Synonyms in a broader sense
bacterial meningitis, hood meningitis, convexity meningitis, leptomeningitis, meningococcal meningitis Medical: Meningitis purulenta
Definition
The term purulent meningitis (purulent meninges) describes a purulent inflammation (-itis) of the meninges (meninges), which can be caused by various pathogens. The purulent meningitis (purulent meningitis) is usually caused by bacteria. It is accompanied by high fever and a severe general clinical picture such as clouding of consciousness and is an absolute emergency that must be treated immediately.
Symptoms
The symptoms of purulent meningitis are usually similar for all pathogens. It often begins with a phase of flu-like symptoms like: This phase is medically called the prodromal stage. The prodromal stage is followed by the generalization stage.
In this stage, the pathogen floods the body and then enters a very acute, severe clinical picture:
- Lassitude
- Temperature RiseFever
- Limb Pain
- High fever
- Severe headache (stage of meningitis)
- Neck stiffness (meningismus)
In infants and toddlers it is more difficult to detect meningitis as such. The symptoms are not as pronounced as in adults. Children can be apathetic or shrill and refuse to eat.
Signs of intracranial pressure are vomiting and a bulging fontanel (bone gap in the infant’s skull). The child’s meningitis should be treated in a pediatric clinic if possible. Patients cannot place their head on the chest or can only do so in severe pain because this movement stretches and irritates the inflamed meninges surrounding the spinal cord neck marrow (positive stretch sign).
Patients show increased sensitivity to all sensory stimuli; touching the skin, bright light or loud sounds are perceived as painful. There is often dizziness and chills. Often encephalitic symptoms develop.
This means that not only the meninges but also the brain is irritated, which can be accompanied by disturbance of consciousness and psychological symptoms. Meningitis often also affects the brain, as it is flushed with the “pathogenic” nerve fluid (meningoencephalitis). Consciousness is then often clouded and can range from mild dizziness to delirious states to coma.
Patients may be confused and misunderstand their surroundings, which is why older patients are at risk of misinterpreting the disease as a stroke or acute confusion. Other symptoms may include marked agitation or seizures (epilepsy). In 10 % of patients, there is a cerebral nerve involvement, in 10-20 % hearing disorders due to a co involvement of the labyrinth of the inner ear.
Due to the inflammation in the brain, intracranial pressure may also build up (intracranial pressure increase), because inflammatory processes tend to be accompanied by swelling and water retention (edema), so that the body’s own defenses can work better (as is also known from insect bites, for example). In most inflammatory processes, this swelling can move outwards. However, since the skull is limited by bones on the outside and there is not much room on the inside, the brain literally squeezes itself together when it swells (brain edema).
Signs of increased intracranial pressure are vomiting and rapid deterioration of consciousness. Vital centers in the brain are then compressed and irritated. Sometimes the cerebral pressure builds up so quickly that it can no longer be controlled, and life-threatening conditions can occur despite immediate treatment.
In particular, meningococcal meningitis (meningococcal encephalitis) can cause small punctiform bleedings of the skin that cannot be pushed away (petechial exanthema). If they occur, the utmost urgency is required, as they are signs of blood poisoning (sepsis) by the bacteria or their components, the endotoxins = bacterial toxins. 75% of patients with meningococcal meningitis have such or other skin lesions.
Meningococcal sepsis (approx. 50% of cases of meningococcal meningitis) is more dangerous than meningitis itself because the endotoxin toxins of the bacteria activate the coagulation system in the blood and consume the coagulation factors dissolved in the blood (consumption coagulopathy, disseminated intravascular coagulation).This causes bleeding not only into the skin, but also into other organs, especially into the adrenal gland (Waterhouse-Friedrichsen syndrome), shock symptoms may occur (endotoxin shock). Despite timely treatment, the lethality (mortality rate) for this sudden course of disease is still 85%.
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