otogenic meningitis
Introduction
Introduction to otogenic meningitis Otogenic meningitis (otogenic meningitis) is an acute or chronic suppurative otitis media with pia mater, arachnoid acute suppurative inflammation. The disease is characterized by high fever, headache and vomiting. There may be chills when the disease starts, followed by fever, body temperature can be as high as 40 °C, headache is severe, diffuse full headache, often the occipital is heavy, vomiting is jetting Shape, not related to diet. It can also be accompanied by mental and neurological symptoms: irritability, convulsions, severe cramps, coma, and related cranial nerve palsy. Otogenic meningitis is treated with adequate antibiotics (penicillin, cephalosporin, levofloxacin) and sulfa drugs to control the mastoid exploration, radical surgery, remove the lesions, remove the bone plate to normal meningeal exposure If necessary, lumbar puncture, inject appropriate amount of antibiotics; at the same time pay attention to supportive therapy and water and electrolyte balance. basic knowledge The proportion of illness: 0.0007% Susceptible people: no specific population Mode of infection: non-infectious Complications: chronic suppurative otitis media
Cause
Etiology of otogenic meningitis
It is a common intracranial complication. The middle ear infection can directly invade the pia mater and the arachnoid membrane through various routes, and can also pass other complications (such as suppurative labyrinthitis, sigmoid sinus thrombophlebitis, Brain abscess, etc.) indirectly causes soft meningitis.
Prevention
Otogenic meningitis prevention
1. Nursing staff should pay close attention to observe changes in the condition.
2, the hospital should be quiet, soft light, air circulation, but avoid direct air blowing, winter anti-cold, summer heat and sunlight.
3, pay attention to oral hygiene, you can use fresh salt soup or silver flower water to gargle, such as those with dentures, take out.
4. Drink plenty of water.
5, for those who are unconscious, pay attention to sputum, prevent their tongues from falling, take the lateral position to keep their respiratory tract unobstructed, prevent sputum blocking the throat, when too much, promptly pump.
6, for the eyes can not be closed, the eye is coated with eye ointment, and gently massage to make it closed.
7, when coma, avoid feeding from the mouth, you can use nasal feeding to supply drugs or juice food.
8. If you have difficulty breathing, you should give oxygen immediately.
9, those who have incontinence, change the bedding in time, vomit should also be removed in time.
10. After the symptoms disappear during the recovery period, gradually resume activities, and be careful not to be too early or excessively active.
Complication
Otitis meningitis complications Complications chronic suppurative otitis media
Usually appear as a complication of chronic suppurative otitis media and mastoiditis, referred to as otogenic complications.
Symptom
Otogenic meningitis symptoms Common symptoms Sleepiness, loss of appetite, high fever, chills, severe headache, convulsions, skin ecchymosis
(1) With high fever, headache and vomiting as the main symptoms, there may be chills at the onset, followed by fever, body temperature can be as high as 40 °C, headache is severe, diffuse full headache, often occipital weight, vomiting Spray, not related to diet.
(B) can be associated with mental and neurological symptoms: such as irritability, convulsions, severe convulsions, coma, and related cranial nerve palsy.
Examine
Examination of otogenic meningitis
(1) Meningeal irritation: neck resistant to resistin or neck stiffness, even angulation, Kerning and Brudzinskin positive.
(2) Cerebrospinal fluid pressure increased, turbidity, increased number of cells, mainly polymorphonuclear leukocytes, increased protein content, reduced sugar content, reduced chloride, bacterial culture can be positive, blood leukocytosis, polymorphonuclear leukocytes increased.
Diagnosis
Diagnosis and differentiation of otogenic meningitis
Need to be identified with other types of meningitis, such as epidemic meningitis.
