How can we determine the beginning of the development of meningitis in a child?
- 1 Meningitis
- 2 Classification
- 3 Symptoms
- 4 Diagnostics
- 5 Treatment
- 6 Prevention
The disease is very dangerous, requires immediate treatment. Often has a poor prognosis, ends in disability or death.
The most susceptible to the disease are premature babies, children who have had purulent inflammatory diseases in infancy, who have suffered a birth trauma, who have been adversely affected by pathological pregnancy. It is believed that genetic predisposition is an important factor in the development of pathology.
Among other factors, poor nutrition, chronic fatigue, metabolic disorders, reduced immunity are noted.
The disease is transmitted by:
- household contact;
- by eating contaminated foods;
- when swimming in pools or open water;
- through the placenta from mother to fetus.
Read also … Is meningitis contagious: ways of transmission and preventive measures
Depending on the origin, the pathogen, the area of the lesion, the characteristics of the course, there are different types of meningitis.
Analyzing the genesis of the disease, isolated primary and secondary meningitis. Primary appears as an independent disease in a healthy child before infection. The cause may be the meningococcal bacterium or various viruses. Secondary develops as a complication of any disease, for example, otitis or sinusitis.
In the event of a disease, damage to different areas of the brain can occur. If the arachnoid membranes are inflamed, they talk about arachnoiditis. This is the rarest form of the disease.
The lesion of hard shells occurs with pachymeningitis. Leptomeningitis occurs in the pathology of arachnoid and soft shells.
Nature of the flow
Depending on the characteristics of the course and the speed of occurrence, a lightning, acute, subacute and chronic form is distinguished. In the case of the fulminant disease, the disease develops so quickly that even the treatment started on time does not always have time to help.
Signs of meningitis infection in a child appear less than a day after the detection of the first non-specific symptoms. Infectious toxic shock occurs in most cases. Such dynamics are usually characteristic of bacterial meningitis.
The acute course is also characterized by rapid development. However, the patient’s condition does not deteriorate so rapidly. Toxic shock is extremely rare. Symptoms of acute intoxication occur almost always.
In subacute, the first signs of the disease appear with some delay. Symptoms are not as pronounced as with the lightning and acute forms. Sluggish development is a feature of the course of secondary forms caused by syphilis, acquired by the state of immunodeficiency, tuberculosis.
The chronic form is characterized by a long (more than a month) preservation of signs of pathology. Perhaps the appearance of seizures, mental disorders, increased intracranial pressure. Sometimes a separate chronic recurrent form is isolated, in which the symptoms may temporarily disappear and then recur.
Composition of cerebrospinal fluid
Detection in the composition of the cerebrospinal fluid lymphocytes suggests a serous form. It is usually caused by viruses. Early treatment leads to recovery in a week or 10 days. Complications do not occur often.
A more complex form is purulent meningitis. During spinal cord puncture, neutrophils are detected in the cerebrospinal fluid.
The disease is caused by bacteria, for example, meningococci, streptococci, Pseudomonas aeruginosa. It is heavy and causes dangerous consequences.
Pathology can have a non-infectious and infectious nature. The first type is based on tumors, the reaction to the introduction of drugs into the cerebrospinal fluid. Infectious disease is caused by viruses, bacteria.
Meningitis is caused by various bacteria, viruses, parasites, fungi. The most common viral and bacterial forms are found, the latter being considered the most dangerous.
Each of these forms is also divided into separate species depending on the specific pathogen. Streptococci cause pneumococcal meningitis, diplococcus – meningococcal, staphylococcus – staphylococcal, escherichiosis – escherichiosis.
Any form of meningitis is characterized by general and specific symptoms and features of the dynamics. The disease always develops suddenly. An outwardly healthy child feels sharply worse, the first signs appear that are characteristic of some forms of ARVI: weakness, fever, vomiting. At this point, often the most questions arise about how to recognize the symptoms of meningitis in children, to differentiate it from a common cold.
The incubation period lasts up to 10 days, the period depends on the immunity of the child. During this time, the pathogen manages to get into the lining of the brain and lead to their inflammation. At the end of the incubation period appear:
- Heat. The thermometer rises to 39-40 ° C and practically does not fall even when taking antipyretic drugs. Keeps a few days.
- Vomiting. Associated with the influence of toxins on the centers of the brain, and not with indigestion. It does not bring relief, can be continuous. As E. Komarovsky says, if vomiting and fever appear, an urgent need to call a doctor. Without the additional symptoms that characterize ARVI and enterovirus infection, these two points may be the first signs of meningitis in a child.
- Stiff neck. The muscular tissue in the occipital region and on the neck is spasmed, the child is unable to move his head, pull it up to the chest. “Pointing Dog” posture is found – the body is arched, arms are clenched in the chest area, the head is thrown back. These three symptoms constitute the so-called meningeal syndrome.
- Headache. It is intense in nature, it increases with the development of the disease, when it is tilted down, from strong sounds, light. There is a feeling of bursting head. Localized mainly in the occipital region, in the area of the forehead, gives to all parts of the spine. After a particularly powerful painful attack, the child may lose consciousness. Such intense pain is associated with an increase in intracranial pressure.
- Pallor. It is a sign of vascular spasm.
- Weakness. Serious pathological processes occurring in the body lead to it.
- Photophobia. Bright light intensifies headache, irritates eyes. The child seeks to hide from him, to avoid his annoying effects.
- Confusion and impairment of consciousness. Appears in severe form of the disease. In many cases, hallucinations are observed, possibly the development of coma.
- Cramps. Manifest in the form of startle, chin tremor. Infants may be the first sign of illness. The deterioration of the condition is characterized by tonic-clonic convulsions, accompanied by tension of the whole body, stretching of the legs, flexion of the arms, loss of consciousness. The attack resembles an epileptic seizure.
Symptoms of purulent meningitis
The most dangerous is the purulent type of meningitis. At the beginning of the disease, a common meningeal syndrome appears. With meningococcal meningitis, a rash of purple or red color is almost immediately formed. The primary focus of damage is the foot, later it spreads throughout the body. If you click on the spot, it does not disappear.
When a rash appears, it is important to immediately call an ambulance and hospitalize the child. In a few hours, meningococcal meningitis can lead to death.
Other symptoms include strabismus, facial paralysis. In some cases, there is hydrocephalus, arrhythmia. Often there is confusion, passing into a coma. Infants have noticeable tension and swelling of a large spring, the temperature can either rise or fall. There is regurgitation fountain, strong cry.
Shortly after the onset of symptoms, signs of meningitis encephalitis are found.
Usually viral meningitis is characterized by an acute course. Symptoms appear step by step. The first sign is a high temperature that cannot be removed with antipyretic drugs. It is joined by vomiting and confusion.
The next day, there are severe pains in the head, muscle stiffness, drowsiness, runny nose. The child refuses to eat, the touch causes pain and irritation. A rash may occur, but it is almost always allergic. Approximately in a week these signs subside, but after 2-3 days they appear again. The illness lasts 14-17 days. Convulsions and coma do not occur.
Diagnostic measures are mainly carried out in the hospital. The main method of diagnosis is spinal puncture to study the composition of the cerebrospinal fluid. This analysis allows you to confirm the diagnosis, to clarify the cause, the pathogen, to recognize the type of disease – serous or purulent, bacterial or viral. Normally, cerebrospinal fluid is transparent. White color indicates a purulent process.
MRI or CT is often prescribed before puncture. The purpose of the study is to exclude tumors and confirm the safety of sampling liquor.
In some cases, in order to determine the pathogen, several microbiological studies are required: sowing on a nutrient medium, Gram stain. In particular, they are carried out in order to distinguish meningococcal meningitis from pneumococcal meningitis. Such studies can take a long time, but they allow you to accurately recognize the cause and prescribe the exact treatment.
Additionally, a complete blood count, urine, bacterioscopy, bacteriological examination. KLA shows an increase in ESR and an increase in white blood cells. In the urine are blood and proteins.
Defining in terms of diagnosis is to clarify the nature of muscle rigidity. The most indicative symptom is Brudzinsky. It includes 4 manifestations. The head of a child lying on his back is attracted to the chest. If you stop holding it, it hangs in the air. In parallel, there is an uncontrolled flexion of the legs in the hip joints and knees.
Another sign – when pressed under the cheekbone of the patient, his arm is bent at the elbow from the side of pressing. Sometimes the wrist is lifted. Tapping on the cheekbone and pressing on the pubis cause involuntary compression of the knees. When one leg is bent at the knee, the same movement automatically repeats the other.
Kerning symptom is also associated with stiff neck. In a patient lying on his back, the body remains in a curved position, the back of the head lies on the surface, the neck, shoulders and partly chest hang in the air. When turning on its side, the pose does not change.
In infants, a characteristic feature is the symptom of Lessage. The doctor takes the baby by the armpits, supports the head with the index fingers of both hands, raises it. The child immediately takes a certain position. It automatically tightens legs bent at the knees to the tummy and remains in this position for a long time. The legs do not unbend and relax.
Older children conduct additional tests. So check the reflex Flatau. At that moment, when the doctor bends the neck of the patient, the latter’s pupils are dilated. A sign of meningitis is Mondonesi syndrome – the patient closes his eyes and feels pain when the doctor presses them slightly.
Hospitalization is indicated for any suspected meningitis. The disease is extremely dangerous, it develops very quickly, so there should not be any delays with the definition of therapy. Even a relatively mild viral form is unacceptable to treat at home.
The recognized disease of the bacterial form is treated with antibiotics, mainly penicillin. Upon receipt of the results of spinal fluid puncture, therapy is adjusted, an antibacterial agent is prescribed that is most effective against the identified pathogen.
Antibiotics do not affect viruses, therefore, with viral meningitis, diuretics are given to prevent cerebral edema and decrease pressure, anticonvulsant, antihistamine drugs. Symptomatic treatment aimed at anesthesia and temperature reduction is shown.
To eliminate the risk of meningitis vaccination. Currently there are hemophilic, meningococcal, pneumococcal vaccines. They are being vaccinated against measles and chickenpox.
Prevention also includes hygiene, healthy eating, physical activity.
Meningitis in children is characterized by rapid dynamics of development. Therapy depends on the species, developmental features and pathogen. Any delay in prescribing drugs can lead to dangerous complications or even death.