Meningococcal meningitis in children. Acute edema and swelling of the brain. Diagnosis of meningococcal infection

Sudden onset of unbearable headache high temperature often indicates infection with meningitis. This pathology is associated with a long stay in the cold. Often, meningitis occurs against the background of inflammatory processes, among which are sinusitis, otitis, caries. Despite the infectious nature of the pathology, it is also referred to the group neurological diseases. This is due to the fact that due to meningitis, irritation of the substance of the brain occurs. Sometimes, inflammation of the membranes is combined with encephalitis.

The typical form is meningococcal meningitis. It is found in patients with bacterial inflammation of the meninges in most cases. The disease is considered dangerous, as it often leads to complications and death. In the case of the development of a generalized form of infection, treatment is carried out under conditions intensive care and resuscitation.

Causes

The disease occurs in case of infection with a specific pathogen - meningococcus. It belongs to Gram(-) bacteria. Meningococcus is poorly stable in the environment. When the temperature changes, it quickly dies. The bacterium is sensitive to both cold and heat. The causative agent dies under the influence of sunlight. However, it has the ability to change. Due to the presence of a capsule, meningococcus is a highly pathogenic microorganism. It protects bacteria from phagocytes - cells of the immune system.

The symptoms that develop with meningitis are due to exposure to endotoxin. It is a lipopolysaccharide with high pathogenicity. There are several types of bacteria with different antigenic structure. In countries Western Europe infection is caused by strains B and C. In Russia and Ukraine, meningococcus group A is more often found.

Microscopically, the pathogen resembles coffee beans. It refers to immobile diplococci, which can be located both inside and outside the cell. Favorable environment for bacteria of this species, blood, ascitic fluid, yolk and milk are considered. The pathogen grows and multiplies at a temperature of 36-37 degrees.

Epidemiological data

The source of pathology is not only sick people, but also people infected with meningococcus, even in the absence of clinical manifestations. They cause infection in 70-80% of cases. In some cases, meningococcal infection proceeds according to the type of nasopharyngitis, that is, the common cold. At the same time, patients do not realize that they have this dangerous pathogen in their body. In such cases, the main route of transmission of pathology is airborne infection. Bacteria get into environment when coughing, talking and breathing the patient. The risk of infection is high when the source of infection is less than 50 meters away.

There are 3 forms of the disease:

Meningococcal nasopharyngitis.
Generalized (spread) infection.
Asymptomatic carriage of the causative agent of pathology.

People with a normally functioning immune system have low susceptibility to meningococcus. It is less than 1%. Children are more often affected. The chance of getting infected increases when you are in crowded places, high concentration meningococci indoors. The peak of infection occurs at the end of winter and the beginning of spring, as unstable weather and decline defensive forces organism.

Pairwise arrangement of meningococci on microscopy

If a pathology is detected, an urgent notification is submitted to the sanitary supervision authorities. All cases meningococcal infection strictly registered. Lethal outcome occurs in 10% of patients with a generalized form of pathology. Each year, meningitis of this etiology is detected in approximately 300 people.

The mechanism of the development of the disease

When bacteria penetrate the mucous membrane of the throat or nose, nasopharyngitis develops only in 10-15% of cases. Often, meningococci are quickly destroyed due to various defense mechanisms. These include cellular and humoral immunity, the complement system. The mucous membrane itself has a bactericidal property. If the immune system is not weakened, then the risk of infection with nasopharyngitis is low. In some cases, there is an asymptomatic carriage of meningococci.

With the weakening of the protective forces and the pronounced virulence of bacteria, adhesion of pathogens to the mucous membranes is possible. In this case, a local inflammatory response. Less commonly, some meningococci enter the bloodstream causing primary bacteremia. It leads to the appearance of single hemorrhagic and roseolous-papular elements on the skin.

In the blood test, leukocytosis is noted, which indicates the presence of an inflammatory process. It is believed that primary bacteremia is not capable of leading to generalization of infection.

The spread of meningococci throughout the body is associated with the formation of secondary pathological foci. They are localized on the endothelium of capillaries. This causes fast development clinical picture and severe organ complications.

Bacteremia and the release of endotoxins are accompanied by a violent reaction from immune cells. They start the process of formation of biologically active substances that are mediators of inflammation. Damage to capillaries and an increase in vascular permeability leads to the penetration of bacteria through the blood-brain barrier. Meningococci enter the subarachnoid space, causing inflammation meninges. Less commonly, the disease develops as a result of trauma to the skull and a defect in the ethmoid bone.

Pathological examination

At morphological study changes are found in the pia mater and ependyma of the ventricles. With a widespread infection, the substance of the brain itself also suffers. On the early stages disease observed serous inflammation. However, the exudate quickly acquires a purulent and fibrinous character. The biopsy shows small hemorrhages, tissue edema, obturation of the holes of Luschka and Magendie, granulation, sclerosis of perivascular fissures. All this leads to the development of hydrocephalus. This symptom due to a violation of the outflow and stagnation of cerebrospinal fluid in the membranes and ventricles of the brain.

As the process progresses, the affected area increases. Inflammation passes first to the membranes, and then to the substance spinal cord. The clinical picture of myelitis develops in rare cases.

Symptoms

Incubation period lasts from 2 days to 1 week. At this time, there are catarrhal phenomena from the nasopharynx, general weakness, fever, malaise. Subsequently, other symptoms of meningococcal meningitis join. In most cases, they occur rapidly, within 1-2 days.

The main syndromes that develop with this disease include:

intracranial hypertension.
Infectious-toxic manifestations.
meningeal symptoms.

Muscle and headache appear in the incubation period

First of all, toxic manifestations develop. They determine the severity of the patient's condition. Signs of intoxication occur abruptly, against the background of a relatively satisfactory condition. In some cases, they are preceded by nasopharyngitis. Generalization of the infection leads to a systemic response of the body. The patient's body temperature rises sharply, there are muscle pains, fever. A bursting headache appears. The temperature reaches 39-40 degrees. Antipyretics help bring it down only on short span time.

Other signs of intoxication syndrome include:

Nausea and vomiting that is not associated with eating and does not bring relief.
Dizziness.
Pain on moving the eyeballs.
Loss of appetite and thirst.
Hyperesthesia - hypersensitivity to pain, light and sound stimuli.

Consciousness can be confused, hallucinations and delirium are noted against the background of intoxication. When the substance of the brain is involved, paralysis and paresis of the limbs, convulsive syndrome, hearing and vision impairment occur. In some cases, there is strabismus, facial asymmetry, ptosis. Hypertension syndrome characterized by headache, nosebleeds, in children - bulging of a large fontanel.

Clinical varieties

The classification of meningococcal infection is based on the location inflammatory focus. Localized forms include asymptomatic carriage and nasopharyngitis. It flows like bacterial infection upper respiratory tract.

Symptoms of meningococcal nasopharyngitis include nasal congestion due to purulent discharge, sore throat, fever, and weakness. At timely treatment inflammation does not go to the membranes of the brain.

Common forms of pathology include meningitis, meningococcemia and meningoencephalitis. In some cases, a mixed variant of the course of the disease is observed.

In rare cases, there are atypical forms infections. They are caused by meningococcus, but do not affect the nervous system, but internal organs. Among them are the heart, lungs, joints, iris. Depending on the localization of inflammation, meningococcal endocarditis, pneumonia, arthritis, and iridocyclitis are distinguished. These forms of infection can be detected only after performing a laboratory or morphological study.

Symptoms of meningococcemia

Doctors note that meningococcal meningitis is most severe in children. This is especially true for morbidity in babies of the first year of life. In children, the infection quickly spreads throughout the body and becomes a generalized form. The main manifestation of the disease is intoxication syndrome. In children under 1 year old, it may be the only sign of meningitis. Also, the features of the course of the disease at an early age include impaired consciousness and convulsions.

A malignant form of pathology is meningococcemia. This variant of the flow develops rapidly, within a few hours. The mechanism of development of this form of meningococcal infection is the defeat of capillaries by blood clots, which lead to the development of local tissue necrosis. The main symptom of the disease is the appearance on the body of a hemorrhagic rash of stellate or irregular shape. It is formed in 70-90% of children infected with meningococcus. Small hemorrhages quickly increase in size, tend to merge. Subsequently, they reach up to 5-15 cm in diameter. The spots resemble large hematomas. They are dense to the touch and protrude above the surface of the skin. Necrosis is formed in the center of the spot. The tissue in this place begins to be rejected, leaving defects.

Rashes in meningococcemia

The rash is most often localized on the legs, buttocks, eyelids, less often on the hands. In the absence of timely treatment, gangrene develops. In some cases, meningococcemia affects small joints hands and choroid of the eyes. In addition to skin rashes and severe intoxication, focal neurological symptoms are noted.

Possible Complications

Complications of meningococcal meningitis include cerebral edema, ependymatitis, cerebral hypotension, and toxic shock. These consequences often become the cause of death from this pathology. Due to edema, the medulla oblongata is infringed, leading to acute vascular and respiratory failure.

Ependymatitis develops with untimely treatment or its absence. The complication is characterized by total muscle rigidity, convulsive syndrome and vomiting. Body temperature may be normal or subfebrile, despite serious condition patient.

Cerebral hypotension syndrome leads to ventricular collapse. At the same time, the retraction of the diseased fontanel is noted. Most often this complication develops in children under 1 year of age against the background of toxicosis and exsicosis. It is dangerous for the development of a hematoma in the subdural space.

Diagnostics

Diagnosis of the disease is based on the data of the examination and anamnesis, which must be collected in detail from the parents of the child. Typical for bacterial inflammation meninges are meningeal symptoms Brudzinsky, Kernig and Lessage (in children). With a generalized infection, they are pronounced. If the doctor suspects meningitis, it is performed to identify the causative agent of the infection. Lumbar puncture is important for diagnosis and instrumental methods research - MRI of the brain, echoEG, EEG.

Features of treatment

With common forms of meningitis, treatment is performed in stationary conditions. It includes antibacterial, detoxification and anti-inflammatory therapy. Medications for meningitis penicillin series at the rate of 200 thousand units per 1 kg of body weight. They are combined with caffeine, which improves the penetration of the drug through the blood-brain barrier. Meningococcemia is an indication for the appointment of the drug Levomycetin, which prevents the release of endotoxin. As pathogenetic therapy using prednisone. To avoid cerebral edema, Furosemide and Mannitol are prescribed medications.

Further forecast

With untimely treatment of meningococcal inflammation of the meninges, deafness, mental retardation, hydrocephalus, and blindness may develop. The prognosis for complications is poor. Complete recovery with timely treatment is more common in adults and school-age children.

Preventive measures

Vaccination is performed to prevent meningococcal infection. It is carried out to persons in contact with the carrier of the bacterium, as well as to those who travel to areas endemic for this disease. Mono-, di- and polyvalent vaccines are used.

To nonspecific prevention include quarantine measures, hardening, fortification of the body. During the peak of the incidence, crowded rooms and exposure to the cold for a long time should be avoided.

meningococcal meningitis- a disease with serious consequences.

Some infectious diseases able to hit the most important organs bodies - the spinal cord and brain, thus causing irreparable harm to the body. So dangerous infection is meningococcal meningitis.

What is meningococcal meningitis

Meningococcal meningitis is an acute infectious disease that has a generalized form (that is, it spreads throughout the body through the lymphohematogenous route), the causative agent of which is meningococcus. The infection affects only the human body.

Allocate different forms diseases, one of which is the most dangerous because of the lightning speed of its course and possible complications. The incubation period can last from 12 hours to 4 days.

The pathogen is divided into 13 groups. In Russia and post-Soviet space group A meningococcus is the leader, group B bacteria are sometimes found.

Young children are most susceptible to infection, but newborns are more often protected by antibodies obtained from the mother, which last up to six months.

The disease is based on damage to the central nervous system (namely, blood vessels) by toxins that are released after the death of meningococci, as a result of which the brain swells. If bacteria penetrate the blood-brain barrier (BBB), it develops purulent inflammation, hemorrhage and blood clots are formed. Such a process, moreover, can cover the nerves located in the skull. With a lightning-fast course of the disease, an infectious-toxic shock develops.

Meningococcal meningitis can be of the following types:

uncomplicated;
complicated ONGM with dislocation (edema and swelling of the brain with displacement of its tissues inside the skull);
meningoencephalitis (inflammation of both the tissues of the brain and its membranes).

Localized (nasopharyngitis) and generalized (damage to the whole body) forms can occur with or without the formation of metastases in the internal organs.

According to the severity of the course of the disease, the following conditions are distinguished:

lung;
moderate;
heavy;
very heavy.

According to the duration of the course, the disease is divided into:

acute (up to 3 months);
long-term (more than 3 months);
chronic (more than six months).

The main danger of the disease lies in the possible swelling of the brain with dislocation syndrome and infringement of its trunk. The mortality rate for this reason is quite high.

The reasons

The disease is characterized by a certain seasonality, outbreaks of mass morbidity are recorded every 15-20 years in the spring season. Experts suggest that infection with meningitis at certain intervals is associated with a decrease in herd immunity, as well as with the ability of the infection to mutate, giving rise to new strains.

If a person has strong immunity, then the bacterium, once in the nasopharynx, will die, or, in some cases, will cause nasopharyngitis.

Otherwise, if the body is weakened by stress, poor nutrition, ecology and other diseases, the infection overcomes the blood-brain barrier and affects the membranes of the brain and spinal cord, a severe form of the disease develops. A person can die from intoxication of the body before the onset of acute meningitis.

Ways of disease transmission

coccal infection is transmitted only by airborne droplets. The contact route is excluded, since meningococcus is extremely unstable in the external environment and dies from:

drying;
sun rays;
cold;
temperatures above 50 degrees Celsius.

Meningococcus is a bacterium that requires the presence of oxygen in the tissues.

The main sources of the disease:

carriers generalized form, such patients are most often immediately isolated in the infectious diseases department.
sick nasopharyngitis(a localized form of infectious meningitis, when inflammatory processes), the patient is contagious as long as meningococcus is found on his mucosa.
So called "healthy" carriers. A person can be a carrier of the infection for about 2-3 weeks, while being able to infect others by airborne droplets, but it the immune system eventually suppresses meningococcus.

Often, nasopharyngitis gives rise to a generalized form of the disease.

Children under 3 years of age cannot be carriers of the infection. In some cases, a meningococcal infection is carried by a child in utero, then the baby is already born with hydrocephalus.

Symptoms

In 25% of cases, meningococcal meningitis is characterized by an acute onset, in 50% with mild degree diseases, if the infection could not pass beyond the nasopharynx, nasopharyngitis occurs. At the same time, the patient experiences symptoms similar to those of influenza and SARS:

difficult nasal breathing;
cough, sore throat;
discharge from the nose, as in a coryza;
headache;
elevated temperature up to 38.5-39 degrees Celsius;
aches in muscles and joints;
general weakness;
mucous membrane rear wall swollen throat.

The symptoms last for about a week, after which, thanks to a properly selected drug therapy pass.

If a generalized form of meningitis develops, completely different signs appear.

Primary symptoms:

elevated body temperature (up to 40 degrees Celsius);
loss of appetite;
severe headache of aching and squeezing nature in the frontal and temporal regions;
nausea, followed by vomiting, which does not alleviate the condition.

Symptoms at the height of the disease:

pain in eyeballs, inability to move them;
painful light perception;
intolerance to loud and sharp sounds;
strong thirst;
damage to the facial, hypoglossal nerves;
convulsions;
hallucinations;
symptom of Lasegue (when the legs are bent at the hip joint, there are severe pain in the lumbosacral zone and along the sciatic nerve);
Kernig's symptom (the leg does not straighten in knee joint or the head cannot be pressed to the chest);
the appearance of a rash first on the buttocks, shins and hands, and then on the whole body.

Symptoms in severe form:

meningococcal posture: lying on your side with legs bent to the body and head thrown back;
unbearable headache;
strabismus;
anisocoria (deviation in the size of the pupils and their deformation);
increased sweating and sebum secretion;
facial asymmetry;
herpetic rash on the face and oral mucosa;
meningococcal eruptions, ranging from small specks to extensive hemorrhages, which protrude somewhat above the skin and are quite dense to the touch;
gastrointestinal and internal bleeding.

Symptoms of the fulminant form of the disease:

failures in cardiovascular activity (arrhythmia, tachycardia, bariccardia);
activity disruption respiratory system(shortness of breath, respiratory arrhythmia, tachypnea);
overheating of the body, the onset of hyperthermia;
convulsions;
loss of consciousness;
constriction of the pupils and almost no reaction to light.

At severe development disease, cerebral edema and the onset of coma are possible.

Diagnostics

Meningococcal meningitis is difficult to distinguish from other types of meningitis and CNS disease by outward signs Therefore, a key role is given to laboratory research.

The most informative in the diagnosis of meningococcus puncture cerebrospinal fluid(liquor). In the first day of the disease, it flows out under pressure. The doctor selects a certain amount of cerebrospinal fluid between the vertebrae and sends the fluid for bacteriological, biochemical and cytological analysis.

Liquor, which in the normal state should have a transparent color, with meningococcus is cloudy and whitish. The protein content in it is increased, and glucose is reduced. CSF samples contain Gram-negative meningococcus bacteria. In the future, pus may form in the cerebrospinal fluid.

In addition, blood, urine, and the contents of the nasopharynx are examined. All samples are searched for Gram-negative cocci or diplococci. At the same time, an increase in leukocytes and ESR is observed in the blood (erythrocyte sedimentation rate is indirect sign the presence of an inflammatory process).

Laboratory studies include:

PCR method (polymerase chain reaction) is highly informative and exact method molecular genetic diagnostics, with the help of which it is possible to identify infectious diseases, both in the acute and chronic stages.
RLA method (Reaction of latex agglutination) - an express method for diagnosing infectious diseases.
immunological diagnosis of meningococcus.

A clear sign of meningococcus is a hemorrhagic rash that begins with small pinpoint subcutaneous hemorrhages. With the course of the disease, they are able to grow and combine into large spots.

If necessary, CT or MRI of the brain is performed (before puncture of the cerebrospinal fluid).

Treatment

Treatment usually begins with examining the cerebrospinal fluid to determine the type of causative agent of meningitis and administering glucocorticoid drugs (a type of hormone produced by the adrenal glands). Then, as needed, apply:

antibiotics penicillin, tetracycline series (Cefotaxime, Ceftriaxone, Meropenem);
solution crystalloids With high content sodium and glucose to replenish lost fluid;
plasma and plasma substitutes;
diuretics funds;
at need drugs that increase blood pressure;
preparations containing heparin for the prevention of intravascular coagulation syndrome;
steroid hormones (hydrocortisone, prednisolone);
anticonvulsants drugs;
vitamins C, B1, B2, B6, glutamic acid;
immunocorrective drugs (Viferon, Ergoferon).

Oxygen therapy is also carried out, and with kidney failure hemodialysis.

After the main medical measures when the condition is stabilized, the following medications are prescribed:

drugs that improve microcirculation in vessels (Agapurin);
nootropic drugs that improve cellular metabolism in brain tissues (Pantocalcin);
funds adaptogenic actions (Pantea and Leuzea);
multivitamins.

Rehabilitation after suffering meningitis plays a huge role, especially for children, so that their development does not lag behind. Recovery period includes physiotherapy exercises and various physiotherapy procedures:

aerotherapy;
mud treatment;
electrophoresis;
UHF therapy;
massage;
medicinal baths;
magnetotherapy;
therapeutic electrosleep.

In addition, it is necessary Spa treatment and special diet. Those who have recovered should eat 5-6 times a day in small portions. The menu should include: boiled lean meat, fish, steamed vegetables, fruits, cereals from various cereals, compotes and jelly.

Consequences and complications

In case of timely hospitalization and treatment, it is possible to avoid negative consequences for the body as a whole and for the brain in particular.

Effects organic damage brain:

oligophrenia;
hydrocephalus;
defeat optic nerve and the retina of the eye;
damage to the auditory nerve, complete or partial deafness.

Functional Consequences:

Delay mental development.
Asthenic syndrome.
Neuroses: surface, restless sleep, obsessive movements, hysteria.
cerebrosthenic syndrome: hyperdynamic form: overexcitability, lack of self-control, aggressiveness; hypodynamic form: lethargy, fearfulness, emotional sensitivity, sleep disturbance.
Syndrome hypothalamic dysfunctions: rapid or vice versa slow pulse, impaired thermoregulation, dry mouth or vice versa increased salivation, hypertrichosis (increased hairiness of body parts) or, conversely, baldness.
Focal violations of the central nervous system: paresis, epileptic seizures.

The severity of the consequences directly depends on how badly the brain was damaged.

Forecast

Meningococcal meningitis in children older than 2 years, with timely assistance, ends in complete recovery, without complications.

With a fulminant form of the disease, when an infectious-toxic shock occurs, and the brain swells, it is quite high percent lethal outcome. At the same time, 75% of children who died from this infection were under the age of 2 years.

The earlier the symptoms of the disease are detected and adequate treatment is started, the more favorable the prognosis.

Prevention

There is a vaccine for meningococcal infection, however, it is not on the mandatory list. It is shown if:

AT close environment (at work, at school, kindergarten, in the family) someone fell ill with meningitis.
Planned the trip to countries where this infection is common (Saudi Arabia, UAE, Nepal, Kenya).

Vaccination can be made against meningococcus type A or C, there are no vaccines for type B, because immunity to it is poorly developed. In addition, you can make a vaccine simultaneously from 2 (A + C) or 4 (A + Y + C + W135) types. Immunity lasts for 2-3 years.

Patients with a generalized form in without fail should be isolated in separate boxes in the infectious diseases departments of the hospital. Patients with nasopharyngitis are also isolated at home. You can visit crowds only if at least 10 days after the start of taking an antibiotic, a nasopharyngeal examination for infection will give a negative result.

Family members of the sick person should preventive measures take immunoglobulin and antibacterial drugs (Sumamed, Ciprofloxacin).

Disease prevention includes:

strengthening immunity.
Rejection smoking(smokers are several times more likely to get infected).
Complete dream and rest.
avoiding the big clusters people during periods of acute respiratory infections.
Frequent the washing up hands
Use of personal hygiene accessories(e.g. towels).

For people who have never experienced meningococcal infection, it is quite difficult to self-diagnose this disease. Any unusual or unclear symptoms should be called immediately. ambulance, because on time Taken measures can save not only health, but also life.

In the vast majority of cases, the development this disease contribute to bacteria that penetrate into the blood, cause pathology of the membranes of the brain and cerebrospinal fluid.

In the case of meningococcal meningitis, the route of infection most often lies through the nasopharynx and oral cavity. The infection is transmitted from a sick person to a healthy person or from a carrier of the infection who has no signs of the disease. In this case, infection will not necessarily occur if a meningococcal infection enters the body.

The main reason for the development of meningococcal meningitis is a weakened immune system, close contact with a sick person or a carrier of the infection.

Most often, the development of meningitis contributes to nasopharyngitis and meningococcemia, which also develops as a result of infection with meningococcal infection.

The infection is transmitted by airborne droplets or household contact. Children are most susceptible to this disease.

Symptoms

Meningococcal meningitis is characterized by an acute onset. The first signs of the disease appear already on the first or second day.

The disease begins with the following symptoms:

severe intoxication of the body,
high body temperature and chills,
hemorrhagic rash,
noise and pain in the ears,
pallor of the skin,
rapidly growing headache
dizziness,
secretion of mucus and pus from the nasal passages,
loss of appetite,
nausea and vomiting,
neck muscle stiffness,
lethargy,
anxiety.

These symptoms develop in the first few hours of illness.

In infants, the disease develops gradually and is accompanied by symptoms such as fever, headache, pain when moving the eyes, fever, vomiting, restlessness, confusion.

The child has meningeal symptoms of Kerning and Brudzinsky, which are expressed by the fact that he cannot bend his neck and straighten his lower limbs at the knee joint. There is a tremor of the limbs and convulsions. A typical posture for a patient with meningitis: lying on his side with his head thrown back, legs tucked up to his stomach.

Diagnosis of meningococcal meningitis in a child

At the first signs of the development of the disease in a child, you should consult a doctor, since this disease requires immediate treatment. Ignoring treatment is great danger. Early treatment has a favorable prognosis.

Symptoms of brain damage are pronounced. The presence of a hemorrhagic rash in combination with clinical manifestations makes it easy to make an accurate diagnosis.

The main diagnostic method for any form of meningitis is spinal tap necessary for the study of cerebrospinal fluid. This diagnostic method is highly informative, simple and safe.

A blood test of a bacteriological direction is also required to identify the pathogen.

An important point in the study of the state of cerebrospinal fluid is the determination of the proportions of cells, the ratio of sugar and protein levels.

Complications

Without adequate treatment meningitis can develop complications such as:

toxic-infectious shock,
kidney failure,
internal bleeding
stroke,
cerebral edema,
pulmonary edema,
paralysis and paresis,
hydrocephalus,
epilepsy.

With timely treatment, the outcome of the disease is favorable.

Treatment

What can you do

If meningitis of any form is suspected, the child must be hospitalized without fail. Do not treat meningitis at home. Ignoring treatment can lead to death, infection of others. Therefore, if signs of meningitis appear, if the condition worsens, it is necessary to call an ambulance.

What does a doctor do

The main tactic for the treatment of meningitis caused by meningococcus is the appointment antibacterial drugs- antibiotics of a wide range of action.

Therapy also includes:

drugs whose action is aimed at improving microcirculation in the vessels of the brain;
"nootropic" means that improves metabolism in brain tissues;
restorative means of adaptogenic action.

Prevention

To protect your child from developing meningitis, you must adhere to the following recommendations:

avoid contact with patients with nasopharyngitis,
take measures to strengthen the immune system,
more often walk with the child in the fresh air,
observe elementary rules personal hygiene,
provide the baby with a balanced diet,
avoid places large cluster people during epidemics of influenza and SARS.

Vaccination is also used as a preventive measure.

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Take care of the health of your loved ones and be in good shape!

Meningitis is dangerous infectious process, inflammatory membranes of the spinal cord and brain (soft, arachnoid, hard). If it develops in children, then it is doubly dangerous, since what younger age the child, the more vulnerable he is to this pathology. 80% of cases of meningitis in childhood account for meningococcal meningitis. It is about him that I, together with the editors of the site www.site, would like to talk in an article about meningococcal meningitis, symptoms in children, treatment, and the consequences of this disease.

Meningococcal meningitis - what is it?

This is a generalized form of meningococcal infection, the consequences of which are often very severe. Meningitis is caused by gram-negative diplococcus (Neisseria meningitidis). The only source disease is served by a sick person or a "healthy" carrier. Infection occurs by airborne droplets. Meningococcus is not stable in environmental conditions, it dies within 5 minutes under the influence of a temperature of + 50C. The incubation period averages from 2 to 7 days.

Symptoms accompanying meningococcal meningitis in children:

The clinical picture of the disease is based on three syndromes:

Infectious-toxic;
meningeal;
hypertensive;

It is not possible to clearly distinguish between them. The infectious-toxic syndrome plays a leading role during meningitis, since even before the development of all the symptoms of the disease, children can die from it. And in babies up to a year, all other signs of the disease may be completely absent or not significantly pronounced. A distinctive feature of meningococcal meningitis is an acute, violent onset. Often, the mother can accurately indicate the hour of the onset of the disease. The body temperature reaches high numbers (38-40C), there is a chill. Children under one year old become sharply restless, the cry is painful. Older children complain headache bursting nature, pain in the eyeballs. There is no appetite, there is an excruciating thirst, vomiting develops in a "fountain", which does not bring relief. There is a sharp hyperesthesia to all external stimuli: touch, bright light, loud noise.

The appearance of trembling of the limbs, twitching of small muscles, clonic-tonic convulsions is considered a poor prognostic sign, especially in children of school and preschool age. Approximately 60% of sick children may experience impaired consciousness: delirium, hallucinations, motor restlessness.

For children under one year old, seizures are often the first signs of a generalized meningococcal infection. Rigidity of the occipital muscles develops somewhat later. In them, a violation of consciousness is observed in the form of adynamism, lethargy, stupor, sometimes a complete loss of consciousness.

Meningeal syndrome develops after 10-12 hours from the onset of the disease. There is stiffness of the occipital muscles, symptoms of Kernig, Brudzinsky, etc., which indicates damage to the meninges.

At severe forms ah, there may be no reflexes, be involved in the process cranial nerves which is manifested by paresis.

specific symptom meningococcal meningitis - the appearance of a hemorrhagic-necrotic rash in 70-90% of sick children 4-5 hours after the onset of the disease. It can be of various irregular shapes, shallow or confluent. Its difference is that it never rises above the surface of the skin, has necrosis in the center, most often localized on the buttocks, thighs, eyelids, sclera. Subsequently, necrotic areas of the skin are torn off, leaving behind scars. In the faucet severe cases gangrene develops, auricles, stop, nail phalanges.

Treatment of meningococcal meningitis in children:

To be carried out only in a hospital setting. Adequate, timely started therapy for meningococcal meningitis is the key to saving the lives of young patients. It determines the favorable outcome of the disease, reduces the risk of complications and consequences.

For treatment, etiotropic drugs are used that can fight an infectious agent (menincoccus). The drug of choice is benzylpenicillin. It is prescribed in conjunction with substances that improve its penetration through the blood-brain barrier (caffeine sodium benzoate). In the presence of allergic reaction reserve drugs are prescribed for benzylpenicillin: kanamycin, rifampicin, levomycetin-succinate.

Given the severe intoxication, they are prescribed intravenous infusions. Heparin is prescribed for the prevention of DIC (intravascular coagulation syndrome). It is very important to prevent the growth of cerebral edema, the appointment of glucocorticoids, especially in the first hours of the disease. Prescribed drugs that improve tissue trophism, vitamins, etc.

If necessary, a spinal puncture is performed.

Consequences to which meningococcal meningitis leads:

About half of children who recover from meningitis experience its consequences throughout their lives:

Headache;
memory loss, ability to absorb new material;
tendency to convulsions;
the consequences of severe forms of meningitis (1-2%) can lead to deafness, blindness, mental retardation;

Meningococcal meningitis is a potentially deadly infection. Its symptoms develop very quickly, sometimes at lightning speed, if you are late with treatment, then this threatens with very serious consequences, even death.

- an infectious disease that combines a whole group of diseases that have a variety of clinical manifestations: from nasopharyngitis to meningococcal sepsis and meningitis. What unites them is that they are all caused by meningococci, which are carried by airborne droplets. Meningococcal infection is dangerous because it is widespread, transient, can cause severe complications and lead to death.

Meningococcemia is an acute meningococcal sepsis that typically has an acute onset, high fever, a range of septic events, including significant changes in activity of cardio-vascular system, early appearance rashes and severe course. The rash appears more often on the trunk and lower limbs in the form of roseolous and papular elements of an intense pink or slightly cyanotic hue. In addition, on the skin there are hemorrhagic elements of various sizes and star-shaped red spots, turning into necrosis.

With meningococcemia, hemorrhages are noted in the conjunctiva, sclera and mucous membranes of the nasopharynx. Patients may experience nasal, uterine, gastric bleeding, subarachnoid hemorrhage, micro- and macrohematuria. In some cases, arthritis and polyarthritis occur. Severe meningococcemia in adults is often associated with meningitis.

Meningococcal meningoencephalitis is characterized by convulsions and impaired consciousness from the first days of the disease, often there are visual or auditory hallucinations. Typical for him early paralysis and paresis.

Complications

Possible specific complications in the early and late course of the disease. These include:

gastrointestinal and uterine bleeding;
parenchymal-subarachnoid hemorrhage;
acute swelling and edema of the brain;
cerebral hypotension;
pulmonary edema;
paralysis and paresis;
hormonal dysfunction;

Nonspecific complications include such as herpes, otitis media, pneumonia, pyelonephritis and others.

Diagnosis of meningococcal infection

To put correct diagnosis, it is necessary to study clinical picture diseases. Take into account also epidemiological data, anamnesis, results laboratory research blood and cerebrospinal fluid taken by lumbar puncture. If meningococcal or meningococcal nasopharyngitis is suspected, a bacteriological examination of mucus is performed, which is collected from the back of the pharynx. Immunological methods are also used.

Differential diagnosis should be made with other diseases. Nasopharyngitis is differentiated from acute viral infections, angina , pharyngitis . Mixed form of meningococcal infection and meningococcemia are compared with other infectious diseases. Meningococcal meningitis is differentiated from purulent meningitis other etiology.

Treatment of meningococcal infection

With meningococcal infection, early hospitalization in specialized departments of the infectious diseases hospital is necessary. With the development of complications, patients are determined in the intensive care unit. In cases of severe intoxication, fever, antibiotics are prescribed. In severe cases, anti-shock measures, dehydration and detoxification, anticonvulsant therapy are carried out. Analgesics are prescribed, corticosteroids, oxygen therapy, artificial ventilation of the lungs and other means are used. According to indications, vitamins are used, nootropic drugs and cardiac glycosides. Discharge from the hospital can be made after the disappearance clinical symptoms, upon the onset of recovery and the absence of bacteriological research mucus from the throat and nose of meningococci.

In most cases, with timely treatment of meningococcal infection, the prognosis is favorable. According to statistics deaths possible with such complications as edema and swelling of the brain, infectious-toxic shock. Residual effects occur in patients whose treatment was started only in late dates diseases. Can be functional disorders neuropsychic activity. Patients who have had a meningococcal infection are shown outpatient observation and follow-up care by a neurologist.

Prevention of meningococcal infection

It is important to diagnose patients with different types meningococcal infection and hospitalize them. Anti-epidemic measures are the identification of carriers of the infection and their sanitation of the nasopharynx. Great importance for prevention has an increase in the immunity of people. For those who were in contact with the patient, it is established medical supervision and bacteriological examination is carried out. According to the indications, vaccination is carried out with a complex polysaccharide vaccine against meningococci of serological groups A and C, immunity from which lasts for 3-5 years. Re-immunization with the threat of an epidemic can be carried out after three years.