Symptoms of meningitis that every parent should know

Meningitis in children is an acute infectious disease in which inflammation of the membranes of the brain and spinal cord develops. Children's meningitis is severe. If antimicrobial therapy is not started in a timely manner or is inadequate, severe complications develop in children with meningitis. The Yusupov Hospital has all the conditions for the treatment of meningitis:

• the wards are equipped with forced-air ventilation and air conditioning;
• patients are provided with individual personal hygiene products and dietary nutrition;
• Patients are examined using devices from leading global manufacturers and modern laboratory diagnostic methods;
• Doctors use the latest generation antibacterial and antiviral drugs, which are highly effective and have minimal side effects.

Severe cases of meningitis are discussed at a meeting of the expert council with the participation of candidates and doctors of medical sciences. Leading specialists in the field of treatment of infectious diseases of the central nervous system make a collegial decision regarding the management of patients with severe meningitis. The clinic accepts patients aged 18+.

Causes of meningitis in children

Children's meningitis can be primary (develop without previous signs of a pathological process caused by the corresponding pathogen) or secondary, when damage to the meninges is preceded by other manifestations of infection (mumps, measles, leptospirosis).

The following microorganisms can cause meningitis:

• bacteria (pneumococcus, meningococcus, Haemophilus influenzae and tuberculosis bacilli, spirochetes);
• viruses (enteroviruses of the Coxsackie-ECHO group, mumps and measles virus);
• chlamydia;
• mycoplasma;
• protozoa;
• mushrooms.

Meningitis most often affects children who belong to the following risk groups:

• premature;
• those born with intrauterine fetal hypoxia or as a result of difficult labor;
• with congenital or acquired immunodeficiency;
• who have undergone craniocerebral, spinal, vertebral trauma, neurosurgical operations and surgical interventions on the abdominal organs.

Children under 5 years of age are more likely to get meningitis. The risk of getting meningitis increases in children who attend preschool institutions and schoolchildren. Children who do not follow the rules of personal hygiene, swallow contaminated water when swimming in reservoirs, and eat food contaminated with rodent excrement are more likely to get sick. The causative agents of meningitis are transmitted by ixodid ticks.

There is a high risk of developing meningitis in children who have not been vaccinated against mumps, measles and rubella, or who have missed vaccinations with Haemophilus influenzae, meningococcus, or pneumococcal conjugate vaccines. When traveling to places dangerous for meningitis, children must be vaccinated no later than 2 weeks before the child’s departure.

The source of pathogens of childhood meningitis are sick people or bacteria carriers. Infectious agents can be transmitted by airborne droplets (with dust and saliva particles), contact (through dirty hands), waterborne, transmissible (through insect bites) and fecal-oral mechanisms. The entry points for infection are the mucous membranes of the upper respiratory tract and digestive organs. The causative agents of meningitis spread throughout the body in the following ways:

• hematogenous (through blood vessels);
• lymphogenous (lymph flow);
• geirogenic (with cerebrospinal fluid).

Meningitis in children is accompanied by the following pathological changes:

• increased production of cerebrospinal fluid;
• increased intracranial pressure and permeability of the blood-brain barrier;
• toxic damage to the brain substance;
• disorders of cerebral circulation, especially microcirculation;
• liquorodynamic disorder;
• hypoxia (insufficient oxygen supply) of the brain.

Eventually, swelling of the brain tissue develops. This is facilitated by the spread of the inflammatory process to the ventricles and brain matter, which is characteristic of purulent meningitis. With viral meningitis, cerebral edema is less pronounced, but the medulla is also involved in the pathological process. When the inflammatory process spreads to the brain, focal neurological symptoms appear.

Edema and swelling of the brain leads to its displacement with compression of the brain stem by the cerebellar tonsils. At the same time, the function of vital organs, especially breathing, is disrupted in children, which can lead to death. After suffering viral meningitis, most children do not develop complications. Children who have had bacterial meningitis may be retarded in mental development, and they sometimes develop impaired vision and hearing to the point of complete deafness.

How can you get infected?

If you are interested in how you can become infected with meningitis, then first you should know about the way the infection multiplies. The methods of its reproduction are different, but the most common are:

• Airborne (the patient may sneeze and cough).
• Contact and household (personal hygiene rules are not followed).
• Oral-fecal (eating unwashed foods or eating with unwashed hands).
• Hematogenous (infection occurs through blood).
• Lymphogenic (infection through lymph).
• Placental (at the time of pregnancy and birth of a child from mother to her fetus).
• If a person bathes in dirty water, the infection enters the body.

The incubation period for this disease ranges from 2 to 4 days, this period from infection to the first signs. But sometimes it lasts a couple of hours or, on the contrary, it takes up to 20 hours. It is also important to consider that the disease can be primary and secondary. The first option is an independent disease. The second is a consequence of the fact that there is already an infection in the body, for example, a person suffers from influenza, otitis media, tuberculosis.

meningitis symptoms

If it is serous meningitis, then it is considered contagious. If the disease is secondary, then other people will not become infected with it.

Symptoms of meningitis in children

The clinical picture of meningitis in children depends on the type of pathogen. In all cases of childhood meningitis, general symptoms predominate, which are united by the concept of “meningeal” syndrome. Meningitis in children often begins acutely rather than gradually. Typically, the symptoms of meningitis are preceded by general signs of an infectious disease: fever, weakness, pain in the joints and muscles. With meningococcal infection, hemorrhagic rashes appear in children, with pneumococcal infection - signs of rhinitis, pneumonia, otitis, with mumps - damage to the salivary glands, with enterovirus infection - dyspeptic disorders and catarrhal phenomena.

Meningeal syndrome has the following symptoms:

• rigidity or stiffness of the neck muscles due to a pathological increase in their tone;
• Kernig's symptom - the patient is unable to fully straighten a previously bent leg at a right angle at the knee and hip joints;
• Brudzinski's symptom: upper - when the patient tilts his head to the chin and lies on his back, the lower limbs automatically bend, lower - if the patient bends one leg at the knee joint, the second limb bends automatically;
• hyperesthesia – increased sensitivity to painful, auditory, olfactory and tactile stimuli, intolerance to bright light;
• local complete or partial paralysis.

Children develop the following signs of meningitis:

• Lesage's symptom - when the baby is taken by the armpits, he presses his legs to his tummy, which cannot be straightened (typical for children under one year old);
• “tripod” symptom – a child, sitting on a flat surface with his legs extended forward, bends his legs or leans back;
• bulging fontanelle;
• Filatov's symptom - when the baby tilts his head quickly or sharply, his pupils dilate.

In children under three years of age, it is extremely rare to have all the signs of meningeal syndrome. Symptoms of meningitis in children 7-8 years old do not differ from signs of the disease in adults. The temperature during meningitis in children rises to 41-42o. Children are bothered by a severe headache that spreads throughout the head. They cry, sometimes screaming.

From the first days of the disease, small dark cherry pinpoint rashes appear on the child’s body. In the presence of severe meningococcal infection, the elements of the hemorrhagic rash merge, and large spots or bruises may appear. The child's consciousness is impaired, convulsions and epileptic seizures develop. Children are worried about nausea, continuous vomiting, not associated with food intake, which does not bring relief.

Who is at risk?

A key factor contributing to the onset of meningitis is a weak immune system. It is the body’s defense against various infections. Human immunity becomes weak due to:

• previously suffered infectious diseases (respiratory, pneumonia, pharyngitis, influenza, sore throat),
• chronic pathologies, especially syphilis, HIV, tuberculosis, liver cirrhosis, severe stress,
• vitamin deficiency and strict diets,
• head and back injuries,
• total hypothermia of the body,
• alcohol and drug abuse,
• long-term use of tablets with non-compliance with recommendations.

All this can cause infection in a person, as the body becomes weak.

Diagnosis of meningitis in children

Decisive for confirming the diagnosis of meningitis in children is the examination of cerebrospinal fluid. It is obtained by lumbar puncture. According to indications, children undergo additional studies:

• radiography of the skull and paranasal sinuses;
• fundus examination;
• electroencephalography;
• echo-encephalography;
• computer and nuclear magnetic resonance tomography.

During a spinal puncture, the pressure of the cerebrospinal fluid, the visual characteristics of the cerebrospinal fluid (color, transparency) are determined, and the cerebrospinal fluid dynamic tests of Stuckey and Queckenstedt are performed. In the liquid sediment, the number and composition of cells and the presence of microorganisms are determined. Biochemical (glucose, protein, chloride content, sediment samples) and microbiological studies are carried out.

With meningococcal meningitis in children, the cerebrospinal fluid is cloudy, yellowish or milky white. One milliliter of cerebrospinal fluid contains several thousand neutrophils. Characteristic bean-shaped diplococci are often visible in their cytoplasm. When sowing, a culture of the pathogen is isolated. An increased amount of protein and a decreased level of glucose are detected in the cerebrospinal fluid. Using immunological methods, the pathogen's antigen is detected in the cerebrospinal fluid, and its DNA is detected using the polymerase chain reaction. Signs of a pronounced inflammatory process are detected in the blood.

With pneumococcal meningitis in children, meningeal syndrome is detected somewhat later than with meningococcal infection. Even if the child is hospitalized early, the disease progresses rapidly. Disorders of consciousness, convulsions, and often paresis of cranial nerves or partial paralysis of half the body appear early. The cerebrospinal fluid is purulent. In it, under a microscope, extracellularly located lanceolate-shaped diplococci are visible.

Meningitis caused by Haemophilus influenzae is most often observed in children under one year of age. The disease can begin either acutely or gradually. Meningeal symptoms appear on days 2–5 of illness. In children under one year of age, the most serious signs of meningitis are regurgitation or vomiting, bulging and cessation of pulsation of the fontanel, and an unmotivated high-pitched cry.

Viral meningitis is preceded by a clinical picture characteristic of the corresponding infection. Symptoms of meningitis appear later. With viral meningitis, body temperature rises to moderate numbers, meningeal symptoms appear on the 2-3 or 5-7 seventh day from the onset of the disease. Children are bothered by an intense headache, which goes away after a diagnostic lumbar puncture and evacuation of a small amount of cerebrospinal fluid.

How is the treatment carried out?

Treatment of meningitis is performed using several methods:

• Antimicrobial. Used when illness is caused by germs.
• Antiviral. Here doctors prescribe interferon and glucocorticosteroids to block the spread of the virus and improve the functioning of the immune system.
• Antifungal. If the disease appears due to candida, then antimycotic medications are used.

Therapy is also aimed at eliminating symptoms, that is, they give pain-relieving injections, normalize body temperature, and eliminate intoxication and dehydration.

Prevention measures

Prevention of meningitis depends on the etiology. Patients are urgently hospitalized and isolated. Persons in contact with the sick person are examined for carriage and observed for 10 days.

To prevent a dangerous disease, immunization is carried out. There are several vaccines, both foreign and Russian. For example, the imported vaccine against pneumococcal meningitis “Prevenar” is approved for children from 3 months of age. Well tolerated and does not cause side effects. After completing the full course of vaccination, by the age of two years the child develops stable immunity.

Vaccinations against meningococcal infection are carried out with the Russian vaccine from 1.5 years, and the American vaccine from 2 years.

Vaccination is not included in the scheduled vaccination calendar; it is carried out according to indications or at the personal request of the parents.

Consequences

{banner_banstat7}
Severe consequences of meningitis are more often recorded in young children and with delayed treatment.

If the diagnosis is not made on time and therapy is delayed, dangerous complications develop: sepsis, endocarditis, pneumonia, abscess or cerebral edema.

The most common consequences of meningitis suffered in childhood:

• hydrocephalus;
• mental retardation;
• epileptic seizures;
• paresis;
• decreased or loss of hearing;
• damage to the cranial nerves.

Even with a successful outcome, after discharge the child experiences asthenoneurotic conditions: sleep disturbance, anxiety, headaches, memory loss, fatigue.