Meningitis

Description:

Meningitis - an inflammation of covers of a head and spinal cord. The inflammation of a firm meninx is designated a pachymeningitis, and an inflammation of a soft and web meninx - a pia-arachnitis.
In clinic the inflammation of a soft meninx most often meets and at the same time use the term "meningitis".

Meningitis symptoms:

Symptoms of all forms of acute meningitis very similar irrespective of an etiology. The diagnosis of meningitis is established on the basis of a combination of three syndromes:
    * all-infectious;
    * shell (meningeal);
    * inflammatory changes of cerebrospinal liquid.
Existence of one of them does not allow to diagnose meningitis authentically. For example, the shell symptoms can be caused by irritation of covers without their inflammation (meningism). Increase in quantity of cells in cerebrospinal liquid can be connected with reaction of covers to a tumor or the streamed blood. The diagnosis is specified on the basis of visual examination of cerebrospinal liquid, and also bacteriological, virologic and other diagnostic methods of infectious diseases taking into account an epidemiological situation and features of a clinical picture.
From all-infectious symptoms the fever, heat, usually temperature increase, inflammatory changes in peripheral blood (a leukocytosis, increase in SOE, etc.), sometimes skin rashes are characteristic. Heart rate in an early stage can be slowed down, however in process of progressing of a disease tachycardia develops. Breath becomes frequent, its rhythm is broken.
The headache, nausea, vomiting, the general hyperesthesia of skin, photophobia, meningeal pose, rigidity of cervical muscles, Kernig's signs, Brudzinsky, a malar symptom of Bekhterev, etc. belong to a meningeal syndrome. An initial symptom is the headache which accrues in the intensity. It is caused by irritation of pain receptors of a meninx and their vessels owing to inflammatory process, effect of toxin and irritation of baroreceptors as a result of increase in intracranial pressure. The headache intensive also has the holding apart, breaking off character. It can be diffusion or be localized more in frontal and occipital areas, irradiate in a neck and along a backbone, sometimes extends also to extremities. In an early stage the nausea and vomiting which are not connected with meal, arising against the background of strengthening of a headache can already be observed. At children often, and less often at adults, spasms develop. Psychomotor excitement, nonsense and hallucinations are possible, however when progressing a disease drowsiness and a sopor which then can pass into a coma develops.
Meningeal symptoms are shown by a reflex muscle tension owing to irritation of a meninx. Most often muscle tension of a nape and a Kernig's sign come to light. At the heavy course of meningitis the head is thrown back kzad, the stomach is pulled in, the front abdominal wall is strained, legs are given to a stomach, the opisthotonos (a meningeal pose of the patient) is found. The lockjaw, a malar symptom of Bekhterev (local morbidity are quite often observed at effleurage on a zygoma), morbidity of eyeglobes during the pressing and the movements by eyes, a skin hyperesthesia, hypersensitivity to noise, a loud conversation, smells, Brudzinsky's symptom (upper and lower). Patients prefer to lie not movably blindly in the darkened room.
At babies tension and protrusion of a fontanel, a symptom of "suspension" of Le Sage are observed.
On an eyeground the venous hyperemia, a papilledema can come to light. At a severe disease pupils are usually expanded, squint and a diplopia are sometimes noted. Swallowing difficulties, paresis and paralyzes of extremities with a hypomyotonia, Babinsky's sign, the diskoordination of movements and a tremor indicate defeat not only covers, but also brain substance that it is observed in a final stage of a disease. Control over sphincters of pelvic bodies is broken late, however the expressed mental disorders can promote development of a delay or incontience of urine.
The lumbar puncture should be carried out all patient with signs of irritation of a meninx. At meningitis likvorny pressure is more often increased. Low pressure happens at obstruction of likvorny ways usually in the field of a base of skull.
At senile age meningitis usually proceeds atypically: headaches are insignificant or are absent, Kernig's signs and Brudzinsky can not be; trembling of extremities and the head, psychomotor excitement or apathy, drowsiness are often observed.

Meningitis reasons:

Various pathogenic microorganisms can be its activators: viruses, bacteria, the elementary.

Treatment of Meningitis:

Characteristic of purulent meningitis is the activator of the bacterial nature. It can be actually any bacteria which got to soft tissues of a brain. The general for them is the principle of a massive antibioticotherapia, drugs of a broad spectrum of activity, the specific type of the activator and its sensitivity to antibiotics is not defined yet. Use of the drugs destroying population of bacteria allows to remove an origin of a disease and, respectively, leads to recovery. When determining like the activator a specific antibioticotherapia is carried out by the most effective drug concerning this bacterium.