Otitis

Complications of serous meningitis. Serous meningitis - consequences

Serous meningitis is one of the serious diseases of the brain, characterized by inflammation of its membranes. Usually the cause is a viral infection or the proliferation of bacterial and fungal flora, but most of the recorded cases of this disease were caused by viruses. Most often it is recorded in children of primary school and preschool age.

It usually begins with symptoms characteristic of purulent inflammation of the meninges - nausea and vomiting, headache. The main difference between this form of the disease and all others is that inflammation develops sharply, but does not become a violent clinic. Rather, it occurs in a mild form, without disturbing the clarity of consciousness and passes without meningeal complications.

The diagnosis is established by clinical manifestations and data from bacteriological analysis of cerebrospinal fluid and PCR analysis.

Treatment is aimed at eliminating the pathogen and alleviating the general condition - prescribing painkillers, antipyretics, and antivirals. If, according to the treatment plan, the patient’s condition does not stabilize, additional antibacterial drugs belonging to broad-spectrum antibiotics are prescribed.

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ICD-10 code

A87.8 Other viral meningitis

Causes of serous meningitis

The causes of serous meningitis can be very diverse. Based on their form, they distinguish between primary and secondary. With primary inflammation, the painful condition is an independent process. With a secondary manifestation, it occurs as a complicated course of an existing disease of an infectious or bacterial nature.

Symptoms of serous meningitis

Symptoms of serous meningitis at an early stage are similar to a cold - fatigue, irritability, passivity appear, the temperature rises, and an unpleasant, raw sensation in the throat and nasopharynx. At the next stage, the temperature jump occurs - it rises to 40 degrees, the condition worsens, a severe headache appears, accompanied by dyspeptic disorders, muscle spasms, and delirium. Key manifestations of inflammation:

positive reaction with Brudzinsky's test;
"brain" vomiting;
impaired muscle activity of the limbs, difficulty swallowing;
significant hyperthermia - 38-40 degrees.

On days 5-7 from the onset of the disease, the symptoms may become weaker and the fever decreases. This period is the most dangerous, since if treatment is interrupted at the first sign of recovery, meningitis may develop again. A relapse is especially dangerous, as it can be accompanied by severe, persistent brain damage and pathologies of the nervous system. The nature of the pathogens can be confirmed using virological and serological examination of blood and cerebrospinal fluid.

The incubation period of serous meningitis lasts from the moment the pathogen enters the nasopharyngeal mucosa until the first signs of the disease appear. This can take a period of time from two to five days, but the timing largely depends on the nature of the pathogen and the resistance of the person’s immune system. In the prodromal stage, the disease is manifested by a decrease in general tone, headaches, a slight increase in temperature and the course is more similar to ARVI. In the incubation stage, a person is already a carrier of the pathogen and releases it into the environment, therefore, when the diagnosis is confirmed, it is necessary to isolate everyone who had contact with the patient as soon as possible.

But very often, serous inflammation of the brain begins acutely - with high fever, vomiting, and almost immediately characteristic symptoms of inflammation of the meninges appear:

the appearance of stiffness in the neck muscles;
positive reaction with the Kernig test;
positive reaction with Brudzinski's test.

The prognosis is generally favorable, but in rare cases there are complications - visual impairment, hearing impairment, and persistent changes in the central nervous system. The first days after confirmation of the diagnosis, increased levels of lymphocytes are observed. A few days later - moderate lymphocytosis.

How is serous meningitis transmitted?

Inflammation of the meninges or meningitis develops rapidly. The main reason is representatives of the enterovirus group. You can easily become infected or become a carrier of the virus in the following situations:

Contact infection. Bacteria and microorganisms enter the body with dirty food - fruits and vegetables with dirt particles, when drinking water that is not suitable for drinking, and when personal hygiene rules are neglected.
Airborne infection. Infectious agents enter the mucous membranes of the nasopharynx upon contact with an already sick person or with a carrier of the virus. Most often, pathogens are first released by patients into the environment, and then settle on the nasal and pharyngeal mucosa of a healthy person.
Water route of infection. Possible when swimming in dirty waters, when the risk of ingesting contaminated water is high.

Serous inflammation of the lining of the brain is especially dangerous for children in the first year of life - during this period, exposure to infectious agents has such a detrimental effect on the children's brain and nervous system that it can cause mental retardation and partial impairment of visual and auditory functions.

Acute serous meningitis

It develops when enteroviruses enter the body, as well as viruses that cause mumps, lymphocytic choriomeningitis, herpes simplex type 2, and tick-borne encephalitis. With the viral etiology of this disease, a bacteriological examination of blood and spinal fluid will not give positive data; the manifestation of lymphocytic pleocytosis is diagnosed, the content is slightly higher than normal.

The clinical picture of the disease differs from the picture of the purulent form. The course of the disease is milder, manifested by headaches, pain when moving the eyes, spasms in the muscles of the arms and legs (especially flexors), positive Kernig and Brudzinski symptoms. In addition, the patient is bothered by vomiting and nausea, pain in the epigastric region, against the background of which physical exhaustion develops and photophobia develops. Persistent disturbances of consciousness, epileptic attacks, focal lesions of the brain and cranial nerves are also not recorded.

Acute serous meningitis does not cause severe complications and is easily treated, recovery occurs on the 5th-7th day of illness, but headaches and general malaise can last from several weeks to several months.

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Secondary serous meningitis

Meningoencephalitis occurs with concomitant viral conditions caused by mumps virus, herpes virus, etc. Most often, the cause of this process is mumps. It manifests itself like acute meningitis - the temperature rises, severe pain in the head, eyes water from the light, nausea, vomiting, pain in the stomach. The main role in diagnosing confirmation of damage to the meninges is played by a positive Kernig and Brudzinsky reaction, accompanied by stiffness of the neck muscles.

Serious changes are recorded only in moderate and severe forms of the disease, but in general, the secondary form of inflammation of the meninges goes away quite easily. More severe cases are characterized by a proliferative phenomenon not only of the salivary glands and meninges, but also by pancreatitis, inflammatory processes in the testicles. The course of the disease is accompanied by fever, basic cerebral symptoms, dyspeptic disorders, laryngitis, pharyngitis, and sometimes a runny nose. After 7-12 days, with a mild course, the general condition improves, but for another 1-2 months a person can be a carrier of the pathogen and pose a danger to others.

Viral serous meningitis

It is considered one of the most common uncomplicated forms of this disease. Caused by coxsackie viruses, mumps, herpes simplex, measles, enteroviruses and sometimes adenoviruses. The onset of the disease is acute, beginning with a sharp increase in temperature, painful sensations in the throat, sometimes a runny nose, dyspeptic disorders, and muscle spasms. In severe cases - clouding of consciousness and diagnosing stupor, coma. Signs of meningeal syndrome appear on the second day - rigidity of the neck muscles, Kernig syndrome, Brudzinski syndrome, increased blood pressure, very severe headaches, cerebral vomiting, pain in the abdomen. The analysis of spinal fluid shows a pronounced form of cytosis and many lymphocytes.

The prognosis for almost all adults with viral non-purulent inflammation of the meninges is favorable - complete recovery occurs in 10-14 days. In just a few cases of the disease, survivors suffer from headaches, hearing and vision disorders, poor coordination and exhaustion. Children in the first year of life may develop persistent developmental dysfunctions - minor mental retardation, lethargy, decreased hearing and vision.

Enteroviral serous meningitis

This is a type of meningitis caused by the Coxsackie and ECHO viruses. It can be either a single recorded case of infection or it can be in the nature of an epidemic. Most often, children become infected with it in the summer and spring, and the epidemic spreads especially quickly in communities - in kindergartens, schools, and camps. You can become infected from a sick person or child, as well as from a healthy carrier; this type of inflammation of the meninges spreads mainly through airborne droplets or when hygiene rules are not followed.

After the viral agent enters the body, after a day or three the first signs appear - redness and swelling of the pharynx, enlarged lymph nodes, abdominal pain and diffuse pain, and a rise in temperature. The disease moves to the next stage when the pathogen penetrates directly into the blood and, spreading through the bloodstream, concentrates in the nervous system, which leads to an inflammatory process in the lining of the brain. At this stage, meningeal syndrome becomes pronounced.

The course of the disease in general dynamics rarely entails severe complications. On the second or third day, the brain syndrome disappears, but on days 7-9 of illness, the clinical symptoms of serous inflammation may return and the temperature may also rise. In children under one year of age, the process is sometimes accompanied by the formation of inflammatory foci of the meningeal membranes of the spinal cord and persistent damage to the central nervous system.

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Serous meningitis in adults

It proceeds quite easily and does not cause serious complications. Its causes are viral agents, bacteria and fungi; primary inflammation of the meninges is caused by the Coxsackie virus, Echo enterovirus. Secondary cases are caused by the virus that causes polio, mumps, and measles.

In adulthood, viral inflammation occurs in an uncomplicated form, but this does not mean that this form does not require treatment. The onset is similar to a cold - headache, swollen throat, muscle pain and dyspeptic symptoms, meningeal syndrome and, in severe cases, convulsions. By the end of the first week of illness, the temperature is fixed at a normal level, muscle spasms and headaches are not disturbing. This stage requires special observation, since the likelihood of relapse increases, and the first signs of pathologies of the central nervous system and intracranial nerves may appear.

The most effective way to identify the pathogen is a serological and bacteriological analysis of blood and spinal fluid, PCR. After this, specific antibacterial and antiviral treatment is prescribed in combination with antipyretic, antiemetic, analgesic and sedative drugs.

Serous meningitis in adults is treatable, and the earlier it is started, the lower the risk of the disease returning and developing complications.

Serous meningitis in children

It is more severe than in adults and, if not treated promptly, can lead to serious complications. The incubation period lasts about 2-4 days; those who attend events with large concentrations of children of different ages - school and preschool institutions, clubs, various sections, camps - get sick more often. The root cause of the disease are viruses that cause measles, mumps, herpes, various enteroviruses, etc. At first, inflammation of the lining of the brain is similar to other forms of meningitis - it also suffers from severe headaches, dyspeptic disorders, and cerebral syndrome manifests itself. The main difference between the viral form and others is the sudden, acute onset of the disease, with relatively clear consciousness.

The diagnosis is confirmed by PCR and analysis of spinal cerebrospinal fluid. After determining the nature of the pathogen, a treatment plan is prescribed - for a viral etiology, a course of antiviral drugs is prescribed, if other pathogens are identified, antibiotics and antifungal drugs are prescribed. In addition to eliminating the cause of inflammation of the meninges, therapeutic measures are aimed at alleviating the general condition - for this, antipyretic, analgesic, antiemetic, and sedative medications are prescribed.

Serous meningitis in children ends quite quickly and without complications, but it is dangerous for babies in the first year of life.

Complications of serous meningitis

Complications of serous meningitis for an adult pose minimal danger, but for children in the first year of life they are especially dangerous. Most often, the consequences of inflammation of the meninges make themselves felt when the course is aggravated, due to unqualified drug therapy or non-compliance with medical prescriptions.

Disorders that occur during severe inflammatory pathology of the meninges:

Impaired functioning of the auditory nerve - hearing loss, dysfunction of motor coordination.
Weakening of visual function - decreased acuity, strabismus, uncontrolled movements of the eyeballs.
Decreased vision and motor activity of the eye muscles are completely restored, but persistent hearing impairment is mostly irreversible. The consequences of meningeal pathology suffered in childhood later manifest themselves in intellectual delay and hearing loss.
Development of arthritis, endocarditis, pneumonia.
Threat of strokes (due to obstruction of cerebral vessels).
Epileptic seizures, high intracranial pressure.
Development of cerebral and pulmonary edema, leading to death.

If you seek qualified medical help in a timely manner, severe systemic changes can be avoided and there will be no relapses during treatment.

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Consequences of serous meningitis

The consequences of serous meningitis, subject to treatment and proper rehabilitation after recovery, are expressed only in half of all cases of the disease. Basically, they manifest themselves in general malaise, headaches, decreased memory and memorization speed, and sometimes involuntary muscle spasms appear. In complex forms, the consequences will be more serious, including partial or complete loss of the ability to see and hear. Such violations are observed only in isolated cases and with timely organized drug therapy this can be easily avoided.

If the disease occurred as a complicated course of another disease, then the person who has recovered from the disease will be more concerned about the problems that were associated with the root cause. Regardless of what form a person is ill with (primary or secondary), treatment measures should begin immediately. Basically, antibacterial, antifungal and antiviral drugs are used for this, as well as a complex of drugs for symptomatic therapy and alleviation of the general condition.

After suffering a pathological condition, a person requires special care and gradual recovery - this is a vitamin nutrition program, moderate physical activity and activities aimed at the gradual restoration of memory and thinking.

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Diagnosis of serous meningitis

Diagnosis is carried out in two directions - differential and etiological. For etiological differentiation, they resort to the serological method - RSC, and the neutralization reaction also plays an important role in isolating the pathogen.

As for the distinctive diagnosis, its conclusion depends on clinical data, epidemiological summary and virological conclusion. When diagnosing, pay attention to other types of disease (tuberculosis and inflammation of the meninges caused by influenza, mumps, polio, Coxsackie, ECHO, herpes). Due attention is given to confirming meningeal syndrome:

Rigidity of the neck muscles (the person cannot touch the chin to the chest).
Positive Kernig test (with the leg bent at 90 degrees at the hip and knee joint, a person cannot straighten it at the knee due to hypertonicity of the flexors).
Positive result of the Brudzinski test.

Consists of three stages:

A person cannot press his head to his chest - his legs are pulled towards his stomach.
If you press on the area of the pubic fusion, the legs bend at the knees and hip joints.
When checking the Kernig symptom on one leg, the second involuntarily bends at the joints simultaneously with the first.

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Liqueur for serous meningitis

Liqueur in serous meningitis has an important diagnostic value, since the nature of its components and the results of bacteriological culture can make a conclusion about the causative agent of the disease. Cerebrospinal fluid is produced by the ventricles of the brain; normally its daily volume is no more than 1150 ml. To take a sample of biomaterial (CSF) for diagnosis, a special manipulation is performed - lumbar puncture. The first milliliters obtained are usually not collected because they contain blood. The analysis requires several milliliters of CSF collected in two test tubes - for general and bacteriological examination.

If there are no signs of inflammation in the collected sample, then the diagnosis is not confirmed. With non-purulent inflammation, leukocytosis is observed in the punctate; the protein is usually slightly elevated or normal. In severe forms of pathology, neutrophilic pleocytosis is recorded and the content of protein fractions is significantly higher than acceptable values; when punctured, the sample flows out not drop by drop, but under pressure.

Liquor not only helps to accurately differentiate from other forms of this disease, but also to identify the pathogen, severity, and select antibacterial and antifungal drugs for therapy.

Differential diagnosis of serous meningitis

Differential diagnosis of serous meningitis is aimed at a more detailed study of the patient’s medical history, current symptoms and serological conclusion. Despite the fact that the meningeal complex is characteristic of all types of inflammation of the meninges, in some of its forms significant differences are observed. With a viral etiology, general meningeal manifestations may be mild or absent altogether - moderate headache, nausea, pain and cramping in the abdomen. Lymphocytic choriomeningitis is characterized by violent symptoms - severe headaches, repeated cerebral vomiting, a feeling of squeezing in the head, pressure on the eardrums, pronounced spasm of the neck muscles, a pronounced Kernig and Brudzinsky sign; during a lumbar puncture, cerebrospinal fluid flows out under pressure.

The pathological process caused by the polio virus is accompanied by signs characteristic of this disease - Lasegue, Amossa, etc. During EMS, cerebrospinal fluid flows out under slight pressure. Often the disease is accompanied by nystagmus (due to damage to the medulla oblongata).

The tuberculous form, unlike the serous one, develops slowly and occurs in people suffering from chronic tuberculosis. The temperature rises gradually, the general condition is sluggish and depressed. Spinal puncture contains a lot of protein, the presence of Koch's bacillus is determined, and the collected material is covered with a specific film over time.

Differential diagnosis is mainly based on virological and immunological examination of CSF and blood. This provides the most accurate information about the nature of the pathogen.

Treatment of serous meningitis

Treatment of serous meningitis requires special attention. Depending on what tactics will be taken in the first days of the disease, the further prognosis of medical prescriptions depends. Drug therapy for non-purulent inflammation of the meninges is carried out in a hospital - this way the person receives the necessary care and can observe all changes in well-being and carry out the necessary diagnostic manipulations.

Prescription largely depends on the severity of pathological changes, the nature of the pathogen and the general condition of the patient. According to the study of CSF and PCR, specific therapy is prescribed - for the viral form, these are antiviral drugs (Acyclovir, etc.), for the bacterial form, broad-spectrum antibiotics or specific antibacterial drugs (Ceftriaxone, Meropenem, Ftivazid, Chloridine, etc.), and also antifungal (Amphotericin B, Fluorocytosine), if the identified pathogen belongs to the group of fungi. Measures are also being taken to improve the general condition - detoxification medications (Polysorb, Hemodez), painkillers, antipyretics, antiemetics. In some cases, when the course of the disease is accompanied by high blood pressure, diuretics and sedatives are prescribed. After complete recovery, a course of rehabilitation is carried out, including exercise therapy, myostimulation, electrophoresis, and psychorehabilitation is also required.

Treatment can be carried out at home, but only if the disease is mild, and the patient’s well-being and compliance with the principles of medication prescriptions are monitored by an infectious disease specialist.

Treatment of serous meningitis in children requires special attention and a responsible attitude towards compliance with all medical prescriptions. In childhood, this disease is often accompanied by complications; it is especially dangerous for babies in the first year of life, when the consequences are persistent and can cause mental retardation, hearing loss, and poor vision.

Most of the recorded cases of non-purulent inflammation of the meninges are caused by viruses, so antibacterial therapy does not give the desired result. Acyclovir, Arpetol, Interferon are prescribed. If the child’s condition is severe and the body is weakened, immunoglobulins are administered intravenously. In case of significant hypertension, diuretics are additionally prescribed - Furosemide, Lasix. In severe forms, when the disease is accompanied by severe intoxication, glucose, Ringer's solution, Hemodez are injected intravenously - this promotes the adsorption and elimination of toxins. For severe headaches and high blood pressure, a spinal tap is performed. The rest of the treatment measures are symptomatic - antiemetics, painkillers, antipyretics, and vitamins are recommended.

Treatment, subject to the doctor's instructions, ends with recovery after 7-10 days and is not accompanied by long-term complications.

Prevention of serous meningitis

Prevention of serous meningitis is aimed at preventing the causative agent of this disease from entering the body. General preventative rules should include:

Measures prohibiting swimming in polluted water bodies in the summer and autumn.
Drink only boiled, purified or bottled water from certified wells.
Careful preparation of products for cooking, proper heat treatment, washing hands before eating and after visiting crowded places.
Maintaining a daily routine, maintaining an active lifestyle, quality nutrition according to the body’s expenses. Additional use of vitamin complexes.
During a seasonal outbreak, avoid attending mass performances and limit your circle of contacts.
Carry out regular wet cleaning of the premises and treatment of the child’s toys.

In addition, the serous form of inflammation of the meninges can be secondary, which means that it is necessary to promptly treat chickenpox, measles, mumps, and influenza. This will help eliminate the risk of inflammation of the membranes of the brain and spinal cord, both in adults and in children. You should not neglect preventive rules, because it is easier to prevent infection than to treat it and recover from complications associated with it.

Prognosis of serous meningitis

The prognosis of serous meningitis has a positive trend, but the final result largely depends on the state of the patient’s immune system and the timing of seeking medical help. Non-purulent changes in the membranes of the brain most often do not cause persistent complications, are quickly treated and do not relapse on days 3-7 of the disease. But if the root cause of tissue degeneration is tuberculosis, without specific drug treatment the disease is fatal. Treatment of the serous form of tuberculous meningitis is protracted and requires inpatient treatment and care for six months. But if the instructions are followed, residual pathologies such as weakening of memory, vision and hearing disappear.

In childhood, especially in babies under one year of age, a non-purulent form of inflammation of the meninges can cause serious complications - epileptic seizures, visual impairment, hearing impairment, developmental delays, low learning ability.

In rare cases, after an illness, adults develop persistent memory disorders, decreased concentration and coordination, and regularly experience severe pain in the frontal and temporal parts. The disorders persist from several weeks to six months, after which, with proper rehabilitation, complete recovery occurs.

Serous meningitis is a severe infectious pathology of the membranes of the brain. There is a widespread misconception about the causes of this disease. Many people believe that meningitis occurs due to exposure to the cold without a hat. However, this disease is exclusively infectious in origin. Most often it is caused by viruses. Hypothermia of the head can only be a provoking factor in the development of the inflammatory process.

Pathogens

With serous meningitis, inflammation affects the pia mater of the brain, which is located closest to the surface of the organ. There are a large number of nerves and blood vessels here, so the symptoms of the pathology are pronounced and difficult to tolerate.

This disease is caused by various microorganisms. The most common cause of inflammation is the Coxsackie virus. Also in the etiology of serous meningitis, the causative agents of the following diseases play an important role:

flu;
infectious mononucleosis;
herpetic infection;
measles;
rubella;
adenoviral infection ("stomach flu");
(pigs).

In rare cases, damage to the meninges is caused by bacteria: Koch's bacillus or Treponema pallidum. This happens in patients with tuberculosis or syphilis. The infection enters the brain through the bloodstream. The disease can also be a consequence of damage to the body by the yeast fungus Candida. But such a pathology is rarely observed, mainly in people with sharply reduced immunity, for example, in HIV-infected people. Serous-viral meningitis is milder and has a more favorable prognosis than serous-bacterial meningitis.

There are primary and secondary forms of pathology. In the first case, the disease occurs if the infection immediately enters the brain from outside. Secondary meningitis occurs as a complication of other ailments.

Routes of transmission

Damage to the soft meninges always occurs very quickly, the symptoms of the disease rapidly increase. The most common cause of serous viral meningitis is a microorganism called Coxsackie. These viruses live in the intestines (hence the name enteroviruses), but do not lead to damage to the gastrointestinal tract, but to general intoxication of the body. They can cause an infectious disease with fever and rash (hand-foot-mouth syndrome), but damage to the central nervous system often occurs.

A viral infection that leads to inflammation of the membranes of the brain spreads in the following ways:

Airborne. If viruses accumulate on the mucous membrane of the respiratory tract, then a person releases them when coughing, sneezing and talking.
Contact path. Microorganisms are found on the skin and move to various objects. By sharing things with a sick person, you can easily become infected. The disease is often spread through dirty fruits and vegetables and unwashed hands.
Through the water. Outbreaks of enterovirus infections often occur in resorts where people swim in communal pools. This microorganism can survive in aquatic environments.

Most often, infection with enteroviruses occurs in the summer. Children are especially susceptible to infection. Adults get sick less often.

There is also a special form of viral serous pathology - lymphocytic choriomeningitis. With it, inflammation affects not only the soft membranes, but also the vessels of the ventricles of the brain. This infection is spread by rodents - mice and rats. A person becomes infected by consuming food and water contaminated with the secretions of sick animals.

Provoking factors

Infection in the body does not always lead to serous viral meningitis. For the disease to occur, additional unfavorable conditions are necessary. The development of inflammation in the membranes of the brain can be provoked by the following factors:

Low immunity. This is the main reason for the activity of viruses. Most often, people with weakened bodies are susceptible to meningitis. These are patients with chronic diseases, various immunodeficiency conditions, and also undergoing treatment with cytostatics and corticosteroids.
Frequent viral infections. If a child constantly has a cold, there is a high risk of getting a complication of the disease in the form of inflammation of the meninges.
Hypothermia of the body. This factor does not play a major role in the occurrence of serous meningitis. Excessive exposure to cold can only indirectly affect the development of the disease. Usually, hypothermia contributes to frequent colds, and meningitis occurs as a complication.

In childhood, the following circumstances may contribute to the development of meningitis:

prematurity of the baby;
intrauterine infection with rubella and other viral diseases;
birth injuries;
congenital immune deficiency.

Such children have an increased risk of the disease.

The difference between the serous form of the disease and the purulent form

It is important to carry out a differential diagnosis of serous and purulent meningitis. This is necessary to choose the right treatment tactics. The two types of disease differ in etiology, pathological changes and clinical picture. The serous form of meningitis is most often caused by viruses; during inflammation, not pus, but exudate is formed in the membranes of the brain. Nerve cells do not die.

The purulent form is most often associated with brain damage by meningococci. It is characterized by the death of neurons. Purulent contents appear in the membranes. This is much more severe and has more dangerous consequences than serous. Diagnostic tests help distinguish one form of the disease from another.

Incubation period

The incubation period of serous meningitis can vary in length. Its duration depends on the type of pathogen. For most viral infections, the latent period is 2 to 5 days. With rubella, it can increase to 2 weeks. In children 2-6 years old, the incubation period can last 1-2 weeks.

At this time, the person does not feel any deviations in health. Only in small children under 1 year of age can some changes in behavior be noticed. Babies often cry, are capricious, their appetite decreases and their sleep is disturbed.

General symptoms of the disease

After the incubation period, the intermediate (prodromal) stage of the disease begins. It is characterized by a slight increase in temperature, weakness, fatigue, and decreased appetite. After this, acute signs of serous meningitis develop:

A severe headache occurs, which is localized in the temporo-frontal region and radiates to the neck. Patients describe this feeling as extremely painful. With noise and bright light, the pain intensifies. Analgesics practically do not help.
The temperature rises sharply (up to 40 degrees). The fever lasts 2-4 days, then decreases slightly. But after some time the temperature rises again.
Pain in the head is accompanied by nausea, severe vomiting “fountain” due to increased intracranial pressure and irritation of the vomiting center.
A sick person cannot tolerate bright light and harsh sounds. His skin becomes very sensitive to touch. The condition improves somewhat when staying in a quiet, darkened room.
The patient lies in a characteristic position: legs are pulled up to the body, arms are pressed to the chest, and the head is thrown back. In this position it becomes somewhat easier for him.
Signs of general intoxication appear: severe weakness and malaise, aching joints.
There may be slight fog.
If there are nerve lesions, then disturbances in swallowing, movements and double vision occur.

Features of symptoms in children

In childhood, the signs of serous inflammation of the meninges have their own characteristics. In addition to the symptoms listed above, the child may have colds: cough, runny nose, sore throat. High fever is accompanied by limb cramps, delirium and hallucinations.

In infants, there is bulging and tension in the fontanel area. The child becomes irritable, whiny, and capricious. The baby constantly screams in a monotonous voice; doctors call this sign a “brain scream.”

A rash with this disease usually does not appear, except in cases where meningitis occurs against the background of a viral infection with skin manifestations (measles, rubella).

Meningeal symptoms

The general manifestations of serous meningitis associated with intoxication of the body were described above. But there are also specific signs of this disease that play an important role in diagnosis. These include:

Tension of the neck and neck muscles. The patient cannot press his head to his chest due to increased muscle tone.
Kernig's sign. If the patient's leg is bent in a supine position, severe muscle tension is observed. Sometimes the patient cannot even straighten the limb.
Brudzinski's symptoms. When the head is tilted, a person involuntarily pulls his legs towards his body. This is a sign of irritation of the membranes of the brain. Also, when one leg is bent, the other limb is pulled towards the body. These symptoms are not always observed with the serous form of the disease.
Lesage's sign. It is observed in children in infancy. If the child is lifted and held in an upright position, he bends his legs and pulls them towards his body.

The doctor identifies these symptoms during a diagnostic examination of the patient.

Complications in adults

Severe consequences of serous meningitis in adults are rare. The disease can be complicated by pneumonia, inflammation of the heart membrane, and arthritis. Sometimes vision or hearing deteriorates. Periodic pain and noise in the head may occur.

The most dangerous complication of serous meningitis is the addition of a bacterial infection and the transition of the disease to a purulent form. Inflammation can also spread from the meninges to the gray matter. To avoid such severe consequences, it is necessary to begin treatment of the disease in a timely manner.

Complications in children

Complications occur more often in children than in adults. Pathology can negatively affect the development of the child. The following consequences of serous meningitis in children are possible:

mental retardation;
hearing impairment;
strabismus;
decreased clarity of vision;
trembling and involuntary movements of the eyeballs;
epileptic seizures.

At the first signs of illness, you should urgently call a doctor. Timely treatment will reduce the risk of complications to a minimum.

Diagnostics

During the examination, the doctor determines signs of damage to the membranes of the brain. The specialist identifies Kernig, Brudzinski and Lesage symptoms (in children), as well as tension in the neck muscles.

An important role in the differential diagnosis of serous meningitis is played by spinal puncture. Under anesthesia, a puncture is made with a long needle in the lumbar region. Cerebrospinal fluid (CSF) is taken for analysis. Its study makes it possible to distinguish the serous form of the disease from the purulent one. If the protein in the cerebrospinal fluid is slightly increased and lymphocytes predominate, this indicates viral meningitis. If the protein content standards are greatly exceeded and the number of neutrophils is increased, then this indicates a purulent form of the disease.

Additionally, they may prescribe an MRI and CT scan of the brain, as well as a blood test for viral infections.

Treatment methods

In case of serous inflammation of the meninges, the patient is urgently hospitalized. It is advisable to place the patient in a darkened room, where there are no external stimuli (noise, bright light). It is recommended to maintain strict bed rest. In the hospital, drug treatment is carried out:

To reduce intoxication of the body, patients are given droppers with saline solutions, as well as with ascorbic acid and corticosteroids.
To reduce intracranial pressure, diuretics are prescribed: Veroshpiron, Furosemide, Lasix.
At high temperatures, medications with paracetamol and ibuprofen are prescribed.
Antiviral therapy is carried out with interferon-type drugs. If meningitis is caused by a herpes pathogen or infectious mononucleosis, then the use of Acyclovir is indicated.
Antibiotics will not cure viral meningitis. But broad-spectrum antibacterial drugs are still used to prevent the development of a purulent form of the disease.
For pain, the use of "No-Shpy" is useful.
If a child experiences convulsions, the drugs Domosedan or Seduxen are used.
To strengthen the immune system, B vitamins and ascorbic acid are prescribed.
If the disease is caused by Koch's bacillus, Treponema pallidum or yeast fungus, then the use of antituberculosis, antisyphilitic and antifungal agents is indicated.

In some cases, spinal taps are used for therapeutic purposes. Removing part of the cerebrospinal fluid helps reduce intracranial pressure and reduce headaches.

During the recovery stage, patients are prescribed nootropic drugs (Piracetam, Nootropil, Glycine), as well as drugs with succinic acid. This helps the brain recover after illness.

Disease prognosis

The prognosis for serous meningitis of viral etiology is usually favorable. Improvement in the patient's condition with proper treatment occurs after 5-6 days. The disease lasts about 2 weeks, after which complete recovery occurs.

If serous inflammation is caused by tuberculosis bacteria or yeast fungi, then it requires long and persistent treatment. Such forms of the disease often recur.

With complications and the transition of the disease to a purulent form, as well as with the spread of pathology to the brain, the prognosis significantly worsens.

Prevention

Currently, specific prevention of this disease has not been developed. To protect yourself from serous inflammation of the meninges, you need to protect your body from infections. You should avoid contact with patients with viral pathologies, and also strengthen your immune system. If an outbreak of enteroviral diseases occurs in the summer, it is necessary to avoid swimming in closed reservoirs.

It is impossible to vaccinate against the serous form of the disease, since it is caused by various types of viruses. The Mencevax vaccine is ineffective in this case. It is intended to protect against purulent meningitis, which is caused by meningococci. You can only undergo a course of vaccinations against various viral infections (measles, rubella, influenza). This will slightly reduce the risk of disease. However, enteroviruses are often the causative agent of inflammation, and there are no vaccines against them yet.

Meningitis is a disease characterized by inflammation of the lining of the brain. The difference between serous meningitis and other types of this disease is that the fluid released from the vessels in the cavity and tissue does not contain pus.

Because of this, brain cells do not “melt” and die. In this regard, this type of disease is milder than the purulent type of meningitis and has a more favorable prognosis.

Children aged 3–6 years are most susceptible to serous meningitis. In adults, it occurs less frequently; most often these are patients aged 20–30 years. This is due to the fact that people of these ages are most susceptible to contacts and aggressive external environments.

The development of the disease begins with the penetration of a pathogen into the body or a traumatic brain injury. Once in the meninges, the pathogen provokes an inflammatory process. If you do not notice this disease in time, you can get disastrous consequences. The disease is very serious and dangerous.

The most common causative agents of serous meningitis are viruses:

polio;
flu;
herpes;
measles;
enteroviruses;
adenoviruses;
Epstein-Barr virus;
cytomegaloviruses;
paramyxoviruses.

Attention! The main reason for the occurrence of meningitis is a weakened immune system, which is unable to cope with pathogenic microorganisms.

Aseptic serous meningitis caused by concomitant diseases is distinguished:

Brain cysts and tumors.
Systemic diseases.

Classification

Depending on the type of pathogen, there are:

Routes of infection and incubation period

The disease is seasonal; cases of infection are most often detected in the summer.

The pathogen enters the body in the following ways:

Airborne. The pathogenic agent located on the mucous membranes of the respiratory tract spreads into the environment through breathing and sneezing.
Contact. The pathogen is found on personal hygiene items of an infected person. If hygiene rules are not followed, it is transmitted to healthy people and provokes the development of the disease.
Water. Infection occurs when swimming in open water through water.

The placental route is distinguished separately, when the pathogen is transmitted from an infected mother to the fetus.

The incubation period is the time between the infection entering the body and the development of the first symptoms of the disease. For serous meningitis it is 2–4 days.

Important! After diagnosis, it is necessary to examine everyone who came into contact with the patient during this period. However, often the disease begins acutely with an increase in temperature and copies ARVI and influenza.

Symptoms in adults

After the end of the incubation period, the first signs of the disease appear. They differ in the degree of manifestation depending on the individual characteristics of the patient.

The first symptoms of serous meningitis in adults:

The main symptoms that help distinguish serous meningitis from other diseases in adults:

Rigidity of the neck and back muscles, which manifests itself in the inability to tilt the head to the chest.
Impaired muscle activity, difficulty swallowing.
Positive reaction to the Kernig test: after bending the leg at the knee and hip joints, it is impossible to straighten the knee joint.
Positive reaction to the Brudzinski test: when bending the neck forward, lying on his back, the patient pulls his legs to his chest.

Important! If these symptoms appear, consult a doctor immediately. This will help avoid the development of complications and deterioration of well-being, and will not lead to irreparable consequences.

After 5–7 days, the intensity of symptoms decreases, but this does not mean that the disease has passed.

Diagnostic methods

Diagnosis of serous meningitis in adults is primarily aimed at identifying meningeal syndrome.

Meningeal syndrome manifests itself in the form of:

positive reaction to Kernig and Brudzinsky tests;
stiffness of the neck and back muscles.

Anamnesis is also collected, including the presence of contact with infected people in the last days before the disease. In addition, laboratory tests and other diagnostic methods are performed:

The main task of differential diagnosis is to distinguish serous meningitis from purulent, tick-borne encephalitis, subarachnoid hemorrhage and arachnoiditis.

Treatment of serous type

If this disease is suspected, the patient is immediately hospitalized in a hospital. After which he is examined and treated by an infectious disease specialist and a neurologist. The duration of treatment is 7 – 10 days.

Refusal from hospitalization is possible only if the disease is mild. However, with meningitis, it is necessary to constantly monitor changes in the patient’s condition, which a non-specialist cannot do.

It is also possible to carry out diagnostic procedures and timely adjust the course of therapy only during inpatient treatment. This is impossible at home; in addition, improper treatment will lead to complications, even death.

The main goal of treating serous meningitis in adults is to destroy the causative agent of the disease. Depending on the type of agent, different drugs are prescribed:

Acyclovir.
Broad spectrum antibiotics, Ceftriaxone, Ftivazid, Chloridine.
Fluorocytosine, Amphoterecin B.
To remove toxins - Plisorb, Hemodez.
Painkillers - analgin.
Antiemetics – Cerucal.

Attention! Do not take medications without a doctor's prescription. Incorrect administration will not only not improve the patient’s well-being, but will also cause irreparable harm to him.

Consequences and complications

Serous meningitis leaves behind the following consequences, which persist in the first few months after the disease. The main complications after the disease include:

headaches;
weakness;
deterioration of attention and memory.

It is also possible to develop complications in severe cases of the disease:

Serous meningitis is a very dangerous and serious disease, the same for children and adults. When this disease occurs, inflammation occurs in the membranes of the brain.

According to etiology, the following types of serous meningitis are distinguished: fungal, viral and bacterial (syphilitic, tuberculous, etc.) meningitis. In addition, primary and secondary forms are distinguished.

Primary meningitis occurs due to primary damage to the meninges, which is not preceded by any infectious agents. Secondary damage to the meninges occurs after an infection, as a complication.

The mildest form of meningitis is considered to be that caused by viral infections. The disease occurs without serious complications, and with timely treatment by highly qualified specialists, it goes away without a trace. If treatment is late or not entirely adequate, then in the case of viral meningitis, the consequences for an adult or child can be very sad.

How is serous meningitis transmitted and what is it?

What is it? Serous meningitis is a rapid lesion of the membranes of the brain, which is characterized by a serous inflammatory process, the causative agent of which can be viruses, bacteria or fungi.

Inflammation of the meninges develops rapidly. The main reason is representatives of the enterovirus group. You can easily become infected or become a carrier of the virus in the following situations:

Contact infection. Bacteria and microorganisms enter the body with dirty food - fruits and vegetables with dirt particles, when drinking water that is not suitable for drinking, and when personal hygiene rules are neglected.
Serous meningitis is transmitted by airborne droplets when the pathogen is localized in the mucous membrane of the respiratory tract. When coughing or sneezing, infectious agents, being in the air in the form of an aerosol, enter the body of a healthy person with contaminated air.
This virus is most likely to be contracted while swimming - in water bodies, pools, and the greatest likelihood of becoming infected is in people with weak immune systems.

Specific symptoms

When examining a person with serous meningitis, the symptoms are expressed in excessive tension of the neck muscle group, their rigidity, that is, the inability to bring the chin to the chest.

There are also several meningeal symptoms, such as:

Kernig's sign is the inability to straighten a leg bent at a right angle.
Brudzinski's sign: lower - if you straighten one bent leg, this leads to reflex flexion of the second leg, upper - if you bend your head, your legs involuntarily bend.

All these symptoms of serous meningitis can be expressed to varying degrees, to a lesser or greater extent; in very rare cases, these signs can be combined with generalized damage to other organs.

Signs

In the prodromal, or intermediate stage between the incubation period and the disease itself, there is a slight increase in temperature, weakness, and loss of appetite.

On average, the period lasts up to 3 weeks, and then the signs of serous meningitis appear:

the temperature rises to 38 degrees and even higher;
sharp headache in the forehead and temples;
pain in the eyes, pain when looking from one object to another;
nausea, vomiting;
photophobia;
dizziness.

In children, in addition to the described symptoms, the following are observed:

hallucinations;
rave;
swelling of the fontanel in young children;
convulsions.

Some patients experience only slight discomfort, which is often attributed to overwork. That is why, if serous meningitis is suspected, it is necessary to carry out a diagnosis.

Symptoms of serous meningitis in children

Adults very rarely suffer from serous meningitis, since their immunity is already “familiar” with many different infections. But the child’s body is just beginning to “master” the world, including recognizing new viruses. Therefore, their body reacts violently to the infection. Serous meningitis in children is quickly diagnosed and easily treated.

At the very beginning, this disease in children is very acute, and its symptoms are pronounced, that is, the child’s temperature rises, which sometimes reaches 40 degrees, the child feels pain in the muscles and a constant headache appears. In addition, with the disease, diarrhea and vomiting are possible, the child becomes restless, he may have a stomach ache or cramps, and the patient may become delirious in his sleep.

Very often, against the background of the main symptoms, serous meningitis in children also manifests itself with signs - sore throat, cough, runny nose, eye sensitivity. The child feels better in a darkened room in a position on his side with his head thrown back.

Serous meningitis in adults: symptoms

With this type of meningitis, the first symptoms in adults are mild. These may be: general weakness, fatigue, mild headache, sore and sore throat, cough, runny nose.

Such symptoms are characteristic of various acute respiratory viral infections, which are easily treatable, so most patients do not pay much attention to them; in extreme cases, they begin to take various medications aimed at improving their well-being.

The obvious symptoms of serous meningitis in adults are:

high body temperature;
migraine-type headache that does not stop even after taking painkillers;
vomiting without nausea, regardless of food intake;
chills, fever, clouding of consciousness;
state of delirium, hallucinations;
abdominal pain, indigestion, diarrhea;
irritability;
lack of appetite;
convulsions, loss of consciousness (in severe cases).

There is an increased level of lymphocytes in the patient's cerebrospinal fluid. Diagnosis is based on data from lumbar puncture, laboratory diagnostics of blood and urine.

Treatment

If there is any suspicion of meningitis, you should immediately call an ambulance and hospitalize the child or adult in a hospital.

Due to the viral etiology of the disease, the use of antibiotics is inappropriate. Arpetol, interferon, acyclovir can play a significant role in the treatment of serous meningitis in children and adults.

In case of immunodeficiency, the patient is prescribed a course of normal human immunoglobulin, donor and placental gamma globulin. If serous meningitis is provoked by measles, then anti-measles immunoglobulin is used; for influenza, anti-influenza immunoglobulin is used.

Dehydration is essential for reducing intracranial pressure, so diuretics are prescribed - Lasix, Furosemide. At temperatures above 38C, use paracetamol, ibuprofen. Also, each patient is prescribed antihistamines that relieve fever and the main signs of meningeal syndrome. Such drugs include suprastin, tavegil and the well-known diphenhydramine.

With timely and adequate treatment, serous meningitis in children, unlike purulent ones, is benign, short in duration and rarely causes complications.

Consequences of serous meningitis

According to doctors, half of the patients cured of meningitis continue to experience health problems for many years. After meningitis, patients complain of difficulties with remembering information, spontaneous muscle contractions, and mild migraine-like pain.

But these complications are typical for mild forms of the disease. If the disease is complicated, the person may even lose hearing or vision. In addition, some forms of this disease can cause disruption in the functioning of the brain and difficulties with mental activity.

In fairness, it must be said that, fortunately, such consequences of the disease occur only in one and a half percent of all those who have suffered this disease. But in very rare and difficult cases, this disease can even lead to death.

Serous meningitis is inflammatory process concentrated in the pia mater serous in nature.

The disease can be provoked not only by viruses, bacteria or fungi, but also by the development of tumors or systemic diseases.

Prognosis for serous meningitis directly depends on the timeliness of diagnosis of the pathological process.

Therapy for the disease is always carried out comprehensively and includes not only the prescription of certain categories of drugs to the child, but also special procedures to restore the functionality of the affected areas of brain tissue. ABOUT symptoms of serous meningitis in children We'll tell you in the article.

How to recognize mouse fever in a child? Find out about this from ours.

Concept and features

Serous meningitis can be infectious or non-infectious.

Regardless of the pathogen, the inflammatory process always develops in the soft tissues of the brain.

The child tries to press his legs to his stomach, but he the head is thrown back. This position is considered a characteristic symptom of serous meningitis.

Symptoms The following conditions can cause serous meningitis:

Serous meningitis is accompanied by several specific symptoms. For example, if you bend one of a child’s arms, the second one bends reflexively. When you bend your neck forward, your knees bend. All movements can cause discomfort and pain to the child.

Serous meningitis affects the soft tissues of the brain, but its consequences affect the performance of the baby’s entire body.

Complications and consequences

At the initial stage of development, serous meningitis affects the soft tissues of the brain, but in the presence of complications, the inflammatory process spreads on its hard tissues, as well as the spinal cord.

In the absence of timely treatment, risk of death little patient. Due to the intense symptoms of the disease, late treatment is excluded in most cases.

If the child is examined in a timely manner and given proper medical care, the prognosis will be favorable.

Serous meningitis can cause the following: complications:

endocarditis;
pneumonia;
arthritis;
epilepsy;
paresis of legs and arms;
partial paralysis;
cerebral edema;
violation of the child’s speech development;
tendency to constant headaches;
delayed intellectual development of the child;
uncontrolled muscle contraction;
hearing impairment (partial or complete deafness);
damage to the visual organs (strabismus, decreased vision).

Diagnostics

Not only a neurologist, but also a pediatrician can suspect serous meningitis in a child.

The disease is characterized by certain symptoms, which distinguishes it from other inflammatory processes.

Confirmation of the diagnosis is carried out by consultation with specialized specialists, laboratory and instrumental studies. Additional diagnostic measures are necessary to establish the etiology of serous meningitis in a child and assess his general health.

Diagnostics serous meningitis in children includes the following procedures:

cerebrospinal fluid analysis;
MRI of the brain;
ophthalmoscopy;
lumbar puncture;
tuberculin tests;
virological studies of biological material;
general blood and urine analysis;
culture of swabs from the nose and throat;
biochemical analysis of blood and urine;
bacteriological research.

Treatment methods

In most cases, treatment of serous meningitis in children is carried out in stationary conditions.

The first stage of therapy is to take etiotropics.

The further treatment regimen depends on the causes of serous meningitis. Therapy is always planned individually.

As an addition to drug therapy, therapeutic lumbar punctures or oxygen therapy (a special oxygen treatment technique) are prescribed.

The following may be used in the treatment of serous meningitis in children: drugs:

B vitamins according to the child’s age.
Broad-spectrum antibiotics (Ceftazidime, Ceftriaxone).
Diuretics (Furosemide, Acetazolamide).
Means for increasing the body's protective functions (Immunoglobulin).
nootropic drugs (Glycine, Piracetam).
Antispasmodics (No-shpa, Drotaverine).
Antiviral agents (Interferon, Acyclovir).
Anti-tuberculosis drugs (Isoniazid, Ftivazid).
Antipyretics (Paracetamol, Ibuprofen).
Anticonvulsants (Diazepam, Detomidine).

Rehabilitation

With the implementation of timely therapeutic measures, the prognosis of serous meningitis is favorable.

The average duration of the disease is approximately two weeks. During this time, the child may be in the hospital.

If there are good trends towards recovery, the baby may be discharged earlier than this date. At home during the rehabilitation period it is necessary to provide certain care look after the child and follow all the specialist’s instructions.

During rehabilitation, the following must be observed: recommendations:

Within two years after the illness, the child should be observed by a pediatric neurologist.
Preventing your baby from staying in the sun for long periods of time.
Elimination of excessive physical activity (for two years).
Compliance with the rules of a balanced diet.
Vaccination against meningitis (vaccination provides protection for three years, but does not guarantee the exclusion of recurrence of the disease).
Taking vitamin complexes appropriate for the child’s age.
Drug therapy (if there are complications, doctors prescribe drugs for symptomatic treatment for children).

Prevention measures

The main measure to prevent serous meningitis is strengthening the protective functions of the child’s body.

Babies with good immunity are minimally prone to infectious diseases.

If the child's health is weakened, then provoke serous meningitis Any inflammatory process can occur (including acute respiratory infections, acute respiratory viral infections, etc.).

Strengthening the immune system includes many activities. If necessary, children are prescribed immunomodulators and immunostimulants.

Preventive measures include the following recommendations:

All diseases in a child must be treated fully and in a timely manner.
Timely vaccination (no deviations from the accepted vaccination schedule should be allowed).
Compliance with personal hygiene rules and providing the child with conditions that meet sanitary standards.
If you have alarming symptoms, you should consult a doctor and diagnose the existing condition.
Control of the child’s diet (complete and balanced menu, eating only washed vegetables and fruits, high-quality food products).
The child should drink only boiled water.
The child’s immunity must be strengthened from the first days of life (nutrition, lifestyle, gentle hardening, taking vitamins appropriate for the baby’s age).

If symptoms of serous meningitis occur in a child, it is necessary to call an ambulance as soon as possible. Self-medication for such a disease should be completely excluded.

The inflammatory process affects the baby’s brain. Any delay in providing qualified medical care may cause death little patient.

You can learn about the symptoms and signs of serous meningitis in a child from the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!