Brainstorming: How meningitis cripples health
Meningitis is so dangerous to health that the World Health Organization has even developed a roadmap to get rid of this infection as much as possible by 2030. Doctors dream of eliminating epidemics of the most insidious forms of the disease, reducing mortality from the disease and doing everything to improve the quality of life of patients who have been ill. Izvestia asked experts about the most common signs of meningitis and learned about the main preventive measures.
The main symptoms of meningitis
Meningitis is a general term for inflammation of the membranes of the brain and spinal cord, Andrey Matyukhin, chief specialist in the field of infectious diseases at the Be Healthy clinic network, explained to Izvestia. The different forms of this disease differ dramatically in their causes, course, treatment, and degree of danger. Meningitis requires a quick and accurate diagnosis, as the patient's life directly depends on the timeliness of treatment.
Meningitis can be primary and secondary, Denis Prokofiev, a general practitioner with the status of "Moscow Doctor," recalled in an interview with Izvestia. In the primary case, the pathogen affects only the meninges without previous infectious diseases in other organs. And the secondary one develops against the background of other diseases, as a complication of the infectious process.
— For example, with sinusitis, meningitis occurs after the bacterial background spreads from the nasal sinuses and its transfer to the meninges. Therefore, untreated sinusitis and sinusitis are really quite a high risk of meningitis, warns Prokofiev.
The first symptoms of meningitis include, first of all, high fever (often up to 39-40 degrees), chills, pain in muscles and joints, intense, bursting, thunderous headache, disruption of the nervous system, causing hypersensitivity to light (photophobia) and sounds (phonophobia). Such patients are also characterized by nausea and vomiting like a fountain, which does not bring relief. One of the main symptoms is the rigidity of the occipital muscles: a condition in which they seem to stiffen, lose elasticity, become stiff and overly tense.
— In infants, classical rigidity of the occipital muscles may be absent, — says Matyukhin. — Nonspecific signs come to the fore: constant monotonous crying, refusal to eat, regurgitation, bulging and tension of the large fontanel, lethargy or, conversely, severe anxiety.
However, other health problems may be hidden under the mask of meningitis, the infectious disease specialist warns. The condition of irritation of the brain or spinal cord, in which the symptoms characteristic of this disease are present, is called meningism. Muscle stiffness and headache due to high fever occur without real inflammation of the meninges, for example, with pneumonia and flu.
Doctors consider the analysis of cerebrospinal fluid obtained during lumbar puncture to be the main and most accurate method of diagnosing the disease. Cerebrospinal fluid analysis allows you to quickly and accurately diagnose, says Prokofiev.
It is very important for doctors to take into account not only the symptoms, but also the collection of medical history, the specialist adds. If a person with characteristic symptoms comes from Africa or other exotic countries, then they are most likely to have meningitis. In any case, the expert advises not to guess and not to delay time, but to urgently seek medical help.
Dirty hands and an airborne pathway
Doctors divide a dangerous disease according to the nature of the pathogen, the severity of clinical manifestations, the nature of inflammation and origin.
— Bacterial (purulent) meningitis is caused by meningococcus, pneumococcus, hemophilic bacillus type b (Hib), — says Andrey Matyukhin. — This is the most dangerous and rapid form. It develops acutely, sometimes lightning fast (in a matter of hours). It is transmitted by airborne droplets (coughing, sneezing, close contact). It is characterized by a high risk of complications.
Even adequate treatment in this case does not guarantee complete healing, the doctor emphasizes. Mortality in meningococcal meningitis is 10-15%, and in sepsis — up to 60%. Surviving patients may lose their hearing and eyesight, lose limbs, and suffer from epilepsy in the future. Infants are likely to have mental retardation and hydrocephalus.
"Viral (serous) meningitis is caused by enteroviruses (Coxsackie, ECHO), mumps viruses, and herpes," the source continues. — The inflammation proceeds with less pronounced symptoms and often ends in self-healing. The pathogen is transmitted mainly through dirty hands, water, food, and airborne droplets. Serious complications and deaths are extremely rare.
The least common, but some of the most severe forms of meningitis — fungal and protozoal — are caused by fungi of the genus Candida, Cryptococcus, and protozoa (toxoplasma). They develop gradually, are difficult and difficult to treat. They are most susceptible to people with severe immunodeficiency, as well as patients after transplantation, patients receiving chemotherapy and premature babies.
— Tuberculosis meningitis is caused by Mycobacterium tuberculosis, — adds Matyukhin. — The disease develops gradually, over a period of several weeks. Inflammation most often affects the base of the brain, which leads to characteristic complications. Without treatment, it always ends in death. Even with therapy, 25% of patients still have neurological disorders such as hydrocephalus, cranial nerve paralysis, epilepsy, and neuroendocrine disorders.
According to the expert, the most common cause of death in lightning—fast and severe purulent meningitis is swelling and swelling of the brain, in which its volume increases, but it is limited to the bones of the skull.
— There is a sharp increase in intracranial pressure, and the brain begins to shift towards the only natural opening — the large occipital. The tonsils of the cerebellum are wedged into the large occipital foramen and the respiratory and vasomotor centers located there are compressed. Respiratory and circulatory arrest occurs," the infectious disease specialist gives an example.
Why is immunity important?
Denis Prokofiev believes that it is almost impossible for a person with normal immunity to get meningitis after walking in cold weather without a hat or swimming in a dirty pond. But for people with weakened immune systems, this is an undeniable risk.
— But the most dangerous bacterial meningitis are meningococcal and tuberculosis, — warns the doctor. — Absolutely anyone can catch them, because the causative agents of such meningitis are very strong bacterial agents.
It is impossible to try to cope with the disease at home — it is deadly dangerous, the general practitioner emphasizes. Treatment is carried out exclusively in the hospital with the use of antibacterial and hormonal therapy, detoxification therapy.
— All members of the patient's family are prophylactically prescribed antibiotics. The scenario for the future depends on the speed of antibiotic use," the specialist points out.
The prognosis of survival for a patient diagnosed with meningitis is always very alarming. According to Dr. Prokofiev, the mortality rate is quite high, therefore, not only recovery, but also a person's life depends on the timely start of treatment. Follow-up of patients by doctors after meningitis lasts up to three years.
It is not only the disease itself that is terrible, but also its consequences, which can be so severe that the patient cannot avoid disability. Andrey Matyukhin emphasizes that their nature directly depends on the causative agent of the disease, the rate of initiation of therapy, the patient's age and what complications (for example, cerebral edema, vascular thrombosis) have developed.
— The most common complication of bacterial meningitis, which occurs in 10-30% of patients, is hearing loss, from mild loss to complete deafness, warns the infectious disease specialist.
In addition, due to damage to vital areas of the brain, patients may lose their eyesight - from strabismus and double vision to complete blindness.
"The consequences can also be motor and speech disorders: paresis and paralysis, which develop as a result of brain infarctions or during the formation of an abscess," Matyukhin continues. — And postmeningitis epilepsy can develop months or even years after recovery and requires constant intake of anticonvulsants.
Long after the illness, cognitive and behavioral disorders are also detected, which significantly affect the quality of life and socialization, especially in children, the Izvestia interlocutor adds. The IQ index decreases, there are difficulties with abstract and logical thinking, there are problems with memory and attention. School-age patients are characterized by forgetfulness, they are unable to concentrate, which inevitably causes learning difficulties. Also, those who have suffered from the disease eventually become hyperactive and aggressive, while others, on the contrary, are characterized by apathy and depression. The infectious disease specialist calls endocrine disorders among the serious disorders. In particular, for children, this is a threat of stunting and puberty.
— For many months and even years, those who have been ill may suffer from postmeningitis syndrome: frequent headaches (including migraine type), fatigue, weather dependence and poor tolerance to heat or physical exertion, — the specialist lists.
Who has meningitis
The infectious disease specialist calls vaccination the most effective method of protection against bacterial forms that pose a serious threat. It is also important to comply with general sanitary and hygienic standards and emergency chemoprophylaxis for those who have been in contact with the patient.
Doctors note that children (especially under the age of five), teenagers and students living in dormitories, as well as people with immunodeficiency and chronic diseases such as congenital immunodeficiency, HIV infection, diabetes mellitus, chronic heart, lung and kidney diseases are the most vulnerable.
— People with anatomical or functional asplenia, the absence of a spleen or a violation of its function, are at risk of infection. Travelers traveling to endemic regions such as the meningitis belt of Africa or the Middle East are at risk. There are also professional risk groups — medical workers, military personnel, laboratory staff, those who come into contact with patients in the foci of infection, warns Andrey Matyukhin.
According to the infectious disease specialist, general preventive measures are to avoid prolonged stay in crowded places, especially during periods of seasonal increase in morbidity, wash hands regularly and thoroughly with soap, ventilate rooms and carry out wet cleaning, and lead a healthy lifestyle to maintain immunity.
Переведено сервисом «Яндекс Переводчик»
