Meningitis - SpeedyLook encyclopedia

Responsible germs

Meningitides correspond to an inflammatory attack of the meninges. The person in charge is generally of infectious origin:

Virus, in 80% of the cases (Coxsackie often has virus in question). They are then benign and the re-establishment is generally spontaneous;
Bacterium, in 20 to 25% of the cases. These infections are particularly serious and can be fatal;
more rarely by a parasite or a mushroom.

The agents responsible for bacterial meningitides are mainly:

méningocoque the Neisseria meningitidis of the type B (60% of the cases) or C (26% of the cases); more rarely of type has, Y (in 3% of the cases) or W135 (6% of the cases),
the Streptococcus pneumoniae ,
Listeria monocytogenes (Listériose),
the bacillus of Koch (Tuberculose)

and in certain circumstances:

the Streptocoque B (at the premature one),
the staphilococcus gilded (Neurosurgery)
Salmonella typhi

Main doors of meningitis

surgery
cranial traumatism or ORL
angina
sinusitis
otitis
other causes…

Signs and symptoms

Bacterial meningitis causes serious reactions which appear in the space of a few hours.

Of the infectious signs (fever, shivers)
a Syndrome meninx including:

violent one headaches (cephalgias);
vomiting out of jet;
Photophobia (dazzling by the light);

one will purpura (red-purplished tasks or bruises)

Sometimes signs of Encéphalite are added:

somnolence, confusion, epilepsy, deficit sensitivo-engine (paralysis or parasthesy).

One then will speak about meningoencephalitis, which constitutes a medical emergency.

The symptoms at the babies comprise:

difficult alarm clock;
high fever;
irritability;
loss of appetite;
vomiting;
acute tears or moanings;
tints pale or blafard;
fever, evils of tète, hypotonia at the baby, sensitivity to the light;
eruption of purplished spots or fontanelle Bruise S.
tended

Characteristics: it is about a Medical emergency. Gravity is related to the neurological risks of after-effects (frequent in the older child of less than four years, psychomotor delay, Surdité).

The symptoms at the old subjects are:

behavioral problem
convulsions
cephalgias

Obligatory declaration

In France and Belgium, this disease is on the list of the Infectious illness to obligatory declaration.

Incidence

Pathology

Symptoms

The principal symptom is the Céphalée. It is often intense and diffuse and can be accompanied by vomiting.

A clinical examination makes it possible to confirm the syndrome meninx (in particular by a observation of a stiffness of the nape of the neck).

Diagnosis

The interrogation by the doctor makes it possible to specify:

- the mode of appearance (if the pain appeared brutally, the diagnosis will be directed rather towards a méningée hemorrhage, whereas a less brutal appearance makes think of an infectious cause).
- the context (surgery of cranium, certain diseases…)

Complementary examinations are necessary:

- Tomodensitométrie cerebral;
- lumbar Puncture. This impressive and unpleasant but not very dangerous examination (unless being reached of intracranial hypertension with obviousness of expansive lesion of the brain a such abscess, a tumor, a hemorrhage, etc) consists in taking a little liquid céphalorachidien, the fluid which surrounds the meninges to see whether it contains germs and if its composition and its pressure level are modified.

It is according to the results of this analysis that an adapted treatment will be managed with the patient.

Treatment

A hospitalization in urgency is imperative.

The injectable administration of 500mg of amoxicilline improves the forecast without compromising the continuation of the diagnosis (identification of the bacterium). The treatment depends on the diagnosis carried out. The treatment of a viral meningitis is not specific of this disease, but rests mainly on a symptomatic treatment.

The treatment of a bacterial meningitis rests on a antibiothérapie with strong amount by probabilistic intravenous way before the first results, adapted secondarily to the germ found with the direct examination then with the antibiogramme (24-48h afterwards).

Vaccination

Vaccines available

To prevent meningitides with méningocoques three vaccines are available today in France:

the vaccine combined against the méningocoque one of sérogroupe C;
the vaccine against the méningocoques ones of sérogroupes A+C;
the tetravalent vaccine against the méningocoques ones of the sérogroupes has, C, Y, W135 reserved in the approved centers of vaccination.

Vaccine recommendations

In France, vaccination the vaccine recommendations concerning the invasive infections with méningocoques C (except travellers) appeared in the calendar 2003. Thus, the vaccine anti-méningocoque C combined is recommended by the health authorities for the following groups at the risk:

the subjects contacts of a case of infections with méningocoque C;
In the geographical areas where the infections méningocoque C are frequent;
children presenting of immunizing deficiencies.

Vaccination against the méningocoque a.c. an effectiveness of more than 90%. It is practiced in only one injection in the children of more than one year, the teenagers and the adults and in three injections in the infants from 2 to 12 months.

If these recommendations do not concern your child, you can, if you wish it, make it vaccinate. Do not hesitate to speak about it with your doctor. Meningitis is a fatal disease, but a disease which one can prevent today. It would be a shame to occur some.

Complications

The possible complications of meningitis are numerous:

focal neurological Deficits (for example, paralysis of cranial nerves)
neurosensory Deafness
Behavioral problem
Backwardness
Epilepsy
Syndrome of inappropriate secretion of ADH (SiADH)
Coma
Death

Legends and beliefs

Rainwater contained in the basin at the top of the " Pierre with the nine steps " in Soubrebost, Digs, was supposed to cure the children of meningitis.

'Is Cameroun one has protects the children against meningitis in their giving alcohol to drinking.

Notes and references of the article

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