Purulent meningitis

Disease of an acute infectious nature with a primary 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 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 belongs 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, meningeal symptoms develop. At the initial stages of the disease, consciousness is conserved, however, in the absence of the necessary treatment, the patient quickly falls into a co-morbid state (oppressed consciousness). Often observed herpetic rashes on the mucous membranes and skin, as well as hemorrhagic rash. The 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 tinge. A low sugar content 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 manifestations. In the period preceding hospitalization, a 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 maxillary sinusitis or otitis infection from the foci of pathology.

The onset of the disease is characterized by the appearance of chills, increased temperature, the onset of 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 a background of frequent psychomotor agitation, convulsions, hallucinations. Liqvor grows dull. There is an increase in ESR.

When diagnosing it is necessary to differentiate the brain abscess and purulent meningitis. These pathologies share many common features. For the abscess of the brain, bradycardia is typical, an increase in focal symptoms against the background of signs of inflammation subsiding, displacement of midline structures during echography.

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 suspected of developing meningitis, a lumbar puncture with the study of cerebrospinal fluid is mandatory. 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").