Serous meningitis

The main feature of these different etiology forms of serous meningitis is the nature of inflammation. Serous meningitis are as purulent, primary and secondary. Primary meningitis occur when the process is primarily affects meninges without previous total infections and secondary meningitis - when a process in the brain membranes develops on the basis of common or as a consequence of local infectious disease. Most often caused by serous meningitis, both primary and secondary, are different viruses: viruses, Coxsackie and ECHO, the virus choriomeningitis, polio, epidemic parotitis (mumps), measles, etc., Coxsackie Virus, ECHO, choriomeningitis cause, as a rule, the primary serous meningitis, characterized sometimes prone to epidemic outbreaks with a clearly pronounced focality. The virus mumps and measles cause secondary serous meningitis. Viral serous meningitis differ from purulent a benign course. They very rarely give complications and deaths. However, by the serous meningitis applies tuberculous meningitis, which by its nature is a secondary sero-fibrinous meningitis and prognostically is a terrible disease, if not started specific treatment.
The clinical picture. Primary serous meningitis usually begin sharply: from rise in temperature to 38-39°, headache, repeated vomiting. Headaches can be very strong and are accompanied by the pain in his eyes. Vomiting is repeated, multiple. Good effect has lumbar puncture (see Spinal tap), greatly reducing or even eliminating the headaches and vomiting. Along with headaches and vomiting with the first-the second day of the disease is detected meningeal syndrome. However, serous meningitis it is not as strongly pronounced as in introducing. Sometimes when there is inflammation in the spinal fluid and headache and vomiting meningeal symptoms may even be absent or to be pronounced slightly. Sometimes there is a two-character fever. In young children, the disease can begin with the total seizures. Of particular importance for diagnosis are changes in the spinal fluid and especially the dynamics of these changes. The pressure of the cerebrospinal fluid is usually higher - up to 300-400 mm waters. tbsp. Liquid transparent and colorless, but sometimes it is opal. The number of cells is increased from a few dozen to several hundred and even up to 1000-2000 cells in 1 mm3 and, as a rule, at the expense of lymphocytes. Only when serous meningitis caused by viruses, Coxsackie and ECHO, in the first days of the disease lymphocytosis is mixed (lymphocytes and neutrophils), but later turned quickly into lymphocytic. The protein content or normal or slightly reduced. For serous meningitis is usually acute, benign, with fast reverse development of symptoms, and no residual phenomenon.
The diagnosis. It is very important to differentiate serous meningitis from and purulent meningitis. The diagnosis is made on the basis of clinical symptoms of acute serous meningitis (fever, meningeal symptoms) and the characteristic changes in the spinal fluid.

Serous meningitis - serous inflammation of soft meninges different etiology. The process shells can be primary, caused by a variety of agents, mostly viruses, and can have a secondary character, when developing common diseases (tuberculosis, measles, the fever, brucellosis and other), injuries and poisoning. Depending on the etiology recognized several serous forms Meters Disease primary serous M is observed in the form of epidemic outbreaks and sporadic cases.
In acute serous M macroscopically Pia mater sharply full impregnated serous slightly turbid liquid, sometimes with small foci of hemorrhage. Convolutions of the brain smoothed, the substance of it in the context of full-blooded, edematous, in cases meningoencephalitis with small tricks softening and point hemorrhages. Choroid plexus swollen, red-blooded, with blackish areas of hemorrhage. Possible reasonable hydrocephalus. Ependyma ventricular worthwhile. Edema of the meninges picture serous M differs pronounced hyperemia, availability of hemorrhages and greater turbidity shells. The presence of smears from the exudate cells inflammatory infiltrate helps diagnosis. Microscopically shell when serous M thickened, impregnated with a homogeneous protein liquid, sometimes with admixture of strands of fibrin. Among cellular elements prevail mononuclear cells (lymphoid and macrophage cells), there are few neutrophils. In the perivascular infiltration zones most intense. In chronic forms of serous M shell already macroscopically look thick, whitish. In developing sclerotic changes that lead to the violation of circulation of cerebrospinal fluid. Hence the possibility of developing cysts (leaf serous M) and hydrocephalus.