nerves are also not fixed.

Acute serous meningitis does not give serious complications and is easily treated, recovery occurs on the 5th-7th day of illness, but headaches and general malaise can last from several weeks to several months.

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Secondary serous meningitis

Meningoencephalitis occurs with concomitant viral conditions caused by the mumps virus, herpes, etc. The most common cause of this process is parotitis. It manifests itself, like acute meningitis - the temperature rises, severe pain in the head worries, eyes watery from the light, nausea, vomiting, pain in the stomach. The main role in the diagnosis of confirmation of lesions of the meninges is played by a positive Kernig and Brudzinsky reaction, accompanied by stiff neck muscles.

Serious changes are recorded only in moderate and severe forms of the disease, but in general, the secondary form of inflammation of the meninges passes quite easily. More severe cases are characterized by a proliferative phenomenon not only of the salivary glands and membranes of the brain, but also by pancreatitis, inflammatory processes in the testicles. The course of the disease is accompanied by fever, main brain symptoms, dyspeptic disorders, laryngitis, pharyngitis, and sometimes a runny nose. After 7-12 days, with a mild course, the general condition improves, but for another 1-2 months a person can be a carrier of the pathogen and pose a danger to others.

Viral serous meningitis

It is considered one of the most common uncomplicated forms of this disease. Caused by coxsackieviruses, mumps, herpes simplex, measles, enteroviruses and sometimes adenoviruses. The onset of the disease is acute, begins with a sharp increase in temperature, sore throat, sometimes a runny nose, dyspeptic disorders, muscle spasms. In severe cases - clouding of consciousness and diagnosing stupor, coma. Signs of meningeal syndrome appear on the second day - this is stiff neck muscles, Kernig's syndrome, Brudzinsky's, increased pressure, very severe headaches, cerebral vomiting, pain in the abdomen. In the analysis of cerebrospinal fluid, a pronounced form of cytosis, many lymphocytes.

The prognosis for almost all adults with viral non-purulent inflammation of the meninges is favorable - complete recovery occurs in 10-14 days. In just a few cases of the disease, those who have been ill are tormented by headaches, hearing and vision disorders, impaired coordination and exhaustion. In children of the first year of life, persistent developmental dysfunctions can develop - slight mental retardation, lethargy, hearing loss, vision loss.

Enteroviral meningitis serous

This is a type of meningitis caused by the Coxsackie and ECHO viruses. It happens as a single recorded case of infection, and can be in the nature of an epidemic. Most often, children become infected with it in the summer-spring time, the epidemic spreads especially quickly in the team - in kindergartens, schools, camps. You can get infected from a sick person or child, as well as from a healthy carrier, this type of inflammation of the meninges spreads mainly by airborne droplets or if hygiene rules are not followed.

After the viral agent enters the body, after a day or three, the first signs appear - redness and swelling of the pharynx, lymph nodes increase, pain in the abdomen and soreness of a diffuse nature are disturbed, the temperature rises. The disease passes to the next stage when the pathogen penetrates directly into the bloodstream and, spreading through the bloodstream, concentrates in the nervous system, which leads to an inflammatory process in the brain membrane. At this stage, the meningeal syndrome becomes pronounced.

The course of the disease in general dynamics rarely entails severe complications. On the second or third day, the brain syndrome disappears, but on the 7th-9th day of illness, the clinical symptoms of serous inflammation may return and the temperature may also rise. In children under one year old, the process is sometimes accompanied by the formation of inflammatory foci of the meningeal membranes of the spinal cord, a persistent lesion of the central nervous system.

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Serous meningitis in adults

It proceeds quite easily and does not cause serious complications. Its causes are viral agents, bacteria and fungi, the primary inflammation of the meninges is caused by the Coxsackie virus, Echo enterovirus. Secondary cases are caused by a virus that causes polio, mumps, measles.

In adulthood, viral inflammation occurs in an uncomplicated form, but this does not mean that this form does not require treatment. The onset is similar to a cold - a headache, swollen throat, muscle pain and dyspepsia, meningeal syndrome and, in severe cases, convulsions. By the end of the first week of illness, the temperature is fixed at a normal level, muscle cramps and headache do not bother. This stage requires special monitoring, as the likelihood of relapse increases, and the first signs of pathologies of the central nervous system and intracranial nerves may also appear.

The most effective way to identify the pathogen is a serological and bacteriological analysis of blood and cerebrospinal fluid, PCR. After that, specific antibacterial and antiviral treatment is prescribed in combination with antipyretic, antiemetic, analgesic and sedative drugs.

Serous meningitis in adults is treatable, and the sooner it is started, the lower the risk of recurrence of the disease and the development of complications.

Serous meningitis in children

It proceeds more severely than in adults and, if not treated in time, can lead to serious complications. The incubation period lasts about 2-4 days, those who attend events with a large concentration of children of different ages are more likely to get sick - school and preschool institutions, circles, various sections, camps. The root cause of the disease are viruses that cause measles, mumps, herpes, various enteroviruses, etc. At first, inflammation of the lining of the brain is similar to other forms of meningitis - it also suffers from a severe headache, dyspeptic disorders, and a cerebral syndrome manifests itself. The main difference between the viral form and others is a sharp, acute onset of the disease, with a relatively clear consciousness.

The diagnosis is confirmed by PCR, analysis of cerebrospinal fluid. After determining the nature of the pathogen, a treatment plan is prescribed - with a viral etiology, a course of antiviral drugs is prescribed, if other pathogens are detected, antibiotics, antifungal drugs. In addition to eliminating the cause of inflammation of the meninges, therapeutic measures are aimed at alleviating the general condition - for this, antipyretic, analgesic, antiemetic, sedative medications are prescribed.

Serous meningitis in children ends quickly enough and without complications, but for babies in the first year of life it is dangerous.

Complications of serous meningitis

Complications of serous meningitis for an adult represent a minimal danger, but for children of the first year of life they are especially dangerous. Most often, the consequences of inflammation of the meninges make themselves felt with a aggravated course, with unqualified drug therapy or non-compliance with medical prescriptions.

Disorders that occur in severe inflammatory pathology of the meninges:

• Violation of the auditory nerve - hearing loss, dysfunction of coordination of movements.
• Weakening of visual function - a decrease in sharpness, strabismus, uncontrolled movements of the eyeballs.
• Decreased vision and motor activity of the muscles of the eyes are fully restored, but persistent hearing impairment is mostly irreversible. The consequences of meningeal pathology transferred in childhood are manifested in the future in a delay in intelligence, hearing loss.
• The development of arthritis, endocarditis, pneumonia.
• Threat of strokes (due to obstruction of cerebral vessels).
• Epileptic seizures, high intracranial pressure.
• The development of cerebral edema, lungs, leading to death.

With timely seeking qualified medical help, severe systemic changes can be avoided and there will be no relapses during treatment.

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Consequences of serous meningitis

The consequences of serous meningitis, subject to treatment and competent rehabilitation after recovery, are expressed in only half of all cases of the disease. Basically, they manifest themselves in general malaise, headaches, decreased memory and memorization speed, sometimes involuntary muscle spasms appear. With complex forms, the consequences will be more serious, up to a partial or complete loss of the ability to see and hear. Such violations are observed only in isolated cases, and with timely organized drug therapy, this can be easily avoided.

If the disease proceeded as a complicated course of another disease, then those who were ill will be more worried about those problems that were associated with the root cause. Regardless of what form the person fell ill with (primary or secondary), therapeutic measures should begin immediately. Basically, antibacterial, antifungal and antiviral drugs are used for this, as well as a complex of drugs for symptomatic therapy and alleviation of the general condition.

After a pathological condition, a person requires special care and gradual recovery - this is a vitamin nutrition program, moderate physical activity and activities aimed at the gradual restoration of memory and thinking.

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Diagnosis of serous meningitis

Diagnosis is carried out in two directions - differential and etiological. For etiological differentiation, they resort to the serological method - RSK, and the neutralization reaction also plays an important role in the isolation of the pathogen.

As for the differential diagnosis, its conclusion depends on the clinical data, the epidemiological summary and the virological conclusion. When diagnosing, attention is paid to other types of disease (tuberculous and inflammation of the meninges caused by influenza, mumps, poliomyelitis, Coxsackie, ECHO, herpes). Due attention is given to the confirmation of meningeal syndrome:

1. Rigidity of the neck muscles (the person cannot touch the chest with the chin).
2. A positive Kernig test (with a leg bent at 90 degrees in the hip and knee joint, a person cannot straighten it at the knee due to hypertonicity of the flexors).
3. Positive result of the Brudzinsky test.

Consists of three stages:

• A person cannot press his head to his chest - his legs are pulled up to his stomach.
• If you press the area of ​​​​pubic fusion - the legs are bent at the knees and hip joints.
• When checking the symptom according to Kernig on one leg, the second involuntarily bends at the joints at the same time as the first.

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Liquor in serous meningitis

Liquor in serous meningitis is of great diagnostic value, since by the nature of its components and by the results of bacteriological culture, it is possible to draw a conclusion about the causative agent of the disease. Cerebrospinal fluid is produced by the ventricles of the brain, normally its daily volume is no more than 1150 ml. To take a sample of biomaterial (CSF) for diagnosis, a special manipulation is performed - lumbar puncture. The first milliliters received are usually not collected, as they have an admixture of blood. For analysis, several milliliters of CSF are needed, collected in two test tubes - for general and bacteriological examination.

If there are no signs of inflammation in the collected sample, then the diagnosis is not confirmed. With non-purulent inflammation in the punctate, leukocytosis is observed, the protein is usually slightly elevated or normal. In severe forms of the pathology, neutrophilic pleocytosis is recorded and the content of protein fractions is much higher than the permissible values, the sample during a puncture does not flow out drop by drop, but under pressure.

Liquor not only helps to accurately differentiate with other forms of this disease, but also to identify the pathogen, the severity, and to select antibacterial and antifungal drugs for therapy.

Differential diagnosis of serous meningitis

Differential diagnosis of serous meningitis is aimed at a more detailed study of the patient's history, current symptoms and serological findings. Despite the fact that the meningeal complex is characteristic of all types of inflammation of the meninges, significant differences are observed in some of its forms. With a viral etiology, general meningeal manifestations may be mild or absent altogether - moderate headache, nausea, pain and cramps in the abdomen. Lymphocytic choriomeningitis is characterized by violent symptoms - severe headaches, recurrent cerebral vomiting, a feeling of pressure in the head, pressure on the eardrums, pronounced spasm of the neck muscles, a pronounced symptom of Kernig and Brudzinsky, during a lumbar puncture, cerebrospinal fluid flows out under pressure.

The pathological process caused by the polio virus is accompanied by signs characteristic of this disease - Lasegue, Amossa, etc. During the SMP, the cerebrospinal fluid flows out under slight pressure. Often the disease is accompanied by nystagmus (due to damage to the medulla oblongata).

The tuberculous form, unlike the serous form, develops slowly and occurs in people with chronic tuberculosis. The temperature rises gradually, the general condition is lethargic, depressed. There is a lot of protein in the spinal punctate, the presence of Koch's bacillus is determined, the collected material is covered with a specific film after a while.

Differential diagnosis, however, is mainly based on a virological and immunological study of the CSF and blood. This gives the most accurate information about the nature of the pathogen.

Treatment of serous meningitis

Treatment of serous meningitis requires special attention. Depending on what tactics will be taken in the first days of the disease, the further prognosis of medical prescriptions depends. Drug therapy for non-purulent inflammation of the meninges is carried out in a hospital - this is how a person receives the necessary care and you can observe all the changes in well-being, carry out the necessary diagnostic manipulations.

Appointments largely depend on the severity of pathological changes, the nature of the pathogen and the general condition of the patient. According to the study of CSF and PCR, specific therapy is prescribed - in the case of a viral form, these are antiviral (Acyclovir, etc.), in case of a bacterial form, broad-spectrum antibiotics or specific antibacterial ones (Ceftriaxone, Meropenem, Ftivazid, Chloridine, etc.), and also antifungal (Amphotericin B, Fluorocytosine), if the identified pathogen belongs to the group of fungi. Measures are also being taken to improve the general condition - detoxification drugs (Polysorb, Hemodez), painkillers, antipyretics, antiemetics. In some cases, when the course of the disease is accompanied by high blood pressure, diuretics and sedatives are prescribed. After complete recovery, a rehabilitation course is carried out, including exercise therapy, myostimulation, electrophoresis, psychorehabilitation is also required.

Treatment can be carried out at home, but only if the disease is mild, and the patient's well-being and adherence to the principles of medication prescriptions are controlled by an infectious disease specialist.

Treatment of serous meningitis in children requires special attention and responsible attitude to compliance with all medical prescriptions. In childhood, this disease is often accompanied by complications, it is especially dangerous for babies in the first year of life, when the consequences are persistent and can cause mental retardation, hearing loss, and poor vision.

Most of the recorded cases of a non-purulent form of inflammation of the meninges are caused by viruses, so antibiotic therapy does not give the proper result. Assign Acyclovir, Arpetol, Interferon. If the child's condition is severe and the body is weakened, immunoglobulins are administered intravenously. With significant hypertension, diuretics are additionally prescribed - Furosemide, Lasix. In severe forms, when the disease is accompanied by severe intoxication, glucose, Ringer's solution, Hemodez are dripped intravenously - this contributes to the adsorption and elimination of toxins. With severe headaches and high pressure, a lumbar puncture is performed. Otherwise, treatment measures are symptomatic - antiemetics, painkillers and antipyretics, vitamins are recommended.

Treatment, subject to the doctor's instructions, ends with recovery after 7-10 days and is not accompanied by long-term complications.

Prevention of serous meningitis

Prevention of serous meningitis is aimed at preventing the causative agent of this disease from entering the body. General preventive rules should include:

• Measures prohibiting swimming in polluted water bodies in the summer-autumn period.
• The use of only boiled, purified or bottled water from certified wells.
• Careful preparation of products for cooking, competent heat treatment, washing hands before eating, after visiting crowded places.
• Compliance with the daily routine, maintaining an active lifestyle, high-quality nutrition according to the costs of the body. Additional use of vitamin complexes.
• During the seasonal outbreak, refuse to attend mass performances and limit the circle of contacts.
• Carry out regular wet cleaning of the room and processing of the child's toys.

In addition, the serous form of inflammation of the meninges can be secondary, which means that it is necessary to treat chickenpox, measles, mumps, and influenza in a timely manner. This will help eliminate the risk of inflammation of the membranes of the brain and spinal cord, both in adults and in children. Do not neglect preventive rules, because it is easier to prevent infection than to treat it and recover from complications associated with it.

Prognosis of serous meningitis

The prognosis of serous meningitis has a positive trend, but the final result largely depends on the state of the patient's immune system and the timing of seeking medical help. A non-purulent change in the membranes of the brain most often does not cause persistent complications, is quickly treated and does not give relapses on the 3-7th day of the disease. But if tuberculosis is the root cause of tissue degeneration, without specific drug treatment, the disease ends in death. Treatment of the serous form of tuberculous meningitis is protracted, requires inpatient treatment and care for six months. But if the prescriptions are followed, such residual pathologies as the weakening of memory, vision and hearing disappear.

In childhood, especially in babies under one year old, a non-purulent form of inflammation of the meninges can cause serious complications - epileptic seizures, visual impairment, hearing impairment, developmental delay, low learning ability.

In adults, in rare cases, after an illness, persistent memory disorders form, concentration of attention and coordination decrease, and severe pain in the frontal and temporal parts regularly disturbs. Disorders persist from several weeks to six months, after which, with proper rehabilitation, full recovery occurs.

Serous meningitis is a disease manifested by inflammation of the meninges, accompanied by the release of serous exudate with an admixture of blood cells and protein products.

Of all types of inflammation of the meninges, this one proceeds more gently, without forming pus and tissue necrosis. It is more common in children under the age of six. Rare in adults.

Causes of serous meningitis

The origin of the disease, conditions and causes are as follows:

• viruses (adenovirus , herpes , enterovirus , , polio , ).
• complications of infection , ).
• fungus (occurs with immunodeficiencies).
• previous pathological conditions of the central nervous system, leading to the formation of serous effusion (tumors and cysts).
• infected house mice and rats (lymphocytic choriomeningitis).

Infection occurs through household contact (through wounds or using objects of the sick person), airborne droplets (when sneezing or coughing), through water (pool).

Classification

According to the ICD-10, the disease has the code A87.8, belongs to the section "other viral meningitis". The section tells what it is, provides an etiological list:

• Depending on the causative agent of serous meningitis:
  • viral;
  • bacterial;
  • fungal.
• Depending on the focus:
  • primary (beginning of development in the brain);
  • secondary (the disease appears in other organs, then migrates through the blood-brain barrier).

Pathogenesis (the mechanism of the onset of serous meningitis in the human body)

An infection or virus, entering through the focus of penetration, enters the bloodstream and spreads throughout the body. Immunity begins to attack a foreign object.

Lymphocytes, together with the fluid, go beyond the vascular wall, which provokes the development of edema.

The virus multiplies, the immune system cannot cope without drug treatment. The amount of cerebrospinal fluid in serous meningitis increases, hypertension develops. Clinical manifestations begin. The membranes of the brain thicken, which leads to complications.

Symptoms of serous meningitis

After the end of the incubation period, which lasts up to 20 days, sharp symptoms begin:

• headache, aggravated by noise and bright light, not amenable to relief with painkillers;
• dizziness;
• loss of consciousness;
• convulsions;
• swelling of fontanelles in newborns;
• frequent vomiting and nausea;
• hypertension;
• with paralysis and paresis - difficulty or impossibility of breathing;
• critical temperature up to 40 degrees with sharp drops and rises, which is most difficult for a child's body;
• intoxication (arthralgia, weakness, myalgia).

In rare cases, there are symptoms of other diseases, which can make diagnosis difficult:

• typical symptoms: cough with sputum, sore throat;
• symptoms of inflammation of the cranial nerves: omission of the eyelid, strabismus, diplopia.

Characteristic signs and postures with pathological changes in the meninges:

• a typical posture for stiff muscles of the back of the neck - the patient lies on his side, his head is thrown back;
• Kernig's symptom - the tone of the muscles of the lower leg is increased, the patient cannot straighten the leg from a bent state;
• Brudzinsky's symptoms (a group of symptoms that occur due to irritation of the meninges):
  • upper: when you try to reach your chest with your chin, your legs bend involuntarily;
  • lower: when you try to straighten one leg, the second bends even more, reaching for the stomach;
• symptom of Lesage. The baby is lifted, holding the armpits, the head is held with the thumbs. If the child pulls his legs up to his stomach, the test is positive.

Clinical manifestations of forms of meningitis

• tuberculosis form occurs with a disease of this type of various organs (lungs, kidneys). The incubation period lasts two weeks, after which dizziness, subfebrile condition, fatigue, sweating occur. Further, neurological signs appear (strabismus, decreased visual acuity). In the absence of therapy, complications develop (paresis, aphasia, coma) or a chronic process. Catarrhal phenomena are short-term, replaced by neurological ones.

With this form of the disease, there is a severe headache with pressure on the eyeballs and ears. Vomiting often recurs. Inflammation of the optic nerves develops. The pressure is reduced after a lumbar puncture, the symptoms in children are reduced.

Liquor (cerebrospinal fluid) is transparent, the protein is slightly elevated (globulins are present), lymphocytes predominate from the first days of the disease. Glucose appears. In half of the cases, a fibrin film falls out. Antibodies in the blood appear a week after the onset of the disease, before that the test results may be negative.

• Acute lymphocytic choriomeningitis. Signs begin to occur a week after infection, characterized by general symptoms of malaise and pharyngitis. The temperature rises sharply. With damage to the vessels of the ventricles, neurological symptoms begin.
• Fungal meningitis in AIDS. the lesion proceeds with a small number of clinical manifestations. This form is a complication of immunodeficiencies (congenital and acquired, for example, with AIDS). It develops poorly, most of the typical symptoms in children are not detected. This makes it difficult to make a diagnosis.
• At inflammation in the central nervous system is observed a month after the onset of the virus. Symptoms of inflammation of the meninges are pronounced, there is severe vomiting, weakness, drowsiness, paresthesia, convulsions, abdominal pain. More often the disease develops in boys. According to this scheme, all viral forms of serous meningitis (, Echovirus) proceed.

In the CSF (indicators of cerebrospinal fluid) in the first days there is a large number of polynuclear cells, which is replaced by pleocytosis. From the cerebrospinal fluid, immunological studies are carried out (compliment binding and agglutination delay), which makes it possible to derive the virus genome.

Toxoplasma form is divided into congenital and acquired. The first is the most dangerous, since the baby's immunity is poorly developed. It is characterized by dangerous complications: frequent convulsions, eye damage, myoclonus, calcification of the medulla.

When taking CSF (cerebrospinal fluid) observed xanthochromia, pleocytosis with a predominance of lymphocytes. A smear is made from the liquor. Looking through it under a microscope, the laboratory assistant detects Toxoplasma. The diagnosis is confirmed by subcutaneous and compliment binding reactions.

• Enteroviral serous meningitis. It is transmitted fecal-oral, airborne, vertically (from mother to fetus through the placenta). Complications are on the cardiovascular and nervous system. More often, serous viral meningitis causes ARVI or intestinal disorders, inflammation in the central nervous system, and occurs in children with weak immunity. When it passes through the blood-brain barrier, cold symptoms begin, then the person loses consciousness, hallucinations and convulsions appear. Violent fever with attacks of headache. In children under one year old, the symptoms are blurred, the nasolabial triangle is bluish, the doctor may mistake a skin rash for measles. Therefore, it is difficult to diagnose the disease.

Enterovirus is manifested by liver necrosis, intravascular coagulation and enterocolitis. The disease resembles, but does not go away with the introduction of antibiotics.

When taking CSF for diagnosis, it becomes easier for the patient, since the pressure at the exit of the CSF decreases. This condition serves as a signal to the doctor about CNS disorders.

During puncture, the fluid flows out in a jet, it contains a large number of cells. At the beginning of the disease, neutrophilic leukocytes predominate, which leads specialists to two diagnoses: serous and purulent meningitis. Later, lymphocytes begin to predominate.

The prognosis is favorable, after medication the fever disappears, the patient gets better, neurology disappears on the fifth day. An accurate diagnosis is made after, when the enterovirus genome is detected.

• Aseptic meningitis- this is an inflammation of the meninges, in the absence of an identified pathogen. It is caused by tumors, cysts, drugs, pathogens of enteroviral etiology and infections. Aseptic meningitis is dangerous, only the form with the presence of the pathogen is detected in the laboratory, the symptoms are blurred (similar to the flu) with fever, headache, and intoxication. Typical neuralgic signs are absent. The temperature in some cases does not rise. Cerebrospinal fluid has normal values, there is no protein, there is a small number of neutrophils. If a tumor is suspected, a CT or MRI should be done.

Meningeal symptoms in adults are more pronounced than in children. This is due to the maturity of the nervous system.

Diagnostics

The disease has a clear clinical picture; a pediatrician can assume the presence of inflammation in the central nervous system when examining a child. The doctor needs to conduct a thorough analysis, the development of an epidemic is unacceptable.

The specialist gives directions for laboratory and other types of analyzes:

• general blood analysis. There is a slight leukocytosis and increased ​ . According to these indicators, the general condition of the patient is monitored;
• bacterial culture. The material is taken from the nose and throat. Determine the type of pathogen and identify sensitivity to antimicrobial drugs. This research cannot be done without. With the erroneous use of antibiotics, the patient's condition will worsen, and the pathogen will become resistant to the selected drug;
• definitions of the virus: PCR, ELISA, RIF. The state of immunity should be taken into account, with its deficiency, the results may be false-negative.
• CSF puncture. In acute serous meningitis, it will be transparent with an admixture of protein. In the tuberculous form, the content of glucose in the cerebrospinal fluid is increased. When taking a punctate, the liquid flows with increased pressure. There is a high content of lymphocytes;
• staining of a part of the cerebrospinal fluid and examination under a microscope. Infections are found;
• tuberculin test;
• additional, ECHO-EG, MRI, CT.

Differential Diagnosis

Differential diagnosis is based on clinical symptoms and CSF analysis. The main goal is to distinguish between two diseases: serous and purulent meningitis. It is necessary to distinguish between forms of serous inflammation of the meninges.

Treatment of serous meningitis

The therapy is carried out in a hospital setting. Quarantine must be observed, with the patient to contact only after putting on a mask. When the disease is prescribed the following:

• (Interferon, Acyclovir);
• antimicrobial agents. Sowing is done for a long time, which the patient does not have, so a wide range of agents are used. Are used penicillin preparations;
• agents that restore the microflora of the gastrointestinal tract;
• antimycotics in fungal etiology. Fungal disease is caused by immunodeficiency, relapse is possible;
• drugs against tuberculosis;
• to raise immunity, immunoglobulins are prescribed intravenously;
• anti-inflammatory drugs;
• dehydration drugs are used to combat high blood pressure. They reduce hypertension by removing fluid. Diuretics are administered Lasix);
• antipyretic at high temperature;
• to stop seizures, sedatives are prescribed, which are not addictive and are gently tolerated by children;
• nootropics for the protection of nerve cells;
• vitamins intravenously (namely);
• cerebral cortex polypeptides are administered after the end of therapy and are repeated every six months.

If aseptic meningitis is detected due to medication, all drugs should be immediately discontinued and symptomatic therapy should be carried out.

It is necessary to create the following conditions for a comfortable stay of the child in the hospital:

• subdued light, preferably thick curtains;
• there should be no sharp sounds;
• lack of stress (when crying, the child's nervous system is in a state of tension, his health deteriorates sharply);
• diet with no sweet, fatty, salty, hot.

Complications

With timely therapy, they should not be. After treatment of an advanced form of serous meningitis, the following conditions appear:

• frequent headaches;
• sleep disorders;
• memory impairment;
• convulsions;
• hearing or vision loss;
• lag in development and speech;
• epileptic seizures;
• paralysis;
• weakness of the musculoskeletal system.

Forecast

Favorable outcome with timely diagnosis and treatment of serous meningitis. After the introduction of antibiotics, the temperature subsides on the third day.

All symptoms in children completely disappear after ten days.

In some cases, after serous meningitis, memory is disturbed, and symptoms of cephalalgia appear (pass in a few months).

If the doctor did not suspect a tuberculosis form and did not prescribe anti-tuberculosis drugs, the outcome is fatal. In the case of his late therapy, there will be complications.

Prevention

• Before traveling to water bodies, parents need to make sure that there are no outbreaks of various diseases anywhere.
• Wash hands before meals and throughout the day.
• Wash meat, process fruits and vegetables with boiling water or special means.
• Eat right, walk a lot, temper, observe sleep patterns.
• Treat all diseases to the end, fully observing all the recommendations of specialists.

It is also imperative to exclude contact with street and unvaccinated animals. The house should be free of insects and rats.

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Serous meningitis is an inflammation of the membranes of the brain, provoked by the activation of pathogenic microflora of viral, fungal and bacterial origin. Accompanied by a pronounced symptom complex, which helps in the diagnosis. It is possible to determine the presence of serous meningitis and differentiate its pathogen only by bacteriological examination of the cerebrospinal fluid.

There are two routes of infection:

1. Direct - pathogenic microorganisms enter through mucous membranes, wounds and household appliances from a sick person to a healthy one.
2. Indirect - the inflammatory process develops as a result of a skull injury, in which the meninges become infected.

A distinctive feature of the serous type of meningitis is the active production of serous exudate. There is no necrotic process, as well as purulent accumulations, which makes this type of disease less dangerous.

After the penetration of microbes into the body and reduced immunity, they spread and settle in biological fluids. Weakened immunity plays a key role in the onset of the disease. If the natural defenses are immediately included in the work, then meningitis can be suppressed on its own without outside help at the stage of the first signs of a respiratory disease.

Most often, the inflammatory process is provoked by a viral infection, which develops with the activation of cytomegalovirus, herpes virus, enteroviruses, measles and mumps viruses. Less commonly, the disease is of a bacterial nature, and fungal infections are diagnosed extremely rarely and are the result of the progression of autoimmune processes in the body.

The risk group includes preschool children attending kindergarten. Frequent respiratory infections weaken the immune system, putting meningitis at risk. At a more mature age, to most of the bacteria that provoke the development of serous meningitis, a person develops stable immunity.

Routes of infection and incubation period

There are 5 routes of infection:

1. Airborne - viruses are released along with the air, saliva, tears of the patient. If a healthy person does not follow personal protective measures, the risks of infection are extremely high.
2. Contact - when touching the skin and mucous membranes of the patient, viruses can spread over different distances and infect several dozen people at once.
3. Household - the use of other people's personal hygiene items, clothing or other items guarantees infection, since viruses are perfectly adapted to life outside the human body, while maintaining their biological activity.
4. Water - characteristic for infection with enteroviruses that can accumulate in the intestine and spread with the bloodstream to the brain.
5. From rodents - infectious disease specialists have found that rats and mice are able to carry viruses that can provoke meningitis.
6. Non-infectious - associated with the progression of tumors inside the meninges, which compress the gray matter and cause a violation of brain activity.

The incubation period lasts on average 3-10 days. During this time, pathogenic microorganisms actively multiply, causing the release of serous exudate. In turn, this substance causes irritation and pressure on the membranes of the brain, causing a number of characteristic neurological symptoms.

Symptoms

Symptoms of serous meningitis depend on the degree of progression of the disease. The manifestation of the disease is accompanied by a sharp increase in temperature, which subsides on the 3rd-4th day of the disease, but returns on the 5th-6th day.

Manifestations in children

In childhood, in the presence of weak immunity, serous meningitis can have an acute course, the clinical manifestations of which are growing rapidly. The child shows anxiety, constantly lies and complains of pain in the head. Cephalgia increases with movement, so it is more convenient for the baby to lie on a flat surface with the back of the head thrown back.

A high temperature rises, after which signs of intoxication develop:

• drying of the mucous membranes and skin, intense thirst;
• lack of appetite, nausea, gushing vomiting;
• spasmodic abdominal pain, profuse diarrhoea.

After the active production of serous exudate, neurological and meningeal symptoms develop, which are characteristic exclusively for meningitis:

• tilting the back of the head and pulling the legs under the chest;
• constant tearfulness, lack of sleep;
• convulsions and muscle hypertonicity;
• paresis of the limbs, decreased reflexes.

Lack of help leads to the development of infectious-toxic shock, after which irreversible processes develop in the body.

Manifestations in adults

Serous meningitis in adults is characterized by a more prolonged incubation period and the gradual addition of clinical manifestations. Primary symptoms are associated with increasing intoxication:

• decrease in endurance;
• lack of appetite;
• muscle and joint pain.

The body temperature is rapidly rising, which cannot be eliminated with the help of medicines and any improvised means. Pronounced cephalalgia, which is aggravated by light and sharp sounds. On the 5-7th day, there are signs of a respiratory disease in the form of a runny nose, cough, sore throat.

With damage to the cranial nerves, drooping of the upper eyelid, strabismus, impaired hearing and vision, paralysis of the facial nerves appear. Rigidity of the posterior cervical muscles develops, in which it is impossible to press the chin to the chest. A slight relief in general well-being occurs when the back of the head is tilted back and the legs are pulled up to the chest (pose of a pointing dog).

Extremely rarely, serous meningitis provokes the development of a coma in adults. Usually, the disease slows down on the 15th day, and with complex treatment, the condition improves after a week.

Diagnostics

The clinic of serous meningitis helps to suggest the presence of the disease according to the characteristic symptom complex (tilting the head back and reflex bending of the legs in the joints). But the etiology of the disease and the pathogen is determined solely with the help of complex diagnostics:

1. A blood test is not an informative indicator, since ESR and leukocytosis only slightly exceed the norm.
2. The study of cerebrospinal fluid - the cerebrospinal fluid is almost transparent, sometimes it has impurities of gray threads. There is a slight increase in protein inclusions and a decrease in glucose levels.
3. Crops from the throat and nose - help to determine the quantitative and qualitative composition of the microflora of the mucous membranes, identifying the pathogen.

Lumbar puncture should be performed daily, since serous meningitis is characterized by a constant change in the picture. In the first days of the manifestation of the disease, leukocytosis develops with a predominance of neutrophils. The next day, the number of lymphocytes increases. After another 2-3 days, proteins and a lack of glucose may appear in the cerebrospinal fluid.

As auxiliary research methods, MRI and CT of the brain, encephalogram, tuberculin tests, electroneuromyography can be used.

Diagnosis of serous meningitis is a fairly lengthy procedure. To minimize the risks of complications, therapy is started as soon as data on the etiology of the disease are obtained. Further research methods can be carried out in the course of treatment.

Treatment

Treatment for serous meningitis depends on the pathogen causing the meningitis. This is determined in the cultures and analysis of the lumbar puncture.

The viral etiology of the disease is stopped with the help of antiviral therapy, which is based on drugs containing interferon. In the presence of pathologically reduced immunity, immunoglobulin injections can be administered. Herpes infection is effectively treated with Acyclovir.

The bacterial etiology of the disease requires antibiotic therapy with broad-spectrum drugs: Ceftriaxone, Cefazolin, Cefix, Ceftazidime. If the tuberculous nature of meningitis is detected, anti-tuberculosis therapy is prescribed in parallel.

Restoration of the water-lytic balance is possible with the help of drip introduction of biological mixtures. With their help, you can normalize the volume of freely circulating blood, as well as speed up the process of removing toxins and toxins.

Diuretics are prescribed to prevent the development of hydrocephalus. With their help, excess fluid is removed from the body, preventing the development of edema. In the case of the development of kidney pathologies, an artificial blood purification procedure may be indicated.

Symptomatic treatment involves the use of drugs of the NSAID group, which have antipyretic and moderate analgesic effects. Neuroprotectors and nootropics contribute to the restoration of the peripheral nervous system, as well as normalize brain activity. Anticonvulsants help reduce muscle hypertonicity, and also help eliminate cramps by normalizing sensitivity in the limbs.

Complications

With delayed treatment or an incorrectly selected drug, the following complications may develop:

• violation of brain activity;
• speech problems;
• distraction of attention;
• decreased fine motor skills;
• strabismus and decreased quality of vision;
• hearing loss;
• decreased sensation in the limbs;
• slow reflexes;
• epileptic seizures.

In especially neglected cases, which are preceded by the development of an infectious-toxic shock, a lethal outcome may develop. According to statistics, the serous form of meningitis is one of the easiest for the body. Mortality develops in the presence of severe immunodeficiencies and chronic diseases, which is only 1% of all cases of meningitis.

The consequences of serous meningitis for a child's body are more dangerous. Violation of brain activity provokes the development of inhibition of perception of information, which causes mental retardation. In more adult childhood, such children may differ in level of development from their peers.

Prevention

There are 5 essential principles of prevention that will help reduce the likelihood of infection:

1. Comprehensive strengthening of immunity - during the off-season, you need to support the body with vitamin complexes, spend more time in the fresh air, giving preference to proper healthy nutrition. Bad habits should be abandoned.
2. Minimizing contact with sick people (especially children) - during a period of high epidemiological danger, it is worth reducing visits to public places to a minimum.
3. Compliance with the rules of personal hygiene - hands should be washed after each visit to the toilet, as well as before eating.
4. Refuse to use personal hygiene items of strangers, as they may be infected.
5. Timely treatment of any inflammatory processes in the body, without triggering them to a chronic form.

Serous-purulent meningitis requires long-term treatment and further observation by a specialist, which will help reduce the likelihood of relapse.

Prevention of serous meningitis in young children involves a monthly visit to the pediatrician, as well as immediate seeking help if there are characteristic signs of meningitis. Self-medication is extremely life-threatening, as it entails a number of complications.

Forecast

With proper treatment, the symptoms of meningitis begin to recede for 3-5 days, and after 10-12 days there is a complete recovery. Up to 1 month, periodic headaches may persist, which later disappear. A favorable prognosis is due to the predominantly viral etiology of the disease, which allows the body to produce its own antibodies and effectively fight pathogens.

An unfavorable prognosis is observed with the tuberculous form of meningitis, as well as with delayed treatment in the presence of infectious-toxic shock. The risk group includes children under 1 year old and the elderly. Several specialists should be involved in their treatment at once. It is extremely important to visit a neurologist once a month to monitor the rehabilitation process and further development of the child, since meningitis can cause complications.