Serous meningitis in adults: symptoms and treatment

Serous meningitis is a polyethiologic disease characterized by inflammation of the membranes of the brain and spinal cord of a non-gonadic nature.

The main feature of serous meningitis is the non-exudate nature of the exudate (in the cerebrospinal fluid, lymphocytes predominate). They are characterized by a lighter course and a more favorable prognosis for recovery.

Classification of serous meningitis

Depending on the agent that caused the disease, serous meningitis is divided into several types:

• Viruses, that is, viral. The main "culprits" are Coxsackie and Echo viruses;
• caused by bacteria, that is, bacterial. The causes are such pathogens that cause syphilis and tuberculosis;
• caused by fungi. So-called opportunistic infections: fungi of the genus Candida, Coccidioides immitis.

Depending on the origin, serous meningitis is divided into:

• primary (the agent directly caused damage to the meninges, for example, enteroviruses);
• secondary (as a complication of another infection: measles, influenza meningoencephalitis, etc.).

How do they usually get sick with this ailment? I would like to note that this pathology is more common in children, and adults are mostly sick with immunodeficiency. The incubation period takes an average of several days. Seasonality is also characteristic: summer time of the year. There are following ways of infection:

• airborne (the pathogen is in the airway of the patient and transmitted by coughing, sneezing, talking);
• contact (pathogenic agents, being on mucous, get on various subjects, therefore, not adhering to rules of personal hygiene, it is possible to catch and be ill);
• water (outbreaks of enterovirus infection are most often recorded in the summer, when swimming in open water).

Symptoms of enterovirus serous meningitis

Disease debuts with fever and severe headache.

After a short prodromal period, a high body temperature reaches 40 degrees C and general signs of intoxication in the form of pronounced general weakness, pain in the muscles and joints, and malaise. The patient is also concerned about abdominal pain, bloating, upset of the stool. The disease proceeds wavy, after a certain decrease in temperature on the 4th day there may be a repeated candle. If there is a slight current, on the 5th day the body temperature normalizes. Throughout this time, the patient is worried about a constant intense bursting headache, which increases with the slightest movement. At the peak of the headache, vomiting that does not bring relief is possible, hallucinations are possible. Due to hyperesthesia (hypersensitivity to the slightest irritants), it is easier for a patient to be in a darkened quiet room or to wrap himself up in a blanket. Bright light, loud sounds, touch increase the headache. Serous meningitis proceeds much more easily than purulent, so there is no expressed disorder of consciousness, the patient may be in stunning. Clinical examination reveals a positive meningeal syndrome, as well as syndromes of Kernig and Brudzinsky.

Lymphocytic choriomeningitis

This disease is also called the meningitis of Armstrong. In the inflammatory process, not only the meninges are involved, but also pneumonia, myocarditis, parotitis. Infection occurs from domestic mice. The disease occurs more often in the winter-spring period of the year. The process also involves the vascular plexus of the ventricles of the brain, which ultimately leads to hypertensive-hydrocephalic syndrome. The disease begins abruptly, with fever, vomiting, headache. The patient has a marked excitement, often there are visual and auditory hallucinations. In neurologic symptoms, a non-stable lesion of the visual, auditory nerve, sometimes leading and oculomotor, is possible. After 10 days the patient's condition improves significantly, but the headache can persist for several weeks.

Secondary serous meningitis can develop in tick-borne encephalitis, influenza, herpes, measles.

Diagnosis of serous meningitis

The presence of only meningeal syndrome does not allow verifying the diagnosis of meningitis. The appearance of meningism is observed with any kind of brain edema. To confirm the diagnosis, the data of anamnesis of the disease, examination of the patient, data clinical and laboratory examination, as well as the diagnosis of lumbar puncture (puncture of the spinal cord liquid). Characteristic for serous cerebrospinal fluid is the transparency and predominance of lymphocytes. In controversial cases, according to the indications, a CT scan is performed, and the most accurate is PCR and ELISA, which are related to express diagnostics.

Treatment of serous meningitis

The majority of patients with serous meningitis are hospitalized in the infectious department, which is due to the high contagiousness (infectiousness) of these pathogens. This disease is caused by viruses, therefore for its treatment antiviral drugs (acyclovir, interferon) are used. There is no specific therapy, so symptomatic therapy is used:

• infusion;
• decongestant;
• antipyretic;
• anti-inflammatory;
• vitamin therapy.

The prognosis for recovery is favorable, but this does not mean that one should practice self-medication at home, since only a specialist can diagnose the disease by symptoms and prescribe adequate treatment, using an individual approach to each patient.

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