An overview of inflammation in Encephalomyelitis

Encephalomyelitis refers to the pia mater thermostatic inflammatory changes, as the meninges in the anatomy of the spinal cord with the film continued, meningeal inflammation often spread to the spinal cord, Encephalomyelitis can also be called cerebrospinal Encephalomyelitis. According to the change of pathogens and cerebrospinal fluid into the purulent and non-suppurative two categories, the main manifestations of cerebrospinal Encephalomyelitis fever, headache, vomiting, meningeal irritation and brain focal symptoms. Diagnosis is based on the whereabouts of the season in the high fever, headache, vomiting, with consciousness changes, physical examination skin, mucous membrane petechiae, ecchymosis, meningeal irritation positive, clinical diagnosis can be initially established. Diagnosis depends on cerebrospinal fluid examination and pathogen detection, immunological examination is conducive to early diagnosis.

Causes of Encephalomyelitis

Neisseria meningococcus, Gram-negative cocci, oval, often in pairs. The bacteria exist only in the human body, from the carrier nasopharynx, the patient's blood, cerebrospinal fluid and skin petechiae detected. Bacterial cerebrospinal fluid more common in neutrophils, only a few in the extracellular. Common medium is not easy to grow, containing blood, serum, exudate and egg yolk growth medium on the growth of good, usually in 5% to 10% of the carbon dioxide environment to grow better. The bacteria on the cold, dry and very sensitive to disinfectants. Easy to die in vitro, the bacteria can form their own dissolved enzymes, it must immediately after the collection of specimens for vaccination. Pathogens from the nasopharynx invade the human body, such as human immunity, you can quickly kill the pathogens, or become carriers of the state; if the body lacks specific anti-bacterial antibodies, or bacterial virulence, the bacteria from the nasopharynx Mucosal into the blood, the development of sepsis, and then involving the cerebral spinal cord, the formation of purulent encephalomyelitis. In sepsis, bacteria often invade the skin wall of blood vessels caused by embolism, necrosis, bleeding and cell infiltration, which appears petechia or ecchymosis. Due to thrombosis, thrombocytopenia or endotoxin, visceral bleeding in varying degrees.

Fulminant sepsis is a special type, formerly known as China - Buddha's syndrome, has been considered due to bilateral adrenal hemorrhage and necrosis, caused by acute adrenal insufficiency caused. Has been proved that the majority of adrenal cortex function did not failure in the pathogenesis does not play a major role, and because of meningococcal lipopolysaccharide lipopolysaccharide can cause microcirculation and endotoxin shock, leading to disseminated intravascular coagulation (DIC) is the main pathological basis of the onset and development of fulminant meningoencephalitis and endotoxin. Type III allergy may also play a role in the pathogenesis of the disease, such as in the damaged blood vessel wall can be seen immunoglobulin, complement and meningococcal antigen deposition.

Clinical symptoms of Encephalomyelitis

Meningococcal mainly caused by latent infection, according to statistics, 60% -70% of asymptomatic carriers about 30% of deep breathing to the infected and bleeding type, 1% of the typical ECM patients. Incubation period of 1-10 days, usually 2-3 days.

Pathological characteristics of Encephalomyelitis

Infants and young children:

The characteristics of Encephalomyelitis: clinical manifestations often atypical, in addition to high fever, antifeedant, spit milk, irritability and cries, the convulsions, diarrhea and cough more common in adults, and meningeal irritation can be absent. Pre-halo subsidence.

The elderly:

1, the elderly immunocompromised, the more inadequate in the preparation of the element, the sensitivity of endotoxin increased, so the incidence of fulminant type.

2, the clinical manifestations of upper respiratory tract infection symptoms more common, significant disturbance of consciousness, skin and mucous membrane deposition rate of high incidence of ecchymosis.

3, long duration, more than 10d or so; complications and pod miscellaneous diseases, poor prognosis, high mortality. According to statistics, the mortality rate was 17.6%, while adults only 1.19%.

4, the number of laboratory tests may not be high white blood cells, showing severe illness, the body reaction is poor.

Diagnostic basis

Where in the popular season of high fever, headache, vomiting, with consciousness changes, physical examination skin, mucous membrane petechiae, ecchymosis, meningeal irritation positive, clinical diagnosis can be initially established. Diagnosis depends on cerebrospinal fluid examination and pathogen detection, immunological examination is conducive to early diagnosis.

Prevention of Encephalomyelitis

1, early detection of patients, local isolation therapy.

2, do a good job during the popular health promotion, should avoid large gatherings and collective activities, not to bring children to public places, not to bring children to public places, should wear masks out.

3, drug prevention Domestic still use sulfa drugs, close contacts available iodine pyrimidine (SD), adult 2g / day, 2 times with the same amount of sodium bicarbonate with clothes, even for 3 days; children daily 100mg / kg . In epidemic cerebrospinal Encephalomyelitis, where there are: fever with headache; apathetic; acute pharyngitis; skin, oral mucosal bleeding in two of the four, can give adequate full treatment of sulfa drugs, can effectively reduce Incidence and prevention of epidemics. Foreign rifampicin or dimethylamine tetracycline for prevention. Rifampicin daily 600mg, even for 5 days, 1 to 12 years old children daily dose of 10mg / kg.

4, vaccine prevention At home and abroad is widely used in both groups A and C capsular polysaccharide vaccine. The rate of protection was 94.9%, and the average antibody titer increased 14.1 times after immunization. There are polysaccharide vaccine for domestic "emergency" prevention, if 1 to 2 months, the incidence of ECM greater than 10/10 million, or higher than the same period the previous year, you can vaccination in the crowd.