Bacterial meningitis is caused by the transmission of certain bacteria. There are 3 types, Haemophilus influenzae type B, Neisseria meningitidis (diplococcus) and Streptococcus pneumoniae (pneumococcus). About 80% are bacterial meningitis. Usually a small percentage of healthy people carry these germs in the nose or on the surface of the body and do not attack the body, he spreads through coughing or sneezing. Some studies have suggested that people are most susceptible to catching the germs when they have a cold, because an inflamed nose makes it extremely easy for the bacteria to get inside the skull.
Tuberculous meningitis is a nonsuppurative inflammation of the meninges caused by Mycobacterium tuberculosis, which accounts for about 6 percent of systemic tuberculosis. Mycobacterium tuberculosis infection spreads through the blood and then plants under the soft meninges to form tuberculous nodules, and a large number of tuberculosis bacilli enter the subarachnoid space after the nodules break down. In recent years, the morbidity and mortality of tuberculous meningitis have increased. Early diagnosis and treatment can improve the efficacy and reduce the mortality rate.
Viral meningitis can be caused by several viruses, including several viruses associated with diarrhea, one of which may be infected by a bite from a vole, for example.
Cryptococcal meningitis: can also be caused by fungi. The most common type is Cryptococcus, which can be found in pigeons. Healthy people are less susceptible to fungal-related meningitis, but not those infected with HIV, a human immunodeficiency virus that can cause AIDS.
Bacterial meningitis is a life-threatening illness that should be treated immediately. You should go to the emergency room as soon as symptoms appear. Routine treatment If you develop meningitis, you should go to the hospital until the infection is completely eradicated, which takes about 2 weeks. If you contract bacterial meningitis, high doses of antibacterial medication will be used, intravenously. Antibiotics are widely used to treat bacterial meningitis. Because antibiotics do not work for viral meningitis, antiviral medications should be added. Infusion and rest therapy is used. Because meningitis is contagious, it will be isolated for at least 48 hours. Large amounts of fluids should be ingested and aspirin should be given to reduce fever and headache. The doctor may need to drain the patient's infected sinus area and mastoid (the bone behind the ear) to prevent reinfection. If you have pneumococcal meningitis, your doctor may give prophylactic antibiotic injections to more exposed people. When a small epidemic of meningitis occurs some people will be injected with the vaccine used to combat diphtheria meningitis, likewise private individuals traveling overseas to a meningitis endemic risk area, such as by the Sahara Desert in Africa. Further, the vaccine against Haemophilus influenzae type 6 is now a fixture of childhood immunization.
Adjunctive treatment. Because meningitis is fast-onset and life-threatening, you should receive emergency treatment before resorting to choice therapy. The intent of Choice Therapy is to help you recover and rebuild your immune system to prevent recurrence. Undergo biofeedback therapy, undergo systemic therapy or see a Traditional Chinese Medicine (TCM) practitioner. The herbalist may recommend acupuncture and needle pressure or a combination of herbal therapies to increase your immunity.
Nutrition and diet
To maintain a healthy immune system and prevent reinfection with meningitis, eat nutritious recipes that are low in fat and high in fiber, avoiding sugar and processed foods as much as possible. Vitamin A (2,500 to 10,000 international units per day), compounded vitamin B (500 milligrams taken three times a day), and vitamin C (500 to 2,000 milligrams per day).
Differential diagnosis of meningitis
1. Septic meningitis: one of the most confusing is Haemophilus influenzae meningitis, as it is most common in children under 2 years of age, and the cerebrospinal fluid cell count is sometimes not very high. The next most common are meningococcal meningitis and pneumococcal meningitis. In addition to the history of tuberculosis exposure, tuberculin reaction and lung X-ray examination can help diagnosis, the important thing is the cerebrospinal fluid examination, in the cell count is higher than the other, the important thing is the cerebrospinal fluid examination, in the cell count is higher than 1000 × 106 / L (1000/mm2), and classification of neutral polymorphonuclear granulocytes accounted for most of the time, since it should be considered suppurative meningitis; but more importantly is the cytological examination.
2. Viral central nervous system infections: mainly viral encephalitis, viral meningoencephalitis and viral myelitis can be confused with meningoencephalitis, in which disseminated viral encephalitis is more important to distinguish than epidemic. The diagnostic points of various viral meningitis are: ① there is often a specific epidemic season. ④ Various viral encephalitis or meningitis have their own specific laboratory diagnostic methods, such as serologic examination and virus isolation (refer to the relevant special chapters). Mild viral encephalitis and early conjunctivitis is difficult to distinguish, the principle of treatment is: ① first with anti-tuberculosis drug treatment, at the same time to carry out various tests, such as conjunctivitis test, lung X-ray, etc. to assist in the diagnosis. If the cerebrospinal fluid returns to normal in a short period of time, it is more likely to be viral encephalitis rather than cerebral node. ③ Intrathecal injection of any drug, so as not to cause changes in the composition of the cerebrospinal fluid to increase the difficulty of differential diagnosis.
3. New type of cryptococcal meningoencephalitis: its clinical manifestations, chronic course and cerebrospinal fluid changes can be similar to cerebral tuberculosis, but the course of the disease is longer, and can be accompanied by spontaneous remission. Chronic progressive cranial hypertension is more prominent and unequal to other manifestations of meningitis. The disease is rare in germanium and is therefore easily misdiagnosed as cerebral nodes. Confirmation of the diagnosis depends on cerebrospinal fluid smear, with ink staining black ground reflecting light method can be seen round, with thick pods refractive cryptococcal spores, Shabao medium with a new type of cryptococcal growth.
4. Brain abscess: children with brain abscess have a history of otitis media or head trauma, sometimes secondary to sepsis. Often accompanied by congenital heart disease. In addition to meningitis and symptoms of high cranial pressure, children with brain abscess often have focal brain signs. Cerebrospinal fluid changes may range from normal to hundreds of cells, mostly lymphocytes, with mostly normal sugars and chlorides and normal or elevated proteins in the absence of secondary septic meningitis. Differential diagnosis is made with the help of ultrasound, EEG, brain CT and cerebral angiography.
5. However, the differences between brain tumor and cerebral tuberculosis are: ① Fever is less common. ② Convulsions are less common, and even if there are convulsions, most of them are clear after convulsions, which is different from that of the children with advanced encephalocele who fall into coma after convulsions. Coma is rare. Symptoms of high cranial pressure are not parallel to cerebral signs. Cerebrospinal fluid changes are rare or mild. The cerebrospinal fluid changes are rare or mild. ⑥ The conjugate test is negative and the lungs are normal. In order to confirm the diagnosis of brain tumor, CT scan of the brain should be performed promptly to assist the diagnosis.
Typical nodes are easy to diagnose, but some atypical ones are more difficult to diagnose. Atypical cerebral neuromas can be found in the following cases: ① infants and young children have a rapid onset of the disease, and the progression of the disease is relatively fast, and sometimes convulsions can be the first symptom. ② Early onset of cerebral parenchymal damage, manifested as chorea or mental disorders. (iii) Early appearance of cerebrovascular damage, manifested as limb paralysis. (iv) When combined with cerebral tuberculosis tumor at the same time, it may seem like intracranial tumor manifestation. ⑤ Extreme severity of tuberculosis lesions in other parts of the body may mask the signs and symptoms of meningitis and cannot be easily recognized. ⑥ When meningitis occurs in the course of anti-tuberculosis treatment, it often manifests as a tonic type. For all the above atypical scale cases, the diagnosis needs to be particularly careful to prevent misdiagnosis.
Prevention of epidemic meningitis
(1) Early detection of patients, local isolation and treatment.
(ii) Do a good job of hygiene promotion during the epidemic, large gatherings and collective activities should be avoided, do not bring children to public **** places, and go out should wear a mask.
(3) drug prevention: the domestic still use sulfa drugs, close contacts can be used iodopyrimidine (SD), adults 2g / day, divided into two times with an equal amount of sodium bicarbonate with the same dose, served for three days; children daily for 100mg / kg. in the epidemic, where there are: ① fever with headache; ② depression; ③ acute pharyngitis; ④ skin, oral mucosal hemorrhage in the four of the two, can give Sulfonamides can be given to those who have: ① fever with headache; ② mental depression; ③ acute pharyngitis; ④ skin and oral mucous membrane hemorrhage and other two of the four items, can be given a sufficient amount of sulfonamides throughout the treatment, which can effectively reduce the incidence and prevent the epidemic. Overseas, rifampicin or dimethylaminotetracycline is used for prophylaxis. Rifampicin is 600 mg daily for 5 days, and the daily dose for children aged 1-12 years is 10 mg/kg.
(4) Bacterial vaccine prophylaxis: At present, the two groups of podoconiosis vaccine A and C are widely used both at home and abroad. Group A polysaccharide bacterial vaccine purified by ultracentrifugation, the protection rate is 94.9%, and the average antibody titer increases 14.1 times after immunization. There is still a polysaccharide vaccine for "emergency" prevention, if the incidence rate of epidemic encephalitis in January to February is more than 10/100,000, or the incidence rate is higher than that of the same period of the previous year, you can carry out preventive vaccination in the population.
Does tuberculous meningitis affect a child's intelligence?
Tuberculous meningitis is one of the most serious forms of pediatric tuberculosis and is part of systemic tuberculosis, which is caused by Mycobacterium tuberculosis entering the brain tissue through the bloodstream.
Tuberculous meningitis is characterized by a change in the child's mental state, such as when a quiet child becomes irritable and cries, or when a child who was originally active becomes dull and doesn't like to play. There may also be low fever, loss of appetite, vomiting, sleep disturbance, emaciation, and older children may complain of headache. If the disease is serious, the headache is persistent and aggravated, the vomiting is aggravated and can become jet, and gradually appear sleepy, there may also be convulsions, and after the convulsions stop, the child's consciousness is awake. Further aggravation of the disease is coma, frequent convulsions, limb muscle relaxation, paralysis. There may also be breathing irregularities, and some patients die.
Tuberculous meningitis can have serious sequelae such as hydrocephalus, cerebral hemorrhage, paralysis of limbs, epilepsy, blindness, mental retardation, and so on, if treatment is untimely or irregular.
The most basic method of preventing tuberculous meningitis is to prevent children from being infected by tuberculosis bacteria, and children should be properly vaccinated, receive BCG vaccine after birth, and repeat the vaccination every 3-4 years, and avoid contact with tuberculosis patients. When a child has recurrent low-grade fever and cough that cannot be easily cured, he should go to the hospital to take a chest X-ray, and if it is determined to be tuberculosis, it should be treated thoroughly to prevent it from spreading to the brain. If the child has a prolonged low fever, mental status changes, persistent headache, vomiting should go to the hospital to check the cerebrospinal fluid, if the diagnosis of tuberculous meningitis, to be thorough and regular treatment to reduce the sequelae.