TB meningitis - the consequences of the spread of the pathogen

November 16, 2013

  • TB meningitis - the consequences of the spread of the pathogen
  • Diagnosis and treatment

 tuberculous meningitis
 The inflammatory process in the brain structures caused by exposure to the causative agent of an infectious disease. This may be tuberculosis Tuberculosis - a full recovery is not guaranteed  Tuberculosis - a full recovery is not guaranteed
   in active form, or any localization previously infectious diseases. TB meningitis is caused by ingestion of mycobacteria. From a wide variety of human genus Mycobacterium most dangerous are the human and bovine type of pathogen.


The manifestation of the pathogenic properties of the pathogen

The genus Mycobacterium comprises more than 70 species of bacteria. Conventionally, one was isolated Mycobacterium tuberculosis complex that combines several strains of pathogens. They have a common feature of the species - the presence of pathogenic properties, which are manifested in the virulence of microorganisms. The state of virulence affect environmental conditions and state of health of the human body.

With the development in humans of tuberculosis infection in the tissues formed pockets of "cold" inflammation. This type of inflammatory response is a characteristic feature associated with the presence of granulation (multiple bumps are formed with a tendency to decay). The patient's blood can detect specific human antibody Antibodies - "soldiers' immunity  Antibodies - "soldiers' immunity
 Which carry basic information about the antigenic properties of the pathogen. Specificity of the proteins can be seen in the reaction of the delayed type hypersensitivity.

Mycobacteria are composed of cell wall that protects the exciter from chemical and mechanical strength. The cell wall of the cell gives a stable shape and dimensions. As part of the cell wall are specific lipids, which are a factor in the virulence of the causative agent of tuberculosis. The value is only a fraction of phosphatidic lipids.


Stages in the development of pathological process

The defeat of the meninges occurs in several stages. Mycobacterium tuberculosis by hematogenous penetrate this major route of infection is recognized for meningitis tubercular etiology. Conventionally, there are the following steps:

  • in the presence of primary tuberculosis outbreak Primary tuberculosis - a negative contact with mycobacteria  Primary tuberculosis - a negative contact with mycobacteria
   there is sensitization of the organism to the pathogen. Later mycobacteria infected vascular plexus of the pia mater, penetrating through the blood-brain barrier
  • Mycobacterium subsequently spread from the vascular plexus and penetrate into the cerebrospinal fluid. At this stage, the development of specific inflammation of the brain membranes base

Pathological process affects not only the lining of the brain and blood vessels. Changes observed in all layers of blood vessels of the brain, but the greatest changes of the intima. To describe changes in tuberculous meningitis, it should be emphasized that inflammation regards shells and cerebral vessels, while the parenchyma of the brain remains intact.

In the process of dissemination of mycobacteria from the source of the primary lesion is formed tubercles specific nature. Tubercles cause inflammation in the meninges, and the narrowing of blood vessels due to inflammation of the brain. Inflammation of blood vessels leading to the development of local cerebrovascular secondary character.


The main periods of the development of the disease

Symptoms of tuberculous meningitis develop gradually, so the clinical picture traced periods of development of pathological changes. Pathogen exposure is accompanied by the initial signs of the disease that have no specific symptoms. The prodromal period there are complaints of nausea, vomiting, headache, fever unexpressed (rarely develops fever). Low-grade fever of the body is not a constant symptom, often meningitis Meningitis - an inflammation of the meninges  Meningitis - an inflammation of the meninges
   It takes place against the backdrop of a lack of temperature reaction. In the initial period without developing symptoms of acute manifestations of the stage, the gradual development of the clinical picture can be seen in the way from one to eight weeks.

The following period is characterized by expanded symptom, which is the criterion for the diagnosis of the specific nature of meningitis (irritation of the period). Within a week after the prodromal period the patient has been a dramatic increase in symptoms. There are complaints of a headache in the neck and forehead intensified amid a sharp rise in temperature. In severe disease increases lethargy, weakness, depression of consciousness may occur. It notes the existence of evidence of vegetative disorders that manifest themselves in the presence of red dermographism. On the face and chest spontaneously appear and disappear red spots.

The detailed clinical picture of meningitis is characterized by meningeal symptoms. These include the presence of neck stiffness, nausea and headache. The pathological exudate can lead to compression of vascular and nerve plexus, which would indicate the presence of hydrocephalus and largely determine the prognosis for the patient's life. The presence of hydrocephalus is causing a loss of consciousness in tuberculous meningitis. In the terminal stages of disorders develop paresis, paralysis, who have a central character. The main symptoms in the terminal period are associated with symptoms of encephalitis (rapid pulse, a rare breath, lack of consciousness, high numbers of body temperature).

Meningitis - an inflammation of the meninges - Complications

October 31, 2013

  • Meningitis - an inflammation of the meninges
  • How is
  • Complications
  • Bacterial
  • Forum

 complications of meningitis

Complications of meningitis

How dangerous is meningitis? One of the most dangerous complications of meningitis is brain edema. Cerebral edema in meningitis is more common in children and adolescents. This complication is more likely to develop at the end of the first - the beginning of the second day of the disease. With this background, heat, toxicity and symptoms of meningeal syndrome and psychomotor agitation patient may suddenly lose consciousness. At the same time he develops general convulsions, blood pressure initially falls and then rises sharply, palpitations, which at first was a rare (bradycardia), is frequent (tachycardia), shortness of breath increases, there are signs of pulmonary edema.

Meningeal symptoms disappear, reduced increased cerebrospinal pressure, there are involuntary defecation and urination. The death of the patient occurs when you stop breathing due to paralysis of the respiratory center.

Another serious complication of meningitis is an infectious-toxic shock, which is a consequence of contact with infectious agents (meningococcus) in the blood - a condition called fulminant meningococcemia. Against the background of high temperature, hemorrhagic rash, general intoxication temperature falls, increased skin sensitivity, sensitivity to light and sound. Patient agitated, pale, shortness of breath, cyanosis. Then the excitement gives way to apathy, seizures occur. The patient may die within several hours to three days. Often young patients develop simultaneously and the swelling of the brain, and toxic shock.

The consequences of suffering a meningitis - a paralysis, paresis, epilepsy, hydrocephalus, hormonal dysfunction, and so on.

Complications Meningitis can stay for life, but in some cases, the timely appointment of adequate treatment can restore health.

The consequences of meningitis of childhood, frequently detected in adults.

The consequences of meningitis require immediate treatment for a long time.


Fulminant meningitis

One of the most serious forms of meningitis is a form of lightning, the main feature of which is toxic shock in violation of the microcirculation and the development of a capillary failure. Fulminant meningitis - a form of meningococcal infection.

Cerebrospinal meningitis in this case begins suddenly, with a temperature rise to high numbers, headache and vomiting. Sometimes joining cramps, nausea, pain and discomfort in the abdomen. From the first hours of the disease on the patient's body appears purpura. The patient's condition is deteriorating rapidly while increasing rash, the appearance of cyanosis (cyanosis) of the lips and fingertips, as well as increased heart rate (tachycardia).

Rash in the early stages of meningitis appears first on the legs and torso. How does the rash of meningitis? Differently. At first, the rash of meningitis The rash of meningitis  The rash of meningitis
   morbilliform a character in the form of red spots and papules. Such stains with meningitis and pass quickly replaced hemorrhagic rash of pinpoint hemorrhages. With lightning-fast form of meningitis rash almost always from the beginning is hemorrhagic in nature, it is becoming more abundant, merged, forming large foci of hemorrhage in the whole body of the patient. On the limbs, torso and then appear bluish-purple spots.

The disease progresses very quickly, shortness of breath increases, patients periodically fall into the unconscious state, the state of the motor drive, which is often joined by cramps. Meningeal syndrome is usually pronounced.

At the final stage of the disease can be reduced and the temperature returns to normal, there are signs of cerebral edema, developed sudden changes in blood coagulation system, signs of respiratory failure, acidosis, acute renal failure Kidney failure - when treatment is vital  Kidney failure - when treatment is vital
 . All this often leads to death of the patient.


Diagnosis of meningitis

How to recognize meningitis? Usually, the diagnosis of meningitis is not difficult, as it always develops meningeal syndrome. The difficulty is to determine what caused the disease, meningitis is a primary or secondary, to identify the pathogen infection and prescribe adequate treatment in a timely manner a differential diagnosis of meningitis is quite complicated.

How to diagnose meningitis? Many diagnostic and therapeutic importance puncture spinal meningitis (lumbar puncture). During puncture of the patient is removed some amount of cerebrospinal fluid, which leads to a decrease in pressure and considerably facilitates the patient's condition. Lumbar puncture in meningitis is of great diagnostic value. As of cerebrospinal fluid can make the correct diagnosis. Analysis of meningitis - is, first of all, the laboratory diagnosis of meningitis. Also has a value and the pressure of cerebrospinal fluid.


How to help a patient with meningitis

Emergency treatment of meningitis - is timely hospitalization. In the hospital to reduce cerebral edema patient intravenous diuretics, and glucocorticoid hormones. Lumbar puncture in meningitis as a means of emergency.

As part of an integrated treatment of meningitis patients is not the last role played by diet. Power meningitis must be complete, contain large amounts of protein and a minimal amount of salt. In acute renal failure Acute renal failure - causes and consequences  Acute renal failure - causes and consequences
   limit the amount of protein.

Rehabilitation after meningitis - it is long. But if all the prescription, life after meningitis can come to normal.

For the prevention of meningitis vaccine is used. As part of some combination vaccines for infants includes a vaccine against Haemophilus influenzae and pneumococcus, which often cause meningitis in children Meningitis in children - a dangerous disease  Meningitis in children - a dangerous disease
 . There is a vaccine and from meningococcal disease. Meningitis Vaccination is done to children after two years living on the territory of outbreaks of meningococcal disease.

Recovery after meningitis, as well as its prevention - one of the major health challenges.