The symptom of brain edema with meningitis
Meningitis in children is quite dangerousa disease developing in the central nervous system. Morphologically it is characterized by an inflammatory process in the membranes (soft and arachnoid) of the brain.
The cause of inflammation of the meninges in the childany age are different microbial agents (bacteria and viruses). The appearance of these changes in the skin of the brain is promoted by chronic diseases, low level of immunity, anomalies of the development of the skull.
At the slightest signs of meningitis, you should immediately look for a doctor. Treatment of this disease is carried out only in a hospital with antibiotics and intravenous solutions.
Self-treatment can lead tothe spread of the process, there is encephalopathy and inflammation of the brain itself, as a result, irreversible changes in personality, motor and sensory functions can form. If there is no necessary treatment, the child dies.
Immediate cause in children of any age are all kinds of infectious agents. Among them the most common are:
- bacteria (meningococcus, tuberculosis bacillus, syphilis pathogen, pneumococcus, numerous varieties of streptococcus and staphylococcus);
- viruses (influenza, adenovirus, measles, rubella, causative agent of mumps, herpes viruses and especially the virus of varicella, enteroviruses, human immunodeficiency virus);
- protozoa (toxoplasm);
- fungi (cryptococcus).
In different age groups, there is a certain predominant influence of this or that microbial agent as the cause of meningitis. The following regularities are noted:
- in newborns the disease develops very rarely, is the result of intrauterine infection, which is transmitted from the mother to the fetus (toxoplasmosis, herpetic);
- in infants it can be a manifestation of congenital syphilis or human immunodeficiency virus (combined with other signs of infection);
- in children up to a year, a bacterium such as meningococcus is most often relevant;
- in children of school age, the effect of staphylo- and streptococci is more significant;
- in adolescents, as in adults, a tuberculous process of affecting the meninges can be diagnosed.
If you know how meningitis is transmitted to children,then you can protect your children from this disease. Most of the above-described infectious agents are transmitted by airborne droplets, that is, in close direct contact with a sick person (of any age).
In some cases (tuberculosis. enteroviruses, streptococcus, staphylococcus), the microbial agent is fairly stable in the environment, so it is possible to infect by using common toys, dishes, towels. Even with the slightest suspicion of contact with such pathogens, mum should disinfect (enough hot water and soap) for all suspicious items.
More senior it is desirable for a child to refuse visiting a sick companion (both at home and even more so in a hospital). The incubation period of various infectious diseases can be quite long, so do not let the child go to a sick school friend 2-3 days after the onset of his illness. If this is absolutely necessary, then you need to wear a face mask on your nose and mouth, after the visit, wash your hands thoroughly.
The development of meningitis is greatly facilitated by:
- various chronic nonspecific inflammatory processes of the ENT organs (sinusitis, adenoids, otitis);
- congenital and acquired abnormalities of the development of the skull (curvature of the nasal septum);
- diseases of the oral cavity (carious teeth).
All this creates conditions for the reduction of local andgeneral immunity, fast and easy penetration of the microbial agent into the brain cavity. From any purulent foci (furuncle pneumonia), a microbe can enter the brain and provoke a disease. This is how secondary bacterial meningitis develops in children.
From how this disease manifests itself, one can judgeabout the signs of meningitis. The infectious agent along the spaces along the nerves, with the blood or lymph flow from the nasopharyngeal mucosa or other organ, penetrates into the cranial cavity onto the brain envelope. Develops its edema and inflammation, there is a compression of the brain tissue, a violation of the outflow of cerebrospinal fluid.
There are many options for classifying meningitis. Most often doctors say about such kinds of disease:
- primary - appears as an independent process without the defeat of other organs (meningococcal);
- secondary - is a complication of another infectious process (measles, tuberculosis, epidemic parotitis).
Another common form of form descriptiondiseases - a classification, depending on the changes in cerebrospinal fluid, the analysis of which is mandatory conducted with inflammation of the meninges. Isolate serous and purulent meningitis.
Bacterial purulent meningitis occurs morea heavier, higher risk of complications, consequences and death. The same patterns are typical for bacterial (tuberculous) serous meningitis. Serous viral meningitis is characterized by a more favorable course and outcome.
Most variants have similar clinicalmanifestations in children of any age. The precise definition of the type of disease is important for the doctor to prescribe the correct and effective treatment that destroys the microbial pathogen.
Symptoms and signs of the disease
The final diagnosis will be made by the doctor,parents need to have a general idea of how to recognize a child's meningitis. Children's meningitis differs somewhat in its course in infants, preschoolers and adolescents, the common symptom is only a rise in temperature.
In a tiny toddler, the symptoms in the foreground are nonspecific, which can easily be confused with other diseases. In any case, should not be ignored:
- persistent, unmotivated crying;
- rejection of the breast or bottle;
- a characteristic position: the baby lies on its side, the head is thrown back, and the legs are bent in the knees and pinned to the tummy (the so-called pose of a cocked cock or a dog);
- when raising the baby in an upright position, holding the armpits, the baby's legs are pulled up to the tummy (a symptom of the Lessoyage).
Convulsive syndrome in infantsmay also be a sign of meningitis. Regardless of the specific pathogen in such small children in the forefront of the phenomenon of general intoxication, and neurologic manifestations are expressed moderately.
At an older age (preschool or junior school), parents should alert such changes in the behavior and well-being of the child:
- against a background of a slight increase in temperature, the child strives to lie down in the middle of the day, refuses to play (even quiet);
- he is capricious and cries for no reason;
- eats and drinks without appetite and with reluctance;
- in the intervals between meals (not immediately after the releasefrom the table) there is a sudden profuse vomiting (the so-called vomiting of the central origin caused by severe intoxication), which does not bring relief to the child (unlike intestinal disease);
- too long sitting over a school assignment and complains of sudden weakness and a general decline in strength;
- the child complains of the growing headache (spilled and bursting nature);
- painful feelings intensify with loud sounds, bright light, sometimes when you touch the body of rough tissue or a cold object;
- a characteristic position of the dog is possible.
Symptoms of inflammation of the meninges in adolescents are similar to those in adulthood. Typical changes (the so-called meningeal triad) are typical:
- Strongest to intolerable headache without clear localization;
- vomiting without concomitant nausea;
- temperature increase.
A teenager clearly describes the first signs of hisIllness, because they can not go unnoticed. The leading manifestations will be specific neurological signs, and not cerebral symptoms.
Separate attention deserves a meningococcaloption, since it is meningococcus most frequent causative agent of the inflammatory process of meninges in children of the first six years of life. Perhaps the combined development of meningitis and meningococcemia (a specific infection of the blood). In this case, there is a characteristic rash in meningitis in children. For a mixed form of meningococcal infection in a child of any age is characterized by:
- a sudden onset of the illness (literally within an hour);
- at the beginning of the disease, the strongest general intoxication predominates (lethargy, lack of appetite), then a specific neurological symptomatology appears;
- already in the first hours formed a characteristic hemorrhagic rash: on the skin of the legs and buttocks appear small irregular forms of hemorrhage, they are prone to fusion and peripheral growth.
With timely treatment are rare. The most dangerous are the following:
- encephalitis and myelitis (inflammation of the brain and spinal cord, respectively);
- edema of the brain;
- acute adrenal insufficiency (Waterhouse-Friederichsen syndrome);
- pulmonary edema;
- myocardial infarction;
- cerebral hypotension;
- gangrene skin.
Most of the parents are reasonably afraid of the consequences of meningitis, namely:
- postinfection myocardiosclerosis;
- blindness and deafness;
- hydrocephalus (in young children);
- dysarthria and other disorders of higher nervous activity.
Irreversible changes in the body and personalitythe child is most typical for bacterial meningitis, the most relevant for the tuberculosis process. The consequences of serous meningitis are extremely rare.
For treatment, please contact the pediatrician (forestablishing a preliminary diagnosis), then to an infectious inpatient facility. An adult or infant infectious disease specialist is involved in the final diagnosis (indicating the specific infectious agent) and the treatment of this disease.
Diagnosis and examination with meningitis
How to determine if there is inflammation of the meningesor not - in the end only the doctor knows. A number of specific neurological signs (meningeal signs) are studied, after which lumbar puncture is necessary.
Specific diagnostics is based on changescerebrospinal fluid. It can be obtained only if a lumbar puncture is performed - a lumbar puncture with a special needle between the vertebrae. There is no need to be afraid of this study (infantile cerebral palsy does not develop from it), as puncture under local anesthesia takes place, in a strictly defined place where there is no spinal cord, therefore it is impossible to damage it.
The extracted liquid is examined in the laboratory. As a result, the doctor makes a final conclusion about the type of meningitis that takes place (serous or purulent), which infectious agent provoked the process.
The complex of mandatory studies for meningitis of any etiology includes:
- general clinical tests of blood and urine;
- study of blood sugar;
- chest radiograph.
In some cases, to exclude brain damage requires magnetic resonance imaging.
General directions of treatment of meningitis
Treatment at any age should be comprehensive, including exposure to a microbial agent (causative agent of the disease) and correction of disorders of various types of metabolism (pathogenetic therapy).
To destroy the bacterial pathogenintramuscular or intravenous antibacterial agents with a wide range of effects, most often from the group of cephalosporins (cefuroxime, ceftriaxone, cefazolin) are prescribed. In viral meningitis, various antiviral agents (acyclovir, valaciclovir) are used.
For the correction of metabolic disorders are used:
- Colloidal and saline solutions to reduce intoxication;
- Urea preparations (mannitol, mannitol, ureitis) to reduce edema of the brain tissue;
- steroid hormones for stabilization of cardiac activity;
- vitamins of group B;
- various nootropics for the normalization of metabolic processes of the brain (vinpocetine, cerebrolysin, nootropil, piracetam).
It is necessary to gradually return to the usual way of life. In the acute period (10-14 days), strict bed rest is necessary. If this is not done, complications may develop.
Only after improvement of cerebrospinal parametersa gradual expansion of the motor regime is possible. The child actually learns to re-sit, get out of bed, walk. A more rapid recovery is promoted by general restorative massage and physiotherapy exercises. The food ration should be enriched with proteins and vitamins, a special diet is not required.
Prevention of meningitis in children is aimed atprevention of contact with the microbe, compliance with sanitary and hygienic standards and general strengthening of immunity. Prevention of viral meningitis implies compliance with quarantine measures in children's institutions with outbreaks of measles, rubella, chicken pox.
Specific prophylaxis is quite effective. Immunizations from meningitis to children - is the implementation in accordance with the age of the calendar of preventive vaccinations. Creating a tense immunity against measles, rubella, hemophilus bacillus - will avoid the development of this disease.
For meningitis of any etiology should always be remembered:
- disease can occur at any age;
- treatment is most effective in the early stages of the disease;
- self-categorically is unacceptable.
At the slightest suspicion of meningitis, you must consult a pediatrician or infectious disease specialist. It is better to reject unreasonable doubts, than it is late to start treatment of a meningitis and its complications.
Meningitis - Dr. Komarovsky's School - Inter