Reactive meningitis. Reactive meningitis: mortal danger and consequences Fulminant meningitis

Meningitis is an inflammation of the lining of the brain and spinal cord. The process is triggered by an infection, the causative agent of which can be various pathogenic bacteria. These include meningococcus, Pseudomonas aeruginosa, staphylococcus and others. They enter the body through airborne droplets, through consumption of contaminated food, and also through household means, for example, through shared objects or when visiting public places.

Reactive meningitis, the symptoms of which imply fulminant spread and course of the disease, requires special attention. To understand how to prevent and stop a deadly disease, it is important to know the causes of its occurrence, as well as the main symptoms and methods of treatment.

The most common causative agent of meningitis is meningococcal bacillus, which is transmitted by airborne droplets. You can catch the infection anywhere: in a hospital or clinic, on public transport, in a store, and so on. Infection of children usually occurs during epidemics in kindergartens, schools and other educational institutions.

In addition, other types of bacteria can also infect the membranes of the brain; this could be staphylococcus or an enterovirus infection. The following diseases also act as provocateurs of the disease:

mumps;
rubella;
measles;
otitis;
sinusitis;
purulent lesions and abscesses;
furunculosis.

Often, reactive meningitis can be caused by injuries to the skull and spine. The risk group includes children with weakened immune systems and adults with established or latent immunodeficiency.

Signs of pathology

This life-threatening disease, like other disorders, has its own characteristic symptoms. For the reactive type of disease, the distinctive feature remains the speed of development of symptoms.

The first clinical signs include:

clouding of consciousness;
increased body temperature;
drowsiness;
fatigue;
fever;
muscle weakness;
urge to vomit and nausea;
severe headaches radiating to the back and cervical spine;
increased sensitivity to light;
heart rhythm disturbance;
shortness of breath;
paresis of limbs;
hearing and visual impairment;
skin manifestations.

For infants, a symptom of meningitis is also swelling and tension in the area of the large fontanel.

Headaches that occur when the membranes of the brain are damaged do not go away when taking medications. Posture, which is also a kind of sign of meningitis, helps relieve pain. If you feel better with your head thrown back and your knees bent and pressed to your stomach, you can assume that the person has infectious reactive meningitis.

Diagnosis and treatment

The rapid appearance of symptoms is a cause for concern and immediate consultation with a doctor. Rash, fever and headaches give reason to suspect a meningococcal infection in a patient. Only a specialist can make an accurate diagnosis and identify the pathogen after conducting the necessary research and laboratory tests.

The cerebrospinal fluid allows you to find out which infection is the causative agent. It is collected using a lumbar puncture. A general blood test is also quite informative, but only helps determine the presence of an inflammatory process. In meningitis, leukocyte counts and erythrocyte sedimentation rate are elevated. Reactive meningitis causes changes in the quality characteristics of urine. Traces of protein and blood elements can be found in it.

Once the diagnosis is confirmed, whether in a child or an adult, hospitalization and intensive care are required.

Treatment involves the patient being in a hospital setting. He is given intravenous sodium salt solutions to prevent dehydration, as well as plasma expanders to reduce bacterial activity. Reactive meningitis is often accompanied by acute adrenal insufficiency. In such cases, corticosteroids are prescribed. If convulsions and muscle spasms are observed among the symptoms, antispasmodics and muscle relaxants are included in the treatment regimen.

To suppress the activity of pathogenic bacteria, antibacterial therapy is carried out. Drugs active against infection are administered strictly on an hourly basis in doses prescribed by the doctor. For meningitis, the penicillin group is most often used, as well as cephalosporins and macrolides.

Since the symptoms increase quite rapidly and the patient’s condition worsens, medications are administered intravenously, and only when they improve they switch to medications in tablets. To prevent cerebral edema, diuretics are prescribed (most often Furosemide). If symptoms are already obvious, Sorbilact is administered as part of infusion therapy.

The basis for preventing meningitis is vaccination. Of course, it cannot completely guarantee safety, but it reduces the risk of infection. During epidemics, it is recommended to refrain from visiting crowded places, and also adhere to a number of simple rules:

observe the rules of personal hygiene;
if you suspect infection, immediately contact a medical facility;
when leaving your usual area, study the epidemiological situation;
avoid contact with carriers of infection.

Since household transmission of pathogenic bacteria is quite common, it is recommended to avoid sharing personal hygiene items with other people to avoid getting sick.

Forecast

Reactive meningitis without treatment is fatal. Only a patient who seeks help on time can count on a favorable result. The prognosis for recovery largely depends on the general condition of the body, the presence of concomitant diseases and the age of the patient.

It is easier for middle-aged people to cope with the disease than for the elderly and children, who have reduced body defenses.

In infants, the disease develops so rapidly that therapy in most cases does not guarantee full recovery. If the child can be saved, severe complications such as blindness, paralysis and developmental delays often occur.

Only timely access to a medical facility increases the chances of recovery and helps prevent premature death from cerebral edema.

Reactive meningitis is an acute infectious inflammatory disease of the brain and spinal cord. It occurs in people of any age, but most often it affects premature newborns, people with back injuries, and diseases of the central nervous system.

The peculiarity of this disease is its suddenness, spontaneity, and transience. Therefore, it is also called “fulminant meningitis” - it can kill adults in one day, and small children in a few hours. This is what distinguishes it from other forms.

Causes of the disease

The causative agent of the disease is meningococcal bacillus, which is spread by airborne droplets. Therefore, you can become infected by visiting a clinic, while riding in transport, in a store, and so on.

For children attending kindergartens, there is a chance of getting an infection there during an epidemic. In addition to meningococcal bacillus, the cause of the lesion may be enterovirus infection or other varieties.

Measles, rubella, and mumps can provoke reactive meningitis. The provocateurs of the disease are otitis media, sinusitis, furunculosis, lung abscess and other purulent diseases, as well as the presence and injuries of the back. Premature and weakened children are also at risk.

Features of the disease in children

In young children, the disease can develop in utero if the mother is already sick with meningitis or another disease that provoked a corresponding infection in the newborn.

Childhood reactive meningitis strikes a child with lightning speed and can lead to death within a few hours. In all cases, there are complications that can occur immediately or arise later.

Symptoms of the disease

Reactive meningitis is manifested by the following characteristic symptoms:

Adults and children tend to lie in the “pointing dog” position: pressing their legs to their stomach and throwing their head back, all this happens while lying on their side. This is also one of the signs of meningitis.

How is the diagnosis made?

An accurate diagnosis can only be made using a lumbar puncture. Only this study can distinguish it from other diseases with similar symptoms.

But such a study takes time, so blood is urgently taken for general and biochemical analysis. In addition, an examination of the fundus, radiography of the skull, etc. is carried out.

An accurate diagnosis of the patient is made based on three main signs: specific symptoms of meningitis, signs indicating infection of the patient and changes in the cerebrospinal fluid.

Health care

Treatment of reactive meningitis is carried out only in a hospital, most often in the intensive care unit. For small patients and adults, the principle of treatment is almost the same; there may only be prescriptions of different groups of antibiotics, but this depends on the patient’s well-being and his body’s reaction to the drug. Young patients always have complications that occur immediately during illness or later.

The goal of therapy is to prevent sad consequences for the patient, as well as to begin treatment as early as possible.

Treatment with broad-spectrum antibiotics, in the highest possible doses, begins immediately. For this purpose, drugs from the groups of penicillins, cephalosporins and macrolides are used.

In 20% of cases, the cause of the disease is never identified, which is why antibiotics are immediately prescribed that act on all harmful microorganisms.

If the patient's condition worsens, the drug can be injected into the spinal canal. A course of antibiotics is prescribed for a period of at least 10 days, but if there are purulent lesions in the brain area, the course is extended.

If the drugs used: Penicillin, Ceftriaxone and Cefotaxime do not help, and the patient faces fatal complications, then Vancomycin and Carbapenem, which have serious side effects, are used.

In addition, therapy is carried out to relieve symptoms with the following drugs:

antispasmodics and muscle relaxants - relieving cramps and spasms in muscles;
glucocorticoids – improving the functioning of the adrenal glands;
Furosemide – prevention of cerebral edema;
Sorbilact - if there is already swelling;
for general therapy, saline solutions, plasma expanders, and antipyretics are administered using droppers.

In the first hours of treatment, all drugs are administered intravenously - this is how the medicine acts most effectively, helping to avoid toxic shock. It is timely treatment that will help to cope with the disease without serious consequences for the patient.

Before the ambulance arrives, the patient must be provided with physical and mental peace and maximum comfort, because all his senses are heightened.

It is necessary to close the windows with curtains, isolate from noise and screaming, to reduce pain, put ice or rags soaked in cold water on the head, arms to the elbows and legs to the knees, changing them as they warm up. The patient can be given a medication for headaches.

Complications and prognosis

With reactive meningitis, the prognosis can be favorable for middle-aged people if treatment is started in a timely manner. For infants and older people, treatment often does not bring any effect, since the course of the disease progresses rapidly, and symptoms and complications arise progressively.

Possible complications of fulminant meningitis are:

DIC - the formation of clots in the blood, spots on the skin merge into one spot, gangrene may begin on the hands and feet, as well as blood accumulations in the mouth, eyes and sclera;
delayed mental development in children;
paralysis;
deafness;
septic shock;
blindness;
decrease in sodium ions in the blood.

If all points of treatment are completed, mortality from reactive meningitis occurs in 10% of all cases.

The main point of preventing fulminant meningitis is vaccination, however, vaccination does not guarantee complete protection against infection.

In addition, you should avoid crowded places, especially during an epidemic. Patients with meningitis should be isolated from healthy people by sending them to the hospital. All personal hygiene procedures must be strictly followed. When going on a trip or trip, study the situation with infections in the area.

If you find symptoms similar to meningitis in yourself or your loved ones, you should immediately consult a doctor, or better yet, call an ambulance. Only timely and correct treatment gives a chance to avoid death or serious consequences for the patient.

Meningitis is called inflammation of the membranes of the spinal cord and brain, which is accompanied by tissue swelling, disruption of the movement of blood and cerebrospinal fluid.

The result is increased intracranial pressure, as well as irritation of the cranial and spinal nerves.

There are several forms of pathology based on the nature of the course. Let's consider the features of reactive meningitis.

Some experts identify the reactive form of inflammation of the meninges with the fulminant course of the disease.

It is characterized by a rapid increase in symptoms. Without help, a person dies within 24 hours.

Other sources contain information that reactive pathology is called in connection with the developmental mechanism. Inflammation does not occur in the brain or spinal cord, but in another location, after which it spreads to the central nervous system.

In fact, these definitions are not mutually exclusive. Secondary meningitis can develop rapidly, especially in children and people with weakened immune systems.

To completely cure meningitis without further complications, it is important to be able to identify the first sign of meningitis in order to begin treatment on time. Let's look at the main signs of the disease in children, adolescents and adults.

With fulminant meningitis, symptoms develop over 24-48 hours. Main manifestations:

Hyperthermia. The temperature rises to 40º C or more. In the first hours, it can go astray with the help of standard antipyretics. But then there is a sharp jump, and the drugs lose their effectiveness. At the same time, a person feels weakness, chills, aching joints, and muscle pain.
Vomit. Multiple gushing attacks occur. The amount the patient eats does not matter. Vomiting is accompanied by sharp pain in the abdomen.
Strong headache. It is caused by increased intracranial pressure. The unpleasant sensations are bursting in nature. They intensify with sharp sounds, light, and movement.
Impaired consciousness. At first, excitement and anxiety appear. After a few hours, they are replaced by apathy, confusion of thoughts, and in severe cases, coma.

Other possible signs:

tachycardia, hypotension, shortness of breath;
unilateral paralysis, strabismus;
earthy tone and hypothermia of the skin;
a sore throat;
decrease in the amount of urine, its darkening;
swelling of the fontanelle in children under one year of age.

Due to irritation of the meninges, specific (meningeal) symptoms of the disease occur.

They are expressed in painful tension of certain muscles, especially the occipital muscles. The patient lies on his side, throws his head back and pulls his bent legs to his chest. Children may experience clonic-tonic convulsions, followed by muscle flaccidity.

A characteristic feature of reactive meningitis caused by meningococci is a change in blood counts and vascular damage, leading to the appearance of a hemorrhagic rash on the skin. First, small spots appear that fade when pressed. They then enlarge and darken, resembling “ink splatters.”

In addition, DIC syndrome develops - a condition in which hemostasis is disrupted and blood clotting begins: blood clots form in some vessels, blocking blood circulation. As a result, capillaries rupture and hemorrhagic lesions form on the mucous membranes and internal organs. Bleeding in the brain may occur, as well as gangrene of the fingers.

At the terminal stage of the disease, the temperature returns to normal. But if the patient does not receive help, signs of respiratory and renal failure occur.

Reactive meningitis can be caused by various etiological factors.

Most often, inflammation of the meninges occurs as a result of toxic damage to the blood vessels of the brain and pleocytosis (increase in the number of cells) in the cerebrospinal fluid.

Shock is caused by a high concentration of breakdown products of microbial agents in the blood. This condition can be observed with tuberculosis, brucellosis, syphilis, mumps, polio, enterovirus and other infections.

Often, reactive meningitis is a complication of inflammatory diseases caused by pneumococci, streptococci, and fungi. The main ones are pneumonia, sinusitis, otitis, furunculosis, glomerulonephritis. Microbes spread from the primary focus through the bloodstream (lymph), or penetrate directly into the brain when purulent formations rupture.

Other causes of meningitis:

traumatic brain injury and spinal injury;
introduction of antibiotics, anesthetics, and chemotherapy drugs into the spinal canal;
vaccination against measles, whooping cough, rabies, polio;
breakthrough of cysts and abscesses of the brain;
brain tumors, dura mater, meningeal leukemia, Behcet's disease, multiple sclerosis - all these conditions can lead to pathological fluid entering the cerebrospinal fluid;
subarachnoid hemorrhages, ischemic foci during strokes;
fetal hypoxia during labor occurring prematurely;
intracranial hemorrhages in premature infants.

Primary fulminant meningitis is most often caused by the penetration of meningococcus into the body. The infection is transmitted by airborne droplets and can cause an epidemic. Doctors call it “uncontrollable” due to its severity.

Threat to life

Reactive meningitis is one of the most dangerous forms of the disease. Due to the rapid development of symptoms, doctors do not always have time to make a diagnosis and prescribe treatment.

In 10-20% of cases, the pathology leads to death. The causes of death are disseminated intravascular coagulation syndrome, infectious-toxic shock, cerebral edema, respiratory arrest.

Inflammation of the meninges can also have long-term consequences.

The main ones:

paralysis;
deafness;
developmental delay in children;
epilepsy;
hydrocephalus and so on.

Meningitis is an infectious disease. The infection is distributed throughout the lining of the brain and spinal cord.

In an adult, the greatest danger arises a day after infection. The body of a small child is not able to fight this disease. The infection begins to progress, spreading throughout the body within a few hours.

In especially severe cases, reactive meningitis can have a fulminant course. A purulent infection of the meninges can cause coma and be fatal.

The cause of the disease may be meningococcal infection. It is this disease that is most often transmitted from a sick person to a healthy person by airborne droplets.

Other pathogens include:

group B streptococci;
viruses;
pneumococci.

On this topic

In addition, infection occurs due to exacerbation of certain diseases:

otitis;
glomerulonephritis;
endocarditis;
sinusitis;
pneumonia.

More rare causes of the disease are:

injection of a medicinal product into the spinal canal;
syphilis, tuberculosis;
vaccinations against rabies, whooping cough, measles;
neoplasms of the central nervous system that are malignant;
rupture of echinococcal cysts;
ischemic strokes;
fetal hypoxia during premature birth;
intracranial hemorrhages in premature infants;
formation of a purulent abscess in the subarachnoid space.

Fleet meningitis is a very rapidly developing infectious disease, so doctors consider it extremely dangerous. Already in the first 24 hours, the patient needs to receive urgent assistance, because death usually occurs on the second day. If it concerns a child, then there is even less time. Death from reactive meningitis in a baby occurs within 3-4 hours after infection, so doctors simply do not have enough time to make this diagnosis and begin treatment. Already in the first stages of pathology, the development of inflammatory as well as autoimmune processes in the membranes of the brain is observed.

Reactive or, as it is popularly called, fulminant meningitis has the following causes:

Back or head injury;
Chronic diseases;
Furunculosis localized in the face and neck.

This type of meningitis sometimes occurs as a consequence of diseases that are characterized by an inflammatory process:

Abscess;
Carditis;
Otitis;
Pyelonephritis;
Sinusitis.

You can find out what reactive meningitis is by its principle of action. This disease is characterized by disruptions in the microcirculation of the cerebrospinal fluid. It begins to be produced and absorbed worse, and cerebral edema develops. Such pathological changes are not the worst.

The disease has no specific localization and can be found in any part of the planet, but most often people suffer from this type of meningitis in poor countries, for example, in African countries. The main source of the disease is another person who is its carrier. Most cases of infection occur in autumn and spring due to high air humidity.

According to data provided by the Ministry of Health, 20% of the total number of meningitis patients suffer from its fulminant form. That is why it is important to detect it in time by the symptoms characteristic of this disease:

A swollen fontanel (the area at the back of the head) in a baby;
Rash localized throughout the body;
A sore throat;
Temporary weakening (paresis) and paralysis of muscles;
Loss of orientation in space;
Temporary deafness;
Arrhythmia (rhythm failure) of the heart;
General weakness;
Temperature surges;
Groundless irritability;
Drowsiness;
Nausea and vomiting;
Feelings of heaviness and aches in the body;
Pain in the head, neck and back;
Consolidation of muscle tissue on the back of the head and neck.

Due to the manifestations of reactive meningitis, it is convenient for the patient to be in a certain position in which the head is thrown back, and the legs bent at the knees are pressed tightly to the stomach. It is in this position that it becomes a little easier for a person and the headache, which cannot be reduced even with special medications, is reduced.

What kind of disease is reactive meningitis: symptoms, causes, photos, diagnosis, treatment and prevention

Meningitis is a well-known disease. At least the average person, without any special medical education, knows the word “meningitis” and, although the specifics of the disease itself are not very clear, everyone is afraid of meningitis. An emergency doctor may say: “You have a sore throat (flu, pneumonia, enterocolitis, sinusitis, etc.).

Get ready to the hospital quickly." In response, he will definitely hear: “Doctor, is there no way to get treatment at home?” But if the word “meningitis” is uttered, even if not categorically: “You have meningitis!”, but with doubt: “It looks like meningitis,” you can say with confidence: a normal person will not even mention any treatment at home.

This attitude towards meningitis is generally understandable - less than 50 years have passed since it became possible to treat it (meningitis). But if mortality from most childhood diseases decreased during this time by 10-20 or more times, then for meningitis - only 2 times.

So what kind of disease is this, meningitis? First of all, it should be noted that meningitis is an infectious disease. That is, the direct cause of the disease is certain microbes. Most human infections allow us to establish a clear relationship between the name of the disease and the name of its specific pathogen.

The word “meningitis” itself means inflammation of the membranes of the brain, and the cause of this inflammation can be a huge number of microorganisms - bacteria, viruses, fungi. Infectious disease experts say, not without confidence, that under certain conditions any microorganism can cause meningitis in a person of any age.

For meningitis to occur, a specific pathogen must enter the cranial cavity and cause inflammation of the membranes of the brain. Sometimes this happens when foci of infection occur in the immediate vicinity of the membranes of the brain - with purulent otitis media, for example, or with sinusitis. Often the cause of meningitis is traumatic brain injury.

It should be noted that there are a number of, usually congenital defects of the immune system, that predispose to the occurrence of meningitis. It is not surprising that in some families all children suffer from meningitis - although this disease is not so common, in comparison, for example, with sore throat, whooping cough, chickenpox or rubella.

Reactive meningitis is an infectious disease that affects the membranes of the spinal cord and brain. This disease develops rapidly, which is why it is also called “fulminant meningitis.” For an adult patient, the main danger occurs a day after infection, but a sick child can die within a couple of hours after the bacteria enters the body.

Let's take a closer look at how and why it is possible to get reactive meningitis.

This disease can be caused by the following microorganisms:

viruses and fungi;
meningococci;
pneumococci;
group B streptococci.

Routes of transmission of reactive meningitis:

contact;
airborne;
lymphogenous;
hematogenous;
perineural;
transplacental.

When the causative agent of meningitis enters the body, it causes inflammation of the meninges and tissues. Subsequently, cerebral edema occurs, which causes disruption of microcirculation in the cerebral vessels, a decrease in the release and absorption of cerebrospinal fluid.

This leads to a rapid increase in intracranial pressure, resulting in hydrocephalus (dropsy of the brain).

The next stage is the spread of inflammation to the substance of the brain, cranial and spinal nerves.

Reactive meningitis: the essence of the disease, causes, symptoms and treatment directions

Reactive meningitis is an acute infectious disease that affects the membranes of the brain or spinal cord. The disease can affect people of any age, but most often these are newborn premature babies and patients who have head injuries, back injuries, and various lesions of the nervous system.

Reactive meningitis has its own peculiarity. The disease occurs unexpectedly, spontaneously. In this form, the clinical course of meningitis is difficult, violent and fleeting.

Reactive meningitis is essentially one of the most dangerous and serious forms of infection. The clinical picture of the disease is extremely transient, it is often called fulminant. Medical care for the patient must be immediate and urgent, since many purulent foci appear in the brain area, the person can fall into a coma and die.

Reactive meningitis, causes

The causative agent of this infectious disease is usually meningococcal bacillus. Transmission of a viral infection usually occurs by airborne droplets from the carrier of the infection - a sick person. The source of infection can be located in almost any public place: in a clinic, in a store, or when traveling on public transport. Meningitis can lead to an epidemiological situation among children attending kindergartens and group events.

The cause of meningitis is the meningococcal bacillus, and it can also be an enterovirus infection or various other viruses. Diseases such as mumps, rubella, measles can also trigger the development of the disease. At risk are also patients who suffer from otitis media (in acute or chronic form), sinusitis, those suffering from lung abscesses, patients with many boils on the face and neck, and other other diseases.

Reactive meningitis, symptoms

Reactive meningitis manifests itself in the following symptoms: high body temperature (up to 40 degrees), prolonged fever lasting for several days. The patient experiences severe pain in the throat, frequent bouts of vomiting, and neck stiffness may occur.

Treatment of this disease is carried out immediately in hospital departments. Comprehensive treatment is prescribed, including antibacterial therapy, corticosteroids and supportive care. With timely diagnosis and properly prescribed treatment, meningitis can be managed. The mortality rate from this disease is about ten percent of the total number of cases.

Antibacterial therapy is based on the empirical prescription of medicinal drugs, since it is not always possible to accurately determine the nature of the causative agent of a given disease. To prevent the proliferation of viruses in the body in the future and to destroy all possible pathogens, the doctor prescribes one or another antibiotic. The antibacterial course of treatment depends on the patient’s condition and the characteristics of his illness.

The percentage of deaths, unfortunately, increases significantly with late diagnosis of reactive meningitis, as well as if the patients are elderly, frail people or children.

The opinion has become firmly established among the population that reactive meningitis is one that is characterized by an extremely rapid development of the clinical picture. In fact, such meningitis is called fulminant, or fulminant.

The mechanism of development of reactive meningitis is based on:

autoimmune processes;
aseptic inflammation;
allergic reactions;
damage to the vessels of the membranes by bacterial waste products.

There are many causes of reactive meningitis. The main ones include:

medications administered endolumbarally, that is, into the spinal canal;
toxoplasmosis, syphilis, leptospirosis, tuberculosis and other diseases in which microorganism toxins irritate the meninges;
vaccination;
malignant neoplasms of the central nervous system;
extensive ischemic strokes;
subarachnoid hemorrhages;
rupture of echinococcal cysts;
breakthrough of a purulent abscess into the subarachnoid space.

The following infections can cause a fulminant type of meningitis:

Pneumococcal;
Meningococcal;
Streptococcal.

In rare cases, pathology is caused by a fungus or even a virus. It is transmitted using the following ways:

Lymphogenic. The spread of infection occurs through the lymph;
Contact. Infection occurs due to head trauma;
Perineural. The infection spreads to the brain tissue due to inflammation of the nerves;
Airborne. The disease is transmitted through the air, for example, when an infected person coughs near a healthy person;
Hematogenous. The infection initially enters the blood and then reaches the brain;
Placental. This route of transmission occurs through the placenta from mother to baby.

There have often been cases when, against the background of a severe head or back injury, a reactive type of meningitis developed. That is why, even with minor injuries in these departments, doctors advise staying in the hospital for some time. The disease can be spread by eating unwashed food or poor hygiene, such as dirty hands. In children, meningitis occurs due to tonsillitis or pneumonia.

When the perineural process begins, when inflammation is transferred to the brain tissue from the affected nerves, the disease progresses very quickly. In such a situation, you need to have time to stop the pathology, focusing on the emerging symptoms.

The color of urine (urine) becomes darker;
Cutting pains appear in the stomach area;
Changes occur in the composition of the blood;
Muscle pain increases significantly and reacts to loud sounds and light;
Hemorrhages become noticeable under the skin;
There are cramps in the lower extremities, especially in the calf muscles;
Sensitivity is impaired;
The patient becomes apathetic to the world around him;
Tonic convulsions occur;
The temperature rises up to 40°

During the development of fulminant meningitis, small blood clots often form in a person, which can affect the development of shock. This phenomenon has its own signs:

The skin on the feet and hands becomes closer to an ashy shade;
The patient's speech becomes confused;
Pain appears in the chest area and heart rate increases;
Blood pressure rises.

During a state of shock, the skin, despite the high temperature, remains cold. The patient feels restless and overexcited.

All the described symptoms occur in the patient in the first 24 hours of the development of reactive meningitis. If 2-3 signs are detected, you should immediately go to the hospital to prevent further complications.

The first signs of meningitis

Despite the modern level of development of medical science, meningitis to this day remains a disease that requires immediate medical attention.

For this reason, the first signs of meningitis, such as a sharp, very severe headache and excessive sensitivity to light, should alert the doctor and his patient. Often, along with such signs, spasms of the neck muscles are observed. In this case, the patient cannot reach his chest with his chin. A doctor's attempt to bend a person's head, as a rule, leads to sharp and severe pain and simultaneous bending of the arms and legs.

The patient may also experience an increase in body temperature, a feeling of chills, aching joints, severe sweating, photophobia, high sensitivity to extraneous sounds, a change in consciousness, which is accompanied by communication with fictional characters.

Timely treatment begins to guarantee a person’s recovery. Therefore, when the first symptoms of the disease occur, you should immediately seek help from doctors. Signs of meningitis in children deserve special attention, since they are the ones who suffer this infection much worse than adults.

Causes of the disease

Meningococcal bacillus is the main causative agent of meningitis. In addition to it, the causative agents of this disease can be enterovirus infection and some viruses. In addition, meningitis can develop as a complication after diseases such as mumps, measles, and rubella. The risk group also includes patients suffering from sinusitis or otitis, suffering from abscesses or having boils in the neck and face.

Reactive miningitis is a dangerous form of the disease

Reactive meningitis is often confused with a simple respiratory disease. Remember that the symptoms of this type of disease are fleeting. If treatment is not started on time, then literally in 1-3 days an adult can turn into a hopeless patient, and in a small child this happens within a day.

Body temperature is about 40 degrees;

Severe pain in the throat;

Rigidity (tension, spasm) of the neck muscles;

Severe nausea or frequent attacks, vomiting;

Disorders of the facial and oculomotor muscles;

In some cases, partial paralysis or deafness may develop.

How to treat reactive meningitis?

Treatment for reactive meningitis should be started immediately and only in the inpatient department of the hospital! The doctor prescribes complex therapy, which includes taking corticosteroids and antibacterial drugs, as well as supportive procedures. Quick diagnosis and modern medical methods, as a rule, make it possible to cope with this dangerous infection: today the mortality rate from meningitis is only 10 percent.

Antibacterial therapy for reactive meningitis is based on empirical prescription of medications due to the fact that doctors are not always able to accurately and quickly determine the type of pathogen. The course of treatment with antibacterial agents depends on the characteristics of the disease and the patient’s condition.

meningococcal;
streptococcal;
pneumococcal.

Causative agents of meningitis

Depending on the type of pathogen, meningitis can be viral, bacterial, or fungal. Some protozoa (such as amoeba and toxoplasma) can also cause meningitis.

The development of viral meningitis can accompany the course of well-known infections - chickenpox, measles, rubella, mumps; damage to the meninges occurs with influenza and infections caused by herpes viruses. In weakened patients, in the elderly, and in infants, meningitis caused by fungi occurs (it is clear that in these situations it is the lack of immunity that plays the leading role in the occurrence of the disease).

Bacterial meningitis is of particular importance. Any purulent focus in the body - pneumonia, an infected burn, tonsillitis, various abscesses, etc. - can cause meningitis, provided that the pathogen enters the blood and reaches the meninges with the blood flow. It is clear that the causative agents of purulent processes (staphylococci, streptococci, Pseudomonas aeruginosa, etc.) are known to everyone.

slight runny nose, redness of the throat – meningococcal nasopharyngitis. It was not for nothing that I used the phrase “can cause” - the fact is that the entry of meningococcus into the body quite rarely leads to the onset of disease, the leading role here belongs to very special individual changes in immunity.

Two facts are easily explained in this regard: the first is the risk of developing meningitis during contact, for example, in children's institutions is 1/1000, and the second is the frequent detection of meningococcus in the nasopharynx in completely healthy individuals (from 2 to 5% of children are healthy carriers). The body's inability to localize the microbe in the nasopharynx is accompanied by the penetration of meningococcus through the mucous membrane into the blood.

Sometimes meningococcus enters the blood quickly and in huge quantities. Meningococcal sepsis, or meningococcemia, occurs - perhaps the most terrible of all childhood infectious diseases. The microbe secretes poisons (toxins), under their influence multiple blockages of small vessels occur, blood clotting is impaired, and multiple hemorrhages appear on the body.

There is an amazingly dramatic pattern in the occurrence of meningococcemia, which is as follows. The fact is that when a microbe penetrates the blood, it begins to react with certain antibodies that try to destroy meningococcus. It has been proven that there is cross-activity of a number of antibodies - that is, if there are large quantities of antibodies, for example, to streptococcus, pneumococcus, staphylococcus - then these antibodies can have an inhibitory effect on meningococcus.

So it turns out that children who are sick, have chronic foci of infections, have had pneumonia and many other illnesses, almost never get meningococcemia. The scary thing about meningococcemia is that within 10-12 hours an absolutely healthy child who has never been sick before can die!

Reactive meningitis, its symptoms, causes and treatment

All the above information is not intended to intimidate readers. Meningitis is treatable. But the results (duration and severity of the disease, the likelihood of complications) are closely related to the time that will be lost before the start of adequate therapy.

Obviously, the above-mentioned “timing of initiation of adequate therapy” depends on when human subjects seek medical attention. Hence the urgent need for specific knowledge, so that later there will be no excruciating pain...

The essence of specific knowledge regarding meningitis is that the appearance of certain signs indicating the possibility of this disease requires immediate medical attention.

Inflammation of the meninges is characterized by a number of symptoms, but many of them are not specific - that is, their (symptoms) may also occur in other diseases that are much less dangerous. Most often this happens, but the slightest suspicion of the development of meningitis does not allow you to take risks and requires immediate hospitalization and careful medical supervision.

Let us now consider the most typical situations, each of which does not allow us to exclude the development of meningitis.

If against the background of any infectious disease - acute respiratory infections, chickenpox, measles, mumps, rubella, "fever" on the lips, etc. - perhaps not at the beginning of the disease (even more often not at the beginning) an intense headache appears, so severe that it worries more than all other symptoms if the headache is accompanied by nausea and vomiting.
In all cases, when, against the background of increased body temperature, there is pain in the back and neck, aggravated by moving the head.
Drowsiness, confusion, nausea, vomiting.
Convulsions of any intensity and any duration.
In children of the first year of life - fever, monotonous crying, bulging fontanel.
Any (!!!) rash against a background of elevated temperature.

In addition to the symptoms described above, some reflexes change in a very definite way, and only a doctor can detect this.

It is important to remember and understand that such frequent symptoms as vomiting, nausea and headache necessarily require a medical examination - God protects the best. Any rash accompanied by an elevated temperature may be meningococcemia. You (or your smart neighbors) may be confident that it is rubella, measles or “diathesis”.

But the doctor must see the rash, and the sooner the better. If the elements of the rash look like hemorrhages, if new rashes appear quickly, if this is accompanied by vomiting and high fever, every chance should be taken to ensure that the patient immediately ends up in the hospital, preferably immediately in the infectious diseases department. Remember: with meningococcemia, the count is not in hours, but in minutes.

Reactive meningitis is the most dangerous form of an infectious disease that affects parts of the spinal cord and brain. Anyone can suffer from this inflammation, but premature newborns, people with head and back injuries, and damage to the nervous system are most susceptible to it.

A feature of reactive meningitis is its spontaneity and unexpectedness. The clinic proceeds rapidly and fleetingly. If medical assistance was provided too late, the patient falls into a coma and dies from multiple purulent foci in the brain area. If doctors began to treat reactive meningitis within the first 24 hours, the consequences will not be so serious, but they can also threaten a person’s life.

The rapid development of fulminant meningitis often leaves doctors no time for diagnosis, because even an adult in the absence of treatment measures will not live more than 1-2 days, children have even less time.

Meningitis is a dangerous infectious disease that affects the membranes of the brain, thereby causing inflammation in them. It can appear either independently or as an infection from another source.

The disease has 5 different forms, it can be bacterial, viral, fungal. The nature of the inflammatory process is purulent and serous.

At the slightest suspicion of the development of meningitis, an adult or child should be taken to the hospital as quickly as possible, since the disease can only be treated in a hospital under the supervision of experienced doctors.

Treatment of meningitis must begin from the moment the first signs of the disease are detected, since its consequences are very dangerous for a person, regardless of age. Children are more likely to get meningitis because their immunity is underdeveloped and the blood-brain barrier is imperfect, unlike adults.

Causes of meningitis

The causative agent of meningococcal infection is the bacterium meningococcus, which belongs to the genus Neisseria, which contains 2 types of bacteria - meningococci and gonococci. The source of infection is carriers of the infection, which is transmitted by airborne droplets.

The most pathogenic are group A meningococci; when infected, they lead to the development of severe meningococcal infection. In children, meningitis is caused mainly by enteroviruses that enter the body through food, water, and dirty objects. It can develop against the background of chickenpox, measles or rubella.

The disease can be transmitted during childbirth, by airborne droplets, through mucous membranes, dirty water, food, bites of rodents and various insects. You can also become infected through a kiss.

Secondary meningitis occurs when infection enters the brain from other foci of inflammation - boils, osteomyelitis, otitis media, etc. Men and children under 10 years of age are most susceptible to this infection.

Symptoms of meningitis

This is a very dangerous disease that is transmitted by airborne droplets, which increases the risk of contracting this disease. In this regard, it is important to know the first symptoms of meningitis, as well as how it manifests itself in children and adults. Timely detection of meningitis and its symptoms will help to promptly seek medical help, which will minimize possible complications.

The duration of the incubation period for meningitis depends on the main pathogen; in the case of meningococcal infection, it is 5-6 days, in some cases the period increases to 10 days.

Symptoms with the bacterial form usually occur suddenly. Symptoms of the viral type may appear suddenly or gradually over several days.

The most common first signs of meningitis in adults are:

severe and persistent headache;
high body temperature;
muscle and joint pain;
stiffness of the neck muscles - difficult or impossible flexion of the head;
shortness of breath, rapid pulse, cyanosis of the nasolabial triangle;
increased sensitivity to light and sound;
nausea and vomiting, general weakness, loss of appetite.

Meningeal syndrome is expressed by Kernig and Brudzinski symptoms.

Kernig's sign (inability to straighten a leg bent at the hip and knee joints), pain when pressing on the eyeballs.
Brudzinski's sign (when you try to tilt your head forward while lying down, your legs bend at the knees; when you press on the pubis, your legs bend at the knee joints).

Patients lie on their side, their head is thrown back strongly, their arms are pressed to their chest, and their legs are bent at the knees and brought to the stomach (“pointing dog pose”). Meningitis and meningococcal septicemia cannot always be identified immediately, since the symptoms are very similar to influenza. It is important to understand that the disease can be accompanied by other symptoms, which can complicate self-diagnosis.

It is not easy to suspect meningitis in a child, since he cannot yet complain about the symptoms that bother him.

In a small child, signs of meningitis may include high fever, increased excitability, in which it is difficult to calm the baby, decreased appetite, rash, vomiting and high-pitched crying. There may be tension in the muscles of the back and limbs. In addition, children may cry when they are picked up.

Parents should definitely call a doctor if they notice the above signs.

Treatment of meningitis

For meningitis, treatment in children and adults should be comprehensive and carried out in a hospital. To clarify the diagnosis, as well as identify the causative agent of meningitis, a spinal puncture is performed.

Therapeutic measures for meningococcal infection include etiotropic, pathogenetic and symptomatic therapy.

The basis of treatment for meningitis is antibacterial therapy. The drug is prescribed taking into account the identified causative agent of the disease and is administered intravenously. The use of medications will be carried out for at least a week after the person’s temperature returns to normal. To destroy meningococcus, antibiotics of the penicillin group or their semisynthetic analogues (amoxicillin) are most often used.
Anti-inflammatory and antihistamine drugs are prescribed to alleviate the symptoms of the disease and reduce the risk of complications, including an allergic reaction to any antibiotic.
If cerebral edema develops, dehydration is carried out using diuretics (diuretics). When using diuretics, it should be taken into account that they contribute to the leaching of calcium from the body.

Depending on the clinical form of meningitis, the severity of meningococcal infection, the combination of drugs and therapeutic approaches are different. After completion of inpatient treatment, it is necessary to continue treatment on an outpatient basis. In case of correct and timely treatment, the probability of death is no more than 2%.

In most cases, the meningococcal vaccine, the Haemophilus influenzae type B vaccine, and the triple vaccination against measles, rubella and mumps are used. The meningitis vaccine is valid for 3 years and is up to 80% effective. The vaccine is not given to children under 18 months.

Prevention

The main preventive measure today is still vaccination. You can get vaccinated if you wish, it is not mandatory. Nonspecific prevention involves avoiding contact with adults or children who show signs of the disease.

The consequences will depend on how the disease progressed in the person.

High body temperature, chills. In patients with reactive meningitis, a two-humped temperature curve is observed, that is, an increase in body temperature to 40 degrees at the onset of the disease quickly responds to action antipyretic drugs, and after a few hours, with a sharp rise in temperature again, antipyretics are no longer completely ineffective.
Intense headache bursting, all over the head, aggravated by movement, sudden noise or light stimulus.
Vomiting, it occurs from the first hours of illness, debilitating, repeated, not related to food intake.
Muscle pain; in young children, clonic-tonic convulsions may also occur.
Characteristic symptoms of meningitis - meningeal signs, neck stiffness, Kernig's symptoms, Brudzinski's symptoms may not always be present all together (see signs of meningitis).
Signs of shock: tachycardia, arterial hypotension, cold skin at high body temperature, the patient’s feet and hands become ashy.
Excitement, anxiety, which appear in the first hours of the disease, are replaced by confusion, prostration and coma. Shortness of breath, hypoxemia, oliguria, and other manifestations of respiratory distress syndrome occur.
Some patients die from serious neurological changes caused by increased intracranial pressure.
The skin becomes gray in color; with meningococcal infection, a rash appears and rapidly spreads, which is first maculopapular and then becomes hemorrhagic. The rash is most often localized on the lower extremities, on the body, on the buttocks and in the area of large joints.
DIC syndrome (disseminated intravascular coagulation syndrome) develops in the absence of adequate treatment and an increase in the manifestations of septic shock. In this case, the rash acquires a necrotic, confluent character, collaptoid spots appear, and develops gangrene of the toes and hands, hemorrhages occur in the sclera, oral mucosa, conjunctiva, the patient’s death occurs from multiple organ failure and refractory septic shock.

Course of therapy

In most cases, if the patient consulted a doctor on time, the disease could be stopped. First of all, it will be necessary to carry out an urgent diagnosis. It includes a general examination, a patient interview and an analysis of the composition of the cerebrospinal fluid, and it is taken using a lumbar puncture. The last point is especially important and it is on this point that the doctor will make his conclusion and, if necessary, prescribe a course of therapy.

There are complications that arise after the course of treatment, namely:

Septic shock (reduced tissue circulation);
Hyponatremia (low sodium concentration in the blood);
Increased blood clotting.

If such a terrible disease is diagnosed, it is necessary to urgently begin a course of treatment to prevent irreversible consequences. For this purpose, doctors usually use the following groups of medications:

Muscle relaxants;
Antipyretics;
Antispasmodics.

Saline solutions, plasma substitutes and Diazepam may also be useful in treatment. If the patient has kidney failure, the doctor will prescribe glucocorticosteroids by injection. For reactive meningitis, the following classes of antibiotics are often prescribed:

Cephalosporins;
Macrolides;
Penicillins.

Due to the lightning-fast development of the disease, medications are used in the form of injections. In particularly advanced cases, medications are injected directly into the spinal canal.

With meningitis, swelling of the brain very often occurs. To prevent it, you should take Furasemide and Sorbilact. This should be done in conjunction with the main treatment.

It is not possible to cure the pathology at home. Self-medication will not only worsen the patient’s condition, but can also lead to death. In such a situation, folk remedies should be taken only after the disease has been stopped. Among them, decoctions of linden and rose hips are best suited.

The reactive type of meningitis is an extremely dangerous disease that can be fatal already on the 2nd day of development. Such a rapid spread of infection must be stopped immediately after the first symptoms of the disease appear.

symptoms characterizing the presence of infection;
pronounced signs of meningitis;
deviation in structure cerebrospinal liquids.

Symptoms such as rash and fever should already alert a person. The patient must be urgently hospitalized in a hospital, where he will receive the necessary intensive care. After taking a cerebrospinal fluid test, specialists determine the causative agent of the disease. This fact allows you to make an accurate diagnosis and begin effective treatment.

The patient undergoes a general urine test. With meningitis, it is dark in color and contains protein and blood. The characteristic presence of leukocytes is observed.

It should be noted that even the most highly qualified doctor can diagnose meningitis with absolute certainty only in one case - when the symptoms of irritation of the meninges are combined with the typical rash described above. In all other cases, the diagnosis can only be suspected with varying degrees of probability.

The only way to confirm or exclude meningitis is a spinal (lumbar) puncture. The fact is that a special cerebrospinal fluid circulates in the brain and spinal cord - cerebrospinal fluid. With any inflammation of the brain and (or) its membranes, inflammatory cells accumulate in the cerebrospinal fluid; the appearance of the cerebrospinal fluid (normally colorless and transparent) often changes - it becomes cloudy.

Unfortunately, at a purely philistine level, there is a very widespread opinion about the enormous dangers that a spinal puncture poses. In fact, these fears are absolutely unfounded - the puncture of the spinal canal is carried out between the lumbar vertebrae at the level where no nerve trunks extend from the spinal cord, so there are no mythical paralysis after this manipulation.

From a legal point of view, the doctor is obliged to perform a spinal tap if there is a real suspicion of meningitis. It should be noted that puncture has not only diagnostic, but also therapeutic usefulness. With any meningitis, as a rule, there is an increase in intracranial pressure, the consequence of which is a severe headache.

Taking a small amount of cerebrospinal fluid can reduce blood pressure and significantly alleviate the patient’s condition. During a puncture, antibiotics are often administered into the spinal canal. For example, with tuberculous meningitis, the only chance to save the patient is frequent (often daily) punctures, during which a special version of streptomycin is injected into the spinal canal.

Meningeal symptoms

When examining the patient, positive symptoms of meningeal irritation are observed. The occipital muscles are tense, the patient's head is thrown back. Children under one year old often take the position of a gun dog - on their side, with their head thrown back and legs pulled up to their stomach. If you overcome the rigidity of the neck muscles and try to bring the patient’s chin to the chest, you will experience flexion of the legs at the knee and hip joints.

The same reaction occurs in response to pressure on the pubis. These are the upper and lower Brudzinski symptoms. Kernig's symptom is that after the patient bends the leg at the hip and knee joints at a right angle while lying down, its extension becomes very painful and almost impossible.

All patients undergo a lumbar puncture and cerebrospinal fluid analysis. In this case, an increase in intracranial pressure, macroscopic and microscopic changes are noted, which differ depending on the cause of the disease.

If there is a suspicion of fulminant meningitis, immediate diagnosis will be required. This can only be done in a hospital setting. A person will definitely need to see a specialist as soon as the first signs are noticed.

A spinal puncture is performed, during which fluid is taken from the lumbar region for analysis. It will be possible to detect the pathogen that led to the disease. A general blood test is performed. When reactive meningitis appears, the ESR will increase, and the number of leukocytes will increase.

Urine is taken for analysis; when the brain is inflamed, it becomes dark in color. During the study, protein will be detected in it, as well as the presence of blood. An examination of the fundus, radiography of the head area, electroencephalography, and CT are performed.

Any of the signs of meningitis, especially the appearance of a rash, fever, and catarrhal symptoms should be suspicious of meningococcal infection. A sick child or adult should be urgently hospitalized for intensive care.

By analyzing the cerebrospinal fluid using a lumbar puncture, the causative agent of meningitis is detected, which makes it possible to establish a diagnosis. In the general blood test, increased leukocytes, increased ESR. Urine with meningitis is usually dark in color and contains blood elements and protein.

Treatment of meningitis should be carried out immediately in intensive care units, the patient is given intravenous saline solutions, plasma expanders, antipyretics; for acute adrenal insufficiency, corticosteroids may be prescribed; for muscle spasms and cramps, muscle relaxants, antispasmodics, diazepam.

The maximum doses of antibiotics are administered intramuscularly, most often cephalosporins, penicillins or macrolides. If the patient is in shock, all drugs are administered only intravenously. As the severity of the patient's condition increases, antimicrobial agents are injected directly into the spinal canal. To avoid cerebral edema, furosemide is prescribed, and in the presence of clinical symptoms of cerebral edema, sorbilact is included in the infusion therapy.

Routes of transmission

Meningitis has a number of ways of transmitting the disease:

airborne;
contact;
hematogenous;
perineural;
transplacental;
lymphogenous.

On this topic

Reactive meningitis can appear as a result of spinal or traumatic brain injury.

Infectious pathogens, once inside, provoke the process of inflammation of brain tissue. The resulting edema causes improper microcirculation in the cerebral vessels. Absorption of cerebrospinal fluid slows down. The infected person gradually begins to increase intracranial pressure.

Reactive meningitis: mortal danger and consequences

The peculiarity of this disease is its suddenness, spontaneity, and transience. Therefore, it is also called “fulminant meningitis” - it can kill adults in one day, and small children in a few hours. This is what distinguishes it from other forms of meningitis.

Causes of the disease

Measles, rubella, and mumps can provoke reactive meningitis. The provocateurs of the disease are otitis media, sinusitis, furunculosis, lung abscess and other purulent diseases, as well as the presence of traumatic brain injury and back injury. Premature and weakened children are also at risk.

Children and the elderly have weak bodies, so the prognosis for them is often unfavorable. The disease progresses very quickly. Timely assistance in the form of therapeutic treatment does not always save from death.

Treatment is more successful in middle-aged patients. A correct diagnosis can be the key to a quick recovery.

Disseminated intravascular coagulation syndrome is a mortal danger for those infected with reactive meningitis. As a result, blood clots form in many vessels. Blockage of the blood supply can lead to the death of many organs. When blood vessels rupture, hemorrhages occur in the brain.

Causes of the disease

Prevention

For preventive purposes, vaccination should be performed to prevent infection and the development of meningitis in adults and children. However, a single vaccination does not provide a 100% guarantee to completely protect the body from the occurrence of the disease. To do this, it is necessary to perform a number of important preventive actions:

complete isolation of the vaccinated person;
compliance with all prescribed rules of personal hygiene;
avoiding contact with people infected with meningitis;
restricting travel to dangerous places. Be fully vaccinated before traveling to areas where there is a large increase in the disease.

Reactive or fulminant meningitis– an inflammatory disease of the membranes of the brain, characterized by the rapid development of symptoms, the serious condition of the patient and a fairly high mortality rate. The most common cause of the development of this form is bacteria - meningococci, streptococci, pneumococci, transmitted by airborne droplets from person to person. Reactive meningitis can be either a primary infection or a secondary one - for example, with cracks and fractures of the skull and cervical vertebrae, the microflora easily penetrates the meninges, multiplies and provokes an inflammatory reaction.

Symptoms

The course of reactive meningitis is hyperacute, all the symptoms that the infected person experiences are within 24-48 hours, mixing and erasing. As with other forms of inflammation of the meninges, symptoms of damage to the nervous system are of diagnostic importance:

Exhausting vomiting with attacks of cutting pain in the abdomen;
Spastic tension in the muscles of the back of the head, neck and calf, causing the patient’s characteristic position - lying on his side, head thrown back, legs bent at the knees and pressed to the stomach;
Clonic-tonic convulsions, followed by lethargy and apathy;
Severe headache and muscle pain;
Increased tactile, auditory and visual sensitivity.

The temperature in patients with reactive meningitis, as a rule, exceeds forty degrees. With rapidly spreading purulent inflammation of the meninges, the cranial and spinal nerves are often affected, which is clinically expressed as unilateral paralysis of the face or limbs.

Reactive meningitis is also characterized by a sharp shift in blood counts, increased vascular permeability - spots of hemorrhages and hemorrhagic diathesis appear on the skin. The breakdown of red blood cells and the release of hemoglobin leads to an increase in the level of hemosiderin in the blood, liver and kidneys - a very characteristic black rash may appear on the skin, and the patient’s urine becomes dark in color.

An integral symptom of fulminant meningitis is disseminated intravascular coagulation (DIC) - blood clotting inside the vessels with the formation of small blood clots that block the blood flow in the capillaries. At the same time, small pockets of infarctions form on the skin, mucous membranes and internal organs; rupture of capillaries can cause hemorrhage in the brain.

Diagnostics

The rapid development of the clinical picture does not allow doctors to conduct a full diagnosis, since there is virtually no time for it. However, using the lumbar puncture method, cerebrospinal fluid is taken for examination, applied to a glass slide, Gram stained and microscopically examined. Detection of coccal forms of bacteria allows an accurate diagnosis to be made.

Changes in the composition of the blood are considered characteristic - increased breakdown of red blood cells with the release of iron, extremely. Due to the rapid development of the disease, the immune system does not have time to react properly and is only rarely detected. In hyperacute meningitis, urine becomes dark in color, and protein and blood elements are found in it.

Treatment

Therapy for reactive meningitis must be immediate and intensive, otherwise death cannot be avoided. Because there is no time to determine the sensitivity of microflora, antibacterial drugs are prescribed empirically, choosing groups that can affect all possible microbes - penicillins, cephalosporins, macrolides.

Antibiotics are administered intramuscularly at the maximum therapeutic dose every three to four hours; the time and dose of each injection are recorded on paper. If treatment is delayed and the patient’s condition is severe, then in addition to the general course, antibiotics are administered into the spinal canal.

If the patient is able to drink, he is prescribed a plentiful drinking regime. Electrolyte solutions and plasma expanders are administered intravenously, while furosemide is prescribed to avoid cerebral edema. To relieve cramps and muscle spasms, antispasmodics and muscle relaxants are prescribed.

Reactive meningitis is an extremely dangerous disease, the prognosis for which in most cases is unfavorable. Only timely and intensive treatment can avoid death; in children and the elderly, the progression is so rapid that medicine is often powerless. To avoid infection with reactive meningitis, it is necessary to avoid contact with possible sources of infection, not to visit places of outbreaks of the disease, and to strictly observe the rules of personal hygiene.

Reactive meningitis - what is it?

Many people know about meningitis as a very serious, dangerous disease. But not everyone knows what reactive meningitis is and why it appears. Moreover, an interesting situation has developed on the Russian-language Internet with this term, where this disease is identified with the high speed of its development, compared with the speed of, for example, a jet plane.

The phrase "Jet Meningitis" is, as you might expect, associated with Latin rather than terminology from the aerospace industry. In this case, the reactive process should be understood not as the rate of its progression, but as inflammation that develops as a rebound from the main inflammatory process.

Examples of such inflammation are:

reactive arthritis due to chlamydial infection of the genitourinary system or intestinal infection
reactive pancreatitis against the background of duodenal ulcer.

At the same time, the role of infectious agents in the development of reactive meningitis fades into the background and aseptic inflammation and autoimmune processes in the meninges come to the fore.

A striking example of aseptic meningitis is drug-induced meningitis. It can be caused by the introduction into the body of non-steroidal anti-inflammatory drugs, carbamazepine, isoniazid, penicillin, ciprofloxacin, ranitidine, azathioprine, trimethoprim. When antibiotics, air, chemotherapy drugs, and anesthetics are introduced into the spinal canal, the membranes of the brain may react. In this case, meningitis develops as an allergic hypersensitivity reaction.
During a bacterial or viral process in the body, infectious agents may not penetrate the meninges, but the products of their breakdown or metabolic activity cause systemic vascular damage (vasculitis) and reactive pleocytosis in the cerebrospinal fluid. Reactive meningitis can accompany brucellosis, toxoplasmosis, leptospirosis, tuberculosis, syphilis, mycoplasmosis, granuloma venereum, chickenpox, mumps, infectious mononucleosis, HIV, cytomegalovirus infection, polio, enterovirus infection.
Post-vaccination reactions are another cause of reactive meningitis. After vaccinations against whooping cough, rabies, measles, and polio, cases of meningeal reactions have been observed.
Against the background of tumors of the central nervous system: craniopharygioma, brain tumors, meningeal leukemia, tumors of the dura mater of the brain or sarcoidosis, multiple sclerosis, Behcet's disease, a pathological effusion with cells characteristic of changes in meningitis may enter the cerebrospinal fluid.
Extensive ischemic foci (during strokes) often produce reactive changes nearby, which can also affect the membranes of the brain.
Another case of the development of reactive meningitis is rupture of cysts (for example, echinococcal) or brain abscesses, subarachnoid hemorrhages.
The diagnosis of reactive meningitis is often made in premature newborns after hypoxia during childbirth, intracranial hemorrhages, when laboratory methods fail to isolate the pathogen, but clinical symptoms of meningitis are present.

Among the bacterial infections that affect the membranes of the brain, the most often isolated are: meningococci, pneumococci, streptococci. Meningococcal infection is most often the causative agent of primary meningitis, 20% of cases of which are fatal. Meningococcal is one of the most “uncontrollable infections”, causing both isolated cases and epidemic outbreaks of the disease.

Reactive meningitis can occur against the background of streptococcal, pneumococcal and other infections, when it penetrates into the meninges with the bloodstream from an inflammatory focus in the nasopharynx, bronchi, and trachea. Typically, the spread of infection occurs when infectious foci appear in the body - pneumonia, otitis, sinusitis, sinusitis, bronchiectasis, furunculosis, etc.

High body temperature, chills. In patients with reactive meningitis, a double-humped temperature curve is observed, that is, an increase in body temperature to 40 degrees at the onset of the disease quickly responds to the action of antipyretic drugs, and a few hours later, with a sharp repeated rise in temperature, antipyretics are no longer completely ineffective.
Intense headache bursting, all over the head, aggravated by movement, sudden noise or light stimulus.
Vomit, it occurs from the first hours of illness, debilitating, repeated, not related to food intake.
Muscle pain, in young children it is also possible to experience clonic-tonic seizures.
Characteristic symptoms of meningitis - meningeal signs, neck stiffness, Kernig's symptoms, Brudzinski's symptoms may not always be present all together (see signs of meningitis).
Signs of shock: tachycardia, arterial hypotension, cold skin at high body temperature, the patient’s feet and hands acquire an ashy hue.
Excitement, anxiety, which appear in the first hours of the disease, are replaced by confusion, prostration and coma. Shortness of breath, hypoxemia, oliguria, and other manifestations of respiratory distress syndrome occur.
Some patients die from serious neurological changes caused by increased intracranial pressure.
Leather becomes gray in color, with meningococcal infection it appears and spreads rapidly rash, which is initially maculopapular and then becomes hemorrhagic. The rash is most often localized on the lower extremities, on the body, on the buttocks and in the area of large joints.
DIC syndrome(disseminated intravascular coagulation syndrome) develops in the absence of adequate treatment and an increase in the manifestations of septic shock. In this case, the rash becomes necrotic, confluent in nature, collaptoid spots appear, gangrene of the toes and hands develops, hemorrhages occur in the sclera, oral mucosa, conjunctiva, the patient’s death occurs from multiple organ failure and refractory septic shock.

Diagnosis and treatment of reactive meningitis

Any of the signs of meningitis, especially the appearance of a rash, fever, and catarrhal symptoms should be suspicious of meningococcal infection. A sick child or adult should be urgently hospitalized for intensive care.

The maximum doses of antibiotics are administered intramuscularly, most often cephalosporins, penicillins or macrolides. If the patient is in shock, all drugs are administered only intravenously. As the severity of the patient's condition increases, antimicrobial agents are injected directly into the spinal canal. To avoid cerebral edema, furosemide is prescribed, and in the presence of clinical symptoms of cerebral edema, sorbilact is included in the infusion therapy.

Reactive meningitis: mortal danger and consequences

Causes of the disease

Measles, rubella, and mumps can provoke reactive meningitis. The provocateurs of the disease are otitis media, sinusitis, furunculosis, lung abscess and other purulent diseases, as well as the presence of traumatic brain injury and back injury. Premature and weakened children are also at risk.

Features of the disease in children

In young children, the disease can develop in utero if the mother is already sick with meningitis or another disease that provoked a corresponding infection in the newborn.

Childhood reactive meningitis strikes a child with lightning speed and can lead to death within a few hours. In all cases, there are complications that can occur immediately or arise later.

Symptoms of the disease

Reactive meningitis is manifested by the following characteristic symptoms:

How is the diagnosis made?

An accurate diagnosis can only be made using a lumbar puncture. Only this study can distinguish meningitis from other diseases with similar symptoms.

But such a study takes time, so blood is urgently taken for general and biochemical analysis. In addition, fundus examination, EEG, skull radiography, CT and MRI are performed.

An accurate diagnosis of the patient is made based on three main signs: specific symptoms of meningitis, signs indicating infection of the patient and changes in the cerebrospinal fluid.

Health care

The goal of therapy is to prevent brain swelling and sad consequences for the patient, as well as to begin treatment as early as possible.

Treatment with broad-spectrum antibiotics, in the highest possible doses, begins immediately. For this purpose, drugs from the groups of penicillins, cephalosporins and macrolides are used.

If the drugs used: Penicillin, Ceftriaxone and Cefotaxime do not help, and the patient faces fatal complications, then Vancomycin and Carbapenem, which have serious side effects, are used.

In addition, therapy is carried out to relieve symptoms with the following drugs:

antispasmodics and muscle relaxants - relieving cramps and spasms in muscles;
glucocorticoids – improving the functioning of the adrenal glands;
Furosemide – prevention of cerebral edema;
Sorbilact - if there is already swelling;
for general therapy, saline solutions, plasma expanders, and antipyretics are administered using droppers.

Before the ambulance arrives, the patient must be provided with physical and mental peace and maximum comfort, because all his senses are heightened.

Complications and prognosis

Possible complications of fulminant meningitis are:

DIC - the formation of clots in the blood, spots on the skin merge into one spot, gangrene may begin on the hands and feet, as well as blood accumulations in the mouth, eyes and sclera;
delayed mental development in children;
paralysis;
deafness;
septic shock;
blindness;
decrease in sodium ions in the blood.

If all points of treatment are completed, mortality from reactive meningitis occurs in 10% of all cases.

The main point of preventing fulminant meningitis is vaccination, however, vaccination does not guarantee complete protection against infection.

Reactive meningitis

Reactive meningitis is a special and most dangerous form of inflammation of the membranes of the brain and spinal cord, characterized by rapid progression, the development of undesirable consequences and death.

Treatment of the disease is difficult; a sharp deterioration in the patient’s well-being, coma or death in this case can occur within a few hours from the moment of its first manifestations. Reactive meningitis is especially dangerous for people with weakened immune systems and young children.

Causes of reactive meningitis

Meningitis is an infectious disease, its main causative agent is various pathogens, including meningococcus, staphylococcus, Pseudomonas aeruginosa, etc. Main routes of infection:

airborne, when bacteria are inhaled;
nutritional, when eating food contaminated with this bacterium;
household, when visiting a public swimming pool, etc.

Secondary reactive meningitis is also an extremely common pathology; it usually occurs against the background of a streptococcal or meningococcal infection in the body. The primary focus of inflammation can be located in its various systems. Thus, in young children, meningitis often occurs as a complication of tonsillitis and pneumonia. The prefix “reactive” means in this case that the disease develops rapidly, within 9-10 hours from the moment bacteria penetrate the brain area. If the patient is not provided with qualified assistance during this period of time, the probability of death is almost 100%.

Symptoms of reactive meningitis

First signs of reactive meningitis it is necessary to know in order to promptly distinguish the disease from another, less dangerous infection and prevent the onset of irreversible consequences for the patient.

Inflammation of the meninges begins with a severe headache, accompanied by chills and vomiting, indicating a sharp increase in intracranial pressure. The pain can be local in nature, concentrated in the temples, parietal, and occipital regions. This symptom intensifies when the body is in an upright position, when walking, or when turning the head. Vomiting with reactive meningitis, just like with other types of this disease, does not depend on food intake, is not accompanied by nausea and does not bring relief.

Another symptom characteristic of brain inflammation is a sharp increase in body temperature to a high level. This temperature is not eliminated by antipyretic drugs and may be accompanied by hallucinations, a state of delirium, loss of consciousness, and convulsions. Each next attack of convulsions can be fatal for the patient.

Reactive meningitis disrupts normal brain activity. As a result, a person experiences confusion, loss of coordination of movements, and decreased muscle tone. In infants, during the development of the disease, protrusion of the so-called fontanelle usually occurs.

The presence of complications of meningitis can be judged by the following signs:

heart rhythm disturbance;
decreased blood pressure;
shortness of breath, breathing problems;
change in skin color (the skin becomes pale gray), the appearance of a characteristic rash on it;
coma.

In the absence of help, the rash on the patient’s body quickly spreads and becomes necrotic. The place of its localization most often are the lower and upper extremities. Necrotic processes on the skin are irreversible and can lead to sepsis or gangrene. In such cases, amputation is often necessary to save the patient's life.

Treatment of reactive meningitis

A patient with suspected reactive meningitis must be urgently hospitalized. Treatment is prescribed after the diagnosis is established. It is based on antibiotics (depending on the identified pathogen - penicillins or macrolides), agents whose action is aimed at detoxifying the body (saline solution, potassium preparations).

When the development of the disease has been prevented and nothing threatens the patient’s life, antipyretics, antihistamines, vitamins can be prescribed, and for cerebral edema, diuretics (Furosemide). Antibiotics for reactive meningitis can be combined with hormonal agents (glucocorticoids) aimed at eliminating the inflammatory process, antispasmodic drugs that prevent the occurrence of seizures and muscle spasms.

During the first hours of treatment, all drugs are administered intravenously into the patient’s body. In this case, the medicine acts instantly and avoids the development of toxic shock.