An acute infectious disease with a predominant lesion in the meninges is called meningitis. Signs of pathology are manifested depending on the nature of the developing inflammatory process. The disease can be primary and secondary.
Separate purulent and serous meningitis.
In the first case, there is a group of primary and secondary pathologies in which the predominant lesion of the meninges is of a bacterial nature.
Meningococcal cerebrospinal epidemic meningitis is included in this group and refers to primary diseases.
Manifestations of the disease are acute. 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. A sharp pain is accompanied by general hyperesthesia (hypersensitivity), vomiting, meningeal symptoms develop. At the initial stages of the disease, preservation of consciousness is noted, however, in the absence of the necessary treatment, the patient quickly falls into a soporous (depressed consciousness) state . Often there are herpetic rashes on the mucous membranes and skin, as well as a hemorrhagic rash. A blood test shows an 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-grayish or grayish hue. Low sugar is also detected.
Purulent meningitis caused by meningococcal infection is diagnosed in accordance with information about the patient, the course of the disease and its clinical manifestation. In the period prior to hospitalization, differential diagnosis of this type of disease with secondary pathology is performed.
Secondary purulent meningitis can develop as a result of dissemination (dissemination) with purulent sinusitis or otitis media from foci of pathology.
The onset of the disease is characterized by the appearance of chills, fever, headache, and a sharp deterioration in the general condition of the patient. Meningeal symptoms form early. Secondary purulent meningitis is accompanied by a rapid violation of consciousness against the background of frequent psychomotor agitation, convulsions, hallucinations. Liquor grows turbid. An increase in ESR is noted.
When diagnosing, it is necessary to differentiate a brain abscess and purulent meningitis. These pathologies have many common symptoms. For a brain abscess, bradycardia is characteristic, increased focal symptoms against the background of subsidence of signs of inflammation, a shift in the midline echography.
Methods for diagnosing purulent meningitis include biochemical and bacteriological studies of blood samples, ECG, MRI and CT of the brain, X-ray of the skull.
With the manifestation of signs of pathology, urgent hospitalization in the infectious ward is necessary. If a secondary disease is established, the patient is placed in an appropriate hospital.
If you suspect the development of meningitis, lumbar puncture is mandatory with the study of cerebrospinal fluid. The procedure is carried out under the guise of antibacterial drugs. Until the pathogen is identified and its sensitivity is determined, a wide range of drugs are prescribed. These antibiotics can penetrate the blood-brain barrier. These include Ampicillin, Benzylpenicillin, third-generation cephalosporins (Ceftriaxone, Cefotaxime).