Acute serous meningitis. Serous meningitis in children - symptoms, treatment, prevention

Serous meningitis- inflammation of the meninges of a non-purulent nature, which is accompanied by severe intoxication and the development of life-threatening damage to the central nervous system... It is more common in the elderly, young children and people with immunodeficiency, but can occur in anyone, regardless of age.

Treatment is carried out only in specialized hospitals. It is important to notice the first signs of meningitis in order to promptly apply for medical help and minimize complications and consequences.

What is Serous Meningitis

Serous meningitis is characterized by the occurrence of aseptic (non-purulent) inflammation of the meninges with increased production of cerebrospinal fluid (cerebrospinal fluid), in which protein impurities and single blood cells are found.

Serous meningitis is not an independent disease, as the lesion of the meninges is called. Theoretically, in this form, any viral infection and some are bacterial. Therefore, we can say that serous meningitis is a complication of infectious diseases or a variant of their course in persons with latent or overt immunodeficiency (while in healthy people these same infections will proceed without affecting the meninges of the brain).

Unlike purulent exudate in bacterial meningitis, proteolytic enzymes are not part of the serous exudate. This means that inflammation does not melt the brain tissue, therefore the disease in most cases is easier to carry and has more favorable forecasts .

By their origin, meningitis is divided into:

1. Primary - damage to the membranes of the brain occurs initially.
2. Secondary - signs of meningitis develop against the background of a previous viral or bacterial pathology, for example, after enterovirus infection or flu.

By the nature of the course, the pathology can be acute, subacute or chronic form.

In the clinical practice of infectious disease doctors and neurologists, the anatomical classification of serous meningitis is used:

1. Pachymeningitis - with a predominant lesion of the solid meninges(located just under the bones of the skull).
2. Leptomeningitis - with the involvement of the soft (located immediately under the hard) and arachnoid (covers the brain cells) membranes in the pathological process.

Due to the peculiarities of the course and changes occurring in the body, an isolated lesion arachnoid, is not included in the group of meningitis.

Causes

The risk group includes all people who have temporary or permanent immunodeficiency states:

• premature babies;
• patients with HIV / AIDS;
• persons with blood diseases, severe pathologies internal organs;
• cancer patients undergoing radiation and chemotherapy, immunosuppressive drugs, or high doses corticosteroids;
• emaciated people;
• children with congenital immunodeficiencies.

By etiology, all serous meningitis is divided into microbial (caused by viruses, bacteria, fungal microorganisms), tumor and traumatic (arising after open or closed traumatic brain injury).

More than 80% of cases of serous meningitis are provoked by viruses:

• Coxsackie;
• flu;
• herpes simplex;
• Epstein-Barr;
• chickenpox, measles, mumps;
• cytomegalovirus, adenovirus and enterovirus.

Less commonly, bacterial agents cause serous meningitis. Specific serous brain damage is observed in patients with tuberculosis, syphilis, leptospirosis. Fungal variants of the disease, which develop when the spores of the fungus are inhaled from the environment, are also diagnosed.

Transmission routes

Since meningitis can be caused by a variety of pathogens, the routes of transmission for these infectious agents are numerous.

Diseases that can be complicated by inflammation of the brain can be transmitted in the following ways:

1. Airborne droplets on contact with a source of infection. This is how the causative agents of serous meningitis are transmitted, which are localized in the mucous membrane of the respiratory tract. When talking, coughing or sneezing, pathogens enter the environment and then enter healthy body with contaminated air.
2. Contact route of infection. It is implemented when a healthy person comes into contact with the infected skin of the patient, contaminated household items (dishes, towels, bed linen, toys).
3. Eating contaminated food (fruits, vegetables), accidentally swallowing water when swimming in open water bodies and pools, neglect of personal hygiene rules.

Anyone can contract viruses and some bacteria that cause serous meningitis. However, not all cases develop inflammation of the meninges.. Pathologies are more susceptible to persons with weakened immunity.

Pathogenesis

Through the "entrance gate", which can be the mucous membrane of the respiratory tract or gastrointestinal tract, skin, infectious agents (viruses, bacteria or fungi) enter the bloodstream and spread throughout the body, where they begin to attack immune cells... In the presence of specific immunity, obtained as a result of vaccination or after an illness, such as chickenpox, the disease quickly passes.

If the body's defenses are weakened by concomitant pathology or due to the intake of certain medications (cytostatics, immunosuppressants, corticosteroids), microbes penetrate the blood-brain barrier and cause inflammation of the meninges with pathological vascular reaction.

The vessels expand, fill with blood, and fluid and blood cells - erythrocytes, lymphocytes - go out of them. This leads to edema, an increase in cerebrospinal fluid volume and intracranial hypertension (increased pressure of cerebrospinal fluid on the surrounding tissue). This provokes compression of brain cells and the appearance clinical symptoms.

Special forms

Almost all variants of serous viral meningitis have a similar onset, symptoms and test data. But in the practice of infectious disease doctors, there are special forms of the disease, the course of which differs from the standard ones, these include:

• Tuberculous meningitis. Secondary inflammation of the meninges, which occurs against the background of tuberculosis of the lungs or other internal organs (kidneys, gastrointestinal tract, bones). Most often develops in malnourished patients and young children. The incubation period is 10-14 days, after which the body temperature rises, dizziness occurs. With tuberculous meningitis, patients are disturbed by severe headaches, indomitable nausea and vomiting, squint develops, and vision decreases. In the absence of therapy, the disease becomes chronic or is complicated by paralysis, coma.
• Acute lymphocytic choriomeningitis (Armstrong's meningitis). The causative agent of the disease is an adenovirus that enters the body through the use of contaminated products, by airborne droplets or by damage to the skin. The source of infection is house mice, rats, Guinea pigs, dogs. Clinical signs develop one week after infection. The disease at the very beginning is manifested by pharyngitis, general intoxication, then neurological symptoms develop.
• Meningitis with mumps. Inflammation of the central nervous system occurs 1 month after infection with "mumps". Symptoms are pronounced, patients have drowsiness, intense headaches, severe vomiting, cramps and abdominal pain. Enlarged submandibular The lymph nodes, due to which the face is greatly rounded. Pathology is diagnosed more often in boys than in girls.
• Fungal meningitis. It occurs in patients with HIV / AIDS and in people taking immunosuppressive drugs in connection with organ or bone marrow transplants. Pathology develops slowly and is almost asymptomatic, which complicates its diagnosis and treatment.

Apart from infectious lesions of the meninges, there is aseptic serous meningitis. Doctors make such a diagnosis in the absence of an identified pathogen. The disease occurs against the background of certain tumors, cysts, when taking certain drugs... Aseptic meningitis is dangerous, since significant neurological symptoms are absent during its development.

Clinically, the pathology resembles the flu with fever, headache and signs of intoxication. Liquor has normal performance, viruses and bacteria are not detected in it, there is no protein, there is no a large number of neutrophils.

If aseptic meningitis is suspected, CT or MRI of the brain should be done.

Serous meningitis symptoms

Serous meningitis can be the onset of the disease, in this case, immediately appear neurological symptoms... Or it can be a complication / stage in the development of pathology, then at first the usual symptoms of infection are characteristic, and as the disease progresses, neurological symptoms appear.

Massive diseases of serous meningitis are possible in close groups, more often in kindergartens - in kindergartens and schools. Perhaps this is because it causes inflammation in such situations by a virus (less often a bacterium) with airborne droplets or contact-household transmission, which has a tropism for the tissues of the meninges. In some, the infection can proceed easily, for example, in a flu-like variant, while in weakened children and adults, the membranes of the brain are immediately affected.

Serous meningitis usually begins acutely, with a sharp increase in body temperature and the appearance of a headache. Sometimes the symptoms of the underlying disease come to the fore, for example, flu, chickenpox, etc. After a while, signs of intoxication join:

• muscle and joint pain;
• general weakness, lethargy;
• severe drowsiness;
• decreased appetite.

After several hours of intoxication syndrome, signs of damage to the central nervous system are clearly manifested.

Table - Neurological symptoms in serous meningitis

Cerebral	Meningeal	Focal
Moderate to severe persistent headache, which is not stopped by the use of conventional analgesics and is enhanced by the influence of external stimuli (loud sounds, bright light, strong odors). Severe nausea, vomiting in a fountain, not relieving. Cutaneous hyperesthesia - increased sensitivity to stimuli, touch. Increased receptivity to sounds - hyperacusis. Photophobia. Dizziness, generalized tonic-clonic seizures, impaired consciousness and coma.	A specific meningeal posture is the Pointing Dog Pose. With her, the stomach is pulled in in the form of a boat, the legs are bent at the knee and hip joints, tense, pulled up to the stomach. The arms are bent at the elbows, tightly pressed to the body. Stiff neck. The result of irritation of the meninges is a strong tension in the muscular frame of the occiput. The head of a patient with meningitis is thrown back, a person cannot lower it, touch his chin to his chest.	They occur when the cranial nerves or areas of the cerebral cortex are damaged. These include: ● Strabismus. ● Diplopia (double vision). ● Omission upper eyelid. ● Impaired swallowing. ● Decreased or lost hearing. ● Impaired sense of smell. ● Unsteadiness of gait. ● Amnesia. ● Hallucinations and delusions.

Signs of serous meningitis in infants are:

• Lethargy, drowsiness, breast refusal.
• Constant loud screaming, crying, anxiety.
• Convulsions, typical "Pointing Dog" pose.
• Bulging fontanelle on the head, which is well felt when you touch it with your palm.

When these symptoms appear, it is necessary to call an ambulance team or urgently go to an infectious diseases hospital.

How to diagnose serous meningitis

To establish a diagnosis, the doctor collects complaints and anamnesis from the patient or, in the event of a pathology in little child, interview his parents. It is important to determine when the first symptoms appeared, how the disease began and how it developed, not to miss the presence of contact with infectious patients.

Meningitis is a disease characterized by inflammation of the lining of the brain. The difference between serous meningitis and other types of this disease is that the fluid released from the vessels in the cavity and tissue does not contain pus.

Because of this, there is no "melting" of brain cells and their death. In this regard, this type of disease is easier than purulent type meningitis, and has a better prognosis.

Children 3 - 6 years old are most susceptible to serous meningitis. In adults, it manifests itself less often, most often in patients aged 20-30 years. This is due to the fact that people of these ages are most susceptible to contacts and an aggressive external environment.

The development of the disease begins with the penetration of the pathogen into the body or traumatic brain injury. Getting into the meninges, the pathogen provokes inflammatory process... If this disease is not noticed in time, you can get disastrous consequences. The disease is very serious and dangerous.

The most common causative agent of serous meningitis are viruses:

• polio;
• flu;
• herpes;
• measles;
• enteroviruses;
• adenoviruses;
• Epstein-Barr virus;
• cytomegalovirus;
• paramyxoviruses.

Attention! The main reason for the occurrence of meningitis is a weakened immune system that is unable to cope with pathogenic microorganisms.

Aseptic serous meningitis caused by concomitant diseases is distinguished:

1. Cysts and brain tumors.
2. Systemic diseases.

Classification

Depending on the type of pathogen, there are:

Infection routes and incubation period

The disease is seasonal in nature, most often cases of infection are detected in the summer.

The pathogen enters the body in the following ways:

• Airborne. The pathogenic agent, located on the mucous membranes of the respiratory tract, spreads into the environment during breathing and sneezing.
• Contact. The pathogen is found on the personal hygiene items of an infected person. If the rules of hygiene are not followed, it is transmitted to a healthy person and provokes the development of the disease.
• Water. Infection occurs when swimming in open reservoirs through water.

Separately, the placental pathway is isolated, when the pathogen is transmitted from an infected mother to the fetus.

The incubation period is the time between the entry of infection into the body and the development of the first symptoms of the disease. For serous meningitis, it is 2 to 4 days.

Important! After the diagnosis is made, it is necessary to examine everyone who came into contact with the patient during this period. However, the disease often begins acutely with a rise in temperature and copies SARS and influenza.

Symptoms in adults

After the end of the incubation period, the first signs of the disease appear. They differ in degree of manifestation depending on individual characteristics the patient.

The first symptoms of serous meningitis in adults:

The main symptoms that help distinguish serous meningitis from other diseases in adults are:

• Stiffness of the muscles of the neck and back, which manifests itself in the inability to tilt the head to the chest.
• Muscle dysfunction, difficulty swallowing.
• Positive reaction to Kernig's test: after bending the leg at the knee and hip joints, it is impossible to straighten the knee joint.
• A positive reaction to the Brudzinsky test: when bending the neck forward, lying on his back, the patient pulls his legs to the chest.

Important! If you experience these symptoms, see your doctor immediately. This will help to avoid the development of complications and deterioration of health, and also will not lead to irreparable consequences.

After 5-7 days, the intensity of symptoms decreases, but this does not mean that the disease has passed.

Diagnostic methods

Diagnosis of serous meningitis in adults is primarily aimed at identifying the meningeal syndrome.

Meningeal syndrome manifests itself in the form of:

• positive reaction to samples of Kernig and Brudzinsky;
• stiff neck and back muscles.

Anamnesis is also collected, including the presence of contact with those infected in last days before the disease. In addition, laboratory tests and other diagnostic methods are carried out:

The main task differential diagnosis- to distinguish serous meningitis from purulent, tick-borne encephalitis, subarachnoid hemorrhage and arachnoiditis.

Serous type treatment

If this disease is suspected, the patient is immediately admitted to the hospital... After that, he is examined and treated by an infectious disease specialist and a neurologist. The duration of treatment is 7-10 days.

Refusal of hospitalization is possible only if the disease is mild. However, with meningitis, it is necessary to constantly monitor changes in the patient's condition, which a non-specialist cannot do.

Also spend diagnostic procedures and it is possible to correct the course of therapy in a timely manner only if inpatient treatment... At home, this is impossible, besides wrong treatment will lead to complications, up to the death of a person.

The main goal of treating serous meningitis in adults is to eradicate the causative agent of the disease. Different drugs are prescribed depending on the type of agent:

• Acyclovir.
• Antibiotics wide range, Ceftriaxone, Ftivazid, Chloridine.
• Fluorocytosine, Amphotericin B.
• For the elimination of toxins - Plisorb, Gemodez.
• Pain relievers - analgin.
• Antiemetic - Cerucal.

Attention! Do not take medications without a doctor's prescription. The wrong reception will not only not improve the patient's well-being, but will also cause him irreparable harm.

Consequences and complications

Serous meningitis leaves behind the following consequences, which persist in the first few months after the illness. The main complications after illness include:

• headache;
• weakness;
• deterioration of attention and memory.

It is also possible to develop complications in a severe course of the disease:

Every person during his life regularly encounters a headache. Sometimes it is a consequence chronic fatigue and passes after rest, but there are cases in which this symptom indicates a serious damage to the nervous system. One of these diseases is serous. This ailment occurs in patients of different ages and sex, leading to adverse effects on the body. That is why it is necessary to know the first signs of the development of the disease and promptly seek help from a specialist.

What is serous meningitis

Serous meningitis is an infection of the head and spinal cord which is caused by various pathogenic agents. In their role can be bacteria, viruses, fungi and even protozoa. When a microbe enters the patient's body, it begins to multiply with the formation of a large amount of toxic substances. The spread of infection occurs mainly along the nerve fibers, as a result of which damage to the brain and spinal cord develops.

Meningitis causes the brain to swell

With serous meningitis, no blood or pus impurities are observed in the cerebrospinal fluid, which is typical for other varieties of this pathology.

The transmission of the disease is carried out mainly by aerogenic means. Particles of saliva and other biological secretions of the patient in the form of droplets hang in the air and are swallowed a healthy person... A weakened immune system cannot adequately respond to infection, resulting in a clinical picture with general intoxication.

Existing varieties of the disease

Classification of meningitis depending on its origin:

• primary (the disease arose independently in an initially healthy body);
• secondary (formed against the background of an already existing infection and is its complication: tuberculosis, syphilis, HIV).

Varieties of ailment by type of pathogen:

Serous meningitis develops against the background of infection with pathogenic microorganisms (bacteria, viruses, or fungi). In a person with a strong immune systemic disease, the disease is mild or does not occur at all. Factors that increase the likelihood of developing an ailment include:

• malignant or benign formations of various organs;
• colds (flu, ARVI);
• infectious pathologies (rubella, scarlet fever, syphilis, HIV, tuberculosis, diphtheria);
• inflammatory processes (colitis, enteritis, gastritis, cystitis);
• primary and secondary immune deficiencies;
• living in an ecologically unfavorable region with air, water and soil pollution;
• work in hazardous enterprises (contact with heavy metals, radiation);
• frequent stress;
• alcohol and nicotine abuse;
• taking narcotic drugs.

The main clinical manifestations of serous meningitis

The incubation period of the pathology is from 2 to 12 days. Often, the disease develops acutely, with a predominance of symptoms of intoxication and weakening of the body. As the patient progresses, the patient's condition worsens. The main manifestations of serous meningitis include:

• a rise in body temperature up to 39 degrees;
• change in behavior (aggressiveness, inadequate response to external factors);
• chills and heavy sweats at night;
• the presence of profuse mucous discharge from the nose;
• the formation of rashes on the skin, surrounded by a hemorrhage corolla;
• sleep disturbances;
• excruciating headaches with nausea and vomiting;
• photophobia;
• hypersensitivity to sound stimuli and odors;
• loss of appetite and refusal to eat;
• forced position (cocked position);
• soreness of the bones of the skull and spine when probing;
• change in the size of the pupils;
• violation of orientation in time, space, self;
• loss of hearing, sight and smell;
• loss of sensitivity;
• the rise muscle tone(inability to straighten a limb).

Photo gallery: the main symptoms of the development of the disease

Changes in pupil size are observed when the brain is damaged Intense headache is the first sign of meningitis The appearance of a rash indicates a generalization of the process.

Features of the disease in infants

The course of the pathological process in a child is significantly different from the development of serous meningitis in an adult. The baby's body, due to the weakness of the immune system, is unable to fully activate defense mechanisms: that is why the disease begins with a pronounced intoxication syndrome. In infants, the body temperature rises to 39-40 degrees, they refuse to eat and constantly sleep. Development of nausea and vomiting is possible, negative reaction to the light in the form of crying. An unfavorable prognostic sign is the formation of febrile seizures - uncoordinated spontaneous twitching of the limbs and head.

Due to dehydration and a deficiency of mineral elements, the baby has a large fontanel - the opening between the bony plates of the skull. Such a patient must be urgently admitted to the intensive care unit.

A retraction of the fontanelle is a sign of dehydration

An important clinical sign is the symptom of suspension: a newborn baby is taken under the armpits and lifted. With the development of meningitis, there is an increase in the bent in knee joints legs to chest.

Suspension symptom is positive in the development of meningitis in infants

Video: Elena Malysheva talks about the symptoms of the disease

Methods for the diagnosis of serous meningitis

If an infection is suspected, the patient should seek help from a neurologist. To begin with, the doctor conducts a general examination, assessing the condition of the person. Serous meningitis is characterized by an increase in heart rate (tachycardia), growth blood pressure and body temperature. When trying to lower the chin to the chest, there is a sharp soreness in the neck. Next, the doctor evaluates the following symptoms:

1. The leg of the patient lying on his back bends at the knee and hip joint... If pain is observed when trying to extend and straighten the limb, this indicates a meningeal infection.
2. The doctor puts his hands on the pubic articulation of the patient and produces pressure. Emergence unpleasant sensations- a sign of the development of the disease.

Such tests are not 100% informative and are only additional in nature. In my practice, I had to deal with the fact that the patient also had pain when pressing on the pubic articulation, but it was associated with a recent spinal injury. One of the junior residents interpreted this symptom as a sign of meningitis and began specific treatment... This led to the development of dysbiosis of the gastrointestinal tract in the victim.

It is necessary to differentiate the disease with the following pathologies:

• encephalitis;
• traumatic brain injury (hematoma, concussion, hemorrhage);
• malignant neoplasm;
• cysts and benign tumors.

Methods for diagnosing serous meningitis:

How is serous meningitis treated?

Disease therapy is carried out in the conditions of the neurological department of the hospital. At easy form ailment without massive damage to the nervous system, the course of treatment takes from 2 to 6 weeks and includes mainly antimicrobial medicines, with more severe course recovery may take up to a year. Patients are prescribed special diet with a high content of proteins, vitamins and minerals to restore energy costs. During rehabilitation, physiotherapy is actively used, remedial gymnastics and massages: they help to achieve an effect even in those patients who long time carried out bedridden.

The main goals of treatment for serous meningitis are:

• elimination pain syndrome;
• prevention of secondary purulent complications;
• protecting the brain from the damaging effects of toxins;
• strengthening the immune system;
• normalization of water-salt balance.

Drug therapy of the disease

All drugs are divided into symptomatic and etiotropic. The former allow you to cope with the clinical manifestations of the disease, and the latter affect the cause that caused it. Almost all medications are prescribed in the form of injections for intravenous and intramuscular injection and also in the form of droppers, which facilitates the availability of pharmaceuticals.

Do not forget that serous meningitis can be eliminated only by acting on the cause that caused it. One of the patients in the neurology department at my hospital was hospitalized with serious complications, life threatening... On the recommendation of one of his acquaintances, he began to drink antibacterial drugs on his own, while his meningitis was caused by a virus. As a result of improper therapy, the disease continued to progress, and the man did not go to the hospital. After suffocation of health and emergency hospitalization, a diagnosis was made and specific treatment began.

Drugs for etiotropic therapy:

1. Antiviral agents prevent the growth and development of these pathogenic microorganisms. The most effective medicines are Acyclovir, Ganciclovir, Foscarnet, Bonafton, Megosin, Cycloferon, Vidarabin, Remantadin, Viferon, Immunal.
2. Antibiotics cause death various bacteria and accelerate their excretion from the body. For this purpose, doctors prescribe Amoxiclav, Augmentin, Carbenicillin, Cephalexin, Keflex, Rocefin, Fortum, Keyten, Meronem, Tienam, Primaxin, Tetracycline.
3. Anti-tuberculosis drugs are used for tuberculous meningitis. These include Isoniazid, Rifampicin, Salusid, Pyrazinamide, Ethambutol, Cycloserine, Capreomycin.
4. Fugaricidal drugs are used if the causative agent of the disease is a fungus. Doctors prescribe Nystatin, Levorin, Griseofulvin, Miconazole, Clotrimazole, Naftifine, Ketoconazole, Nitrofungin, Natamycin.

Photo gallery: medicines for the etiotropic treatment of serous meningitis

Nystatin causes the death of fungi Amoxiclav inhibits the growth of bacteria Acyclovir destroys viruses

Drugs to eliminate the symptoms of the disease:

1. Detoxification therapy helps restore lost fluid and removes harmful decomposition products from the body. For this purpose, Reabmerin, Glucosolan, Disol, Trisol, Acesol are used.
2. Diuretic drugs are prescribed for excretion from the body excess water and prevention of cerebral edema. These include Furosemide, Torasemide, Hydrochlorothiazide, Mannitol, Urea, Lasix, Spironolactone.
3. Steroidal anti-inflammatory drugs reduce the severity of pain and relieve discomfort. To do this, appoint Hydrocortisone, Prednisolone, Methylprednisolone, Cortef, Dexamethasone.

Photo gallery: medicines for symptomatic therapy

Dexamethasone relieves inflammation Furosemide removes excess fluid from the body Reopolyglucin restores water-salt balance

Potential consequences and complications of serous meningitis

Any infection brings significant harm to the body. During their vital activity, microbes release toxins that damage various tissues and cells, which is the cause of the development of secondary complications. Undesirable consequences often occur in vulnerable groups of the population: children, adolescents, pregnant women and the elderly. The likelihood of complications is influenced by the patient's health, weight, duration of therapy, patient compliance with the doctor's recommendations.

Diabetes mellitus significantly complicates the treatment of serous meningitis. With this violation of metabolic processes in the body, a large amount of glucose accumulates, which damages the vascular wall. They become more brittle and brittle, and the patient develops a tendency to form blood clots. In my practice, I met a man who, in the background diabetes mellitus Serous meningitis was treated. The patient had to significantly reduce his weight and constantly monitor his diet in order to avoid the development of complications.

The undesirable consequences of serous meningitis include:

1. Paralysis and paresis of the upper and lower limbs... If during the illness the nerve plexuses of the spinal cord and parts of the brain are affected, the conduction of impulses to the tissues is disrupted. The patient loses the ability to control the arms and legs, the sensitivity of the limbs decreases. Damage to the facial nerve leads to drooping of the eyelid, lifting of the corner of the mouth and the formation of various grimaces. Rehabilitation period and restoration of functions takes from six months to several years.
2. Hydrocephalus is the accumulation of fluid in the ventricles of the brain. Due to inflammatory edema, the choroid plexus begins to produce a large amount of cerebrospinal fluid, which is not excreted. The patient's head increases in size and deforms, he experiences severe pain... To treat this complication, surgery is used with the installation of a shunt, which drains fluid into the natural cavity of the body.
3. Damage to the senses. Often in patients with serous meningitis, hearing decreases and visual acuity drops sharply. This is directly related to the effect of microbes and their toxins on the nerves of the same name.

Photo gallery: possible complications of serous meningitis

Facial paralysis leads to the formation of grimaces Deafness with meningitis is predominantly irreversible Hydrocephalus is a buildup of fluid in the ventricles of the brain

How to protect yourself from developing disease

Prevention of infections and their complications is one of the most important tasks of domestic medicine. To this end, doctors regularly develop plans for vaccination of the population and conduct lectures and seminars on serous meningitis and its consequences. Patients can receive complete and detailed information about the disease, as well as choose the best way to protect themselves.

During my internship in one of the overseas hospitals, I happened to be in the midst of an epidemic of meningitis. 40% of patients were infected, as a result of which the hospital had to be closed for quarantine. For the purpose of prevention, all students, residents, doctors and nurses were vaccinated against meningococcal infection to reduce the risk of infection. As a result of the implementation of measures for the treatment of sick patients and the observance of the rules of asepsis and antiseptics, it was possible to prevent a repeated outbreak of pathology. Within a week, the medical staff of the clinic completely eliminated the consequences of the disease.

The rules for individual prevention of serous meningitis include:

• use only organic products without the addition of harmful chemical additives, flavoring enhancers and dyes;
• drink plenty of fluids;
• give up alcohol, smoking and narcotic drugs;
• take medications only as directed by a doctor (especially cytostatics, antibiotics and hormones);
• dress appropriately for the weather and stay cool;
• observe a rational regime of work and rest;
• do sports activities and lead active image life;
• Donate blood, urine and feces once every six months to assess the general condition of the body;
• come through medical examinations from a therapist or pediatrician;
• carry out all vaccinations according to the vaccination calendar (in the absence of any contraindications);
• strengthen immunity: hardening and vitamins will help you with this;
• when the first symptoms of the disease appear, try to see a doctor right away;
• if you have been in contact with a patient suffering from meningitis, consult an infectious disease specialist.

Mening is extremely dangerous pathology, which is a threat to the life and health of every person. Without timely treatment, the disease can end. lethal outcome... The disease is prone to recurrence in immunocompromised patients: that is why doctors advise to follow the rules of prevention throughout life.

The main causative agent of acute meningitis is meningococcus, which enters the human bloodstream and then is transferred to the brain. Less commonly, the cause of the infection is a fungal or bacterial factor, in which purulent meningitis is formed. There are a number of factors that can influence the development of the disease.:

Initially, the penetration of the causative agent of meningitis into the body does not carry any clinical manifestations. But then meningococcus enters the bloodstream, from where it seeks to reproduce - the brain where, under the influence of a favorable environment, brain cells develop and are affected.

Incubation period

The incubation period for the development of pathology is from 2 to 10 days. During this time, a gradual increase in symptoms begins.

Symptoms and signs of acute meningitis

Acute serous meningitis begins to manifest itself with a rise in body temperature to 39-40 ° C, there is a strong chill.

As the disease progresses, the following symptoms are added:

• Severe headaches without clear localization, which are aggravated by movement, turning the head, exposure to light and sound. Any, even a light touch to the patient, causes severe anxiety and an increase in pain.
• The presence of insomnia is observed.
• Very important diagnostic criterion with meningitis - vomiting, which begins from the first day. Its occurrence is not affected by food intake.
• The main clinical manifestation, characteristic only for this disease - a stellate rash that initially appears on the feet, and then gradually rises higher. The appearance of this clinical sign speaks of a serious danger of developing sepsis and requires urgent hospitalization of the patient.
• From the first day of acute meningitis, tonic-clonic seizures may occur. This is especially true for children.
• There is a stiff neck - the inability of the patient to bend the neck due to muscle resistance.

If at least one of the clinical symptoms mentioned above, it is necessary to urgently consult a doctor for diagnostic measures.

Diagnostics

Diagnosis of acute meningococcal infection is based on the identification of clinical symptoms, as well as on the following patient examination results:

In addition, a patient with suspected acute meningitis is prescribed general analysis blood and a swab from the nose, which may indicate the cause of the pathology. Upon confirmation of the disease, the patient is urgently hospitalized and treated in a hospital.

How is it treated?

Treatment of patients with acute meningitis is carried out taking into account the severity of the disease. Patients are placed in a specialized department or diagnostic box, where they undergo full-fledged therapy.

The main principle of the treatment of the disease is the appointment antibacterial drugs ... The main drugs we use, which begin to be introduced even during the examination of the patient. This is due to the high risk of a complicated course of the pathology and the development of meningococcal sepsis, which can cause irreparable harm to the body.

Antibiotics can reduce the development of the pathological process, improve the general condition of the patient and relieve the patient of all symptoms.

The main drugs used in the treatment of the disease are as follows:

• Penicillin antibiotics (Benzylpenicillin, Penicillin) or cephalosporin (Ceftriaxone).
• Simultaneously with etiotropic therapy, drugs are prescribed that normalize metabolic processes in the body: intravenous administration crystalloids and colloids (saline, rheopolyglucin, glucose). These drugs provide an optimal water-salt balance of the body, help to improve metabolism and the intake of essential vital elements into the body. In addition, such drugs help the rapid elimination of pathological microorganisms from the body.

The use of such drugs is permissible only under the supervision of a specialist. In no case should you use them yourself.

This is due to the fact that acute form the disease has many different forms of the course and factors affecting the process. In addition, therapy should be prescribed by a doctor and selected individually, for each patient based on age, clinical picture and form of the disease.

Rehabilitation

Rehabilitation measures are of great importance in full recovery after suffering meningitis. The main method of rehabilitation is constant monitoring of your health., as well as the implementation of general strengthening procedures, which include the following:

1. adherence to diet and diet therapy(high in vitamins and minerals);
2. physiotherapy activities- pine baths, electrophoresis, therapeutic electrosleep.

These procedures contribute to overall strengthening immunity, and also have a beneficial effect on nerve cells and the development of the body as a whole.

Consequences and complications

Acute serous meningitis - very dangerous disease , which threatens not only the development of complications, but also the possible death of the patient. In case of untimely initiation of therapy, as well as inadequate or unskilled care for a patient with meningitis, complications such as:

• loss of vision;
• increased fatigue;
• persistent headaches;
• absent-mindedness;
• sleep disturbance;
• convulsive seizures, less often - status epilepticus;
• children may have mental retardation.

Most of the patients who promptly sought help, as well as underwent a full course of therapy, were able to avoid the development of pathological complications.

Prevention of meningitis

Preventive procedures that can help avoid acute serous meningitis are simple measures:

1. preventive vaccinations for children under 5 years old;
2. full treatment of infectious and colds, under the supervision of a physician;
3. compliance with hygiene standards (washing hands with soap, regular baths);
4. rejection of bad habits;
5. refusal of self-medication - any disease requires a full examination and measures to eliminate it.

Conclusion

As you can see, acute meningitis is a very dangerous disease that is fraught with the development of very serious consequences. It is important to remember that if you find symptoms or suspect a disease, you should immediately consult a doctor. Any disease is easier to prevent than to deal with the consequences. Only timely started treatment will avoid the development of serious complications.

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Inflammation of the pia mater of a serous nature, which can be caused by viruses (most often), bacteria, fungi, systemic diseases, tumors, cerebral cysts. In most cases, the disease is acute with febrile condition, headache, meningeal symptom complex, sometimes with damage to the cranial nerves. Diagnostics is based on epidemiological data, results of neurological examination, data from analysis of cerebrospinal fluid, bacteriological and virological studies, EEG, MRI of the brain. Therapy includes etiotropic treatment, dehydration, detoxification, antibiotic therapy, antipyretic, anticonvulsant, neurometabolic drugs.

General information

Diagnostics of the serous meningitis

According to the characteristic clinical picture and the presence of a meningeal symptom complex (a typical posture, stiffness of the posterior muscles, positive Kerneg symptoms, lower and upper Brudzinsky symptoms, in infants - a Lesage symptom), not only a neurologist, but also a local therapist or pediatrician can suggest the presence of meningitis. A thorough study of the history of the disease (identifying contacts with sick persons, determining the duration of the incubation period, the nature of the onset of the disease, etc.) and conducting complementary methods examinations are necessary to establish the type and etiology of meningitis.

Serous meningitis is accompanied by typical inflammatory changes in the clinical analysis of blood, but usually the rise in ESR and leukocytosis are less pronounced than with purulent meningitis. To isolate the pathogen, bacterial inoculation of swabs from the throat and nose, virological studies PCR methods, RIF, IFA. In immunocompromised patients immunological studies, aimed at verifying the pathogen, are not very informative, since they can give false results.

Serous meningitis can be confirmed by examining the cerebrospinal fluid. For serous inflammation of the piazza, a slightly opalescent or transparent cerebrospinal fluid with a slightly increased protein content is characteristic. Tuberculous and fungal meningitis is accompanied by a decrease in glucose levels. Cerebrospinal fluid flows out under high blood pressure... In the first few days, neutrophilic leukocytosis may occur, which resembles a picture of bacterial meningitis. Then, lymphocytes begin to predominate in the cerebrospinal fluid, which is more characteristic of viral meningitis. Therefore, lumbar puncture must be repeated and compared data from the study of cerebrospinal fluid in different periods of the disease.

With tuberculous and syphilistic etiology of meningitis, pathogens can be detected by microscopy of cerebrospinal fluid after special staining of smears. If serous meningitis is of a viral origin, then the pathogen is not detected. If necessary, the following examinations can be additionally assigned:

For the purpose of detoxification, infusion therapy is carried out, to combat CSF-hypertensive syndrome - dehydration (administration of diuretics: furosemide, acetazolamide). With febrile condition, antipyretics (ibuprofen, paracetamol) are prescribed, with convulsive syndrome- detomidine, diazepam, valproic acid. At the same time, neuroprotective and neurotropic therapy is carried out - nootropics (gamma-aminobutyric acid, piracetam, glycine), B vitamins, hydralizate of the pig's brain, etc. are prescribed.

Prediction and prevention of serous meningitis

In the overwhelming majority of cases, with correct and timely therapy serous meningitis has a favorable outcome. Usually, the temperature begins to subside already on the 3-4th day, a second wave of febrile condition is rarely observed. On average, serous meningitis lasts about 10 days, with a maximum of 2 weeks. As a rule, it passes without leaving behind any consequences. V individual cases after meningitis, liquor-hypertensive syndrome, frequent cephalgia, asthenia, emotional instability, memory impairment, and difficulty concentrating may persist. However, these residual effects disappear within a few weeks or months. Tuberculous meningitis has a serious prognosis, without the use of anti-tuberculosis pharmaceuticals, it leads to death on the 23-25th day of illness. With a late start of anti-tuberculosis treatment, the prognosis is serious - relapses and complications are possible.

The best prevention of meningitis of any etiology is a strong immune system, i.e. healthy eating, active lifestyle, hardening, etc. Preventive measures should also include timely treatment acute infections, isolation of the sick, vaccination against tuberculosis, drinking only purified or boiled water, thorough washing of vegetables and fruits, personal hygiene.