Purulent purulent meningitis is a bacterial invasion of the brain of different spinal cord membranes, causing an acute infection of the central nervous system diseases. For common diseases, particularly in patients with multiple children. Clinically, a rapid onset, high fever, headache, vomiting and meningeal irritation springing characteristics. If not treated early or not complete, may be due to shock, DIC, or life-threatening legacy aphasia, hemiplegia, and mental disorders after-effects. Case-fatality rate for pneumococcal meningitis, the highest, about 30 ~ 60%.
Many bacteria can cause the disease, including meningitis, caused by bacteria most often, followed by Haemophilus influenzae, pneumococcus, Escherichia coli and other gram-positive bacteria (eg Klebsiella pneumoniae, Pseudomonas aeruginosa) bacteria Staphylococcus and Lee Division Intuit , anaerobes, and so on.
(A), the symptoms
A sudden high fever, chills, severe headache, vomiting associated with spray. Infant may have alternating irritability and lethargy, eyes staring; shrill cry, refusal to milk, easy to panic and so on. In severe cases, quick access to a coma.
2, poisoning face, skin petechia, neck stiffness, pathological reflex positive. Babies fontanelle bulge full, horn bow against Zhang. Such as the dehydration of the infant, do not justify the performance.
3, a variety of acute purulent meningitis features:
(1) meningitis: incidence of more than 2 ~ in April. More common in preschool children. Early stage of skin petechia or ecchymoses, its more than 2 mm in diameter. 3 to 5 days after the illness often with a nose around the perioral herpes simplex.
(2), pneumococcal meningitis: incidence in spring and autumn season in the main. More common in children less than 2 years of age or adults over the age of 50. Often accompanied by pneumonia or otitis media.
(3) The influenza bacillus meningitis: more common in children less than 2 years of age, compared with the above-mentioned two types of onset has slowed down, the more obvious early symptoms of upper respiratory tract.
(4), Staphylococcus aureus meningitis: often accompanied by purulent skin infections such as pyoderma, folliculitis, etc. can be seen in some patients with scarlet fever in early stage disease, or urticaria-like rash.
(5) Pseudomonas aeruginosa meningitis: more common in cases of craniocerebral trauma can also be a result of lumbar puncture or spinal anesthesia when the disinfection of lax pollution caused by the development of more moderate course.
4, laboratory examination:
(1) CSF: cerebrospinal fluid pressure was significantly increased, turbid appearance, showing rice soup-like. Cell count increased to 1,000 / mm3 and above, with the main neutral multinucleated cells. Protein and blood, she was test positive. Reduction of sugar and chloride. Smear or culture can find the corresponding pathogen. Pneumococcal meningitis in advanced cases can be expressed as proteins, cell separation.
(2) blood culture: a pathogen generation.
(3) blood count: white blood cells increased significantly, mainly in neutral multinucleated cells. Staphylococcus aureus meningitis, but when the WBC count may be normal or slightly lower, with a clear shift to the left phenomenon, and there are toxic particles appear.
(4) skin petechia smears: ECM the patient's examination, can be found in meningococcus.
5, immunological test: CIE, lactic acid and collaborative agglutination test agglutination test for rapid diagnosis of meningitis positive rate of 80% or more; indirect hemagglutination, hemagglutination inhibition test, fluorescent antibody staining, radioimmunoassay Dengjun help rapid diagnosis.
(B), prevention and prognosis of
1, exercise the body, enhance physical fitness, improve disease resistance.
2, such as the existence of pneumonia, otitis media, skin infections, etc., should make early use of antibiotics to prevent bacteria and the incidence of meningeal invasion.
3, early treatment, the treatment properly, may be cured, such as delays in treatment, poor prognosis, or sequelae.
4, for children under 15 years of age may be vaccinated meningitis vaccine, there is a certain role in the prevention of epidemic cerebrospinal meningitis, immunization is valid for 1 year.
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