Purulent meningitis

The clinical picture and over. The beginning of purulent meningitis almost always sudden, much less take place prodromal phenomena in the form of General weakness, malaise, headache, aches in the extremities and other Disease begins with fever to 40 degrees chills and sudden headache. The pulse is usually faster, weak filling, but in the late stages may slow down to 50 times per 1 minute of the shortness of Breath; nausea, vomiting. In children, total and partial seizures, sometimes epileptic seizures, contractures, pronounced meningeal symptoms. Patients are restless, irritable, consciousness of the oppressed, there Zaporozhie state, and sometimes coma; some patients may be delusional experiences; marked psychomotor agitation and hallucinations.
At purulent meningitis changes in the spinal fluid is expressed very clearly: the pressure was significantly increased, turbid liquid, purulent, with grayish-yellow tint. Pleoticus is growing rapidly and 2-3-day sickness he is beyond calculation (D. A. Shaburov); initially dominated by polinucleari, replaced gradually by lymphocytes. With traumatic meningitis pleoticus comes to 38 200 1 mm3. The amount of protein corresponds to pleocytosis and the increase comes at the expense of all factions, reaching 7,8-10,0 permil; the amount of sugar and chlorides in the spinal fluid is reduced, but to a lesser extent than M. tuberculosis In the cerebrospinal fluid are often found pathogenic microorganisms. In blood at purulent M. there leukocytosis to 15 000-20 000, ROE accelerated left shift formula.
For purulent meningitis very fast, sometimes lightning. With traumatic M. marked re-sharpening, "wave" at intervals of 2-3 days. In connection with the use of sulfa drugs and antibiotics disease has changed. Under the influence of these kinds of treatments can occur not only as acute disease, but subacute, and sometimes chronic relapses.
The diagnosis. Recognition of purulent M. is not that difficult. Typical beginning of the disease, clinical picture, purulent the cerebrospinal fluid with a large number polinucleares indicate purulent M. the Presence of epidemic outbreaks in the children's team in this clinical picture makes it likely that the diagnosis of epidemic meningococcal M when purulent M. develops on the background of total infections (pneumonia, fever, septic endocardit, purulent otitis, childhood infections, and others), the phenomenon can be observed sharp mild irritation of the meninges (see Meningismus) or acute effects of serous meningitis; the issue is decided primarily by the cerebrospinal fluid - purulent fluid, detection of microorganisms decide diagnosis in favour of purulent M. With traumatic meningitis sometimes you have to differentiate between purulent M and abscess of the brain, especially in the stage of its breakthrough into the subarachnoid space.