Pediatric meningitis is a disease that we should pay attention to. There are many abnormal phenomena after the children get sick. We must make prompt judgments and make reasonable tests to diagnose them.
Pediatric meningitis symptoms
1, just started with the symptoms of a cold, cough, stuffy nose, runny nose, often misdiagnosed. Then the disease will rapidly develop into a high fever, severe headache, nausea, frequent vomiting, vomiting and more spray-like appearance, which may also appear drowsiness, fatigue, neck stiffness, sensitivity to light, skin and mucous membrane petechia petechia these Phenomenon, this time the condition has been very serious. If convulsions, coma, shock and other phenomena, it has endanger the health of people.
2, in newborns and infants, not necessarily high fever, and sometimes there will be a low-grade fever. Also accompanied by sharp and continuous crying, unusual drowsiness, abnormal sensitivity, poor appetite, eyes stare and so on.
3, children with meningitis will have sinus infection, and there will be upper respiratory tract infection. Bacterial meningitis is a particularly serious condition that requires prompt treatment if there is no aggressive treatment. Otherwise, bacterial meningitis is not treated, it will be life-threatening.
4, Pediatric meningitis is relatively rare, in the United States, annual incidence of children with meningitis or even no more than three thousand patients, most children with meningitis are infants under the age of two. The symptoms of infantile meningitis are similar to those of a cold. Pediatric meningitis patients have symptoms of fever and headache, and can vomit.
5, children with meningitis if the treatment is not enough, then the child will certainly die within a few hours, do not die, then even cause permanent mental injury. And viral meningitis is even more serious disease, if aggressive treatment. Most of you can fully recover without sequelae.
6, due to different pathogens causing meningitis, their symptoms are also different. The main symptoms of meningitis are fever, vomiting, restlessness, headache, and malaise. This is a general symptom of a meningitis episode, which is most often seen in most children.
7, different age, the performance of meningitis is also different. For newborn babies, they still can not speak, the response ability is relatively poor. Usually manifested as not drinking milk, it is difficult to appease emotions, crying all day, irritability, and fever symptoms, but his body temperature did not rise significantly, there is little vomiting. If meningitis is more serious, listen to the concert pale or blushing, head back, no energy, the whole body such as sludge, and sometimes convulsions, frequent vomiting.
8, the skin feeling is allergic, easily irritated is the main feature of this period. Some children are shocked when they are touched by some voices or adults, and at the same time there is a possibility of being pulled out. 2-year-old children in disguise and adults is no different, there will be a significant increase in intracranial pressure, as well as headache and fever difficult to fever symptoms.
1, blood: acute peripheral leukocyte count increased significantly to neutrophils may appear immature cells.
2, cerebrospinal fluid: increased pressure, the appearance of turbidity, pus-like, white blood cell count at 1000 ~ 10000 / mm , a few cases higher, mainly neutrophils, accounting for more than 90% of the total white blood cells. Sometimes pus accumulation of lumps and smear and pathogen culture at this time were mostly positive. Occasionally wear the first normal waist, a few hours later became purulent review. Increased protein, up to 1.0g / L sugar content decreased, usually less than 2.2mmol / L, chloride content also decreased, immunoglobulin IgM and IgG were significantly higher.
3, bacterial antigen determination: commonly used methods are polymerase chain reaction, convective immuno-electrophoresis, latex agglutination test, enzyme-linked immunosorbent assay, radioimmunoassay and so on.
4, other selective examination: including blood, blood electrolytes, blood sugar, urea nitrogen, urine routine.
5, X-ray examination: chest X-ray of patients with purulent meningitis is particularly important, pneumonia lesions or abscesses can be found. Skull and sinus flat film can be found skull osteomyelitis, nasal sinusitis, mastoiditis, but more clear CT examination of the above lesions.
6, CT, MRI examination: early CT lesions or brain MRI examination can be normal. Neurological complications can be seen when the enlarged ventricles, sulci narrowing, brain swelling and brain abnormalities such as abnormal displacement. And may find ependymal inflammation, subdural effusion and limitations of brain abscess. Enhanced MRI scans are more sensitive to diagnosing meningitis than enhanced CT scans. MRI scans can show meningioma and cortical reaction. Take the appropriate technical conditions, can show venous occlusion and the corresponding part of the infarction.
Differential diagnosis of children with meningitis
1, purulent meningitis, the most confused of which is Haemophilus influenzae meningitis.
2, viral central nervous system infection is mainly viral encephalitis, viral meningoencephalitis and viral myelitis can be confused with the brain knot, which distributed viral encephalitis than the epidemic who need to be identified.
3, cryptococcal meningitis, its clinical manifestations, chronic disease course and changes in cerebrospinal fluid may resemble knot brain, but longer duration, may be accompanied by spontaneous remission. Chronic progressive high intracranial pressure symptoms more prominent, and other manifestations of meningitis are not equal. The disease is rare in small Germanium is easy to misdiagnosed as knot brain.
4, brain abscess Brain abscess in children with more history of otitis media or head trauma, sometimes secondary to sepsis. Often accompanied by congenital heart disease. Children with brain abscess in addition to meningitis and high intracranial pressure symptoms, there are often focal brain signs.