Reactive meningitis – what is it?

Update: October 2018

They know about meningitis as a very serious, dangerous disease.
many. But reactive meningitis – what is it and why is it
appears, they know not all. Moreover, an interesting situation has developed
in the Russian-language Internet with this term, where is the disease
identified with a high rate of its development, comparing with
speed, for example, jet aircraft.

The phrase “reactive meningitis”, as expected,
associated with the Latin language, and not with terminology from
aerospace industry. Under the jet process in
In this case, it is necessary to understand not the speed of its progression, but
recoil-type inflammation
inflammatory process. Examples of such inflammation
become:

  • reactive arthritis with chlamydial infection of the genitourinary system
    or intestinal infection
  • reactive pancreatitis on the background of peptic ulcer 12-duodenal
    guts.

The role of infectious agents in the development of reactive
meningitis fades into the background and comes to the fore
aseptic inflammation and autoimmune processes in the brain
shells.

Реактивный менингит - что это такое?

  • A striking example of aseptic meningitis is a medicinal
    meningitis. It can be caused by the introduction of nonsteroid
    anti-inflammatory, carbamazepine, isoniazid, penicillin,
    ciprofloxacin, ranitidine, azathioprine, trimethoprim. With the introduction of
    spinal canal of antibiotics, air, drugs for
    chemotherapy, anesthetics can respond to the lining of the brain. With
    this meningitis develops the type of allergic reaction
    hypersensitivity.
  • With бактериальном или вирусном процессе в организме
    infectious agents may not penetrate the meninges, but
    products of their decay or vital activity cause systemic
    vascular lesion (vasculitis) and reactive pleocytosis in
    cerebrospinal fluid. Reactive meningitis may accompany
    brucellosis, toxoplasmosis, leptospirosis, tuberculosis, syphilis,
    mycoplasmosis, venereal granuloma, chickenpox, parotitis,
    infectious mononucleosis, HIV, cytomegalovirus infection,
    poliomyelitis, enterovirus infection.
  • Vaccine reactions are another cause of reactive
    meningitis. After vaccination against whooping cough, rabies, measles, polio
    cases of reaction of a meninx were observed.
  • Against the background of CNS tumors: craniopharygiomas, brain tumors,
    meningeal leukemia, dura mater tumors or
    sarcoidosis, multiple sclerosis, Behcet’s disease in the cerebrospinal fluid may
    to get a pathological effusion with cells characteristic of
    changes in meningitis.
  • Extensive ischemic foci (with strokes) are often given near
    yourself reactive changes that can affect and shell
    the brain.
  • Another case of reactive meningitis is cyst breakthrough.
    (eg, echinococcal) or abscesses of the brain, subarachnoid
    hemorrhage.
  • The diagnosis of reactive meningitis is often made premature.
    newborn after hypoxia in labor, intracranial
    hemorrhages when laboratory methods fail to isolate
    возбудителя, но присутствует клиника meningitis.

Among bacterial infections affecting the lining of the brain, more often
just emit: meningococci, pneumococci, streptococci.
Meningococcal infection is most often the causative agent.
первичного менингита,  20% случаев которого протекает с
fatal. Meningococcal disease is one of the most
�“Unmanaged infections” that cause both isolated cases and
epidemic outbreaks of the disease.

Reactive meningitis may occur on the background of streptococcal,
pneumococcal and other infections when it penetrates into the brain
shell with blood flow from the inflammatory focus in the nasopharynx,
bronchi, trachea. Usually the infection occurs when
the occurrence in the body of infectious foci – pneumonia, otitis,
sinusitis, sinusitis, bronchiectasis, furunculosis, etc.

Symptoms of reactive meningitis

  • High body temperature, chills. In patients with
    reactive meningitis, there is a two-humped temperature curve,
    that is, an increase in body temperature to 40 degrees at the beginning
    the disease is quickly susceptible to the action of antipyretic drugs, and
    a few hours later, with a sharp repeated temperature jump,
    antipyretics are completely ineffective.
  • Интенсивная головная боль, распирающая, по
    whole head, aggravated by movement, sudden noise or light
    irritant.
  • Рвота, она возникает с первых часов болезни,
    exhausting, multiple, not associated with eating.
  • Мышечные боли, у маленьких детей также
    possible occurrence of clonic-tonic
    судорог.
  • The characteristic symptoms of meningitis are meningeal signs,
    neck stiffness, Kernig symptoms, Brudzinsky symptoms
    not always all can be present in the complex (see signs
    meningitis).
  • Withзнаки шока: тахикардия, артериальная
    hypotension, cold skin with high body temperature, foot and
    brushes of the patient get an ashy shade.
  • Возбуждение, беспокойство, которые появляются
    в первые часы болезни, сменяются спутанностью
    сознания
    , прострацией и комой. There is shortness of breath,
    hypoxemia oliguria, other respiratory manifestations
    distress syndrome.
  • Некоторые пациенты умирают от серьезных неврологических
    изменений
    , вызванных повышением внутричерепного
    pressure.
  • Кожа становится серого оттенка, при
    meningococcal infection appears and spreads rapidly
    сыпь, которая сначала пятнисто-папулезная, а затем
    acquires hemorrhagic nature. Localized rash most often
    on the lower limbs, on the body, on the buttocks and in the area of ​​large
    joints.
  • ДВС-синдром (синдром диссеминированного
    intravascular coagulation) develops in the absence
    adequate treatment and increase of manifestations of septic shock. With
    this rash becomes necrotic, draining character, appear
    Collaptoid spots, gangrene of toes and hands develops,
    hemorrhages in the sclera, mucous membranes of the mouth,
    conjunctiva, the death of the patient comes from polyorgan
    failure and refractory septic shock.

Diagnosis and treatment of reactive meningitis

Any signs of meningitis, especially the appearance of a rash,
fever, catarrhal phenomena should be suspicious by
against meningococcal infection. Sick child or adult
must be urgently hospitalized to provide
intensive care.

Using the analysis of cerebrospinal fluid method lumbar
punctures detect the causative agent of meningitis, which allows
establish a diagnosis. In general, the analysis of blood leukocyte elevation,
increased ESR. Urine with meningitis is usually dark in color.
detect the elements of blood and protein.

Treatment of meningitis should be carried out in intensive care units.
therapy immediately, the patient is administered intravenous saline
solutions, plasma substitutes, antipyretic, with acute
adrenal insufficiency may assign
corticosteroids, muscle spasms and convulsions – muscle relaxants,
antispasmodics, diazepam.

Intramuscularly administered strictly on the clock maximum doses
antibiotics, most often cephalosporins, penicillins or macrolides.
With шоковом состоянии пациента все препараты вводятся только
intravenously.  With нарастании тяжести состояния больного
antimicrobial agents are injected directly into the spinal
channel. In order to avoid cerebral edema, furosemide is prescribed, and in the presence of
clinical symptoms of cerebral edema in the composition of infusion therapy
sorbilact is included.

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