Disease of acute infectious nature withthe primary lesion in the meninges is called meningitis. The signs of pathology are manifested depending on the nature of the developing inflammatory process. The disease can be primary and secondary.
Separate meningitis purulent and serous.
In the first case, there is a group of primary and secondary pathologies in which the primary lesion of the meninges is bacterial in nature.
Meningococcal cerebrospinal epidemic meningitis belongs to this group and refers to primary diseases.
Manifestations of the disease have acute development.Purulent meningitis of this type is accompanied by an increase in body temperature to 38-39 degrees. In addition, the patient complains of a severe headache, radiating to the legs, back, neck. Sharp soreness is accompanied by general hyperesthesia (hypersensitivity), vomiting, developing meningeal symptoms. At the initial stages of the disease, consciousness is conserved, however, in the absence of necessary treatment, the patient quickly enough falls into a co-morbid condition (depressed consciousness). Often observed herpetic rashes on the mucous membranes and skin, as well as hemorrhagic rash. A blood test shows increased ESR, high leukocytosis (neutrophilic). Changes in cerebrospinal fluid during the first hours of the disease are not detected. However, during the first or second day there is a sharp increase in its pressure, turbidity, it acquires a yellowish-gray or grayish hue. A low sugar content is also detected.
Purulent meningitis caused by meningococcalinfection, is diagnosed in accordance with the information about the patient, the course of the disease and its clinical manifestation. In the period preceding hospitalization, differential diagnosis of this type of disease with secondary pathology is carried out.
Secondary purulent meningitis can develop as a result of dissemination (dissemination) with purulent maxillary sinusitis or otitis infection from the foci of pathology.
The onset of the disease is characterized bychills, fever, headache, and a sharp deterioration in the general condition of the patient. Meningeal symptoms are formed early. Secondary purulent meningitis is accompanied by a rapid impairment of consciousness against a background of frequent psychomotor agitation, convulsions, hallucinations. Liqvor grows dull. There is an increase in ESR.
When diagnosing it is necessary to differentiateabscess of the brain and purulent meningitis. These pathologies share many common features. The brain abscess is characterized by a bradycardia, an increase in focal symptoms against the background of the signs of inflammation subsiding, a shift in the echography of the median structures.
Methods of diagnosing purulent meningitis include biochemical and bacteriological examination of blood samples, ECG, MRI and CT of the brain, radiography of the skull.
When manifesting the signs of pathology, urgent hospitalization in the infectious department is necessary. If a secondary disease is established, the patient is placed in the appropriate hospital.
If a suspected development of meningitis is mandatoryLumbar puncture is performed with the study of cerebrospinal fluid. The procedure is carried out under the cover of antibacterial drugs. Until the pathogens are identified and the degree of sensitivity is determined, a wide range of preparations is prescribed. These antibiotics are able to penetrate the blood-brain barrier. These include drugs "Ampicillin", "Benzylpenicillin", cephalosporins of the third generation ("Ceftriaxone", "Cefotaxime").
