Overview.
Gram-negative coccus meningitis mainly includes meningococcal meningitis and Catamoeba meningitis. Inflammation of the meninges is manifested by posterior neck pain and cervical rigidity. After the diagnosis of Gram-negative coccus meningitis is confirmed, prompt treatment with sensitive antibiotics is required.
Causes
1. Meningococcal meningitis
Meningococcus is a genus of Neisseria, which is only found in humans and can be detected in the nasopharynx of carriers and in the blood, cerebrospinal fluid, and skin lesions of patients.
2. Catamorium meningitis
Meningitis caused by C. catarrhalis is most often secondary to C. catarrhalis septicemia, especially in patients with combined left endocarditis, and invades the meninges through the bloodstream via bacterial emboli.
Meningitis can also be caused by infectious lesions near the meninges, such as acute otitis media, maxillary sinusitis, conjunctivitis and keratitis in infants and children.
Symptoms
1. Most patients in the upper respiratory tract infection stage do not have any symptoms, but some patients have sore throat, congestion of the mucous membrane in the nasopharynx and increased secretion.
2. Patients in the sepsis stage often have no prodromal symptoms, and there are symptoms of toxemia such as chills, high fever, headache, vomiting, generalized fatigue, muscle pain, lack of appetite and indifference.
3. Patients with meningitis stage have high fever and persistence of toxemia, still have bruises and bruises all over the body, have splitting headache due to increased intracranial pressure, vomit frequently, blood pressure can be increased and pulse slowed down, and often have skin sensory allergy, photophobia, mania and convulsions.
Inflammation of the meninges is manifested by posterior neck pain and cervical rigidity. 1 to 2 days later, the patient may enter delirium and coma, at which time the condition is already severe and respiratory or circulatory failure or other complications may occur.
Examination
1. Laboratory examination
Routine blood test: white blood cell count and neutrophil count are significantly increased, and there may be left shift of nucleus.
2. Smear examination
Gram-negative cocci can be found on smear, and positive bacterial culture can confirm the diagnosis.
Diagnosis
Diagnosis can be made on the basis of history, clinical manifestations and the presence of gram-negative cocci on smear.
Treatment
1. General treatment
Diet should be fluid, if necessary, nasal tube feeding, and give appropriate fluid input, closely observe the change of condition. The confused person should strengthen nursing care, such as protecting the cornea to prevent ulcer formation, keeping the skin clean, changing position and patting the back frequently to prevent pressure sores and respiratory infections, preventing inhalation when vomiting, preventing tongue bite when convulsing, and giving oxygen when respiratory distress.
2.Drug treatment
(1) For Catamorium meningitis, amoxicillin-clavulanic acid and/or aminoglycoside antibiotics are recommended. In addition, the treatment of the primary disease, strengthen the resistance to strengthen the nutritional support therapy is also very important.
(2) After the diagnosis of meningococcal meningitis, penicillin is preferred, and cefotaxime or ceftriaxone can be used for those who are resistant to penicillin, which can be used in conjunction with ampicillin or chloramphenicol, and chloramphenicol can be used for those who are allergic to penicillin or β-lactam antibiotics.
Prognosis
The disease has a high mortality and disability rate. The prognosis is closely related to the pathogenic bacteria, the condition of the body and whether early and effective antibiotic treatment is applied. A small number of patients may be left with mental retardation, epilepsy, hydrocephalus and other sequelae.
Prevention
Actively treat the primary disease, such as otitis media, mastoiditis and paranasal sinusitis and other localized lesions.