Central nervous system infections – types, symptoms, treatment

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Infections of the central nervous system are among the most common causes of acute neurological disorders in children. They very often lead to long-term complications and permanent disability. Only prompt and proper treatment can prevent irreversible consequences.

Central nervous system infections – types

1. Acute anterior spinal cord inflammation (Heine-Medin disease) – it is a viral disease of the nervous system, which practically does not occur in Poland anymore. It should be noted that preventive vaccinations contributed significantly to this. For virus infection poliomyelitis it comes by food, but it is also possible by inhalation.

The hatching period of Heine and Medin is: about 3 weeks.

This disease very often ends in death or leads to permanent disability resulting from paralysis of peripheral nerves and paresis.

2. Bacterial meningitis

Bacterial meningitis affects all age groups of the developmental period, but is most common in newborns and infants. The main pathogens (depending on the age of the child) are bacteria: Neisseria meningitidis, Streptococcus pneumoniae, as well as bacteria: Haemophilus influenzae, Escherichia coli, Proteus, Klebsiella, Salmonella.

The meninges are most commonly affected by blood from the nasopharynx cavity, less often from the skin or the navel. Some developmental defects (e.g. skin fistulas, open meningeal hernias) as well as bone fissures following skull injuries may play a significant role.

The child’s age and the route of infection play a very important role in shaping the picture of the disease.

Symptoms

1. In newborns: The symptoms are not very specific. In the initial stage of the disease, there is a general deterioration of the child’s condition that cannot be explained by other causes, a decrease in physical activity, or vice versa – excessive agitation, loss of appetite, respiratory disorders, fever or lower body temperature. The earliest symptoms of the central nervous system are nystagmus, convulsions, and head positioning.
2. In infants: has a high temperature which does not or only briefly responds to commercially available antipyretics. Additionally, there is vomiting, huge hyperalgesia and the general picture of a suffering, seriously ill child, often with disturbed consciousness. The fontanel is bulging and excessively pulsating. It should be mentioned here that in infection Neisseria meningitidis the course of the disease can be dramatic, with symptoms of sepsis up to and including the death of the child.
3. In older children: high temperature, headaches, vomiting, general malaise, neck stiffness (the child’s inability to bend the head to the sternum) and other diarrhea are noticeable.

The diagnosis of the disease is made on the basis of the symptoms of the symptoms, confirmed by the examination of the cerebrospinal fluid obtained by lumbar puncture.

Treatment: only in a hospital setting.

3. Viral meningitis

The most common gateways for viral meningitis are the respiratory tract and digestive system, and exceptionally the skin (tick-borne encephalitis). The primary source of infection develops at the site of invasion. During this period of the disease, various non-specific symptoms occur. Then, from the primary site of infection, the virus enters the central nervous system through the bloodstream. Viral meningitis typically occurs in preschool and early school children. It is most often caused by the common parotitis virus.

Symptoms

The course of viral meningitis in most cases (except for viral infection Herpes) is much milder than inflammation caused by bacteria (meningeal symptoms are mildly severe). The fever is often bactrian (two fever peaks during the day), there is vomiting, headache and abdominal pain, as well as symptoms characteristic of general viral infection. Viral meningitis is extremely rare as an isolated form in infants, it is associated with immature immune mechanisms and the inability to limit the infection in infants to the meninges only. As a rule, the inflammatory process also affects the brain tissue.

Diagnosis

During the diagnosis, tests similar to those in bacterial meningitis are performed.

Treatment: hospital.

4. Fungal meningitis

Fungal meningitis is a rare disease. It most often affects older children treated with immunosuppressants. The course is not very specific.

The diagnosis and treatment of the disease are similar to those used in the previous forms with a different pathogen.

5. Inflammation of the brain

The causes of encephalitis in children:

1. viruses: recurrent parotitis (mumps), Herpes simplex, enteroviruses, adenoviruses, Epstein-Barr virus, measles, rubella, cytomegalovirus, influenza A and B, arboviruses.
2. bacteria: H. influenzae, N. meningitidis, S. pneumoniae, Mycobacterium tuberculosis, Borrelia/Lyme disease, leptospira, Treponema pallidum, B. pertussis, Mycoplasma.
3. parasites: Toxoplasm, Toxocara, trypanosoma, plasmodium.
4. mushrooms: Cryptococcus.

Viral encephalitis

It can occur only in the cerebral form or together with meningitis, sometimes with involvement of the cranial nerves. Viral encephalitis can take many forms, ranging from very mild to very severe. The disease is seasonal, with a predominance in the autumn and summer period.

The course of infection can be divided into two phases. After a catarrhal period lasting several days and apparent recovery, cerebral symptoms appear in the form of disturbance of consciousness, convulsions, paresis of various severity and localization, which are sometimes very turbulent and end in death. Cerebral symptoms are sometimes accompanied by cardiovascular symptoms, also of varying severity (up to and including circulatory failure).

Procedure: as in meningitis.

Bacterial encephalitis

Bacterial encephalitis is relatively rare.

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