Meningitis in adults and children: symptoms, signs, treatment

Causes of meningitis

Meningitis can be of infectious or non-infectious origin. The infectious form of the disease develops as a result of the penetration of microorganisms into the body: bacteria, viruses, fungi and parasites. Non-infectious meningitis develops in patients as a result of taking certain medications and the formation of tumors.

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In medicine, classification is used according to the type of pathogenic microorganisms. It is important for a modern person to know how to recognize meningitis and what types of disease exist:

• bacterial meningitis is most often caused by streptococci, meningococci, pneumococci and Haemophilus influenzae, which are transmitted by airborne droplets;
• viral meningitis. The most common form of the disease. This type is characterized by the least severity. The causative agents of viral meningitis are enteroviruses;
• fungal meningitis develops as a result of the activity of certain types of fungal microorganisms;
• parasitic meningitis.

The list of therapeutic measures for meningitis is determined by the factors that caused the development of the disease. Thus, when treating bacterial meningitis, antibiotics are prescribed, which are ineffective for viral meningitis. If a person knows how to recognize meningitis, then the likelihood of diagnosing the disease at the initial stage and the effectiveness of therapeutic measures are high.

It is not possible to determine meningitis on your own. The clinical picture of the disease is varied. Signs differ according to the etiological factor. The initial symptoms of meningitis are often mistaken for cold symptoms. As the infection spreads, the condition worsens sharply. The high risk of death due to meningitis persists for 1-2 days from the onset of the first pathological symptoms. Delayed diagnosis and therapy lead to the development of severe, life-threatening complications.

Misconceptions regarding the treatment of meningitis

• You can get meningitis if you don't wear a hat. Usually these phrases scare children. Sources of infection are considered to be a consequence of the inflammatory process, but not cold.
• Meningitis is not a dangerous disease at all. In reality, death is possible.
• Meningitis cannot be cured. In reality, fungal and bacterial forms can be treated with drugs, since special drugs have been created against such infections. If the form is viral, then things are worse, since there are no effective antiviral agents.
• After meningitis, a person is prescribed disability. In reality, after suffering bacterial meningitis, only 20% of people become disabled. The most common complication is hearing loss, but there are also problems with remembering and completing schoolwork if meningitis is detected in children.

Risk group

Children and the elderly are at risk for meningitis. In addition, this disease is often diagnosed in people with an absent spleen and immunodeficiency.

The spread of meningitis, like all other infectious diseases, is more active in crowded places, closed groups, for example, in kindergartens, schools, student dormitories, barracks, since it is easier to get meningitis if you are in the company of asymptomatic carriers.

Most often, meningitis is transmitted by airborne droplets. This mechanism of infection transmission is considered the most common and characteristic of meningitis of viral origin. The infectious agent is transmitted through coughing, sneezing, kissing and sexual contact.

Newborn babies can become infected from an infected mother through the birth canal. The likelihood of infection is especially high in children born by caesarean section. Bacterial and viral meningitis can be transmitted this way.

Infection with meningitis can occur through the oral-fecal route: through dirty food or untreated water.

In addition, meningitis can develop as a result of the bite of an insect or animal that carries an infectious agent.

What prevention is there?

There is a special vaccination against meningitis. This is what helps prevent the spread of the disease. It should be done for people who often communicate with infected people. Doctors also recommend doing this to children, as they are often exposed to this disease. Vaccination against meningitis is indicated for people with weak immune systems.

Moreover, prevention consists of increasing human immunity. It is necessary to strengthen the body, lead a healthy lifestyle, play sports, often be in the fresh air, and also protect yourself from infectious sources. You can also drink complexes with vitamins and minerals to boost your immunity. It is very important to maintain a balanced diet.

Symptoms of meningitis in adults

Meningitis usually has a sudden onset. The first symptoms of meningitis in adults are: fever, headaches, vomiting (the so-called meningeal triad). However, these pathological signs of meningitis also accompany other infectious diseases, so it is important to know the features of the manifestation of meningitis.

Meningitis is characterized by rapid development with pronounced signs of intoxication:

• headache;
• high fever and chills;
• confusion and loss of consciousness;
• convulsions;
• skin rash;
• muscle weakness;
• drowsiness;
• photophobia, increased skin sensitivity, reaction to sound;
• stiff neck;
• loss of appetite, nausea, vomiting;
• conjunctivitis;
• increased heart rate.

In patients with meningitis, the first sign of the disease is often a rash on the skin and mucous membranes. The rash is initially hemorrhagic in nature, sometimes spots and papules appear on the skin. The rash is considered an allergic reaction to medication.

Headache

A severe headache should alert you. Headaches caused by meningitis feel different from other types of pain. Their intensity is much higher than that of headaches associated with dehydration or migraines. Taking over-the-counter pain medications does not provide relief.

Nausea and vomiting

Nausea and vomiting that occur with a headache are not absolute signs of meningitis. These symptoms may accompany other diseases, such as migraine. Close attention should be paid to other conditions that occur along with vomiting and nausea.

Vomiting with meningitis rarely occurs once, most often it is repeated, repeated, and is not associated with food intake.

Heat

An increase in body temperature, like other symptoms, may indicate the development of meningitis. With this disease, the temperature is usually much higher than with acute respiratory infections. In addition, taking antipyretic drugs for meningitis is ineffective - it is very difficult and short-term to reduce the temperature.

The temperature during meningitis can be moderate, high and ultra-high. Moderate temperature ranges from 380 to 390C, high from 390 to 420C, ultra-high from 420C above.

Meningitis in a child without fever occurs in several cases:

• if a child has a concomitant infection of the nasopharynx, meningitis in this case is considered a secondary disease.
• if the child is premature, the infection occurred in utero, during childbirth, after childbirth, then often the disease does not manifest itself as an increase in temperature - the symptoms of meningitis are smoothed out. This condition is associated with poor functioning of the baby’s immune system and morphofunctional immaturity of the body.
• if meningitis develops in a newborn after birth, the first symptoms of the disease will appear after 20-25 days. At this point, the level of antibodies received from the mother in the child’s blood decreases. Very often, such meningitis occurs in the initial stages without fever.
• Viral meningitis often occurs without fever. It goes away in a mild form within a few days.

Regardless of whether the child has a fever or not, when the first symptoms of meningitis appear, you should immediately consult a doctor.

Pain in the neck

Quite often, patients with meningitis complain of pain and a feeling of tension in the neck, and it is difficult for them to turn or raise their head. This is due to pressure from the inflamed membranes of the brain. This symptom can also be observed when the neck muscles are strained or injured from a sudden movement of the head.

The suspicion of meningitis can be confirmed by bending the patient's hips in a horizontal position - the occurrence of pain in the neck while performing this movement is a sign of meningitis.

Difficulty concentrating

Inflammation of the meninges during meningitis is associated with perception difficulties in patients. It is difficult for them to read an article to the end, concentrate on a conversation, or complete the task at hand. The degree of confusion may worsen as brain swelling increases. In addition to lethargy and confusion, patients experience a drop in blood pressure, shortness of breath, and noisy shallow breathing.

Lethargy, drowsiness

Patients become unable to act independently, they develop drowsiness and lethargy. This condition occurs as a consequence of general intoxication of the body or cerebral edema. Bacterial meningitis can be accompanied by a sharp depression of consciousness and even coma.

Photophobia

A manifestation of photophobia in patients with meningitis is severe pain that occurs in bright light. The appearance of pain and sensitivity of the eyes, as a reaction to light, is considered an alarming signal, as it is a characteristic sign of meningitis.

Convulsions

Convulsions, sometimes with involuntary urination and disorientation in space, are observed in 20% of patients with meningitis. Their course is similar to epileptic, or the appearance of tremor of individual muscles and individual parts of the body is observed. The occurrence of seizures (generalized and local) is associated with irritation of the cortex and subcortical structures of the brain.

Characteristic rash

A hemorrhagic rash on the skin and mucous membranes is not a specific symptom of meningitis. It appears in 25% of patients with bacterial meningitis and is most often observed in diseases of a meningococcal nature, since it is meningococcus that causes damage to the internal walls of blood vessels. The appearance of skin rashes is usually observed 15-20 hours after the onset of the disease. In this case, the rash is polymorphic - it can be roseolous, papular, in the form of nodules or petechiae. The rashes have an irregular shape and may protrude above the skin level.

Psychomotor agitation, anxiety

Anxiety, agitation and disorientation occur in patients with a form of the disease such as meningoencephalitis at the onset of the disease. With the bacterial form of meningitis, similar symptoms may appear 4-5 days after the onset of the disease. After psychomotor agitation, patients may experience loss of consciousness or coma.

At the beginning of the disease, as well as in later stages, patients with meningitis may develop symptomatic psychosis, manifested by agitation or, conversely, lethargy, delirium, visual and auditory hallucinations.

Delusions and hallucinations can occur in patients with lymphocytic choriomeningitis and meningitis, which is caused by the tick-borne encephalitis virus.

Among the etiological factors of meningitis, sinusitis is distinguished. The accumulation of purulent contents in the sinuses without proper treatment can lead to the spread of infection to the meninges. In such cases, meningitis is considered as a complication of sinusitis. The effectiveness of treatment for sinus inflammation depends on the quality of the diagnosis.

How to prepare for going to the doctor?

To go to the doctor, you don’t need to make any extensive preparations; on the contrary, if there are symptoms of meningitis , you shouldn’t put off going to the doctor, in this case you need to react immediately. Just remember all the signs that you had and tell your doctor about them. This will help make a correct diagnosis. You can't ignore these signs. Signs of meningitis in an adult can appear within a couple of hours, so urgent help is needed to avoid complications and even death.

Sinusitis and meningitis: the relationship of diseases

Meningitis develops as an independent disease and can be a complication of pathological processes. Sinusitis and meningitis are interrelated, since the accumulation of pus in the maxillary sinuses can cause inflammation of the lining of the brain. It is important for people at risk to know how sinusitis turns into meningitis and what symptoms the patient experiences.

The development of complications with sinusitis is rare, since modern specialists use effective treatment methods. However, if treatment is untimely and ineffective against the background of reduced immunity, the patient may develop meningitis. If a patient suspects meningitis or their health has sharply worsened, it is necessary to consult a general practitioner or neurologist, who will prescribe an examination and determine the cause of the problem.

The most important and revealing test for suspected inflammatory processes in the membranes of the brain and spinal cord is a lumbar puncture. It is necessary to examine the cerebrospinal fluid to identify the cause of inflammation and prescribe adequate therapy.

Pain due to meningitis

The most characteristic sign of pathology is headache. It occurs in any form of meningitis and appears from the first days of the disease. Headaches can vary in nature, but, as a rule, patients complain that their entire head hurts. Also, attacks of nausea and vomiting are often observed against the background of headaches.

What kind of pain occurs?

The manifestation of pain directly depends on the localization of the area of ​​brain damage, the nature of the occurrence of meningitis (viral or infectious, or as a consequence of the development of the disease due to narrowing of blood vessels and spinal disorders).

In all cases, the nature of the headache will be different. Pain depends on the location of the inflammation, its prevalence, and the degree of impact on brain function.

Headache with serous meningitis

With serous meningitis, moderate pain is observed throughout the skull. In this case, there is no fever or increase in body temperature. The patient also experiences chills, nausea and vomiting against the background of constant headaches. However, after vomiting the patient does not feel any relief.

How does a headache occur with purulent meningitis?

With this form of meningitis, the patient develops severe headaches that are bursting in nature. The pain either subsides or increases again. Characteristic symptoms in this case are nausea, vomiting, fever, and chills.

Pain from subarachnoid hemorrhage

In this situation, headaches are constant, that is, they do not subside either day or night, neither in summer nor in winter. Headache is characterized by intense, sharp and acute manifestation.

How does a headache occur with tuberculous meningitis?

This is the weakest form of meningitis in its manifestations, characterized by an increasing nature of the manifestation of symptoms. Patients experience constant weakness, increased sweating, and depression. Nausea and vomiting occur very rarely.

With any form of meningitis, headaches lead to blurred vision. Patients often develop intolerance to loud sounds and photophobia. The pain intensifies several times when pressing on the area of ​​the temples or eyes.

When should you see a doctor?

Every person needs to know how to detect signs of meningitis in children . There is no need to delay contacting a doctor if you often experience headaches, nausea and vomiting, an increase in body temperature, photophobia, sensitivity to sounds, or muscle pain in the back of the head. Also considered key symptoms are apathy and a constant desire to sleep, fainting, anxiety, and convulsions. A rash with meningitis is also observed; it affects the skin and mucous membranes. Mental disorders are also observed.

diagnosis of meningitis

Meningitis must be treated by a doctor in the infectious diseases department.

Diagnosis of meningitis

The diagnosis of meningitis can be made based on the results of additional studies - laboratory and instrumental:

• detailed blood test;
• fundus examination;
• X-ray examination of the skull;
• heart electrocardiograms;
• electroencephalography;
• computer and magnetic resonance imaging.

To confirm the diagnosis of meningitis, doctors use bacteriological examination of mucus from the nasopharynx and cerebrospinal fluid. During bacterioscopic examination of cerebrospinal fluid, smears are stained with Gram or methylene blue. To exclude fungal meningitis, the specimen containing cerebrospinal fluid is stained with ink. Laboratory assistants isolate a pure culture on media with the addition of normal horse serum or cattle serum and identify it by biochemical activity and antigenic structure.

In case of viral meningitis, in preparations prepared with Gram staining and ink, it is impossible to identify the causative agent of the infection. Cultivation of bacteria and fungi also gives negative results. By culturing cellular material with standard laboratory cell lines, a pathogen serologically identical to the measles virus can be isolated. Rubella virus is isolated using the co-cultivation method.

To identify oligoclonal immunoglobulins, the method of agarose gel electrophoresis or isoelectric focusing of cerebrospinal fluid gamma globulins is used. Immunoglobulins appear in a number of viral infections. As a result of immunological studies, viral antigens or antibodies are detected in the cerebrospinal fluid, and the nucleic acid of the virus is detected using the polymerase chain reaction method. The enzyme immunoassay method detects pathogen antigens in feces, urine or saliva. Express methods allow you to quickly and early determine the presence of the herpes simplex virus antigen in the cerebrospinal fluid and blood or the DNA of the virus (using the polymerase chain reaction method).

CSF cytosis in meningitis

Analysis of cerebrospinal fluid allows not only to confirm the diagnosis, but also to differentiate purulent and serous meningitis, identify the causative agent of the disease, determine the degree of intoxication, and also makes it possible to monitor the effectiveness of treatment.

Bacteriological examination of cerebrospinal fluid in the case of tuberculous meningitis may give a false negative result. Detection of tubercle bacilli in the cerebrospinal fluid depends on the thoroughness of the research. At the Yusupov Hospital, all diagnostic procedures are performed using modern medical equipment and the use of new drugs and techniques. The results of studies conducted at the Yusupov Hospital are reliable and as informative as possible.

How does it manifest in newborns?

Many parents are interested in the question of how meningitis manifests itself in infants, because they cannot make complaints, and the disease is dangerous and poses a threat to life.

Meningitis in newborns is accompanied by characteristic symptoms:

• dyspepsia;
• monotonous scream;
• hyperexcitability;
• frequent regurgitation;
• twitching of hands and chin;
• vomit;
• throwing back the head;
• loss of appetite;
• low-grade fever;
• increased muscle tone.

The same symptoms occur after severe birth injuries and hypoxia, so an accurate diagnosis is made only after examining the cerebrospinal fluid.

The disease in newborns and children in the first months of life occurs with severe intoxication, muscle hypotonia, respiratory failure, and repeated convulsions are possible.

How is meningitis treated?

At the Yusupov Hospital, patients can receive a full range of medical services for the detection and treatment of meningitis, rehabilitation after illness and prevention. Patients with meningitis can contact the neurologist clinic of the Yusupov Hospital every day for 24 hours to receive emergency care.

When patients are admitted to the Yusupov Hospital, a comprehensive diagnosis is carried out, including a number of examinations to identify the causes of meningitis, collection of complaints and symptoms. Patients with meningitis need inpatient treatment, so the Yusupov Hospital has created comfortable living conditions and ensures interaction with qualified personnel.

How is the treatment carried out?

Treatment of meningitis is performed using several methods:

• Antimicrobial. Used when illness is caused by germs.
• Antiviral. Here doctors prescribe interferon and glucocorticosteroids to block the spread of the virus and improve the functioning of the immune system.
• Antifungal. If the disease appears due to candida, then antimycotic medications are used.

Therapy is also aimed at eliminating symptoms, that is, they give pain-relieving injections, normalize body temperature, and eliminate intoxication and dehydration.

Consequences of meningitis

Since men are less likely to consult a doctor in a timely manner and more often than women suffer from cerebrospinal meningitis, they often develop complications during the illness. Mild complications include headaches when the weather changes or overwork, slight decreases in hearing, concentration, and memory. Depending on the severity of meningitis and the timeliness of seeking medical attention, the following complications may develop:

• a sharp decrease in visual acuity;
• stuttering;
• strabismus;
• significant hearing loss;
• decreased intelligence;
• dropsy of the brain;
• epilepsy;
• mental disorder;
• development of schizophrenia;
• dementia.

The patient may fall into a coma, he may develop paralysis, and with complicated meningitis, death is possible.

The Yusupov Hospital effectively diagnoses the disease. The patient undergoes examination at the hospital's diagnostic center, which is equipped with modern equipment from leading global manufacturers. You can make an appointment with a doctor by calling the Yusupov Hospital.

Can it be determined during the incubation period?

The incubation period for bacterial meningitis lasts 2–7 days, for a viral infection it lasts 2–4 days. In infants it may be less than a day. Its duration largely depends on the state of the child’s immunity; the stronger it is, the longer there are no clinical manifestations.

It is very difficult to determine the disease during this period. Clinical manifestations are very vague or completely absent. But parents should pay attention to changes in the child’s behavior: sudden drowsiness, lethargy, increasing headache, nausea, loss of appetite - may be the first signals of a dangerous infection.