Serous meningitis is a severe infectious pathology of the meninges of the brain. There is a widespread misconception about the causes of this disease. Many people believe that meningitis is caused by being out in the cold without a hat. However, this disease has an exclusively infectious origin. Most often it is caused by viruses. Hypothermia of the head can only be a provoking factor in the development of the inflammatory process.
Pathogens
In serous meningitis, inflammation affects the pia mater of the brain, which is closest to the surface of the organ. There are a large number of nerves and blood vessels here, so the symptoms of the pathology are pronounced and hard to bear.
This disease is caused by various microorganisms. The most common cause of inflammation is the Coxsackie virus. Also, in the etiology of serous meningitis, an important role is played bycausative agents of the following diseases:
- flu;
- infectious mononucleosis;
- herpetic infection;
- measles;
- rubella;
- adenoviral infection ("stomach flu");
- mumps (mumps).
In rare cases, lesions of the meninges are caused by bacteria: Koch's bacillus or pale treponema. This happens in patients with tuberculosis or syphilis. The infection enters the brain through the bloodstream. The disease can also be a consequence of the defeat of the body by the yeast fungus Candida. But such a pathology is rarely observed, mainly in people with sharply reduced immunity, for example, in HIV-infected people. Serous-viral meningitis is milder and has a better prognosis than sero-bacterial meningitis.
There are primary and secondary forms of pathology. In the first case, the disease occurs if the infection immediately enters the brain from outside. Secondary meningitis occurs as a complication of other ailments.
Transmission routes
The affection of the soft meninges always occurs very quickly, the symptoms of the disease are growing rapidly. Most often, microorganisms called Coxsackie become the cause of serous viral meningitis. These viruses live in the intestines (hence the name - enteroviruses), but do not lead to damage to the gastrointestinal tract, but to general intoxication of the body. They can cause an infectious disease with fever and a rash (hand-foot-mouth syndrome) but are often affected.central nervous system.
A viral infection that leads to inflammation of the membranes of the brain is spread in the following ways:
- Airborne. If viruses accumulate on the mucous membrane of the respiratory tract, then a person releases them when coughing, sneezing and talking.
- Contact way. Microorganisms are on the skin and move to various objects. Using common things with a sick person, you can easily become infected. The disease is often spread through contaminated fruits and vegetables and unwashed hands.
- Through the water. Outbreaks of enterovirus infections often occur in resorts where people swim in communal pools. This microorganism can persist in the aquatic environment.
Most often, enterovirus infection occurs in the summer. Children are especially susceptible to infection. Adults get sick less often.
There is also a special form of viral serous pathology - lymphocytic choriomeningitis. With it, inflammation affects not only the soft membranes, but also the vessels of the ventricles of the brain. This infection is spread by rodents - mice and rats. A person becomes infected by eating food and water contaminated with the secretions of sick animals.
Provoking factors
Infection does not always lead to sero-viral meningitis. For the occurrence of the disease, additional unfavorable conditions are necessary. The development of inflammation in the membranes of the brain can provoke the following factors:
- Low immunity. This is the main reason for the activity.viruses. Most often, people with a weakened body are susceptible to meningitis. These are patients with chronic diseases, various immunodeficiency conditions, as well as those undergoing treatment with cytostatics and corticosteroids.
- Frequent viral infections. If a child constantly has a cold, there is a high risk of getting a complication of the disease in the form of inflammation of the meninges.
- Hypocooling of the body. This factor plays a far from major role in the occurrence of serous meningitis. Excessive exposure to cold can only indirectly affect the development of the disease. Usually hypothermia contributes to frequent colds, and meningitis occurs as a complication.
In childhood, the following circumstances may contribute to the development of meningitis:
- premature baby;
- intrauterine infection with rubella and other viral diseases;
- birth trauma;
- congenital deficiency of immunity.
These children are at increased risk of the disease.
The difference between the serous form of the disease and the purulent one
It is important to differentiate between serous and purulent meningitis. This is necessary to select the correct treatment tactics. The two types of the disease differ in etiology, pathological changes and clinical presentation. The serous form of meningitis is most often caused by viruses, with inflammation in the membranes of the brain, not pus is formed, but exudate (serous fluid). Nerve cells do not die.
The purulent form is most often associated with brain damage to meningococci. It is characterized by the death of neurons. Purulent contents appear in the shells. This type of meningitis is much more severe and has more dangerous consequences than serous. Diagnostic tests help distinguish one form of the disease from another.
Incubation period
The incubation period for serous meningitis can vary in length. Its duration depends on the type of pathogen. For most viral infections, the latent period is 2 to 5 days. With rubella, it can increase up to 2 weeks. In children 2-6 years old, the incubation period can last 1-2 weeks.
At this time, a person does not feel any deviations in well-being. Only in young children under 1 year of age, some changes in behavior can be noticed. Toddlers often cry, act up, their appetite decreases and sleep is disturbed.
General symptoms of the disease
After the incubation period comes the intermediate (prodromal) stage of the disease. It is characterized by a slight increase in temperature, weakness, fatigue, decreased appetite. After that, acute signs of serous meningitis develop:
- There is a severe headache, which is localized in the temporal-frontal region and radiates to the neck. Patients describe this sensation as extremely painful. Noise and bright light make the pain worse. Analgesics do little to help.
- The temperature rises sharply (up to 40 degrees). The fever lasts 2-4 days, then decreases somewhat. But after a while the temperature rises again.
- Pain in the headaccompanied by nausea, severe vomiting "fountain" due to increased intracranial pressure and irritation of the vomiting center.
- A sick person cannot stand bright lights and harsh sounds. His skin becomes very sensitive to touch. The condition improves somewhat when in a quiet, darkened room.
- The patient lies in a characteristic position: legs are pulled up to the body, arms are pressed to the chest, and the head is thrown back. In this position, it becomes somewhat easier for him.
- Signs of general intoxication appear: severe weakness and malaise, aching joints.
- Maybe a little foggy.
- If there are nerve lesions, then there are violations of swallowing, movements and double vision.
Features of symptoms in children
In childhood, signs of serous inflammation of the meninges have their own characteristics. In addition to the symptoms listed above, the child may have colds: cough, runny nose, sore throat. High fever is accompanied by leg cramps, delusions and hallucinations.
In infants, there is bulging and tension in the fontanel. The child becomes irritable, whiny, capricious. The baby constantly screams in a monotonous voice, doctors call this sign "brain scream".
Rash usually does not occur with this disease, except when meningitis occurs in the background of a viral infection with skin manifestations (measles,rubella).
Meningeal symptoms
Above were described the general manifestations of serous meningitis associated with intoxication of the body. But there are specific signs of this disease, which play an important role in the diagnosis. These include:
- Tension of the cervical and occipital muscles. The patient cannot press his head to his chest due to increased muscle tone.
- Kernig's symptom. If the patient's leg is bent in the supine position, then a strong muscle tension is observed. Sometimes the patient cannot even extend the limb.
- Brudzinsky's symptoms. When the head is tilted, the person involuntarily pulls the legs towards the body. This is a sign of irritation of the membranes of the brain. Also, when one leg is bent, the other limb is pulled up to the body. These symptoms are not always observed in the serous form of the disease.
- Lesage's symptom. It is observed in children in infancy. If the child is lifted and held upright, he bends his legs and pulls them towards the body.
The doctor identifies these symptoms during a diagnostic examination of the patient.
Complications in adults
Severe sequelae of serous meningitis in adults are rare. The disease can be complicated by pneumonia, inflammation of the heart membrane, arthritis. Sometimes vision or hearing deteriorates. There may be occasional pain and noise in the head.
The most dangerous complication of serous meningitis is the addition of a bacterial infection and the transition of the disease to a purulent form. Alsoinflammation can spread from the meninges to the gray matter. To avoid such severe consequences, it is necessary to start treatment of the disease in a timely manner.
Complications in children
Complications occur more frequently in children than in adults. Pathology can adversely affect the development of the child. Possible consequences of serous meningitis in children include:
- mental retardation;
- hearing loss;
- strabismus;
- decrease in clarity of vision;
- trembling and involuntary movements of the eyeballs;
- epileptic seizures.
At the first signs of illness, you must urgently call a doctor. Timely treatment will minimize the risk of complications.
Diagnosis
During the examination, the doctor determines the signs of damage to the meninges. The specialist identifies the symptoms of Kernig, Brudzinsky and Lesage (in children), as well as neck muscle tension.
An important role in the differential diagnosis of serous meningitis plays a spinal puncture. Under anesthesia, a puncture is made with a long needle in the lumbar region. Cerebrospinal fluid (CSF) is taken for analysis. Her study makes it possible to distinguish the serous form of the disease from the purulent one. If the protein in the cerebrospinal fluid is slightly elevated and lymphocytes predominate, then this indicates viral meningitis. If the norms of protein content are greatly exceeded and the number of neutrophils is increased, then this indicates a purulent form of the disease.
Additionally, MRI and CT may be prescribedbrain, as well as a blood test for viral infections.
Treatment methods
With serous inflammation of the meninges, the patient is urgently hospitalized. It is advisable to place the patient in a darkened room, where there are no external irritants (noises, bright lights). It is recommended to observe strict bed rest. Medical treatment in the hospital:
- To reduce intoxication of the body, patients are given droppers with saline solutions, as well as with ascorbic acid and corticosteroids.
- To reduce intracranial pressure, diuretics are prescribed: Veroshpiron, Furosemide, Lasix.
- For high fever, drugs with paracetamol and ibuprofen are prescribed.
- Carry out antiviral therapy with interferon drugs. If meningitis is caused by the causative agent of herpes or infectious mononucleosis, then the use of Acyclovir is indicated.
- Antibiotics will not cure viral meningitis. But broad-spectrum antibacterial drugs are still used to prevent the development of a purulent form of the disease.
- When pain is useful, the use of "No-Shpy".
- If a child has convulsions, then use the drugs "Domosedan" or "Seduxen".
- To strengthen the immune system, B vitamins and ascorbic acid are prescribed.
- If the disease is caused by Koch's bacillus, Treponema pallidum or yeast fungus, then the use of antituberculous, antisyphilitic and antifungalfunds.
In some cases spinal taps are used for therapeutic purposes. Removing part of the CSF helps to reduce intracranial pressure and reduce headaches.
At the recovery stage, patients are prescribed nootropic drugs ("Piracetam", "Nootropil", "Glycine"), as well as drugs with succinic acid. This contributes to the recovery of the brain after illness.
Disease prognosis
Prognosis for serous meningitis of viral etiology is usually favorable. Improving the patient's condition with proper treatment occurs in 5-6 days. The disease lasts about 2 weeks, after which there is a complete recovery.
If serous inflammation is caused by tuberculosis bacteria or yeast, then it requires a long and persistent treatment. These forms of the disease often recur.
With complications and the transition of the disease to a purulent form, as well as with the spread of pathology to the substance of the brain, the prognosis is significantly worse.
Prevention
At present, specific prevention of this disease has not been developed. To protect yourself from serous inflammation of the meninges, you need to protect your body from infections. Contact with patients with viral pathologies should be avoided, as well as strengthen the immune system. If there is an outbreak of enterovirus diseases in the summer, swimming in closed water should be avoided.
Vaccination against the serous form of the diseaseimpossible to do, as it is caused by viruses of various kinds. The vaccine "Mentsevax" is ineffective in this case. It is designed to protect against purulent meningitis, which is caused by meningococci. You can only take a course of vaccinations against various viral infections (measles, rubella, influenza). This will slightly reduce the risk of disease. However, enteroviruses often become the causative agent of inflammation, and there are no vaccines against them yet.
