Пока инфекционисты и клинецисты не подошли, может стаьябудет интересной:[Ссылки доступны только зарегистрированным пользователям ] Episodes of recurrent meningitis fall into 2 groups: recurrent bacterial meningitis, and recurrent episodes of nonpurulent meningitis. Symptomatology and cerebrospinal fluid changes in recurrent bacterial meningitis are those typical of bacterial meningitis in general. Symptoms in recurrent nonpurulent meningitis are much more variable, and cerebrospinal fluid may contain lymphocytes, neutrophils, or a mixed pleocytosis. Recurrent bacterial meningitis did not exist as a clinical entity prior to the advent of antibiotics because a single episode of meningitis was almost invariably fatal. Up to 9% of patients surviving acute bacterial meningitis may go on to have further episodes (Durand et al 1993). In children, recurrent bacterial meningitis is associated with congenital defects of the middle ear or with persistent dermal sinuses along the spinal column. In adults, recurrent episodes of bacterial meningitis are most commonly associated with traumatic defects at the skull base (Adriani et al 2007). In a minority of cases, recurrent bacterial meningitis is associated with defects in the complement system or, rarely, with agammaglobulinemia or selective IgM deficiency (Ersoy et al 1990; Goldstein et al 2008). In recurrent bacterial meningitis, identification of the infectious agent is straightforward, and the major task, after the episode of meningitis has been successfully treated, is to identify and, if possible, treat the anatomical or immunological defects that allow recurrent infections to occur
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