At the location of the location distinguish:

Because of the characteristic clinical features The defeat of the cute shell, the so-called arachnoiditis, stands out in an independent group. Moreover, meningites are divided into serous and purulent.

Meningitis meet primary and secondary. Primary meningitis develops when when infected with the body simultaneously, the brain shells occurs (at the same time the disease immediately affects the brain directly). Secondary meningitis is characterized by the fact that against the background of the main disease, such as leptospirosis, epidemic vapotitis, Otitis and others, the infection spreads and subsequently defeated brain shells.

Meningitis current in all cases it is characterized as acute (the disease is progressing for several days). Make an exception only tuberculous meningitis, It can develop for several weeks or even months.

By ways of infection of the brain shells distinguish:

Meningeal syndrome Such as an increase in intracranial pressure is present in any meningitis and is characterized by sawing pains in the head, while there is a pressure on the ears, eyes, vomiting appears, photophobia (irritation), hyperactus (response to sound), increased temperatureEpiprigances, rash. Symptoms and treatment of meningitis differ.

Causes of meningitis

Meningitis can develop as a result of the lesion of cerebral shells with a causative agent of viral or bacterial nature.
The main pathogens of primary meningitis are as follows:
1. Bacteria. The main cause of meningitis is a meningococcal infection (Neisseria Meningitidis). As a source of infection, carriers of meningococcal infection (patients with intestinal infections, Noodopalitis,). Usually this kind of infection applied by air-droplet. In a large percentage of cases, meningococcal infection affects the population of cities (it affects the busy in transport, observed in autumn and winter). In children's teams, meningococcal infection can provoke meningitis outbreaks. As a result of meningococcal meningitis develops purulent meningitis. In addition to meningococcus, there are such pathogens of meningitis, like tuberculous wand, pneumococcus, hemophilic stick, spirochetes.
2. Viruses. Another reason for meningitis may be viral infection (viral meningitis). In most cases, meningitis is manifested against the background of enterovirus infection, but it can develop against the background of rubella, herpes (chickenpox), pigs, measles. Viral meningitis are called serous.

Secondary meningitis can provoke the following factors:

If poor-quality treatment has been carried out, the proliferation of infection on brain shells can occur, which leads to the appearance of meningitis.

Characteristic symptoms and signs of meningitis in adultery and childhood age

Meningitis in most cases treats acute and sudden start. Primary symptoms Meningitis is very similar to the symptoms of a strong cold or influenza:

During the period from a pair of hours to several days against the background of high temperature, manifest characteristic (specific) symptoms of meningitis. These include:
1. Strong pain in the head. During meningitis, the character of the headache diffuse, that is, the pain is distributed throughout the head. Over time, the pains increase and acquire the nature of the cutting pain. After a certain period of time pain progresses to unbearable (from such a pain an adult man moans, and children can shout). Then the pain in most cases is accompanied by a feeling of nausea, vomiting. Usually, when meningitis, pain in the head increases, if you change the position of the body, as well as under the action of irritants from the outside (loud sound, noise).
2. Meningococcal meningitis is characterized the appearance of rash. If meningitis manifests itself in a light form, rash can be expressed as small dotted dark cherry blossoms. On the third or fourth day, from the moment of formation, the rash during meningococcal meningitis disappears. When meningitis, a heavier shape of rash appears in the form of large spots and bruises. The rashes during the severe form of meningitis disappear within ten days.
3. Confusion of consciousness.
4. Multi-time vomiting After which the sense of relief comes.
5. Meningheal symptoms: Muscles The nape is strongly tense; Patients with meningitis, as a rule, prefer to lie on the side, while their knees are tightened to the stomach, the head is trapped back, while changing the position of the patient's head, tilting it to the chest, or try to break the legs in the knees, severe pain appear.
6. In some cases, meningitis occurs the defeat of the cranial nerves, which leads to the squint.

In children under the age of the year, except for the already listed symptoms, such signs of meningitis are also observed as:

Symptoms of chronic tuberculosis meningitis

We have already said that the development of tuberculosis meningitis occurs in a few weeks. Primary symptom, manifested with tuberculosis meningitis, is increasing pain in the head, the strengthening of which is happening every day, As a result, it becomes simply unbearable. Headache may be accompanied by multiple vomiting, the patient may have a confusion of consciousness, and also worsens general state.

Diagnosis of meningitis

The diagnosis of meningitis is carried out using the following characteristic methods:
1. Study of the cerebrospinal fluid. It is possible to obtain a cerebrospinal fluid with a lumbar puncture. The diagnosis of meningitis involves the definition of various characteristics of the fluid (the number and composition of the cells, the transparency and the color of the liquid, the amount of glucose, protein, as well as the presence of microflora). This data is needed to identify changes characteristic of meningitis.
2. Study of the eye dna.
3. Radiography of the skull.
4. Electricencephalography.
5. Nuclear magnetic resonance and computed tomography.

The diagnosis of "Meningit" becomes based on their combination of three signs:

Treatment of meningitis in children and adults

Meningitis refers to urgent states. Patients with meningitis requires urgent hospitalization. Forbidden independent treatment Patient with meningitis at home, as it can lead to a fatal outcome. The earlier the adequate treatment of the patient is organized, the greater the likelihood of its complete recovery.

Treatment of patients with meningitis includes several directions.
1. Receive antibiotics. The main method of treating meningitis in adults and children is antibiotic therapy. It must be said that it is not possible to determine the nature of the pathogen from the blood. 20 % Cases. Usually, with meningitis, drugs are prescribed empirically (that is, with an unidentified accurate cause of the disease). The drug is selected in such a way that it is possible to cover the entire spectrum of the most possible pathogens. The duration of taking antibiotics should be at least 10 days, In mandatory, antibiotics must be taken at least a week from the date of establishing the normal temperature.

If there are purulent foci in the cavity of the skull, antibacterial therapy should take longer. When meningitis, the following antibiotics are applied: Cephalosporins (Cefotaxim, Ceftriaxone), Penicillin. As reserve antibiotics use Vancomycin, carbapenes (These drugs apply only in cases where the effect of the previously mentioned drugs is absent). If the course of meningitis is severe, antibiotics are introduced into the spinal channel (so-called. EndoLumbal administration of antibiotics).
2. Prevention and treatment of brain edema. In order to treat and prevent brain edema, diuretics are used ( Seged, Laziks, diakar). Diuretics must be combined with the introduction of the fluid.
3. Infusion therapy (disintellation). When meningitis, crystalloid and colloidal solutions are usually used. Intravenous injections of liquids must be made extremely careful because there is a danger of what the brain swelling will develop.
4. Individual therapy. After an outpatient treatment, the patient continues the course of treatment already at home. The question of visiting the children's preschool institution or the closure of a temporary disability sheet is solved individually for each patient. Usually suffering Meningitis a person is exempt from work for a period of about a year.

Preventive measures (vaccination) of meningitis in children and adults

The greatest effect in the prevention of meningitis gives vaccination of children and adults directed against the pathogens of this disease. The vaccine against the bacteria is Haemophilus Influenzae. In childhood, three doses are introduced - three, four and a half and six months, at the age of one year they are revaccination. Upon reaching a child of two years, a meningococcal vaccination is carried out. For an adult who has reached 65 years ago The pneumococcal vaccine is shown.

To prevent secondary meningitis, such a measure is extremely effective as competent and timely treatment of diseases that give complications in the form of meningitis. So, for example, it is strictly forbidden to squeeze or rub the furuncular, as well as acne in the field of face or neck of large sizes. If there is a sinusitis or otitis, it is necessary to seek medical attention to the shortest possible time. and carry out treatment under the control of physicians.

Infection of the central nervous system

This section discusses the basic infections of the CNS bacterial etiology: meningitis, brain abscess, subdural empya and epidural abscess.

Bacterial meningitis

Bacterial meningitis - inflammation of cerebral shells, acute or chronic manifested characteristic clinical symptoms and Pleocytosis of the SMG.

Acute bacterial meningitis

Basic pathogens

The incidence of bacterial meningitis is an average of about 3 cases per 100 thousand population. In more than 80% of cases, bacterial meningitis are caused N.Meningitidis, S.Pneumoniae. and H.INFLUENZAE.

In Russia N.Meningitidis is the cause of about 60% of cases of bacterial meningitis, S.pneumoniae. - 30% and H.INFLUENZAE. - ten%. It should be noted that in developed countries after the introduction of large-scale vaccination against H.INFLUENZAE. Type B, the incidence of bacterial meningitis of this etiology decreased by more than 90%.

In addition, bacterial meningitis can be caused by other microorganisms (sheets, streptococci groups B, enterobacteria, S.Aureus., and etc.).

The pathogens of bacterial meningitis can be spirochetes: during Lime disease in 10-15% of patients in the first 2 weeks after infection there is a meningeal syndrome. In general, etiology is largely determined by age and premorbid background of patients (Table 2).

Table 1. Dependence of etiology of bacterial meningitis from the age of patients and a premorbid background

Bacterial meningitis may occur in the hospital after neurosurgery or otorinolaryngological operations, in this case the gram-negative (up to 40%) and gram-positive flora (up to 30%) plays an important role in etiology. Nosocomial flora, as a rule, is characterized by high resistance and mortality with such etiology reaches 23-28%.

Success treatment acute bacterial meningitis Depends on a number of factors and, first of all, from the timeliness and correctness of the appointment of AMP. When choosing antibiotics, it is necessary to remember that not all of them penetrate the BGB (Table 2).

Table 2. Passage of antimicrobial preparations through the BC

Antimicrobial therapy should be started immediately after the preliminary diagnosis. It is important that the lumbacal puncture and the fence of the material (SMG, blood) for microbiological studies were performed before the introduction of antibiotics.

The choice of AMP is carried out according to the results of the examination, including the preliminary identification of the causative agent after the color of the smears of the CMZH in gram and serological express tests.

If fast diagnostic methods do not allow pre-identify the pathogen, or for any reason a delay is delayed with the implementation of lumbar puncture, the antibacterial therapy is assigned empirically. The choice of AMP in this situation is dictated by the need to overlap the entire spectrum of the most likely pathogens (Table 3).

Table 3. Empirical antimicrobial therapy of bacterial meningitis

Antimicrobial therapy can be changed when the pathogen is selected and obtain the results of the sensitivity (Table 4).

Table 4. Antimicrobial therapy of bacterial meningitis installed etiology

In the treatment are used maximum doses AntibioticsIt is especially important when using AMP, poorly penetrating through the BGB, so it is necessary to strictly adhere to the adopted recommendations (Table 5). Special attention is necessary when prescribing antibiotics to children (Table 6).

Table 5. Doses of antimicrobial preparations for the treatment of CNS infections in adults

Table 6. Doses of antimicrobial preparations for the treatment of acute bacterial meningitis in children *

* A.R. Tunkel, W.M. Scheld. Acute Meningitis. IN.: Principles and Practice of Infectious Diseases, 5 Th Edition. Edited by: G.L. Mandell, J.E. Bennett, R. Dolin. Churchill Livingstone, 2000; p. 980.

The main way of introducing AMP is in / c. According to the indications (secondary bacterial meningitis against the background of sepsis, especially polyimicrobial, purulent complications of cranial and brain injuries and operations, etc.) can be combined with / in and endoomumbal administration (Table 7). Only AMP is administered to the endoomolumbo, well penetrating in the SMG (aminoglycosides, vancomycin). Preparations can be used in the form of mono or combined therapy. The indication for the change of AMP is the lack of positive clinical and laboratory dynamics of the patient's state or the appearance of signs of undesirable drug action.

Table 7. Doses of antimicrobial preparations for endolumbal administration

In addition to respecting one-time and daily doses of AMP, the duration of their purpose is important in bacterial meningitis.

For the treatment of meningitis caused by spirochetes, preparations are used with an appropriate activity spectrum (Table 4).

Meningitis as a chronic infection syndrome

In a number of infections characterized chronic flow, it is possible to distribute the process to the brain shell. In this case, meningeal syndrome may occur and the composition of the SMG changes.

From the point of view of complications of chronic infections, tuberculous meningitis represents the greatest danger. The initial treatment of this meningitis often leads to an unfavorable outcome. The emergence of diagnostic systems based on PCR significantly reduced the duration of the survey and significantly increased the effectiveness of treatment.

Defeating of the brain shells can be observed with other infections: brucellosis, cysticercosis, syphilis, borreliosis, coccidioidosis, histoplasmosis, cryptococcosis, etc.

Selection of antimicrobial drugs

Treatment of this meningitis is determined by the main disease. Very often to find out the etiology of the process seems almost impossible. In this case, along with the continuation of the search for the pathogen, the so-called trial empirical treatment is used. For example, with suspected tuberculous meningitis, anti-tuberculosis drugs are prescribed and, when the clinical improvement appears, the course of therapy is adjusted to the end. If the candidoid nature is suspected, test treatment with fluconazole is used.

Abscess brain

Abscess brain - Limited capsule accumulation of brain detritus, leukocytes, pus and bacteria.

Basic pathogens

The etiological cause of brain abscesses can be bacteria, mushrooms, simplest and helminths. From bacterial pathogens, green streptococci are most frequent ( S.GINOSUS, S.CONSTELLATUS. and S.interMedius.), which are found in 70% of cases. In 30-60%, they are accompanied by other bacteria. S.Aureus. It is seeded in 10-15% of patients, often in monoculture, especially during crank-brain injury, infectious endocarp. Anaerobes are released at 40-100%, and in 20-40% these are bacteroids or anthells. Enterobacteria is found in 23-33% of cases, especially often with from all-generated infection or in patients with immunological disorders.

When using immunosuppressive therapy, the antibiotics of a wide range of action, corticosteroids increases the risk of developing abscesses of the brain of fungal etiology. As with meningitis, the etiology of the brain abscess depends on the premorbid background (Table 8).

Definition and etiopathogenesis

Inflammation caused by penetration of microbes in spinal fluid (SMG), exciting web and soft shell, as well as subarachnoid space. Without treatment, the process applies to brain fabric (meningitis and encephalitis). Infection occurs most often through blood; Bacterial and fungal infections can also be distributed on adjacent areas as due to the injury of bones of the skull and shells, as well as the complication of chronic medium otitis. Top.

1. Ethiological factor

1) Viral meningitis (so-called aseptic) - most often: enteroviruses, epidemic inflammation virus (vapotitis), flaviviruses (among others, tick-borne encephalitis virus (CE) [Europe and Asia], Western Nile Virus [Africa, North and Central America, Europe], Virus of Japanese Encephalitis [Asia], Encephalitis Virus of St. Louis [North America]), a virus of a simple herpes (HSV), Virus VIZELLULL ZOSTER (GDP); Rarely Epstein-Barr virus (EBX), cytomegalovirus (CMW), Herpes Virus of the 6th type (VGH-6), adenoviruses (in patients with disorders of cellular immunity), HIV, virus lymphocytic choriomengit (VLHM, English Lymphocytic Choriomeningitis Virus , LCMV).

2) Bacterial purulent meningitis - in adults most often (in order): Neisseria Meningitidis, Streptococcus Pneumoniae, Haemophilus Influenzae Type B (Hib; Rarely in adults, with vaccination introduction also becomes less often in children) and listeria monocytogenes; More rarely, under special circumstances (→ Risk factors): Gram-negative enterobacteria, streptococcus group B and A (Streptococcus Pyogenes) also staphylococcus aureus and staphyloloccus epidermidis; The newborn predominates infections caused by E. coli, Streptococcus Agalactiae, L. monocytogenes and other gram-negative enterobacteria; in babies and in children 5 years old - N. Meningitidis and S. Pneumoniae

3) bacterial ungounted meningitis: acid-resistant mycobacteria, more often than Mycobacterium tuberculosis group (tuberculosis meningitis); spirochetes from the genus Borrelia (neuroborreliosis → sec. 18.5.1) or Leptospira (leptospirosis), Listeria Monocytogenes (often as purulent), Treponema Pallidum (Syphilis CNS), Francisella Tularensis (Tulyarania), Bacillus Brucella genus (Brucellosis)

4) fungal meningitis (ungounted or purulent): Candida (most often C. albicans), Cryptococcus Neoformans, Aspergillus.

2. Source of infection and distribution path: depend on the etiological factor; reservoir - most often people (patients or carriers), less often wild and pets (eg L. monocytogenes, Borrelia), including birds (Cryptococcus Neoformans, Western Nile Virus) or external environment (mold mushrooms); The path of infection - depending on the pathogen of the airborne path, through direct contact, insects (mosquitoes, ticks - flaviviruses [eg. KVM], Borrelia SPP.), Digestive tract, less often another (eg L. monocytogenes due to the use of contaminated milk and Dairy products, uncapped sausages and poultry meat, salads or seafood).

3. Epidemiology: virus meningitis - 3-5 cases / 100,000 / year; Bacterial purulent - ≈3 / 100,000 / year; tuberculosis - several dozens of diseases per year; Others are very rare. Risk factors: stay in closed institutions (boarding school, barracks, hostels) → N. Meningitidis, viruses (enteroviruses, cortex, epidemic vapotitis); use of public baths and pools → Enteroviruses; Age\u003e 60 years → S. Pneumoniae, L. monocytogenes; Sinusitis, acute or chronic purulent average otitis or mastoiditis → S. pneumoniae, HIB; Alcoholism → S. Pneumoniae, L. monocytogenes, tuberculosis; Drug addiction → Tuberculosis; Cell immunodeficiency (including HIV and AIDS, immunosuppressive therapy - especially after organ transplants or corticosteroid therapy, treatment malignant tumors), diabetes, hemodialysis, liver cirrhosis, cachexia during cancer and others, pregnancy → L. monocytogenes, tuberculosis, fungi; The fracture of the base of the skull with the breakdown of the bones of the front part of the skull and the solid cerebral shell followed by the expiration of the liquor → S. pneumoniae, HIB, β-hemolytic streptococci groups A; Penetrating wounds of head → S. aureus, S. Epidermidis, aerobic gram-negative bacteria, including Pseudomonas Aeruginosa; Complement components deficiencies → N. Meningitidis (meningitis happens in family members or recurrences), Moraxella, Acinetobacter; Neutropenia 39 ° C, light

4) Other symptoms of meningitis and encephalitis - psychomotor arousal and disturbance (to coma inclusive), local or common epileptiform attacks (crashes), spastic paresis or other symptoms of lesions of pyramidal pathways, paresa or paralysis of cunning nerves (especially with tuberculosis meningitis; more than vi , III, IV and VII), symptoms of damage to the brain and cerebellum barrel (in particular, in the active stage of inflammation caused by L. monocytogenes)

5) other accompanying symptoms - herpes on lips or face skin; Petechia and ecchimosis on the skin, more often on the limbs (indicative of meningococcal meningitis); Symptoms of ORDS, DVS, shock and polyorgan deficiency.

2. Natural flow: the dynamics of the flow and severity of symptoms depends on the etiology, but the clinical picture does not allow you to accurately determine the cause. Results of general analysis of SMG → Sec. 27.2 confirm the presence of meningitis and help to pre-determine its cause (etiological group). In case of bacterial purulent meningitis, a sudden beginning and rapid progression; The patient's condition is usually heavy, a threat to life occurs within a few hours. Viral meningitis, as a rule, proceeds easier. In case of bacterial innocent meningitis (eg tuberculosis) and fungal meningitis, a non-specific, subacute or chronic. If untreated or incorrectly treated cases, inflammation applies to the brain → Disruption of consciousness and focal symptoms (inflammation of the brain).

In suspected meningitis → Stabilization of the overall condition of the patient and blood collection on the sowing → It is necessary to determine the presence of contraindications to the lumbar puncture (→ sec. 24.13); If not → It is necessary to perform a lumba puncture and obtain a CMF for overall analysis and microbiological research → It is necessary to begin the corresponding empirical treatment and clarify therapy after obtaining the results of microbiological research (including sowing) and / or the spinal fluid of blood and antibioticogram evaluation. In the case of suspicion of purulent meningitis, the period of time from the first contact of the patient with a medical worker and before the start of antibiotic therapy should not exceed 3 hours (1 hour from the moment of receiving the patient to the department), in the case of probable meningococcal etiology - 30 minutes. Top.

1. General analysis of SMG: interpretation of the result → section. 27.2; The pressure of the SMF is usually increased (\u003e 200 mm H 2 O), most often with purulent meningitis. In Candidiasis, the cell composition is purulent or lymphocytic, protein concentration is increased, the glucose level is moderately reduced. When cryptococcosis, the result of the analysis may be normal, but usually the lymphocytic cell composition, the protein concentration is increased, and the glucose level is reduced. With aspergillosis in 50% of cases, the result of the analysis is normal, and in the rest most often - uncharacteristic changes.

2. Microbiological research

1) SMG: The direct drug of a centered precipitate of the gram painted by gram is the preliminary identification of bacteria or fungi; Casch painting India - Pre-identification C. Neoformans. Latex agglutination tests (result for 15 minutes) - Detection of Hib and S. Pneumoniae antigens, N. Meningitidis, C. neoformans; It is especially useful in patients already treated with antibiotics or with a negative result of a study with painting a drug in gram or sowing. The definition of antigens (galactomannamed in the case of aspergillaz and mannanovoy in the case of candidiasis) - a positive result is diagnosed. Sowing on bacteria and fungi - it allows you to finally install the etiology of meningitis and determine the sensitivity to drugs of dedicated microorganisms; for bacterial infection The result is usually within 48 hours (with the exception of tuberculosis); With fungal infection, it is often necessary to repeat the study before the growth of fungi. PCR (bacteria, DNA viruses, fungi) or from-PCR (RNA viruses) - allows you to determine etiology in the event of a negative sowing (for example, in patients treated with antibiotics before the CMF fence); The main method of diagnosis of viral meningitis. Serological study - determination of specific IGM (possibly an IGG) by the ELISA method; Helps in the diagnosis of some virus meningitis and neuroboreliosis

2) Sowing blood (bacteria, fungi) - it is necessary to perform in all patients with suspicion of meningitis before treatment with antibiotics (sensitivity 60-90%)

3) smear from the throat and rectum - with suspected enteroviral infection - the release of viruses in cell culture.

3. CT or MRI of the head: are not mandatory for the diagnosis of insulated meningitis (can cause suspicion of tuberculous meningitis), help exclude edema or brain tumor before performing a lumbar puncture, also detect early and late complications of meningitis in patients with persistent neurological symptoms ( For example, with focal, with violations of consciousness), the positive result of control seeds of the SMG or recurrent meningitis. Studies are performed before and after the introduction of contrast. MRI can identify a rare complication of purulent meningitis - thrombophlebitis of sagittal sinus.

4. In the case of suspicion of tuberculous etiology, the search for the primary focus + microbiological diagnosis of tuberculosis. The tuberculin test does not help in the diagnosis of TBNS tuberculosis (in\u003e 60% of patients with a negative test).

1) Subarachnoid hemorrhage

2) Local CNS infection (abscess or empieme), brain tumor

3) irritation of cerebral shells with non-infectious process or infection out-CNS (there may be symptoms of increased intracranial pressure, always unchanged in SMG)

4) meningitis with a neoplasm - as a result of cancer metastases in the shell or their involvement in the lymphoproliferative process (changes in the CMF more often resemble bacterial unmarital meningitis; the diagnosis determines the detection of tumor cells at cytological examination SMG and the detection of the primary tumor)

5) Medicines - NSAIDs (especially in the treatment of rheumatoid arthritis or other systemic diseases connective tissue), catrimoxazole, carbamazepine, cytosinarabinoside, intravenous drugs of immunoglobulins; The clinical picture resembles aseptic meningitis

6) systemic diseases of the connective tissue (including systemic vasculitis) - the picture resembles aseptic meningitis

In the acute phase of the disease - in the intensive care unit (better in the center, having experience in the diagnosis and treatment of CNS infections). Top.

Etiotropic therapy of bacterial meningitis

Antibacterial treatment should be started immediately after the intake of the material for the microbiological research. The direct product of the SMF and the result of latex tests can help in the early selection of target antibiotic therapy. Empirical therapy Refine after receiving sowing results. If the clinical picture and the results of the conducted SMF study testify to tuberculosis meningitis → begin the empirical treatment of the TBNS tuberculosis and expect bacteriological confirmation of the diagnosis.

1. Empirical antibiotic therapy

1) adult patient aged 0.064 mg / l) → cefotaxim or ceftriaxone (see above), as an alternative to cefepim or meropene (see above) or Moxifloxacin 400 mg V / every 24 hours for 10-14 days; In case of resistance to cephalosporins (MIC ≥2 μg / ml) → Vancomycin V / in 1 g every 8-12 h + rifampicin P / O 600 mg every 24 hours or rifhampicin (see above) + ceftriaxone / cefotaxim (see above) ; As an alternative to Vancomycin (see above) + Moxifloxacin (see above) or Linzolid (see above) - the duration of treatment is 10-14 days

2) N. Meningitidis: Penicillin-sensitive strains (MIC ×

What antibiotics with meningitis appoints a doctor?

Treatment of this dangerous diseaseAs meningitis should be carried out with potent drugs, therefore antibiotics in meningitis in adults are an important component of a common treatment plan.

In general terms about illness

Meningitis is an acute inflammatory disease (more often than infectious nature), which strikes the human brain, causing a sharp increase in temperature, severe headaches, increased light and noise sensitivity, as well as other meningeal symptoms.

• purulent;
• serous;
• reactive;
• bacterial;
• tuberculosis.

Features of treatment

Meningitis of the brain in adults, as a rule, is treated in stationary conditions, since there is a chance of complications capable of leading to death.

The basis of treatment is antibiotics during meningitis, however, there is a feature of the diagnosis, which is that it is not always possible to determine the type of disease, and, as a rule, the doctor prescribes the patient with the preparations of the wide range of action.

The prescribed medications are usually introduced to the patient intravenously, however, in particularly severe cases, the antibiotic during meningitis can be directed directly in the spinal cord.

Broad spectrum preparations

Depending on the external manifestations and analyzes, the doctor may assign:

1. Antibiotics with good penetrating properties.
2. Antibiotics with medium penetrating properties.
3. Antibiotics with low penetrating properties.

Under penetrating properties it is understood as the ability of the drug to overcome the hematorecephalic barrier

Low penetrating ability does not mean bad effectiveness, the medicine from meningitis should have not only good penetrating properties, but also be able to fight viruses. Therefore, depending on the severity of the disease, the doctor can combine the introduction of drugs, exactly how to assign the introduction of the medicine directly into the spinal cord.

Preparations 1 include:

• Amoxicylylin (penicillin group);
• Cefuroxime (cephalosporic group 2 generations);
• Azitreon (MONOBACTAM).

Preparations 2 groups:

Preparations 3 groups:

Preparations are not antibiotics

Antibiotics treatment is not the only one, since this disease is rather cunning and requires an integrated approach in treatment.

So, for removing the edema of the doctor's brain, preparations are prescribed, which have the so-called diuretics, or diuretic drugs to which:

As there are side effects On the human body (for example, the ability to flush calcium), when receiving diouterotics, the abundant fluid flowing is prevailing. This is due to the fact that there is a possibility of aggravating the situation and provoking brain edema.

In addition, with meningitis in adults it is necessary to carry out therapy aimed at intoxicating the body. It is achieved by the appointment of a patient with a 5% glucose solution or saline, which contributes to the organism of the organism with the necessary substances and the elimination of accumulated toxins.

It should be remembered that the basis successful treatment It is not in tablets, but an integrated approach to the elimination of the problem and observing patients with doctors. Therefore, in no case should not be engaged in self-medication, as this may lead to serious consequences, but with particularly launched cases even to the death of the patient.

Is it possible to prevent the disease?

In order to prevent the appearance of this dangerous disease, there is now a vaccination from meningitis. However, there are several such vaccines and are directed to the fight against different types of illness.

For example, vaccination against measles, rubella or vapotitis protects a person from the occurrence of meningitis, since these diseases provoke inflammatory processes In the human brain, and accordingly, the occurrence of meningitis.

It also exists directly vaccine against meningitis or meningococcal vaccine, which is able to protect the human body from the occurrence of purulent or serous meningitis, but is not able to cope with tuberculous meningitis.

Among other things, as prevention of the disease, you can adhere to standard rules of behavior, such as:

• compliance with hygiene;
• maintaining immunity;
• avoiding contact with infected people;
• application of disposable masks, while in dangerous to infect place.

The presence of information about the drugs used during treatment will not allow the patient to effectively cure the disease independently, and can only aggravate its condition, so do not attempt to use the data for self-treatment.

Antibiotics during meningitis are prescribed due to the fact that urgent help is required. The causative agents of the disease can be both viruses and bacteria. To block the entire spectrum of bacteria, without waiting for the results of the tests, the doctor makes an appointment. The drug is chosen on the basis of the assessment of the alleged pathogen of the disease.

This is the inflammation of the shells of the brain, which arises for several reasons:

1. As a result of infection.
2. Due to the infection of pathogenic bacteria and microorganisms.
3. Against the background of pneumonia, otitis and tuberculosis.

IMPORTANT: infection can occur with air-droplet, it is most often infected with meningitis in public transport during the cold season.

Contact with pathogenic microorganisms: staphylococcal, pneumococcal, etc. - often leads to the fact that the person develops sinusitis, sinusitis. Meningitis acts as a complication of these diseases in the absence of adequate therapy and timely treatment.

If we consider the possibility of transition of pneumonia to meningitis, then it exists, especially if the disease is chronic and reduces the activity of the immune system. Tuberculosis is the most frequent cause Chronic meningitis, while the disease can leak without pronounced symptoms over several weeks or months.

Attention! Under adverse conditions, Otitis is also able to cause inflammation of the shells of the brain. It is fear of furunculus, which are located on the neck or face.

The disease is diagnosed in both children and adults. If you believe the statistics, then 1,000 sick children account for 1 case of infection with meningitis.

There are several types of disease, they are distinguished on the form of the flow:

• acute;
• instantaneous;
• chronic;
• meningococcal.

The most dangerous is the instant form of meningitis: the name of the disease speaks for itself. Inflammation develops rapidly, and the person is able to die after 2 - 4 days from the date of the appearance of the first symptoms.

Acute meningitis is no less dangerous: the symptoms of the disease are developing quickly, the patient's condition deteriorates. In the absence of adequate therapy, a person may die within a few days, and the late appeal to the doctor can lead to severe complications.

Important: Do not treat meningitis yourself, using herbs and folk Methods. Such therapy is able to cause complications.

Chronic meningitis develops gradually, the symptoms of the disease are poorly pronounced, but if there are adverse factors, the disease may begin to progress.

Meningococcal meningitis is another kind of inflammation of the shells of the brain. Its characteristic feature is worth considering the appearance of spots on the body. The rash resembles bruises that increase in sizes when pressing.

Recognize the disease is easy, it is enough to know what the meningitis characterizes itself.

Basic symptoms

There are several symptoms that are peculiar to the inflammation of the shells of the brain:

1. Strong headache.
2. The inability to press the head to the chest.
3. Violation of the perception of consciousness.
4. Fever.
5. The inability to break the legs in the knees.
6. Cramps.

Headache is the brightest and frequently encountered sign of meningitis. The pain in the head is unbearable, it is constantly intensified and leads to vomiting and nausea. After vomiting improvement of well-being is not observed. Remove spasm with the help of drugs does not work, possibly a short relief, and then the pain is intensified again. From pain in the head adults moan, and children shout. Suffer the child is difficult, he refuses meals, jumps and reacts painfully to external stimuli.

Due to the fact that the muscles of the neck are tense, a person cannot press his head to the chest. Patients with meningitis are sleeping in a specific pose: they throw the head back, the hands bend in the elbows and pressed to the chest, and the legs bend in the knees and pressed to the stomach. When trying to break the legs, a person is experiencing severe pain.

The pain in the head and the general condition of the patient leads to the fact that the perception of consciousness is disturbed. The excitation is replaced by stunning, hearing loss. A person can acute to respond to bright light and sound, while not understanding what they are talking about. Often there are hallucinations, problems with vision and hearing.

Initially, inflammation of the shells of the brain resembles flu or colds: the temperature rises sharply, weakness occurs and the appetite is reduced. If the indicators exceed 39 degrees, then it is worth contacting the doctor as soon as possible.

Muscle activity decreases due to the fact that protein production is broken in the blood. Most often, patients complain about pain in the knees and the inability to disperse the limbs.

Against the background of all the above symptoms, a person has convulsions. The totality of signs leads to the fact that the doctor can diagnose in patient meningitis.

If we talk about children up to the year, then the swelling and pulsation of the spring can be considered another symptom of the disease. In addition, large veins are on the baby's head. All this is accompanied by a cry and rejection of food.

In children, metabolic processes in the body are faster. For this reason, the disease develops rapidly. If the baby, without visible, the reasons have risen the temperature, appeared convulsions and other signs of meningitis, it is worth calling ambulance.

Specific sign of inflammation of the brain shells is considered rash, it appears on the whole body. The rash is small, point, can be painful, has a red or blue shade.

To the doctor it is worth contacting with several signs of meningitis. It should be understood that the symptoms increase and after 2 - 3 hours a person will not be better - his condition will deteriorate with every minute. The pain becomes cut, it is impossible to tolerate it, the cause of everything is not only infection, but also an increase in intracranial pressure.

How to wait ambulance?

Treat inflammation of the shells of the brain is not recommended independently. But you can also have a patient first help.

What to do with suspected meningitis:

• put a person to the sofa and provide peace for him;
• give a patient to drink diuretics and provide him with abundant drink;
• take vitamin C to strengthen immunity.

Attention! Before the doctor provides a diagnosis, you should not take those or other antibiotics, because this is not necessary.

If a person suffers from severe headaches, you need to put it in the room, to provide peace. There should be no loud sounds and bright lights, as well as everything that can worsen the state of the person, strengthen the pain in the head.

Diuretics are prescribed as the prevention of brain edema, the drug is prescribed by a patient in the form of tablets. If diuretics were accepted, then a person needs to provide abundant drink.

Vitamin C strengthens the immune system, for this reason it is often prescribed to people with inflammation of the shells of the brain, but after the diagnosis.

Important: "Interferon" is a drug that has antiviral and anti-inflammatory effect. Its use helps with bacterial meningitis.

If we are talking about a child, then its treatment must be under the control of the doctor. Independently give the baby drugs should not be, since such experiments will not lead to anything good.

Diagnostics

The diagnosis is not particularly difficult. Suspicion of inflammation of the shells of the brain may occur during inspection, during which the doctor tries to bend or disperse the patient's knees, press his head to the chest.

Also for diagnostics use:

• blood analysis;
• puncture.

The analysis take the spinal fluid. It is estimated for the presence of infection pathogens. At the same time, the doctor prescribes drugs even before obtaining results of analyzes.

The puncture is also used to reduce intracranial pressure, save the patient from severe and painful pain in the head.

The liquor is evaluated by several parameters and, if necessary, send a liquid to an additional analysis. Bacterial sowing is carried out, which helps to identify the sensitivity of bacteria to antibiotics.

Puncture make several times, it acts as a diagnostic method, as well as a method of treatment. Likvor is taken, assessing the effectiveness of treatment in this way. If drug therapy does not bring the result, the doctor adjusts the treatment.

Treatment in hospital

Therapy passes using several drugs, depending on the severity of the symptoms of the disease.

For carrying therapy, meningitis is used:

1. Antibiotics treatment.
2. The introduction of anti-inflammatory drugs.
3. Detoxification using oxygen.
4. Hormonal treatment.

Antibiotics treatment is considered to be the most efficient. Use several drugs that can help get rid of brain-shell inflammation. Penicillin and ampicillin in maximum dosage are most often used. The drug is administered intravenously or invasive, but the pills are not used. "Penicillin" is introduced for 10 days. If we are talking about a child, then less toxic drugs are chosen, which are not able to put the body of the kid irreparable harm.

To enhance the effectiveness of therapy, the doctor may prescribe Interferon patient, as well as other anti-inflammatory or antiseptic drugs. Comprehensive treatment The most efficient, but here is an individual approach. More prescribed vitamin C injections in the maximum dosage.

Detoxification using oxygen is used if necessary, such an appointment is quite justified when meningitis. It is suitable for the therapy of children and adults.

Hormonal preparations, such as "prednisolone", are also used in therapy, but not for the treatment of children under the age of the year.

The most dangerous is the purulent form of meningitis, which is capable of painting into the abscess of the brain. In this case, surgery is required due to the fact that drug therapy is considered to be ineffective.

In addition, treatment should be aimed at eliminating the initial focus of infection. If we are talking about hymorite or otitis, then a reservation is carried out. If the rehanging is impossible, then the course of therapy includes additional drugs that are struggling with the main cause of the disease.

Methods of prevention

There are several methods that help to avoid meningitis. Prevention belongs to:

1. Vaccination.
2. Timely treatment of sinusitis, otitis and pneumonia.
3. Failure to extrude on the face of boils and large acne.

Modern medicine has advanced in the prevention of meningitis: children put vaccinations in 2 months, 4 months and 2 years. Adults vaccination is carried out up to 65 years. In order to put the vaccination worth contacting the therapist with this request. Children vaccination are carried out by default.

Timely treatment of sinusites, sinusitis, otites and other inflammatory and infectious diseases helps to avoid inflammation of the shells of the brain. For this reason, when the first signs of one or another illness, it is necessary to contact the doctor, since only it can adequately choose treatment to avoid complications.

Furuncul or other purulent pimple Created to lead to the recurrence of meningitis. For this reason, it is impossible to press furbula and other purulent education, especially if they are on the face or neck.

Attention! In addition to the listed, clarine-brain injury can lead to inflammation of the brain shells. If, after successful treatment of meningitis, a person received damage to the head, he needs to undergo an additional examination.

Meningitis treatment takes place in the resuscitation department. The inflammation of the brain shells can lead to severe consequences, for this reason it is not worth tightening with the appeal to a neurologist when the first signs of the disease appears.