| Abstract | Upalu moždanih ovojnica (meninga) nazivamo meningitis, a možemo ga podijeliti na dva glavna tipa, a to su bakterijski meningitis i virusni meningitis. Bakterijski meningitis kod djece može uzrokovati velik broj bakterija, ali bakterije koje se najviše izdvajaju i koje su najčešće su Neisseria meningitidis i Haemophilus influenzae. Bolesti uzrokovane bakterijom Neisseria meningitidis su tzv. meningokokne bolesti koje se prvenstveno očituju kao gnojni meningitis, a ponekad i nekim drugim kliničkim oblicima kao što je, primjerice, sepsa. Epidemiološki se gnojni meningitis razlikuje od ostalih gnojnih meningitisa zato što je samo on prenosiv, zbog čega je i dobio ime epidemijski meningitis. Infekcija bakterijom Haemophilus influenzae danas je sve rjeđa nakon što je 1993. godine uvedeno obavezno cijepljenje djece protiv te bakterije. Bakterijski meningitis iznimno je teška bolest koja se treba neodloženo liječiti; što je prije liječenje započeto to je sam ishod i tijek bolesti bolji. Liječenje bakterijskog meningitisa podrazumijeva liječenje antibioticima i prevenciju cjepivom. Virusni meningitis nije toliko opasan kao bakterijski meningitis, a mogu ga uzrokovati mnogi virusi uključujući viruse gripe, virus vodenih kozica, virusi koji uzrokuju sindrom infekciozne mononukleoze te HIV. Ipak, najčešće se radi o enterovirusima, a samo liječenje je simptomatsko. Simptomi kod meningitisa često nalikuju simptomima gripe, kod bakterijskog i virusnog meningitisa u početnom stadiju simptomi su dosta slični. Ipak, kod bakterijskog meningitisa simptomi se brže razvijaju (već za nekoliko sati). Simptomi kod meningitisa su povišena tjelesna temperatura, glavobolja, pospanost, ukočenost vrata, povraćanje, osjetljivost na svjetlost, smetenost, kod djeteta često plakanje i nemir. Dijagnostika kod meningitisa provodi se prvenstveno lumbalnom punkcijom ili spinalnim uzorkom. Uzimaju se i uzorci krvi, mokraće i sekreta iz nosa ili ušiju. Uloga visoko educirane medicinske sestre u dijagnostičko-terapijskim postupcima kod bolesnika koji je zaražen meningitisom jest pružanje adekvatne zdravstvene njege, adekvatne terapije te pružanje suportivne njege, kao i psihičke i fizičke pomoći. |
| Abstract (english) | Inflammation of the membranous brain envelopes (meninges) is called meningitis, and is usually divided into two main types: bacterial meningitis and viral meningitis. Bacterial meningitis in children can be caused by a myriad of bacterial species, although the species that are most commonly implicated are Neisseria meningitidis and Haemophilus influenzae. A disease caused by a bacterium Neisseria meningitidis is known under an umbrella term ‘meningococcal disease’ and usually manifests as purulent meningitis; however, other clinical forms are also observed, such as sepsis. In epidemiological terms purulent meningitis differs from other purulent meningitides because only this type is transmissible, which is the reason why it was named epidemiological meningitis. Today Haemophilus influenzae infection is becoming less frequent after the compulsory vaccination of children against that bacterium was introduced in 1993. In any case, bacterial meningitis represents a particularly serious disease that needs to be treated promptly. The sooner the treatment begins, the better the outcome and course of the diseases will be. The treatment of bacterial meningitis includes antibiotic treatment and vaccination for preventative purposes. Viral meningitis is not as dangerous as bacterial meningitis and can be caused by a wide array of viruses, including influenza virus, varicella zoster virus, viruses that cause infectious mononucleosis and HIV. Most commonly implicated viruses are enteroviruses, and the treatment is symptomatic. The symptoms of the meningitis often resemble symptoms of influenza, while in bacterial and viral meningitis the symptoms are quite similar in the initial phase of the disease. Nonetheless, in bacterial meningitis, the symptoms develop more rapidly (in a few hours). Main symptoms in meningitis are fever, headache, drowsiness, neck stiffness, vomiting, sensitivity to light, confusion, and in children often crying and restlessness. Meningitis can be diagnosed by lumbar puncture and further analysis of spinal specimen. Blood samples, urine, nose or ear secretions can also be used. The role of highly educated nurse in diagnostic and therapeutic approach when considering a patient with meningitis is providing proper health care, adequate treatment, as well as ensuring supportive, psychological and physical care. |
