Meningoencephalitis in children and adults: what it is and what is the danger of the disease
- 1 Causes of the pathological process
- 2 Classification
- 3 How does the inflammation of the brain
- 4 Diagnostic measures
- 5 Treatment methods
- 6 Prognosis and consequences of the disease
The patient simultaneously detects 2 inflammatory processes: meningitis, expressed in inflammation of the cerebral cortex, and encephalitis, in which the brain is inflamed. This is the difference between meningitis and encephalitis. In children, the disease is particularly difficult, characterized by a number of irreversible effects and high mortality.
Causes of the pathological process
In the international classification of diseases ICD-10 pathology assigned code G04. Meningoencephalitis in children and adults has an infectious, allergic or toxic nature. When the pathogen enters the brain cells, inflammation foci form that worsen the blood microcirculation. The volume of spinal fluid increases, which increases intracranial pressure. The brain membranes are damaged, leading to the development of meningeal symptoms.
The cause of brain inflammation may be demyelinating diseases, which lead to damage to the tissues of the peripheral and central nervous system. Usually the disease occurs as a result of the invasion of infectious pathogens:
- bacteria – meningococci, streptococci, tubercular bacilli, listeria;
- viruses – rabies, herpes, tick-borne encephalitis, chicken pox, measles, arboviruses.
The causative agents of toxoplasmosis and malaria also cause the development of meningoencephalitis.
Note! ENT pathologies and purulent dental diseases often lead to the development of encephalitic meningitis.
Pathology can manifest in primary and secondary form. Primary encephalitis meningitis develops after infection with herpes, syphilis, rabies. The secondary form develops as a complication after suffering from tuberculosis, chickenpox, rubella, sinusitis.
The virus enters the body when a tick bites or as a result of the pathogen entering the nasopharynx. The mode of infection depends on the viral type. A contact route of infection is also possible when the integrity of the cranial bones is compromised.
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Meningeal encephalitis in newborns and young children is often diagnosed, since children’s immune status is not sufficiently developed. The risk of developing the disease increases in the presence of intrauterine infections, prematurity. Small children suffer illness, the consequences of which are manifested in neurological disorders.
Inflammation of the brain occurs in a lightning, acute, subacute and chronic form. The lightning current progresses in a few hours, often fatal. Acute and subacute forms are characterized by a standard course of the disease. Chronic variant is accompanied by sluggish development, alternating with periods of exacerbation.
Meningoencephalitis differentiate and the quality of spinal fluid: serous, hemorrhagic, purulent. The composition and shade of liquor indicates the nature of the inflammatory process.
If a live vaccine is vaccinated at the time of the weakening of the immune forces, the pathogen can penetrate the encephalic barrier, resulting in encephalitis meningitis.
Manifestations of the disease vary depending on the type of meningoencephalitis. Distinguish brucellosis, influenza hemorrhagic, varicella, amebic, herpetic, viral and purulent type. Fungal meningoencephalitis is less commonly diagnosed.
It develops as a complication after suffering flu. It is heavy.
Symptomatology is expressed in a sharp rise in temperature, epileptic seizures, chills, confusion. This form is difficult to cure, usually causes serious complications.
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The form can manifest itself as a separate disease or occur along with a viral infection. The danger of this species is the absence of clinical manifestations at the initial stage of development. There are vivid symptoms of intoxication, the brain swells, accompanied by the death of neurons.
This species is often diagnosed in infants. Infection occurs in the prenatal period or in the process of delivery. The disease is able to manifest itself even in people who have antibodies to viral strains.
Occurs due to the bite of an infected tick or after drinking the milk of infected goats and cows. The frequency of diagnosis increases in spring and summer, when insects are most active.
Initially, symptoms are manifested in fever, intense pain in the head, and vomiting. After a week, the symptoms are complemented by damage to the central nervous system, which is expressed in neurological disorders.
Rare type of pathology, characterized by high mortality. Infection in the form of the smallest amoebas (protozoa) penetrates the upper respiratory tract. Infection occurs in freshwater bodies of water, by drinking tap water.
The pathogen can be found on mushrooms, fruits, in the soil. The incubation period lasts about 2 weeks.
Damage to the soft shell of the brain, which affects the occurrence of granules of brucellosis type. Paralysis occurs, there are neuropsychiatric disorders. Requires long-term treatment.
The development of purulent meningoencephalitis occurs as a result of the invasion of staphylococci, bacteria, meningococci, hemophilic bacilli. Usually pathogens enter the body through the nasal mucosa.
Infectious agents damage the cerebral cortex and brain structures. The risk of developing the pathology increases with immunodeficiency, traumatic brain injuries, and head surgery.
This form manifests itself as a result of secondary inflammation of the meninges. It is diagnosed in people with different types of tuberculosis, as well as in children under one year. The disease is accompanied by systematic pains in the head, weakness, irritability, decreased appetite and sleep quality.
Appears as a complication of chickenpox in young children. It is in severe form. It is expressed in the development of convulsive seizures, pain in the head, fever, dizziness.
How does the inflammation of the brain
The signs of the disease depend on the cause of the pathology and the extent of damage to other organs. The latent period of meningitis encephalitis is about 2 weeks, in some forms the incubation period lasts a month. In this phase, the virus in the body actively replicates and penetrates all tissues.
In case of convulsive seizures and loss of consciousness, an ambulance should be called in immediately.
The body temperature begins to increase. Painful headache and vomiting indicate the progression of intoxication processes. The defeat of the nervous system is expressed in the increase of sensitive susceptibility, restlessness. After a few days, stiffness of the muscles of the neck appears, in which the patient cannot bend his head forward due to severe pain. In infants, the fontanel swells.
As the disease progresses, speech skills are impaired, it is difficult for a person to swallow and breathe. Heart rate gradually decreases, swelling of the brain, which leads to death.
The diagnosis is made on the basis of a comprehensive examination of the victim. Clinical manifestations are initially evaluated. Then the doctor checks a number of symptoms characteristic of the pathology: Kernig, Hermann, Brudzinsky, Mondonesi.
When examining a newborn, the doctor pays attention to the fontanel – it is bulging. It is also necessary to conduct a test of the Massage, when the baby is raised, holding the armpits. With meningoencephalitis, the child does not straighten the legs.
The fundamental diagnostic method is puncture. The specialist makes the collection of cerebrospinal fluid, piercing tissue in the lumbar spine. The appearance of the biological material and its composition are evaluated. The diagnosis is confirmed with an increased protein concentration, lowering the amount of glucose.
Also requires magnetic resonance imaging, radiography of the lungs.
Encephalitis meningitis therapy is performed in a medical institution, the patient is placed in the infectious disease ward. The choice of therapeutic methods depends on the form of pathology.
Bacterial forms of purulent meningoencephalitis are treated with antibiotics: carbapenems, penicillins. Ameba species require additional administration of antifungal drugs.
The disease of viral etiology is eliminated by intramuscular injection of globulin, interferon. Children with the herpetic form of the disease are prescribed corticosteroids.
Common therapeutic measures include the use of:
- infusions, normalizing blood composition;
- antihistamines – Suprastin, diphenhydramine;
- nootropics, restoring the work of the central nervous system;
- blood circulation enhancers;
- medication anticonvulsant action.
In addition to medical treatment, patients need rehabilitation therapy, which includes massages, physical therapy, acupuncture.
Prognosis and consequences of the disease
The survival rate for meningeal encephalitis is low. The disease leads to the development of irreversible effects in the elderly and in childhood. In case of late treatment to a doctor and a reduced immune status, complications such as epileptic seizures and paralysis develop. Decreased visual acuity and hearing. Intellectual abilities deteriorate.
The result of herpetic or fungal meningitis in children becomes hydrocephalus, delayed psychophysical development. If there is a loss of speech skills, inability to swallow and pain in the heart, then the virus has damaged the cranial areas. In this case, the person dies.
People who have had meningoencephalitis should be monitored by the neurologist for the rest of their lives. The cunning of the disease lies in the difficulty of identifying the first signs of pathology. Therefore, when detecting unusual symptoms should consult a doctor.
The following sources were used to prepare the article:
Zavodnova O.S. Features of treatment and outcomes of herpes, candida and candida-staphylococcal meningoencephalitis in newborns // Scientific Journal of Belgorod State University. Series: Medicine. Pharmacy – 2014.
Zubritsky M. G. Chronic herpetic meningoencephalitis, complicated by generalization of the process with damage to internal organs // Journal of Grodno State Medical University – 2006.
Rubin A.N., Scherbuk Yu.A., Lyapin A.P. Complications of purulent meningoencephalitis in children // Journal of Surgery named after I. Grekov – 2015.