What are the symptoms and causes of encephalomyelitis?

Encephalomyelitis is a common disease that occurs frequently and is mainly caused by infection with meningococci, which can be detected from the patient's nasopharynx, blood, or skin petechiae. From a clinical perspective, patients will experience some symptoms such as low fever, sore throat, and cough in the early stages, while some patients do not have these symptoms; afterwards, patients will shift to the sepsis stage and experience symptoms such as high fever, headache, muscle aches all over the body, and loss of appetite.

1. Causes of encephalomyelitis

Meningococci belong to the genus Neisseria and are gram-negative cocci that are oval in shape and often arranged in pairs. The bacteria only exist in the human body and can be detected from the nasopharynx of carriers, the blood, cerebrospinal fluid and skin petechiae of patients. Bacteria in cerebrospinal fluid are mostly found inside neutrophils, with only a few outside the cells. It is not easy to grow on ordinary culture medium, but grows well on culture medium containing blood, serum, exudate and egg yolk fluid. It generally grows better in an environment of 5% to 10% carbon dioxide. This bacterium is extremely sensitive to cold, dryness and disinfectants. It is very easy to die in vitro, and the bacteria can form their own lytic enzymes, so the specimen must be sent for inspection and vaccination immediately after collection. Pathogens invade the human body from the nasopharynx. If the human body has strong immunity, the pathogens can be quickly killed or the person may become a carrier. If the body lacks specific bactericidal antibodies or the bacteria are highly virulent, the pathogens can enter the blood from the nasopharyngeal mucosa and develop into sepsis, and then affect the meninges and form purulent encephalomyelitis. During the sepsis stage, bacteria often invade the lining of skin blood vessels, causing embolism, necrosis, hemorrhage, and cell infiltration, resulting in petechiae or ecchymoses. There are varying degrees of bleeding in the internal organs due to thrombosis, thrombocytopenia or endotoxin action.

2. Symptoms of Encephalomyelitis

1. Prodromal period (upper respiratory tract infection period): about 1-2 days, with symptoms of upper respiratory tract infection such as low fever, sore throat, and cough. Most patients do not have this symptom.

2. Septicemia stage: After the sudden or prodromal period, there is a sudden onset of chills and high fever, accompanied by headache, muscle aches, loss of appetite, mental atrophy and other symptoms of septicemia. Young children may cry and be restless, refuse to be held due to skin allergies, and have convulsions. 70%-90% of patients have skin or mucous membrane ecchymosis or bruises, 1mm-2cm in diameter, which are bright red at first and then purple-red. In severe cases, the ecchymosis expands rapidly and the center becomes necrotic due to thrombosis. A small number of patients experience joint pain and splenomegaly. Most cases enter the meningitis stage after 1-2 days.

3. Meningitis stage: Meningitis symptoms often appear at the same time as sepsis symptoms. On the basis of the prodromal symptoms, new symptoms appear, such as severe headache, frequent vomiting, mania and meningeal irritation. Blood pressure may rise and pulse rate may slow down. In severe cases, delirium, mental disorder and convulsions may occur. Usually the recovery period begins after 2-5 days.

4. Recovery period: After treatment, the body temperature gradually returns to normal, and the skin spots and ecchymosis disappear. An ulcer formed in the central necrotic area of ​​the large ecchymosis, which later scabbed over and healed; the symptoms gradually improved, and the neurological examination was normal. About 10% of patients develop herpes labialis. Patients usually recover within 1-3 weeks.