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Meningeal management for optimal revascularization from middle meningeal artery.  

Science.gov (United States)

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. PMID:23101445

McLaughlin, Nancy; Martin, Neil A

2013-01-01

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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

2012-08-01

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Middle meningeal artery arising from the basilar artery.  

Science.gov (United States)

Various anomalies for the origin of the middle meningeal artery (MMA) have been described in the literature. However, origin of the MMA from the basilar trunk is an extremely rare variant. We report on a 54-year-old female who presented with frequent headaches; magnetic resonance imaging showed a right parietal meningioma. The abnormal origin of the middle meningeal artery from the basilar artery was diagnosed by angiography performed for preoperative embolization of the tumor. We report on the case with a review of the embryologic basis, possible explanations for this aberrant origin, and its clinical implications. PMID:25599045

Salem, Mohamed M; Fusco, Matthew R; Dolati, Parviz; Reddy, Arra S; Gross, Bradley A; Ogilvy, Christopher S; Thomas, Ajith J

2014-12-01

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Meningitis  

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Full Text Available Meningitis Introduction Meningitis is a serious infection of the fluid that surrounds the brain and spinal cord. ... explains how meningitis is diagnosed, treated and prevented. Meningitis The brain and the spinal cord are the ...

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Meningitis  

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Full Text Available ... serious infection of the fluid that surrounds the brain and spinal cord. Meningitis can be fatal. But ... meningitis is diagnosed, treated and prevented. Meningitis The brain and the spinal cord are the command centers ...

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Meningitis  

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Full Text Available ... quite severe and may result in brain damage, hearing loss or learning disability if not treated early. ... complications than viral meningitis. Meningitis can affect the hearing nerve, resulting in permanent deafness. Meningitis could also ...

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Meningitis  

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Full Text Available ... seeing in bright light, confusion and sleepiness. In newborns and small infants, the classic symptoms of fever, ... complications than viral meningitis. Meningitis can affect the hearing nerve, resulting in permanent deafness. Meningitis could also ...

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Variant middle meningeal artery origin from the ophthalmic artery: a case report.  

Science.gov (United States)

We present a rare case of a variant middle meningeal artery (MMA) originating from the ophthalmic artery. During cadaveric dissection of the cranial base of an adult female, it was noted that the foramen spinosum was absent unilaterally. After identifying the MMA, its origin was traced back to the ophthalmic artery within the orbit. Although exceedingly rare, a variant MMA originating from the ophthalmic artery should be kept in mind by surgeons during skull base procedures in order to avoid unwanted complications including potential retrograde thrombosis of the ophthalmic artery with MMA manipulation or coagulation. PMID:24782096

Kimball, David; Kimball, Heather; Shane Tubbs, R; Loukas, Marios

2015-01-01

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Meningitis  

Science.gov (United States)

... meninges (say: muh-NIN-jeez), which are the membranes that cover the brain and spinal cord. Meningitis (say: men-un-JYE-tus) is a disease involving inflammation (swelling), or irritation, of the meninges. There are different kinds of meningitis, but most of the time it ...

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Possibility of Middle Meningeal Artery-to-Petrous Internal Carotid Artery Bypass: An Anatomic Study  

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The possibility of creating a middle meningeal artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in six cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spino...

U?stu?n, Mehmet Erkan; Bu?yu?kmumcu, Mustafa; S?eker, Muzaffer; Karabulut, Ahmet Kag?an; Uysal, I?smihan I?lknur; Ziylan, Taner

2004-01-01

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Meningitis  

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Full Text Available ... what type of bacteria is causing the meningitis. Antibiotics are essential in treating patients with bacterial meningitis ... important so the health care provider knows which antibiotics to prescribe. A CAT scan of the brain ...

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Meningitis  

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Full Text Available ... started early in the course of the disease. Antibiotic treatment for most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%. But ...

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Meningitis  

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Full Text Available ... nr210105 Last reviewed: 12/29/2013 1 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  

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Full Text Available ... medications. The patient is treated with IV fluids, rest and close observation. Complications Bacterial meningitis tends to ... protect themselves. Meningitis cases should be reported to state or local health departments to assure follow-up ...

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Meningitis  

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Full Text Available ... Introduction Meningitis is a serious infection of the fluid that surrounds the brain and spinal cord. Meningitis ... Speak. • Hear. • Understand. • See. • Move. • Feel. A clear fluid, called cerebro-spinal fluid or CSF, surrounds the ...

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Meningitis  

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Full Text Available ... doing a physical examination. Headache, neck stiffness and increased sleepiness are common signs of meningitis. A sample ... the patient. People who would be considered at increased risk of acquiring your meningitis include: • Household members. • ...

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Meningitis  

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Full Text Available ... Bacterial meningitis can be quite severe and may result in brain damage, hearing loss or learning disability ... bacterial meningitis can be quite severe and may result in brain damage, hearing loss or learning disability. ...

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Meningitis  

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Full Text Available ... reviewed: 12/29/2013 1 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  

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

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Homologies of the meningeal-orbital arteries of humans: a reappraisal.  

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Two arteries connect the anterior branch of the middle meningeal artery to the lacrimal artery. One vessel, the sphenoidal artery, passes through the superior orbital fissure. The other vessel, the meningolacrimal artery, passes through the cranio-orbital foramen. An analysis of data derived from embryology, comparative anatomy, and patterns of adult variation indicates that the meningolacrimal artery is homologous with the ramus superior of the stapedial artery, an embryologically and phylog...

Diamond, M. K.

1991-01-01

 
 
 
 
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An undocumented variation involving auriculotemporal nerve, inferior alveolar nerve and middle meningeal artery  

Directory of Open Access Journals (Sweden)

Full Text Available Auriculotemporal nerve typically has two roots, encircling the middle meningeal artery, one anterior to it and another posterior to it as well as maxillary artery. The middle meningeal artery is largest of the meningeal arteries, ascends between the sphenomandibular ligament and lateral pterygoid muscle and traverses between the roots of the auriculotemporal nerve before entering the cranial cavity through the foramen spinosum. The knowledge of the neurovascular relationships of the infratemporal region is significant in surgical practice. We present a case of unusual communication between the auriculotemporal nerve and inferior alveolar nerve together with an extraordinary change in relations with the middle meningeal artery. Some clinical implications that these relations may have on the development of the supplementary innervations and the surgical interventions in this region are discussed in this article. [Int J Res Med Sci 2014; 2(4.000: 1720-1722

Sunita Kalra

2014-08-01

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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  

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Full Text Available ... If symptoms occur, you should see a health care provider immediately. The health care provider suspects a diagnosis of meningitis after obtaining ... tests on the CSF can help the health care provider decide whether meningitis is present and whether ...

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Meningitis  

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Full Text Available ... 2013 4 People who are often in close contact with a person who has some types of bacterial meningitis should get antibiotics to protect themselves. Meningitis cases should be ... of close contacts and protect against outbreaks. Although large epidemics of ...

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Meningitis  

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Full Text Available ... com nr210105 Last reviewed: 12/29/2013 2 Diagnosis Early diagnosis and treatment of meningitis are very important in ... provider immediately. The health care provider suspects a diagnosis of meningitis after obtaining a detailed medical history ...

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Meningitis  

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Full Text Available ... request on the CSF sample include: • Checking the number of cells. • Checking levels of sugar and protein. • ... cells help fight infections. Treatment There are a number of antibiotics that treat bacterial meningitis. However, it ...

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Meningitis  

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Full Text Available ... check whether the white blood cell count is higher than normal. White blood cells help fight infections. ... meningitis to below 15%. But the risk is higher among the elderly. This document is for informational ...

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Meningitis  

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Full Text Available ... be obtained by calling the Centers for Disease Control and Prevention at (404) 639-3311. Summary Meningitis ... care provider or call the Centers for Disease Control and Prevention at (404) 639-3311 to check ...

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Meningitis  

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Full Text Available ... care provider knows which antibiotics to prescribe. A CAT scan of the brain may need to be ... vaccinated against meningitis. If you are traveling overseas, particularly to developing countries in Africa, ask your health ...

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Meningitis  

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Full Text Available ... quite severe and may result in brain damage, hearing loss or learning disability if not treated early. For ... quite severe and may result in brain damage, hearing loss or learning disability. Treatment of bacterial meningitis involves ...

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Meningitis  

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Full Text Available ... meningitis progresses, patients of any age may have seizures. A seizure is a sudden, violent, uncontrollable contraction of muscles. A seizure may also be a sudden but brief loss ...

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Meningitis  

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Full Text Available ... light, confusion and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be difficult to detect. Infants with meningitis may: • Be slow or inactive. • Be ...

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Meningitis  

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Full Text Available ... should see a health care provider immediately. The health care provider suspects a diagnosis of meningitis after obtaining a detailed medical history and doing a physical examination. Headache, neck stiffness ...

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Meningitis  

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Full Text Available ... for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X-Plain.com nr210105 Last reviewed: 12/29/2013 2 Diagnosis Early diagnosis and treatment of meningitis are very important ...

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Meningitis  

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Full Text Available ... to people who have had close or prolonged contact with the patient. People who would be considered at increased risk of acquiring your meningitis include: • Household members. • ...

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Meningitis  

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Full Text Available ... the same daycare. • Anyone in direct contact with oral secretions, such as a boyfriend or girlfriend. This ... are very safe and effective. Ask your health care provider if you should be vaccinated against meningitis. ...

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Meningitis  

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Full Text Available ... health departments to assure follow-up of close contacts and protect against outbreaks. Although large epidemics of meningitis do not typically occur in the United States, some countries experience large epidemics. An epidemic is ...

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Meningitis  

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Full Text Available ... and neck stiffness may be difficult to detect. Infants with meningitis may: • ... contraction of muscles. A seizure may also be a sudden but brief loss of contact for a few moments. The person may appear ...

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Meningitis  

Centers for Disease Control (CDC) Podcasts

This podcast gives a general overview of meningitis, including what it is, the five types, and the causes.  Created: 10/24/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/24/2012.

2012-10-24

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Meningitis  

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Full Text Available ... may include nausea, vomiting, difficulty seeing in bright light, confusion and sleepiness. In newborns and small infants, ... be obtained by calling the Centers for Disease Control and Prevention at (404) 639-3311. Summary Meningitis ...

 
 
 
 
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Meningitis  

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Full Text Available ... with bacterial meningitis and can also prevent some types of bacteria from spreading and infecting other people. ... in bright light, confusion and sleepiness. In newborns and small infants, ...

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Meningitis  

Science.gov (United States)

... have had close or prolonged contact with the patient. People who would be considered at increased risk of acquiring your meningitis include: • Household members. • Anyone in the same daycare. • Anyone in direct contact with oral secretions, such as a boyfriend or ...

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Meningitis  

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Full Text Available ... have had close or prolonged contact with the patient. People who would be considered at increased risk of acquiring your meningitis include: • Household members. • Anyone in the same daycare. • Anyone in direct contact with oral secretions, such as a boyfriend or ...

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Meningitis  

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Full Text Available ... have had close or prolonged contact with the patient. People who would be considered at increased risk of acquiring your meningitis include: • Household members. • Anyone in the same daycare. • Anyone in direct contact with oral secretions, such as a boyfriend or girlfriend. This ...

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Effect of intra-arterial injection of lidocaine and methyl-prednisolone into middle meningeal artery on intractable headaches  

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The present report describes the effect of intra-arterial injection of a dose of 40 mg lidocaine and 20 mg methylprednisolone into the middle meningeal artery of two patients suffering from severe headaches. The effect of injection of lidocaine and methylprednisolone was short lasting with effect manifesting within 5 min and lasting 5–8 h after injection. Both patients reported improvement in headache intensity after 24 h post-procedure. Intra-arterial injection of lidocaine and methylpredn...

Qureshi, Adnan I.; Qureshi, Mushtaq H.; Khan, Asif A.; Suri, M. Fareed K.

2014-01-01

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Angiographically progressive change of traumatic pseudoaneurysm arising from the middle meningeal artery.  

Science.gov (United States)

Traumatic pseudoaneurysms of the middle meningeal artery (MMA) are rare phenomenon, which are usually associated with head trauma such as an underlying skull fracture. They were usually known to cause acute or delayed epidural hematomas but can be associated with subdural, subarachnoid, or even intracerebral hemorrhage. Sometimes, a high mortality rate was reported in these circumferences. But the natural course of these pseudoaneurysms is not well recognized. The indication and guideline of treatment for pseudoaneurysm are also unclear. This report describes a rare case of angiographically progressive change of traumatic pseudoaneurysm of the middle meningeal artery for one week, which was treated with endovascular embolization. PMID:25535521

Lee, Jae-Yoon; Lee, Cheol-Young; Kim, Hyun-Woo

2014-11-01

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Sacral meningeal arteriovenous fistula fed by branches of the hypogastric arteries and drained through medullary veins  

Energy Technology Data Exchange (ETDEWEB)

The authors report a new case of intra-spinal extra-medullary meningeal arteriovenous fistula draining through medullary veins. Discovered in a 33-year-old black man suffering from a cauda equina syndrome, this malformation suspected in myelography was confirmed by a selective angiographic procedure of both internal iliac arteries. This investigation specified the sacral site of the fistula as well as its feeding arteries from several branches of the left and right internal iliac arteries and its posterior and intra-meningeal venous medullary drainage. An embolization procedure followed by a surgical approach and a second embolization session brought a fair improvement to this young patient who could walk again. The acquired traumatic origin of the fistula is discussed for this patient who had been previously operated at his L5-S1 level.

Burguet, J.L.; Dietemann, J.L.; Wackenheim, A.; Kehr, P.; Buchheit, F.

1985-05-01

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Infarto maligno de la arteria cerebral media en una paciente con meningitis bacteriana Malignant middle cerebral artery territory infarct in one patient with bacterial meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available The mortality of acute bacterial meningitis (BM has remained stable in the last decades in spite of the use of new antibiotics, probably due to vascular complications. We report a 68-year-old woman with BM who had a malignant infarction of left middle cerebral artery territory 72 hours after admission to the hospital. The patient experienced a bad evolution and died four days after admission. The arterial involvement in patients with BM is explained by vasospasm of large arteries and vasculitis of small arteries. The medical treatment of a malignant middle cerebral artery infarct has a high mortality (Rev Méd Chile 2004; 132: 1217-20

Mirta López G

2004-10-01

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Intracerebral Hematoma Caused by Ruptured Traumatic Pseudoaneurysm of the Middle Meningeal Artery : A Case Report  

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Hematomas caused by ruptured traumatic pseudoaneurysms of the middle meningeal artery (MMA) usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are extremely rare. We report a case of traumatic pseudoaneurysm of the MMA giving rise to an intracerebral hematoma after head trauma. A 70-year-old man suffered a massive intracerebral temporoparietal hemorrhage after a head injury. CT angiogram of the brain revealed a large hematoma in the right middle cranial f...

Lim, Dong-ho; Kim, Tae-sun; Joo, Sung-pil; Kim, Soo Han

2007-01-01

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The measure for problematic case with middle meningeal artery origin ophthalmic artery in front-temporal craniotomy and a part of DSA. Preservation of visual function  

International Nuclear Information System (INIS)

Because of the recent development of high-performance 3-dimensional computed tomography (3D-CTA), magnetic resonance angiography (MRA) and the consideration of the risk of digital subtraction angiography (DSA), DSA is not always necessary in performing surgery for cerebral aneurysms. However, DSA was necessary in patients in whom the ophthalmic artery from the internal carotid artery (IC) was not visualized on 3D-CTA or MRA, in order to predict the risk of blindness after front-temporal craniotomy. In this study, we investigated the preoperative evaluation and the surgical procedure for 330 cases of front-temporal craniotomy for surgery of aneurysm over the past 4.5 years. There were 5 cases without ophthalmic artery from IC in DSA or 3D-CTA, 4 cases with an anomalous ophthalmic artery arising from the middle meningeal artery and 1 case with an anomalous ophthalmic artery arising from unknown origin. Microsurgical procedure is needed to preserve the middle meningeal artery in front-temporal craniotomy in these cases with an anomalous ophthalmic artery arising from the middle meningeal artery, because this anomaly places the ophthalmic artery at risk during procedures in which the dura is elevated from the greater and lesser wings of the sphenoid or when the sphenoid ridge is removed in front-temporal craniotomy. Front-temporal craniotomy is difficult in cases with an anomalous ophthalmic artery arising from an unknown origin. (author)(author)

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Infarto maligno de la arteria cerebral media en una paciente con meningitis bacteriana / Malignant middle cerebral artery territory infarct in one patient with bacterial meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english The mortality of acute bacterial meningitis (BM) has remained stable in the last decades in spite of the use of new antibiotics, probably due to vascular complications. We report a 68-year-old woman with BM who had a malignant infarction of left middle cerebral artery territory 72 hours after admiss [...] ion to the hospital. The patient experienced a bad evolution and died four days after admission. The arterial involvement in patients with BM is explained by vasospasm of large arteries and vasculitis of small arteries. The medical treatment of a malignant middle cerebral artery infarct has a high mortality (Rev Méd Chile 2004; 132: 1217-20)

Mirta, López G; Patricio, Mellado T; Isidro, Huete L.

1217-12-01

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Lymphocyte subset distribution in steroid responsive meningitis-arteriitis in comparison to different canine encephalitides.  

Science.gov (United States)

Steroid responsive meningitis-arteriitis (SRMA) is a well-known disease in dogs, but the aetiology and pathogenesis are not yet understood. In the peripheral blood an overrepresentation of B cells was found. In the present study we therefore evaluated the distribution of lymphocyte subsets in SRMA in paraffin-embedded tissue sections directly at the lesion sites and compared the results to different canine encephalitides. An intriguing finding was that the B cell/T cell distribution varied depending on the aetiology of the disease: in viral encephalitides, T cells were the predominant cell population in perivascular cuffs, whereas in protozoal and bacterial diseases B cells prevailed. In SRMA an overrepresentation of B cells occurred in meningeal lesions, as already found in the peripheral blood. The distribution of lymphocyte subsets was similar to bacterial and protozoal diseases and was not a unique phenomenon for this specific inflammatory lesion in the canine central nervous system (CNS). Multiple mechanisms seem to be responsible for recruitment and activation of different leukocyte subsets after alteration of the CNS tissue by an environmental factor. A specific finding in SRMA was that the distribution of T and B cells depended also on the lesion site. In contrast to meningeal lesions, in inflamed arteries T cells were the only lymphocyte population found. In these vessels, diffuse infiltration with immunoglobulins was revealed. Inactivated or resting lymphocytes and large granular lymphocytes occurred in each of the diseases examined. These similarities between SRMA and infectious CNS diseases of the dog support earlier suggestions that the disease is somehow triggered by a hitherto unknown environmental factor which leads to the dysregulation of the immune system. PMID:10216444

Tipold, A; Moore, P; Zurbriggen, A; Vandevelde, M

1999-03-01

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[Spontaneous occlusion of PICA-involved dissecting aneurysm with development of a collateral channel from the posterior meningeal artery].  

Science.gov (United States)

A 53-year-old man suffered severe headache, which continued for three days. No abnormality was shown on CT scan, and a dissecting aneurysm of the right vertebral artery was suspected on MRI. Cerebral angiography revealed a dissection aneurysm of the right vertebral artery involved with the posterior inferior cerebellar artery (PICA) as pearl and string sign. The patient was conservatively managed under careful blood pressure control, and was followed by serial MRI. He presented with Wallenberg syndrome three weeks later. Second angiography revealed the occlusion of the PICA-involved dissecting aneurysm and the lateral medullary segment of the PICA supplied by a newly arising vessel from the right posterior meningeal artery (PMA). For the conservative treatment of a vertebral dissection aneurysm involved with PICA presenting with only pain, observation of the course by MRI was effective, and the PMA could develop as the collateral channel to the PICA territory. PMID:23100389

Arai, Atsushi; Miyamoto, Hirohito; Ashida, Noriaki; Kohmura, Eiji

2012-11-01

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The preservation of middle meningeal artery in surgical revascularization for moyamoya disease  

International Nuclear Information System (INIS)

We present the preservation of middle meningeal artery (MMA) in surgical revascularization for moyamoya disease. We examined 10 patients with moyamoya disease and performed surgical revascularization. The mean age of the patients was 27.8 years. We presurgically evaluated the three-dimensional (3-D) relationships of MMA and cranial sutures in the pterion by volumetric imaging of 3-D contrast enhanced computed tomography (CT). The 3-D anatomies were visualized by adjusting the window width, window level, and opacity level of the specific CT value for each structure, and the relationship of the MMA and the suture. This visualization was crucial for drilling to perform craniotomies. The MMA from bone to dura is exposed for drilling around the pterion. The preservation of the MMA with this method was achieved in all patients with moyamoya disease. Presurgical evaluation using volumetric imaging of 3-D CT is a convenient and valuable method for obtaining the anatomic information. The usefulness of the drilling distal to the pterion in patients with moyamoya disease to preserve MMA was confirmed. (author)

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Central projections of the sensory innervation of the rat middle meningeal artery  

DEFF Research Database (Denmark)

Headaches, especially migraine, involve not only pain but also aspects such as vasodilation of cranial vessels and sensitization of nerve endings, processes dependent on and connected to the central nervous system. To understand pathogenic mechanisms of headache, it is important to elucidate the central projections of sensory nerves that innervate cranial vessels, of which the middle meningeal artery (MMA) is the largest artery supplying the dura mater. In this study, cholera toxin subunit b (CTb) or wheat germ agglutinin-horseradish peroxidase conjugate (WGA-HRP) was applied on the adventitia of MMA. After perfusion fixation, the brainstem, the C1-C4 spinal segments and the trigeminal and C2 dorsal root ganglia were removed and sections from these tissues were processed to visualize transported tracers. Labeled cell bodies were seen ipsilaterally in the trigeminal and C2 dorsal root ganglia. Labeled nerve terminations were found ipsilaterally in the lateral part of the spinal dorsal horn of segments C1-C3 and in the caudal and interpolar parts of the spinal trigeminal nucleus. WGA-HRP labeled terminations were mainly located in laminae I and II, whereas CTb labeled terminations located in laminae III-V. These results indicate that sensory information from the MMA is transmitted through both trigeminal and cervical spinal nerve branches to a region in the central nervous system extending rostrally from the C3 dorsal horn to the interpolar part of the spinal trigeminal nucleus. Our data further substantiates that the sensory innervation of the MMA, in addition to putative nociceptive afferents, include a population of large caliber afferents with an as yet unclear but presumably non-nociceptive role Udgivelsesdato: 2008/5/7

Liu, Y.; Broman, J.

2008-01-01

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Chemotactic activity and IL-8 levels in the cerebrospinal fluid in canine steroid responsive meningitis-arteriitis.  

Science.gov (United States)

Steroid responsive meningitis-arteriitis (SRMA) is a systemic immune disorder, characterized by inflammatory-stenosing lesions of the meningeal arteries and meningitis. The predilection of the disease for the central nervous system (CNS) remains unexplained. In this study, chemotactic activity and chemotactic factors were measured in the cerebrospinal fluid (CSF) of dogs with SRMA. CSF of dogs with SRMA exerted a marked chemotactic activity for leukocytes. Neutrophils were attracted to a similar degree as by CSF from animals with bacterial encephalitis. Chemotactic activity was also noted for mononuclear cells, however, by far weaker than in CSF from animals with viral encephalitis. While the inflammatory process could be suppressed with glucocorticoid treatment, the chemotactic activity of CSF persisted. We could identify IL-8-like activities using a desensitization assay in the CSF of animals with SRMA and also found increased IgA levels. Increased chemotactic activity for polymorphonuclear leukocytes correlated positively with the levels of IL-8-like activity in CSF. Our observations clearly suggest that in SRMA chemotactic factors are generated in the CNS. These include IL-8, but probably also others. The intensity of this production appears to correlate with IgA levels in the CSF suggesting either a causal link or reflecting the severity of the inflammation. PMID:9726841

Burgener, I; Van Ham, L; Jaggy, A; Vandevelde, M; Tipold, A

1998-08-14

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[Autoantibodies against structures of the central nervous system in steroid responsive meningitis-arteriitis in dogs].  

Science.gov (United States)

Steroid-responsive meningitis-arteriitis (SRMA) is a disease of dogs familiar in small animal practice for decades. A combined evaluation of IgA in serum and cerebrospinal fluid (CSF) is an important diagnostic tool. It is suspected that immunpathological mechanisms are involved in the pathogenesis of SRMA because of the marked response to steroids. Excessive production of IgA seems to play a central role and might be caused by an immune reaction to self-antigens of the central nervous system (CNS). To test this hypothesis, we analyzed CSF samples from 55 dogs with SRMA using the western blot method. After blotting canine brain tissue, IgA, IgM and IgG of the CSF samples were tested for their binding to CNS antigens. We also evaluated CSF samples from 45 dogs with other brain diseases, including different encephalitides and intracranial tumors, and from healthy dogs as controls. Positive reactions (mostly IgA) were observed in the CSF samples from dogs with SRMA, different encephalitides and brain tumors (a total of 8% positive samples). The occurrence of autoantibodies against CNS structures was significantly higher in the control group "other brain diseases" than in the SRMA group (p = 0.0135). There was no significant difference in the number of positive samples between dogs with SRMA and the negative control group (healthy dogs, p = 0.1535). Despite the small number of positive samples, only dogs with abnormal findings in the CSF analysis also had autoantibodies in the CSF. There was no significant correlation between the occurrence of autoantibodies and levels of IgA, protein content and cell counts in the cerebrospinal fluid. However, there was a certain trend toward positive reactions in CSF samples with high protein content. The occurrence of autoantibodies in dogs with SRMA thus seems to be an epiphenomenona rather than the cause of the disease. PMID:16450710

Schulte, Kolja; Carlson, Regina; Tipold, Andrea

2006-01-01

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Transzygomatic-Subtemporal Approach for Middle Meningeal-to-P2 Segment of the Posterior Cerebral Artery Bypass: An Anatomical and Technical Study  

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We evaluated the use of a bypass between the middle meningeal artery (MMA) and P2 segment of the posterior cerebral artery (PCA) as an alternative to an external carotid artery (ECA-to-PCA) anastomosis. Five adult cadaveric heads (10 sides) were used. After a temporal craniotomy and zygomatic arch osteotomy were performed, the dura of the floor of the middle cranial fossa was separated and elevated. The MMA was dissected away from the dura until the foramen spinosum was reached. Intradurally,...

Ustun, Mehmet Erkan; Buyukmumcu, Mustafa; Ulku, Cagatay Han; Guney, O?nder; Salbacak, Ahmet

2006-01-01

59

Traumatic pseudoaneurysm of the middle meningeal artery with an arteriovenous fistula on a non-fractured site.  

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We describe a rare case of a combined traumatic pseudoaneurysm and arteriovenous fistula (AVF) of the middle meningeal artery (MMA) on a non-fractured site. A 24-year-old man was admitted to our hospital with head trauma. He underwent a craniotomy and removal of an epidural hematoma on the right side. Twenty-five days later, he complained of pulsatile tinnitus on the left non-fractured side. Angiography revealed a markedly dilated proximal MMA with flow shunting to the pterygoid plexus. We performed proximal occlusion on the proximal MMA for the traumatic pseudoaneurysm and the AVF of the MMA using coils. Although immediate angiography showed retrograde contrast filling from the collateral vessels into the distal part of the pseudoaneurysm, follow-up angiography revealed that the lesion had successfully disappeared. PMID:24976099

Ko, Jung Ho; Kim, Young-Joon

2014-01-01

60

Direct access to the middle meningeal artery for embolization of complex dural arteriovenous fistula: a hybrid treatment approach.  

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Endovascular embolization has become increasingly favored over microsurgical resection for treatment of complex dural arteriovenous fistulas (DAVFs). However, endovascular treatment can be restricted by tortuous transarterial access and a transvenous approach is not always feasible. We present a Borden III DAVF treated by direct access to the middle meningeal artery (MMA) and Onyx embolization performed in a hybrid operating room-angiography suite. A middle-aged patient with pulsatile headaches was found to have left transverse sinus occlusion and DAVF with retrograde cortical venous drainage fed by multiple external carotid artery (ECA) feeders. Endovascular attempts via conventional transvenous and transarterial routes were unsuccessful, and the major MMA feeder was accessed directly after temporal craniotomy was performed under neuronavigation. Onyx embolization was performed; complete occlusion of the fistula was achieved. Three-month follow-up angiography showed no residual filling; the patient remains complication-free. A combined surgical-endovascular technique in a hybrid operating room-angiography suite can be an effective treatment for DAVFs complicated by inaccessible arterial and transvenous approaches. PMID:24916414

Lin, Ning; Brouillard, Adam M; Mokin, Maxim; Natarajan, Sabareesh K; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H

2014-06-10

 
 
 
 
61

Subdural and intracerebral hemorrhage caused by spontaneous bleeding in the middle meningeal artery after coil embolization of a cerebral aneurysm.  

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Nontraumatic acute subdural hemorrhage (SDH) with intracerebral hemorrhage (ICH) is rare and is usually caused by severe bleeding from aneurysms or arteriovenous fistulas. We encountered a very rare case of spontaneous bleeding from the middle meningeal artery (MMA), which caused hemorrhage in the temporal lobe and subdural space 2 weeks after coil embolization of an ipsilateral, unruptured internal cerebral artery aneurysm in the cavernous portion. At onset, the distribution of hematoma on a computed tomography scan led us to believe that the treated intracavernous aneurysm could bleed into the intradural space. Emergency craniotomy revealed that the dura of the middle fossa was intact except for the point at the foramen spinosum where the exposed MMA was bleeding. Retrospectively, angiography just before and after embolization of the aneurysm did not show any aberrations in the MMA. Although the MMA usually courses on the outer surface of the dura and is unlikely to rupture without an external force, physicians should be aware that the MMA may bleed spontaneously and cause SDH and ICH. PMID:25134456

Kohyama, Shinya; Kakehi, Yoshiaki; Yamane, Fumitaka; Ooigawa, Hidetoshi; Kurita, Hiroki; Ishihara, Shoichiro

2014-10-01

62

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 certai

Ana Teresa Alvarado Guevara

2006-03-01

63

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: ...

64

Chronic Meningitis  

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... caused by an infection. Many microorganisms can cause chronic meningitis. Among the most important microorganisms are Bacteria that cause tuberculosis ( Mycobacterium tuberculosis —see Tuberculosis ) Bacteria that cause Lyme disease ( Borrelia burgdorferi —see Lyme Disease ) Fungi, including Cryptococcus ...

65

Meningitis - tuberculous  

Science.gov (United States)

... eds. Cecil Medicine . 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 332. Fitzgerald DW, Sterling TR, Haas ... Practice of Infectious Diseases . 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 250. Swartz MN. Meningitis: ...

66

K-ATP channel expression and pharmacological in vivo and in vitro studies of the K-ATP channel blocker PNU-37883A in rat middle meningeal arteries  

DEFF Research Database (Denmark)

Background and purpose: Dilatation of cerebral and dural arteries causes a throbbing, migraine-like pain, indicating that these structures are involved in migraine. Clinical trials suggest that adenosine 5'-triphosphate-sensitive K+ (K-ATP) channel opening may cause migraine by dilatating intracranial arteries, including the middle meningeal artery (MMA). We studied the K-ATP channel expression profile in rat MMA and examined the potential inhibitory effects of the K-ATP channel blocker PNU-37883A on K-ATP channel opener-induced relaxation of the rat MMA, using the three K-ATP channel openers levcromakalim, pinacidil and P-1075. Experimental approach: mRNA and protein expression of K-ATP channel subunits in the rat MMA were studied by quantitative real-time PCR and western blotting, respectively. The in vivo and in vitro effects of the K-ATP channel drugs on rat MMA were studied in the genuine closed cranial window model and in myograph baths, respectively. Key results: Expression studies indicate that inwardly rectifying K+ (Kir)6.1/sulphonylurea receptor (SUR) 2B is the major K-ATP channel complex in rat MMA. PNU-37883A (0.5 mg kg(-1)) significantly inhibited the in vivo dilatory effect of levcromakalim (0.025 mg kg(-1)), pinacidil (0.38 mg kg(-1)) and P-1075 (0.016 mg kg(-1)) in rat MMA. In vitro PNU-37883A significantly inhibited the dilatory responses of the three K-ATP channel openers in rat MMA at 10(-7) and 3 x 10(-7) M. Conclusions and implications: We suggest that Kir6.1/SUR2B is the major functional K-ATP channel complex in the rat MMA. Furthermore, we demonstrate the potent in vivo and in vitro blocking potentials of PNU-37883A on K-ATP channel opener-induced relaxation of the rat MMA Udgivelsesdato: 2008/5

Ploug, K.B.; Boni, L.J.

2008-01-01

67

Bacterial Meningitis  

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... be signs of meningitis. If you think your infant has any of these symptoms, call the doctor or clinic right away. Later symptoms ... plenty of rest, and not coming into close contact with people who are sick, can ... for young infants, the elderly, and people with a weakened immune ...

68

The in vivo effect of VIP, PACAP-38 and PACAP-27 and mRNA expression of their receptors in rat middle meningeal artery  

DEFF Research Database (Denmark)

The parasympathetic nervous system is probably involved in migraine pathogenesis. Its activation releases a mixture of signalling molecules including vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP), which subsequently stimulate VPAC(1), VPAC(2) and PAC(1) receptors. The objective of the present study was to investigate the in vivo effect of VIP, PACAP-27, PACAP-38, the selective VPAC(1) agonist ([Lys15, Arg16, Leu27]-VIP(1-7)-GRF(8-27)) and a PAC(1) agonist, maxadilan on rat middle meningeal artery (MMA) diameter using the closed cranial window model. Selective antagonists were used for further characterization of the responses. Reverse transcriptase-polymerase chain reaction experiments were also conducted to determine expression of mRNA of PACAP receptors in the MMA. The results showed that VIP, PACAP-38, PACAP-27 and the VPAC(1) specific agonist evoked significant dilations with the rank order of potency; VIP = PACAP-38 > PACAP-27 = [Lys15, Arg16, Leu27]-VIP(1-7)-GRF(8-27). Significant inhibition of dilation was only observed for the VPAC(1) antagonist PG97-269 on PACAP-38-induced dilation of MMA. The VPAC(2) antagonist PG99-465 and PAC(1) antagonist PACAP(6-38) did not significantly block VIP- or PACAP-induced dilation. Expression of mRNA of all three receptors was detected in the MMA. In conclusion, the VPAC(1) receptor seems to be predominant in mediating MMA dilation. A selective VPAC(1) antagonist may be a candidate molecule in the treatment of migraine headacheThe parasympathetic nervous system is probably involved in migraine pathogenesis. Its activation releases a mixture of signalling molecules including vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP), which subsequently stimulate VPAC(1), VPAC(2) and PAC(1) receptors. The objective of the present study was to investigate the in vivo effect of VIP, PACAP-27, PACAP-38, the selective VPAC(1) agonist ([Lys15, Arg16, Leu27]-VIP(1-7)-GRF(8-27)) and a PAC(1) agonist, maxadilan on rat middle meningeal artery (MMA) diameter using the closed cranial window model. Selective antagonists were used for further characterization of the responses. Reverse transcriptase-polymerase chain reaction experiments were also conducted to determine expression of mRNA of PACAP receptors in the MMA. The results showed that VIP, PACAP-38, PACAP-27 and the VPAC(1) specific agonist evoked significant dilations with the rank order of potency; VIP = PACAP-38 > PACAP-27 = [Lys15, Arg16, Leu27]-VIP(1-7)-GRF(8-27). Significant inhibition of dilation was only observed for the VPAC(1) antagonist PG97-269 on PACAP-38-induced dilation of MMA. The VPAC(2) antagonist PG99-465 and PAC(1) antagonist PACAP(6-38) did not significantly block VIP- or PACAP-induced dilation. Expression of mRNA of all three receptors was detected in the MMA. In conclusion, the VPAC(1) receptor seems to be predominant in mediating MMA dilation. A selective VPAC(1) antagonist may be a candidate molecule in the treatment ofmigraine headache Udgivelsesdato: 2009

Boni, L.J.; Ploug, Kenneth Beri

2009-01-01

69

Meningitis - gram-negative  

Science.gov (United States)

Gram-negative meningitis ... Acute bacterial meningitis can be caused by Gram-negative bacteria. Meningococcal and H. influenzae meningitis are due to Gram-negative bacteria and are covered in detail in other articles. This article ...

70

Non-Infectious Meningitis  

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... Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Non-Infectious Meningitis Share Compartir On this Page Causes ... meningitis is not spread from person to person. Non-infectious meningitis can be caused by cancers, systemic ...

71

The in vivo effect of VIP, PACAP-38 and PACAP-27 and mRNA expression of their receptors in rat middle meningeal artery.  

Science.gov (United States)

The parasympathetic nervous system is probably involved in migraine pathogenesis. Its activation releases a mixture of signalling molecules including vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP), which subsequently stimulate VPAC(1), VPAC(2) and PAC(1) receptors. The objective of the present study was to investigate the in vivo effect of VIP, PACAP-27, PACAP-38, the selective VPAC(1) agonist ([Lys15, Arg16, Leu27]-VIP(1-7)-GRF(8-27)) and a PAC(1) agonist, maxadilan on rat middle meningeal artery (MMA) diameter using the closed cranial window model. Selective antagonists were used for further characterization of the responses. Reverse transcriptase-polymerase chain reaction experiments were also conducted to determine expression of mRNA of PACAP receptors in the MMA. The results showed that VIP, PACAP-38, PACAP-27 and the VPAC(1) specific agonist evoked significant dilations with the rank order of potency; VIP = PACAP-38 > PACAP-27 = [Lys15, Arg16, Leu27]-VIP(1-7)-GRF(8-27). Significant inhibition of dilation was only observed for the VPAC(1) antagonist PG97-269 on PACAP-38-induced dilation of MMA. The VPAC(2) antagonist PG99-465 and PAC(1) antagonist PACAP(6-38) did not significantly block VIP- or PACAP-induced dilation. Expression of mRNA of all three receptors was detected in the MMA. In conclusion, the VPAC(1) receptor seems to be predominant in mediating MMA dilation. A selective VPAC(1) antagonist may be a candidate molecule in the treatment of migraine headache. PMID:19220306

Boni, L J; Ploug, K B; Olesen, J; Jansen-Olesen, I; Gupta, S

2009-08-01

72

Cryptococcal meningitis  

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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.

DING Wen-ting

2013-01-01

73

Cochlear-Meningitis Vaccination  

Science.gov (United States)

Cochlear-Meningitis Vaccination Cochlear-Meningitis Vaccination Patient Health Information News media interested in covering the latest from AAO-HNS/F can find information on embargoes, Annual Meeting ...

74

MR angiography in tuberculous meningitis  

International Nuclear Information System (INIS)

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 inf% 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

75

MR angiography in tuberculous meningitis  

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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

76

Cerebral infarct and meningitis secondary to Lemierre's syndrome.  

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The case is reported of a young man with Fusobacterium necrophorum septicemia who developed cavernous sinus thrombosis, meningitis, carotid artery stenosis and stroke. This article presents the only reported case of arterial stroke in Lemierre's syndrome. Clinical presentation, diagnostic difficulty and treatment are discussed. © 2004 by Elsevier Inc. All rights reserved.

Bentham, JR; Pollard, Aj; Milford, Ca; Anslow, P.; Pike, Mg

2004-01-01

77

Pasteurella multocida meningitis.  

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Pasteurella multocida appears to be a very rare cause of meningitis. The bacterium has morphological similarities with other causative organisms, particularly Haemophilus influenzae, and its apparent rarity may be due partly to misidentification. This case, only the fourth reported from the United Kingdom, could not be distinuished clinically from the meningitis, owing to other pyogenic bacteria.

Smith, F. R.

1987-01-01

78

Serratia marcescens meningitis.  

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A case of Serratia marcescens meningitis in a 66-year-old man is reported. The infection occurred 4 weeks after apparently successful otic surgery, and a nidus of infection in the middle ear was established at autopsy. This is the second case of S. marcescens meningitis following ear surgery reported in the English-language literature.

Theccanat, G.; Hirschfield, L.; Isenberg, H.

1991-01-01

79

Syringomyelia following tuberculous meningitis  

International Nuclear Information System (INIS)

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)

80

Laboratorial diagnosis of lymphocytic meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 agen [...] ts 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.

2007-10-01

 
 
 
 
81

Laboratorial diagnosis of lymphocytic meningitis  

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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

2007-10-01

82

Laboratorial diagnosis of lymphocytic meningitis  

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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 d...

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

2007-01-01

83

MR imaging and angiography in tuberculous meningitis  

International Nuclear Information System (INIS)

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.)

84

Primary Meningeal Rhabdomyosarcoma  

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Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imagin...

Kirkpatrick, John P.; Zheng Chang; Scott Green; Vredenburgh, James J.; Cummings, Thomas J.; Riedel, Richard F.; Manisha Palta

2011-01-01

85

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 carriage caused by these encapsulated bacteria. The major challenge in prevention of meningitis remains the delivery of vaccines worldwide, especially to resource-poor regions with the greatest disease bu...

Segal, S.; Pollard, A. J.

2004-01-01

86

Meningitis bacteriana aguda Acute bacterial meningitis  

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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

1998-08-01

87

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

2013-01-01

88

Bacterial meningitis in children  

International Nuclear Information System (INIS)

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)

89

Iatrogenic meningitis / Meningites iatrogenicas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 produzid [...] os por uma única farmácia de produção. Diversos medicamentos podem causar meningite por provável mecanismo de hipersensibilidade. 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. Sever [...] al 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.

Eduardo Genaro, Mutarelli; Tarso, Adoni.

2013-09-01

90

Bacteroides fragilis meningitis.  

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A fatal case of pyogenic meningitis due to Bacteroides fragilis in a 6-year-old boy is reported. The need for processing cerebrospinal fluid of patients with underlying conditions such as chronic otitis media for recovery of both aerobes and anaerobes is discussed.

Odugbemi, T.; Jatto, S. A.; Afolabi, K.

1985-01-01

91

JAMA Patient Page: Meningitis  

Science.gov (United States)

Skin Bone Cerebrospinal Fluid Brain Spinal Cord Meninges CROSS-SECTION VIEW Brain I N F E C T I O U S D I S ... the CSF that bathes the spinal cord and brain. Supportive therapy, including medications to ... on 01/13/2015 Cerebrospinal Fluid

92

Cerebrospinal fluid concentration of fibronectin in meningitis.  

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Fibronectin concentrations in the cerebrospinal fluid were assessed in 20 patients with acute meningitis using a turbidimetric immunoassay. A significant increase in fibronectin concentrations was observed in patients with bacterial meningitis; decreased concentrations were observed in patients with viral meningitis. The determination of fibronectin concentration in patients with bacterial meningitis may represent a useful marker in differentiating bacterial from viral meningitis.

Torre, D.; Zeroli, C.; Issi, M.; Fiori, G. P.; Ferraro, G.; Speranza, F.

1991-01-01

93

Meningeal hemangiopericytoma in childhood  

Energy Technology Data Exchange (ETDEWEB)

Meningeal hemangiopericytoma (MHP) is extremely rare in childhood. Mean age at diagnosis is between 38 and 43 years. We present an 8-year-old boy with MHP of the middle cranial fossa. Imaging findings were indistinguishable from an aggressive bone tumor such as Ewing's sarcoma. Imaging findings are presented and discussed. Our case indicates that MHP should be considered in the differential diagnosis of skull-base tumors despite the fact that MHP is extremely rare in childhood. (orig.)

Huisman, T.A.G.M.; Willi, U.V.; Martin, E. [Department of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Brandner, S. [Institute of Neuropathology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Niggli, F. [Division of Paediatric Oncology, University Children' s Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Kacl, G. [Institute of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland)

2000-07-01

94

Meningeal hemangiopericytoma in childhood  

International Nuclear Information System (INIS)

Meningeal hemangiopericytoma (MHP) is extremely rare in childhood. Mean age at diagnosis is between 38 and 43 years. We present an 8-year-old boy with MHP of the middle cranial fossa. Imaging findings were indistinguishable from an aggressive bone tumor such as Ewing's sarcoma. Imaging findings are presented and discussed. Our case indicates that MHP should be considered in the differential diagnosis of skull-base tumors despite the fact that MHP is extremely rare in childhood. (orig.)

95

CT scanning in meningitis  

International Nuclear Information System (INIS)

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

96

Chemical meningitis in metrizamide myelography  

International Nuclear Information System (INIS)

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.)

97

Meningitis sifilítica aguda / Acute syphilitic meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish 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 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 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.

2011-09-01

98

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

99

Meningococcemia without meningitis in Japan.  

Science.gov (United States)

We report a case of meningococcemia without meningitis, which is a rare infectious disease in Japan. A 32-year-old woman was referred to our hospital with fever and joint pain. Her clinical presentation and the results of laboratory examination on admission suggested viral infection. However, her condition rapidly progressed to septic shock with fulminans purpura. Blood culture grew Neisseria meningitidis. She received antimicrobial therapy and underwent localized therapy for skin lesions. Meningococcal infection should be considered in patients who have fever along with skin rash or petechiae even when there are no signs of meningitis. In this report, we also review case reports of meningococcemia without meningitis in Japan. PMID:18758132

Horino, Tetsuya; Kato, Tetsuro; Sato, Fumiya; Sakamoto, Mitsuo; Nakazawa, Yasushi; Yoshida, Masaki; Onodera, Shoichi; Kohda, Masato; Matsuo, Koma; Ishiji, Takaoki; Takahashi, Hideyuki; Watanabe, Haruo

2008-01-01

100

Meningitis tras anestesia espinal Meningitis after a spinal anesthesia  

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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

2008-03-01

 
 
 
 
101

Neonatal meningitis complicating with pneumocephalus  

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Pneumocephalus is a rare condition characterized by the presence of gas within the cranial cavity. This gas may arise either from a trauma, a tumor, a surgical, or a diagnostic procedure or occasionally from an infection. Pneumocephalus as a complication of bacterial meningitis, in absence of trauma or a procedure, is extremely rare, particularly in a newborn. A case of pneumocephalus occurring in a baby, suffering from neonatal meningitis, acquired probably through unsafe cutting and tying o...

Kumari, Anita; Agrawal, Satish C.

2014-01-01

102

Meningeal tumors histologically mimicking meningioma.  

Science.gov (United States)

A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma. In the present paper, we review meningeal non-meningothelial tumors which may also mimic different histotypes of meningioma at the histological examination. Awareness that these lesions exist may facilitate their recognition and correct diagnosis, which is of fundamental importance for prognosis and an appropriate therapeutic approach. Histological and immunohistochemical clues for the differential diagnosis are discussed. PMID:22885109

Barresi, Valeria; Caffo, Maria; Branca, Giovanni; Caltabiano, Rosario; Tuccari, Giovanni

2012-10-15

103

Naegleria meningitis : a rare survival.  

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Acute amebic meningoencephalitis caused by free-living amebae naegleria fowleri is extremely rare and uniformly fatal with only seven survivals reported till date. An interesting case of naegleria meningitis diagnosed by wet mount cytology of cerebrospinal fluid (CSF) and treated with amphoterecin B, rifampicin and ornidazole with complete recovery is presented. In cases of suspected pyogenic meningitis, if CSF staining, antigen detection or culture is negative for bacteria, a wet mount cytol...

Jain R; Prabhakar S; Modi M; Bhatia R; Sehgal R

2002-01-01

104

Spinal perineurial and meningeal cysts  

Science.gov (United States)

Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue. When initial myelography fails to reveal an adequate cause for the patient's symptoms and signs referable to the caudal nerve roots, then about a millilitre of Pantopaque should be left in the canal for delayed myelography which may later reveal a sacral perineurial cyst or, occasionally, a meningeal cyst. Meningeal diverticula occur proximal to the posterior root ganglia and usually fill on initial myelography. They are in free communication with the subarachnoid space and are rarely in my experience responsible for clinical symptoms. Meningeal diverticula and meningeal cysts appear to represent a continuum. Pantopaque left in the subarachnoid space may convert a meningeal diverticulum into an expanding symptomatic meningeal cyst, as in the case described. Many cases described as perineurial cysts represent abnormally long arachnoidal prolongations over nerve roots or meningeal diverticula. In general, neither of the latter is of pathological significance. Perineurial, like meningeal cysts and diverticula, may be asymptomatic. They should be operated upon only if they produce progressive or disabling symptoms or signs clearly attributable to them. When myelography must be done, and this should be done only as a preliminary to a probable necessary operation, then patient effort should be made to remove the Pantopaque. Images PMID:5531903

Tarlov, I. M.

1970-01-01

105

Diagnosis dan Penatalaksanaan Meningitis Otogenik  

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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 neuronal toxicity, contribute to the pathophysiology of the disease. Streptococcus pneumoniae is the predominant mocroorganism. Haemophylus influenzae dan P. aeruginosa being the second most important...

Ritarwan, Kiking

2010-01-01

106

Otogenic pneumococcal meningitis with pneumocephalus.  

Science.gov (United States)

Streptococcus pneumoniae accounts for approximately 50% of bacterial meningitis cases in the United States annually. Since the advent of antibiotics, pneumococcal meningitis as a complication of a primary otogenic focus has been rare in the United States. The widespread use of immunosuppressants and increasing bacterial resistance to commonly prescribed antibiotics may contribute to a higher incidence of complications of otitis media in the future, similar to that of the pre-antibiotic era. We report a case of otogenic pneumococcal meningitis with pneumocephalus in an adult male on chronic immunosuppressant therapy. A 33-year-old man with Crohn's disease and azathioprine use presented to our Emergency Department with progressive headache while taking antibiotics for otitis media. Initial computed tomography scan of the brain revealed pneumocephaly, and cerebrospinal fluid analysis and culture diagnosed pneumococcal meningitis. The patient continued to have fevers while receiving intravenous antibiotics and underwent bilateral myringotomies; his clinical course subsequently improved significantly. Meningitis is a rare complication of Streptococcus pneumoniae infections since the advent of antibiotics; however, it may become more frequent with increasing antibiotic resistance and a growing population of immunocompromised patients. Additionally, pneumocephalus in the setting of meningitis and otitis media should raise the suspicion for mastoiditis (even without overt clinical findings) and early consultation with an otolaryngologist is warranted. PMID:18597973

Damergis, Jennifer A; Chee, Kerlen; Amitai, Allon

2010-09-01

107

Meningitis bacteriémica por Pasteurella multocida / Pasteurella multocida bacteremic meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish 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 mu [...] jer 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. 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 w [...] ith 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.

2008-12-01

108

Acute meningitis by Streptococcus suis  

Directory of Open Access Journals (Sweden)

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

2012-12-01

109

Naegleria meningitis : a rare survival.  

Directory of Open Access Journals (Sweden)

Full Text Available Acute amebic meningoencephalitis caused by free-living amebae naegleria fowleri is extremely rare and uniformly fatal with only seven survivals reported till date. An interesting case of naegleria meningitis diagnosed by wet mount cytology of cerebrospinal fluid (CSF and treated with amphoterecin B, rifampicin and ornidazole with complete recovery is presented. In cases of suspected pyogenic meningitis, if CSF staining, antigen detection or culture is negative for bacteria, a wet mount cytology of CSF for naegleria is suggested. Early treatment with amphoterecin B and rifampicin may improve survival.

Jain R

2002-10-01

110

Mycobacterium Bovis Meningitis: Case Report  

Directory of Open Access Journals (Sweden)

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

2012-06-01

111

Meningitis as cochlear implant complication  

Directory of Open Access Journals (Sweden)

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

2009-01-01

112

Cryptococcal meningitis. An atypical presentation.  

Science.gov (United States)

A previously healthy 23-year-old white female presented with a history of horizontal diplopia prior to any other symptoms. Physical examination revealed bilateral sixth cranial nerve palsies, papilledema, right Horner's syndrome, and right hemiparesis. Cryptococcus neoformans was isolated from the cerebrospinal fluid. This is the first documented case of Horner's syndrome associated with cryptococcal meningitis. PMID:6226684

Custer, P; Breen, L A; Burde, R M

1982-03-01

113

Acute bacterial meningitis in Qatar.  

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OBJECTIVES To study the changes in the epidemiology, clinical and bacteriological profiles of bacterial meningitis in the era of the Haemophilus influenzae type b (Hib)vaccine and pneumococcus resistance. METHODS This is a retrospective study of children aged <12 years admitted to the Hamad Medical Corporation, Qatar between January 1998 through December 2002 with positive cerebrospinal fluid culture. RESULTS

Elsaid, Mahmoud F.; Flamerzi, Amina A.; Bessisso, Mohammed S.; Elshafie, Sittana S.

2006-01-01

114

Climate Change and Cerebrospinal Meningitis in the Ghanaian Meningitis Belt  

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Cerebrospinal meningitis (CSM) is one of the infectious diseases likely to be affected by climate change. Although there are a few studies on the climate change-CSM nexus, none has considered perceptions of community members. However, understanding public perception in relation to a phenomenon is very significant for the design of effective communication and mitigation strategies as well as coping and adaptation strategies. This paper uses focus group discussions (FGDs) to fill this knowledg...

Samuel Nii Ardey Codjoe; Vivian Adams Nabie

2014-01-01

115

Bacteriological study of meningococcal meningitis.  

Directory of Open Access Journals (Sweden)

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

1991-04-01

116

Meningeal osteosarcoma in a dog.  

Science.gov (United States)

A meningeal osteosarcoma was diagnosed in a dog displaying neurologic signs compatible with a space-occupying cerebellar lesion. Gross lesions, restricted to the brain, consisted of a solitary, compressive mass attached to the dura mater overlying the left cerebellum. The mass was composed of single and multinucleated, atypical polygonal cells that lined or rested within lacuna surrounded by eosinophilic, mineralized matrix. The matrical component stained dark green-yellow to blue with Movat's pentachrome stain, deep blue to red with Heidenhain aniline blue stain, and brown-black with Von Kossa stain. Results of these stains were interpreted as tumor osteoid. Foci of dural mineralization and osseous metaplasia were present at the point of tumor attachment. The microscopic observations were interpreted as an osteosarcoma of extraskeletal origin. To our knowledge, these findings represent the first documented case of a meningeal osteosarcoma in a domestic animal species. PMID:11105956

Ringenberg, M A; Neitzel, L E; Zachary, J F

2000-11-01

117

Clinical research progress of tuberculous meningitis  

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Tuberculous meningitis is an infectious disease of central nervous system caused by Mycobacterium tuberculosis. It mainly invades into brain meninges and parenchyma, and may spread to the spinal cord and spinal meninges. The disability rate and mortality rate of this disease are very high. In recent years, incidence of tuberculosis increased significantly due to the increase of drug-resistant tuberculosis cases, population mobility, acquired immunodeficiency syndrome (AIDS) epidemic ...

Ma, Zhan-yun; Chen, Peng; Fan, Xue-wen

2014-01-01

118

Evaluation and Treatment of Chronic Meningitis  

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Chronic meningitis is defined as an inflammatory cerebrospinal fluid (CSF) profile that persists for at least 1 month. The presentation often includes headache, nausea, vomiting, cranial neuropathies, symptoms of elevated intracranial pressure, or focal neurologic deficits. The most common etiologies of chronic meningitis fall into 3 broad categories: infectious, autoimmune, and neoplastic. Evaluation of the patient with suspected chronic meningitis should include a detailed history and physi...

Baldwin, Kelly J.; Zunt, Joseph R.

2014-01-01

119

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

120

Chapter 28: a history of bacterial meningitis.  

Science.gov (United States)

Thomas Willis (1621-1675) described patients with, "inflammation of the meninges with a continual fever" as well as an early (1661) epidemic of meningitis. Robert Whytt (1714-1766) provided a classic depiction of tuberculous meningitis and its stages, later extended by John Cheyne (1777-1836). Gaspard Vieusseux (1746-1814) and Andre Matthey (1778-1842) in Geneva, and Elisa North (1771-1843) in Massachusetts, described epidemic (meningococcal) meningitis. Heinrich Quincke (1842-1922) utilized his new technique of lumbar puncture (1891) to provide an early analysis of cerebrospinal fluid (CSF). William Mestrezat (1883-1929), and H. Houston Merritt (1902-1979) later compiled large series of CSF profiles in meningitis. Organisms causing meningitis were identified in the late 19th century including Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae. Vladimir Kernig (1840-1917) and Josef Brudzinski (1874-1917) described their eponymous signs in 1882 and 1909. Successful treatment of meningitis began with the introduction of serum therapy for meningococcal meningitis by Georg Joachmann (1874-1915) in Germany and Simon Flexner (1863-1946) in America. Antibiotic therapy began in the 20th century with the use of sulfonamides by Francois Schwentker (1904-1954) and penicillin by Chester Keefer (1897-1972). Vaccination against meningitis debuted in the early 20th century, and progressed to the development of vaccines against Neisseria meningitidis and Haemophilus influenzae, which remain mainstays of modern medicine. PMID:19892131

Tyler, Kenneth L

2010-01-01

 
 
 
 
121

Group A streptococcal meningitis: a case report.  

Science.gov (United States)

Streptococcus pyogenes (Group A streptococcus, GAS) is a rare cause of bacterial meningitis, accounting for less than 1% of cases. GAS meningitis has rarely been reported in children, and is associated with a high (46%) rate of morbidity and a high (10-17%) case fatality rate. This paper describes a case of meningitis caused by GAS in a previously healthy child; M protein genotyping demonstrated an emm type 12. Although not common, GAS meningitis must be considered in children vaccinated for other invasive pathogens. Continuous monitoring of the molecular epidemiology of circulating invasive GAS strains is of crucial importance for planning intervention policies. PMID:24177305

Busetti, Marina; Marchetti, Federico; Croci, Eleonora; L'erario, Ines; Creti, Roberta; D'Agaro, Pierlanfranco

2013-10-01

122

[Autopsy findings of meningitis associated with multiple brain infarctions in two adult patients].  

Science.gov (United States)

Cerebrovascular complications of meningitis have been extensively documented in the literature. It is little known, however, that paroxysmal, devastating, and potentially fatal complications can occur when the early signs of infection are subtle and missed. We describe the clinical course and neuropathological findings of the occurrence of brain infarctions during two atypical clinical courses of meningitis. In one patient, it was due to Serratia marcescens detected only by an autopsy specimen, and in the other, it was due to Aspergillus detected by a surgical biopsy. Death followed multiple, extensive, and progressively multiplicative infarctions in the basal ganglia, brainstem, and cerebral cortices. Autopsies revealed that the infarctions were caused by severe inflammatory change in the vascular walls, mainly of the arteries of the skull base, including the basilar and carotid arteries. Thrombus formation was also recognized in the lumen of several arteries. A number of characteristic Aspergillus hyphae were recognized in the arterial wall of one patient. Meningitis, which may be associated with severe vasculitis and lead to cerebral infarction, should be considered in the differential diagnosis of these conditions. Early diagnosis and initiation of vigorous therapy should be stressed for therapeutic success. PMID:15912768

Yokosuka, Kimihiko; Ishii, Ryoji; Sekihara, Yoshinobu; Ishii, Norihiro; Mohri, Yutaka; Hirano, Kazuhiro; Suzuki, Yasuo; Irei, Isao; Shirabe, Teruo

2005-05-01

123

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

124

Candida tropicalis meningitis in a young infant.  

Science.gov (United States)

Candida tropicalis is a rare species of Candida causing meningitis. The authors report a young infant who developed Candida tropicalis meningitis following a prolonged stay in a neonatal intensive care unit for respiratory distress and intra-cranial hemorrhage. The child was successfully treated with recommended doses of Amphotericin B and 5-flucytosine for eight weeks. PMID:14703236

Ahuja, Sanjeev R; Karande, Sunil; Kulkarni, Madhuri V; Tendolkar, Uma

2003-11-01

125

Japanese Encephalitis Virus in Meningitis Patients, Japan  

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Cerebrospinal fluid specimens from 57 patients diagnosed with meningitis were tested for Japanese encephalitis virus. Total RNA was extracted from the specimens and amplified. Two products had highest homology with Nakayama strain and 2 with Ishikawa strain. Results suggest that Japanese encephalitis virus causes some aseptic meningitis in Japan.

Kuwayama, Masaru; Ito, Mikako; Takao, Shinichi; Shimazu, Yukie; Fukuda, Shinji; Miyazaki, Kazuo; Kurane, Ichiro; Takasaki, Tomohiko

2005-01-01

126

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

127

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

128

CT finding of cryptococcal meningitis  

International Nuclear Information System (INIS)

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)

129

Epidemiología de la meningitis Venezuela 2010  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish 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 causas. 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 the [...] se 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. Epidemiological 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.

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

2010-12-01

130

Method for inducing experimental pneumococcal meningitis in outbred mice  

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Abstract Background Streptococcus pneumoniae is the leading cause of bacterial meningitis. Pneumococcal meningitis is associated with the highest mortality among bacterial meningitis and it may also lead to neurological sequelae despite the use of antibiotic therapy. Experimental animal models of pneumococcal meningitis are important to study the pathogenesis of meningitis, the host immune response induced after infection, and the efficacy of novel drugs and vaccines...

Cintorino Marcella; Blasi Elisabetta; Oggioni Marco R; Tripodi Sergio; Parigi Riccardo; Chiavolini Damiana; Pozzi Gianni; Ricci Susanna

2004-01-01

131

Meningitis de Mollaret: reporte de caso / Mollaret´s meningitis: A case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish La meningitis de Mollaret es una enfermedad rara caracterizada por episodios recurrentes y autolimitados de meningitis linfocítica. Se presenta un caso de meningitis de Mollaret asociado a la infección por herpes simple tipo 2 en una mujer de 27 años con confirmación por reacción en cadena de la pol [...] imerasa (PCR) del líquido cefalorraquídeo y se hace una revisión del tema. Abstract in english Mollaret´s meningitis is a rare disease characterized by recurrent and self-limited episodes of lymphocytic meningitis. We present a case of a 27-year-old woman with Mollaret´s meningitis related to viral infection with herpes simplex virus type 2 confirmed by cerebrospinal fluid polymerase chain re [...] action ( PCR ).

Luz Clemencia, Zárate C; Juan Diego, Vélez L.

2013-06-01

132

Kikuchi disease presenting with aseptic meningitis.  

Science.gov (United States)

Kikuchi disease is a self-limited disease characterized primarily by regional lymphadenopathy. Kikuchi disease was first described in 1972 as a lymphadenitis with specific histopathologic findings. Extranodal manifestations have been reported, including rare neurologic complications such as aseptic meningitis. This case report discusses a patient who presented to the ED with signs and symptoms suggestive of aseptic meningitis and was ultimately diagnosed with Kikuchi disease. We also review the epidemiology, clinical presentation, and laboratory findings typically found in patients with Kikuchi disease. Inclusion of Kikuchi disease in the differential diagnosis for meningitis may help establish a diagnosis in patients also presenting with regional lymphadenopathy. PMID:24746858

Khishfe, Basem F; Krass, Laurie M; Nordquist, Erik K

2014-10-01

133

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

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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 ...

Ali Moghtaderi; Roya Alavi-Naini; Saideh Rashki

2013-01-01

134

Meningitis  

Medline Plus

Full Text Available ... the advice of a doctor or a healthcare professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X-Plain.com nr210105 Last reviewed: 12/29/2013 4 People who are often in close contact with a person who has some types of ...

135

Meningitis  

Medline Plus

Full Text Available ... CSF is a clear fluid that looks like water. CSF acts as a shock absorber and protects ... than normal. White blood cells help fight infections. Treatment There are a number of antibiotics that treat ...

136

Meningitis  

Medline Plus

Full Text Available ... CSF is a clear fluid that looks like water. CSF acts as a shock absorber and protects ... doctor or a healthcare professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www. ...

137

Meningitis  

Medline Plus

Full Text Available ... the lower back and fluid from the spinal canal is withdrawn. It may take 1-2 days ... sample include: • Checking the number of cells. • Checking levels of sugar and protein. • Looking for bacteria under ...

138

Meningitis  

Medline Plus

Full Text Available ... or a healthcare professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X- ... or a healthcare professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X- ...

139

Meningitis  

Medline Plus

Full Text Available ... the advice of a doctor or a healthcare professional for your specific condition. ... after obtaining a detailed medical history and doing a physical examination. Headache, neck ...

140

Meningitis  

Medline Plus

Full Text Available ... due to a bacteria or a virus. Some tests a health care provider might request on the CSF sample include: • Checking the number of cells. • Checking levels of sugar and protein. • Looking for ...

 
 
 
 
141

Meningitis  

Medline Plus

Full Text Available ... anyone over the age of 2 years include: • High fever. • Headache. • Stiff neck. These symptoms can develop ... for any particular treatment plan. Like any printed material, it may become out of date over time. ...

142

Meningitis  

Medline Plus

Full Text Available ... the CSF sample include: • Checking the number of cells. • Checking levels of sugar and protein. • Looking for ... be drawn to check whether the white blood cell count is higher than normal. White blood cells ...

143

Meningitis  

Medline Plus

Full Text Available ... to people who have had close or prolonged contact with the patient. People who would be considered at increased risk ... professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. ... 4 People who are often in close contact with a person who has some types of ...

144

Meningitis  

Medline Plus

Full Text Available ... a doctor or a healthcare professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X-Plain.com nr210105 Last reviewed: 12/29/2013 4 People who are often in close contact with a person who has some types of ...

145

Meningitis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs Homer A. Boushey, Associate Professor of Medicine, and David G. Warnock, Associate Professor of Medicine, under the direction of Dr Lloyd H. Smith, Jr, Professor of Medicine and Chairman of the Department of Medicine. Requests for reprints should be sent to the Department of Medicine, University of Californ...

1984-01-01

146

Meningitis  

Medline Plus

Full Text Available ... professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X-Plain.com nr210105 Last ... professional for your specific condition. ©1995-2013, The Patient Education Institute, Inc. www.X-Plain.com nr210105 Last ...

147

Meningitis  

Medline Plus

Full Text Available ... also be a sudden but brief loss of contact for a few moments. The person may appear to ... a spinal tap, a needle is inserted into an area of the lower back and fluid from the ...

148

[Meningeal carcinomatosis in solid tumors].  

Science.gov (United States)

Meningeal carcinomatosis (MC) originating from non-haematological tumours is a late event in the course of a malignant disease. MC must be suspected in patients with disperse neurological symptoms from at least two of the following three parts of the central nervous system: the brain, the cranial nerves, and the spinal cord, and if a discrepancy between symptoms and objective findings is found. A suspicion of MC must be confirmed by lumbar puncture and/or MR with Gadolinium in patients where a confirmation of MC will lead to active therapy. Therapy depends on tumour type, performance status of the patient, and present status of the malignant disease. Patients with good performance status and with a chemo-sensitive tumour are offered a combination of radiotherapy and chemotherapy. Median survival is one to three months and active therapy does not prolong survival with certainty. Therefore, therapy primarily aims at an improvement of quality of life for the patient. PMID:7483086

Pfeiffer, P; Tange, M R; Hansen, O; Bastholt, L

1995-10-30

149

Pasteurella pneumotropica: meningitis following a dog bite.  

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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.

1990-01-01

150

Latex agglutination testing in bacterial meningitis.  

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The value of the latex agglutination test in meningitis was assessed. This was positive in 60% cases of Streptococcus pneumoniae, 93% of Haemophilus influenzae type b, and 39% of Neisseria meningitidis infections. We cannot support the view that this test was more valuable than Gram staining in partially treated meningitis and cannot recommend its routine use. It may, however, be valuable if Gram staining does not identify an organism or if it suggests meningococcal infection.

Finlay, F. O.; Witherow, H.; Rudd, P. T.

1995-01-01

151

TRANSETHMOIDAL MENINGOCELE AND RECURRENT MENINGITIS. CASE REPORT  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Navazo Egui?a, A. I.; Garci?a Vicario, F.; Sua?rez Mun?iz, E.; Castilla Diez, J. M.

2010-01-01

152

Cryptococcus and lymphocytic meningitis in Botswana  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english We retrospectively reviewed microbiological data from a tertiary care hospital in Botswana, and found that Cryptococcus neoformans was cultured from 15% (193/1 307) of all cerebrospinal fluid (CSF) specimens submitted for analysis, making it the most common diagnosed cause of meningitis in this popu [...] lation. Moreover, almost 70% of CSF samples with significant lymphocytosis did not yield a pathogen, suggesting that many causes of lymphocytic meningitis go undiagnosed.

Gregory P, Bisson; Ramishwari, Thakur; Rob Roy, MacGregor; John, Lukes; Isaac, Mtoni.

2008-09-01

153

Cryptococcal meningitis: Clinical, diagnostic and therapeutic overviews  

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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...

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

2007-01-01

154

Bacterial meningitis--ten years experience.  

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Between January 1968 and December 1977, 635 cases of acute bacterial meningitis were admitted to hospitals in the Birmingham Area Health Authority. The epidemiology of these cases was analysed and compared with the 270 cases which were admitted to the regional infectious diseases unit at East Birmingham Hospital (E.B.H.). In children and young adults the meningococcus was the commonest causative organism while over the age of 25 pneumococcal meningitis predominated. Although Haemophilus influ...

Davey, P. G.; Cruikshank, J. K.; Mcmanus, I. C.; Mahood, B.; Snow, M. H.; Geddes, A. M.

1982-01-01

155

Carcinomatous meningitis mimicking Creutzfeldt-Jakob disease  

Directory of Open Access Journals (Sweden)

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

2004-07-01

156

MRI enhancing patterns of non-meningioma meningeal lesions  

International Nuclear Information System (INIS)

Objective: To analyze the MRI appearances of meningeal diseases and to study MRI diagnostic value of enhancing patterns in different meningeal processes. Methods: Sixty-one patients with integrated clinical data, including 27 infectious meningitis, 4 inflammatory meningitis (2 eosinophilic granuloma, 1 Wegener granuloma, and 1 unknown etiological factor), 12 meningeal metastasis, 2 meningeal lymphoma, 8 cerebrovascular disease, and 8 postoperative changes, were reviewed retrospectively. All patients were examined on MRI before and after contrast administration. Results: (1) MR plain scan: positive findings of plain scan were revealed in only 3 cases, including 1 linear meningeal thickening pattern and 2 nodular pattern. (2) MR enhancement: All cases showed 3 kinds of enhancing patterns: 19 dural-arachnoid pattern, 32 pia-arachnoid pattern, and 10 total meninges pattern, respectively. Conclusion: Different meningeal diseases have different MR imaging manifestations. Creating the enhancement patterns of various diseases can have great clinical significance. (authors)

157

Spontaneous remission of acromegaly: apoplexy mimicking meningitis or meningitis as a cause of apoplexy?  

Science.gov (United States)

Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome characterized by ischemic infarction or hemorrhage into a pituitary tumor. The diagnosis of pituitary tumor apoplexy is frequently complicated because of the nonspecific nature of its signs and symptoms, which can mimic different neurological processes, including meningitis. Several factors have been associated with apoplexy, such as dopamine agonists, radiotherapy, or head trauma, but meningitis is a rarely reported cause. We describe the case of a 51-year-old woman with acromegaly due to a pituitary macroadenoma. Before surgical treatment, she arrived at Emergency with fever, nausea, vomiting and meningismus. Symptoms and laboratory tests suggested bacterial meningitis, and antibiotic therapy was initiated, with quick improvement. A computerized tomography (CT) scan at admission did not reveal any change in pituitary adenoma, but a few weeks later, magnetic resonance imaging (MRI) showed data of pituitary apoplexy with complete disappearance of the adenoma. Currently, her acromegaly is cured, but she developed hypopituitarism and diabetes insipidus following apoplexy. We question whether she really experienced meningitis leading to apoplexy or whether apoplexy was misinterpreted as meningitis. In conclusion, the relationship between meningitis and pituitary apoplexy may be bidirectional. Apoplexy can mimic viral or bacterial meningitis, but meningitis might cause apoplexy, as well. This fact highlights the importance of differential diagnosis when evaluating patients with pituitary adenomas and acute neurological symptoms. PMID:24728169

Villar-Taibo, Rocío; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Alvarez-San Martín, Rosa M; Kyriakos, Georgios; Cano-Rodríguez, Isidoro

2014-02-01

158

TRANSETHMOIDAL MENINGOCELE AND RECURRENT MENINGITIS. CASE REPORT  

Directory of Open Access Journals (Sweden)

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

2010-01-01

159

Cryptococcal meningitis: Clinical, diagnostic and therapeutic overviews  

Directory of Open Access Journals (Sweden)

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

2007-01-01

160

An unusual case of chronic meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Chronic meningitis is defined as symptoms and signs of meningeal inflammation and persisting cerebrospinal fluid abnormalities such as elevated protein level and pleocytosis for at least one month. Case presentation A 62-year-old woman, of unremarkable past medical history, was admitted to hospital for investigation of a four-week history of vomiting, malaise an associated hyponatraemia. She had a low-grade pyrexia with normal inflammatory markers. A CT brain was unremarkable and a contrast MRI brain revealed sub-acute infarction of the right frontal cortex but with no evidence of meningeal enhancement. Due to increasing confusion and patient clinical deterioration a lumbar puncture was performed at 17 days post admission. This revealed gram-negative coccobacilli in the CSF, which was identified as Neisseria meningitidis group B. The patient made a dramatic recovery with high-dose intravenous ceftriaxone antibiotic therapy for meningococcal meningitis. Conclusions 1 Chronic bacterial meningitis may present highly atypically, particularly in the older adult. 2 There may be an absent or reduced febrile response, without a rise in inflammatory markers, despite a very unwell patient. 3 Early lumbar puncture is to be encouraged as it is essential to confirm the diagnosis.4 Despite a delayed diagnosis appropriate antibiotic therapy can still lead to a good outcome.

Hinton Anna

2004-10-01

 
 
 
 
161

Pathophysiology of neonatal acute bacterial meningitis.  

Science.gov (United States)

Neonatal meningitis is a severe acute infectious disease of the central nervous system and an important cause of morbidity and mortality worldwide. The inflammatory reaction involves the meninges, the subarachnoid space and the brain parenchymal vessels and contributes to neuronal injury. Neonatal meningitis leads to deafness, blindness, cerebral palsy, seizures, hydrocephalus or cognitive impairment in approximately 25-50?% of survivors. Bacterial pathogens can reach the blood-brain barrier and be recognized by antigen-presenting cells through the binding of Toll-like receptors. They induce the activation of NF?B or mitogen-activated protein kinase pathways and subsequently upregulate leukocyte populations and express numerous proteins involved in inflammation and the immune response. Many brain cells can produce cytokines, chemokines and other pro-inflammatory molecules in response to bacterial stimuli, and polymorphonuclear leukocytes are attracted, activated and released in large amounts of superoxide anion and nitric oxide, leading to peroxynitrite formation and generating oxidative stress. This cascade leads to lipid peroxidation, mitochondrial damage and breakdown of the blood-brain barrier, thus contributing to cell injury during neonatal meningitis. This review summarizes information on the pathophysiology and adjuvant treatment of acute bacterial meningitis in neonates. PMID:23946474

Barichello, Tatiana; Fagundes, Glauco D; Generoso, Jaqueline S; Elias, Samuel Galvão; Simões, Lutiana R; Teixeira, Antonio Lucio

2013-12-01

162

Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis  

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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....

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

2010-01-01

163

Leukemic meningitis involving the cauda equina: a case report  

Energy Technology Data Exchange (ETDEWEB)

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

164

Listeria monocytogenes Meningitis in Adults: The Czech Republic Experience  

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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...

Dzupova, Olga; Rozsypal, Hanus; Smiskova, Dita; Benes, Jiri

2013-01-01

165

Leukemic meningitis involving the cauda equina: a case report  

International Nuclear Information System (INIS)

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

166

Meningitis tras anestesia y analgesia espinal / Meningitis after spinal anesthesia and analgesia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El objetivo de esta revisión es una puesta al día en la etiología, diagnóstico, profilaxis y tratamiento de la meningitis tras anestesia y analgesia espinales. Aunque es una complicación mayor de esta técnica y su incidencia es baja, cada vez son más frecuentes los casos publicados en la literatura [...] médica. Según su etiología se les clasifica en meningitis sépticas, víricas y asépticas. Las meningitis sépticas son las más frecuentes, y en su etiología cada vez juega un papel más destacado como agente implicado el estreptococo salivarius. Como meningitis asépticas se clasifican aquellas en las que el cultivo de líquido cefalorraquídeo es negativo, con un periodo de latencia de síntomas inferior a seis horas, que pueden cursar con eosinofilia en el líquido cefalorraquídeo y unos niveles cercanos a la normalidad en la glucorraquia. Suelen tener buena respuesta y evolución con tratamiento antibiótico con vancomicina y cefalosporinas de tercera generación. Como profilaxis incidir en las medidas de asepsia, sobre todo en el uso de mascarilla facial para realizar la técnica, como práctica para disminuir la incidencia de gérmenes cuyo origen está en la cavidad oral y orofaringe. Asimismo podrían reducir la incidencia de meningitis las medidas de asepsia tales como el lavado de manos, uso de guantes y asepsia de la piel. La diferenciación entre meningitis séptica y aséptica se hará con mayor seguridad cuando se estandaricen las técnicas para detectar genoma bacteriano en el líquido cefalorraquídeo; actualmente se etiquetan como meningitis asépticas aquellas en las que el cultivo de líquido cefalorraquídeo es negativo y cuya tinción de Gram es negativa. Pese a que el pronóstico y evolución en rasgos generales de las meningitis tras anestesia y analgesia espinal es bueno, en comparación con las meningitis adquiridas en la comunidad, por la escasa virulencia de las bacterias implicadas (Estreptococo salivarius), hay descritos casos con mala evolución de meningoencefalitis supurativa que han llevado a la muerte en pocas horas. Abstract in english The objective of this review is an update on etiology, diagnosis, prevention and treatment of meningitis after spinal anesthesia and analgesia. Although it is a major complication of this technique and its incidence is low, there are more and more frequent cases in the medical literature. According [...] to its etiology are classified in septic meningitis, viral and aseptic. The septic meningitis are the most common, and its etiology increasingly plays a more prominent role as Streptococcus salivarius agent involved. Aseptic meningitis are classified as those in which cerebrospinal fluid culture is negative, with a latency period of symptoms less than six hours, which may present with eosinophilia in the cerebrospinal fluid and levels close to normal in the CSF glucose. They usually have good response and evolution with antibiotic treatment with vancomycin and third-generation cephalosporins. Prophylaxis influence the aseptic precautions, especially the use of a face mask to perform the technique, as practical to reduce the incidence of bacteria whose origin is in the oral cavity and oropharynx. They could also reduce the incidence of aseptic meningitis measures such as hand washing, use of gloves and skin antisepsis. The differentiation between aseptic meningitis and septic will more securely when standardize techniques for detecting bacterial genome in the cerebrospinal fluid, now labeled as aseptic meningitis those in which cerebrospinal fluid culture is negative and whose negative Gram stain. Although the prognosis and evolution in general features of meningitis after spinal anesthesia and analgesia is good, compared with community-acquired meningitis, the low virulence of the bacteria involved (Streptococcus salivarius), cases have been described with poor outcome suppurative meningoencephalitis have led to death within hours.

M., Robles Romero; M.A., Rojas Caracuel; C. del, Prado Álvarez.

2013-08-01

167

Vascular supply with angio-CT for superselective intra-arterial chemotherapy in advanced maxillary sinus cancer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Recently popularised, the combined angiography and CT (angio-CT) system is useful for correctly identifying the feeding arteries and their perfusion in various organs. We applied this system for advanced maxillary cancer to expose its feeding arteries and their supplying territories. In addition to the maxillary artery, extramaxillary feeding arteries were usually observed, including the ophthalmic, accessory meningeal, facial, transverse facial and ascending palatine arteries. These extramax...

Kashiwagi, N.; Nakanishi, K.; Kozuka, T.; Sato, Y.; Tanaka, K.; Tsukaguchi, I.; Uemura, H.; Fujii, T.; Yoshino, K.; Tomiyama, N.

2010-01-01

168

Neuroimmunological studies in steroid-responsive meningitis-arteritis in dogs.  

Science.gov (United States)

The clinical and pathological expression of steroid-responsive meningitis-arteritis (SRMA) is predominantly neurological and the present study was therefore mostly concerned with the intrathecal humoral immune responses of 13 dogs suffering from the disease. All the dogs synthesised IgG intrathecally, indicating that the immune response in SRMA is in part specifically directed towards the central nervous system (CNS). Half of the dogs also had high levels of IgM only in the cerebrospinal fluid (CSF) and nearly all of them had high levels of IgA in the CSF as well as in the serum. Six of the dogs had circulating immune complexes in the serum, but not in the CSF. Neither IgM nor IgA rheumatoid factors were found. A chemotaxis assay revealed enhanced migration of neutrophils into the CSF in three cases. All the dogs had marked meningeal inflammation and arterial lesions of the meningeal blood vessels. Only one dog had arterial involvement outside the CNS. The acute vascular lesions consisted mostly of degenerative changes of the media and periarterial inflammation, and there was no evidence of immune complex deposition. Chronic lesions were mostly characterised by stenosis, adventitial thickening and periarteritis. Focal deposits of IgA were found in the vascular wall of one chronic case. It was concluded that the meningeal lesions in SRMA are a primary event, rather than the result of a generalised immune complex disease. These lesions are associated with an intrathecal humoral immune response, in which IgA appears to play a central role.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7761686

Tipold, A; Vandevelde, M; Zurbriggen, A

1995-03-01

169

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 angiographonal, 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.)

170

Evaluation and treatment of chronic meningitis.  

Science.gov (United States)

Chronic meningitis is defined as an inflammatory cerebrospinal fluid (CSF) profile that persists for at least 1 month. The presentation often includes headache, nausea, vomiting, cranial neuropathies, symptoms of elevated intracranial pressure, or focal neurologic deficits. The most common etiologies of chronic meningitis fall into 3 broad categories: infectious, autoimmune, and neoplastic. Evaluation of the patient with suspected chronic meningitis should include a detailed history and physical examination as well as repeated CSF diagnostics, serologic studies, and biopsy of the brain or other abnormal tissue (eg, lymph node or lung), when indicated. Early identification of the etiology and rapid treatment are crucial for improving morbidity and mortality, but potential infectious and neoplastic conditions should be excluded prior to empirically starting steroids or immunosuppressive medications. PMID:25360204

Baldwin, Kelly J; Zunt, Joseph R

2014-10-01

171

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.)

172

Anthrax Meningitis - Report Of An Autopsied Case  

Directory of Open Access Journals (Sweden)

Full Text Available Anthrax is a rare cause of hemorrhagic meningitis in man. This report illustrates the characteristic hemorrhagic manifestations in the brain of a patient dying of anthrax meningitis secondary to overwhelming bacteremia. Gross examination of the brain revealed a thick dense subarachnoid hemorrhage with numerous petechial hemorrhages in the cortex. Histologically, meningoencephalitis with vascular necrosis, edema, perivascular cortical hemorrhages and clumps of Gram positive bacilli in the vascular lumen and invading vessel wall were the salient features. The anthrax bacillus was isolated from CSF and brain tissue and further its pathogenecity was confirmed by animal inoculation.

Mahadevan A

1999-01-01

173

Neurosonographic findings of bacterial meningitis in Infants  

International Nuclear Information System (INIS)

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

174

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

175

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.

176

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish 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 i [...] nfausto. 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.

MJ, Pérez Álvarez; M, Moreno López.

2004-11-01

177

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

Directory of Open Access Journals (Sweden)

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

2004-11-01

178

Case-fatality ratio of bacterial meningitis in the African meningitis belt: we can do better.  

Science.gov (United States)

In the African meningitis belt, reported case-fatality ratio (CFR) for meningitis are usually calculated on the basis of presumed cases. We reviewed 3509 presumed cases of bacterial meningitis reported in Niger for which a cerebrospinal fluid (CSF) sample had been tested later at the reference laboratory. The main aetiologies were Neisseria meningitidis (1496 cases), Streptococcus pneumoniae (303 cases) and Haemophilus influenzae (105 cases). The CFR of meningococcal meningitis was lower for serogroup A (5.5%) than for serogroups X (12%) and W135 (12.7%). With a CFR of 49.8%, pneumococcal meningitis, albeit representing only 20.7% of confirmed cases, accounted for 50% of the deaths. The disease burden of pneumococcal meningitis must be better taken into consideration in the future. As most treatments are presumptive, there is a urgent need for an easy-to-administer, cheap first-line treatment effective on N. meningitidis as well as on S. pneumoniae and H. influenzae that would replace the single-dose oily chloramphenicol treatment which is the most frequent treatment administered today, independent of microbial aetiology and season. The development of diagnostic tools really suitable for remote health facilities also is an urgent challenge. PMID:17521784

Boisier, Pascal; Maïnassara, Halima Boubacar; Sidikou, Fati; Djibo, Saacou; Kairo, Kiari Kaka; Chanteau, Suzanne

2007-09-01

179

October 2012 Multistate Fungal Meningitis Outbreak  

Centers for Disease Control (CDC) Podcasts

This podcast gives an overview of the October 2012 multistate fungal meningitis outbreak, including symptoms to watch for and a website for up-to-date information.  Created: 10/17/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/17/2012.

2012-10-17

180

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

2010-01-01

 
 
 
 
181

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

2010-04-01

182

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

Katsura T

2012-04-01

183

Analysis of Cerebrospinal Fluid in Viral Meningitis Patients  

Directory of Open Access Journals (Sweden)

Full Text Available Aim: Meningitis - an inflammation of the meninges, globally distributed as either sporadic or epidemic forms. Acute meningitis of infectious etiology involves viruses or bacteria making the differential diagnosis very difficult. Material and Methods: The present study was designed to evaluate the alterations in different biochemical parameters including glucose, protein, C-reactive proteins (CRP, electrolytes (sodium, potassium and chloride and enzymes (ALT, AST, ALP, CK and LDH in the CSF and serum samples of the viral meningitis patients (n=20 and compared with control subjects (n=20. Results: Our study revealed significant (p<0.0001 increase in CSF glucose and protein levels in viral meningitis patients as compared to their respective controls. The C-reactive protein was negative in all the cases of viral meningitis, as it is the diagnostic test to differentiate between viral and bacterial meningitis. Significant decrease (p<0.0001 was observed in the CSF electrolytes concentration particularly in case of sodium and potassium levels while insignificant decrease was observed in the concentration of chloride. We observed extremely significant (p<0.0001 high levels of all the enzymes (ALT, AST, ALP, CK and LDH in the CSF samples of viral meningitis as compared to their respective normal controls. Conclusion: The present study suggests that the combination of differential analysis of biochemical indices such as CRP, CSF protein, glucose, electrolytes and enzyme profiles is used to establish the more accurate strategy in order to diagnose viral meningitis and also in differentiating it with other types of meningitis.

Afshan Zeeshan Wasti,

2013-10-01

184

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

185

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.

Johansson, Helle Wulf; Hay-Schmidt, Anders

2008-01-01

186

Intracranial meningeal melanocytoma: CT and MRI  

International Nuclear Information System (INIS)

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.)

187

Meningites bacterianas recidivantes / Recurrent bacterial meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O estudo das fístulas liquóricas, envolvendo anormalidades otorrinolaringológicas, deve se basear na procura da causa fundamental que leva às meningites recidivantes. As malformações congênitas, as anormalidades pós-traumáticas e pós-operatórias ou, ainda, associadas a doenças que envolvem ossos cra [...] nianos, constituem as causas básicas a serem pesquisadas. Os traumas cranianos podem resultar em fístula liquórica com possibilidade de meningites bacterianas de repetição. Abstract in english The study of CSF fistulae, and especially those involving otolaryngological anomalies, must be based on the search for the causative problem of recurrent meningitis. Congenital malformations, post-traumatic and post-operative situations or even diseases involving the cranial bones are basic causes t [...] hat should be studied. Currently, cranial trauma is the most usual cause of CSF fistulae, with the possibility of recurrent bacterial meningitis.

Maria Valeriana L., Moura-Ribeiro; Wilma Terezinha, Anselmo-Lima; José Antonio A. de, Oliveira.

1992-06-01

188

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

2008-10-01

189

Treatment for meningeal carcinomatosis in breast cancer  

International Nuclear Information System (INIS)

Forty breast cancer patients with meningeal carcinomatosis were treated with a combined program of whole brain irradiation therapy with intrathecal and intraventricular methotrexate and citrovorum factor rescue. Responses were seen in 26 patients (65%); 13 patients (35%) failed to respond. The median survival time for the responding patients was six months, and for the nonresponders, one month. Factors affecting response and survival included pretreatment spinal fluid glucose, protein, and duration of CNS-related symptomatology prior to onset of therapy. In contrast, pretreatment CSF tumor cell count, CEA and initial CNS functional status did not appear to have prognostic significance. The authors conclude that following intensive therapy there can be much improvement in the quality of life and disease-free survival in breast cancer patients with meningeal carcinomatosis

190

Listeria monocytogenes meningitis in previously healthy adults.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A retrospective study of four sporadic cases of Listeria monocytogenes meningitis is reported. Contrary to the conventional epidemiology these patients were adults who were not immuno-compromised. Although all four cases produced positive cerebrospinal fluid cultures, in three, listeria was not microscopically identified. Protein and glucose contents of cerebrospinal fluids were variable and all samples showed lymphocytic pleocytosis. All four had neutrophil leucocytosis in peripheral blood. ...

Hearmon, C. J.; Ghosh, S. K.

1989-01-01

191

The Role of Vancomycin on Meningitis  

Directory of Open Access Journals (Sweden)

Conclusion: After the previous discussion of the results obtained from this study, the researchers concluded that most of the cases diagnosed meningitis was aseptic and there was no need for antibiotics. Also in those who diagnosed as bacterial vancomycin was not essential in all cases, this confirmed by the absence of any differences in the outcome. [Cukurova Med J 2014; 39(3.000: 501-511

Ahmed I. Shatat and P.I.C.U team

2014-06-01

192

Optic nerve sheath fenestration in cryptococcal meningitis  

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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...

Tatyana Milman; Neena Mirani; Turbin, Roger E.

2008-01-01

193

[Pneumococcal meningitis in a pregnant woman].  

Science.gov (United States)

Bacterial meningitis is a life-threatening disease. The incidence of meningitis is about 2.6-6 cases per 100.000 adults per year in developed countries. The most common causative microorganisms are Sreptococcus pneumoniae and Neisseria meningitidis. A 33-year-old multigravida, at 24 week of gestation was admitted to the hospital because of ear pain, haedache, fever and confusion. Lumbal puncture was performed and cerebrospinal fluid analysis showed signs of bacterial meningitis. Latex agglutination test was positive for S. pneumoniae, Gram-positive diplococci have seen under microscope and later cultivation verified S. pneumoniae as the causative agent. After ceftriaxon, dexamethasone administration and treatment in intensive care unit, left side mastoidectomy was performed since cranial computed tomography showed acut exacerbation of chronic mastoiditis on the left side. After extubation, mobilisation and 14 days antibiotic treatment the patient, who had residual hearing loss on the left side, was discharged from the hospital. During the treatment the foetal parameters were normal. The patient at 39 week of gestation gave birth to a healthy infant. Forty-eight case reports have been published in this topic around the world until April, 2012. The most common causative agents were S. pneumoniae and Listeria monocytogenes. Because of the little amount of data, it is hard to appreciate the actual incidence and prognosis of this life-threatening illness both for mother and infant. As far as we know this is the first published case report of meningitis during pregnancy in Hungary. By this article we would like to draw attention to the importance of teamwork, of prevention of brain abscess formation and of the removal of the infection's focus. PMID:24654448

Scharek, Petra; Jekkel, Csilla; Budai, József; Szilasi, Zsuzsanna; Helferich, Frigyes; Arva, Ilona; Váradi, András; Létay, Erzsébet; Katona, Katalin; Rókusz, László

2014-01-30

194

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 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

195

Cutaneous manifestations in acute meningococcal meningitis  

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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

1991-01-01

196

CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII POSTOPERATIVE MENINGITIS  

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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...

Laura Ghibu; Egidia Miftode; Olivia Dorneanu; Carmen Dorobat

2011-01-01

197

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

2011-02-01

198

Treatment of bacterial meningitis with ceftizoxime.  

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Ceftizoxime was evaluated in the treatment of 18 patients (6 adults and 12 children) with bacterial meningitis. In seven patients Haemophilus influenzae was the causative agent, in three Neisseria meningitidis, in five Streptococcus pneumoniae, and in one each alpha-streptococcus and Escherichia coli; one case was culture negative. Ceftizoxime was administered intravenously in doses of 200 mg/kg per day. Clinical response was appropriate in all patients with a mean time of defervescence of 3....

Overturf, G. D.; Cable, D. C.; Forthal, D. N.; Shikuma, C.

1984-01-01

199

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

2003-06-01

200

Staphylococcus aureus meningitis: 26 years' experience at Vancouver General Hospital.  

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The records of all patients with Staphylococcus aureus meningitis admitted to Vancouver General Hospital between 1956 and 1981 were reviewed. All the patients had clinical and laboratory features of meningitis, and in all cases S. aureus was isolated from the cerebrospinal fluid. S. aureus was responsible for 21 (3%) of the 710 cases of acute bacterial meningitis. Therapy with cloxacillin or methicillin, or both, with or without other agents, was successful in 14 of the 21 patients. Three of ...

Roberts, F. J.; Smith, J. A.; Wagner, K. R.

1983-01-01

 
 
 
 
201

Rheumatoid meningitis presenting with stroke-like episodes  

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Neurologic symptoms in patients with rheumatoid arthritis (RA) are most often caused by osseous compression, affecting the cervical spine or peripheral neurologic structures. CNS involvement in RA is infrequent, consisting of CNS vasculitis or meningitis with or without meningeal nodules.1 When meningeal infiltration is seen, symptoms of presentation can include focal neurologic deficits, seizure, cranial nerve dysfunction, or altered consciousness.1 Here we describe a patient with an unusual...

Bourgeois, Pascale; Rivest, Jean; Bocti, Christian

2014-01-01

202

Meningeal Rosai-Dorfman disease mimicking meningioma.  

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Rosai-Dorfman disease of the central nervous system is extremely rare and difficult to diagnose also for pathologists. We describe three unusual cases of meningeal Rosai-Dorfman disease and illustrate the difficulties of preoperative and pathological diagnosis. We retrospectively analyzed three patients who underwent surgery for a suspected meningioma for whom the final diagnosis was Rosai-Dorfman disease of the central nervous system. Pathological initial diagnosis was schwannoma, lymphoplasmacyte-rich meningioma, or inflammatory tumor, but final diagnosis in all cases was Rosai-Dorfman disease. These cases underline the preoperative and pathological difficulties of such diagnosis. Pathologists and physicians should be aware of the occurrence of such rare localization of this disease and should think about this differential diagnosis in lymphocyte-rich meningeal tumors mimicking, clinically and radiologically, a meningioma. Communication of significant previous medical history to pathologists and careful examination of slides with appropriate medical history and the use of S100 antibody in the diagnosis of meningeal tumors mimicking Rosai-Dorfman disease could lower the rate of misdiagnosis. PMID:24366336

Forest, Fabien; N'guyen, Anh Tuan; Fesselet, Jacques; Metellus, Philippe; Bouvier, Corinne; de Paula, André Maues; Roche, Pierre-Hughes; Figarella-Branger, Dominique

2014-06-01

203

Daptomycin in experimental murine pneumococcal meningitis  

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Full Text Available Abstract Background Daptomycin, a lipopeptide antibiotic, could be an alternative to vancomycin for treatment of pneumococcal meningitis. We determined the activity of daptomycin versus vancomycin, with dexamethasone as an adjuvant, in a murine model of pneumococcal meningitis. Methods Ninety-six 25–30 gram mice were inoculated intracisternally with serotype 3 Streptococcus pneumoniae modified by the integration of a luminescent lux operon. All mice were treated with either dexamethasone 1 mg/kg intraperitoneally every 6 hours alone or in combination with either vancomycin or daptomycin, also administered intraperitoneally. Serum antimicrobial concentrations were selected to approximate those achieved in humans. Following treatment, bioluminescence and cerebrospinal fluid (CSF bacterial concentrations were determined. Caspase-3 staining was used to assess apoptosis on brain histopathology. Results Sixteen hours post intracisternal inoculation, bacterial titers in CSF were 6.8 log10 cfu/ml. Amongst the animals given no antibiotic, vancomycin 50 mg/kg at 16 and 20 hours or daptomycin 25 mg/kg at 16 hours, CSF titers were 7.6, 3.4, and 3.9 log10 cfu/ml, respectively, at 24 hours post infection (p-value, Conclusion Daptomycin or vancomycin, when given in combination with dexamethasone, is active in the treatment of experimental pneumococcal meningitis.

Steckelberg James M

2009-04-01

204

Meningitis and encephalitis in infants and children.  

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Despite the availability of modern therapies, meningitis and encephalitis remain potentially life-threatening infections in children with mortality rates reaching up to 25%. Treated patients are at a high risk of long term sequelae including epilepsy, learning, and behavioral disorders. The golden rule of early diagnosis and treatment to achieve a good outcome has not yet been challenged by the new, often expensive antibiotics or contemporary critical care. In this article, an updated overview of meningitis and encephalitis in infants and children is presented. It is important to note that routine childhood immunization has significantly decreased the number of serious infections. However, meningitis and encephalitis remain problematic particularly in developing countries where immunization rates are suboptimal. The most common viral etiologies include enteroviruses, herpes simplex virus, and arboviruses. However, the causative virus may not be identified in up to 70% of cases. This is not the case for bacterial infections unless the patient had received prior oral antibiotics. The causative bacterial organisms vary with age, and the less common fungal infections occur mainly in immune compromised patients.

Mohammed M. Jan

2012-01-01

205

First adult case of Helicobacter cinaedi meningitis.  

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Helicobacter cinaedi, a gram-negative spiral bacillus that inhabits the intestinal tracts of rodents and primates, is associated with gastroenteritis in humans. H. cinaedi infection has been commonly reported in immunocompromised individuals such as human immunodeficiency virus-infected patients, but rarely in immunocompetent individuals. Prior contact with animals has attracted attention as a possible source of H. cinaedi infection. We report a case of meningitis in an immunocompetent 34-year-old woman who had daily contact with a kitten for a month. She developed acute headaches, fevers, and chills. Neurological examination revealed neck stiffness and her cerebrospinal fluid (CSF) exhibited polymorphonuclear pleocytosis and a decreased concentration of glucose. Blood and CSF cultures were negative; however, the pathogen responsible for her condition was identified as H. cinaedi by polymerase chain reaction in CSF. This is the first adult case of meningitis caused by H. cinaedi. Thus, this bacillus should be considered a possible causative agent of bacterial meningitis in healthy adults. PMID:24169225

Sugiyama, Atsuhiko; Mori, Masahiro; Ishiwada, Naruhiko; Himuro, Keiichi; Kuwabara, Satoshi

2014-01-15

206

Acute childhood bacterial meningitis in Luanda, Angola.  

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Incidence, morbidity and mortality of bacterial meningitis in developing countries are manifold greater than those in the industrialized world. We reviewed retrospectively children with meningitis treated in the paediatric hospital of Luanda in 2004. Among the 555 children, median age 11.0 months, the leading agents were Haemophilus influenzae type b (Hib), pneumococcus, and meningococcus in 60%, 24%, and 10%, respectively. The median length of illness before admission was 7 d. 65% had convulsed. Altered level of consciousness was observed in 61% and blood haemoglobin lower than 8 g/dl in 36% of cases. Case fatality was 35% and, of survivors, 24% were left with severe neurological sequelae. Blood transfusion appeared beneficial since fatality of children with and without transfusion was 23% versus 39% (p=0.003). While awaiting large-scale vaccinations, tools to improve the prognosis of meningitis in Angola comprise generating better awareness to reduce the delay, better fluid treatment and monitoring and active use of blood transfusions. PMID:18622806

Pelkonen, Tuula; Roine, Irmeli; Monteiro, Lurdes; Joao Simoes, Maria; Anjos, Elizabete; Pelerito, Ana; Pitkaranta, Anne; Bernardino, Luis; Peltola, Heikki

2008-01-01

207

Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri.  

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After a 36-week diamniotic dichorionic gestation, an infant was delivered by elective caesarean section due to growth restriction and altered diastolic flow in the umbilical artery. Birth weight was 2140 g. The patient was admitted for exclusive parenteral nutrition, with umbilical venous catheter placement. Sinus tachycardia and temperature instability with positive inflammatory markers occurred at 51 h. Penicillin and gentamicin were started, but 6 h later septic shock with disseminated intravascular coagulation was noted. Vancomycin and meropenem were started and penicillin suspended. Citrobacter koseri was isolated from blood culture. Generalised clonic convulsions occurred on day 4, and an electroencephalogram revealed severe encephalic dysfunction. Cerebrospinal fluid cytochemical analysis was suggestive of meningitis, although culture was negative. Cefotaxime was added to the drug regimen. Cranioencephalic MR showed a temporal abscess and diffuse hemispheric destruction, with no indications for neurosurgery. After 6 weeks of therapy, neuroimaging follow-up showed multiloculated cystic encephalomalacia. Currently, the patient is 14 months old with axial hypotonia and decreased movements. The source of infection has not been determined. Nosocomial infection cannot be excluded and vertical transmission is unlikely. PMID:22665908

Vaz Marecos, Clara; Ferreira, Marta; Ferreira, Maria Manuela; Barroso, Maria Rosalina

2012-01-01

208

An update on steroid responsive meningitis-arteritis.  

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Steroid responsive meningitis-arteriitis (SRMA) is an immunemediated disorder commonly recognised in dogs in small animal practice. Two different forms of SRMA may occur. The typical, acute form of SRMA is characterised by cervical rigidity, pain, pyrexia and a polymorphonuclear pleocytosis of the cerebrospinal fluid (CSF). In a less common, chronic form of SRMA, additional neurological deficits consistent with a spinal cord or a multi-focal neurological disorder may be present, often accompanied by a mononuclear CSF pleocytosis. The prognosis for young dogs in the acute stage of SRMA is relatively good with early and aggressive anti-inflammatory or immunosuppressive therapy. In more protracted, relapsing cases of SRMA the prognosis is guarded, and therapy requires more aggressive, long term immunosuppression. The complete etiopathogenesis of SRMA is unknown; however, an aberrant immune response directed against the central nervous system (CNS) is most likely. Neutrophilic pleocytosis in SRMA seems to be facilitated by chemotactic factors in the CSF and upregulation of integrins and metalloproteinases that disrupt the blood brain barrier. Upregulation of IgA, induced by a Th2 immune response, also plays a central role in the pathogenesis of SRMA. PMID:20070497

Tipold, A; Schatzberg, S J

2010-03-01

209

Sub-meninges implantation reduces immune response to neural implants.  

Science.gov (United States)

Glial scar formation around neural interfaces inhibits their ability to acquire usable signals from the surrounding neurons. To improve neural recording performance, the inflammatory response and glial scarring must be minimized. Previous work has indicated that meningeally derived cells participate in the immune response, and it is possible that the meninges may grow down around the shank of a neural implant, contributing to the formation of the glial scar. This study examines whether the glial scar can be reduced by placing a neural probe completely below the meninges. Rats were implanted with sets of loose microwire implants placed either completely below the meninges or implanted conventionally with the upper end penetrating the meninges, but not attached to the skull. Histological analysis was performed 4 weeks following surgical implantation to evaluate the glial scar. Our results found that sub-meninges implants showed an average reduction in reactive astrocyte activity of 63% compared to trans-meninges implants. Microglial activity was also reduced for sub-meninges implants. These results suggest that techniques that isolate implants from the meninges offer the potential to reduce the encapsulation response which should improve chronic recording quality and stability. PMID:23370311

Markwardt, Neil T; Stokol, Jodi; Rennaker, Robert L

2013-04-15

210

PET-CT in detection of meningeal metastasis in neuroblastoma.  

Science.gov (United States)

Neoplastic meningitis is being recognized with increasing frequency in patients with cancer: the common causes being adenocarcinomas originating from the lung, stomach, breast, ovary, malignant melanoma, leukemia, lymphoma, Ewings sarcoma, rhabdomyosarcoma, retinoblastoma and primary CNS malignancies. Meningeal metastases, though rare can be seen in advanced stages of neuroblastoma. Recognition of meningeal metastases is crucial for successful diagnosis and prompt treatment of these patients. Here, we present two patients of neuroblastoma in whom positron emission tomography-computed tomography (PET-CT) examination resulted in detection of meningeal metastases at diagnosis; thus, emphasizing the need of inclusion of brain imaging in PET-CT protocol in all cases of advanced neuroblastoma. PMID:19130063

Chawla, Madhavi; Reddy, Ramamohan; Kumar, Rajender; Das, Chandan J; Agarwala, Sandeep; Tiwari, Amar M; Malhotra, Arun; Kumar, Rakesh

2009-02-01

211

[A rare cause of recurrent meningitis in children: Cochleovestibular dysplasia].  

Science.gov (United States)

Recurrent bacterial meningitis is an uncommon disease of childhood. It occurs most often in children who have an underlying predisposing disorder that can result from anatomic fistula or immunodeficiency. Cochleovestibular dysplasia is a rare malformation of the inner ear that is often associated with translabyrinthine cerebrospinal fistula and then can cause recurrent bacterial meningitis. We report an unusual case of recurrent meningitis revealing cochleovestibular dysplasia in a 9-year-old child. The malformation was confirmed by imaging and the child had surgery. The outcome was favourable with no recurrence of meningitis during the 3 years after the operation. PMID:25282453

Ajmi, H; Lahmar, I; Zouari, N; Kadri, K; Hassayoun, S; Belkadhi, M; Chemli, J; Abroug, S; Tlili, K; Harbi, A

2015-01-01

212

Meningitis registry of hospitalized cases in children: epidemiological patterns of acute bacterial meningitis throughout a 32-year period  

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Abstract Background Bacterial meningitis remains a source of substantial morbidity and mortality in childhood. During the last decades gradual changes have been observed in the epidemiology of bacterial meningitis, related to the introduction of new polysaccharide and conjugate vaccines. The study presents an overview of the epidemiological patterns of acute bacterial meningitis in a tertiary children 's hospital during a 32-year period, using information from a disease regis...

Syriopoulou Vassiliki P; Mostrou Glyceria J; Pangalis Anastasia M; Atsali Erato E; Vasilopoulou Vasiliki A; Theodoridou Maria N; Hadjichristodoulou Christos S

2007-01-01

213

Herpes simplex type 2 meningitis treated with acyclovir.  

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A case of meningitis due to a primary genital herpes simplex type 2 infection, and its prompt response to therapy with intravenous acyclovir is reported. This complication of genital herpes is probably underdiagnosed and it is worthwhile searching for evidence of genital herpetic lesions in a young patient presenting with viral meningitis.

Levy, D. M.; Sagar, H. J.

1984-01-01

214

Spinal meningeal cyst: analysis with low-field MRI  

International Nuclear Information System (INIS)

Objective: To analyze the characteristics of spinal meningeal cyst in low-field MRI and to discuss its classification, subtype, clinical presentation, and differential diagnosis. Methods: Forty-two patients (20 male, 22 female) were examined with sagittal T1-and T2-, axial T2-weighted MR imaging. Twelve patients were also examined with contrast-enhanced MRI. Results: The cysts were classified using Nakors' classification as type Ia extradural meningeal cysts (4 patients), type Ib sacral meningeal cysts (32), type II extradural meningeal cysts with spinal nerve root fibers (4), and type III spinal intradural meningeal cysts (2). All 42 spinal meningeal cysts had well-defined boundaries with low T1 and high T2 signal intensities similar to cerebral spinal fluid. In type Ia, the lesions were often on the dorsum of mid-lower thoracic spinal cord compressing the spinal cord and displacing the extradural fat. In type Ib, the lesions were in the sacral canal with fat plane between the cyst and dural sac. In type II, the lesions contained nerve roots and were lateral to the dural sac. In type III, the lesions were often on the dorsum of spinal cord compressing and displacing the spinal cord anteriorly. Conclusion: Low-field MRI can clearly display the spinal meningeal cyst. Types Ia and Ib spinal meningeal cysts had typical features and can be easily diagnosed. Types II and III should be differentiated from cystic schwannould be differentiated from cystic schwannomas and enterogenous cysts, respectively. (authors)

215

Meningococcal meningitis presenting with bilateral deafness and ataxia.  

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A 50-year-old man presented with bilateral deafness and ataxia of sudden onset and without constitutional symptoms or signs of meningeal irritation. He was subsequently proved to have meningococcal meningitis, and the deafness and ataxia resolved following appropriate antibiotic therapy.

Sandyk, R.; Brennan, M. J.

1984-01-01

216

Method for inducing experimental pneumococcal meningitis in outbred mice  

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Full Text Available Abstract Background Streptococcus pneumoniae is the leading cause of bacterial meningitis. Pneumococcal meningitis is associated with the highest mortality among bacterial meningitis and it may also lead to neurological sequelae despite the use of antibiotic therapy. Experimental animal models of pneumococcal meningitis are important to study the pathogenesis of meningitis, the host immune response induced after infection, and the efficacy of novel drugs and vaccines. Results In the present work, we describe in detail a simple, reproducible and efficient method to induce pneumococcal meningitis in outbred mice by using the intracranial subarachnoidal route of infection. Bacteria were injected into the subarachnoid space through a soft point located 3.5 mm rostral from the bregma. The model was tested with several doses of pneumococci of three capsular serotypes (2, 3 and 4, and mice survival was recorded. Lethal doses killing 50 % of animals infected with type 2, 3 and 4 S. pneumoniae were 3.2 × 10, 2.9 × 10 and 1.9 × 102 colony forming units, respectively. Characterisation of the disease caused by the type 4 strain showed that in moribund mice systemic dissemination of pneumococci to blood and spleen occurred. Histological analysis of the brain of animals infected with type 4 S. pneumoniae proved the induction of meningitis closely resembling the disease in humans. Conclusions The proposed method for inducing pneumococcal meningitis in outbred mice is easy-to-perform, fast, cost-effective, and reproducible, irrespective of the serotype of pneumococci used.

Cintorino Marcella

2004-09-01

217

Neonatal meningitis caused by Elizabethkingia meningoseptica in Saudi Arabia.  

Science.gov (United States)

Elizabethkingia meningoseptica is a multi-drug resistant organism that can cause meningitis in premature neonates. We report a case of Elizabethkingia meningoseptica meningitis that was detected early in an extremely premature low birth weight infant. He was successfully treated with a combination of ciprofloxacin and piperacillin-tazobactam. The spread of infection was controlled with no other reported cases. PMID:21997946

Amer, Malaka Z; Bandey, Manzour; Bukhari, Abdalla; Nemenqani, Dalal

2011-10-01

218

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

2001-01-01

219

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

2012-11-01

220

Tuberculous Meningitis: Diagnostic and Radiological Features, Pathogenesis and Biomarkers  

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Central nervous system tuberculosis is the most severe form of extrapulmonary tuberculosis disease. We aim to review the diagnostic and radiological features, pathogenesis, and biomarkers of tuberculous meningitis. We also aim to look at the latest development of research of the disease. The diagnosis of tuberculous (TB) meningitis is difficult because the disease present...

Mei-Ling Sharon Tai

2013-01-01

 
 
 
 
221

Chemical meningitis in metrizamide myelography. A report of seven cases  

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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

222

Purulent meningitis with unusual diffusion-weighted MRI findings  

International Nuclear Information System (INIS)

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

223

Serogroup W135 meningococcal meningitis, Northern Cameroon, 2007-2008.  

Science.gov (United States)

We analyzed results of recent microbiologic surveillance of meningitis in northern Cameroon. During the 2007 and 2008 meningitis seasons, all 57 identified meningococcal isolates were serogroup W135. This situation might indicate that the area is experiencing a period between epidemic waves due to 2 different clones of serogroup A meningococci. PMID:19193290

Massenet, Denis; Inrombe, Jermias; Mevoula, Dave Etienne; Nicolas, Pierre

2009-02-01

224

Serogroup W135 Meningococcal Meningitis, Northern Cameroon, 2007–2008  

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We analyzed results of recent microbiologic surveillance of meningitis in northern Cameroon. During the 2007 and 2008 meningitis seasons, all 57 identified meningococcal isolates were serogroup W135. This situation might indicate that the area is experiencing a period between epidemic waves due to 2 different clones of serogroup A meningococci.

Massenet, Denis; Inrombe, Jermias; Mevoula, Dave-etienne; Nicolas, Pierre

2009-01-01

225

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Spanish 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 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. 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 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.

2006-05-01

226

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

2006-05-01

227

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

2011-08-01

228

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.

Wittwer Matthias

2010-03-01

229

Osseous and meningeal involvement in secondary syphilis.  

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Osseous involvement, although typically described in congenital or tertiary syphilis, has rarely been reported in secondary syphilis. Spirochetes are transported to the medullary cavity or within the deep periosteal vasculature via hematological spread and may be seen in biopsies of the osseous lesions. The skull, shoulder girdle, and long bones are most commonly affected. Patients present with bone pain, which may manifest as headaches or shin splits, depending on the affected bone. This case illustrates the importance of including secondary syphilis in the differential diagnosis of a cutaneous eruption accompanied with headaches. Although the CT scan and CSF testing were negative, the MRI showed osseous and meningeal involvement. PMID:22559016

Egan, Kendall M; Walters, Michelle C

2012-01-01

230

Molecular surveillance of meningococcal meningitis in Africa.  

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Analysis of meningococcal strains recovered from outbreaks and epidemics in the African meningitis belt, using molecular methods, has demonstrated for nearly 20 years the dominance among serogroup A organisms of a single clone complex, the sequence type 5 (ST-5) complex. However, a shift was observed since the mid-1990s when ST-5 gradually was replaced by ST-7 in all countries of the region. Since 2001, outbreaks caused by serogroup W135 strains belonging to the ST-11 complex became an additional problem. Monitoring of the clones responsible for meningococcal disease provides important insights on the biology and epidemiology of this most serious pathogen. PMID:17521785

Caugant, Dominique A; Nicolas, Pierre

2007-09-01

231

Dexamethasone in bacterial meningitis: to use or not to use?  

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Permanent neurologic disabilities are seen in up to a quarter of survivors of bacterial meningitis despite major improvements in therapy. Experimental studies have demonstrated that most of the pathology in meningitis is mediated by inflammatory cytokines such as tumor necrosis factor (TNF) and interleukin-1 (IL-1), which are produced by host cells in response to bacterial invasion of the meninges. Dexamethasone has been used in a number of clinical trials to moderate the host response and to improve neurologic outcome of meningitis. Results of six randomized, placebo controlled trials are summarized in this review. Dexamethasone treatment did not lower mortality. Only a moderate, but not a significant reduction in the neurologic and audiologic sequelae was seen in dexamethasone recipients when Haemophilus influenzae type b (Hib) was the causative agent of meningitis. Following routine use of Hib vaccine, meningitis caused by this agent has virtually disappeared in the USA. Hence, findings from these trials may no longer be applicable in countries with high rates of immunization against Hib. Presently, there is little or no evidence showing a benefit of dexamethasone therapy in meningitis caused by S. pneumoniae or N. meningitidis. Global emergence of penicillin and cephalosporin resistant S. pneumoniae has raised new concerns about the use of dexamethasone in pneumococcal meningitis. Since dexamethasone significantly decreases the penetration and concentration of vancomycin and ceftriaxone in the CSF and delays CSF sterilization, adjunctive dexamethasone therapy may increase the risk of treatment failure in meningitis caused by antibiotic resistant pneumococci. An antibiotic combination should be used in the treatment of meningitis caused by antibiotic resistant pneumococci, particularly if dexamethasone is also being administered concurrently. PMID:10830026

Kaul, A; Chandwani, S

1996-01-01

232

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)

233

Stages of tuberculous meningitis: a clinicoradiologic analysis  

International Nuclear Information System (INIS)

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. (author)

234

Meningitis epidemics in Africa: a brief overview.  

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Every year, meningococcal meningitis causes thousands of deaths within the meningitis belt in sub-Saharan African countries. Large epidemic waves occur with a periodicity of 5-12 years. The waves do correspond to molecular changes in the expression of capsular or subcapsular antigens, which allow the bug to spread in susceptible populations. Serogroup A remains the major killer, even if in 2002, serogroup W135 ST-11 emerged in Burkina Faso, causing an important epidemic. However, the surveillance in the following years has showed a decrease in the W135 incidence and a clear predominance of serogroup A. Moreover, a new serogroup A strain belonging to ST-2859 seems to emerge and does represent a new threat for the coming seasons. In a vaccine perspective, and especially in the context of the development of an A conjugate vaccine; it is the key to strengthen the surveillance systems and to include molecular epidemiology as a tool for monitoring the molecular evolution of Neisseria meningitidis in Africa. PMID:17643560

Teyssou, Rémy; Muros-Le Rouzic, Erwan

2007-09-01

235

Epidemiology of Meningitis in an HIV-Infected Ugandan Cohort.  

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There is limited understanding of the epidemiology of meningitis among human immunodeficiency virus (HIV)-infected populations in sub-Saharan Africa. We conducted a prospective cohort study of HIV-infected adults with suspected meningitis in Uganda, to comprehensively evaluate the etiologies of meningitis. Intensive cerebrospiral fluid (CSF) testing was performed to evaluate for bacterial, viral, fungal, and mycobacterial etiologies, including neurosyphilis,16s ribosomal DNA (rDNA) polymerase chain reaction (PCR) for bacteria, Plex-ID broad viral assay, quantitative-PCR for HSV-1/2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Toxoplasma gondii; reverse transcription-PCR (RT-PCR) for Enteroviruses and arboviruses, and Xpert MTB/RIF assay. Cryptococcal meningitis accounted for 60% (188 of 314) of all causes of meningitis. Of 117 samples sent for viral PCR, 36% were EBV positive. Among cryptococcal antigen negative patients, the yield of Xpert MTB/RIF assay was 22% (8 of 36). After exclusion of cryptococcosis and bacterial meningitis, 61% (43 of 71) with an abnormal CSF profile had no definitive diagnosis. Exploration of new TB diagnostics and diagnostic algorithms for evaluation of meningitis in resource-limited settings remains needed, and implementation of cryptococcal diagnostics is critical. PMID:25385864

Rajasingham, Radha; Rhein, Joshua; Klammer, Kate; Musubire, Abdu; Nabeta, Henry; Akampurira, Andrew; Mossel, Eric C; Williams, Darlisha A; Boxrud, Dave J; Crabtree, Mary B; Miller, Barry R; Rolfes, Melissa A; Tengsupakul, Supatida; Andama, Alfred O; Meya, David B; Boulware, David R

2015-02-01

236

Meningitis registry of hospitalized cases in children: epidemiological patterns of acute bacterial meningitis throughout a 32-year period  

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Full Text Available Abstract Background Bacterial meningitis remains a source of substantial morbidity and mortality in childhood. During the last decades gradual changes have been observed in the epidemiology of bacterial meningitis, related to the introduction of new polysaccharide and conjugate vaccines. The study presents an overview of the epidemiological patterns of acute bacterial meningitis in a tertiary children 's hospital during a 32-year period, using information from a disease registry. Moreover, it discusses the contribution of communicable disease registries in the study of acute infectious diseases. Methods In the early 1970s a Meningitis Registry (MR was created for patients admitted with meningitis in Aghia Sofia Children's Hospital in Athens. The MR includes demographic, clinical and laboratory data as well as treatment, complications and outcome of the patients. In 2000 a database was created and the collected data were entered, analyzed and presented in three chronological periods: A (1974–1984, B (1985–1994 and C (1995–2005. Results Of the 2,477 cases of bacterial meningitis registered in total, 1,146 cases (46.3% were classified as "probable" and 1,331 (53.7% as "confirmed" bacterial meningitis. The estimated mean annual Incidence Rate (IR was 16.9/100,000 for bacterial meningitis, 8.9/100,000 for Neisseria meningitidis, 1.3/100,000 for Streptococcus pneumoniae, 2.5/100,000 for Haemophilus influenzae type b (Hib before vaccination and 0.4/100,000 for Hib after vaccination. Neisseria meningitis constituted the leading cause of childhood bacterial meningitis for all periods and in all age groups. Hib was the second most common cause of bacterial meningitis before the introduction of Hib conjugate vaccine, in periods A and B. The incidence of bacterial meningitis due to Streptococcus pneumoniae was stable. The long-term epidemiological pattern of Neisseria meningitidis appears in cycles of approximately 10 years, confirmed by a significant rise of IR in period C. The Case Fatality Rate (CFR from all causes was 3.8%, while higher CFR were estimated for Streptococcus pneumoniae (7.5%, RR=2.1, 95% CI 1.2–3.7 and Neisseria meningitidis (4.8%, RR=1.7, 95% CI 1.1–2.5 compared to other pathogens. Moreover, overall CFR varied significantly among the three time periods (p = 0.0015, and was estimated to be higher in period C. Conclusion By using the MR we were able to delineate long-term changes in the epidemiology of bacterial meningitis. Thus the MR proved to be a useful tool in the study and the prevention of communicable diseases in correlation with prevention strategies, such as vaccinations.

Syriopoulou Vassiliki P

2007-08-01

237

Environmental enrichment restores cognitive deficits induced by experimental childhood meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Objective: To evaluate the influence of environmental enrichment (EE) on memory, cytokines, and brain-derived neurotrophic factor (BDNF) in the brain of adult rats subjected to experimental pneumococcal meningitis during infancy. Methods: On postnatal day 11, the animals received either artificia [...] l cerebrospinal fluid (CSF) or Streptococcus pneumoniae suspension intracisternally at 1 × 106 CFU/mL and remained with their mothers until age 21 days. Animals were divided into the following groups: control, control + EE, meningitis, and meningitis + EE. EE began at 21 days and continued until 60 days of age (adulthood). EE consisted of a large cage with three floors, ramps, running wheels, and objects of different shapes and textures. At 60 days, animals were randomized and subjected to habituation to the open-field task and the step-down inhibitory avoidance task. After the tasks, the hippocampus and CSF were isolated for analysis. Results: The meningitis group showed no difference in performance between training and test sessions of the open-field task, suggesting habituation memory impairment; in the meningitis + EE group, performance was significantly different, showing preservation of habituation memory. In the step-down inhibitory avoidance task, there were no differences in behavior between training and test sessions in the meningitis group, showing aversive memory impairment; conversely, differences were observed in the meningitis + EE group, demonstrating aversive memory preservation. In the two meningitis groups, IL-4, IL-10, and BDNF levels were increased in the hippocampus, and BDNF levels in the CSF. Conclusions: The data presented suggest that EE, a non-invasive therapy, enables recovery from memory deficits caused by neonatal meningitis.

Tatiana, Barichello; Glauco D., Fagundes; Jaqueline S., Generoso; Caroline S., Dagostin; Lutiana R., Simões; Márcia C., Vilela; Clarissa M., Comim; Fabricia, Petronilho; João, Quevedo; Antonio L., Teixeira.

2014-12-01

238

Environmental enrichment restores cognitive deficits induced by experimental childhood meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Objective: To evaluate the influence of environmental enrichment (EE) on memory, cytokines, and brain-derived neurotrophic factor (BDNF) in the brain of adult rats subjected to experimental pneumococcal meningitis during infancy. Methods: On postnatal day 11, the animals received either artificia [...] l cerebrospinal fluid (CSF) or Streptococcus pneumoniae suspension intracisternally at 1 × 106 CFU/mL and remained with their mothers until age 21 days. Animals were divided into the following groups: control, control + EE, meningitis, and meningitis + EE. EE began at 21 days and continued until 60 days of age (adulthood). EE consisted of a large cage with three floors, ramps, running wheels, and objects of different shapes and textures. At 60 days, animals were randomized and subjected to habituation to the open-field task and the step-down inhibitory avoidance task. After the tasks, the hippocampus and CSF were isolated for analysis. Results: The meningitis group showed no difference in performance between training and test sessions of the open-field task, suggesting habituation memory impairment; in the meningitis + EE group, performance was significantly different, showing preservation of habituation memory. In the step-down inhibitory avoidance task, there were no differences in behavior between training and test sessions in the meningitis group, showing aversive memory impairment; conversely, differences were observed in the meningitis + EE group, demonstrating aversive memory preservation. In the two meningitis groups, IL-4, IL-10, and BDNF levels were increased in the hippocampus, and BDNF levels in the CSF. Conclusions: The data presented suggest that EE, a non-invasive therapy, enables recovery from memory deficits caused by neonatal meningitis.

Tatiana, Barichello; Glauco D., Fagundes; Jaqueline S., Generoso; Caroline S., Dagostin; Lutiana R., Simões; Márcia C., Vilela; Clarissa M., Comim; Fabricia, Petronilho; João, Quevedo; Antonio L., Teixeira.

2014-07-25

239

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish 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 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. Abstract in english [...] s 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.

2006-05-01

240

Neoplastic meningitis presenting with dysphagia and bilateral vocal cord paralysis.  

Science.gov (United States)

Neoplastic meningitis is the infiltration of the leptomeninges and subarachnoid space by tumor cells occurring in 3% to 5% of patients with systemic malignancies. Most cases present with multifocal neurological symptoms that vary according to the central nervous system territory involved. Here, we describe the first reported case to our knowledge of neoplastic meningitis causing bilateral vocal cord paralysis. Early diagnosis of this progressive disease process is essential to achieving a better treatment response and improved survival. This report demonstrates that neoplastic meningitis should be considered in the investigation of bilateral vocal cord paralysis, particularly in patients with a history of metastatic disease. PMID:24510714

Dixon, Peter R; Alsaffar, Hussain; Symons, Sean P; Enepekides, Danny; Higgins, Kevin M

2014-08-01

 
 
 
 
241

Chickenpox complicated by pneumococcal meningitis: a rare coinfection.  

Science.gov (United States)

Bacterial complications, particularly skin superinfections, are common during chickenpox. However, reports of acute bacterial meningitis associated with chickenpox are unusual and amount to only a very few observations. For the most part, they are caused by Neisseria meningitidis or Streptococcus pyogenes. We report an infrequent occurrence of pneumococcal meningitis 2 days after the onset of a chickenpox rash in a 7-year-old previously healthy boy. Based on data from the literature, we attempt to understand the possible mechanisms resulting in bacterial complications, particularly meningitis, during chickenpox and to determine the means to prevent it. PMID:25282451

Rebahi, H; Mouaffak, Y; Soraa, N; Younous, S

2014-11-01

242

Case report: Greater meningeal inflammation in lumbar than in ventricular region in human bacterial meningitis  

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Differences in the composition of ventricular and lumbar cerebrospinal fluid (CSF) based on single pairs of samples have previously been described. We describe a patient that developed post-surgical recurrent meningitis monitored by daily biochemical and bacteriological CSF analysis, simultaneously withdrawn from lumbar space and ventricles. A 20-year-old Caucasian man was admitted to the ICU after a resection of a chordoma that extended from the sphenoidal sinus to the anterior face of C2. C...

Naija, Walid; Mate?o, Joaquim; Raskine, Laurent; Timsit, Jean-franc?ois; Lukascewicz, Anne-claire; George, Bernard; Payen, Didier; Mebazaa, Alexandre

2004-01-01

243

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

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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 overdi...

Kenneth Nugent; Grerk Sutamtewagul; Chok Limsuwat; Erwin Argueta; Pavis Laengvejkal; Charoen Mankongpaisarnrung

2013-01-01

244

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

Directory of Open Access Journals (Sweden)

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

2008-09-01

245

Meningitis de etiología poco habitual en niños  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish 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 s [...] e 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 recibió 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 fluid 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.

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

2004-06-01

246

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

2005-12-01

247

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

2013-02-01

248

Intra-arterial vasodilator therapy for parainfectious cerebral vasospasm.  

Science.gov (United States)

Cerebrovascular complications of bacterial meningitis may include vasculitis, vasospasm or vasoconstriction, delayed cerebral infarction, venous and arterial thrombosis, intracranial aneurysm formation. The role of invasive endovascular therapies has not been well studied for infectious vasospasm, which can lead to dire neurologic consequences. We present 2 patients who were diagnosed with bacterial meningitis. Brain MRI showed areas of acute ischemia. Neurologic worsening was seen in both patients despite aggressive medical management. Follow-up imaging demonstrated significant narrowing of the intracranial vessels with associated new scattered infarcts. Both patients underwent targeted intra-arterial vasodilator infusion with angiographically improved vessel caliber and distal flow. The neurological exam subsequently stabilized in both cases. Follow-up radiographic images demonstrated no further ischemia in one of the 2 patients. Vasculopathy and vasospasm causing delayed ischemic neurologic deficit is a rare, but severe complication of acute meningitis. It can be a significant predictor of poor prognosis, and the disease may progress despite aggressive medical therapy. Although frequently used in subarachnoid hemorrhage-related vasospasm, to our knowledge, this is the first report of endovascular vasodilator treatment as adjunctive intervention in patients with meningitis associated vasculopathy. PMID:24655738

Taqui, Ather; Koffman, Lauren; Hui, Ferdinand; Gomes, Joao; Hussain, M Shazam; Bain, Mark; Toth, Gabor

2014-05-15

249

Paradoxical reaction in HIV negative tuberculous meningitis.  

Science.gov (United States)

This review focusses on paradoxical reactions occurring during the treatment of tuberculous meningitis (TBM) in human immunodeficiency virus-negative cases. A paradoxical reaction is defined as the worsening of a pre-existing lesion or the appearance of new lesion in a patient whose clinical symptoms initially improved with anti-tuberculosis treatment. A number of different paradoxical reactions have been reported in patients with TBM including expansion of existing cerebral tuberculomas, and appearance of new tuberculomas, hydrocephalus, and optochiasmatic and spinal arachnoiditis. While the exact mechanism of paradoxical reactions is uncertain, an exaggerated immune reaction against Mycobacterium tuberculosis-associated antigens is currently the most accepted theory for tuberculous paradoxical reaction. Corticosteroids are considered to have a beneficial effect in the management of paradoxical reactions. Immuno-modulatory drugs, including tumor necrosis factor-? antagonists, thalidomide and interferon-? have been used in isolated cases with more severe forms of paradoxical reactions. PMID:24680563

Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Kumar, Neeraj

2014-05-15

250

[Acute bacterial meningitis as an occupational disease].  

Science.gov (United States)

Streptococcus suis is a zoonotic pathogen with worldwide distribution, responsible for more than 700 human cases globally reported. This infection affects mostly men, exposed to pig or pork, which leads to its usual classification as an occupational disease. We report a case of acute bacterial meningitis in a 44 years old male. According to his past medical history, the patient had chronic alcoholism and worked in a restaurant as a piglet roaster. Microbiological examination of blood and CSF revealed S. suis. After 14 days of ceftriaxone the patient fully recovered. The authors review the clinical reports previously described in Portugal. In all of them was possible to identify risk exposition to pork. We alert to this microorganism's importance in Portugal where it is probably underdiagnosed. PMID:25203963

Seixas, Diana; Lebre, Ana; Crespo, Pedro; Ferreira, Eugénia; Serra, José Eduardo; Saraiva da Cunha, José Gabriel

2014-01-01

251

IL-6 and IL-8 in cerebrospinal fluid from patients with aseptic meningitis and bacterial meningitis: their potential role as a marker for differential diagnosis  

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Cytokines are molecules that act as mediators of immune response; cerebral spinal fluid (CSF) IL-6 is found in all meningeal inflammatory diseases, but IL-8 is associated with acute bacterial meningitis (ABM). A case control study was done to ascertain the discriminatory power of these cytokines in differentiating ABM from aseptic meningitis (AM); IL-6 and IL-8 CSF concentrations were tested through ELISA in samples collected from patients who underwent investigation for meningitis. Sixty pat...

Vitor Laerte Laerte Pinto Junior; Maria Cristina Rebelo; Rachel Novaes Gomes; Edson Fernandes de Assis; Castro-faria-neto, Hugo C.; Marcio Neves Bóia

2011-01-01

252

The use of magnetic resonance and MR angiography in the detection of cerebral infarction: A complication of pediatric bacterial meningitis  

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Full Text Available Bacground. Association of both cerebral infarction and acute bacterial meningitis is more common in younger patients than in the elderly. The rate of mortality and the frequency of sequel are very high inspite of the use of modern antibiotic therapy. In more than 30% of the cases of childhood bacterial meningitis, both arterial and venous infarctions can occur. The aim of this study was to present the role of the use of magnetic resonance (MRI, and MR angiography (MRA in the detection of bacterial meningitis in children complicated with cerebral infarctions. Method. In the Centre for MR, the Clinical Centre of Serbia, 25 patients with the diagnosis of bacterial meningitis, of which 9 children with cerebral infarction whose clinical conditon deteriorated acutely, despite the antibiotic therapy, underwent MRI and MR angiography examination on a 1T scanner. Examination included the conventional spin-echo techniques with T1-weighted saggital and coronal, and T2- weighted axial and coronal images. Coronal fluid attenuated inversion recovery (FLAIR and the postcontrast T1-weighted images in three orthogonal planes were also used. The use MR angiography was accomplished by the three-dimensional time-of-flight (3D TOF technique. Results. The findings included: multiple hemorrhagic infarction in 4 patients, multiple infarctions in 3 patients, focal infarction in 1 patient and diffuse infarction (1 patient. Common sites of involvement were: the frontal lobes, temporal lobes and basal ganglia. The majority of infarctions were bilateral. In 3 of the patients empyema was found, and in 1 patient bitemporal abscess was detected. In 8 of the patients MR angiography confirmed inflammatory vasculitis. Conclusion. Infarction is the most common sequel of severe meningitis in children. Since the complication of cerebral infarction influences the prognosis of meningitis, repetitive MRI examinations are very significant for the evaluation of the time course of vascular involvement. The use of MRI, especially FLAIR imaging, confirmed its value in the detection and determination of the site and the extent of cerebral infarction. Non-invasive technique of examination, 3D TOF MR angiography clearly should show the presence of inflammatory vasculitis.

Stoši?-Opin?al Tatjana

2005-01-01

253

Diagnostic and prognostic features of tuberculous meningitis on CT scanning  

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CT scans of 34 patients with severe tuberculous meningitis were reviewed. These patients were subsequently followed for a minimum period of nine months. Several diagnostic and prognostic features on CT scanning are discussed.

Bullock, Mrr; Welchman, Jm

1982-01-01

254

Mycobacterium bovis meningitis in young Nigerian-born male.  

Science.gov (United States)

In Denmark, tuberculous meningitis is rare. Central nervous system (CNS) involvement with Mycobacterium bovis is even rarer and has only been seen three times since 1992. We present a case of M. bovis meningitis in a previously healthy young Nigerian-born male, who had been exposed to unpasteurized dairy products in Nigeria but had no known contact with larger mammals. Before the development of meningitis, the patient had several contacts with the health system due to fever and non-specific symptoms. Finally, upon hospital admission, the patient was diagnosed with M. tuberculosis complex meningitis and treated empirically. After 13 days he was discharged without neurological sequelae. Later, the culture revealed M. bovis and treatment was adjusted accordingly. PMID:25134644

Faurholt-Jepsen, Daniel; Lillebaek, Troels; Nielsen, Ming-Yuan; Nielsen, Susanne Dam

2014-10-01

255

Meningitis caused by maltose-negative variant of Neisseria meningitidis.  

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A maltose-negative variant of Neisseria meningitidis, Slaterus Y, was recovered from a patient with meningitis. A report of the case is presented and the medical-legal significance of such an isolate is briefly discussed.

Granato, P. A.; Howard, R.; Wilkinson, B.; Laser, J.

1980-01-01

256

Vitamin B6 prevents cognitive impairment in experimental pneumococcal meningitis.  

Science.gov (United States)

Streptococcus pneumoniae is the relevant cause of bacterial meningitis, with a high-mortality rate and long-term neurological sequelae, affecting up to 50% of survivors. Pneumococcal compounds are pro-inflammatory mediators that induce an innate immune response and tryptophan degradation through the kynurenine pathway. Vitamin B6 acts as a cofactor at the active sites of enzymes that catalyze a great number of reactions involved in the metabolism of tryptophan, preventing the accumulation of neurotoxic intermediates. In the present study, we evaluated the effects of vitamin B6 on memory and on brain-derived neurotrophic factor (BDNF) expression in the brain of adult Wistar rats subjected to pneumococcal meningitis. The animals received either 10?µL of artificial cerebral spinal fluid (CSF) or an equivalent volume of S. pneumoniae suspension. The animals were divided into four groups: control, control treated with vitamin B6, meningitis, and meningitis treated with vitamin B6. Ten days after induction, the animals were subjected to behavioral tests: open-field task and step-down inhibitory avoidance task. In the open-field task, there was a significant reduction in both crossing and rearing in the control group, control/B6 group, and meningitis/B6 group compared with the training session, demonstrating habituation memory. However, the meningitis group showed no difference in motor and exploratory activity between training and test sessions, demonstrating memory impairment. In the step-down inhibitory avoidance task, there was a difference between training and test sessions in the control group, control/B6 group, and meningitis/B6 group, demonstrating aversive memory. In the meningitis group, there was no difference between training and test sessions, demonstrating impairment of aversive memory. In the hippocampus, BDNF expression decreased in the meningitis group when compared to the control group; however, adjuvant treatment with vitamin B6 increased BDNF expression in the meningitis group. Thus, vitamin B6 attenuated the memory impairment in animals subjected to pneumococcal meningitis. PMID:24903161

Barichello, Tatiana; Generoso, Jaqueline S; Simões, Lutiana R; Ceretta, Renan A; Dominguini, Diogo; Ferrari, Pâmela; Gubert, Carolina; Jornada, Luciano K; Budni, Josiane; Kapczinski, Flávio; Quevedo, João

2014-10-01

257

Cat scratch disease complicated with aseptic meningitis and neuroretinitis  

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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 cerebros...

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

258

[Chronic meningococcemia with meningitis triggered by steroid therapy].  

Science.gov (United States)

We present a case of chronic meningococcemia in a 27-year-old male with seven weeks of cyclic fever, arthralgia, and exanthema. While numerous blood cultures were negative, immunosuppressive treatment led to acute meningitis, and Neisseria meningitidis was detected. Serial meningococcal antibody tests were retrospectively analyzed and showed discrete seroconversion. Chronic meningococcemia is important to recognize since it can lead to acute meningitis in immunosuppressed or untreated patients resulting in high morbidity and mortality. PMID:20569662

Molly-Søholm, Mette; Nielsen, Jeppe Sylvest

2010-06-21

259

Candida parapsilosis meningitis associated with Gliadel (BCNU) wafer implants.  

LENUS (Irish Health Repository)

A 58-year old male presented with meningitis associated with subgaleal and subdural collections 6 weeks following a temporal craniotomy for resection of recurrent glioblastoma multiforme and Gliadel wafer implantation. Candida parapsilosis was cultured from cerebrospinal fluid (CSF) and Gliadel wafers removed during surgical debridement. He was successfully treated with liposomal amphotericin B. To our knowledge, this is the first reported case of Candida parapsilosis meningitis secondary to Gliadel wafer placement.

O'brien, Deirdre

2010-12-15

260

Candida parapsilosis meningitis associated with Gliadel (BCNU) wafer implants.  

LENUS (Irish Health Repository)

A 58-year old male presented with meningitis associated with subgaleal and subdural collections 6 weeks following a temporal craniotomy for resection of recurrent glioblastoma multiforme and Gliadel wafer implantation. Candida parapsilosis was cultured from cerebrospinal fluid (CSF) and Gliadel wafers removed during surgical debridement. He was successfully treated with liposomal amphotericin B. To our knowledge, this is the first reported case of Candida parapsilosis meningitis secondary to Gliadel wafer placement.

O'Brien, Deirdre

2012-02-01

 
 
 
 
261

Ovarian small cell carcinoma complicated by carcinomatous meningitis  

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Meningeal metastasis is rare in the clinical course of ovarian carcinoma and its prognosis is extremely poor. We experienced a case of carcinomatous meningitis from metastatic ovarian small cell carcinoma. A 33-year-old woman with atypical genital bleeding, was diagnosed with a right ovarian tumor and referred to our department. She underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy. It was an optimal debulking surgery. She was diagnose...

Hisashi Narahara; Kenji Kashima; Kaei Nasu; Masakazu Nishida; Terukazu Ishii; Kentaro Kai; Noriyuki Takai; Naoko Kira

2012-01-01

262

Ambulant neuropsykologisk opfølgning af patienter indlagt med aseptisk meningitis  

DEFF Research Database (Denmark)

Aseptic meningitis is considered to be a benign illness with mild symptoms, and the prognosis is usually good. However, retrospective studies have demonstrated that these patients may experience cognitive sequelae. A neuropsychologist was affiliated to the Department of Infectious Diseases, and neuropsychological findings in patients with aseptic meningitis were assessed. In conclusion, at twelve months of follow-up cognitive dysfunction persist among the majority of patients; 75% had mental fatigue and 45% had changed their work status.

Damsgaard Gunst, Jesper; Klostergaard, Kirsten Rose

2014-01-01

263

Scrub Typhus Meningitis in South India — A Retrospective Study  

Science.gov (United States)

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. PMID:23799119

Viswanathan, Stalin; Muthu, Vivekanandan; Iqbal, Nayyar; Remalayam, Bhavith; George, Tarun

2013-01-01

264

Intracranial hypertension causing visual failure in cryptococcus meningitis.  

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Thirty four patients with cryptococcal meningitis seen in the University of Malaya medical centre since 1980 were reviewed. Eleven patients had bilateral papilloedema and visual impairment but eventually survived. Seven patients had intensive aggressive measures, including shunting to reduce intracranial hypertension irrespective of ventricular size shown in CT scan, and showed substantial improvement in vision. It is concluded that papilloedema and visual failure in cryptococcal meningitis r...

Tan, C. T.

1988-01-01

265

Progress towards meningitis prevention in the conjugate vaccines era  

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Acute bacterial meningitis is an important cause of morbidity and mortality among children less than five years old. Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis are the most important agents of bacterial meningitis in developing countries. The development of the conjugate vaccines in the beginning of the 90's, especially type b H. influenzae (Hib), and more recently the heptavalent pneumococcal and the serogroup C meningococcal vaccines, have contributed direct...

Cristina Aparecida Borges Laval; Fabiana Cristina Pimenta; João Guimarães de Andrade; Andrade, Soraya S.; Andrade, Ana Lucia S. S.

2003-01-01

266

Diagnostic features of tuberculous meningitis: a cross-sectional study  

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Abstract Background Tuberculous meningitis (TBM) is a common central nervous system infection in the Philippines; however it is difficult to diagnose as findings are non-specific. Hence we decided to determine if, among patients with chronic meningitis syndrome, the following are associated with the diagnosis: new-onset seizures; focal neurologic deficit; pulmonary tuberculosis (PTB) on chest X-ray; cerebrospinal fluid (CSF) pleocytosis with lymphocytic predominance; decrease...

Pasco Paul

2012-01-01

267

Approaches to prevent acute bacterial meningitis in developing countries.  

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Endemic acute bacterial meningitis of childhood appears to be neglected as a cause of morbidity and mortality in developing countries, probably because it has been overshadowed by the dramatic epidemics of meningococcal disease in sub-Saharan Africa. The available data based on reviews of hospitalized patients suggest that endemic meningitis is mostly a disease of young infants, Streptococcus pneumoniae and Haemophilus influenzae type b being the most important etiologic agents. The epidemiol...

Wright, P. F.

1989-01-01

268

Isolated Torticollis May Present as an Atypical Presentation of Meningitis  

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Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an ab...

Roger Chirurgi; Samrina Kahlon

2012-01-01

269

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis  

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Summary: The epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to ascertain public health measures and ensure appropriate management. In this review, we describe the changing epidemiology of bacteria...

Brouwer, Matthijs C.; Tunkel, Allan R.; Beek, Diederik

2010-01-01

270

Tuberculous meningitis: role of CT in management and prognosis.  

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Serial computed tomographic scans were performed during the course of tuberculous meningitis in 25 patients aged 1-70 years. Hydrocephalus rarely occurred without other abnormalities. Marked ventricular enlargement was associated with extensive basal enhancement. Basal meningeal enhancement was not a good indicator of the clinical state although marked enhancement was a risk factor for the development of basal ganglia infarction. Infarcts were much more common in children than in adults and w...

Kingsley, D. P.; Hendrickse, W. A.; Kendall, B. E.; Swash, M.; Singh, V.

1987-01-01

271

Does Meningitis Stop CSF Rhinorrhea following Lateral Skull Base Surgery?  

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In cases of cerebrospinal fluid (CSF) rhinorrhea following lateral skull base surgery, fibrosis and fibrin formation resulting from meningitis has been postulated as a mechanism of spontaneously resolving the CSF leak. This study was undertaken to explore any possible relationship between the cessation of CSF leak and meningitis. A retrospective study at a tertiary referral center of 232 consecutive patients was performed. Out of a total of 232 procedures, 29 patients developed CSF rhinorrhea...

Malik, Tass H.; Bruce, Iain A.; Kelly, Gerard; Ramsden, Richard T.; Saeed, Shakeel R.

2007-01-01

272

Arterial embolism  

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Surgical and intensive care patients are at a heightened risk for arterial embolization due to pre-existing conditions such as age, hypercoagulability, cardiac abnormalities and atherosclerotic disease. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds where they cause arterial occlusion, ischemia, and potentially infarction. Other emboli form on the surface of eroded arterial plaque or within its lipid core. Thromboemboli are large clots that disl...

Melville, R. M.

2013-01-01

273

Paediatric Meningitis and Hearing Loss in a Developing Country: Exploring the Current Protocols Regarding Audiological Management Following Meningitis  

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The purpose of this study was to establish audiology referral protocols for post meningitis paediatric populations in two academic hospitals in Gauteng, South Africa. Specific objectives of this study included determining if audiological assessment referrals were made following infection; determining the time of referral post meningitis diagnosis; establishing what audiological assessments were conducted on this population, as well as determining any correlations between signs and symptoms of...

Katijah, Khoza-shangase; Emma, Rifkind Romi

2010-01-01

274

The ‘pulsatile’ sebaceous cyst: beware of a superficial temporal artery aneurysm  

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True aneurysms of the superficial temporal artery (STA) are quite uncommon. Only 14 such cases are described in the literature. Ultrasound scan (USS) is an appropriate and easily accessible non-invasive diagnostic modality, as it can show both the anatomical and flow characteristics of the aneurysmal vessel. Other conditions to be included in the differential diagnosis are haematoma, angiofibroma, eroding middle meningeal artery aneurysm, abscess or a parotid mass. Operative intervention is i...

Gull, Sadaf; Badawy, Ayman; Chaudhuri, Arindam

2009-01-01

275

Meningitis bacteriana por Streptococcus pyogenes: revisión de la literatura / Bacterial meningitis due to Streptococcus pyogenes: literature review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: el Streptococcus pyogenes (S. pyogenes) es una etiología poco habitual de meningitis bacteriana a pesar de ser un germen que frecuentemente produce infecciones en otras localizaciones en la edad pediátrica. Material y métodos: se revisaron los casos de bacteriemia por S. pyogenes y los [...] factores de riesgo asociados en la base de datos del Servicio de Microbiología del Hospital Universitario La Paz desde junio de 2002 a junio de 2012. Resultados: únicamente se encontró un caso de bacteremia por S. pyogenes asociado a meningitis, que se describe en este artículo. Conclusiones: a pesar de su baja incidencia, se debe tener en cuenta el S. pyogenes en el diagnóstico diferencial de meningitis bacterianas, especialmente en pacientes con factores de riesgo asociados Abstract in english Introduction: Streptococcus pyogenes (S. pyogenes) is a rare cause of meningitis despite being a common source of pediatric infections in other sites. Material and methods: A search was performed of the pediatric patients with S. pyogenes bacteremia in the microbiology database of the Hospital Infan [...] til La Paz from June 2002 until June 2012. Results: A single case of S. pyogenes meningitis was found and is reported in this article. Conclusions: Despite its low incidence, S. pyogenes should be considered in the differential diagnosis of meningitis, particularly in patients with associated risk factors.

E., Ballesteros Moya; L., Herrera Castillo; L., Escosa García; M.P., Romero González; F., Lázaro Perona; M.I. de, José Gómez.

2013-12-01

276

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

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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

2011-08-01

277

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish 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 d [...] e 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. 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 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.

2011-08-01

278

Specificity of immunoblotting analyses in eosinophilic meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 contro [...] ls. 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 serological 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.

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

2011-08-01

279

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

280

Protective effects of cisternal irrigation on leptomeningeal and cortical structures in meningitis: An experimental study  

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BACKGROUND: Meningitis, termed as foreign material collection in the subarachnoid space, leads to various meningeal, cerebral and spinal cord pathologies. Meningitis still remains a problematic disease with severe complications in spite of advanced medical technology. AIMS: In this study, we aimed to investigate the role of cisternal irrigation in the prevention of meningitis complications. SETTING AND STUDY DESIGN: Experimental study was done in the Social Security Hospital of Erzurum. Histo...

Aydin Mehmet; Gundogdu C; Akcay F; Gursan N

2005-01-01

 
 
 
 
281

Effects of Hypertonic (7%) Saline on Brain Injury in Experimental Escherichia coli Meningitis  

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We sought to know whether hypertonic (7%) saline (HTS) attenuates brain injury by improving cerebral perfusion pressure (CPP) and down-modulating acute inflammatory responses in experimental bacterial meningitis in the newborn piglet. Twenty-five newborn piglets were assorted into three groups: 6 in the control group (C), 10 in the meningitis group (M), and 9 in the meningitis with HTS infusion group (H). Meningitis was induced by intracisternal injection of 108 colony forming units of Escher...

Choi, Chang Won; Hwang, Jong Hee; Chang, Yun Sil; Park, Won Soon; Kim, Beyong Il; Choi, Jung-hwan; Lee, Munhyang

2005-01-01

282

Detection of Acute Childhood Meningitis by PCR, Culture and Agglutination Tests in Tabriz, Iran  

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Meningitis is one of the hazardous and life threatening infections and is associated with mortality and morbidity. The aim of this study was to determine etiological agents of childhood bacterial meningitis. The culture, Gram staining, agglutination and PCR assays were used to examine CSF specimens from 277 patients with presumed bacterial meningitis for the occurrence of 4 most common infectious agents consist of N. meningitis, H. influnsae, S. pneumoniae and S. agalactiae between 2008 and 2...

Mohammad Ahangarzadeh Rezaee; Shahram Abdoli-Oskouei; Fatemeh Yeganeh; Safar Farajnia; Reza Ghotaslou; Mohammad Barzegar

2012-01-01

283

A cascade of morphogenic signaling initiated by the meninges controls corpus callosum formation  

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The corpus callosum is the most prominent commissural connection between the cortical hemispheres, and numerous neurodevelopmental disorders are associated with callosal agenesis. Using mice with either meningeal overgrowth or selective loss of meninges, we’ve identified a cascade of morphogenic signals initiated by the meninges that regulates corpus callosum development. The meninges produce BMP7, an inhibitor of callosal axon outgrowth. This activity is overcome by the induction of expres...

Choe, Youngshik; Siegenthaler, Julie A.; Pleasure, Samuel J.

2012-01-01

284

Hearing loss diagnosis followed by meningitis in Danish children, 1995-2004  

DEFF Research Database (Denmark)

A higher risk of meningitis associated with cochlear implants may be explained in part by a generally higher risk of meningitis in children with severe to profound hearing loss. We investigated whether children with hearing loss have an increased risk of meningitis.

Parner, Erik T; Reefhuis, Jennita

2007-01-01

285

The changing epidemiology of pediatric aseptic meningitis in Daejeon, Korea from 1987 to 2003  

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Abstract Background Aseptic meningitis is a relatively frequent childhood disease and virologic data suggest that enteroviruses are the commonest etiologic agents. We evaluated the epidemiologic characteristics of aseptic meningitis in Daejeon, South Korea from 1987 to 2003. Methods 2201 medical records of children with aseptic meningitis admitted to The Catholic University of Korea, Daejeon St Mary's Hospital were retrospectively analyzed. Results

Lee Mi-Hee; Hong Ja-Hyun; Lee Hyung-Shin; Burgner David; Lee Kyung-Yil; Kang Jin-Han; Lee Byung-Churl

2005-01-01

286

Gadolinium enhancement of the cerebrospinal fluid in a patient with meningeal fibrosis and cryptococcal infection  

International Nuclear Information System (INIS)

We describe the case of a 52-year-old man, with cryptococcal meningitis and meningeal fibrosis who had undergone ventricular shunting. Gd-DTPA-enhanced T1-weighted MRI revealed diffuse meningeal enhancement. Remarkably, there was enhancement of the pia mater and posterior fossa subarachnoid space. (orig.). With 3 figs

287

Cat scratch disease complicated with aseptic meningitis and neuroretinitis  

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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.

2008-04-01

288

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.)

289

MR features in patients with residual paralysis following aseptic meningitis  

Energy Technology Data Exchange (ETDEWEB)

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). The clinical manifestations associated with the EV 71 infection include aseptic meningitis, hand-food-mouth disease (HFMD), acute respiratory illness and gastrointestinal disease(6). Although rarely fatal, flaccidparalysis can be followed by EV 71 induced aseptic meningitis. Anterior horn cell necrosis was suggested on MR in two patients with residual paralysis (7). MR features, however, have not yet been described in detail. In this report we present three cases of patients with clinical evidence of EV 71 induced aseptic meningitis whose MR studies showed residual changes in spinal cord.

Suh, Dae Chul; Park, Young Seo [College of Medicine, Asan Meidcal Center, University of Ulsan, Seoul (Korea, Republic of)

1991-01-15

290

Progress towards meningitis prevention in the conjugate vaccines era  

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Full Text Available Acute bacterial meningitis is an important cause of morbidity and mortality among children less than five years old. Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis are the most important agents of bacterial meningitis in developing countries. The development of the conjugate vaccines in the beginning of the 90's, especially type b H. influenzae (Hib, and more recently the heptavalent pneumococcal and the serogroup C meningococcal vaccines, have contributed directly to changes in the epidemiological profile of these invasive diseases (direct effect and of their carriage status (indirect effect. We review the impact of the Hib conjugate vaccine in Latin American countries, where this vaccine has been implemented, and the potential of pneumococcal and meningococcal conjugate vaccines for the reduction of meningitis worldwide. We also address constraints for the development and delivery of these vaccines and review new candidate state-of-the-art vaccines. The greatest challenge, undoubtedly, is to implement these vaccines worldwide, especially in the developing regions.

Cristina Aparecida Borges Laval

2003-10-01

291

Meningitis associated with Vancomycin resistant Enterococcus casseliflavus: First report  

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Full Text Available Enterococci are present in the gastrointestinal system as normal floral components. In the past two decades membersof the genus Enterococcus have emerged as important nosocomial pathogens worldwide. Enterococci may cause arange of different disorders such as urinary tract, intraabdominal, and wound infections, as well as endocarditis, meningitisand bacteraemia. Nosocomial enterococcal meningitis is most commonly observed following ventriculoperitonealshunt operations. Vancomycin resistant enterococcus (VRE represents 30% of all enterococci infections.This report presents a vancomycin-resistant Enterococcus casseliflavus meningitis case in a 66-year-old patient withventriculoperitoneal shunt, which has not been reported in the literature before. Successful outcomes were obtainedwith daptomycin plus linezolid combined treatment in VRE meningitis. Treatment recommendations in VRE meningitisare also discussed in this article. J Microbiol Infect Dis 2011;1 (3:138-140

Nilay Sefa Uçar

2011-12-01

292

Meningitis due to Fusobacterium necrophorum in an adult  

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Full Text Available Abstract Background Fusobacterium necrophorum may cause a number of clinical syndromes, collectively known as necrobacillosis. Meningitis is a significant cause of mortality, rarely reported in the adult population. Case presentation We report a fatal case of meningitis, caused by Fusobacterium necrophorum, secondary to otitis media in an alcoholic male. Diagnosis was delayed due to the typical slow growth of the organism. The clinical course was complicated by encephalitis and by hydrocephalus. The patient failed to respond to metronidazole and penicillin. The patient died on day 12 from increased intracranial pressure and brain stem infarction. Conclusions This case emphasizes the need for a high index of clinical suspicion to make the diagnosis of Fusobacterium necrophorum meningitis. We recommend the use of appropriate anaerobic culture techniques and antimicrobial coverage for anaerobic organisms when the gram stain shows gram negative bacilli.

Herchline Thomas

2004-08-01

293

Meningeal carcinomatosis as first manifestation of gastric carcinoma  

International Nuclear Information System (INIS)

Meningeal carcinomatosis is defined as the malignant and widespread infiltration of the meninges due to the planting and growth of cancer cells within the leptomeningeal space. It occurs more frequently in patients with disseminated neoplastic disease, but it may occur after a disease free interval and may even be the first manifestation of cancer. The most common primary tumors in adults are breast (30-50%), lung (15-25%), melanoma (11%) and gastric cancer (0.16-0.69%); in marked contrast with pediatric cases in which lymphocytic leukemia is the most common. The following article describes an autopsy case of a patient with psychiatric symptoms, with no antecedents of importance, with progressive and fatal neurological impairment, whose pathological studies show meningeal carcinomatosis attributable to advanced gastric adenocarcinoma discovered de novo post mortem.

294

Primary meningeal osteosarcoma of the brain during childhood. Case report.  

Science.gov (United States)

Primary meningeal osteosarcomas are rare tumors, with only 19 reported cases in the literature; only 4 of these, including the present case, are in pediatric patients. In this report, the authors present the case of an 8-year-old boy with a history of generalized tonic-clonic seizures who was found to harbor a meningeal osteosarcoma within the sylvian fissure. Initial working diagnoses included meningioma and glioma. After tumor enlargement and progressive symptoms, the patient underwent a large frontotemporal craniotomy and complete resection of the lesion, which recurred 6 and 12 months after the initial surgery and was surgically treated after each recurrence. The rarity of primary meningeal osteosarcomas can make their diagnosis difficult, and histopathological evaluation is mandatory for diagnosis. Because of their fast progression, they must be treated aggressively by means of surgery, chemotherapy, and radiotherapy. PMID:18377310

Dagcinar, Adnan; Bayrakli, Fatih; Yapicier, Ozlem; Ozek, Memet

2008-04-01

295

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

296

Hospital-based surveillance of meningococcal meningitis in Salvador, Brazil.  

Science.gov (United States)

This study aimed to describe the clinical, epidemiological and microbiological features of meningococcal meningitis in Salvador, Brazil. Between February 1996 and January 2001, a hospital-based surveillance prospectively identified cases of culture-positive meningococcal meningitis. Demographic and clinical data were collected through interview and medical chart review. Antisera and monoclonal antibodies were used to determine the serogroup and serotype:serosubtype of the isolates, respectively. Surveillance identified a total of 408 cases of meningococcal meningitis, with a case fatality rate of 8% (32/397). The mean annual incidence for the 304 culture-positive cases residing in metropolitan Salvador was 1.71 cases per 100,000 population. Infants W135 and Y, respectively. A single serotype:serosubtype (4,7:P1.19,15) accounted for 64% of all cases. Continued surveillance is necessary to characterise strains and to define future prevention and control strategies. PMID:17681359

Cordeiro, Soraia M; Neves, Alan B; Ribeiro, Cássio T; Petersen, Maya L; Gouveia, Edilane L; Ribeiro, Guilherme S; Lôbo, Tatiana S; Reis, Joice N; Salgado, Kátia M; Reis, Mitermayer G; Ko, Albert I

2007-11-01

297

The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico [Dept. of Surgical and Oncological Disciplines, University of Palermo, Palermo (Italy); Anastasi, Giuseppe; Milardi, Demetrio; Favaloro, Angelo; Caradonna, Luigi; Cutroneo, Giuseppina [Biomorphology and Biotechnologies, University of Messina, Messina (Italy); De Pietro, Anita; Angileri, Tommaso Maurizio [Villa Santa Teresa, Diagnostica per Immagini, Palermo (Italy)

2013-03-15

298

The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications  

International Nuclear Information System (INIS)

The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

299

[Peripheral arteries].  

Science.gov (United States)

Peripheral arterial disease is a main cause of morbidity in industrialised countries. It chiefly affects older people. The most common causes are atherosclerosis and vasodilatatory abnormalities. In the presence of unexplained leg symptoms, peripheral arterial disease can be diagnosed or ruled out by non-invasive diagnostic methods such as history, clinical examination and the measurement of ankle and brachial artery pressure by Doppler ultrasound, as well as by calculating the ankle brachial index. Colour coded duplex sonography, computer tomography angiography, magnetic resonance angiography and arteriography are the imaging modalities used. Current diagnostic strategies are analysed for the different peripheral artery diseases. PMID:17479237

Vosshenrich, R; Reimer, P; Landwehr, P

2007-06-01

300

Clinical and microbiological features of cryptococcal meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Introduction In this study, the clinical features, underlying diseases and clinical outcomes of patients with cryptococcosis were investigated. In addition, a molecular analysis of the Cryptococcus neoformans species complex isolated from these patients was performed. Methods A prospective study [...] of 62 cases of patients with cryptococcal infection was conducted at the Hospital de Doenças Tropicais de Goiás Dr. Anuar Auad from 2009-2010. Cryptococcal meningitis cases were diagnosed by direct examination and cerebrospinal fluid (CSF) sample culture. The profiling of these patients was assessed. The CSF samples were submitted to India ink preparation and cultured on Sabouraud dextrose agar, and C. neoformans was identified by the production of urease, a positive phenoloxidase test and assimilation of carbohydrates. C. neoformans and C. gattii isolates were distinguished by growth on L-canavanine-glycine-bromothymol blue medium, and molecular analysis was conducted via PCR fingerprinting reactions using M13 and (GACA)4 primers. Results From the 62 patients with cryptococcosis, 71 isolates of CSF were obtained; 67 (94.4%) isolates were identified as C. neoformans var. grubii/VNI, and 4 (5.6%) were identified as C. gattii/VGII. Of these patients, 53 had an HIV diagnosis. The incidence of cryptococcosis was higher among patients 20-40 years of age, with 74.2% of the cases reported in males. Cryptococcus-related mortality was noted in 48.4% of the patients, and the symptoms were altered sensorium, headache, fever and stiff neck. Conclusions The high morbidity and mortality observed among patients with cryptococcosis demonstrate the importance of obtaining information regarding the epidemiological profile and clinical course of the disease in the State of Goiás, Brazil.

Lucia Kioko Hasimoto e, Souza; Carolina Rodrigues, Costa; Orionalda de Fatima Lisboa, Fernandes; Fernando Yano, Abrao; Thaisa Cristina, Silva; Carolina Martins, Tremea; Maria do Rosario Rodrigues, Silva.

2013-06-01

 
 
 
 
301

Meningeal carcinomatosis in a patient with Crohn's disease.  

Science.gov (United States)

Leptomeningeal carcinomatosis, also known as carcinomatous meningitis, is defined by spreading of neoplastic cells to the meninges and ventricles, and is a form of cancer dissemination. In this case, a patient with inflammatory bowel disease had developed a neoplastic process that spread to the meninges. A 49-year-old woman developed an abdominal pain, and was diagnosed the same month with Crohn's disease, complicated with intestinal perforation, for which she was hospitalized. Pathological examination revealed acute phase-terminal ileitis. She undergone many hospitalizations during which she was suspected to have celiac disease, inflammatory bowel disease, and tuberculous meningitis, as well as femoral head necrosis after she had been unsuccessfully treated with Prednisone for Crohn's disease. After she developed peripheral bilateral facial paresis, bilateral hypoacusia, hypotonia, tetraparesis and diminished osteotendinous reflexes at the legs, the patient was admitted in our department. Several lumbar punctures were performed but no specific disease could be detected. The MRI performed showed pachymeningeal and leptomeningeal inflammation. Tuberculous meningitis was taken into consideration and the patient was transferred into an Infectious Disease Department where this diagnostic was infirmed. The patient was retransferred into the Department of Neurology where after an episode of hematemesis she had a cardiac arrest and deceased. Inflammatory bowel disease may involve different segments of the intestine, and may be accompanied by a variety of conditions, such as neurologic findings, osteoarticular manifestations and also may be the starting point of a neoplastic process. The patient had an inflammatory bowel condition, which by the time it was appropriately diagnosed as being Crohn's disease, a neoplastic process spread to the meninges, causing multiple cranial nerve palsy, tetraparesis, along other neurological manifestations. PMID:25338348

Tra?c?, Daniela; ?erban, Adelina Simona; ?tef?nescu, V; Ro?ianu, Elena; Amet, Zela Cofoian; Morari, Oana; Zurac, Sabina; Pop, Cristiana; Haidar, A; Gogulescu, Rodica; Bumbea, H; Antonic?, Doina; Ionescu, V; Cojocaru, Inimioara Mihaela

2014-01-01

302

Spectrum of Meningitis in Adult at the Douala General Hospital  

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Full Text Available Objectives: Describe the clinical, aetiological and prognostic features of infectious meningitis in adults at the Douala General Hospital (DGH. Patients and Methods: We carried out a 5-year retrospective cross-sectional study at the DGH, on data from the registers of the bacteriology and biochemistry laboratories. Cases of meningitis were identified from the results of the cerebrospinal fluid (CSF analysis, and the patient clinical file was obtained. Cases files of patients aged 15 years and above were included. For each patient, sociodemographic, clinical features and hospital mortality data were extracted. Results: During study period, 1877 CSF analyses were recorded and 135 were enrolled for data analysis. Up to 74 patients (55% were male and the mean age was 40.04 ± 12.5 years. The time lapse between the onset of symptoms and consultation was 12.24 ± 11.16 days. The main clinical signs were meningeal syndrome (96.3%, neck stiffness (71.1%, reduced alertness (64.4% and confusional states (55.6%. The main aetiology was bacterial (45.19% with Streptococcus pneumoniae (45.90% and Neisseria meningitis (29.51% leading. The other aetiologies were viral (21.48%, fungal with Cryptococcus neoformans (20% and meningeal tuberculosis (13.33%. Fifty eight patients (42.9% had a positive HIV serology. The mean duration of hospitalization was 9.05 ± 8.1 days, and the total in-hospital mortality was 25.18%. 117 patients (86.8% had received antibiotherapy before diagnosis. Conclusion: The clinical features of meningitis in the DGH are as in classical description. However, the mortality is high and the major aetiologies appear to be associated with HIV infection at least in part. Prospective multi-centric studies are needed to provide more evidence for the development of staged management guidelines in our resource-limited settings.

Yacouba N. Mapoure

2014-04-01

303

Diagnostic Accuracy of Intracellular Mycobacterium tuberculosis Detection for Tuberculous Meningitis  

Science.gov (United States)

Rationale: Early diagnosis and treatment of tuberculous meningitis saves lives, but current laboratory diagnostic tests lack sensitivity. Objectives: We investigated whether the detection of intracellular bacteria by a modified Ziehl-Neelsen stain and early secretory antigen target (ESAT)-6 in cerebrospinal fluid leukocytes improves tuberculous meningitis diagnosis. Methods: Cerebrospinal fluid specimens from patients with suspected tuberculous meningitis were stained by conventional Ziehl-Neelsen stain, a modified Ziehl-Neelsen stain involving cytospin slides with Triton processing, and an ESAT-6 immunocytochemical stain. Acid-fast bacteria and ESAT-6–expressing leukocytes were detected by microscopy. All tests were performed prospectively in a central laboratory by experienced technicians masked to the patients’ final diagnosis. Measurements and Main Results: Two hundred and eighty patients with suspected tuberculous meningitis were enrolled. Thirty-seven had Mycobacterium tuberculosis cultured from cerebrospinal fluid; 40 had a microbiologically confirmed alternative diagnosis; the rest had probable or possible tuberculous meningitis according to published criteria. Against a clinical diagnostic gold standard the sensitivity of conventional Ziehl-Neelsen stain was 3.3% (95% confidence interval, 1.6–6.7%), compared with 82.9% (95% confidence interval, 77.4–87.3%) for modified Ziehl-Neelsen stain and 75.1% (95% confidence interval, 68.8–80.6%) for ESAT-6 immunostain. Intracellular bacteria were seen in 87.8% of the slides positive by the modified Ziehl-Neelsen stain. The specificity of modified Ziehl-Neelsen and ESAT-6 stain was 85.0% (95% confidence interval, 69.4–93.8%) and 90.0% (95% confidence interval, 75.4–96.7%), respectively. Conclusions: Enhanced bacterial detection by simple modification of the Ziehl-Neelsen stain and an ESAT-6 intracellular stain improve the laboratory diagnosis of tuberculous meningitis. PMID:24450377

Feng, Guo-dong; Shi, Ming; Ma, Lei; Chen, Ping; Wang, Bing-ju; Zhang, Min; Chang, Xiao-lin; Su, Xiu-chu; Yang, Yi-ning; Fan, Xin-hong; Dai, Wen; Liu, Ting-ting; He, Ying; Bian, Ting; Duan, Li-xin; Li, Jin-ge; Hao, Xiao-ke; Liu, Jia-yun; Xue, Xin; Song, Yun-zhang; Wu, Hai-qin; Niu, Guo-qiang; Zhang, Li; Han, Cui-juan; Lin, Hong; Lin, Zhi-hui; Liu, Jian-jun; Jian, Qian; Zhang, Jin-she; Tian, Ye; Zhou, Bai-yu; Wang, Jing; Xue, Chang-hu; Han, Xiao-fang; Wang, Jian-feng; Wang, Shou-lian

2014-01-01

304

The angiographic demonstration of trauma to intracranial arteries  

International Nuclear Information System (INIS)

Damage to intracranial arteries was demonstrated angiographically in 24 patients with severe trauma to the skull and brain. The most common abnormalities were damage to the intima and traumatic carotid-cavernous fistulae (nine cases each). In addition, there were six traumatic aneurysms of the internal carotid artery, two extravasates from ruptured intracranial branches and one traumatic A-V fistula between the middle meningeal artery and the spheno-parietal sinus. The arterial damage was diagnosed either during the acute stage or after a latent period of days and weeks, if there were signs of intracranial bleeding or other evidence of vascular damage. Cerebral angiography in two or more projections is the method of choice for demonstrating even minor vascular lesions. (orig.)

305

Oral wooden stick injury complicated by meningitis and brain abscess.  

Science.gov (United States)

Meningitis is rarely seen following oral injury. We describe a 3-year-old boy developing meningitis and brain abscess following a penetrating oral wooden stick injury. There was no cerebrospinal fluid rhinorrhea noted. A cerebrospinal fluid culture yielded viridans streptococcus. Brain magnetic resonance imaging and computed tomography revealed a multiloculated ring-enhancing mass. This patient underwent surgical drainage and completed 8-week antibiotic therapy. The patient demonstrated a late and dismal complication of a penetrating oral injury. At 2-year follow-up the patient was in good condition. A penetrating oral wooden stick inury should be regarded as potentially serious. PMID:12079161

Chang, Chin-Jung; Huang, Li-Tung; Lui, Chun-Chung; Huang, Song-Chei

2002-04-01

306

Chronic mycobacterial meningitis due to Mycobacterium chelonae: a case report.  

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We report a case of chronic meningitis due to Mycobacterium chelonae. This organism is a rapidly growing Mycobacterium (RGM) and can be found worldwide in environmental sources such as soil, dust, and water. M. chelonae is an uncommon cause of meningitis; the majority of infections caused by this organism are localized cutaneous or soft tissue infections, and rarely lung infections. The organism is indistinguishable phenotypically, so we applied PCR based on the rpoB gene sequence followed by restriction fragment length polymorphism (RFLP) for molecular identification. The subsequent sequencing of RFLP products revealed 99.7% similarity with M. chelonae. PMID:25195074

Salmanzadeh, Shokrallah; Honarvar, Negin; Goodarzi, Hamed; Khosravi, Azar Dokht; Nashibi, Roohangiz; Serajian, Amir Arsalan; Hashemzadeh, Mohammad

2014-10-01

307

[Cryptococcal meningitis following cryptococcal pneumonia in an immunocompetent].  

Science.gov (United States)

Cryptococcal meningitis (CM) is common in the immunocompromised (especially due to AIDS), but also occurs in immunocompetent subjects. CM can complicate cryptococcal pneumonia (CP) not only in the immunocompromised but also in the immunocompetent. We describe a healthy 26-year-old man who developed a prolonged lung infection. Diagnosis of cryptococcal pneumonia was established from bronchoscopic washings. He recovered spontaneously, so no antifungal treatment was given. 4 months later he was admitted with cryptococcal meningitis and was treated successfully with amphotericin B. An extensive immunologic study revealed no abnormalities. Since CM can complicate cryptococcal pneumonia, it is recommended that patients with CP be followed, even if recovery is apparently complete. PMID:12415973

Reichman, N; Elias, M; Raz, R; Flatau, E

1999-10-01

308

Meningeal involvement in Behcet`s disease: MRI  

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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.) With 4 figs., 11 refs.

Guma, A. [Department of Radiology, Hospital Duran i Reynals, Llobregat (Spain); Aguilera, C.; Pons, L. [Institut de Diagnostic per la Imatge, Centre de Bellvitge, Llobregat (Spain); Acebes, J. [Department of Neurosurgery, Universitaria de Bellvitge, Llobregat (Spain); Arruga, J. [Department of Ophthalmology, Universitaria de Bellvitge, Llobregat (Spain)

1998-08-01

309

Prevalence and antimicrobial resistance pattern of bacterial meningitis in Egypt  

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Full Text Available Abstract Infectious diseases are the leading cause of morbidity and mortality in the developing world. In Egypt bacterial diseases constitute a great burden, with several particular bacteria sustaining the leading role of multiple serious infections. This article addresses profound bacterial agents causing a wide array of infections including but not limited to pneumonia and meningitis. The epidemiology of such infectious diseases and the prevalence of Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae are reviewed in the context of bacterial meningitis. We address prevalent serotypes in Egypt, antimicrobial resistance patterns and efficacy of vaccines to emphasize the importance of periodic surveillance for appropriate preventive and treatment strategies.

Shaban Lamyaa

2009-09-01

310

Carga de enfermedad por meningitis bacteriana, Cuba 2006 / Burden of disease due to bacterial meningitis, Cuba 2006  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: la meningitis bacteriana constituye una preocupación para los médicos y los sistemas de salud en general de cualquier país, así como para los organismos internacionales. Objetivo: estimar las cargas por morbilidad y mortalidad por meningitis bacteriana en Cuba para 2006. Métodos: se ut [...] ilizaron los datos de mortalidad y de incidencia de la encuesta epidemiológica de la Vigilancia Nacional de Meningitis Bacteriana del Instituto de Medicina Tropical "Pedro Kourí". Los procedimientos de estimación se basaron en las recomendaciones de la Organización Mundial de la Salud con el uso del DISMOD y las hojas de cálculos establecidas al efecto. Resultados: la carga global de meningitis bacteriana se estimó en 3527,26 años de vida ajustados por discapacidad (AVAD), lo que representó la pérdida de 31,3 años por cada 100 000 habitantes. La carga por morbilidad y mortalidad de meningitis bacteriana sin ponderar la secuela resultó 2056,25 años de vida ajustados por discapacidad, 55,9 % correspondió sin agente etiológico identificado, seguida de las originadas por Streptococcus pneumoniae (30,9 %), Neisseria meningitidis (9,5 %) y por Haemophilus influenzae tipo b (3,6 %). La carga por mortalidad fue aproximadamente 2 039 años de vida perdidos (AVP) por muerte prematura, o sea 57,8 %. Los menores de 5 años aportaron la mayor carga global de años de vida ajustados por discapacidad y dentro de ellos S. pneumoniae el que generó la mayor carga. Conclusión: la carga por meningitis bacteriana resultó elevada y corroboró su alta utilidad para evaluar los problemas de salud. Abstract in english Introduction: bacterial meningitis is a real concern for physicians and general health systems of any country as well as the international bodies. Objective: to estimate burdens of disease from morbidity and mortality caused by bacterial meningitis in Cuba during 2006. Methods: the mortality and the [...] incidence data of the epidemiological survey from the National Surveillance of Bacterial Meningitis of "Pedro Kourí" Institute of Tropical Medicine were used. The estimation methods were based on the WHO recommendations by using the DISMOD and the required Excel spreadsheets. Results: the global burden of bacterial meningitis was estimated at a total of 3527.26 Disability Adjusted Lost Years (DALYs), which accounted for 31.3 years lost per 100 000 inhabitants. Morbidity and mortality burden of bacterial meningitis without sequel weighing was 2056.25 disability adjusted lost years, being the 55.9 % caused by unidentified agent, followed by S. pneumoniae (30.9 %), N. meningitidis (9.5 %) and H influenza type b (3.6 %). The mortality burden was 2 039 years of life lost from premature death, that is, 57.8 % of the global burden. Children under five years of age contributed the biggest global burden of disability adjusted lost years, and S. penumoniae generated the biggest burden. Conclusion: the burden of bacterial meningitis was high. Burden of disease is an important measure to assess health problems.

Antonio E, Pérez Rodríguez; Lorenzo, de la Fuente Ricardo; Armando, Seuc Jo.

2011-12-01

311

Meningitis bacteriana por Lactococcus lactis cremoris / Bacterial meningitis caused by Lactococcus lactis cremoris  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN: Lactococcus lactis cremoris es una bacteria perteneciente a la familia Streptococcaceae que normalmente puede aislarse como parte de la microbiota transitoria o residente del tracto gastrointestinal en el ser humano. Se considera esencial en la industria alimenticia donde se emplea en [...] la fermentación de la leche para la obtención de productos derivados como el queso, yogur, mantequilla, entre otros. OBJETIVOS: este caso constituye el primer reporte de un paciente adulto sin evidencias anteriores de inmunodepresión con una meningitis bacteriana por L. lactis. MÉTODOS: se estudió la evolución del caso de una paciente de 73 años de edad, que llegó al cuerpo de guardia del hospital con un cuadro clínico sobreagudo dado por trastornos de la conducta como irritabilidad con inmediata evolución a estado de obnubilación y desorientación. Se realizó el diagnóstico microbiológico utilizando las técnicas convencionales de identificación y los estudios de sensibilidad antimicrobiana. RESULTADOS: se diagnosticó una meningitis bacteriana por L. lactis, bacteria asociada a procesos infecciosos fundamentalmente en pacientes pediátricos e inmunodeprimidos. CONCLUSIONES: el modo de transmisión de la infección es indirecto por vía oral. No se determinó el foco primario de infección a partir del cual se produjo la diseminación dentro del organismo, la cual se considera fue por vía hematógena según la localización anatómica de los sitios donde se encontraron signos de sepsis. En los datos referidos en la historia clínica de la paciente no se encontró ningún antecedente de compromiso de su inmunidad antes del cuadro clínico que motivó el ingreso. Abstract in english BACKGROUND: Lactococcus lactis cremoris is a bacteria from Streptococcaceae family that may usually be isolated as part of transient or residing microbiota in the human gastrointestinal tract. It is considered essential element in the food industry where it is used as milk fermenter to obtain byprod [...] ucts such as cheese, yoghurt, butter and others. OBJECTIVES: this is the first report of an adult patient with bacterial meningitis by L. lactis, without a previous history of immunosuppresion. METHODS: the evolution of a 73 years-old female patient, who came to the Emergency Department with a very acute clinical picture of behavioural disorders like irritability, immediately evolving into obnulation condition and lack of proper orientation. The conventional identification techniques together with the antimicrobial sensitivity studies allowed making the microbiological diagnosis. RESULTS: bacterial meningitis caused by L. lactis was diagnosed. This bacterium is linked to infectious processes mainly in pediatric and inmmunosuppresed patients. CONCLUSIONS: the mode of transmission is indirect and orally. The primary focus of infection from which the virus disseminated inside the body was not found. It was considered then that it occurred according to the anatomical location of the sites where sepsis signs were found. According to the data provided by the patient´s medical history, not a single antecedent of compromised immunity was found before appearing the above-mentioned clinical picture.

Danais, Vidal Rosell; María de los Ángeles, Fernández Ferrer; Carlos, Alfonso Sabatier.

2008-12-01

312

Meningitis bacteriana por Lactococcus lactis cremoris Bacterial meningitis caused by Lactococcus lactis cremoris  

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Full Text Available INTRODUCCIÓN: Lactococcus lactis cremoris es una bacteria perteneciente a la familia Streptococcaceae que normalmente puede aislarse como parte de la microbiota transitoria o residente del tracto gastrointestinal en el ser humano. Se considera esencial en la industria alimenticia donde se emplea en la fermentación de la leche para la obtención de productos derivados como el queso, yogur, mantequilla, entre otros. OBJETIVOS: este caso constituye el primer reporte de un paciente adulto sin evidencias anteriores de inmunodepresión con una meningitis bacteriana por L. lactis. MÉTODOS: se estudió la evolución del caso de una paciente de 73 años de edad, que llegó al cuerpo de guardia del hospital con un cuadro clínico sobreagudo dado por trastornos de la conducta como irritabilidad con inmediata evolución a estado de obnubilación y desorientación. Se realizó el diagnóstico microbiológico utilizando las técnicas convencionales de identificación y los estudios de sensibilidad antimicrobiana. RESULTADOS: se diagnosticó una meningitis bacteriana por L. lactis, bacteria asociada a procesos infecciosos fundamentalmente en pacientes pediátricos e inmunodeprimidos. CONCLUSIONES: el modo de transmisión de la infección es indirecto por vía oral. No se determinó el foco primario de infección a partir del cual se produjo la diseminación dentro del organismo, la cual se considera fue por vía hematógena según la localización anatómica de los sitios donde se encontraron signos de sepsis. En los datos referidos en la historia clínica de la paciente no se encontró ningún antecedente de compromiso de su inmunidad antes del cuadro clínico que motivó el ingreso.BACKGROUND: Lactococcus lactis cremoris is a bacteria from Streptococcaceae family that may usually be isolated as part of transient or residing microbiota in the human gastrointestinal tract. It is considered essential element in the food industry where it is used as milk fermenter to obtain byproducts such as cheese, yoghurt, butter and others. OBJECTIVES: this is the first report of an adult patient with bacterial meningitis by L. lactis, without a previous history of immunosuppresion. METHODS: the evolution of a 73 years-old female patient, who came to the Emergency Department with a very acute clinical picture of behavioural disorders like irritability, immediately evolving into obnulation condition and lack of proper orientation. The conventional identification techniques together with the antimicrobial sensitivity studies allowed making the microbiological diagnosis. RESULTS: bacterial meningitis caused by L. lactis was diagnosed. This bacterium is linked to infectious processes mainly in pediatric and inmmunosuppresed patients. CONCLUSIONS: the mode of transmission is indirect and orally. The primary focus of infection from which the virus disseminated inside the body was not found. It was considered then that it occurred according to the anatomical location of the sites where sepsis signs were found. According to the data provided by the patient´s medical history, not a single antecedent of compromised immunity was found before appearing the above-mentioned clinical picture.

Danais Vidal Rosell

2008-12-01

313

Using Relative Humidity Forecasts to Manage Meningitis in the Sahel  

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Meningitis epidemics in the Sahel occur quasi-regularly and with devastating impact. In 2008, for example, eighty-eight thousand people contracted meningitis and over five thousand died. Until very recently, the protection provided by the only available vaccine was so limited and short-lived that the only practical strategy for vaccination was reactive: waiting until an epidemic occurred in the region and then vaccinating in that region to prevent the epidemic's further growth. Even with that strategy, there were still times when demand outpaced available vaccine. While a new vaccine has recently been developed that is effective and inexpensive enough to be used more broadly and proactively, it is only effective against the strain of bacteria that causes the most common kind of bacterial meningitis. As a result, there will likely be continued need for reactive vaccination strategies. It is widely known that meningitis epidemics in the Sahel occur only in the dry season. Our project investigated this relationship, and several independent lines of evidence demonstrate a robust relationship between the onset of the rainy season, as marked by weekly average relative humidity above 40%, and the end of meningitis epidemics. These lines of evidence include statistical analysis of two years of weekly meningitis and weather data across the Sahel, cross-correlation of ten years of meningitis and weather data in the Upper East region of northern Ghana, and high-resolution weather simulations of past meningitis seasons to interpolate available weather data. We also adapted two techniques that have been successfully used in public health studies: generalized additive models, which have been used to relate air quality and health, and a linearized version of the compartmental epidemics model that has been used to understand MRSA. Based on these multiple lines of evidence, average weekly relative humidity forecast two weeks in advance appears consistently and strongly related to the number cases of meningitis in the Sahel. Using currently available forecast models contributed through the WMO Thorpex-Tigge project, and applying quantile regression to enhance their accuracy, we can forecast the average weekly relative humidity to two weeks in advance which allows us to anticipate the end of an epidemic in a region of the Sahel up to four weeks in advance. This would allow public health officials to deploy vaccines to areas in which the epidemics are likely to persist due to continued dryness and avoid vaccinating in areas where the epidemics will end with higher humidity. Our presentation will conclude by introducing the relative humidity decision-information tool developed for use by public-health officials. We will also summarize the results of a weekly meningitis forecast exercise held during the 2011-2012 dry season with public health decision makers from several African countries and the World Health Organization. Finally, we highlight some results of concurrent socio-economic research that suggests other interventions for managing meningitis and helps quantify the economic impact of the disease in Ghana. Overall, while our research has demonstrated an actionable relationship between weather and disease, this relationship is only one factor in a complex and coupled human-natural system which merits continued investigation.

Pandya, R. E.; Adams-Forgor, A.; Akweogno, P.; Awine, T.; Dalaba, M.; Dukic, V.; Dumont, A.; Hayden, M.; Hodgson, A.; Hopson, T. M.; Hugonnet, S.; Yoksas, T. C.

2012-12-01

314

Efficacy of Ceftaroline Fosamil against Escherichia coli and Klebsiella pneumoniae Strains in a Rabbit Meningitis Model  

Science.gov (United States)

In this study, the efficacy of ceftaroline fosamil was compared with that of cefepime in an experimental rabbit meningitis model against two Gram-negative strains (Escherichia coli QK-9 and Klebsiella pneumoniae 1173687). The penetration of ceftaroline into inflamed and uninflamed meninges was also investigated. Both regimens were bactericidal, but ceftaroline fosamil was significantly superior to cefepime against K. pneumoniae and E. coli in this experimental rabbit meningitis model (P ceftaroline was approximately 15% into inflamed meninges and approximately 3% into uninflamed meninges. PMID:24002097

Stucki, A.; Acosta, F.; Cottagnoud, M.

2013-01-01

315

Acute arterial occlusion - kidney  

Science.gov (United States)

Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... back. Blood clots that travel through the bloodstream ( emboli ) can lodge in the renal artery. Pieces of ...

316

Coronary artery spasm  

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Coronary artery spasm is a temporary, sudden narrowing of one of the coronary arteries (the arteries that supply blood to ... with angina (chest pain and pressure) have coronary artery spasm. Coronary artery spasm occurs most commonly in people ...

317

The risk of meningitis following expanded endoscopic endonasal skull base surgery: a systematic review.  

Science.gov (United States)

Objective?To examine the risk of postoperative meningitis following expanded endoscopic endonasal skull base (EESB) surgery. Setting?A systematic analysis of publications identified through searches of the electronic databases from Embase (1980-July 17, 2012), Medline (1950-July 17, 2012), and references of review articles. Main Outcome Measures?Incidence of meningitis following EESB surgery. Results?A total of 2,444 manuscripts were selected initially, and full-text analysis produced 67 studies with extractable data. Fifty-two contained data regarding the frequency of postoperative meningitis. The overall risk of postoperative meningitis following EESB surgery was 1.8% (36 of 2,005). For those reporting a cerebrospinal fluid (CSF) leak, meningitis occurred in 13.0% (35 of 269). For those not reporting a CSF leak, meningitis occurred in 0.1% (1 of 1,736). The odds ratio for the development of meningitis in the presence of a postoperative CSF leak was 91.99 (95% confidence interval, 11.72-721.88; p?meningitis or CSF leak between anterior and posterior cranial fossa surgery. There was one reported case of meningitis-related mortality following EESB surgery. Conclusion?The evidence in skull base surgery is limited. This study demonstrates a low incidence of meningitis (1.8%) following EESB procedures. The incidence of meningitis from EESB surgery without an associated CSF leak is uncommon. PMID:24498585

Lai, Leon T; Trooboff, Spencer; Morgan, Michael K; Harvey, Richard J

2014-02-01

318

Predictive Value of Decoy Receptor 3 in Postoperative Nosocomial Bacterial Meningitis  

Science.gov (United States)

Nosocomial bacterial meningitis requires timely treatment, but what is difficult is the prompt and accurate diagnosis of this disease. The aim of this study was to assess the potential role of decoy receptor 3 (DcR3) levels in the differentiation of bacterial meningitis from non-bacterial meningitis. A total of 123 patients were recruited in this study, among them 80 patients being with bacterial meningitis and 43 patients with non-bacterial meningitis. Bacterial meningitis was confirmed by bacterial culture of cerebrospinal fluid (CSF) culture and enzyme-linked immunosorbent assay (ELISA) was used to detect the level of DcR3 in CSF. CSF levels of DcR3 were statistically significant between patients with bacterial meningitis and those with non-bacterial meningitis (p 24 h before CSF sampling, which was much higher than that of non-bacterial meningitis. CSF leucocyte count yielded the highest diagnostic value, with an area under the receiver operating characteristic curve (ROC) of 0.928, followed by DcR3. At a critical value of 0.201 ng/mL for DcR3, the sensitivity and specificity were 78.75% and 81.40% respectively. DcR3 in CSF may be a valuable predictor for differentiating patients with bacterial meningitis from those with non-bacterial meningitis. Further studies are needed for the validation of this study. PMID:25372942

Liu, Yong-Juan; Shao, Li-Hua; Wang, Qian; Zhang, Jian; Ma, Rui-Ping; Liu, Hai-Hong; Dong, Xiao-Meng; Ma, Li-Xian

2014-01-01

319

Treatment of murine coccidioidal meningitis with SCH39304.  

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The triazole SCH39304 was compared with itraconazole and fluconazole for treatment of murine coccidioidal meningitis. Mice were treated for 30 days with 1, 5, 10, or 30 mg of each drug per kg of body weight. Survival and brain tissue counts were measured. At equivalent doses, SCH39304 was more effective than the other triazoles.

Defaveri, J.; Sun, S. H.; Graybill, J. R.

1990-01-01

320

Chronic Aspergillus sp. meningitis successfully treated with fluconazole: case report  

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We a case of chronic Aspergillus sp. meningitis in a healthy 43-year-old woman successfully treated with fluconazole given orally (300 ms/day). The diagnosis was made by detection of anti-aspergillus antibodies and positive culture to Aspergillus sp. in the cerebrospinal fluid.

MARIUSHI WAGNER MUNEMORI; ARRUDA WALTER OLESCHKO; TSUBOUCHI MÁRIO HENRIQUE; RAMINA RICARDO

1999-01-01

 
 
 
 
321

Psychrobacter sanguinis: an unusual bacterium for nosocomial meningitis.  

Science.gov (United States)

We report the first case of postneurosurgical meningitis due to Psychrobacter sanguinis, identified only by 16S rRNA analysis. Psychrobacter spp. usually live in deep sea environments and cold habitats. Despite a strict questioning of the patient and the medical staff, we did not find the source of this bacterium. PMID:24989605

Le Guern, Rémi; Wallet, Frédéric; Vega, Emmanuel; Courcol, René J; Loïez, Caroline

2014-09-01

322

Pneumococcal meningitis secondary to intra-sphenoidal encephalocoele.  

Science.gov (United States)

Basal encephalocoeles are rare congenital abnormalities of the skull base. The authors describe a rare case of spontaneous CSF leak and meningitis secondary to an intra-sphenoidal encephalocoele. Initial endoscopic transsphenoidal repair was unsuccessful, necessitating a combined subtemporal and transsphenoidal approach to close the defect. PMID:19148569

Sare, Gillian M; Varma, Anoop; Green, Kevin; Herwadkar, Amit; Gnanalingham, Kanna K

2009-01-01

323

Meningites bacterianas agudas complicações vasculares: vascular complications Bacterial meningitis  

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Os autores apresentam o estudo de quatro crianças que tiveram arterite como complicação vascular de meningite bacteriana aguda. Apresentam revisão dos mecanismos fisiopatológicos envolvidos nas alterações vasculares que têm trazido reais progressos no entendimento dessas complicações.The authors present the study of four children with arteritis as vascular complication of acute bacterial meningitis. They report pathophysiological mechanisms involved in vascular lesions, and prog...

Moura-ribeiro, Maria Valeriana L.; Rocha, Cristiane M.; Fernandes, Walter L. M.; Guerreiro, Marilisa M.

1993-01-01

324

Chronic Aspergillus sp. meningitis successfully treated with fluconazole: case report  

Directory of Open Access Journals (Sweden)

Full Text Available We a case of chronic Aspergillus sp. meningitis in a healthy 43-year-old woman successfully treated with fluconazole given orally (300 ms/day. The diagnosis was made by detection of anti-aspergillus antibodies and positive culture to Aspergillus sp. in the cerebrospinal fluid.

MARIUSHI WAGNER MUNEMORI

1999-01-01

325

Diffusion-weighted imaging in acute bacterial meningitis in infancy  

International Nuclear Information System (INIS)

Bacterial meningitis is frequently fatal or leads to severe neurological impairment. Complications such as vasculitis, resulting in infarcts, should be anticipated and dealt with promptly. Our aim was to demonstrate the complications of meningitis by diffusion weighted imaging (DWI) in patients who deteriorated despite therapy. We studied 13 infants between the ages of 1 day and 32 months who presented with symptoms ranging from fever and vomiting to seizures, encephalopathy and coma due to bacterial meningitis, performing MRI, including DWI, 2-5 days after presentation. Multiple infarcts were found on DWI in 12 of the 13, most commonly in the frontal lobes (in 10). Global involvement was seen in four children, three of whom died; the fourth had a very poor outcome. In one case abnormalities on DWI were due to subdural empyemas. We diagnosed vasculitis in three of five patients studied with MRA. We think DWI an important part of an MRI study in infants with meningitis. Small cortical or deep white-matter infarcts due to septic vasculitis can lead to tissue damage not easily recognized on routine imaging and DWI can be used to confirm that extra-axial collections represent empyemas. (orig.)

326

Ovarian small cell carcinoma complicated by carcinomatous meningitis  

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Full Text Available Meningeal metastasis is rare in the clinical course of ovarian carcinoma and its prognosis is extremely poor. We experienced a case of carcinomatous meningitis from metastatic ovarian small cell carcinoma. A 33-year-old woman with atypical genital bleeding, was diagnosed with a right ovarian tumor and referred to our department. She underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy. It was an optimal debulking surgery. She was diagnosed with ovarian carcinoma classified as Stage IIIc according to the Féderation Internationale de Gynécologie et d’Obstétrique classification system. Histological findings showed small cell carcinoma of the pulmonary type. The tumor was bilateral with paraaortic lymph node involvement. The patient was treated with irinotecan and cisplatin (CPT-P therapy. After 4 courses of CPTP therapy, multiple liver metastases and Virchow’s lymph node metastases were found. She was treated with amrubicin as a secondline chemotherapy, but the treatment was ineffective. Five months after surgery, the patient complained of severe headache and nausea. Lumbar puncture was performed and cytology was positive. Magnetic resonance brain imaging indicated meningeal thickening. The patient was diagnosed with meningeal metastasis and received 19-Gy whole cranial irradiation. In spite of these treatments, her disease progressed rapidly and she was often drowsy. She died of aspiration pneumonia 6 months after surgery.

Terukazu Ishii

2012-04-01

327

Diffusion-weighted imaging in acute bacterial meningitis in infancy  

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Bacterial meningitis is frequently fatal or leads to severe neurological impairment. Complications such as vasculitis, resulting in infarcts, should be anticipated and dealt with promptly. Our aim was to demonstrate the complications of meningitis by diffusion weighted imaging (DWI) in patients who deteriorated despite therapy. We studied 13 infants between the ages of 1 day and 32 months who presented with symptoms ranging from fever and vomiting to seizures, encephalopathy and coma due to bacterial meningitis, performing MRI, including DWI, 2-5 days after presentation. Multiple infarcts were found on DWI in 12 of the 13, most commonly in the frontal lobes (in 10). Global involvement was seen in four children, three of whom died; the fourth had a very poor outcome. In one case abnormalities on DWI were due to subdural empyemas. We diagnosed vasculitis in three of five patients studied with MRA. We think DWI an important part of an MRI study in infants with meningitis. Small cortical or deep white-matter infarcts due to septic vasculitis can lead to tissue damage not easily recognized on routine imaging and DWI can be used to confirm that extra-axial collections represent empyemas. (orig.)

Jan, W.; Zimmerman, R.A.; Bilaniuk, L.T.; Hunter, J.V.; Simon, E.M.; Haselgrove, J. [Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States)

2003-09-01

328

Prognostic indicators in bacterial meningitis: a case-control study  

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Full Text Available SciELO Brazil | Language: English Abstract in english This was a case-control study to identify prognostic indicators of bacterial meningitis in a reference hospital in Pernambuco/Brazil. The data were collected from charts of 294 patients with bacterial meningitis between January 2000 and December 2004. Variables were grouped in biological, clinical, [...] laboratory and etiologic agent/treatment. Variables selected in each step were grouped and adjusted for age. Two models were created: one containing clinical variables (clinical model) and other containing laboratory variables (laboratory model). In the clinical model the variables associated with death due to bacterial meningitis were dyspnea (p = 0.006), evidence of shock (p = 0.051), evidence of altered mental state (p = 0.000), absence of headache (p = 0.008), absence of vomiting (p = 0.052), and age >40 years old (p = 0.013). In the laboratory model, the variables associated with death due to bacterial meningitis were positive blood cultures (p = 0.073) and thrombocytopenia (p = 0.019). Identification of prognostic indicators soon after admission may allow early specific measures, like admission of patients with higher risk of death to Intensive Care Units.

Maria de Fátima Magalhães Acioly, Mendizabal; Phelipe Cunha, Bezerra; Diego Lins, Guedes; Diogo Buarque Cordeiro, Cabral; Demócrito de Barros, Miranda-Filho.

2013-10-01

329

Streptococcal Meningitis Resulting from Contact with an Infected Horse  

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We report a case of group C streptococcal meningitis in a woman with a history of close animal contact as well as head trauma as a result of a kick by a horse. Blood and cerebrospinal fluid cultures grew Streptococcus equi subsp. zooepidemicus, as did a throat culture taken from the colt that had kicked her 2 weeks prior to admission.

Downar, James; Willey, Barbara M.; Sutherland, Jeffrey W.; Mathew, Kelly; Low, Donald E.

2001-01-01

330

Bacteriological Profile of Pyogenic Meningitis in Tertiary Care Hospital, Ahmedabad  

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Full Text Available 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 from July 2010 to December 2011 included 1470 CSF samples of clinically suspected pyogenic meningitis cases in all age groups. The samples were subjected to macroscopic examination, microscopic examination, Gram’s stain and culture tests. The organisms isolated in the study were characterized by standard procedure and antibiotic susceptibility tests according to CLSI guidelines. Results: Bacterial pathogens were isolated from 205 samples showing an isolation rate of 13.94%. Gram’s stain positivity was 61.95%. Among the isolated organisms, 69.26% were gram negative bacilli and 30.74% were gram positive cocci. The most commonly isolated bacteria were K. pneumoniae (22.92% & S. aureus in 19.02%. Pyogenic meningitis was more common in paediatric patients than adults. K. pneumoniae and Enterococci spp. were most common isolated in neonatal age group. Most common organisms isolated in neurosurgical patients were Pseudomonas aeruginosa and Staphylococci aureus. 09.10% gram negative organisms were ESBLs. Only 2 Gram positive isolates were MRSA. Conclusion: The frequency of single as well as multiple drug resistance was very high among the bacterial isolates. Antibiogram study indicated that the third generation cephalosporins and aminoglycosides can be used as single or in combinations for the empirical treatment of bacterial meningitis till culture and sensitivity report is awaited. [National J of Med Res 2012; 2(3.000: 313-317

Gaurav B Modi

2012-06-01

331

Culture- and antigen-negative meningitis in Guatemalan children / Meningitis negativa a pruebas antigénicas y de cultivo en niños guatemaltecos  

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Full Text Available SciELO Public Health | Language: English Abstract in spanish OBJETIVO: Comparar los casos infantiles de meningitis bacteriana confirmada (MBC) y meningitis negativa a pruebas de látex y de cultivo (MNLC). MÉTODOS: Se evaluaron los niños de 1 a 59 meses de edad ingresados en tres grandes hospitales de referencia de la Ciudad de Guatemala entre el 1 de octubre [...] de 1996 y el 31 de diciembre de 2005 con signos clínicos de infección bacteriana. Se realizaron cultivos bacterianos y pruebas de aglutinación antigénica con látex en muestras de líquido cefalorraquídeo (LCR). RESULTADOS: La tasa de letalidad fue significativamente mayor en los 493 niños con MBC que en los 528 niños con MNLC (27,6% y 14,9%, respectivamente; P Abstract in english OBJECTIVE: To compare children with confirmed bacterial meningitis (CBM) and those with culture- and latex-negative meningitis (CLN). METHODS: Children 1 to 59 months of age admitted to three major referral hospitals in Guatemala City with clinical signs compatible with bacterial infections were eva [...] luated prospectively between 1 October 1996 and 31 December 2005. Bacterial cultures and latex agglutination antigen testing were performed on samples of cerebrospinal fluid (CSF). RESULTS: The case-fatality rate was significantly higher in the 493 children with CBM than in the 528 children with CLN (27.6% and 14.9%, respectively; P

Erica L., Dueger; Edwin J., Asturias; Neal A., Halsey.

2008-10-01

332

Meningitis bacteriana: factores de riesgo para el desarrollo de complicaciones agudas / Bacterial meningitis: risk factors for development of acute complications  

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Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Introducción. A pesar del diagnóstico precoz y del tratamiento antibiótico adecuado, la meningitis bacteriana se asocia a una alta tasa de complicaciones neurológicas y morbilidad a largo plazo. Objetivos. Estimar la incidencia de complicaciones neurológicas agudas en las meningitis bacterianas. Val [...] orar la correlación entre valores de laboratorio, la edad del paciente y complicaciones neurológicas. Población, materiales y métodos. Estudio retrospectivo. Se incluyeron pacientes de un mes a quince años de edad con diagnóstico de meningitis que ingresaron al Hospital "Dr. Pedro de Elizalde" entre enero de 2003 y noviembre de 2005. Las variables estudiadas fueron: edad de los pacientes, características citoquímicas del líquido cefalorraquídeo (LCR) obtenido por punción lumbar al ingreso: celularidad, proteinorraquia y glucorraquia, agente etiológico por aglutinación en látex en LCR, cultivo de LCR y de sangre periférica. En los análisis unifactoriales se utilizó la prueba de X², para las variables numéricas se empleó la prueba de Wilcoxon. La información se evaluó mediante un análisis multifactorial, con un modelo de regresión logística. Resultados. Se incluyeron 81 pacientes con meningitis bacteriana. Presentaron complicaciones neurológicas 18,51%, fallecieron 3,7%. La hiperproteinorraquia (p= 0,011; ?=5,68; IC 95%= 1,5-21,52), la menor edad del paciente (p= 0,022; ?=0,61; IC 95%= 0,40-0,93) y los hemocultivos positivos (p= 0,003; ?=13,22: IC 95%= 2,35-74) se asociaron a mala evolución. El S. pneumoniae se asoció con más complicaciones (p= 0,028; ?=15). Conclusión. Los hemocultivos positivos, el aumento de la proteinorraquia y la menor edad de los pacientes exhiben una asociación estadísticamente significativa con la aparición de complicaciones agudas en la meningitis bacteriana. Abstract in english Introduction. Bacterial meningitis is a severe disease. Though it is early diagnosed and proper antimicrobial therapy is indicated, neurological complications and long term morbility still occur. Objective. To update acute neurological complications incidence in bacterial meningitis. To describe the [...] relationship between laboratory tests, patient age, neurological complications and death. Population, material and methods. Patients aged one month to fifteen years old with diagnosis of meningitis admitted at Dr. Pedro de Elizalde Hospital, between January 2003 and November 2005 were analyzed. The variables applied were patients' age, cerebroespinal fluid (CSF) laboratory values obtained by lumbar puncture at hospital admission: CSF white blood cells, CSF glucose, CSF proteins, agent identification by CSF latex agglutination test, CSF culture and peripheral blood culture. Multivariate analyses was conducted using logistic regression modele. Chi squared test was used for univariate analyses. Numeric variables were analyzed by Wilcoxon test. Results. 81 patients with bacterial meningitis were included, 18.51% presented neurological complications, 3.7% died. High CSF proteins (p= 0.011; ?=5,68; CI 95%= 1,5-21,52),), younger age (p= 0.022; ?=0,61; CI 95%= 0,40-0,93) and positive blood culture (p= 0.003; ?=13,22: CI 95%= 2,35-74) were associated to worse evolution. Streptococcus pneumoniae had greater percentage of neurologic complications (p= 0.028; ?=15). Conclusion. Positive peripheral blood culture, high CSF proteins and younger age present a significative statistical association with the development of acute complications of bacterial meningitis.

María Carolina, Davenport; María de la Paz, Del Valle; Paulina, Gallegos; Ana Lucila, Kannemann; Vivian S, Bokser.

2007-10-01

333

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

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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.

Mónica Zuluaga Quintero

2010-02-01

334

Cerebral Arterial Variations Associated with Moyamoya Disease Diagnosed by MR Angiography.  

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Moyamoya disease is a rare progressive cerebrovascular steno-occlusive disease associated with different variations of the cerebral arteries. We evaluated the types and prevalence of such variations among patients with moyamoya disease. In our institution during the past seven years, we diagnosed 72 patients (24 male, 48 female; aged 6 to 75 years, mean, 42 years) with moyamoya disease by magnetic resonance (MR) angiography using either a 3-Tesla or one of two 1.5-T imagers and a standard time-of-flight technique without contrast media. An experienced neuroradiologist retrospectively reviewed the images. There were 15 cerebral arterial variations in 13 of 72 patients with moyamoya disease (18.1%), including four basilar artery fenestrations, three ophthalmic arteries arising from the middle meningeal artery, two intracranial vertebral artery fenestrations, two persistent first cervical intersegmental arteries, two persistent trigeminal arteries, one extracranial origin of the posterior inferior cerebellar artery, and one persistent stapedial artery. Although our number of patients was small, moyamoya disease was frequently associated with variations of the cerebral arteries, especially fenestrations in the vertebrobasilar system and persistent trigeminal artery. PMID:25489893

Uchino, Akira; Saito, Naoko; Takahashi, Masahiro; Kurita, Hiroki; Ishihara, Shoichiro

2014-12-01

335

Picornaviruses in cerebrospinal fluid of children with meningitis in Luanda, Angola.  

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Human enteroviruses are the most common cause of viral meningitis. Viral-bacterial interaction may affect the clinical course and outcome of bacterial meningitis. In Africa, viruses might be responsible for 14-25% of all meningitis cases. However, only few studies from Africa have reported detection of viruses in the cerebrospinal fluid (CSF) or mixed viral-bacterial infections of the central nervous system (CNS). The aim of the present study was to investigate the presence of picornaviruses in the CSF of children suffering from meningitis in Luanda, Angola. The study included 142 consecutive children enrolled in a prospective study of bacterial meningitis in Luanda between 2005 and 2006, from whom a CSF sample was available. CSF samples were obtained at hospital admission, stored in a deep-freeze, and transported to Finland for testing by real-time PCR for picornaviruses. Enteroviruses were detected in 4 (3%) of 142 children with presumed bacterial meningitis. A 5-month-old girl with rhinovirus and Haemophilus influenzae meningitis recovered uneventfully. An 8-year-old girl with human enterovirus and pneumococcal meningitis developed no sequelae. A 2-month-old girl with human enterovirus and malaria recovered quickly. A 7-month-old girl with human enterovirus was treated for presumed tuberculous meningitis and survived with severe sequelae. Mixed infections of the CNS with picornaviruses and bacteria are rare. Detection of an enterovirus does not affect the clinical picture and outcome of bacterial meningitis. PMID:22585725

Pelkonen, Tuula; Roine, Irmeli; Anjos, Elizabete; Kaijalainen, Svetlana; Roivainen, Merja; Peltola, Heikki; Pitkäranta, Anne

2012-07-01

336

An unusual case of neonatal meningococcal meningitis complicated by subdural empyema and hydrocephalus  

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Full Text Available SciELO South Africa | Language: English Abstract in english Neisseria meningitidis is a leading cause of pyogenic meningitis worldwide, as well as causing large epidemics in parts of Africa. With the dramatic decline in cases of Haemophilus influenzae B, N. meningitidis has emerged as one of the most common causes of acute bacterial meningitis in children an [...] d adults in South Africa. However, it remains an uncommon cause of meningitis in the neonatal period. Subdural empyema together with hydrocephalus has been infrequently described as a complication of meningococcal meningitis. We report a rare case of neonatal meningococcal meningitis, complicated by subdural empyema and hydrocephalus. To the best of our knowledge only a few cases of neonatal meningococcal meningitis have been reported from South Africa, with none of these cases having the complication of subdural empyema.

Y, Ramsamy; P, Mahabeer; M, Archary; R A, Bobat; Y M, Coovadia.

2013-01-01

337

MRI of primary meningeal sarcomas in two children: differential diagnostic considerations  

International Nuclear Information System (INIS)

Meningeal sarcomas are very rare, highly aggressive tumours affecting children more frequently than adults. The clinical course and MRI of meningeal sarcomas in two cases are discussed with special regard to possible misinterpretation. In one case MRI demonstrated a circumscribed mass in contact with the meninges, with central areas of haemorrhage. In the other, a case of primary leptomeningeal sarcomatosis, several MRI examinations over the course of almost a year were unhelpful, despite severe neurological complaints. Then MRI revealed meningeal contrast enhancement all over the brain and spinal canal, together with cerebral infarcts. MRI of meningeal sarcomas has not been discussed in the literature. MRI did not permit specific diagnosis, but enabled visualisation of the extent of the tumour and/or meningeal involvement. Early histological diagnosis is indispensable for adequate treatment. (orig.)

338

Population-based surveillance for bacterial meningitis in China, September 2006-December 2009.  

Science.gov (United States)

During September 2006-December 2009, we conducted active population and sentinel laboratory-based surveillance for bacterial meningitis pathogens, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b, in 4 China prefectures. We identified 7,876 acute meningitis and encephalitis syndrome cases, including 6,388 among prefecture residents. A total of 833 resident cases from sentinel hospitals met the World Health Organization case definition for probable bacterial meningitis; 339 of these cases were among children bacterial meningitis in 74 of 3,391 tested cases. The estimated annual incidence (per 100,000 population) of probable bacterial meningitis ranged from 1.84 to 2.93 for the entire population and from 6.95 to 22.30 for children bacterial meningitis cases in China, but more complete laboratory testing is needed to better define the epidemiology of the disease in this country. PMID:24377388

Li, Yixing; Yin, Zundong; Shao, Zhujun; Li, Manshi; Liang, Xiaofeng; Sandhu, Hardeep S; Hadler, Stephen C; Li, Junhong; Sun, Yinqi; Li, Jing; Zou, Wenjing; Lin, Mei; Zuo, Shuyan; Mayer, Leonard W; Novak, Ryan T; Zhu, Bingqing; Xu, Li; Luo, Huiming

2014-01-01

339

Pasteurella multocida bacterial meningitis caused by contact with pigs  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Pasteurella multocida belongs to the normal flora of the respiratory and digestive tract of many animals. Animal exposure is a considerable risk factor for Pasteurella infection. P. multocida is the most common cause of local infection after an animal bite but is an unusual cause of meningitis. We p [...] resent a case of bacterial meningitis by P. multocida in a 37-year-old man who worked in a pig farm and was bitten by a pig. The patient had a defect located in the lamina cribosa and this lesion could be the gateway of the infection, although in this case the infection could also be acquired through the pig bite. The bacteria was identified as P. multocida with the biochemical test API 20E (bioMérieux). In agreement with findings in the literature, the strain was susceptible in vitro to penicillin, ampicillin, cefotaxime, ceftriaxone ciprofloxacin, levofloxacin, imipenem and tetracycline.

C., López; P., Sanchez-Rubio; A., Betrán; R., Terré.

340

Recurrent Bacterial Meningitis in a Child with Mondini Dysplasia  

Science.gov (United States)

Mondini dysplasia, also known as Mondini malformation, is a developmental abnormality of the inner and middle ears that can cause hearing loss, cerebrospinal fluid (CSF) leakage, and recurrent bacterial meningitis (RBM), which is defined as two or more episodes of meningitis separated by a period of convalescence and the complete resolution of all signs and symptoms. An accurate diagnosis of the underlying pathology is crucial to prevent further episodes from occurring. Herein, we present a three-year-old boy with RBM and unilateral sensorineural hearing loss. During the evaluation to determine the etiology of the RBM, cystic malformation in the cochlea and vestibular dilatation consistent with Mondini dysplasia were detected via computerized tomography (CT) of the temporal bone. PMID:25431719

Kepenekli-Kadayifci, Eda; Karaaslan, Ay?e; At?c?, Serkan; Binneto?lu, Adem; Sar?, Murat; Soysal, Ahmet; Alt?nkanat, Gül?en; Bak?r, Mustafa

2014-01-01

 
 
 
 
341

[Cryptococcus meningitis in an immunocompetent child: a case report].  

Science.gov (United States)

Cryptococcus meningitis is uncommon in childhood. We report a Senegalese case of cryptococcus meningitis diagnosed in an apparently immunocompetent child. A 9-year-old boy was admitted for acute meningoencephalitis. A computerized tomography scan of the brain showed an ischemic lesion in the left caudate and study of cerebrospinal fluid (CSF) revealed cytological and biochemical abnormalities and Cryptococcus neoformans on direct exam and culture. HIV and syphilis antibodies were negative and the blood CD4 lymphocyte count was 804/mm(3). The child had no immunocompromising factors such as hematologic abnormalities, solid tumor, or undernutrition. He was treated with fluconazole intravenously, but clinical outcome was unsuccessful. The patient died after 1 month from cardiovascular and respiratory distress. PMID:20400277

Ndiaye, M; Hagerimana, R; Diagne, N S; Faye, M W; Sène, M S; Sow, A D; Sène-Diouf, F; Diop, A G; Ndiaye, M M

2010-07-01

342

Improving Decision-Making Activities for Meningitis and Malaria  

Science.gov (United States)

Public health professionals are increasingly concerned about the potential impact that climate variability and change can have on infectious disease. The International Research Institute for Climate and Society (IRI) is developing new products to increase the public health community's capacity to understand, use and demand the appropriate climate data and climate information to mitigate the public health impacts of climate on infectious disease, in particular meningitis and malaria. In this paper, we present the new and improved products that have been developed for: (i) estimating dust aerosol for forecasting risks of meningitis and (ii) for monitoring temperature and rainfall and integrating them into a vectorial capacity model for forecasting risks of malaria epidemics. We also present how the products have been integrated into a knowledge system (IRI Data Library Map Room, SERVIR) to support the use of climate and environmental information in climate-sensitive health decision-making.

Ceccato, Pietro; Trzaska, Sylwia; Garcia-Pando, Carlos Perez; Kalashnikova, Olga; del Corral, John; Cousin, Remi; Blumenthal, M. Benno; Bell, Michael; Connor, Stephen J.; Thomson, Madeleine C.

2013-01-01

343

Improving Decision-Making Activities for Meningitis and Malaria  

Science.gov (United States)

Public health professionals are increasingly concerned about the potential impact that climate variability and change can have on infectious disease. The International Research Institute for Climate and Society (IRI) is developing new products to increase the public health community's capacity to understand, use, and demand the appropriate climate data and climate information to mitigate the public health impacts of climate on infectious disease, in particular Meningitis and Malaria. In this paper we present the new and improved products that have been developed for monitoring dust, temperature, rainfall and vectorial capacity model for monitoring and forecasting risks of Meningitis and Malaria epidemics. We also present how the products have been integrated into a knowledge system (IRI Data Library Map room, SERVIR) to support the use of climate and environmental information in climate-sensitive health decision-making.

Ceccato, P.; Trzaska, S.; Perez, C.; Kalashnikova, O. V.; del Corral, J.; Cousin, R.; Blumenthal, M. B.; Connor, S.; Thomson, M. C.

2012-12-01

344

Subdural collections associated with pediatric bacterial meningitis MR imaging  

International Nuclear Information System (INIS)

To evaluate meningitis complications caused by spontaneously resolving sterile subdural (SD) effusions in children, the authors used CT and MR imaging to examine six children (age range, 2 months to 5 years) with bacterial meningitis; two patients also underwent Gadolinium-enhanced MR imaging. Seven SD collections were identified, ranging from nearly isointense (two) to hyperintense (five) relative to cerebrospinal fluid. Both collections evaluated with gadolinium enhanced markedly. Although the presence of hyperintense, enhancing SD collections might suggest that they were empyemas, all patients were clinically stable or improving. This contrasted with the acutely ill adolescents with otorhinologic-related empyemas who required immediate extensive craniotomy. Clinical factors (age, type of bacteria, severity of illness) might be more helpful than MR features to assess clinical status and surgical requirements

345

Cryptococcal meningitis with an antecedent cutaneous Cryptococcal lesion.  

Science.gov (United States)

Cutaneous cryptococcosis, caused by an encapsulated yeast, Cryptococcus neoformans, is generally associated with concomitant systemic infection. Here we report a case of primary cutaneous cryptococcosis with spread to central nervous system in an HIV seronegative young boy. In the present case, a 17-year-old boy who was suffering from a non-healing ulcer on his right great toe for 5 months, presented with the signs and symptoms of meningitis. Cryptococcus neoformans var. gattii was isolated from the CSF of the patient. Amphotericin B administration produced recovery from the meningitis as well as from the ulcer. This case study suggests that primary cutaneous cryptococcosis can be diagnosed provisionally by a simple Gram stained smear and India ink examination in order to avoid occurrence of disseminated cryptococcosis, including meningial involvement, which may have a fatal outcome. PMID:19930999

Tilak, Ragini; Prakash, Pradyot; Nigam, Chaitanya; Tilak, Vijai; Gambhir, I S; Gulati, A K

2009-01-01

346

Prevalence and antimicrobial resistance pattern of bacterial meningitis in Egypt  

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Abstract Infectious diseases are the leading cause of morbidity and mortality in the developing world. In Egypt bacterial diseases constitute a great burden, with several particular bacteria sustaining the leading role of multiple serious infections. This article addresses profound bacterial agents causing a wide array of infections including but not limited to pneumonia and meningitis. The epidemiology of such infectious diseases and the prevalence of Streptococcus pneumoniae, ...

Shaban Lamyaa; Siam Rania

2009-01-01

347

Meningitis by Toxocara canis after Ingestion of Raw Ostrich Liver  

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Recently reports on toxocariasis are increasing by serodiagnosis in Korea. A previously healthy 17-yr-old boy complained of headache, fever, dyspnea, and anorexia. He showed symptoms and signs of eosinophilic meningitis with involvement of the lungs and liver. Specific IgG antibody to Toxocara canis larval antigen was positive in serum and cerebrospinal fluid by ELISA. He took raw ostrich liver with his parents 4 weeks before the symptom onset. His parents were seropositive for T. canis antig...

Noh, Young; Hong, Sung-tae; Yun, Ji Young; Park, Hong-kyun; Oh, Jung-hwan; Kim, Young Eun; Jeon, Beom S.

2012-01-01

348

Multi Drug Resistant Tuberculous Meningitis in Pediatric Age Group  

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Objective: Past decade has seen increase in cases of tuberculous meningitis (TBM) and multidrug resistance in such cases. The mortality rate for a mismanaged TBM is very high which increases manifold in presence of associated complicating factors. The present study was thus planned to evaluate the prevalence of MDR-TBM and look for associated complicating factors and carry out drug sensitivity pattern in all culture positive isolates. Methods: One hundred cerebro-spinal fluid (CSF) samples fr...

Bibek Talukdar; Monica Chaudhary; Manisha Jain; Vidyanidhi Gumma; Chander Prakash Baveja; Vinay Kumar Sharma

2008-01-01

349

Gene expression in cortex and hippocampus during acute pneumococcal meningitis  

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Full Text Available Abstract Background Pneumococcal meningitis is associated with high mortality (~30% and morbidity. Up to 50% of survivors are affected by neurological sequelae due to a wide spectrum of brain injury mainly affecting the cortex and hippocampus. Despite this significant disease burden, the genetic program that regulates the host response leading to brain damage as a consequence of bacterial meningitis is largely unknown. We used an infant rat model of pneumococcal meningitis to assess gene expression profiles in cortex and hippocampus at 22 and 44 hours after infection and in controls at 22 h after mock-infection with saline. To analyze the biological significance of the data generated by Affymetrix DNA microarrays, a bioinformatics pipeline was used combining (i a literature-profiling algorithm to cluster genes based on the vocabulary of abstracts indexed in MEDLINE (NCBI and (ii the self-organizing map (SOM, a clustering technique based on covariance in gene expression kinetics. Results Among 598 genes differentially regulated (change factor ? 1.5; p ? 0.05, 77% were automatically assigned to one of 11 functional groups with 94% accuracy. SOM disclosed six patterns of expression kinetics. Genes associated with growth control/neuroplasticity, signal transduction, cell death/survival, cytoskeleton, and immunity were generally upregulated. In contrast, genes related to neurotransmission and lipid metabolism were transiently downregulated on the whole. The majority of the genes associated with ionic homeostasis, neurotransmission, signal transduction and lipid metabolism were differentially regulated specifically in the hippocampus. Of the cell death/survival genes found to be continuously upregulated only in hippocampus, the majority are pro-apoptotic, while those continuously upregulated only in cortex are anti-apoptotic. Conclusion Temporal and spatial analysis of gene expression in experimental pneumococcal meningitis identified potential targets for therapy.

Wittwer Matthias

2006-06-01

350

Tuberculous meningitis in BCG vaccinated and unvaccinated children  

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Background: A modified clinical presentation of tuberculous meningitis (TBM) in children vaccinated with BCG has been described in the literature. However, most reports are old and not based on actual comparisons and tests of significance. Also, neuroimaging features were not compared. With large scale BCG coverage, it becomes pertinent to describe the "modified" presentation and identify any significant differences between vaccinated and unvaccinated children with TBM.

Kumar, R.; Dwivedi, A.; Kumar, P.; Kohli, N.

2005-01-01

351

Management of Paradoxical Response in Pediatric Tubercular Meningitis with Methylprednisolone  

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Paradoxical response to anti-tubercular drugs remains a diagnostic dilemma. In India where tuberculosis is quite prevalent, paradoxical response to anti-tubercular treatment (ATT) is either misdiagnosed or under-diagnosed. We report two cases of optochiasmatic arachnoiditis due to paradoxical response in children suffering from tuberculous meningitis. Visual acuity was recorded as no light perception in all eyes of both patients while they were taking 4-drug ATT (isoniazid, rifampicin, pyrazi...

Nema, Nitin; Verma, Abha; Singh, Kuldeep; Mehar, Virendra

2014-01-01

352

A review of tuberculous meningitis in a Canadian pediatric hospital  

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Tuberculous meningitis is a disease associated with high morbidity and mortality. Experience with this disease at the Hospital for Sick Children in Toronto was reviewed to determine whether changes in prognosis have occurred in the past decade. All patients from whom the organism was recovered from the cerebrospinal fluid, or who had a positive Mantoux test in association with a compatible history, were included. Thirteen patients were identified from 1978 to 1989. The median age was six year...

Navas, Lissette; Wang, Elaine

1991-01-01

353

TRAIL limits excessive host immune responses in bacterial meningitis  

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Apart from potential roles in anti-tumor surveillance, the TNF-related apoptosis-inducing ligand (TRAIL) has important regulatory functions in the host immune response. We studied antiinflammatory effects of endogenous and recombinant TRAIL (rTRAIL) in experimental meningitis. Following intrathecal application of pneumococcal cell wall, a TLR2 ligand, we found prolonged inflammation, augmented clinical impairment, and increased apoptosis in the hippocampus of TRAIL–/– mice. Administration...

Hoffmann, O.; Priller, J.; Prozorovski, T.; Schulze-topphoff, U.; Baeva, N.; Lunemann, J. D.; Aktas, O.; Mahrhofer, C.; Stricker, S.; Zipp, F.; Weber, J. R.

2007-01-01

354

Characteristics of acute bacterial meningitis in Southeast Turkey  

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BACKGROUND: Acute bacterial meningitis (ABM) remains a significant worldwide cause of death in adults. Even in the antibiotic era, the mortality rate in ABM remains significant and has been reported in the range of 8-40%. AIM: The aim of this study was to assess the characteristics of epidemiology, clinical manifestations, treatment modalities and outcome of patients with ABM in Southeast Turkey. SETTINGS AND DESIGN: This retrospective study included all cases of community-acquired ABM...

Celal Ayaz; Faruk Geyik Mehmet; Salih Hosoglu; Kemal Celen Mustafa; Serife Akalin; Faruk Kokoglu Omer

2004-01-01

355

Cerebral malaria versus bacterial meningitis in children with impaired consciousness.  

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Cerebral malaria (CM) and acute bacterial meningitis (ABM) are the two common causes of impaired consciousness in children presenting to hospital in sub-Sahara Africa. Since the clinical features of the two diseases may be very similar, treatment is often guided by the initial laboratory findings. However, no detailed studies have examined the extent to which the laboratory findings in these two diseases may overlap. We reviewed data from 555 children with impaired consciousness admitted to K...

Berkley, JA; Mwangi, I.; Mellington, F.; Mwarumba, S.; Marsh, K.

1999-01-01

356

Ventricular Pneumocephalus with Meningitis after Lumbar Nerve Root Block  

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Lumbar nerve root block is a common modality used in the management of radiculopathy. Its complications are rare and usually minor. Despite its low morbidity, significant acute events can occur. Pneumocephalus is an accumulation of air in the intracranial space. It indicates a violation of the dura or the presence of infection. The object of this report is to describe the case of a patient with intraventricular pneumocephalus and bacterial meningitis after lumbar nerve root block. A 70-year-o...

Shin Ahn; Young Sang Ko; Kyung Soo Lim

2013-01-01

357

Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitis  

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We report the case of a 17-year-old male on long-term steroid therapy for minimal lesion glomerulopathy who, after an upper respiratory infection, presented with Haemophilus influenzae type b meningitis. Twenty-four hours later he developed depression of consciousness which progressed to coma and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple lesions (hyperintense on T2 and slightly hypointense on Tl) involving mainly white matter suggestive of inflammation. MRI fe...

Beleza, P.; Ribeiro, M.; Pereira, J.; Jorda?o, Mj; Almeida, F.

2008-01-01

358

Meningites bacterianas agudas complicações vasculares: vascular complications Bacterial meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available Os autores apresentam o estudo de quatro crianças que tiveram arterite como complicação vascular de meningite bacteriana aguda. Apresentam revisão dos mecanismos fisiopatológicos envolvidos nas alterações vasculares que têm trazido reais progressos no entendimento dessas complicações.The authors present the study of four children with arteritis as vascular complication of acute bacterial meningitis. They report pathophysiological mechanisms involved in vascular lesions, and progress in the understanding of these complications.

Maria Valeriana L. Moura-Ribeiro

1993-11-01

359

Evaluation of aztreonam in experimental bacterial meningitis and cerebritis.  

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Aztreonam (SQ 26,776), a new monocyclic beta-lactam agent, was compared with ampicillin, ampicillin plus chloramphenicol, and gentamicin in rabbits with experimental meningitis induced by, respectively, ampicillin-susceptible Haemophilus influenzae, ampicillin-resistant H. influenzae, and Escherichia coli. Aztreonam was also compared with gentamicin in experimentally induced E. coli cerebritis in rats. Doses of the various agents were delivered that produced near-peak concentrations in serum ...

Scheld, W. M.; Brodeur, J. P.; Gratz, J. C.; Foresman, P.; Rodeheaver, G.

1983-01-01

360

Molecular Detection of Common Bacterial Pathogens Causing Meningitis  

Directory of Open Access Journals (Sweden)

Full Text Available "nBackground: The clinical diagnosis of meningitis is crucial, particularly in children. The early diagnosis and empiric an­tibi­otic treatments have led to a reduction in morbidity and mortality rates. PCR and the enzymatic digestion of 16SrDNA frag­ment which is produced by universal primers led up fast and sensitive determination. The purpose of this study was to investi­gate a rapid method for detection of common bacterial pathogens causing meningitis."nMethods: According to the gene encoding 16SrDNA found in all bacteria, a pair of primers was designed. Then the univer­sal PCR was performed for bacterial agents of meningitis (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influ­enzae, etc. by employing broad- range DNA extraction method. The ob­tained uni­versal PCR products were digested with restriction enzymes (HaeIII, AluI and MnlI to identify bacterial species. "nResults: By the enzymatic digestion of the universal products of each standard strain of the above bacteria, specific patterns were achieved. These specific patterns may be used for comparison in CSF examination. The analytical sensitivity of the as­say was approximately 1.5´102 CFU/ml of CSF even in samples with high amount of proteins. Conclusion: The universal PCR coupled with enzymatic digestion can be used to detect and identify bacterial pathogens in clini­cal specimens rapidly and accurately. Molecular diagnostic of bacterial meningitis, though expensive and labor-inten­sive, but is valuable and critical in patient management.

H Sadighian

2009-03-01

 
 
 
 
361

Otogene Meningitis bei ossären Dehiszenzen des Tegmen tympani  

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Einleitung: Obwohl spontane knöcherne Dehiszenzen im Bereich des Tegmen tympani beim Erwachsenen in Einzelfällen vorliegen, kommt es nur selten zu symptomatischen Verläufen. Eine Meningitis auf dem Boden einer akuten Otitis media oder Mastoiditis kann den ersten Hinweis auf eine solche Normvariante liefern. Methoden: In einer retrospektiven Analyse berichten wir über zwei Patienten mit Pneumokokkenmeningitis. Ursächlich war in beiden Fällen ossäre Dehiszenzen im Bereich des Tegm...

Thiele, A.; Ko?sling, S.; Mu?ller, T.; Neumann, K.; Knipping, S.

2009-01-01

362

Neonatal Meningitis: Clinical and Bacteriologic Findings in 120 Patients  

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In this retrospective study, clinical signs and bacteriological findings in 120 neonates (82 males, 38 female) with meningitis have been evaluated. 60 were premature and 60 full term infants. Clinical signs consisted of weak neonatal reflexes in 86 neonates (70%), poor feeding 62 (41%), jaundice 41 (34%), fever 29 (24%), apnea 19 (16%), restlessness 18 (15%), respiratory distress 14 (11%), vomiting 10 (8%) and abdominal distension 8 (7%). The signs of central nervous system involvement were o...

Sh, Behjati

2000-01-01

363

Role of cerebrospinal fluid IL-8 as a marker for differentiation between acute bacterial and aseptic meningitis.  

Science.gov (United States)

No doubt, the distinguishing between bacterial and aseptic meningitis in the emergency department could help to limit unnecessary antibiotic use and hospital admissions. This study evaluated the role of cerebrospinal fluid IL-8 in differentiating acute bacterial meningitis (ABM) from aseptic meningitis (AM). A total of 80 hospitalized patients with clinical presentations of suspected acute meningitis were subjected to estimation of IL-8 CSF concentrations. The results showed that CSF IL-8 levels were higher in acute bacterial meningitis than in aseptic ones (p bacterial meningitis was 3.6 ng/ml with a sensitivity of 82.5% and a specificity of 85.0%. PMID:24961026

Abdelmoez, Amal Tohamy; Zaky, Doaa Zakaria; Maher, Amany M

2014-04-01

364

Coronary Artery Bypass Graft  

Science.gov (United States)

Coronary Artery Bypass Graft Introduction Sometimes people have serious problems with their heart and the arteries that go into it. Coronary artery bypass graft surgery, or CABG, bypasses clogged arteries in the ...

365

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available Coronary Artery Bypass Graft Introduction Sometimes people have serious problems with their heart and the arteries that go into it. Coronary artery bypass graft surgery, or CABG, bypasses clogged arteries in the ...

366

Relative Frequency of Enteroviruses in Children With Aseptic Meningitis Referred to Aboozar Hospital in Ahvaz  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Human Enteroviruses are members of the Picornaviridae family, they are nonenveloped,with icosahedral symmetry, positive RNA viruses and causes aseptic meningitis in both infants and adults.Objectives: The aim of this study was to determine the relative frequency of Enteroviral meningitis among children referred to Ahvaz Aboozar hospital.Patients and Methods: 57 Cerebrospinal fluid samples were collected from patients with aseptic meningitis and White Blood Cell (WBC) count of more...

Mojtaba Rasti; Ali Reza Samarbaf-Zadeh; Manoochehr Makvandi; Ahmad Shamsi-Zadeh

2012-01-01

367

A simple kit system for rapid diagnosis of cerebrospinal meningitis in rural areas of developing countries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A simple, easily operated, portable diagnostic kit, employing coagglutination reagents, has been developed for the rapid, bedside diagnosis of cerebrospinal meningitis. Field trials using this kit were conducted in a rural area of sub-Saharan Africa for identifying the etiological agents of meningitis outbreaks. West African village medical attendants were taught to use this kit and succeeded in making rapid specific diagnoses of meningitis cases. Other acute infections such as cholera and ty...

Sanborn, Warren R.; Toure?, Isak M.

1984-01-01

368

Spinal meningeal melanocytoma with benign histology showing leptomeningeal spread: Case report  

International Nuclear Information System (INIS)

Meningeal melanocytoma is a rare benign tumor with relatively good prognosis. However, local aggressive behavior of meningeal melanocytoma has been reported, especially in cases of incomplete surgical resection. Malignant transformation was raised as possible cause by prior reports to explain this phenomenon. We present an unusual case of meningeal melanocytoma associated with histologically benign leptomeningeal spread and its subsequent aggressive clinical course, and describe its radiological findings.

369

Spinal meningeal melanocytoma with benign histology showing leptomeningeal spread: Case report  

Energy Technology Data Exchange (ETDEWEB)

Meningeal melanocytoma is a rare benign tumor with relatively good prognosis. However, local aggressive behavior of meningeal melanocytoma has been reported, especially in cases of incomplete surgical resection. Malignant transformation was raised as possible cause by prior reports to explain this phenomenon. We present an unusual case of meningeal melanocytoma associated with histologically benign leptomeningeal spread and its subsequent aggressive clinical course, and describe its radiological findings.

Kim, Ok Hwa; Kim, Seon Jeong; Choo, Hye Jung; Lee, Sun Joo; Kim, Ji Yeon; Kim, Hoon [Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Lee, In Sook [Dept. of Radiology, Busan National University Hospital, Busan (Korea, Republic of)

2013-06-15

370

Twelve year outcomes following bacterial meningitis: further evidence for persisting effects  

Digital Repository Infrastructure Vision for European Research (DRIVER)

AIM—To determine whether intellectual and cognitive impairments observed seven years following early childhood bacterial meningitis persist into adolescence.?METHODS—Blinded neuropsychological, auditory, and behaviour assessments were conducted in 109 (69%) subjects from an original cohort of 158 children, seven and 12 years after their meningitis, and in 96controls.?RESULTS—Meningitis subjects remained at greater risk than controls for any disability (odds ratio ...

Grimwood, K.; Anderson, P.; Anderson, V.; Tan, L.; Nolan, T.

2000-01-01

371

Epidemics of viral meningitis caused by echovirus 6 and 30 in Korea in 2008  

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Abstract Background Enteroviruses (EVs) are the leading cause of aseptic meningitis, which is the most frequent central nervous system infection worldwide. We aimed to characterize the EVs involved in an aseptic meningitis outbreak in Korea in 2008. In Korea, Echovirus type 30 (E30) and E6 have been associated with outbreaks and frequent meningitis. Methods During 2008, through nationwide surveillance, we collected specimens from 758 patients with aseptic mening...

Kim Hye-Jin; Kang Byounghak; Hwang Seoyeon; Hong Jiyoung; Kim Kisang; Cheon Doo-Sung

2012-01-01

372

Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

BACKGROUND: The diagnosis of tuberculous meningitis is difficult. Discrimination of cases from those of bacterial meningitis by clinical features alone is often impossible, and current laboratory methods remain inadequate or inaccessible in developing countries. We aimed to create a simple diagnostic aid for tuberculous meningitis in adults on the basis of clinical and basic laboratory features. METHODS: We compared the clinical and laboratory features on admission of 251 adults at an infecti...

Thwaites, GE; Chau, Tt; Stepniewska, K.; Phu, Nh; Chuong, Lv; Sinh, Dx; White, Nj; Parry, Cm; Farrar, Jj

2002-01-01

373

Phenotypic Characterization and Antibiogram of CSF Isolates in Acute Bacterial Meningitis  

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Context: Acute bacterial meningitis (ABM) is a medical emergency, which warrants an early diagnosis and an aggressive therapy. Despite the availability of potent newer antibiotics, the mortality rate caused by acute bacterial meningitis remains significantly high in India and in other developing countries, which ranges from 16 - 32%. There is a need of a periodic review of bacterial meningitis worldwide, since the pathogens which are responsible for the infection may vary with time, geography...

Modi, Syamal; Anand, Amit Kumar

2013-01-01

374

Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis  

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AIMS: To determine the level of serum procalcitonin and cerebrospinal fluid cytokines in children with bacterial or viral meningitis and to document the use of these parameters in differential diagnosis. RESULTS: Before the start of antibiotic treatment, serum procalcitonin and tumor necrosis factor alpha levels were found to be higher in acute bacterial meningitis compared with viral meningitis and with the control group. Similarly, cerebrospinal fluid interleukin-6 levels were found to be s...

Denizmen Aygun, A.; Handan Akbulut; Mehmet K?l?c; Mehmet Turgut; Erdal Task?n

2004-01-01

375

Study of Antibiotics Resistance in Pediatric Acute Bacterial Meningitis with E-Test Method  

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Background: Appropriate treatment of bacterial meningitis especially in children is a important problem due to multiple drug resistance. The determination MIC of conventional antibiotics for bacterial meningitis with quantitative E. test is exactly practical and essential. We studied MIC of conventional antibiotics in pediatric acute bacterial meningitis older than two months, center children hospital, 1382-1384. Methods: In this prospective and cross sectional process research we measured MI...

Aligholi, M.; Pourakbari, B.; Sr, Tabatabaei; Fb, Hashemi; Siadati, A.; Noorbakhsh, S.; Mamaishi, S.; Ar, Fahimzad; Abedini, M.

2006-01-01

376

Spontaneous gram-negative bacillary meningitis in adult patients : characteristics and outcome  

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Background: Spontaneous meningitis caused by gram-negative bacilli in adult patients is uncommon and poorly characterized. Our objective is to describe and compare the characteristics and the outcome of adult patients with spontaneous gram-negative bacilli meningitis (GNBM) and spontaneous meningitis due to other pathogens. Methods: Prospective single hospital-based observational cohort study conducted between 1982 and 2006 in a university tertiary hospital in Barcelona (Spain). The Main Outc...

Pomar, Virginia

2013-01-01

377

Cytokine-induced meningitis is dramatically attenuated in mice deficient in endothelial selectins.  

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Leukocyte accumulation in cerebrospinal fluid and disruption of the blood-brain barrier are central components of meningitis and are associated with a poor prognosis. Genetically engineered deficiencies or functional inhibition of endothelial leukocyte adhesion receptors P-, or P- plus E-selectins, lead to deficits in leukocyte rolling and extravasation. However, their impact on meningeal inflammation has not been tested previously. An acute cytokine-induced meningitis model associated with s...

Tang, T.; Frenette, P. S.; Hynes, R. O.; Wagner, D. D.; Mayadas, T. N.

1996-01-01

378

Indicators of acute bacterial meningitis in children at a rural Kenyan district hospital.  

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OBJECTIVE: Acute bacterial meningitis remains an important cause of death and neurologic sequelae in African children. The clinical features of meningitis are often nonspecific and in this setting may overlap with those of malaria. Early diagnosis and appropriate antibiotic treatment are perhaps the most important steps in management, but published data suggest that fewer than half of the cases of childhood meningitis are identified at first assessment in hospitals in this region. The objecti...

Berkley, JA; Versteeg, Ac; Mwangi, I.; Lowe, Bs; Newton, CR

2004-01-01

379

Bacterial Cytolysin during Meningitis Disrupts the Regulation of Glutamate in the Brain, Leading to Synaptic Damage  

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Streptococcus pneumoniae (pneumococcal) meningitis is a common bacterial infection of the brain. The cholesterol-dependent cytolysin pneumolysin represents a key factor, determining the neuropathogenic potential of the pneumococci. Here, we demonstrate selective synaptic loss within the superficial layers of the frontal neocortex of post-mortem brain samples from individuals with pneumococcal meningitis. A similar effect was observed in mice with pneumococcal meningitis only when the bacteria...

Wippel, Carolin; Maurer, Jana; Fo?rtsch, Christina; Hupp, Sabrina; Bohl, Alexandra; Ma, Jiangtao; Mitchell, Timothy J.; Bunkowski, Stephanie; Bru?ck, Wolfgang; Nau, Roland; Iliev, Asparouh I.

2013-01-01

380

Cat scratch disease complicated with aseptic meningitis and neuroretinitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

2008-04-01

 
 
 
 
381

Carcinomatous meningitis appearing as acoustic neuromas. Two cases  

International Nuclear Information System (INIS)

Background: For acoustic neuromas, stereotactic radiotherapy (radiosurgery or stereotactic fractionated radiotherapy) has been established as an important alternative to microsurgery. In most cases initial symptoms are slow progression of unilateral hearing loss, tinnitus or vertigo or acute hearing loss with vertigo. MRI scan shows a contrast-enhancing tumor within the inner auditory channel. If the patient undergoes primary radiotherapy, diagnosis is usually not verified histologically. Therefore, careful evaluation of the medical history is mandatory despite a typical appearance on the MRI scan. If medical history does not match with acoustic neuroma, further diagnostics are necessary to rule out infectious disease or carcinomatous meningitis. Case Report: Two patients with hearing loss, vertigo and the diagnosis of acoustic neuromas by MRI scan were referred for radiotherapy. In both cases the symptoms progressed very rapidly, not typical of acoustic neuromas, and in both patients repeated liquor puncture finally revealed carcinomatous meningitis. One patient died during therapy; in the second patient intrathecal chemotherapy and additional radiotherapy of the skull base led to partial remission continuing for several months. Conclusion: Before primary radiotherapy of small intrameatal lesions diagnosis must be reassessed carefully. This is especially true for bilateral lesions suspicious for acoustic neuromas and rapid progression and persistence of clinical sympogression and persistence of clinical symptoms where carcinomatous meningitis has to be taken into account. (orig.)

382

Antibiotic Therapy in Pyogenic Meningitis in Paediatric Patients  

International Nuclear Information System (INIS)

Objective: To isolate and identify the causative pathogen, antibiotic sensitivity testing and success rate of empirical antibiotic therapy in pyogenic meningitis. Study Design: Analytical study. Place and Duration of Study: The Children's Hospital and Institute of Child Health, Lahore, Pakistan, from March to July 2012. Methodology: The study was performed on 72 culture positive meningitis cases in children less than 15 years of age. This therapy was evaluated by monitoring the patient's clinical picture for 14 - 21 days. The collected data was analyzed by Chi-square test. Results: Seventeen different bacteria were isolated. The most commonly occurring bacteria were coagulase negative Staphylococci (25%), E. coli (12.5%), Klebsiella pneumoniae (8.3%), Streptococcus pneumoniae (8.3%) and Pseudomonas aeruginosa (8.3%). All the bacteria were sensitive to vancomycin (96.7%), meropenem (76.7%), amikacin (75%), ciprofloxacin (65.3%), chloramphenicol (46.5%), ceftazidime (44.2%), cefepime (41.9%), co-amoxiclav (38.0%), oxacillin (34.8%), cefotaxime (21.4%), penicillin (20.7%), ceftriaxone (18.6%), cefuroxime (14%) and ampicillin (6.9%). The combination of sulbactam and cefoperazone showed antimicrobial sensitivity of 81.4%. The success rate of empirical antibiotic therapy was 91.7%. Conclusion: It was found that Gram negative bacteria were the major cause of pyogenic meningitis. Mostly there were resistant strains against all commonly used antibiotics except vancomycin. All empirical antibiotic therapies were found to be most successful. (author)

383

[Cryptococcal meningitis in children: description of 3 cases].  

Science.gov (United States)

Cryptococcal meningitis is much less common in children than adults. The purpose of this report is to describe 3 cases of cryptococcal meningitis observed in children admitted to the Neurology Department of the Fann University Hospital Center in Dakar, Senegal between July 2003 and November 2008. There were 2 girls whose ages were 8 and 15 years and one 9-year-old boy. All 3 patients presented acute or chronic meningoencephalitis. Diagnosis was based on direct microscopic examination of India ink preparations of cerebrospinal fluid (CSF) showing Cryptococcus neoformans at direct exam. Two patients were immunocompromised including one presenting severe protein-caloric malnutrition and one infected by HIV-1. The third patient was immunocompetent. All 3 patients were treated by intravenous Fluconazole. The immunocompetent boy died after 1 month of hospitalization due to cardiovascular and respiratory insufficiency. Both girls survived with severe neurosensory sequels. Cryptococcal meningitis that is relatively frequent in adulthood may be underestimated in children and should be tested for in any children presenting meningoencephalitis of undetermined cause. PMID:21695878

Ndiaye, M; Diagne, N R; Seck, L B; Sow, A D; Sène, M S; Diop, A G; Sow, H D; Ndiaye, M M

2011-04-01

384

Carcinomatous meningitis appearing as acoustic neuromas. Two cases  

Energy Technology Data Exchange (ETDEWEB)

Background: For acoustic neuromas, stereotactic radiotherapy (radiosurgery or stereotactic fractionated radiotherapy) has been established as an important alternative to microsurgery. In most cases initial symptoms are slow progression of unilateral hearing loss, tinnitus or vertigo or acute hearing loss with vertigo. MRI scan shows a contrast-enhancing tumor within the inner auditory channel. If the patient undergoes primary radiotherapy, diagnosis is usually not verified histologically. Therefore, careful evaluation of the medical history is mandatory despite a typical appearance on the MRI scan. If medical history does not match with acoustic neuroma, further diagnostics are necessary to rule out infectious disease or carcinomatous meningitis. Case Report: Two patients with hearing loss, vertigo and the diagnosis of acoustic neuromas by MRI scan were referred for radiotherapy. In both cases the symptoms progressed very rapidly, not typical of acoustic neuromas, and in both patients repeated liquor puncture finally revealed carcinomatous meningitis. One patient died during therapy; in the second patient intrathecal chemotherapy and additional radiotherapy of the skull base led to partial remission continuing for several months. Conclusion: Before primary radiotherapy of small intrameatal lesions diagnosis must be reassessed carefully. This is especially true for bilateral lesions suspicious for acoustic neuromas and rapid progression and persistence of clinical symptoms where carcinomatous meningitis has to be taken into account. (orig.)

Astner, S.T.; Nieder, C.; Grosu, A.L. [Technical Univ. of Munich (Germany). Dept. of Radiation Oncology; Stock, K. [Technical Univ. of Munich (Germany). Dept. of Internal Medicine; Gaa, J. [Technical Univ. of Munich (Germany). Dept. of Radiology

2007-05-15

385

Progress towards meningitis prevention in the conjugate vaccines era  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Acute bacterial meningitis is an important cause of morbidity and mortality among children less than five years old. Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis are the most important agents of bacterial meningitis in developing countries. The development of the conju [...] gate vaccines in the beginning of the 90's, especially type b H. influenzae (Hib), and more recently the heptavalent pneumococcal and the serogroup C meningococcal vaccines, have contributed directly to changes in the epidemiological profile of these invasive diseases (direct effect) and of their carriage status (indirect effect). We review the impact of the Hib conjugate vaccine in Latin American countries, where this vaccine has been implemented, and the potential of pneumococcal and meningococcal conjugate vaccines for the reduction of meningitis worldwide. We also address constraints for the development and delivery of these vaccines and review new candidate state-of-the-art vaccines. The greatest challenge, undoubtedly, is to implement these vaccines worldwide, especially in the developing regions.

Cristina Aparecida Borges, Laval; Fabiana Cristina, Pimenta; João Guimarães de, Andrade; Soraya S., Andrade; Ana Lucia S. S. de, Andrade.

2003-10-01

386

Meningeal carcinomatosis as the initial manifestation of a gallbladder adenocarcinoma associated with a Krukenberg tumor  

Directory of Open Access Journals (Sweden)

Full Text Available A case of malignant neoplasm is described in which the initial manifestations were mental dysfunction and meningeal irritation, mimicking chronic or subacute meningitis. Physical examination showed cranial nerve involvement and a pelvic tumor. There was progressive deterioration, and death occurred in 2 weeks. The autopsy revealed a gallbladder adenocarcinoma, meningeal carcinomatosis, and ovarian metastasis presenting as a Krukenberg tumor. The authors emphasize the importance of including meningeal carcinomatosis as a possibility in the differential diagnosis of non-characteristic clinical pictures, as well as the importance of the cerebrospinal fluid cytologic examination, repeated as needed, in order to confirm this diagnosis.

Miyagui Tizuko

2003-01-01

387

An unusual case of E coli meningitis in a patient with Marfan's syndrome.  

Science.gov (United States)

Spontaneous non-traumatic Escherichia coli meningitis is very rare in adults. We report a case of a 48-year-old woman with Marfan's syndrome with E coli meningitis. Apparently, the relation between an increased risk of meningitis and Marfan's syndrome is not well known. This patient was discharged on intravenous antibiotic therapy after a diagnosis of E coli meningitis without looking for the cause by imaging studies previously. Her blood cultures were negative ruling out haematogenous spread. Our work-up revealed extensive dural ectasia with intrasacral meningoceles extending into the pelvis possibly acting as a portal of entry for the bacteria into the brain from the gastrointestinal tract. PMID:23462652

Kangath, Raghesh Varot; Midturi, John

2013-01-01

388

Meningitis simultánea por candida y tuberculosis como debut de sida / Simultaneous meningitis caused by candida and tuberculosis as AIDS manifestation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Las meningoencefalitis por gérmenes oportunistas ocupan un lugar importante dentro de la patología neurológica del sida. Treponema pallidum y Mycobacterium tuberculosis dentro de las baceterias, Crytptococcus neoformans dentro de los hongos, Toxoplasma gondii dentro de los protozoos y el Papovavirus [...] JC dentro de los virus, son los gérmenes más frecuentes dentro de cada grupo. Con cierta frecuencia las infecciones son mixtas, tal como ocurrió en el caso que se presenta de meningitis simultánea por Candida albicans y Mycobacterium tuberculosis, que cursó con pleocitosis neutrófila y normoglucorraquia, constituyendo la primera manifestación de un sida. El estudio secuencial del LCR es clave para el diagnóstico de estos casos, que, pese a su gravedad, pueden tener un tratamiento efectivo, tal como ocurrió en el que se describe. Es el primer caso descrito de meningitis simultánea candidiásica y tuberculosa en paciente portador de VIH. Abstract in english Opportunistic germs meningoencephalitis plays an important role within neurologic pathology in aids. Treponema pallidum and Mycobacterium tuberculosis among bacteries, Cryptococcus neoformans in fungus group, Toxoplasma gondii in protozoos group and Papovavirus JC in virus one are the most frequentl [...] y implicated germs. Sometimes infections are mixed. We present a simultaneous meningitis case produced by Candida albicans and Mycobacterium tuberculosis that coursed with neutrophilic pleocytosis in CSF and normal glucose CSF levels, consisting the clinical debut of aids. Repeated CSF examinations are the diagnostic clue owing, as in our case, instauration of early treatment. Present case of simultaneous tuberculous and candidiasic meningitis is the first one described in a HIV positive patient.

M., Arias Gómez; I., Requena Caballero; C., Lema Devesa; J., Suárez Dono; J., Llovo Martínez; V., Martino.

2001-09-01

389

Cerebrospinal fluid lactate: Is it a reliable and valid marker to distinguish between acute bacterial meningitis and aseptic meningitis?  

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Cerebrospinal fluid (CSF) lactate assay has been a subject of research since 1925. A systematic review by Huy and colleagues in the previous issue of Critical Care summarizes data from 25 studies evaluating the role of CSF lactate in the differential diagnosis between acute bacterial and aseptic meningitis. The authors concluded that CSF lactate is a good single indicator and a better marker compared with conventional markers. But concerns remain because of poor quality of included studies, l...

Prasad, Kameshwar; Sahu, Jitendra Kumar

2011-01-01

390

The cerebrospinal fluid cytological features of tuberculous meningitis in children  

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Full Text Available Background Tuberculous meningitis (TBM is a common central nervous system (CNS infectious disease, and is a serious threat to people's health. Due to its diverse clinical manifestations, especially atypical in infants and young children, it is easy to be misdiagnosed and can lead to high disablility rate and mortality rate. At present, cerebrospinal fluid (CSF cytology still plays an important role in the etiological diagnosis of CNS infectious diseases. Based on the observation of CSF cytological changes of children with TBM, this study is to further understand the performance and evolution characteristics of this disease, so as to improve the ability of early diagnosis and judgment on the treatment effect. Methods Fresh CSF was collected to make smears by using cytological slide centrifugation, and apply May-Grunwald-Giemsa (MGG staining for morphological classification. Results CSF cytology of all patients were abnormal. The average leukocyte count of children with TBM was (310.19 ± 156.26× 106/L, and was significantly different from that of children with purulent meningitis (P = 0.000. Lymphocyte proportion of TBM group was (66.56 ± 14.08%, and there were significant differences among different groups ( P = 0.037, 0.000. Compared to children with purulent meningitis, higher proportion of monocytes ( P = 0.000, 0.020 and plasma cells ( P = 0.001, 0.004 were found in children with TBM and viral meningitis. The positive detection rate of plasma cells in children with TBM was higher than that in children with purulent meningitis ( P = 0.001. Conclusion The CSF cytology changing characteristics of children with TBM are revealed. In the beginning the lymphocyte proportion is dominant in CSF cytology, and then different extents of mixed cellular response appear as disease develops. For children with effective treatment, the proportion of neutrophils decreases rapidly and turns to lymphocyte reaction gradually, with monocytes and plasma cells, lasting for a long time. Long-term mixed cellular response will happen in children with ineffective treatment. All in all, the CSF cytology changing characteristics are significant in clinical diagnosis and differential diagnosis of TBM in children.

KONG Fan-yuan

2013-02-01

391

Arterial embolism  

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... arm or leg. There may be signs of tissue death or gangrene. Tests to diagnose arterial embolism or reveal the source of emboli may include: Angiography of the affected extremity or organ Doppler ultrasound exam of an extremity Duplex Doppler ultrasound ...

392

Cerebral blood flow and carbon dioxide reactivity in children with bacterial meningitis  

International Nuclear Information System (INIS)

We examined total and regional cerebral blood flow (CBF) by stable xenon computed tomography in 20 seriously ill children with acute bacterial meningitis to determine whether CBF was reduced and to examine the changes in CBF during hyperventilation. In 13 children, total CBF was normal (62 +/- 20 ml/min/100 gm) but marked local variability of flow was seen. In five other children, total CBF was significantly reduced (26 +/- 10 ml/min/100 gm; p less than 0.05), with flow reduced more in white matter (8 +/- 5 ml/min/100 gm) than in gray matter (30 +/- 15 ml/min/100 gm). Autoregulation of CBF appeared to be present in these 18 children within a range of mean arterial blood pressure from 56 to 102 mm Hg. In the remaining two infants, brain dead within the first 24 hours, total flow was uniformly absent, averaging 3 +/- 3 ml/min/100 gm. In seven children, CBF was determined at two carbon dioxide tension (PCO2) levels: 40 (+/- 3) mm Hg and 29 (+/- 3) mm Hg. In six children, total CBF decreased 33%, from 52 (+/- 25) to 35 (+/- 15) ml/min/100 gm; the mean percentage of change in CBF per millimeter of mercury of PCO2 was 3.0%. Regional variability of perfusion to changes in PCO2 was marked in all six children. The percentage of change in CBF per millimeter of mercury of PCO2 was similar in frontal gray matter (3.1%) but higher in white matter (4.5%). In the seventh patient a paradoxical response was observed; total and regional CBF increased 25% after hyperventilation. Our finreased 25% after hyperventilation. Our findings demonstrate that (1) CBF in children with bacterial meningitis may be substantially decreased globally, with even more variability noted regionally, (2) autoregulation of CBF is preserved, (3) CBF/CO2 responsitivity varies among patients and in different regions of the brain in the same patient, and (4) hyperventilation can reduce CBF below ischemic thresholds

393

Cerebral blood flow and carbon dioxide reactivity in children with bacterial meningitis  

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We examined total and regional cerebral blood flow (CBF) by stable xenon computed tomography in 20 seriously ill children with acute bacterial meningitis to determine whether CBF was reduced and to examine the changes in CBF during hyperventilation. In 13 children, total CBF was normal (62 +/- 20 ml/min/100 gm) but marked local variability of flow was seen. In five other children, total CBF was significantly reduced (26 +/- 10 ml/min/100 gm; p less than 0.05), with flow reduced more in white matter (8 +/- 5 ml/min/100 gm) than in gray matter (30 +/- 15 ml/min/100 gm). Autoregulation of CBF appeared to be present in these 18 children within a range of mean arterial blood pressure from 56 to 102 mm Hg. In the remaining two infants, brain dead within the first 24 hours, total flow was uniformly absent, averaging 3 +/- 3 ml/min/100 gm. In seven children, CBF was determined at two carbon dioxide tension (PCO2) levels: 40 (+/- 3) mm Hg and 29 (+/- 3) mm Hg. In six children, total CBF decreased 33%, from 52 (+/- 25) to 35 (+/- 15) ml/min/100 gm; the mean percentage of change in CBF per millimeter of mercury of PCO2 was 3.0%. Regional variability of perfusion to changes in PCO2 was marked in all six children. The percentage of change in CBF per millimeter of mercury of PCO2 was similar in frontal gray matter (3.1%) but higher in white matter (4.5%). In the seventh patient a paradoxical response was observed; total and regional CBF increased 25% after hyperventilation. Our findings demonstrate that (1) CBF in children with bacterial meningitis may be substantially decreased globally, with even more variability noted regionally, (2) autoregulation of CBF is preserved, (3) CBF/CO2 responsitivity varies among patients and in different regions of the brain in the same patient, and (4) hyperventilation can reduce CBF below ischemic thresholds.

Ashwal, S.; Stringer, W.; Tomasi, L.; Schneider, S.; Thompson, J.; Perkin, R. (Loma Linda Univ. School of Medicine, CA (USA))

1990-10-01

394

Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid  

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Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier secondary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Ente...

Khan, Fida A.

2004-01-01

395

Description of primary multidrug-resistant tuberculous meningitis in an Italian child.  

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Tuberculous meningitis is the most severe form of tuberculosis and causes substantial morbidity and mortality in adults and children. The prevalence of multidrug-resistant (rifampin-isoniazid) strains requires the use of more toxic second-line drugs. We report a case of tuberculous meningitis in a 3-year-old Italian child. PMID:21711151

Mauro, Maria Vittoria; Cavalcanti, Paolina; Ledonne, Raffaella; Giraldi, Cristina; Sperlì, Domenico

2012-02-01

396

Vaccine-induced waning of Haemophilus influenzae empyema and meningitis, Angola.  

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In Angola during 2003-2012, we detected Haemophilus influenzae in 18% of 2,634 and 26% of 2,996 bacteriologically positive pleural or cerebrospinal fluid samples, respectively, from children. After vaccination launch in 2006, H. influenzae empyema declined by 83% and meningitis by 86%. Severe H. influenzae pneumonia and meningitis are preventable by vaccination. PMID:25340259

Peltola, Heikki; Pelkonen, Tuula; Bernardino, Luis; Monteiro, Lurdes; Silvestre, Silvia da Conceição; Anjos, Elizabete; Cruzeiro, Manuel Leite; Pitkäranta, Anne; Roine, Irmeli

2014-11-01

397

Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants  

Science.gov (United States)

... surgical site infections and prevention and treatment of acute otitis media and meningitis . Pediatrics . 2010; 126:381. Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, et al. Bacterial meningitis in the United States, 1998-2007 . N ...

398

Excacerbation of systemic lupus erythematodes, aseptic meningitis and acute mental symptoms, following metrizamide lumbar myelography  

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A clinical constellation of excacerbation of systemic lupus erythematodes (SLE), together with aseptic meningitis, and acutre mental symptoms occurred following lumbar myelography with metrizamide. Excacerbation of SLE has not been previously described following myelography with any contrast agent. Meningeal reactions and acute mental symptoms have been reported earlier, but this clinical constellation is new.

Gelmers, H.J.

1984-01-01

399

Cerebrospinal Fluid Stem Cell Factor Concentrations in the Children with Meningitis  

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Full Text Available The aim of this study was to determine the level of Cere Brospinal Fluid (CSF Stem Cell Factor (SCF concentrations in the children with acute bacterial and viral meningitis. The presence of SCF in the CSF was confirmed by western blot using anti-SCF antibody as a probe. Using Enzyme Linked Immunosorbent Assay (ELISA, it was shown that the level of CSF SCF in the patients with acute bacterial meningitis is higher than in acute viral meningitis. We have also shown that the concentration of CSF SCF in the patients with acute viral and bacterial meningitis samples was higher than in normal CSF with the same age. It is concluded that CSF could be involved in the pathophysiology of meningitis. SCF may be important in neurogenesis and neural cell survival and provide a basis for future studies related to neuroprotective mechanisms exerted by SCF in meningitis. Moreover, CSF SCF levels can be used in the early diagnosis of meningitis. Similarly, they may be useful adjuncts in differential diagnosis of bacterial and viral meningitis.

Farhad Mashayekhi

2007-01-01

400

Detection of Acute Childhood Meningitis by PCR, Culture and Agglutination Tests in Tabriz, Iran  

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Full Text Available Meningitis is one of the hazardous and life threatening infections and is associated with mortality and morbidity. The aim of this study was to determine etiological agents of childhood bacterial meningitis. The culture, Gram staining, agglutination and PCR assays were used to examine CSF specimens from 277 patients with presumed bacterial meningitis for the occurrence of 4 most common infectious agents consist of N. meningitis, H. influnsae, S. pneumoniae and S. agalactiae between 2008 and 2009 at different wards of the Children Hospital of Tabriz. The mean age of patients was 35±2 (Mean±SEM month, (minimum 11 days maximum14 years, of all cases 59.6% male and 40.4% female. Overall the diagnosis was confirmed with a CSF culture in 11/277 (3.97%, by agglutination test in 14/277 (5.05%. The isolated bacteria included S. pneumoniae 5 cases, H. influnsae 2 cases, N. meningitis 3 cases and P. aeroginusae 1 case. A positive PCR assay allowed us to diagnose bacterial meningitis in 19 patients (6.8%. In the present study, we found PCR to be a useful and sensitive method for the detection of bacterial DNA in the CSF samples from suspected meningitis patients. Furthermore, to maximize management of meningitis cases, a combination of culture and PCR is necessary.

Mohammad Ahangarzadeh Rezaee

2012-03-01

 
 
 
 
401

Meningeal worm evokes a heterogeneous immune response in elk.  

Science.gov (United States)

Meningeal worm (Parelaphostrongylus tenuis) is a neurotropic nematode of ungulates in eastern North America. Lack of an effective diagnostic test increases the concern of translocating potentially infected ungulates into western North America, where P. tenuis does not occur naturally. In an attempt to identify serodiagnostic molecules, we determined (1) whether elk (Cervus elaphus) experimentally infected with P. tenuis produce antibodies against infective larvae or adult worms, and (2) if sera consistently recognize antigens that distinguish P. tenuis from a common nematode parasite of elk, the lungworm Dictyocaulus viviparus. Each of 10 elk were exposed to 15 or 300 infective P. tenuis larvae. Serum was collected (0, 41, and 83 days post-exposure and at necropsy) and monitored for antibodies using the enzyme-linked immunosorbent assay (ELISA) and immunoblot. When reactivity of sera with larval P. tenuis protein was compared (day 0 versus 83), ELISA values were significantly higher on day 83 for elk exposed to 15 or 300 parasites. Likewise, ELISA values using protein of adult P. tenuis were higher for elk exposed to 300 larvae. Immunoblots showed that sera from elk, with adult worms in the central nervous system, consistently recognized the 25-27, 28-30, and 34-36 kDa antigens of infective larvae after 83 days. However, many D. viviparus molecules were found to cross-react with antibodies formed against meningeal worm antigens. Use of adult worm proteins for serodiagnosis appears limited, because no protein was consistently recognized by sera collected from elk exposed to 15 larvae. We believe that development of a reliable diagnostic test for meningeal worm requires more research addressing cross-reactivity and detection of P. tenuis during the incubation stage. PMID:9577781

Bienek, D R; Neumann, N F; Samuel, W M; Belosevic, M

1998-04-01

402

Meningeal enhancement of Gd-DTPA-enhanced MR images in the postoperative pediatric neurosurgical patient  

International Nuclear Information System (INIS)

Postoperative meningeal enhancement on gadolinium MR images occurs often in children. A retrospective evaluation of meningeal enhancement of 49 MR images was completed in 29 children with surgically treated brain tumors. Surgery included tumor excision, needle biopsy, and ventricular shunting. Twenty-four of 49 studies in clinically well children showed mile linear enhancement at the craniotomy site, adjacent to the ventricular catheter or remote from the surgical site. Seven of 49 showed enhancement that was moderate in severity, nodular, or within the ventricle and was associated with ventriculitis, meningitis, recurrent tumor, leptomeningeal tumor or a subdural hematoma. Seven of eight children who shoed no meningeal enhancement had received radiation therapy. Thick, nodular, or intraventricular meningeal enhancement implies active leptomeningeal disease

403

Meningococcal serogroup W135 in the African meningitis belt: epidemiology, immunity and vaccines.  

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In the sub-Saharan African meningitis belt there is a region of hyperendemic and epidemic meningitis stretching from Senegal to Ethiopia. The public health approaches to meningitis epidemics, including those related to vaccine use, have assumed that Neisseria meningitidis serogroup A will cause the most disease. During 2001 and 2002, the first large-scale epidemics of serogroup W135 meningitis in sub-Saharan Africa were reported from Burkina Faso. The occurrence of N. meningitidis W135 epidemics has led to a host of new issues, including the need for improved laboratory diagnostics for identifying serogroups during epidemics, an affordable supply of serogroup W135-containing polysaccharide vaccine for epidemic control where needed, and re-evaluating the long-term strategy of developing a monovalent A conjugate vaccine for the region. This review summarizes the existing data on N. meningitidis W135 epidemiology, immunology and vaccines as they relate to meningitis in sub-Saharan Africa. PMID:16827617

Mueller, Judith E; Borrow, Raymond; Gessner, Bradford D

2006-06-01

404

Idiopathic CD4 lymphocytopenia presenting as refractory cryptococcal meningitis  

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Full Text Available Idiopathic CD4 T-lymphocytopenia (ICL is a syndrome characterized by depletion of CD4 T-cells without evidence of human immunodeficiency virus (HIV infection. There are a few reported cases of ICL associated with different diseases and clinical conditions, most commonly the opportunistic infections like Tuberculosis, fungal and parasitic diseases which are also seen in HIV-positive patients. We report a case without risk factors or laboratory evidence of HIV infection who presented with refractory cryptococcal meningitis and was found to have ICL.

Sharma A

2010-01-01

405

Idiopathic CD4 lymphocytopenia presenting as refractory cryptococcal meningitis.  

Science.gov (United States)

Idiopathic CD4 T-lymphocytopenia (ICL) is a syndrome characterized by depletion of CD4 T-cells without evidence of human immunodeficiency virus (HIV) infection. There are a few reported cases of ICL associated with different diseases and clinical conditions, most commonly the opportunistic infections like Tuberculosis, fungal and parasitic diseases which are also seen in HIV-positive patients. We report a case without risk factors or laboratory evidence of HIV infection who presented with refractory cryptococcal meningitis and was found to have ICL. PMID:20814499

Sharma, A; Lal, V; Modi, M; Khurana, D; Bal, S; Prabhakar, S

2010-04-01

406

Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis  

International Nuclear Information System (INIS)

Spinal arachnoiditis is one of the common and disabling complication of tuberculous meningitis (TBM). We focused on early diagnosis of spinal arachnoiditis by spinal MRI in asymptomatic patients in whom neurological examination was normal. We studied 16 patients with a diagnosis of probable or highly probable TBM with symptoms for less than 1 month; three had radiological evidence of spinal arachnoiditis. High cerebrospinal fluid protein appeared to be a risk factor for development of spinal arachnoiditis. MRI is sensitive to detect early spinal arachnoiditis. Earlier diagnosis may be helpful in management of spinal arachnoiditis in TBM. (orig.)

407

Two rare presentations of fatal anthrax: meningeal and intestinal.  

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Anthrax is an ancient disease of animals and men, caused by Bacillus anthracis. The diagnosis of cutaneous infection is relatively easy, but other clinical forms might escape recognition. We present two rare and fatal forms of anthrax: meningeal in a 33-year-old male shepherd and intestinal in a 4-year-old boy. The former was admitted to the hospital with complaints of headache, vomiting, fever, and decreased level of consciousness. The latter presented with abdominal pain and distension, vomiting, and fever. Both cases were proven by animal inoculation. PMID:20804313

Khoddami, Maliheh; Shirvani, Fariba; Esmaeili, Jaleh; Beladimogaddam, Nahid

2010-09-01

408

Primary pituitary abscess with coexisting pyogenic meningitis: an unexpected diagnosis.  

Science.gov (United States)

Primary pituitary abscess is a very rare disease most likely associated with pyogenic infection. A 27-year-old woman was initially diagnosed and treated as a case of acute pyogenic meningitis. In view of persistent headache, impaired visual fields, galactorrhea and menstrual irregularities, she underwent evaluation of pituitary mass lesion. Magnetic resonance imaging of the pituitary reported the mass as pituitary macroadenoma. However, transsphenoidal surgery revealed copious collection of purulent materials confirmed as pyogenic pituitary abscess. A follow-up magnetic resonance imaging of the pituitary 2 years later confirmed secondary empty sella. She has developed panhypopituitarism; she remains on appropriate anterior pituitary hormone replacement. PMID:23262813

Bangera, Sachin; Chattopadhyay; Singh, Ranjit Kumar; Al Asousi, Adnan Ali; Joseph, Elizabeth

2013-01-01

409

Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis  

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Spinal arachnoiditis is one of the common and disabling complication of tuberculous meningitis (TBM). We focused on early diagnosis of spinal arachnoiditis by spinal MRI in asymptomatic patients in whom neurological examination was normal. We studied 16 patients with a diagnosis of probable or highly probable TBM with symptoms for less than 1 month; three had radiological evidence of spinal arachnoiditis. High cerebrospinal fluid protein appeared to be a risk factor for development of spinal arachnoiditis. MRI is sensitive to detect early spinal arachnoiditis. Earlier diagnosis may be helpful in management of spinal arachnoiditis in TBM. (orig.)

Srivastava, T. [Department of Neurology, CN Centre, All India Institute of Medical Sciences, New Delhi (India); Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India); Kochar, D.K. [Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India)

2003-10-01

410

Meningites bacterianas agudas complicações vasculares: vascular complications / Bacterial meningitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os autores apresentam o estudo de quatro crianças que tiveram arterite como complicação vascular de meningite bacteriana aguda. Apresentam revisão dos mecanismos fisiopatológicos envolvidos nas alterações vasculares que têm trazido reais progressos no entendimento dessas complicações. [...] Abstract in english The authors present the study of four children with arteritis as vascular complication of acute bacterial meningitis. They report pathophysiological mechanisms involved in vascular lesions, and progress in the understanding of these complications. [...

Maria Valeriana L., Moura-Ribeiro; Cristiane M., Rocha; Walter L. M., Fernandes; Marilisa M., Guerreiro.

1993-11-01

411

Evaluation of pefloxacin in experimental Escherichia coli meningitis.  

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The therapeutic efficacy of the fluoroquinolone pefloxacin mesylate was compared with those of cefotaxime and chloramphenicol in a rabbit model of Escherichia coli meningitis. The mean percent penetration (+/- the standard deviation) of pefloxacin (range, 1 to 30 mg/kg per h) into cerebrospinal fluid of infected rabbits was 51.3 +/- 14.0 compared with 11.1 +/- 1.0 for cefotaxime (100 mg/kg per h) and 22.3 +/- 1.5 for chloramphenicol (60 mg/kg per h). The rate of bacterial killing (delta log10...

Shibl, A. M.; Hackbarth, C. J.; Sande, M. A.

1986-01-01

412

Penetration of pefloxacin into cerebrospinal fluid of patients with meningitis.  

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We evaluated the diffusion of pefloxacin into the cerebrospinal fluid (CSF) in 15 patients with bacterial meningitis or ventriculitis, 14 of whom were treated with other antibiotics. Three doses of pefloxacin were administered at 12-h intervals to 11 patients intravenously and to 4 patients orally. Individual doses were 7.5 mg/kg in seven patients and 15 mg/kg in eight patients. Plasma and CSF levels were determined by a high-performance liquid chromatographic assay. The concentrations of pef...

Wolff, M.; Regnier, B.; Daldoss, C.; Nkam, M.; Vachon, F.

1984-01-01

413

Triphasic waves in a patient with tuberculous meningitis.  

Science.gov (United States)

We report on the case of a 32-year-old woman with tuberculous meningitis (TBM) with electroencephalogram (EEG) output displaying triphasic waves (TWs). The EEG on day 8 revealed generalized slowing, frontal bilateral TWs, a background of 2Hz delta waves, and no epileptiform activity. The patient's condition improved slowly with antituberculosis chemotherapy treatment. A follow-up EEG on day 34 showed marked improvement, with no TWs, background activity improved to a 12Hz symmetric alpha wave pattern, and no epileptiform activity, as before. To our knowledge, this is the first report of TWs observed in a TBM case. PMID:20116807

Konno, Shingo; Sugimoto, Hideki; Nemoto, Hiroshi; Kitazono, Hisao; Murata, Mayumi; Toda, Takahiro; Nakazora, Hiroshi; Nomoto, Nobuatsu; Wakata, Nobuo; Kurihara, Teruyuki; Fujioka, Toshiki

2010-04-15

414

Oral Wooden Stick Injury Complicated by Meningitis and Brain Abscess  

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Full Text Available Meningitis is rarely seen following oral injury. We describe a 3-year-old boy developingmeningitis and brain abscess following a penetrating oral wooden stick injury. Therewas no cerebrospinal fluid rhinorrhea noted. A cerebrospinal fluid culture yielded viridansstreptococcus. Brain magnetic resonance imaging and computed tomography revealed amultiloculated ring-enhancing mass. This patient underwent surgical drainage and completed8-week antibiotic therapy. The patient demonstrated a late and dismal complication of apenetrating oral injury. At 2-year follow-up the patient was in good condition. A penetratingoral wooden stick inury should be regarded as potentially serious.

Chin-Jung Chang

2002-04-01

415

Experiences of diagnosis and treatment of 102 cases with cryptococcal meningitis and/or cryptococcal meningoencephalitis  

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Full Text Available Objective To summarize the clinical manifestations and diagnostic and therapeutic strategies of 102 cases with cryptococcal meningitis and/or cryptococcal meningoencephalitis, and to improve the diagnosis and treatment of cryptococcal meningitis.  Methods The clinical manifestations, diagnostic and therapeutic strategies and outcomes of 102 cases with cryptococcal meningitis and/or cryptococcal meningoencephalitis were analyzed retrospectively.  Results The incidence of cryptococcal meningitis and/or cryptococcal meningoencephalitis raised in recent years. The signs of high intracranial pressure, meningeal irritation and cranial nerves impairment are the main clinical manifestations of cryptococcal meningitis, while seizures, hemiplegia, mental disorders and ataxia can occur when the brain parenchyma is involved. Cryptococcal meningitis and/or cryptococcal meningoencephalitis is easy to be misdiagnosed, especially misdiagnosed as tuberculous meningitis. Repeated cerebrospinal fluid (CSF smear and latex agglutination test can ensure the diagnostic accuracy. Amphotericin B, flucytosine and fluconazole combined therapy is the most widely used therapeutic strategy at present, which has been proved to be effective; surgery operations (such as ventriculo-peritoneal shunt are effective in the treatment of cryptococcal meningitis complicating hydrocephalus.  Conclusions The diagnosis of cryptococcal meningitis and/or cryptococcal meningoencephalitis is difficult for its lack of specific clinical manifestations. Suspected patients should receive repeated CSF smear, latex agglutination test as well as imageological examination to make an accurate diagnosis. Combined, long-term antifungal therapy should be used immediately in confirmed cases, and surgery operations can be used in necessity to improve outcomes. doi: 10.3969/j.issn.1672-6731.2014.08.008

Yan-yu CHANG

2014-08-01

416

Renal artery stenting via brachial artery approach  

International Nuclear Information System (INIS)

Objective: To assess the effectiveness and safety of brachial artery access for percutaneous renal artery stenting. Methods: From January 2002 to January 2005, transbrachial artery renal angioplasty and stenting(RAS) was performed in 8 patients(7 males, 1 female)with severe renal artery stenosis. Imaging assessment of the target renal artery was performed before all procedures, which precluded the possibility of femoral approach. Either long guiding sheath or otherwise pigtail methods were selected according to patients' status for evaluation of the target renal artery during the procedure. Monitoring the blood pressure and renal function was followed up of 6 months after the procedure. Results: The technical success was 100% with no procedure-related complication and good outcome follow up to 6 months. Conclusion: Brachial artery access for renal artery stenting is a safe and technically feasible for renal artery stenosis, providing an alternative for unsuitable femoral approach. (authors)

417

Neuro-Behçet: differential diagnosis of recurrent meningitis / Presentación de enfermedad de Behçet como meningitis recurrente: Informe de un caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish La enfermedad de Behçet is una perivasculitis sistémica inflamatoria caracterizada por episodios recurrentes de úlceras orales y genitales asociadas a lesiones cutáneas y oculares. El 5 a 10% de los casos tiene compromiso neurológico y el compromiso meníngeo aislado es muy poco común. Presentamos un [...] hombre de 21 años con enfermedad de Behçet y una historia de síndrome meníngeo en dos crisis previas y meningoencefalitis en tres otras. El paciente tenía una historia de conjuntivitis y úlceras orales y genitales. Al examen se encontraron lesiones aftosas, edema macular, compromiso de nervios craneanos, signos piramidales e irritación meníngea. El recuento celular del líquido cefalorraquídeo fue de 1.800 células/ml con predominancia polimorfonuclear. La resonancia magnética mostró lesiones en los ganglios basales y tronco encefálico. El paciente mejoró dramáticamente con el uso de corticoides endovenosos. Abstract in english Behçet disease is a systemic inflammatory perivasculitis characterized by recurrent episodes oforal 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.

Andreya, Fonseca Cardoso; Pedro Augusto, Rocha-Filho; Ana Rosa, Melo Correa-Lima.

2013-01-01

418

Predictors of Acute Bacterial Meningitis in Children from a Malaria-Endemic Area of Papua New Guinea  

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Predictors of acute bacterial meningitis (ABM) were assessed in 554 children in Papua New Guinea 0.2–10 years of age who were hospitalized with culture-proven meningitis, probable meningitis, or non-meningitic illness investigated by lumbar puncture. Forty-seven (8.5%) had proven meningitis and 36 (6.5%) had probable meningitis. Neck stiffness, Kernig’s and Brudzinski’s signs and, in children < 18 months of age, a bulging fontanel had positive likelihood ratios (LRs) ? 4.3 for proven/...

Laman, Moses; Manning, Laurens; Greenhill, Andrew R.; Mare, Trevor; Michael, Audrey; Shem, Silas; Vince, John; Lagani, William; Hwaiwhanje, Ilomo; Siba, Peter M.; Mueller, Ivo; Davis, Timothy M. E.

2012-01-01

419

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

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Full Text Available 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. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health. Methods We retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a Microsoft® excel spreadsheet. Results Records of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8% were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6% were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8% culture positive bacteria, 19 (11.7% culture positive Cryptococcus neoformans and 27(16.6% Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%, followed by E.coli 4 (3.4%, Salmonella species 4 (3.4%, Neisseria meningitidis 3 (2.5%, Pseudomonas species 3(2.5% and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%, 83.0% (95%CI: 73.4% to 90.1% and 100.0% (95%CI: 95.8% to 100.0% respectively. Conclusion Streptococcus pneumoniae is an important cause of meningitis among all age groups and its susceptibility to penicillin and ceftriaxone still remains very high. Ghanaians of all ages and possibly other developing countries in the meningitis belt could benefit from the use of the pneumococcal vaccine. Other bacterial and fungal pathogens should also be considered in the management of patients presenting with meningitis.

Owusu Michael

2012-10-01

420

Meningococcal Meningitis: Monitoring the Use of Appropriate Antibiotic Prophylaxis  

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Full Text Available Aim: The aim of this study was to evaluate the use of recommended antibiotic prophylaxis in reported cases of meningococcal meningitis. Method: All cases of meningococcal meningitis reported to the public health authority of the Puy-de- Dôme (Direction départementale des affaires sanitaires et sociales during 1999 and 2000 were studied. Each report included the date of infection and the number of individuals exposed. This information was compared to data on rifampicin prescriptions during the same period obtained from the specific drug-codes contained in French national health insurance’s computer database. Results: We selected those treatments which were likely to represent prophylactic rifampicin use and, by using a correction coefficient, identified a theoretic number of prophylactic prescriptions. This number was considered to be the high threshold for prophylactic prescriptions. Using these two indicators, we quantified the disparity between recommendations and the actual implementation of appropriate antibiotic prophylaxis. Finally, we propose an efficiency indicator by determining how soon after exposure prophylactic rifampicin was prescribed. Conclusion: The specific drug-codes can provide us with indicators for quantifying the implementation of appropriate antibiotic prophylaxis.

Baris B

2001-09-01

 
 
 
 
421

Simvastatin attenuates leukocyte recruitment in experimental bacterial meningitis.  

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Statins exert multiple effects besides lowering the serum cholesterol level, which might be beneficial for patients with sepsis and infections. We designed this study to assess the therapeutic potential of simvastatin in an established animal model of pneumococcal meningitis, a disease characterized by high morbidity and mortality despite effective antibiotic treatment. 24 h after injection of live pneumococci into the cisterna magna of mice, animals were clinically evaluated, cerebrospinal fluid (CSF) leukocyte counts and intracranial pressure were determined, and brains were removed for assessment of bacterial titer and blood-brain barrier breakdown. The following experimental groups were investigated: (I) no infection and treatment with vehicle; (II) infection and treatment with vehicle; infection and treatment with (III) 20 mg/kg or (IV) 40 mg/kg simvastatin s.c. 18 h before and just prior to infection. Treatment with simvastatin dose-dependently decreased CSF leukocyte counts, a marker for CNS inflammation. In addition, hypothermia was completely abolished in the 40 mg/kg simvastatin group. In contrast, a neurological clinical score, and intracranial complications like increase in intracranial pressure and blood-brain barrier breakdown were not altered by the treatment. In conclusion, simvastatin attenuates CNS leukocyte recruitment and systemic complications of experimental pneumococcal meningitis. PMID:19130904

Winkler, Frank; Angele, Barbara; Pfister, Hans-Walter; Koedel, Uwe

2009-03-01

422

Meningitis y artritis por Haemophilus influenzae en un adulto  

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Full Text Available Tradicionalmente el Haemophilus influenzae ha sido considerado un germen causante de infecciones en niños; en adultos se lo ha relacionado con Infecciones respiratorias, pero en los últimos tiempos se han descrito en ellos infecciones severas cuando hay algunos factores predisponentes. Se describe un paciente drogadicto de 30 años con cuadro de meningitis y artritis y prueba de látex y cultivo de LCR positivos para HaemophiIus influenzae, quien recibió tratamiento con ampicilina, 2 gramos Intravenosos cada 4 horas y evolucionó a la mejoría sin secuelas. Se plantea la necesidad de tener en cuenta al Haemophilus influenzae como patógeno del adulto y más en aquellas personas con factores predisponentes.

Haemophilus influenzae has traditionally been considered as an infectious agent that predominantly affects children; instead, in adults It has been Linked either to respiratory infections or to gevere infections occurring when predisposing factors are present. We describe a 30 year-old drug adict patient that presented with meningitis and arthritis; both latex test and cerebrospinal fluid culture were positive for Haemophilus influenzae. He was treated with ampicilin 2 gm, I. V. every four hours and improved without sequelae. This microorganism must be considered among those affecting adult patients specially when predisposing factors for infection are present.

Javier Molina

1988-02-01

423

Unusual Tonsillar Herniation in Meningeal Melanocytoma: A Case Report  

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Full Text Available Meningeal melanocytoma is a primary melanocytic neoplasm with certain MR and immunohistochemical characteristics worthy to note. In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study. Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal. Contrast-enhanced MRI revealed diffuse enhancement in the basal cisterns extending throughout the spinal canal. Immunohistochemical analysis on one of the intraspinal nodules proposed leptomeningeal melanocytoma. The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process. Moreover, there are unique immunohistochemical characteristics for this varied lesions.In appropriate clinical settings, certain radiologic findings, especially both T1 and T2 shortening in nodular CNS lesions should propose meningeal melanocytoma.

Kaveh Samimi

2012-01-01

424

Epidemiology of Cryptococcal Meningitis in the US: 1997–2009  

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Cryptococcal meningitis (CM) causes significant morbidity and mortality globally; however, recent national trends have not been described. Incidence and trends for CM-associated hospitalizations in 18 states were estimated using the Agency for Healthcare and Research Quality (AHRQ) State Inpatient Databases (SID) datasets for 1997 through 2009. We identified 30,840 hospitalizations coded for CM, of which 21.6% were among HIV-uninfected patients. CM in-hospital mortality was significant (12.4% for women and 10.8% for men) with a total of 3,440 deaths over the study period. Co-morbidities of CM coded at increased frequency in HIV-uninfected CM hospitalized populations included hydrocephalus and acute/chronic renal failure as well as possible predispositions including transplantation, combined T and B cell defects, Cushing’s syndrome, liver disease and hypogammaglobulinemia. Median hospitalization costs were significant for CM and higher for HIV-uninfected patients (16,803.01 vs. 15,708.07; p<0.0001). Cryptococcal meningitis remains a disease with significant morbidity and mortality in the U.S. and the relative burden among persons without HIV infection is increasing. PMID:23457543

Pyrgos, Vasilios; Seitz, Amy E.; Steiner, Claudia A.; Prevots, D. Rebecca; Williamson, Peter R.

2013-01-01

425

Diagnosis of meningococcal meningitis in Brazil by use of PCR.  

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Fever and a petechial rash are strongly associated with meningococcal disease in the city of Rio de Janeiro. Early antibiotic therapy is indicated and, consequently, a reduction of confirmed cases by culture, Gram stain, and latex agglutination test is expected. We evaluated a multiplex PCR assay to identify Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in biological samples from cases of non-culture proven meningitis with a petechial rash at presentation. To detect DNA in cerebrospinal fluid (n = 71) or blood (n = 5), a PCR screen was performed, based on the crgA, ply and bexA targets, respectively. Of the total, 70 CSF and 3 blood samples (96%) were positive by PCR for the presence of N. meningitidis DNA. Another PCR assay predicted in 82% of these samples N. meningitidis serogroups A (2%), B (60%), C (7%), X (3%), Y (2%), 29E (2%) or W135 (24%). In non-culture proven meningitis, PCR was found to be a valuable adjunct for the demonstration of meningococcal aetiology. PMID:17366009

Pedro, Luciana G F; Boente, Renata F; Madureira, Danielle J; Matos, Juliana A; Rebelo, Cristina M; Igreja, Ricardo P; Barroso, David E

2007-01-01

426

Neurologic deterioration in a child undergoing treatment for tuberculosis meningitis.  

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Clinical deterioration while receiving antituberculosis (anti-TB) therapy can be due to a number of etiologies, including drug resistance, disease progression despite effective therapy, or alternative diagnoses. We present the case of a 22-month-old girl diagnosed with TB meningitis 4 months prior to presentation. At time of her initial diagnosis, computed tomography showed hydrocephalus and basilar meningitis with some evidence of ischemic damage. She required placement of a ventriculoperitoneal shunt and was discharged on multidrug anti-TB therapy and corticosteroids. At the time of her second emergency department presentation, she had developed new-onset seizures and hemiparesis. Her steroids had been tapered and discontinued. Differential diagnosis included shunt malfunction and/or shunt infection. Magnetic resonance imaging of the brain showed interval development of tuberculomas. Symptomatic and radiographic improvement was seen after initiation of corticosteroids for immune reconstitution inflammatory syndrome, which can be seen in immunocompetent children, with onset weeks to months after starting antituberculous therapy. PMID:25098802

Birnbaum, Gilad D; Marquez, Lucila; Hwang, Kevin M; Cruz, Andrea T

2014-08-01

427

Cryptococcal meningitis with secondary cutaneous involvement in an immunocompetent host.  

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Cryptococcosis is a potentially fatal fungal disease caused by variants of Cryptococcus neoformans species.  The respiratory tract is the usual portal of entry, with a peculiar predilection to invade the central nervous system.  The skin can be secondarily involved in disseminated infection or be exceptionally involved as primary cutaneous infection by inoculation.  The disease is mostly seen in immunodeficiency states.  The diagnosis is frequently unsuspected in immunocompetent patients. We report a case of disseminated cryptococcal meningitis in an immunocompetent young adult. The cutaneous eruption prompted the accurate diagnosis.  The patient, a 20-year-old female, had fever, cough, headache and intractable vomiting for the past two months and was being managed as a case of tuberculous meningitis. Two weeks after starting antituberculous treatment she developed umbilicated papules on the head and neck region. Necessary laboratory workup identified C. neoformans in cerebrospinal fluid (CSF) and skin specimens.  The titers of cryptococcal antigen were measured in CSF and serum for diagnostic and prognostic purposes.  Anti-fungal treatment resulted in regression of the cutaneous lesions and resolution of systemic complaints. The case highlights the need for high degree of suspicion, especially in healthy young adults, in the diagnosis of cryptococcosis. The cutaneous eruptions can be the first manifestation or a diagnostic clue of enormous significance. PMID:24042105

Tabassum, Saadia; Rahman, Atiya; Herekar, Fivzia; Masood, Sadia

2013-01-01

428

The diagnosis and medical management of tuberculous meningitis in adults  

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Full Text Available SciELO South Africa | Language: English Abstract in english Tuberculous meningitis (TBM) is a medical emergency for which tuberculosis (TB) treatment should be initiated as soon as possible after diagnosis. Owing to the low diagnostic yields of confirmatory tests, TBM is often diagnosed based on suggestive clinical and cerebrospinal fluid findings, evidence [...] for TB outside the central nervous system (CNS), typical brain imaging features and exclusion of other causes of meningitis. TB drug regimens used in TBM may be suboptimal as they are informed by studies of TB outside the CNS, rather than being based on randomised controlled trials in TBM. TBM has a high mortality and the management of HIV-co-infected patients is further complicated by neurological TB-immune reconstitution inflammatory syndrome (IRIS), which frequently occurs after starting antiretroviral therapy (ART) during TBM treatment and contributes to the poor outcome in HIV-associated TBM. HIV-infected TBM patients due to start ART should be counselled about the risk of developing neurological TB-IRIS, typical symptoms that could be expected and need to return to hospital should any of these develop. Currently, the only evidence-based treatment for TB-IRIS is with corticosteroids, which should be considered in all cases of neurological TB-IRIS.

S, Marais; R J, Wilkinson.

2014-12-01

429

Coronary Artery Bypass Graft  

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Full Text Available ... known as coronary arteries. Symptoms and Their Causes Cholesterol deposits accumulate in the coronary arteries, forming “plaques” ... Healthy diet and medications that lower your blood cholesterol can help slow the process that clogs arteries. ...

430

Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid  

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Full Text Available SciELO Brazil | Language: English Abstract in english Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier seco [...] ndary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Enterobacter species and post-neurosurgical infection. More recently, risk factors for nosocomial Enterobacter meningitis have been characterized by Parodi et al. Adipose graft, as an independent risk factor has not yet been reported. A patient with acoustic neuroma resection, who developed bacterial meningitis from an abdominal fat pad graft to a mastoidectomy bed is described. A brief overview was made of post-neurosurgical Gram-negative meningitis.

Fida A., Khan.

2004-10-01

431

Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid  

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Full Text Available Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier secondary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Enterobacter species and post-neurosurgical infection. More recently, risk factors for nosocomial Enterobacter meningitis have been characterized by Parodi et al. Adipose graft, as an independent risk factor has not yet been reported. A patient with acoustic neuroma resection, who developed bacterial meningitis from an abdominal fat pad graft to a mastoidectomy bed is described. A brief overview was made of post-neurosurgical Gram-negative meningitis.

Fida A. Khan

2004-10-01

432

Middle cerebral artery territory infarct due to Cryptococcus infectionstitle: An uncommon indication for cerebrospinal fluid analysis in stroke patients.  

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Cryptococcal meningitis is the most common manifestation of cryptococcosis and is caused by the encapsulated yeast organism Cryptococcus neoformans. It occurs most commonly in patients with impaired cell-mediated immunity such as in HIV infection; patients with hematological malignancies; patients post solid-organ transplantation; on chronic steroids or immunosuppressants. Clinically, stroke can arise as a complication of cryptococcal meningitis. While cerebrospinal fluid (CSF) examination is usually not indicated for evaluation of stroke patients, demonstration of cryptococcal yeast forms in CSF is valuable in guiding appropriate therapy in arterial stroke caused by Cryptococci. Herein, we describe the CSF and radiologic correlation in a female patient who presented with disseminated cryptococcosis, cryptococcal meninigitis and a middle cerebral artery infarct. Diagn. Cytopathol. 2014. © 2014 Wiley Periodicals, Inc. PMID:25352313

Cachia, David; Singh, Charanjeet; Tetzlaff, Michael T; Penas-Prado, Marta

2014-10-28

433

Protective effects of cisternal irrigation on leptomeningeal and cortical structures in meningitis: An experimental study  

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Full Text Available BACKGROUND: Meningitis, termed as foreign material collection in the subarachnoid space, leads to various meningeal, cerebral and spinal cord pathologies. Meningitis still remains a problematic disease with severe complications in spite of advanced medical technology. AIMS: In this study, we aimed to investigate the role of cisternal irrigation in the prevention of meningitis complications. SETTING AND STUDY DESIGN: Experimental study was done in the Social Security Hospital of Erzurum. Histopathological specimens were evaluated in the Pathology Department in the Ataturk University Research Hospital, Erzurum, Turkey. MATERIALS AND METHODS: This study was conducted on twelve lambs. Experimental meningitis was achieved with streptococcus pneumonia. Two animals were not treated. Ten animals were given CefotaximeR (4x1 g/day for 20 days, and additionally half of these animals underwent cisternal irrigation. Then, all animals were sacrificed and brains were observed histopathologically. RESULTS: Massive purulent CSF formation, hemorrhagic cortical lesions, vascular congestion, leptomeningeal and cortical adhesions and brain edema were observed in the non-irrigated group, but these findings were observed slightly or absent in the irrigated group. CONCLUSION: Meningitis can affect all central neural tissues, consequently serious central nervous system lesions may develop. The irrigation procedure may decrease the percentage and severity of meningitis complications by way of the excretion of inflammed purulent collection from the subarachnoid spaces.

Aydin Mehmet

2005-01-01

434

Anti-granulocyte-macrophage colony stimulating factor autoantibodies in patients with cryptococcal meningitis  

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Background 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. Methods We performed clinical histories, immunological evaluation, and anticytokine autoantibody screening in 4 current patients with cryptococcal meningitis, and identified and tested 103 archived plasma/CSF samples from patients with cryptococcal meningitis. We assessed the ability of anti-GM-CSF autoantibody containing plasmas to inhibit GM-CSF signaling. Results We recognized anti-GM-CSF autoantibodies in an otherwise healthy female with cryptococcal meningitis who later developed pulmonary alveolar proteinosis. Her diagnosis prompted screening of patients with cryptococcal meningitis for anticytokine autoantibodies. We identified 7 HIV uninfected patients with cryptococcal meningitis who tested positive for high-titer anti-GM-CSF autoantibodies. Two of the 7 later developed evidence of PAP. Plasma from all patients prevented GM-CSF-induced STAT-5 phosphorylation and MIP-1? production in normal PBMC. This effect was limited to their IgG fraction. Conclusions Anti-GM-CSF autoantibodies are associated with some cases of cryptococcal meningitis in otherwise immunocompetent patients. These cases need not have associated pulmonary alveolar proteinosis. PMID:23509356

Rosen, Lindsey B.; Freeman, Alexandra F.; Yang, Lauren M.; Jutivorakool, Kamonwan; Olivier, Kenneth N.; Angkasekwinai, Nasikarn; Suputtamongkol, Yupin; Bennett, John E.; Pyrgos, Vasilios; Williamson, Peter R.; Ding, Li; Holland, Steven M.; Browne, Sarah K.

2013-01-01

435

Arthritis in adults with community-acquired bacterial meningitis: a prospective cohort study  

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Full Text Available Abstract Background Although the coexistence of bacterial meningitis and arthritis has been noted in several studies, it remains unclear how often both conditions occur simultaneously. Methods We evaluated the presence of arthritis in a prospective nationwide cohort of 696 episodes of community-acquired bacterial meningitis, confirmed by culture of cerebrospinal fluid, which occurred in patients aged >16 years. The diagnosis of arthritis was based upon the judgment of the treating physician. To identify differences between groups Fisher exact statistics and the Mann-Whitney U test were used. Results Arthritis was recorded in 48 of 696 (7% episodes of community-acquired bacterial meningitis in adults. Joint-fluid aspirations were performed in 23 of 48 patients (48% and joint-fluid cultures yielded bacteria in 6 of 23 patients (26%. Arthritis occurred most frequently in patients with meningococcal meningitis (12%. Of the 48 patients with bacterial meningitis and coexisting arthritis, four died (8% and 10 (23% had residual joint symptoms. Conclusion Arthritis is a common manifestation in patients with community-acquired bacterial meningitis. Functional outcome of arthritis in bacterial meningitis is generally good because meningococcal arthritis is usually immune-mediated, and pneumococcal arthritis is generally less deforming than staphylococcal arthritis. Nevertheless, additional therapeutic measures should be considered if clinical course is complicated by arthritis. In patients with infectious arthritis prolonged antibiotic therapy is mandatory.

de Gans Jan

2006-03-01

436

Bacterial meningitis in newborn and infant: correlation between organism, CT findings and clinical outcome  

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Acute bacterial meningitis often results in significant neurologic complications regardless of the antibiotics treatment Computed tomographic (CT) finding of tuberculous meningitis is fairly well known but not the findings of bacterial meningitis. This study was performed to determine the incidence of causative organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bacterial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates without no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outcomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cisternal obliteration and enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.

Choi, Hye Young; Park, Young Seo; Yoo, Shi Joon; Suh, Dae Chul; Chung, Young Kyo [College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

1993-03-15

437

Maternal and perinatal factors associated with subsequent meningococcal, Haemophilus or enteroviral meningitis in children: database study.  

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We used a database of 248 659 births, with follow-up to subsequent disease, in the Oxford record linkage archive (1979-1999) to study the influence of family, maternal, and perinatal factors on subsequent hospital admission for meningococcal, Haemophilus, and enteroviral meningitis in the children. In this summary, we report key findings that were significant in multivariate analysis. Meningococcal meningitis was significantly associated with maternal smoking [odds ratio (OR) 2·1, 95% confidence interval (CI) 1·2-3·7]. Haemophilus meningitis was associated with having older siblings (e.g. second child compared to first-born, OR 3·3, 95% CI 2·0-5·6). Enteroviral meningitis was associated with low birth weight (OR 2·2, 95% CI 1·3-3·6) and male sex (OR 1·7, 95% CI 1·2-2·3). The mothers of six of the 312 children with enteroviral meningitis had previously had enteroviral meningitis themselves. We concluded that several maternal characteristics influence the risk of these types of meningitis. PMID:23659618

Goldacre, M J; Wotton, C J; Maisonneuve, J J

2014-02-01

438

Epidemiological, Clinical and Prognostic Profile of Acute Bacterial Meningitis among Children in Alexandria, Egypt  

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Full Text Available Purpose: To address the epidemiological characteristics and clinical indices that may predict the prognostic profile of meningitis among children. Methods: Children admitted to Alexandria fever hospital with clinical diagnosis of meningitis/meningoencephalitis during the period 2002-2003 were recruited for the study. They were subjected to clinical examination as well as CSF bacteriological and serological investigations Results: Three hundred and ten patients (195 males and 115 females were included. About 65.2% of them were infected with acute bacterial meningitis (ABM and 34.8% were infected with aseptic meningitis. In this study, ABM was caused by Haemophilus influenzae (21%, Streptococcus pneumoniae (13.9%, Neisseria meningitidis (14.2% and other undetermined bacteria (16.1%. ABM showed significant association with age group 1-9 years (66.3%, low socio-economic class (96%, working mother (83.2%, more than two smokers in the family (62.9% and cold seasons(fall 35.1% and winter 48.5%. Aseptic meningitis showed significant association with age group 3-15 months (100%