Haemophilus influenzae meningitis
Introduction
Introduction to Haemophilus influenzae meningitis In 1892, Pfeiter was isolated from the nasopharynx secretion of a flu patient. The majority of influenza bacilli meningitis was caused by influenza B bacteria. The influenza bacilli are generally found in the upper respiratory tract of humans, according to the capsular polysaccharide antigen component. The difference is that the type-specific immune serum is used for the capsular swelling test, and the bacteria are divided into six serotypes, namely, a, b, c, d, e and f types, wherein the type B bacteria cause disease to humans (infants). The sex is the strongest. Influenza bacilli only invade humans, and the age of onset is mainly from 3 months to 3 years old. Because infants within 2 months have bactericidal antibodies from the mother, they are rarely sick, and then grow with the mother. The specific bactericidal antibody is decreased, and it has not yet produced sufficient antibodies, so it is susceptible to the disease. Children and adults over the age of 5 rarely develop symptoms. For example, after the age of 5, the patient should pay attention to check whether there is anatomy and immunodeficiency. The disease can occur throughout the year, but it is the most in autumn and winter. There are also two reports of children in the family. basic knowledge The proportion of illness: 0.003% Susceptible people: good for children under 5 years old Mode of infection: non-infectious Complications: hydrocephalus brain abscess
Cause
Haemophilus influenzae meningitis etiology
(1) Causes of the disease
Most of the influenza bacilli meningitis is caused by influenza B bacteria. The influenza bacilli are generally found in the upper respiratory tract of humans. According to the different antigen components of capsular polysaccharide, the type-specific immune serum is used for the capsular swelling test. Divided into six serotypes, namely a, b, c, d, e and f type, of which type B is the most pathogenic to humans (infants), influenza bacilli only invade humans, the age of onset is 3 months to 3 Older babies are the mainstay, because infants within 2 months have bactericidal antibodies from the mother, so they are rarely ill, and then with age, the specific bactericidal antibodies from the mother decline, but they have not yet produced enough Antibody, it is susceptible to this disease.
(two) pathogenesis
The pathogenic factor of influenza B type is related to the capsule. Influenza bacilli invade the body through the respiratory tract, causing nasopharyngitis. The infection spreads from the local area, involving the sinus and middle ear. The bacteria invade the blood circulation to form sepsis, and the meninges are the most common invasion through the blood circulation. Pathway, otitis media, mastoid inflammation bacteria can directly invade the meninges, bacteria invade the meninges and cause arachnoid and pia mater inflammation, the beginning of purulent exudate mostly at the top of the brain, and then spread to the brain and spinal membrane, sometimes involving Brain parenchyma, producing encephalitis and brain abscess.
Prevention
Haemophilus influenzae meningitis prevention
Usually, we should establish a good living system, more sunshine, more fresh air, more outdoor activities, enhance resistance, prevent respiratory infections, use influenza vaccine to prevent injection, and have a protective effect on susceptible infants.
Complication
Haemophilus influenzae meningitis complications Complications hydrocephalus brain abscess
There are subdural effusion, hydrocephalus, brain abscess and so on.
Symptom
Haemophilus influenzae meningitis symptoms common symptoms nausea and vomiting hydrocephalus ataxia drowsiness neck tonic brain abscess meningitis deafness repeated upper respiratory tract infection coma
The onset is slower. There are obvious upper respiratory tract infections in the early stage of the disease, pneumonia or symptoms of middle ear inflammation. After several days to one or two weeks, meningitis symptoms appear. Most of the children have fever, vomiting, lethargy, coma, convulsions, and neck stiffness. And the performance of anterior iliac bulging, occasionally skin, mucous membrane defects, complications such as subdural effusion, hydrocephalus, brain abscess, etc., mainly subdural effusion (various suppurative meningitis can occur, However, it is more common in influenza bacillus meningitis. It usually occurs in infants under 1 year old, and there is no symptom of subdural effusion, but there is also a rise in fever or a rise in body temperature after several days of treatment; or symptoms After getting better, there will be convulsions, vomiting, anterior sacral bulging and head circumference. At this time, cranial X-ray examination and subdural puncture should be used to assist diagnosis. In severe cases, sequelae may be left behind, such as ataxia, paralysis, blindness, deafness, Mental retardation, etc.
Examine
Examination of Haemophilus influenzae meningitis
Cerebrospinal fluid routine is similar to other bacterial meningitis. Gram-negative bacilli are often seen on smear. The positive rate is higher than that of meningitis, and the positive rate of blood culture is also high. The capsular swelling test can identify influenza bacillus type, sputum cell lysate. The test results of endotoxin in cerebrospinal fluid, positive results contribute to the diagnosis of this disease. In recent years, convective electrophoresis, latex agglutination test, ELISA and other immunological methods are used to detect the capsular polysaccharide antigen in cerebrospinal fluid, which can quickly make a pathogenic diagnosis. The positive rate can be Up to 80%.
An abnormality can be found on the skull X-ray.
Diagnosis
Diagnosis and identification of Haemophilus influenzae meningitis
diagnosis
Cerebrospinal fluid smear and culture positive are the main basis for diagnosis.
Differential diagnosis
This disease should be distinguished from pneumococcal meningitis.
