What is serous meningitis in children: symptoms, causes, consequences, and methods of its treatment. Serous meningitis in children Serous viral meningitis in children

Serous meningitis is a dangerous disease for human life and health. This is an inflammatory process in the soft membranes of the brain. Unlike other types of meningitis, the serous type affects the inner lining of the brain. The process of inflammation in the brain can be both secondary and primary. Primary serous meningitis develops due to viruses, and secondary against the background of major diseases (tuberculosis, measles). Serous meningitis with improper or untimely treatment can cause quite serious complications for the body, such as hearing loss, epileptic seizures, hydrocephalus, and mental retardation in children.

Serous meningitis has been known to mankind since ancient times, even Hippocrates described a similar disease. Avicenna in his writings mentioned meningitis patients. The first case of tuberculous meningitis was considered in detail in scientific writings by Robert Witt in the distant eighteenth century. At that time, there was no cure for this disease. There have even been cases of epidemic meningitis, for example, a small outbreak of serous meningitis occurred in the nineteenth century, in one of the quarters of Geneva.

Historical data says that for a couple of centuries, serous meningitis flared up in African countries, then in the USA and Europe. At that time, the etiology of the disease was still not understood, and the medicines for it were extremely ineffective. Anton Weikselbaum was the first to point out a possible causative agent of the disease, namely a bacterial infection. A thorough study of the pathogenesis of serous meningitis was carried out by the specialists of the Obukhov hospital, and already in the second half of the twentieth century they finally established the etiological relationship between adenoviruses, group A viruses and serous meningitis.

How is the disease transmitted?

The causative agents of serous meningitis are enteroviruses (in the case of the primary picture of the disease). In secondary serous meningitis, the causative agent is the polio and mumps virus. The disease with competent and timely treatment is benign, which cannot be said about the clinical picture of purulent meningitis. The infection can be obtained from a person who has had serous meningitis, but, nevertheless, is its carrier. The virus is transmitted through unwashed hands, food, using common items or personal hygiene items. Serous meningitis in adults is milder than in children, but children and adults can get infected under certain conditions in the same way. Transmission is also possible by airborne droplets, in places where there are many people. The largest peak of incidence is observed in the summer, which indicates the seasonality of the disease.

Symptoms of meningitis

Serous meningitis, the symptoms of which are quite specific, begins with an acute or subacute course. Why does it depend? First of all, from the etiology of the disease. Is the patient experiencing primary or secondary meningitis?

With primary serous meningitis begins:

• A sharp rise in temperature, and often it can rise to 40 degrees;
• Strong and painful headaches begin, which are paroxysmal in nature;
• Diarrhea can be observed, the stool becomes liquid, painful sensations are felt in the intestines;
• The patient feels muscle weakness, dizziness, causeless vomiting.
• Sometimes there are convulsions;
• In advanced stages, cuts or impaired brain activity are possible.

Serous meningitis in adults flows peculiarly. Around the fifth day of the disease, many symptoms disappear, the temperature stabilizes. However, first impressions are deceptive, and, as a rule, a relapse of the disease occurs. With improper treatment, signs appear that indicate damage to the peripheral and central nervous system.

If we talk about the secondary nature of serous meningitis, then it is not acute, but subacute. The flow is smooth, not abrupt. The patient has increased fatigue, general weakness, headaches, sweating and sometimes anorexia. The temperature is at a subfebrile level, children, having become ill with a secondary type of serous meningitis, are often naughty, refuse to eat, experience a constant feeling of fatigue and drowsiness. This course of the disease lasts quite a long time, about three weeks. And it is advisable to consult a doctor as soon as possible if these symptoms are detected. After a three-week period, irreversible meningeal changes in the body occur, such as Kernig's symptom, stiff neck muscles. Vision deteriorates significantly, all objects in the distance are visible fuzzy and blurry, pain in the eyeballs may begin. With advanced serous meningitis of a secondary nature, almost irreversible changes in the brain occur, which are focal in nature. Aphasia sets in, mental activity becomes difficult, the patient is tormented by convulsions and paresis.

Diagnostic methods

In infants, one of the meningeal syndromes is considered to be swelling of an unovergrown parietal fontanel. In adult patients, a triad of signs of meningitis is subdivided. These are syndromes of intoxication of the body, meningeal symptom complex, syndromes of the inflammatory process in the cerebrospinal fluid. Tests for puncture of the spinal cord is mandatory if serous meningitis is suspected, as the quality and composition of the CSF of the spinal fluid changes.

The meningcal symptom complex consists of headaches and vomiting, even delirium and hallucinations are possible. Therefore, in addition to spinal cord puncture, an MRI is often prescribed to track the dynamics of the disease and to understand whether there is a brain lesion. Specialists are also forced to take clinical blood samples in order to assess the overall picture of the state of the body.

Prevention

Serous meningitis is a rather dangerous disease, and the consequences of complications after an illness can make themselves felt throughout a person's life. Even with a treated disease, the pathogen can be in the body and cause a recurrence of serous meningitis. Therefore, it is important to take preventive measures to prevent infection. If you have small children, be careful what they eat and drink. Do not let your child drink tap water, the water must be boiled or thoroughly filtered.

The highest outbreaks of serous meningitis occur during the summer, so wash your hands, don't eat dirty vegetables. Vegetables are recommended to be washed in warm running water. Do not buy food from your hands, especially if you are not sure of its quality. Be sure to follow the rules of personal hygiene, after each trip to the toilet wash your hands thoroughly with soap. If you are traveling or relaxing with children in open water, make sure that the child does not swallow water from a lake or river.

It has been proven that in reservoirs with stagnant water, such as lakes, quarries, dams, during the summer months, pathogens of serous meningitis may well be present.

Go in for sports, temper your health and increase immunity in order to resist this dangerous disease. At the first suspicion of serous meningitis, immediately contact a qualified doctor for help.

Treatment

The earlier serous meningitis is diagnosed and treated, the greater the chance of a successful recovery. In the acute period, the treatment of serous meningitis takes place exclusively in stationary conditions under the supervision of the attending physician. The type of treatment, forms and terms depend on the nature and severity of the pathological process in the patient's body. Antibacterial therapy is mandatory. The types of antibiotics are selected strictly individually for each patient, because some people are suitable for antibiotics of the penicillin group, while others have to prescribe mucolide antibiotics or erythromycins.

When treating young patients, doctors prescribe antiviral drugs such as Abidol or Interferon. If it has been established that serous meningitis is caused by the Epstein-Barr virus or viruses of the herpetic group, then Acyclovir is prescribed. Often patients come to doctors with severely weakened immunity, and in such cases, immunoglobulin is administered intravenously. Diuretics such as Furosemide or Lasix are used to reduce headaches and intracranial pressure. In advanced and severe cases of serous meningitis, isotonic saline solutions are administered orally to reduce the degree of general intoxication of the body (albumin, Hemodez, glucose solution, Ringer). Lumbar punctures of the spine reduce intracranial pressure, and high temperature is brought down by ibuprofen and other antipyretic substances. Antihistamines, vitamins, a balanced diet and bed rest are also prescribed until complete recovery.

Serous meningitis is a fairly common disease. And, according to statistical studies, mainly children suffer from such an ailment. In the absence of timely treatment, inflammation can lead to severe and irreversible consequences.

That is why today many parents are interested in additional information about this disease. What are the reasons for its development? What do the first symptoms look like? Are there methods of prevention? Awareness in this matter will help to notice the signs of the disease in time and, accordingly, get rid of the mass of dangerous complications.

What is a disease?

Today, many are interested in what constitutes serous meningitis, the symptoms and causes of its occurrence, etc. This is a group of diseases of infectious origin. And such diseases are accompanied by inflammation of the soft membranes of the spinal cord and brain.

A distinctive feature is the rapid development of the inflammatory process according to the serous type. At the same time, the main meningeal symptoms are not so pronounced, and the inflammation is benign. Nevertheless, even a mild form of such a disease requires appropriate treatment, since the lack of therapy is fraught with dangerous consequences.

The main causes of the development of serous meningitis

Serous meningitis is an infectious disease. In most cases, the cause of its appearance is a viral infection, in particular, representatives of the enterovirus group. Moreover, in modern medicine it is customary to distinguish two groups of this pathology:

• Primary serous meningitis develops as independent diseases. The causative agents in this case are the ECHO virus, the Coxsackie virus and some others.
• The secondary form of the disease occurs, as a rule, against the background of another infectious disease. For example, serous meningitis in children can appear with measles, chickenpox, influenza, mumps, and some other viral diseases. Much less often, the culprits of inflammation are bacterial and fungal microorganisms.

Of course, the method of transmission of the infection is also an important issue. And, unfortunately, you can catch the virus in different ways:

• Viral particles can be transmitted through the air, as the pathogen is often localized in the mucous membrane of the upper respiratory tract. The infection is brought out when coughing or sneezing along with saliva and can easily enter the respiratory system of a healthy person, especially when it comes to close contact.
• A household transmission route is also possible, in which viral particles fall on various household items, toys, towels, etc. In addition, the infection can be caught by eating unwashed vegetables or fruits.
• Enteroviral serous meningitis can be waterborne. For example, in the summer, outbreaks of this disease are often recorded among children and adults swimming in closed water bodies.

Of course, the main source of infection is a sick person. On the other hand, it is also possible to become infected from carriers whose body is infected, but they do not have the manifestations of the main symptoms.

Who is at risk?

Of course, there are some risk groups. Since the disease develops against the background of an infection, the state of the human immune system is important in this case. That is why serous meningitis is most often diagnosed in preschool children, since the protective systems of their body are in the process of formation.

In adults, such inflammation is usually associated with a strong weakening of the immune system. Risk factors include the presence of various chronic diseases that gradually deplete the body. Serous meningitis is often diagnosed in patients with cancer and various immunodeficiencies. In addition, constant stress, malnutrition, sudden hypothermia and vitamin deficiency also increase the likelihood of developing this disease.

Risk factors include non-compliance with sanitary requirements, as well as poor living conditions. After all, rats are carriers of some viruses. By the way, in most cases, outbreaks of this disease are recorded in spring and summer.

Development mechanism

As mentioned earlier, children are most prone to this disease, since in adult patients a fully formed blood-brain barrier is a powerful barrier to viral infection.

Viruses infect the membranes of the brain, in the cells of which the rapid formation of new viral particles begins. Gradually, the infection changes the hemodynamics of the vascular system, which leads to the removal of a large amount of water from the bloodstream into the cerebrospinal fluid. Thus, serous meningitis is accompanied by an increase in the volume of cerebrospinal fluid, which in turn compresses the brain structures, causing characteristic symptoms.

The inflammatory process is often accompanied by a gradual thickening of the meninges, which can lead to dangerous consequences.

Serous meningitis: incubation period and first signs

The sooner help is provided to the patient, the faster and easier the therapy will be. So what are the symptoms of serous meningitis?

The incubation period, as a rule, lasts from 2-4 to 6-10 days, depending on the age of the patient, the state of his immune system and the type of infection. The first symptom in this case is fever. Body temperature rises sharply, sometimes up to 40 degrees. Along with this, there are also general symptoms of intoxication of the body - weakness, drowsiness, chills, body aches.

What other changes are accompanied by serous meningitis? Symptoms are also severe headaches that are almost impossible to stop with the usual pain medications. Pain may be aggravated by turning the head, making loud noises, moving the eyes, etc. As for the characteristic meningeal signs (for example, neck stiffness, confusion), they may be mild or absent altogether.

Serous meningitis: symptoms and clinical picture

As the disease progresses, other symptoms appear. For example, headache attacks are often accompanied by severe nausea and vomiting, which, however, does not bring much relief to the patient. There are also disorders of the digestive system, in particular, lack of appetite, abdominal pain, diarrhea.

There are other changes that accompany serous meningitis. Symptoms in children include increased irritability as well as some mild disturbances in consciousness. In newborn babies, you can see a significant swelling of the fontanel, which is associated with an increase in the amount of cerebrospinal fluid.

In some cases, serous meningitis is accompanied by muscle cramps, especially often this phenomenon is observed in children. On the other hand, the sensitivity is greatly increased. For example, the patient may overreact to light, while in the twilight his condition improves slightly. Some people become too sensitive to sounds (noise can trigger an acute headache), changes in temperature conditions, etc.

Basic diagnostic methods

It should immediately be noted that the correct diagnosis in this case is extremely important, since the treatment regimen for such a disease differs from therapy for other types of meningitis. First of all, the doctor should examine the patient and get acquainted with the main complaints.

If there is suspicion of meningitis, the patient needs to take a blood test, as well as samples of cerebrospinal fluid. Already during the lumbar puncture, one can notice important symptoms of meningitis - cerebrospinal fluid flows out under pressure, and after taking it, the patient's condition improves significantly.

The doctor receives additional information after laboratory tests. As a rule, a decrease in the level of proteins is found in the cerebrospinal fluid with a simultaneous increase in the number of leukocytes. In a blood test, you can also notice an increase in the number of white blood cells (in particular, neutrophils) and an increase in the level of proteins in the globulin fraction.

How to treat?

What therapy does serous meningitis require? Treatment can only be prescribed by a doctor - home remedies can not only not bring benefits, but even aggravate the situation. Naturally, the scheme in this case differs from the usual set of drugs for meningitis. After all, antibacterial agents for a viral disease are completely ineffective.

First of all, patients are prescribed antiviral drugs. The most effective are Acyclovir, Arpetol, Interferon. People with severely weakened immune systems need additional therapy. In such cases, human immunoglobulin is used, as well as placental and donor gamma globulin. The treatment regimen may change if serous meningitis has developed against the background of another disease. So, for measles, patients are prescribed anti-measles immunoglobulin, etc.

In connection with the increase in the volume of cerebrospinal fluid, dehydration is also extremely important. That is why patients take diuretics, including Furosemide and Lasix, which help remove excess fluid from the body. In some cases, therapeutic punctures are performed - the periodic removal of a small amount of cerebrospinal fluid helps to eliminate headaches and significantly improve the patient's condition.

What medications does serous meningitis require? Treatment in adults and children also necessarily includes the use of antihistamines, including Tavegil, Suprastin and some other drugs. These medications help relieve some symptoms, relieve fever, and prevent an allergic reaction.

In some cases, steroidal anti-inflammatory drugs are also used, in particular, Hydrocortisone and Prednisolone. In the presence of seizures, patients are prescribed muscle relaxants - Domosedan and Seduxen are considered the most effective.

With the right treatment, bed rest and proper nutrition, improvements usually occur after a few days. After 8-10 days, the main symptoms of serous meningitis completely disappear. Nevertheless, patients (especially if we are talking about a child) should still be registered with a neurologist for some time and undergo regular examinations - this will help to notice the appearance of certain complications in time and take appropriate measures.

Meningitis in children and adults: what is the danger?

Of course, serous viral meningitis is dangerous to human health, especially in the absence of adequate treatment. Therefore, in no case should you resort to traditional medicine methods or self-medicate.

But the right therapy can eliminate the disease without any consequences. In most cases, after treatment, some “side effects” remain - these are headaches, drowsiness and weakness, which disappear after 1 to 3 months.

Serous meningitis in adults rarely causes any complications. On the other hand, severe consequences of inflammation are still not excluded. For example, the appearance of certain disorders in the functioning of the brain is possible - it all depends on which parts of it were irreversibly damaged. Various speech disorders are also possible. If inflammation affects the area of ​​the nerves responsible for the movement of the eyeball, the patient may develop strabismus.

Much less often, the serous form of meningitis causes blindness or deafness - as a rule, these complications are associated with improper treatment or its absence, or the presence of some other serious concomitant diseases. In young children, this disease can cause a delay in psychomotor development.

Naturally, in modern medical practice there are more severe cases. Serous meningitis can lead to paralysis, coma, or even death. But such complications are considered very rare, especially if the patient has undergone therapy.

Basic Prevention Measures

As you can see, serous meningitis is a fairly serious disease that children are most susceptible to. Therefore, today many parents are interested in questions about whether there are effective precautions. Prophylactic agents can be divided into two groups - medical and regime.

As already mentioned, in most cases it is the viruses that cause serous meningitis. Symptoms in children often occur against the background of diseases such as measles, rubella, etc. Medical prevention includes mandatory standard vaccinations against infectious diseases. In addition, doctors recommend taking multivitamin and immunomodulatory drugs from time to time, which reduce the likelihood of developing the disease.

Naturally, these are not all measures that can prevent serous meningitis. Prevention includes other equally important aspects. In particular, it is extremely important to maintain the normal state of the immune system, which is facilitated by a healthy diet, physical activity, hardening, lack of stress, etc.

On the other hand, do not forget about hygiene standards. In particular, you can not eat unwashed fruits and vegetables, as well as drink contaminated water. Personal hygiene is also extremely important. And, of course, the first signs of serous meningitis are a serious reason to immediately see a doctor. Take care of your health and the health of your loved ones!

Serous meningitis is the rapid spread of an inflammatory process in the membranes of the brain, the causative agent of which is fungi, bacteria or viruses.

At the same time, about 80% of clinical cases are associated with an inflammatory process due to viruses. Such a serious disease mainly affects children of preschool age of three to six years, and the symptoms of serous meningitis are somewhat less common in schoolchildren and quite rarely in adult patients.

Like meningitis of other origins, serous meningitis has characteristic common signs, including repeated vomiting, severe headache, and nausea. A distinctive feature of the viral origin of the serous type of meningitis is its abrupt onset, while there is a slight impairment of consciousness, such meningitis proceeds rapidly and has a favorable outcome.

Based on the clinical picture of the disease, the results of PCR and data from the analysis of cerebrospinal fluid, a diagnosis of serous meningitis is made. Treatment of patients with such meningitis is based on antiviral and symptomatic therapy - antiviral, antipyretic and analgesic drugs. If the etiology of inflammation of the meninges is not clear and the child's condition worsens, it is necessary to prescribe broad-spectrum antibiotics in order to affect all possible infectious agents.

Causes of Serous Meningitis

In most cases, serous meningitis is caused by enteroviruses - Coxsackie, ECHO viruses, less often the Epstein-Barr virus (infectious mononucleosis), measles, herpes infection, adenoviruses, influenza, cytomegalovirus, mumps virus can act as a cause of serous meningitis.

Serous meningitis can be not only viral, but also bacterial in nature (syphilis, tuberculosis), and in some cases fungal. A typical bacterial lesion is meningococcal meningitis (purulent). Serous meningitis is typically a viral variant.

Recently, outbreaks of serous meningitis in children, which is caused by various enteroviruses, have been recorded quite often, so it is important to consider serous viral meningitis, their symptoms and transmission options, as well as treatment in children.

Serous inflammation can provoke cerebral edema. In this case, there is a violation of the outflow of cerebrospinal fluid, cerebral edema causes an increase in intracranial pressure. Unlike purulent meningitis of a bacterial nature, the serous form does not provoke a massive release of neutrophils, brain cells do not die, therefore the viral form of meningitis is less dangerous, has a favorable prognosis and does not provoke serious complications.

Ways of infection, the incubation period of the serous form of meningitis

The incubation period in most cases of viral meningitis is 2-4 days. Based on the type of pathogen, the following ways of infection with serous type meningitis are distinguished:

• Airborne route.

Serous meningitis is transmitted by airborne droplets when the pathogen is located on the mucous membrane of the respiratory tract. When sneezing, coughing, infectious agents in the form of an aerosol are released into the air and enter the human body in the process of inhaling the affected air.

contact path.

The causative agent is also localized on the mucous membrane, but the eye, in the oral cavity and on the surface of wounds and skin, from these areas the infectious agent enters various objects and settles on them. A healthy person who comes into contact with the skin of a sick person or shared objects is at risk of becoming infected. Therefore, unwashed fruits and vegetables, dirty hands, and poor general hygiene are risk factors for infection with serous meningitis.

Water route of infection.

Serous meningitis quite often occurs in the summer. It has been established that some enteroviruses that can cause serous type meningitis can be transmitted through water, therefore, just during the swimming season, outbreaks of serous meningitis are recorded in children who bathe in reservoirs with enteroviruses.

The peak incidence of serous meningitis is the summer period of the year, the risk group is the immuno-unprotected segments of the population - children of preschool and primary school age, this group also includes people who are weakened after long-term serious illnesses, and patients with immunodeficiency states. At the same time, not only those already ill, but also carriers of the meningitis virus are at risk.

Symptoms of serous viral meningitis in adults and children

After the end of the incubation period, the pathology is manifested by severe symptoms - meningeal syndrome from the first or second day of the disease.

A mandatory sign of serous type meningitis is a fever with an increase in body temperature up to 40 degrees, after 3-4 days the temperature may decrease, after which it rises again, thus two bursts of temperature are recorded. With a mild course of meningitis, the temperature may not appear.

An excruciating headache, which is constantly present, begins with the temples and becomes more pronounced with eye movement, exposure to noise and light stimuli. Such a headache is difficult to stop with painkillers and antipyretic drugs for children.

Children may experience cramps in the limbs, general irritability, such children become whiny and capricious.

Characteristic is the state of general weakness, intoxication syndrome, malaise, in which pain in the joints and muscles develops.

Diarrhea, abdominal pain, lack of appetite, and nausea with vomiting are signs of serous meningitis.

Often in children, in addition to meningeal symptoms, there are signs of SARS - cough, runny nose, sore throat.

The sensitivity of hearing, eyes, skin to touch, sharp noise, light and sounds increases. The patient becomes much easier when in a dark, quiet room. At the same time, in bed, the child takes a forced position with his knees pulled up to his stomach, his arms pressed to his chest and his head thrown back.

In infants, the fontanelles bulge, the Lesage symptom or the suspension symptom develops - when the child is lifted up, he pulls the legs to the stomach and bends them.

With serous meningitis of viral origin, mild disturbances of consciousness may be present, namely drowsiness and stupor.

Possible damage to the cranial nerves (strabismus, diplopia, difficulty swallowing) are also observed respiratory disorders (paresis, paralysis).

When examining a child with serous meningitis, the symptoms are expressed by tension and rigidity of the cervical muscle groups, namely, the child cannot bring his chin to his chest. Several meningeal symptoms are also present, including:

Brudzinsky's symptom: upper - if the legs involuntarily bend when the head is bent;

Kernig's symptom - the inability to straighten the leg, bent at a right angle.

Viral serous meningitis passes quite quickly, by 3-5 days from the onset of the disease the temperature is restored, in rare cases a second wave of fever is possible. The duration of serous meningitis in a child is usually 10 days on average and ranges from 1 to 2 weeks in general.

With the development of severe disorders of consciousness - stupor or coma - it is necessary to reconsider the diagnosis and conduct a re-examination.

Symptoms of serous meningitis can have varying degrees of severity, in rare cases, the clinical picture can be combined with generalized lesions of other organs. It should be borne in mind that the symptoms of the serous form of meningitis are very similar to the meningeal form of tick-borne encephalitis, which is characterized by a seasonal nature and is more often recorded in the summer, while it can affect both children and adults.

Treatment of serous meningitis in children

If you suspect the development of meningitis, you should immediately call an ambulance and hospitalize the sick child. Since the causative agent is most often viruses, the use of antibiotics for serous meningitis is impractical. But in some cases, they can be prescribed when the diagnosis is uncertain.

In the treatment of viral serous meningitis in children, antiviral agents are used - interferon. If meningitis is caused by the herpes virus or Epstein-Barr virus, Acyclovir is prescribed.

Infants and immunocompromised children require specific and nonspecific antiviral therapy, and intravenous immunoglobulin is required.

Dehydration is the most important measure in the fight against a decrease in intracranial pressure, therefore, diuretics are used - Aztazolamide, Furosemide, Lasix.

Colloids (albumins, hemodez) are inappropriate due to the high risk of developing heart failure.

Antispasmodics are shown - No-shpa, Drotaverine.

Intravenous administration of isotonic saline solutions is also shown to reduce the degree of intoxication, ascorbic acid and prednisolone are added to the saline solution (once).

Reducing intracranial pressure and alleviating headaches is possible through therapeutic lumbar punctures.

With an increase in body temperature above 38 degrees, antipyretic drugs are used - ibuprofen, paracetamol.

With the development of seizures in a child, domosedan or seduxen is used.

Patients are shown bed rest and rest, it is best if the patient is in a darkened room.

Broad-spectrum antibiotics are prescribed due to the fact that many forms of meningitis can proceed as a serous one, while even in the cerebrospinal fluid there may be signs of serous meningitis. But timely antibacterial treatment can prevent the development of severe consequences of the bacterial process (hemorrhage in the adrenal glands, cerebral edema).

The complex therapy of serous meningitis should include vitamin therapy, especially vitamin C, B6, B2, carboxylase.

As an auxiliary measure, oxygen treatment is indicated - oxygen therapy.

Nootropic drugs - Pirocetam, Glycine.

Also other drugs for the treatment of pathologies of the nervous system (succinic acid + riboflavin + nicotinamide + inozyme).

With timely adequate therapy, serous meningitis in children, unlike purulent, has a favorable prognosis and rarely causes complications.

Prevention of serous meningitis in children

During outbreaks of serous meningitis, young children and adolescents should not swim in open water.

You need to drink only boiled or purified water, especially in the summer.

Wash hands thoroughly with soap and practice personal hygiene before eating. Wash vegetables and fruits before eating and, if possible, pour boiling water over fruits and berries.

From childhood, teach children to a healthy lifestyle, provide the child with a balanced diet, engage in hardening of the body and sports. It is necessary not to allow the child to be at the computer or in front of the TV for a long time, as this increases the visual load, which means it introduces the body into a stressful state, which reduces immunity. The child should have a full sound sleep for 10 hours a day, daytime sleep is especially valued, not only for babies, but also for teenagers.

As one of the types of prevention of serous meningitis is a serious attitude to any viral diseases in children - mumps, measles, chickenpox, SARS, influenza. It is necessary to minimize the possibility of contact with rodents and ticks, since they are carriers of the virus.

Despite a five-day fever and severe headaches, the prognosis for serous meningitis is favorable, and most children recover fairly quickly.

The inflammatory process that affects the meninges is called meningitis. One of its variants is the serous form. In this case, leukocytes and inflammatory elements are present in the cerebrospinal fluid. Treatment of the disease must be carried out on time. Delay can lead to dangerous complications.

What's this?

Inflammation in the membranes of the spinal cord and brain begins after exposure to a provoking factor. It can be both external agents and internal ones. Most often, serous meningitis is viral in nature. In about 85% of cases, the disease is caused by various viruses.

The most common causes leading to the disease can be noted:

Viral infections. In most cases - adenovirus variants. Adenoviruses are highly resistant to adverse environmental factors and easily spread through the air. Babies often get sick through airborne droplets. After 3-5 days, the first clinical symptoms appear.

Bacterial. In mild cases, they can also cause serous inflammation. Coccal flora has a high neurotoxic effect and quickly contributes to damage to the nervous system. Penetrating through the blood-brain barrier, bacteria multiply quickly enough in the child's body and contribute to the development of inflammation.

Traumatic injuries. The most common option is the consequences of birth trauma. In older children, serous meningitis may occur as a complication after a traumatic brain injury resulting from an accident or an accident. The course of the disease in such a situation is usually quite severe. A consultation with a neurosurgeon is required.

Congenital pathologies. Such cases occur when expectant mothers become infected during pregnancy with measles or rubella viruses. The baby, being in the mother's womb, can also easily become infected. The consequences of infection are quite dangerous. In born children, there are violations of mental and neurological functions.

Causes and provoking factors

Not a single child is immune from the development of serous meningitis. Even in a perfectly healthy baby, infection and a decrease in general immunity can develop this dangerous disease. The viral etiology of the disease does not allow specialists to come up with effective vaccines that would prevent all possible variants of the disease. For some children, the risk is significantly increased.

Risk groups include:

Premature babies, as well as children with extremely low birth weight. As a rule, these children do not yet have a well-formed and functioning immune system. This leads to a high susceptibility of the child's body to various infectious diseases. The nervous system of a premature baby is also not well adapted to the external environment.

Congenital or birth injuries of the head, as well as damage to the organs of the nervous system. With various types of traumatic brain injuries in babies, signs of serous inflammation may appear. Damaged pia maters are quickly drawn into the inflammatory process. The disease can develop in the first days after the birth of the baby.

intrauterine infection. Rubella infection is most dangerous for the unborn fetus. Also, in some cases, infection with the Epstein-Barr virus can lead to the development of meningitis.

Congenital or acquired immunodeficiencies. A low level of the immune system does not allow the child's body to cope with any infection. The leukocyte link of the blood, which is designed to fight foreign agents, practically does not fulfill its duties. As a result, the multiplication of microorganisms in the body occurs rapidly and inflammation increases rapidly.

Incubation period

The first clinical signs in the serous variant of meningitis appear quite early. The incubation period for viral inflammations is usually 3-5 days. With rubella - this period can be 2 weeks. During the incubation period of the disease, the baby is practically not bothered by anything.

In some cases, attentive mothers may notice some change in the child's behavior. The kid becomes more silent, naughty, asks for more hands.

In some babies, appetite may decrease and sleep may be somewhat disturbed. However, the general condition of the child during the incubation period suffers slightly. The main manifestations of the disease occur after a few days.

Symptoms and first signs

It is often difficult to recognize serous meningitis at home. A pediatrician will be able to determine this disease after examining the child and checking for special, characteristic meningeal signs.

Seek advice from a doctor with suspected meningitis, mom should if the following manifestations appear:

Increase in body temperature. Usually up to 38-39 degrees. In a more severe course, the temperature can rise even to 39.5. It is poorly reduced even under the influence of antipyretic drugs. The usual dosages of paracetamol do not bring a pronounced clinical effect.

Violent headache. It is usually spilled, without a clear localization. The pain syndrome increases with a change in body position or focusing of vision. The horizontal position brings more comfort to the baby. Children try to lie more, with their heads thrown back a little. This is the characteristic meningeal posture.

Soreness of the muscles in the back of the neck. This is due to the manifestation of rigidity of the occipital muscles. Pulling the legs to the stomach can increase the pain syndrome. This symptom appears in connection with damage to the nerves and inflammation of the meninges of the spinal cord.

General pronounced weakness. In the acute period of the disease, the baby suffers greatly from well-being. Children refuse to eat, become very sleepy. They hardly play with toys. Infants refuse breastfeeding, may spit up more often.

Strong nausea. This symptom is a classic manifestation of meningitis and occurs in 90% of cases. During the whole day, babies feel a strong feeling of heaviness behind the sternum and constant nausea. Against the background of high fever or severe headache, even vomiting may occur. Usually it is very plentiful and single. Nausea or vomiting occurs without connection with meals.

Soreness in the muscles. More often, when trying to bring the legs to the stomach or torso, the pain syndrome increases significantly. Soreness can also occur in the cervical spine.

When infected with an enterovirus infection, there may appear abdominal pain and stool disorders. These symptoms can also increase dyspeptic manifestations and lead to an increase in nausea.

The appearance of a rash. This sign is typical only for those viral infections that occur with the appearance of skin rash elements. It can most often occur with meningococcal infection, as well as with rubella or measles. In more rare cases, the appearance of serous meningitis is recorded with chicken pox.

In rare severe cases - the appearance of convulsions and clouding of consciousness. With an unfavorable course of the disease, even coma can occur. This condition requires urgent hospitalization of the baby in the intensive care unit.

Diagnostics

Establishing the correct diagnosis is a necessary guarantee for the appointment of timely and effective treatment. To date, the diagnosis of serous forms of meningitis plays a leading role in pediatrics. A huge number of adverse effects that occur after the disease, give great importance to diagnostic procedures.

One of the simplest and most affordable diagnostic methods is a complete blood count. It allows you to clarify the etiology of the process. The leukocyte formula shows the presence of a viral flora that caused the inflammatory process. Accelerated ESR also indicates the presence of inflammation. By analyzing blood counts, doctors can determine the presence of complications.

An equally informative method of diagnosis is bacteriological studies. The test material can be saliva, urine or blood. With the help of special analyzers, laboratory doctors detect the causative agent of the disease. During such bacteriological tests, it is also possible to determine the sensitivity of the microbe to various medicines.

Serological blood tests can detect specific antibodies. For these tests, venous blood is taken. After a couple of days, as a rule, doctors have a ready result. With the help of this analysis, it is possible with a high degree of probability to say which pathogen caused the disease.

In doubtful cases, neurologists resort to the collection of cerebrospinal fluid. This analysis is usually prescribed during the differential diagnosis of serous and purulent meningitis. It also helps to exclude rare forms of the disease. For example, tuberculosis. The abundance of leukocytes in the cerebrospinal fluid (CSF) allows you to clarify the nature of the inflammation.

Treatment Methods

All forms of meningitis must be treated in a hospital setting. This disease is very dangerous. A huge number of possible complications can develop spontaneously, even despite ongoing treatment. A sick child requires constant monitoring by medical workers.

Treatment of the disease is complex. The main principle of therapy is to eliminate the cause of the disease and reduce adverse symptoms. If meningitis is of a viral nature, then in this case, the child is prescribed antiviral and immunostimulating drugs. Such drugs are administered intravenously for better absorption of the active substances that make up the composition.

In bacterial forms of meningitis, various antibiotics are used. Currently, pediatricians prefer antibacterial drugs with a wide spectrum of action. These drugs do an excellent job with a variety of microbes and have a good tolerability profile. The most commonly prescribed macrolides or injectable cephalosporins of the latest generations.

To reduce headaches and prevent swelling of the brain, doctors use diuretics. Diuretic drugs can effectively reduce intracranial pressure and save the baby from persistent pain. In severe cases of the disease, the use of diuretics is carried out in the conditions of the intensive care unit and intensive care.

Some babies, especially those under three years of age, may experience complications from the cardiovascular system. Most often there are various forms of arrhythmias. To treat such rhythm disturbances, doctors resort to prescribing special antiarrhythmic drugs based on propanol or beta-blockers.

To maintain immunity and quickly recover from meningitis, injectable forms of B vitamins are administered to babies. These drugs have a positive effect on the nervous system and contribute to the speedy regeneration of damaged meninges.

Hospital stay

European and Russian clinical recommendations include the obligatory presence of a child in a children's hospital for the entire duration of meningitis therapy. Newborns or infants undergo medical treatment in specialized units. Medical institutions providing care to sick children with meningitis must be equipped with all necessary resuscitation equipment.

Is home treatment possible?

In severe cases of the disease or in children under one year old, at the first sign of meningitis, mandatory hospitalization is required. Delay in the provision of medical care can provoke the appearance of life-threatening complications. Monitoring the baby at home is possible only during the recovery period. This condition is necessary for the complete recovery of the child's body after a severe infection.

Consequences and possible complications

With the right treatment, as a rule, most children recover. However, some babies may experience different consequences. All complications after serous meningitis can be divided into:

Lungs: impaired memory and attention, fatigue, inability to concentrate. For several months after suffering meningitis, babies may complain of a mild headache.

Heavy: development of heart and kidney failure due to infectious systemic inflammation, arrhythmias, episyndrome, impaired muscle contraction.

Prevention

To minimize the possibility of infection with various infections that can lead to meningitis, you should remember about the obligatory observance of personal hygiene measures.

Each kid should have their own mug, cutlery. Towels and hygiene products for children must be washed at least twice a week. In newborn babies - daily.

During epidemic outbreaks of infections in educational institutions, babies should be quarantined. It usually lasts 1-2 weeks. Such a forced measure helps to significantly reduce the risk of possible infection and protect the baby from infection.

Strengthening immunity- also plays an important role in maintaining good health.

Walking and playing outdoors will be a great option to keep your immune system working well.

Proper treatment of serous meningitis avoids the appearance of formidable complications and leads to recovery. It should be remembered that when the first signs of inflammation occur, you should definitely consult a doctor. Timely diagnosis and the appointment of drug therapy will save lives, as well as preserve the health of the baby.

For more information about what is meningitis in children and how to prevent your child from getting sick, see the following video.

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

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

Causes of serous meningitis

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

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

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

Classification

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

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

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

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

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

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

Symptoms of serous meningitis

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

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

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

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

Characteristic signs and postures with pathological changes in the meninges:

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

Clinical manifestations of forms of meningitis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Diagnostics

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

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

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

Differential Diagnosis

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

Treatment of serous meningitis

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

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

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

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

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

Complications

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

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

Forecast

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

All symptoms in children completely disappear after ten days.

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

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

Prevention

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

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

Related videos

Interesting