Bacterial meningitis: symptoms, treatment, consequences, prevention, how it is transmitted

Today, bacterial meningitis is a rare disease that can be diagnosed anywhere in the world. Some peoples have a genetic predisposition to this pathology, but in each age group the disease can develop for many reasons. This type of meningitis is transmitted by airborne droplets; it is especially easy to become infected when you are in the same room with a sick person. This disease has its own characteristics, symptoms and treatment methods, which differ from other forms of meningitis.

Characteristics and description of the problem

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Bacterial meningitis is an infectious disease of the brain and spinal cord, which is provoked by bacteria of the streptococcus group. Pathology contributes to the development of the inflammatory process in the membranes of the central nervous system. The prevalence of meningitis is insignificant, but it is easily transmitted from an infected person to a healthy person, which can cause an epidemic among the population. The main changes are observed in the soft and arachnoid membranes of the brain; often the gray matter is also involved in the pathological process.

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In medicine, bacterial meningitis in adults and children is divided into the following types:

streptococcal;
staphylococcal;
pneumococcal;
meningococcal;
uncertain.

The disease is rapidly progressive and therefore requires immediate treatment. In the absence of therapy, the risk of complications and even death increases, this is important in childhood and old age, as well as in cases of reduced human immunity.

Infection of the meninges develops due to bacteria entering them. This happens as a result of the body’s reactions to pathogenic microorganisms. In the human body, activation of many physiologically active substances and leukocytes occurs in combination with endothelial damage. All this causes cerebral edema, increases intracranial pressure and reduces blood flow in the brain.

Attack to the head. How to protect yourself from summer meningitis?

Headache and pain are different. Of course, none of them should be left unattended. However, the disease that is accompanied by severe headaches, and which we will talk about today, belongs to the category of truly formidable ones.

Neurologist Yulia Vladimirovna Roshchupkina told us about such a pathology as meningitis.

— Yulia Vladimirovna, meningitis – what kind of disease is this?

This is a pathology, the essence of which is the inflammatory process in the membranes of the brain and spinal cord (hard, arachnoid and soft). The last two membranes are most often affected.

Meningitis is an infectious disease. It can be caused by bacteria, viruses, protozoa and fungi.

SUSPECTED MENINGITIS IS ALWAYS AN INDICATION FOR IMMEDIATE HOSPITALIZATION. CALL AN AMBULANCE

In origin, this pathology can be primary or secondary.

The infectious agent penetrates the membranes through the mucous membrane of the nasal cavity and pharynx, moving by contact to its final destination.

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— Many people think that meningitis is a disease that affects people in the winter season. But from year to year the media publish information about outbreaks of summer meningitis. Where does meningitis lie in wait for us in the summer months?

Meningitis, which is recorded in the summer, is usually viral in nature and is caused by an enterovirus. Children and adolescents (usually 2-5 and, accordingly, 14-19 years old) are especially susceptible to it. Most of the sick people “bring it” from their summer vacation at sea. Patients note that they froze when swimming and often swallowed water.

MENINGITIS IS AN INFECTIOUS DISEASE. IT CAN BE CAUSED BY BACTERIA, VIRUSES, PROTOTOZA FUNGI

Infection occurs through airborne droplets (for example, when sneezing) through dirty hands. The virus survives well in soil and water and “loves” heat and humidity.

— Can you get meningitis from another person?

Yes, but not always. For example, primary meningitis caused by bacteria and viruses is contagious.

If the inflammation is secondary (for example, against the background of tuberculosis, HIV infection, ENT pathology), patients are not contagious. Those. when meningitis is a complication of the underlying disease, and not acquired from the outside. Of course, the causative agents of tuberculosis and HIV themselves are contagious, but in this case we are talking about infectivity in general, and not about meningitis in particular.

— How does meningitis begin? What symptoms does it manifest?

There may be a runny nose and sore throat (reminiscent of symptoms of ARVI). The first characteristic signs of meningitis include significant fever, which is difficult to reduce. Another typical early symptom is an intense headache. Sometimes it is a little easier with the patient lying on his side, with his head thrown back and his legs brought up to his chest.

Bright lights and loud noises are annoying.

The next characteristic manifestation is uncontrollable vomiting, which does not bring relief.

MENINGITIS, WHICH IS RECORDED DURING SUMMER, IS USUALLY VIRAL IN NATURE AND CAUSED BY ENTEROVIRUS

With meningitis of enteroviral origin, in addition, loose stools and abdominal pain may be observed. There is a blush on the cheeks, reddened eyes, dry, bright red lips, and a pale nasolabial triangle.

If meningitis is caused by meningococcus, you may notice a bright, red or red-purple rash. It does not rise above the skin and does not disappear when pressed (for example, you can try to press the rash with a transparent glass: you can see through the bottom that it persists).

— What to do at the first signs of meningitis? Which doctor should I contact?

Suspicion of meningitis is always an indication for immediate hospitalization. Call an ambulance.

Meningitis is treated by an infectious disease doctor (for children or, respectively, for adults).

— What diseases can meningitis be confused with?

With ARVI, flu, mushroom poisoning, canned food.

YOU SHOULD NOT ATTEMPT TO DIAGNOSIS OR RULE OUT THE DIAGNOSIS OF MENINGITIS ON YOURSELF AT HOME, SINCE THERE IS A SERIOUS RISK OF WASTING TIME

The so-called meningism is very similar to meningitis. This is a condition in which almost identical symptoms are observed, but the meninges are not inflamed. Meningism develops due to irritation of the membranes in certain infectious pathologies.

I repeat: you should not try to make or exclude a diagnosis of meningitis on your own at home, since there is a serious risk of wasting time, and the likelihood of death from this disease increases.

— Who gets meningitis more often—children or adults?

Children. More than 80% of cases are children in the first 5 years of life.

— Is meningitis always treated in a hospital setting or is it acceptable for the patient to stay at home?

He is treated exclusively in a hospital setting.

— Yulia Vladimirovna, what determines the outcome of meningococcal infection?

On the timeliness of diagnosis and the adequacy of treatment, as well as (in relation to meningitis in general, and not just those caused by meningococcus) the form of the disease.

— Suppose a person went to the doctor on time and recovered. Will meningitis have irreversible consequences on the body or not?

If meningitis is detected on time and properly treated, then no. The prognosis in such cases is good. For the most part, the disease is cured completely, with no negative consequences remaining.

If assistance is provided late, or the patient has severe comorbidities, serious consequences may occur.

Some neurological and systemic complications include: increased intracranial pressure, epileptic seizures, cerebral hydrops, damage to cranial nerves, blood clots in arteries or veins (both in the brain and, in particular, the pulmonary artery), paresis and paralysis, dementia, sepsis.

— How to protect the body from summer meningitis? Tell us about the prevention of this scourge

Nonspecific prevention is of primary importance for this type of meningitis. What is needed? Lead a healthy lifestyle: rationally distribute time for sleep and wakefulness, engage in physical exercise and general strengthening procedures, and harden up. It is important to ensure a balanced diet.

It is necessary to eliminate foci of chronic infection. In childhood, this is often an ENT pathology, so the child should be regularly shown to an otolaryngologist.

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Existing diseases of the digestive system, including parasitic ones, should be treated.

Physiotherapy and massage have proven themselves to be effective preventive measures.

Among the medications prescribed by the doctor, some adaptogens, protective ointments for intranasal use during periods of increased incidence of ARVI, vitamin D, and immunomodulators can be used.

If we talk about specific prevention in the form of a vaccine against meningitis, then there is no such vaccine against enterovirus.

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To prevent the incidence of bacterial meningitis, vaccines have been created aimed at creating immunity against the main “causal” bacteria - meningococcus, pneumococcus, and Haemophilus influenzae. Vaccination is carried out in risk groups and according to epidemiological indications.

Epidemiology

In developed countries, the disease occurs in 80% of cases in people under sixteen years of age. Males are most often affected. In 10% of cases, this pathology leads to death, and another 10% of infected people develop permanent neurological disorders. An increase in incidence is observed in winter, primarily due to climatic conditions (temperature changes, increased humidity), as well as prolonged stay in enclosed spaces. Every ten years there is an increase in the incidence rate.

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How bacterial meningitis is transmitted is described above; it is widespread in all countries of the world, especially in African countries, where the pathology occurs in 500 cases per 100,000 people. For a long time, this pathology was considered childhood, since, according to statistics, it was previously observed in children aged 12-18 months. After the introduction of vaccination, the disease began to be frequently observed in the adult population. Today, pathology is diagnosed in 33% of cases among all infectious diseases of the central nervous system.

Risk factors for meningitis

There are some factors that increase your risk of getting meningitis.

Refusal of vaccination. Children and adults who are not vaccinated against meningococcus and pneumococcus have a much higher risk of getting sick than those who are vaccinated.

Age. Viral meningitis most often affects children under 5 years of age, while bacterial meningitis occurs in people under 20 years of age.

Accommodation in closed institutions . Students living in dormitories, personnel of military bases and educational institutions with army discipline, children in orphanages and boarding schools are at risk of meningococcal meningitis. This is due to the fact that the likelihood of airborne transmission of infection is much higher; meningococcus spreads faster throughout establishments. Therefore, in the Russian Federation, children and young people living in barracks, orphanages and boarding schools are primarily vaccinated against meningococcus and pneumococcus.

Pregnancy . During pregnancy, the likelihood of becoming infected with listeria, a bacteria that can lead to fetal death, stillbirth or death of the newborn, increases.

Immunodeficiency states. People whose immunity is weakened due to AIDS, alcoholism, diabetes, or simply taking immunosuppressants are more likely to develop meningitis. This may also include people who have had their spleen removed, since this organ is an important organ of the immune system.

Causes of the disease

Purulent bacterial meningitis can be caused by various bacteria (see above), including Salmonella, Klebsiella and Pseudomonas aeruginosa. These microorganisms live in the environment and in the human body. When exposed to negative factors, they begin to rapidly multiply and infect brain cells.

There are many reasons why the disease can affect the body of each person:

head injuries;
decreased immunity;
transfer of severe inflammatory diseases;
genetic predisposition of some peoples;
infection from a carrier.

Like any infectious disease, bacterial meningitis is transmitted by food or airborne droplets, as well as by direct contact with a carrier of the infection: shaking hands, kissing, sneezing, or using shared household items. Therefore, doctors recommend strictly observing the rules of personal hygiene.

Symptoms of meningitis that every parent should know

10.03.2020

Hearing the word “meningitis” from a doctor when diagnosing a child, any parent will be horrified. Having an extremely poor understanding of the symptoms and etymology of the disease, everyone has heard about the terrible consequences. The disease is insidious, sometimes taking a lightning-fast form. Therefore, all parents need to know the enemy as best as possible, so as not only to give the child the opportunity to rest at home with a general malaise, but to call an ambulance and provide emergency assistance.

What is meningitis?

Meningitis is an inflammation of the membranes of the brain that develops as a result of a bacterial, viral or fungal infection.

The cause of bacterial meningitis can be any purulent lesion in the body. This species is of particular importance because it is the most dangerous type of disease.

Symptoms appear unexpectedly, and the disease develops at lightning speed. That's when minutes count.

With viral meningitis, the causative agent can be any of the common infections - chickenpox, measles, rubella, mumps, and influenza. Accordingly, it can be infected from another person. What makes it even more dangerous is that parents have no way to track and check all the people who come into contact with their child. It turns out that no one is immune from the disease.

The fungal form of meningitis most often affects people with weakened immune systems . At risk are carriers of HIV infection and people with cancer undergoing chemotherapy. This form is not transmitted by airborne droplets.

Symptoms

Sudden rise in temperature. The fever begins suddenly, the child complains of chills. High body temperature, which is very difficult to bring down with antipyretics, and at the same time cold hands and feet .
Unbearable stabbing headache. In infants, one of the symptoms may be swelling of the fontanel.
Deterioration of vision , impaired mobility of the eyeballs and, as a result, double vision . Also, the patient does not have the ability to focus his gaze on an object.
Stomach pain , nausea , vomiting, loss of appetite. Typically, “fountain” vomiting is characteristic, which is not associated with food intake and does not bring relief. Afterwards the headache only gets worse.
Tearing and increased nausea in bright sunlight. The child squints and experiences pain when exposed to direct sunlight. In this case, it is recommended to curtain the windows and wait for the doctor in the twilight.
Increased tone of the occipital muscles, or Brudzinski's sign. You can identify it yourself. To do this, you need to put the back of the child's head on your hand and bend your neck , bringing your chin to your chest . A patient with meningitis will experience pain during such manipulations, and his legs will instantly bend at the knees .
Pointer dog pose. In severe cases of the disease, the child lies in a certain position: legs bent at the knees and pressed to the stomach , arms leaning against the chest, head tilted back.
Skin rashes. to distinguish a meningitis from a normal rash. To do this, take a glass glass, place it on the rash and press firmly. If the spots do not fade, you should urgently call a doctor .

What to do if you notice symptoms?

If a child exhibits at least one of these symptoms, you should immediately call a doctor or an ambulance. On site, an experienced employee will conduct a full examination and confirm or refute the diagnosis. If the disease is still detected, it is recommended not to refuse hospitalization and undergo treatment in a hospital . In this case, the likelihood of avoiding consequences is much higher.

Published in Neurology Premium Clinic

Risk group

But when an infection enters the body, meningitis does not always develop. For its occurrence, special conditions are necessary: a disorder of the immune system and a throughput reaction of the body. In the presence of these factors, harmful bacteria freely penetrate the circulatory system and move to the brain. Therefore, the risk group includes:

persons with chronic diseases;
people who abuse alcohol, nicotine, and drugs;
HIV-infected;
children under three years old.

Causes of bacterial meningitis

Pneumococcus (Streptococcus pneumoniae). The most common bacterium that causes meningitis, which can also cause pneumonia, otitis media. To protect yourself from this bacterium, it is enough to get vaccinated, for example, Prevenar 13 or Pneumovax 23.

Meningococcus (Neisseria meningitidis). It is the second most common cause of bacterial meningitis. Meningitis from this bacterium develops after meningococci migrate through the upper respiratory tract through the bloodstream to the brain. The infection is extremely contagious and deadly. Among other things, it can cause a local epidemic in dormitories, boarding schools, barracks and beyond. To protect yourself, it is enough to get vaccinated with the Menactra vaccine. Unfortunately, it is not included in the national vaccination calendar. But your child must have it, since only this vaccine can protect him from the deadly meningococcal meningitis.

Listeria. They are spread through hot dogs, soft cheeses and some types of fast food, since these products are not well-processed thermally. Most healthy people do not get sick when exposed to this bacterium. But those at risk include pregnant women, newborns, the elderly and people with immunodeficiency. Listeria can cross the placenta and lead to stillbirth or death of the newborn baby and the early neonatal period.

Symptoms and signs of pathology

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Bacterial meningitis usually does not show symptoms right away. The length of the incubation period depends on the age and health of the person, but it is usually fourteen days. After this, the disease begins to show the first signs, which are similar to those of other infectious diseases:

increase in body temperature;
severe headache, dizziness, fever;
inflammation of the upper respiratory tract, nasopharyngitis;
nausea accompanied by periodic vomiting;
lack of appetite, diarrhea;
hyperesthesia and increased muscle tone.

Meningitis - what is it?

Meningitis is an infectious disease in which the lining of the brain and spinal cord becomes inflamed, leading to swelling. Swelling is the cause of the main symptoms of meningitis - headache, fever and stiff neck.

The most common cause of meningitis is a virus, but bacterial and fungal infections can also lead to meningitis. The severity of meningitis ranges from mild and self-limiting within a few weeks to life-threatening and requires immediate aggressive medical attention, depending on the cause of the infection.

If you suspect that your family members or yourself have meningitis, you should seek medical help immediately. This will not only help prevent serious complications, but also save a person’s life.

Specific signs

Specific signs of the disease include:

Kerning's sign. In this case, a person is unable to raise his straight leg ninety degrees in a horizontal position.
Brudzinski's sign. It is characterized by the inability to lean the head to the chest, raise the shoulders when pressing on the cheek, bend the legs when pressing on the pubic area, involuntary bending of the second leg when trying to bend the first.

In especially severe cases, the symptoms of bacterial meningitis in adults manifest themselves in the form of hemorrhagic exanthema, when spider veins or large areas of subcutaneous hemorrhages appear throughout the body. Then cerebral edema, convulsions and shortness of breath occur, the person develops coma and pulmonary edema.

In newborns, the disease manifests itself as tension in the fontanel and neurological symptoms. Often the pathology is complicated by meningoencephalitis or ependymatitis. In this case, severe drowsiness, paresis and paralysis, and hydrocephalus develop. In the absence of proper therapy, the disease develops very quickly, within one day. Therefore, when the first symptoms appear, you should immediately consult a doctor.

Meningitis in children

Regardless of the etiology, the course of meningitis in children is accompanied by general infectious, cerebral, meningeal symptoms, as well as typical inflammatory changes in the cerebrospinal fluid.

General infectious symptoms of meningitis in children are characterized by a sharp increase in temperature, chills, tachypnea and tachycardia, and the child’s refusal to eat and drink. There may be pallor or hyperemia of the skin, a hemorrhagic rash on the skin associated with bacterial embolism or toxic paresis of small vessels. Certain nonspecific symptoms occur in certain forms of meningitis in children: acute adrenal insufficiency - with meningococcal, respiratory failure - with pneumococcal, severe diarrhea - with enterovirus infection.

The cerebral syndrome that accompanies the course of meningitis in children is characterized by intense headaches associated with both toxic and mechanical irritation of the meninges. Headache can be diffuse, bursting, or localized in the frontotemporal or occipital region. Due to reflex or direct irritation of the receptors of the vomiting center in the medulla oblongata, repeated vomiting occurs, not associated with food intake and not bringing relief. Impaired consciousness during meningitis in children can be expressed in doubt, psychomotor agitation, development of a soporous state or coma. Often, with meningitis, children experience convulsions, the severity of which can vary from twitching of individual muscles to a generalized seizure. It is possible to develop focal symptoms in the form of oculomotor disorders, hemiparesis, and hyperkinesis.

The most common type of meningitis in children is meningeal syndrome. The child lies on his side, with his head thrown back; arms bent at the elbows and legs bent at the hip joints (“cocked position”). There is increased sensitivity to various irritants: hyperesthesia, blepharospasm, hyperacusis. A characteristic sign is a stiff neck (the inability to press the child’s chin to the chest due to tension in the neck muscles). Due to increased intracranial pressure, infants experience tension and bulging of the large fontanel, a pronounced venous network on the head and eyelids; When the skull is percussed, the sound of a “ripe watermelon” appears. The membrane signs characteristic of meningitis in children include Kernig's, Brudzinski's, Lessage's, Mondonesi's, and Bechterew's symptoms.

The course of purulent meningitis in children may be accompanied by other infectious and septic complications - pneumonia, arthritis, endocarditis, pericarditis, epiglottitis, osteomyelitis, sepsis. Late complications from the nervous system can include intellectual impairment, hypertensive-hydrocephalic syndrome, epilepsy, paralysis and paresis, hypothalamic syndrome, damage to the cranial nerves (strabismus, ptosis of the upper eyelid, hearing loss, facial asymmetry, etc.).

Complications and consequences

The consequences of bacterial meningitis for human health are catastrophic. One of the most dangerous complications is cerebral edema, which provokes the development of coma, respiratory paralysis and death. Pathology can also cause disturbances in the psyche and central nervous system.

Often the consequences of bacterial meningitis in adults and children are as follows:

hydrocephalus;
pathologies of the kidneys and heart;
hearing loss;
vasculitis, causing paralysis of the cranial nerve;
cerebral infarction, accompanied by focal seizures, which gradually develop into epilepsy;
brain abscess.

After the disease, children often develop mental retardation, speech and memory impairment, and mental disorders. Apathy, passivity or, conversely, aggressiveness are often observed.

Diagnostic measures

A diagnosis of purulent bacterial meningitis can only be made with the results of all laboratory tests and a lumbar puncture, which is performed by inserting a needle into the spine to collect cerebrospinal fluid.

The following diagnostic methods are used in medicine:

Collecting and studying anamnesis, studying the symptoms of pathology.
Laboratory tests of blood and urine to determine the inflammatory process and damage to internal organs.
Spinal puncture and examination of the obtained material.
Culture of mucus from the nose for the presence of meningococcus or pneumococcus.
PCR and ELISA.
MRI to detect hydrocephalus, abscess.
Blood test for acid-base balance.

The primary diagnosis is made on the basis of a meningeal complex of symptoms, signs of intoxication and inflammation syndrome in the cerebrospinal fluid. Based on the results of a comprehensive examination, a final diagnosis is made.

Treatment of the disease

Treatment of bacterial meningitis is carried out in a hospital setting using intensive care. Broad-spectrum antibacterial drugs and quinolones are prescribed even before diagnostic results are obtained. Medicines are administered intravenously or by injection into the spinal cord canal. In this case, the patient must be constantly monitored, and in case of convulsions or seizures, he is provided with the necessary assistance. When seizures occur, anticonvulsants and drugs to reduce intracranial pressure are prescribed. Treatment of concomitant pathologies is also carried out jointly. The doctor prescribes antipyretic, painkillers and anti-inflammatory drugs.

Also, doctors must monitor the patient’s water-salt balance and carry out appropriate treatment measures in case of dehydration as a result of diarrhea and vomiting. Since bacterial meningitis often leads to the development of complications, it is necessary to monitor the condition of internal organs and control blood pressure.

To eliminate the symptoms of intoxication, detoxification therapy is carried out and diuretics are prescribed. But such measures are contraindicated in case of cerebral edema. To treat pathology, glucocorticosteroids are also used to eliminate the inflammatory process, which makes it possible to reduce the risk of death and the occurrence of long-term complications. If necessary, perform artificial ventilation.

Rehabilitation

After treatment of the pathology, the patient must be monitored by a neurologist for two years. In the first year, he must be examined once every three months, and then once every six months. Recovery from illness is a complex and multifaceted process that includes:

Dieting. All foods consumed must be boiled or steamed. It is recommended to consume lean meat and fish, dairy products, compotes and jelly.
Physiotherapy, which includes massage, electrophoresis, electrosleep, magnetic therapy.
Exercise therapy using gymnastic exercises and robotic simulators.
Occupational therapy aimed at a person’s everyday adaptation due to a decrease in the patient’s physical capabilities.
Cognitive therapy to restore attention, thinking and memory.

Bacterial meningitis: prevention

In order to prevent meningitis, it is necessary to follow all antiseptic rules when treating TBI, as well as isolate patients who are infected in separate rooms. Doctors recommend timely vaccination against this disease. If you come into contact with a carrier of the infection, you must visit a doctor to prescribe an antibacterial drug to prevent meningitis. It is necessary to lead a healthy lifestyle, observe the rules of personal hygiene, monitor your health, and promptly treat chronic diseases.

Meningitis is a dangerous disease that is better to prevent than to treat later. Often the disease leads to serious health problems that are permanent.

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