bacterial meningitis
Introduction
Introduction to bacterial meningitis Bacterial meningitis is a serious infectious disease of the central nervous system with a high incidence of mortality and sequelae. Adults are common, especially children. Many bacteria can cause this disease, of which meningococcal bacteria are the most, followed by influenza bacillus, pneumococcal, Escherichia coli and other Gram-positive bacilli, Staphylococcus, Lisi seedlings, anaerobic bacteria and so on. It can be caused by bacterial or viral infection. The symptoms of viral meningitis are very mild, but the symptoms of bacterial meningitis can be life-threatening. Children under the age of 5 are most likely to develop this disease. It usually occurs as a sporadic case. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: pericarditis, arrhythmia
Cause
Cause of bacterial meningitis
Bacterial infection (95%)
80% of bacterial meningitis is caused by the following three types of bacterial infections, namely Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae. Under normal circumstances, these bacteria are widely present in the external environment and can be parasitic in the human nose and respiratory tract without causing harm. Occasionally these pathogens can infect the central nervous system without a clear cause. Meningitis can also be caused by a penetrating penetrating injury or an abnormality of the autoimmune system. Bacterial meningitis is more likely to occur in patients who have alcohol, splenectomy, chronic ear and nasal infections, and pneumococcal pneumonia and sickle cell anemia.
Less common meningitis-causing bacteria are Escherichia coli (found in colon and feces) and Klebsiella. These bacterial infections can occur on the basis of head injury, brain or spinal surgery, extensive blood system infections or iatrogenic infections. However, patients with immune system dysfunction are more susceptible to infection. Patients with renal failure and taking corticosteroids are more likely to develop Listeria bacterial meningitis.
Meningitis is more common in infants from 1 month to 2 years of age. Adults have a much lower chance of developing meningitis unless there are special risk factors. In close contact with people, such as military training camps, college dormitory, there may be a small epidemic of meningococcal meningitis.
Prevention
Bacterial meningitis prevention
Routine immunization can prevent infection with Haemophilus influenzae. Immunization can also prevent meningococcal meningitis in a short period of time and can be used in epidemic encephalitis. Taking antibiotics in children who are in close contact with children is another way to prevent the spread of bacterial meningitis.
Complication
Bacterial meningitis complications Complications pericarditis arrhythmia
Concurrent pericarditis, arrhythmia.
Symptom
Bacterial meningitis symptoms Common symptoms Hypotension irritability Uneasy neck straight coma convulsions
The main early symptoms of bacterial meningitis are fever, headache, neck stiffness, sore throat, vomiting, often accompanied by respiratory diseases, neck stiffness does not necessarily have pain, but when the ankle is close to the chest, it can cause pain or can not be close . The above symptoms can reach a peak in adults within 24 hours, and children may take longer. Adolescents and adults can manifest as irritability, confusion, lethargy, and develop into stupor, coma, and even death. Infection can cause edema in the brain tissue, hinder blood flow, and cause stroke-like symptoms. Some people have seizures. Waterhouse-Friderichsen's syndrome ( progressive progressive infection caused by Neisseria) manifests as severe nausea, vomiting, internal bleeding, hypotension, shock, and even death.
Meningitis in children under two years of age can be characterized by fever, refusal to eat, vomiting, irritability, convulsions, crying loudly, and tension or even bulging. Obstruction of cerebrospinal fluid circulation can cause enlarged cranial cavity (hydrocephalus). Infant meningitis under 1 year of age is not like adolescents and adults, and neck stiffness cannot occur.
Examine
Examination of bacterial meningitis
1, peripheral blood examination: the elderly due to decreased immune function, the total number of white blood cells can not be high, but the neutral classification often increases.
2, cerebrospinal fluid examination: typical bacterial meningitis cerebrospinal fluid: appearance turbid or pus-like, increased pressure, protein quantitatively increased, up to 1000 ~ 5000mg / L or more, sugar content decreased, generally 0.055 ~ 0.1mmol / L, and even Lower. When measuring the content of cerebrospinal fluid, blood glucose should be measured at the same time. When meningitis aggravates diabetes, the sugar content in cerebrospinal fluid can be increased or normal. Chloride is reduced. The total number of white blood cells is mostly (500 ~ 1000) × 106 / L, mainly neutral. Gram smears and bacterial cultures can be found in the corresponding pathogens.
3, imaging examination: generally should start after treatment, the condition is stable and then proceed. There may be inflammatory changes in the sinus and chest. In general, there was no obvious abnormality in CT scan of bacterial meningitis. In some patients, the enhancement of the cerebellum was obvious and patchy enhancement.
Diagnosis
Diagnosis and identification of bacterial meningitis
Diagnosis of bacterial meningitis:
Due to the high mortality rate of bacterial meningitis, especially Neisseria meningitis can cause death within a few hours, it must be given high priority. Children over the age of two with unexplained fever, irritability, lethargy, refusal to eat, vomiting, convulsions, neck stiffness should consider the possibility of the disease. Antibiotics should be given before the results of the test.
lumbar puncture
A hollow needle was inserted into the 3rd and 4th lumbar vertebrae near the end of the spinal cord, the ridge was dropped into the test tube, and the specimen was sent to the laboratory for examination.
Special attention should be paid to abnormal rashes (usually red or purple spots), bun, neck stiffness and other meningeal irritation. One sign is that when the child's head is bent to the chest, the hip and knee are involuntarily bent; the other is that when the patient's thigh is flexed, the doctor has a greater resistance to the knee that is bent and bent.
Once clinically suspected of bacterial meningitis, it must be quickly determined that the source of infection is a bacterial, viral or other type of infection. Different treatments are taken according to different causes.
In order to clearly diagnose bacterial meningitis and determine pathogenic bacteria, lumbar puncture can be performed. The cerebrospinal fluid is taken, and the sugar, protein, white blood cell count and classification, pathogenic bacteria are examined, and cultured to treat different pathogens with different antibiotics.
In addition to waist wear, blood, urine, vomit, and pharyngeal test paper can be cultured to check skin pus to help diagnose.
