Мeningeal syndrome in clinic of infectious diseases. Meningococcal infection

MENINGITIS - inflammation of meninges of brain and spinal cord. Acute

By character of inflammation and changes in the cerebrospinal fluid:
• Serous;
•

PATHOGENESIS
The entrance gates for causative agent can be:
nasopharynx,
respiratory tract,

- Destruction of bacteria,
- releasing of endotoxins,
- development of toxemia,
- increased

Irritation of structures of the diencephalic region
(centers of thermoregulation, vomiting and

Cerebral syndrome:
headache – strong, diffused, sometimes local, increases when changing

Meningeal syndrome - develops due to irritation of cerebral baroreceptors by

- Brudzinski’s contralateral reflex sign – has two components:

2-d group – symptoms of general hyperesthesia and hypersensitivity of the

Syndrome of inflammatory changes in the cerebrospinal fluid
The investigation of CSF

Inflammation of meninges is accompanied by the following changes of CSF:
•

Type A – turbid, mononuclear cells < 50, polymorphic( 90%)

Differential-diagnostic signs of meningitis by CSF

Differential-diagnostic signs of meningitis by CSF

Differential-diagnostic signs of meningitis by CSF

Primary purulent meningitis is of meningococcal, pneumococcal, Haemophilus influenzae etiology.
Secondary purulent

Diagnostic criteria of primary purulent meningitis
Meningococcal infection – is acute respiratory

EPIDEMIOLOGY - anthroponosis
Source: Epidemiological danger
- patients with generalised forms of

Causative agent - Neisseria meningitidis
- Small gram-negative diplococci;
- typical

CLASSIFICATION
Localized forms:
- Carriage –without clinical manifestation, can

CLINIC
1. Acute onset;
2. Rise of body temperature (to 39-40ºC),
3. Expressed intoxication,
4.

• Meningeal syndrome appears in the first days of the disease

• 30-40% cases of meningitis is combined with Meningococcemia:
hemorrhagic rash on

• CBC: leukocytosis, neutrophilia, shift of the formula to myelocytes, lymphopenia,

• Bacteriological examination of mucus from the nasopharynx, blood, cerebrospinal fluid

NASOPHARYNGITIS - clinical manifestations:
Moderate parietofrontal headache - 52 %

TREATMENT
Morbidity of generalized forms of a meningococcal infection is changed in

- Cefatoxim 1g. IV or IM in q 12h
-

Pneumococcal meningitis
• Anamnesis –
Source - patient with various forms

• Onset is acute.
- Rapid rising of body temperature

• Course of the disease varies from malignant forms with lethal

• Cerebrospinal fluid is turbid, of yellow-grey color with metallic shade.
Cell

SEROUS MENINGITIS
- is a group of CNS diseases with

The etiology of primary serous meningitis is most often of viral

Pathogenesis
Penetration of the pathogens in the blood
2. Activation of biologically active

Clinical manifestations in serous meningitis are formed from the same syndromes

Enteroviral meningitis
Is caused by ECHO and Coxacky virus of different

Incubation - 2 - 8 days;
Acute onset with expressed intoxication syndrome

6. Hypertensive-hydrocephalic syndrome - in the first days of the disease