Inflammation of the cortex and meninges of the brain occurs as a result of a viral, bacterial or fungal infection, the latter of which is much less common than the others. In addition, a similar condition occurs when non-communicable diseases: tumor damage, heavy metal poisoning. Symptoms of brain inflammation are:

• general symptoms (headache, fever);
• focal neurological defects (impaired skin sensitivity in a certain place).

With the development of any of specified symptoms, you need to apply for medical care due to the severe course of the disease and the development of serious complications.

Causes of the disease

Inflammation of the membranes of the brain and cortex occurs as a result of exposure to a number of factors on the brain. Similar situation occurs as a result of a viral or bacterial infection. Among the viruses, ECHO viruses, enteroviruses, polio viruses, influenza viruses, and measles viruses especially often affect the brain. Bacterial agents causing symptoms inflammation of the cerebral cortex is the most aggressive. These include meningitis diplococcus (Neisseria meningitides), as well as various types streptococci, Haemophilus influenzae, a number of fungal pathogens.

The causes of the development of the inflammatory process in the tissues of the brain and its membranes include the above viruses, which have an increased affinity for nervous tissue and directly affect it. In addition to infectious agents, the inflammatory response is mediated by a number of tumors (acute and chronic leukemia, primary tumors in the brain or its metastatic lesions), poisoning heavy metals(lead, mercury), as well as taking neurototoxic medications (methotrexate).

A special group worth highlighting are inflammatory diseases in the body without primary brain damage, but with the risk of the infectious process spreading to the central nervous system. Similar diseases include acute, otitis and others purulent diseases in the body.

Main symptoms

Symptoms and treatment of brain inflammation are closely related. Therefore, knowing the symptoms allows you to suspect the disease in time and seek medical help. Inflammation of the brain () or meninges(meningitis) begins acutely. In the first case, focal neurological symptoms, and with meningitis - general symptoms of damage to the central nervous system.

The first symptom is a severe, bursting headache, quickly followed by nausea and vomiting. As a rule, patients’ body temperature quickly rises to 39-40 o C and intoxication syndrome develops: general weakness, pain in muscles and joints. Various neurological symptoms may appear - impaired sensitivity and movement in the joints (impaired swallowing), aphasia (problems with speech articulation), impaired eye movement. Such manifestations reflect symptoms of inflammation of the blood vessels of the brain and its tissue.

In most cases, patients experience disturbances in mental sphere: anxiety, sleep disturbances, appetite disturbances, mood changes, hallucinations. In severe cases, disturbances of consciousness up to coma are possible. Convulsive syndrome may occur.

Diagnostic measures

For diagnostics inflammatory diseases the brain and its membranes are used external inspection patient, studying the neurological status (sensitivity, movements, special symptoms meningitis, the so-called Brudzinski symptoms). It is very important to qualitatively collect an anamnesis of the disease and the patient’s life.

When examining blood, if the disease is bacterial in nature, leukocytosis (increased number of white blood cells) and acceleration of ESR (erythrocyte sedimentation rate) are noted. When caused by a virus, lymphocytosis is pronounced (increased number of lymphocytes). In a biochemical blood test, the content of fibrinogen and C-reactive protein was increased. All of these changes indicate an inflammatory process in the body.

Additional information is studied when examining the cerebrospinal fluid: there is an increase in the number of immune cells, protein, and a decrease in the amount of glucose. In some cases, to determine the location of the lesion, the use of neuroimaging methods - computed tomography or magnetic resonance imaging - is indicated.

Treatment of inflammation of the brain and membranes

First of all, treatment of the disease is aimed at combating the infectious agent. For bacterial infection it is prescribed antibacterial drugs: 2nd and 3rd generation cephalosporins (Cefotaxime, Cefipem), penicillins (Amoxiclav) and aminoglycosides. If the disease is caused by a virus, it is indicated antiviral drugs, including interferon and its inducers.

All patients are recommended to be hospitalized medical institution with the organization of constant monitoring of vital important functions body (breathing, work of the cardiovascular system) with maintenance in case of their changes.

Severe intoxication syndrome serves as a basis for infusion therapy, aimed at diluting toxins and removing them through the kidneys. For this purpose, Hemodez, isotonic sodium chloride solution, glucose solutions, etc. are used.

Treatment of inflammatory diseases of the brain and its membranes requires an integrated approach. In this regard, it is easiest to prevent such diseases. For a row viral infections(viral tick-borne encephalitis, Haemophilus influenzae) there are developed preventative vaccines, providing lasting immunity against viruses.

Among viruses, these are most often pathogens mumps, measles and rubella, spring summer encephalitis, HIV and herpes simplex virus.

Pathogens usually enter the brain through the bloodstream. However, the penetration of infection perhaps from neighboring areas (for example, with inflammation of the middle ear and paranasal sinuses). Head injuries in severe may also contribute to the development of meningitis.

Symptoms (complaints)

Important: If you experience severe headaches, high fever, stiff neck and sharp deterioration state of health in general, it is necessary to urgently call a doctor or emergency service (phone number 144).

• Rigidity of the neck (doctors in this case talk about meningism)
• Headache
• High body temperature (39-40°C)
• P feeling bad generally
• Vomiting, diarrhea (often with viral nature meningitis)
• Photophobia
• When the disease progresses in a severe form: loss of consciousness, confusion, seizures, coma.
• Warning signs: the appearance of multiple bluish spots, dark spots or large patchy areas on the skin (minor bruising)
• Complaints in infants and young children oftenless pronounced:they become sleepy, behave sluggishly when feeding, seem to be “naughty”, have Bad mood, and in some cases even seizures.

Diagnostics (research)

• During the examination, the doctor determines whether there are manifestations of meningism
• Cerebrospinal fluid examination (conducting lumbar puncture): to diagnose infection and determine the presence of a pathogen in the brain fluid
• Blood test: to confirm inflammation and the presence of a pathogen

Therapy (treatment)

Inflammation of the meninges is very dangerous disease which, if left untreated, leads to death. Therefore, prompt hospitalization and immediate treatment are vital factors.

For meningitis caused by bacterial infection, antibiotic therapy is carried out.If there is even the slightest suspicion of inflammation of the meninges family doctor immediately prescribes therapy. The sooner the better!

If the disease is caused by viruses, then symptomatic therapy is carried out (to eliminate the main symptoms - headache, fever, diarrhea, etc.). In doubtful cases, it is important to remember: treatment must begin before the final diagnosis is made!

Possible complications

Without treatment, meningitis is fatal. Early diagnosis and immediate initiation of therapy are vital. As a rule, treatment is started by the family doctor; if this is not possible, then the most late date for therapy - this is the moment of admission to the clinic. Further complications include inflammation of the medulla and brain abscess. When treating an abscess it is necessary surgery, in which the inflammatory focus is removed along with the capsule, then antibiotics are prescribed. And yet, despite the therapy, 20% of patients die.

Syphilism is one of the most common sexually transmitted diseases (STDs). The causative agent of the disease is the bacterium Treponema pallidum. Modern medicine This disease can be easily treated, but if the patient is not treated, he will face a slow and painful death with a wide range of symptoms.

According to 2014 data, 26 people per 100 thousand population of our country are sick with syphilis. Morbidity venereal diseases is decreasing at a slow pace, so the government is educating the population about STDs. Awareness about STD prevention helps to avoid serious problems with the health of both young people and adults.

Syphilitic infection symptoms

Once in the human body, the bacterium Treponema pallidum, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person is unaware of the infection, as he has no signs of illness. Even most tests cannot detect the disease at this stage. Eat high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of his actions.
The first signs of the disease appear after incubation period upon the onset of primary syphilis. They can be located on the skin in the form of hard chancre, multiple chancre, syphilitic rash, baldness (cutaneous syphilides) and on the mucous membranes - chancre in the mouth, on the genitals, rash on the mucous membranes (syphilides of the mucous membranes).

Symptoms of syphilitic infection in women

The end of the asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). A hard chancre forms where the bacterium enters. Its appearance indicates the primary stage of syphilis. Hard chancre is formed as an immune response to the introduction of Treponema pallidum. It is localized in the mouth, in the area of ​​the external and internal genital organs, and in the anus.

A chancre is a round inflammatory growth with a flat base. In the initial stages of its appearance there is practically no pain. Appears at sites of infection. If treatment is not carried out, then a syphilitic rash is added to the chancre on visible parts of the body and on mucous membranes.

Signs of syphilism in men

In men, as in women, the first noticeable sign of infection appears in the form of a chancre. Ulcers often form on the penis, at its base and on the head. However, it can also appear in the oral cavity, on the scrotum, and in the anus. The symptoms and course of the disease are practically no different in the male and female parts of the population. Further description of syphilism will be given without division by gender.

How does sifak manifest in women?

• The primary stage of sifak in women begins with the detection of hard chancre on the skin or mucous membranes. At the initial stage, this does not cause serious discomfort. Then a gradual inflammation of the chancre occurs, it takes on a red or bluish color, characteristic of a severe inflammatory process.
• During the first week after the first symptoms appear, inflammation begins in women lymph nodes and vessels near the chancre (regional scleradenitis). The lymph nodes become inflamed in the form of balls, forming significant edema and swelling around the chancre. If the sore is localized in the oral cavity, it threatens with inflammation of one tonsil and swelling of the throat, making it difficult to swallow and breathe. The symptoms cause significant distress with verbal communication and eating. Scleradenitis in the genital area makes walking and defecation difficult.

Photo: Jarun Ontakrai/Shutterstock.com

The end of primary and the beginning of secondary syphilis is considered to be the appearance of a specific rash on the patient’s body. Modern diagnostic methods make it possible to detect syphilism immediately after the first symptoms appear. Most often used enzyme immunoassay(ELISA) and polymerase chain reaction (PCR). These tests are prescribed by a therapist at a clinic or a venereologist at a dermatovenereal dispensary. Average cost analysis costs 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. Earlier tests will not show anything other than a seronegative reaction, indicating the absence of Treponema pallidum in the body.

Symptoms of secondary syphilis

• The skin around the chancre becomes covered with spots and ulcers with a diameter of up to 15 mm. The rash can grow and unite into large areas on the skin and mucous surfaces, causing the patient severe discomfort. There are three types of syphilitic rash.
  Roseola rash - pink or red spots with clear or blurred boundaries 5-50 mm in diameter. There are no cavities. Do not protrude above the skin.
  Papular rash - small conical growths pink color. May peel off at the top of the cone. This kind of cheese looks extremely unpleasant.
  Pustular rash - growths with purulent cavities.
• Along with the appearance of a rash, damage to the nervous system may begin. Degradation of nervous tissue negatively affects vision, memory, attention, and coordination of movements. Unfortunately, treatment of the disease will not lead to the restoration of lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
• Signs of partial or complete baldness appear. Hair falls out, usually on the head. First, the quality of the hairline deteriorates: the hair splits, becomes thinner, and thins out. Then the hair thinning intensifies and large bald patches of skin appear. After recovery from syphilis, hair growth does not renew.

Stages of syphilis

Nowadays, every person infected with Treponema pallidum can quickly and efficiently receive adequate and effective treatment. Only a few go through all stages of syphilis. Without treatment, a person lives in terrible agony for 10 or even 20 years, after which he dies.
Below is brief description stages of syphilis.
Incubation stage

Stage name	Temporal boundaries	Description of symptoms
Incubation period	From the moment of infection to 189 days.	During this period, there are objectively no manifestations in the patient’s body. If the infection gets into several places in the body at once, this shortens the incubation period to 1-2 weeks. If an infected person takes antibiotics, for example, for the flu or for a sore throat, then the incubation period can last even six months. The end of this period occurs with the appearance of the first symptom - chancre and inflammation of the lymph nodes. If the pathogen enters directly into the blood, then the stage of primary syphilis does not appear and the disease passes directly to the secondary stage.

Stage of primary syphilis

Stage name	Temporal boundaries	Description of symptoms
Stage of primary syphilis	From the moment hard chancre appears until the appearance of a rash and inflammation of the lymph nodes in the chancre area	A chancre is a single solid formation that penetrates slightly deeper, but does not fuse with the tissues, caused by an immune reaction to treponema pallidum. It has a rounded shape and clearly defined edges. Localized in the area of ​​infection (Genitals, oral cavity, anal area, fingers). Does not cause pain, but should cause serious concern and motivate the patient to stop all sexual intercourse and immediately consult a doctor to begin treatment before a syphilitic rash appears. At the end of the primary stage, multiple chancre may appear. The second symptom is the appearance inflamed lymph nodes next to chancre. At the end of the stage of primary syphilis, malaise, dizziness, and body temperature rise. At this stage, atypical symptoms sometimes occur, which will be described below in the corresponding section of the article.
Headless syphilis	Boundaries are difficult to define	Observed when infected through blood. There are no symptoms, the disease goes directly into the secondary or latent stage, bypassing the primary one.

Stage of secondary syphilis. It is divided into four stages of the disease. In the absence of adequate treatment, the order will be approximately as follows:

Course of secondary syphilis	Temporal boundaries	symptoms of secondary syphilis
Early (Lues secundaria recens)	From 60-70 days after infection. From 40-50 days after the appearance of chancre. Lasts from several days to 1-2 weeks	There are three types of rashes caused by an active immune response and the production of endotoxins that fight infection. The nervous system, internal organs, and bones suffer. The temperature rises to 37-37.5 °C, accompanied by malaise, cough, runny nose, and conjunctivitis. Extensive inflammation of the lymph nodes without pain and discomfort, which feel hard and cool to the touch. Hair often falls out, and complete baldness is possible.
Hidden	From 60 days after the appearance of chancre or later	IN certain moment The immune system blocks the action of infection that destroys the body. The rash stops. Of course, the infection does not leave the organs and tissues; the patient lives in anxious anticipation of a second relapse.
Recurrent (recurrent)	After the hidden phase	With any weakening of the immune system (stress, cold, skipping meals, injury), a relapse can occur. It manifests itself in the appearance of a new rash, more extensive, with areas of skin hemorrhage. All symptoms characteristic of early syphilis are repeated. Multiple genital chancre often forms.
Early neurosyphilis	Starting from 2 years from the moment of illness	Associated with inflammation and damage to blood vessels and neurons of the brain, internal organs(almost always this is the heart and liver), as well as bones and joints. It manifests itself in the form of chronic meningitis, a violation of the ability of the pupils to constrict when exposed to light. Miliary gummas are formed inside the brain vessels, which increase intracranial pressure, worsening general health and causing headaches. Many symptoms impair higher mental functions, such as attention, memory, and coordination of movements. The changes are irreversible.

Stage of tertiary syphilis. It is divided into three stages of the disease. In the absence of adequate treatment, the order will be as follows:

Name of stage of tertiary syphilis	Temporal boundaries	Description of symptoms
Hidden chronic stage	Lasts from 1 year to 20 years	About 70% of patients in the absence of treatment live as carriers of the infection, moving from the latent phase of tertiary syphilis to the recurrent phase. However, sooner or later the immune system fails. A person moves to the next stage with a high probability of disability or death.
Tertiary syphilis	With the onset of corresponding symptoms	Extensive damage occurs to all organs and tissues, bones and the nervous system. Gummas are formed in the most merciless way in many places. Gummas are characteristic purulent tumors, often bleeding and moist with lymph and pus. Often appear on the face. They heal very hard, forming ugly scars. Often gummas become infected with other bacteria, leading to serious complications: abscess and gangrene.
Late neurosyphilis	The final stage, leading to disability and inevitable death. 10-15 years from the onset of the disease.	Extensive damage to the central nervous system, leading to loss of vision, paralysis, and impairment of cognitive functions of the psyche. Infectious diseases of the brain develop - meningitis, gumma of the brain and bones.

Neurosyphilis begins towards the end of secondary syphilis. Usually manifests itself in the form of the following diagnoses:

• Asymptomatic neurosyphilis – in which there are no painful manifestations yet, but tests already show inflammation and infection of the cerebrospinal fluid. This stage of neurosyphilis usually begins a year and a half after infection.
• Gummy neurosyphilis is accompanied by the formation of gummas inside the brain and spinal cord. This is a painful symptom that feels like a large tumor, causes permanent pain, and causes an increase in pressure inside the patient’s skull.
• Syphilitic meningitis is a lesion of the membranes of the brain at the base and in the area of ​​the cranial vault. Accompanied by severe symptoms, including disturbances of attention, thinking, memory, and the emotional sphere of a person.
• Meningovascular form of neurosyphilis - destroys the blood vessels of the brain, accompanied by chronic meningitis. In the absence of therapy, it leads to headaches, personality and behavior changes, sleep is disturbed, and convulsions begin. This ultimately leads to strokes.
• Taste dorsalis is a disorder of the nerve fibers of the spinal cord, their thinning and dysfunction. This leads to an irreversible impairment of the ability to move in space: the gait is bent, the patient may fall, losing the feeling of the ground under his feet. When you close your eyes, you lose orientation in space.
• Progressive paralysis - causes dysfunction of the central nervous system, accompanied by personality disorders, behavior dangerous to society, and all higher mental functions are degraded. A person turns into a madman and can easily end up in a psychiatric clinic if he is not diagnosed with syphilis. Ultimately, progressive paralysis leads to complete paralysis of the body.
• Optic nerve atrophy - degradation visual function. At first, the vision of only one eye deteriorates, but gradually the infection approaches the second optic nerve. Leads to complete blindness if left untreated. Changes in the visual apparatus are irreversible.
• Late visceral syphilis is degradation of tissues of internal organs. Mainly the cardiovascular system and liver are affected. Other organs are rarely affected. Patients complain of deterioration in health at the slightest exertion, and they develop systolic heart murmurs due to dilation of the aorta. When localizing late visceral syphilis a heart attack may occur.
• Late syphilism of bones and joints - causes local expansion of bones and large joints. Accompanied by the formation of gumma on the bones.

Atypical syphilis

In addition to hard chancre, others, so-called, may also appear at the stage of primary syphilis. atypical chancre. That is why this variant of the development of the disease is called atypical syphilis. Atypical chancres are of the following types:

• Indurative edema.
  Looks like a change in color of the scrotum in men, the clitoris and labia in women. The color varies from scarlet to bluish in the center, turning pale at the edges of the swelling. Women are susceptible to this symptom more often than men. Usually the patient perceives indurative syphilitic edema as an infectious-inflammatory disease of a different kind, since a blood test at this stage of syphilis does not provide information about the real reason swelling. It can be distinguished from another infection by the absence of an inflammatory process in the blood and the presence of inflammation of the lymph nodes.
• Chancre felon.
  May appear in people caring for people with syphilis: medical personnel, relatives. Affects the thumb, index finger and middle fingers hands. This is a very painful attack. The skin pulls away from the fingers, revealing large areas of bleeding, similar to second-degree burns. Panaritium is also accompanied by swelling and inflammation of the fingers, which interfere with normal human functioning. Often appears together with chancre of the genital organs.
• Chancroid-amygdalitis.
  It manifests itself in the form of inflammation of one tonsil, and its surface is not disturbed and remains smooth. The oral cavity is exposed severe pain, the swallowing process becomes difficult. The patient experiences a fever, as if he had a sore throat. The difference from a sore throat is that with amygdalitis, only one tonsil becomes inflamed.

Congenital syphilis

It is highly undesirable for a mother to suffer from illness during pregnancy. The fetus is exposed to Treponema pallidum, which leads to irreversible morphological consequences and disruption of intrauterine development.
Medicine knows three main symptoms:

• • Parenchymal keratitis is a pathology of the external epithelium of internal organs and eyeball. Appears as severe redness and inflammation of the organ outside. Sometimes the inflammation penetrates a little deeper into the surface. After healing, scars remain and an eyesore may remain. The most a common consequence for the eye is a decrease in visual acuity. Keratitis is accompanied by clouding visual perception, acute pain, lacrimation.
  • Deafness from birth. The causative agent of syphilis actively destroys the nerve tissue of the fetus during pregnancy. One option may be a pathology of the auditory nerve, which leads to irreversible deafness.
  • Congenital dental anomalies. Occur due to underdevelopment of tooth tissue during fetal development. This pathology called Hutchinson's teeth. The teeth grow in the shape of a screwdriver with a rounded notch on the cutting edge, and are set sparsely. Sometimes teeth are not completely covered with enamel. Which leads to their early destruction and unflattering appearance.

A child who has had intrauterine syphilis has poor health, even if the mother has successfully completed treatment. If adequate treatment is not followed, the child will have severe deformities and remain disabled for life. If the mother is infected with syphilis, breast-feeding the child should be stopped immediately, as syphilis is transmitted through mother's milk.

If a woman who has previously had syphilis wants to become pregnant, she should be tested for Treponema pallidum (ELISA or PCR). After receiving confirmation of the absence of the disease, you can safely decide to become pregnant.

The causative agent of syphilis

Treponema pallidum ( Treponema pallidum) is a bacterium that is the causative agent of syphilis. German scientists in 1905 discovered the cause of one of the most common venereal diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists found the key to quickly curing syphilis, and the way was opened for them to invent methods for early diagnosis of the disease.

Properties of the pathogen

The bacterium was named pale due to the fact that for a long time scientists could not examine it with a microscope. The transparent color of treponema is difficult to stain in other colors for subsequent research. For staining, the Romanovsky-Gizma and silver impregnation methods are used, which make it possible to detect bacteria under a dark-field microscope for subsequent study.
It was discovered that under favorable conditions (it should only be a human or animal body), Treponema pallidum divides every 30 hours. Weak point Treponema pallidum is that it lives and reproduces only at a temperature of 37 °C. This explains the effectiveness of archaic methods of treating syphilis, when, by artificially increasing the patient’s body temperature to 41 °C with the help of malaria, some relief of the symptoms of the underlying disease occurred.
The length of the bacterium is 8-20 microns with a thickness of 0.25-0.35 microns. Relatively long, its body forms curls in the form of a ball. At the same time, it constantly changes the shape and number of curls due to the ability of the Treponema pallidum cell to contract.

Incubation period

Entering the body through microdamages of the skin and mucous membranes, the causative agent of syphilis begins the incubation period. Dividing at a rate of about once every 30 hours, it accumulates at the site of infection. There are no visible symptoms. After about a month, a hard chancre forms on the body in combination with inflammation of the lymph nodes next to it. This means the transition from incubation to the stage of primary syphilis. The strength of immunity varies from patient to patient, which makes the length of the initial period of infection vary widely. It can last from 1-2 weeks to six months.

How is syphilis transmitted?

The process of transmission of the pathogen occurs in most cases through sexual contact. Infection is guaranteed through traditional, anal and oral sexual contact, even with a patient in the incubation period. Hard chancre forms where bacteria enter.

When caring for patients, infection is likely through contact with the patient's clothing, his personal belongings, and his body. In this case, chancre-felon appears, affecting the fingers and toes. This is one of the most painful symptoms in the stage of primary syphilis. Then hard chancre of the genital organs may appear.
Syphilis can also be transmitted through blood. When transfusing contaminated blood, when reusing a patient’s syringe, his razor, scissors, or utensils.

How to treat syphilis

Treatment should begin at the first signs of syphilis. This way the healing process will take place as quickly as possible. Since the 50s of the 20th century, antibiotics have been used in the treatment of syphilis. Penicillin-based drugs were used. Nowadays, drugs based on it are also used, since Treponema pallidum cannot adapt to this species antibiotics. Sufficient doses of penicillin effectively fight the disease. For the treatment of syphilis in patients with allergic reactions for penicillin, use erythromycin or tetracycline.
If the course of the disease has progressed to neurosyphilis, then treatment becomes more complicated. Pyrotherapy (artificial increase in body temperature) and intramuscular administration of antibacterial drugs are added.

At tertiary syphilis Along with antibiotics, highly toxic bismuth-based drugs are used. Treatment occurs strictly in a hospital with multi-level supportive therapy.

If a patient is diagnosed with primary syphilis, it is necessary to compulsorily treat all his sexual partners with whom there was contact during last trimester.
If secondary syphilis is diagnosed, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the past year.

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing fixtures, dishes, bedding and underwear, clothing, etc.
Hospitalization in the initial stages of syphilis is not required, it is enough outpatient treatment. Only when severe forms, starting from the secondary stage, the patient is admitted to the hospital. Treatment of syphilis by compulsory medical insurance policy is free and anonymous.

Coping with illness folk remedies highly not recommended. Only well-designed treatment can defeat Treponema pallidum. Otherwise, there is a high probability of the disease progressing to more severe stages.

Which doctor treats sifak disease?

Since sifak is a disease transmitted primarily through sexual contact, treatment is carried out by a venereologist. The patient can contact a general practitioner and receive a referral to a venereologist. The option of direct contact with a skin and venereal disease clinic is possible.

After examination and receipt of test results, the patient is treated either by a venereologist himself, specializing in all STDs, or the patient is referred to a highly specialized specialist - a syphilidologist.

There is a syphilidologist in everyone big city at skin and venereal dispensaries. He can select the maximum effective dosages medications and develop a treatment program that must be strictly followed. In case of complications in men (when the head of the penis is pinched), syphilis is treated together with a urologist.
In case of complications in women (chancre in the vagina, on the cervix), you need to go to a gynecologist.

How long to treat syphilis

The duration of treatment for the disease is determined solely by the doctor. Depending on the stage of the disease, complications and general condition of the body, healing may take from two weeks to six months.

It is very important to know that under no circumstances should you interrupt the course of treatment. If treatment is not completed, the patient will soon experience a relapse. Therefore, treatment must be taken extremely seriously.

- inflammation of the meninges. The disease is caused various bacteria, viruses, rickettsia, fungi. The soft and arachnoid membranes and the closely associated choroid plexuses of the ventricles become inflamed.

With meningitis, the absorption and circulation of cerebrospinal fluid is impaired, which leads to the development intracranial hypertension. The process may involve the substance of the brain and spinal cord, roots, cranial nerves, and cerebral vessels. Primary meningitis occurs as an independent disease, while secondary meningitis is a complication of somatic diseases.

Symptoms of meningitis

Meningitis is characterized by meningeal syndrome: vomiting, stiffness of the neck muscles, Kernig and Brudzinski symptoms, general hyperesthesia, high fever, inflammatory changes cerebrospinal fluid.

Depending on the nature of the disease and its stage, the severity individual symptoms varies widely. The diagnosis of meningitis is based on the characteristics of the clinical picture and the composition of the cerebrospinal fluid, as well as on data from its bacteriological and virological examination.

Meningism is irritation of the meninges without penetration of infection into the subarachnoid space (the composition of the cerebrospinal fluid is normal), often observed at the height of general diseases accompanied by intoxication and high fever. Depending on the composition of the cerebrospinal fluid, meningitis is divided into purulent and serous.

Purulent meningitis is characterized by the presence of neutrophilic pleocytosis in the cerebrospinal fluid, exceeding 500 cells per cubic meter. ml. Purulent meningitis can be caused by various pathogens: meningococci, pneumococci, Haemophilus influenzae, streptococci, Escherichia coli, etc.

Meningococcal meningitis - see Meningococcal infection.

Pneumococcal meningitis mainly affects young children and people over 40 years of age (in the latter it is the most common form purulent meningitis). Sources of infection and factors contributing to the transition of lesions to the membranes of the brain are chronic otitis and sinusitis, mastoiditis, skull injuries, alcoholism, and immune disorders. As with meningococcal meningitis, there may be prodromal symptoms such as general malaise and low-grade fever. Skin rashes uncharacteristic, with the exception of herpes labialis. The clinical picture is typical of severe bacterial meningoencephalitis. Characterized by short-term loss of consciousness, convulsions and paralysis of the cranial nerves. The greenish color of turbid cerebrospinal fluid is very typical. Without treatment, the disease leads to death after 5-6 days, however, even with adequate treatment, mortality is high (up to 50%).

Treatment of meningitis

Identification of the pathogen by bacteriological research, which sometimes requires a long time, is possible only in 70-80% of cases. In the most acute stage, many sporadic cases of purulent meningitis do not have sufficiently convincing etiological signs, therefore, first of all, penicillin is prescribed at the rate of 200,000-300,000 units/kg, and for infants 300,000-400,000 units/kg per day, which is on average for adult patients 24,000,000 units/day.

Penicillin is administered at 4-hour intervals (6 times a day) in adults and at 2-hour intervals in infants. More high doses penicillin are necessary only when starting treatment late or when obvious symptoms meningoencephalitis. In such cases, along with intramuscular administration, intravenous administration of benzylpenicillin sodium salt is also indicated - from 4,000,000 to 12,000,000 units/day.

Instead of benzylpenicillin, semisynthetic penicillins - ampicillin - can be used for purulent meningitis sodium salt, oxacillin, methicillin. Ampicillin is administered 2 g every 4 hours IM or IV (up to 12 g/day), for children - 200-400 mg/kg IV every 6 hours.

Sometimes penicillin is supplemented with intravenous administration of sulfamonomethotoxin on the 1st day, 2 g 2 times, and on subsequent days, 2 g 1 time per day.

If you are intolerant to penicillin, use gentamicin (up to 5 mg/kg per day), chloramphenicol (up to 4 g/day), vancomycin (up to 2 g/day). Wide spectrum Cephaloridine (ceporin) has action.

The optimal range of antibiotics is as follows: meningococcus, pneumococcus - benzylpenicillin, or amoxicillin, or chloramphenicol, or cephaloridin (6 g/day); Afanasyev-Pfeiffer stick - ampicillin and chloramphenicol.

Combined treatment of meningococcal meningitis with several antibiotics has no advantage over massive doses of penicillin or ampicillin. However, for meningitis caused by Haemophilus influenzae, it is necessary to combine ampicillin and chloramphenicol, if E. coli is detected in the cerebrospinal fluid - ampicillin and gentamicin, if streptococcus is detected - penicillin and gentamicin. In severe cases, penicillin, gentamicin or streptomycin are added intralumbarally. In severe cases, immediate plasmapheresis is required, followed by the administration of fresh frozen plasma up to 1-2 liters (adult dose).

Serous meningitis is characterized by lymphocytic pleocytosis within several hundred cells in 1 μl

Tuberculous meningitis

Tuberculous meningitis in most cases develops gradually, manifesting itself as an increasing headache against a background of low fever, which is only followed by vomiting, adynamia, and stupor after a few days. At the beginning of the 2nd week of the disease, damage to the cranial nerves, usually the oculomotor and (or) abducens, is detected; at the end of the 2nd week, dysfunction occurs pelvic organs and confusion. In half of the cases, tuberculous meningitis occurs against the background of an active tuberculosis process, most often in patients with hematogenously disseminated pulmonary tuberculosis. Currently, the disease is observed equally often in both children and adults. On early stages disease, it is difficult to differentiate tuberculous meningitis from viral meningitis. Even minor signs of impaired oculomotor innervation and a decrease in glucose content in the cerebrospinal fluid are the most important arguments in favor of tuberculous lesions of the membranes.

Treatment of tuberculous meningitis

Isoniazid (tubazid) 0.3 g 3 times a day (adults), streptomycin intramuscularly once a day at a dose of 1,000,000 units, rifampicin. Atambutol is often additionally prescribed. Chemotherapy drugs are combined with glucocorticoid hormones - 15-30 mg/day of prednisolone orally. In cases of meningoencephalitis, intensive therapy for cerebral edema is necessary. To prevent polyneuropathy and seizures sometimes caused by tubazide and its analogues, vitamin B6 and phenobarbital are prescribed.

Forecast. With timely initiation of treatment, which lasts many months, complete recovery usually occurs. In case of delayed diagnosis, especially if blackouts, focal brain lesions and hydrocephalus are observed, the outcome is unfavorable, and among those who survive, the majority have residual symptoms.

Viral meningitis

Causative agents of viral meningitis: Coxsackie viruses, ECHO, benign lymphocytic choriomeningitis and mumps; serous meningitis can be caused by any other neurotropic virus, when at the height of viremia the membranes of the brain are involved in the process. Outside of an epidemic outbreak, the clinical picture of aseptic meningitis, as a rule, is not specific.

The disease begins acutely or subacutely: with a moderate increase in temperature, headache, vomiting, general malaise, tension in the neck muscles and Kernig's sign appear. Significant signs of general intoxication are usually not observed. Pharyngitis is not uncommon. There are no blood changes. In the cerebrospinal fluid, lymphocytic pleocytosis is noted with a slight increase in protein with normal glucose levels. Among viral meningitis highest value has meningitis (or meningoencephalitis), which occurs in 0.1% of cases of mumps. Neurological syndrome develops 3-6 days after the onset of the disease. Occasionally, mumps meningitis takes a severe course, accompanied by brain damage. When treating patients with mumps meningitis, one should remember the possibility of developing polyneuropathies, isolated damage to the auditory nerve, as well as concomitant damage to the pancreas (abdominal pain) and gonads (orchitis).

Treatment of viral meningitis

Treatment is symptomatic: analgesics, diuretics, tranquilizers, antihistamines, bed rest. The vast majority of patients with aseptic meningitis are subject to hospitalization in infectious diseases departments due to their high contagiousness enteroviral infections. Forecast. In most cases, recovery occurs within a few days or weeks.

Encephalitis of the brain is a whole group of inflammatory diseases of this organ, and inflammation can be caused not only by an infectious pathogen, but also by infectious-allergic processes and the action of toxic substances. Consequently, there are many causes for cerebral encephalitis. Encephalitis caused by each specific cause has its own characteristics, but general signs, however, are preserved. Symptoms of encephalitis vary and depend on the area of ​​the brain affected. Treatment depends on the cause and is aimed at restoring brain tissue and its functions. In this article you can get acquainted with the main causes, symptoms and treatment methods of encephalitis.

Encephalitis may be independent disease, in which case it is primary. If encephalitis develops within general illness(that is, it is one of the symptoms), then it is called secondary.

The causes of primary encephalitis can be:

• viruses (arboviruses that cause tick-borne and mosquito-borne encephalitis, Coxsackie and ECHO viruses, herpes viruses, rabies virus, and so on);
• microbes and rickettsia (causative agents of syphilis, typhus).

The causes of secondary encephalitis are:

Separately, there are situations when the cause of the development of encephalitis is allergic and toxic processes in the brain, but such cases are much less common. An infectious agent is most often the cause of encephalitis.

Symptoms

Encephalitis is a disease that is accompanied by a whole group of symptoms. They can be divided into:

• general inflammatory reactions body;
• cerebral symptoms;
• focal symptoms (indicating which part of the brain is affected).

Depending on the cause of encephalitis (infection, allergy or toxic effects), one or another group of symptoms may be more severe. For example, with encephalitis with a bacterial and viral onset, the general inflammatory reactions of the body will be more pronounced than with the allergic nature of the process, but the diagnosis of encephalitis is valid only if all three groups of symptoms are present.

General inflammatory reactions of the body

After the incubation period (the time from the moment the pathogen enters the body until the first symptoms appear), general weakness, malaise, a feeling of weakness and fatigue occur. Sleep and appetite are disturbed. Aches appear in the body and muscles, and there is a feeling of “twisting” in the joints. Body temperature rises to 38°C - 40°C. Possible manifestations of catarrh of the upper respiratory tract(mucous discharge from the nose, sore throat, coughing, etc.) or the occurrence of gastrointestinal disorders, a rash may appear on the body. All these symptoms are nonspecific (occur in other diseases) and depend on the type of pathogen. Not every encephalitis is accompanied by all of the listed symptoms.

General cerebral symptoms

This subgroup of symptoms includes:

• disturbance of consciousness;
• headache;
• dizziness;
• nausea and vomiting;
• increased sensitivity of the senses;
• generalized convulsive seizures;
• mental disorders.

Impaired consciousness can range from minor confusion (the patient is slightly inhibited and does not immediately answer questions) to coma. Moreover coma can develop almost at lightning speed.

Headache is an almost obligatory sign of encephalitis. It can be very diverse in nature (dull, sharp, aching, pulsating, shooting, drilling, and so on) and intensity, and tends to increase. Headache may be associated with intoxication of the body, or may be the result of impaired blood circulation and circulation of cerebrospinal fluid.

Dizziness also tends to get worse and may be accompanied by nausea and vomiting, the latter not always bringing relief and may recur several times.

Characterized by so-called hyperesthesia ( increased sensitivity) sense organs: fear of light and noise, perception of tactile touches as painful.

Generalized epileptic seizures may be one of the first signs of encephalitis. They appear as a result of irritation of brain tissue.

Mental disorders in encephalitis are acutely occurring and emotionally excessive manifestations. Usually this crazy ideas, hallucinations and even psychosis. The patient may suddenly develop psychomotor agitation, during which he has absolutely no control over his actions and behaves inappropriately. Just like other general cerebral symptoms, mental disorders can increase. A situation is possible when, after an attack of hallucinations or psychomotor agitation, the patient falls into a coma.