Acute meningitis
Release time : 01/18/2025 18:13:27
Acute meningitis, actually caused by meningococcus bacteria, is a rapidly progressive infectious disease with acute onset and severe symptoms.
1 to 2 days before onset, symptoms similar to upper respiratory tract infection, general malaise, sore throat, headache, and high fever, etc.
As the incidence of pediatric acute meningitis is higher than that in adults, mothers must pay close attention to their child's health condition. They should understand, prevent, and treat acute meningitis.
What is acute meningitis? Acute meningitis, also known as "meningococcemia," is an acute infectious disease caused by Neisseria meningitidis. It can affect individuals from the newborn period to people over 70 years old, but it is more common among children under the age of 15.
The bacteremia is mainly occurring in winter and spring, especially in February and March.
The reason is that the climate changes frequently during this period, with significant differences in temperature between day and night. The resistance of the nasal and pharyngeal mucosa to pathogens is weak, making it easier for pathogens to invade the respiratory tract. Furthermore, due to the cold weather, indoor activities increase, and pathogens can spread through coughing droplets.
Whether illness occurs or not after pathogens enter the body depends on who wins and who loses in the battle between the human body and the pathogen.
If the human body is healthy and immune, it will not be susceptible to illness.
For individuals with weakened constitutions or deficiencies in immunity, the progression of pathogens within the human body can be described as follows: initially, they settle in the nasopharynx, subsequently entering the bloodstream, and finally reaching the meninges.
Acute meningitis is actually divided into several types, and each type has its own cause. We need to understand the causes of different types of acute meningitis to effectively treat it.
1. Bacterial meningitis is caused by the infection of certain bacteria.
Three types are classified: Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae B, and Neisseria meningitidis (meningococcus).
About 80% of the United States suffers from meningitis.
Generally, a small number of healthy people carry these germs in their nose or body surface and do not harm the human body. They can be spread by coughing or sneezing.
Some studies have shown that people are most likely to be infected with bacteria when they have a cold, because the inflammation of the nose makes it very easy for bacteria to enter the brain.
2. Tuberculous meningitis is caused by Mycobacterium tuberculosis and is characterized by nonsuppurative inflammation of the meninges, accounting for approximately 6% of all cases of TB.
After the TB bacilli infection spreads through the blood, they can form nodules under the dura mater. When these nodules rupture, a large amount of TB bacilli enter the subarachnoid space.
In recent years, the incidence and mortality rates of tuberculous meningitis have been on the rise.
Early diagnosis and treatment can improve the efficacy and reduce mortality.
3. Viral meningitis can be caused by several viruses, including several that are associated with diarrhea, one of which may be transmitted by being bitten by squirrels such as the common field mouse.
4. Cryptococcal meningitis: It can also be caused by fungi.
One of the most common is cryptococcus, which can be found in pigeons.
Healthy people are not prone to meningitis related to fungi, but those infected with HIV virus are different. This is a human immunodeficiency virus that can cause AIDS.
5. The type of pathogen causing acute purulent meningitis varies with the patient's age.
In patients of adolescent age, meningococcal infection is predominant.
The bacteria are present in the nasopharynx of patients and carriers, transmitted through respiratory droplets. Once inside the upper respiratory tract, most bacteria only cause local inflammation to become healthy carriers.
Only a small proportion of patients with reduced immunity can allow bacteria to invade the bloodstream through the upper respiratory tract mucosa, causing tuberculous meningitis and proliferation in the blood. Once they reach the meninges, they cause meningitis.
An epidemic can occur in winter and spring, known as epidemic meningitis.
6. The most common cause of neonatal meningitis is Escherichia coli, often originating from the birth canal.
Because the IgM is lacking in the body, the E. coli can multiply and cause disease.
7. Influenza bacteremia, particularly in infants under the age of three years, is commonly observed.
Pneumococcal meningitis is common in young children and the elderly. In young children, it usually results from otitis media, while in the elderly, it often occurs as a complication of lobar pneumonia.
Symptoms of Acute Meningitis, Compared with ordinary meningitis, the most characteristic feature is that the clinical manifestation starts suddenly, the disease is fierce and rapidly changes.
This often leads to mothers struggling to react in time, resulting in delayed treatment. Even after recovery from meningitis, significant and severe sequelae persist.
1 to 2 days before the onset, symptoms similar to those of upper respiratory tract infection are present, with general malaise, sore throat, headache, etc.
However, after the onset of symptoms, chills and a rapid rise in temperature to over 39°C are observed. Subsequently, significant headaches and recurrent vomiting occur, accompanied by stiff neck and petechiae throughout various parts of the body, which then rapidly enlarge into large ecchymoses.
In infants under 2 years old, the symptoms differ from those in older children; at the onset of illness, there is usually no chills, but rather manifestations such as lethargy, refusal to eat, vomiting, and susceptibility to convulsions and exophthalmos.
Prior to the onset of symptoms, there may have been a history of upper respiratory tract infection.
Newborns and infants often exhibit symptoms such as high fever, irritability, lethargy, difficulty breathing, jaundice, and may subsequently present with convulsions, torticollis, and apnea. However, there are relatively few neurological manifestations.
Prenatally, neonates may have prematurity, perinatal trauma, or a history of maternal infection.
Upon early physical examination, signs of meningeal irritation may be observed, such as stiff neck.
However, in infants and young children, nuchal rigidity is often not evident, instead commonly presenting as an enlarged fontanelle and kyphosis.
The cerebritis caused by pneumococcus and Haemophilus influenzae can present with localized signs of the brain early, characterized by persistent local brain damage and uncontrollable epileptiform seizures.
In the late course, cerebral nerve disturbances may occur, with the most common being ocular motor disorders. Among patients with pneumococcal meningitis, the incidence of such disturbances is highest.
Additionally, conscious disturbances and optic disc edema may be present. Elevated intracranial pressure can sometimes lead to a brain herniation.
During an epidemic of meningitis, if the disease progresses rapidly and there is a skin or mucous membrane petechiae at onset, which then rapidly enlarge, and shock occurs, meningococcal meningitis should be considered.
The primary diagnostic basis is as follows: 1. Emergence or acute onset.
2. Fever, headache, and signs of meningeal irritation.
3. The inflammatory changes in cerebrospinal fluid are primarily characterized by the presence of nucleated cells with lobulated nuclei.
4. In the presence of fever in newborns and infants accompanied by unexplained vomiting, lethargy, convulsions, bulging fontanelles, and headache suggestive of purulent meningitis, even if there are no neurological objective signs, lumbar puncture should be performed early on, and sometimes multiple lumbar punctures may be necessary to confirm the diagnosis.
5. The accurate diagnosis of this disease should be based on pathological evidence.
In addition to making cerebrospinal fluid culture for bacteria, routine culturing of cerebrospinal fluid cultures is required.
Recently the bacterial antigen determination technique has developed rapidly. Its sensitivity and specificity are high, and it is not influenced by antibiotic treatment. Its positive rate is much higher than that of current domestic bacteria culture. The method is simple and fast. Therefore it is currently used as an early and rapid diagnostic tool.
Can acute meningitis be transmitted? Can it be transmitted? Adults are generally less likely to be infected with meningitis than children. Meningitis is a disease that affects the delicate meninges (the membrane between the skull and the brain).
Infections are commonly accompanied by complications involving any part of the body, such as infections of the ear, mastoid or upper respiratory tract.
Bacterial meningitis is a particularly serious condition that requires prompt treatment.
If treatment is not administered in a timely manner, it may cause death within hours or result in permanent brain damage.
Viral meningitis is more serious, but most people recover completely with a few having residual sequelae.
The treatment of acute meningitis involves both traditional Chinese and western medicine. Both approaches are viable options, yet the most crucial aspect remains the prompt identification and timely referral of the child to a hospital for appropriate care.
To avoid complications that may result from inappropriate treatments.
1. Western medicine therapy: Antibiotics with good penetration through the blood-brain barrier, such as 6 million to 8 million U of Penicillin and 4 to 6g of Sulfadiazine sodium, are administered intravenously via drip infusion.
In radical mastoidectomy, the cholesteatoma, granulation tissue, and necrotic bone must be cleared, and fistulae penetrating into the brain and congenital defects must be excised.
Currently, spinal cord injections are seldom employed due to the low concentration of medication administered, which often leads to adverse drug reactions.
The usual dose of penicillin should not exceed 10,000 units.
In encephalitis, the incidence of brain abscess is 2% to 7%.
Therefore, after the symptoms of meningitis have subsided, it is essential to rigorously examine whether the meningitis has truly been cured.
Available cerebrospinal fluid re-examination and CT scans of the brain can be used to rule out the possibility of a brain abscess. Follow-up examinations should be closely conducted after discharge.
Before the advent of antibiotics, mortality rates from meningitis caused by ear infections were very high.
Since the introduction of sulfonamides and antibiotics, mortality has been reduced from 90% to less than 5%.
Currently, many deaths result from misdiagnosis and treatment, or complications such as cerebral abscesses.
2. Traditional Chinese Medicine Therapy: Diagnosis, pathogenic heat and epidemic toxins, deep invasion of the nutritive blood, and internal descent into the pericardium.
The treatment principle is to clear the camp and dispel heat, and clear the heart to open its orifices.
Prescription Name: Epidemic Disease Elimination and Clearing Heart Decoction.
Composition: 200g of Gypsum, 10g of Rhinoceros Horn, 10g of Coptis, 15g of Scutellaria baicalensis, 50g of Scrophularia nodosa, 50g of Anemarrhena asphodeloides, 15g of Achyranthes bidentata, 15g of Gardenia jasminoides, 15g of Prunella vulgaris, 100g of Mung bean, 15g of fresh Ophiopogon japonicus, and 100g of Imperata cylindrica.
Administer orally, one dose per day, twice daily.
Prevention of acute meningitis is important since the disease can be so rapid that once it is treated, it may result in long-lasting sequelae. Therefore, if we can prevent it at its source, then we can effectively deal with it and ensure the health of our babies.
1. During the epidemic, it is advisable to carry out public health campaigns, avoid large gatherings and collective activities, do not take children to public places, and wear masks when going out.
2. Medication Prevention: In China, sulfonamides are still used as the primary medication. For close contacts, Iodomycin (SD) may be used. Adults should take 2g per day in divided doses with an equal amount of sodium bicarbonate, for a total of three days.
Pediatric dose is 100mg/kg.
During a meningococcal epidemic, any individual exhibiting symptoms of: ① fever accompanied by headache.
② Mental Lethargy.
3. Acute pharyngitis.
4. In four items of skin and oral mucosa bleeding, two or more, sulfonamides should be given in full dose for the entire course to reduce the incidence and prevent epidemic.
Foreign countries have adopted rifapentine or diammonium tetracycline for prophylaxis.
Rifampin 600 mg daily for 5 days, and 10 mg/kg. daily for children aged from 1 to 12 years.
3. Vaccination: Currently, A and C two groups of capsular polysaccharide vaccines are widely used both domestically and internationally.
The protective rate of A group polysaccharide vaccine prepared by high speed centrifugation was 94.9% and the average antibody titer increased 14.1 times after immunization.
If a baby accidentally contracted acute meningitis, we still need to know some nursing knowledge to prevent the worsening of meningitis.
① Psychological care is crucial.
For children with encephalitis in the recovery phase, it is essential to help them enhance their self-care abilities and confidence, assisting them in continuing active exercise to facilitate better recovery.
② Place the comatose child in a supine position with their head turned to one side, allowing for the ease of drainage of secretions at any time.
Every two hours, turn the child over once, and gently pat the back of the child's body to help the phlegm flow smoothly.
During encephalitis, there is often a high fever. When the child's temperature rises and experiences chills, it is important to keep the child warm.
When administering antipyretics, it is essential to ensure that the child adequately hydrates.
After fever subsides, it is important to promptly change the child's damp clothes.
④ For children who are bedridden, it is important to avoid bedsores, so mothers should help them turn over frequently and use anti-bed-sores air cushions.
If bedsores have already occurred, and the symptoms are mild, a lamp can be used. The method is to place a 60-watt lamp 3-4 centimeters away from the bedsore, and for 15 minutes each time, two times a day, to help promote blood circulation.
*The medical content involved in this text is for reference only.
In case of discomfort, it is recommended to seek immediate medical attention for a face-to-face consultation and for medical diagnosis and treatment.