Types of meningitis. Pre-hospital treatment


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

People die from meningitis

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

The causative agent of meningitis

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

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

Viral meningitis: how is it transmitted?

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

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

Causes of meningitis

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

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

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

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

Brain meningitis disease

Why can’t other infections reach the brain, but meningococcus, pneumococcus and Haemophilus influenzae manage to do so and develop the disease meningitis?

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

Signs of meningitis

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

Meningitis infection

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

What are the signs of meningitis?

The disease develops rapidly - literally in a few hours.

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

How does meningitis manifest?

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

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

The first symptoms of meningitis

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

Course of meningitis

Course of meningitis bacterial etiology usually rapid.

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

The most important questions about the treatment of bacterial meningitis

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

Diagnosis of meningitis

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

Tests for meningitis

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

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

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

How to treat meningitis

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

Treatment of meningitis

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

Antibiotics for meningitis

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

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

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

Purulent meningitis: consequences and complications

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

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

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

Prevention of meningitis

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

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

This article has been read 99,993 times.

Meningitis- This dangerous disease, which is an inflammation of the membrane of the brain (usually) or the spinal cord. Meningitis is short incubation period(up to 7 days) and can lead the patient to death in just a few hours. Therefore, everyone needs to know the symptoms of this disease.

Meningitis in adults can be primary or secondary. Primary is independent disease, which is called meningococcal infection, and inflammation immediately begins in the lining of the brain. Secondary meningitis is a consequence of diseases such as osteomyelitis of the skull bones, sinusitis, neck and face, as well as other foci of inflammation.

Symptoms of meningitis

The very first signs of meningitis in adults resemble progressive colds and then the following symptoms appear:

  • chills and fever, which are most severe in young adults and adolescents;
  • vomiting and constant nausea;
  • increased sensitivity to the light. The patient often lies facing the wall or covers his head with a blanket;
  • spasm of the muscles of the back of the head, due to which the patient cannot turn his head or tilt it;
  • acute, often unbearable, which intensifies significantly with loud sounds, bright light or head movements;
  • Kerning's sign. It lies in the fact that the patient cannot straighten the leg, bent at the hip and knee joints.

  • Brudzinski's sign:

– if the patient’s head in a supine position is raised to the chest, the legs are bent at the hips and knee joints;

– if light pressure is applied to the pubic plexus, the legs bend at the hip and knee joints;

– when testing for Kernig’s sign, the second leg also bends.


Brudzinski's sign - if the patient's head in a supine position is raised to the chest, the legs are bent at the hip and knee joints
  • the patient may experience increased sensitivity skin, and even a light touch can be painful;
  • decreased appetite;
  • shortness of breath and rapid shallow breathing;
  • Possible skin rash.

Symptoms of the disease largely depend on the type of meningitis, of which there are seven.

Meningitis in adults - there are 7 types

Aseptic meningitis

It is a consequence of undertreatment or can lead to death. The main symptoms are:

– fever;

– mental disorders;

– vomiting and nausea;

– decreased vision;

– curvature of the neck;

– increased sensitivity to light;

– chills and fever.

Treatment is the same as for viral form diseases. If the disease does not proceed at lightning speed, then when timely treatment after 10-12 days recovery occurs. In the fulminant form, a person dies in less than a day from renal, respiratory or cardiovascular failure.

Pneumococcal meningitis

Pneumococcus very often causes bacterial meningitis in adults, it is in second place after meningococcus. This type of disease is extremely difficult for patients to tolerate, with a high percentage of deaths. Increased risk people who have recently suffered a head injury, who have had meningitis before, people who have had their spleen removed and infectious lesions heart valve. and other long-term chronic diseases increase the likelihood of pneumococcal infection.

The main features are:

– raising the temperature to 40 degrees;

– blueness of hands and feet;

The disease develops very quickly, the patient can fall into a coma and die without leaving it. Deaths are common because meningitis develops quickly and the bacteria are quite resistant to antibiotics.

Tuberculous meningitis

This is a form of the disease that develops slowly. They have mild symptoms common to meningitis, as well as the following signs:

– chills and fever, temperature persists long time, but increases very slowly;

– appetite decreases, general malaise and weakness appear;

– catarrhal, nasopharyngitis;

– asthenia, lethargy, weight loss.

Diagnosis requires skin, brain tissue and x-ray tests. chest.

Despite its sluggish course, tuberculous meningitis can pose a threat to human life. The danger is that it is extremely difficult to diagnose it on your own, and the symptoms at the onset of the disease are not so significant for a person to see a doctor. Treatment lasts at least a year, the patient must take anti-tuberculosis drugs, sometimes steroids. BCG vaccination excludes the possibility of contracting tuberculous meningitis.

Diagnosis of the disease

A doctor can diagnose meningitis or suspicion of it based on the following signs:

  • fever;
  • torticollis;
  • mental disorders.

After the listed symptoms have been detected, the patient is referred to spinal tap. This analysis allows you to evaluate the bacterial picture of the spinal cord, as well as the structure and number of cells. A lumbar puncture is done between the 3rd and 4th lumbar vertebrae, with the game being inserted into the space between the spinal cord and its membrane (subarachnoid space).

Depending on the additional symptoms Encephalography, chest x-ray, fundus assessment, various immunological and bacteriological studies, as well may also be prescribed. All these studies are needed in order to determine the type of meningitis a person has and prescribe treatment.

Important! You cannot treat meningitis on your own, since if the drugs are selected incorrectly, death is likely. Most people who died from did not see a doctor in time or tried to treat the disease on their own.


Treatment of meningitis

The specifics of treatment depend on the type of disease diagnosed. In the vast majority of cases, the patient is hospitalized. Until a lumbar puncture has been performed, the patient is prescribed antibiotics general spectrum actions, and then prescribe more targeted treatment.

Bacterial and purulent meningitis are treated with antibiotics different spectrum actions. It is often necessary to change several drugs in order to identify the greatest sensitivity of bacteria to the drug. The selection of antibiotics also depends on the patient’s age and health status.


Viral meningitis is much more serious and causes severe nausea and headache. The patient is prescribed antiemetics and analgesics, and paracetamol is prescribed for high temperatures.

From general condition The organism and the type of pathogen determine how long the disease will last. On average, the treatment period lasts from 10 days to 3 weeks, if there are no complications.

Prevention of meningitis

Even now, in 2016, people are dying from meningitis due to the fact that the disease was not prevented in time. The most reliable way to protect yourself against most types of meningitis is through vaccinations. Most vaccinations are given in childhood, but adults and teenagers who have not previously been vaccinated can still get vaccinated. First of all, these are vaccinations against rubella, chickenpox, mumps, etc. These diseases themselves are dangerous in adulthood, and can also become causative agents of meningitis. A vaccine with meningococcal bacteria has also been developed, which reliably protects against this type of meningitis. Is not compulsory vaccination, but it is recommended for children and people who are at risk of getting meningitis (for example, they travel frequently).

People who have implants and whose spleen has been removed should be vaccinated with pneumococcal conjugate vaccine (PCV).

In addition to vaccination, the following rules will help protect against the disease:

  • Avoid contact with a person who has meningitis. When caring for a patient, you need to wash your hands with soap and change clothes that have touched the patient. If a person is being treated at home, then he must be isolated from other family members until he recovers so that the disease is not transmitted to them;
  • avoid animals and insects that are carriers. Primarily these are rats, mosquitoes and ticks. Therefore, when going to the forest, you must use insect repellent. Deratization should be carried out regularly in houses;
  • meningitis primarily affects people with weakened immune systems, so it is important to eat well, take periodic vitamins and healthy image life. Hypothermia in winter can also end in disaster, as it causes a sharp decline immunity.

Meningitis- this is dangerous and serious illness, which is much easier to prevent than to cure.

Among the many human diseases meningitis- one of the most dangerous. You can suffer from pneumonia on your feet, you can walk with tuberculosis for years, you can, with the help of “healers,” try to recover from venereal diseases for a long time. WITH meningitis Such “numbers” do not go through - either to the hospital, or...
Meningitis- a known disease. By at least, average person, without any special medical education, word " meningitis"knows and, although the features of the disease itself are not very clear, meningitis Everyone is afraid. An emergency doctor may say: “You have a sore throat (flu, pneumonia, enterocolitis, sinusitis, etc.). Get ready to the hospital quickly.” In response, he will definitely hear: “Doctor, is there no way to get treatment at home?” But if the word “meningitis” is uttered, even if not categorically: “You have meningitis!”, but with doubt: “It looks like meningitis,” you can say with confidence: a normal person will not even mention any treatment at home.
This attitude towards meningitis is generally understandable - less than 50 years have passed since the time when it became possible to treat it (meningitis). But if the mortality rate from most childhood diseases decreased during this time by 10-20 times or more, then for meningitis - only 2 times.
So what kind of disease is this, meningitis?
First of all, it should be noted that meningitis is an infectious disease. That is, the direct cause of the disease is certain microbes. Most human infections allow us to establish a clear relationship between the name of the disease and the name of its specific pathogen. Syphilis is a pale spirochete, scarlet fever is streptococcus, salmonellosis is salmonella, tuberculosis is Koch's bacillus, AIDS is the immunodeficiency virus, etc. At the same time, there is no specific connection between meningitis and the causative agent of meningitis.
The word "meningitis" itself means inflammation of the membranes of the brain, and the cause of this inflammation can be a huge number of microorganisms - bacteria, viruses, fungi. Infectious disease experts say, not without confidence, that under certain conditions any microorganism can cause meningitis in a person of any age. From this it is clear that meningitis can be different - different in the speed of development, in the severity of the condition, in the frequency of occurrence, and, most importantly, in the methods of treatment. All meningitis has one thing in common - real threat life and a high probability of complications.
For meningitis to occur, a specific pathogen must enter the cranial cavity and cause inflammation of the membranes of the brain. Sometimes this occurs when foci of infection occur in the immediate vicinity of the membranes of the brain - when purulent otitis, for example, or for sinusitis. Often the cause of meningitis is traumatic brain injury. But most often, microbes enter the cranial cavity through the bloodstream. It is obvious that the very fact of a microbe entering the blood, the very possibility of its “introduction” and subsequent reproduction on the meninges is determined by the state of immunity.
It should be noted that there are a number of, as a rule, birth defects immune system predisposing to the occurrence of meningitis. It is not surprising that in some families all children suffer from meningitis - although this disease is not so common, in comparison, for example, with sore throat, whooping cough, chickenpox or rubella. But if the role of immunity is generally clear, then so far it has not been possible to find a convincing explanation for the fact that boys suffer from meningitis 2-4 times more often than girls.
Depending on the type of pathogen, meningitis can be viral, bacterial, or fungal. Some protozoa (such as amoeba and toxoplasma) can also cause meningitis.
The development of viral meningitis can accompany the course of well-known infections - chickenpox, measles, rubella, mumps(mumps), defeat meninges occurs with influenza and infections caused by herpes viruses. In weakened patients, in the elderly, and in infants, meningitis caused by fungi occurs (it is clear that in these situations it is the lack of immunity that plays the leading role in the occurrence of the disease).
Of particular importance are bacterial meningitis. Any purulent focus in the body - pneumonia, infected burn, sore throat, various abscesses, etc. - can cause meningitis, provided that the pathogen enters the blood and reaches the meninges with the blood flow. It is clear that the well-known causative agents of purulent processes (staphylococci, streptococci, Pseudomonas aeruginosa, etc.) will be the causative agent of meningitis in this case. One of the most terrible is tuberculous meningitis - almost forgotten, it is now occurring more and more often.
At the same time, there is a microorganism that causes meningitis most often (60-70% of all bacterial meningitis). No wonder it's called that - meningococcus. Infection occurs by airborne droplets, meningococcus settles on the mucous membranes of the nasopharynx and can cause a condition very similar to a common respiratory viral infection - slight runny nose, redness of the throat - meningococcal nasopharyngitis. It was not for nothing that I used the phrase “may cause” - the fact is that hitting meningococcus into the body quite rarely leads to the onset of disease - the leading role here belongs to very special individual changes in immunity. In this regard, two facts are easily explained: the first is the risk of developing meningitis during contact, for example, in children's institutions is 1/1000 and the second is the frequent detection of meningococcus in the nasopharynx in completely healthy individuals (from 2 to 5% of children are healthy carriers) .
The body's inability to localize the microbe in the nasopharynx is accompanied by the penetration of meningococcus through the mucous membrane into the blood. With the bloodstream, it enters the meninges, eyes, ears, joints, lungs, adrenal glands, and in each of these organs a very dangerous inflammatory process. It is obvious that damage to the meninges is accompanied by the development meningococcal meningitis.
Sometimes meningococcus enters the blood quickly and in huge quantities. Arises meningococcal sepsis, or meningococcemia - perhaps the most terrible of all childhood infectious diseases. The microbe secretes poisons (toxins), under their influence multiple blockages of small vessels occur, blood clotting is impaired, and multiple hemorrhages appear on the body. Sometimes, within a few hours after the onset of the disease, hemorrhage occurs in the adrenal glands, and the arterial pressure and the person dies.
There is an amazingly dramatic pattern in the emergence of meningococcemia, which is as follows. The fact is that when a microbe penetrates the blood, it begins to react with certain antibodies that try to destroy meningococcus. It has been proven that there is cross-activity of a number of antibodies, i.e. if in large quantities There are antibodies, for example, to streptococcus, pneumococcus, staphylococcus - then these antibodies can have an inhibitory effect on meningococcus. So it turns out that children who are sick, have chronic foci of infections, have had pneumonia and many other illnesses, almost never get meningococcemia. The scary thing about meningococcemia is that within 10-12 hours an absolutely healthy child who has never been sick before can die!
All the above information is not intended to intimidate readers. Meningitis is treatable. But the results (duration and severity of the disease, the likelihood of complications) are closely related to the time that will be lost before the start of adequate therapy.
Obviously, the above-mentioned "timing of initiation of adequate therapy" depends on when human subjects present for medical care. Hence the urgent need for specific knowledge, so that later there will be no excruciating pain...
The essence of specific knowledge regarding meningitis is that the appearance of certain signs indicating the possibility of this disease requires immediate medical attention.
Inflammation of the meninges is characterized by a number of symptoms, but many of them are not specific - that is, their (symptoms) may also occur in other diseases that are much less dangerous. Most often this is what happens, but the slightest suspicion of the development of meningitis does not allow you to take risks and requires immediate hospitalization and careful medical supervision.
Let us now consider the most typical situations, each of which does not allow us to exclude the development of meningitis.

    If there is any background infectious disease- acute respiratory infections, chicken pox, measles, mumps, rubella, “fever” on the lips, etc. - perhaps not at the beginning of the disease (even more often not at the beginning) an intense headache appears, so strong that it worries more than all other symptoms if the headache is accompanied by nausea and vomiting.

    In all cases, when in the background elevated temperature body there are pains in the back and neck, aggravated by moving the head.

    Drowsiness, confusion, nausea, vomiting.

    Convulsions of any intensity and any duration.

    In children of the first year of life - fever + monotonous crying + bulging fontanel.

    Any (!!!) rash against a background of elevated temperature.

In addition to the symptoms described above, some reflexes change in a very definite way, and only a doctor can detect this.
It is important to remember and understand that common symptoms such as vomiting, nausea and headache in mandatory require medical examination- God saves man, who save himself.
Any rash accompanied by an elevated temperature may be meningococcemia. You (or your smart neighbors) may be confident that it is rubella, measles or “diathesis”. But the doctor must see the rash, and the sooner the better. If the elements of the rash look like hemorrhages, if new rashes appear quickly, if this is accompanied by vomiting and high fever, every chance should be taken to ensure that the patient immediately ends up in the hospital, preferably immediately in the infectious diseases department. Remember: when meningococcemia The count is not by hours, but by minutes.
It should be noted that even a highly qualified doctor can diagnose meningitis with absolute certainty only in one case - when the symptoms of irritation of the meninges are combined with the typical rash, which is described above. In all other cases, the diagnosis can only be suspected with varying degrees of probability.
The only way to confirm or exclude meningitis is a spinal (lumbar) puncture. The fact is that a special cerebrospinal fluid circulates in the brain and spinal cord - cerebrospinal fluid. With any inflammation of the brain and (or) its membranes, inflammatory cells accumulate in the cerebrospinal fluid; the appearance of the cerebrospinal fluid (normally colorless and transparent) often changes - it becomes cloudy. The study of cerebrospinal fluid allows not only to establish a diagnosis meningitis, but also to answer the question of what kind of meningitis it is - bacterial (purulent) or viral, which is crucial in choosing a treatment option.
Unfortunately, at a purely philistine level, there is a very widespread opinion about the enormous dangers that a spinal puncture poses. In fact, these fears are absolutely unfounded - the puncture of the spinal canal is carried out between the lumbar vertebrae at the level where no nerve trunks extend from the spinal cord, so there are no mythical paralysis after this manipulation. From a legal point of view, the doctor is obliged to conduct spinal tap if there is a real suspicion of meningitis. It should be noted that puncture has not only diagnostic, but also therapeutic usefulness. For any meningitis, as a rule, there is an increase intracranial pressure, the consequence of the latter is a severe headache. Taking a small amount of cerebrospinal fluid can reduce blood pressure and significantly alleviate the patient’s condition. During a puncture, antibiotics are often administered into the spinal canal. So, for example, when tuberculous meningitis the only chance to save the patient is frequent (often daily) punctures, during which spinal canal a special version of streptomycin is introduced.
Taking into account the above information, it becomes clear that meningitis treatment depends on the type of pathogen. The main thing in the treatment of bacterial meningitis- use of antibiotics. The choice of a specific drug depends on the sensitivity of the particular bacterium and whether the antibiotic is able to penetrate into cerebrospinal fluid. With timely use antibacterial drugs the chances of success are very high.
With viral meningitis the situation is fundamentally different - antiviral drugs practically none, the exception is acyclovir, but it is used only for herpes infections (let me remind you that chicken pox is one of the variants of herpes). Fortunately, viral meningitis have a more favorable course compared to bacterial ones.
But helping a patient is not limited to just influencing the pathogen. The doctor has the opportunity to normalize intracranial pressure, eliminate toxicosis, improve work nerve cells and cerebral vessels, use powerful anti-inflammatory drugs.
Timely treatment started meningitis within two to three days leads to a significant improvement in the condition, and in the future almost always to a complete cure without any consequences.
I emphasize once again: timely treatment started...

The first symptoms of meningitis are most often:

  • heat(39-40 degrees);
  • severe chills;
  • headache;
  • weakness;
  • loss of appetite;
  • excitement or, conversely, lethargy.

On the first or second day (against the background of a headache and high temperature), a pink or red rash may appear, which begins from the feet and legs, gradually spreading higher and higher - up to the face. The rash resembles small bruises that disappear with pressure.

If you notice this symptom in yourself or in a patient, immediately call an ambulance, since this is a signal that sepsis is developing and if delayed (without qualified medical care), the matter can end in death.

Also, attention should be paid to a number of early symptoms meningitis:

  1. Rigidity of the neck (immobility) - the head is difficult or impossible to bend, the patient cannot reach his chin to his chest. This is one of the earliest signs.
  2. Brudzinski's symptoms - involuntary flexion of the legs occurs (at the knees and hip joints) when tilting the head towards the chest area.
  3. Kernig's symptoms - legs bent at the knees do not straighten.
  4. a large fontanelle may swell.
  5. Another characteristic symptom is that the patient turns his face to the wall and covers his head with a blanket, while curling up in a ball position and throwing his head back.
  6. In addition, you can note: blurred vision, double vision, confusion, hearing loss.

Signs of meningitis by type

Primary

With primary meningitis, an acute infectious process occurs, which is caused by. The trigger for the development of the disease is weakened immunity caused by hypothermia and viral infections. In this case, the disease develops independently, without progression infectious processes in any organ. For example, bacteria can enter the body through the respiratory system.

How does primary meningitis begin?:

  • Strong headache;
  • fever, chills;
  • high body temperature;
  • light intolerance and sharp sounds;
  • the appearance of a rash on the body;
  • motor activity, which is often replaced by lethargy;
  • loss of consciousness may occur;
  • stiff neck;
  • Sometimes convulsions occur.

Secondary

The disease occurs against the background of any infectious disease (after measles, mumps, syphilis, tuberculosis, pneumonia, sinusitis, tonsillitis, otitis, with skull injuries), and is often caused by pneumococci, less often staphylococci, streptococci, but also meningococci (as in case of primary meningitis).

  • general weakness;
  • malaise;
  • dizziness;
  • chills with fever;
  • temperature rise up to 40 degrees;
  • a sharp headache that gradually gets worse;
  • nausea and profuse vomiting;
  • mental changes occur;
  • the patient refuses to eat and drink;
  • children may experience an increase in head size;
  • insomnia;
  • hallucinations;
  • in rare severe cases - coma.

Symptoms of primary and secondary disease may be of a similar nature. Only a doctor can determine the truth and prescribe appropriate treatment.

General symptoms

Besides the above signs(headache, fever, etc.), which can occur both with primary and secondary meningitis, there are a number of other characteristic of this disease symptoms.

General infectious signs of meningitis:

  • pale skin;
  • pain in joints and muscles;
  • nasolabial triangle bluish in color;
  • a constant feeling of thirst;
  • decreased blood pressure;
  • dyspnea;
  • rapid pulse;
  • Lesage's symptom in children - when a child is held in the armpits (suspended), he bends his legs to his stomach;
  • increased tactile sensitivity.

Meningeal syndrome

This the first cerebral symptoms of the disease, which can be characterized by signs:

  1. Severe bursting headache - occurs in all patients and occurs due to increased intracranial pressure. The pain spreads throughout the head and is not localized in one place. This may cause pressure on the eyes and ears. Analgesics do not give the desired effect - the pain does not go away.
  2. Dizziness, “fountain” vomiting, fear of light and sound - these symptoms appear on the second or third day of the disease. Vomiting usually occurs with increased headache and does not bring relief. Due to increased tactile sensitivity (due to irritation of the receptors of the meninges), the patient may experience pain even with a light touch to any area of ​​the skin.
  3. noted strong excitement and restlessness, diarrhea, frequent regurgitation, drowsiness and cramps.

What to do in such a situation?

If you notice symptoms of meningitis in yourself or your relative/friend, you should immediately call an ambulance to prescribe appropriate therapy. At severe forms illness, patients are hospitalized in the infectious diseases department of the hospital.

This is necessary for two reasons:

  1. without inpatient treatment, the patient’s condition may deteriorate significantly and lead to irreversible consequences (disability, death);
  2. Close relatives can also catch the infection.

An infectious disease specialist treats this disease. If the disease occurs without pronounced symptoms (chills, high temperature), is accompanied only by a headache, and the patient doubts that these are signs of meningitis, you can consult a neurologist.

However, if confidence in correct diagnosis is absent, it is better to consult an infectious disease specialist or a general practitioner, who will decide on subsequent tactics. There is no point in taking any painkillers - it will not help.

Meningitis is an inflammatory process in the membranes of the brain and spinal cord. The disease is very dangerous and if meningitis is suspected, the patient should be hospitalized as soon as possible, since it can only be treated in a hospital, regardless of the patient’s age.

Meningitis is believed to be more common in children. The failure or high permeability of the blood-brain barrier in children determines not so much the incidence of morbidity in children, but the severity of the disease and the frequency of deaths (substances that should not penetrate there penetrate into the brain, causing seizures and other cortical or pyramidal disorders).

Meningitis is dangerous because even with timely, proper therapy it can cause serious complications and long-term consequences, such as recurrent headaches, decreased hearing, vision, dizziness, epileptic seizures, which can last several years or remain for life.

Regardless of the causes of occurrence, the causative agent of infection, the localization of the process, clinical manifestations diseases have several common first signs of meningitis.

The first symptoms of meningitis

Meningitis is such a serious, dangerous disease, complications of which can lead to disability and even fatal outcome Therefore, every person should know how to identify meningitis, what its characteristic symptoms are, how meningitis manifests itself, in order to seek medical help as early as possible and begin adequate treatment on time.

General infectious symptoms

One of the symptoms of meningitis: if you lay the patient on his back and tilt his head to his chest, his legs will involuntarily bend.

This is primarily intoxication:

  • high body temperature
  • pale skin
  • pain in muscles and joints
  • dyspnea, rapid pulse, cyanosis of the nasolabial triangle
  • at severe course may have low blood pressure
  • loss of appetite, complete refusal to eat
  • patients feel thirsty and therefore drink a lot; refusal to drink is regarded as an unfavorable sign.

Meningeal syndrome

These are the first cerebral symptoms of meningitis, such as:

Headache

occurs due to the toxic effect of infection on the meninges, due to increased intracranial pressure, it is observed in all patients with any meningitis. Headache bursting, very intense, intensifies during movement, sharp sounds and light stimulation, is not localized in individual parts, but is felt throughout the head. Moreover, taking analgesics has no effect and does not relieve pain.

Dizziness, photophobia, sound sensitivity, vomiting

They appear on the 2-3rd day of illness. Vomiting may occur at the peak of the headache; it does not bring relief. Usually this vomiting is a fountain and is not associated with food intake. Increased visual, tactile and sound sensitivity develops due to irritation of the cells of the brain ganglia, dorsal roots and receptors of the meninges; this significantly reduces the threshold of sensitivity to any irritants. Even a slight touch of the patient can cause increased pain in the patient.

Features of symptoms in infants

Infants are very excited, restless, often cry out, become very excited when touched, they also often have diarrhea, drowsiness, and repeated regurgitation. In young children, one of the first signs of meningitis is often convulsions, often repeated. Adult patients usually cover their heads with a blanket and lie facing the wall. If at the onset of the disease in adults and adolescents it is accompanied by convulsive twitching, this is an unfavorable sign.

From the first days of the disease, the first symptoms of meningitis are observed:

    • stiff neck– difficult or impossible bending of the head. This is the most early sign meningitis and permanent.
    • Kernig's symptoms– a condition when the legs, bent at the knees and hip joints, cannot straighten.
    • Brudzinski's symptoms – upper symptom characterized by involuntary bending of the legs when the head is tilted to the chest. If you lay the patient on his back and tilt his head to his chest, the legs at the knee and hip joints will involuntarily bend. Average symptom– involuntary bending of the patient’s legs if pressure is applied to the area of ​​the symphysis pubis. Lower symptom– when checking the Kernig sign, the other leg involuntarily bends.
  • Lesage's symptoms– in young children, some characteristic meningeal symptoms are not clearly expressed, so the large fontanel is examined. It bulges, throbs and is tense. They also check for the posture of a pointing dog - when the child is held under the armpits, he throws his head back, pulls his legs towards his stomach - this is Lesage's symptom.
  • The man takes a forced kicking dog (trigger) pose. This is when the patient covers his face with a blanket and turns to the wall, brings his bent legs to his stomach in a position on his side and throws back his head, as this relieves the tension of the membranes and reduces headaches.
  • Patients with meningitis may also have the following characteristic pain:
    • Bekhterev's symptom - contraction of facial muscles when tapping on the zygomatic arch
    • Pulatov's symptom - pain when tapping the skull
    • Mendel's sign - pain when pressing on the area of ​​the external auditory canal
    • Pain when pressing on the exit points of the cranial nerves ( for example, trigeminal, under the eye, in the middle of the eyebrow).
  • In addition, damage to the cranial nerves can clinically manifest itself as the following symptoms:
    • decreased vision
    • double vision
    • nystagmus
    • ptosis
    • squint
    • paresis of facial muscles
    • hearing loss
    • in most cases, patients experience changes and confusion.
  • In the first days of illness, the patient generally experiences the following first signs of meningitis:
    • excitement, which may increase in the future
    • accompanied by hallucinations, motor restlessness
    • or, on the contrary, be replaced by stupor, lethargy
    • up to entering a comatose state.

From the first to second day, against the background of a rise in temperature and headache, a pink or red rash appears that disappears with pressure. Within a few hours it becomes hemorrhagic, that is, a rash in the form of bruises (cherry pits) with a darker middle of varying sizes. It starts from the feet, legs, creeping onto the hips and buttocks and spreading higher and higher (up to the face).

This - dangerous signal, and an ambulance must be called immediately, otherwise the matter could quickly end in death. The rash is the necrosis of soft tissues against the background of incipient sepsis caused by meningococcus. Septicemia can occur without pronounced cerebral symptoms. A rash combined with fever is enough to urgently call an ambulance.