It must be emphasized that in infants (with no overgrown fontanel) at the age of 4 months rigidity neck and Kernig's sign may be physiological phenomena. The main symptoms of meningitis, they are stress and a bulging fontanelle, restlessness and crying at the beginning of the disease, sometimes wearing character sudden sharp piercing cry, as well as "a symptom of suspension." In cases of meningitis that occur with severe dehydration and intoxication patients in the presence of thick pus on the surface of the brain convexital subarachnoid space. Changes in cerebrospinal fluid occur gradually, so in the early hours of the first day and it may remain normal or resemble his picture in the cerebrospinal fluid serous meningitis. However, even in this period is usually lleotsitoz neutrophilic in nature. Often, the first day of illness at the puncture are turbid cerebrospinal fluid.
Recently, cases of meningococcal infection without pus was 3 – 4 weeks, only occasionally observed during the abortive ending with recovery in 5-12 days, sometimes the disease took a long undulating course (2-12 months) in such cases is usually observed as phenomenon ependimatita (drowsiness, muscle rigidity is very high, a disorder of the intellect, and progressive cachexia, severe headache, CSF hypertension, vomiting, congestion nipples optic nerves). Death could occur at any stage of the disease. With lightning-fast form of epidemic meningitis death may occur in the first duck of the disease, when changes in the cerebrospinal fluid have not time to develop. In such cases, particularly strongly expressed intoxication and often develops psychomotor agitation, convulsions, coma replaceable. In the pathogenesis of fulminant forms of pain belongs to the main toxicosis. One of the immediate causes of death are acute swelling and edema of the brain, leading to wedging of the brain in the foramen magnum and the medulla oblongata mindalikami infringement of the cerebellum. Characterized by increasing bradycardia, convulsions, increased blood pressure, arrhythmia, respiratory system.