Purulent meningitis

Pathological anatomy. At the very beginning of the disease is an inflammatory process in the soft brain membranes is sero-purulent and sometimes purely severe character. 2-3-day sickness exudate acquires all the characteristics of pus. Pia mater muddy, sharply worthwhile. When large amounts of exudate he impregnates the shell solid yellowish or greenish layer, located on the surface of the brain in the form of spots. Simultaneously with the Foundation also struck the surface of the hemisphere. Festering mass located on the base of the brain are usually the most voluminous and compact. In the spinal cord exudate is located mainly on the dorsal side, soplease in the lower part of the spinal canal.
The substance of the brain succulent, full-blooded. In some cases, the volume of the brain is increased, the brains flattened, furrow smoothed, brain edema, consistency him loose, in the brain tissue meet hemorrhage. Changes in the ventricles appear in later periods of the disease. The ventricles are enlarged and made muddy liquid mixed with purulent flakes, ependyma their cloudy, thickened, full-bodied, with smaller hemorrhages.
Histologically in the soft and web meninges rich leukocytic infiltration, the boundaries between the individual elements of shells erased. Gradually between cells appear strands of fibrin. Especially thick cells are about vessels whose walls the first time remain free from infiltration. Leukocyte infiltration can meet and in the substance of the brain. In nerve cells and fibers degenerative changes.
By the end of the 1st week, and later the number of Klebsiella in the infiltrate is reduced, increasing the number of lymphocytes and histiocytes, blood vessels richly infilterate cells, which leads to a sharp thickening them. The disappearance of fibrinous-purulent exudate is mainly through enzymatic breakdown and absorption, and not by the organization. So sclerotic changes in the brain membranes are very moderate.