To be able to recognize signs of meningitis in children should all parents, since the danger of getting sick is about 10 times higher in childhood. If the child does not provide timely medical assistance, the consequences can be catastrophic, even to a lethal outcome.
Causative agent of meningitis
Meningitis is a group of diseases in which inflammation of the membranes of the brain or spinal cord occurs. Inflammation of soft or spider webs is called leptomeningitis, solid shells - pachymeningitis. Before the invention of vaccines and antibiotics in the early 20th century, mortality in the diagnosis of purulent meningitis in children was about 90%. So far, in countries of West Africa (the "meningitis belt" area) outbreaks of this disease occur with thousands of infected.
Meningitis is both an independent disease (primary meningitis) and a form of complication (secondary meningitis). Infection can occur by airborne droplets, through dirty hands, food, water. To get into the body infection can and through open wounds, venous catheters. Often, infection with the causative agent of meningitis occurs against a background of reduced immunity or already existing diseases of the central nervous system - cerebral palsy, cysts in the brain.
The causative agents of meningitis are:
- viruses;
- bacteria;
- fungi;
- spirochaetes;
- malarial plasmodium and toxoplasma .
Causes of meningitis in children
Viral meningitis in children is more common than other forms. Viruses are the causes of meningitis:
- enteroviruses, including Coxsackie ;
- viruses of influenza, chicken pox, shingles;
- Arboviruses, including encephalitis virus,
- herpes viruses of the 1 st and 2 nd types;
- mumps virus;
- cytomegalovirus .
Bacterial meningitis in children and adults causes:
- meningococcus ;
- Pneumococcus;
- staphylococcus aureus;
- Listeria (with weak immunity and in the elderly);
- tubercle bacillus (causes secondary meningitis);
- E. coli (a common cause of meningitis in newborns);
- Haemophilus influenzae .
From fungi cause meningitis in children can:
- cryptococci;
- Candidates.
Spirochaetes that cause meningitis are:
- pale treponema, causing syphilis;
- Borrelia, which causes Lyme disease;
- Leptospira.
How to recognize meningitis - symptoms in children
To know how meningitis develops in children, it is necessary to learn the main signs of the disease, which include:
- high fever and chills;
- headache;
- pain in the muscles of the neck;
- drowsiness, unconsciousness;
- vomiting;
- photophobia;
- stiff neck.
Symptoms of some forms of meningitis in children:
- rash on the skin;
- convulsions;
- anxiety;
- increased excitability;
- mental disorders.
The incubation period of meningitis in children
When the disease is meningitis in children, the symptoms and symptoms manifest themselves swiftly, but often are similar to manifestations of other diseases. Meanwhile, the danger of meningitis requires immediate hospitalization, and the sooner this happens, the more favorable the forecast will be. The duration of the incubation period of the disease depends on many factors, including the state of the immune system, and can vary from 2 to 10 days. The onset of the disease is acute.
The first signs of meningitis in children
The main sign of meningitis is headache, which is read from the first days of the disease and continues almost to recovery. Often the headache is accompanied by a "bubbling" vomiting without nausea, which does not bring relief to the patient. The localization of pain is different - especially often in the forehead or in the neck, sometimes the pain is diffuse. The severity of the pain syndrome may vary, but the most severe is a headache in tuberculous meningitis. From noise and light, the pain syndrome always increases.
The first sign of meningitis in children in the vast majority of cases is high fever. With purulent meningitis, the temperature rises to critical values - 40-41ºС, with serous meningitis and some other types of the disease, the temperature is raised less pronounced, with syphilitic meningitis the temperature is normal. Chills in the disease occurs if the temperature of the skin decreases at an elevated body temperature - this phenomenon with meningitis can also be the first sign of the disease.
Rash with meningitis in children
A typical rash with meningitis appears in about a quarter of cases of the disease and is almost always a sign of the meningococcal type of the disease. With this type of disease, bacteria damage the vessel walls, and 14-20 hours after the onset of the disease, hemorrhagic rash (hemorrhage) appears. Rash with meningitis in children - photos and characteristic signs:
- red or red-violet color;
- irregular "stellate" form, tendency to merge spots;
- when pressing on the skin with a glass wall, the rash does not turn pale and the birch glass is visible (this is one of the diagnostic methods);
- localization - on the limbs and sides, the appearance of a rash on the face is a very bad symptom.
Meningeal syndromes
Exactly answer the question of how to recognize meningitis in a child will help symptoms that are characteristic only of this disease. Meningeal syndrome includes such signs:
- Rigidity of neck muscles. When checking the syndrome, the doctor asks to put the child on his back, with one hand gently presses his chest, and the other - bends his head to his chest. Because of the rigidity of the muscles, this movement is painful for the child.
- Reflex muscle tension. This syndrome can be observed in a sleeping child who takes an uncharacteristic pose of a "cocked cock" - the body is arched, the head is thrown back, the hands are pressed to the chest, the legs - to the stomach.
- Symptom of Brudzinsky. Checked in the supine position on the back - if the child lift his head, his legs in the hip and knee joints will reflexively reflex. With the passive bending of one leg in the hip and knee joints, the other will be reflexively reflexed.
- Kerning Symptom. Check lying on the back - if the child bend the leg with the hip and knee joints, and then try to straighten the knee joint - this action will not work.
- Symptom of Lesage. If the child is lifted by holding the armpits, his legs will be pulled to the stomach.
- Symptom Flatau. With a sharp raising of the child's head forward from the prone position, the pupil will expand. In this way, the signs of meningitis in children are checked mainly in infants.
Characteristic for meningitis are:
- seizures - by epileptic type or in the form of a small tremor;
- drowsiness (observed in 70% of cases) - begins due to the inhibition of brain functions, in addition - there is a depression of vital centers and the patient develops dyspnea, lowering blood pressure;
- excitation - can be observed at the onset of the disease, but more often - begins on the 4th-5th day, accompanied by disorientation;
- delusions, hallucinations, fears - the symptoms of psychosis vary with different types of infection, often intensify with increasing temperature.
Meningitis - symptoms in children under one year of age
It is almost impossible to diagnose meningitis in children under the symptoms of Brudzinsky, Kerning and Lesage because they have a general muscle tone, so doctors with suspicion of meningitis in children under the age of one check them on the Flautau symptom. In addition, doctors inspect a large fontanel of newborns - with meningitis, it strongly strains, swells. Another characteristic sign of meningitis in a child of the first year of life is a hydrocephalic cry (sharp screaming amid unconsciousness or confused consciousness). A sick child can:
- cry;
- tremble;
- Too much sleep;
- his skin becomes pale;
- on the head there is clearly a venous setochka.
Meningitis in children - diagnosis
Complex diagnosis of meningitis includes a survey, laboratory and instrumental studies, neurological examination. During the questioning, the doctor finds out the existing or recently transferred diseases, separately specifying the presence of such diagnoses as tuberculosis, rheumatism, syphilis. It is important to inform the doctor if the child has recently had the flu, otitis media, sinusitis, sinusitis, pneumonia, pharyngitis, undergone surgical intervention, injured, traveled to another country, received antibiotic or antiviral medication.
Neurologic examination allows to reveal the characteristic signs of meningitis in children. First, the doctor checks the symptoms of Brudzinsky, Kerning, Lesage, Flatau, looks, whether there is rigidity of muscles. In addition, soreness and sensitivity are investigated - they are increased with meningitis. It is compulsory for the doctor to conduct an examination of the cranial nerves, which are damaged during meningitis.
Instrumental research for the detection of signs of meningitis in children includes an electroencephalogram and computed tomography. The number of laboratory tests includes general and biochemical blood tests, PCR or latex test, cerebrospinal puncture, analysis of cerebrospinal fluid. Varieties of meningitis on the pathological morphology of cerebrospinal fluid:
- serous meningitis in children - the number of lymphocytes in the cerebrospinal fluid increased, the membranes of the brain swollen;
- purulent meningitis in children - in the cerebrospinal fluid a high content of neutrophils, high protein content, brain envelopes - purulent, compacted.
Meningitis in a child - treatment
If the study revealed signs of meningitis in children, the patient is given urgent treatment in a hospital. Since independent treatment of meningitis in children can lead to serious health consequences, a qualified physician should prescribe medications. Meningitis therapy includes treatment aimed at:
- destruction of a bacterial, viral or other infection;
- elimination of cerebral edema and increased intracranial pressure;
- elimination of certain pathological symptoms - restoration of the liquid level, reduction of temperature, pain and seizures, elimination of oxygen starvation.
Consequences of meningitis in children
The negative consequences of meningitis in the absence of adequate treatment can be catastrophic. Children may have mental, auditory, speech disorders, convulsive seizures, hydrocephalus, facial nerve damage, as well as serious complications in the form of paralysis or paresis, deafness, blindness, dementia. Often after the meningitis has passed, the child has headaches and increased intracranial pressure, mental and intellectual development is delayed, strabismus, ptosis (eyelid depression), asymmetry of the face can develop.
Prevention of meningitis in children
Preventive measures against meningitis are divided into two groups - specific and nonspecific. The first category includes vaccination:
- Meningococcal vaccine - an inoculation against meningitis to children of 10-12 years provides protection from a number of pathogenic microorganisms, additionally recommended to people who visit other countries, students, recruits.
- The vaccine from Haemophilus influenzae B is given to children aged 2-5 months.
- Pneumococcal vaccine - there are two types: for children under 2 years and for the elderly.
- Vaccines against measles, mumps, chickenpox, measles rubella are done to minimize the risk of meningitis in the background of these diseases.
Nonspecific prevention of meningitis includes:
- strengthening immunity;
- adherence to hygiene rules;
- normalization of nutrition;
- minimizing the possibility of becoming infected in crowded places;
- protection against insects that can carry the infection;
- bathing only in proven water bodies;
- timely vaccination when going on vacation;
- timely and complete cure for cold and viral diseases.