Symptoms of purulent meningitis and basic methods of treating the disease

The most severe inflammatory disease of the central nervous system is purulent meningitis. This disease can affect a person at any stage of life, but is most often diagnosed in children under five years of age.

What is purulent meningitis

This disease is characterized by an acute inflammatory nature; the infection affects the membranes of the brain, causing the formation of purulent foci. The development of purulent meningitis is provoked by pathogenic bacteria that enter the nervous system through the blood.

The disease mainly affects people with weak immune systems, those who have previously suffered from severe infectious diseases, those with head injuries, as well as premature babies.

If treatment is started in a timely manner, there is a chance of complete recovery. In some cases, the disease leads to serious complications. The brain substance itself is not affected during the disease process. However, cerebral edema and purulent accumulations in its cortex cause dangerous symptoms that can pose a threat to the patient’s life.

Causes and types

It is customary to distinguish primary and secondary types of purulent meningitis, depending on the nature of the disease.

Primary disease occurs due to the entry of pathogenic bacteria into the human body from the external environment, such as:

• Pneumococcus;
• hemophilus influenzae type "B";
• meningococcus;
• other microorganisms.

Infection occurs mainly by contact and airborne droplets.

In children, infection occurs more often, since weak immunity may not be able to cope with even the least dangerous pathogen. Throughout life, the body of an adult produces antibodies to those infections that they may have encountered previously. Therefore, meningitis is diagnosed less often in them.

The secondary form occurs only when there is some source of infection in the patient’s body. This applies to acute respiratory diseases, otitis media, sinusitis, etc.

From the source of the disease, microbes enter the cerebral cortex and become the cause of the development of purulent processes.

The risk of developing a secondary type of purulent meningitis is minimal among those people who have previously suffered from the primary form.

Epidemiology

The peculiarity of the development of purulent meningitis depends on the bacteria that provoked the disease. In this regard, several types of disease are distinguished.

Meningococcal an acute course already in the initial stages, sometimes with symptoms of colds. A sharp increase in body temperature, nausea, vomiting, constant headache. A day after the onset of the disease, tension in the muscles of the back of the head appears.

The disease progresses rapidly - the patient experiences hallucinations, the aggressive state changes to passivity and loss of concentration. Vision and hearing may deteriorate. The obvious symptom is a rash over the body, which subsequently increases in size and forms ulcers. A possible complication in the form of hemorrhages in the adrenal cortex leads to the death of the patient.

Often, pneumococcal meningitis affects children and adults over the age of forty years. Foci of infection can be both skull injuries and inflammation of the ears or nasopharynx. Meningitis of this type can also occur in the primary form of the disease.

The symptoms are similar to meningococcus. With untimely and inadequate treatment, there is a high probability of complications and death. The secondary form is severe and protracted, as well as frequent relapses. Without proper treatment, death can occur within a week.

Hib meningitis is caused by Haemophilus influenzae and is only of the secondary type. It can occur with otitis media, pneumonia or sinusitis. It most often affects newborn children and preschoolers.

In the first stages, the disease develops gradually. There are often cases of temporary imaginary improvement in well-being even before the start of the treatment process. This species is characterized by a decrease in the secretion of cerebrospinal fluid.

Staphylococcal meningitis also refers to a secondary disease, as a complication after purulent inflammatory processes in the body, pneumonia and blood poisoning. This infection is resistant to medications, making treatment difficult. Abscesses often develop. The disease poses a great danger to life.

Symptoms

In the initial stages, it is difficult to independently identify purulent meningitis, since the main symptoms are similar to other diseases. In subsequent stages, the underlying disease develops.

At first, a sick person feels a loss of strength, drowsiness, symptoms of a cold, nausea, loose stools, and a rash on the body that resembles chickenpox or rubella are not excluded.

With the secondary type of purulent meningitis, pain in the joints and bones, high fever, discharge from the ears and nose, and blurred vision are observed. In case of exacerbation of pneumonia - cough, shortness of breath, discomfort in the chest area.

Signs in young children

It is difficult to determine what is bothering a child who has not yet learned to speak. In this case, parents should carefully monitor his behavior. The main symptoms of the disease are the following:

1. During sleep, your hands constantly reach for your head.
2. The fontanel protrudes or sinks relative to the level of the cranial bone.
3. If you take a sick child by the armpits and lift him up, he will try to press his legs to his stomach.
4. In a lying position, the child tries to throw his head back.
5. Spots appear on the body.
6. Chills and occur .

Usually, before the development of purulent meningitis, a child experiences bronchitis, pneumonia, otitis media or conjunctivitis.

If the above symptoms appear, parents should immediately seek medical help.

In newborns, the disease is fleeting. In the absence of urgent and adequate treatment, death can occur within three days.

Symptoms in adults

Most of the signs of purulent meningitis at the initial stage of the disease can be simply ignored or temporarily alleviated with the help of simple medications. This only delays the start of treatment and leads to an exacerbation of the disease.

The main signs of concern are:

• chronic headaches , accompanied by a feeling of internal pressure in the skull, increased pain when moving the head in different directions, loud sounds or bright lighting;
• tension in the occipital region - a sick person, lying on his back, is forced to tilt his head back;
• constant nausea and vomiting, regardless of the number of meals;
• high fever, heavy sweating, chills;
• decreased concentration , ignoring verbal requests from others, aggressive behavior, hallucinations;
• cramps and spontaneous urination;
• visual impairment and strabismus.

The appearance of such symptoms indicates the seriousness of the progression of the disease and requires urgent medical attention. The patient is sent to the hospital as soon as possible for diagnosis and development of a treatment plan.

Diagnostics

To establish an accurate diagnosis, the attending physician studies the patient's medical history in detail. Diseases that were previously suffered, possible foci of chronic infections, contacts with infected people, and injuries received are taken into account.

Next, the patient is referred for examinations:

• analysis . Confirmation of the disease may be a change in the number of white blood cells, an increase in the erythrocyte sedimentation rate, a decrease in hemoglobin concentration, or a decrease in the number of platelets.
• Analysis of urine.
• Computed tomography or MRI.
• Radiography.

But the main method for diagnosing purulent meningitis is a spinal puncture. To do this, material is collected using a syringe with a needle, which is inserted between the third and fourth lumbar vertebrae into the space between the spinal cord and the membrane.

In case of illness, the cerebrospinal fluid will have increased pressure, a cloudy consistency of green or yellow color, depending on the type of infection. In this case, an excessive amount of protein is determined.

The main confirmation of the disease is the detection of a large number of neutrophils in the fluid.

Features of treatment

After studying the test results, the infectious pathogen is identified and treatment is prescribed.

Adults and seriously ill children are hospitalized in the infectious diseases department or intensive care unit.

First of all, an antibiotic is introduced into the patient’s body, which can stop further progression of the inflammatory process. The maximum dosage is set, and the frequency of administration is more than once every four hours. With the help of diuretics, swelling of the brain is relieved.

In parallel, the patient is prescribed medications to reduce the severity of symptoms (headaches, nausea, fever).

• In the secondary form of the disease, the infectious focus is treated.
• A craniotomy may be performed to remove the pus.
• When the patient's health improves, he is discharged from the hospital for further treatment at home.

Subsequently, for two years, children are regularly observed by a neurologist, pediatrician and infectious disease specialist. At first, the survey is carried out once a quarter, then this period is six months. Adults are under the supervision of a therapist, psychiatrist, infectious disease specialist and neurologist.

If your health condition worsens, the schedule for visiting doctors changes.

Recovery after trepanation

The process of rehabilitation after surgery and removal of pus from the meninges is difficult. The patient experiences severe pain and fatigue. He has swelling of the face and head.

You can get up on your feet only a day after the operation. The patient remains under the supervision of doctors in the hospital for 2 to 14 days. Depending on the circumstances, medications may be prescribed to relieve pain, swelling and cramps.

After discharge, you should do household chores at home that do not require maximum physical and mental effort.

Restoring health after trepanation can take up to two months, taking into account the person’s age and the complexity of the disease.

During rehabilitation, you should give up some activities and habits:

• driving a vehicle ;
• consumption of alcoholic beverages;
• immobile for a long time ;
• significant physical activity;
• activities involving sudden head movements.

Failure to follow the doctor's recommendations can lead to paralysis and other neurological complications.

Consequences and prognosis

According to statistics, every seventh patient diagnosed with purulent meningitis does not survive. A high chance of recovery is provided by timely and correct treatment. It should be borne in mind that this disease will not go away on its own, and it will not be possible to recover without the help of doctors.

Due to the rapid progression of the disease, it is necessary to urgently contact a medical facility.

There are a number of possible consequences of suffering purulent meningitis in both children and adults:

• frequent headaches depending on pressure changes in the external environment;
• epileptic seizures, paralysis, hydrocephalus;
• decreased concentration, memory impairment;
• developmental delay in children;
• deterioration of hearing, vision, speech, pathology of internal organs;
• intracranial hypertension.

Depending on the severity of the disease, some patients are able to recover without any health complications.

Prevention

Purulent meningitis is one of those types of diseases that are most often caused by infectious agents that enter the human blood. Therefore, first of all, it is necessary to monitor your health.

In addition, preventive vaccination shows high effectiveness in counteracting meningitis. Doctors recommend vaccinations for children before entering kindergarten or school, as well as for people with weak immune systems.

For timely diagnosis and treatment, you should consult a doctor at the first symptoms. It should be remembered that an advanced form of purulent meningitis can lead not only to disability, but also to death.

Expert commentary

The appearance of a hemorrhagic rash on a patient’s skin is a very bad sign. It means that meningitis has progressed to the stage of sepsis (meningococcus circulates in the blood). In this case, there is a very high probability of developing infectious-toxic shock; treatment is possible only in the intensive care unit.

Source: https://nevralgia.ru/meningit/gnoyniy/

Purulent meningitis - symptoms, treatment and consequences

The development of the disease depends on the causative microbe and on the state of the human immune system. If painful symptoms are ignored, pathology leads to irreversible consequences.

Mechanism of infection

Purulent meningitis is a bacterial disease in which the membranes of the brain become inflamed. The main cause of purulent meningitis is the penetration into the body of the causative agent of the disease - Neisseria meningitidis - meningococcal infection. Depending on the method of penetration of microbes, primary and secondary meningitis are distinguished.

In primary meningitis, pathogens enter the body through contact with an infected person. Microorganisms penetrate the meninges through the nasopharynx. Direct infection can occur due to traumatic brain injuries or failure to comply with aseptic rules during operations.

Interesting! For every hundred carriers of meningococcal infection, 1 person becomes ill.

Secondary meningitis develops as a result of infection with staphylococcal, streptococcal infections, Escherichia coli, and Haemophilus influenzae. Bacteria enter the brain through the paranasal sinuses, teeth affected by caries, and inflamed ears. Microbes are able to penetrate barriers during pneumonia, furunculosis, and stomach diseases.

Is meningitis contagious: methods of transmission and preventive measures

The penetration of pyogenic bacteria through the barrier is facilitated by a weakening of the immune defense, which occurs as a result of repeated colds and stress.

The disease is diagnosed in people of all ages, but children under 5 years of age are most susceptible to the pathology. Purulent meningitis in young children usually develops against the background of a low immune status.

Classification of species

Depending on the severity of the disease, the disease manifests itself in mild, moderate and severe forms. A severe course of the pathology is recorded with a sharp decrease in immune status and in people with the absence of a spleen.

According to the characteristics of progression, abortive, fulminant, recurrent and acute purulent meningitis are classified. The latter type is diagnosed more often than others and is accompanied by characteristic symptoms.

With lightning-fast progression, the brain rapidly swells, causing impaired consciousness. The abortive variety is characterized by the absence of characteristic symptoms, only signs of poisoning appear.

Recurrent meningitis occurs when the acute form is not treated in a timely manner and in the presence of a pyogenic infection.

Depending on the causative agent of the disease, meningococcal, pneumococcal and hemophilic meningitis are distinguished.

The meningococcal variety appears due to exposure to various meningococci. These pathogens provoke inflammation most often because they have a capsule that protects against the destructive effects of the immune system. This property allows microbes to replicate unhindered, which leads to the formation of suppuration.

Pneumococci cause the pneumococcal form of the disease, which is rarely diagnosed. It is manifested by the formation of pus and the intensive development of inflammation.

Haemophilus influenzae most often affects babies under one year of age. The bacterium has a toxic effect on the body, which contributes to the immediate development of the inflammatory process.

Symptoms of the disease

The disease is manifested by the development of meningeal syndrome, which is expressed in infectious damage to the cerebrovascular fluid. The first signs of meningitis are similar to flu symptoms. But after several hours, consciousness is disturbed, the muscles of the back of the head tense, and vomiting develops.

The incubation period lasts from 2 to 5 days. On the first day, purulent meningitis manifests itself as follows:

• a sharp increase in body temperature;
• increasing headache;
• chills;
• vomit;
• confusion;
• mental disorders.

The most informative signs are the meningeal signs: rigidity of the neck muscles, Brudzinski’s and Kernig’s signs. They manifest themselves in the fact that the patient cannot tilt his head to his chest, but throws it back to relieve pain in the back of his head. The patient is also unable to straighten the lower limbs; the knee joints bend uncontrollably.

On the 3rd day of progression of inflammation, a malfunction of the optic nerve occurs, which causes strabismus and blurred vision. Decreased hearing, hallucinations, and impaired speech skills are recorded. Usually the disease is accompanied by convulsive syndrome. Hemorrhagic rashes appear on the skin.

An increase in symptoms indicates the progression of inflammation and its spread to the brain. As a result, vascular dysfunction appears due to spasms of cerebral capillaries. Meningoencephalitis develops, which causes paralysis and speech impairment.

Diagnostic methods

To make a diagnosis, it is necessary to collect an anamnesis: identify the source of infection, determine concomitant diseases, find out about contact with infected people.

The most important test is spinal fluid analysis. With purulent meningitis, the cerebrospinal fluid will be cloudy, with a yellow or green tint. The color of the liquid indicates a specific pathogen. The results show an increase in cytosis and protein concentration.

In addition to examining the spinal material, the patient must undergo the following examinations:

• clinical blood test to detect leukocytosis;
• Analysis of urine;
• computed tomography;
• X-ray of lungs, skull.

You will also need to consult with an infectious disease specialist or neurologist.

Therapeutic measures

Treatment of purulent meningitis is carried out in a medical facility. After an emergency lumbar puncture, antibacterial therapy is prescribed.

Ampicillin with Cefotaxime is usually used. In severe cases of the disease, drugs are administered intravenously.

To reduce cerebral edema and eliminate hydrocephalus, Mannitol and Furosemide are used as dehydration agents.

It is also important to choose the right symptomatic treatment based on the cause of the disease. For sleep disorders, sedatives are prescribed, for convulsive syndrome - Diazepam, Chlorpromazine. When anaphylactic shock develops, infusion treatment is carried out. During the rehabilitation period, it is recommended to take multivitamin complexes and neuroprotective medications.

Prevention measures

Vaccination is the most effective method to prevent the development of meningeal infection. Vaccinations are given against pathogens: meningococci, pneumococci, Haemophilus influenzae.

It is especially important to vaccinate children on time (from 3 months to 5 years), since the disease causes high mortality among newborns.

Due to the ease of transmission of purulent meningitis, adults are recommended to be vaccinated if they have immunodeficiency, frequent pneumonia, or otitis media.

Doctors are required to isolate the patient in a timely manner to minimize the risk of spreading the infection.

Possible complications and prognosis

Inflammation of the meninges is the most dangerous condition for the life of adults and children. Indeed, even with the necessary therapeutic measures, people with weakened immune systems develop many consequences, one of which is death.

Neurological complications after meningitis are recorded in 20% of patients, the majority of whom are elderly people and children.

In severe cases of the disease, cerebral edema develops, causing clinical death. To prevent this condition, it is necessary to introduce electrolyte solutions into the body.

Other serious complications include:

• sepsis;
• hydrocephalus, causing increased intracranial pressure;
• multiple organ failure, which affects the heart muscle and kidneys;
• asymmetry of the face, strabismus due to damage to the nerves of the skull;
• arrhythmia, which is caused by the spread of pathogens on the inner lining of the heart;
• empyema, in which pus flows under the base of the skull;
• prolonged convulsive syndrome;
• hearing loss;
• coma.

Without treatment, the mortality rate is 50%. The most unfavorable prognosis is typical for pneumococcal meningitis: death is diagnosed in 20% of cases.

After recovery, you must regularly visit a neurologist. Competent rehabilitation measures are required, including taking medications, exercise therapy, massage, and medicinal baths. An integrated approach to treatment helps to minimize undesirable consequences.

Source: https://neuromed.online/gnoynyy-meningit/

Purulent meningitis

Purulent meningitis is an infectious disease manifested by the development of a purulent-inflammatory process in the soft membranes of the brain.

As the disease worsens, foci of infection can spread to the arachnoid membrane and brain matter.

Purulent, pyogenic, pyogenic meningitis is described in the International Classification of Diseases, 10th revision (ICD-10) under code G00.9.

Causes and mechanism of development

Severe microbial disease is the result of infection of the body and the activity of bacteria of various groups, including:

• meningococci;
• pneumococci;
• streptococci;
• staphylococci;
• Pseudomonas aeruginosa;
• intestinal infections.

The source of infection is first-order carriers (infected but not sick individuals) and second-order carriers (persons suffering from ARVI, tonsillitis, pharyngitis, sinusitis). Microbial infection is transmitted by airborne droplets or household contact. The contagiousness rate of pathogens is low, not exceeding 0.2%.

Primary types of bacterial purulent meningitis occur when the pathogen spreads hematogenously (through the blood) from the “entry gate” - the nasopharyngeal cavity.

The purulent-inflammatory process can be started by direct infection of brain structures with open contact injuries to the skull.

Primary forms of the disease sometimes start due to non-compliance with sterility during neurosurgical operations.

Secondary purulent meningitis is the result of the presence in the body of a primary focus of purulent diseases. From non-pyogenic microorganisms spread hematogenously (through the blood) or lymphogenous (with lymph flow) route. Damage to the meninges most often occurs with purulent otitis, sinusitis, frontal sinusitis, and tonsillitis.

Risk factors

The penetration of pathogens through the blood-brain barrier is facilitated by a decrease in the body's protective capabilities. Risk factors:

• frequent cases of acute respiratory diseases;
• smoking;
• alcohol abuse;
• hypothermia;
• poor nutrition, dieting;
• hypovitaminosis;
• insolation;
• chronic stress;
• lack of rest, regular overload.

Classification

Based on the localization of the inflammatory process, it is customary to distinguish forms of purulent meningitis :

• basal (deep);
• convexitial (superficial).

The forms are divided according to the severity of the flow:

• light;
• moderate severity;
• heavy.

Clinical symptoms

Purulent meningitis, provoked by meningococci, has a sudden fulminant onset. Against the background of complete physical well-being, a person’s body temperature spontaneously and sharply rises to high values. The patient complains of debilitating chills and severe cephalalgia.

Psychomotor agitation is recorded. The patient reports nausea and repeated bouts of vomiting. Sensitivity to external stimuli increases. Photophobia occurs. After a few hours, meningeal symptoms develop and rapidly progress.

Motor restlessness gives way to drowsiness and lethargy. Disorders of consciousness arise. Some patients develop delusions or hallucinations. A common symptom of meningococcal meningitis is seizures.

If the pathological process spreads to the substance of the brain and the cranial nerves are affected, paresis occurs.

Symptoms of meningitis in children of the first year of life differ from the manifestations of the disease in adults. The child's excited state informs about the development of the disease. The baby cries a lot and touches his head with his hands. Convulsions occur. In newborns, protrusion of the fontanel is detected. Children often develop dyspeptic disorders.

Purulent meningitis of another etiology is very similar in clinical picture to the meningococcal form.

Diagnostics

Measures are taken to diagnose purulent meningitis:

• study of anamnesis on the subject of chronic infectious diseases;
• collecting information about the epidemiological environment;
• cerebrospinal fluid examination;
• detailed blood test;
• blood test for sterility;
• general urine analysis;
• CT scan;
• radiography of the skull;
• neurological examination;
• consultation with an infectious disease specialist;
• ophthalmological examination of the fundus.

With purulent meningitis, the cerebrospinal fluid becomes cloudy, the liquid is white, yellow or green. Cytosis is determined - an increased (compared to the norm) content of cellular elements.

The number of protein compounds increases.

A blood test reveals leukocytosis (increased number of leukocytes) with a shift of the formula to the left, which is indicated by an increase in the number of immature (band) neutrophils.

Treatment

For a complete recovery, it is necessary to begin treatment for purulent meningitis at the first symptoms of the disease. Early start of treatment prevents the development of serious complications and reduces the risk of death.

It is advisable to begin drug treatment directed against the cause of the disease with the administration of high doses of penicillin, which is recognized as the most effective antibiotic in the treatment of purulent meningitis. The drug is started to be used immediately after differential diagnosis.

In severe cases of the disease, the daily dose of the drug is determined at the rate of 1,000,000 units per 1 kg of body weight.

The therapeutic effect from the use of penicillin is observed within the first day from the moment of treatment. The first evidence of the extinction of the disease is the normalization of consciousness and the disappearance of cephalgia. Three days after starting antibiotic use, body temperature normalizes.

The basis for discontinuing antibiotics is the complete normalization of the structure of the cerebrospinal fluid.

For mild cases of the disease, tetracyclines or sulfonamides can be used. When the etiology of the disease is unknown, the semisynthetic antibiotic ampicillin is most often used. The combined use of antibiotics is resorted to if purulent meningitis is provoked by Staphylococcus aureus.

In parallel with antibacterial treatment, dehydration and detoxification therapy is carried out. In severe forms of the disease, the treatment program includes corticosteroids - synthetic hormonal substances. Non-steroidal anti-inflammatory drugs are used to eliminate fever.

After discharge from the inpatient department of the hospital, the convalescent is admitted to the work or children's group no earlier than a week later. A person who has recovered from purulent meningitis is registered at the dispensary for two years. Medical examination and laboratory tests are recommended to be carried out once every three months.

After cessation of antibacterial treatment for purulent meningitis, the patient often develops asthenic syndrome, sleep disorders are observed, and increased excitability of the nervous system occurs.

Such conditions require long-term treatment using sedatives, hypnotics, herbal adaptogens and stimulants. Paresis and paralysis require additional neurological treatment.

Forecast

The outcome of purulent meningitis depends on a number of factors, including: the general health of the person, the presence or absence of chronic inflammatory diseases, the timeliness and usefulness of drug therapy, and immune status.

If treatment is not started in a timely manner, differential diagnosis is incorrect, the treatment program is incorrectly drawn up, or non-compliance with medical recommendations, the disease can have serious consequences. Mortality from purulent meningitis ranges from 10 to 15% of the total number of cases.

At risk are young children, the elderly, and people with primary or secondary immunodeficiency.

Young children may experience reversible deterioration in cognitive abilities, difficulties in perceiving educational material, and problems with remembering information.

With timely initiation of therapy and treatment according to the established protocol, the prognosis for purulent meningitis is often favorable.

Prevention

Currently, the most effective option for preventing purulent meningitis is vaccination. In Western European countries, traditional practice is vaccination using a polysaccharide vaccine to prevent meningitis caused by meningococci of serogroups A, C, W135 and Y.

In the Russian Federation, such vaccination is not a mandatory activity and is performed on the patient’s personal initiative.

Since the price of Menactra solution for intramuscular administration (a meningococcal 4-valent conjugate vaccine with indications from 9 months to 55 years) averages 4,000 rubles, purchasing the product is not always affordable for some categories of citizens.

The low vaccination coverage can also be explained by the insufficient level of public awareness about the dangers and consequences of viral meningitis. The increase in the number of cases in Russia can also be explained by the negligent attitude of many people towards their own health and the assessment of many symptoms of meningitis as harmless manifestations of acute respiratory diseases.

To avoid viral meningitis, you must strictly follow the recommendations of doctors:

• promptly treat upper respiratory tract diseases;
• if your health worsens, your temperature rises, or symptoms of malaise develop, you should immediately consult a doctor;
• Acute respiratory viral infections cannot be tolerated “on your feet”; bed rest and medical prescriptions should be strictly observed;
• in the off-season (autumn and spring periods), when an increase in the number of cases of ARVI is recorded, it is recommended to avoid staying in crowded places;
• when visiting hospitals and clinics, you must wear a gauze bandage on your face;
• after being outside your own home, you should thoroughly wash your hands with soap;
• if there is a possibility of contact with a virus carrier, you should rinse your mouth with products with antiviral and bactericidal effects;
• when the protective functions of the immune system are weakened, in case of frequent cases of colds, it is advisable to take vitamin complexes with antioxidant effects twice a year, and, as prescribed by a doctor, undergo a course of treatment with immunomodulators;
• effective methods for preventing viral diseases - good nutrition, exercise, hardening, and maintaining personal hygiene.

Source: http://mozg.me/infektsionny-ei-parazitarny-e-zabolevaniya/meningity/gnojnyj-meningit.html

Purulent meningitis: causes, symptoms and consequences in adults. Treatment of meningitis in Moscow

Purulent meningitis is an inflammation of the soft membrane of the brain, which is caused by pyogenic microorganisms (meningococci, pneumococci, streptococci, etc.) embedded in it.

The disease can be diagnosed in all age categories of people, but most often in children under the age of five. The development of purulent meningitis is facilitated by a weakened state of the immune system, so the peak of the disease occurs in the winter-spring period.

With purulent meningitis, patients have increased body temperature, intense headache, nausea, vomiting, disorders of the cranial nerves, early appearance of meningeal syndrome, hyperesthesia, disturbance of consciousness, and psychomotor agitation.

Thanks to the development of modern medicine, today the incidence of purulent meningitis has decreased significantly, the number of severe complications and deaths has decreased.

Services for the diagnosis and treatment of meningitis are offered by the neurology clinic of the Yusupov Hospital, a leading multidisciplinary medical center in Moscow. Thanks to the modern equipment of the clinic, the impressive medical experience of our specialists and the use of the latest technologies, the Yusupov Hospital achieves high efficiency in the treatment of meningitis, including purulent meningitis.

The diagnosis of purulent meningitis in the Yusupov Hospital is based on a typical clinical picture and data from a study of cerebrospinal fluid.

For purulent meningitis, patients at the Yusupov Hospital are required to undergo antibacterial therapy. In addition, the use of decongestants, glucocorticosteroids, tranquilizers, anticonvulsants and other symptomatic treatment is prescribed.

Purulent meningitis in adults and children: causes of development

The development of purulent meningitis is caused not only by meningococcal infection, but also by pneumococci, Haemophilus influenzae and other microorganisms.

Purulent meningitis in children is often associated with infection with streptococci, salmonella, and E. coli.

In accordance with the mechanism of penetration of the pathogen into the meninges, meningitis can be primary or secondary.

The occurrence of secondary purulent meningitis is associated with a primary septic focus present in the patient’s body and subsequent penetration of infection into the meninges.

Purulent meningitis: symptoms

The duration of the incubation period for primary purulent meningitis is, on average, from two to five days. The disease has an abrupt onset.

Patients experience increased body temperature, which can reach 40°C, intense and worsening headache, severe chills, nausea and repeated vomiting.

The appearance of delirium, psychomotor agitation, confusion, and convulsive syndrome may occur.

Purulent meningitis in adults and children is accompanied by specific symptoms (Brudzinsky, Kernig, Guillain, stiff neck), which occur at an early stage of the disease and intensify after 2-3 days. Patients exhibit severe hyperesthesia and decreased abdominal reflexes, while deep reflexes are increased. In some cases, a diffuse hemorrhagic rash appears.

• With purulent meningitis, patients experience double vision, strabismus, drooping of the upper eyelid, and anisocoria, which is associated with damage to the oculomotor nerves.
• In more rare cases, there is damage to the trigeminal nerve, the development of neuritis of the facial nerve, dysfunction of the vestibulocochlear (progressive development of hearing loss) and optic nerve (decreased visual acuity, loss of visual fields).
• If the inflammatory process spreads to brain tissue, patients develop meningoencephalitis.

Purulent meningitis: consequences in adults

One of the early and serious complications of purulent meningitis is cerebral edema, as a result of which the brain stem and vital centers located in it are compressed. The development of acute cerebral edema occurs on days 2-3 of the disease, but in the fulminant form - within the first few hours.

In addition to cerebral edema, patients may experience the development of septic shock, subdural empyema, adrenal insufficiency, infective endocarditis, pneumonia, purulent arthritis, pyelonephritis, cystitis, septic panophthalmitis, etc.

Purulent meningitis: diagnosis

1. Experienced neurologists at the Yusupov Hospital can assume the presence of purulent meningitis if the patient has meningeal syndrome and focal neurological symptoms in the form of damage to the cranial nerves.

2. In case of abortive course of purulent meningitis or its secondary occurrence against the background of symptoms of an existing septic focus of another localization, diagnosis is more difficult and requires a lumbar puncture with subsequent detection of increased cerebrospinal fluid pressure, its turbidity or opalescent color.
3. When performing a study of cerebrospinal fluid in patients with purulent meningitis, an increased level of cellular elements and protein is determined.
4. In order to identify the type of causative agent of the disease, the Yusupov Hospital conducts a microscopic examination of smears of cerebrospinal fluid and its inoculation on nutrient media.
5. During the diagnosis, a study of the discharge elements of the skin rash and a blood test are carried out.
6. If the secondary nature of purulent meningitis is suspected, additional studies are prescribed to determine the primary infectious focus:

• consultations with a pulmonologist, otolaryngologist, therapist and other specialists;
• otoscopy;
• X-ray of the lungs and paranasal sinuses.

During diagnosis, specialists at the Yusupov Hospital differentiate purulent meningitis from viral meningitis, subarachnoid hemorrhage, meningeal phenomena in other infections (severe forms of influenza, typhus, leptospirosis, etc.).

Purulent meningitis: treatment

All patients with purulent meningitis are recommended to be hospitalized for subsequent treatment in a hospital setting. After diagnostics, confirmation of the diagnosis and identification of the causative agent of meningitis, patients at the Yusupov Hospital are prescribed antibacterial therapy, most often with ampicillin and cephalosporin drugs.

For purulent meningitis of unknown etiology, therapy begins with intramuscular administration of aminoglycosides (gentamicin, kanamycin) or their combination with ampicillin. In severe cases of the disease, intravenous or intrathecal administration of antibacterial drugs is prescribed.

Dehydration therapy with furosemide or mannitol helps reduce hydrocephalus and cerebral edema in patients with purulent meningitis.

In addition, the necessary symptomatic therapy is carried out. Sleep disturbance is corrected with the help of tranquilizers, psychomotor agitation and convulsions are stopped with lytic mixtures, diazepam, valproic acid. Patients with hypovolemia and infectious-toxic shock are given infusion therapy.

During the recovery period, patients are prescribed nootropic and neuroprotective drugs, vitamin complexes and restorative therapy.

Patients with secondary purulent meningitis, first of all, need to eliminate the primary septic focus, incl. and surgically. Operation for secondary meningitis is a sanitizing surgical intervention for otitis media, sphenotomy, ethmoidotomy, frontotomy, removal of intracerebral abscess, etc.

To diagnose and treat meningitis, the neurology clinic of the Yusupov Hospital uses expensive and advanced equipment.

Successful therapy and speedy recovery of patients is ensured thanks to the clinic’s experienced specialists, who are constantly improving their professional qualifications.

For a comfortable stay for patients, the Yusupov Hospital provides cozy, modern wards, nutritious meals, and round-the-clock assistance from highly qualified personnel.

You can make an appointment with a doctor and undergo diagnostics at the Yusupov Hospital by phone or on the clinic’s website. Coordinating doctors will answer all your questions.

Psychotherapist, doctor of the highest category

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• "Diagnostics". — Brief Medical Encyclopedia. - M.: Soviet Encyclopedia, 1989.
• “Clinical assessment of laboratory test results”//G. I. Nazarenko, A. A. Kishkun. Moscow, 2005
• Clinical laboratory analytics. Fundamentals of clinical laboratory analysis V.V. Menshikov, 2002.

*The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer, defined by the provisions of Art. 437 Civil Code of the Russian Federation. For accurate information, please contact the clinic staff or visit our clinic.

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Source: https://yusupovs.com/articles/neurology/gnoynyy-meningit-simptomy-diagnostika-i-lechenie-zabolevaniya/