And whether you know...
The meningococcal infection meets rather infrequently now. It is an illness which you have antroponozny character and it is transferred from the person to the person in the airborne way. Clinical manifestations at development of an infection are especially various: it can be and the carriage of a meningokokk, and heavy meningococcal sepsis which proceeds immediately is exclusive.
Prevalence of a meningococcal infection
Infestant — the gram-negative diplococcus of Neisseria meningitidis who shows high sensitivity to external factors. Out of a human body he perishes in 30 minutes. Today scientists allocate 13 serotypes of the activator.
As a rule, the meningococcal infection in civilized countries meets seldom: on only 100 thousand of the population it is fixed from 1 to 3 cases. At the same time the meningococcal infection is most often diagnosed for children (about 80% of total quantity of cases of incidence). Most often symptoms of a disease are fixed at children to three-year age. Children aged till one year are especially susceptible to influence of the activator. For this reason prevention of an illness is so important. And at the slightest suspicions on its development the operational address to the doctor that timely diagnosis and adequate treatment were undertaken in time is necessary.
Increase in number of the diseased which characterizes so-called epidemiological rises is fixed in the world each 10-20 years. In spite of the fact that the illness affects people for a year, a certain tendency to seasonality of a disease is noted.
It is possible to catch a disease from the carrier of bacteria or the sick person. In view of the fact that the illness is transmitted in the airborne way, special danger to people around is constituted by patients at whom catarral manifestations are noted. Children can be infected in children's collectives at close contacts as infection and from externally healthy person is possible.
The most often lethal outcome at a course of a disease is fixed at children of the first year of life. The matter is that at children of this age category superacute meningococcal sepsis which effect is infectious and toxic shock, as a rule, develops. Sometimes the infection also provokes development of heavy purulent meningitis which is complicated by brain hypostasis.
Symptoms of a meningococcal infection
If at the child or the adult the meningococcal nasopharyngitis develops, then the clinical picture of an illness is, as a rule, similar to a nasopharyngitis at ORZ. About three days at the patient can be celebrated subfebrile body temperature. Sometimes fervescence does not occur in general. The person is disturbed by a headache in moderate degree, a small congestion of a nose. The expressed catarral phenomena are not noted. The soft hyperemia of a pharynx can be also shown, and at a back wall of a throat there can be a path from pus and slime. As a rule, the meningococcal nasopharyngitis is shown before development of generalized forms of an illness. Sometimes the patient does not even note an aggravation of symptoms.
The sharp beginning is characteristic of a meningokoktsemiya: jump of body temperature which increases 38-39 °C, strong pain in joints and mice, a fever, vomiting, headaches. A characteristic symptom of this state — hemorrhagic rash. As a rule, it appears in the first days of an illness or at the beginning of second day.
At especially severe forms of a disease such rash develops at the person literally during the first hours after an onset of the illness. Specialists consider this sign adverse from the point of view of the forecast of development of an illness. Rash initially develops small spots of light pink color on extremities and a trunk of the person. Sometimes mistakenly such rash is taken for displays of an allergy. Soon after on site spots hemorrhages which have the wrong contours develop and, being formed on pale skin, are similar to a tracing of the star sky. Such rash imitates generally lower part and lateral zones of a trunk of the patient, it is shown also on hips. A bit later rash becomes more dark, in the center of hemorrhages necroses are formed. Gradually elements of rash are enlarged, merge and strike big body parts. In this case it is mainly extremities, toes and hands. Sometimes the necrosis which consequence dry gangrene of a nose, auricles, phalanxes of fingers turns out to be progresses. If rash develops on centuries, a face, auricles, then the forecast similarly adverse. At this state at the patient hemorrhages in a mucous membrane of eyes can be shown. If the illness proceeds hard, bleedings — uterine, nasal, renal, gastrointestinal are possible.
In the course of an aggravation of symptoms at the person different degree of infectious and toxic shock can develop.
At purulent meningitis illness symptoms are shown sharply at once. Body temperature of the patient reaches a point of 39-40 °C, sometimes above. Generally the patient complains of very severe headache which extends to a forehead and a nape. Pain sharply amplifies, becomes absolutely intolerable. The person suffers from vomiting attacks, at the same time he does not feel nausea. If the patient accepts drugs analgetics, then they give only very weak effect for a short time. In such state at the patient the hyperacusia, a hyperesthesia, a photophobia is shown.
If purulent meningitis is shown at the small child, then he, unlike stay in other painful states, does not want to go on hands to mother, and remains in a bed, accepting the stood pose as the headache becomes more severe at any movement. The pose on one side is most convenient in this state, at the same time knees are given to a stomach, and the head is thrown back.
At the baby at purulent meningitis the fontanel strains though at very frequent vomiting it can sink down inside. During the first hours after the beginning of a disease the child is excited, later he becomes slowed down and sluggish. The kid can faint, suffer from periodically shown spasms.
At development of generalized forms of a meningococcal infection sometimes manifestation of the main symptoms accompanies development of symptoms of arthritis and polyarthritis. Joints, as a rule, are surprised on one side of a body. Generally there is a damage of small joints, large suffer less often.
Less often the meningococcal infection is shown in the form of an endocarditis, a panophthalmia, an iridocyclitis, a pericardis, pneumonia.
Weight disease, and also recovery directly depends on whether timely diagnosis and the correct approach to treatment was provided. If the patient is brought on treatment to a hospital only in a day after emergence of the first symptoms of an illness, then such address is considered late. Therefore, the probability of manifestation of complications, and also risk of a failure sharply increases. But if treatment was begun in time and carried out correctly, then the patient completely recovers.
As complications of an illness damage of acoustical nerves can be shown that becomes afterwards the relative deafness reason. At chest kids complications which have bacterial character are often shown. It is hydrocephaly, ventrikulit, a subarachnoidal empyema, paresis, brain abscess, paralyzes. If at a meningokoktsemiya necroses do not begin to live too long, their secondary infection is possible.
In view of fulminant disease, and also too big risk of a lethal outcome it is very important to diagnose an illness as soon as possible and to start its treatment. The last is especially important if it is about the sick child.
At a stage of first aid doctors can already identify symptoms of an illness and quickly send the patient to a hospital.
It is necessary to consider that for establishment of the diagnosis at a meningococcal infection of the child the doctor has not enough time. If during the first hours diseases specific symptoms still are not even shown, then already 24 hours later the illness threatens the patient's life.
Suspicion on this illness at the general practitioner can arise if at the child so-called basic signs are noted: acute onset of the illness, fever, hemorrhagic rash.
If there are such suspicions, then the patient needs to conduct specific laboratory research quickly. In this case carry out both bacteriological, and serological researches. In bacteriological analyses cerebrospinal fluid, slime from the patient's nasopharynx, blood is used.
To diagnose meningitis, the lumbar puncture is carried out.
At a meningokoktsemiya it is important to differentiate rash from allergic reaction. At a meningococcal infection rash is changeable, disappears for a short span. Prodromal rash reminds also rash at measles. However clumsy rash arises only in 4-5 days after at the patient the beginning of the catarral period was noted.
At an infectious mononucleosis rash also reminds measles. But before an onset of the illness at the patient quinsy symptoms are noted, it increases lymph nodes. Rash at scarlet fever has accurate differences with rash at a meningokoktsemiya, but also in this case the hemorrhagic component is shown. Rash at scarlet fever affects flexion surfaces of extremities, generally it develops in places of natural folds.
At hemorrhagic vasculites rash at the child is shown on skin of buttocks, ankle joints symmetrically, most often it develops after the postponed acute respiratory disease.
It is very important that treatment began at once after establishment of the diagnosis. The scheme of therapy depends on that, disease, and also from existence of complications is how heavy.
Initially help to the patient is given surely by that doctor who diagnosed a meningococcal infection, or he has a suspicion message on its development. To the patient intravenously levomycetinum succinate and Prednisolonum is entered at once. If the patient has signs of infectious and toxic shock, then for therapy high doses of corticosteroids are used.
Patients with generalized forms of a meningococcal infection are urgently hospitalized in infectious department of hospital. If the condition of the patient heavy, then is carried out it hospitalization to the intensive care care unit. In out-patient conditions it is possible to treat only the localized disease forms.
At a nasopharyngitis, a meningokokkonositelstvo antibacterial therapy is also carried out.
If purulent meningitis is diagnosed for the child or the adult, then after first-aid treatment infusional therapy with use of saline and colloidal solutions is carried out. Also in the course of complex treatment drugs-antipyretics, furosemide are applied, and in case of spasms diazepam is used. Also the doctor appoints complex antibacterial therapy, individually selecting doses and kinds of drugs.
Besides, it is important to provide to the patient plentiful and frequent drink, reception of a complex of vitamins. It is important to enter the vitamins belonging to group B, ascorbic acid, Cocarboxylase. In the course of treatment will be applied also an oxygenotherapy.
According to supervision of physicians, at an extract from hospital still it is impossible to call most of patients completely healthy, therefore, all functions which are not broken in the course of an illness are recovered. Those children for whom purulent meningitis was diagnosed after an extract on an extent of several years have to visit the neurologist regularly. Most often after a meningococcal infection at children the tserebrastenichesky syndrome of which the high level of fatigue, disorder of appetite and a dream, low progress is characteristic is observed. If the small child, he can show emotional instability, absent-mindedness and even signs of aggression. The child with such syndrome needs to provide the facilitated day regimen, good rest, to limit contact with the TV and office equipment, to practice more long dream, daily walks. During recovery after an illness nootropic means, reception of polyvitamins, vascular drugs can be appointed.
It should be noted that at signs of a meningokokk it is impossible to be treated at home without call of the doctor at all. By means of national methods it is possible only at first to try to facilitate the general condition of the person. The patient needs absolute rest, the twilight in the room. Extremities lay over wet cold rags, the cold can be put to the head. It is recommended to drink much. If at the child spasms are shown, then before arrival of the doctor it is possible to wrap it in the sheet moistened in solution of salt and vinegar which are dissolved in warm water. The sheet is well wrung out, and the child is wrapped up in it for half an hour. From above he needs to be wrapped up with warm blankets.
If the diagnosis "a meningococcal infection" was established to the child, then in institution which he visited, 10-day quarantine is established, it is observed children. For the purpose of prevention it appoints reception of rifampicin for two days.
The main preventive measure promoting protection against an infection which provokes meningokokk is this disease inoculation. If the child received a vaccine earlier, then it gives a guarantee that even at infection at him serious consequences will not develop. Vaccination is carried out if in children's collectives there is a threat of epidemic outbreak of an illness. Immunity after an inoculation develops from the fifth to the fourteenth day. Repeatedly vaccination is carried out 3 years later.
Other general measures of prevention is increase of protective forces of an organism by public methods, healthy and active lifestyle, timely treatment of infectious diseases.
Section: Infectious diseases