The virus that causes serous meningitis. What is serous meningitis in adults: how is it treated, what are the symptoms and consequences? Main signs and symptoms in children

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

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

Primary meningitis results from a primary lesion of the meninges that is not preceded by any infectious agent. Secondary damage to the meninges occurs after the transferred infection, as a complication.

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

How is serous meningitis transmitted and what is it?

What it is? Serous meningitis is a rapid lesion of the lining of the brain, characterized by a serous inflammatory process that can be caused by 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 foodstuffs - fruits and vegetables with dirt particles, when drinking water unsuitable for drinking, when personal hygiene is neglected.
Serous meningitis is transmitted by airborne droplets when the pathogen is localized in the mucous membrane of the respiratory tract. When coughing, 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 when swimming - in ponds, swimming pools, and is most likely to become infected in people with weak immunity.

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, partial impairment of visual and auditory functions.

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 symptom is the inability to extend the leg bent at a right angle.
Brudzinsky's symptom: lower - if you unbend one bent leg, this leads to reflex flexion of the second leg, upper - if the head is bent, the 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 signs of serous meningitis appear directly:

the temperature rises to 38 degrees and even higher;
a 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 symptoms described, there are:

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

In some patients, only slight malaise is noted, 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 rarely get sick with 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 infection. Serous meningitis in children is quickly diagnosed and easy to treat.

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 be delirious in a dream.

Very often, against the background of the main symptoms, serous meningitis in children is also manifested by signs - a sore throat, cough, runny nose, sensitivity of the eyes. The child becomes easier in a darkened room in a position on the side with the head thrown back.

Serous meningitis in adults: symptoms

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

Similar symptoms are characteristic of various acute respiratory viral infections that are easily treatable, therefore, most patients do not pay special attention to them, in extreme cases, they begin to take various drugs aimed at improving their well-being.

The obvious symptoms of serous meningitis in adults are:

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

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

Treatment

If you suspect meningitis, you should immediately call an ambulance and hospitalize the child or adult in the hospital.

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

With 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, influenza - anti-influenza.

Dehydration is essential for lowering intracranial pressure, therefore diuretics are prescribed - Lasix, Furosemide. At temperatures above 38C, paracetamol, ibuprofen are used. 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 adequate treatment, serous meningitis in children, unlike purulent ones, is benign, not long-lasting and rarely cause complications.

Consequences of serous meningitis

According to doctors, half of patients who have recovered from meningitis still have health problems for many years. After meningitis, patients complain of difficulties in memorizing information, spontaneous muscle contractions, and not severe migraine-like pains.

But these complications are typical for mild forms of the disease. If the disease was difficult, then the person may even lose hearing or vision. In addition, some forms of this disease can provoke a disturbance in the work 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 had the disease. But in very rare and difficult cases, this disease can even lead to death.

Serous meningitis is an inflammation of the membranes of the brain, provoked by the activation of pathogenic microflora of viral, fungal and bacterial genesis. It is accompanied by a pronounced symptom complex that helps in diagnosis. It is possible to determine the presence of serous meningitis and differentiate its causative agent only by bacteriological examination of the cerebrospinal fluid.

There are two ways of infection:

Direct - pathogenic microorganisms enter through mucous membranes, wounds and household appliances from a sick person to a healthy one.
Indirect - the inflammatory process develops as a result of a skull injury, in which the meninges are infected.

A distinctive feature of the serous type of meningitis is the active production of serous exudate. There is no necrotic process, as well as purulent accumulations, which makes this type of disease less dangerous.

After the penetration of microbes into the body and reduced immunity, they spread and settle in biological fluids. Weakened immunity plays a key role in the onset of the disease. If the natural defenses are included in the work immediately, then meningitis can be suppressed on its own without outside help at the stage of the appearance of the first signs of a respiratory disease.

Most often, the inflammatory process is provoked by a viral infection, which develops with the activation of cytomegalovirus, herpes virus, enteroviruses, measles and mumps viruses. Less often, the disease is of a bacterial nature, and fungal lesions are diagnosed extremely rarely and are a consequence of the progression of autoimmune processes in the body.

The risk group includes preschool children attending kindergarten. Frequent respiratory infections weaken the immune system, putting meningitis at risk. At a more mature age, a person develops stable immunity to most of the bacteria that provoke the development of serous meningitis.

Infection routes and incubation period

There are 5 ways of infection:

Airborne - viruses are released along with the air, saliva, and tears of the patient. If a healthy person does not follow personal protective measures, the risks of infection are extremely high.
Contact - when touching the skin and mucous membranes of the patient, viruses can spread over various distances and infect several dozen people at once.
Household - the use of other people's personal hygiene items, clothing or other items guarantees infection, since viruses are perfectly adapted to life outside the human body, while maintaining their biological activity.
Water - characteristic for infection with enteroviruses that can accumulate in the intestines and are carried with the bloodstream to the brain.
From rodents - infectious disease specialists have established that rats and mice are capable of carrying viruses that can provoke meningitis.
Non-infectious - associated with the progression of tumors inside the meninges, which compress the gray matter and cause impaired brain activity.

The incubation period lasts on average 3-10 days. During this time, pathogenic microorganisms actively multiply, causing the release of serous exudate. In turn, this substance causes irritation and pressure on the lining of the brain, causing a number of characteristic neurological symptoms.

Symptoms

Symptoms of serous meningitis depend on the degree of disease progression. The manifestation of the disease is accompanied by a sharp increase in temperature, which falls on the 3-4th day of the disease, but returns on the 5-6th day.

Manifestations in children

In childhood, in the presence of weak immunity, serous meningitis can have an acute course, the clinical manifestations of which are increasing rapidly. The child shows anxiety, constantly lies and complains of pain in the head. Cephalalgia increases with movement, so it is more convenient for the baby to lie on a flat surface with the back of the head thrown back.

A high temperature rises, after which signs of intoxication develop:

dryness of mucous membranes and skin, great thirst;
lack of appetite, nausea, gushing vomiting;
cramping abdominal pain, profuse diarrhea.

After the active production of serous exudate, neurological and meningeal symptoms develop, characteristic exclusively for meningitis:

throwing the back of the head back and tucking the legs under the chest;
constant tearfulness, lack of sleep;
muscle cramps and hypertonicity;
paresis of the limbs, decreased reflexes.

Lack of help leads to the development of an infectious-toxic shock, after which irreversible processes develop in the body.

Manifestations in adults

Serous meningitis in adults is characterized by a more prolonged incubation period and a gradual addition of clinical manifestations. Primary symptoms are associated with increasing intoxication:

decreased endurance;
lack of appetite;
muscle and joint pain.

The body temperature rises rapidly, which cannot be eliminated with the help of medicines and any available means. Cephalalgia is pronounced, which increases with light and harsh sounds. On the 5-7th day, signs of a respiratory disease appear in the form of a runny nose, cough, sore throat.

With the defeat of the cranial nerves, there is a ptosis of the upper eyelid, strabismus, impaired hearing and vision, paralysis of the facial nerves. The stiffness of the posterior cervical muscles develops, in which it is impossible to press the chin to the chest. A slight relief of general well-being occurs when the back of the head is thrown back and the legs are drawn to the chest (the pose of a cop dog).

It is extremely rare that serous meningitis provokes the development of a coma in adults. Usually, the disease slows down by 15 days, and with complex treatment, the condition improves after a week.

Diagnostics

The clinic of serous meningitis helps to suggest the presence of the disease according to the characteristic symptom complex (tilting the head back and reflex bending of the legs in the joints). But the etiology of the disease and the causative agent is determined exclusively with the help of a comprehensive diagnosis:

A blood test is not an informative indicator, since ESR and leukocytosis only slightly exceed the norm.
Examination of cerebrospinal fluid - the cerebrospinal fluid is almost transparent, sometimes it has an admixture of gray threads. There is a slight increase in protein inclusions and a decrease in glucose levels.
Crops from the throat and nose - help to determine the quantitative and qualitative composition of the microflora of the mucous membranes, identifying the pathogen.

Lumbar puncture should be performed daily, since serous meningitis is characterized by a constant change in the picture. In the first days of the manifestation of the disease, leukocytosis develops with a predominance of neutrophils. The next day, the number of lymphocytes increases. After another 2-3 days, proteins and a lack of glucose may appear in the cerebrospinal fluid.

As auxiliary research methods, the following can be used: MRI and CT of the brain, encephalogram, tuberculin tests, electroneuromyography.

Diagnosis of serous meningitis is a lengthy procedure. To minimize the risks of complications, therapy is started as soon as data on the etiology of the disease is obtained. Further research methods can be carried out during treatment.

Treatment

Treatment for serous meningitis depends on which pathogen triggered the meningitis. This is determined in bacterial cultures and lumbar puncture analysis.

The viral etiology of the disease is stopped with the help of antiviral therapy, which is based on medicines containing interferon. In the presence of pathologically reduced immunity, injections of immunoglobulin can be administered. Herpes infection is effectively treated with Acyclovir.

The bacterial etiology of the disease requires antibacterial therapy with broad-spectrum drugs: Ceftriaxone, Cefazolin, Cefix, Ceftazidime. If the tuberculous nature of meningitis is detected, anti-tuberculosis therapy is prescribed in parallel.

Restoration of the water-lytic balance is possible with the help of drip introduction of biological mixtures. With their help, you can normalize the volume of freely circulating blood, as well as speed up the process of removing toxins and toxins.

Diuretics are prescribed to prevent the development of hydrocephalus. With their help, excess fluid is removed from the body, preventing the development of edema. In the case of the development of kidney pathologies, an artificial blood purification procedure may be indicated.

Symptomatic treatment involves the use of drugs of the NSAID group, which have antipyretic and moderate analgesic effects. Neuroprotective agents and nootropics contribute to the restoration of the peripheral nervous system, as well as normalize brain activity. Anticonvulsants help to reduce muscle hypertonicity, and also help to eliminate seizures, normalizing sensitivity in the limbs.

Complications

With delayed treatment or an incorrectly selected drug, the following complications may develop:

violation of brain activity;
problems with speech;
distraction of attention;
decreased fine motor skills;
squint and decreased vision quality;
hearing loss;
decreased sensitivity in the limbs;
slowing down reflexes;
epileptic seizures.

In especially advanced cases, which are preceded by the development of an infectious-toxic shock, a lethal outcome may develop. According to statistics, the serous form of meningitis is one of the easiest for the body. Mortality develops in the presence of serious immunodeficiencies and chronic diseases, which accounts for only 1% of all cases of meningitis.

The consequences of serous meningitis for the child's body are more dangerous. Impaired brain activity provokes the development of inhibition of information perception, which causes mental retardation. In older childhood, such children may differ in developmental level from their peers.

Prophylaxis

There are 5 essential prevention principles that will help reduce the likelihood of infection:

Comprehensive strengthening of immunity - during the off-season, you need to support the body with vitamin complexes, more often be in the fresh air, giving preference to proper healthy nutrition. Bad habits should be abandoned.
Minimizing contact with sick people (especially children) - in a period of high epidemiological danger, it is worth reducing visits to public places to a minimum.
Compliance with the rules of personal hygiene - hands should be washed after each visit to the toilet, as well as before eating.
Refuse to use personal hygiene items of strangers, as they can be infected.
Timely treatment of any inflammatory processes in the body, without starting them to a chronic form.

Serous-purulent meningitis requires long-term treatment and further monitoring by a specialist, which will help reduce the likelihood of relapse.

Prevention of serous meningitis in young children involves a monthly visit to the pediatrician, as well as immediate seeking help if there are characteristic signs of meningitis. Self-medication is extremely life-threatening, as it entails a number of complications.

Forecast

With proper treatment, the symptoms of meningitis begin to recede by 3-5 days, and after 10-12 days, complete recovery occurs. Periodic headaches may persist for up to 1 month, which later disappear. A favorable prognosis is mainly due to the viral etiology of the disease, which allows the body to develop its own antibodies and effectively fight pathogens.

An unfavorable prognosis is observed in tuberculous meningitis, as well as in late treatment in the presence of infectious-toxic shock. The risk group includes children under 1 year old and the elderly. Several specialists should deal with their treatment at once. It is extremely important to visit a neurologist once a month to monitor the rehabilitation process and further development of the child, since meningitis can cause complications.

One of the serious infectious diseases is meningitis. It can be primary or occur against the background of other inflammatory processes. The disease often affects children, but infection of the adult population is possible. One of the forms of inflammation of the lining of the brain is serous meningitis. It is most commonly caused by viral agents.

The disease is characterized by the development of inflammation of the meninges with the formation of serous exudate. Unlike purulent meningitis, pathology in most cases is easier. However, this does not exclude serious complications of the disease in case of untimely or inadequate treatment.

The main symptoms of meningitis include intoxication and severe headache. If pathology is detected, inpatient treatment is required.

History of the study of the disease

The first mentions of serous meningitis are found in ancient sources. Such a disease was described by such scientists as Hippocrates and Avicenna. The complete clinical picture of pathology was published by Robert Witt. He described the disease in detail using the example of tuberculous meningitis, which is one of the varieties of serous inflammation of the meninges. Robert Witt told the world about this disease in the 18th century. Then, the treatment of this pathology was impossible due to the lack of necessary medicines. In the 19th and 20th centuries, there were several epidemic outbreaks of viral meningitis in the Americas, Europe and Africa.

Nothing was known about the etiology of the disease for many years. For this reason, only symptomatic treatment was carried out. The first assumption about a possible etiological factor was expressed by the scientist Weikselbaum. He associated the pathology with the infection of the meninges of the brain with bacterial agents. However, his assumption was wrong. In the 20th century, the doctors of the famous Obukhov hospital were actively studying the etiology of this disease. In the second half of the 20th century, a link was established between meningitis and viral particles. To date, there are many known causative agents of serous inflammation of the meninges.

Causes of occurrence

The etiological factors in the development of serous meningitis include infection of the meninges of the brain with various pathogens. In most cases, these include viruses. However, serous inflammation can also be provoked by some types of bacteria, as well as pathogenic fungi. The causative agents of infection enter the meninges in various ways. The most common of these is the hematogenous pathway.

The causative agents of serous inflammation of the meninges of the brain include the following microorganisms:

Enteroviruses. They are represented by several groups. The most common are Coxsackie and ECHO.
Epstein-Barr virus. This is a rather dangerous pathogen that causes various pathologies, in particular, infectious mononucleosis, lymphomas.
Measles and mumps virus. In these cases, meningitis is a complication of an infectious disease.
Herpes simplex viruses and CMV. These infections lead to the development of serous inflammation of the meninges in people with reduced immunity.
Adenoviruses are more likely to affect children.
Koch's wand. In most cases, meningitis occurs with disseminated tuberculosis.
Pale treponema. Serous inflammation of the meninges is a complication of long-term syphilis.
Mushrooms of the genus Candida. They belong to opportunistic microorganisms and lead to the development of meningitis only with severe immunodeficiency.

Viruses enter the central nervous system by a hematogenous route

In addition to the listed pathogens, benign formations (cysts), oncological and systemic pathologies can lead to inflammation of the meninges of the brain. In most cases, meningitis is a complication of other diseases. Primary serous inflammation of the meninges is diagnosed less often than secondary. Identifying the cause of meningitis is important for treatment choices.

Transmission routes

The way viruses enter the membranes of the brain can be different. The period of time when the pathogen has already entered, but specific manifestations of the disease have not yet been observed, is called the incubation period. With viral meningitis, it is 2 to 4 days.

There are 3 ways of infection:

Contact.
Water.
Airborne.

Infection by contact is possible if hygiene is not observed. In sick people, viruses are found on the mucous membranes and skin, wound surfaces, in the oral cavity. From open areas of the body, pathogens get onto household items, food. As a result, they can easily enter the body of healthy people. The likelihood of contracting the virus increases if there are scratches, wounds or cracks on the surface of the mucous membranes or skin. Most often people with reduced immunity are infected.

The waterway of contamination prevails in the summer. Several viruses live in various rivers and lakes, causing outbreaks of meningitis epidemics. The infection is spread both by bathing and by drinking contaminated water. Most often, the pathogens of enteroviral meningitis enter the body in this way.

Airborne infection is predominant during the cold season. Pathogenic viruses are localized on the mucous membranes of the nose and mouth. In people with normal immunity, these pathogens cause the common cold. However, with a decrease in the body's defenses, they can lead to the development of meningitis.

Classification of pathology

Depending on the pathogen, viral, fungal and bacterial serous meningitis is isolated. A separate type of pathology is aseptic inflammation of the meninges. It is caused by various systemic diseases and tumors. This classification is based on the etiology of meningitis.

The origin of inflammation can be primary and secondary. More often meningitis is a complication of infectious diseases such as rubella, measles, mumps, flu, etc. In some cases, the infection of the meninges occurs immediately, that is, primary inflammation occurs.

Symptoms of the disease

Intoxication, general cerebral symptoms and focal manifestations correspond to serous meningitis in adults. First of all, general weakness and an increase in body temperature develop. Intoxication is accompanied by headache, body aches, decreased ability to work. These symptoms appear during the incubation period and continue for several days, sometimes weeks. General cerebral manifestations are characterized by severe headache. Due to pressing and bursting unpleasant sensations, fear of light and noise appears.

With meningitis developing against the background of ARVI, cerebral symptoms are preceded by a runny nose, sore throat, nausea, conjunctivitis, or pain when swallowing. As the general condition worsens, it becomes easier for the patient to be in a dark and quiet room. Any irritants cause an increase in the headache.

To alleviate the condition, a person takes a specific posture. His legs are pressed to his stomach, his arms to his chest, and his head is thrown back. This position of the body is called the "Pointing Dog Pose".

In some cases, focal symptoms are detected. They develop due to irritation of the brain by inflamed membranes. The manifestations depend on the area of the lesion. These include: impaired vision or hearing, decreased sensitivity on the body, paresis of the limbs. Sometimes convulsive syndrome develops.

Specific signs include meningeal symptoms. With serous inflammation, they can be mild. Typical are: stiff neck and Kernig's symptom. An increase in the tone of the cervical muscles is detected in the supine position of the patient. The patient is asked to press his head to his chest. With muscle stiffness, the patient cannot perform this movement.

To check Kernig's symptom, the patient is placed on his back. One leg must be bent at the knee and hip joints. The symptom is positive if excessive muscle tension is noted. It reaches such strength that a person cannot straighten his leg. Symptoms of Brudzinsky with serous meningitis may be absent or only slightly expressed.

Features in children

Typical signs of inflammation of the meninges in children are an increase in body temperature up to 40 degrees, refusal to breast, constant crying, headache, aggravated by touch, noise and bright light. The child may be disturbed by nausea, vomiting, and diarrhea. Unlike adults, children have a more pronounced dyspeptic syndrome. Consciousness can be disturbed. Most often it is stunning or stupor.

The distinguishing symptoms of serous meningitis in young children are bulging of the large fontanelle and seizures against a background of high fever. If you lift the baby by the armpits in an upright position, then it can be noted that he reflexively presses his legs to his stomach. This indicates a positive Lessage symptom.

Meningitis is often preceded by catarrhal symptoms.

Serous viral meningitis in children of the first year of life can be complicated by encephalitis and hydrocephalus. Subsequently, these pathologies lead to mental retardation. Such consequences do not arise if antiviral therapy is carried out on time.

Certain forms of the disease

Specific forms of the disease include acute lymphocytic choriomeningitis, inflammation caused by Mycobacterium tuberculosis, mumps virus and fungi. These types of pathology have a longer incubation period and characteristic features. Acute lymphocytic choriomeningitis develops within 1-2 weeks. In some cases, symptoms may be disguised as influenza or a common viral upper respiratory tract infection. This form of meningitis differs not only in the defeat of the membranes, but also in the vessels located in the ventricles of the brain. There is a lesion of the cranial nerves, hypertensive-hydrocephalic syndrome. Also, other organs are exposed to inflammation - the heart, lungs, kidneys. Another name for pathology is Armstrong's disease. The virus is carried by mice.

Meningitis of tuberculous etiology may have a chronic course. If untreated, it leads to irreversible changes in the nervous system. In addition to specific symptoms, coughing, sweating, and weight loss are noted. The incubation period lasts up to 3 weeks.

Fungal meningitis more often occurs against the background of HIV infection or primary immunodeficiencies. A feature of this form of pathology is considered to be an erased clinical picture. Body temperature does not exceed subfebrile values, headache is mild, muscle symptoms are absent. General weakness, drowsiness, and inhibited state are noted.

Meningitis associated with mumps in most cases it develops within 1-3 weeks after the onset of infection. More often it is observed in the male population. A pronounced clinical picture with a predominance of neurological symptoms and intoxication is characteristic.

Diagnostics

If meningitis is suspected, blood and urine tests are done to assess the general condition and the presence of specific muscle symptoms. The main material for research is the cerebrospinal fluid. It should have a transparent or opalescent color. Lymphocytes predominate. Purulent meningitis, unlike serous meningitis, is characterized by an increase in the number of neutrophils.

In addition to the analysis of cerebrospinal fluid, smears from the pharynx and nose, and serological studies are carried out. For differential diagnosis, echoEG, electroencephalography, and MRI of the brain are performed.

Study of Kernig's symptom

Treatment of the disease

Timely started therapy will help improve the prognosis of pathology and avoid complications. It includes the appointment of antiviral, pain relievers, diuretics and immunomodulatory agents. Treatment is carried out in an infectious diseases hospital. After investigating the cerebrospinal fluid and conducting serological diagnostics, it is possible to choose an etiotropic therapy. For viral infections, these are preparations containing interferon. If meningitis is a complication of herpes, Acyclovir is prescribed.

Saline solutions are administered to all patients to reduce toxicity. They should not be given in large quantities due to the risk of cerebral edema. To reduce body temperature, antipyretic medicines are used - Ibufen, Paracetamol. With tuberculous etiology of meningitis, specific antibiotic treatment is necessary.

Complications of pathology

The possible consequences of serous meningitis are inflammation of the brain (encephalitis), hydrocephalus, and cerebral edema. In severe cases, they can be fatal. If not properly treated, the patient develops complications such as hearing loss, visual impairment, systematic headaches, cramps of certain muscle groups. Young children may develop physical or mental retardation.

Forecast for life

Most often, the prognosis for serous viral meningitis is favorable. The effectiveness of therapy is noticeable as early as 3-4 days. On average, the course of treatment lasts about 2 weeks. In most cases, there is a complete recovery and no complications.

An exception may be tuberculous and fungal meningitis. With these forms of pathology, long-term treatment is required. Inadequate therapy can lead to patient death. These forms of inflammation are characterized by relapses.

Disease prevention

To avoid the development of meningitis, nonspecific prophylaxis has been developed. It consists in supporting the immune system through vitamin therapy, hardening, and maintaining a healthy lifestyle. During outbreaks of infection, places where large numbers of people congregate should be avoided. If viruses are detected in water bodies, swimming in it is prohibited. Children should be warned about hand hygiene and the need to wash vegetables and fruits.

Meningitis is an inflammatory lesion of the membranes of the central nervous system. This disease is often diagnosed in babies aged 3-7 years, as well as in adolescence and much less often in adults. The disease proceeds with various clinical manifestations, which depend on the type of pathology. A classic form of inflammation is considered to be purulent, in which dead cellular elements predominate in the exudate. Such meningitis is caused by infections involving bacterial agents, in particular meningococcus and streptococcus. However, the disease is provoked not only by microbes, but also by viruses. A similar etiology is common in children and leads to the formation of serous inflammation. This exudate is characterized by a high protein content, especially albumin, and a low cell concentration. Unlike purulent, the serous form is associated with an easier course and a good prognosis. Signs of serous meningitis vary but are quite specific, making it easier to diagnose early.

In medicine, it is customary to distinguish several etiological factors in the development of the disease. The main reasons for its formation are as follows:

Viral agents are the most common pathogens that cause symptoms of serous meningitis in children. This extracellular life form is capable of fully existing and multiplying only in the cell of the host organism. That is why diseases of this etiology are so contagious. A child can become infected with serous meningitis when dealing with a sick person, eating poorly peeled vegetables or fruits, and during the swimming season when swallowing water while swimming. Pathogens that can cause inflammation of the meninges include enteroviruses, herpes, cytomegaloviruses, tick-borne encephalitis virus and a number of other agents. Children are especially susceptible to such an infection due to imperfect defense mechanisms of the immune system.
The bacterial nature of meningitis is characterized by a purulent course. Only a few types of microorganisms cause a serous form of inflammation of the cerebral membranes. These include the causative agents of tuberculosis and syphilis. Children rarely get sick with such ailments due to limited contact with sick people.
Serous meningitis develops not only against the background of viral or bacterial infections. This type of inflammatory reaction is also inherent in lesions of the membranes in cancer of the nervous system, as well as benign neoplasms, among which cysts are common.

Classification by the nature of the pathogen helps clinicians diagnose and treat the disease.

Infection routes and incubation period

Viruses are an extremely mobile life form. Each family of the pathogen has a specific localization. These organisms are tropic, that is, they prefer to live and reproduce in tissues of a certain type. It is with this property that the ways of spreading pathogens are associated. Infection of a child, as a result of which the baby develops signs of serous meningitis, occurs in one of the following ways:

Airborne - viruses are transmitted that spread when an infected person sneezes and coughs. At a high concentration in natural fluids, the release of the pathogen into the environment occurs during respiration. Children become infected through contact with the carrier, as well as when they are in rooms where quarantine has been established or should not have been sanitized properly.
Contact - implies close interaction of the pathogen with the mucous membranes. This happens when you eat unwashed vegetables and fruits, when personal hygiene is not observed, since viruses can settle on the skin or surrounding objects.
Water is partly a kind of contact, but it also involves an alimentary transmission mechanism. Such infection is possible when water is swallowed while swimming in a river or lake.
Transmissive - realized in nature with the help of arthropods. Insects and arachnids are carriers of a number of dangerous diseases, including the tick-borne encephalitis virus, which is accompanied by serous meningitis. This method of spreading the infection is not typical for children, since their contact with carriers is usually limited.

The incubation period for viral diseases ranges from 3-4 hours to 14 days. At this time, no symptoms of damage appear. This is due to the fact that the virus needs to accumulate a certain concentration of antigen in the patient's body, which can cause the development of an inflammatory reaction.

Symptoms of viral serous meningitis

The clinical manifestation of meningitis in children always begins acutely, with a serious rise in temperature up to 40 degrees. The fever is accompanied by severe headache and arthralgia - discomfort in the joints. Children often cry for a long time, turn red, and sweat. Serous meningitis is characterized by a specific lesion of the muscles in the back of the neck, which makes it difficult for the patient to tilt his head forward. Toddlers take an unnatural position. There are gagging, impaired coordination. With inflammation of various parts of the meninges of the brain, excessive sensitivity to sound, visual and tactile stimuli is formed. In young patients, serous meningitis is accompanied by symptoms of acute respiratory infections: cough, rhinitis, and sneezing. With a severe course of the disease, the development of convulsive phenomena is possible, which is dangerous with respiratory disorders.

The consequences of serous meningitis in children can be catastrophic. In infants, with the formation of general intoxication, sepsis rapidly develops, which is difficult to respond to antibiotic therapy. A common complication of inflammation of the cerebral membranes in children is the occurrence of cerebral edema, which requires placement in the intensive care unit.

The viral etiology of serous meningitis has one positive feature - a rapid course. Convalescence with supportive treatment and the absence of concomitant diseases occurs as early as 10–12 days, and a decrease in temperature occurs within 3–4 days. This does not mean that children should be treated independently if they develop symptoms characteristic of inflammation of the membranes of the central nervous system. Suspicion of this or that pathology is a reason for seeking medical help, since any infectious diseases at an early age cause serious multiple organ disorders.

Diagnosis and treatment of the disease

A local pediatrician can suspect meningitis in a child, since there are several specific tests to determine the inflammatory processes of the cerebral membranes. Further examination includes checking blood and urine parameters, as well as immunological diagnostics using methods such as polymerase chain reaction and enzyme-linked immunosorbent assay. Lumbar puncture and further examination of the obtained samples of cerebrospinal fluid for the presence of a foreign agent are valuable in identifying meningitis.

Treatment for serous meningitis depends on the etiology of the disease. Unfortunately, at the moment, drug control against viral pathogens is very limited due to the lack of specific therapy against many agents. An exception is, for example, herpes, which is successfully fought with "Acyclovir". In most cases, treatment is carried out with interferons - stimulants of the antiviral immune response. Antibiotics are widely used, since the disease proceeds with the addition of secondary and secondary microflora, which can negatively affect the health of the child. General supportive therapy is used in the form of parenteral administration of vitamins, as well as infusion infusions, which normalize the rheological properties of the blood and help cleanse the body of toxic waste products of the pathogen. If complications arise, appropriate means are used, for example, diuretics and nootropics.

Preventing the transition of the disease into a purulent form is important in the treatment of serous meningitis. The abundance of leukocytes and necrotic cells creates a kind of film on the surface of the brain and its membranes, which aggravates the course and negatively affects the prognosis of the disease.

With timely diagnosis and adequate care, serous meningitis is easily treatable. Strict adherence to the doctor's recommendations leads to a quick recovery.

Prevention of the incidence of serous meningitis in children

Prevention of inflammatory diseases of the brain and its membranes is primarily reduced to maintaining the child's immunity. Defense mechanisms play an important role in the fight against both viral and bacterial pathogens. Proper and complete feeding is required, which provides the growing body with the necessary vitamins and minerals for normal growth and development. Compliance with the rules of personal hygiene is an important condition for the prevention of diseases caused by foreign antigens. Only heat-treated water is allowed for use by children. Fruits and vegetables must be thoroughly washed, and it is better to pour over boiling water. Swimming in bodies of water during a meningitis outbreak is not recommended. Since some viral and bacterial pathogens are characterized by a cycle with the participation of vectors, it is worthwhile to walk with caution with children in the forest during the active life of ticks and rodents, which are potential carriers of dangerous ailments.

Serous meningitis is a polyetiological disease characterized by non-suppurative inflammation of the membranes of the brain and spinal cord.

The main feature of serous meningitis is the non-purulent nature of the exudate (lymphocytes predominate in the cerebrospinal fluid). They are characterized by a milder course and a more favorable prognosis for recovery.

Classification of serous meningitis

Depending on the agent that caused the disease, serous meningitis is divided into several types:

caused by viruses, that is, viral. The main culprits are the Coxsackie and Echo viruses;
caused by bacteria, i.e. bacterial. The causes are pathogens that cause syphilis and tuberculosis;
caused by fungi. So-called opportunistic infections: fungi of the genus Candida, Coccidioides immitis.

Depending on the origin, serous meningitis is divided into:

primary (the agent directly caused damage to the meninges, for example, enteroviruses);
secondary (as a complication of another infection: measles, influenza meningoencephalitis, etc.).

How do you usually get sick with this ailment? I would like to note that this pathology is more common in children, and among adults, people with immunodeficiency are mostly sick. The incubation period takes several days on average. Seasonality is also characteristic: summer season. The following routes of infection are distinguished:

airborne (the pathogen is in the patient's respiratory tract and is transmitted by coughing, sneezing, talking);
contact (pathogenic agents, being on mucous membranes, get on various objects, therefore, without adhering to the rules of personal hygiene, you can get infected and get sick);
water (outbreaks of enterovirus infection are most often recorded in the summer, when swimming in open water).

Symptoms of enteroviral serous meningitis

The disease debuts with fever and severe headache.

After a short prodromal period, there is a high body temperature of up to 40 degrees C and general signs of intoxication in the form of severe general weakness, pain in muscles and joints, and malaise. The patient is also worried about abdominal pain, bloating, upset stools. The disease proceeds in waves, after a slight decrease in temperature on the 4th day there may be a second candle. If there is a mild course, then on the 5th day the body temperature is normalized. Throughout this time, the patient is worried about a constant intense bursting headache, which intensifies with the slightest movements. At the peak of the headache, vomiting is possible, which does not bring relief, hallucinations are possible. Due to hyperesthesia (increased sensitivity to the slightest irritants), it is easier for the patient to be in a darkened quiet room or to wrap his head in a blanket. Bright lights, loud noises, and touching make headaches worse. Serous meningitis proceeds much easier than purulent, therefore there are no pronounced disturbances of consciousness, the patient may be stunned. A clinical examination reveals a positive meningeal syndrome, as well as Kernig and Brudzinsky syndromes.

Lymphocytic choriomeningitis

This disease is also called Armstrong's meningitis. The inflammatory process involves not only the meninges, but also pneumonia, myocarditis, and mumps are observed. Infection occurs from domestic mice. The disease occurs more often in the winter-spring period of the year. The process also involves the choroid plexus of the ventricles of the brain, which ultimately leads to hypertensive-hydrocephalic syndrome. The disease begins abruptly, with an increase in body temperature, vomiting, headache. The patient has a pronounced agitation, there are often visual and auditory hallucinations. In neurological symptoms, unstable damage to the optic, auditory nerve, sometimes the abductor and oculomotor nerves is possible. After 10 days, the patient's condition improves significantly, but the headache may persist for several more weeks.

Secondary serous meningitis can develop with influenza, herpes, measles.

Diagnostics of the serous meningitis

The presence of only one meningeal syndrome does not allow verification of the diagnosis. With any type of cerebral edema, the phenomena of meningism are observed. To confirm the diagnosis, data from the anamnesis of the disease, examination of the patient, data of clinical and laboratory examination, as well as the diagnosis of lumbar puncture (puncture of the cerebrospinal fluid) are taken into account. Transparency and predominance of lymphocytes will be characteristic of serous cerebrospinal fluid. In disputable cases, according to the indications, a CT study is carried out, and the most accurate is PCR and ELISA, which relate to express diagnostics.