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1

Meningeal management for optimal revascularization from middle meningeal artery.  

UK PubMed Central (United Kingdom)

Numerous surgical techniques have been developed and refined for the treatment of moyamoya disease. Among the indirect techniques of revascularization, encephaloduroarteriosynangiosis has been recognized as effective in promoting revascularization and reversing symptomatology. Neovascularization occurs between the donor artery, either the superficial temporal artery or the occipital artery, and the underlying ischemic cortex. Additionally, the middle meningeal artery and its dural branches have also been shown to contribute to collateral blood supply. In this report the authors describe an integrated management of the meninges for optimal revascularization. They emphasize the importance of recognizing the 3 major layers of the dura and describe a technique of dural splitting at the locus minoris resistentiae between the dura mater's vascular (middle) layer and internal median layer. Applying the dura's vascular layer to the surface of the brain after opening of the arachnoid is designed to optimize dural-pial synangiosis related to middle meningeal artery branches.

McLaughlin N; Martin NA

2013-01-01

2

Vertebral artery dissection associated with viral meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Vertebral artery dissection (VAD) is often associated with trauma or occurs spontaneously, inevitably causing some neurological deficits. Even though acute infection can be related to the development of spontaneous VAD (sVAD), VAD associated with viral meningitis has never been reported in the literature. CASE PRESENTATION: A 42-year-old man with fever, sore throat, and runny nose developed sudden onset of occipital headache, vertigo, transient confusion, diplopia, and ataxia. Brain stem encephalitis was diagnosed initially because the cerebrospinal fluid (CSF) study showed inflammatory changes. However, subsequent diffusion-weighted (DWI) magnetic resonance imaging of his brain demonstrated left lateral medullary infarction, and the digital subtraction angiography (DSA) confirmed VAD involving left V4 segment of the artery. Consequently, the patient was diagnosed as VAD accompanied by viral meningitis. CONCLUSION: This case suggests that viral meningitis might lead to inflammatory injury of the vertebral arterial wall, even sVAD with multiple neurological symptoms.

Pan X; Ma A; Wang K; Nie S; Wu M

2012-01-01

3

Vertebral artery dissection associated with viral meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Vertebral artery dissection (VAD) is often associated with trauma or occurs spontaneously, inevitably causing some neurological deficits. Even though acute infection can be related to the development of spontaneous VAD (sVAD), VAD associated with viral meningitis has never been reported in the literature. Case presentation A 42-year-old man with fever, sore throat, and runny nose developed sudden onset of occipital headache, vertigo, transient confusion, diplopia, and ataxia. Brain stem encephalitis was diagnosed initially because the cerebrospinal fluid (CSF) study showed inflammatory changes. However, subsequent diffusion-weighted (DWI) magnetic resonance imaging of his brain demonstrated left lateral medullary infarction, and the digital subtraction angiography (DSA) confirmed VAD involving left V4 segment of the artery. Consequently, the patient was diagnosed as VAD accompanied by viral meningitis. Conclusion This case suggests that viral meningitis might lead to inflammatory injury of the vertebral arterial wall, even sVAD with multiple neurological symptoms.

Pan Xudong; Ma Aijun; Wang Kun; Nie Shumin; Wu Mei

2012-01-01

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Meningitis  

Medline Plus

Full Text Available ... to meningitis as spinal meningitis. Causes Bacteria and viruses are organisms that can infect the meninges and CSF. When a virus infects the CSF, it is called viral meningitis. ...

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Meningitis  

Medline Plus

Full Text Available ... to meningitis as spinal meningitis. Causes Bacteria and viruses are organisms that can infect the meninges and ... is called bacterial meningitis. Bacteria are bigger than viruses under a microscope. It is important to know ...

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Meningitis  

Medline Plus

Full Text Available ... sometimes refer to meningitis as spinal meningitis. Causes Bacteria and viruses are organisms that can infect the ... the CSF, it is called viral meningitis. When bacteria infect the CSF, it is called bacterial meningitis. ...

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Meningitis  

Medline Plus

Full Text Available ... may result in brain damage, hearing loss or learning disability if not treated early. For bacterial meningitis, it ... Meningitis could also lead to severe brain damage, learning disability or even death. Fortunately, early diagnosis and treatment ...

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Meningitis  

Medline Plus

Full Text Available ... a virus infects the CSF, it is called viral meningitis. When bacteria infect the CSF, it is called ... or bacterium so it can be properly treated. Viral meningitis is usually less severe and may need no ...

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Meningitis  

Medline Plus

Full Text Available ... may result in brain damage, hearing loss or learning disability if not treated early. For bacterial meningitis, ... Meningitis could also lead to severe brain damage, learning disability or even death. Fortunately, early diagnosis and ...

10

Meningitis  

Medline Plus

Full Text Available ... Meningitis is a very serious infection of the fluid that surrounds the brain and spinal cord. Meningitis ... Last reviewed: 01/30/2011 1 A clear fluid, called cerebro-spinal fluid or CSF, surrounds the ...

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Meningitis  

Medline Plus

Full Text Available ... of meningitis. In1996, 213,658 people in West Africa had meningitis and 21,830 died from it. ... are traveling overseas, particularly to developing countries in Africa, ask your doctor or call the Centers for ...

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Meningitis  

Medline Plus

Full Text Available ... Overseas travelers should check to see if a vaccine against meningitis is recommended for their trip. Vaccination There are vaccines against some of the bacteria that cause meningitis. ...

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Meningitis  

Medline Plus

Full Text Available X-Plain Meningitis Reference Summary Introduction Meningitis is a very serious infection of the fluid that surrounds the ... 1995-2011, The Patient Education Institute, Inc. www.X-Plain.com nr210104 Last reviewed: 01/30/2011 1 ...

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Meningitis  

Science.gov (United States)

X-Plain Meningitis Reference Summary Introduction Meningitis is a very serious infection of the fluid that surrounds the ... 1995-2011, The Patient Education Institute, Inc. www.X-Plain.com nr210104 Last reviewed: 01/30/2011 1 ...

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Pharmacological characterization of VIP and PACAP receptors in the human meningeal and coronary artery  

DEFF Research Database (Denmark)

We pharmacologically characterized pituitary adenylate cyclase-activating polypeptides (PACAPs), vasoactive intestinal peptide (VIP) and the VPAC(1), VPAC(2) and PAC(1) receptors in human meningeal (for their role in migraine) and coronary (for potential side effects) arteries.

Chan, Kayi Y; Baun, Michael

2011-01-01

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Meningitis  

Medline Plus

Full Text Available ... due to a bacteria or a virus. A sample of spinal fluid is grown in a lab ... meningitis bacteria exist. If so A spinal fluid sample is taken by performing a spinal tap. For ...

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Meningitis  

Medline Plus

Full Text Available ... called bacterial meningitis. Bacteria are bigger than viruses under a microscope. It is important to know whether ... levels of sugar and protein • Looking for bacteria under the microscope using staining techniques Identification of the ...

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Meningitis  

Medline Plus

Full Text Available ... changed if needed. Patients are also usually given IV fluid and kept under close observation. The spinal ... or antiviral medications; the patient is treated with IV fluids, rest and close observation. Complications Bacterial meningitis ...

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Meningitis  

Medline Plus

Full Text Available ... of the body. They allow us to • speak • hear • understand • see • move Meninges Brain CSF • feel This ... quite severe and may result in brain damage, hearing loss or learning disability if not treated early. ...

20

Meningitis  

Medline Plus

Full Text Available ... understand • see • move Meninges Brain CSF • feel This document is for informational purposes and is not intended ... be irritable • vomit often • not eat well This document is for informational purposes and is not intended ...

 
 
 
 
21

Pneumococcal meningitis, cerebral venous thrombosis, and cervical arterial dissection: a run of bad luck?  

UK PubMed Central (United Kingdom)

BACKGROUND: Pneumococcal meningitis in adults is widely associated with intracranial complications, which occur in up to 74.7% of the patients. METHOD: Case report. RESULTS: We report the case of a 40-year-old white female with pneumococcal meningitis after a sinus surgery, who developed a concomitant cerebral venous thrombosis and multiple cervical artery dissections. Following treatment with antibiotics and intravenous heparin, she had complete neurological recovery. CONCLUSIONS: Vascular complications should always be remembered and adequately treated in patients with bacterial meningitis. Cervical arterial dissections should be investigated as potential embolic sources of intracranial ischemic lesions.

Panicio MI; Foresto RD; Mateus L; Monzillo PH; Alves MB; Silva GS

2013-01-01

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Headache and prolonged dilatation of the middle meningeal artery by PACAP38 in healthy volunteers  

DEFF Research Database (Denmark)

To explore a possible relationship between vasodilatation and delayed headache we examined the effect of pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) on the middle meningeal artery (MMA) and middle cerebral artery (MCA) using high resolution magnetic resonance angiography (MRA).

Amin, Faisal Mohammad; Asghar, Mohammad Sohail

2012-01-01

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Persistent dorsal ophthalmic artery and ophthalmic artery arising from the middle meningeal artery diagnosed by MR angiography at 3 T.  

UK PubMed Central (United Kingdom)

INTRODUCTION: A persistent dorsal ophthalmic artery (OA) is a rare variation that originates from the cavernous segment of the internal carotid artery (ICA) and enters the orbit via the superior orbital fissure (SOF). Occasionally, the OA also arises from the middle meningeal artery (MMA) and enters the orbit via the SOF. These two major variations of the OA have not been well described by magnetic resonance (MR) angiography. We evaluated their prevalence on MR angiography at 3 T. METHODS: We retrospectively reviewed our database of MR angiographic images obtained using a 3 T imager. Of images of 846 patients, we evaluated those of 826 patients (1,652 OAs) with special attention to OA origin and its course into the orbit. We excluded images of the 20 because quality was insufficient to assess. RESULTS: We found 7 (0.42 %) persistent dorsal OAs among 1,652 OAs (right/left, 6/1; male/female, 3/4). Twenty-four (1.45 %) OAs arose from the MMA (right/left/bilateral, 11/5/4; male/female, 10/10), three of which also demonstrated a small normally branching OA. In one patient, we observed both right persistent dorsal OA and left OA arising from the MMA. CONCLUSIONS: Per OA, the prevalence of persistent dorsal OA was 0.42 % and of OA arising from the MMA, 1.45 %, with a tendency toward right-side predominance. OA arising from the MMA can be seen bilaterally; preprocedural knowledge of this variation is important because of the danger associated with endovascular procedures of the external carotid system when the OA arises from the MMA.

Uchino A; Saito N; Takahashi M; Kozawa E; Mizukoshi W; Nakajima R; Okano N

2013-02-01

24

Meningitis Mutants  

Science.gov (United States)

... Bookmarks Twitter Case file: Meningitis Mutants Real name: viral meningitis and Bacterial Meningitis Known aliases: Viral Meningitis aka Aseptic Meningitis Bacterial Meningitis aka Hib, Pneumococcus, ...

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Risks of presurgical embolization of feeding arteries in 137 intracranial meningeal tumors.  

UK PubMed Central (United Kingdom)

BACKGROUND: Embolization of extra-axial tumors has shown its effectiveness in reducing perisurgical blood loss. However, the complication rate of this procedure is poorly reported. We aimed to evaluate the rate of procedure-related complications and their risk factors. METHODS: From 1998 to 2011, 193 consecutive patients (141 females, 52 males; mean age = 52.9 years) were referred to our institution for presurgical embolization of an extra-axial tumor (meningiomas: n = 178; solitary fibrous tumors: n = 3; other: n = 12). Of 193 patients, 137 (71 %) underwent 141 embolizations (by microparticles: n = 133; by glue: n = 8). The remaining 56 patients (29 %) were not embolized due to unstable catheterization or dangerous anastomosis. Occurrence of neurological deficit was systematically assessed during and after embolization. The risk factors of procedure-related neurological complications were evaluated. RESULTS: Neither intratumoral hemorrhage nor procedure-related death was reported. Two of the 137 patients (1.5 %) had ischemic events with permanent neurological deficit after microparticles embolization. One patient had cortical blindness and one had hemiparesis. Both complications involved the vertebrobasilar system. The first patient had direct intratumoral anastomosis between the middle and the posterior meningeal arteries (PMA); the second one had reflux in the vertebral artery during particles injection in the PMA. Occurrence of ischemic complication was not related to the size of the microparticles. CONCLUSIONS: Though embolization of meningeal tumors is considered as a safe technique, serious neurological complications may occur. Opening of dangerous anastomosis or uncontrolled reflux caused two neurological complications (1.5 %). The size of the microparticles was not associated with the occurrence of neurological event.

Law-ye B; Clarençon F; Sourour NA; Di Maria F; Jean B; Bonneville F; Biondi A; Iosif C; Navarro S; Cornu P; Chiras J

2013-04-01

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Stroke Secondary to Aseptic Meningitis After Endovascular Treatment of a Giant Aneurysm with Parent Artery Occlusion  

International Nuclear Information System (INIS)

Aseptic meningitis related to hydrogel-coated coils is a known complication, but it is extremely rare after platinum bare coil aseptic meningitis. Here we report the development of aseptic meningitis causing brain stem and cerebellar infarct in a patient with a giant aneurysm treated with bare platinum coils. We conclude that aneurysm size is an important factor affecting the occurrence of aseptic meningitis associated with stroke.

2009-01-01

27

Usefulness of embolization of the middle meningeal artery for refractory chronic subdural hematomas  

Science.gov (United States)

Background: Chronic subdural hematoma (CSDH) is generally treated by burr hole irrigation. However, sometimes repeated recurrence is observed, and treatment may consequently become difficult. We examined the efficacy of embolization of the middle meningeal artery (MMA) for such cases. Methods: We considered embolization of the MMA for three patients who had refractory CSDH with repeated recurrence and two CSDH patients who were at risk of recurrence and showed signs of recurrence after surgery. A microcatheter was advanced through the MMA as peripherally as possible, and embolization was performed with 15-20% n-butyl-2-cyanoacrylate or 200 ?m polyvinyl alcohol particles. Results: Embolization was performed in the three patients who had refractory CSDH with repeated recurrence: The procedure was performed after burr hole irrigation of the hematoma in two patients and before the irrigation in one patient. In the two CSDH patients at risk of recurrence, embolization was performed when signs of recurrence appeared. The timing of embolization differed for each patient. However, in all the patients, the hematoma tended to decrease in size, and no recurrence was observed. Conclusion: Embolization of the MMA is effective for refractory CSDH or CSDH patients with a risk of recurrence, and is considered an effective therapeutic method to stop hematoma enlargement and promote resolution.

Hashimoto, Takao; Ohashi, Tomoo; Watanabe, Daisuke; Koyama, Syunichi; Namatame, Hiroaki; Izawa, Hitoshi; Haraoka, Rei; Okada, Hirofumi; Ichimasu, Norio; Akimoto, Jiro; Haraoka, Jo

2013-01-01

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Dilation by CGRP of middle meningeal artery and reversal by sumatriptan in normal volunteers  

DEFF Research Database (Denmark)

BACKGROUND: Calcitonin gene-related peptide (CGRP) plays a fundamental role in the pathophysiology of neurovascular headaches. CGRP infusion causes headache and dilation of cranial vessels. However, it is unknown to what extent CGRP-induced vasodilation contributes to immediate head pain and whether the migraine-specific abortive drug sumatriptan, a 5-hydroxytryptamine 1B/1D agonist, inhibits CGRP-induced immediate vasodilation and headache. METHODS: We performed a double-blind, randomized, placebo-controlled, crossover study in 18 healthy volunteers. We recorded circumference changes of the middle meningeal artery (MMA) and middle cerebral artery (MCA) using magnetic resonance angiography before and after infusion (20 minutes) of 1.5 µg/min human aCGRP or placebo (isotonic saline) as well as after a 6-mg sumatriptan subcutaneous injection. RESULTS: Compared with placebo, CGRP caused significant dilation of MMA (p = 0.006) and no dilation of MCA (p = 0.69). Sumatriptan caused a marked contraction of MMA (15%-25.2%) and marginal contraction of MCA (3.9% to 5.3%). Explorative analysis revealed that sumatriptan had a more selective action on MMA compared with MCA on the CGRP day (p <0.0001) and on the placebo day (p = 0.007). CONCLUSION: These data suggest that exogenous CGRP dilates extracranial vessels and not intracranial, and that sumatriptan exerts part of its antinociceptive action by constricting MMA and not MCA. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that IV GCRP causes dilation of the MMA but not the MCA in healthy volunteers, and that sumatriptan reverses the dilation of the MMA caused by CGRP.

Asghar, M S; Hansen, A E

2010-01-01

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Meningitis bacteriana Bacterial meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available En Costa Rica la meningitis bacteriana se ha convertido en un tema prioritario en lo que a vigilancia epidemiológica se refiere, en los últimos meses se ha dado un aumento en la atención pública de este tema, debido a este fenómeno se hace necesario realizar una revisión del tema. La meningitis es una inflamación de las leptomeninges y colonización del líquido cefalorraquídeo (LCR) debido a diferentes agentes, lo cual produce síntomas meníngeos (Ej., cefalea, rigidez nucal, fotofobia) y pleocitosis a nivel de LCR. Dependiendo de las variables se pueden agrupar en diferentes clasificaciones, tomando en cuenta el tiempo de evolución se pueden dividir en agudas o crónicas, a las primeras con pocas horas o días de inicio de la sintomatología, mientras que la crónica presenta un curso mas larvado de la enfermedad de aproximadamente 4 semanas de instauración. Existe también diferencia según su etiología, pueden ser infecciosas y no infecciosas. Causas no infecciosas incluyen: drogas antiinflamatorias, antibióticos y carcinomatosis. A su vez existe una clasificación según el agente causal. La meningitis bacteriana aguda remarca el origen bacteriano de este síndrome, el cual se caracteriza por el inicio agudo de sus síntomas y pleocitosis de predominio neutrofílico. Cada uno de los agentes bacterianos, parasíticos o fúngicos terminan por categorizar las diferentes presentaciones de este cuadro clínico (Ej., meningitis meningocóccica, meningitis criptocóccica). Es en este grupo en específico de etiología en el cual se basara el siguiente artículo. Por último pero no menos importante tenemos la meningitis aséptica, denominada de esta forma debido a una respuesta celular no pirógena causada por muchos tipos de agentes. Los pacientes muestran un inicio agudo de síntomas meníngeos, fiebre y pleocitosis pero de predominio linfocítico. Después de análisis especializados, se da pro concluido que la mayoría de los agentes causales son virales lo cual conlleva a las diferentes sub-clasificaciones. También en ciertos casos puede ser ocasionada por hongos, bacterias atípicas, micobacterias y parásitos.In Costa Rica the bacterial meningitis had turn into a high-priority subject in which to monitoring epidemiologist. It had been talked about in the last months, to dice an increase in the attention is published of this subject, due to this phenomenon it becomes necessary to make a revision of topic. Meningitis is an inflammation of leptomeninges and colonization of the subarachnoid cerebrospinal fluid (LCR) due to different agents, which produces meningeal symptoms (ex. migraine, neck rigidity, and photophobia) and pleocytosis in LCR. De pending on the variables to take into account is possible to group it in different classifications, taking into account the time of evolution are possible to be divided in acute or chronic, to first with few hours or days of beginning of the symptoms, whereas the chronicle also presents a silence course but of the disease of approximately 4 weeks of instauration. There is a difference according to its etiologic agent; they can be infectious and non-infectious. Examples of common non-infectious causes include medications (ex, nonsteroidal anti-inflammatory drugs, and antibiotics) and carcinomatosis. A classification exists as well according to the causal agent. The acute bacterial meningitis remarks a bacterial origin of the syndrome, which characterizes by the by an acute onset of meningeal symptoms and neutrophilic pleocytosis. Each one of the bacteriological agents, parasitic or fungus finishes by characterizing the different presentations of the clinical features (ex, meningocóccica meningitis, Cryptococcus meningitis). Finally, there is also the aseptic meningitis, denominated in this form because it’s nonpyogenic cellular response caused by many types of agents. The patients show an acute beginning of symptoms, fever and lymphocytic pleocytosis. After specialized analyses, concluded that majority cause is different viral agents. Also in

Ana Teresa Alvarado Guevara; Lizzie Marie Castillo Solano

2006-01-01

30

Burkholder meningitis.  

Science.gov (United States)

We report two cases of Burkholder meningitis. Case 1 presented with subacute lymphocytic meningitis, low sugar profile in CSF and positive culture for Burkholder. Case 2 presented with purulent meningitis that emerged during treatment of cryptococcal meningitis which, to our knowledge, has not been reported. Thus, Burkholder should be considered as one of the etiologic agents in this clinical setting. PMID:8708515

Chotmongkol, V; Sukeepaisarncharoen, W

1996-04-01

31

Burkholder meningitis.  

UK PubMed Central (United Kingdom)

We report two cases of Burkholder meningitis. Case 1 presented with subacute lymphocytic meningitis, low sugar profile in CSF and positive culture for Burkholder. Case 2 presented with purulent meningitis that emerged during treatment of cryptococcal meningitis which, to our knowledge, has not been reported. Thus, Burkholder should be considered as one of the etiologic agents in this clinical setting.

Chotmongkol V; Sukeepaisarncharoen W

1996-04-01

32

Aseptic meningitis.  

UK PubMed Central (United Kingdom)

This chapter describes the clinical presentation, diagnosis, and treatment of patients with both aseptic meningitis and encephalitis. It also addresses the major causes of aseptic meningitis. Although bacterial meningitis is quite rare in an era of widespread conjugate vaccines, diagnosis often depends on the results of bacterial cultures which may take several days. Aseptic meningitis, on the other hand, is typically a benign childhood infection requiring supportive care alone. It also reviews available clinical decision rules that may assist the clinician in distinguishing which children with aseptic meningitis are at very low risk of bacterial meningitis using predictors available at the time of clinical presentation.

Nigrovic LE

2013-01-01

33

Meningitis - cryptococcal  

Science.gov (United States)

Cryptococcal meningitis is caused by the fungus Cryptococcus neoformans . This fungus is found in soil around the world. Cryptococcal meningitis most often affects people with a weakened immune system. Risk factors include: ...

34

Viral Meningitis  

Science.gov (United States)

... Añadir en... Favorites Delicious Digg Google Bookmarks Viral Meningitis On This Page Causes Risk Factors Transmission Signs & Symptoms Diagnosis Treatment Prevention Viral meningitis is generally less severe and resolves without specific ...

35

Treating Meningitis  

Science.gov (United States)

... 2012;79;e190-e192 Neurology Steven Karceski Treating meningitis This information is current as of November 26, ... 2012;79;e190-e192 Neurology Steven Karceski Treating meningitis This information is current as of November 26, ...

36

Fungal Meningitis  

Science.gov (United States)

... Añadir en... Favorites Delicious Digg Google Bookmarks Fungal Meningitis On This Page Causes Transmission Risk Factors Signs & ... to the central nervous system. Investigation of Fungal Meningitis, 2012 The Centers for Disease Control and Prevention ( ...

37

Bacterial Meningitis  

Science.gov (United States)

... Añadir en... Favorites Delicious Digg Google Bookmarks Bacterial Meningitis On this Page Causes Risk Factors Transmission Signs & ... severe disease. Laboratory Methods for the Diagnosis of Meningitis This manual summarizes laboratory techniques used in the ...

38

[Eosinophilic meningitis].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Diagnosis of Angiostrongylus cantonensis meningitis is not always obvious, even in endemic areas. CASE REPORT: We report a 51-year-old Polynesian man, farmer without past medical history, who was admitted for mild fever, headache, neurological subjective symptoms, and severe muscle pain impeding walking. The diagnosis of A. cantonensis meningitis, guided by hypereosinophilia was confirmed by lumbar puncture and positive specific serology. Lumbar puncture and administration of corticosteroids rapidly reduced headache whereas paraesthesias declined more progressively. CONCLUSION: Diagnosis of A. cantonensis meningitis should be considered in patients living or returning from endemic areas with headache associated with subjective neurological symptoms and hypereosinophilia.

Oehler E

2013-08-01

39

Meningitis (For Parents)  

Science.gov (United States)

About Meningitis Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord. Most ... illness, seek medical care right away. Causes of Meningitis Many of the bacteria and viruses that cause ...

40

Eosinophilic meningitis.  

UK PubMed Central (United Kingdom)

Eosinophilic meningitis is defined by the presence of at least 10% eosinophils in the total cerebrospinal fluid (CSF) leukocyte count. Although there are several possible causes of eosinophils in the CSF, parasitic infection is the main cause. The three common parasites causing eosinophilic meningitis include Angiostrongylus cantonensis, Gnathostoma spinigerum, and Taenia solium. Even though these parasites are endemic in tropical countries, they are now spreading globally due to extensive traveling, and physicians worldwide should pay more attention to this condition. This chapter will review risk factors, clinical manifestations, and treatment of these three parasites.

Sawanyawisuth K; Chotmongkol V

2013-01-01

 
 
 
 
41

Eosinophilic meningitis.  

Science.gov (United States)

Eosinophilic meningitis is defined by the presence of at least 10% eosinophils in the total cerebrospinal fluid (CSF) leukocyte count. Although there are several possible causes of eosinophils in the CSF, parasitic infection is the main cause. The three common parasites causing eosinophilic meningitis include Angiostrongylus cantonensis, Gnathostoma spinigerum, and Taenia solium. Even though these parasites are endemic in tropical countries, they are now spreading globally due to extensive traveling, and physicians worldwide should pay more attention to this condition. This chapter will review risk factors, clinical manifestations, and treatment of these three parasites. PMID:23829911

Sawanyawisuth, Kittisak; Chotmongkol, Verajit

2013-01-01

42

Meningitis and Encephalitis  

Science.gov (United States)

... and are caused by bacterial or viral infections. Viral meningitis is sometimes called aseptic meningitis to indicate it ... irritability or fatigue, lack of appetite, and fever. Viral meningitis usually resolves in 10 days or less, but ...

43

JAMA Patient Page: Meningitis  

Science.gov (United States)

... of the American Medical Association JAMA PATIENT PAGE Meningitis M eningitis (infection of the coverings of the ... about meningitis in children. SIGNS AND SYMPTOMS OF MENINGITIS FOR MORE INFORMATION • National Institute of Neurological Disorders ...

44

Acute Bacterial Meningitis  

Science.gov (United States)

... for several forms of meningitis are available. Meningococcal meningitis: A vaccine can help prevent this type of ... ROCEPHIN given by injection) as a preventive measure. Meningitis due to Streptococcus pneumoniae: A vaccine that helps ...

45

Cefuroxime in bacterial meningitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In order to find an alternative antimicrobial treatment for childhood bacterial meningitis 30 infants and children with meningitis, due to Haemophilus influenzae (n = 13), Neisseria meningitis (n = 9), Streptococcus pneumoniae (n = 5), or meningitis of unknown aetiology (n = 3), were treated with ce...

Pfenninger, J; Schaad, U B; Lütschg, J; Nussbaumer, A; Zellweger, U

46

Cryptococcal meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Cryptococcus neoformans is a kind of encapsulated fungal organism that widely exists in the nature. Because of its neurotropic nature, the central nervous system becomes its major target organ. Cryptococcus neoformans can use "transcellular pathway", "paracellular pathway" and "Trojan horse approach" to cross blood-brain barrier, and then make the devastating diffusion. Despite antifungal therapy, the mortality rate remains between 10% and 25% in patients with cryptococcal meningitis (CM) and acquired immunodeficiency syndrome (AIDS), and at least one-third of patients have experienced failure of antifungal therapy. Consequently, it is very important for us to understand the pathogenesis of CM, to diagnose as soon as possible and to explore more reasonable treatment.

WANG Yun-can; HE Jun-ying; BU Hui; ZOU Yue-li; DING Wen-ting

2013-01-01

47

[Meningeal melanocytoma: a rare meningeal tumor  

UK PubMed Central (United Kingdom)

Meningeal melanocytoma is a rare benign pigmented tumor. It develops from melanocytes normally present in the meninges of the posterior fossa and medulla. It is an extra axial tumor, that manifests due to compression of adjacent structures. The authors report a case of meningeal melanocytoma located at the foramen magnum. They insist on the characteristic paramagnetic signal of the tumor on the different MRI sequences.

Châabane M; Ellouze S; Hamrouni A; Mlika N; Ben Hammouda M; Khoudja F

2003-04-01

48

Carcinomatous meningitis  

International Nuclear Information System (INIS)

[en] Carcinomatous meningitis (CM) occurs in approximately 10%-30% of patient with various malignant neoplasms and commonly eludes standard radiographic techniques or spinal fluid examination. Fifteen New Zealand white rabbits were used in this study. Twelve rabbits were injected with 10/sup 6/ VX2 tumor cells into the cisterna magna, while four rabbits received sterile culture medium. Animals were scanned 6-12 days later at 0.5 or 1.5 using a surface coil, 3-5-mm section thickness, and a field of view of 8-12 cm. Spin-echo (SE) (repetion time ms/echo time ms) pulse sequence with SE500-300/20-40 or SE 2,000/80 pulse sequences were used. Animals were scanned before and after intravenous administration of Gd-DTPA, 0.1 mM/kg. Contrast enhancement (CE) was demonstrated as increased signal intensity in the images along the base of the brain and spinal canal in all tumor-bearing rabbits compared with CE absence in control rabbits. These results indicate that Gd-DTPA-enhanced MR imaging can accurately delineate CM in an animal model

1987-12-04

49

Meningitis and Encephalitis  

Science.gov (United States)

Meningitis and Encephalitis Fact Sheet See a list of all NINDS Disorders Get Web page suited for ... Where can I get more information? What is meningitis? What is encephalitis? Infections in the brain and ...

50

Non-Infectious Meningitis  

Science.gov (United States)

... en... Favorites Delicious Digg Google Bookmarks Non-Infectious Meningitis On This Page Causes Transmission Signs & Symptoms Causes Non–infectious meningitis causes include Cancers Systemic lupus erythematosus (lupus) Certain ...

51

MR angiography in tuberculous meningitis  

Energy Technology Data Exchange (ETDEWEB)

Background: Infarctions in tuberculous meningitis (TBM) are common but there is a paucity of studies on MR angiography (MRA). Purpose: To evaluate the pattern and predictors of MRA abnormality in patients with TBM. Material and Methods: Sixty-seven patients with TBM were subjected to clinical, laboratory, magnetic resonance imaging (MRI), and MRA evaluation. The severity of meningitis, focal deficit, CSF findings, and stroke co-morbidities were recorded. Presence of exudates, infarction, hydrocephalous, and tuberculoma on MRI were noted. On intracranial MRA, occlusion or more than 50% narrowing of proximal middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA), and basilar artery were considered abnormal. The MRA abnormality was correlated with clinical, laboratory, and MRI findings. Results: Sixty-seven patients, aged 3-75 years (median 34 years) were included. MRI was abnormal in 61 (91%) patients; basal exudates in 24, hydrocephalous in 23, tuberculoma in 33, and infarction in 40. MRA was abnormal in 34 (50.7%); MCA was most commonly involved (n = 21), followed by PCA (n = 14), ICA (n = 8), ACA (n 5), basilar artery (n = 5), and vertebral and superior cerebellar artery (1 each). One-fourth of the patients had abnormality in both anterior and posterior circulations. MRA abnormality was related to hydrocephalous and infarction; corresponding infarct was present in 61.8% patients; 41.7% patients with abnormal MRA developed infarct at 3 months but none with normal MRA. Conclusion: Half the patients with TBM had MRA abnormality involving both anterior and posterior circulations and 61.8% of them had corresponding infarcts

Kalita, Jayantee; Prasad, Sreeram; Maurya, Pradeep K.; Misra, Usha K. (Dept. of Neurology, Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India)), Email: drukmisra@rediffmail.com; Kumar, Sunil (Dept. of Radiodiagnosis, Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India))

2012-04-15

52

MR angiography in tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Background: Infarctions in tuberculous meningitis (TBM) are common but there is a paucity of studies on MR angiography (MRA). Purpose: To evaluate the pattern and predictors of MRA abnormality in patients with TBM. Material and Methods: Sixty-seven patients with TBM were subjected to clinical, laboratory, magnetic resonance imaging (MRI), and MRA evaluation. The severity of meningitis, focal deficit, CSF findings, and stroke co-morbidities were recorded. Presence of exudates, infarction, hydrocephalous, and tuberculoma on MRI were noted. On intracranial MRA, occlusion or more than 50% narrowing of proximal middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA), and basilar artery were considered abnormal. The MRA abnormality was correlated with clinical, laboratory, and MRI findings. Results: Sixty-seven patients, aged 3-75 years (median 34 years) were included. MRI was abnormal in 61 (91%) patients; basal exudates in 24, hydrocephalous in 23, tuberculoma in 33, and infarction in 40. MRA was abnormal in 34 (50.7%); MCA was most commonly involved (n = 21), followed by PCA (n = 14), ICA (n = 8), ACA (n 5), basilar artery (n = 5), and vertebral and superior cerebellar artery (1 each). One-fourth of the patients had abnormality in both anterior and posterior circulations. MRA abnormality was related to hydrocephalous and infarction; corresponding infarct was present in 61.8% patients; 41.7% patients with abnormal MRA developed infarct at 3 months but none with normal MRA. Conclusion: Half the patients with TBM had MRA abnormality involving both anterior and posterior circulations and 61.8% of them had corresponding infarcts

2012-01-01

53

Stroke in tuberculous meningitis.  

UK PubMed Central (United Kingdom)

Stroke in tuberculous meningitis (TBM) occurs in 15-57% of patients especially in advance stage and severe illness. The majority of strokes may be asymptomatic because of being in a silent area, deep coma or associated pathology such as spinal arachnoiditis or tuberculoma. Methods of evaluation also influence the frequency of stroke. MRI is more sensitive in detecting acute (DWI) and chronic (T2, FLAIR) stroke. Most of the strokes in TBM are multiple, bilateral and located in the basal ganglia especially the 'tubercular zone' which comprises of the caudate, anterior thalamus, anterior limb and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal and thalamostriate arteries which are embedded in exudates and likely to be stretched by a coexistent hydrocephalus. Cortical stroke can also occur due to the involvement of proximal portion of the middle, anterior and posterior cerebral arteries as well as the supraclinoid portion of the internal carotid and basilar arteries which are documented in MRI, angiography and autopsy studies. Arteritis is more common than infarction in autopsy study. The role of cytokines especially tumor necrosis factor (TNF?), vascular endothelial growth factor (VEGF) and matrix metaloproteineases (MMPs) in damaging the blood brain barrier, attracting leucocytes and release of vasoactive autocoids have been suggested. The prothrombotic state may also contribute to stroke in TBM. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in reducing strokes has not been proven. Aspirin also reduces mortality and its role in reducing stroke in TBM needs further studies.

Misra UK; Kalita J; Maurya PK

2011-04-01

54

Stroke in tuberculous meningitis.  

Science.gov (United States)

Stroke in tuberculous meningitis (TBM) occurs in 15-57% of patients especially in advance stage and severe illness. The majority of strokes may be asymptomatic because of being in a silent area, deep coma or associated pathology such as spinal arachnoiditis or tuberculoma. Methods of evaluation also influence the frequency of stroke. MRI is more sensitive in detecting acute (DWI) and chronic (T2, FLAIR) stroke. Most of the strokes in TBM are multiple, bilateral and located in the basal ganglia especially the 'tubercular zone' which comprises of the caudate, anterior thalamus, anterior limb and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal and thalamostriate arteries which are embedded in exudates and likely to be stretched by a coexistent hydrocephalus. Cortical stroke can also occur due to the involvement of proximal portion of the middle, anterior and posterior cerebral arteries as well as the supraclinoid portion of the internal carotid and basilar arteries which are documented in MRI, angiography and autopsy studies. Arteritis is more common than infarction in autopsy study. The role of cytokines especially tumor necrosis factor (TNF?), vascular endothelial growth factor (VEGF) and matrix metaloproteineases (MMPs) in damaging the blood brain barrier, attracting leucocytes and release of vasoactive autocoids have been suggested. The prothrombotic state may also contribute to stroke in TBM. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in reducing strokes has not been proven. Aspirin also reduces mortality and its role in reducing stroke in TBM needs further studies. PMID:21272895

Misra, Usha Kant; Kalita, Jayantee; Maurya, Pradeep Kumar

2011-01-26

55

Chronic and subacute meningitis.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: This article describes the background, clinical presentation, diagnosis, and treatment of selected etiologies of subacute and chronic meningitis. Key diagnostic considerations when evaluating a patient presenting with chronic inflammation of the CNS are discussed, and several specific infectious, neoplastic, and autoimmune etiologies are reviewed in detail. RECENT FINDINGS: With recent advancement in serologic and CSF diagnostic testing, specific infectious, neoplastic, or autoimmune etiologies of chronic meningitis can be identified. Eliminating previous diagnostic uncertainty of chronic inflammation in the CNS has led to rapid and specific treatment regimens that ultimately improve patient outcomes. Recent advances in imaging have also aided clinicians in both their diagnostic approach and the detection of inflammatory complications such as hydrocephalus, hemorrhage, and ischemic stroke. SUMMARY: Meningitis is defined as inflammation involving the meninges of the brain and spinal cord. Meningitis can be categorized as acute, subacute, or chronic based on duration of inflammation. This article focuses on the most common causes of subacute and chronic meningitis. Chronic meningitis is commonly defined as inflammation evolving during weeks to months without resolution of CSF abnormalities. Determining the time course of meningitis is important for creating a differential diagnosis. Most organisms causing acute meningitis rarely persist more than a few weeks. Although numerous etiologies of subacute and chronic meningitis have been identified, this article focuses on the most common etiologies: (1) infectious, (2) autoimmune, and (3) neoplastic.

Zunt JR; Baldwin KJ

2012-12-01

56

Primary diffuse meningeal melanomatosis.  

UK PubMed Central (United Kingdom)

Primary diffuse meningeal melanomatosis can clinically mimic a wide variety of other conditions, including lymphoma, leukemia, neurosarcoidosis, metastatic carcinoma, acute disseminated encephalomyelitis, subacute meningitis, viral encephalitis, and idiopathic hypertrophic cranial pachymeningitis. We report on a young patient with primary diffuse meningeal melanomatosis who presented with papilledema, flaccid paraparesis, and cognitive impairment. The importance of imaging of the whole central nervous system, cerebrospinal fluid analysis, and pathohistological examination is emphasized in making the appropriate diagnosis.

Zadro I; Brinar VV; Barun B; Ozreti? D; Pazanin L; Grahovac G; Habek M

2010-03-01

57

Intracranial meningeal pathology  

International Nuclear Information System (INIS)

To assess the role of Gd-DTPA-enhanced imaging in the detection of meningeal pathology, the authors reviewed 100 consecutive patients with suspected intracranial disease. Fifteen patients demonstrated abnormal meningeal enhancement that represented sarcoid (n = 6), lymphoma (n = 4), carcinomatosis (n = 2), glioblastoma (n = 1), aseptic meningitis (n = 1), and subdural empyema (n = 1). Seven patients had accompanying parenchymal abnormalities, but the majority did not show any abnormalities before contrast enhancement. A diffuse pattern of enhancement was seen in 12 patients, with the remaining three showing a nodular/segmental pattern. In these patients, the demonstration of abnormal enhancement provided the initial evidence of meningeal involvement leading to critical therapeutic decisions

1989-12-01

58

Bacterial meningitis in children. MR findings  

International Nuclear Information System (INIS)

[en] We analyzed MRI findings for 17 children with bacterial meningitis. Contrast-enhanced T1-weighted images revealed meningeal enhancement at the basal cistern and/or the convex surface of the brain in 15 cases. Cerebral infarcts were found in the distribution of perforating and/or medullary arteries in four cases. In one neonatal case, venous infarction with hemorrhagic transformation was evident. Communicating hydrocephalus was noted in three cases, subdural effusion in two, subdural empyema in one, and encephalitis in one. In one neonatal case ventriculitis was found. We conclude that MRI is useful for the evaluation of the active inflammatory process of the meninges and the identification of the focal lesions in central nervous system complications. (author)

1998-01-01

59

Bacterial meningitis in children. MR findings  

Energy Technology Data Exchange (ETDEWEB)

We analyzed MRI findings for 17 children with bacterial meningitis. Contrast-enhanced T1-weighted images revealed meningeal enhancement at the basal cistern and/or the convex surface of the brain in 15 cases. Cerebral infarcts were found in the distribution of perforating and/or medullary arteries in four cases. In one neonatal case, venous infarction with hemorrhagic transformation was evident. Communicating hydrocephalus was noted in three cases, subdural effusion in two, subdural empyema in one, and encephalitis in one. In one neonatal case ventriculitis was found. We conclude that MRI is useful for the evaluation of the active inflammatory process of the meninges and the identification of the focal lesions in central nervous system complications. (author)

Kinoshita, Toshibumi; Ishii, Kiyoshi; Nakagawa, Hiroshi; Onuma, Takehide [Sendai City Hospital (Japan)

1998-09-01

60

Localized basal meningeal enhancement in tuberculous meningitis  

Energy Technology Data Exchange (ETDEWEB)

Focal basal meningeal enhancement may produce a confusing CT picture in children with suspected tuberculous meningitis (TBM). To demonstrate the incidence, distribution and appearance of localized basal meningeal enhancement in children with TBM. CT scans of patients with definite (culture proven) and probable (CSF suggestive) TBM were retrospectively evaluated by two observers. Localized basal enhancement was documented as involving: unilateral cistern of the lateral fossa (CLF), unilateral sylvian fissure, unilateral CLF and sylvian fissure in combination, unilateral CLF and sylvian fissure with ipsi- or contralateral ambient cistern and isolated quadrigeminal plate cistern. The study included 130 patients with TBM (aged 2 months to 13 years 9 months). Focal basal enhancement was seen in 11 patients (8.5%). The sylvian fissure was involved most commonly, followed by the lateral fossa cistern. The ambient cistern was involved in three patients and the quadrigeminal plate cistern in one. Focal areas of enhancement corresponded to the areas of infarction in every patient. Focal basal meningeal enhancement is common (8.5%) in paediatric TBM. This must be kept in mind when evaluating CT scans in children presenting with focal neurological findings, seizures or meningism in communities where TBM is endemic. (orig.)

Theron, Salomine; Andronikou, Savvas; Grobbelaar, Marie; Steyn, Freda; Mapukata, Ayanda; Plessis, Jaco du [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. BOX 19063, Tygerberg (South Africa)

2006-11-15

 
 
 
 
61

Localized basal meningeal enhancement in tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Focal basal meningeal enhancement may produce a confusing CT picture in children with suspected tuberculous meningitis (TBM). To demonstrate the incidence, distribution and appearance of localized basal meningeal enhancement in children with TBM. CT scans of patients with definite (culture proven) and probable (CSF suggestive) TBM were retrospectively evaluated by two observers. Localized basal enhancement was documented as involving: unilateral cistern of the lateral fossa (CLF), unilateral sylvian fissure, unilateral CLF and sylvian fissure in combination, unilateral CLF and sylvian fissure with ipsi- or contralateral ambient cistern and isolated quadrigeminal plate cistern. The study included 130 patients with TBM (aged 2 months to 13 years 9 months). Focal basal enhancement was seen in 11 patients (8.5%). The sylvian fissure was involved most commonly, followed by the lateral fossa cistern. The ambient cistern was involved in three patients and the quadrigeminal plate cistern in one. Focal areas of enhancement corresponded to the areas of infarction in every patient. Focal basal meningeal enhancement is common (8.5%) in paediatric TBM. This must be kept in mind when evaluating CT scans in children presenting with focal neurological findings, seizures or meningism in communities where TBM is endemic. (orig.)

2006-01-01

62

Chronic and recurrent meningitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Chronic meningitis is defined as the persistence of clinical symptoms and signs of meningitis, with or without abnormal cerebrospinal fluid, for more than four weeks. In as many as one third of cases, no cause is found. In the remainder, infective, neoplastic and so-called aseptic disorders may be i...

Ginsberg, L; Kidd, D

63

Syringomyelia following tuberculous meningitis  

International Nuclear Information System (INIS)

[en] We present three cases with syringomyelia after tuberculous meningitis. The MR findings suggested the syrinx was formed by blockage of the CSF flow at the outlets of the fourth ventricle. We consider this complication is not a rare condition following tuberculous meningitis. (author)

1988-01-01

64

Meningitis retention syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available A 50-year-old Caucasian woman presented with signs and symptoms of meningitis preceded by a 3 day history of flu-like symptoms and progressive difficulty with urination. Cerebrospinal Fluid (CSF) analysis was consistent with aseptic meningitis. She was found to have a significant urinary retention secondary to atonic bladder. MRI of the brain and spine were normal and CSF-PCR (polymerase chain reaction) was positive for HSV-2. Urinary retention in the context of meningitis and CSF pleocytosis is known as Meningitis Retention Syndrome (MRS). MRS is a rare but important complication of meningitis most commonly associated with HSV-2. Involvement of central pathways may have a role in the pathogenesis of MRS but this is poorly documented. MRS is different from Elsberg syndrome wherein patients display features of lumbosacral polyradiculitis or radiculomyelitis. Early treatment with antiviral therapy was associated with a favorable outcome in our patient.

Abhishek Krishna; Pavan Devulapally; Ibrahim Ghobrial

2012-01-01

65

Meningitis Research Foundation  

Science.gov (United States)

Based in the United Kingdom, the Meningitis Research Foundation is a charity organization focused on the prevention and treatment of meningitis (and associated infections) through research and public education. The Foundation website describes common symptoms (with photographs); and contains a variety of specific information about meningitis and septicaemia. For health professionals, the site offers "guidance notes and protocols to promote best practice in the diagnosis and treatment of patients with meningitis and septicaemia." The website's Research section contains separate Public Information and Scientific Information sections as well as separate Scientific and Layperson's Archive sections with reports from funded projects. The Foundation website provides audio and written information about meningitis and speticaemia in 18 languages.

66

Laboratorial diagnosis of lymphocytic meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Meningitis is the main infectious central nervous system (CNS) syndrome. Viruses or bacteria can cause acute meningitis of infectious etiology. The term "Aseptic Meningitis" denotes a clinical syndrome with a predominance of lymphocytes in the cerebrospinal fluid (CSF), with no common bacterial agents identified in the CSF. Viral meningitis is considered the main cause of lymphocyte meningitis. There are other etiologies of an infectious nature. CSF examination is essenti (more) al to establish the diagnosis and to identify the etiological agent of lymphocytic meningitis. We examined CSF characteristics and the differential diagnosis of the main types of meningitis.

Almeida, Sérgio Monteiro de; Nogueira, Meri Bordignon; Raboni, Sonia Mara; Vidal, Luine Rosele

2007-10-01

67

Laboratorial diagnosis of lymphocytic meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Meningitis is the main infectious central nervous system (CNS) syndrome. Viruses or bacteria can cause acute meningitis of infectious etiology. The term "Aseptic Meningitis" denotes a clinical syndrome with a predominance of lymphocytes in the cerebrospinal fluid (CSF), with no common bacterial agents identified in the CSF. Viral meningitis is considered the main cause of lymphocyte meningitis. There are other etiologies of an infectious nature. CSF examination is essential to establish the diagnosis and to identify the etiological agent of lymphocytic meningitis. We examined CSF characteristics and the differential diagnosis of the main types of meningitis.

Sérgio Monteiro de Almeida; Meri Bordignon Nogueira; Sonia Mara Raboni; Luine Rosele Vidal

2007-01-01

68

Lamotrigine and aseptic meningitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The purpose of this case series is to characterize a recently identified association of the antiepileptic drug (AED) lamotrigine with aseptic meningitis based on cases reported to the Food and Drug Administration (FDA)'s Adverse Event Reporting System (AERS) database. METHODS: We performed a data mining analysis of 9 AEDs from the FDA's AERS database. We applied the multi-item gamma Poisson shrinker (MGPS) algorithm to the entire AERS database through November 2, 2009, to generate empirical Bayes geometric mean (EBGM) values with corresponding confidence intervals for 9 AEDs and the adverse event code "meningitis aseptic." The AERS database was also searched for postmarketing reports of aseptic meningitis associated with lamotrigine and a detailed review of each case was performed. RESULTS: Forty AERS cases were identified in this review. Findings from the AERS reports revealed CSF profiles with features of both bacterial as well as viral meningitis. Fifteen cases documented a positive rechallenge; the median time to onset of symptoms upon rechallenge was only 60 minutes. Data mining analysis of several anticonvulsants resulted in disproportionate reporting solely for lamotrigine. CONCLUSION: There appears to be an association between lamotrigine use and aseptic meningitis. It is notable that nearly 40% of cases in this case series reported a positive rechallenge. Lamotrigine-associated aseptic meningitis should be considered in the differential diagnosis of culture-negative meningitis. This case series highlights the need for continued pharmacovigilance and the importance of systematic monitoring of patients treated with antiepileptic medications.

Simms KM; Kortepeter C; Avigan M

2012-03-01

69

Viral meningitis and encephalitis.  

UK PubMed Central (United Kingdom)

Meningitis is an inflammation of the meninges, whereas encephalitis is inflammation of the parenchymal brain tissue. The single distinguishing element between the 2 diagnoses is the altered state of consciousness, focal deficits, and seizures found in encephalitis. Consequently meningoencephalitis is a term used when both findings are present in the patient. Viral meningitis is not necessarily reported as it is often underdiagnosed, whereas encephalitis cases are on the increase in various areas of North America. Improved imaging and viral diagnostics, as well as enhanced neurocritical care management, have improved patient outcomes to date.

Tuppeny M

2013-09-01

70

Viral meningitis and encephalitis.  

Science.gov (United States)

Meningitis is an inflammation of the meninges, whereas encephalitis is inflammation of the parenchymal brain tissue. The single distinguishing element between the 2 diagnoses is the altered state of consciousness, focal deficits, and seizures found in encephalitis. Consequently meningoencephalitis is a term used when both findings are present in the patient. Viral meningitis is not necessarily reported as it is often underdiagnosed, whereas encephalitis cases are on the increase in various areas of North America. Improved imaging and viral diagnostics, as well as enhanced neurocritical care management, have improved patient outcomes to date. PMID:23981453

Tuppeny, Misti

2013-06-20

71

Seizure heralding tuberculous meningitis.  

Science.gov (United States)

Seizures may frequently occur during tuberculous meningitis. We describe a patient with an apparent generalised tonic-clonic seizure, initially not associated with any magnetic resonance imaging (MRI) abnormality, which was the presenting symptom of tuberculous meningitis. Follow-up MRI, performed after gadolinium administration, showed signs of meningeal involvement. Seizures may be the presenting symptoms of tuberculous meningitis even in the absence of evident intracerebral lesions on MRI. Therefore, contrast-enhanced brain MRI should be performed in the diagnostic workup for each first seizure, especially in patients with a clinical suspicion of CNS infectious disease. The term "heraldic seizure", indicating a subset of acute symptomatic seizures presenting at the onset of a brain/systemic injury or preceding the full clinical manifestation of a cerebral insult, may be helpful to classify these seizures retrospectively, based initially on unknown aetiology. PMID:22940820

Brigo, Francesco; Ausserer, Harald; Zuccoli, Giulio; Tezzon, Frediano; Nardone, Raffaele

2012-09-01

72

Seizure heralding tuberculous meningitis.  

UK PubMed Central (United Kingdom)

Seizures may frequently occur during tuberculous meningitis. We describe a patient with an apparent generalised tonic-clonic seizure, initially not associated with any magnetic resonance imaging (MRI) abnormality, which was the presenting symptom of tuberculous meningitis. Follow-up MRI, performed after gadolinium administration, showed signs of meningeal involvement. Seizures may be the presenting symptoms of tuberculous meningitis even in the absence of evident intracerebral lesions on MRI. Therefore, contrast-enhanced brain MRI should be performed in the diagnostic workup for each first seizure, especially in patients with a clinical suspicion of CNS infectious disease. The term "heraldic seizure", indicating a subset of acute symptomatic seizures presenting at the onset of a brain/systemic injury or preceding the full clinical manifestation of a cerebral insult, may be helpful to classify these seizures retrospectively, based initially on unknown aetiology.

Brigo F; Ausserer H; Zuccoli G; Tezzon F; Nardone R

2012-09-01

73

Group C streptococcal meningitis.  

UK PubMed Central (United Kingdom)

Group C streptococci have been infrequently described as human pathogens. A case of meningitis caused by Streptococcus dysgalactiae, in a 73-year-old man with alcoholic liver disease, was treated successfully with penicillin and chloramphenicol.

Mollison LC; Donaldson E

1990-03-01

74

Meningitis por Streptococcus suis/ Streptococcus suis meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La infección humana por Streptococcus suis (S. suis) es una zoonosis, con un riesgo ocupacional conocido y que suele presentarse como meningitis purulenta, que tiene baja mortalidad y frecuentes secuelas de hipoacusia y ataxia. Se han publicado menos de 150 casos humanos desde el informe original de hace 30 años. Hay una reconocida distribución geográfica viviendo la mayoría de los afectados en el norte de Europa y el sudeste Asiático. En España se han comunicado d (more) os pacientes con enfermedad por S. suis. Presentamos dos pacientes con meningitis por S. suis, que acudieron a nuestro hospital en el plazo de un mes. Ambos eran hombres con exposición laboral a cerdos. Presentaron hipoacusia neurosensorial y ataxia de la marcha. Un paciente tuvo parálisis facial periférica y diplopía por paresia del sexto par contralateral con resolución completa a los tres meses. Lo excepcional de la meningitis por S. suis en nuestro país, no debe hacernos olvidar la importancia de registrar el riesgo laboral en la anamnesis. Abstract in english Human infection by Streptococcus suis (S. suis) is a zoonosis, with a known occupational risk and clinical presentation mainly as a purulent meningitis with low mortality and frequent hearing loss and ataxia sequela. Less than 150 human cases have been reported since original one thirty years ago. There is a geographical distribution most patients living in northen Europe and south Asia. S. suis disease in human has been reported in two patients in Spain the last years. W (more) e present two patients with S. suis meningitis, both were men with occupation related by pork meet, and good outcome. They come at our hospital in a lapse of one month. Both had neurosensorial hearing loss and walking ataxia. One patient had peripheral facial paralysis and diplopia because of paresia of contralateral sixth nerve, with complete resolution at three months.The rare presentation of S. suis meningitis in our country must not forget us to record the working risk at anamnesis.

Geffner Sclarsky, D. E.; Moreno Muñoz, R.; Campillo Alpera, Mª.S.; Pardo Serrano, F.J.; Gómez Gómez, A.; Martínez-Lozano, Mª.D.

2001-06-01

75

Meningitis bacteriana aguda Acute bacterial meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: describir las causas, evolución y complicaciones de la meningitis bacteriana aguda. Pacientes y método: en una encuesta retrospectiva a 14 unidades de cuidados intensivos pediátricos se registraron 358 pacientes que reunión los criterios de diagnostico de meningitis bacteriana aguda (MBA) durante 1996. Resultados: en 36,6% la etiologia fue Neisseria meilngifidis, Streptococcus pneumonioe en 19,8% y Haemophilus influenzae tipo b en  6%. En 21% no se aisló el agente. La letalidad fue 3,5% para N meningitidis-, 14% para S. pneumonioe y 3% para H. influenzae tipo b. De los 358 pacientes, 21% se hospitalizaron en sola común durante toda su evolución. Las complicaciones mas frecuentes fueron falla circulatoria o cheque (35%), convulsiones (22%) e hipertensión intracraneala (18%). Se uso asistencia respiratoria mecánica en 31% de los pacientes, variando su empleo de 9 o 71% Según centre. Fallecieron 23 pacientes 16,3%), 40% antes de 24 h desde el ingresa, 60,8% por hipertensión intracraneana y enclavamiento encefálico, 30,8% por falla circulatoria. Conclusión: los niños con meningitis bacteriana aguda deben ingresar a unidades de cuidados intensivos en las primeras 24 horas. Se requiere uniformar criterios de asistencia mecánico a la respiración.Objective: to describe etiology and evolution of bacterial meningitis as seen from pediatric intensive care units. Patients and methods: a retrospective survey was done to 358 patients who met diagnostic criteria of acute bacterial meningitis and were odmited Jo 14 chilean hospitals along year 1996. Results: most frequently isolated bacteriae were: Neisseria meningitidis (36,6%), Streptococcus pneumoniae (19,8%) end Haemophilus influenzae type b (16%). In 2 1 % of the coses no etiology was identified. Specific mortality was 3,5% for N. meningitidis, 14% for 5. pneumonioe and 3% for H. influenzae type b. One in five patients was never admitted to an intensive care unit JICU). Shock (35%), seizures (22%) and int-acraneal hypertension (13%) were the most frecuent complications. Mechanical ventilation was used en 31% patients (9 to 71% depending of center; 23% patients died, 40% ofthern in the first 24hours after admission. Main causes of death were inlracraneal hypertension (61%] and shock (30,8%). Conclusion: most patients with acute bacterial meningitis should be admitted to inlensive care units. Uniform criteriae for mechanical respiratory assistance must be settled.

Marcela Castro R; Jaime Cordero T

1998-01-01

76

Locations of cerebral infarctions in tuberculous meningitis  

International Nuclear Information System (INIS)

[en] The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.)

1992-01-01

77

MR imaging and angiography in tuberculous meningitis  

International Nuclear Information System (INIS)

[en] MRI was performed on 26 patients with tuberculous meningitis, with particular reference to document the cranial nerve abnormalities. MR angiography (MRA) was performed in 20 of the patients. Meningeal enhancement in the basal cisterns or over the convexity of brain was seen in all patients; two show ependymal enhancement. Tuberculomas, single (3), multiple (12) or military (2) were detected in 17 patients. Of the 9 patients with cranial nerve palsies, 7 showed contrast enhancement with or without thickening of the involved nerve. Abnormality signal intensity of the involved nerve was seen on proton density and T2-weighted images in one of these patients. MRA revealed focal arterial narrowing in 10 patients, the vessels commonly affected being the terminal segment of the internal carotid artery and the proximal segments of the middle and anterior cerebral arteries. One patient also had a small aneurysm of the proximal middle cerebral artery. Infarcts, haemorrhagic (8) or bland (6), were detected in 14 patients; most were the basal ganglia and internal capsules, large middle or anterior cerebral arterial territory infarcts being seen in only two cases. (orig.)

1994-01-01

78

Eosinophilic meningitis caused by primary angiitis of the central nervous system.  

UK PubMed Central (United Kingdom)

Eosinophilic meningitis is defined as the presence of 10 eosinophils/mm(3) in the cerebrospinal fluid (CSF) or eosinophils accounting for more than 10% of CSF leukocytes. A 76-year-old man who developed cognitive dysfunction and consciousness disturbance had eosinophilic meningitis (his CSF contained 19.0% eosinophils). Because the etiology was unknown, we performed a brain biopsy. The pathological findings showed inflammatory infiltration in the small-sized arteries of the meninges. The patient was ultimately diagnosed as having primary angiitis of the central nervous system (PACNS). Eosinophilic meningitis occurring in a patient with PACNS is extremely rare, and this is the first report of this condition in Japan.

Hirano K; Fukae J; Hieda S; Fujimaki M; Ishii H; Tsuboi Y; Kawamura M; Arai H; Hattori N

2013-01-01

79

Computed tomography angiography in patients with tuberculous meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Strokes in tuberculous meningitis are important determinant of prognosis. Strokes are caused by tuberculosis-related vasculopathy. In this study, we aimed to demonstrate the value of computed tomography angiography. We also assessed value of angiographic findings in determining the prognosis. METHODS: We included consecutive patients of tuberculous meningitis and prospectively followed them for 6 months. Computed tomography angiography was performed at inclusion. Follow-up angiography, after 6 months, was done in the patients, who had given consent. Angiographic findings were evaluated by experienced neuroradiologists. RESULTS: Initial computed tomography angiography revealed arterial narrowing or occlusion in 33 patients. In 30 patients the anterior cerebral circulation and in 9 patients posterior cerebral circulation was involved. Six (18.2%) patients had lesions in both the territories. The most frequently involved arteries were supraclinoid portion of the internal carotid artery, and proximal portions of the anterior cerebral and middle cerebral arteries. On univariate analysis, predictors of angiographic abnormalities were impaired vision (p = 0.019), hemiparesis (p = 0.002), hydrocephalous (p < 0.001), basal exudates (p < 0.001), meningeal enhancement (p = 0.026) and infarcts (p < 0.001). On multivariate analysis basal exudates was a significant predictor. Angiographic abnormalities were associated with insignificantly poorer prognosis. On follow-up angiograms, 3 patients showed resolution in vascular abnormalities. Two patients had developed new angiographic abnormalities. CONCLUSION: Arterial narrowing and occlusion is seen in majority of patients with tuberculous meningitis. Angiographic abnormalities may be associated with poor prognosis.

Singh B; Garg RK; Singh MK; Verma R; Malhotra HS; Jain A; Singh R; Kohli N; Phadke RV; Shukla R; Parihar A

2012-06-01

80

Possibility of diagnosing meningitis by gas chromatography: cryptococcal meningitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cerebrospinal fluid (CSF) from eight patients with cryptococcal meningitis, from ten patients with viral meningitis, and from four control patients without meningitis were analyzed by electron-capture gas-liquid chromatography (EC-GLC). All cryptococcal specimens had similar EC-GLC profiles, and the...

Schlossberg, D; Brooks, J B; Shulman, J

 
 
 
 
81

CT finding of tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Computerized tomographic findings of three cases with tuberculous meningitis in childhood were reported and compared with pathological findings in 2 autopsy cases of tuberculous meningitis. (J.P.N.)

1982-01-01

82

IATROGENIC MENINGITIS AFTER SPINAL ANESTHESIA  

Digital Repository Infrastructure Vision for European Research (DRIVER)

"nBacterial meningitis after spinal and epidural anesthesia is a very rare but serious complication. We report a case of meningitis developing a number of hours after a spinal block for Caesarean section. No organism was grown but the CSF pattern was suggestive of bacterial meningitis. Severe n...

R Hashemi; A Okazi

83

Bacterial meningitis in children  

International Nuclear Information System (INIS)

[en] To demonstrate the epidemiology, clinical manifestations and bacteriological profile of bacterial meningitis in children beyond the neonatal period in our hospital. This was a retrospective descriptive study conducted at Prince Rashid Hospital in Irbid, Jordan. The medical records of 50 children with the diagnosis of bacterial meningitis during 4 years period, were reviewed. The main cause of infection was streptococcus pneumoniae, followed by Haemophilus influenza and Niesseria meningitides. Mortality was higher in infants and meningococcal infection, while complications were more encountered in cases of streptococcus pneumoniae. Cerebrospinal fluid culture was positive in 11 cases and Latex agglutination test in 39. There is a significant reduction of the numbers of bacterial meningitis caused by Haemophilus influenza type B species. (author)

2007-01-01

84

Iatrogenic meningitis/ Meningites iatrogenicas  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese As meningites iatrogênicas podem ser provocadas por uma série de mecanismos. Os recentes relatos de casos de meningite por fungos após a aplicação de injeção epidural de metilprednisolona causou alerta na comunidade médica. Os casos foram causados por lotes contaminados de metilprednisolona produzidos por uma única farmácia de produção. Diversos medicamentos podem causar meningite por provável mecanismo de h (more) ipersensibilidade. Neurologistas devem ficar alerta para a recente descrição do uso de lamotrigina e o desenvolvimento de meningite asséptica. Abstract in english Iatrogenic meningitis can be caused by a number of mechanisms. The recent case reports of fungal meningitis after application of epidural methylprednisolone caused warning in the medical community. Cases were caused by contaminated lots of methylprednisolone from a single compounding pharmacy. Several medications can cause meninigitis by probable hypersensitivity mechanism. Neurologists should be alert to the recent description of the use of lamotrigine and development of aseptic meningitis.

Mutarelli, Eduardo Genaro; Adoni, Tarso

2013-09-01

85

Cortical venous thrombosis – a rare complication of tuberculous meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Occlusion of the central veins and sinuses occurs owing to thrombus, thrombophlebitis, or tumours. Cerebral venous thrombosis (CVT) is less frequent than arterial thrombosis, but can produce a cascade of sequelae and may be fatal. The usual predisposing factors for CVT include infections, pregnancy and puerperium, hypercoagulable states, etc. Many infectious causes are related to CVT, but a review of literature showed only few cases related to tuberculosis. Vascular changes consisting of arterial narrowing with or without occlusion are frequently seen at autopsy in cases of tuberculous meningitis. We report one such case of tuberculous meningitis where the patient developed cortical venous thrombosis after 5 days of illness. She was treated empirically, initially, till confirmation of the diagnosis and later was put on antitubercular drugs along with prednisolone therapy and anticoagulation, which led to complete recovery. Thus, if treated aggressively and in time, tuberculous meningitis and its complications are completely curable.

Swati C Aundhakar; Sanket K Mahajan; Makarand B Mane; Shirish Agrawal

2013-01-01

86

Fatal Prevotella oralis meningitis.  

UK PubMed Central (United Kingdom)

Prevotella oralis, an obligate Gram-negative anaerobe, was detected as the cause of acute meningitis in a four-year-old cocker spaniel. Clinical signs included acute onset collapse and severe depression. Despite treatment, the animal died. A post-mortem examination was performed which revealed a fibrinosuppurative meningitis with no significant inflammation of the brain or spinal parenchyma. The aetiological diagnosis was confirmed by anaerobic bacterial culture. This report discusses the nature and extent of the lesions and possible routes of infection of the causative organism.

Cahalan SD; Hick G; Rossiter A; Callanan JJ

2013-03-01

87

Squamous cell carcinomatous meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available A case of leptomeningeal carcinomatosis due to a poorly differentiated malignancy is presented. Immunohistochemistry was used to characterize it as a squamous cell carcinoma. Squamous cell carcinomas rarely invade the meninges. There are few well-founded guidelines for managing patients with this condition. Prognosis is generally poor. A literature review of this entity is provided.

Syed M. Karim; Victor E. Nava; Edina Paal; Steven H. Krasnow; MacArthur Drake Jr.

2011-01-01

88

Recurrent meningitis in children.  

UK PubMed Central (United Kingdom)

Recurrent meningitis in children, although rare, results in an increased risk of acute complications and long-term morbidity. We did a retrospective case series to analyze the clinical presentation, predisposing factors, treatment and outcome of children with recurrent meningitis admitted at Shifa International hospital, Islamabad. All children presenting with recurrent meningitis from December 2006 to May 2011 were included in the study. There were a total of 8 children with a mean age of 6 +/- 2.97 years (2-10 years). Majority (87%) were males. There was an average of 4 +/- 4.92 (2-9) episodes of meningitis in each patient. Fever with vomiting was the most common (87%) presenting symptom, followed by seizures (62%) and headache (50%). The underlying etiology was confirmed on CSF analysis, computed tomography scan (CT) and magnetic resonance imaging (MRI). About half of them had history of head trauma. All responded to antibiotics and six needed surgery. On follow up, 2 (25%) children had some neurological impairment.

Khan EA; Choudhry S; Roohullah M; Hashmi I; Nazir R

2013-02-01

89

Vaccines against bacterial meningitis  

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Meningitis remains an important cause of morbidity and mortality among children >5 years of age and is especially prevalent in developing countries. Effective routine immunization against Hib, pneumococcus and serogroupC meningococcus has had a significant impact on both invasive disease and carriag...

Segal, S.; Pollard, A. J.

90

Vaccines against bacterial meningitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Meningitis remains an important cause of morbidity and mortality among children >5 years of age and is especially prevalent in developing countries. Effective routine immunization against Hib, pneumococcus and serogroupC meningococcus has had a significant impact on both invasive disease and carriag...

Segal, S; Pollard, AJ

91

Listeria monocytogenes Meningitis in Adults: The Czech Republic Experience  

Science.gov (United States)

Background. Listeria monocytogenes (LM) is currently the third most frequent pathogen of bacterial meningitis in adults. Methods. A prospective study of patients with LM meningitis in a Czech tertiary care hospital, carried out from 1997 to 2012. Results. Thirty-one patients were diagnosed with LM meningitis, which was 7% of a total of 440 adult patients with acute bacterial meningitis (ABM) over a 16-year period. Their median age was 63 years, range 26–80 years. Nineteen patients (61%) had underlying immunocompromising comorbidity; 15 patients (48%) were older than 65 years. Fourteen patients (45%) had arterial hypertension. The typical triad of fever, neck stiffness, and altered mental status was present in 21 patients (68%). The median count of cerebrospinal fluid (CSF) leukocytes was 680/?L, protein level 2.6?g/L, and glucose ratio 0.28. Four patients (13%) died, and nine (29%) survived with moderate to severe sequelae. Conclusion. LM meningitis is known to affect immunosuppressed and elderly patients. Arterial hypertension seems to be another important predisposing factor. Clinical symptoms, CSF findings, and disease outcomes, did not significantly differ from other community-acquired ABM in our study, although the CSF leukocyte count was lower. Ampicillin showed good clinical and bacteriological efficacy in the majority of patients.

Rozsypal, Hanus; Smiskova, Dita; Benes, Jiri

2013-01-01

92

Vascular extracellular signal-regulated kinase mediates migraine-related sensitization of meningeal nociceptors.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine changes in the response properties of meningeal nociceptors that might lead to migraine pain and examine endogenous processes that could play a role in mediating them using a clinically relevant model of migraine triggering, namely infusion of the nitric oxide (NO) donor nitroglycerin (NTG). METHODS: Single-unit recordings made in the trigeminal ganglion of rats were used to test changes in the activity and mechanosensitivity of meningeal nociceptors in response to administration of the migraine trigger NTG or another NO donor S-nitroso-N-acetyl-DL-penicillamine (SNAP) at doses relevant to the human model of migraine headache. Immunohistochemistry and pharmacological manipulations were used to investigate the possible role of meningeal vascular signaling in mediating the responses of meningeal nociceptors to NO. RESULTS: Infusion of NTG promoted a delayed and robust increase in the mechanosensitivity of meningeal nociceptors, with a time course resembling the development of the delayed migraine headache. A similar sensitization was elicited by dural application of NTG and SNAP. NTG-evoked delayed meningeal nociceptor sensitization was associated with a robust extracellular signal-regulated kinase (ERK) phosphorylation in meningeal arteries. Pharmacological blockade of meningeal ERK phosphorylation inhibited the development of NTG-evoked delayed meningeal nociceptor sensitization. INTERPRETATION: The development of delayed mechanical sensitization evoked by the migraine trigger NTG is potentially of great importance as the first finding of a neurophysiological correlate of migraine headache in meningeal nociceptors. The arterial ERK phosphorylation and its involvement in mediating the NTG-evoked delayed sensitization points to an important, yet unappreciated, role of the meningeal vasculature in the genesis of migraine pain.

Zhang X; Kainz V; Zhao J; Strassman AM; Levy D

2013-06-01

93

CT scanning in meningitis  

International Nuclear Information System (INIS)

[en] 12 pediatric cases of acute meningitis were reviewed retrospectively. Findings on CT scan were compared with the clinical course and resulting neurological sequelae. Complications detected by CT scanning include subdural effusion, empyema, hydrocephalus, cerebral atrophy, oedema and infarction. The CT scan results adequately correlated with neurological signs in most cases. Infarction was a reliable indicator of neurological sequelae. Cerebral atrophy alone, however, did not correlate well with the clinical sequelae. (author). 19 refs.; 5 figs.; 6 tabs

1991-01-01

94

Serum procalcitonin in septic meningitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the role of serum procalcitonin (PCT) in diagnosis of septic meningitis in children and its efficacy in differential diagnosis. METHODS: The study included 40 children of septic meningitis admitted in pediatric ward with fever, headache, vomiting and seizure, up to 14 y of age. The diagnosis of septic meningitis was based on clinical features; physical examination, blood and cerebrospinal fluid (CSF) cytochemical findings, gram's stain and bacterial culture. Fifteen cases of aseptic meningitis admitted during same period were also included in the study, and 15 children with normal CSF were taken as control. Serum PCT was measured by ELISA Kit. RESULTS: Serum PCT level was significantly higher in children with septic meningitis than those with aseptic meningitis or in controls (p?meningitis(14,451.24?±?4,266.15 pg/mL) (p?meningitis as compared to aseptic meningitis cases (p?meningitis. CONCLUSIONS: Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis.

Prasad R; Kapoor R; Mishra OP; Srivastava R; Kant Singh U

2013-05-01

95

[Prognosis of bacterial meningitis  

UK PubMed Central (United Kingdom)

OBJECTIVES: To review the literature on the risk factors for bacterial meningitis (BM) and evaluate these factors in children diagnosed as having BM in the Paediatric Department of the University Hospital of Maracaibo between 1996 and 1998. PATIENTS AND METHODS: We made a retrospective study of children diagnosed as having BM in the University of Maracaibo. We evaluated different factors related to BM. RESULTS: From 1 January 1996 to 31 December 1998 a total of 152 children were diagnosed as having bacterial meningitis; 69.7% were boys and 30.3% were girls. The commonest causal germ was Haemophilus influenzae. Disorders of sensation (42.7%) and signs of meningism (32.8%) were the most frequent neurological alterations. The main laboratory findings were leucocytosis (51.3%), thrombocytosis (49.3%), pleocytosis (70.3%), cerebrospinal fluid protein (49.3%) and low cerebrospinal fluid glucose (72.8%). Twelve patients (7.5%) died. Of this group, 10 were under one year of age and had septic shock. CONCLUSIONS: BM represents a major group of hospital admissions in everyday paediatric practice. Although the mortality has decreased, an increased risk of sequelas must be borne in mind. Clinico-neurological examination on admission and simultaneous analysis of laboratory investigations allows identification of prognostic indicators of morbidity and mortality.

Peña JA; Jiménez L

1999-08-01

96

Steroids in bacterial meningitis: yes.  

UK PubMed Central (United Kingdom)

Bacterial meningitis is an infectious condition associated with severe morbidity and mortality, even with rapid diagnosis and appropriate antibiotic therapy. Despite decrease in the rate of bacterial meningitis brought about by vaccination programs against Haemophilus influenzae type-B and Streptococcus pneumonia, the incidence of meningitis is still unacceptably high and acute treatment remains the mainstay of therapy. The infection is accompanied by intense inflammatory response, which may carry deleterious effects upon the tissue. This led to the possibility of adjuvant corticosteroid therapy, as an anti-inflammatory agent, in bacterial meningitis. The debate focuses on the rational and evidence supporting and refuting such an approach.

Benninger F; Steiner I

2013-02-01

97

Locations of cerebral infarctions in tuberculous meningitis  

Energy Technology Data Exchange (ETDEWEB)

The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.).

Hsieh, F.Y.; Chia, L.G. (Section of Neurology, Taichung Veterans General Hospital (Taiwan)); Shen, W.C. (Section of Neuroradiology, Taichung Veterans General Hospital (Taiwan))

1992-06-01

98

Haemophilus influenzae Meningitis in Adults  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Haemophilus influenzae meningitis though common in childhood is rarely seen in the adult. During the past four years eight cases of H. influenzae meningitis have been seen in St. Thomas's Hospital and four of these were in patients over 20 years old. There was a possible predisposing condition in tw...

Eykyn, Susannah J.; Thomas, Roderic D.; Phillips, Ian

99

Diagnosis dan Penatalaksanaan Meningitis Otogenik  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Otogenic meningitis can be defined as an acute bacterial meningitis that develop secondary to acute, chronic otitis media, chronic mastoiditis and related disorders. Many factors like bacterial virulence, release of cytokines (IL-1,IL-6, TNF alpha), change in blood brain barrier permeability and neu...

Ritarwan, Kiking

100

Chemical meningitis in metrizamide myelography  

International Nuclear Information System (INIS)

[en] Seven patients with acute chemcial meningitis after metrizamide myelography are described. Five of the cases occurred within a time span of two months. Clinical and cerebrospinal fluid findings in the acute stage of the illness were similar to findings in acute bacterial meningitis. Possible causes of this complication are discussed. (orig.)

1986-01-01

 
 
 
 
101

Acute bacterial and viral meningitis.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Most cases of acute meningitis are infectious and result from a potentially wide range of bacterial and viral pathogens. The organized approach to the patient with suspected meningitis enables the prompt administration of antibiotics, possibly corticosteroids, and diagnostic testing with neuroimaging and spinal fluid analysis. RECENT FINDINGS: Acute meningitis is infectious in most cases and caused by a potentially wide range of bacterial and viral pathogens. Shifts in the epidemiology of bacterial pathogens have been influenced by changes in vaccines and their implementation. Seasonal and environmental changes influence the likely viral and rickettsial pathogens. SUMMARY: The organized approach to the patient with suspected meningitis enables the prompt administration of antibiotics, possibly corticosteroids, and diagnostic testing with neuroimaging and spinal fluid analysis. Pertinent testing and treatment can vary with the clinical presentation, season, and possible exposures. This article reviews the epidemiology, clinical presentation, diagnosis, and treatment of acute meningitis.

Bartt R

2012-12-01

102

IATROGENIC MENINGITIS AFTER SPINAL ANESTHESIA  

Directory of Open Access Journals (Sweden)

Full Text Available "nBacterial meningitis after spinal and epidural anesthesia is a very rare but serious complication. We report a case of meningitis developing a number of hours after a spinal block for Caesarean section. No organism was grown but the CSF pattern was suggestive of bacterial meningitis. Severe neurological sequelae were present after three months of hospitalization. Meningitis is a serious complication and its early diagnosis and effective treatment is essential. Meningitis should always be considered as a possible differential diagnosis in patients suspected of having post spinal headache, convulsion and changes in mental statues. A thorough knowledge and practice of aseptic techniques is crucial in performing spinal and epidural anesthesia.

R Hashemi; A Okazi

2008-01-01

103

[Neonatal meningitis: recent results  

UK PubMed Central (United Kingdom)

The better outcome of the patients with neonatal meningitis is reported in the last 3 years with ampicillin and chloramphenicol plus one aminoglucoside. (27/51). The use of intrathecal gentamicin was beneficial in 7 out of 9 babies in whom this procedure was used. The mortality rate on the years 1963-1974 in 86 cases was 70.9% in contrast with 43% (51 cases) for the years 1975-1978. Exchange-transfusion was done to 8 patients, with 6 survivals.

Nocetti Fasolino J; Ageitos ML; Teresa Martín M

1979-11-01

104

Natalizumab and HSV meningitis.  

Science.gov (United States)

Natalizumab (Tysabri, Biogen Idec and Elan Pharmaceuticals) is a monoclonal antibody approved for use in patients with relapsing multiple sclerosis (MS) as well as moderate to severe Crohn's disease. We report the first case of a patient with a history of MS, on monthly natalizumab, who developed HSV-2 meningitis. We discuss the mechanism of action of natalizumab and review what is known about the reactivation of herpes infection in association with this medication. The question of herpes simplex virus (HSV) and varicella zoster virus (VZV) prophylaxis for patients is raised. PMID:21487835

Shenoy, Erica Seiguer; Mylonakis, Eleftherios; Hurtado, Rocio M; Venna, Nagagopal

2011-04-13

105

Natalizumab and HSV meningitis.  

UK PubMed Central (United Kingdom)

Natalizumab (Tysabri, Biogen Idec and Elan Pharmaceuticals) is a monoclonal antibody approved for use in patients with relapsing multiple sclerosis (MS) as well as moderate to severe Crohn's disease. We report the first case of a patient with a history of MS, on monthly natalizumab, who developed HSV-2 meningitis. We discuss the mechanism of action of natalizumab and review what is known about the reactivation of herpes infection in association with this medication. The question of herpes simplex virus (HSV) and varicella zoster virus (VZV) prophylaxis for patients is raised.

Shenoy ES; Mylonakis E; Hurtado RM; Venna N

2011-06-01

106

Neonatal Sepsis and Meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available This article discusses the etiology, predisposing factors, clinical signs, therapy and prognosis of the neonatal septicemia and meningitis. Beta-hemolytic streptococcus of group B has been reported as the most frequent infectious agent in the recent years, the next being E.coli. The natural humoral and cellular immune immaturity of newborns and particularly premature predisposes the newborn infant to the infection. Early onset septicemia has a higher mortality rate while late onset sepsis has a better prognosis. The therapy of choice consists in a combination of a penicillin and an aminoglycoside till the results of cultures and antibiograms are reported.

GH.R Walizadeh

1986-01-01

107

Tuberculous meningitis: The challenges  

Directory of Open Access Journals (Sweden)

Full Text Available Tuberculous meningitis (TBM) is a serious meningitic infection commonly found to occur in the developing countries endemic to tuberculosis. Based on the clinical features alone, the diagnosis of TBM can neither be made nor excluded with certainty. Unfortunately there is still no single diagnostic method that is both sufficiently rapid and sensitive. Most factors found to correlate with poor outcome can be directly traced to the stage of the disease at the time of diagnosis. The only way to reduce the mortality and morbidity is by early diagnosis and timely recognition of complications and institution of the appropriate treatment strategies.

Murthy J. M. K.

2010-01-01

108

Meningitis sifilítica aguda/ Acute syphilitic meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se trata de un paciente de 28 años de sexo femenino, que presentó un cuadro clínico rápidamente progresivo de cambios en el comportamiento y deterioro del estado de conciencia. Ingresó con puntaje de Glasgow de 8/15 y requirió intubación traqueal. Tenía respuesta plantar extensora bilateral, pupila izquierda midriática de 5 mm, sin respuesta a la luz, ptosis palpebral del mismo lado y nistagmo con componente rápido hacia la izquierda. El contenido de proteínas (more) del líquido cefalorraquídeo fue de 0,86 g/l con pleocitosis moderada de predominio linfocitario. Tres semanas antes del ingreso, presentó parto vaginal eutócico; no tuvo control prenatal durante el embarazo. En el recién nacido se demostró serología reactiva para sífilis y FTA-ABS positivo. La paciente también fue hallada reactiva para serología de sífilis en el líquido cefalorraquídeo, con diagnóstico de meningitis sifilítica aguda. La prueba ELISA para VIH fue negativa. Abstract in english A 28 year-old woman presented with a rapidly progressive clinical picture of behavioral changes and altered level of consciousness. She was admitted with Glasgow Coma Score 8/15, 5 mm dilated non-reactive left pupil, right ptosis and nystagmus with left lateral gaze. Protein content at cerebrospinal fluid was 0,86 g/L with pleocytosis. Three weeks earlier, the patient underwent vaginal delivery of a pregnancy without prenatal care, and the newborn was found to be reactive (more) to syphilis serology and positive on FTA-ABS test. The patient was found positive as well for syphilis on serologic tests for syphilis, corresponding yhe picture to neurosyphilis.HIV testing was negative in the patient.

Riveros, Efraín; Manrique-Abril, Fred; Bustamante, Manuel

2011-09-01

109

Meningitis sifilítica aguda Acute syphilitic meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Se trata de un paciente de 28 años de sexo femenino, que presentó un cuadro clínico rápidamente progresivo de cambios en el comportamiento y deterioro del estado de conciencia. Ingresó con puntaje de Glasgow de 8/15 y requirió intubación traqueal. Tenía respuesta plantar extensora bilateral, pupila izquierda midriática de 5 mm, sin respuesta a la luz, ptosis palpebral del mismo lado y nistagmo con componente rápido hacia la izquierda. El contenido de proteínas del líquido cefalorraquídeo fue de 0,86 g/l con pleocitosis moderada de predominio linfocitario. Tres semanas antes del ingreso, presentó parto vaginal eutócico; no tuvo control prenatal durante el embarazo. En el recién nacido se demostró serología reactiva para sífilis y FTA-ABS positivo. La paciente también fue hallada reactiva para serología de sífilis en el líquido cefalorraquídeo, con diagnóstico de meningitis sifilítica aguda. La prueba ELISA para VIH fue negativa.A 28 year-old woman presented with a rapidly progressive clinical picture of behavioral changes and altered level of consciousness. She was admitted with Glasgow Coma Score 8/15, 5 mm dilated non-reactive left pupil, right ptosis and nystagmus with left lateral gaze. Protein content at cerebrospinal fluid was 0,86 g/L with pleocytosis. Three weeks earlier, the patient underwent vaginal delivery of a pregnancy without prenatal care, and the newborn was found to be reactive to syphilis serology and positive on FTA-ABS test. The patient was found positive as well for syphilis on serologic tests for syphilis, corresponding yhe picture to neurosyphilis.HIV testing was negative in the patient.

Efraín Riveros; Fred Manrique-Abril; Manuel Bustamante

2011-01-01

110

[Neuropsychiatric sequelae of viral meningitis in adults].  

UK PubMed Central (United Kingdom)

Viral meningitis is considered to be a benign illness with only mild symptoms. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. However, retrospective studies have demonstrated that patients suffering from viral meningitis may experience cognitive impairment following the acute course of infection. Larger controlled studies are needed to elucidate the potential neuropsychiatric adverse outcome of viral meningitis.

Damsgaard J; Hjerrild S; Renvillard SG; Leutscher PD

2011-10-01

111

[Neuropsychiatric sequelae of viral meningitis in adults].  

Science.gov (United States)

Viral meningitis is considered to be a benign illness with only mild symptoms. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. However, retrospective studies have demonstrated that patients suffering from viral meningitis may experience cognitive impairment following the acute course of infection. Larger controlled studies are needed to elucidate the potential neuropsychiatric adverse outcome of viral meningitis. PMID:21985833

Damsgaard, Jesper; Hjerrild, Simon; Renvillard, Signe Groth; Leutscher, Peter Derek Christian

2011-10-10

112

Etiological structure of bacterial meningitis in children  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The microbiological investigation of 14 year old children with meningeal and infectious syndromes was held. Bacterial meningitis was diagnosed in 90,9% patients. The meningococcal meningitis was diagnosed in 18 (30%) patients, H. influenzae meningitis - in 9 (15%), S. pneumoniae - in 8 (13,3%). Meni...

K.A. Jafarova

113

Neuropsychiatric sequelae of viral meningitis in adults  

DEFF Research Database (Denmark)

Viral meningitis is considered to be a benign illness with only mild symptoms. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. However, retrospective studies have demonstrated that patients suffering from viral meningitis may experience cognitive impairment following the acute course of infection. Larger controlled studies are needed to elucidate the potential neuropsychiatric adverse outcome of viral meningitis.

Damsgaard, Jesper; Hjerrild, Simon

2011-01-01

114

Drug-resistant tuberculous meningitis.  

UK PubMed Central (United Kingdom)

Drug-resistant tuberculosis, including drug-resistant tuberculous meningitis, is an emerging health problem in many countries. An association with Beijing strains and drug resistance-related mutations, such as mutations in katG and rpoB genes, has been found. The pathology, clinical features and neuroimaging characteristics of drug-resistant tuberculous meningitis are similar to drug-responsive tuberculous meningitis. Detection of mycobacteria in cerebrospinal fluid (CSF) by conventional methods (smear examination or culture) is often difficult. Nucleic acid amplification assays are better methods owing to their rapidity and high sensitivity. The Xpert MTB/RIF assay (Cepheid, CA, USA) is a fully-automated test that has also been found to be effective for CSF samples. Treatment of multidrug-resistant tuberculous meningitis depends on the drug susceptibility pattern of the isolate and/or the previous treatment history of the patient. Second-line drugs with good penetration of the CSF should be preferred. Isoniazid monoresistant disease requires addition of another drug with better CSF penetration. Drug-resistant tuberculous meningitis is associated with a high mortality. HIV infected patients with drug-resistant tuberculous meningitis have severe clinical manifestations with exceptionally high mortality. Prevention of tuberculosis is the key to reduce drug-resistant tuberculous meningitis.

Garg RK; Jain A; Malhotra HS; Agrawal A; Garg R

2013-06-01

115

Meningitis tras anestesia espinal/ Meningitis after a spinal anesthesia  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La meningitis post-punción es una importante complicación de la anestesia espinal. Describimos el caso de un varón de cuarenta y seis años que ingresó para tratamiento quirúrgico de una hernia umbilical, la cirugía se realizó bajo anestesia intradural. Tras la intervención el paciente comenzó con un cuadro clínico compatible con meningitis, que se confirmó tras examen del líquido cefalorraquídeo. Se trató con antibióticos a pesar de la no identificación d (more) e gérmenes, siendo la evolución favorable. El diagnóstico etiológico de una meningitis iatrogénica no siempre es posible, pero siempre debemos tener en cuenta esta posibilidad. En este artículo queremos revisar la situación actual del problema, especialmente la profilaxis y la actitud terapéutica. Abstract in english Post-dural puncture meningitis is a serious complication of spinal anesthesia. We describe the case of a forty six years old male who was admitted for surgical intervention of an umbilical hernia, performed under spinal anesthesia. After surgery the patient developed a clinical syndrome compatible with meningitis, the diagnosis was confirmed by examination of the cerebrospinal fluid. Broad-spectrum antibiotics were started although spinal cultures were negatives, and the (more) patient's clinical course was favourable. The meningitis differential diagnosis may be difficult, but we must think about this possibility. In this case report ,we want to check the present situation, specially the prevention and medical treatment.

Vázquez-Martínez, A. L.; Castro, F.; Illodo, G.; Freiré, E.; Camba, M. A.

2008-03-01

116

Meningitis tras anestesia espinal Meningitis after a spinal anesthesia  

Directory of Open Access Journals (Sweden)

Full Text Available La meningitis post-punción es una importante complicación de la anestesia espinal. Describimos el caso de un varón de cuarenta y seis años que ingresó para tratamiento quirúrgico de una hernia umbilical, la cirugía se realizó bajo anestesia intradural. Tras la intervención el paciente comenzó con un cuadro clínico compatible con meningitis, que se confirmó tras examen del líquido cefalorraquídeo. Se trató con antibióticos a pesar de la no identificación de gérmenes, siendo la evolución favorable. El diagnóstico etiológico de una meningitis iatrogénica no siempre es posible, pero siempre debemos tener en cuenta esta posibilidad. En este artículo queremos revisar la situación actual del problema, especialmente la profilaxis y la actitud terapéutica.Post-dural puncture meningitis is a serious complication of spinal anesthesia. We describe the case of a forty six years old male who was admitted for surgical intervention of an umbilical hernia, performed under spinal anesthesia. After surgery the patient developed a clinical syndrome compatible with meningitis, the diagnosis was confirmed by examination of the cerebrospinal fluid. Broad-spectrum antibiotics were started although spinal cultures were negatives, and the patient's clinical course was favourable. The meningitis differential diagnosis may be difficult, but we must think about this possibility. In this case report ,we want to check the present situation, specially the prevention and medical treatment.

A. L. Vázquez-Martínez; F. Castro; G. Illodo; E. Freiré; M. A. Camba

2008-01-01

117

[Meningitis due to streptococcus viridans  

UK PubMed Central (United Kingdom)

Viridans Streptococci (VS) may cause meningitis although, in most cases, they are isolated as contaminants in CSF. However VS should not be systematically underestimated as contaminants in CSF without a suitable clinical and analytical evaluation. Meningitis as a result of VS is being diagnosed with increasing frequency, especially in new born babies. Classic predisposition factors and illnesses (traumatism, surgery and infection) have increased, one frequent pathogenic mechanism being rupture of the mucous membrane with subsequent meningitis. VS are normally sensitive to penicillin G. However VS may be resistant to penicillin (low affinity of PBP to penicillin) and cause serious infections, including meningitis. For this reason it is convenient to perform sensitivity tests on VS in vitro in isolation to determine the appropriate therapy.

Alba D; Torres E

1995-05-01

118

Computed tomography of tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Recently, tuberculous meningitis has become rather rare except in areas where tuberculosis is still endemic. Six adolescents and young adults with tuberculous meningitis were evaluated by means of serial computerized tomography (CT), and the results were correlated with the findings of surgical specimens or autopsies. All cases showed meningeal irritation and fever at onset. CSF cultures revealed the presence of tuberculous bacilli. Four cases advanced rapidly to the clinical stage III and expired in a short period-between two weeks to one month from onset. On initial CT scanning, the disappearance of the basal cistern was a characteristic finding in all these cases. With the progression, an enhancement of the basal cistern on contrast injection, a localized hypodensity in adjacent parenchyma, and symmetrical ventricular dilatation appeared. Two autopsied cases showed tuberculous granulomas with purulent materials, thickened meninges, and caseous necrosis in the parenchyma around the basal cistern. The other two cases progressed rather slowly. CT findings at Stage II showed multiple enhanced spots in the basal subcortical area following contrast injection. Tuberculous granulomas were identified in these parts by means of explorative craniotomy. The authors point out the pathognomonic CT findings of tuberculous meningitis and emphasize the necessity of serial CT for the early detection and management of tuberculous meningitis. (author)

1982-01-01

119

Computed tomography of tuberculous meningitis  

Energy Technology Data Exchange (ETDEWEB)

Recently, tuberculous meningitis has become rather rare except in areas where tuberculosis is still endemic. Six adolescents and young adults with tuberculous meningitis were evaluated by means of serial computerized tomography (CT), and the results were correlated with the findings of surgical specimens or autopsies. All cases showed meningeal irritation and fever at onset. CSF cultures revealed the presence of tuberculous bacilli. Four cases advanced rapidly to the clinical stage III and expired in a short period-between two weeks to one month from onset. On initial CT scanning, the disappearance of the basal cistern was a characteristic finding in all these cases. With the progression, an enhancement of the basal cistern on contrast injection, a localized hypodensity in adjacent parenchyma, and symmetrical ventricular dilatation appeared. Two autopsied cases showed tuberculous granulomas with purulent materials, thickened meninges, and caseous necrosis in the parenchyma around the basal cistern. The other two cases progressed rather slowly. CT findings at Stage II showed multiple enhanced spots in the basal subcortical area following contrast injection. Tuberculous granulomas were identified in these parts by means of explorative craniotomy. The authors point out the pathognomonic CT findings of tuberculous meningitis and emphasize the necessity of serial CT for the early detection and management of tuberculous meningitis.

Sato, Noriko; Sato, Hiromi; Kawaguchi, Tetsuro; Fujita, Katsuzo; Tanaka, Makoto (Kobe Univ. (Japan). School of Medicine)

1982-12-01

120

Etiological structure of bacterial meningitis in children  

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Full Text Available The microbiological investigation of 14 year old children with meningeal and infectious syndromes was held. Bacterial meningitis was diagnosed in 90,9% patients. The meningococcal meningitis was diagnosed in 18 (30%) patients, H. influenzae meningitis - in 9 (15%), S. pneumoniae - in 8 (13,3%). Meningitis as a monoinfection was revealed in 85% cases; mixed infection - in 15%. In 28 patients the etiologic agents of disease were gram-negative, in 16 children -gram-positive bacteria. Causative agents of bacterial meningitis were more resistant to penicillin, ampicillin and eritromycin

K.A. Jafarova

2010-01-01

 
 
 
 
121

Neonatal meningitis caused by Achromobacter xylosoxidans.  

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The clinical and bacteriological findings in a case of neonatal meningitis caused by Achromobacter xylosoxidans are presented. This appears to be only the second report of meningitis caused by this species.

Namnyak, S S; Holmes, B; Fathalla, S E

122

Meningitis bacteriémica por Pasteurella multocida Pasteurella multocida bacteremic meningitis  

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Full Text Available Las infecciones por Pasteurella multocida en seres humanos habitualmente están relacionadas con mordeduras o arañazos de perros y gatos. Muchas de ellas se acompañan de otros microorganismos de la orofaringe de estos animales. Se presenta un caso de meningitis bacteriémica por P. multocida en una mujer de 86 años que convivía con siete gatos. Si bien no se documentó una infección de piel o de partes blandas, es posible que ésta haya pasado inadvertida inicialmente y que fuera la causa de la bacteriemia con impacto en meninges, o bien que la meningitis se haya producido luego de la colonización nasofaríngea (no demostrada). Los aislamientos de hemocultivos y de líquido cefalorraquídeo fueron identificados como P. multocida por medio de API 20NE, API 20E y Vitek 1. La cepa aislada presentó sensibilidad a penicilina, cefotaxima, levofloxacina y tetraciclinas, en coincidencia con lo descrito en la literatura.Human infections by Pasteurella multocida are usually associated with bites or scratches from dogs and cats. Many of them are accompanied by other oropharyngeal microorganisms of these animals. We herein present a case of bacteremic meningitis by P. multocida in an 86-year-old woman who was living with seven cats. Even though no skin or soft tissue infection was recorded, it is possible that a mild infection had gone undetected and a subsequent bacteremia had impacted on the meninges, or that meningitis could have occurred after nasopharyngeal colonization (not demonstrated). The isolates obtained from blood cultures and cerebrospinal fluid were identified as P. multocida by API 20NE, API 20E, and Vitek 1. In agreement with findings in the literature, this strain was susceptible to penicillin, cefotaxime, levofloxacin and tetracyclines.

R. Soloaga; N. Carrión; J. Pidone; M. Suar; A. Salinas; L. Guelfand; V. Alvarez; A. Margari; D. Cococcella

2008-01-01

123

Meningitis bacteriémica por Pasteurella multocida/ Pasteurella multocida bacteremic meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Las infecciones por Pasteurella multocida en seres humanos habitualmente están relacionadas con mordeduras o arañazos de perros y gatos. Muchas de ellas se acompañan de otros microorganismos de la orofaringe de estos animales. Se presenta un caso de meningitis bacteriémica por P. multocida en una mujer de 86 años que convivía con siete gatos. Si bien no se documentó una infección de piel o de partes blandas, es posible que ésta haya pasado inadvertida inicialment (more) e y que fuera la causa de la bacteriemia con impacto en meninges, o bien que la meningitis se haya producido luego de la colonización nasofaríngea (no demostrada). Los aislamientos de hemocultivos y de líquido cefalorraquídeo fueron identificados como P. multocida por medio de API 20NE, API 20E y Vitek 1. La cepa aislada presentó sensibilidad a penicilina, cefotaxima, levofloxacina y tetraciclinas, en coincidencia con lo descrito en la literatura. Abstract in english Human infections by Pasteurella multocida are usually associated with bites or scratches from dogs and cats. Many of them are accompanied by other oropharyngeal microorganisms of these animals. We herein present a case of bacteremic meningitis by P. multocida in an 86-year-old woman who was living with seven cats. Even though no skin or soft tissue infection was recorded, it is possible that a mild infection had gone undetected and a subsequent bacteremia had impacted on (more) the meninges, or that meningitis could have occurred after nasopharyngeal colonization (not demonstrated). The isolates obtained from blood cultures and cerebrospinal fluid were identified as P. multocida by API 20NE, API 20E, and Vitek 1. In agreement with findings in the literature, this strain was susceptible to penicillin, cefotaxime, levofloxacin and tetracyclines.

Soloaga, R.; Carrión, N.; Pidone, J.; Suar, M.; Salinas, A.; Guelfand, L.; Alvarez, V.; Margari, A.; Cococcella, D.

2008-12-01

124

Meningitis associated with familial Mediterranean fever.  

Science.gov (United States)

Neurologic involvement in patients with familial Mediterranean fever is relatively uncommon, and rarely described in the literature. Although headache occurs frequently, meningitis and convulsions are rare. We describe the case of a 30-year-old man with attacks of meningitis. After colchicine therapy, no further recurrence of fever and meningitis were observed. These findings suggest that meningitis should be considered as an unusual manifestation of familial Mediterranean fever. PMID:15875625

Karachaliou, I; Karachalios, G; Charalabopoulos, A; Charalabopoulos, K

2005-04-01

125

Meningitis associated with familial Mediterranean fever.  

UK PubMed Central (United Kingdom)

Neurologic involvement in patients with familial Mediterranean fever is relatively uncommon, and rarely described in the literature. Although headache occurs frequently, meningitis and convulsions are rare. We describe the case of a 30-year-old man with attacks of meningitis. After colchicine therapy, no further recurrence of fever and meningitis were observed. These findings suggest that meningitis should be considered as an unusual manifestation of familial Mediterranean fever.

Karachaliou I; Karachalios G; Charalabopoulos A; Charalabopoulos K

2005-04-01

126

Eosinophilic meningitis secondary to intravenous vancomycin.  

UK PubMed Central (United Kingdom)

Eosinophilic meningitis may be due to infectious or noninfectious etiologies. Parasitic infections cause this entity most frequently and of the noninfectious causes, medications play an important role. We describe a 32-year-old male who developed eosinophilic meningitis while receiving intravenous vancomycin. No other apparent cause of the eosinophilic meningitis was appreciated. This case represents the first description of eosinophilic meningitis due to systemic vancomycin.

Kazi R; Kazi HA; Ruggeri C; Ender PT

2013-06-01

127

[Meningitis due to Enterococcus faecalis].  

Science.gov (United States)

Enterococcus faecalis meningitis is an infrequent entity that accounts for less than 1% of all suppurative meningitis in the adult. Usually, this infection affects patients with compromised host defenses or those who have congenital or acquired CNS lesions mainly as intrahospitalary infections. An 85 year old woman from our community (Tandil county) without any predisposed condition, was admitted in the hospital in an unconscious state (grade 3 Glasgow's index), meningeal signs and purulent CSF, from which E. faecalis was isolated. The patient was treated with IV Ampicillin and Gentamycin (17 days), intrathecal Gentamycin (4 days) and IV dexametasona (6 days). The clinical and bacteriological remission was achieved, without any sequel or relapse during 2 years follow up. PMID:8728774

Gentile, J H; Sparo, M D; Pipo, V B; Gallo, A J

1995-01-01

128

[Meningitis due to Enterococcus faecalis  

UK PubMed Central (United Kingdom)

Enterococcus faecalis meningitis is an infrequent entity that accounts for less than 1% of all suppurative meningitis in the adult. Usually, this infection affects patients with compromised host defenses or those who have congenital or acquired CNS lesions mainly as intrahospitalary infections. An 85 year old woman from our community (Tandil county) without any predisposed condition, was admitted in the hospital in an unconscious state (grade 3 Glasgow's index), meningeal signs and purulent CSF, from which E. faecalis was isolated. The patient was treated with IV Ampicillin and Gentamycin (17 days), intrathecal Gentamycin (4 days) and IV dexametasona (6 days). The clinical and bacteriological remission was achieved, without any sequel or relapse during 2 years follow up.

Gentile JH; Sparo MD; Pipo VB; Gallo AJ

1995-01-01

129

Acute meningitis by Streptococcus suis  

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Full Text Available Streptococcus suis is a coccus Gram positive, anaerobic optional. Human infection by this microorganism is a zoonoticdisease that usually presents as purulent meningitis. Mortality is low but is common sequelae. A case of meningitis byS. suis secondary to contact with pigs is presented here. A 35-year-old male patient was admitted to the hospital complainingof high fever, malaise, vomiting and headache. A physical examination revealed decreased level of consciousness,with adequate response to painful stimulus and his eyes with deconjugated gaze. S. suis was isolated in bloodculture. He was treated with cefotaxime, vancomycin and acyclovir in the intensive care unit. He experienced progressiveimprovement. He was discharged with severe deafness and a minimally unstable gait as sequellae. J Microbiol Infect Dis2012; 2(4): 160-162Key words: Streptococcus suis, meningitis, deafness.

Maria-Jesus Corrales-Arroyo; Maria Angeles Del Real-Francia; Amalia Hernandez-Gonzalez; Jose Manuel Morales Puebla; Gema Lopez-Gallardo; Juan Jose Caston-Osorio

2012-01-01

130

Meningitis postquirúrgica: Características diferenciales de la meningitis aséptica post-quirúrgica Postsurgical meningitis: Differential characteristics of aseptic postsurgical meningitis  

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Full Text Available Introducción. La meningitis postquirúrgica es una complicación infrecuente que se acompaña de un incremento de la estancia hospitalaria y de una elevada mortalidad. Algunos de estos casos no son debidos a una verdadera infección sino a una inflamación aséptica de las meninges denominada meningitis aséptica post-quirúrgica (MAPQ). La adecuada identificación de estos casos permitiría una mejor utilización de los fármacos antimicrobianos. Material y métodos. Estudio retrospectivo de los pacientes con meningitis postquirúrgica en un hospital terciario durante 14 años comparando las características clínicas de los pacientes con meningitis bacteriana postquirúrgica (MBP) frente a las de pacientes con MAPQ Resultados. Durante el período analizado se identificaron 35 pacientes (71%) con MBP y 14 pacientes (29%) con MAPQ. La edad media de los pacientes con MBP fue similar a la de los pacientes con MAPQ. Hubo predominio de varones en el grupo de MBP (71%) en relación con los pacientes con MAPQ (36%, p=0,020). La proporción de pacientes con hemorragia intracraneal tendió a ser más frecuente en pacientes que posteriormente desarrollaron MAPQ (9 pacientes, 64 %) que en los pacientes con MBP (12 casos, 34%, p=0,055). Los pacientes sometidos a craneotomía posterior (p=0,092) y los que recibían tratamiento esteroideo (p=0,051) mostraron una mayor tendencia a padecer MAPQ. Siete pacientes MBP (20%) presentaron un recuento celular superior a 5000 células/mm³ en el LCR, cifra no encontrada en ningún caso de MAPQ. No se detectaron diferencias en la glucorraquia y proteinorraquia entre ambos grupos. La bacterias más frecuentemente aisladas fueron Staphylococcus coagulasa negativa y S. aureus. En 5 pacientes (14%) se aislaron bacilos gramnegativos no fermentadores (Pseudomonas aeruginosa y Acinetobacter spp). No hubo ningún fallecimiento atribuido a meningitis postquirúrgica. Conclusión. Los pacientes sometidos a neurocirugía que fueron ingresados por hemorragia cerebral, intervenidos de la fosa posterior o tratados con esteroides presentan una mayor tendencia a presentar MAPQ. Los recuentos celulares en LCR elevados (superiores a 5000 células /mm³) sugieren la existencia de MBP.Background. Postsurgical meningitis is a rare complication that is accompanied by an increase of hospital stay and high mortality. Some of these cases are not due to a true infection but due to an aseptic inflammation of the meninges denominated aseptic postsurgical meningitis (APSM). Proper identification of these cases would allow better use of antimicrobial drugs. Methods. A retrospective study of patients with postsurgical meningitis in a universitary hospital for 14 years. We describe the clinical characteristics of patients with postsurgical bacterial meningitis (PBM) compared to those of patients with APSM. Results. During the studied period 35 patients (71%) with PBM and 14 patients (29%) with (APSM) were identified. The mean age of patients with PBM was similar to that of patients with APSM. There was a male predominance in the group of PBM (71%) compared with patients with APSM (36%, p = 0.020). Patients with intracranial hemorrhage tended to present more cases of APSM (64%) than of PBM (34%, p = 0.055). Patients undergoing posterior fossa craniotomy (p = 0.092) and those receiving steroids (p = 0.051) showed a greater tendency to suffer APSM. It was also noted a trend towards present PBM in patients who had suffered an infection in the previous month (p=0.072). There were seven patients with PBM (20%) with a cell count above 5000 cells/mm³ in CSF, values not found in any patients with APSM. No differences were detected in the glycorrachia and proteinorrachia between the two groups. The most common bacteria isolated were coagulase negative Staphylococcus and S. aureus. In 5 patients (14%) non fermenting gram-negative bacillus (Pseudomonas aeruginosa and Acinetobacter spp) were isolated. There were no deaths attributed to any type of postsurgical meningitis. Conclusion. Patients admitted for brain haemo

A. Ramos-Martínez; T. de las Heras-Carballo; C. Fernández-Mateos; L. de Reina; T. Álvarez de Espejo-Montiel; N. Escamilla-Fernández; I. Sánchez-Romero; I. Millán

2009-01-01

131

TUBERCULOUS MENINGITIS (TBM)  

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Full Text Available OBJECTIVES: To study clinical and diagnostic laboratory features of tuberculous meningitis (TBM) inchildren. STUDY DESIGN: Prospective cohort study. PATIENTS & METHODS: Children diagnosedas TBM in Paediatric ward Allied Hospital, Punjab Medical College Faisalabad were included in the study.Complete history and clinical examination was recorded. Complete blood count, ESR, Chest X Ray, Mantouxtest were done. CSF was subjected to biochemical and microscopic examination. CT scan (computerized axialtomogram) of brain, plain and contrast was done in all patients. RESULTS: One hundred children wereincluded in the study. 67% were below five years of age. 78% belonged to lower socioeconomic status. 82% weremalnourished. 26% were vaccinated while 74% were unvaccinated. History of contact with a tuberculous patientwas found in 48% of patients. 69% were in stage III TBM, 31% in stage II. 74% had focal neurological deficitwith hemiplegia being the commonest one. 73% had convulsions. Most patients presented quite late, 29% werecomatose for more than two weeks before coming to the hospital . 28% were in decerebrate or decorticate posture.Atypical clinical findings were also noticed. 43% had high grade fever from the onset of illness, 14% had anabrupt onset with symptoms developing in less than one week. 39% had encephalitic TBM. 31% had extrapyramidal signs. Mantoux test was >10 mm in 17% cases, suggestive chest X-Ray in 80% and typical CSFfindings in 46%. 37% had normal CSF glucose, 8% had predominant polymorphs in CSF. Abnormal CT scanwas found in 85% cases with hydrocephalus as commonest CT abnormality observed. CONCLUSIONS: Ahigh index of suspicion is needed to diagnosis TBM in children. A combination of epidemiological , clinical andlaboratory data should be used to make an early diagnosis.

Hina Ayesha

2002-01-01

132

Subdural effusion following purulent meningitis  

International Nuclear Information System (INIS)

[en] The authors experienced 6 cases of subdural effusion following purulent meningitis. All patients were less than one year old. Subdural puncture revealed subdural effusion in all cases. CT scan was performed in 4 cases at an acute stage and showed a low density area in the anterior parietal region. In 3 of them, although neurological symptoms disappeared after subdural puncture, CT findings did not improve. Follow-up CT scan revealed ventricular dilatation and cerebral atrophy. CT is considered to be useful for diagnosis of subdural effusion after meningitis and follow-up the effect of treatment. (Ueda, J.)

1981-01-01

133

Meningeal metastasing of malignant melanomas  

International Nuclear Information System (INIS)

Two woman patients with malignant melanoma of the skin known from their case history and with acutely emerging neurological symptoms were examined both by CT and by MR tomography (both plain and with intravenous contrast medium). The radiologically derived suspicion of meningioma could not be confirmed by intraoperatively performed histological examination. In both cases the patients had meningeal melanoma metastases with low melanin content and without noticeable bleeding into the metastases. MR diagnosis is rendered difficult by the absence of paramagnetic substances typical of melanoma metastases. Hence, if the case history is known, it should be considered whether there is meningeal metastasising with atypical histology. (orig.)

1989-01-01

134

Mycobacterium Bovis Meningitis: Case Report  

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Full Text Available Mycobacterium bovis is a zoonotic bacteria infecting human. Early diagnosis and initiation of therapy is important for prognosis. Here,we present a three-year-old boy treated for bacterial meningitis. Because of inadequate clinical improvement, advanced diagnostic techniques were used and M. bovis was isolated from the cerebrospinal fluid. The patient survived with minimal sequela after 18 months therapy. In children without immune deficiency M. bovis meningitis is rare. In order to diagnose this disease, the clinician should suspect and use advanced diagnostic techniques like DNA Fingerprinting Spoligotyping. This rare case is presented to draw attention to M. bovis infections for public health.

Nihan Uygur Külcü

2012-01-01

135

Meningitis postquirúrgica: Características diferenciales de la meningitis aséptica post-quirúrgica/ Postsurgical meningitis: Differential characteristics of aseptic postsurgical meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción. La meningitis postquirúrgica es una complicación infrecuente que se acompaña de un incremento de la estancia hospitalaria y de una elevada mortalidad. Algunos de estos casos no son debidos a una verdadera infección sino a una inflamación aséptica de las meninges denominada meningitis aséptica post-quirúrgica (MAPQ). La adecuada identificación de estos casos permitiría una mejor utilización de los fármacos antimicrobianos. Material y métodos. Es (more) tudio retrospectivo de los pacientes con meningitis postquirúrgica en un hospital terciario durante 14 años comparando las características clínicas de los pacientes con meningitis bacteriana postquirúrgica (MBP) frente a las de pacientes con MAPQ Resultados. Durante el período analizado se identificaron 35 pacientes (71%) con MBP y 14 pacientes (29%) con MAPQ. La edad media de los pacientes con MBP fue similar a la de los pacientes con MAPQ. Hubo predominio de varones en el grupo de MBP (71%) en relación con los pacientes con MAPQ (36%, p=0,020). La proporción de pacientes con hemorragia intracraneal tendió a ser más frecuente en pacientes que posteriormente desarrollaron MAPQ (9 pacientes, 64 %) que en los pacientes con MBP (12 casos, 34%, p=0,055). Los pacientes sometidos a craneotomía posterior (p=0,092) y los que recibían tratamiento esteroideo (p=0,051) mostraron una mayor tendencia a padecer MAPQ. Siete pacientes MBP (20%) presentaron un recuento celular superior a 5000 células/mm³ en el LCR, cifra no encontrada en ningún caso de MAPQ. No se detectaron diferencias en la glucorraquia y proteinorraquia entre ambos grupos. La bacterias más frecuentemente aisladas fueron Staphylococcus coagulasa negativa y S. aureus. En 5 pacientes (14%) se aislaron bacilos gramnegativos no fermentadores (Pseudomonas aeruginosa y Acinetobacter spp). No hubo ningún fallecimiento atribuido a meningitis postquirúrgica. Conclusión. Los pacientes sometidos a neurocirugía que fueron ingresados por hemorragia cerebral, intervenidos de la fosa posterior o tratados con esteroides presentan una mayor tendencia a presentar MAPQ. Los recuentos celulares en LCR elevados (superiores a 5000 células /mm³) sugieren la existencia de MBP. Abstract in english Background. Postsurgical meningitis is a rare complication that is accompanied by an increase of hospital stay and high mortality. Some of these cases are not due to a true infection but due to an aseptic inflammation of the meninges denominated aseptic postsurgical meningitis (APSM). Proper identification of these cases would allow better use of antimicrobial drugs. Methods. A retrospective study of patients with postsurgical meningitis in a universitary hospital for 14 (more) years. We describe the clinical characteristics of patients with postsurgical bacterial meningitis (PBM) compared to those of patients with APSM. Results. During the studied period 35 patients (71%) with PBM and 14 patients (29%) with (APSM) were identified. The mean age of patients with PBM was similar to that of patients with APSM. There was a male predominance in the group of PBM (71%) compared with patients with APSM (36%, p = 0.020). Patients with intracranial hemorrhage tended to present more cases of APSM (64%) than of PBM (34%, p = 0.055). Patients undergoing posterior fossa craniotomy (p = 0.092) and those receiving steroids (p = 0.051) showed a greater tendency to suffer APSM. It was also noted a trend towards present PBM in patients who had suffered an infection in the previous month (p=0.072). There were seven patients with PBM (20%) with a cell count above 5000 cells/mm³ in CSF, values not found in any patients with APSM. No differences were detected in the glycorrachia and proteinorrachia between the two groups. The most common bacteria isolated were coagulase negative Staphylococcus and S. aureus. In 5 patients (14%) non fermenting gram-negative bacillus (Pseudomonas aeruginosa and Acinetobacter spp) were isolated. There were no deaths attributed to any type of postsurgical m

Ramos-Martínez, A.; Heras-Carballo, T. de las; Fernández-Mateos, C.; Reina, L. de; Álvarez de Espejo-Montiel, T.; Escamilla-Fernández, N.; Sánchez-Romero, I.; Millán, I.

2009-04-01

136

CT scan of bacterial and aseptic meningitis  

International Nuclear Information System (INIS)

[en] CT scans of the patients with aseptic and bacterial meningitis were reviewed and compared to previous reports. In aseptic meningitis, no abnormal CT findings were observed. In bacterial meningitis, CT findings were ventricular dilatation, subdural fluid collection, parenchymal low density, intracerebral hematoma and meningeal enhancement after contrast injection. Three patients among 48 suffered from status epileptics during the course of the illness. All of 3 patients developed parenchymal inhomogeneous low density and progressive ventricular dilatation which did not improve after ventricular peritoneal shunt surgery. We believe that these changes are most likely due to hypoxic hypoxemia during epileptic seizure and meningitis itself seems to play a little role. (author)

1983-01-01

137

CT scan of bacterial and aseptic meningitis  

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CT scans of the patients with aseptic and bacterial meningitis were reviewed and compared to previous reports. In aseptic meningitis, no abnormal CT findings were observed. In bacterial meningitis, CT findings were ventricular dilatation, subdural fluid collection, parenchymal low density, intracerebral hematoma and meningeal enhancement after contrast injection. Three patients among 48 suffered from status epileptics during the course of the illness. All of the 3 patients developed parenchymal inhomogeneous low density and progressive ventricular dilatation which did not improve after ventricular peritoneal shunt surgery. We believe that these changes are most likely due to hypoxic hypoxemia during epileptic seizure and meningitis itself seems to play a little role.

Takemoto, Kazumasa; Saiwai, Shigeo; Tamaoka, Koichi (Kobe Central Municipal Hospital (Japan))

1983-01-01

138

Serum procalcitonin in viral and bacterial meningitis  

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Full Text Available Background: In children with meningitis, there is a difficulty to verify the etiology as viral or bacterial. Therefore, intensive research has been carried out to find new and rapid diagnostic methods for differentiating bacterial from viral meningitis. Objectives: The aim of this work was to study the behavior of procalcitonin (PCT) and whether it can be used to differentiate children with bacterial from those with viral meningitis. We also compared PCT to C-reactive protein (CRP) and white blood cell count. Patients and Methods: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. Results: PCT levels were significantly higher in patients with bacterial meningitis (mean, 24.8 ng/ml) compared to patients with viral meningitis (mean, 0.3 ng/ml) (P2 ng/ml showed sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 66%, 68%, and 100%, respectively, for the diagnosis of bacterial meningitis. Conclusion: Serum procalcitonin level has a better diagnostic and prognostic value than CRP or leukocyte count to distinguish between bacterial and viral meningitis. It is also a good indicator of the efficacy of treatment of bacterial meningitis.

Alkholi Usama; Abd Al-monem Nermin; Abd El-Azim Ayman; Sultan Mohamed

2011-01-01

139

Meningitis as cochlear implant complication  

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Full Text Available Over the last several decades, cochlear implantation has been fully proven as the treatment for profound hearing losses. The direct electrical stimulation of the spiral ganglion hair cells through the electrode inserted in the cochlear scala tympani is the essence of the cochlear implant (CI) functioning. Modern technological development has introduced unexpected technical quality possibilities of the device itself, as well as coding strategies, which further enable improved patients' rehabilitation results. Nevertheless, in spite of cochlear implantation becoming a routine surgical procedure, which has been changing lives of thousands of profoundly deaf adults and children, it has possible complications. Though rare, these complications could lead to severe, even fatal consequences. Bacterial meningitis represents one of the most severe postoperative complications. In this article, our five-year experience with cochlear implantation is shown, compared to other, much bigger, experiences. Despite severity and a potentially fatal outcome of meningitis, it has rarely been seen, and the precise connection between surgical procedure and this complication is not yet clear. Do cochlear implants increase the risk of bacterial meningitis? Are deafness-associated factors predisposing the bacterial meningitis occurrence, independently from the implant? These are the questions that the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the CI surgeons have been facing, as well as manufacturers and patients with their families.

Kosanovi? Rade; Ivankovi? Zoran; Babac Snežana; Stojanovi? Sandra; Petrovi?-Lazi? Mirjana; Je?menica Jovana

2009-01-01

140

Bacterial meningitis in older adults.  

UK PubMed Central (United Kingdom)

OPINION STATEMENT: The burden of disease due to bacterial meningitis is shifting toward older adults. Clinicians should maintain a high level of suspicion of meningitis in older adults, since they may present without classic signs and symptoms. Clinicians should remember that more older patients are at risk of healthcare-associated meningitis and may be at risk of more resistant organisms. A lumbar puncture should be performed as quickly as possible. If a CT scan is required before the lumbar puncture, blood cultures should be drawn and appropriate empiric antibiotics should be started before sending the patient to the CT scanner. Empiric antibiotics should be chosen based on patient history, review of patient's known illnesses and risk factors, results of CSF Gram stain, and local institution antibiotic resistance patterns. Clinicians should remember that Streptococcus pneumoniae may be resistant to penicillin and cephalosporins, so vancomycin is usually also administered until the bacterial resistance pattern is known. Adjunctive dexamethasone may be started before or at the time of antibiotic therapy based on risk versus benefit analysis, and may be discontinued if patient is found to not have Streptococcus pneumoniae meningitis.

Hofinger D; Davis LE

2013-08-01

 
 
 
 
141

[Laboratory diagnosis of lymphocytic meningitis].  

UK PubMed Central (United Kingdom)

Lymphocytic meningitis, mainly those with an acute and benign course, are caused by viruses. In our area, the most commonly involved agents are enteroviruses, herpes simplex, varicella zoster and Toscana viruses. Nucleic acids amplification techniques (NAAT) are the methods of choice to diagnose viral meningitis from cerebrospinal fluid (CSF) samples. They are more rapid and sensitive, and indeed, they are not influenced by the viability of the virus in the clinical specimen as traditional methods are. The development of commercial equipments, the degree of automation, and the use of real-time polymerase chain reaction (PCR) systems are the most important premises to choose the molecular method in each laboratory. Recently, commercial kits of real-time PCR are available for the detection of enteroviruses and herpesviruses, which are the most frequently viruses involved in meningitis. Although NAAT from the clinical sample have replaced cell culture for diagnostic purposes, the combination of both methods remain useful. When the detection of the causal agent from the CSF sample is not possible, other specimens (pharyngeal exudates, stools) or serological methods can be used. Serology is the reference method for meningitis caused by West Nile virus and lymphocytic choriomeningitis virus, which are less frequently detected in our area.

Marí JM; Ruiz MP; Anza DV

2010-01-01

142

Aseptic Meningitis in Kikuchi's Disease  

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The involvement of the nervous system in Kikuchi's disease (KD) is rare. Although some reports of meningeal involvement in KD were described in the literature from Japan, it has rarely been reported in Korea. A 23-year-old man presented with severe headache, fever, and vomiting. Cerebrospinal fluid ...

Yang, Hyun-Duk; Lee, Sung-Ik; Son, Il-Hong; Suk, Seung-Han

143

Drug-induced aseptic meningitis.  

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Drug-induced aseptic meningitis (DIAM) is an important entity. This article reviews the literature on this rare idiosyncratic event which may occur after local or systemic drug administration. The data on this adverse reaction is predominantly collated from anecdotal case reports and case series.

Hopkins, S; Jolles, S

144

Meningitis due to aeromonas hydrophila  

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Full Text Available A 3-month-old male child with the history of fever, of not sucking the breast and exhibitingsymptoms of meningitis was brought to the hospital for medical advice and was investigated. Aeromonas hydrophila was isolated thrice from CSF, blood samples as well as the water source.

Seetha K; Jose B; Jasthi A

2004-01-01

145

The future of meningitis vaccines.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Without effective vaccines meningitis remains a substantial worldwide threat with major health-care implications. A number of advances have been made in vaccine design and implementation over the last decade, with new vaccine initiatives providing substantial promise for the future reduction of glob...

Segal, S; Pollard, AJ

146

Klebsiella meningitis in Taiwan: an overview.  

Science.gov (United States)

Klebsiella infection has been considered to be an uncommon cause of meningitis. To determine its incidence and clinical features, we reviewed the microbiologic records of cerebrospinal fluid (CSF) and blood cultures and the medical records of patients with bacterial meningitis admitted between 1981 and 1995. Klebsiella meningitis was diagnosed in 79 patients with 83 episodes. All patients had klebsiella isolated from CSF and/or blood and typical symptoms and signs of acute bacterial meningitis. Of these, 74 were over 16 years of age and 2 of the 5 children were infants. There was an increased prevalence rate of klebsiella meningitis after 1986. Of the 83 episodes, only 9 occurred between 1981 and 1986, accounting for 7.8% of 115 cases with CSF and/or blood culture-proven acute bacterial meningitis, whereas in 1987-95, there were 74 episodes accounting for 17.7% of 419 bacteriologically proven cases. K. pneumoniae accounted for 69 episodes, K. oxytoca, 11 episodes and K. ozaenae, 3 episodes. Male gender, diabetes mellitus and liver cirrhosis were commonly associated with K. pneumoniae meningitis. Neurosurgical procedures were frequently associated with K. oxytoca meningitis. All three patients with K. ozaenae meningitis had a primary disease of the nasopharyngeal pathway. The mortality rate due to K. pneumoniae was 48.5%, K. oxytoca, 10% and K. ozaenae, 0%. In patients with K. pneumoniae meningitis, poor prognostic factors included age over 60 years, diabetes mellitus, bacteremia and severe neurological deficits on the first day of treatment. PMID:9363011

Tang, L M; Chen, S T; Hsu, W C; Chen, C M

1997-10-01

147

Klebsiella meningitis in Taiwan: an overview.  

UK PubMed Central (United Kingdom)

Klebsiella infection has been considered to be an uncommon cause of meningitis. To determine its incidence and clinical features, we reviewed the microbiologic records of cerebrospinal fluid (CSF) and blood cultures and the medical records of patients with bacterial meningitis admitted between 1981 and 1995. Klebsiella meningitis was diagnosed in 79 patients with 83 episodes. All patients had klebsiella isolated from CSF and/or blood and typical symptoms and signs of acute bacterial meningitis. Of these, 74 were over 16 years of age and 2 of the 5 children were infants. There was an increased prevalence rate of klebsiella meningitis after 1986. Of the 83 episodes, only 9 occurred between 1981 and 1986, accounting for 7.8% of 115 cases with CSF and/or blood culture-proven acute bacterial meningitis, whereas in 1987-95, there were 74 episodes accounting for 17.7% of 419 bacteriologically proven cases. K. pneumoniae accounted for 69 episodes, K. oxytoca, 11 episodes and K. ozaenae, 3 episodes. Male gender, diabetes mellitus and liver cirrhosis were commonly associated with K. pneumoniae meningitis. Neurosurgical procedures were frequently associated with K. oxytoca meningitis. All three patients with K. ozaenae meningitis had a primary disease of the nasopharyngeal pathway. The mortality rate due to K. pneumoniae was 48.5%, K. oxytoca, 10% and K. ozaenae, 0%. In patients with K. pneumoniae meningitis, poor prognostic factors included age over 60 years, diabetes mellitus, bacteremia and severe neurological deficits on the first day of treatment.

Tang LM; Chen ST; Hsu WC; Chen CM

1997-10-01

148

Increased anisotropy in neonatal meningitis: an indicator of meningeal inflammation  

International Nuclear Information System (INIS)

Increased anisotropy in brain abscesses has been shown to be due to adhesion of inflammatory cells and is suggestive of an active inflammatory process. The objective of this study was to determine if similar changes occur in the pia-arachnoid on the surface of the cerebral cortex in patients with pyogenic meningitis, and if these changes regress following antibiotic therapy. Diffusion tensor imaging (DTI) was performed on 14 term neonates (mean age 13 days) with bacterial meningitis and 10 healthy age- and sex-matched controls. Regions of interest (ROIs) were placed on areas including the leptomeninges, the cerebral cortex and adjoining subcortical white matter for quantitation of mean fractional anisotropy (FA) and diffusivity (MD) values. Follow-up MRI was performed in five of the neonates in the patient group after 2 weeks of antibiotic treatment. FA and MD values were compared in patients before and after antibiotic treatment as well as with those in the healthy controls. Significantly higher FA values but no difference in MD values were observed in the patient group as compared to the healthy controls at both time points (before and after antibiotic treatment). Significantly decreased FA values in the frontal, occipital and temporal cortical regions were observed in patients following antibiotic treatment. DTI-derived FA may be of value in the noninvasive assessment of meningeal inflammatory activity and treatment response in neonates. (orig.)

2007-01-01

149

Increased anisotropy in neonatal meningitis: an indicator of meningeal inflammation  

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Increased anisotropy in brain abscesses has been shown to be due to adhesion of inflammatory cells and is suggestive of an active inflammatory process. The objective of this study was to determine if similar changes occur in the pia-arachnoid on the surface of the cerebral cortex in patients with pyogenic meningitis, and if these changes regress following antibiotic therapy. Diffusion tensor imaging (DTI) was performed on 14 term neonates (mean age 13 days) with bacterial meningitis and 10 healthy age- and sex-matched controls. Regions of interest (ROIs) were placed on areas including the leptomeninges, the cerebral cortex and adjoining subcortical white matter for quantitation of mean fractional anisotropy (FA) and diffusivity (MD) values. Follow-up MRI was performed in five of the neonates in the patient group after 2 weeks of antibiotic treatment. FA and MD values were compared in patients before and after antibiotic treatment as well as with those in the healthy controls. Significantly higher FA values but no difference in MD values were observed in the patient group as compared to the healthy controls at both time points (before and after antibiotic treatment). Significantly decreased FA values in the frontal, occipital and temporal cortical regions were observed in patients following antibiotic treatment. DTI-derived FA may be of value in the noninvasive assessment of meningeal inflammatory activity and treatment response in neonates. (orig.)

Trivedi, Richa; Gupta, Rakesh K.; Nath, Kavindra [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, UP (India); Malik, Gyanendra K.; Gupta, Amit [King George' s Medical University, Department of Pediatrics, Lucknow (India); Prasad, Kashi N. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Microbiology, Lucknow (India); Purwar, Ankur; Rathore, Divya; Rathore, Ram K.S. [Indian Institute of Technology, Department of Mathematics, Kanpur (India); Narayana, Ponnada A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Houston, TX (United States)

2007-09-15

150

Keeping an open mind about meningitis: a case report of carcinomatous meningitis.  

UK PubMed Central (United Kingdom)

Carcinomatous meningitis is defined as leptomeningeal infiltration by malignant cells. A case of carcinomatous meningitis, originally diagnosed as viral meningitis, is presented here to highlight the importance of maintaining a broad differential diagnosis in patients with evidence of meningeal irritation. Clinical and laboratory clues that suggest a diagnosis of carcinomatous meningitis in a patient with meningeal irritation include the presence and type of underlying malignancy (more common with breast cancer, lung cancer, and melanoma), absence of fever, presence of radicular pain, evidence of both cranial and spinal involvement, consistent cerebrospinal fluid (CSF) findings (increased opening pressure, elevated protein concentration, decreased glucose, increased white cell count), and supportive neuroimaging. Diagnosis is based on positive CSF cytology results, which may require multiple lumbar puncture procedures to obtain. For patients with a known primary malignancy who present to the emergency department with symptoms and/or signs of meningeal irritation, carcinomatous meningitis should be included in the differential diagnosis.

Walkty A; Abbott B; Swirsky N; Safneck J; Embil JM

2011-09-01

151

Keeping an open mind about meningitis: a case report of carcinomatous meningitis.  

Science.gov (United States)

Carcinomatous meningitis is defined as leptomeningeal infiltration by malignant cells. A case of carcinomatous meningitis, originally diagnosed as viral meningitis, is presented here to highlight the importance of maintaining a broad differential diagnosis in patients with evidence of meningeal irritation. Clinical and laboratory clues that suggest a diagnosis of carcinomatous meningitis in a patient with meningeal irritation include the presence and type of underlying malignancy (more common with breast cancer, lung cancer, and melanoma), absence of fever, presence of radicular pain, evidence of both cranial and spinal involvement, consistent cerebrospinal fluid (CSF) findings (increased opening pressure, elevated protein concentration, decreased glucose, increased white cell count), and supportive neuroimaging. Diagnosis is based on positive CSF cytology results, which may require multiple lumbar puncture procedures to obtain. For patients with a known primary malignancy who present to the emergency department with symptoms and/or signs of meningeal irritation, carcinomatous meningitis should be included in the differential diagnosis. PMID:21955418

Walkty, Andrew; Abbott, Burton; Swirsky, Neil; Safneck, Janice; Embil, John M

2011-09-01

152

Bacteriological study of meningococcal meningitis.  

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Full Text Available One hundred and thirty samples of cerebro spinal fluid were collected from patients admitted with suspected signs and symptoms of meningococcal meningitis (M. meningitis) during the period from January 1986 to April 1989 and were processed for gram?s staining, cultivation and latex agglutination tests for detection of polysaccharide antigen in the CSF. Totally 41.5% of turbid and hazy spinal fluid were positive for N. meningitidis by smear examination. Only 24.6% were positive by culture but 61.5% of sample were positive by latex agglutination tests. All the strains were sensitive to all antibiotics except one strain which was resistant to penicillin but it was sensitive to rifampicin.

Vadher P; Vaidya N; Soni P; Kale V

1991-01-01

153

Corticosteroids for acute bacterial meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: In experimental studies, the outcome of bacterial meningitis has been related to the severity of inflammation in the subarachnoid space. Corticosteroids reduce this inflammatory response. OBJECTIVES: To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with acute bacterial meningitis. SEARCH METHODS: We searched CENTRAL 2012, Issue 12, MEDLINE (1966 to January week 2, 2013), EMBASE (1974 to January 2013), Web of Science (2010 to January 2013), CINAHL (2010 to January 2013) and LILACS (2010 to January 2013). SELECTION CRITERIA: Randomised controlled trials (RCTs) of corticosteroids for acute bacterial meningitis. DATA COLLECTION AND ANALYSIS: We scored RCTs for methodological quality. We collected outcomes and adverse effects. We performed subgroup analyses for children and adults, causative organisms, low-income versus high-income countries, time of steroid administration and study quality. MAIN RESULTS: Twenty-five studies involving 4121 participants were included. Corticosteroids were associated with a non-significant reduction in mortality (17.8% versus 19.9%; risk ratio (RR) 0.90, 95% confidence interval (CI) 0.80 to 1.01, P = 0.07). A similar non-significant reduction in mortality was observed in adults receiving corticosteroids (RR 0.74, 95% CI 0.53 to 1.05, P = 0.09). Corticosteroids were associated with lower rates of severe hearing loss (RR 0.67, 95% CI 0.51 to 0.88), any hearing loss (RR 0.74, 95% CI 0.63 to 0.87) and neurological sequelae (RR 0.83, 95% CI 0.69 to 1.00).Subgroup analyses for causative organisms showed that corticosteroids reduced mortality in Streptococcus pneumoniae (S. pneumoniae) meningitis (RR 0.84, 95% CI 0.72 to 0.98), but not in Haemophilus influenzae (H. influenzae) orNeisseria meningitidis (N. meningitidis) meningitis. Corticosteroids reduced severe hearing loss in children with H. influenzae meningitis (RR 0.34, 95% CI 0.20 to 0.59) but not in children with meningitis due to non-Haemophilus species.In high-income countries, corticosteroids reduced severe hearing loss (RR 0.51, 95% CI 0.35 to 0.73), any hearing loss (RR 0.58, 95% CI 0.45 to 0.73) and short-term neurological sequelae (RR 0.64, 95% CI 0.48 to 0.85). There was no beneficial effect of corticosteroid therapy in low-income countries.Subgroup analysis for study quality showed no effect of corticosteroids on severe hearing loss in high-quality studies.Corticosteroid treatment was associated with an increase in recurrent fever (RR 1.27, 95% CI 1.09 to 1.47), but not with other adverse events. AUTHORS' CONCLUSIONS: Corticosteroids significantly reduced hearing loss and neurological sequelae, but did not reduce overall mortality. Data support the use of corticosteroids in patients with bacterial meningitis in high-income countries. We found no beneficial effect in low-income countries.

Brouwer MC; McIntyre P; Prasad K; van de Beek D

2013-01-01

154

Gallium-67 uptake in meningeal sarcoidosis  

International Nuclear Information System (INIS)

A case of sarcoidosis limited to the central nervous system is described in which the diagnosis was suggested by high Ga-67 uptake in the cranial and spinal meninges. The diagnosis was confirmed by meningeal biopsy. Treatment with oral corticosteroids resulted in clinical improvement and marked reduction in Ga-67 uptake in the meninges. This is the first reported case of the central nervous system sarcoid diagnosed by Ga-67 imaging

1986-01-01

155

Gallium-67 uptake in meningeal sarcoidosis  

Energy Technology Data Exchange (ETDEWEB)

A case of sarcoidosis limited to the central nervous system is described in which the diagnosis was suggested by high Ga-67 uptake in the cranial and spinal meninges. The diagnosis was confirmed by meningeal biopsy. Treatment with oral corticosteroids resulted in clinical improvement and marked reduction in Ga-67 uptake in the meninges. This is the first reported case of the central nervous system sarcoid diagnosed by Ga-67 imaging.

Ayres, J.G.; Hicks, B.H.; Maisey, M.N.

1986-07-01

156

The bacterial meningitis score to distinguish bacterial from aseptic meningitis in children from sao paulo, Brazil.  

UK PubMed Central (United Kingdom)

In a retrospective cohort of 494 children with meningitis in Sao Paulo, Brazil, the Bacterial Meningitis Score identified all the children with bacterial meningitis (sensitivity 100%, 95% confidence interval: 92-100% and negative predictive value 100%, 95% confidence interval: 98-100%). Addition of cerebrospinal fluid lactate to the score did not improve clinical prediction rule performance.

Filho EM; Horita SM; Gilio AE; Alves AC; Nigrovic LE

2013-09-01

157

Acute Bacterial Meningitis in Children  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To evaluate the clinical and laboratory findings and etiological spectrum of the patients with acute bacterial meningitis in the last 9 years.Material and methods: A retrospective chart review was conducted of 44 patients with acute bacterial meningitis.Results: The median age of patients was 11 months (1 month-13 years) and the male/female ratio was 2.38. The most common symptoms were fever (90.9%), vomiting (61.4%), lethargy (40.9%), headache (38.6%) and convulsion (25%). The agents were detected in 25 patients (56.8%). The most frequently detected agents were Streptococcus pneumoniae (27.3%), Haemophilus influenzae type b (11.4%) and Neisseria meningitidis (11.4%), and in 19 patients (43.2%) no agents could be determined. In 11 patients (25%) complications developed, these being subdural effusion (3 patients), subdural empyema (3 patients), hydrocephalus (2 patients), hearing loss (2 patients), and hydrocephalus-epilepsy (1 patient). None of the patients died.Conclusions: Streptococcus pneumoniae is the most common agent. Despite advances in vaccine development, chemoprophylaxis and treatment, acute bacterial meningitis remains a significant cause of substantial morbidity in children.

Halil Özdemir; An?l Tap?s?z; Ergin Çiftçi; Erdal ?nce; Ülker Do?ru

2010-01-01

158

Radiation in the treatment of meningeal leukemia  

International Nuclear Information System (INIS)

At the present time, a successful regimen for the eradication of occult meningeal leukemia is the combination of cranial radiotherapy in a dose of 1800 rads in 10 fractions in 12 to 14 days with six doses of intrathecal methotrexate. This regimen, when given with prednisone and vincristine can be expected to give a relapse rate for isolated meningeal leukemia of approximately 5% during the first 2 years of follow-up. A modification of this regimen utilizing craniospinal radiation with prior and concurrent intrathecal methotrexate is given for the treatment of overt meningeal leukemia at diagnosis or for an isolated first relapse with meningeal leukemia. Radiation technique and morbidity are discussed

1979-01-01

159

Serum procalcitonin in viral and bacterial meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: In children with meningitis, there is a difficulty to verify the etiology as viral or bacterial. Therefore, intensive research has been carried out to find new and rapid diagnostic methods for differentiating bacterial from viral meningitis. OBJECTIVES: The aim of this work was to study the behavior of procalcitonin (PCT) and whether it can be used to differentiate children with bacterial from those with viral meningitis. We also compared PCT to C-reactive protein (CRP) and white blood cell count. PATIENTS AND METHODS: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. METHODS: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. RESULTS: PCT levels were significantly higher in patients with bacterial meningitis (mean, 24.8 ng/ml) compared to patients with viral meningitis (mean, 0.3 ng/ml) (P<0.001). PCT levels in bacterial meningitis group decreased after 3 days of starting treatment, but remained higher than viral meningitis group (mean, 10.5 ng/ml). All CSF parameters, blood leukocytes, and CRP showed overlapping values between the two groups. Serum PCT with cut off value >2 ng/ml showed sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 66%, 68%, and 100%, respectively, for the diagnosis of bacterial meningitis. CONCLUSION: Serum procalcitonin level has a better diagnostic and prognostic value than CRP or leukocyte count to distinguish between bacterial and viral meningitis. It is also a good indicator of the efficacy of treatment of bacterial meningitis.

Alkholi UM; Abd Al-Monem N; Abd El-Azim AA; Sultan MH

2011-01-01

160

Diagnostic value of MRI in tuberculous meningitis  

International Nuclear Information System (INIS)

[en] In this study 15 patients with clinical findings and positive cerebrospinal fluid analyses for tuberculous meningitis were evaluated with magnetic resonance imaging (MRI). Tuberculous meningitis was diagnosed in 11 cases when thick meningeal enhancement was present after intravenous injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) in T1-weighted images. Intra-axial tuberculomas were present in 8 patients, 2 of whom had intra-axial tuberculomas without MRI evidence of meningitis. Tuberculomas showed ring or nodular enhancement in postcontrast T1-weighted images, but the most significant MR feature of intraparenchymal tuberculomas was the hypointense appearance of the lesions on T2-weighted images. (orig.)

1996-01-01

 
 
 
 
161

Diagnostic value of MRI in tuberculous meningitis  

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In this study 15 patients with clinical findings and positive cerebrospinal fluid analyses for tuberculous meningitis were evaluated with magnetic resonance imaging (MRI). Tuberculous meningitis was diagnosed in 11 cases when thick meningeal enhancement was present after intravenous injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) in T1-weighted images. Intra-axial tuberculomas were present in 8 patients, 2 of whom had intra-axial tuberculomas without MRI evidence of meningitis. Tuberculomas showed ring or nodular enhancement in postcontrast T1-weighted images, but the most significant MR feature of intraparenchymal tuberculomas was the hypointense appearance of the lesions on T2-weighted images. (orig.)

Tayfun, C. [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey); Uecoez, T. [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey); Tasar, M [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey); Atac, K. [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey); Ogur, E. [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey); Oeztuerk, T. [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey); Yinanc, M.A. [Dept. of Diagnostic Radiology, Guelhane Military Medical Academy and Medical School, Ankara (Turkey)

1996-06-01

162

[A case of traumatic middle meningeal arteriovenous fistula on the side of the head opposite to the injured side].  

UK PubMed Central (United Kingdom)

A rare case of a traumatic middle meningeal arteriovenous fistula on the side of the head opposite to the injured side was reported. A 21-year-old man was admitted to our hospital after a traffic accident in which the right side of his head was hit. CT scans and MR images on admission showed a right temporal bone fracture, traumatic subarachnoid hemorrhage, and a left frontal lobe contusion. Three months after the head injury, he complained of tinnitus and exophthalmos. One year after the head injury, left external carotid angiograms showed a dural arteriovenous fistula fed by the left dilated middle meningeal artery and draining into the middle meningeal vein. Early filling of the sphenoparietal sinus, cavernous sinus, superior ophthalmic vein, and the cortical vein were also detected. Transarterial embolization of the left middle meningeal fistula was performed, resulting in the disappearance of the lesion. The postoperative course was uneventful.

Takeuchi S; Takasato Y; Masaoka H; Hayakawa T; Otani N; Yoshino Y; Yatsushige H; Sugawara T; Aoyagi C; Suzuki G

2009-10-01

163

Study of tuberculous meningitis by CT  

International Nuclear Information System (INIS)

[en] Computed tomography is a very valuable method by which the pathogenic evolution of tuberculous meningitis may be followed, thereby facilitating its differential diagnosis and controlling the efficiency of therapy. The initial miliary tuberculosis in the brain, very often unaccompanied by neurological symptoms, may offer very evident CT images. CT may also demonstrate the fibrogelatinous exudate which fills the basal cisterns and surrounds the arterial vessels which cross this region. Because of this, secondary arteritis is frequent and may be indirectly detected by CT in the form of foci of ischemic infarcts. Tuberculomas may be multiple, and are found equally in the cerebral and the cerebellar parenchyma. These tuberculomas present different images on CT, depending on the evolution of the disease at that moment. Hydrocephalus is a common complication of TM and is caused by a lack of reabsorption of the cerebrospinal fluid, or by an obstructive lesion in the ventricular drainage pathways due to a tuberculoma. This complication is usually easily identified by CT, which, moreover, permits the control of its evolution. (orig.)

1980-01-01

164

Rapid diagnosis of meningitis using reagent strips.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Identification of causative agent with estimation of cerebrospinal fluid (CSF) glucose, protein, cells is necessary for accurate diagnosis of meningitis. Unfortunately, even these facilities are not available in many areas. Reagent strips that measure glucose and protein in blood and urine can serve this task but have been used with varying results in the past. This study was carried out to evaluate the utility and efficacy of Combur 10 strips in the diagnosis of meningitis. DESIGN, SETTINGS AND METHODS: A prospective clinical single blinded study of 63 children suspected to have meningitis undergoing CSF analysis. Each CSF sample was divided in to two and was utilised for reagent strip analysis in addition to standard laboratory evaluation and a correlation analysis were made. STATISTICAL METHOD USED: Results were analysed using standard statistical tests. Accuracy of the reagent strips as a screening tool was established using Godyn's test. RESULTS: The sensitivity, specificity of the reagent strips for the diagnosis of meningitis was 97.14%, 96.42%. The sensitivity, specificity for tuberculous meningitis and bacterial meningitis were 100%, and 96.55%. That for the aseptic meningitis was 70% and 96.55%. Accuracy for the diagnosis of meningitis as a whole, bacterial meningitis, tuberculous meningitis, and aseptic meningitis were 96.78%, 98.2%, 98.27% and 83.0% respectively. CONCLUSION: Combur10 strips thus can be used for the rapid CSF analysis and screening with good accuracy. In situations where facilities of routine laboratory testing are not available this can be of an immense help.

Parmar RC; Warke S; Sira P; Kamat JR

2004-02-01

165

Bilateral agenesis of internal carotid artery.  

UK PubMed Central (United Kingdom)

This could be the first case of bilateral agenesis of the internal carotid artery reported "in vivo." Angiogrpahic study has allowed us to recognize the anatomic details of this malformation. The absence of the two carotids is being compensated for by a trigeminal artery on the (left) side and by a hypertrophied accessory meningeal artery on the (right) side. Standard x-rays of the base of the skull (including tomography) revealed a dilation of the foramen ovale, related to the hypertrophied right accessory meningeal artery, and a complete atresia of the two carotid canals. This latter finding permits us definitely to postulate the nature of the congenital anomaly. Finally, the carotid agenesis was associated with the presence of three arterial aneurysms, situated respectively in each carotid territory and in the territory of the basilar artery.

Dilenge D

1975-06-01

166

Serial angiography of dynamic changes of traumatic middle meningeal arteriovenous fistula: case report.  

UK PubMed Central (United Kingdom)

A 48-year-old woman suffered head trauma and presented with an acute epidural hematoma with a linear fracture of the right temporal bone across the middle meningeal groove. Initial angiography demonstrated no vascular abnormalities. Eight months later, she again suffered head trauma and computed tomography demonstrated traumatic subarachnoid hemorrhage. Right external carotid angiography revealed a middle meningeal arteriovenous fistula (AVF) which drained into the superficial sylvian veins via the sphenoparietal sinus. Serial angiography showed progressive dilation of the draining veins, but she refused surgical intervention and dropped out of our outpatient clinic. Fifteen years after the first head trauma, she presented with subarachnoid hemorrhage. Angiography demonstrated formation of venous aneurysms on the drainer of the AVF. The dilated superficial sylvian vein was removed together with the ruptured venous aneurysm. Histological examination of the drainer revealed an arterialized vein. The serial angiographic evaluations revealed dynamic changes of the traumatic middle meningeal AVF, including progressive dilation of the drainers, simplification of the drainage routes, and the formation of venous aneurysms, which presumably represents the entire natural course of traumatic middle meningeal AVF manifesting as hemorrhage. The present case of traumatic middle meningeal AVF with a deteriorating course suggests that surgical removal or embolization of the AVF is strongly indicated if follow-up angiography shows dilation of the drainers, which implies increased shunt flow.

Sakata H; Nishimura S; Mino M; Hori E; Fujita T; Midorikawa H; Kaimori M; Nishijima M

2009-10-01

167

Hydrocephalus in herpes simplex type 2 meningitis.  

UK PubMed Central (United Kingdom)

A 34-year-old woman presented to hospital with symptoms of meningitis, later confirmed to be due to herpes simplex virus type 2. She developed hydrocephalus on day 2 of her admission. We describe the first case of hydrocephalus associated with herpes simplex type 2 meningitis in an adult.

Yap E; Ellis-Pegler R

2006-08-01

168

MRI of intracranial meningeal malignant fibrous histiocytoma  

International Nuclear Information System (INIS)

We describe the CT and MRI findings in a patient with primary intracranial meningeal malignant fibrous histiocytoma (MFH). CT delineated the anatomical relations and MRI aided in tissue characterisation. To our knowledge, this is the first report describing the MRI findings in primary intracranial meningeal MFH. (orig.). With 1 fig

1996-01-01

169

MRI of intracranial meningeal malignant fibrous histiocytoma  

Energy Technology Data Exchange (ETDEWEB)

We describe the CT and MRI findings in a patient with primary intracranial meningeal malignant fibrous histiocytoma (MFH). CT delineated the anatomical relations and MRI aided in tissue characterisation. To our knowledge, this is the first report describing the MRI findings in primary intracranial meningeal MFH. (orig.). With 1 fig.

Ogino, A. [Department of Radiology, Nagasaki University School of Medicine (Japan); Ochi, M. [Department of Radiology, Nagasaki University School of Medicine (Japan); Hayashi, K. [Department of Radiology, Nagasaki University School of Medicine (Japan); Hirata, K. [Department of Neurosurgery, Nagasaki University School of Medicine (Japan); Hayashi, T. [Department of Pathology, Nagasaki University School of Medicine (Japan); Yasunaga, A. [Department of Neurosurgery, Nagasaki University School of Medicine (Japan); Shibata, S. [Department of Neurosurgery, Nagasaki University School of Medicine (Japan)

1996-11-01

170

Cryptococcal meningitis: Clinical, diagnostic and therapeutic overviews  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cryptococcal meningitis has emerged as a leading cause of infectious morbidity and mortality in patients with AIDS. Among the human immunodeficiency virus (HIV)-seropositive subjects, cryptococcal meningitis is the second most common cause of opportunistic neuro-infection. Current trends are changin...

Satishchandra P; Mathew T; Gadre G; Nagarathna S; Chandramukhi A; Mahadevan A; Shankar S

171

Pituitary apoplexy initially mistaken for bacterial meningitis.  

UK PubMed Central (United Kingdom)

We presented a case of a 62-year-old man whose initial clinical picture was suggestive of bacterial meningitis, but instead had pituitary apoplexy. We highlighted how pituitary apoplexy can mimic bacterial meningitis, learning points on how clinical assessment can aid earlier diagnosis and the importance of considering this differential diagnosis, particularly with the associated morbidity and mortality if missed.

Wong SH; Das K; Javadpour M

2013-01-01

172

Bacterial meningitis by streptococcus agalactiae  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: bacterial meningitis is an infectious disease considered a medicalemergency. The timely management has an important impact on the evolution of thedisease. Streptococcus agalactiae, a major causative agent of severe infections innewborns can colonize different tissues, including the central nervous system.Case report: Male patient 47 years old from rural areas, with work activity as amilker of cattle, referred to tertiary care, with disorientation, neck stiffness, and grandmal seizure. CSF study indicates neuroinfection. ICU care with steroids, antibiotics andmechanical ventilation. Cerebrospinal fluid culture reports growth of Streptococcus agalactiae. In coexistencewith the central nervous system involvement appeared otomastoidea infection.Conclusion: Bacterial meningitis can be caused by Streptococcus agalactiae,germ infrequently involved in this pathology. Work activities in non-tech agribusiness,had to be considered risk.RESUMEN:Introducción: la meningitis bacteriana (MB) es una enfermedad infecciosa consideradauna emergencia médica. El manejo oportuno tiene importante impacto en la evoluciónde la entidad. El Streptococcus agalactiae, significativo agente causal de infeccionesseveras en recién nacidos, puede colonizar diferentes tejidos, entre ellos el sistemanervioso central.Caso clínico: paciente masculino de 47 años de edad, procedente de zona rural,con actividad laboral ordeñador de reses bovinas, remitido a tercer nivel de atención,con desorientación, rigidez de nuca y convulsión tónico-clónica. Estudio de líquidocefalorraquídeo indica neuroinfección. Manejo en UCI con esteroides, antibióticosy ventilación mecánica. Cultivo de líquido cefalorraquídeo, informa crecimiento deStreptococcus agalactiae. En coexistencia con el compromiso del sistema nerviosocentral se presentaba infección otomastoidea.Conclusión: la MB puede ser causada por el Streptococcus agalactiae, germeninfrecuentemente involucrado en este tipo de patología. Actividades laborales en laagroindustria no tecnificada, debiesen ser consideradas situaciones de riesgo.

Villarreal-Velásquez Tatiana Paola; Cortés-Daza César Camilo

2012-01-01

173

Meningitis due to Xanthomonas maltophilia.  

Directory of Open Access Journals (Sweden)

Full Text Available During 1st week of post-operative period, a 28 year old female patient operated for left cerebellopontine angle tumor, continued to get fever. Lumbar puncture did not reveal any organisms. She responded to ciprofloxacin. Two months later, she was readmitted with signs and symptoms of meningitis. The CSF tapped on lumbar puncture grew Xanthomonas maltophilia, Gram negative bacilli, sensitive to various antibiotics, ciprofloxacin being one of them. The patient was given ciprofloxacin for 3 weeks. On follow up, a year later she was found to be asymptomatic.

Girijaratnakumari T; Raja A; Ramani R; Antony B; Shivananda P

1993-01-01

174

[Serous meningitis in Lyme's borreliosis  

UK PubMed Central (United Kingdom)

The authors relate the results of clinical, epidemiological, immunological, neurophysiological, EMG, ED and REG studies in patients in the early period of Lyme's disease. The patients with clinical and subclinical signs of nervous system lesions and those with serous meningitis were examined. Different levels of the impairment, multiple neuropathies running a subclinical course, interest of the subcortical brain structures and spinal motoneuronal pool are demonstrated. Cases of the mixed infection (tick-borne encephalitis and borreliosis) were revealed. 91% of the patients (50 cases out of 55) were verified serologically.

Kravchuk LN; Kuvshinov IuA; Sergovskaia VD; Minina AP; Korotkevich NA; Klimovitskaia VS

1992-01-01

175

Onkologisk behandling af meningeal carcinomatose  

DEFF Research Database (Denmark)

Meningeal carcinomatosis (MC) occurs in 5-8% of cancer patients. In the       majority of cases, MC appears in patients with advanced disease. The       increase in incidence is probably caused by improved survival due to       improvements in systemic therapy and an increased awareness of MC among       clinicians. Diagnosis is based on CSF cytology and neuroimaging. MC is a       devastating condition that is associated with a poor prognosis, with a       median survival time of 4-11 weeks. The treatment is in most cases       palliative and involves radiotherapy and/or chemotherapy

Sulim, S.; HØyer, Morten

2005-01-01

176

Meningitis Caused by Pseudallescheria boydii.  

Directory of Open Access Journals (Sweden)

Full Text Available We present a 43-year-old immunocompetent man who developed meningitis caused byPseudallescheria boydii. The patient had no history of near drowning, trauma, steroidadministration, operations or any other underlying systemic disease. He presented withintermittent fever associated with headache, bilateral eye pain, and vomiting. Progressivehydrocephalus was noted during the course of the disease. Cerebrospinal fluid (CSF) fromthe ventricular system allowed culture of the organism. Although the disease was diagnosedantemortemly, the patient died after antifungal treatment. This case is reported because ofthe unusual pathogen, unresponsiveness to amphotericin B combined with 5-fluocytocin,and immunocompetence of the patient without any predisposing factors.

Teng-Yeow Tan; Chia-Wei Liou; Ling-Chang Kung

2004-01-01

177

MR of childhood tuberculous meningitis  

Energy Technology Data Exchange (ETDEWEB)

MR imaging was performed on 27 children with stage II-III tuberculous meningitis for the specific purpose of examining the brainstem, as well as comparison with other CT features of the disease. In addition to defining the ischemic disturbances of basal ganglia and diencephalon more clearly, MR also demonstrates the frequent occurrence of parenchymal signal abnormalities in the brainstem and adjacent temporal lobes, which are invisible or uncertain on CT. Although the presence of brainstem abnormalities on MR correlated well with clinical findings of brainstem dysfunction, clinical staging on admission remains the best prognostic indicator in advanced TBM. We also review the MR features of basal exudation, hydrochephalus and tuberculoma.

Schoeman, J.; Donald, P.; Hewlett, R.

1988-12-01

178

Focal parenchymal lesions in community-acquired bacterial meningitis in adults: a clinico-radiological study  

International Nuclear Information System (INIS)

Here, we analyzed the frequency, morphological pattern, and imaging characteristics of focal lesions as a consequence of community-acquired bacterial meningitis. We hypothesized that diffusion-weighted imaging combined with contrast-enhanced imaging, serial scanning, and multimodal vascular studies would provide further insight into the pathological basis of such parenchymal lesions in bacterial meningitis. We reviewed clinical and imaging data (i.e., magnetic resonance tomography, magnetic resonance angiography, computed tomography angiography, digital subtraction angiography) of 68 adult patients admitted to our neurological intensive care unit between March 1998 and February 2009 with the diagnosis of community-acquired bacterial meningitis. We identified seven patients with parenchymal lesions. These lesions could be attributed to four morphological patterns: (1) territorial cerebral ischemia, (2) perforating vessels ischemia, (3) ischemia of presumed cardiac origin, and (4) isolated cortical lesions. Whereas the patterns (1) and (2) were associated with vasculopathy of large- and medium-sized vessels (as shown by cerebral vascular imaging), vessel imaging in (3) and (4) did not show abnormal findings. Our study implies that parenchymal lesions in acute bacterial meningitis are mainly ischemic and due to involvement of large-, medium-, and small-sized arteries of the brain. Diffusion-weighted imaging combined with conventional, CT-, or MR-based cerebral angiography revealed the underlying pathophysiological mechanisms in the majority of patients. Furthermore, we detected two patients with isolated bilateral cortical involvement and normal vessel imaging. These lesions might represent ischemia due to the involvement of small pial and intracortical arteries. (orig.)

2009-01-01

179

Focal parenchymal lesions in community-acquired bacterial meningitis in adults: a clinico-radiological study  

Energy Technology Data Exchange (ETDEWEB)

Here, we analyzed the frequency, morphological pattern, and imaging characteristics of focal lesions as a consequence of community-acquired bacterial meningitis. We hypothesized that diffusion-weighted imaging combined with contrast-enhanced imaging, serial scanning, and multimodal vascular studies would provide further insight into the pathological basis of such parenchymal lesions in bacterial meningitis. We reviewed clinical and imaging data (i.e., magnetic resonance tomography, magnetic resonance angiography, computed tomography angiography, digital subtraction angiography) of 68 adult patients admitted to our neurological intensive care unit between March 1998 and February 2009 with the diagnosis of community-acquired bacterial meningitis. We identified seven patients with parenchymal lesions. These lesions could be attributed to four morphological patterns: (1) territorial cerebral ischemia, (2) perforating vessels ischemia, (3) ischemia of presumed cardiac origin, and (4) isolated cortical lesions. Whereas the patterns (1) and (2) were associated with vasculopathy of large- and medium-sized vessels (as shown by cerebral vascular imaging), vessel imaging in (3) and (4) did not show abnormal findings. Our study implies that parenchymal lesions in acute bacterial meningitis are mainly ischemic and due to involvement of large-, medium-, and small-sized arteries of the brain. Diffusion-weighted imaging combined with conventional, CT-, or MR-based cerebral angiography revealed the underlying pathophysiological mechanisms in the majority of patients. Furthermore, we detected two patients with isolated bilateral cortical involvement and normal vessel imaging. These lesions might represent ischemia due to the involvement of small pial and intracortical arteries. (orig.)

Katchanov, Juri [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); University Hospital Charite, Campus Benjamin Franklin, Department of Neurology, Berlin (Germany); Siebert, Eberhard; Klingebiel, Randolf [Campus Charite Mitte, Charite, Department of Neuroradiology, Berlin (Germany); Endres, Matthias [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); Charite-Universitaetsmedizin Berlin, Center for Stroke Research Berlin, Berlin (Germany)

2009-11-15

180

Epidemiology of bacterial meningitis in Niamey, Niger, 1981-96.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the African meningitis belt the importance of endemic meningitis is not as well recognized as that of epidemics of meningococcal meningitis that occur from time to time. Using retrospective surveillance, we identified a total of 7078 cases of laboratory-diagnosed bacterial meningitis in Niamey, N...

Campagne, G.; Schuchat, A.; Djibo, S.; Ousséini, A.; Cissé, L.; Chippaux, J. P.

 
 
 
 
181

Acute bacterial meningitis in Nepal.  

Science.gov (United States)

This study was conducted at Tribhuvan University Teaching Hospital, a tertiary care hospital in Nepal from January 2001 to March 2002. The prevalence of bacterial meningitis, its causative organisms and their antibiotic sensitivity patterns were studied in cerebrospinal fluid of 448 suspected cases. The prevalence of acute bacterial meningitis was 8.3%. There was no significant association (p > 0.05) of the disease with gender (X2 = 0.0234) and among different age groups (X2 = 6.07875) studied. The causative bacteria were Pseudomonas aeruginosa (24.3%), Klebsiella pneumoniae (16.2%), Staphylococcus aureus (16.2%), coagulase negative staphylococci (10.8%), Escherichia coli (10.8%), Streptococcus pneumoniae (8.2%), Neisseria meningitidis (5.4%), Acinetobacter spp. (5.4%) and Aeromoanas spp. (2.7%). Imipenem was the most effective antibiotic, however, 11.1% of P. aeruginosa, 25.0% of E. coli and 50.0% of Acinetobacter spp. were resistant to the drug. PMID:17899958

Tiwari, Kiran Babu; Rijal, Basista; Ghimire, Prakash; Sharma, Achyut Prasad

2007-06-01

182

Acute bacterial meningitis in Nepal.  

UK PubMed Central (United Kingdom)

This study was conducted at Tribhuvan University Teaching Hospital, a tertiary care hospital in Nepal from January 2001 to March 2002. The prevalence of bacterial meningitis, its causative organisms and their antibiotic sensitivity patterns were studied in cerebrospinal fluid of 448 suspected cases. The prevalence of acute bacterial meningitis was 8.3%. There was no significant association (p > 0.05) of the disease with gender (X2 = 0.0234) and among different age groups (X2 = 6.07875) studied. The causative bacteria were Pseudomonas aeruginosa (24.3%), Klebsiella pneumoniae (16.2%), Staphylococcus aureus (16.2%), coagulase negative staphylococci (10.8%), Escherichia coli (10.8%), Streptococcus pneumoniae (8.2%), Neisseria meningitidis (5.4%), Acinetobacter spp. (5.4%) and Aeromoanas spp. (2.7%). Imipenem was the most effective antibiotic, however, 11.1% of P. aeruginosa, 25.0% of E. coli and 50.0% of Acinetobacter spp. were resistant to the drug.

Tiwari KB; Rijal B; Ghimire P; Sharma AP

2007-06-01

183

CT finding of cryptococcal meningitis  

International Nuclear Information System (INIS)

[en] We have experienced 14 cases of cryptococcal meningitis in the last 6 years. Their neurological signs, CT findings, and prognoses were studied. They fall into three types: the brain-stem-encephalitis type, the cortical-encephalitis type, and the meningitis type, according to the clinical course. The first type (6 cases) revealed mainly cerebellar signs, eye-movement damage, and so forth. The second type (5 cases) demonstrated ''Personality'' changes, chiefly aphasia. The third type (5 cases) did not show any focal signs. Prognosis of the brain-stem-encephalitis type was very poor, with a 50% mortality rate. In the survivors, also, clinical signs did not disappear for a long time. Repeated CT was performed in 13 among the 14 cases; abnormal CT findings were revealed in 5 cases because of cryptococcal infection. Granuloma shadow and ventriculitis shadow were observed in 3 cases each. These abnormal findings disappeared upon treatment except in one case. The clinical signs are not completely related with the CT finding, but it is useful that the site which has been infiltrated by the cryptococcus can be observed. Abnormal CT findings were observed in the 4 cases of the brain-stem-encephalitis type among the 5 abnormal cases. It is very useful to know the severity of the condition. (author)

1981-01-01

184

CT finding of cryptococcal meningitis  

Energy Technology Data Exchange (ETDEWEB)

We have experienced 14 cases of cryptococcal meningitis in the last 6 years. Their neurological signs, CT findings, and prognoses were studied. They fall into three types: the brain-stem-encephalitis type, the cortical-encephalitis type, and the meningitis type, according to the clinical course. The first type (6 cases) revealed mainly cerebellar signs, eye-movement damage, and so forth. The second type (5 cases) demonstrated ''Personality'' changes, chiefly aphasia. The third type (5 cases) did not show any focal signs. Prognosis of the brain-stem-encephalitis type was very poor, with a 50% mortality rate. In the survivors, also, clinical signs did not disappear for a long time. Repeated CT was performed in 13 among the 14 cases; abnormal CT findings were revealed in 5 cases because of cryptococcal infection. Granuloma shadow and ventriculitis shadow were observed in 3 cases each. These abnormal findings disappeared upon treatment except in one case. The clinical signs are not completely related with the CT finding, but it is useful that the site which has been infiltrated by the cryptococcus can be observed. Abnormal CT findings were observed in the 4 cases of the brain-stem-encephalitis type among the 5 abnormal cases. It is very useful to know the severity of the condition.

Takahashi, Y.; Sato, H.; Ueda, M.; Ito, K.; Matsuoka, T. (Ohkawara Neurosurgical Hospital, Muroran (Japan))

1981-08-01

185

Effect of severity of meningitis on fungicidal activity of flucytosine combined with fluconazole in a murine model of cryptococcal meningitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We studied the effect of the severity of meningitis on the response to therapy with fluconazole and flucytosine in a murine model of cryptococcal meningitis. Meningitis was established by intracerebral injection of Cryptococcus neoformans. The severity of meningitis was varied by delaying the onset ...

Ding, J C; Bauer, M; Diamond, D M; Leal, M A; Johnson, D; Williams, B K; Thomas, A M; Najvar, L; Graybill, J R; Larsen, R A

186

Epidemiología de la meningitis Venezuela 2010  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Las meningitis en Venezuela constituyen un importante problema de salud pública, que afecta de manera especial a los niños menores de 5 años. Las vacunas antineumocócicas, antimeningocócicas, contra Haemophilus influenzae tipo b, así como la BCG, obligan a revisar la dinámica de la morbi-mortalidad en nuestro país. La etiología más frecuente es viral, seguida de las meningitis bacterianas y las tuberculosas, mientras que se conoce poco de la micótica y otras ca (more) usas. Los sistemas de vigilancia epidemiológica muestran cifras altas de la incidencia de las meningitis que ameritan acciones más enérgicas de salud pública para vigilar, prevenir y mejorar los Programas Nacionales de Inmunizaciones y sus coberturas, además de tratar médicamente las meningitis en cualquiera de sus causas infecciosas. Abstract in english Meningitis constitutes an important public health problem in Venezuela that affects children, specially under 5 years of age. Antimeningococcal, anti-pneumococcal, vaccines against Haemophilus influenzae type b and BCG induce pediatricians to review the dynamics of the morbidity and mortality of these diseases. The most common etiology is the viral followed by bacterial meningitis followed by tuberculosis, while little is known of the fungal or other causes. Epidemiologic (more) al surveillance systems show high figures of the incidence which warrant a more intense public health action to monitor, prevent and improve national programs of immunization and their vaccine coverage, and to treat medically any infectious cause of meningitis.

Echezuría, Luis; León, Raiza; Rodríguez, Eva; Rísquez, Alejandro

2010-12-01

187

Meningitis and encephalitis in Poland in 2011.  

UK PubMed Central (United Kingdom)

INTRODUCTION: About 2 000-3 000 cases of meningitis and/or encephalitis of viral or bacterial etiology are recorded every year in Poland. AIM OF THE STUDY: The aim of this study was to assess the epidemiology of meningitis and/or encephalitis in Poland in 2011 and compare it to the situation in previous years. MATERIALS AND METHODS: Assessment of the epidemiological situation of meningitis and/or encephalitis in Poland in 2011, was based on the results of analysis of epidemiological interviews sent to the NIZP-PZH by the Regional Sanitary-Epidemiological Stations published in the annual bulletin "Infectious diseases and poisonings in Poland in 2011" and "Preventive immunizations in Poland in 2011" (Czarkowski MP. et al., Warsaw, NIZP-PZH, GIS). RESULTS: In 2011 in Poland it was recorded 2 915 cases of meningitis and/or encephalitis. This included 1 438 cases of viral etiology, 888 of bacterial etiology and 589 of other etiology specified or unspecified. Among the reported cases of bacterial meningitis and/or encephalitis dominant etiological factor was N. meningitidis (193), S. pneumoniae (192) and H. influenzae type B (11). Among the infections of viral etiology predominated was virus of tick-borne encephalitis (221). SUMMARY AND CONCLUSIONS: The epidemiological situation of inflammatory meningitis - meningitis and/or brain in Poland in 2011 compared to 2010 did not change significantly.

Lipke M; Karasek E

2013-01-01

188

Fatal subdural empyema following pyogenic meningitis.  

Science.gov (United States)

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should be borne in mind in patient with pyogenic meningitis who exhibit neurological deterioration. PMID:21556239

Lee, Seok Ki; Kim, Seok Won

2011-03-31

189

Meningitis  

Medline Plus

Full Text Available ... the age of 2 years include • high fever • headache • stiff neck These symptoms can develop in several ... and small infants, the classic symptoms of fever, headache, and neck stiffness may be difficult to detect, ...

190

Meningitis  

Medline Plus

Full Text Available ... nr210104 Last reviewed: 01/30/2011 1 A clear fluid, called cerebro-spinal fluid or CSF, surrounds the brain and spinal cord. CSF is a clear fluid that looks like water. CSF acts as ...

191

Meningitis  

Medline Plus

Full Text Available ... over the age of 2 years include • high fever • headache • stiff neck These symptoms can develop in ... newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be difficult to ...

192

Meningitis  

Medline Plus

Full Text Available ... or a healthcare professional for your specific condition. ©1995-2011, The Patient Education Institute, Inc. www.X- ... or a healthcare professional for your specific condition. ©1995-2011, The Patient Education Institute, Inc. www.X- ...

193

Meningitis  

Medline Plus

Full Text Available ... healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out ... healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out ...

194

Differential vasoactive effects of sildenafil and tadalafil on cerebral arteries  

DEFF Research Database (Denmark)

Phosphodiesterase 5 (PDE5) is associated with migraine pathophysiology, stroke recovery and vasospasm treatment. The potential vascular interplay of PDE5 inhibitors sildenafil, tadalafil and UK-114,542 was studied by intra- versus extra-luminal administration in rat middle cerebral arteries in vitro and on middle meningeal arteries in vivo. By Western blot PDE5 was detected in both cerebral and meningeal arteries, though with minor variations in band intensity between vascular beds. Rat middle cerebral artery diameter was investigated using pressurised arteriography, applying UK-114,542, sildenafil, and tadalafil intra- or extra-luminally. Effects on the dural middle meningeal artery were studied in the in vivo closed cranial window model. At high concentrations, abluminal sildenafil and UK-114,542, but not tadalafil, induced dilatation of the middle cerebral artery. Luminal application elicited a contraction of 4% (sildenafil, P=0.03) and 10% (tadalafil, P=0.02). In vivo, sildenafil, but not tadalafil, dose-dependently dilated middle meningeal artery concomitant to blood pressure reduction (1-3mg/kg);1mg/kg sildenafil inducing 60 ± 14% (P=0.04) and vehicle (DMSO) 13 ± 6% dilatation. In conclusion, PDE5 inhibitors applied luminally had minor contractile effect, whereas abluminal sildenafil induced middle cerebral artery dilatation above therapeutic levels. In vivo, sildenafil dilated middle meningeal artery concomitant with a reduction in blood pressure. Tadalafil had no dilatory effects. PDE5 inhibitors show differential vascular activity in cerebral arteries from healthy animals; arterial dilatation is seen primarily above therapeutic levels. Such findings support clinical studies showing no vasodilator effects of sildenafil on cerebral arteries in healthy subjects.

Kruuse, Christina Rostrup; Gupta, Saurabh

2012-01-01

195

Computed tomography in suppurative meningitis  

International Nuclear Information System (INIS)

[en] Computed tomography abnormalities revealed in 18 of 29 patients (62%) with infantile supprative meningitis. The abnormalities included ventricular dilatation (12 cases), subdural edema (8), cerebral infarction (4), cerebral atrophy (3), encephalitis (2), and cerebral herniation (1). The comparative study of CT pictures and clinical findings in the acute stage of the disease showed that the high incidence of these abnormalities occurred in the following conditions: 1) The age was less than 1 year, 2) establishment of the diagnosis took more than 5 days, 3) glucose of the cerebrospinal fluid was less than 200 mg/dl, 4) protein of the cerebrospinal fluid was more than 200 mg/dl, and 5) convulsion occurred 24 hrs after institution of the treatment. (Ueda, J.)

1982-01-01

196

MR of childhood tuberculous meningitis  

International Nuclear Information System (INIS)

[en] MR imaging was performed on 27 children with stage II-III tuberculous meningitis for the specific purpose of examining the brainstem, as well as comparison with other CT features of the disease. In addition to defining the ischemic disturbances of basal ganglia and diencephalon more clearly, MR also demonstrates the frequent occurrence of parenchymal signal abnormalities in the brainstem and adjacent temporal lobes, which are invisible or uncertain on CT. Although the presence of brainstem abnormalities on MR correlated well with clinical findings of brainstem dysfunction, clinical staging on admission remains the best prognostic indicator in advanced TBM. We also review the MR features of basal exudation, hydrochephalus and tuberculoma. (orig.)

1988-01-01

197

Salmonella enteritidis meningitis - A case report  

Directory of Open Access Journals (Sweden)

Full Text Available A male infant admitted with pyogenic meningitis with protein energy malnutrition developed fatal infection due to Salmonella enteritidis. The same organism was isolated from CSF and blood cultures.

Varaiya A; Saraswathi K; Tendolkar U; De A; Shah S; Mathur M

2001-01-01

198

Pasteurella pneumotropica: meningitis following a dog bite.  

Science.gov (United States)

A 38 year old man developed meningitis following a dog bite. Pasteurella pneumotropica, usually an animal pathogen, was isolated from the cerebrospinal fluid. The patient made a complete recovery after antibiotic therapy. The relevant literature is reviewed. PMID:2349182

Minton, E J

1990-02-01

199

Pasteurella pneumotropica: meningitis following a dog bite.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 38 year old man developed meningitis following a dog bite. Pasteurella pneumotropica, usually an animal pathogen, was isolated from the cerebrospinal fluid. The patient made a complete recovery after antibiotic therapy. The relevant literature is reviewed.

Minton, E. J.

200

Pasteurella pneumotropica: meningitis following a dog bite.  

UK PubMed Central (United Kingdom)

A 38 year old man developed meningitis following a dog bite. Pasteurella pneumotropica, usually an animal pathogen, was isolated from the cerebrospinal fluid. The patient made a complete recovery after antibiotic therapy. The relevant literature is reviewed.

Minton EJ

1990-02-01

 
 
 
 
201

Pneumocephalus associated with Bacteroides fragilis meningitis  

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Full Text Available Gas within the intracranial cavity (pneumocephalus) commonly results from trauma or after surgery and rarely from infection by gas-forming organisms. The presence of pneumocephalus in the absence of injury or surgery should raise the suspicion of anaerobic infection of the central nervous system. I present a case of pneumocephalus associated with Bacteroides fragilis meningitis where the diagnosis was suspected after CT findings become available. Bacteroides fragilis meningitis is rare and often occurs in premature infants and neonates; only few cases are reported in adults. Pneumocephalus associated with Bacteroides fragilis meningitis is not described in the literature. This case also illustrates the absence of classic findings of meningeal irritation in the elderly. The literature is reviewed.

Parmar Malvinder

2004-01-01

202

Spontaneous pneumocephalus caused by pneumococcal meningitis.  

UK PubMed Central (United Kingdom)

Pneumocephalus is a condition characterized by the presence of air in the cranium, and it is mainly caused by trauma or a neurosurgical procedure. In the absence of head trauma or a neurosurgical procedure, meningitis is an extremely rare cause of pneumocephalus. Here, the authors present a rare case of spontaneous pneumocephalus caused by pneumococcal meningitis, in which simple lateral radiography and computed tomography (CT) findings of the skull suggested the diagnosis. Cerebrospinal fluid analysis showed bacterial meningitis which later revealed streptococcus pneumonia. The patient was treated with antibiotics and responded remarkably well. Repeat CT performed after 2 weeks of treatment showed complete resolution of the intracranial gas. Here, the authors report an unusual case of a pneumocephalus caused by meningitis in the absence of head trauma or a neurosurgical procedure.

Kim HS; Kim SW; Kim SH

2013-04-01

203

Cryptococcal meningitis among HIV infected patients  

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Full Text Available Cryptococcal meningitis is an emerging opportunistic infection among HIV infected patients and an important cause of mortality among these patients. The incidence of cryptococcal meningitis varies from place to place. A total of 31 specimens of CSF out of 89 samples processed from known HIV positive cases yielded Cryptococcus neoformans during the period of 3 years. C.neoformans was the most common opportunistic pathogen isolated from CSF samples of these patients with an incidence of 34.8%

Manoharan G; Padmavathy B; Vasanthi S; Gopalte R

2001-01-01

204

Cryptococcal meningitis in acute lymphoblastic leukemia.  

UK PubMed Central (United Kingdom)

The occurrence of cryptococcal meningitis in acute lymphoblastic leukemia (ALL), despite being immunosuppresed state is uncommon. We report a 28-year gentleman in the maintenance treatment phase of ALL developing cryptococcal meningitis. The diagnosis was made by positive India ink staining and detection of cryptola antigen by latex agglutination. The patient was successfully treated with amphotericin B. The rarity of this condition in ALL is briefly discussed.

Malhotra P; Chauhan S; Bhatt P; Varma N; Chakrabarti A; Kumari S; Jain S; Varma S

2004-10-01

205

Carcinomatous meningitis mimicking Creutzfeldt-Jakob disease  

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Full Text Available We report a case of carcinomatous meningitis diagnosed at autopsy that was clinically diagnosed as a case of Creutzfeldt-Jakob disease (CJD) because of rapidly evolving dementia. Pathological study revealed diffusely spreading carcinomatous meningitis, infiltrating into cortex along Virchow Robin space. Immunostaining for Prion protein was negative. Despite advances in clinical diagnosis, tissue diagnosis remains a pre-requisite for confirmation of CJD.

Vas C; Mallya M; Desai M; Mahadevan A; Nadkarni N; Shankar S

2004-01-01

206

Urinoma and arterial hypertension complicating neonatal renal candidiasis  

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During antibiotic treatment for E.coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abcess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal.

Sirinelli, D.; Schmit, P.; Biriotti, V.; Bensman, A.; Lupold, M.

1987-02-01

207

Neisseria sicca meningitis following intracranial hemorrhage and ventriculostomy tube placement.  

UK PubMed Central (United Kingdom)

A normal component of the flora of the oropharynx, Neisseria sicca was first isolated in 1906 and has since been reported as a rare cause of various human infections including endocarditis, pneumonia, sinusitis, sepsis, and urethritis. We report the case of a 44-year-old African-American female with a history of hypertension who presented with complaints of right frontal headache, nausea, photophobia, and vomiting. A computed tomography scan of the patient's brain showed a large subarachnoid hemorrhage, and an arteriogram confirmed a large posterior communicating artery aneurysm. A ventriculostomy tube was placed, and the patient subsequently developed an elevated temperature and elevated white blood cell count. Cerebrospinal fluid studies showed elevated protein and glucose levels and cultures positive for N. sicca. This is only the seventh reported case of culture-proven meningitis related to N. sicca, and the first reported case associated with intracranial hemorrhage and ventriculostomy tube placement.

Carter JE; Mizell KN; Evans TN

2007-12-01

208

Neisseria sicca meningitis following intracranial hemorrhage and ventriculostomy tube placement.  

Science.gov (United States)

A normal component of the flora of the oropharynx, Neisseria sicca was first isolated in 1906 and has since been reported as a rare cause of various human infections including endocarditis, pneumonia, sinusitis, sepsis, and urethritis. We report the case of a 44-year-old African-American female with a history of hypertension who presented with complaints of right frontal headache, nausea, photophobia, and vomiting. A computed tomography scan of the patient's brain showed a large subarachnoid hemorrhage, and an arteriogram confirmed a large posterior communicating artery aneurysm. A ventriculostomy tube was placed, and the patient subsequently developed an elevated temperature and elevated white blood cell count. Cerebrospinal fluid studies showed elevated protein and glucose levels and cultures positive for N. sicca. This is only the seventh reported case of culture-proven meningitis related to N. sicca, and the first reported case associated with intracranial hemorrhage and ventriculostomy tube placement. PMID:17904282

Carter, J Elliot; Mizell, Kelly N; Evans, Tara N

2007-09-27

209

Acute Urinary Retention due to Aseptic Meningitis: Meningitis-Retention Syndrome  

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Acute urinary retention in aseptic meningitis is rarely encountered, and the diagnosis of aseptic meningitis may be less than straightforward, because its symptoms and neurological signs are occasionally mild or absent. We report a case in which acute urinary retention provided an appropriate indica...

Kim, Tae-Wan; Whang, Jin-Chul; Lee, Soo-Hyeong; Choi, Jong-In; Park, Sang-Myung; Lee, Jong-Bouk

210

Syphilitic meningitis in HIV-patients with meningeal syndrome: report of two cases and review  

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Full Text Available Few patients with symptomatic neurosyphilis present with signs and symptoms of acute meningitis. Here we report two cases of syphilitic meningitis diagnosed in HIV patients with meningeal syndrome. The first case, a 30-year-old black bisexual male, had concurrent meningeal and ocular syphilis with persistent unusually low CSF glucose levels. He responded well to 21 days of intravenous penicillin therapy. The second case was a 55-year-old female with epilepsy, depression, behavioral disorder and confusion. The diagnosis of HIV infection was made after onset of the syphilitic meningitis. She was treated with 21 days i.v. penicillin with improvement in her clinical condition. The clinical aspects of combined neurosyphilis and HIV infection, plus special features of diagnosis and treatment are discussed.

Carmo Ricardo Andrade; Moura Alexandre Sampaio; Christo Paulo Pereira; Morandi Ana Cláudia; Oliveira Marcelo Silva

2001-01-01

211

Syphilitic meningitis in HIV-patients with meningeal syndrome: report of two cases and review  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Few patients with symptomatic neurosyphilis present with signs and symptoms of acute meningitis. Here we report two cases of syphilitic meningitis diagnosed in HIV patients with meningeal syndrome. The first case, a 30-year-old black bisexual male, had concurrent meningeal and ocular syphilis with persistent unusually low CSF glucose levels. He responded well to 21 days of intravenous penicillin therapy. The second case was a 55-year-old female with epilepsy, depression, (more) behavioral disorder and confusion. The diagnosis of HIV infection was made after onset of the syphilitic meningitis. She was treated with 21 days i.v. penicillin with improvement in her clinical condition. The clinical aspects of combined neurosyphilis and HIV infection, plus special features of diagnosis and treatment are discussed.

Carmo, Ricardo Andrade; Moura, Alexandre Sampaio; Christo, Paulo Pereira; Morandi, Ana Cláudia; Oliveira, Marcelo Silva

2001-10-01

212

[Meningitis due to Listeria monocytogenes in adults].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Listeria monocytogenes is the third most common cause of community-acquired bacterial meningitis in adults. AIMS: To describe the characteristics of meningitis caused by Listeria (LM) in adults and to compare them with those of meningitis due to other causations (nLM). PATIENTS AND METHODS: A retrospective analysis of a series of hospital cases was conducted, including patients aged between ? 14 years diagnosed with LM in a referral hospital between 1982 and 2011. RESULTS: The study involves 16 cases of LM, 12.1% of the cases of community-acquired meningitis with an identified aetiology. Predisposing factors were age (mean of 65 versus 52 years; p = 0.019) and immunosuppression/comorbidity (62.5% versus 3.4%; p < 0.001), treatment with corticoids (37.5%) and chronic liver disease (25%) being the most frequent. The classical triads of acute bacterial meningitis, clinical features and analysis of the cerebrospinal fluid (CSF) were observed in 50 and 75% of the cases, respectively. Patients with LM presented lower leukocyte counts in CSF, a lower percentage of neutrophils, a greater frequency of lymphocytic pleocytosis and a lower frequency of Gram stain positive than those with nLM. The mortality rate was 12.5%, similar to that of patients with nLM. CONCLUSIONS: LM mainly affects patients who are immunosuppressed or with comorbidity, as well as elderly patients, although it may occur in the absence of risk factors. Clinically it does not differ from other causes of meningitis, but the initial CSF study may suggest it. Its mortality rate is similar to that of meningitis due to other aetiologies.

Laguna-Del Estal P; Lledó-Ibáñez GM; Ríos-Garcés R; Pintos-Pascual I

2013-01-01

213

Non-small cell lung carcinoma presenting as carcinomatous meningitis  

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Meningeal carcinomatosis is a diffuse infiltration of leptomeninges and sub arachnoid space by malignant cells metastasizing from systemic cancer. Primary bronchogenic carcinoma presenting as carcinomatous meningitis is a very rare occurrence in clinical practice, often occurring during the treatmen...

Paramez, A. R.; Dixit, Ramakant; Gupta, Neeraj; Gupta, Rakesh; Arya, Manoj

214

TRANSETHMOIDAL MENINGOCELE AND RECURRENT MENINGITIS. CASE REPORT  

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Full Text Available Introduction: Transethmoidal meningoceles are rare. The diagnosis is usually delayed and often made by the presence of recurrent meningitis.Case report: A 10-year boy with history of recurrent pneumococcal meningitis. Nasal endoscopy: mass in the right nostril between middle turbinate and septum. CT: soft tissue density lesion with disruption of the cortex adjacent to the "crista gali". MRI: cystic component injury with pedicle in anterior cranial fossa. Right frontal craniotomy was performed, removing meningocele with exit point on the cribriform plate,posterior dural closure, bone itself and scalp. Pathologic Study: fibrovascular tissue as an aspect membranes and glial tissue. Discussion: Intranasal meningocele is a rare malformation characterized by herniation of the meninges into the nasal cavity through a defect in the cribriform plate, due to a congenital abnormality, but also secondary to trauma or chronic intracranial hypertension. More common in certain geographic areas, especially in Southeast Asia. Usually cause nasal obstruction with or without recurrent meningitis. Differential diagnosis must be made with dermoid cyst, hemangioma, glioma and nasal polyp. CT and MRI are essential in the diagnosis and should precede the biopsy. The treatment is surgical or endoscopic nasal intracranial approach. Conclusions: In the presence of recurrent acute meningitis, it is necessary to rule out occult malformations of the skull base.

A.I. Navazo Eguía; F. García Vicario; E. Suárez Muñiz; J.M. Castilla Diez

2010-01-01

215

Cryptococcal meningitis: Clinical, diagnostic and therapeutic overviews  

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Full Text Available Cryptococcal meningitis has emerged as a leading cause of infectious morbidity and mortality in patients with AIDS. Among the human immunodeficiency virus (HIV)-seropositive subjects, cryptococcal meningitis is the second most common cause of opportunistic neuro-infection. Current trends are changing due to the marked improvement of quality and length of life produced by highly active antiretroviral therapy (HAART). The introduction of generic HAART in India has resulted in an increase in the number of individuals getting treatment for HIV infection, as the cost of highly active antiretroviral therapy (HAART) has decreased 20- fold. Cryptococcal meningitis occurs in non-HIV patients who are immunodeficient due to diabetes, cancer, solid organ transplants, chemotherapeutic drugs, hematological malignancies etc and rarely in healthy individuals with no obvious predisposing factors. Diagnosis of cryptococcal meningitis is fairly straightforward once the diagnosis is considered in the differential diagnosis of chronic meningitis. Treatment of a patient with cryptococcal infection is a challenge for both the physician and the patient, but rewarding, as many would recover with timely and adequate antifungal therapy.

Satishchandra P; Mathew T; Gadre G; Nagarathna S; Chandramukhi A; Mahadevan A; Shankar S

2007-01-01

216

Meningitis in children: Analysis of 92 cases  

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Full Text Available Objective: In this study, we aimed to evaluate cases ofmeningitis for epidemiologic, clinical, laboratory findingsand the treatment response.Materials and methods: We evaluated ninety two patientswhose diagnosis were meningitis retrospectivelybetween January 2010 and December 2011, for age, gender,presenting symptoms, physical examination, laboratoryfindings and treatments. The patients who were hospitalizedwith central nervous system infection were diagnosedas meningitis by examination of cerebrospinal fluid(CSF) under a microscope and evaluation of biochemical(glucose, protein, chloride) results and / or culture.Results: Fifty patients were male and 42 were female,mean age was 4.2 ± 4.1 years. The most common symptomswere fever (91.3%), vomiting (87.0%), headache(68.5%), and convulsion (20.7%). On physical examinationin descending order neck stiffness (60.9%), Brudzinskiphenomenon (50%), Kernig sign (46.7%), alteredconsciousness (16.3%) and rash (2.2%) were detected.When patients were classified in terms of clinical andlaboratory findings; bacterial meningitis was determined53.4%, aseptic in 38% and tuberculous meningitis in7,6%. CSF and blood culture were positive in 13 of andseven of the cases respectively. The most frequent complicationswere seizures, cranial nerve palsy, hydrocephalusand the syndrome of inappropriate ADH. Mortalityrate was determined as 2.2%.Conclusion: The patients especially with symptoms offever, vomiting, headache and convulsions, meningitisshould be considered primary disease.Key words: Child, meningitis, clinical signs, treatment

Mahmut Abuhandan; Mustafa Çal?k; Ye?im Oymak; Veysi Almaz; Cemil Kaya; Erdal Eren; Ak?n ??can

2013-01-01

217

Leukemic meningitis involving the cauda equina: a case report  

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The CNS involvement by leukemia may either be meningeal or parenchymal, although meningeal infiltration of leukemic cells, known as leukemic meningitis is more common. We report a case of leukemic meningitis involving the cauda equina in a patient with an acute lymphoblastic crisis which transformed from the chronic phase of chronic myeloid leukemia. An MR image revealed diffuse enlargement and peripheral ring enhancement of the nerve roots of the cauda equina.

Lee, Dong Hyun; Kim, Ho Kyun; Lee, Young Hwan [School of Medicine, Catholic University of Daegu, Daegu (Korea, Republic of)

2008-07-15

218

A Case of Meningitis Caused By Pneumococcus Serotype 20  

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Full Text Available Streptococcus pneumoniae is the major bacterium of morbidity and mortality in children. The risk of development of meningitis can increase in periorbital cellulitis. Bacteremia secondary to infection of the periorbital tissue may result in meningeal seeding. Alternatively, concomitant seeding to both meninges and periorbital tissue during a bacteremic episode can occur. We report a case with meningitis caused by pneumococcus serotype 20, a rare etiology, during the course of periorbital cellulitis after head trauma.

Emrah Can; Melike Keser; Nevin Hatipo?lu; Ayper Somer; Nuran Salman; I??k Yalç?n; Nezahat Gürler

2009-01-01

219

Acute bacterial meningitis: current review and treatment update.  

UK PubMed Central (United Kingdom)

Bacterial meningitis is an infection of the meninges that can be infected by bacteria, virus, or fungus. The classic triad of bacterial meningitis consists of fever, neck stiffness, and altered mental status; headache is also another common symptom. Interventions for bacterial meningitis include prompt diagnosis, and initiation of antimicrobial therapy to optimize bacterial kill and decrease inflammatory response in the subarachnoid space. Nursing management consists of effective delivery of antibiotic therapy, fluid management, and supportive care.

VanDemark M

2013-09-01

220

Tuberculous meningitis in a 3 month old infanta case report  

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Full Text Available Tuberculosis especially tuberculous meningitis rarely accurs before 3 months of age. Though treatable, it may be fatal despite modern treatment. The diagnosis of congenital TB/TB meningitis should be considered in any neonate/infant with pneumonia –meningitis who fails to respond to conventional treatment, particularly in a child from ethnic or socioeconomic environment where tuberculosis is prevalent.

M.J. Saffar; V. Ghafari Saravi

2006-01-01

 
 
 
 
221

Meningitis Due to Gemella haemolysans in a Pediatric Case?  

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Gemella haemolysans is a rare pathogen in cases of bacterial meningitis. We present a case of meningitis due to G. haemolysans in a 17-month-old boy. This is the first reported case of Gemella meningitis in a child. The patient completely recovered following intravenous therapy with linezolid and ch...

Anil, Murat; Ozkalay, Nisel; Helvaci, Mehmet; Agus, Neval; Guler, Ozlem; Dikerler, Aysu; Kanar, Berat

222

Use of radiologic modalities in coccidioidal meningitis  

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The diagnostic utility of pentetate indium trisodium CSF studies, technetium Tc 99m brain scans, and computerized tomographic (CT) scans was evaluated in eight patients in whom coccidioidal meningitis developed following a dust storm in the Central Valley of California. The 111In flow studies and the CT scans demonstrated hydrocephalus in five patients with clinical findings suggesting this complication. Ventriculitis has not previously been diagnosed before death in patients with coccidioidal meningitis; however, it was demonstrated in two patients by the technetium Tc 99m brain scan. The finding that communicating hydrocephalus occurs early in meningitis and interferes with CSF flow into infected basilar regions has important therapeutic implications in that antifungal agents injected into the lumbar subarachnoid space may not reach these regions.

Stadalnik, R.C.; Goldstein, E.; Hoeprich, P.D.; McGahan, J.P.

1981-01-01

223

Use of radiologic modalities in coccidioidal meningitis  

International Nuclear Information System (INIS)

[en] The diagnostic utility of pentetate indium trisodium CSF studies, technetium Tc 99m brain scans, and computerized tomographic (CT) scans was evaluated in eight patients in whom coccidioidal meningitis developed following a dust storm in the Central Valley of California. The 111In flow studies and the CT scans demonstrated hydrocephalus in five patients with clinical findings suggesting this complication. Ventriculitis has not previously been diagnosed before death in patients with coccidioidal meningitis; however, it was demonstrated in two patients by the technetium Tc 99m brain scan. The finding that communicating hydrocephalus occurs early in meningitis and interferes with CSF flow into infected basilar regions has important therapeutic implications in that antifungal agents injected into the lumbar subarachnoid space may not reach these regions

1981-01-01

224

Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa  

International Nuclear Information System (INIS)

The etiology of arteriovenous meningeal fistulas (AVMFs) of the posterior fossa often remains unclear. Analyses of three personal cases, however, suggest a change in venous hemodynamics due to a primary lesion, the cases being of sinus thrombosis, intracerebral abcess with oedema and arteriovenous malformation. It is suggested that increase of venous pressure in the posterior fossa leads to increased drainage and, consequently, to dilatation of infratentorial veins and of meningeal branches of the external carotid and vertebral artery. Clinical findings and anatomical facts underlying AVMF lesions tend to confirm the view that the concept of a congenital malformation decompensating with age cannot be upheld for all AVMFs, especially when located in the posterior fossa and when clinical symptoms arise in middle age. It is proposed that a pressure activated mechanism of growth results in widening of normally insignificantly small dural vessels. (orig.)

1983-01-01

225

Meningitis-retention syndrome as a presentation of west nile virus meningitis.  

UK PubMed Central (United Kingdom)

A 26-year-old previously healthy man presented with fever, urinary retention, nuchal rigidity, and hyperreflexia but with a clear sensorium. His initial spinal fluid results were consistent with aseptic meningitis from West Nile virus infection, and this was confirmed by serological studies on blood and cerebrospinal fluid. Computed tomography and magnetic resonance imaging studies were unremarkable. He received supportive care and urinary catheterization to prevent bladder injury from overdistension. He was discharged home without recurrence of urinary retention after five days of hospitalization. Therefore, this case report describes the first case of West Nile virus meningitis in a patient with the meningitis-retention syndrome.

Mankongpaisarnrung C; Laengvejkal P; Argueta E; Limsuwat C; Sutamtewagul G; Nugent K

2013-01-01

226

Meningitis-Retention Syndrome as a Presentation of West Nile Virus Meningitis  

Science.gov (United States)

A 26-year-old previously healthy man presented with fever, urinary retention, nuchal rigidity, and hyperreflexia but with a clear sensorium. His initial spinal fluid results were consistent with aseptic meningitis from West Nile virus infection, and this was confirmed by serological studies on blood and cerebrospinal fluid. Computed tomography and magnetic resonance imaging studies were unremarkable. He received supportive care and urinary catheterization to prevent bladder injury from overdistension. He was discharged home without recurrence of urinary retention after five days of hospitalization. Therefore, this case report describes the first case of West Nile virus meningitis in a patient with the meningitis-retention syndrome.

Laengvejkal, Pavis; Argueta, Erwin; Limsuwat, Chok; Nugent, Kenneth

2013-01-01

227

Differential diagnosis of scrub typhus meningitis from bacterial meningitis using clinical and laboratory features.  

UK PubMed Central (United Kingdom)

Background: Central nervous system (CNS) involvement in the form of meningitis or meningoencephalitis is common in scrub typhus. As specific laboratory methods remain inadequate or inaccessible in developing countries, prompt diagnosis is often difficult. Aim: To identify the clinical and laboratory parameters that may help in differentiating scrub typhus meningitis from bacterial meningitis. Setting and Design: This is a cross-sectional analysis of adult patients admitted with scrub typhus and bacterial meningitis to a tertiary care teaching institute in South India. Materials and Methods: A comparison of clinical and laboratory features of 25 patients admitted with meningitis to a university teaching hospital during a 15-month period was made. These patients had meningitis diagnosed based on abnormal cerebrospinal fluid (CSF) analysis with either positive IgM scrub typhus ELISA serology (n =16) or with CSF culture isolating bacteria known to cause bacterial meningitis (n =9). The clinical and laboratory features of the patients with scrub typhus meningitis and bacterial meningitis were compared. Results: The mean age was similar in the scrub typhus and bacterial meningitis groups (44.0 ± 18.5 years vs. 46.3 ± 23.0 years). Features at admission predictive of a diagnosis of scrub typhus meningitis were duration of fever at presentation >5 days (8.4 ± 3.5 days vs. 3.3 ± 4.2 days, P < 0.001), CSF white cell count of a lesser magnitude (83.2 ± 83.0 cells/cumm vs. 690.2 + 753.8 cells/cumm, P < 0.001), CSF lymphocyte proportion >50% (83.9 ± 12.5% vs. 24.8 ± 17.5% P < 0.001), and alanine aminotransferase (ALT) elevation more than 60 IU (112.5 ± 80.6 IU vs. 35 ± 21.4 IU, P =0.02). Conclusion: This study suggests that clinical features, including the duration of fever and laboratory parameters such as CSF pleocytosis, CSF lymphocyte proportion >50%, and ALT values are helpful in differentiating scrub typhus from bacterial meningitis.

Varghese GM; Mathew A; Kumar S; Abraham OC; Trowbridge P; Mathai E

2013-01-01

228

CSF Proteins as Discreminatory Markers of Tubercular and Pyogenic Meningitis.  

UK PubMed Central (United Kingdom)

Introduction: Meningitis is still a major cause of illness in many parts of the world. Though substantial improvement has been occurred in the diagnosis of meningitis, conclusive differentiation between tubercular and pyogenic meningitis remains to be an unsolved problem. Patients with meningitis often have severe neurological deficit or die inspite of antibiotic therapy. Thus, improvement in diagnostic test and therapy is required. The objective of the present study was to find a simple biochemical marker for diagnosis of meningitis and differentiation of tubercular and pyogenic meningitis. Materials and Methods: CSF samples were collected from 90 paediatric patients from Nilofer Hospital, Hyderabad, India, from age group of 4 months to 12 years. CSF samples were collected by performing Lumbar Puncture under aseptic conditions and with required precaution. CSF samples were divided into 3 groups where Group 1 included Control that was without CSF inflammation, Group 2 with Tuberculous Meningitis & Group 3 consisting of Pyogenic Meningitis with 30 samples in each group. Electrophoretic analysis of CSF proteins was performed which separated as bands of pre-albumin, albumin, alpha, beta and gamma globulins. Result: Protein content in CSF was 259 ± 409 mg/dl in tuberculous meningitis, whereas in pyogenic meningitis it was 111 ± 83.94 mg/dl and in control group was 19 ± 13.3 mg/dl. Electrophoretic analysis revealed pre-albumin band to be 2.8 ± 1.2 % in tuberculous meningitis, which was significantly decreased when compared with control and pyogenic meningitis. Albumin band in tuberculous meningitis was 34.8 ± 9.9 %, which was also significantly decreased when compared to control and pyogenic meningitis. Alpha band was 19.7 ± 6.9 % in pyogenic meningitis, but in control and tubeculous meningitis it was 10.4 ± 2.9% and 10.3 ± 5.2% respectively. Beta band was found similar in all the three groups. Gamma band was 33.2 ± 8.08% in tuberculous meningitis, 13.8 ± 4.55% in control and 16.7 ± 13.18% in pyogenic meningitis. Conclusion: Pre-albumin band was found to be decreased and gamma band was shown to be increased in tuberculous meningitis. Alpha band was increased in pyogenic meningitis. Thus, CSF protein fraction separated and quantitated by native Polyacrylamide slab gel electrophoresis, could be used as markers in differentiation of tubercular and pyogenic meningitis.

Shekhar R; Rao JR; Devi KA; Rao RB

2013-08-01

229

Percutaneous transluminal angioplasty in a patient with vasospasm secondary to coccidioidal meningitis: case report and review of the literature.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Coccidioidomycosis is secondary to infection with fungal species Coccidioides immitis or Coccidioides posadasii. One consequence of extrapulmonary coccidioidomycosis dissemination is meningitis, which is associated with high rates of morbidity and mortality if left untreated. Intracranial vasospasm, although rarely described, can occur and may be a result of vasculitic or subacute fibrotic changes. We describe a case of successful percutaneous transluminal angioplasty (PTA) in a patient with severe vasospasm related to coccidioidal meningitis. This is the first report of this endovascular treatment used to treat coccidioidal vasospasm. CLINICAL PRESENTATION: A patient with a history of pulmonary coccidioidomycosis presented with acute confusion, blurry vision and headache. Serology confirmed basilar meningitis and magnetic resonance angiography demonstrated severe symptomatic vasospasm. INTERVENTION: Emergent cerebral angiography confirmed severe vasospasm in the right middle cerebral artery and moderate vasospasm in the left middle cerebral artery. Successful PTA was performed under general anesthesia. The patient demonstrated postprocedural angiographic and clinical improvement. CONCLUSION: We report the first case of successful PTA performed to treat vasospasm related to coccidioidal meningitis. When vasospasm is clinically symptomatic, PTA is a safe and feasible procedure.

Hu YC; Newman CB; Bristol R; McDougall CG; Albuquerque FC

2011-03-01

230

Validación de una regla de predicción clínica para diferenciar meningitis bacteriana de meningitis aséptica/ Validation of a clinical prediction rule to distinguish bacterial from aseptic meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción. La mayoría de las meningitis en la infancia no son bacterianas, pero la dificultad en descartar tal etiología obliga con frecuencia a utilizar antibióticos inicialmente. El objetivo de este trabajo fue validar, en nuestro medio, una regla de predicción clínica para diferenciar la etiología de las meningitis en niños a su ingreso al hospital. Método. Estudio prospectivo que incluyó pacientes (more) s se obtuvo líquido cefalorraquídeo (LCR) para análisis directo, citoquímico y cultivo, y hemograma. Se calculó el BMS (Bacterial Meningitis Score: puntaje de meningitis bacteriana) descripto por Nigrovic (Pediatrics 2002; 110: 712): tinción de Gram en LCR positiva= 2 puntos; proteinorraquia ? 80 mg/dl, neutrófilos en sangre periférica ? 10 000/mm³, neutrófilos en LCR ? 1000/mm³, convulsiones, 1 punto cada uno. Se calculó sensibilidad (S), especificidad (E), valores predictivos positivo y negativo (VPP y VPN) y razones de verosimilitud positiva y negativa (RVP y RVN) del BMS para predecir meningitis bacteriana. Resultados. Se incluyeron 70 pacientes con meningitis (14 bacterianas). Veinticinco pacientes presentaron BMS= 0 puntos, 11 BMS= 1 punto y 34 BMS ? 2 puntos. Un BMS= 0 evidenció S: 100%, E: 44%, VPP: 31%, VPN: 100%, RVP: 1,81 RVN: 0 para predecir meningitis bacteriana. Un BMS ? 2 mostró S: 100%, E: 64%, VPP: 41%, VPN: 100%, RVP: 2,8 RVN: 0 para predecir meningitis bacteriana. Conclusión. La utilización del BMS fue simple y permitió identificar pacientes con bajo riesgo de meningitis bacteriana. Su empleo podría constituir una herramienta útil en la toma de decisiones clínicas. Abstract in english Introduction. Despite most meningitis are not bacterial, antibiotics are usually administered on admission because bacterial meningitis is difficult to be rule-out. Distinguishing bacterial from aseptic meningitis on admission could avoid inappropriate antibiotic use and hospitalization. We aimed to validate a clinical prediction rule to distinguish bacterial from aseptic meningitis in children, on arriving to the emergency room. Methods. This prospective study included p (more) atients aged

Agüero, Gonzalo; Davenport, María C.; Del Valle, María de la P.; Gallegos, Paulina; Kannemann, Ana L.; Bokser, Vivian; Ferrero, Fernando

2010-02-01

231

Meningeal involvement in Behcet's disease: MRI  

International Nuclear Information System (INIS)

Behcet's disease is a multisystem disease that involves the central nervous system up to half of cases. Presentation with neurologic symptoms occurs in 5 % of cases and cerebral venous thrombosis is one of its major manifestations. A feature not previously reported is progressive meningeal thickening with involvement of both optic nerves. We report a patient with cerebral venous thrombosis, meningeal thickening and contrast enhancement on MRI. This patient had two other unusual features: positive antineutrophil cytoplasmic antibodies and later development of central diabetes insipidus. (orig.)

1998-01-01

232

Tuberculosis meningitis presenting as isolated interhemispheric exudates  

International Nuclear Information System (INIS)

Full text: The total number of tuberculosis cases in the world is increasing, and less common forms of tuberculous meningitis (TBM) with varying imaging manifestations are being encountered more often. We describe anterior interhemispheric variety of TBM, which has not been previously described to the best of our knowledge in the literature. Common imaging findings in these five patients include predominant involvement of the meninges in the anterior interhemispheric fissure with relatively little enhancement of the basal cisterns. Knowledge of uncommon radiological findings is vital in early diagnosis and treatment of this common disease.

2008-01-01

233

CANDIDA ALBICANS MENINGITIS ASSOCIATED WITH INTRACRANIAL HEMORRHAGE  

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Full Text Available Invasive fungal infection is an uncommon, but increasing cause of morbidity and mortality in neonates and infants. Majority of the cases of central nervous system (CNS) candidiasis are associated with disseminated or invasive candidiasis. CNS candida infections may be caused by meningitis, microabscesses of the brain, vasculitis from fungal invasion of the vessel wall with thrombosis and secondary infarction and mycotic aneurysms with hemorrhage. In this article thirty one day old patient with candida meningitis complicated with subarachnoid hemorrhage and cerebral infarction, a very rare manifestation, is reported.

Nesrin Gülez; Ferah Genel; Füsun Atl?han; ?eref Targan

2007-01-01

234

Neurosonographic findings of bacterial meningitis in Infants  

International Nuclear Information System (INIS)

[en] 44 infants under 1 year were studied retrospectively during these illness and follow up after 1 week intervals. The spectrum of sonographic features of bacterial meningitis in acute stage included normal scan (20 patients), echogenic sulci (10 patients), echogenic lining of epandymas (8 patients), Abnormal parenchymal echogenecity (6 patients). On follow up examination with 1 week intervals, variety of complications was found in 14 patients (32%) of the infants. There were ventriculomegaly in 7 patients, extraaxial fluid collection in 4 patients, brain abscess in 2 patients and poor encephalic cyst in 1 patient. We conclude that ultrasound was an effective method for evaluation of progression and complications of bacterial meningitis

1989-01-01

235

Neurosonographic findings of bacterial meningitis in Infants  

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44 infants under 1 year were studied retrospectively during these illness and follow up after 1 week intervals. The spectrum of sonographic features of bacterial meningitis in acute stage included normal scan (20 patients), echogenic sulci (10 patients), echogenic lining of epandymas (8 patients), Abnormal parenchymal echogenecity (6 patients). On follow up examination with 1 week intervals, variety of complications was found in 14 patients (32%) of the infants. There were ventriculomegaly in 7 patients, extraaxial fluid collection in 4 patients, brain abscess in 2 patients and poor encephalic cyst in 1 patient. We conclude that ultrasound was an effective method for evaluation of progression and complications of bacterial meningitis.

Kim, Moon Chul; Lee, Sung Sik; Lee, Hong Kue; Lee, Soon Il [Sowa Children' s Hospital, Seoul (Korea, Republic of)

1989-02-15

236

Methods to clear meningitis causing agents using antibodies to peptides representing epitopic sites for bacterial and viral meningitis causing agents  

UK PubMed Central (United Kingdom)

Novel vaccines include polypeptides that comprise regions corresponding to a chemokine and a hapten. The hapten can be an amino acid sequence corresponding to the Meningitis Related Homologous Antigenic Sequences (MRHAS) of bacterial and viral agents known to cause meningitis. Protective immunity in a host susceptible to meningitis can be induced by inoculating the host with immunogenic amount of such a vaccine.

VAN ALSTYNE DIANE; SHARMA LAWRENCE R

237

Outbreak of echovirus 18 meningitis in a rural Missouri community.  

UK PubMed Central (United Kingdom)

This is a case-control study of viral meningitis outbreak in Perry County, Missouri. All case-patients had viral meningitis per routine CSF analysis or PCR testing. Enterovirus VP1-specific RT-PCR and sequencing was performed on CSF. Univariate and multivariable logistic regression analysis was done to evaluate risk factors. The meningitis attack rate was 1/1,000 population. The main risk factor for meningitis was association with childcare. In patients with signs of meningitis, but normal routine CSF analysis, molecular testing of the CSF is helpful for conclusive diagnosis.

Turabelidze G; Lin M; Butler C; Fick F; Russo T

2009-11-01

238

Radioactive bromide partition test in the diagnosis of tuberculous meningitis  

International Nuclear Information System (INIS)

[en] The utility of the radioactive bromide partition test in differentiating tuberculous meningitis (TBM) from other forms of meningitis has been assessed. The test was carried out in 19 patients with TBM, 6 patients with partially treated pyogenic meningitis and 17 non-meningitis controls. Eighteen of the 19 TBM patients gave bromide partition ratio (BPR) value below 1.3 while the value was above this level in all control patients including partially treated meningitis. The results indicate that the test is useful in the differential diagnosis of TBM. (author)

1983-01-01

239

[A case of meningitis complicated by brainstem infarction].  

Science.gov (United States)

A rare case of meningitis complicated by brainstem infarction is reported. A 64-year-old previously healthy female was admitted to our hospital because of a 1-week history of fever and headache. Cefdinir was orally administered for several days before admission. Analysis of cerebrospinal fluid (CSF) on admission showed a white blood cell (WBC) count of 9,013 cells/ micro/(97% polynuclear cells), a protein level of 212.8 mg/d/, and a glucose level of 3 mg/d/. CSF culture was negative for bacteria, including tubercle bacilli, and fungi. A brain computed tomography (CT) scan on admission showed acute hydrocephalus. Six hours after admission the patient developed tetraplegia. Diffusion-weighted magnetic resonance (MR) images on day 2 revealed elevated diffusion coefficients with high signal intensity in the pons and the medulla oblongata. MR angiography demonstrated a narrowing change of the cerebral arteries. Followup MR angiography two months after admission showed normalization of the cerebral arteries. The patient remained tetraplegic at eight months after admission. We speculated that brainstem infarction in our case might have been caused by vascultis or brain edema. PMID:19522288

Takeuchi, Satoru; Takasato, Yoshio; Masaoka, Hiroyuki; Hayakawa, Takanori; Otani, Naoki; Yoshino, Yoshikazu; Yatsushige, Hiroshi; Sugawara, Takashi; Aoyagi, Chikashi; Suzuki, Go

2009-06-01

240

[A case of meningitis complicated by brainstem infarction].  

UK PubMed Central (United Kingdom)

A rare case of meningitis complicated by brainstem infarction is reported. A 64-year-old previously healthy female was admitted to our hospital because of a 1-week history of fever and headache. Cefdinir was orally administered for several days before admission. Analysis of cerebrospinal fluid (CSF) on admission showed a white blood cell (WBC) count of 9,013 cells/ micro/(97% polynuclear cells), a protein level of 212.8 mg/d/, and a glucose level of 3 mg/d/. CSF culture was negative for bacteria, including tubercle bacilli, and fungi. A brain computed tomography (CT) scan on admission showed acute hydrocephalus. Six hours after admission the patient developed tetraplegia. Diffusion-weighted magnetic resonance (MR) images on day 2 revealed elevated diffusion coefficients with high signal intensity in the pons and the medulla oblongata. MR angiography demonstrated a narrowing change of the cerebral arteries. Followup MR angiography two months after admission showed normalization of the cerebral arteries. The patient remained tetraplegic at eight months after admission. We speculated that brainstem infarction in our case might have been caused by vascultis or brain edema.

Takeuchi S; Takasato Y; Masaoka H; Hayakawa T; Otani N; Yoshino Y; Yatsushige H; Sugawara T; Aoyagi C; Suzuki G

2009-06-01

 
 
 
 
241

C-REACTIVE PROTEIN IN BACTERIAL MENINGITIS: DOSE IT HELP TO DIFFERENTIATE BACTERIAL FROM VIRAL MENINGITIS?  

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Full Text Available Introduction. Central nervous system infections are among the most serious conditions in of medical practice. C-reactive Protein has recently been evaluated in terms of its ability to diffeccentiate bacterial from nonbacterial central nervous system inflammations. Methods. We studied the frequency of positive CRP in 61 patients who had signs of meningitis. All the specimens referred to one laboratory and were examined by Slide method. Results. Positive CRP was found in 97.6 percent of those who were finally diagnosed as bacterial meningitis. The frequency of CRP for other types of meningitis was 16.6 percent (P Discussion. In the absence of infection, CSF is free of CRP. Positive CRP may help to the differentiate the different types of meningitis.

A.R EMAMI NAEINI

2001-01-01

242

Meningitis tuberculosa. Un caso: complicaciones oftalmológicas Tuberculous meningitis. One case: ophthalmic complications  

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Full Text Available Caso clínico: Presentamos una mujer de 18 años afecta de meningitis tuberculosa con amaurosis bilateral y oftalmoplegia completa, además de pérdida de conciencia y parálisis de otros pares craneales. Discusión: La meningitis tuberculosa es una causa infrecuente de aracnoiditis basal con pronóstico infausto. Se valoran las posibles causas de la pérdida de agudeza visual y la afectación oculomotora , y se destaca la evolución favorable del caso sin secuelas.Case Report: An 18 year old female suffering from tuberculous meningitis with bilateral amaurosis, ophthalmoplegia, other cranial nerve palsies and loss of consciousness, is presented. Discussion: Tuberculous meningitis is a rare cause of basal arachnoiditis with a bad prognosis. Possible causes of visual acuity loss and ophthalmoplegia are discussed and a favourable outcome without sequelae is noteworthy in our case.

MJ Pérez Álvarez; M Moreno López

2004-01-01

243

Meningitis tuberculosa. Un caso: complicaciones oftalmológicas/ Tuberculous meningitis. One case: ophthalmic complications  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Caso clínico: Presentamos una mujer de 18 años afecta de meningitis tuberculosa con amaurosis bilateral y oftalmoplegia completa, además de pérdida de conciencia y parálisis de otros pares craneales. Discusión: La meningitis tuberculosa es una causa infrecuente de aracnoiditis basal con pronóstico infausto. Se valoran las posibles causas de la pérdida de agudeza visual y la afectación oculomotora , y se destaca la evolución favorable del caso sin secuelas. Abstract in english Case Report: An 18 year old female suffering from tuberculous meningitis with bilateral amaurosis, ophthalmoplegia, other cranial nerve palsies and loss of consciousness, is presented. Discussion: Tuberculous meningitis is a rare cause of basal arachnoiditis with a bad prognosis. Possible causes of visual acuity loss and ophthalmoplegia are discussed and a favourable outcome without sequelae is noteworthy in our case.

Pérez Álvarez, MJ; Moreno López, M

2004-11-01

244

Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department  

Science.gov (United States)

Neoplastic meningitis (NM) is diagnosed by the presence of malignant cells in the cerebrospinal fluid (CSF). We report 3 patients with NM, who were misdiagnosed with infectious meningitis in emergency department (ED). Case 1. A 68-year-old man visited our ED with a 3-month history of headache. With MRI and CSF study, he was diagnosed with tuberculous meningitis. After 20 days, repeated CSF cytology showed malignant cells. His diagnosis was lung cancer with NM. Case 2. A 57-year-old man visited regional hospital ED with a 3-week history of headache and diplopia. Brain MRI was not contributory. With CSF examination, his diagnosis was aseptic meningitis. With worsening headache, he was referred to our ED. Repeated CSF showed malignant cells. His diagnosis was stomach cancer with NM. Case 3. A 75-year-old man visited a regional hospital with headache lasting for 4 months. His diagnosis was sinusitis. Persistent symptom brought him back, and he developed recurrent generalized seizures. Brain MRI showed diffuse leptomeningeal enhancement suggesting meningitis, and he was transferred to our ED. CSF exam showed malignant cells. His diagnosis was NM with unknown primary focus. When evaluating the patients with headache in ED, NM should be kept in mind as a differential diagnosis of meningitis.

Lim, Kyung Soo

2013-01-01

245

Three cases of neoplastic meningitis initially diagnosed with infectious meningitis in emergency department.  

UK PubMed Central (United Kingdom)

Neoplastic meningitis (NM) is diagnosed by the presence of malignant cells in the cerebrospinal fluid (CSF). We report 3 patients with NM, who were misdiagnosed with infectious meningitis in emergency department (ED). Case 1. A 68-year-old man visited our ED with a 3-month history of headache. With MRI and CSF study, he was diagnosed with tuberculous meningitis. After 20 days, repeated CSF cytology showed malignant cells. His diagnosis was lung cancer with NM. Case 2. A 57-year-old man visited regional hospital ED with a 3-week history of headache and diplopia. Brain MRI was not contributory. With CSF examination, his diagnosis was aseptic meningitis. With worsening headache, he was referred to our ED. Repeated CSF showed malignant cells. His diagnosis was stomach cancer with NM. Case 3. A 75-year-old man visited a regional hospital with headache lasting for 4 months. His diagnosis was sinusitis. Persistent symptom brought him back, and he developed recurrent generalized seizures. Brain MRI showed diffuse leptomeningeal enhancement suggesting meningitis, and he was transferred to our ED. CSF exam showed malignant cells. His diagnosis was NM with unknown primary focus. When evaluating the patients with headache in ED, NM should be kept in mind as a differential diagnosis of meningitis.

Ahn S; Lim KS

2013-01-01

246

Meningitis from canine Pasteurella multocida following mastoidectomy.  

UK PubMed Central (United Kingdom)

A case of Pasteurella multocida meningitis, following a mastoidectomy is presented. The association of close contact with pets, many of which harbour Pasteurella multocida as part of their normal buccal flora. This case confirms the potential benefit of taking an ear swab prior to mastoid surgery and in seeking an appropriate 'pet' history.

Dammeijer PF; McCombe AW

1991-07-01

247

Streptococcus equi subsp. zooepidemicus meningitis in Peru.  

UK PubMed Central (United Kingdom)

A 59-year-old man with a history of fever, unsteadiness, hemiparesis, motor aphasia and consciousness disturbance was hospitalized for Streptococcus equi subsp. zooepidemicus meningitis. He denied contact with farm animals, but had a practice of consuming unpasteurized goats' cheese from an uncertain source.

Mori N; Guevara JM; Tilley DH; Briceno JA; Zunt JR; Montano SM

2013-02-01

248

Tuberculous meningitis in a Filipino maid.  

Science.gov (United States)

Tuberculous meningitis, while not uncommon in Taiwan, has not been reported among foreign workers. We report the first case of tuberculous meningitis in a 37-year-old Filipino maid in Taiwan, who presented with headache, fever and vomiting. She had been well before this episode and the small screening films of the chest radiograph obtained on her arrival in Taiwan 15 months previously, and every 6 months thereafter showed no evidence of tuberculosis. The suspicion of tuberculous meningitis was delayed until disturbance of consciousness manifested and a standard chest radiograph showed a diffuse miliary pattern in both lung fields. A cerebrospinal fluid sample that was sent for a polymerase chain reaction-based assay specific for Mycobacterium tuberculosis showed a positive result. The patient recovered with sequelae of mildly incoherent speech and urinary incontinence after antituberculous medication and short-course steroid treatment. Clinicians should be aware of the possibility of tuberculous meningitis in foreign workers with complaints of fever and headache. Because high-quality chest radiographs are a prerequisite for early detection of pulmonary tuberculosis, we recommended that standard posterior-anterior chest radiographs should be obtained as part of the routine health examination for foreign workers. PMID:10705697

Sheu, J J; Yuan, R Y; Lu, J J; Chung, C L; Hsu, C Y

1999-11-01

249

Tuberculous meningitis in a Filipino maid.  

UK PubMed Central (United Kingdom)

Tuberculous meningitis, while not uncommon in Taiwan, has not been reported among foreign workers. We report the first case of tuberculous meningitis in a 37-year-old Filipino maid in Taiwan, who presented with headache, fever and vomiting. She had been well before this episode and the small screening films of the chest radiograph obtained on her arrival in Taiwan 15 months previously, and every 6 months thereafter showed no evidence of tuberculosis. The suspicion of tuberculous meningitis was delayed until disturbance of consciousness manifested and a standard chest radiograph showed a diffuse miliary pattern in both lung fields. A cerebrospinal fluid sample that was sent for a polymerase chain reaction-based assay specific for Mycobacterium tuberculosis showed a positive result. The patient recovered with sequelae of mildly incoherent speech and urinary incontinence after antituberculous medication and short-course steroid treatment. Clinicians should be aware of the possibility of tuberculous meningitis in foreign workers with complaints of fever and headache. Because high-quality chest radiographs are a prerequisite for early detection of pulmonary tuberculosis, we recommended that standard posterior-anterior chest radiographs should be obtained as part of the routine health examination for foreign workers.

Sheu JJ; Yuan RY; Lu JJ; Chung CL; Hsu CY

1999-11-01

250

Cutaneous manifestations in acute meningococcal meningitis  

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Twenty three army recruits with acute meningococcal meningitis were admitted to a military hospital during February-March 1986. Of the 23 patients 11 developed cutaneous lesions, 3 had associated herpes simplex, 6 had arthritis/artharalgia and 3 got conjunctivitis. Maculopapular lesions were the com...

Chakrabarty N; Verma A; Singh G

251

Globicatella sanguinis meningitis associated with human carriage.  

Science.gov (United States)

Globicatella sanguinis is a rare cause of acute meningitis. We demonstrated human carriage of Globicatella by identifying cefotaxime-resistant strains in groin and rectal specimens 9 months after invasive infection. The pathogenic strain isolated from the cerebrospinal fluid and the carriage strains were accurately identified by sodA gene sequence analysis. PMID:20147641

Héry-Arnaud, Geneviève; Doloy, Alexandra; Ansart, Séverine; Le Lay, Geneviève; Le Flèche-Matéos, Anne; Seizeur, Romuald; Garré, Michel; Payan, Christopher; Bouvet, Anne

2010-02-10

252

Globicatella sanguinis Meningitis Associated with Human Carriage?  

Science.gov (United States)

Globicatella sanguinis is a rare cause of acute meningitis. We demonstrated human carriage of Globicatella by identifying cefotaxime-resistant strains in groin and rectal specimens 9 months after invasive infection. The pathogenic strain isolated from the cerebrospinal fluid and the carriage strains were accurately identified by sodA gene sequence analysis.

Hery-Arnaud, Genevieve; Doloy, Alexandra; Ansart, Severine; Le Lay, Genevieve; Le Fleche-Mateos, Anne; Seizeur, Romuald; Garre, Michel; Payan, Christopher; Bouvet, Anne

2010-01-01

253

Globicatella sanguinis meningitis associated with human carriage.  

UK PubMed Central (United Kingdom)

Globicatella sanguinis is a rare cause of acute meningitis. We demonstrated human carriage of Globicatella by identifying cefotaxime-resistant strains in groin and rectal specimens 9 months after invasive infection. The pathogenic strain isolated from the cerebrospinal fluid and the carriage strains were accurately identified by sodA gene sequence analysis.

Héry-Arnaud G; Doloy A; Ansart S; Le Lay G; Le Flèche-Matéos A; Seizeur R; Garré M; Payan C; Bouvet A

2010-04-01

254

Bilateral acute retinal necrosis after herpetic meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

Hirota K; Akimoto M; Katsura T

2012-01-01

255

Salmonella paratyphi B meningitis in an infant.  

UK PubMed Central (United Kingdom)

We report a case of Salmonella paratyphi B meningitis in a 90 day-old male infant who was admitted with complaints of fever, vomiting and one episode of vacant stare. Clinically, the infant was found to be toxic and dull with a bulging anterior fontanelle. Subsequently, blood and cerebrospinal fluid cultures demonstrated the presence of Salmonella Paratyphi B organism.

Mahalakshmi R; Rajeshbabu B; Mohan R; Balakumaran D; Venkataraman P; Ponnurangam Nagarajan V

2013-01-01

256

Clinical and MRI evaluation of tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Objective: To evaluate the relationship of clinical and magnetic resonance imaging (MRI) findings in patients with tuberculous meningitis (TBM), and to improve the understanding of TBM. Methods: The clinical and MRI findings in 42 patients with confirmed TBM were analyzed retrospectively. MRI examination was performed using a 1 Tesla system, including SE T1WI and T2WI. Intravenous contrast was injected in 29 patients, and follow-up scans were performed on 17 patients. Results: Of 24 patients with early TBM, MRI was abnormal in 5(21%) with slight Tl-hypointense meningeal (4) or ependymal thickening (1). MRI on 33/35 (94%) patients with late stage TBM was abnormal with T1 hypointensity and T2 hyperintensity including meningeal thickening (19), mild surrounding brain edema (10), nodules (11), tuberculoma (5) and abscess (2). There was significant plaque-like, nodular or rim enhancement with surrounding brain edema. Conclusion: Tuberculous meningitis has minimal clinical and MRI findings in the early phase and significant clinical and MRI findings in the late phase. The enhanced scan may help to detect the abnormality. (authors)

2010-01-01

257

Citrobacter koseri meningitis: another freediving risk?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We present a rare case of meningitis caused by Citrobacter koseri in an immunocompetent adult who had recently been freediving. Middle ear pressure changes from this recreational activity, and the subsequent inflammatory response, are likely to have provided this environmental organism access to the...

Pollara, G; Savy, L; Cropley, I; Hopkins, S

258

Post-traumatic meningitis in children  

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A retrospective survey over a 66-month period of children admitted with head injury who subsequently developed meningitis within the same period yielded six cases (five boys, one girl), giving an incidence of 0.38 per cent. Two of the six died, and four survived with no sequelae. Four cases occurred...

Lau, YL; Kenna, AP

259

Bacteremia causes hippocampal neural apoptosis in experimental pneumococcal meningitis  

DEFF Research Database (Denmark)

ABSTRACT: BACKGROUND: Bacteremia and systemic complications both play important roles in brain pathophysiological alterations and the outcome of pneumococcal meningitis. Their individual contributions to the development of brain damage, however, still remain to be defined. METHODS: Using an adult rat pneumococcal meningitis model, the impact of bacteremia accompanying meningitis on the development of hippocampal injury was studied. The study comprised of the three groups: I. Meningitis (n=11), II. meningitis with attenuated bacteremia resulting from iv injection of serotype-specific pneumococcal antibodies (n=14), and III. uninfected controls (n=6). RESULTS: Pneumococcal meningitis resulted in a significantly higher apoptosis score 0.22 (0.18-0.35) compared to uninfected controls (0.02 (0.00-0.02), Mann Whitney test, P=0.0003). Also, meningitis with an attenuation of bacteremia by antibody treatment resulted in significantly reduced apoptosis (0.08 (0.02-0.20), P=0.01) as compared to meningitis. CONCLUSIONS: Our results demonstrate that bacteremia accompanying meningitis plays an important role in the development of hippocampal injury in pneumococcal meningitis.

Ostergaard, Christian; Leib, Stephen L

2010-01-01

260

Effects of cervical sympathectomy on vasospasm induced by meningeal haemorrhage in rabbits  

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Full Text Available This study investigates the role of cervical sympathectomy in the prevention of acute vasospasm induced by meningeal haemorrhage in rabbits. Sixteen adult English Norfolk rabbits were divided into 2 experimental groups: bilateral cervical sympathectomy of the superior sympathetic ganglion (SSSG, n=8), and bilateral SSSG and sympathectomy of the inferior sympathetic ganglion (SISG, n=8). Other 24 animals were used as controls. Basilar artery diameter was evaluated by angiography. SSSG protected the animals against developing cerebral vasospasm; SSSG associated with SISG did not increase this effect.

Faleiros Antônio Tadeu de Souza; Maffei Francisco Humberto de Abreu; Resende Luiz Antonio de Lima

2006-01-01

 
 
 
 
261

The first case of Angiostrongylus cantonensis eosinophilic meningitis diagnosed in the city of Sao Paulo, Brazil.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Angiostrongylus cantonensis is a natural parasite found in lung arteries of rats, which in humans may cause eosinophilic meningitis. OBJECTIVE: To report the first case of eosinophilic meningitis caused by Angiostrongylus cantonensis in the city of São Paulo, Brazil. CASE REPORT: A male patient, 11 years old, living in the southern area of São Paulo, was admitted to the Pediatric Emergency Department with ongoing headaches for three days, but no fever or any other complaint. The presence of snails and rodents was reported in the peridomicile. The child was awake, lucid, oriented; muscular strength preserved, isochoric, photo reagent pupils and terminal nuchal rigidity - Glasgow Coma Scale (GCS) = 15. The laboratory tests showed a mild leukocytosis with 1736 eosinophils/mm3 and the CSF analysis disclosed 160 leukocytes/mm3 with 36% of eosinophils. The bacterial culture was negative. Computed Cerebral Tomography showed no alterations. The RT-PCR assay for detecting Angiostrongylus cantonensis larvae and DNA was negative. ELISA antibodies for IgG anti-A. cantonensis was negative in serum and undetermined in CSF and samples collected five days after the onset of symptoms. Seroconversion was observed in the sample collected 135 days later. Conclusion: the epidemiological and clinical data, the CSF alterations with eosinophilia and the seroconversion strongly suggest Angiostrongylus cantonensis eosinophilic meningitis.

Espírito-Santo MC; Pinto PL; Mota DJ; Gryschek RC

2013-03-01

262

An interesting case of eosinophilic meningitis.  

Science.gov (United States)

Angiostrongylus cantonensis is one of the causative agents of eosinophilic meningitis. Humans get infected when they ingest raw or partially cooked snails or monitor lizards (Varanus bengalensis). There is a popular belief that the tongue and the liver of the monitor lizard has aphrodisiac properties. A 20-year-old man was admitted to our hospital with a history of fever, headache and vomiting. His cerebrospinal fluid revealed eosinophilia. He gave a history of the ingestion of a monitor lizard, ten days prior to the onset of the symptoms. So, a diagnosis of eosinophilic meningitis due to Angiostrongylus cantonensis was made. He was treated with oral albendazole and prednisolone. His symptoms improved gradually within two weeks from his admission. PMID:23730662

Pai, Shivanand; Madi, Deepak; Achappa, Basavaprabhu; Mahalingam, Soundarya; Kendambadi, Rakshith

2013-04-01

263

An interesting case of eosinophilic meningitis.  

UK PubMed Central (United Kingdom)

Angiostrongylus cantonensis is one of the causative agents of eosinophilic meningitis. Humans get infected when they ingest raw or partially cooked snails or monitor lizards (Varanus bengalensis). There is a popular belief that the tongue and the liver of the monitor lizard has aphrodisiac properties. A 20-year-old man was admitted to our hospital with a history of fever, headache and vomiting. His cerebrospinal fluid revealed eosinophilia. He gave a history of the ingestion of a monitor lizard, ten days prior to the onset of the symptoms. So, a diagnosis of eosinophilic meningitis due to Angiostrongylus cantonensis was made. He was treated with oral albendazole and prednisolone. His symptoms improved gradually within two weeks from his admission.

Pai S; Madi D; Achappa B; Mahalingam S; Kendambadi R

2013-04-01

264

Optic nerve sheath fenestration in cryptococcal meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Tatyana Milman1, Neena Mirani1,2, Roger E Turbin11Ophthalmology Department, Institute of Ophthalmology and Visual Science, 2Pathology Department, University Hospital, New Jersey Medical School, Newark, NJ, USAAbstract: A patient with acquired immunodeficiency syndrome (AIDS) developed crytpococcal meningitis, complicated by papilledema and severe progressive visual loss despite medical therapy. Bilateral optic sheath fenestration resulted in significant improvement in vision and resolution of papilledema. Histopathologic evaluation of the optic nerve sheath demonstrated numerous cryptococci. Optic nerve sheath fenestration may be an effective treatment method when high intracranial pressure is contributing to visual loss, even in the presence of involvement of the optic nerve sheath by the fungus.Keywords: optic nerve sheath, cryptococcal, meningitis, fenestration

Tatyana Milman; Neena Mirani; Roger E Turbin

2008-01-01

265

[Duration of antibiotic therapy in bacterial meningitis].  

UK PubMed Central (United Kingdom)

The duration of antibiotic therapy in bacterial meningitis is a controversial issue. Antibiotic regimens have changed over time along with the criteria used to determine the ideal antibiotic therapy duration. The authors aim to make an historical overview on this matter and simultaneously add the evidence of recent studies, pointing out some issues in results interpretation, namely, their design and the associated demographic and epidemiological questions. Clinical assays on this subject, with statistically significant results, are quite recent. Most of the scientific knowledge has been acquired empirically through the times. The actual investigation paradigm, in what concerns to antibiotic therapy in bacterial meningitis, lays on the dichotomy: "short versus long duration regimens". Nevertheless, so far, the existing studies have not completely cleared this doubt. Thus, despite some evidence suggests that short duration antibiotic regimens are effective for some patients, in patients with severe disease presentations or with other morbidities its use may be questioned.

Pereira PR; Borges F; Mansinho K

2013-01-01

266

Infratentorial subdural empyemas mimicking pyogenic meningitis.  

UK PubMed Central (United Kingdom)

Infratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill-planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.

Gupta A; Karanth SS; Raja A

2013-04-01

267

Intracranial meningeal melanocytoma: CT and MRI  

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We report the MRI and CT findings of an intracranial meningeal melanocytoma (IMM) arising from Meckel`s cave and review the imaging characteristics of IMM. On CT, IMM constantly appear as well-circumscribed, isodense to slightly dense, extra-axial tumours with homogeneous contrast enhancement. This appearance is nonspecific and similar to that of meningiomas or small neuromas. On MRI, the signal of IMM is strongly related to the amount of melanin pigment: the more melanin, the more shortening of T1 and T2 relaxation times. Only when it shows as a homogeneous mass, bright on T1 and dark on T2 weighting, can a specific diagnosis of a melanin-containing tumour be made. However, this still cannot provide a distinction between IMM and malignant meningeal melanoma. (orig.) With 3 figs., 1 tab., 23 refs.

Chen, C.J.; Hsu, Y.I.; Wang, L.J.; Wong, Y.C. [Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Medical College, 199 Tung Hwa North Road, Taipei (Taiwan, Province of China); Ho, Y.S. [Department of Pathology, Chang Gung Memorial Hospital and Medical College, Taipei (Taiwan, Province of China); Hsu, Y.H. [Department of Neurosurgery, Chang Gung Memorial Hospital and Medical College, Taipei (Taiwan, Province of China)

1997-11-01

268

MRI of primary meningeal tumours in children  

Energy Technology Data Exchange (ETDEWEB)

Childhood meningeal tumours are uncommon and mostly meningiomas. We reviewed the histological and radiological findings in meningeal tumours in six children aged 12 years or less (four benign meningiomas, one malignant meningioma and one haemangiopericytoma). Compared to the adult counterpart, childhood meningiomas showed atypical features: cysts, haemorrhage, aggressiveness and unusual location. MRI features varied according to the site of the tumour, histology, haemorrhage, and presence of intra- or peritumoral cysts. Diagnosis of the extra-axial tumour was relatively easy in two patients with meningiomas, one malignant meningioma and one haemangiopericytoma. MRI findings strongly suggested an intra-axial tumour in two patients with benign meningiomas, because of severe adjacent edema. Awareness of the variable findings of childhood meningiomas and similar tumours may help in differentiation from brain tumours. (orig.)

Yoon, H.K.; Na, D.G.; Byun, H.S.; Han, B.K. [Dept. of Radiology, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Kim, S.S.; Kim, I.O. [Dept. of Radiology, Seoul National Univ. (Korea, Republic of); Shin, H.J. [Dept. of Neurosurgery, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

1999-07-01

269

Meningitis C vaccine (North American vaccine).  

Science.gov (United States)

North American Vaccine Inc (NAVI) has launched a conjugate polysaccharide vaccinefor the prevention of meningitis caused by group C meningococcal bacteria [433475]. The vaccine is based upon conjugate technology, incorporating the serogroup C polysaccharide (CPS) of all three major serogroups. Antibody-dependent, complement-mediated activity was demonstrated in mice and non-human primates, with no detectable adverse effects [277193]. Approval was filed for in the UK in January 2000 [353305]. In July 2000, Baxter received approval for NeisVac-C in the UK, and by September 2000 the vaccine was expected to be incorporated into the NHS's immunization campaign against meningitis C [381225]. NeisVac-C will initially appear labeled from NAVI; Baxter completed its acquisition of NAVI in June 2000 [375389]. Baxter estimates the worldwide global market for the vaccine at US $600 million per year [376204]. PMID:12054072

Lattanzi, Maria; Del Giudice, Giuseppe

2002-01-01

270

Meningitis C vaccine (North American vaccine).  

UK PubMed Central (United Kingdom)

North American Vaccine Inc (NAVI) has launched a conjugate polysaccharide vaccinefor the prevention of meningitis caused by group C meningococcal bacteria [433475]. The vaccine is based upon conjugate technology, incorporating the serogroup C polysaccharide (CPS) of all three major serogroups. Antibody-dependent, complement-mediated activity was demonstrated in mice and non-human primates, with no detectable adverse effects [277193]. Approval was filed for in the UK in January 2000 [353305]. In July 2000, Baxter received approval for NeisVac-C in the UK, and by September 2000 the vaccine was expected to be incorporated into the NHS's immunization campaign against meningitis C [381225]. NeisVac-C will initially appear labeled from NAVI; Baxter completed its acquisition of NAVI in June 2000 [375389]. Baxter estimates the worldwide global market for the vaccine at US $600 million per year [376204].

Lattanzi M; Del Giudice G

2002-01-01

271

An Interesting Case of Eosinophilic Meningitis  

Science.gov (United States)

Angiostrongylus cantonensis is one of the causative agents of eosinophilic meningitis. Humans get infected when they ingest raw or partially cooked snails or monitor lizards (Varanus bengalensis). There is a popular belief that the tongue and the liver of the monitor lizard has aphrodisiac properties. A 20-year-old man was admitted to our hospital with a history of fever, headache and vomiting. His cerebrospinal fluid revealed eosinophilia. He gave a history of the ingestion of a monitor lizard, ten days prior to the onset of the symptoms. So, a diagnosis of eosinophilic meningitis due to Angiostrongylus cantonensis was made. He was treated with oral albendazole and prednisolone. His symptoms improved gradually within two weeks from his admission.

Pai, Shivanand; Madi, Deepak; Achappa, Basavaprabhu; Mahalingam, Soundarya; Kendambadi, Rakshith

2013-01-01

272

Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstracts Background Meningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despi...

Owusu Michael; Nguah Samuel; Boaitey Yaw; Badu-Boateng Ernest; Abubakr Abdul-Raman; Lartey Robert; Adu-Sarkodie Yaw

273

CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII POSTOPERATIVE MENINGITIS  

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Full Text Available Acinetobacter baumannii is an opportunistic pathogen of increasing relevance in hospital infections during the last 15 years.This organism causes a wide range of infection .Extensive use of antibiotics within hospitals has contribute to the emergence of multidrug-resistent A.baumannii strains that exhibit resistance to a wide range of antibiotics ,including carbapenems.We report the case of an 37 years old man diagnosed with Acinetobacter multidrug-resistant post-neurosurgical meningitis with fatal outcome.

Laura Ghibu; Egidia Miftode; Olivia Dorneanu; Carmen Dorobat

2011-01-01

274

Cryptococcus neoformans causing meningitis in AIDS patients  

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Full Text Available Cryptococcus neoformans causes meningitis in AIDS patients. In the São José Hospital, reference center for patients with AIDS in Fortaleza - Ceará State - Brazil, 54 samples of the cerebrospinal fluid were analyzed from January 1st through December 31st 2000. Direct examination with India ink and culture in Sabouraud's agar at 37degreesC were done. Of the specimens studied 5(9.25%) were positive.

Menezes Everardo Albuquerque; Monteiro Maria Neuman Ricarte; Angelo Maria Rozelê F.; Santos Cintia Duarte; Freire Caio César Furtado; Cunha Francisco Afrânio

2002-01-01

275

Kleine-Levin syndrome in tubercular meningitis  

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Full Text Available Kleine Levin syndrome is a rare syndrome that involves hypersomnolence, megaphagia and psychiatric disturbances of unknown etiology and pathogenesis. A 16-year-old male with tuberculous meningitis developed hypersomnia and megaphagia with cranial magnetic resonance imaging (MRI) showing increased T2 hyperintensity in the cerebral peduncles and left occipital cortex. Antitubercular therapy led to the disappearance of clinical symptoms and MRI changes.

Thacker Anup; Aeron Anupam; Haider Jamal; Rao K

2007-01-01

276

Cutaneous manifestations in acute meningococcal meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Twenty three army recruits with acute meningococcal meningitis were admitted to a military hospital during February-March 1986. Of the 23 patients 11 developed cutaneous lesions, 3 had associated herpes simplex, 6 had arthritis/artharalgia and 3 got conjunctivitis. Maculopapular lesions were the commonest cutaneous manifestation although pinkish macules, purpura and cutaneous vasculitis were also seen. All the patients were treated with intravenous pencillin and other supportive measures.

Chakrabarty N; Verma A; Singh G

1991-01-01

277

Acinetobacter baumanii meningitis: a rare complication of incidental durotomy.  

UK PubMed Central (United Kingdom)

Despite the frequency of dural tears in spinal surgery, meningitis is a rare complication reported to occur with a frequency of 0.18%. To the best of our knowledge, no case of Acinetobacter baumanii meningitis has been reported in the literature after a dural tear secondary to lumbar spine discectomy. This case highlights the importance of repairing all dural tears and commencing antibiotics that cover uncommon bacteria in those who develop symptoms of meningitis in this setting.

deFreitas DJ; McCabe JP

2004-04-01

278

An unusual complication of Tuberculous Meningitis: Tuberculous Radiculomyelitis  

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Full Text Available Tuberculous radiculomyelitis (TBRM) is known to be a complication of tuberculous meningitis (TBM) and has been reported rarely in the literature. Subacute radiculomyelopathy progressing over 3 months due to spinal cord compression was the presenting symptom of tuberculous meningitis in our patient with no radiological evidence of spinal tuberculosis. The obstructive myelopathy was the result of proliferative granulomatous meningitis. Early suspicion and antituberculosis treatment with steroids may prevent irreversible neurological deficit in this unusual presentation of central nervous system tuberculosis.

Aysun UNAL; P. Nevin SUTLAS; Ummuhan ALTIN; Nurten COLAK; Dursun KIRBAS

2003-01-01

279

Chemical meningitis: A rare presentation of Rathke's cleft cyst.  

UK PubMed Central (United Kingdom)

Rathke's cleft cysts (RCC) are usually benign, sellar and/or suprasellar lesions originating from the remnants of Rathke's pouch. Rarely, RCC can present with chemical meningitis, sellar abscess, lymphocytic hypophysitis, or intracystic hemorrhage. We describe an unusual presentation of RCC in which the patient presented with a clinical picture of chemical meningitis consisting of meningeal irritation, inflammatory cerebrospinal fluid profile, and enhancing pituitary and hypothalamic lesions, in addition to involvement of the optic tracts and optic nerve.

Mrelashvili A; Braksick SA; Murphy LL; Morparia NP; Natt N; Kumar N

2013-10-01

280

Bacteroides fragilis concealed in an infant with Escherichia coli meningitis.  

UK PubMed Central (United Kingdom)

Anaerobic meningitis in infants is rare, therefore a high index of clinical suspicion is essential as routine methods for processing cerebrospinal fluid (CSF) do not detect anaerobes and specific antimicrobial therapy is required. We present an infant with Escherichia coli meningitis where treatment-resistance developed in association with culture negative purulent CSF. These features should have alerted us to the presence of anaerobes, prompting a search for the causes of polymicrobial meningitis in infants.

Ganeshalingham A; Buckley D; Shaw I; Freeman JT; Wilson F; Best E

2013-10-01

 
 
 
 
281

COMPOSITION AND METHODS OF TREATMENT OF BACTERIAL MENINGITIS  

UK PubMed Central (United Kingdom)

A diluted solution of ceftiofur sodium is intrathecally or ventricularly delivered to effectively treat bacterial meningitis while maintaining the patient's threshold and reducing the likelihood of seizure.

BOYD ROBERT B

282

Gd-DTPA-enhanced MR imaging in meningitis  

International Nuclear Information System (INIS)

[en] Gd-DPTA-enhanced MR imaging was performed in 16 patients with meningitis (seven tuberculous, four bacterial, three fungal, and two viral) on a 2.0-T unit. Hemorrhagic infarcts of basal ganglia and localized enhancement of thickened dura adjacent were demonstrated on T1-weighted images in three patients with tuberculous meningitis and four with bacterial meningitis, respectively, that were not seen on CT. Enhanced T1-weighted images readily differentiated leptomeningeal enhancement from vessels in two cases with CT of equivocal meningeal enhancement. Nonenhanced T2-weighted images were most sensitive for demonstrating ischemia/infarct and edema. Otherwise, MR images generally matched CT scans

1988-12-02

283

FLAIR vascular hyperintensity preceding stroke in cryptococcal meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: Ischemic stroke is a common complication of cryptococcal meningitis. Fluid attenuated inversion recovery vascular hyperintensity (FVH) is a neuroimaging marker of sluggish blood flow usually seen in the setting of acute stroke. FVH have never been described in the setting of meningitis. METHODS: Case report. RESULTS: A 20-year-old man with cryptococcal meningitis and a magnetic resonance imaging demonstrating FVH had subsequent neurological deterioration and was found to have bilateral ischemic stroke. CONCLUSIONS: In conditions with high risk of stroke, such as meningitis, the presence of FVH should alert the clinician to the possibility of impending infarction.

Sanossian N; Shatzmiller RA; Djabiras C; Liebeskind DS

2013-01-01

284

Recurrent meningitis--a review of current literature.  

UK PubMed Central (United Kingdom)

The paper discusses epidemiology, aetiology and the most important predisposing factors associated with recurrent meningitis, as well as the possibilities to prevent this particularly challenging clinical problem. The frequency of recurrent meningitis is estimated to be 2-9%. However, the case fatality is lower compared to a single episode of meningitis. The main causes of recurrent meningitis are considered to be: head injury, congenital or acquired (post-traumatic or post-surgical) cranial or spinal defects, chronic intracranial inflammation, complement system dysfunction, as well as congenital and acquired humoral or cellular immunodeficiency.

Janocha-Litwin J; Simon K

2013-01-01

285

Etiology of bacterial meningitis in children in Tuzla Canton.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Bacterial meningitis is one of the most serious infectious diseases in childhood. AIM: To identify the most common causes of bacterial meningitis in children in Tuzla Canton. PATIENTS AND METHODS: This is a retrospective study which included 140 children, aged from 1 month to 14 years, treated at the Clinic for Infectious Diseases Tuzla, in the period 1999-2009, who had clinical and laboratory parameters of bacterial meningitis. RESULTS: In Tuzla Canton in ten year period were registered 140 cases of bacterial meningitis in children aged 1 month to 14 years. Prevalence was 1.53/1000. The average age of patients was 3.6 +/- 3.8 years. Male to female ratio was 1.3:1. April, May and November were the months with the most reported cases of bacterial meningitis (p = 0.02). Most affected were children 1-12 months of age (p < 0.001). The most common pathogens of bacterial meningitis were Haemophilus influenzae (13.6%), Neisseria meningitides (8.6%) and Streptococcus pneumoniae (5.7%) (p < 0.001). Mortality was 2.14%. CONCLUSION: Bacterial meningitis is present in Tuzla Canton, and three major pathogens are Haemophilus influenzae, Neisseria meningitis and Streptococcus pneumoniae. The most affected were children 1-12 months of age, and most cases of bacterial meningitis occurred in spring.

Porobic-Jahic H; Piljic D; Jahic R; Ahmetagic S; Numanovic F

2013-01-01

286

Septicemia and meningitis Septicemia y meningitis neonatales. 1981-1986. una etiología cambiante?  

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Full Text Available We reviewed the 20 cases of neonatal septicemia diagnosed at HospItal Infantil, Medellin, Colombia, between 1981 and 1986. Eleven were premature babies; in 12 septicemia had an early onset. In 5 the Infective agent was Klebsiella spp. and in another 5 It was a gram negative bacillus different from either Klebsiella or. Escherichia coli. Seven patients died, of whom 6 had been infected with gram negative bacilli. In 5 septicemia was complicated with meningitis, 4 of which occurred In cases with early onset. Relative Risk for death due to septicemia was greater among patients undergoing surgical procedures to correct congenital malformations and In those suffering from perinatal hypoxia. The risk for development of meningitis was greater among patients with early onset septicemia. We conclude that a change is taking place In the etiology of neonatal sepsis In than gram negative bacilli, different from Escherichia coli are now predominant. Se hizo una revisión de los casos de septicemia y meningitis neo natales diagnosticados en el Hospital Infantil de Medellín entre 1981 y 1986; se detectaron 20 casos de septicemia; once niños fueron prematuros; en 12 la enfermedad fue de comienzo precoz; en 5 el agente infectante fue Klebsíella spp. y en otros 5 un bacilo gram negativo diferente de ésta y de Escheríchía colí. Cinco niños sufrieron, además, meningitis; cuatro de los 5 casos de meningitis ocurrieron en niños con septicemia de comienzo precoz; fallecieron 7 pacientes, de los cuales 6 hablan estado Infectados con bacilos gram negativos. El Riesgo Relativo de sufrir meningitis fue mayor entre los casos de septicemia de comienzo precoz y el de fallecer '0 fue entre los Intervenidos para corregir malformaciones congénitas y los que hablan presentado hipos la perinatal. Se llama la atención hacia el cambio en la etiología de las septicemias neonatales atendidas en esta institución en el sentido del predominio de bacilos gram negativos diferentes de la Escheríchía colf.

Luis A. Perez; Ivonne Restrepo; Martha Valencia; Rafael J. Manotas Cabarcas

1988-01-01

287

Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis  

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Full Text Available Abstract Background Despite bacteraemia is present in the majority of patients with pneumococcal, little is known about the influence of the systemic infection on the meningeal inflammatory response. Methods To explore the role of systemic infection on the meningeal inflammation, experimental meningitis was induced by intracisternal injection of ~1 × 106 CFU Streptococcus pneumoniae, type 3, and the 26 rabbits were either provided with ~1 × 106 CFU S. pneumoniae intravenously at 0 hour ("bacteraemic" rabbits, n = 9), immunized with paraformaldehyde-killed S. pneumoniae for 5 weeks prior to the experiment ("immunized" rabbits", n = 8), or not treated further ("control" rabbits, n = 9). WBC and bacterial concentrations were determined in CSF and blood every second hour during a 16 hours study period together with CSF IL-8 and protein levels. We also studied CSF and blood WBC levels in 153 pneumococcal meningitis patients with and without presence of bacteraemia. Results As designed, blood bacterial concentrations were significantly different among three experimental groups during the 16 hours study period (Kruskal Wallis test, P P > 0.05). Blood WBC decreased in bacteraemic rabbits between ~10–16 hours after the bacterial inoculation in contrast to an increase for both the immunized rabbits and controls (P P In patients with pneumococcal meningitis, no significant difference in CSF WBC was observed between patients with or without bacteraemia at admission (n = 103, 1740 cells/?L (123–4032) vs. n = 50, 1961 cells/?L (673–5182), respectively, P = 0.18), but there was a significant correlation between CSF and blood WBC (n = 127, Spearman rho = 0.234, P = 0.008). Conclusion Our results suggest that a decrease in peripheral WBC induced by enhanced bacteraemia in pneumococcal meningitis results in an attenuated CSF pleocytosis.

?stergaard Christian; O'Reilly Terence; Brandt Christian; Frimodt-Møller Niels; Lundgren Jens D

2006-01-01

288

Meningitis Agudas en Córdoba,Colombia 2002 - 2004/ Acute meningitis in Córdoba, Colombia (2002-2004)  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo Establecer las características epidemiológicas y microbiológicas de las meningitis agudas del departamento de Córdoba. Métodos Se realizó un estudio descriptivo de vigilancia epidemiológica en el Hospital San Jerónimo de Montería. Se tomaron todos los casos de meningitis, presentados (junio 2002 - junio 2004), las pruebas de laboratorio incluyeron: citoquímico, prueba de látex, tinción de Gram y cultivo. Resultados Se analizaron 503 muestras de liquid (more) o cefalorraquídeo, confirmados por cultivo 57 (11,3 %) casos y 85 (16,8 %) casos probables. Se presentaron 63 aislamientos distribuidos así: 17 bacilos Gram negativos no fermentadores (26,9 %), 16 Streptococcus pneumoniae (25,4 %), 7 Enterobacterias (1 %), 5 Criptococcus neoformans (8 %), 4 Neisseria meningitidis serotipo B (6,3 %), 3 S. viridans (4,8 %), 2 Streptococcus grupo B (3,2 %), 2 Haemophilus influenzae tipo B (3,2 %), 2 S. aureus (3,2 %), 2 Staphylococcus coagulasa negativos (3,2 %), 2 Enterococcus (3,2 %) y 1 Candida albicans (1,6 %). Los serotipos de S. Pneumoniae fueron: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusión El estudio permitió determinar los aspectos epidemiológicos y microbiológicos hasta ahora desconocidos de las meningitis agudas en el departamento de Córdoba. Streptococcus pneumoniae (25,4%) fue el principal agente causal de meningitis, los aspectos epidemiológicos establecidos confirman la necesidad de fortalecer e implantar medidas para el control y vigilancia de las meningitis en Córdoba. Abstract in english (more) spinal fluid (CSF) were confirmed by culture as being probable cases. There were 6 cases of polymicrobial infection, making a total of 63 isolates: 17 non-fermenting Gram-negative bacilli (26,9 %), 16 Streptococcus pneumoniae (25,4 %), 7 Enterobacteriaceae (11 %), 5 Criptococcus neoformans (8 %) 4 Neisseria meningitidis serotype B (6,3 %), 3 S. viridans (4,8 %), 2 Streptococcus group B (3,2 %), 2 Haemophilus influenzae type B (3,2 %), 2 Staphylococcus negative coagulase (3,2 %), 2 S. aureus (3,2 %), 2 Enterococcus (3,2 %) and 1 Candida albicans (1,6 %). The S. Pneumoniae serotypes found were: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusions The study led to determining epidemiological and microbiological aspects of acute meningitis in the Córdoba department which had been unknown up to now. Streptococcus pneumoniae (25,4 %) was the main aetiological agent of meningitis; the epidemiologic aspects so established confirmed the need for strengthening and implementing measures for controlling meningitis in Córdoba and its surveillance there.

Tique, Vaneza; Alvis, Nelson; Parodi, Renata; Bustos, Alvaro; Mattar, Salim

2006-05-01

289

Spinal meningeal uptake of technetium-99m methylene diphosphonate in meningeal seeding by malignant lymphoma  

Energy Technology Data Exchange (ETDEWEB)

Definite diagnosis of meningeal seeding by systemic cancer relies on the presence of malignant cells in the cerebrospinal fluid (CSF). In the absence of such cells in the CSF, only two other tests strongly suggest the diagnosis - a CT scan and a myelogram. This paper reports a case in which the diagnosis was strongly suggested by an unusual uptake of Tc-99m methylene diphosphonate by the leptomeninges during a skeletal scan and later established by the presence of malignant cells in the CSF. The radionuclide scan may be an additional diagnostic test in some cases with meningeal seeding by systemic cancer.

Siegal, T.; Or, R.; Matzner, Y.; Samuels, L.D.

1980-12-01

290

Spinal meningeal uptake of technetium-99m methylene diphosphonate in meningeal seeding by malignant lymphoma  

International Nuclear Information System (INIS)

Definite diagnosis of meningeal seeding by systemic cancer relies on the presence of malignant cells in the cerebrospinal fluid (CSF). In the absence of such cells in the CSF, only two other tests strongly suggest the diagnosis - a CT scan and a myelogram. This paper reports a case in which the diagnosis was strongly suggested by an unusual uptake of Tc-99m methylene diphosphonate by the leptomeninges during a skeletal scan and later established by the presence of malignant cells in the CSF. The radionuclide scan may be an additional diagnostic test in some cases with meningeal seeding by systemic cancer

1980-12-01

291

Haemangioblastoma with multiple dural arterial supply. Case report  

Energy Technology Data Exchange (ETDEWEB)

A case of primary haemangioblastoma with a marked blood supply from multiple meningeal branches of the internal and external carotid arteries is reported, and the clinical implication of detailed angiographic study of unusual feeders in this highly vascular tumour is discussed.

Handa, J.; Nakazawa, T.; Watanabe, K.; Suzuki, F. (Shiga Univ., Otsu (Japan))

1984-01-01

292

The incidence of postoperative meningitis in neurosurgery: An institutional experience  

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Full Text Available Introduction : Meningitis is the most dreaded cause of morbidity and mortality in neurosurgical patients. The reported incidence of postoperative meningitis is quite varied 0.5-8%. Material and Methods : The study cohort included all the patients who underwent neurosurgery at the department of neurosurgery, National Institute of Mental Health and Neurological Sciences, Bangalore, India over a period of seven years (2001 - 2007). Patients with culture positive meningitis were included for analysis. The incidence of postoperative meningitis was analyzed depending on the type of surgery performed and the microbiological profile of the organisms, and their sensitivity pattern. Results : Of the 18,092 patients who underwent neurosurgical procedures during the study period, 415 patients developed infection. The overall incidence of meningitis was 2.2%. The incidence of meningitis was high (7.7%) in patients who had a pre-existing infection like post-pyogenic meningitis or tuberculosis hydrocephalus. The procedure mainly performed in this subgroup was shunt. The most common organisms causing meningitis were non-lactose fermenting Gram-negative bacillus followed by Pseudomonas and Klebsiella species. The methicillin-resistant Staphylococcus aureus strains were isolated in 2.6% of the patients. Ninety-one strains were multi-drug resistant, among which four strains were resistant to all antibiotics tested. The overall mortality in patients with meningitis was 5%. Conclusion : Meningitis remains one of the most dreaded complications of neurosurgical procedures and is common in patients with preexisting infection. Gram-negative organisms are the most common causative pathogens of postoperative meningitis.

Srinivas Dwarakanath; Veena Kumari H; Somanna Sampath; Bhagavatula Indiradevi; Anandappa Chandramouli

2011-01-01

293

Molecular studies of BKCa channels in intracranial arteries : presence and localization  

DEFF Research Database (Denmark)

  Large conductance calcium-activated potassium channels (BK(ca)) are crucial for the regulation of cerebral vascular basal tone and might be involved in cerebral vasodilation relevant to migraine and stroke. We studied the differential gene expression of mRNA transcript levels and protein expression of the BK(Ca) channel in rat basilar, middle cerebral, and middle meningeal arteries by reverse transcription polymerase chain reaction (RT-PCR), quantitative real-time PCR, and Western blotting. Distribution patterns were investigated using in situ hybridization and immunofluorescence studies. RT-PCR and quantitative real-time PCR detected the expression of the BK(Ca) channel mRNA transcript in rat basilar, middle cerebral, and middle meningeal arteries, with the transcript being expressed more abundantly in rat basilar arteries than in middle cerebral and middle meningeal arteries. Western blotting detected the BK(Ca) channel protein in rat basilar and middle cerebral arteries. In situ hybridization and immunofluorescence studies confirmed that the BK(Ca) channel mRNA and protein expression was localized to smooth muscle cells in all three intracranial arteries. The data thus suggest the presence and localization of both mRNA and protein expression of the BK(Ca) channel in the smooth muscle cell layer in rat basilar, middle cerebral, and middle meningeal arteries.

Wulf, Helle; Hay-Schmidt, Anders

2008-01-01

294

Pefloxacin treatment of meningitis caused by gram-negative bacteria.  

UK PubMed Central (United Kingdom)

Ten patients with acute meningitis caused by gram-negative bacteria were treated with pefloxacin intravenously for a mean period of 10 days. Eight patients responded clinically to pefloxacin treatment, and the causative organisms were eradicated from the cerebrospinal fluid in 9 of the 10 patients. Pefloxacin may offer a new, efficacious, and safe therapy for gram-negative meningitis.

Segev S; Barzilai A; Rosen N; Joseph G; Rubinstein E

1989-06-01

295

Extensive Spinal Cord Injury following Staphylococcus aureus Septicemia and Meningitis.  

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Bacterial meningitis is rarely complicated by spinal cord involvement in adults. We report a case of Staphylococcus aureus septicemia complicated by meningitis and extensive spinal cord injury, leading to ascending brain stem necrosis and death. This complication was investigated by magnetic resonan...

De Schryver, Nicolas; Cosnard, Guy; Van Pesch, Vincent; Godfraind, Catherine; Hantson, Philippe

296

Bacteriological Profile of Pyogenic Meningitis in Tertiary Care Hospital, Ahmedabad  

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Aims: Bacterial meningitis remains a major cause of mortality and long term neurological sequelae worldwide. The purpose of present study was to identify the pathogen in pyogenic meningitis and to determine its antibiotic susceptibility pattern. Material and Methods: Present study was undertaken fro...

Gaurav B Modi; Komal D Patel; Sumeeta T Soni; Kanu J Patel; Jayasukh D Mangukiya; Pooja S Jain

297

Cryptococcal meningitis in aids patients - A report of two cases  

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Full Text Available A fiftyfive year old gentleman with HIV infection was investigated for meningitis.Cryptococcus neoformans was isolated.Second case was a lady of 42 years, with HIV infection, was also investigated for meningitis. Cryptococcus neoformans was isolated. Antigen was detected in CSF as well as serum in both the cases.

Arora U; Aggarwal A

2001-01-01

298

Quantitative proteomics for identifying biomarkers for tuberculous meningitis  

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Full Text Available Abstract Introduction Tuberculous meningitis is a frequent extrapulmonary disease caused by Mycobacterium tuberculosis and is associated with high mortality rates and severe neurological sequelae. In an earlier study employing DNA microarrays, we had identified genes that were differentially expressed at the transcript level in human brain tissue from cases of tuberculous meningitis. In the current study, we used a quantitative proteomics approach to discover protein biomarkers for tuberculous meningitis. Methods To compare brain tissues from confirmed cased of tuberculous meningitis with uninfected brain tissue, we carried out quantitative protein expression profiling using iTRAQ labeling and LC-MS/MS analysis of SCX fractionated peptides on Agilent’s accurate mass QTOF mass spectrometer. Results and conclusions Through this approach, we identified both known and novel differentially regulated molecules. Those described previously included signal-regulatory protein alpha (SIRPA) and protein disulfide isomerase family A, member 6 (PDIA6), which have been shown to be overexpressed at the mRNA level in tuberculous meningitis. The novel overexpressed proteins identified in our study included amphiphysin (AMPH) and neurofascin (NFASC) while ferritin light chain (FTL) was found to be downregulated in TBM. We validated amphiphysin, neurofascin and ferritin light chain using immunohistochemistry which confirmed their differential expression in tuberculous meningitis. Overall, our data provides insights into the host response in tuberculous meningitis at the molecular level in addition to providing candidate diagnostic biomarkers for tuberculous meningitis.

Kumar Ghantasala S Sameer; Venugopal Abhilash K; Mahadevan Anita; Renuse Santosh; Harsha H C; Sahasrabuddhe Nandini A; Pawar Harsh; Sharma Rakesh; Kumar Praveen; Rajagopalan Sudha; Waddell Keith; Ramachandra Yarappa L; Satishchandra Parthasarathy; Chaerkady Raghothama; Prasad T S Keshava; Shankar K; Pandey Akhilesh

2012-01-01

299

Non-small cell lung carcinoma presenting as carcinomatous meningitis  

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Full Text Available Meningeal carcinomatosis is a diffuse infiltration of leptomeninges and sub arachnoid space by malignant cells metastasizing from systemic cancer. Primary bronchogenic carcinoma presenting as carcinomatous meningitis is a very rare occurrence in clinical practice, often occurring during the treatment course of the underlying malignancy. We present this rare presentation in a young non-smoker male.

Paramez A; Dixit Ramakant; Gupta Neeraj; Gupta Rakesh; Arya Manoj

2010-01-01

300

Purulent meningitis with unusual diffusion-weighted MRI findings  

Energy Technology Data Exchange (ETDEWEB)

We describe unusual findings obtained by diffusion-weighted magnetic resonance imaging (MRI) in a patient with acute purulent meningitis caused by penicillin-resistant Streptococcus pneumoniae. Along cerebral convexities and the Sylvian fissure, multiple small intense lesions showed high signal intensity in these sequences. This may be the first report of diffusion-weighted in purulent meningitis.

Abe, M.; Takayama, Y. E-mail: y-taka@fki.fitweb.or.jp; Yamashita, H.; Noguchi, M.; Sagoh, T

2002-10-01

 
 
 
 
301

Aseptic meningitis caused by human parvovirus B19.  

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Reports on aseptic meningitis caused by human parvovirus B19 are extremely rare. A case of aseptic meningitis is described in which human parvovirus B19 DNA was detected in the acute phase in cerebrospinal fluid by the polymerase chain reaction.

Okumura, A; Ichikawa, T

302

Meningitis admitted to a military hospital: a retrospective case series.  

UK PubMed Central (United Kingdom)

Meningitis is a common admission diagnosis. No case series or descriptive studies on meningitis have recently been published. Additionally, no recent data exist on meningitis in the U.S. Military Health System. We reviewed charts of adult patients admitted to Naval Medical Center San Diego between January 2004 and December 2008 with an admission diagnosis of meningitis. Charts were excluded if they did not meet our case definition of meningitis, if missing data, or if meningitis was nosocomial or iatrogenic. We reviewed results of cerebrospinal fluid cultures during this period. We compared rates and characteristics, and outcomes of bacterial and aseptic meningitis. Two hundred twenty-one cases met our criteria. Of these, 208 were aseptic. Cerebrospinal fluid polymerase chain reaction testing was positive for enteroviruses and herpes simplex viruses in 42 (20.2%) and 17 (8.2%) cases, respectively. Of culture/polymerase chain reaction/serologically positive cases, the pathogens were Neisseria meningitidis (3), Streptococcus pneumoniae (3), viridans streptococci (2), Cryptococcus neoformans (2), Coccidioides immitis (2), and Mycobacterium tuberculosis (1). Three patients had poor outcomes: one died from S. pneumoniae and two had long-term neurologic deficits. Meningitis is a common admission diagnosis, but serious virulent pathogens are uncommon and adverse outcomes are rare.

Harrell T; Hammes JS

2012-10-01

303

Meningitis admitted to a military hospital: a retrospective case series.  

Science.gov (United States)

Meningitis is a common admission diagnosis. No case series or descriptive studies on meningitis have recently been published. Additionally, no recent data exist on meningitis in the U.S. Military Health System. We reviewed charts of adult patients admitted to Naval Medical Center San Diego between January 2004 and December 2008 with an admission diagnosis of meningitis. Charts were excluded if they did not meet our case definition of meningitis, if missing data, or if meningitis was nosocomial or iatrogenic. We reviewed results of cerebrospinal fluid cultures during this period. We compared rates and characteristics, and outcomes of bacterial and aseptic meningitis. Two hundred twenty-one cases met our criteria. Of these, 208 were aseptic. Cerebrospinal fluid polymerase chain reaction testing was positive for enteroviruses and herpes simplex viruses in 42 (20.2%) and 17 (8.2%) cases, respectively. Of culture/polymerase chain reaction/serologically positive cases, the pathogens were Neisseria meningitidis (3), Streptococcus pneumoniae (3), viridans streptococci (2), Cryptococcus neoformans (2), Coccidioides immitis (2), and Mycobacterium tuberculosis (1). Three patients had poor outcomes: one died from S. pneumoniae and two had long-term neurologic deficits. Meningitis is a common admission diagnosis, but serious virulent pathogens are uncommon and adverse outcomes are rare. PMID:23113452

Harrell, Travis; Hammes, John S

2012-10-01

304

Fatal Cryptococcal Meningitis in a Patient With Chronic Lymphocytic Leukemia  

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Full Text Available Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache.

Oguzhan S?tk? Dizdar; Faruk Karakeçili; Belk?s Nihan Coskun; Beyza Ener; R?dvan Ali; Re?it M?st?k

2012-01-01

305

Recent experience of four patients with suppurative meningitis  

International Nuclear Information System (INIS)

[en] Four patients with suppurative meningitis, 2 by H. influenzae and 2 by H. parainfluenzae, are reported. Cranial CT showed subdural effusion, enhancement of the meninges, ventricular dilatation, and periventricular low density area. Follow-up CT was useful in deciding indications for operation, leading to better management. (Namekawa, K.)

1985-01-01

306

The incidence of postoperative meningitis in neurosurgery: An institutional experience  

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Introduction : Meningitis is the most dreaded cause of morbidity and mortality in neurosurgical patients. The reported incidence of postoperative meningitis is quite varied 0.5-8%. Material and Methods : The study cohort included all the patients who underwent neurosurgery at th...

Srinivas Dwarakanath; Veena Kumari H; Somanna Sampath; Bhagavatula Indiradevi; Anandappa Chandramouli

307

Salmonella typhimurium meningitis in an adult patient with AIDS  

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Salmonella meningitis is an unusual complication of Salmonella sepsis and occurs mainly in children. A rare case of Salmonella typhimurium meningitis occurring in an adult HIV positive man who presented with a history of fever and diarrhoea is reported. On examination he was dehydrated, and had oral...

Swe Swe, K.; Nagel, G.; Van der Westhuizen, M.; Hoosen, Anwar Ahmed

308

An autopsied case of tuberculous meningitis showing interesting CT findings  

International Nuclear Information System (INIS)

[en] A 61-year-old female patient died of a neurological disorder of unknown origin one month after the first visit and was found to have had tuberculous meningitis at autopsy. CT revealed a low density area showing an enlargement of the cerebral ventricle but did not reveal contrast enhancement in the basal cistern peculiar to tuberculous meningitis. (Namekawa, K.)

1983-01-01

309

Purulent meningitis with unusual diffusion-weighted MRI findings  

International Nuclear Information System (INIS)

[en] We describe unusual findings obtained by diffusion-weighted magnetic resonance imaging (MRI) in a patient with acute purulent meningitis caused by penicillin-resistant Streptococcus pneumoniae. Along cerebral convexities and the Sylvian fissure, multiple small intense lesions showed high signal intensity in these sequences. This may be the first report of diffusion-weighted in purulent meningitis

2002-01-01

310

Chemical meningitis in metrizamide myelography. A report of seven cases  

Energy Technology Data Exchange (ETDEWEB)

Seven patients with acute chemcial meningitis after metrizamide myelography are described. Five of the cases occurred within a time span of two months. Clinical and cerebrospinal fluid findings in the acute stage of the illness were similar to findings in acute bacterial meningitis. Possible causes of this complication are discussed. (orig.).

Sand, T.; Hesselberg, J.P.; Anda, S.; Dale, L.; Hellum, K.

1986-01-01

311

Sonographic Findings in Bacterial Meningitis in Neonates and Young Infants  

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Cranial sonography plays an important role in the initial evaluation of infants with suspected bacterial meningitis and in monitoring for complications of the disease. Echogenic widening of the brain sulci, meningeal thickening and hyperemia suggest the diagnosis in an at-risk population. Sonography...

Yikilmaz, Ali; Taylor, George Anthony

312

Meningitis in a College Student in Connecticut, 2007  

Science.gov (United States)

|The authors describe a case of aseptic meningitis in a college student that was ultimately attributed to infection with lymphocytic choriomeningitis virus (LCMV). The authors also provide a review of LCMV infection, epidemiology, and public health implications. Providers should be aware of LCMV as a cause of meningitis in college students,…

Sosa, Lynn E.; Gupta, Shaili; Juthani-Mehta, Manisha; Hadler, James L.

2009-01-01

313

Radioactive bromide partition test in early diagnosis of tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Use of the radioactive bromide partition test in the early diagnosis of tuberculous meningitis is described briefly. Results of the (1) normal control group, (2) tuberculous menigitis group and (3) non-tuberculous lymphocytic meningitis are reported. Dose rates administered are specified. (K.B.)

1979-01-01

314

Autopsied case of tuberculous meningitis showing interesting CT findings  

Energy Technology Data Exchange (ETDEWEB)

A 61-year-old female patient died of a neurological disorder of unknown origin one month after the first visit and was found to have had tuberculous meningitis at autopsy. CT revealed a low density area showing an enlargement of the cerebral ventricle but did not reveal contrast enhancement in the basal cistern peculiar to tuberculous meningitis.

Abiko, Takashi; Higuchi, Hiroshi; Imada, Ryuichi; Nagai, Kenichi (Iwate Prefectural Central Hospital (Japan))

1983-11-01

315

Meningitis Agudas en Córdoba,Colombia 2002 - 2004/ Acute meningitis in Córdoba, Colombia (2002-2004)  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo Establecer las características epidemiológicas y microbiológicas de las meningitis agudas del departamento de Córdoba. Métodos Se realizó un estudio descriptivo de vigilancia epidemiológica en el Hospital San Jerónimo de Montería. Se tomaron todos los casos de meningitis, presentados (junio 2002 - junio 2004), las pruebas de laboratorio incluyeron: citoquímico, prueba de látex, tinción de Gram y cultivo. Resultados Se analizaron 503 muestras de liquid (more) o cefalorraquídeo, confirmados por cultivo 57 (11,3 %) casos y 85 (16,8 %) casos probables. Se presentaron 63 aislamientos distribuidos así: 17 bacilos Gram negativos no fermentadores (26,9 %), 16 Streptococcus pneumoniae (25,4 %), 7 Enterobacterias (1 %), 5 Criptococcus neoformans (8 %), 4 Neisseria meningitidis serotipo B (6,3 %), 3 S. viridans (4,8 %), 2 Streptococcus grupo B (3,2 %), 2 Haemophilus influenzae tipo B (3,2 %), 2 S. aureus (3,2 %), 2 Staphylococcus coagulasa negativos (3,2 %), 2 Enterococcus (3,2 %) y 1 Candida albicans (1,6 %). Los serotipos de S. Pneumoniae fueron: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusión El estudio permitió determinar los aspectos epidemiológicos y microbiológicos hasta ahora desconocidos de las meningitis agudas en el departamento de Córdoba. Streptococcus pneumoniae (25,4%) fue el principal agente causal de meningitis, los aspectos epidemiológicos establecidos confirman la necesidad de fortalecer e implantar medidas para el control y vigilancia de las meningitis en Córdoba. Abstract in english OBJECTIVE: Establishing characteristic epidemiologic and microbiologic features of acute meningitis in the Córdoba department. Methodology A descriptive epidemiological study was carried out between June 2002 and June 2004 at the Hospital San Jerónimo in Montería. All suspicious cases of meningitis were included; laboratory tests included cytological smear, biochemistry, latex, Gram stain and culture. Results 57 (11,3 %) and 85 (16,8 %) of the 503 samples of cerebrum s (more) pinal fluid (CSF) were confirmed by culture as being probable cases. There were 6 cases of polymicrobial infection, making a total of 63 isolates: 17 non-fermenting Gram-negative bacilli (26,9 %), 16 Streptococcus pneumoniae (25,4 %), 7 Enterobacteriaceae (11 %), 5 Criptococcus neoformans (8 %) 4 Neisseria meningitidis serotype B (6,3 %), 3 S. viridans (4,8 %), 2 Streptococcus group B (3,2 %), 2 Haemophilus influenzae type B (3,2 %), 2 Staphylococcus negative coagulase (3,2 %), 2 S. aureus (3,2 %), 2 Enterococcus (3,2 %) and 1 Candida albicans (1,6 %). The S. Pneumoniae serotypes found were: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusions The study led to determining epidemiological and microbiological aspects of acute meningitis in the Córdoba department which had been unknown up to now. Streptococcus pneumoniae (25,4 %) was the main aetiological agent of meningitis; the epidemiologic aspects so established confirmed the need for strengthening and implementing measures for controlling meningitis in Córdoba and its surveillance there.

Tique, Vaneza; Alvis, Nelson; Parodi, Renata; Bustos, Alvaro; Mattar, Salim

2006-05-01

316

Meningitis Agudas en Córdoba,Colombia 2002 - 2004 Acute meningitis in Córdoba, Colombia (2002-2004)  

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Full Text Available Objetivo Establecer las características epidemiológicas y microbiológicas de las meningitis agudas del departamento de Córdoba. Métodos Se realizó un estudio descriptivo de vigilancia epidemiológica en el Hospital San Jerónimo de Montería. Se tomaron todos los casos de meningitis, presentados (junio 2002 - junio 2004), las pruebas de laboratorio incluyeron: citoquímico, prueba de látex, tinción de Gram y cultivo. Resultados Se analizaron 503 muestras de liquido cefalorraquídeo, confirmados por cultivo 57 (11,3 %) casos y 85 (16,8 %) casos probables. Se presentaron 63 aislamientos distribuidos así: 17 bacilos Gram negativos no fermentadores (26,9 %), 16 Streptococcus pneumoniae (25,4 %), 7 Enterobacterias (1 %), 5 Criptococcus neoformans (8 %), 4 Neisseria meningitidis serotipo B (6,3 %), 3 S. viridans (4,8 %), 2 Streptococcus grupo B (3,2 %), 2 Haemophilus influenzae tipo B (3,2 %), 2 S. aureus (3,2 %), 2 Staphylococcus coagulasa negativos (3,2 %), 2 Enterococcus (3,2 %) y 1 Candida albicans (1,6 %). Los serotipos de S. Pneumoniae fueron: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusión El estudio permitió determinar los aspectos epidemiológicos y microbiológicos hasta ahora desconocidos de las meningitis agudas en el departamento de Córdoba. Streptococcus pneumoniae (25,4%) fue el principal agente causal de meningitis, los aspectos epidemiológicos establecidos confirman la necesidad de fortalecer e implantar medidas para el control y vigilancia de las meningitis en Córdoba.meningitis in the Córdoba department. Methodology A descriptive epidemiological study was carried out between June 2002 and June 2004 at the Hospital San Jerónimo in Montería. All suspicious cases of meningitis were included; laboratory tests included cytological smear, biochemistry, latex, Gram stain and culture. Results 57 (11,3 %) and 85 (16,8 %) of the 503 samples of cerebrum spinal fluid (CSF) were confirmed by culture as being probable cases. There were 6 cases of polymicrobial infection, making a total of 63 isolates: 17 non-fermenting Gram-negative bacilli (26,9 %), 16 Streptococcus pneumoniae (25,4 %), 7 Enterobacteriaceae (11 %), 5 Criptococcus neoformans (8 %) 4 Neisseria meningitidis serotype B (6,3 %), 3 S. viridans (4,8 %), 2 Streptococcus group B (3,2 %), 2 Haemophilus influenzae type B (3,2 %), 2 Staphylococcus negative coagulase (3,2 %), 2 S. aureus (3,2 %), 2 Enterococcus (3,2 %) and 1 Candida albicans (1,6 %). The S. Pneumoniae serotypes found were: 5 (n=4), 23F (n=3), 14 (n=2), 18C (n=2), 18A (n=1), 17F (n=1), 1 (n=1). Conclusions The study led to determining epidemiological and microbiological aspects of acute meningitis in the Córdoba department which had been unknown up to now. Streptococcus pneumoniae (25,4 %) was the main aetiological agent of meningitis; the epidemiologic aspects so established confirmed the need for strengthening and implementing measures for controlling meningitis in Córdoba and its surveillance there.

Vaneza Tique; Nelson Alvis; Renata Parodi; Alvaro Bustos; Salim Mattar

2006-01-01

317

Prognostic factors related to sequelae in childhood bacterial meningitis: Data from a Greek meningitis registry  

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Full Text Available Abstract Background Bacterial meningitis (BM) is a life-threatening disease, often related with serious complications and sequelae. Infants and children who survive bacterial meningitis often suffer neurological and other sequelae. Methods A total of 2,477 patients aged 1 month to 14 years old hospitalized in a Children's Hospital in Greece diagnosed with acute bacterial meningitis were collected through a Meningitis Registry, from 1974 to 2005. Clinical, laboratory and other parameters (sex, age, pathogen, duration of symptoms before and after admission) were evaluated through univariate and multivariate analysis with regard to sequelae. Analysis of acute complications were also studied but not included in the final model. Results The rate of acute complications (arthritis and/or subdural effusion) was estimated at 6.8% (152 out of 2,251 patients, 95%CI 5.8-7.9) while the rate of sequelae (severe hearing loss, ventriculitis, hydrocephalus or seizure disorder) among survivors was estimated at 3.3% (73 out of 2,207 patients, 95%CI 2.6-4.2). Risk factors on admission associated with sequelae included seizures, absence of hemorrhagic rash, low CSF glucose, high CSF protein and the etiology of meningitis. A combination of significant prognostic factors including presence of seizures, low CSF glucose, high CSF protein, positive blood culture and absence of petechiae on admission presented an absolute risk of sequelae of 41.7% (95%CI 15.2-72.3). Conclusions A combination of prognostic factors of sequelae in childhood BM may be of value in selecting patients for more intensive therapy and in identifying possible candidates for new treatment strategies.

Vasilopoulou Vasiliki A; Karanika Maria; Theodoridou Kalliopi; Katsioulis Antonios T; Theodoridou Maria N; Hadjichristodoulou Christos S

2011-01-01

318

Controversies in neurology, Vienna, 2012: steroids in bacterial meningitis: no.  

UK PubMed Central (United Kingdom)

In acute bacterial meningitis long-term morbidity and mortality are still high, in particular, in low and middle income countries where meningococci are the most frequent causative agents of this disease. If at all, dexamethasone has been shown to be helpful in pneumococcal meningitis, i.e., in elderly Europeans and not in adolescent African, Asian or South American patients. Since deranged glucose, in particular, glucose variability and deranged coagulation homeostasis are known to be deleterious in patients with bacterial meningitis, dexamethasone--being capable to cause both--might add to morbidity and mortality. After more than 20 prospective trials evidence still lacks that dexamethasone improves outcome in the majority of patients. Dexamethasone only exerts a positive effect, if given prior to the first dose of antibiotic; therefore, the introduction of empiric antimicrobial chemotherapy into the emergency (= pre-hospital) management of patients with suspected bacterial meningitis, the discussion on dexamethasone in acute bacterial meningitis is rendered almost futile.

Pfausler B; Schmutzhard E

2013-02-01

319

Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis  

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Full Text Available Abstract Background Bacterial meningitis in children causes high rates of mortality and morbidity. In a recent clinical trial, oral glycerol significantly reduced severe neurological sequelae in paediatric meningitis caused by Haemophilus influenzae type b, and a tendency towards a benefit of adjunctive glycerol was seen in pneumococcal meningitis. Methods Here we examined the effects of glycerol in pneumococcal meningitis of infant rats and adult mice. All animals received ceftriaxone, and glycerol or placebo. Brain damage, hearing loss, and inflammatory parameters were assessed. Results Clinically and by histopathology, animals treated with glycerol or placebo did not differ. While both groups showed equally high levels of matrix metalloproteinase-9 at 24 h after infection, a significant difference in favour of glycerol was observed at 40 h after infection. However, this difference in matrix metalloproteinase-9 in late disease did not result in an improvement of histopathologic parameters. Conclusion No benefit of adjunctive glycerol was found in these models of pneumococcal meningitis.

Blaser Cornelia; Klein Matthias; Grandgirard Denis; Wittwer Matthias; Peltola Heikki; Weigand Michael; Koedel Uwe; Leib Stephen L

2010-01-01

320

Malignant melanomas of the meninges (MR and CT)  

International Nuclear Information System (INIS)

Malignant melanoma of the meninges is a rare neoplasm derived from melanocytes of the cranial or spinal meninges. Histologically classified as grade IV tumours, malignant melanoma may present either as a diffuse meningeal neoplasm, first described by Virchow in 1859, or as a circumscribed tumour attached to the meninges. Although diagnosis is rarely established prior to surgery or autopsy, MR and CT may provide indispensable information probably leading to earlier diagnosis. In 4 patients, diagnosis of a primary meningeal melanoma was based on MR and CT findings and histology. Histology was obtained in 3 cases by surgery, in one patient by autopsy and showed a melanotic and an amelanotic malignant melanoma in 2 patients each. Autopsy was carried out in 3 cases after survival of 4, 5, and 18 months; in a single case, the follow-up period is almost 3 years. (orig.)

1990-01-01

 
 
 
 
321

[Acute viral meningitis and encephalitis in children  

UK PubMed Central (United Kingdom)

Both viral meningitis and encephalitis in infants and children give clinical features of various severity. The mechanism of viral encephalitis varies from CNS cellular destruction, immune or oedematous process. The clinical and EEG features of herpes encephalitis in the child are usually well recognizable. CSF characteristics are important for differential diagnosis. Management therapy includes anti-oedema treatment, prevention or cure of seizures. Passive immunisation against rubella, rubeola and measles is the best prevention therapy for post-infectious encephalitis. Herpes encephalitis prognosis has improved with acyclovir therapy. In France, mortality due to post-infectious encephalitis is estimated below 5% and sequellae below 20%.

Tardieu M

1987-01-01

322

[Acute viral meningitis and encephalitis in children].  

Science.gov (United States)

Both viral meningitis and encephalitis in infants and children give clinical features of various severity. The mechanism of viral encephalitis varies from CNS cellular destruction, immune or oedematous process. The clinical and EEG features of herpes encephalitis in the child are usually well recognizable. CSF characteristics are important for differential diagnosis. Management therapy includes anti-oedema treatment, prevention or cure of seizures. Passive immunisation against rubella, rubeola and measles is the best prevention therapy for post-infectious encephalitis. Herpes encephalitis prognosis has improved with acyclovir therapy. In France, mortality due to post-infectious encephalitis is estimated below 5% and sequellae below 20%. PMID:2836787

Tardieu, M

1987-01-01

323

Prognostic factors influencing mortality in meningococcal meningitis.  

UK PubMed Central (United Kingdom)

The clinical features and some laboratory parameters of 247 cases of meningococcal meningitis admitted between January 1983 and April 1990 to a paediatric ward in Jawahar Lal Nehru Medical College Hospital, India were analyzed retrospectively. A total of 189 (76.5%) were more than 5 years of age. The maximum number of cases occurred between October and April each year. Complications included bleeding tendencies, neurological deficits, gangrene of limbs, arthritis, uveitis and cataract. The overall mortality rate was 16%. A scoring system based on some clinical characteristics correctly predicted a fatal outcome in all but three children.

Fakhir S; Ahmad SH; Ahmad P

1992-01-01

324

Evaluation of Patients with Tuberculous Meningitis  

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Full Text Available Objective: Tuberculous meningitis is a form of extrapulmonary tuberculosis which has the highest mortality and morbidity rate. The aim of this study is to evaluate clinical signs and treatment regimens of patients with tuberculous meningitis. Material and Methods: Epidemiological properties, clinical signs, treatment regimens and prognosis of 11 patients with tuberculous meningitis in the Uludag University Medical Faculty Pediatric Infectious Disease Department between 2005-2010 were evaluated. Results: Of the patients, 81.8% were boys with a mean age of 5.15±1.69 years (2 months-15 years). The patients 15 mm enduration in 45.5%. BCG scarring was present in 72.7% of patients. Acid-alcohol-resistant bacillus (AARB) was seen in the cerebrospinal fluid (CSF) of 18.2% patients and grew Mycobacterium tuberculosis complex in cultures. Average cell count in CSF was 130±54.4, 75% lymphocyte in giemza staining. Average CSF protein 173.3±23.5 mg/dL, CSF chlorine 109.3±4.1mEq/L, CSF LDH 390.2±331.1 IU/L were found. Of the patients, 9.1% were in stage 1, 45.5% in stage 2 and 45.5% in stage 3 on admission. Cranial MRI revealed hydrocephaly + leptomeningeal staining in 45.5%, tuberculoma+leptomeningeal staining in 18.2%, leptomeningeal staining in 27.3% and hydrocephaly in 9.1%. Of the patients, 81.8% were treated with izoniazid, rifampicin, pyrazinamid and streptomycine or ethambutole for two months initially, with izoniazid, rifampicin during the following 10 months. Prednisolone at 2 mg/kg/day was given to patients. Ventriculoperitoneal shunt was placed in 36.4% of patients for hydrocephalus. Neurological sequelae developed in 72.7% of patients. Of all the patients, 36.4% had mental-motor retardation, 27.3% learning difficulties and 9.1% hearing loss. One patient (9.1%) died.Conclusion: Because tuberculous meningitis is an infectious disease with high mortality and morbidity rates in childhood, rapid diagnosis and treatment is necessary for reducing complications.

?efika Elmas Bozdemir; Solmaz Çelebi; Mustafa Hac?mustafao?lu; Deniz Çak?r; F. Deniz Aygün; U?ur Çelik; ?ahin Sincar; Melek Özdener

2011-01-01

325

Otobasal liquor fistula causing recurrent bacterial meningitis  

International Nuclear Information System (INIS)

[en] Cerebral subarachnoid space scintigraphy today still is the modality of choice for detection of a liquorrea or a liquor fistula, especially in the case of a recurrent menengitis of unclear origin. This diagnostic method yielded the results required in the case reported for efficient and successful surgical treatment. (orig./CB)[de] Die zerebrale Liquorraumszintigraphie ist aufgrund der hohen Empfindlichkeit auch heute noch die Methode der Wahl zum Nachweis einer Liquorrhoe beziehungsweise einer Liquorfistel, insbesondere bei einer rezidivierenden Meningitis unklarer Genese. Sie ermoeglichte bei unserer Patientin eine gezielte definitive operative Behandlung. (orig.)

2000-01-01

326

Experimental bacterial meningitis in rabbit; evaluation with CT and MRI  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the usefulness of computed tomography(CT) and magnetic resonance imaging(MRI) in experimental bacterial meningitis. CT and MR images of experimental bacterial meningitis were obtained after inoculation of 1ml suspension of 10-6/ml Staphylococcus aureus directly into the supratentorial arachnoid space of 18 New Zealand white rabbits. Each animal was studied with both pre-enhanced and post-enhanced CT and MRI at 12, 24, 48 hours and 1 week. Cerebrospinal fluid of all of 18 rabbits were sampled and cultured for bacterial growth. All of 18 rabbits had the clinical symptoms such as neck stiffness and anorexia within 24 hours after the inoculation. Cerebrospinal fluid cultures were positive for Staphylococcus aureus growth. Gd-enhanced MRI exhibited diffuse enhancement along the thickened supratentorial meninges earlier than CT. In Gd-enhanced MRI, the mean contrast enhancement along the thickened supratentorial meninges earlier than CT. In Gd-enhanced MRI, the mean contrast enhancement ratio(CER) at supratentorial meninges increased to 1.93 at 12 hours and 2.99 at 24 hours from 1.06 at 0 hour. Histologic evaluation demonstrated inflammatory cell infiltration into the meninges. MRI also identified the complications of meningitis such as ependymitis and hydrocephalus more effectively than CT. These results indicated that Fd-enhanced MRI detectred earlier the abnormal findingfs of bacterial meningitis and evaluated more effectively the complications of meningitis compared with CT. MRI was more useful than CT in evaluation of the bacterial meningitis.

1996-01-01

327

Cerebrospinal fluid and serum immunoglobulins and antibody titers in mumps meningitis and aseptic meningitis of other etiology.  

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Cerebrospinal fluid (CSF) and serum from 19 patients with mumps meningitis and 19 patients with meningitis of other etiology were investigated on two or more occasions for at least 1 month after onset. Intrathecal synthesis of immunoglobulin (Ig) G was found in 55%, of IgA in 26%, and of IgM in 24% ...

Fryden, A; Link, H; Norrby, E

328

Report of Two Cases of Aseptic Meningitis with Persistence of Pneumococcal Cell Wall Components in Cerebrospinal Fluid after Pneumococcal Meningitis?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We describe two cases of aseptic meningitis occurring some time after pneumococcal meningitis. Both cases may have resulted from an inflammatory response to persistent pneumococcal cell membrane components, as the cerebrospinal fluid samples were positive by the Binax NOW Streptococcus pneumoniae an...

Angoulvant, François; Lachenaud, Julie; Mariani-Kurkdjian, Patricia; Aubertin, Guillaume; Houdouin, Véronique

329

Prevalencia de meningitis neumocócica en la provincia de Salamanca Prevalence of pneumococcal meningitis in the province of Salamanca  

Directory of Open Access Journals (Sweden)

Full Text Available La incidencia de meningitis neumocócica de forma global ha disminuido tras la introducción de la vacuna heptavalente. Sin embargo, los casos producidos por serotipos no vacunales probablemente han aumentado. Objetivo: Estimar la prevalencia de meningitis neumocócica en nuestra provincia y su evolución en los últimos años. Material y métodos: Estudio prospectivo de las meningitis neumocócicas ingresadas en el Hospital Universitario de Salamanca en los años 2003 a 2008. Resultados: Se registraron 5 casos de meningitis, estimando una prevalencia anual de 6/100.000 niños menores de 5 años. Los serotipos aislados fueron el 7F en 3 ocasiones y el 19A en una. Comparando la prevalencia en los 3 primeros años del estudio con el segundo trienio, ésta se incrementó en un 32%. Conclusiones: En la actualidad, las meningitis neumocócicas en nuestro medio están producidas por serotipos no vacunales, en especial el 7F y 19A. En los últimos años hemos asistido a un aumento en la incidencia de las mismas. Pneumococcal meningitis, globally have decreased since heptavalent conjugate vaccine was introduced. However, cases due to nonvaccine serotypes have increased. Object: To know the prevalence of pneumococcal meningitis in our province and the evolution during last years. Methods: Prospective study of pneumococcal meningitis admitted in the University Hospital of Salamanca during 2003 to 2008. Results: Five cases of meningitis were recorded. Annual prevalence was estimated at 6 per 100.000 children < 5 years. Serotypes isolated were 7F in three patients and one 19A. Prevalence rate during first 3 years compared to last 3 years rised up to 32%. Conclusions: Nowdays, pneumococcal meningitis in our province are due to nonvaccine serotypes, especially to 7F and 19A. During last years incidence rates of these was increased.

J.M. Sánchez Granados; O. Serrano Ayestarán; V. Murga Herrera; S. Kanaan Leis; S. Sabín Carreño; M.J. Cuscó Fernández

2010-01-01

330

[Infective endocarditis appearing with meningeal signs].  

Science.gov (United States)

The authors present the case of a 12-year old girl with infective endocarditis. Following an initial three-day period of malaise, she was admitted to the hospital with meningeal signs. The clinical symptoms and the results of the laboratory examinations, lumbar puncture and hemoculture supported the diagnosis of Staphylococcus sepsis and meningitis. The initiation of antimicrobial therapy resulted in temporary improvement while a systolic cardiac murmur appeared. Transthoracal echocardiogram raised the diagnosis of mitral valve endocarditis. Due to the subsequent deterioration in her condition, the patient was referred to the Pediatric Heart Center of the Gottsegen György National Institute of Cardiology where transoesophageal echocardiogram confirmed the diagnosis. The vegetations were removed by extracorporeal cardiac surgery including mitral valve plasty. Retrospectively, septic embolisation caused multiplex brain infarcts were identified by cranial MRI scan as the underlying cause of the initial clinical symptoms and liquor results. Following her recovery, patient remained well with some mild residual mitral regurgitation and without any residual neurological symptoms. PMID:19801358

Aschenbrenner, Zsuzsanna; Simon, Gábor; Mayer, Gizella; Szokó, Márta; Hartyánszky, István; Szatmári, András; Simon, Gábor

2009-10-11

331

MRI features of cryptococcus neoformans meningitis  

International Nuclear Information System (INIS)

Objective: To explore the features of MRI in the patients with cryptococcus neoformans meningitis (CNM). Methods: All 10 cases with CNM in this group were examined with India-ink capsule staining of CSF. 9 cases were performed with contrast enhanced MRI head scan, 1 case performed with chest CT scan. Results: MRI features of CNM included: (1) There were no abnormalities on MRI plain scan in 2 cases, however with linear-like enhancement in cisterns and meninges after contrast. The leptomeninges and basal cisterns were often involved. (2) Multiple patch or flake-like longer T1 and T2 signals in bilateral basal ganglions, frontal, temporal and parietal lobes were displayed on MRI plain scan in 5 cases. And the lesions were enhanced like flake or no enhancement on contrast enhanced MRI. Basal and pre-pontine cisterns showed linear-like enhancement in 1 case. (3) Multiple round or oval shape longer T1 and T2 signals were occurred in the bilateral cerebral hemispheres, with nodular enhancement in 3 cases. (4) Hydrocephalus was found in 3 cases. Conclusion: CNM has high rate of misdiagnose, and the final diagnosis depend on pathology. Although MRI features of CNM lack specificity, MRI is of very important in the diagnosis and differential diagnosis of CNM. (authors)

2007-01-01

332

Stages of tuberculous meningitis: a clinicoradiologic analysis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the frequencies and percentages of various clinicoradiologic variables of tuberculosis meningitis (TBM) with reference to British Medical Research Council (BMRC) staging of the disease. STUDY DESIGN: A case series. PLACE AND DURATION OF STUDY: Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, from October 2010 to September 2011. METHODOLOGY: The study included 93 adult patients with the diagnosis of tuberculous meningitis (TBM) at the study place. Patients were divided in three groups according to British Medical Research Council (BMRC) staging of TBM. Different clinical and radiological findings were analyzed at different stages of the disease. Data was analyzed using SPSS (Statistical Package of Social Sciences) version 11.0. RESULTS: A majority of patients were found to be in stage-II disease at the time of admission. History of illness at the time of admission was more than 2 weeks in 50% of stage-I patients but around 80% in stage-II and stage-III patients. Neck stiffness was the most commonly reported finding in all stages. Cranial nerve palsies were higher in stage-III (75%) than in stage-II (43%) and in stage-I (24%) patients. Hydrocephalus and basal enhancement was the most frequently reported radiographic abnormalities. CONCLUSION: Duration of illness and cranial nerve palsies are important variables in the diagnosis of TBM stages and if TBM is suspected, empiric treatment should be started immediately without bacteriologic proof to prevent morbidity and mortality.

Sher K; Firdaus; Abbasi A; Bullo N; Kumar S

2013-06-01

333

Post Traumatic Meningitis in Neurosurgery Department  

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Full Text Available Problem statement: Post-Traumatic Meningitis (PTM) is a serious complication followed trauma. It sounds to have different pattern and characteristics. The aim of the current study was to determine the characteristics and outcome of PTM in referral neurosurgery department in Iran. Approach: During 5 years period-2003-2008, all records from meningitis patients in neurosurgery department in the unique referral trauma center in Kerman, Iran were evaluated by researchers, retrospectively. The PTM cases were selected and their data registered in the data collection form. The outcome of the disease as live or death considered, too. Analysis was conducted based on outcome and multivariable ANOVA was done to determine factor associated with death in PTM cases. Results: The incidence of PTM in head trauma patients estimated 3.1% (95% CI = 2.5-3.9%). The most frequent cases were male 89.7%. Average of age was 28.4±17.2 years. Klebsiella was the most common organism in CSF culture. Hospital staying time average in these patients was 25.7±15.8 days. Surgery was done for 52 (66.6%) cases. The fatality rate was 24.4%, (95% CI = 15.4-35.4). All death had undergone operation. Multivariable ANAOVA declared that blood sugar and CSF protein differed statistically between two groups, died and survived. Conclusion: PTM is an important phenomenon that has great mortality. Certainly, it needs antibiotic prophylaxis and immediate intervention and preventive services to reduce its morbidity and mortality rate.

Reza Malekpour-Afshar; Saeed Karamoozian; Hassan Shafei

2009-01-01

334

Communicating hydrocephalus subsequent to purulent meningitis  

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Based on CT findings one year after shunting, ventricular dialtion was classified into five degrees for examining prognosis of communicating hydrocephalus subsequent to purulent meningitis. Factors causing and aggravating hydrocephalus were also examined. Patients with hydrocephalus tended to have spasms frequently as the first symptom within one month after birth when there were few characteristic findings. Spasm and disturbance of consciousness occurred frequently during the first week of the occurrence of disease. Large numbers of cells in the spinal fluid and high volume of spinal cord protein were persistent in patients aged one month or less. Chloride transport decreased in patients aged two months or more. The occurrence of syndrome of the pyramidal tract, eye symptoms, movement of head to the left and right, and involuntary movement suggested serious conditions of the disease. Disturbance of movement could be relieved by giving adequate antibiotics as soon as meningitis was discovered within one month after birth and by giving chloramphenicol when symptoms suggesting the development of serious conditions occurred. However, mental retardation and epilepsy could not be prevented. (Namekawa, K.)

1984-01-01

335

Endoscopic challenges and applications in tuberculous meningitis.  

UK PubMed Central (United Kingdom)

Endoscopy for hydrocephalus caused by infectious diseases presents clear challenges to the surgeon. Hydrocephalus caused by tuberculous meningitis is a good model to explore many of the issues that should be considered in the management of these patients. Tuberculous hydrocephalus may be communicating or noncommunicating management options include medical treatment (for communicating hydrocephalus), ventriculoperitoneal shunting, and endoscopic third ventriculostomy. No guidelines exist currently, and therefore management protocols are specific to each center. Because brain ischemia attributable to vasculitis is common in these patients, optimal treatment of intracranial pressure (ICP) is even more important than usual, and this has implications for the management decisions. Effective treatment of these patients should lead to normalization of ICP and resolution of the hydrocephalus, rather than merely avoiding extreme elevations of ICP. However, this also must be weighed against the surgical and long-term complications associated with the procedures used. There are specific endoscopic challenges that occur as the result of abnormal anatomy and the fact that hydrocephalus presents during the acute phase of the disease, rather than being postinfectious. In this article we examine the arguments for various therapeutic approaches and discuss the gathering experience in the literature about endoscopy in tuberculous meningitis in the context of overall management options.

Figaji AA; Fieggen AG

2013-02-01

336

Viral etiology of aseptic meningitis among children in southern Iran.  

UK PubMed Central (United Kingdom)

Aseptic meningitis refers to a clinical syndrome of meningeal inflammation in which bacteria cannot be identified in the cerebrospinal fluid (CSF). The viral etiology and the epidemiological, clinical, and laboratory characteristics of aseptic meningitis among children aged 2 months to 15 years in Shiraz, southern Iran were determined. From May 2007 to April 2008, 65 patients were admitted to the hospital with aseptic meningitis. Seven viruses, non-polio human enteroviruses, mumps virus, herpes simplex virus (HSV), varicella-zoster virus (VZV), human cytomegalovirus (HCMV), human herpes virus type 6 (HHV-6), and Epstein-Barr virus (EBV) were investigated by polymerase chain reaction (PCR) method. Viruses were detected in 30 (46.2%) patients in whom non-polio human enterovirus and mumps virus were detected in 13 (43.3%) and 11 (36.7%), respectively. The remaining 6 (20%) of the cases were caused by HSV, VZV, HCMV, and HHV-6. Haemophilus influenzae and non-polio human enterovirus were detected in one patient simultaneously. Viral meningitis was found to be more frequent during spring and summer. The majority (66.6%) of the patients were treated in the hospital for 10 days and had received antibiotics in the case of bacterial meningitis. Rapid diagnosis of viral meningitis using PCR testing of CSF can help shorten hospitalization, and avoid the unnecessary use of antibiotics.

Hosseininasab A; Alborzi A; Ziyaeyan M; Jamalidoust M; Moeini M; Pouladfar G; Abbasian A; Kadivar MR

2011-05-01

337

Clinical prediction rule for differentiating tuberculous from viral meningitis.  

UK PubMed Central (United Kingdom)

SETTING: The Professor Dr Matei Bals National Institute of Infectious Diseases, Bucharest, Romania. OBJECTIVE: To create a prediction rule to enable clinicians to differentiate patients with tuberculous meningitis (TBM) from those with viral meningitis. DESIGN: We retrospectively analysed patients admitted to a tertiary care facility between 2001 and 2011 with viral meningitis and TBM. Patients were defined as having TBM according to a recently published consensus definition, and as viral meningitis if a viral aetiology was confirmed, or after ruling out bacterial, fungal and non-infectious causes of meningitis. RESULTS: We identified 433 patients with viral meningitis and 101 TBM patients and compared their clinical and laboratory features. Multivariable analysis showed a statistically significant association between TBM and the following variables: duration of symptoms before admission of ?5 days, presence of neurological impairment (altered consciousness, seizures, mild focal signs, multiple cranial nerve palsies, dense hemiplegia or paraparesis), cerebrospinal fluid/blood glucose ratio < 0.5 and cerebrospinal fluid protein level > 100 mg/dl. We propose a diagnostic score based on the coefficients derived from the logistic regression model with a sensitivity and specificity for TBM of respectively 92% and 94%. CONCLUSIONS: Our study suggests that easily available clinical and laboratory data are very useful for differentiating TBM from other causes of meningitis.

Hristea A; Olaru ID; Baicus C; Moroti R; Arama V; Ion M

2012-06-01

338

Update on bacterial meningitis: epidemiology, trials and genetic association studies.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Bacterial meningitis is a life-threatening disease that continues to inflict a heavy toll. We reviewed recent advances in vaccination, randomized studies on treatment, and genetic association studies in bacterial meningitis. RECENT FINDINGS: The incidence of bacterial meningitis has decreased after implementation of vaccines, and further implementation of existing conjugate vaccines particularly in low-income countries is expected to reduce the global disease burden. Several randomized studies have been performed recently in this field. Clinical studies showed that short duration (5 days) of antibiotic treatment is as effective as longer duration treatment in low-income countries, and that dexamethasone decreases death and neurological sequelae in high-income countries. Ongoing trials will further define the role of paracetamol, glycerol and hypothermia in bacterial meningitis. Genetic association studies identified pathophysiological mechanisms that could be counteracted in experimental meningitis, providing promising leads for future treatments. SUMMARY: Conjugate vaccines have reduced the burden of bacterial meningitis in high-income countries, but implementation of available vaccines in low-income countries is necessary to reduce disease burden worldwide. Adjunctive dexamethasone therapy has beneficial effects in patients with bacterial meningitis but only in high-income countries. Genetic association studies may reveal targets for new treatment strategies.

Kasanmoentalib ES; Brouwer MC; van de Beek D

2013-06-01

339

Anti-GM-CSF autoantibodies in patients with cryptococcal meningitis.  

UK PubMed Central (United Kingdom)

Cryptococcal meningitis has been described in immunocompromised patients, as well as in those for whom no immune defect has been identified. GM-CSF regulates the function of phagocytes and pulmonary alveolar macrophages, critical elements in cryptococcal control. We performed clinical histories, immunological evaluation, and anticytokine autoantibody screening in four current patients with cryptococcal meningitis and identified and tested 103 archived plasma/cerebrospinal fluid samples from patients with cryptococcal meningitis. We assessed the ability of anti-GM-CSF autoantibody-containing plasmas to inhibit GM-CSF signaling. We recognized anti-GM-CSF autoantibodies in an otherwise healthy female with cryptococcal meningitis who later developed pulmonary alveolar proteinosis (PAP). Her diagnosis prompted screening of patients with cryptococcal meningitis for anticytokine autoantibodies. We identified seven HIV-negative patients with cryptococcal meningitis who tested positive for high-titer anti-GM-CSF autoantibodies. Two of the seven later developed evidence of PAP. Plasma from all patients prevented GM-CSF-induced STAT5 phosphorylation and MIP-1? production in normal PBMCs. This effect was limited to their IgG fraction. Anti-GM-CSF autoantibodies are associated with some cases of cryptococcal meningitis in otherwise immunocompetent patients. These cases need not have associated PAP.

Rosen LB; Freeman AF; Yang LM; Jutivorakool K; Olivier KN; Angkasekwinai N; Suputtamongkol Y; Bennett JE; Pyrgos V; Williamson PR; Ding L; Holland SM; Browne SK

2013-04-01

340

Distribution of 82Br between serum and CSF in patients with meningitis  

International Nuclear Information System (INIS)

[en] The ratio between concentrations of 82Br in serum and spinal fluid was determined in patients with meningitis. The ratio was found to be low in three patients strongly suspect for tuberculous meningitis and in eight of nine patients with purulent meningitis, but normal in 13 patients with non-tuberculous, serous meningitis. These results confirm previous investigations and determination of the 82Br ratio is a simple, reliable aid in the diagnosis of tuberculous meningitis. (author)

1977-01-01

 
 
 
 
341

Meningitis in children in Fiji: etiology, epidemiology, and neurological sequelae.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To describe the etiology, epidemiology, neurological sequelae, and quality of life of children aged 1 month to less than 5 years admitted with meningitis to the Colonial War Memorial Hospital (CWMH), Suva, Fiji. METHODS: Over a 3-year period, all eligible children with suspected meningitis admitted to CWMH had blood drawn for culture. Of these children, those for whom is was possible were tested for a four-fold rise in antibody titers to Haemophilus influenzae type b (Hib) and pneumococcal surface adhesin A (PsaA). Cerebrospinal fluid (CSF) was taken for bacteriological culture and antigen testing. CSF was also tested by PCR for Streptococcus species, Neisseria meningitidis, Hib, Mycobacterium tuberculosis, and enterovirus. Pneumococcal isolates were serotyped using multiplex-PCR reverse-line blot hybridization. Following discharge, cases underwent a neurological assessment, audiometry, and quality of life assessment (Pediatric Quality of Life Inventory (PedsQL) tool). RESULTS: There were 70 meningitis cases. Meningitis was more common in indigenous Fijian than Indo-Fijian children. Enterovirus was the most common etiological agent and appeared to be outbreak-associated. Streptococcus pneumoniae was the most common bacterial cause of meningitis with an annual incidence of 9.9 per 100 000 under 5 years old (95% confidence interval 4.9-17.7) and a case fatality rate of 36%. With the exception of deafness, neurological sequelae were more frequent in cases of bacterial meningitis than in viral meningitis (18.5% vs. 0%, p=0.04). Quality of life at follow-up was significantly lower in patients with bacterial meningitis than in those with viral meningitis (p=0.003) or meningitis of unknown etiology (p=0.004). CONCLUSIONS: During the study period an outbreak of enterovirus occurred making it the most common etiological agent identified. However in the absence of this outbreak, S. pneumoniae was the most common cause of childhood meningitis in Fiji. Bacterial meningitis is associated with serious sequelae and a reduced quality of life.

Biaukula VL; Tikoduadua L; Azzopardi K; Seduadua A; Temple B; Richmond P; Robins-Browne R; Mulholland EK; Russell FM

2012-04-01

342

Bacterial meningitis: complement gene expression in the central nervous system.  

UK PubMed Central (United Kingdom)

Inflammation in the subarachnoid space represents the pathological hallmark of bacterial meningitis. The intrathecal accumulation of leukocytes, in response to bacterial pathogens, and the subsequent release of endogenous inflammatory mediators are associated with a breakdown of the blood-brain barrier function and poor prognosis. Complement has been shown to play a major role in the inflammatory response within the intrathecal compartment in bacterial meningitis. In the present review, we provide an outline of the current understanding of the involvement of the complement system in the pathophysiology of bacterial meningitis, and propose future directions of investigation.

Stahel PF; Barnum SR

1997-12-01

343

A case of Mondini dysplasia with recurrent Streptococcus pneumoniae meningitis.  

UK PubMed Central (United Kingdom)

Mondini's dysplasia is a developmental anomaly of the middle ear characterized by cochlear malformation with dilation of the vestibular aquaduct, vestibule, and ampullar ends of the semicircular canals. These deformities may result in a connection between subarachnoid space and the middle ear resulting in recurrent episodes of meningitis. Additionally, it is commonly associated with hearing impairment. We describe here a boy with recurrent meningitis and unilateral sensorineural hearing loss. Mondini dysplasia was demonstrated with computed tomographic scans of the temporal bones in the search for pathogenesis of recurrent meningitis.

Yilmaz Ciftdo?an D; Bayram N; Ozdemir Y; Bayraktaro?lu S; Vardar F

2009-12-01

344

Meningitis por Streptococcus suis en un paciente inmunocompetente Streptococcus suis meningitis in an immunocompetent patient  

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Full Text Available Se describe un caso de meningitis por Streptococcus suis en un paciente inmunocompetente. Presentaba astenia, debilidad generalizada, fiebre (39 °C), vómitos, deterioro del sensorio y desorientación témporo-espacial. Los cultivos de sangre (2/2) y de líquido cefalorraquídeo fueron positivos. La identificación preliminar se realizó utilizando las pruebas bioquímicas convencionales y fue completada en el Servicio Bacteriología Especial del INEI-ANLIS "Dr. Carlos G. Malbrán". Se comenzó el tratamiento con ampicilina y ceftriaxona. El microorganismo aislado demostró sensibilidad a ampicilina, cefotaxima y vancomicina. El paciente evolucionó favorablemente, pero se comprobó leve hipoacusia. Reingresó a los 4 meses con marcha atáxica, anacusia en oído izquierdo e hipoacusia en oído derecho. Continúa con seguimiento neurológico y audiométrico. Retrospectivamente se constató el contacto del paciente con cerdos. Se destaca la importancia de la anamnesis para alertar la sospecha de este agente etiológico en meningitis y bacteriemias.A case of Streptococcus suis meningitis is described in an immunocompetent patient presenting asthenia, general weakness, fever, vomiting, sensory deterioration and temporospatial disorder. The cerebrospinal fluid and two blood cultures (2/2 bottles) were positive. The isolate was preliminary identified by conventional biochemical tests, and the identification was completed at the Special Bacteriology Service of INEI-ANLIS "Dr. Carlos G. Malbrán". Ampicillin and ceftriaxone treatment was initiated. The isolate was susceptible to ampicillin, cefotaxime and vancomycin. The patient experienced a good outcome but suffered hearing loss. However, after four months he returned with walking ataxia, deafness in his left ear, and hearing loss in the right ear. The patient’s retrospective exposure to pigs had been verified. It is important to evaluate predisposing and epidemiologic factors in order to alert about the possible presence of this etiological agent in cases of meningitis or bacteremia.

A. Nagel; V. Manias; N. Busquets; S. Sniadowsky; J. Anzardi; E. De Los A. Méndez

2008-01-01

345

Meningitis por Streptococcus suis en un paciente inmunocompetente/ Streptococcus suis meningitis in an immunocompetent patient  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se describe un caso de meningitis por Streptococcus suis en un paciente inmunocompetente. Presentaba astenia, debilidad generalizada, fiebre (39 °C), vómitos, deterioro del sensorio y desorientación témporo-espacial. Los cultivos de sangre (2/2) y de líquido cefalorraquídeo fueron positivos. La identificación preliminar se realizó utilizando las pruebas bioquímicas convencionales y fue completada en el Servicio Bacteriología Especial del INEI-ANLIS "Dr. Carlos G (more) . Malbrán". Se comenzó el tratamiento con ampicilina y ceftriaxona. El microorganismo aislado demostró sensibilidad a ampicilina, cefotaxima y vancomicina. El paciente evolucionó favorablemente, pero se comprobó leve hipoacusia. Reingresó a los 4 meses con marcha atáxica, anacusia en oído izquierdo e hipoacusia en oído derecho. Continúa con seguimiento neurológico y audiométrico. Retrospectivamente se constató el contacto del paciente con cerdos. Se destaca la importancia de la anamnesis para alertar la sospecha de este agente etiológico en meningitis y bacteriemias. Abstract in english A case of Streptococcus suis meningitis is described in an immunocompetent patient presenting asthenia, general weakness, fever, vomiting, sensory deterioration and temporospatial disorder. The cerebrospinal fluid and two blood cultures (2/2 bottles) were positive. The isolate was preliminary identified by conventional biochemical tests, and the identification was completed at the Special Bacteriology Service of INEI-ANLIS "Dr. Carlos G. Malbrán". Ampicillin and ceftriax (more) one treatment was initiated. The isolate was susceptible to ampicillin, cefotaxime and vancomycin. The patient experienced a good outcome but suffered hearing loss. However, after four months he returned with walking ataxia, deafness in his left ear, and hearing loss in the right ear. The patient’s retrospective exposure to pigs had been verified. It is important to evaluate predisposing and epidemiologic factors in order to alert about the possible presence of this etiological agent in cases of meningitis or bacteremia.

Nagel, A.; Manias, V.; Busquets, N.; Sniadowsky, S.; Anzardi, J.; Méndez, E. De Los A.

2008-09-01

346

Meningitis de etiología poco habitual en niños  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La meningitis por Listeria monocytogenes es una enfermedad infrecuente en la población pediátrica y más aún en pacientes inmunocompetentes. Presentamos un niño de cuatro años, previamente sano, que se internó con diagnóstico de síndrome meníngeo con líquido cefalorraquídeo patológico. Inicialmente se trató con cefotaxima y dexametasona, pero al persistir la fiebre, a las 48 horas se agregó vancomicina y aciclovir al tratamiento anterior. A las 72 horas se r (more) ecibió el informe del líquido cefalorraquídeo (LCR) que mostró bacilos grampositivos, el cultivo informó Listeria monocytogenes, por lo cual se inició tratamiento con ampicilina y se suspendieron los antibióticos indicados previamente. Como complicaciones presentó estado epiléptico por hiponatremia con osmolaridad plasmática normal, a los 20 días evolucionó a una hidrocefalia aguda que requirió colocación de un sistema de derivación ventriculoperitoneal. Ponemos énfasis en la importancia de la tinción de Gram del LCR para orientar el tratamiento empírico inicial y en la observación del equilibrio hidroelectrolítico para disminuir la morbimortalidad en esta enfermedad grave. Abstract in english Meningitis caused by Listeria monocytogenes is an uncommon disease in children and even more uncommon in immuno-competent patients. We report a previously healthy 4-years old patient, who was admitted with a diagnosis of meningeal syndrome with an abnormal spinal fluid. He was initially treated with cefotaxime and dexametasone, but, as fever persisted after 48 hours, vancomycin and acyclovir were added to the previous therapy. After 72 hours, the report of the spinal flui (more) d was received showing gram-positive rods. The culture grew Listeria monocytogenes, and therapy with ampicillin was initiated; previously prescribed antibiotic agents were withdrawn. Complications included an epileptic status caused by hyponatremia with normal plasma osmolarity; after 20 days the patient suffered an acute hydrocephalia which required a ventriculo-peritoneal shunt. We emphasize in the importance of spinal fluid Gram stain in order to orientate the empirical initial therapy, and the hydroelectrolytical balance in order to decrease the morbidity and mortality of this severe disease.

Ávila, Antonio; Lezerovich, Daniela; Sabio Paz, Verónica; Lenz, Miriam; Chede, Cecilia; Varón, Juan; Bogdanowicz, Elizabet; Saporiti, Adrián

2004-06-01

347

[A case of primary meningeal melanocytoma of the left middle fossa].  

UK PubMed Central (United Kingdom)

A 29-year-old woman presented with a primary meningeal melanocytoma of the left middle fossa manifesting as headache and nausea. Computed tomography (CT) with contrast medium demonstrated a clearly demarcated, homogeneously enhanced high density area surrounded by a cyst in the left temporal lobe. Magnetic resonance (MR) imaging showed the mass as a slightly high signal intensity area on the T1-weighted image and as a low signal intensity area on the T2-weighted image. Cerebral angiography revealed shift of the middle cerebral artery but no tumor stain. The solid part of the tumor had rapidly increased in size with reduction of the cyst 3 months later. Left frontotemporal craniotomy disclosed a clearly demarcated jet-black tumor attached to the dura. The black-colored lesion in the dura and the bone extended to the skull base, so malignant melanoma was a possibility. The solid part of the tumor was gross totally removed, and the dura and the skull bone were preserved. Histological examination of the tumor specimen revealed meningeal melanocytoma. Melanophages were present in the specimen of the black-colored lesion in the dura and the bone, but no neoplastic infiltration was present. The postoperative course was uneventful, and the patient's headache and nausea disappeared. CT and MR imaging taken 1 month later confirmed total removal of the tumor. No recurrence has been observed for 2.5 years after surgery. Preoperative differentiation of meningeal melanocytoma from malignant melanoma is difficult, but the primary goal of therapy is gross total resection of the solid part of the tumor irrespective of tumor type.

Yukawa H; Seki H; Sugawara T; Boku N; Higuchi H; Ono S

2003-09-01

348

Meningitis bacteriana y Pseudomonas aeruginosa: a propósito de un caso/ Bacterial meningitis and Pseudomonas aeruginosa: apropos of a case  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se presentó un paciente de 54 años de edad con cuadro clínico de meningitis, que en el estudio del líquido cefalorraquídeo se aisló Pseudomonas aeruginosa. La meningitis por bacilos gramnegativos ha ido incrementándose desde la década de los años 70, con una mayor incidencia en niños pequeños. Dentro de este grupo de infecciones, la causada por Pseudomonas sp. por su poca frecuencia, resulta una rareza. La meningitis por Pseudomonas aeruginosa debe tenerse en cuenta por la severidad del cuadro clínico y el incremento de las cepas resistentes. Abstract in english Meningitis caused by gram-negative bacilli increased since the 1970, with a higher incidence in small children. Within this group of infections, the meningitis caused by Pseudomonas sp is rare. The case of a 54-year-old patient with a clinical picture of meningitis is reported. Pseudomonas aeruginosa was isolated from the cerebrospinal fluid. The meningitis caused by Pseudomonas aeruginosa should be taken into consideration because of the severity of the clinical picture and the high mortality and increasing strain resistance.

Batlle Almodóvar, María del Carmen; Dickinson, Félix; Pérez Monrás, Miriam; Tamargo Martínez, Isis; Similis, Alexis

2005-12-01

349

Meningitis bacteriana y Pseudomonas aeruginosa: a propósito de un caso Bacterial meningitis and Pseudomonas aeruginosa: apropos of a case  

Directory of Open Access Journals (Sweden)

Full Text Available Se presentó un paciente de 54 años de edad con cuadro clínico de meningitis, que en el estudio del líquido cefalorraquídeo se aisló Pseudomonas aeruginosa. La meningitis por bacilos gramnegativos ha ido incrementándose desde la década de los años 70, con una mayor incidencia en niños pequeños. Dentro de este grupo de infecciones, la causada por Pseudomonas sp. por su poca frecuencia, resulta una rareza. La meningitis por Pseudomonas aeruginosa debe tenerse en cuenta por la severidad del cuadro clínico y el incremento de las cepas resistentes.Meningitis caused by gram-negative bacilli increased since the 1970, with a higher incidence in small children. Within this group of infections, the meningitis caused by Pseudomonas sp is rare. The case of a 54-year-old patient with a clinical picture of meningitis is reported. Pseudomonas aeruginosa was isolated from the cerebrospinal fluid. The meningitis caused by Pseudomonas aeruginosa should be taken into consideration because of the severity of the clinical picture and the high mortality and increasing strain resistance.

María del Carmen Batlle Almodóvar; Félix Dickinson; Miriam Pérez Monrás; Isis Tamargo Martínez; Alexis Similis

2005-01-01

350

Cranial Nerve Palsy as a Factor to Differentiate Tuberculous Meningitis from Acute Bacterial Meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Tuberculous meningitis (TBM) and acute bacterial meningitis (ABM) cause substantial mortality and morbidity in both children and adults. Identification of poor prognostic factors at patient’s admission could prepare physicians for more aggressive monitoring of patients with meningitis. The objective of this study was to determine the predictive value of neurological features to differentiate ABM and TBM. A retrospective study was conducted between patients affected with ABM or TBM admitted to three teaching hospitals during the last 14 years in Zahedan the central city of Sistan and Balouchestan province (Iran). The neurological features include seizure, level of consciousness, stroke, focal neurologic deficit and cranial nerve palsy at the time of admission. Mean age for patients with TBM and ABM were 41 ± 22.4 and 24 ± 18.5 years respectively. In univariate analysis, all measured variables revealed significant difference between ABM and TBM patients except for seizure episodes. Multivariate logistic regression analysis showed positive predictive effect of cranial nerve palsy (AOR=1.980, CI 95%: 1.161-3.376) on the diagnosis of TBM. In our study cranial nerve palsies was the most important neurological predictor factor to differentiate TBM from ABM

Ali Moghtaderi; Roya Alavi-Naini; Saideh Rashki

2013-01-01

351

Does this child have bacterial meningitis? A systematic review of clinical prediction rules for children with suspected bacterial meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Acute meningitis is a relatively common phenomenon in children. Identifying which children are most likely to have bacterial meningitis vs. self-limiting aseptic meningitis is important, as these children require investigation and antibiotic treatment. OBJECTIVE: Our aim was to systematically identify and review the quality and performance of published clinical prediction rules (CPRs) for children with suspected bacterial meningitis. METHODS: Medline and Embase were searched for CPRs involving children 0-18 years of age with suspected bacterial meningitis, with cerebral spinal fluid (CSF) culture used as the reference diagnostic standard. CPR quality was assessed using 17 previously published items. CPR performance was evaluated using sensitivity, negative likelihood ratio, and the treatment frequency that would result if the rule was used. RESULTS: Eleven studies involving 6675 children with acute meningitis fulfilled all inclusion criteria and were entered in the study. They all describe the derivation or validation of six unique CPRs. A rigorously developed, high-performing, and well-validated CPR ready for clinical use to guide which children with suspected bacterial meningitis should be hospitalized and treated with intravenous antibiotics and which can be safely discharged home was not identified. Areas for quality improvement for future CPR studies include prospective validation using standardized inclusion criteria, adequate blinding, predictor reproducibility assessment, and meticulous follow-up of outcomes. The Bacterial Meningitis Score had the highest quality and performance and is the best candidate for prospective validation. CONCLUSIONS: Until consistently high methodological quality and diagnostic performance are demonstrated through prospective validation, caution is warranted in the routine clinical use of existing CPRs for children with suspected bacterial meningitis.

Kulik DM; Uleryk EM; Maguire JL

2013-10-01

352

Cryptococcal meningitis in a tertiary care hospital.  

UK PubMed Central (United Kingdom)

Seven cases of cryptococcus meningitis in a tertiary care hospital from 2004-2007 were reviewed. 85.7% of the patients had headache as their predominant clinical feature. The spectrum of CT / MR findings ranged from no abnormality, basal ganglion lesion, to intracerebral and intraventricular granulomas. Findings of cerebrospinal fluid (CSF) cytology and biochemistry analysis were inconclusive. Patients were diagnosed by India ink(100%), CSF cryptococcal antigen detection(100%), and CSF culture in 6(85.7%). With the exception of two patients, co-morbidities associated were HIV, diabetes mellitus, and idiopathic CD4 + lymphocytopenia. Six patients were successfully treated with amphotericin B and discharged. A high index of clinical suspicion and laboratory diagnosis achieved early can reduce the overall morbidity and mortality among patients with cryptococcosis.

Juhi T; BibhaBati M; Aradhana B; Poonam L; Vinita D; Archana T

2009-01-01

353

Successful kidney transplantation after coccidioidal meningitis.  

UK PubMed Central (United Kingdom)

Coccidioidomycosis is a fungal infection primarily found in residents or visitors to geographic areas where Coccidioides species are endemic, including the southwestern United States, northwestern Mexico, and certain areas of Central and South America. The infection rarely disseminates, but certain populations are at higher risk of dissemination. One population at high risk of disseminated disease is solid organ transplant recipients. At our transplant center in Arizona, patients with proven coccidioidal infection before transplantation undergo thorough counseling about the risks of dissemination and possible death from coccidioidomycosis subsequent to the use of immunosuppressive medications after transplantation. Currently, patients with coccidioidal infection before transplantation are maintained on lifelong infection suppression with triazole therapy. We present the first successful case of a kidney transplant in a patient after treatment for coccidioidal meningitis without post-transplant reactivation of the coccidioidal infection.

Kokseng SL; Blair JE

2011-06-01

354

Cryptococcal meningitis in a tertiary care hospital.  

Science.gov (United States)

Seven cases of cryptococcus meningitis in a tertiary care hospital from 2004-2007 were reviewed. 85.7% of the patients had headache as their predominant clinical feature. The spectrum of CT / MR findings ranged from no abnormality, basal ganglion lesion, to intracerebral and intraventricular granulomas. Findings of cerebrospinal fluid (CSF) cytology and biochemistry analysis were inconclusive. Patients were diagnosed by India ink(100%), CSF cryptococcal antigen detection(100%), and CSF culture in 6(85.7%). With the exception of two patients, co-morbidities associated were HIV, diabetes mellitus, and idiopathic CD4 + lymphocytopenia. Six patients were successfully treated with amphotericin B and discharged. A high index of clinical suspicion and laboratory diagnosis achieved early can reduce the overall morbidity and mortality among patients with cryptococcosis. PMID:19430184

Juhi, Taneja; BibhaBati, Mishra; Aradhana, Bhargava; Poonam, Loomba; Vinita, Dogra; Archana, Thakur

2009-01-01

355

Bacterial meningitis post-PCV7: declining incidence and treatment.  

UK PubMed Central (United Kingdom)

The epidemiology of bacterial meningitis in the United States has changed tremendously in the past 20 years. Since the introduction of the Haemophilus influenzae type b vaccine in 1988, the incidence of H. influenzae type b meningitis has declined by at least 97%, and Streptococcus pneumoniae has emerged as the most common etiologic agent. The PCV7 (7-valent pneumococcal conjugate vaccine [Prevnar]; Wyeth Pharmaceuticals) vaccine, which targets 7 pneumococcal serotypes, was introduced in 2000 and has had an enormous impact on both the incidence and epidemiology of bacterial meningitis. This article reviews the impact of the PCV7 vaccine and the most up-to-date evidence on diagnosis and empiric therapy of suspected bacterial meningitis in the current day.

Kowalsky RH; Jaffe DM

2013-06-01

356

Comunicado de la FDA sobre el brote de meningitis fúngica ...  

Science.gov (United States)

... Los indicios y síntomas de meningitis incluyen fiebre, dolor de cabeza, rigidez del cuello, náuseas y vómitos, fotofobia (sensibilidad a la luz) y ... More results from www.fda.gov/drugs/drugsafety

357

Meningitis as the presenting symptom of pituitary adenomata  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We have recently seen two patients, both men in their forties, who presented with a clinical picture of meningitis which was later found to be secondary to infarction of an underlying chromophobe adenoma of the pituitary.

Lascelles, R. G.; Bhalla, K. K.; Tuck, S. J.; Graves, Paul S.

358

[Adult cases of viral meningitis caused by echovirus type 13].  

UK PubMed Central (United Kingdom)

Adult cases of viral meningitis caused by echovirus type 13 (E13) were studied. E13 was isolated from 8 of 11 adult patients (73%) with viral meningitis between April and September 2002 in Fukui Prefecture. The mean age was 27.4 +/- 6.4 years (4 males and 4 females). The disease was prevalent among adults, especially younger adults as well as children. The symptoms and signs were as follows; headache (100%), fever (100%), nausea and/or vomiting (88%), Kernig's sign (88%), and increased deep tendon reflexes (50%). The average cell counts in cerebrospinal fluid (CSF) were 118 +/- 111/mm3. Of the 2 patients, polynuclear cells were dominant during the early phase of the disease. The prognosis was good. Since May 2002, the number of patients with viral meningitis caused by E13 has rapidly increased. Most of the reported patients were children. We should consider the possibility of E13 infection as a cause of adult viral meningitis.

Tsutsui H; Hamano T; Toho M; Nakamura M; Hayashi K; Yamamura O; Nakagawa H; Fujiyama J; Yoneda M; Kuriyama M

2003-06-01

359

Meningitis due to Rhodotorula glutinis in an HIV infected patient  

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Rhodotorula spp, though considered a common saprophyte, recently has been reported as causative agent of opportunistic mycoses. We present a case of meningitis in an immunocompromised human immunodeficiency virus infected patient who presented with longstanding fever. He was diagnos...

Shinde R; Mantur B; Patil G; Parande M; Parande A

360

Diagnostic value of latex agglutination in cryptococcal meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Cryptococcus neoformans is the most common fungal pathogen to infect the central nervous system, and an effective diagnostic method is therefore necessary for the early diagnosis of cryptococcal meningitis. AIM: The efficacy of India ink preparation, cerebrospinal fluid (CSF) culture and CSF cryptococcal antigen detection by the latex agglutination test for diagnosis of cryptococcal meningitis are compared to determine the most efficient test. MATERIALS AND METHODS: Two hundred CSF samples from human immunodeficiency virus - positive patients suspected to be suffering from meningitis were screened for Cryptococcus neoformans. RESULTS: Latex agglutination for cryptococcal antigen detection was found to be more sensitive compared to India ink staining and CSF culture. CONCLUSIONS: Antigen detection by latex agglutination proved to be both sensitive and specific method for the diagnosis of cryptococcal meningitis. Rapid, early diagnosis of infection by detection of cryptococcal antigen by latex agglutination may alter the prognosis for these patients.

Dominic RS; Prashanth H; Shenoy S; Baliga S

2009-07-01

 
 
 
 
361

Enterococcal meningitis caused by Enterococcus casseliflavus. First case report  

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Abstract Background Enterococcal meningitis is an uncommon disease usually caused by Enterococcus faecalis and Enterococcus faecium and is associated with a high mortality rate. Enterococcus casseliflavus has been implicated in a wide variety of infections...

Iaria Chiara; Stassi Giovanna; Costa Gaetano; Di Leo Rita; Toscano Antonio; Cascio Antonio

362

Cryptococcal meningitis presenting concurrently with systemic lupus erythematosus  

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Cryptococcal meningitis is a rare but well recognized complication of systemic lupus erythematosus (SLE). Since in all previously reported cases in the medical literature the patients developed this opportunistic infection as the result of immunosuppressive therapies, whether the intrinsic immunolog...

Mok, CC; Lau, CS; Yuen, KY

363

[Salmonella is a rare cause of meningitis in infants].  

Science.gov (United States)

In developed countries, invasive disease caused by non typhoidal Salmonella spp. is rare. Here we present a Danish case of Salmonella enterica serovar Enteritidis (S. Enteritidis) meningitis in an infant who had no underlying diseases. The child had had no known expositions, and the source of the infection was never identified. The chance of finding uncommon microorganisms as cause of invasive infections such as meningitis and the choice of initial empiric antimicrobial treatments is discussed. PMID:23937875

Jensen, Lotte; Hoffmann, Thomas; Knudsen, Jenny Dahl; Rosenfeldt, Vibeke

2013-08-12

364

Streptococcus sanguinis meningitis following endoscopic ligation for oesophageal variceal haemorrhage.  

UK PubMed Central (United Kingdom)

We report a case of acute purulent meningitis caused by Streptococcus sanguinis after endoscopic ligation for oesophageal variceal haemorrhage in a cirrhotic patient without preceding symptoms of meningitis. Initial treatment with flomoxef failed. The patient was cured after 20 days of intravenous penicillin G. This uncommon infection due to S. sanguinis adds to the long list of infectious complications among patients with oesophageal variceal haemorrhage.

Liu YT; Lin CF; Lee YL

2013-05-01

365

Cryptococcal meningitis presenting as sinusitis in a renal transplant recipient.  

UK PubMed Central (United Kingdom)

Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may delay diagnosis. Therapy is challenging in renal transplant patients because of the nephrotoxicity associated with amphotericin B, the recommended treatment. We present a case of cryptococcal meningitis in a renal transplant recipient presenting as acute sinusitis with successful treatment using fluconazole as primary therapy.

Iyer SP; Movva K; Wiebel M; Chandrasekar P; Alangaden G; Carron M; Tranchida P; Revankar SG

2013-08-01

366

Computed tomography in cases of coccidioidal meningitis, with clinical correlation  

Energy Technology Data Exchange (ETDEWEB)

Cranial computed tomographic (CT) scans of 22 patients with coccidioidal meningitis were reviewed and their clinical course was analyzed. Abnormalities of the ventricular system or the basilar cisterns or both were present in 16 instances. Although it is not a definitive diagnostic tool, the CT scan is helpful in suggesting a diagnosis of coccidioidal meningitis and in predicting the prognosis of patients affected by the disease. 19 references, 4 figures, 2 tables.

Shetter, A.G.; Fischer, D.W.; Flom, R.A.

1985-06-01

367

Fatal group a streptococcal meningitis in an adult  

Directory of Open Access Journals (Sweden)

Full Text Available Despite the recent resurgence in reports of invasive Group A Streptococcal (GAS) infections worldwide, it remains a rare cause of pyogenic meningitis both in children and adults. We report a case of fatal GAS meningitis in a healthy adult emphasizing the need for clinicians to be aware of its fulminant course, prompting early diagnosis and treatment. There is also a need to consider postexposure chemoprophylaxis in close contacts of such cases.

Mani R; Mahadevan A; Pradhan S; Nagarathna S; Srikanth N; Dias M; Chandramuki A

2007-01-01

368

[Salmonella is a rare cause of meningitis in infants].  

UK PubMed Central (United Kingdom)

In developed countries, invasive disease caused by non typhoidal Salmonella spp. is rare. Here we present a Danish case of Salmonella enterica serovar Enteritidis (S. Enteritidis) meningitis in an infant who had no underlying diseases. The child had had no known expositions, and the source of the infection was never identified. The chance of finding uncommon microorganisms as cause of invasive infections such as meningitis and the choice of initial empiric antimicrobial treatments is discussed.

Jensen L; Hoffmann T; Knudsen JD; Rosenfeldt V

2013-08-01

369

Computed tomography in cases of coccidioidal meningitis, with clinical correlation  

International Nuclear Information System (INIS)

[en] Cranial computed tomographic (CT) scans of 22 patients with coccidioidal meningitis were reviewed and their clinical course was analyzed. Abnormalities of the ventricular system or the basilar cisterns or both were present in 16 instances. Although it is not a definitive diagnostic tool, the CT scan is helpful in suggesting a diagnosis of coccidioidal meningitis and in predicting the prognosis of patients affected by the disease. 19 references, 4 figures, 2 tables

1985-01-01

370

Intracranial neurenteric cyst: A rare cause of chemical meningitis.  

UK PubMed Central (United Kingdom)

Intracranial neurenteric cysts are exceedingly rare congenital intracranial lesions that result from disorder of gastrulation. Still, more rarely, the cyst contents may leak into the CSF and give rise to recurrent episodes of chemical meningitis. We present a case of chemical meningitis due to a leaking posterior fossa neurenteric cyst in a young female, with emphasis on its imaging features. The final diagnosis was achieved by sufficiently characteristic imaging features; histopathologic documentation could not be achieved as the patient denied surgery.

Choh NA; Wani M; Nazir P; Saleem SM; Shaheen F; Rabbani I; Gojwari T

2013-04-01

371

Scrub typhus meningitis in South India--a retrospective study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Scrub typhus is prevalent in India although definite statistics are not available. There has been only one study on scrub typhus meningitis 20 years ago. Most reports of meningitis/meningoencephalitis in scrub typhus are case reports. METHODS: A retrospective study done in Pondicherry to extract cases of scrub typhus admitted to hospital between February 2011 and January 2012. Diagnosis was by a combination of any one of the following in a patient with an acute febrile illness--a positive scrub IgM ELISA, Weil-Felix test, and an eschar. Lumbar puncture was performed in patients with headache, nuchal rigidity, altered sensorium or cranial nerve deficits. RESULTS: Sixty five cases of scrub typhus were found, and 17 (17/65) had meningitis. There were 33 males and 32 females. Thirteen had an eschar. Median cerebrospinal fluid (CSF) cell count, lymphocyte percentage, CSF protein, CSF glucose/blood glucose, CSF ADA were 54 cells/µL, 98%, 88 mg/dL, 0.622 and 3.5 U/mL respectively. Computed tomography was normal in patients with altered sensorium and cranial nerve deficits. Patients with meningitis had lesser respiratory symptoms and signs and higher urea levels. All patients had received doxycycline except one who additionally received chloramphenicol. CONCLUSION: Meningitis in scrub typhus is mild with quick and complete recovery. Clinical features and CSF findings can mimic tuberculous meningitis, except for ADA levels. In the Indian context where both scrub typhus and tuberculosis are endemic, ADA and scrub IgM may be helpful in identifying patients with scrub meningitis and in avoiding prolonged empirical antituberculous therapy in cases of lymphocytic meningitis.

Viswanathan S; Muthu V; Iqbal N; Remalayam B; George T

2013-01-01

372

Think fungus NOT just a crypto-meningitis in AIDS!  

UK PubMed Central (United Kingdom)

UNLABELLED: Extrapulmonary cryptococcosis has been defined as AIDS defining illness in HIV infected people. Cryptococcal meningitis is the commonest meningitis with advanced immune deficiency. Therefore clinicians ask for tests only for detection of cryptococci which may be misleading. A prospective study of suspected fungal meningitis with CSF fungal culture is carried out. MATERIAL AND METHODS: 70 ART naive cases of suspected fungal meningitis in HIV cases were subjected to CSF cytochemistry, smear exam and CSF fungal culture. RESULTS: The CSF culture was positive in 75.6% cases of these 21 were C. Neoformans as against 28 of Rhodotorula. In addition candida, aspergillus, geotrichum, trichosporon were isolated. CONCLUSION: Apart from c. neoformans, other fungi also cause meningitis. Each case of suspected fungal meningitis, may be subjected for CSF fungal culture for proper and adequate management. If facility for fungal culture is not available and if CSF smear shows evidence of fungal infection then standard therapy with Amphotericin may be instituted earlier to reduce mortality. This is the largest series isolating Rhodotorula from CSF in AIDS patients.

Badiye A; Patnaik M; Deshpande A; Rajendran C; Chandrashekara KV

2012-12-01

373

[Analysis of 62 adult patients with viral meningitis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the clinical manifestation, cerebrospinal fluid (CSF) and auxiliary examination findings of adult viral meningitis. METHODS: 62 adult patients with viral meningitis were retrospectively analyzed. RESULTS: Headache occurred in all the 62 (100%) patients, fever occurred in 61 (98%) patients, meningeal irritation sign occurred in 48 (77%) patients. The abduction of left eye was limited in one patient. Seizure occurred in 2 patients. The mean duration time was 17 days, 93% patients less than 30 days. The pressure of CSF increased in 80% patients, leukocyte counts increased in 91% patients, protein level increased in 81% patients, chloride level was normal in 35% patients and slightly lower in 65% patients, glucose level was normal in 94% patients. 7 patients had positive IgM antibody of Coxackievirus B group both in serum and CSF, one patient had positive IgM antibody of EB virus in CSF. Cranial CT scan had no special findings in all patients. 23 patients performed MRI examination, meningeal enhancement occurred in 9 patients. 52% patients had abnormal EEG, mainly increased local or diffuse slow waves. CONCLUSION: Adult viral meningitis was a kind of self-limited disease, chloride level was slightly lower in more than half patients, meningeal enhancement was detected in MRI in part patients.

Wang RJ; Wang DX; Wang JW; Feng ZJ

2009-06-01

374

Long-term sequelae of childhood bacterial meningitis.  

UK PubMed Central (United Kingdom)

In most high-income countries, fewer children now acquire meningitis, and many of those who do will survive. Globally, however, meningitis still remains a significant cause of child morbidity and mortality. In this article, the authors review recent evidence on the morbidity faced by childhood survivors of bacterial meningitis. Outcomes vary by bacterial pathogen, with around a 20 % risk for severe sequelae (most commonly, neurocognitive) by all pathogenic causes. Pneumococcal, tuberculosis, and group B streptococcal meningitis lead to the highest rates of sequelae. Recent epidemiological shifts in the major pathogens causing meningitis, as well as varied regional settings between studies, limit generalizability of evidence in the literature, and better research using longitudinal data and case-control methodology is required, especially in low-income countries. However, the consistently high levels of complications described in the literature call for more widespread vaccination programs for prevention and a greater focus on potential complications by educators and health-care providers to support childhood survivors of bacterial meningitis and their families.

Hudson LD; Viner RM; Christie D

2013-06-01

375

Meningitis granulomatosa, glomerulonefritis rápidamente progresiva y vasculitis/ Granulomatous meningitis, crescentic glomerulonephritis and vasculitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El compromiso meníngeo es una manifestación infrecuente de la granulomatosis de Wegener. Puede manifestarse como cefalea con hiperproteinorraquia y engrosamiento de la duramadre con aspecto granulomatoso, que se observa en la resonancia magnética. Presentamos un varón de 57 años con granulomatosis de Wegener que debutó con compromiso de vías aéreas superiores, oídos, órbitas y meningitis granulomatosa asintomática y que posteriormente evolucionó con mononeurit (more) is múltiple y glomerulonefritis crescéntica ANCA positiva. La presencia de ANCA y el compromiso sistémico (vías aéreas superiores, oído, órbitas, nervios periféricos, duramadre y glomerulonefritis rápidamente progresiva) permitieron en este caso llegar a un diagnóstico de certeza e iniciar el tratamiento inmunosupresor combinado (corticoides y ciclofosfamida). Evolucionó con remisión clínica y serológica (negativización de ANCA), pero persistiendo leve deterioro secuelar auditivo y de la función renal, sin recidiva de la enfermedad de base. Abstract in english Meningeal involvement is an infrequent manifestation of Wegener's granulomatosis. Clinical manifestations can be headache with high protein level in the cerebrospinal fluid and an enhanced MRI signal of granulomatous thickening of the duramater in the brain. We report a 57 year-old male with Wegener granulomatosis with onset manifestations of asymptomatic granulomatous meningitis, upper respiratory tract, ears and orbits involvement. He progressively developed ANCA positi (more) ve multiple mononeuritis and crescentic glomerulonephritis. The diagnostic confirmation of Wegener's granulomatosis based on a positive ANCA test and on the evidence of systemic disease (crescentic glomerulonephritis and involvement of the upper respiratory tract, ears, orbits, peripheral nerves and duramater) allowed a prompt initiation of aggressive immunosuppressive treatment with systemic cyclophosphamide and high - dosis corticosteroids. The patient entered into a sustained clinical remission with mild residual neurosensorial hearing loss and renal failure.

Ludueña, Ana; Dorado, Enrique; Sarano, Judith; Semeniuk, Guillermo

2011-08-01

376

Meningitis granulomatosa, glomerulonefritis rápidamente progresiva y vasculitis Granulomatous meningitis, crescentic glomerulonephritis and vasculitis  

Directory of Open Access Journals (Sweden)

Full Text Available El compromiso meníngeo es una manifestación infrecuente de la granulomatosis de Wegener. Puede manifestarse como cefalea con hiperproteinorraquia y engrosamiento de la duramadre con aspecto granulomatoso, que se observa en la resonancia magnética. Presentamos un varón de 57 años con granulomatosis de Wegener que debutó con compromiso de vías aéreas superiores, oídos, órbitas y meningitis granulomatosa asintomática y que posteriormente evolucionó con mononeuritis múltiple y glomerulonefritis crescéntica ANCA positiva. La presencia de ANCA y el compromiso sistémico (vías aéreas superiores, oído, órbitas, nervios periféricos, duramadre y glomerulonefritis rápidamente progresiva) permitieron en este caso llegar a un diagnóstico de certeza e iniciar el tratamiento inmunosupresor combinado (corticoides y ciclofosfamida). Evolucionó con remisión clínica y serológica (negativización de ANCA), pero persistiendo leve deterioro secuelar auditivo y de la función renal, sin recidiva de la enfermedad de base.Meningeal involvement is an infrequent manifestation of Wegener's granulomatosis. Clinical manifestations can be headache with high protein level in the cerebrospinal fluid and an enhanced MRI signal of granulomatous thickening of the duramater in the brain. We report a 57 year-old male with Wegener granulomatosis with onset manifestations of asymptomatic granulomatous meningitis, upper respiratory tract, ears and orbits involvement. He progressively developed ANCA positive multiple mononeuritis and crescentic glomerulonephritis. The diagnostic confirmation of Wegener's granulomatosis based on a positive ANCA test and on the evidence of systemic disease (crescentic glomerulonephritis and involvement of the upper respiratory tract, ears, orbits, peripheral nerves and duramater) allowed a prompt initiation of aggressive immunosuppressive treatment with systemic cyclophosphamide and high - dosis corticosteroids. The patient entered into a sustained clinical remission with mild residual neurosensorial hearing loss and renal failure.

Ana Ludueña; Enrique Dorado; Judith Sarano; Guillermo Semeniuk

2011-01-01

377

Criteria indicating morbidity in tuberculous meningitis  

International Nuclear Information System (INIS)

[en] Objective: To work out a criterion that may indicate morbidity in tuberculous meningitis. Methods: The retrospective study was conducted at the Medical Unit of the Liaquat University of Health Sciences, Jamshoro, Pakistan, and included cases related to a period between January 2006 and June 2011. Record of 50 patients were evaluated for clinical features, chest radiograph, Mantoux test, sputum for acid fast bacilli, routine investigations, cerebrospinal fluid studies, computerised tomography scan and magnetic resonance imaging of head. All the patients in the study had been treated with conventional approach. The severity of the condition was classified in stages, I, II and III. Clinical features, laboratory findings and imaging reports were analysed through SPSS 10 to find out the criteria indicating morbidity. Mean, median, standard deviation were calculated. Student t-test was applied on variables. Results: Of the 50 patients, 26 (52%) were male and 24 (48%) were female. Their ages ranged from 12 to 70 years. Mean age was 37.72 +-19.65 years. Median age was 35.54 years. Of the total, 17 (34%) patients recovered completely without any complications. Their mean age was 24+-8.98 years and their mean time interval from onset of illness to presentation in the hospital was 21.75+-9.75 days. Besides, 30 (60%) patients persisted with neurological sequelae, including cranial nerve palsies, hemiplegia, and hydrocephalus. Patients with neurological sequelae had mean age of 48+-17.48 years and their mean time interval from onset of illness to presentation in the hospital was 41.33+-14.14 days. Hydrocephalus was seen in 10 (20%) patients. Three (6%) patients expired. Clinical features, laboratory findings and imaging reports analysis showed that the criteria indicating morbidity were increasing age of the patient (p=0.037), late diagnosis (p=0.044), advancing stage of disease, and development of hydrocephalus. Conclusion: Increasing age of the patient, late diagnosis, advancing stage of the disease and the development of hydrocephalus indicate morbidity in tuberculous meningitis. (author)

2012-01-01

378

Otobasal liquor fistula causing recurrent bacterial meningitis; Otobasale Liquorfistel als Ursache einer rezidivierenden bakteriellen Meningitis  

Energy Technology Data Exchange (ETDEWEB)

Cerebral subarachnoid space scintigraphy today still is the modality of choice for detection of a liquorrea or a liquor fistula, especially in the case of a recurrent menengitis of unclear origin. This diagnostic method yielded the results required in the case reported for efficient and successful surgical treatment. (orig./CB) [German] Die zerebrale Liquorraumszintigraphie ist aufgrund der hohen Empfindlichkeit auch heute noch die Methode der Wahl zum Nachweis einer Liquorrhoe beziehungsweise einer Liquorfistel, insbesondere bei einer rezidivierenden Meningitis unklarer Genese. Sie ermoeglichte bei unserer Patientin eine gezielte definitive operative Behandlung. (orig.)

Doege, H. [Abteilung fuer Nuklearmedizin, Leipzig Univ. (Germany); Klinghammer, A.; Elix, H. [Klinik fuer Kinder- und Jugendmedizin, Leipzig Univ. (Germany); Pilz, D. [Institut fuer Bildgebende Diagnostik der Klinikum Chemnitz gGmbH (Germany); Bootz, F. [Klinik und Poliklinik fuer Hals-Nasen-Ohren-Heilkunde/ Plastische Operationen, Leipzig Univ. (Germany)

2000-07-01

379

FDG PET in the diagnosis of meningeal carcinomatosis  

International Nuclear Information System (INIS)

Objective: Meningeal involvement is frequent in metastatic lymphoma, leukemia, and other metastatic tumor. Functional signs may be misleading and the neurological examination may be normal or non-specific. Certain diagnosis requires identification of tumor cells in the cerebrospinal fluid. CSF cytology is however sometimes negative and MRI maybe help in providing the diagnosis. The aim of our retrospective study was to assess the role of FDG PET in the diagnosis of meningeal carcinomatosis. Patients and Methods: The diagnosis of meningeal carcinomatosis was made in 5 patients between 1999 and 2001. Two of the patients were suffer from lymphoma, two were lung cancer patients, and another was a breast cancer patient. Cytology examination of the cerebrospinal fluid provided the diagnosis of meningeal carcinomatosis in these 5 patients. All the patients had signs of neurological function impairment, but the neurological examination cannot demonstrate the site of lesions. Therefore, All the patients had MRI examination, but only 1 case was diagnosis correctly (the MRI showing meningeal enhancement). 3 patients' MRI results show normal .Another MRI was suspicious of ischemic change. Results: A brain FDG PET using an ECAT HR + PET examined all the 5 patients. All the FDG PET results show the hypermetabolic foci respectively. The foci were diffused on the brain meninges. Their size is bigger than the foci detected by MRI . 3 of the patients repeated the FDG PET scan after treatment (chemotherapy and radiotherapy). The therapeutic effect can be reflecting by FDG PET (the foci dismissed as the neurological symptoms disappeared), although the simultaneity MRI shows no change before and after treatment. Conclusion: 5 patients proven meningeal carcinomatosis FDG PET has better sensitivity than brain MRI scans and other anatomic modality. The patients who suffer from metastatic lymphoma, leukemia, and other metastatic tumor with nonspecific neurological signs should be explored with a brain FDG PET.

2002-10-02

380

Meningite neofatal: aspectos associados Neonatal meningitis: related features  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUÇÃO: O objetivo deste estudo foi identificar e analisar fatores relacionados à meningite neonatal. MÉTODO: Em estudo de caso-controle, foram examinados neonatos com meningite no período de agosto/2002 a dezembro/2003 na Unidade de Tratamento Intensivo Neonatal (UTIN) e alocados recém-nascidos hígidos como grupo controle (GC). Foram relatados dados referentes à gestação, ao parto e ao neonato. Os resultados foram considerados significativos quando p (alfa)OBJECTIVE: The goal of this study was to identify and to analyze the features related to the occurrence of neonatal meningitis. METHOD: In a case-control study we examined all newborns presenting meningitis between August/2002 and December/2003 in the neonatal Intensive Care Unit. Healthy newborns were enrolled as a Control Group (CG). Data related to pregnancy, labor and the neonate itself were collected. The results with p<0,05 were considered significant. RESULTS: 42 newborns with meningitis were compared to 42 controls. The meningitis group (MG) presented a lower number of medical visits during the prenatal care. The most common abnormalities detected in both groups were: drug addiction, congenital infections, preeclampsia, eclampsia, gestational diabetes mellitus and urinary tract infections. Fetal respiratory distress and the use of respiratory support were related to the occurrence of meningitis. The average weight and the APGAR scores were lower in the MG. The prevalence of premature and small for the gestational age infants was significantly higher in the MG. The neurological examination detected abnormalities in 35.7% of the meningitis cases. CONCLUSION: The association of risk factors related to pregnancy, labor and the newborn itself to the neonatal meningitis outcome in our setting is similar to the described in the literature.

Diogo C. Haussen; Lívia N. Brandalise; Fabiane A. Praetzel; André S. Malysz; Renate Mohrdieck; Marco A.F. Reichelt; Célia B. Magalhães; Sérgio P. Grossi; Ana Guardiola

2005-01-01

 
 
 
 
381

Prospective investigation of pituitary functions in patients with acute infectious meningitis: is acute meningitis induced pituitary dysfunction associated with autoimmunity?  

Science.gov (United States)

Previous case reports and retrospective studies suggest that pituitary dysfunction may occur after acute bacterial or viral meningitis. In this prospective study we assessed the pituitary functions, lipid profile and anthropometric measures in adults with acute bacterial or viral meningitis. Moreover, in order to investigate whether autoimmune mechanisms could play a role in the pathogenesis of acute meningitis-induced hypopituitarism we also investigated the anti-pituitary antibodies (APA) and anti-hypothalamus antibodies (AHA) prospectively. Sixteen patients (10 males, 6 females; mean ± SD age 40.9 ± 15.9) with acute infectious meningitis were included and the patients were evaluated in the acute phase, and at 6 and 12 months after the acute meningitis. In the acute phase 18.7% of the patients had GH deficiency, 12.5% had ACTH and FSH/LH deficiencies. At 12 months after acute meningitis 6 of 14 patients (42.8%) had GH deficiency, 1 of 14 patients (7.1%) had ACTH and FSH/LH deficiencies. Two of 14 patients (14.3%) had combined hormone deficiencies and four patients (28.6%) had isolated hormone deficiencies at 12 months. Four of 9 (44.4%) hormone deficiencies at 6 months were recovered at 12 months, and 3 of 8 (37.5%) hormone deficiencies at 12 months were new-onset hormone deficiencies. At 12 months there were significant negative correlations between IGF-I level vs. LDL-C, and IGF-I level vs. total cholesterol. The frequency of AHA and APA positivity was substantially high, ranging from 35 to 50% of the patients throughout the 12 months period. However there were no significant correlations between AHA or APA positivity and hypopituitarism. The risk of hypopituitarism, GH deficiency in particular, is substantially high in the acute phase, after 6 and 12 months of the acute infectious meningitis. Moreover we found that 6th month after meningitis is too early to make a decision for pituitary dysfunction and these patients should be screened for at least 12 months. In addition, the occurrence of AHA and APA positivity due to acute infectious meningitis was demonstrated for the first time. Further longer-term prospective investigations need to be carried out on a larger cohort of patients to understand the role of autoimmunity in the pathogenesis of late hypopituitarism after acute infectious meningitis. PMID:22228382

Tanriverdi, F; De Bellis, A; Teksahin, H; Alp, E; Bizzarro, A; Sinisi, A A; Bellastella, G; Paglionico, V A; Bellastella, A; Unluhizarci, K; Doganay, M; Kelestimur, F

2012-12-01

382

Prospective investigation of pituitary functions in patients with acute infectious meningitis: is acute meningitis induced pituitary dysfunction associated with autoimmunity?  

UK PubMed Central (United Kingdom)

Previous case reports and retrospective studies suggest that pituitary dysfunction may occur after acute bacterial or viral meningitis. In this prospective study we assessed the pituitary functions, lipid profile and anthropometric measures in adults with acute bacterial or viral meningitis. Moreover, in order to investigate whether autoimmune mechanisms could play a role in the pathogenesis of acute meningitis-induced hypopituitarism we also investigated the anti-pituitary antibodies (APA) and anti-hypothalamus antibodies (AHA) prospectively. Sixteen patients (10 males, 6 females; mean ± SD age 40.9 ± 15.9) with acute infectious meningitis were included and the patients were evaluated in the acute phase, and at 6 and 12 months after the acute meningitis. In the acute phase 18.7% of the patients had GH deficiency, 12.5% had ACTH and FSH/LH deficiencies. At 12 months after acute meningitis 6 of 14 patients (42.8%) had GH deficiency, 1 of 14 patients (7.1%) had ACTH and FSH/LH deficiencies. Two of 14 patients (14.3%) had combined hormone deficiencies and four patients (28.6%) had isolated hormone deficiencies at 12 months. Four of 9 (44.4%) hormone deficiencies at 6 months were recovered at 12 months, and 3 of 8 (37.5%) hormone deficiencies at 12 months were new-onset hormone deficiencies. At 12 months there were significant negative correlations between IGF-I level vs. LDL-C, and IGF-I level vs. total cholesterol. The frequency of AHA and APA positivity was substantially high, ranging from 35 to 50% of the patients throughout the 12 months period. However there were no significant correlations between AHA or APA positivity and hypopituitarism. The risk of hypopituitarism, GH deficiency in particular, is substantially high in the acute phase, after 6 and 12 months of the acute infectious meningitis. Moreover we found that 6th month after meningitis is too early to make a decision for pituitary dysfunction and these patients should be screened for at least 12 months. In addition, the occurrence of AHA and APA positivity due to acute infectious meningitis was demonstrated for the first time. Further longer-term prospective investigations need to be carried out on a larger cohort of patients to understand the role of autoimmunity in the pathogenesis of late hypopituitarism after acute infectious meningitis.

Tanriverdi F; De Bellis A; Teksahin H; Alp E; Bizzarro A; Sinisi AA; Bellastella G; Paglionico VA; Bellastella A; Unluhizarci K; Doganay M; Kelestimur F

2012-12-01

383

Specificity of immunoblotting analyses in eosinophilic meningitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Angiostrongylus cantonensis and Gnathostoma spinigerum are the two most common causative parasites of eosinophilic meningitis (EOM). Serological tests are helpful tools for confirming the identity of the pathogen. Recent reports determined the specificity of such tests by using normal healthy controls. There have been limited studies done to rule out the cross-reactivity between these two causative parasites of EOM. This study aims to assess the specificity of the serolog (more) ical test in EOM by using each condition as a control for the other. Thirty-three patients with a diagnosis of EOM were enrolled. Sera from 22 patients with a positive 29-kDa antigenic diagnostic band of A. cantonensis were tested for the 21 and 24-kDa antigenic bands of G. spinigerum. Similarly, sera of 11 gnathostomiasis patients were tested for the 29-kDa diagnostic band for A. cantonensis. Only one patient in the angiostrongyliasis group had a positive result for the 21 and 24-kDa antigenic bands of G. spinigerum, while no gnathostomiasis patients showed a positive result for the 29-kDa antigenic band of A. cantonensis. The specificity of the 21 and 24-kDa antigenic bands for gnathostomiasis and the 29-kDa antigenic band for A. cantonensis was 95.5% and 100%, respectively. The antigenic bands for the diagnosis of gnathostomiasis and angiostrongyliasis in EOM were highly specific.

Sawanyawisuth, Kanlayanee; Sawanyawisuth, Kittisak; Intapan, Pewpan M; Khotsri, Piyarat; Kanpittaya, Jaturat; Chotmongkol, Verajit; Maleewong, Wanchai

2011-08-01

384

Extreme hypoglycorrhachia: not always bacterial meningitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: A 55-year-old man presented with 4 months of chronic meningitis, neutrophilic pleocytosis and extreme hypoglycorrhachia-an abnormally low concentration of glucose in the cerebrospinal fluid (CSF). A previous neurological work-up had revealed no noteworthy abnormalities. Despite the brief improvements that were seen after numerous trials of antibiotics and corticosteroids, the symptoms relapsed soon after corticosteroids were discontinued. Lumbar puncture revealed cholesterol crystals in the CSF and imaging studies revealed a sickle-shaped sacrum, partial rectal stenosis, and a communicating presacral meningocele with an epidermoid-dermoid mass. Extreme hypoglycorrhachia seems almost always to be bacterial in origin, but its differential diagnosis is, nevertheless, extensive. The definition, physiology, pathophysiology and differential diagnosis of hypoglycorrhachia are reviewed here. INVESTIGATIONS: Physical examination, laboratory testing, multiple imaging studies including CT and MRI of the brain and spinal cord, as well as myelography and CSF analysis. DIAGNOSIS: Cholesterol-induced leptomeningitis in a patient with Currarino syndrome, a triad that consists of sacral bone defects, congenital hindgut anomaly, and a presacral tumor. MANAGEMENT: The patient was initially treated with multiple antimicrobials and steroids. However, once the cholesterol crystals and communicating presacral cyst were identified, the condition was successfully managed with surgically resection of the cyst.

Viola GM

2010-11-01

385

Achromobacter xylosoxidans (Alcaligenes xylosoxidans subsp. xylosoxidans) meningitis associated with a gunshot wound.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The microbiological and clinical features of a case of Achromobacter xylosoxidans (Alcaligenes xylosoxidans subsp. xylosoxidans) meningitis associated with a gunshot wound are described. To our knowledge, this is the third confirmed case report of meningitis caused by this organism.

D'Amato, R F; Salemi, M; Mathews, A; Cleri, D J; Reddy, G

386

Dementia and capsular genu ischemia in patients with severe bacterial meningitis.  

UK PubMed Central (United Kingdom)

Infarction in the genu of the internal capsule causes dementia that is characterized by abulia, lethargy and memory loss without obvious motor palsy (capsular genu syndrome). We found infarction or decreased cerebral blood flow in the genu of the internal capsule in 6 of 13 patients with severe bacterial meningitis. Four of these six patients developed post-meningitis dementia, characterized by abulia, lethargy, and memory loss. Of 24 patients with viral meningitis, none developed capsular genu ischemia or post-meningitis dementia. In patients with severe bacterial meningitis, capsular genu ischemia may play some role in the development of post-meningitis dementia. In patients with viral meningitis, absence of such ischemia may explain, at least in a part, the rarity of post-meningitis dementia.

Naito M; Johkura K; Momoo T; Nomiya T; Kudo Y; Kuroiwa Y

2010-04-01

387

Contrast enhancement of the cerebrospinal fluid on MRI in two cases of spirochaetal meningitis  

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We report two patients with meningitis due to spirochaetal infection, both of whom showed diffusely enhancing meninges around the brain and spinal cord. In addition, there was enhancement of the cerebrospinal fluid after intravenous administration of Gd-DTPA. (orig.)

Good, C.D.; Jaeger, H.R. [Lysholm Radiological Department, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG (United Kingdom)

2000-06-01

388

Carcinomatose das meninges: dados clínico-patológicos de 3 casos Carcinomatosis of the meninges: a report of three cases  

Directory of Open Access Journals (Sweden)

Full Text Available Foram estudados 3 casos de carcinomatose das meninges, autopsiados no serviço de Anatomia Patológica do Hospital Prof. Edgard Santos. O quadro neurológico apresentado era proeminente e representado por sinto- matologia decorrente do envolvimento meníngeo e encefálico, razão pela qual foram considerados como portadores de meningite tuberculosa e encefalomielite. O aspecto de maior interesse neste estudo foi a discrepância entre o quadro clínico e os dados anátomo-patológicos do exame do encéfalo. A sintomatologia clínica foi proeminente, enquanto as lesões anatômicas foram apenas discretas ou moderadas e representadas por espessamento e granulosidade das meninges, com infiltração difusa do espaço subaracnoideano pela neoplasia. Nos casos 1 e 3 a neoplasia estava representada por adenocarcinoma, cujos focos primitivos foram localizados no pulmão e vesícula biliar, respectivamente. O caso 2 era um carcinoma indiferenciado do estômago, com envolvimento difuso do espaço subaracnoideano e subdural, havendo neste último extensa hemorragia recente. Os critérios diagnósticos e a maneira de disseminação desta condição são discutidos.A diffuse involvement of the meninges by carcinoma is described in three cases characterizing the so called "meningeal carcinomatosis". The neurologic symptoms were those of the chronic meningitis or encephalomyelitis, with changes in the spinal fluid. The morphologic features were identical in the three cases and represented by slight to moderate thickening of the meninges by diffuse infiltration of tumor cells and few foci of inflamatory reaction. The cases 1 and 3 were represented by well differentiated adenocarcinoma with primary site in the lung and gallbladder, respectively. In case 2 the tumor was a poorly differentiated carcinoma of stomach with diffuse involvement of the arachnoid and dura mater associated with recent hemorrhage. An interesting point was the lack of correlation between clinical and pathological findings. The clinical symptoms were very prominent and the gross findings only slight to moderate. The criteria for diagnosis of this entity as well as the mechanism of dissemination of the carcinoma to the meninges are reviewed and discussed.

Aristides Cheto de Queiroz; Carlos Renato Melo

1974-01-01

389

Carcinomatose das meninges: dados clínico-patológicos de 3 casos/ Carcinomatosis of the meninges: a report of three cases  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Foram estudados 3 casos de carcinomatose das meninges, autopsiados no serviço de Anatomia Patológica do Hospital Prof. Edgard Santos. O quadro neurológico apresentado era proeminente e representado por sinto- matologia decorrente do envolvimento meníngeo e encefálico, razão pela qual foram considerados como portadores de meningite tuberculosa e encefalomielite. O aspecto de maior interesse neste estudo foi a discrepância entre o quadro clínico e os dados anátomo- (more) patológicos do exame do encéfalo. A sintomatologia clínica foi proeminente, enquanto as lesões anatômicas foram apenas discretas ou moderadas e representadas por espessamento e granulosidade das meninges, com infiltração difusa do espaço subaracnoideano pela neoplasia. Nos casos 1 e 3 a neoplasia estava representada por adenocarcinoma, cujos focos primitivos foram localizados no pulmão e vesícula biliar, respectivamente. O caso 2 era um carcinoma indiferenciado do estômago, com envolvimento difuso do espaço subaracnoideano e subdural, havendo neste último extensa hemorragia recente. Os critérios diagnósticos e a maneira de disseminação desta condição são discutidos. Abstract in english A diffuse involvement of the meninges by carcinoma is described in three cases characterizing the so called "meningeal carcinomatosis". The neurologic symptoms were those of the chronic meningitis or encephalomyelitis, with changes in the spinal fluid. The morphologic features were identical in the three cases and represented by slight to moderate thickening of the meninges by diffuse infiltration of tumor cells and few foci of inflamatory reaction. The cases 1 and 3 were (more) represented by well differentiated adenocarcinoma with primary site in the lung and gallbladder, respectively. In case 2 the tumor was a poorly differentiated carcinoma of stomach with diffuse involvement of the arachnoid and dura mater associated with recent hemorrhage. An interesting point was the lack of correlation between clinical and pathological findings. The clinical symptoms were very prominent and the gross findings only slight to moderate. The criteria for diagnosis of this entity as well as the mechanism of dissemination of the carcinoma to the meninges are reviewed and discussed.

Queiroz, Aristides Cheto de; Melo, Carlos Renato

1974-12-01

390

MRI features of meningeal metastasis from lung cancer  

International Nuclear Information System (INIS)

Objective: To investigate the pathway and MRI findings of meningeal metastasis original from lung cancer. Methods: 44 cases with cerebro-spinal meningeal metastasis original from lung cancer proven by clinical and pathology were retrospectively reviewed. All cases undergone plain MRI scan and Gd-DTPA enhanced MRI scan on brain and/or spine. Results: MRI plain scan indicated 28 cases with brain metastases, 3 cases with meningeal nodosity or irregularly patchy abnormal signal, 1 case with nodule in left cavernous sinus, 10 cases with abnormal signal in spine, 2 cases with abnormal signal in spinal dura mater. 34 cases with cerebro meningeal metastases were found in MRI enhancement scan. Among them, 11 cases displayed cerebral dura mater-arachnoid enhancement, 17 cases revealed cerebral pia mater-arachnoid enhancement and 6 cases with mixed typed enhancement. Osteoclasia in skull was found in 4 cases, spinal metastasis was revealed in 17 cases, and patchy abnormal enhancement in spinal dura mater was showed in 12 cases. Conclusion: Hematogenous metastasis is a main route of meningeal metastasis caused by lung cancer and enhanced MRI scan is of important diagnostic value. (authors)

2009-01-01

391

Early diagnosis model for meningitis supports public health decision making.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To develop a predictive model for rapid differential diagnosis of meningitis and meningococcal septicaemia to support public health decisions on chemoprophylaxis for contacts. METHODS: Prospective study of suspected cases of acute meningitis and meningococcal septicaemia admitted to hospitals in the South West, West Midlands and London Regions of England from July 2008 to June 2009. Epidemiological, clinical and laboratory variables on admission were recorded. Logistic regression was used to derive a predictive model. RESULTS: Of the 719 suspect cases reported, 385 confirmed cases were included in analysis. Peripheral blood polymorphonuclear count of >16 × 10(9)/l, serum C-reactive protein of >100 mg/l and haemorrhagic rash were strongly and independently associated with diagnosis of bacterial meningitis and meningococcal septicaemia. Using a simple scoring system, the presence of any one of these factors gave a probability of >95% in predicting the final diagnosis. CONCLUSION: We have developed a model using laboratory and clinical factors, but not dependent on availability of CSF, for differentiating acute bacterial from viral meningitis within a few hours of admission to hospital. This scoring system is recommended in public health management of suspected cases of meningitis and meningococcal septicaemia to inform decisions on chemoprophylaxis.

Close RM; Ejidokun OO; Verlander NQ; Fraser G; Meltzer M; Rehman Y; Muir P; Ninis N; Stuart JM

2011-07-01

392

Human Parasitic Meningitis Caused by Angiostrongylus cantonensis Infection in Taiwan.  

Science.gov (United States)

The major cause of eosinophilic meningitis in Taiwan is Angiostrongylus cantonensis. Humans are infected by ingesting terrestrial and freshwater snails and slugs. In 1998 and 1999, two outbreaks of eosinophilic meningitis caused by A. cantonensis infection were reported among 17 adult male immigrant Thai laborers who had eaten raw golden apple snails (Pomacea canaliculata). Another outbreak associated with consuming a health drink consisting of raw vegetable juice was reported in 2001. These adult cases differed from reports in the 1970s and 1980s, in which most of the cases were in children. With improvements in public health and education of foreign laborers, there have since been only sporadic cases in Taiwan. Review of clinical research indicates inconsistent association of Magnetic Resonance Imaging (MRI) results with clinical features of eosinophilic meningitis. MRI features were nonspecific but there was an association between the presence of high brain MRI signal intensities and severity of peripheral and cerebrospinal fluid (CSF) eosinophilia. Inflammatory markers have been identified in the CSF of patients with eosinophlic meningitis caused by A. cantonensis infection, and vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), and the matrix metalloproteinase system may be associated with blood-brain barrier disruption. Eosinophilic meningitis caused by A. cantonensis infection is not a reportable disease in Taiwan. It is important that a public advisory and education program be developed to reduce future accidental infection. PMID:23901378

Tsai, Hung-Chin; Chen, Yao-Shen; Yen, Chuan-Min

2013-06-01

393

Human Parasitic Meningitis Caused by Angiostrongylus cantonensis Infection in Taiwan.  

UK PubMed Central (United Kingdom)

The major cause of eosinophilic meningitis in Taiwan is Angiostrongylus cantonensis. Humans are infected by ingesting terrestrial and freshwater snails and slugs. In 1998 and 1999, two outbreaks of eosinophilic meningitis caused by A. cantonensis infection were reported among 17 adult male immigrant Thai laborers who had eaten raw golden apple snails (Pomacea canaliculata). Another outbreak associated with consuming a health drink consisting of raw vegetable juice was reported in 2001. These adult cases differed from reports in the 1970s and 1980s, in which most of the cases were in children. With improvements in public health and education of foreign laborers, there have since been only sporadic cases in Taiwan. Review of clinical research indicates inconsistent association of Magnetic Resonance Imaging (MRI) results with clinical features of eosinophilic meningitis. MRI features were nonspecific but there was an association between the presence of high brain MRI signal intensities and severity of peripheral and cerebrospinal fluid (CSF) eosinophilia. Inflammatory markers have been identified in the CSF of patients with eosinophlic meningitis caused by A. cantonensis infection, and vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), and the matrix metalloproteinase system may be associated with blood-brain barrier disruption. Eosinophilic meningitis caused by A. cantonensis infection is not a reportable disease in Taiwan. It is important that a public advisory and education program be developed to reduce future accidental infection.

Tsai HC; Chen YS; Yen CM

2013-06-01

394

Neoplastic meningitis.Review of a clinical series.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The increase in the ageing population in the last decades has led to an increased frequency of cancer-associated complications. Among these, neurological disorders stand out, as they appear in 10-30% of patients with systemic neoplasia. Neoplastic meningitis accounts for 4-15% of patients with solid tumours and it has a poor prognosis. The objective of this paper is to describe the clinical, imaging and prognostic characteristics as well as cerebrospinal fluid findings in a series of neoplastic meningitis. BACKGROUND AND DEVELOPMENT: We performed a retrospective review of all patients admitted to the Hospital Universitario of Gran Canaria Dr. Negrín with clinical suspicion of neoplastic meningitis between 1990 and 2008. We selected 37 patients with an average age ranging from 15 to 75 years old. A total of 81.8% of the cases in which a primary tumour was found were associated with solid tumours (24.2% were located in the breast, and 24.2% in the lung). The most frequent sign of cranial nerve dysfunction was dyplopia, which was observed in 32.4% of the cases. The average survival rate after diagnosis was 87.9 days (12.6 weeks). The cerebrospinal fluid cytology was positive in 46.4% of the cases. CONCLUSION: Neoplastic meningitis is a severe complication of both solid and haematological tumours. We stress the importance of maintaining a high level of suspicion to achieve early diagnosis, since the average survival probability for neoplastic meningitis patients is low.

Jiménez Mateos A; Cabrera Naranjo F; González Hernández A; Fabre Pi O; Díaz Nicolás S; López Fernández JC

2011-05-01

395

Cryptococcus meningoencephalitis in AIDS: parenchymal and meningeal forms.  

Science.gov (United States)

CT and MRI in one case of Cryptococcus neoformans infection showed contrast-enhancing parenchymal lesions resembling granulomata or abscesses. After an initial phase without contrast enhancement, the full extent of the lesions was visible within 2 weeks of presentation. The enhancing masses were assumed to represent intracerebral cryptococcomas. Despite evidence of massive meningeal infection on cerebrospinal fluid (CSF) examination, no radiological signs of meningitis, invasion of the Virchow-Robin spaces or ventriculitis could be demonstrated. With antimycotic treatment the contrast enhancement disappeared and cystic, partly calcified lesions remained. Recurrence of meningeal infection without radiological correlates was apparent in this stage. In a second case of proven cryptococcus meningitis, dilation of Virchow-Robin spaces or cysts in the adjacent parenchyma were the main abnormalities on MRI. Enhancing masses were not detected. These cases may represent two different reactions of the immunocompromised hosts to infection with C. neoformans: widening of the perivascular spaces as a correlate of the more typical meningeal infection and enhancing parenchymal lesions as a sign of further invasion from the CSF spaces. Enhancement of cryptococcomas, indicating an inflammatory response in the surrounding brain, is not typical in patients with impairment of immune function. PMID:10090606

Berkefeld, J; Enzensberger, W; Lanfermann, H

1999-02-01

396

[Case of Neuro-Behçet disease resembling bacterial meningitis].  

Science.gov (United States)

A 30-year-old man with intractable headache and high fever came to the emergency room. He presented skin eruption, aphtha, drowsiness (E3, V4, M6/GCS), meningeal sign, hyperreflexia, and bilateral papilloedema. He also showed pleocytosis (1,066/microl, polymorphonuclear cells predominantly) and pressure increase in CSF. WBC count and CRP were elevated. Two years before, he had meningeal sign, cervical myelitis, skin eruption, uveitis, and aphtha, and was diagnosed as Neuro-BehCet (NBD) disease. HLA-B52 and B55 were positive. We suspected recurrent NBD, but we couldn't exclude bacterial meningitis because of his symptoms and cell-pattern in CSF. We treated him with intravenous methylpredonisolone and antibiotics (MEPM 6 g/day and VCM 2 g/day). His symptoms dramatically improved within a few days. The rapid improvement might be attributed to the steroids. Furthermore, MRI FLAIR images showed multiple small high lesions in the brainstem, hemispheres, subcortical area, putamen and left cerebellar hemisphere. Serum procalcitonin was not increased. We diagnosed the recurrence of NBD retrospectively. Procalcitonin may be a useful marker for discrimination between meningitis due to NBD and septic meningitis. PMID:19086433

Nezu, Masahiro; Suzuki, Naoki; Mizuno, Hideki; Takai, Yoshiki; Misu, Tatsuro; Aoki, Masashi; Nakashima, Ichiro; Itoyama, Yasuto

2008-10-01

397

[Case of Neuro-Behcet disease resembling bacterial meningitis].  

UK PubMed Central (United Kingdom)

A 30-year-old man with intractable headache and high fever came to the emergency room. He presented skin eruption, aphtha, drowsiness (E3, V4, M6/GCS), meningeal sign, hyperreflexia, and bilateral papilloedema. He also showed pleocytosis (1,066/microl, polymorphonuclear cells predominantly) and pressure increase in CSF. WBC count and CRP were elevated. Two years before, he had meningeal sign, cervical myelitis, skin eruption, uveitis, and aphtha, and was diagnosed as Neuro-BehCet (NBD) disease. HLA-B52 and B55 were positive. We suspected recurrent NBD, but we couldn't exclude bacterial meningitis because of his symptoms and cell-pattern in CSF. We treated him with intravenous methylpredonisolone and antibiotics (MEPM 6 g/day and VCM 2 g/day). His symptoms dramatically improved within a few days. The rapid improvement might be attributed to the steroids. Furthermore, MRI FLAIR images showed multiple small high lesions in the brainstem, hemispheres, subcortical area, putamen and left cerebellar hemisphere. Serum procalcitonin was not increased. We diagnosed the recurrence of NBD retrospectively. Procalcitonin may be a useful marker for discrimination between meningitis due to NBD and septic meningitis.

Nezu M; Suzuki N; Mizuno H; Takai Y; Misu T; Aoki M; Nakashima I; Itoyama Y

2008-10-01

398

Group B Streptococcal Meningitis in Infants Beyond the Neonatal Period.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To describe the clinico-bacteriological profile, and early outcomes of infants diagnosed with Group B streptococcus (GBS) meningitis. METHODS: This was a retrospective review of infants (aged 1 mo to 2 y) diagnosed with GBS meningitis in a tertiary care hospital in New Delhi from October 2010 through January 2012. The clinico-bacteriological data and early outcomes of infants with suspected bacterial meningitis and a positive CSF latex agglutination test for GBS were studied. The CSF samples were subjected to PCR for broad spectrum 16s ribosomal DNA and the GBS species specific gene, the scpB. RESULTS: Twenty seven patients (13 boys, and 14 girls) were diagnosed with GBS meningitis during the study period. Broad spectrum 16s ribosomal DNA PCR was performed on 18 of the 27 CSF samples. Sixteen were positive. All these 16 were also positive for the species specific scpB gene. The median duration of hospital stay was 7 d (range 1-72 d). Nine patients died. One patient each developed ventriculitis, optic atrophy and hydrocephalus. Overall, 12 patients had a complete recovery at discharge. CONCLUSIONS: GBS must be considered in the etiology of bacterial meningitis in Indian infants.

Dwivedi S; Das BK; Aneja S; Sharma S; Chaturvedi MK; Kahn G; Fitzwater SP; Chandran A; Wadhwa N; Bhatnagar S

2013-07-01

399

Implantation of the common cavity malformation may prevent meningitis.  

UK PubMed Central (United Kingdom)

UNLABELLED: OBJECTIVES AND IMPORTANCE: Children with certain congenital malformations of the inner ear, including those with a common cavity defect, have a higher incidence of spontaneous cerebrospinal fluid (CSF) leak and resulting meningitis. However, they may also benefit from cochlear implantation. We suggest that surgical management may be possible that both prevents meningitis and provides hearing rehabilitation during the same procedure. CLINICAL PRESENTATION: A 2-year-old girl with bilateral common cavity defects who had previously undergone cochlear implantation developed contralateral CSF leak resulting in meningitis. INTERVENTION: After resolution of the infection, cochlear implantation was performed at the same time as definitive CSF leak repair. Simultaneous cochlear implantation and repair of the CSF leak successfully decreased the chance of recurrent meningitis in this case. She has been deriving hearing benefit from the bilateral implants. CONCLUSION: This case suggests a role for cochlear implantation to be combined with simultaneous CSF leak repair in children with a cochlear malformation. Furthermore, bilateral cochlear implantation at an early age may be warranted in these patients before CSF leaks and meningitis have occurred.

Roman BR; Coelho DH; Roland JT Jr

2013-01-01

400

Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis.  

DEFF Research Database (Denmark)

BACKGROUND: Bacteremia plays a major role in the outcome of pneumococcal meningitis. This experimental study investigated how bacteremia influences the pathophysiologic profile of the brain. METHODS: Rats with Streptococcus pneumoniae meningitis were randomized to 1 of 3 groups of infected study rats: (1) rats with attenuated bacteremia resulting from intravenous injection of serotype-specific pneumococcal antibody, (2) rats with early-onset bacteremia resulting from concomitant intravenous infection, or (3) a meningitis control group. The blood-brain barrier (BBB) breakdown, ventricle size, brain water distribution, and brain pathologic findings were analyzed using magnetic resonance morphological and functional imaging. Laboratory data and clinical disease scores were obtained. RESULTS: Attenuation of the bacteremic component of pneumococcal meningitis improved clinical disease symptoms and significantly reduced ventricle expansion and BBB breakdown (P< .05). Early-onset bacteremia did not further increase ventricle size or BBB leakage. Significantly increased brain edema developed among rats with both attenuated and early-onset bacteremia (P< .05). Focal brain pathologic findings were unaffected by bacteremia and were found to be associated with cerebrospinal fluid inflammation. CONCLUSION: Although brain lesions appear to result from local meningeal infection, systemic infection significantly contributes to clinical disease presentation and the pathophysiology of BBB breakdown and ventricle expansion. The different end points affected by the systemic and local infectious processes should be addressed in future studies.

Brandt, Christian T; Holm, David

2008-01-01

 
 
 
 
401

Persistent stapedial arteries in human: from phylogeny to surgical consequences.  

UK PubMed Central (United Kingdom)

The stapedial artery is an embryonic artery which disappears during the tenth week in utero, in human species. During its short life, this artery shapes the stapes and transforms the middle meningeal artery from the internal carotid artery to a branch of the external carotid system. Nevertheless, a persistent stapedial artery is seen in 0.2-4.8 per thousand of human adults. This persistence is usually asymptomatic but can sometimes cause pulsatile tinnitus or conductive hearing loss. Despite the risk of facial palsy, hearing loss and even hemiplegia argued by several authors, some surgeons have succeeded in coagulation without side effects. Reviewing the literature, we seek to enlighten the actual knowledge about the persistent stapedial artery to evaluate the risk to coagulate it. Embryologic studies explain the four types of persistent stapedial arteries: the hyoido-stapedial artery, the pharyngo-stapedial artery, the pharyngo-hyo-stapedial artery and aberrant internal carotid with persistent stapedial artery. Phylogenetic studies show that the stapedial artery persists in adulthood in many vertebrates. Its disappearance is therefore either a random effect or an adaptative convergence. This adaptation could be partially linked to the negative allometry of the stapes. Practically, the risk to coagulate a stapedial artery seems limited thanks to anastomoses, for example with the stylomastoid artery. The risk of hemiplegia reported is in fact an extrapolation of variation in rats' embryos. A persistent stapedial artery can therefore reasonably be coagulated, with special attention to the facial nerve, because the facial canal is always dehiscent where the artery penetrates.

Hitier M; Zhang M; Labrousse M; Barbier C; Patron V; Moreau S

2013-05-01

402

Enhanced expression of cytokines/chemokines in cerebrospinal fluids in mumps meningitis in children.  

UK PubMed Central (United Kingdom)

BACKGROUND: ? The mumps virus is frequently the causative agent in aseptic meningitis and mumps has still prevailed in Japan. We compared data obtained from patients with mumps meningitis and patients with aseptic meningitis caused by other viruses in order to identify mumps meningitis-specific cytokine/chemokine alterations in cerebrospinal fluid (CSF). METHODS: ? We elucidated the cytokine/chemokine network based on the cytokine/chemokine profiles in CSF from children with mumps meningitis and meningitis due to other viral infections using multiplex cytokine measurement. Seventeen cytokines/chemokines, namely interleukin (IL)-1?, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12 (p70), IL-13, IL-17, interferon (IFN)-?, tumor necrosis factor (TNF)-?, granulocyte colony-stimulating factor (G-CSF), granulocyte monocyte colony-stimulating factor (GM-CSF), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1? (MIP-1?), were measured simultaneously in CSF supernatants from eight children with mumps meningitis, 11 children with other types of viral meningitis and eight children with fever without neurological complications such as convulsion. RESULTS: ? We found that IL-8, IL-10, IL-12, IL-13 and IFN-? showed a statistically significant increase in CSF from mumps meningitis when compared to other types of viral meningitis and fever without neurological complications. CONCLUSION: ? Mumps meningitis may induce a distinct immunological response when compared with other types of viral meningitis.

Asano T; Ichiki K; Koizumi S; Kaizu K; Hatori T; Fujino O; Mashiko K; Sakamoto Y; Miyasho T; Fukunaga Y

2011-04-01

403

[Usefulness of reactive strips in the diagnosis of suppurative meningitis, at the patient's bedside  

UK PubMed Central (United Kingdom)

The CSF from 68 children suspected of meningitis (20 meningitis, 48 normal) was analyzed with the customary laboratory techniques (cellularity, differential count, glucose, proteins and bacteriology) and with Combur 9 test strips (glucose, proteins and leukocytes-granulocytes) in order to evaluate the suitability of the latter for the rapid diagnosis of meningitis.

Oses Salvador JM; Zarallo Cortés L; Cardesa García JJ

1988-08-01

404

[Usefulness of reactive strips in the diagnosis of suppurative meningitis, at the patient's bedside].  

Science.gov (United States)

The CSF from 68 children suspected of meningitis (20 meningitis, 48 normal) was analyzed with the customary laboratory techniques (cellularity, differential count, glucose, proteins and bacteriology) and with Combur 9 test strips (glucose, proteins and leukocytes-granulocytes) in order to evaluate the suitability of the latter for the rapid diagnosis of meningitis. PMID:3190014

Oses Salvador, J M; Zarallo Cortés, L; Cardesa García, J J

1988-08-01

405

Candida tropicalis as an emerging pathogen in Candida meningitis: case report and review  

Directory of Open Access Journals (Sweden)

Full Text Available Candida species are an uncommon cause of meninigitis. Given the rarity of this infection, the epidemiology, prognosis, and optimal therapy for Candida meningitis are poorly defined. The authors report on a paraplegic patient due to spinal cord injury who developed C. tropicalis meningitis. In addition, we review and discuss other reported cases of C. tropicalis meningitis in the medical literature

Luciano Z Goldani; Rodrigo P Santos

2010-01-01

406

Severe aseptic meningitis with hydrocephalus following iotrolan myelography: A case report  

International Nuclear Information System (INIS)

A case of severe aseptic meningitis with communicating hydrocephalus following iotrolan myelography is presented. The patient's condition improved very quickly after corticosteroid therapy. Rapid improvement and absence of pathogenic organisms in the CSF culture strongly favor an aseptic meningitis. This is the first reported case of aseptic meningitis with the secondary development of hydrocephalus caused by iotrolan myelography

1993-01-01

407

Severe aseptic meningitis with hydrocephalus following iotrolan myelography: A case report  

Energy Technology Data Exchange (ETDEWEB)

A case of severe aseptic meningitis with communicating hydrocephalus following iotrolan myelography is presented. The patient's condition improved very quickly after corticosteroid therapy. Rapid improvement and absence of pathogenic organisms in the CSF culture strongly favor an aseptic meningitis. This is the first reported case of aseptic meningitis with the secondary development of hydrocephalus caused by iotrolan myelography.

Kim, Jae Hyoung; Ha, Choong Kun; Ahn, In Oak [Gyeongsang National University College of Medicine, Jinju (Korea, Republic of)

1993-05-15

408

Diagnostic Value of Serum and Serum and Cerebrospinal Fluid Procalcitonin in Differentiation Bacterial from Aseptic Meningitis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Problem statement: Acute bacterial meningitis is one of the most important causes of medical emergency diseases, which can cause high mortality and morbidity rates. Early antibiotic therapy is life saving in bacterial meningitis. One of the most common etiologies of acute meningitis...

Zhinous B. Makoo; Hamid R. Soltani; Akbar Hasani; Roshanak B. Makoo; Omid Mashrabi

409

Recurrent meningitis in the adult: a diagnostic and therapeutic challenge Meningitis recurrente en el adulto: un reto diagnóstico y terapéutico  

Directory of Open Access Journals (Sweden)

Full Text Available Recurrent meningitis is an uncommon condition with the capability of causing important midand long-term sequelae. Its clinical presentation depends on the etiologic agent, although most patients exhibit at least one of the classical symptoms of acute meningitis (intense headache, fever and neck stiffness). Due to the clinical variability of the disease, a high level of suspicion and an adequate use of laboratory tests are required in order to establish a timely diagnosis. This article contains a literature review regarding epidemiology, etiology, clinical presentation, diagnosis and management of recurrent meningitis. La meningitis recurrente no es una entidad común pero tiene el potencial de generar secuelas importantes a mediano y largo plazo. Su cuadro clínico depende del agente causal aunque en la mayoría de los pacientes se conserva al menos uno de los síntomas clásicos de la meningitis aguda (cefalea intensa, fiebre y rigidez de nuca). Debido a su variabilidad clínica se requieren un alto nivel de sospecha y usar bien las pruebas de laboratorio para llegar oportunamente al diagnóstico. El presente artículo contiene una revisión de la literatura sobre la epidemiología, la etiología, el cuadro clínico, el diagnóstico y el tratamiento de esta enfermedad.

Basilio Vagner Ramírez; María Elizabeth Gaviria Barrera; Mónica Zuluaga Quintero

2010-01-01

410

Symptomatic relapse of HIV-associated cryptococcal meningitis: Recurrent cryptococcal meningitis or cryptococcus-related immune reconstitution inflammatory syndrome?  

UK PubMed Central (United Kingdom)

Cryptococcosis, a significant opportunistic infection, has become a global concern since the advent of immunosuppressive chemotherapy or in immunodeficient patients. Host responses range from a harmless colonization to disseminated disease. An accurate or definitive diagnosis in patients with cryptococcal meningitis is often delayed because of the similar clinical presentation and biochemical or cerebrospinal fluid findings to those of a variety of infectious and non-infectious etiologies, most of which are also especially prevalent in developing countries. Rarely, patients of cryptococcal meningitis can develop immune reconstitution inflammatory syndrome when initiated on highly active antiretroviral therapy, the diagnosis which is often missed and can be fatal. Due to the similar presentation of infection and immune reconstitution inflammatory syndrome, it is often confused with the relapse of cryptococcal meningitis. We report a case of paradoxical recurrent meningitis in response to the initiation of highly active antiretroviral therapy in a patient diagnosed with cryptococcal meningitis and propose that the recurrent symptoms resulted from a therapy-induced reconstitution of the immune response against residual Cryptococcus neoformans.

Jhamb R; Kashyap B; Das S; Berry N; Garg A

2013-10-01

411

Treatment of lymphomatous and leukemic meningitis with liposomal encapsulated cytarabine  

Directory of Open Access Journals (Sweden)

Full Text Available Melanie Kripp, Ralf-Dieter HofheinzOnkologisches Zentrum, III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, GermanyAbstract: Liposomal encapsulated cytarabine (DepoCyte®, Mundipharma GmbH, Limburg/Lahn, Germany) is a slow-release formulation of conventional cytarabine. It is licensed for intrathecal use in patients with lymphomatous and leukemic meningitis. DepoCyte® obtained superior response rates, improved patient quality of life and improved the time to neurological progression in a randomized albeit small clinical trial. In this review we briefly summarize the clinical data and discuss them in light of clinical problems and possible treatment scenarios.Keywords: liposomal cytarabine, leukemic meningitis, lymphomatous meningitis

Melanie Kripp; Ralf-Dieter Hofheinz

2008-01-01

412

[Immunofluorescence in the diagnosis of acute bacterial meningitis  

UK PubMed Central (United Kingdom)

We evaluated immunofluorescence techniques to investigate the presence of S pneumoniae, N meningitidis, H influenzae types a and b and L monocytogenes in 85 samples of CSF fluid: 60 were taken from patients suffering meningitis and 25 from a control group. Results were compared to conventional bacteriologic methods. There were no false positive results in the control group. In patients with meningitis, 28 were positive by both methods. Nine additional patients were positive only to immunofluorescence which allowed identification of S pneumoniae in 6, N meningitidis in 2 and H influenzae in 1. 37 samples were positive by immunofluorescence and 28 of them were positive to conventional bacteriology. There was only 1 case of Group B streptococcus identified by bacteriology which was not diagnosed by immunofluorescence. Thus, immunofluorescence increases the ability to make a bacteriologic diagnosis in patients with meningitis.

Rodríguez G; Iglesias T; Loyola A; Soto L; Boehme C; Soza G; Reichert A; Ossa G; Morales O

1990-07-01

413

Epidemiología de la meningitis Una visión socio-epidemiológica  

Directory of Open Access Journals (Sweden)

Full Text Available Desde el punto de vista de la socio-epidemiología, la meningitis tiene dos diferentes comportamientos tanto en su etiología como en su distribución, morbilidad y letalidad. La meningitis viral o aséptica, con manifestaciones clínicas menos severas, responde principalmente en su distribución a hábitos personales, factores educativos y estilos de vida, siendo principalmente los enterovirus sus agentes etiológicos. La meningitis de origen bacteriano, causada principalmente por Neisseriae meningitidis y el Streptococcus pneumoniae, representa la forma más letal de la enfermedad, y tanto su distribución, morbilidad y mortalidad están determinadas por las condiciones económicas y sociales de los países y comunidades más pobres del mundo, en donde la vacunación para su prevención como los medicamentos para su control están muy limitados por el nivel de desarrollo económico.

Arturo Morales Bedoya; Luz Marina Alonso Palacio

2006-01-01

414

[Meningitis as the first and only manifestation of brucellosis  

UK PubMed Central (United Kingdom)

An 8-year-old girl with no previous symptoms was admitted to hospital with aseptic meningitis syndrome. The girls father is a shepherd and there was a familial antecedent of brucellosis, but the patient did not consume unpasteurized goat milk products nor did she take part in the care of the sheep stock. The clinical evolution did not follow the usual development of a viral or partially treated bacterial meningitis. Brucella melitensis was isolated in the cerebrospinal fluid and blood. Specific treatment (doxycycline and rifampin) produced favorable evolution. The patient may have been infected through the respiratory tract or mucous membranes, or by contact with clothes used by other members of the household who looked after infected animals. These forms of infection should be considered in family members who come into contact with the clothes of those caring for animals and with other utensils used by them. Meningitis as the only sign of brucellosis is exceptional both in children and in adults.

González García H; Fernández Alonso JE; de Paz García M; Ramos Sánchez C; Aguirre Gervás B

2000-09-01

415

Neuro-Behcet: differential diagnosis of recurrent meningitis.  

UK PubMed Central (United Kingdom)

Behçet disease is a systemic inflammatory perivasculitis characterized by recurrent episodes of oral and genital ulcers associated with skin and ocular lesions. Neurological involvement occurs in 5 to 10% of the cases, and isolated meningeal involvement is very uncommon. We report a 21 years old man with a Behçet disease and a history of acute meningeal syndrome in two previous crises and meningoencephalitis in three others. He reported a history of conjunctivitis and oral and genital ulcers. On examination, he presented oral aphthoid lesions, macular edema, involvement of cranial nerves, pyramidal signs and meningeal irritation. The cell count in cerebrospinal fluid was 1800 cells/mm³, with polymorphonuclear predominance. Magnetic resonance imaging showed lesions in basal ganglia and the brainstem. The patient improved dramatically after intravenous steroid therapy.

Fonseca Cardoso A; Rocha-Filho PA; Melo Correa-Lima AR

2013-01-01

416

[Haemophilus meningitis in properly vaccinated children: report of three cases].  

UK PubMed Central (United Kingdom)

The 1993 introduction in France of the vaccine against the serotype b of Haemophilus influenzae (Hib) resulted in a fast reduction of invasive infections caused by this species. However, despite the introduction of a booster dose, cases of Hib meningitis can still be observed, even if they are exceptional. We report here on 3 cases of Hib meningitis observed at Rennes University Hospital, which occurred during the winter seasons between 2007 and 2010, in properly vaccinated infants and children aged 9, 14, and 29 months. Progression after treatment was satisfactory in all 3 cases, and no immune deficiency was detected. After 18 years of the vaccination policy in France, these observations demonstrate that a risk, although much lower, of Hib meningitis persists in infants and children, including in vaccinated patients, and that strains still are circulating within the general population.

Metreau Z; Le Bars H; Desgranges-Federico M; Monnier M; Ryckewaert A; Chasle V; Pierre M; Farges C; Guitteny MA

2013-05-01

417

Multiplex PCR for rapid diagnosis of tuberculous meningitis.  

UK PubMed Central (United Kingdom)

Rapid and specific diagnosis of tubercular meningitis is of paramount importance to decrease morbidity and mortality. The aim of the study was to evaluate multiplex PCR using protein b, MPB 64, and IS6110 primers directed against M. tuberculosis complex for the diagnosis of tuberculous meningitis (TBM). Multiplex PCR was performed on 18 TBM confirmed cases (culture was positive), 92 clinically suspected TBM cases and 100 non-TBM (control group) patients. Multiplex PCR had a sensitivity of 94.4% for confirmed cases and specificity of 100% for confirmed TBM cases. In 92 clinically diagnosed but unconfirmed TBM cases, multiplex PCR was positive in 84.78% cases. The overall sensitivity of microscopy, culture and multiplex cases were 1.81, 16.73, and 86.63% and specificity was 100, 100, and 100% respectively. Multiplex PCR using protein b, MPB 64, and IS6110 primers has a high sensitivity and specificity in diagnosis of tubercular meningitis.

Kusum S; Aman S; Pallab R; Kumar SS; Manish M; Sudesh P; Subhash V; Meera S

2011-10-01

418

Meningitis tuberculosa: Clinical findings and results of cranial computed tomography  

Energy Technology Data Exchange (ETDEWEB)

Guided by 9 own observations between 1977 and 1981, new diagnostic facilities in tuberculous meningitis are discussed. For differentiation from viral meningitis, measurement of CSF lactic acid concentration in addition to that of CSF glucose has proved to be of value in recent years. In accordance with the literature, two cases of this series which were examined for CSF lactic acid concentration showed markedly elevated levels of 8,4 rsp. 10,4 mmol/l. In contrast to this, in viral meningitis usually values of less than 3.5 mmol/l are found. Additionally, the presence of hypochlor- and hyponatremia, which could be demonstrated in 6 of our 9 patients, may raise the suspicion of tuberculous etiology. In the series presented, cranial computed tomography was of greatest diagnostic value, enabling the diagnosis of hydrocephalus internus in 5, and basal arachnoiditis in 2 cases.

Trautmann, M.; Loddenkemper, R.; Hoffmann, H.G.

1982-10-01

419

Meningitis tuberculosa: Clinical findings and results of cranial computed tomography  

International Nuclear Information System (INIS)

Guided by 9 own observations between 1977 and 1981, new diagnostic facilities in tuberculous meningitis are discussed. For differentiation from viral meningitis, measurement of CSF lactic acid concentration in addition to that of CSF glucose has proved to be of value in recent years. In accordance with the literature, two cases of this series which were examined for CSF lactic acid concentration showed markedly elevated levels of 8,4 rsp. 10,4 mmol/l. In contrast to this, in viral meningitis usually values of less than 3.5 mmol/l are found. Additionally, the presence of hypochlor- and hyponatremia, which could be demonstrated in 6 of our 9 patients, may raise the suspicion of tuberculous etiology. In the series presented, cranial computed tomography was of greatest diagnostic value, enabling the diagnosis of hydrocephalus internus in 5, and basal arachnoiditis in 2 cases. (orig.)

1982-01-01

420

Cat scratch disease complicated with aseptic meningitis and neuroretinitis  

Directory of Open Access Journals (Sweden)

Full Text Available Cat scratch disease (CSD) is a self limited condition characterized by fever, lymph node enlargement and less often eye involvement. Central nervous system involvement by Bartonella henselae infection is possibly an important cause of morbidity; its role as an agent of aseptic meningitis is unknown. We report a case of a 40 years-old man with CSD accompanied by aseptic meningitis and neuroretinitis. Serum indirect immmunofluorescence (IFI) assays for B. henselae were positive and the cerebrospinal fluid (CSF) analysis showed mononuclear pleocytosis and increased level of protein. Serological tests for other etiologies were negative. The patient responded well to antibiotic therapy with oral doxycicline plus rifampin and in the 12th day of hospitalization evolved to total regression of the headache and partial regression of the visual loss. Clinicians should consider CSD as a differential diagnosis when assessing previously healthy patients with aseptic meningitis associated with regional lymphadenopathy and epidemiological history of feline contact.

Vitor Laerte Pinto Jr.; André Land Curi; Adriana da Silva Pinto; Estevão Portela Nunes; Maria de Lourdes Benamor Teixeira; Tatiana Rozental; Alexsandra Rodrigues Favacho; Elba Regina Sampaio de Lemos; Márcio Neves Bóia

2008-01-01

 
 
 
 
421

Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus  

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Full Text Available Infection with cryptococcal meningitis is uncommon in immunocompetent patients. The major virulence factor is the polysaccharide capsule, while nonencapsulated mutants are generally considered nonpathogenic. The authors present a case of hydrocephalus caused by meningitis from an indolent, nonencapsulated Cryptococcus sp. requiring placement and multiple revisions of a ventriculoperitoneal shunt (VPS). The patient presented with progressively worsening occipital headaches. Computed tomography and magnetic resonance imaging showed significant hydrocephalus with no apparent cause. Her symptoms initially resolved after placement of a VPS, but returned four months later. Cultures of the shunt tubing and cerebrospinal fluid (CSF) showed no bacterial infection. When the symptoms failed to resolve, CSF fungal culture revealed Cryptococcus-like yeast, although the organisms were nonencapsulated, and the cryptococcal antigen was negative. After antibiotic therapy, the symptoms resolved. The unusual clinical presentation delayed the diagnosis, highlighting the importance of understanding the detection, diagnosis, and treatment of meningeal infections caused by C. neoformans.

Sarah T. Garber; Paul L. Penar

2012-01-01

422

Computed tomography of granulomatous basal meningitis caused by pneumococcus  

Energy Technology Data Exchange (ETDEWEB)

A case of 3-month-old female with ''granulomatous basal meningitis'' caused by pneumococcus was described. She suffered from high fever, vomiting, convulsion and loss of consciousness on January 28th, 1982. On admission the protein content of the spinal fluid was 280 mg/100 ml, the glucose 4 mg/100 ml and the cell count was 1206/3(L : 845, N : 361). Her symptoms and signs were deteriorated in spite of antibiotics and anticonvulsants. CT scan on the 10th day showed the enhanced basal cistern. She died on the 11th day but autopsy was not carried out. In this case, pneumococcus was cultured in CSF. This seemed to be the first case of ''granulomatous basal meningitis'' due to purulent meningitis in Japan.

Sonobe, Makoto; Takahashi, Shinichiro (Mito National Hospital, Ibaraki (Japan)); Ohara, Kazuo

1983-07-01

423

MR features in patients with residual paralysis following aseptic meningitis  

International Nuclear Information System (INIS)

[en] MR studies were performed in three patients with paralysis in the lower extremities. Poliomyelitis-like paralysis can be caused by neurovirulent strains of nonpolioenteroviruses. Entervirus 71 (EV 71) is documented as one of the potentially neurovirulent strains and a causative agent of some epidemics (1-7). Th