WorldWideScience

Sample records for meningeal arteries

  1. Vertebral artery dissection associated with viral meningitis

    OpenAIRE

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

    2012-01-01

    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 atax...

  2. Meningitis

    Science.gov (United States)

    ... Most cases of meningitis are caused by viruses ( viral meningitis ) or bacteria ( bacterial meningitis ). Fungi and other organisms ... cancers or other diseases, or reactions to medications. Viral meningitis is caused by viruses like enteroviruses , which are ...

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

    OpenAIRE

    Üstün, Mehmet Erkan; BÜYÜKMUMCU, Mustafa; ?EKER, Muzaffer; Karabulut, Ahmet Ka?an; UYSAL, ?smihan ?lknur; Ziylan, Taner

    2004-01-01

    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...

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

    OpenAIRE

    Diamond, M K

    1991-01-01

    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...

  5. Morphometric Analysis of the Middle Meningeal Artery Organization in Humans—Embryological Considerations

    OpenAIRE

    Harthmann da Silva, Tales; Ellwanger, Joel Henrique; Silva, Helen Tais da Rosa; de Moraes, Daniela; Dotto, Anderson Cesar; Viera, Vinicius de Aguiar; Campos, Deivis de

    2013-01-01

    The middle meningeal artery (MMA) is the largest branch of the internal maxillary artery supplying the meninges. The complex sequence of MMA development gives many opportunities for variant anatomy. Additionally, the variations in the origin of the MMA are of clinical importance when dealing with fractures of the base of the skull, epidural hematomas, and bypass procedures. Therefore, various anastomosis and aberrant origins of the MMA have been documented in literature. However, there are no...

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

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail

    2012-01-01

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

  7. Meningitis

    Centers for Disease Control (CDC) Podcasts

    2012-10-24

    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.

  8. Comparison of the vasodilator responses of isolated human and rat middle meningeal arteries to migraine related compounds

    DEFF Research Database (Denmark)

    Grände, Gustaf; Labruijere, Sieneke; Haanes, Kristian Agmund; MaassenVanDenBrink, Antoinette; Edvinsson, Lars

    2014-01-01

    BACKGROUND: Migraine attacks occur spontaneously in those who suffer from the condition, but migraine-like attacks can also be induced artificially by a number of substances. Previously published evidence makes the meninges a likely source of migraine related pain. This article investigates the effect of several vasodilators on meningeal arteries in order to find a connection between the effect of a substance on a meningeal vessel and its ability to artificially induce migraine. METHODS: A myogr...

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

    International Nuclear Information System (INIS)

    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. (orig.)

  10. Expression and Characterization of Purinergic Receptors in Rat Middle Meningeal Artery–Potential Role in Migraine

    OpenAIRE

    Haanes, Kristian Agmund; Edvinsson, Lars

    2014-01-01

    The dura mater and its vasculature have for decades been central in the hypothesis of migraine and headache pathophysiology. Although recent studies have questioned the role of the vasculature as the primary cause, dural vessel physiology is still relevant in understanding the complex pathophysiology of migraine. The aim of the present study was to isolate the middle meningeal artery (MMA) from rodents and characterize their purinergic receptors using a sensitive wire myograph method and RT-P...

  11. Traumatic Pseudoaneurysm of the Middle Meningeal Artery Causing an Intracerebral Hemorrhage

    OpenAIRE

    Manoel Jacobsen Teixeira; Eberval Gadelha Figueiredo; Robson Luis Amorim; Almir Ferreira Andrade; Wellingson Silva Paiva

    2010-01-01

    Traumatic aneurysms comprise less than 1% of all intracranial aneurysms. Most of these aneurysms are actually false aneurysms, or pseudoaneurysms, which are caused by the rupture of entire vessel wall layers, with the wall of the aneurysm being formed by the surrounding cerebral structures. Traumatic pseudoaneurysms of the middle meningeal artery are also rare. Only four cases have been reported in the literature with intracerebral hematoma. In this paper, the authors report a case of a patie...

  12. Computed Tomography Angiography for Detection of Middle Meningeal Artery Lesions Associated with Acute Epidural Hematomas

    OpenAIRE

    Wellingson Silva Paiva; Almir Ferreira Andrade; Robson Luis Oliveira de Amorim; Edson Bor-Seng-Shu; Gabriel Gattas; Iuri Santana Neville; Jose Guilherme Caldas; Eberval Gadelha Figueiredo; Manoel Jacobsen Teixeira

    2014-01-01

    Background. The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is not well known, but patients with these lesions are more likely to have delayed bleeds. In this paper, we described a series of patients with epidural hematoma who underwent angiotomography (CTA) for MMA vascular lesion diagnosis. Methods. Eleven patients admitted to our emergency unit with small acute epidural hematoma were prospectively studied. All patients with temporal acute epidural hematomas...

  13. PACAP-38 infusion causes sustained vasodilation of the middle meningeal artery in the rat

    DEFF Research Database (Denmark)

    Bhatt, Deepak K; Gupta, Saurabh; Olesen, Jes; Jansen-Olesen, Inger

    2014-01-01

    BACKGROUND: In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing. Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in co...

  14. Transcranial Direct Middle Meningeal Artery Puncture for the Onyx Embolization of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus

    OpenAIRE

    Oh, Jae-Sang; Yoon, Seok-Mann; Shim, Jai-Joon; Bae, Hack-Gun

    2015-01-01

    A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was pe...

  15. A histological, ultrastructural and immunohistochemical study of superficial temporal arteries and middle meningeal arteries in moyamoya disease.

    Science.gov (United States)

    Li, B; Wang, C C; Zhao, Z Z; Hu, Y; Aihara, K; Ghazizadeh, M; Sasaki, Y; Yang, S Y; Pan, J

    1991-07-01

    Pathologic changes in superficial temporal arteries (STA) and middle meningeal arteries (MMA) biopsied from 15 patients with moyamoya disease (MD) who had undergone cerebro-temporal arterio-synangiosis were studied histologically, ultrastructurally and immunohistochemically. The main pathologic features were: proliferation of smooth muscle cells (SMCs) and thickening of the intima, degeneration and destruction of SMCs in the media and intima, and the presence of condensed organelles in necrosed SMCs or the interstitium among SMCs, or both outside and within the elastica interna (EI). The EI had become thin, porous, fragmented and was even absent in some segments. These changes are different from those of other forms of angiopathy, but identical with those at the ends of internal carotid arteries (ICA) reported by us previously, being pathognomonic for MD. These changes in the STA and MMA reveal that MD involves not only the ICA but also the intra- and extracranial branches of external carotid arteries. The medial necrosis of SMCs seems to be the primary injury of the arterial wall in MD. STA tissue blocks from two cases of MD were stained immunohistochemically. By electron microscopy, IgG-, IgM-, and C3-positive granules were observed on the ER of endothelial and intimal cells. Further studies on more cases are needed to determine whether an immunoreaction has occurred in these arteries. PMID:1755318

  16. Morphometric Analysis of the Middle Meningeal Artery Organization in Humans—Embryological Considerations

    Science.gov (United States)

    Harthmann da Silva, Tales; Ellwanger, Joel Henrique; Silva, Helen Tais da Rosa; Moraes, Daniela; Dotto, Anderson Cesar; Viera, Vinicius de Aguiar; de Campos, Deivis

    2013-01-01

    The middle meningeal artery (MMA) is the largest branch of the internal maxillary artery supplying the meninges. The complex sequence of MMA development gives many opportunities for variant anatomy. Additionally, the variations in the origin of the MMA are of clinical importance when dealing with fractures of the base of the skull, epidural hematomas, and bypass procedures. Therefore, various anastomosis and aberrant origins of the MMA have been documented in literature. However, there are no reports about some morphometric aspects of this important arterial segment. Thus, in this study, we decided to investigate the anatomical organization of the MMA through the bony groove measurements from human skulls (n?=?50 subjects). Six measurements were performed bilaterally: angle of the main trunk, length of the main trunk, angle between the frontal and parietal branches, length of the frontal branch, length of the parietal branch, and length of the bony tunnel formed by the frontal branch. We showed that the anatomical organization of the MMA is bilaterally similar, except for the length of the parietal branch (p?=?0.009). Moreover, our results provide baseline normal values for future studies aimed at further elucidating the functional and morphological pattern of the MMA. PMID:24436897

  17. Morphometric analysis of the middle meningeal artery organization in humans-embryological considerations.

    Science.gov (United States)

    Harthmann da Silva, Tales; Ellwanger, Joel Henrique; Silva, Helen Tais da Rosa; Moraes, Daniela; Dotto, Anderson Cesar; Viera, Vinicius de Aguiar; de Campos, Deivis

    2013-04-01

    The middle meningeal artery (MMA) is the largest branch of the internal maxillary artery supplying the meninges. The complex sequence of MMA development gives many opportunities for variant anatomy. Additionally, the variations in the origin of the MMA are of clinical importance when dealing with fractures of the base of the skull, epidural hematomas, and bypass procedures. Therefore, various anastomosis and aberrant origins of the MMA have been documented in literature. However, there are no reports about some morphometric aspects of this important arterial segment. Thus, in this study, we decided to investigate the anatomical organization of the MMA through the bony groove measurements from human skulls (n?=?50 subjects). Six measurements were performed bilaterally: angle of the main trunk, length of the main trunk, angle between the frontal and parietal branches, length of the frontal branch, length of the parietal branch, and length of the bony tunnel formed by the frontal branch. We showed that the anatomical organization of the MMA is bilaterally similar, except for the length of the parietal branch (p?=?0.009). Moreover, our results provide baseline normal values for future studies aimed at further elucidating the functional and morphological pattern of the MMA. PMID:24436897

  18. Hyperdense large artery sign in meningitis: A marker of ominous thrombogenic potential of pneumococcus?

    Directory of Open Access Journals (Sweden)

    Deb Kumar Mojumder

    2014-01-01

    Full Text Available Hyperdensity in the middle cerebral artery (MCA or posterior cerebral artery (PCA on non-contrast head CT, suggests the presence of a thrombus inside these vessels, often referred to as the "MCA sign" or "PCA sign" respectively. These two signs are classically associated with strokes secondary to cardiovascular etiologies and are only infrequently reported with other types of stroke. Whereas stroke is a recognized complication of pneumococcal meningitis hyperdense large vessel sign (in this case a combination of MCA and PCA has not been previously reported. We report a case of rapidly progressive pneumococcal meningitis that presented as acute stroke involving large vessels in the vicinity of the circle of Willis in a patient with a history of non-Hodgkin lymphoma (NHL in remission for 6 years. This patient had received a week of high dose steroids before admission. Head CT scan on admission showed the presence of hyperdense MCA and PCA signs. The patient rapidly deteriorated and a follow-up head CT revealed diffuse brain edema and increased density in the basal cisterns without evidence of sub arachnoid hemorrhage.Tc99m exametazime brain flow scan showed no intracerebral blood flow both supra and infratentorially. Steptococcus pneumoniae, NHL cells and high-dose steroid use can upregulate tissue factor synthesis and may have led to a hypercoagulable state via activation of the extrinsic pathway in the large intracerbral arteries.

  19. Comparison of the vasodilator responses of isolated human and rat middle meningeal arteries to migraine related compounds

    DEFF Research Database (Denmark)

    Grände, Gustaf; Labruijere, Sieneke

    2014-01-01

    BACKGROUND: Migraine attacks occur spontaneously in those who suffer from the condition, but migraine-like attacks can also be induced artificially by a number of substances. Previously published evidence makes the meninges a likely source of migraine related pain. This article investigates the effect of several vasodilators on meningeal arteries in order to find a connection between the effect of a substance on a meningeal vessel and its ability to artificially induce migraine. METHODS: A myograph setup was used to test the vasodilator properties of the substances acetylcholine (ACh), sodium nitroprusside (SNP), sildenafil, prostaglandin E2 (PGE2), pituitary adenylate cyclase activating peptide-38 (PACAP-38), calcitonin gene-related peptide (CGRP) and NaCl buffer on meningeal arteries from human and rat. An unpaired t-test was used to statistically compare the mean Emax(%) at the highest concentration of each substance to the Emax(%) of NaCl buffer. RESULTS: In the human experiments, all substances except PACAP-38 had an Emax (%) higher than the NaCl buffer, but the difference was only significant for SNP and CGRP. For the human samples, clinically tested antimigraine compounds (sumatriptan, telcagepant) were applied to the isolated arteries, and both induced a significant decrease of the effect of exogenously administrated CGRP. In experiments on rat middle meningeal arteries, pre-contracted with PGF2?, similar tendencies were seen. When the pre-contraction was switched to K+ in a separate series of experiments, CGRP and sildenafil significantly relaxed the arteries. CONCLUSIONS: Still no definite answer can be given as to why pain is experienced during an attack of migraine. No clear correlation was found between the efficacy of a substance as a meningeal artery vasodilator in human and the ability to artificially induce migraine or the mechanism of action. Vasodilatation could be an essential trigger, but only in conjunction with other unknown factors. The vasculature of the meninges likely contributes to the propagation of the migrainal cascade of symptoms, but more research is needed before any conclusions can be drawn about the nature of this contribution.

  20. Expression and Characterization of Purinergic Receptors in Rat Middle Meningeal Artery–Potential Role in Migraine

    DEFF Research Database (Denmark)

    Haanes, Kristian Agmund; Edvinsson, Lars

    2014-01-01

    The dura mater and its vasculature have for decades been central in the hypothesis of migraine and headache pathophysiology. Although recent studies have questioned the role of the vasculature as the primary cause, dural vessel physiology is still relevant in understanding the complex pathophysiology of migraine. The aim of the present study was to isolate the middle meningeal artery (MMA) from rodents and characterize their purinergic receptors using a sensitive wire myograph method and RT-PCR. The data presented herein suggest that blood flow through the MMA is, at least in part, regulated by purinergic receptors. P2X1 and P2Y6 receptors are the strongest contractile receptors and, surprisingly, ADP?S caused contraction most likely via P2Y1 or P2Y13 receptors, which is not observed in other arteries. Adenosine addition, however, caused relaxation of the MMA. The adenosine relaxation could be inhibited by SCH58261 (A2A receptor antagonist) and caffeine (adenosine receptor antagonist). This gives one putative molecular mechanism for the effect of caffeine, often used as an adjuvant remedy of cranial pain. Semi-quantitative RT-PCR expression data for the receptors correlate well with the functional findings. Together these observations could be used as targets for future understanding of the in vivo role of purinergic receptors in the MMA.

  1. Expression and characterization of purinergic receptors in rat middle meningeal artery-potential role in migraine

    DEFF Research Database (Denmark)

    Haanes, Kristian Agmund; Edvinsson, Lars

    2014-01-01

    The dura mater and its vasculature have for decades been central in the hypothesis of migraine and headache pathophysiology. Although recent studies have questioned the role of the vasculature as the primary cause, dural vessel physiology is still relevant in understanding the complex pathophysiology of migraine. The aim of the present study was to isolate the middle meningeal artery (MMA) from rodents and characterize their purinergic receptors using a sensitive wire myograph method and RT-PCR. The data presented herein suggest that blood flow through the MMA is, at least in part, regulated by purinergic receptors. P2X1 and P2Y6 receptors are the strongest contractile receptors and, surprisingly, ADP?S caused contraction most likely via P2Y1 or P2Y13 receptors, which is not observed in other arteries. Adenosine addition, however, caused relaxation of the MMA. The adenosine relaxation could be inhibited by SCH58261 (A2A receptor antagonist) and caffeine (adenosine receptor antagonist). This gives one putativemolecular mechanism for the effect of caffeine, often used as an adjuvant remedy of cranial pain. Semi-quantitative RT-PCR expression data for the receptors correlate well with the functional findings. Together these observations could be used as targets for future understanding of the in vivo role of purinergic receptors in the MMA.

  2. Transcranial Direct Middle Meningeal Artery Puncture for the Onyx Embolization of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus

    Science.gov (United States)

    Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2015-01-01

    A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx. PMID:25674345

  3. Transcranial direct middle meningeal artery puncture for the onyx embolization of dural arteriovenous fistula involving the superior sagittal sinus.

    Science.gov (United States)

    Oh, Jae-Sang; Yoon, Seok-Mann; Shim, Jai-Joon; Bae, Hack-Gun

    2015-01-01

    A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx. PMID:25674345

  4. 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)

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

    DEFF Research Database (Denmark)

    Asghar, M S; Hansen, A E

    2010-01-01

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

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

    DEFF Research Database (Denmark)

    Liu, Yi; Broman, Jonas

    2008-01-01

    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.

  7. Parasitic Meningitis

    Science.gov (United States)

    ... 11 Chapter 12 Chapter 13 Chapter 14 Annex Viral Meningitis Fungal Meningitis Parasitic Meningitis Non-infectious Meningitis Resources ... other more common illnesses, such as bacterial or viral meningitis. People should seek medical care immediately whenever they ...

  8. Abnormality of the Foramen Spinosum due to a Variation in the Trajectory of the Middle Meningeal Artery: A Case Report in Human

    OpenAIRE

    Ellwanger, Joel Henrique; Campos, Deivis de

    2013-01-01

    Originating from the maxillary artery, the middle meningeal artery (MMA) is predominantly periosteal irrigating the bone and dura mater. It enters the floor of the middle cranial fossa through the foramen spinosum, travels laterally through a middle fossa bony ridge, and curves over the previous upper-greater wing of the sphenoid, where it in a variable point is divided into frontal and parietal branches. The complex sequence of the MMA development gives many opportunities for variant anatomy...

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

    Science.gov (United States)

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

    2015-07-01

    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

  10. Viral Meningitis

    Science.gov (United States)

    ... Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Viral Meningitis Recommend on Facebook Tweet Share Compartir On this ... tissue that covers the brain and spinal cord. Viral meningitis is the most common type of meningitis. It ...

  11. Cryptococcal Meningitis

    Science.gov (United States)

    ... PREVENTED? THE BOTTOM LINE WHAT IS CRYPTOCOCCAL MENINGITIS? Cryptococcus is a fungus. It is very common in ... Meningitis is the most common illness caused by Cryptococcus. Meningitis is an infection of the lining of ...

  12. PACAP-38 infusion causes sustained vasodilation of the middle meningeal artery in the rat : Possible involvement of mast cells

    DEFF Research Database (Denmark)

    Bhatt, Deepak K; Gupta, Saurabh

    2014-01-01

    BACKGROUND: In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing. Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in control rats because of a lack of vasodilatory products released during MC degranulation. METHODS: MCs were depleted by chronic treatment with compound 48/80. The effect of 20 minutes' intravenous (i.v.) infusion of calcitonin gene-related peptide (CGRP), PACAP-38, PACAP(6-38) (PAC-1 receptor antagonist) and PACAP-27 on the diameter of the MMA and on mean arterial blood pressure (MABP) in control and MCD rats was recorded by using the genuine closed-cranial window (CCW) model. Vasoactive intestinal polypeptide (VIP) infusion was given only in control rats. A combination of the histamine H1 receptor antagonist mepyramine (4 mg kg(-1) i.v.) and the H2 receptor antagonist famotidine (1 mg kg(-1) i.v.) was given 10 minutes prior to PACAP-38 infusion. Increasing doses of PACAP-38, PACAP-27 and VIP were infused through the intracarotid artery (i.c.) in control and MCD rats to see the direct effects of these peptides on MMA diameter change. RESULTS: There was no significant change in CGRP-induced MMA diameter increase in control and MCD rats, and the dilated MMA immediately returned back to baseline after stopping the infusion. The delayed MMA dilation induced by PACAP-38 was abolished in MCD and antihistamine (AH)-pretreated rats. Compared to PACAP-38, the PACAP-27 i.v. infusion gave smaller peak dilation of MMA in control rats. In MCD rats, PACAP-27 did not induce any significant dilation. VIP i.v. infusion reduced MABP but did not dilate MMA significantly. PACAP(6-38), which is a potent MC degranulator, also gave a significant delayed dilation of MMA. PACAP-38 i.c. responses (direct receptor mediated response) were not affected by MC depletion. Only the maximum response (% E max) value of PACAP-27 (i.c.) was significantly lower in MCD rats compared to control rats. CONCLUSIONS: The delayed MMA dilatory responses to PACAP-38 infusion were attenuated in MCD and AH-pretreated rats, indicating a role of the MC mediator-histamine in PACAP-38-induced delayed dilation of MA.

  13. PACAP-38 infusion causes sustained vasodilation of the middle meningeal artery in the rat : possible involvement of mast cells

    DEFF Research Database (Denmark)

    Bhatt, Deepak K; Gupta, Saurabh

    2014-01-01

    BACKGROUND: In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing. Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in control rats because of a lack of vasodilatory products released during MC degranulation. METHODS: MCs were depleted by chronic treatment with compound 48/80. The effect of 20 minutes' intravenous (i.v.) infusion of calcitonin gene-related peptide (CGRP), PACAP-38, PACAP(6-38) (PAC-1 receptor antagonist) and PACAP-27 on the diameter of the MMA and on mean arterial blood pressure (MABP) in control and MCD rats was recorded by using the genuine closed-cranial window (CCW) model. Vasoactive intestinal polypeptide (VIP) infusion was given only in control rats. A combination of the histamine H1 receptor antagonist mepyramine (4 mg kg(-1) i.v.) and the H2 receptor antagonist famotidine (1 mg kg(-1) i.v.) was given 10 minutes prior to PACAP-38 infusion. Increasing doses of PACAP-38, PACAP-27 and VIP were infused through the intracarotid artery (i.c.) in control and MCD rats to see the direct effects of these peptides on MMA diameter change. RESULTS: There was no significant change in CGRP-induced MMA diameter increase in control and MCD rats, and the dilated MMA immediately returned back to baseline after stopping the infusion. The delayed MMA dilation induced by PACAP-38 was abolished in MCD and antihistamine (AH)-pretreated rats. Compared to PACAP-38, the PACAP-27 i.v. infusion gave smaller peak dilation of MMA in control rats. In MCD rats, PACAP-27 did not induce any significant dilation. VIP i.v. infusion reduced MABP but did not dilate MMA significantly. PACAP(6-38), which is a potent MC degranulator, also gave a significantdelayed dilation of MMA. PACAP-38 i.c. responses (direct receptor mediated response) were not affected by MC depletion. Only the maximum response (% E max) value of PACAP-27 (i.c.) was significantly lower in MCD rats compared to control rats. CONCLUSIONS: The delayed MMA dilatory responses to PACAP-38 infusion were attenuated in MCD and AH-pretreated rats, indicating a role of the MC mediator-histamine in PACAP-38-induced delayed dilation of MA.

  14. Klebsiella meningitis. A case report.

    Science.gov (United States)

    Medhi, N; Goswami, P; Sarma, P; Barkataky, R K; Duarah, R; Saikia, R

    2008-06-01

    Acute bacterial meningitis is a severe CNS infection occurring mostly in infants and older children. Bacterial meningitis caused by gram-negative bacteria is usually fatal. Klebsiella pneumoniae is an uncommon gram-negative bacteria causing meningitis with a poor outcome. Though the commonest presentation of bacterial meningitis is fever, patients usually seek medical attention for uncontrolled seizure and features of raised ICP. The commonest complications of gram-negative bacterial meningitis including Klebsiella meningitis are subdural hygroma / empyema, hydrocephalus, infarcts (both arterial and venous) and cortical blindness due to hypoxic ischaemic insult. MRI is the best modality for evaluating these patients for early diagnosis. Early institution of treatment significantly reduces the mortality and morbidity. We describe a case of acute bacterial meningitis caused by Klebsiella pneumoniae with MR evidence of sinus thrombosis, venous infarcts and subdural hygroma. PMID:24256900

  15. Meningitis bacteriana / Bacterial meningitis

    Scientific Electronic Library Online (English)

    Ana Teresa, Alvarado Guevara; Lizzie Marie, Castillo Solano.

    2006-03-01

    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 u [...] na 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. Abstract in english 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

  16. Meningitis bacteriana Bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Ana Teresa Alvarado Guevara

    2006-03-01

    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

  17. Meningitis - cryptococcal

    Science.gov (United States)

    Most cryptococcal meningitis is caused by the fungus Cryptococcus neoformans . This fungus is found in soil around the world. Another type of Cryptococcus can also cause meningitis, but it will not ...

  18. Abnormality of the Foramen Spinosum due to a Variation in the Trajectory of the Middle Meningeal Artery: A Case Report in Human.

    Science.gov (United States)

    Ellwanger, Joel Henrique; Campos, Deivis de

    2013-12-01

    Originating from the maxillary artery, the middle meningeal artery (MMA) is predominantly periosteal irrigating the bone and dura mater. It enters the floor of the middle cranial fossa through the foramen spinosum, travels laterally through a middle fossa bony ridge, and curves over the previous upper-greater wing of the sphenoid, where it in a variable point is divided into frontal and parietal branches. The complex sequence of the MMA development gives many opportunities for variant anatomy. In a Caucasian cadaver skull of an approximately 35-year-old individual belonging to the didactical collection of the Laboratory of Human Anatomy at the University of Santa Cruz do Sul, Brazil, it was noted that the right foramen spinosum has an abnormal shape. In this report, we discuss an abnormality of the foramen spinosum due to a variation in the trajectory of the MMA. Thus, the present study shall be important for health sciences and those who have some interest in pathologies associated with the MMA. PMID:24294564

  19. 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)

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

    2008-01-01

    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

  20. Fungal Meningitis

    Science.gov (United States)

    ... meningitis for people with weakened immune systems is Cryptococcus . This disease is one of the most common ... types of fungus are transmitted in several ways. Cryptococcus is thought to be acquired through inhaling soil ...

  1. Chronic Meningitis

    Science.gov (United States)

    ... AIDS or who take drugs that suppress the immune system. Less commonly, chronic meningitis is caused by other bacteria (such as those that cause syphilis), other fungi, or parasites such as the protozoa Toxoplasmosis gondii (usually in ...

  2. Meningeal hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    Guang-zhi YANG

    2015-03-01

    Full Text Available Objective To investigate the clinical, neuroimaging and pathological features of meningeal hemangiopericytoma.  Methods One case of meningeal hemangiopericytoma was reported, and the relevant literatures were also reviewed.  Results A 40-year-old male had caught a headache for about 3 months with muscle weakness in the left limb, and became progressively serious for 2 weeks. Brain MRI displayed a space-occupying lesion in the right temporal lobe with equal signals in T1WI, mixed signals in T2WI and obvious enhancements. In surgery, the tumor was found to be located in the cranial fossa, and was completely removed. The tumor was large, with rich blood supply, and had no capsule. In histology, the neoplasm was composed of dense spindle cells with mild atypia. The boundary of the tumor cells was unclear. The nuclei were circular, oval or spindle with obvious mitoses (4/10 HPF. There were plenty of thick-wall blood vessels and blood sinuses with characteristic "staghorn" shape. In immunohistochemistry, CD34 and vimentin (Vim were positive, epithelial membrane antigen (EMA was focally positive and Ki-67 labeling index was 17%-20%. Postoperative radiotherapy was adopted and no relapse was found during the 20-month follow-up period. Conclusions The meningeal hemangiopericytoma is easy to be misdiagnosed as meningioma, however, the prognosis of meningeal hemangiopericytoma is quite worse, thus the differential diagnosis is very important. A clear diagnosis often depends on pathological examination. DOI: 10.3969/j.issn.1672-6731.2015.03.011

  3. Meningitis (For Parents)

    Science.gov (United States)

    ... be life threatening if not treated right away. Viral meningitis (also called aseptic meningitis ) is relatively common and ... rarer. Similarly, many different viruses can lead to viral meningitis, including enteroviruses (such as coxsackievirus and poliovirus) and ...

  4. Meningitis and Encephalitis

    Science.gov (United States)

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

  5. Cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    DING Wen-ting

    2013-01-01

    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.

  6. Meningitis - H. influenzae

    Science.gov (United States)

    ... PA: Elsevier Saunders; 2011:chap 595. Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine . 23rd ed. Philadelphia, PA: Elsevier ... Bacterial meningitis in the United States, 1998-2007. N Engl ...

  7. Pituitary Apoplexy Mimicking Meningitis

    OpenAIRE

    Oh, Keun; Kim, Jang-Hee; Choi, Jin-Wook; Kang, Jae-Kyu; Kim, Se-Hyuk

    2013-01-01

    Pituitary apoplexy is a rare but life-threatening disorder. Clinical presentation of this condition includes severe headaches, impaired consciousness, fever, visual disturbance, and variable ocular paresis. The clinical presentation of meningeal irritation is very rare. Nonetheless, if present and associated with fever, pituitary apoplexy may be misdiagnosed as a meningitis. We experienced a case of pituitary apoplexy masquerading as a meningitis. A 42-year-old man presented with meningitis a...

  8. Primary Spinal Meningeal Melanocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Dong Ho [Dong-A University, Busan (Korea, Republic of)

    2009-12-15

    Primary meningeal melanocytic neoplasms are rare lesions that originate from leptomeningeal melanocytes. An intradural meningeal melanocytoma in the thoracic spine is less common than a malignant melanoma, which is its malignant counterpart. We report a case of a histopathologically confirmed primary intradural meningeal melanocytoma in the thoracic spine along with a literature.

  9. Bacterial meningitis in children. MR findings

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-09-01

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

  10. Meningitis por Streptococcus suis / Streptococcus suis meningitis

    Scientific Electronic Library Online (English)

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

    2001-06-01

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

  11. Laboratorial diagnosis of lymphocytic meningitis

    Scientific Electronic Library Online (English)

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

    2007-10-01

    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 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.

  12. Laboratorial diagnosis of lymphocytic meningitis

    Directory of Open Access Journals (Sweden)

    Sérgio Monteiro de Almeida

    2007-10-01

    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.

  13. Laboratorial diagnosis of lymphocytic meningitis

    OpenAIRE

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

    2007-01-01

    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...

  14. 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.)

  15. Middle Meningeal Arteriovenous Fistula and Its Spontaneous Closure: A Case Report and Review of the Literature

    OpenAIRE

    Chandrashekar, H.S.; Nagarajan, K.; Srikanth, S. G.; Jayakumar, P. N.; Vasudev, M.K.; Pandey, Paritosh

    2007-01-01

    Middle meningeal artery pseudo-aneurysms and arteriovenous fistulas are usually post-traumatic, although occasional iatrogenic cases have been reported. The treatment has been obliteration of the fistula by surgical or endovascular means. Spontaneous closure of fistula is uncommon. We report a case of non-traumatic middle meningeal arteriovenous fistula in a patient with alcoholism, which resolved spontaneously without treatment.

  16. Pseudomonas denitrificans Meningitis

    OpenAIRE

    Fischer, Robert A.; Doern, Gary V.; Cheeseman, Sarah H.

    1981-01-01

    An elderly male patient with Pseudomonas denitrificans bacteremia and meningitis is described. The antimicrobial susceptibility and minimum criteria necessary for the identification of this unusual and rare human pathogen are discussed.

  17. Primary Meningeal Rhabdomyosarcoma

    OpenAIRE

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

    2011-01-01

    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...

  18. Meningitis bacteriana aguda / Acute bacterial meningitis

    Scientific Electronic Library Online (English)

    Marcela, Castro R; Jaime, Cordero T.

    1998-08-01

    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. Abstract in english 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.

  19. Prospective surveillance of neonatal meningitis.

    OpenAIRE

    Thomas, H. M; Riordan, F A; Thomson, A. P; Hart, C A

    1993-01-01

    Neonatal meningitis is a serious problem with a high mortality and frequent neurological sequelae. The incidence of neonatal meningitis was calculated and the aetiology, clinical and laboratory features, and the treatment of cases recorded prospectively over a 7 year 8 month period was documented. It was further investigated whether secondary meningitis had occurred after lumbar puncture. The estimated incidence of bacterial, viral, and fungal meningitis was 0.25, 0.11, and 0.02 per 1000 live...

  20. [Cutaneous heterotopic meningeal nodules].

    Science.gov (United States)

    Battistella, Maxime; Verola, Olivier; Moulonguet, Isabelle; Janin, Anne

    2009-04-01

    Cutaneous heterotopic meningeal nodules are rare lesions whose pathogenesis remain discussed. They are typically located on the scalp or the rachidian axis. They often are congenital and diagnosed during childhood or young adulthood. There are two admitted theories for pathogenesis of heterotopic meningeal nodules: (1) tumoral proliferation of ectopic arachnoïdal cells (true cutaneous meningioma), (2) meningocele-type developmental defect (rudimentary meningocele). Histological and immunohistochemical aspects are characteristic, showing arachnoidal cells, EMA+ and vimentine+, that infiltrate collagene and whorl around collagene or psammomatous bodies. We report the expression of progesterone receptor (PR) in a cutaneous heterotopic meningeal nodule on the scalp of a 23-year-old man, and propose this PR expression as a new diagnosis tool for such lesions. PMID:19364587

  1. 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)

  2. Stroke? Localized, otogenic meningitis!

    DEFF Research Database (Denmark)

    Ingolfsdottir, Harpa Maria; Thomasen, Per Caye

    2011-01-01

    We report the case of a patient admitted with aphasia, treated for a stroke. Subsequently, it was revealed that the symptoms were caused by complicated otitis media with localized meningitis. This case draws attention to the possible intracranial spread of infection when neurological symptoms occur in a patient with otitis media.

  3. Cerebrospinal fluid concentration of fibronectin in meningitis.

    OpenAIRE

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

    1991-01-01

    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.

  4. Natalizumab and HSV meningitis

    OpenAIRE

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

    2011-01-01

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

  5. 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.)

  6. Pseudooutbreak of cryptococcal meningitis.

    OpenAIRE

    Hopfer, R L; Katz, R. L.; Fainstein, V

    1982-01-01

    A pseudooutbreak of cryptococcal meningitis was caused by the use of contaminated albumin solution used in the preparation of Papanicolaou-stained slides of cerebrospinal fluid. Organisms were seen in cytocentrifuge preparations, but not in India ink preparations of cerebrospinal fluid specimens. Cryptococcal antigen tests were positive and Cryptococcus neoformans was cultured from the albumin-treated cerebrospinal fluid specimens and from the albumin solution.

  7. Aseptic Meningitis and Viral Myelitis

    OpenAIRE

    Irani, David N.

    2008-01-01

    Meningitis and myelitis represent common and very infrequent viral infections of the central nervous system (CNS), respectively. Indeed, the number of cases of viral meningitis that occurs annually exceeds the total number of meningitis cases caused by all other etiologies combined. Focal CNS infections, on the other hand, such as occur in the spinal cord with viral myelitis, are much less common and may be confused with non-infectious disorders that cause acute flaccid paralysis (AFP). This ...

  8. Meningitis sifilítica aguda Acute syphilitic meningitis

    Directory of Open Access Journals (Sweden)

    Efraín Riveros

    2011-09-01

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

  9. Meningitis sifilítica aguda / Acute syphilitic meningitis

    Scientific Electronic Library Online (English)

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

    2011-09-01

    Full Text Available Se trata de un paciente de 28 años de sexo femenino, que presentó un cuadro clínico rápidamente progresivo de cambios en el comportamiento y deterioro del estado de conciencia. Ingresó con puntaje de Glasgow de 8/15 y requirió intubación traqueal. Tenía respuesta plantar extensora bilateral, pupila [...] izquierda midriática de 5 mm, sin respuesta a la luz, ptosis palpebral del mismo lado y nistagmo con componente rápido hacia la izquierda. El contenido de proteínas del líquido cefalorraquídeo fue de 0,86 g/l con pleocitosis moderada de predominio linfocitario. Tres semanas antes del ingreso, presentó parto vaginal eutócico; no tuvo control prenatal durante el embarazo. En el recién nacido se demostró serología reactiva para sífilis y FTA-ABS positivo. La paciente también fue hallada reactiva para serología de sífilis en el líquido cefalorraquídeo, con diagnóstico de meningitis sifilítica aguda. La prueba ELISA para VIH fue negativa. 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.

  10. Epidemiology of bacterial meningitis.

    OpenAIRE

    Fortnum, H M; Davis, A.C.

    1993-01-01

    This 10 year retrospective study of all causes of bacterial meningitis for children resident in Nottingham District Health Authority area reports an annual incidence rate per 100,000 children aged 0-16 years of 16.0 (95% confidence interval 14.0 to 18.1). There was a steady increase in incidence from 9.6/100,000 in 1980 to 24.3/100,000 in 1989. This was mainly due to an increase in the incidence of meningococcal infections in the age group 1 month to 5 years. Incidence rates varied with age b...

  11. Neuropsychiatric sequelae of viral meningitis in adults

    DEFF Research Database (Denmark)

    Damsgaard, Jesper; Hjerrild, Simon

    2011-01-01

    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.

  12. Acute bacterial meningitis in Qatar.

    OpenAIRE

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

    2006-01-01

    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 We described 64 patients with culture proven bacterial meningitis....

  13. The effect of sumatriptan on cephalic arteries : A 3T MR-angiography study in healthy volunteers

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail

    2013-01-01

    To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries (BA).

  14. Acute meningitis by Streptococcus suis

    Directory of Open Access Journals (Sweden)

    Maria-Jesus Corrales-Arroyo

    2012-12-01

    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.

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

    Scientific Electronic Library Online (English)

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

    2009-04-01

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

  16. Meningeal metastasing of malignant melanomas

    International Nuclear Information System (INIS)

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

  17. Mycobacterium Bovis Meningitis: Case Report

    Directory of Open Access Journals (Sweden)

    Nihan Uygur Külcü

    2012-06-01

    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.

  18. Meningitis as cochlear implant complication

    Directory of Open Access Journals (Sweden)

    Kosanovi? Rade

    2009-01-01

    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.

  19. Increased anisotropy in neonatal meningitis: an indicator of meningeal inflammation

    International Nuclear Information System (INIS)

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

  20. Increased anisotropy in neonatal meningitis: an indicator of meningeal inflammation

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

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

  1. Study of tuberculous meningitis by CT

    International Nuclear Information System (INIS)

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

  2. Meningitis, Clinical Presentation of Tetanus

    OpenAIRE

    Moniuszko, Anna; Zajkowska, Agata; Tumiel, Ewa; Rutkowski, Krzysztof; Czupryna, Piotr; Pancewicz, S?awomir; Rutkowski, Ryszard; Zdrodowska, Agnieszka; Zajkowska, Joanna

    2015-01-01

    Background. Tetanus is an acute disease caused by a neurotoxin produced by Clostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals. Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays. Why Should Physician Be Aware of This? Even in developed countries...

  3. Salmonella typhimurium meningitis in infancy

    OpenAIRE

    Adhikary, Ranjeeta; Joshi, Sangeeta; Ramakrishnan, Meera

    2013-01-01

    We report a case of meningitis due to Salmonella typhimurium in a four-month-old female infant. The child was brought to the pediatric emergency department with complaints of fever, cold, and generalized convulsion. On examination, the child was febrile and was having seizures. The anterior fontanelle was not bulging. Lumbar puncture was done and Salmonella typhimurium was isolated from cerebrospinal fluid. Initially the infant improved clinically with appropriate management, but had a fatal ...

  4. Endolymphatic sac involvement in bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Brandt, Christian; Andersen, Christian Østergaard; Caye-Thomasen, Per

    2015-01-01

    The commonest sequelae of bacterial meningitis are related to the inner ear. Little is known about the inner ear immune defense. Evidence suggests that the endolymphatic sac provides some protection against infection. A potential involvement of the endolymphatic sac in bacterial meningitis is largely unaccounted for, and thus the object of the present study. A well-established adult rat model of Streptococcus pneumoniae meningitis was employed. Thirty adult rats were inoculated intrathecally wit...

  5. Serum Procalcitonin in Viral and Bacterial Meningitis

    OpenAIRE

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

    2011-01-01

    Background: In children with meningitis, there is a difficulty to verify the etiology as viral or bacterial. Therefore, intensive research has been carried out to find new and rapid diagnostic methods for differentiating bacterial from viral meningitis. Objectives: The aim of this work was to study the behavior of procalcitonin (PCT) and whether it can be used to differentiate children with bacterial from those with viral meningitis. We also compared PCT to C-reactive protein (CRP) and white ...

  6. Differential vasoactive effects of sildenafil and tadalafil on cerebral arteries

    DEFF Research Database (Denmark)

    Kruuse, Christina Rostrup; Gupta, Saurabh

    2012-01-01

    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.

  7. Diagnostic value of MRI in tuberculous meningitis

    International Nuclear Information System (INIS)

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

  8. A multidisciplinary approach to the treatment of severe cerebral vasospasm following bacterial meningitis: A case report and literature review

    Science.gov (United States)

    Nussbaum, Eric S.; Lowary, Jodi; Nussbaum, Leslie A.

    2015-01-01

    Background: Although cerebrovascular complications of bacterial meningitis are common, postmeningitic cerebral vasospasm significant enough to result in ischemic injury has been reported in only limited fashion. Case Description: We describe a case of severe cerebral vasospasm following streptococcal meningitis managed successfully with emergency suboccipital decompression, extracranial-intracranial bypass, intra-arterial vasodilator infusion, and maximal medical therapy. To our knowledge, this may be the first case in which surgical cerebral revascularization has been utilized to limit ischemic injury in the setting of postmeningitic cerebral vasospasm. Conclusions: Patients presenting with abrupt neurological decline following recent treatment for bacterial meningitis may be suffering from a reversible vasoconstriction of the cerebral arteries, and prompt aggressive treatment can result in a favorable outcome even in patients who present in very poor neurological condition.

  9. Deficient cerebrospinal fluid opsonization in experimental Escherichia coli meningitis.

    OpenAIRE

    Bernhardt, L L; Simberkoff, M S; Rahal, J.J.

    1981-01-01

    Infected cerebrospinal fluid from rabbits with Escherichia coli meningitis failed to opsonize the infecting organism. Cerebrospinal fluid from rabbits with Staphylococcus aureus meningitis did opsinize E. coli.

  10. Urinoma and arterial hypertension complicating neonatal renal candidiasis

    International Nuclear Information System (INIS)

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

  11. Urinoma and arterial hypertension complicating neonatal renal candidiasis

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-02-01

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

  12. Personlighedsforandring og hydrocefalus forårsaget af tuberkuløs meningitis

    DEFF Research Database (Denmark)

    von Huth, Sebastian; Pedersen, Court

    2015-01-01

    Tuberculous meningitis (TBM) denotes infection of the meninges with Mycobacterium tuberculosis complex. In Denmark, TBM is rare, but requires correct handling and rapid treatment. We describe a case of TBM in a previously healthy 19-year-old man from Somalia, whose primary symptoms were fever, headache and altered mental state.

  13. Onkologisk behandling af meningeal carcinomatose

    DEFF Research Database (Denmark)

    Sulim, S.; HØyer, Morten

    2005-01-01

    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

  14. Predominant enteroviral serotypes causing meningitis

    OpenAIRE

    Atkinson, P.; Sharland, M; Maguire, H.

    1998-01-01

    All enteroviral reports to the Public Health Laboratory Service from 1975 to 1994 which had been proved by culture were analysed. Of the 40 366 isolates, 5741 reports (14%) were from cultures of cerebrospinal fluid. The groups and serotypes accounting for the largest number of cerebrospinal fluid isolates were A9, E7, E9, E11, E19, and E30, accounting for 70% of all cultured isolates of cerebrospinal fluid. It may be possible to prevent most cases of viral meningitis in t...

  15. Meningitis kan ligne subaraknoidal blødning

    DEFF Research Database (Denmark)

    Elghoura, Nour Foad Diab

    2012-01-01

    A 70 year-old man was admitted under the diagnosis of subarachnoid haemorrhage and presented with a history of ear pain, followed by acute onset of severe headache, nausea, vomiting, impaired consciousness, and fever. However, a computed tomography (CT) showed an acute mastoiditis and pneumocephalus, and a lumbar puncture confirmed the diagnosis meningitis. The increased middle ear pressure relative to the intracranial pressure had caused air and bacteria to penetrate intracerebrally. This case illustrates the importance of a rapid diagnostic workup in acute onset headache including a careful anamnesis, CT and lumbar puncture.

  16. In Brief: Forecasting meningitis threats

    Science.gov (United States)

    Showstack, Randy

    2008-12-01

    The University Corporation for Atmospheric Research (UCAR), in conjunction with a team of health and weather organizations, has launched a project to provide weather forecasts to medical officials in Africa to help reduce outbreaks of meningitis. The forecasts will enable local health care providers to target vaccination programs more effectively. In 2009, meteorologists with the National Center for Atmospheric Research, which is managed by UCAR, will begin issuing 14-day forecasts of atmospheric conditions in Ghana. Later, UCAR plans to work closely with health experts from several African countries to design and test a decision support system to provide health officials with useful meteorological information. ``By targeting forecasts in regions where meningitis is a threat, we may be able to help vulnerable populations. Ultimately, we hope to build on this project and provide information to public health programs battling weather-related diseases in other parts of the world,'' said Rajul Pandya, director of UCAR's Community Building Program. Funding for the project comes from a $900,000 grant from Google.org, the philanthropic arm of the Internet search company.

  17. 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)

  18. Epidemiología de la meningitis Venezuela 2010

    Scientific Electronic Library Online (English)

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

    2010-12-01

    Full Text Available 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.

  19. Meninges: from protective membrane to stem cell niche

    OpenAIRE

    Decimo, Ilaria; Fumagalli, Guido; Berton, Valeria; Krampera, Mauro; Bifari, Francesco

    2012-01-01

    Meninges are a three tissue membrane primarily known as coverings of the brain. More in depth studies on meningeal function and ultrastructure have recently changed the view of meninges as a merely protective membrane. Accurate evaluation of the anatomical distribution in the CNS reveals that meninges largely penetrate inside the neural tissue. Meninges enter the CNS by projecting between structures, in the stroma of choroid plexus and form the perivascular space (Virchow-Robin) of every pare...

  20. Method for inducing experimental pneumococcal meningitis in outbred mice

    OpenAIRE

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

    2004-01-01

    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 w...

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

    Scientific Electronic Library Online (English)

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

    2013-06-01

    Full Text Available 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 ).

  2. Meningitis

    Science.gov (United States)

    ... as enteroviruses (say: en-TEH-row-VYE-rus-ez). Like most viruses, enteroviruses infect your body through ... your hands. Wash up regularly with warm, soapy water — especially before eating, after using the bathroom, and ...

  3. The microbiological diagnosis of tuberculous meningitis

    DEFF Research Database (Denmark)

    Erdem, H; Ozturk-Engin, D; Elaldi, N; Gulsun, S; Sengoz, G; Crisan, A; Johansen, Isik Somuncu; Inan, A; Nechifor, M; Al-Mahdawi, A; Civljak, R; Ozguler, M; Savic, B; Ceran, N; Cacopardo, B; Inal, A S; Namiduru, M; Dayan, S; Kayabas, U; Parlak, E; Khalifa, A; Kursun, E; Sipahi, O R; Yemisen, M; Akbulut, A; Bitirgen, M; Dulovic, O; Kandemir, B; Luca, C; Parlak, M; Stahl, J P; Pehlivanoglu, F; Simeon, S; Ulu-Kilic, A; Yasar, K; Yilmaz, G; Yilmaz, E; Beovic, B; Catroux, M; Lakatos, B; Sunbul, M; Oncul, O; Alabay, S; Sahin-Horasan, E; Kose, S; Shehata, G; Andre, K; Alp, A; Cosi?, G; Cem Gul, H; Karakas, A; Chadapaud, S; Hansmann, Y; Harxhi, A; Kirova, V; Masse-Chabredier, I; Oncu, S; Sener, A; Tekin, R; Deveci, O; Karabay, O; Agalar, C

    2014-01-01

    We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total ...

  4. Testing for Meningitis in Children with Bronchiolitis

    OpenAIRE

    Stefanski, Michael; Williams, Ronald; McSherry, George; Geskey, Joseph

    2014-01-01

    The authors present a retrospective, case-control study of hospitalized infants younger than age one year diagnosed with viral bronchiolitis who underwent lumbar puncture as part of an evaluation for meningitis. The presence of apnea, cyanosis, meningeal signs, positive urine culture results, and young age were factors found to be preliminarily associated with the performance of a lumbar puncture in the setting of bronchiolitis. Young age was the only significant clinical factor found after m...

  5. Cryptococcal meningitis: epidemiology and therapeutic options

    OpenAIRE

    Sloan DJ; Parris V

    2014-01-01

    Derek J Sloan, Victoria Parris Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK Abstract: Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV) infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: inducti...

  6. Cryptococcus and lymphocytic meningitis in Botswana

    Scientific Electronic Library Online (English)

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

    2008-09-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Rocío Villar-Taibo

    2014-02-01

    Full Text Available 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.

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

    Scientific Electronic Library Online (English)

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

    2001-10-01

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

  9. Síndrome de meningitis y retención urinaria / Meningitis-retention syndrome. Report of one case

    Scientific Electronic Library Online (English)

    Luis, Cartier R; Fernando, Hansen B.

    2014-12-01

    Full Text Available [...] Abstract in english The Meningitis-Retention Syndrome associates aseptic meningitis and neurogenic bladder, with a vesical dysfunction that outlasts meningitis widely. Urodynamic assessment shows a detrusor palsy with normal function of the external sphincter. We report a 24-year-old male admitted for headache, fever, [...] myalgias and acute urinary retention, which was diagnosed as a urinary tract infection. Worsening of symptoms and slight meningeal signs prompted for a lumbar puncture that yielded a cerebrospinal fluid with 94 lymphocytes, in which etiological evaluation was inconclusive. Meningeal syndrome and myalgia subsided by the fifth day, while urinary retention persisted. A magnetic resonance imaging of the brain and spinal cord done at the fifth day, showed high intensity signals in basal ganglia and central spinal cord, not altered by contrast. These images disappeared in the imaging control performed two months later. Bladder dysfunction lasted at least until the second month of follow up.

  10. Chronic meningitis and central nervous system vasculopathy related to Epstein Barr virus

    Directory of Open Access Journals (Sweden)

    Anil Kumar B Patil

    2012-01-01

    Full Text Available Chronic active Epstein Barr virus (EBV infection causes a wide spectrum of manifestation, due to meningeal, parenchymal and vascular involvement. An 11-year-old boy presented with chronic headache, fever and seizures of 18 months duration. His magnetic resonance imaging Brain showed fusiform aneurysmal dilatations of arteries of both the anterior and posterior cerebral circulation. Cerebrospinal fluid (CSF showed persistent lymphocytic pleocytosis, raised proteins and low sugar with positive polymerase chain reaction for EBV. He later developed pancytopenia due to bone marrow aplasia, with secondary infection and expired. From clinical, imaging and CSF findings, he had chronic lymphocytic meningitis with vasculopathy, which was isolated to the central nervous system. He later had marrow aplasia probably due to X-linked lymphoproliferative disorder related to EBV infection. Vasculopathy, especially diffuse fusiform aneurysmal dilatation associated with chronic EBV infection, is rare, but has been described, similar to our case report.

  11. Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa

    International Nuclear Information System (INIS)

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

  12. Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa

    Energy Technology Data Exchange (ETDEWEB)

    Brainin, M.; Samec, P.

    1983-06-01

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

  13. Haemophilus influenzae type b meningitis resistant to ampicillin and chloramphenicol.

    OpenAIRE

    Guiscafré, H; Solórzano, F; Delgado, O; Muñoz, O.

    1986-01-01

    We report two cases of meningitis due to Haemophilus influenzae type b resistant to ampicillin and chloramphenicol. In one child the meningitis was preceded by pneumonia and pleural effusion. Both children responded to treatment with cefotaxime.

  14. Risk of Bacterial Meningitis in Children with Cochlear Implants

    Science.gov (United States)

    ... Risk of Bacterial Meningitis in Children with Cochlear Implants Language: English Español (Spanish) Recommend on Facebook Tweet ... Risk of Bacterial Meningitis in Children with Cochlear Implants Many people have received cochlear implants to help ...

  15. Cryptococcal meningitis: Clinical, diagnostic and therapeutic overviews

    Directory of Open Access Journals (Sweden)

    Satishchandra P

    2007-01-01

    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.

  16. Endolymphatic sac involvement in bacterial meningitis

    DEFF Research Database (Denmark)

    MØller, Martin Nue; Brandt, Christian

    2015-01-01

    The commonest sequelae of bacterial meningitis are related to the inner ear. Little is known about the inner ear immune defense. Evidence suggests that the endolymphatic sac provides some protection against infection. A potential involvement of the endolymphatic sac in bacterial meningitis is largely unaccounted for, and thus the object of the present study. A well-established adult rat model of Streptococcus pneumoniae meningitis was employed. Thirty adult rats were inoculated intrathecally with Streptococcus pneumoniae and received no additional treatment. Six rats were sham-inoculated. The rats were killed when reaching terminal illness or on day 7, followed by light microscopy preparation and PAS-Alcian blue staining. The endolymphatic sac was examined for bacterial invasion and leukocyte infiltration. Neither bacteria nor leukocytes infiltrated the endolymphatic sac during the first days. Bacteria invaded the inner ear through the cochlear aquaduct. On days 5-6, the bacteria invaded the endolymphatic sac through the endolymphatic duct subsequent to invasion of the vestibular endolymphatic compartment. No evidence of direct bacterial invasion of the sac through the meninges was found. Leukocyte infiltration of the sac occurred prior to bacterial invasion. During meningitis, bacteria do not invade the endolymphatic sac through the dura, but solely through the endolymphatic duct, following the invasion of the vestibular system. Leukocyte infiltration of the sac occurs prior to, as well as concurrent with bacterial invasion. The findings support the endolymphatic sac as part of an innate immune defense system protecting the inner ear from infection.

  17. Cryptococcal meningitis: clinical, diagnostic and therapeutic overviews.

    Science.gov (United States)

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

    2007-01-01

    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. PMID:17921651

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

    Scientific Electronic Library Online (English)

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

    2013-08-01

    Full Text Available 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.

  19. Aseptic Meningitis with Urinary Retention: A Case Report

    OpenAIRE

    Konstantinos Stravodimos; Dimitrios Bougas; Sofia Kanellopoulou; Kostas Konstantopoulos; Aristidis Alevizopoulos; Fotinie Ntziora

    2011-01-01

    Introduction. Aseptic meningitis is serious inflammation of the meninges caused by agents including viruses, non-viral pathogens, non-infectious conditions and chemicals. Case Presentation. This study concerns the case of a 16-year-old healthy Greek female with persistent fever, mild headache and acute urinary retention, secondary to aseptic meningitis. Physical examination revealed no distinct signs of meningeal irritation. The urinary bladder was palpable, painless and over-distended. Serol...

  20. Leukemic meningitis involving the cauda equina: a case report

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-15

    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.

  1. Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis

    OpenAIRE

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

    2010-01-01

    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 g...

  2. A Case of Meningitis Caused By Pneumococcus Serotype 20

    Directory of Open Access Journals (Sweden)

    Emrah Can

    2009-12-01

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

  3. Clinical, epidemiological and etiological studies of adult aseptic meningitis: Report of 13 cases with mumps meningitis.

    Science.gov (United States)

    Takeshima, Shinichi; Yoshimoto, Takeshi; Shiga, Yuji; Kanaya, Yuhei; Neshige, Shuichiro; Himeno, Takahiro; Kono, Ryuhei; Takamatsu, Kazuhiro; Shimoe, Yutaka; Kuriyama, Masaru

    2015-09-11

    We experienced 13 cases (29.8 ± 7.0 years) of mumps meningitis and 365 cases of adult aseptic meningitis during 11 years from 2004 to 2014. A small epidemic of mumps occurred for 3-4 years, and the incidence rate of adult mumps meningitis coincided with the epidemic without seasonal fluctuation. Parotitis was observed in 8 of the 13 mumps meningitis patients (61.5%) and orchitis in 2 of 7 male patients (28.6%). There were no differences in clinical manifestations, laboratory findings, and outcome between patients with adult mumps meningitis and those with echovirus 9 meningitis (9 patients), except for the low frequency of nausea/vomiting and a high percentage of mononuclear cells of the cerebrospinal fluid in those with mumps. Eight patients had contact with persons with mumps before the symptomatic stage of meningitis. Only one patient had received mumps vaccination in childhood. On the basis of the values of the anti-mumps IgM and IgG antibodies, we speculated primary infection and the re-infection of mumps in 6 and 2 patients, respectively. Moreover, second vaccine failure was suggested in the vaccinated patient. PMID:26156258

  4. FDG PET in Intracranial Carcinomatous Meningitis.

    Science.gov (United States)

    Heimburger, Céline; Bund, Caroline; Namer, Izzie Jacques

    2016-01-01

    A 63-year-old white man, diagnosed with pT3N2 squamous cell lung carcinoma, underwent right upper lobectomy with adjuvant radiochemotherapy. After a partial epileptic seizure, MRI revealed a solitary right frontal metastasis that was treated with surgical resection followed by stereotaxic radiotherapy. Three months later, the patient presented weight loss, weakness, and headache. He underwent a whole-body FDG PET/CT for restaging. It showed intense FDG uptakes on the brain periphery corresponding to nodular meningeal contrast enhancement on MRI leading to the diagnosis of carcinomatous meningitis, despite negative cerebrospinal fluid cytology. PMID:26447391

  5. 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.

  6. Anthrax Meningitis - Report Of An Autopsied Case

    Directory of Open Access Journals (Sweden)

    Mahadevan A

    1999-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    AR EMAMI NAEINI

    2001-03-01

    Full Text Available Introduction. Central nervous system infections are among the most serious conditions in of medical practice. C-reactive Protein has recently been evaluated in terms of its ability to diffeccentiate bacterial from nonbacterial central nervous system inflammations.
    Methods. We studied the frequency of positive CRP in 61 patients who had signs of meningitis. All the specimens referred to one laboratory and were examined by Slide method.
    Results. Positive CRP was found in 97.6 percent of those who were finally diagnosed as bacterial meningitis. The frequency of CRP for other types of meningitis was 16.6 percent (P < 0.05.
    Discussion. In the absence of infection, CSF is free of CRP. Positive CRP may help to the differentiate the different types of meningitis.

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

    Directory of Open Access Journals (Sweden)

    A.R EMAMI NAEINI

    2001-06-01

    Full Text Available Introduction. Central nervous system infections are among the most serious conditions in of medical practice. C-reactive Protein has recently been evaluated in terms of its ability to diffeccentiate bacterial from nonbacterial central nervous system inflammations.
    Methods. We studied the frequency of positive CRP in 61 patients who had signs of meningitis. All the specimens referred to one laboratory and were examined by Slide method.
    Results. Positive CRP was found in 97.6 percent of those who were finally diagnosed as bacterial meningitis. The frequency of CRP for other types of meningitis was 16.6 percent (P < 0.05.
    Discussion. In the absence of infection, CSF is free of CRP. Positive CRP may help to the differentiate the different types of meningitis.

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

    OpenAIRE

    MJ Pérez Álvarez; M Moreno López

    2004-01-01

    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 su...

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

    Scientific Electronic Library Online (English)

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

    2010-02-01

    Full Text Available Introducción. La mayoría de las meningitis en la infancia no son bacterianas, pero la dificultad en descartar tal etiología obliga con frecuencia a utilizar antibióticos inicialmente. El objetivo de este trabajo fue validar, en nuestro medio, una regla de predicción clínica para diferenciar la etiol [...] ogía de las meningitis en niños a su ingreso al hospital. Método. Estudio prospectivo que incluyó pacientes Abstract in english Introduction. Despite most meningitis are not bacterial, antibiotics are usually administered on admission because bacterial meningitis is difficult to be rule-out. Distinguishing bacterial from aseptic meningitis on admission could avoid inappropriate antibiotic use and hospitalization. We aimed to [...] validate a clinical prediction rule to distinguish bacterial from aseptic meningitis in children, on arriving to the emergency room. Methods. This prospective study included patients aged

  11. October 2012 Multistate Fungal Meningitis Outbreak

    Centers for Disease Control (CDC) Podcasts

    2012-10-17

    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.

  12. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    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

  13. Aseptic meningitis due to zona zoster infection

    Directory of Open Access Journals (Sweden)

    Adem Karbuz

    2012-06-01

    Full Text Available Zona Zoster, is a mostly benign disease in immunocompetent children. Those of in immunocompromised children, there is a risk of dissemination. Zona zoster, scarcely causes some neurological complications such as myelitis, aseptic meningitis, encephalitis and ventriculitis in both immunocompetent and immunocompromised children. A 17-year-old girl who had bone marrow transplantation for thalasemia major was admitted to our hospital with fever, itchy rash on the right chest and axillary region and diagnosed as zona zoster. She had severe headache and vomiting on follow-up. We performed lumbar puncture because of the neck stiffness and meningeal irritation signs, pleocytosis and protein elevation were detected in the cerebrospinal fluid (CSF. The diagnosis of aseptic meningitis due to zona zoster was confirmed by VZV-PCR in the CSF. She cured without sequele after the administration of acyclovir treatment for 10 days. If symptoms such as headache and vomiting develop in immunocompromised children with zona zoster, neurological complications like aseptic meningitis should be remembered. (Turk Arch Ped 2012; 47: 143-6

  14. Characterization of a pneumococcal meningitis mouse model

    Directory of Open Access Journals (Sweden)

    Mook-Kanamori Barry

    2012-03-01

    Full Text Available Abstract Background S. pneumoniae is the most common causative agent of meningitis, and is associated with high morbidity and mortality. We aimed to develop an integrated and representative pneumococcal meningitis mouse model resembling the human situation. Methods Adult mice (C57BL/6 were inoculated in the cisterna magna with increasing doses of S. pneumoniae serotype 3 colony forming units (CFU; n = 24, 104, 105, 106 and 107 CFU and survival studies were performed. Cerebrospinal fluid (CSF, brain, blood, spleen, and lungs were collected. Subsequently, mice were inoculated with 104 CFU S. pneumoniae serotype 3 and sacrificed at 6 (n = 6 and 30 hours (n = 6. Outcome parameters were bacterial outgrowth, clinical score, and cytokine and chemokine levels (using Luminex® in CSF, blood and brain. Meningeal inflammation, neutrophil infiltration, parenchymal and subarachnoidal hemorrhages, microglial activation and hippocampal apoptosis were assessed in histopathological studies. Results Lower doses of bacteria delayed onset of illness and time of death (median survival CFU 104, 56 hrs; 105, 38 hrs, 106, 28 hrs. 107, 24 hrs. Bacterial titers in brain and CSF were similar in all mice at the end-stage of disease independent of inoculation dose, though bacterial outgrowth in the systemic compartment was less at lower inoculation doses. At 30 hours after inoculation with 104 CFU of S. pneumoniae, blood levels of KC, IL6, MIP-2 and IFN- ? were elevated, as were brain homogenate levels of KC, MIP-2, IL-6, IL-1? and RANTES. Brain histology uniformly showed meningeal inflammation at 6 hours, and, neutrophil infiltration, microglial activation, and hippocampal apoptosis at 30 hours. Parenchymal and subarachnoidal and cortical hemorrhages were seen in 5 of 6 and 3 of 6 mice at 6 and 30 hours, respectively. Conclusion We have developed and validated a murine model of pneumococcal meningitis.

  15. Utility of cerebrospinal fluid cortisol level in acute bacterial meningitis

    Science.gov (United States)

    Mehta, Anish; Mahale, Rohan R.; Sudhir, Uchil; Javali, Mahendra; Srinivasa, Rangasetty

    2015-01-01

    Background: Meningitis remains a serious clinical problem in developing as well as developed countries. Delay in diagnosis and treatment results in significant morbidity and mortality. The role and levels of intrathecal endogenous cortisol is not known. Objective: To study the cerebrospinal fluid (CSF) cortisol levels and to evaluate its role as a diagnostic and therapeutic marker in acute bacterial meningitis. Materials and Methods: Thirty patients with acute bacterial meningitis with no prior treatment were evaluated. Cortisol levels were compared with 20 patients with aseptic (viral) meningitis and 25 control subjects. Results: Mean CSF cortisol level was 13.85, 3.47, and 1.05 in bacterial meningitis, aseptic meningitis, and controls, respectively. Mean CSF cortisol level in bacterial meningitis was significantly higher as compared to controls (P < 0.001). There was significant difference in CSFcortisol levels in bacterial and aseptic meningitis (P < 0.001). Conclusions: Cortisol levels in CSF are highly elevated in patients with acute bacterial meningitis. This suggests that intrathecalcortisol may serve as a valuable, rapid, relatively inexpensive diagnostic marker in discriminatingbetween bacterial and aseptic meningitis. This helps in earlier institution of appropriate treatment and thereby decreasing morbidity and mortality. PMID:26019421

  16. Cerebrospinal fluid lactic acidosis in bacterial meningitis.

    OpenAIRE

    Eross, J; Silink, M; Dorman, D

    1981-01-01

    A rapid, microenzymatic method was used to measure cerebrospinal fluid lactate levels in 205 children with suspected bacterial meningitis. Fifty children with normal CSF containing fewer than 0.005 X 10(9)/l WBC, no segmented neutrophils, glucose 3.4 +/- 0.8 mmol/l (61.2 +/- 14.4 mg/100 ml), and a protein of less than 0.30 g/l had CSF lactate levels below 2.0 mmol/l (18 mg/100 ml) (mean and standard deviation 1.3 +/- 0.3 mmol/l (11.8 +/- 2.7 mg/100 ml)). In 31 cases of proved viral meningitis...

  17. Cryptococcal meningitis: epidemiology and therapeutic options

    Directory of Open Access Journals (Sweden)

    Sloan DJ

    2014-05-01

    Full Text Available Derek J Sloan, Victoria Parris Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK Abstract: Cryptococcal meningitis causes morbidity and mortality worldwide. The burden of disease is greatest in middle- and low-income countries with a high incidence of human immunodeficiency virus (HIV infection. Patients taking immunosuppressive drugs and some immunocompetent hosts are also at risk. Treatment of cryptococcal meningitis consists of three phases: induction, consolidation, and maintenance. Effective induction therapy requires potent fungicidal drugs (amphotericin B and flucytosine, which are often unavailable in low-resource, high-endemicity settings. As a consequence, mortality is unacceptably high. Wider access to effective treatment is urgently required to improve outcomes. For human immunodeficiency virus-infected patients, judicious management of asymptomatic cryptococcal antigenemia and appropriately timed introduction of antiretroviral therapy are important. Keywords: cryptococcosis, HIV, immunosuppression, antifungal therapy, immune reconstitution inflammatory syndrome, antiretroviral therapy

  18. [Early diagnosis, early therapy and prognosis of epidemic cerebrospinal meningitis].

    Science.gov (United States)

    Lobzin, V S; Al'tfel'd, Iu S; Lobzin, Iu V

    1976-09-01

    The authors convened a special study for purposes of determining early signs of epidemic cerebrospinal meningitis and for the dependence of the prognosis from early etiotropic and pathogenetic therapy. On the basis of a study of 93 cases criteria of early diagnosis are being given. Unlike the data in literature, in 60.2% of the cases it was possible to initiate treatment during the first hours of the disease and in 94.6% -- not later than 48 hours. In most of the cases the disease had a grave course. Changed consciousness was observed in 55.9%, an increased amount of protein in the CSF -- in 58%. In 8 cases there was a syndrome of acute renal insufficiency. Despite these facts all the patients recovered. The authors come to the conclusion that prognosis may be significantly improved in cases of early diagnosis (during the first hours), intensive penicillin therapy (both intravenously and kanamicin into the carotid artery). The authors suggest that during reconvalescence it is feasible to prescribe resolving (pyrogenal lydase) and general therapy. PMID:1015133

  19. Malignant middle-cerebral artery territory infarction in tuberculous vasculitis

    Directory of Open Access Journals (Sweden)

    Salvadeeswaran Meenakshi-Sundaram

    2014-09-01

    Full Text Available Intracranial large vessel involvement is an unusual complication of tuberculous meningitis. The authors report a 39-year-old female presenting with an episode of seizure, followed by rapid decline in sensorium without prominent systemic features. An initial cranial magnetic resonance imaging revealed tuberculomata and patchy infarcts. Despite antituberculous therapy, she progressively worsened. A cranial computed tomography scan done following the worsening revealed a massive middle-cerebral artery (MCA infarct. Unfortunately, the patient died in spite of decompressive craniotomy. Malignant MCA territory infarct is a rare and potentially fatal complication of tuberculous meningitis.

  20. Meningitis and encephalitis in infants and children.

    OpenAIRE

    Mahmood D. Al-Mendalawi

    2012-01-01

    ABSTRACT 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 upd...

  1. The Role of Vancomycin on Meningitis

    Directory of Open Access Journals (Sweden)

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

    2014-06-01

    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

  2. Meningeal chondroma in a young female

    OpenAIRE

    Kumari Niraj; Sahu Rabi; Krishnani Narendra

    2010-01-01

    Meningeal chondroma is a rare intracranial neoplasm. It is usually diagnosed clinically as meningioma. Histologically it may have a differential diagnosis of chordoid meningioma, a malignant lesion, and needs radiotherapy. A chondroma is a benign lesion where surgical removal is the treatment. A 20-year-old female presented with symptoms of space occupying lesion which was clinically and radiologically considered meningioma. On histopathology, the lesion turned out to be a chondroma. Meningea...

  3. Carcinomatous Meningitis from Unknown Primary Carcinoma

    OpenAIRE

    Favier, L.; Ladoire, L.; Guiu, B.; Arnould, L.; S. Guiu; Boichot, C.; Isambert, N.; Besancenot, J.F.; Muller, M.; Ghiringhelli, F

    2009-01-01

    Carcinomatous meningitis (CM) occurs in 3 to 8% of cancer patients. Patients present with a focal symptom, and multifocal signs are often found following neurological examination. The gold standard for diagnosis remains the demonstration of carcinomatous cells in the cerebrospinal fluid on cytopathological examination. Despite the poor prognosis, palliative treatment could improve quality of life and, in some cases, overall survival. We report on a patient who presented with vertigo, tinnitus...

  4. Bilateral acute retinal necrosis after herpetic meningitis

    OpenAIRE

    Katsura T; Hirota K; Akimoto M

    2012-01-01

    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 ...

  5. Listeria monocytogenes meningitis in previously healthy adults.

    OpenAIRE

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

    1989-01-01

    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. ...

  6. Chronic meningitis in systemic lupus erythematosus: An unusual etiology.

    Science.gov (United States)

    Gupta, Anu; Jogi, Vishal; Goyal, Manoj Kumar; Modi, Manish; Khurana, Dheeraj

    2014-10-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus (SLE). Apart from immunological causes and drugs, the aseptic meningitis group can include some unidentified viral infections that cannot be detected by routine microbiological testing. It is imperative to do complete cerebrospinal fluid (CSF) workup before implicating the symptoms to disease activity or drugs, as untreated infections cause significant mortality in SLE. We present a case of young female with SLE who presented with chronic meningitis of an uncommon etiology. PMID:25506165

  7. Diagnostic Accuracy of Intracellular Mycobacterium tuberculosis Detection for Tuberculous Meningitis

    OpenAIRE

    Feng, GD; Shi, M.; Ma, L.; Chen, P.; Wang, BJ; Zhang, M.; Chang, XL; Su, XC; Yang, YN; Fan, XH; Dai, W; Liu, TT; Y He; Bian, T; Duan, LX

    2014-01-01

    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-Ne...

  8. Analysis of Cerebrospinal Fluid in Viral Meningitis Patients

    OpenAIRE

    Afshan Zeeshan Wasti,; Farah Jabeen; Saba Raza Siddiqui; Rakhshinda Maher

    2013-01-01

    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...

  9. Aseptic Meningitis Epidemic during a West Nile Virus Avian Epizootic

    OpenAIRE

    Julian, Kathleen G.; Mullins, James A.; Olin, Annette; Peters, Heather; Nix, W. Allan; Oberste, M. Steven; Lovchik, Judith C.; Bergmann, Amy; Brechner, Ross J.; Myers, Robert A.; Marfin, Anthony A; Campbell, Grant L.

    2003-01-01

    While enteroviruses have been the most commonly identified cause of aseptic meningitis in the United States, the role of the emerging, neurotropic West Nile virus (WNV) is not clear. In summer 2001, an aseptic meningitis epidemic occurring in an area of a WNV epizootic in Baltimore, Maryland, was investigated to determine the relative contributions of WNV and enteroviruses. A total of 113 aseptic meningitis cases with onsets from June 1 to September 30, 2001, were identified at six hospitals....

  10. Neonatal meningitis in England and Wales: 10 years on

    OpenAIRE

    Holt, D.; Halket, S; De Louvois, J; Harvey, D.

    2001-01-01

    OBJECTIVES—To determine the incidence of neonatal meningitis in England and Wales.?DESIGN—A national postal survey using the British Paediatric Surveillance Unit (BPSU) card scheme supplemented by information from other sources.?SETTING—England and Wales 1996-1997.?SUBJECTS—A total of 274 babies less than 28 days of age who were treated for meningitis.?RESULTS—The incidence of neonatal meningitis in England and Wales has not changed since our previous study in 1985-1987. ...

  11. Cryptococcal meningitis in an HIV negative patient with systemic sarcoidosis.

    OpenAIRE

    Botha, R J; Wessels, E.

    1999-01-01

    A case of Cryptococcus neoformans meningitis is described in an HIV negative patient with undiagnosed systemic sarcoidosis. The patient presented with signs of meningitis together with generalised lymphadenopathy and hepatosplenomegaly. Cryptococcal meningitis was diagnosed on lumbar puncture. She was treated with intravenous amphotericin B but died within two weeks of admission. Necropsy revealed lesions in the lungs, liver, spleen, lymph nodes, small intestine, and bone marrow consistent wi...

  12. Gene expression in cortex and hippocampus during acute pneumococcal meningitis

    OpenAIRE

    Wittwer Matthias; Lindberg Raija LP; de Saizieu Antoine B; Voisin Veronique; Coimbra Roney S; Leppert David; Leib Stephen L

    2006-01-01

    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 exp...

  13. Mycobacterium bovis meningitis in young Nigerian-born male

    DEFF Research Database (Denmark)

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

    2014-01-01

    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 symp...

  14. RICKETTSIAL MENINGITIS : FUNDOSCOPY AS DIAGNOSTIC TOOL

    Directory of Open Access Journals (Sweden)

    Patil

    2015-08-01

    Full Text Available BACKGROUND : Mediterranean spotted fever (MSF, also known as boutonneuse fever, is caused by R. conorii . The onset of MSF is typically abrupt. Almost all patients have fever, headache, and a rash. Neurological complications are rarely described. AIM : We report a rare case of meningitis of rickettsial origin. Suspected and later confirmed on the basis of fundoscopy findings. METHODS : 31 yr old female presented with fever, headache and altered sensorium of abrupt onset past one day. On examination she had signs of meningitis. Fundus examination revealed haemorrages and cotton wool spots. Cerebrospinal fluid examination revealed normal protein and sugar , with 2 lymphocytes and no polymorph nuclear cells on cytology. Weil - Felix test showed significantly raised titres to proteus antigen (ag OX 19 (1 : 320 and proteus Ag OX 2 (1 : 640, suggestive of rickettsia of spotted fever group. Later confirmed with PCR based detection. Patient was started on Doxycycline and responded well. CONCLUSION: Meningitis of rickettsial origin require a high index of suspicion and Ocular involvement in rickettsioses is common, easily overlooked. Typical ocular manifestations are helpful in diagnosing a rickettsial disease, would increase the frequency with which rickettsial diseases are diagnosed.

  15. In-depth characterization of CGRP receptors in human intracranial arteries

    DEFF Research Database (Denmark)

    Jansen-Olesen, Inger; JØrgensen, Linda

    2003-01-01

    The purpose of the present study was to characterize the effects of human (h) alpha- and beta-calcitonin gene-related peptide (CGRP) on intracranial arteries from man and to investigate the presence of mRNA for the calcitonin receptor like receptor (CRLR) and the receptor activity modifying proteins (RAMPs) 1, 2 and 3, in cerebral and middle meningeal arteries with and without endothelium, in microvessels and in the endothelial cells isolated from the human basilar artery. Reverse transcriptase-polymerase chain reaction (RT-PCR) revealed the presence of CRLR, RAMP 1, RAMP 2 and RAMP 3 in cerebral and middle meningeal arteries with and without endothelium as well as in microvessels and in the endothelial cells. Human and rat alpha- and beta-CGRP, amylin, adrenomedullin and [acetamidomethyl-Cys(2,7)]human CGRP induced strong concentration-dependent relaxation of human cerebral and middle meningeal arteries. Removal of the endothelium neither changed the maximum relaxant response nor the pIC(50) values for alpha- and beta-CGRP as compared to the responses in arteries with an intact endothelium. Human alpha-CGRP-(8-37) caused a shift of h alpha- and h beta-CGRP-induced relaxations in cerebral and middle meningeal arteries. Calculation of pK(B) values revealed that h alpha-CGRP-(8-37) could not significantly discriminate between relaxations induced by h alpha-CGRP (pK(B) around 6.8) and h beta-CGRP (pK(B) around 5.4). There was no significant difference in pK(B) value of h alpha-CGRP-(8-37) on h beta-CGRP-induced relaxation of human cerebral and middle meningeal arteries with and without endothelium. In conclusion, our molecular and pharmacological data support the existence of a single type of CGRP(1) receptors in the human intracranial circulation.

  16. Gd-DTPA-enhanced MR imaging in meningitis

    International Nuclear Information System (INIS)

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

  17. Value of C reactive protein measurement in tuberculous, bacterial, and viral meningitis.

    OpenAIRE

    de Beer, F. C.; Kirsten, G F; Gie, R. P.; Beyers, N.; Strachan, A F

    1984-01-01

    The value of C reactive protein measurement in the differential diagnosis of meningitis was assessed in a population where tuberculous meningitis is prevalent. C reactive protein was measured serially with a sensitive radioimmunoassay in sera from 31 children with bacterial meningitis, 15 with tuberculous meningitis (6 with miliary tuberculosis), and 28 with viral meningitis. Concentrations of C reactive protein in patients with tuberculous meningitis lay between those of patients with bacter...

  18. From Epidemic Meningitis Vaccines for Africa to the Meningitis Vaccine Project

    Science.gov (United States)

    Aguado, M. Teresa; Jodar, Luis; Granoff, Dan; Rabinovich, Regina; Ceccarini, Costante; Perkin, Gordon W.

    2015-01-01

    Background.?Polysaccharide vaccines had been used to control African meningitis epidemics for >30 years but with little or modest success, largely because of logistical problems in the implementation of reactive vaccination campaigns that are begun after epidemics are under way. After the major group A meningococcal meningitis epidemics in 1996–1997 (250 000 cases and 25 000 deaths), African ministers of health declared the prevention of meningitis a high priority and asked the World Health Organization (WHO) for help in developing better immunization strategies to eliminate meningitis epidemics in Africa. Methods.?WHO accepted the challenge and created a project called Epidemic Meningitis Vaccines for Africa (EVA) that served as an organizational framework for external consultants, PATH, the US Centers for Disease Control and Prevention (CDC), and the Bill & Melinda Gates Foundation (BMGF). Consultations were initiated with major vaccine manufacturers. EVA commissioned a costing study/business plan for the development of new group A or A/C conjugate vaccines and explored the feasibility of developing these products as a public–private partnership. Representatives from African countries were consulted. They confirmed that the development of conjugate vaccines was a priority and provided information on preferred product characteristics. In parallel, a strategy for successful introduction was also anticipated and discussed. Results.?The expert consultations recommended that a group A meningococcal conjugate vaccine be developed and introduced into the African meningitis belt. The results of the costing study indicated that the “cost of goods” to develop a group A – containing conjugate vaccine in the United States would be in the range of US$0.35–$1.35 per dose, depending on composition (A vs A/C), number of doses/vials, and presentation. Following an invitation from BMGF, a proposal was submitted in the spring of 2001. Conclusions.?In June 2001, BMGF awarded a grant of US$70 million to create the Meningitis Vaccine Project (MVP) as a partnership between PATH and WHO, with the specific goal of developing an affordable MenA conjugate vaccine to eliminate MenA meningitis epidemics in Africa. EVA is an example of the use of WHO as an important convening instrument to facilitate new approaches to address major public health problems. PMID:26553665

  19. Herpes simplex type 2 meningitis treated with acyclovir.

    OpenAIRE

    Levy, D. M.; Sagar, H J

    1984-01-01

    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.

  20. Penetration of spectinomycin into cerebrospinal fluid duirng experimental meningitis.

    OpenAIRE

    Delgado, D G; Brau, C J; Avent, C. K.

    1980-01-01

    The concentration of spectinomycin in serum and cerebrospinal fluid was compared in rabbits with and without experimental pneumococcal meningitis. When injected intravenously, spectinomycin could not be detected in the cerebrospinal fluid of normal rabbits. In rabbits with meningeal inflammation, however, spectinomycin penetrated the blood-brain barrier and produced significant cerebrospinal fluid concentrations, equal to or well above spectinomycin minimal inhibitory concentrations for many ...

  1. First epidemic of echovirus 16 meningitis in Cuba.

    OpenAIRE

    L Sarmiento; Mas, P.; Goyenechea, A.; Palomera, R.; Morier, L.; Capó, V; Quintana, I.; Santin, M.

    2001-01-01

    From April to September 2000, an epidemic of aseptic meningitis spread throughout Cuba, with 16,943 reported cases. Virologic studies identified echovirus 16 as the cause of this epidemic. This is the first reported isolate of echovirus 16 from patients with viral meningitis in Cuba.

  2. Quantitative proteomics for identifying biomarkers for tuberculous meningitis

    Directory of Open Access Journals (Sweden)

    Kumar Ghantasala S Sameer

    2012-11-01

    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.

  3. Fatal Cryptococcal Meningitis in a Patient With Chronic Lymphocytic Leukemia

    OpenAIRE

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

    2012-01-01

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

  4. Fatal cryptococcal meningitis in a patient with chronic lymphocytic leukemia.

    Science.gov (United States)

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

    2012-01-01

    Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache. PMID:22811788

  5. Fatal Cryptococcal Meningitis in a Patient with Chronic Lymphocytic Leukemia

    OpenAIRE

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

    2012-01-01

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

  6. Meningococcal meningitis presenting with bilateral deafness and ataxia.

    OpenAIRE

    Sandyk, R; Brennan, M J

    1984-01-01

    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.

  7. Aseptic meningitis caused by human parvovirus B19.

    OpenAIRE

    Okumura, A.; Ichikawa, T.

    1993-01-01

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

  8. Method for inducing experimental pneumococcal meningitis in outbred mice

    Directory of Open Access Journals (Sweden)

    Cintorino Marcella

    2004-09-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Vaneza Tique

    2006-05-01

    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.

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

    Scientific Electronic Library Online (English)

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

    2006-05-01

    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. 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.

  11. Meningitis de etiología poco habitual en niños

    Scientific Electronic Library Online (English)

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

    2004-06-01

    Full Text Available 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.

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

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    Vasilopoulou Vasiliki A

    2011-08-01

    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.

  13. Salmonella enterica Serotype Arizonae Meningitis in a Neonate.

    Science.gov (United States)

    Lakew, Wubishet; Girma, Abayneh; Triche, Elizabeth

    2013-01-01

    Typhoidal and nontyphoidal salmonella infections are common causes of gastroenteritis in the community. However, salmonella only rarely causes invasive infections like meningitis. We report a 13-day-old female neonate with signs and symptoms of meningitis whose cerebrospinal fluid (CSF) culture showed Salmonella enterica serotype Arizonae that was sensitive to ceftriaxone. She presented with fever and failure to feed for 2 days. Despite prompt treatment with ampicillin, gentamicin, and ceftriaxone, she developed communicating hydrocephalus, frequent seizures, and coma that progressed to death after 2 weeks of hospitalization. Salmonella enterica serotype Arizonae is a rare cause of human infection known to leading to meningitis symptoms similar to those caused by other salmonella species. This is the first report of it as a cause of meningitis in a child under one month of age. Therefore, it should be included in the differential diagnosis of Gram-negative bacillary meningitis in immunocompromised children, neonates, and those with contacts with reptiles. PMID:24187642

  14. Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2010-03-01

    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.

  15. Malignant melanomas of the meninges (MR and CT)

    International Nuclear Information System (INIS)

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

  16. Meningeal Melanocytes in the Mouse: Distribution and Dependence on Mitf

    Science.gov (United States)

    Gudjohnsen, Stefán A. H.; Atacho, Diahann A. M.; Gesbert, Franck; Raposo, Graca; Hurbain, Ilse; Larue, Lionel; Steingrimsson, Eirikur; Petersen, Petur Henry

    2015-01-01

    Summary: Melanocytes are pigment producing cells derived from the neural crest. They are primarily found in the skin and hair follicles, but can also be found in other tissues including the eye, ear and heart. Here, we describe the distribution of pigmented cells in C57BL/6J mouse meninges, the membranes that envelope the brain. These cells contain melanosomes of all four stages of development and they depend on Microphthalmia associated transcription factor (MITF), the master regulator of melanocyte development, suggesting that they are bona-fide melanocytes. The location of these pigmented cells is consistent with the location of meningeal melanomas in humans and animal models. Significance: Here, we document and define pigmented cells in the meninges of the mouse brain and confirm that they are melanocytes. This is important for understanding the role of this cell type and for understanding primary meningeal melanoma, a rare disease that likely arises from normal meningeal melanocytes. PMID:26635543

  17. THE VALUE OF PROCALCITONIN MEASUREMENT IN MENINGITIS PATIENTS

    Directory of Open Access Journals (Sweden)

    SHAIMAA A. HAMEED

    2015-04-01

    Full Text Available Background: Meningitis is defined as inflammation of the membranes that surround the brain and spinal cord and can occur at any age, it is caused by infectious microorganisms include (bacteria, viruses, fungi, and parasites and non infectious include (drugs, carcinoma and inflammatory disorder. Objective: The objective of the present study was to evaluate the value of PCT levels to discriminate between bacterial and non-bacterial meningitis patients. Methods: A total of 40 patients with meningitis admitted to emergency department of Baghdad teaching hospital and pediatrics emergency room in child welfare teaching hospital were followed in this prospective study. Cerebrospinal fluid (CSF sample where collected from 40 patients and serum sample collected from these patients and healthy person. NHS real-time PCR technique using to identified the type of bacteria and serum levels of PCT were measured. Results: The diagnosis of meningitis was based on clinical findings, gram staining, culture, and chemical analysis of CSF. Twenty-eight of patients were diagnosed as bacterial meningitis and the other twelve patients as non-bacterial meningitis. The mean PCT level in patients with bacterial meningitis was 658.00 pg/ml, and the lower level was 21. Pg/ml, while the higher level in patients with non-bacterial meningitis was 11.00 pg/ml (mean level, 5.30 pg/ml. It is clear from the range of serum PCT level that there are no overlapping values seen for serum PCT in both groups. Conclusion: Serum PCT levels can be used in the early diagnosis of bacterial meningitis and is more valuable marker than the other predictive marker. Similarly, they may be useful in differential diagnosis of bacterial and non-bacterial meningitis to assess treatment efficacy.

  18. Effect of the calcitonin gene-related peptide (CGRP) receptor antagonist telcagepant in human cranial arteries

    DEFF Research Database (Denmark)

    Edvinsson, Lars; Chan, Kayi Y

    2010-01-01

    INTRODUCTION: Calcitonin gene-related peptide (CGRP) is a neuronal messenger in intracranial sensory nerves and is considered to play a significant role in migraine pathophysiology. MATERIALS AND METHODS: We investigated the effect of the CGRP receptor antagonist, telcagepant, on CGRP-induced cranial vasodilatation in human isolated cerebral and middle meningeal arteries. We also studied the expression of the CGRP receptor components in cranial arteries with immunocytochemistry. Concentration response curves to ?CGRP were performed in human isolated cerebral and middle meningeal arteries in the absence or presence of telcagepant. Arterial slices were stained for RAMP1, CLR and actin in a double immunofluorescence staining. RESULTS: In both arteries, we found that: (i) telcagepant was devoid of any contractile or relaxant effects per se; (ii) pretreatment with telcagepant antagonised the ?CGRP-induced relaxation in a competitive manner; and (iii) immunohistochemistry revealed expression and co-localisation of CLR and RAMP1 in the smooth muscle cells in the media layer of both arteries. CONCLUSIONS: Our findings provide morphological and functional data on the presence of CGRP receptors in cerebral and meningeal arteries, which illustrates a possible site of action of telcagepant in the treatment of migraine.

  19. 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)

  20. 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)

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

    Directory of Open Access Journals (Sweden)

    Syriopoulou Vassiliki P

    2007-08-01

    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.

  2. Environmental enrichment restores cognitive deficits induced by experimental childhood meningitis

    Scientific Electronic Library Online (English)

    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

    Full Text Available 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.

  3. The Relation of Cerebrospinal Fluid Nitric Oxide Levels to Prognosis and Differential Diagnosis of Meningitis

    OpenAIRE

    ÇET?N, Kas?m

    2002-01-01

    This study was designed to investigate the role of nitric oxide (NO) in the differential diagnosis of bacterial, tuberculous and viral meningitis, and the relation between cerebrospinal fluid (CSF) NO levels and meningitis prognosis. Twenty patients with bacterial meningitis, 9 with tuberculous meningitis, 11 with viral meningitis/meningoencephalitis and 21 control patients were included in the study. CSF NO levels were investigated by measuring the levels of nitrite with a colorimetric test...

  4. Cerebrospinal fluid amino acid concentrations in patients with viral and tuberculous meningitis.

    OpenAIRE

    Corston, R. N.; McGale, E H; Stonier, C.; Hutchinson, E. C.; Aber, G M

    1981-01-01

    Serial measurements have been made of the cerebrospinal fluid and plasma amino acid concentrations in 11 patients with viral meningitis and in four with tuberculous meningitis. A small increase in the concentrations of a few amino acids in cerebrospinal fluid has been found in a viral meningitis in contrast to a marked increase in most amino acids in tuberculous meningitis. The findings are compared with those found in patients with purulent meningitis and the possible causes and the diagnost...

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

    Scientific Electronic Library Online (English)

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

    2006-05-01

    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. 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.

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

    OpenAIRE

    A.R EMAMI NAEINI

    2001-01-01

    Introduction. Central nervous system infections are among the most serious conditions in of medical practice. C-reactive Protein has recently been evaluated in terms of its ability to diffeccentiate bacterial from nonbacterial central nervous system inflammations.
    Methods. We studied the frequency of positive CRP in 61 patients who had signs of meningitis. All the specimens referred to...

  7. Chronic meningitis in systemic lupus erythematosus: An unusual etiology

    Directory of Open Access Journals (Sweden)

    Anu Gupta

    2014-01-01

    Full Text Available Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus (SLE. Apart from immunological causes and drugs, the aseptic meningitis group can include some unidentified viral infections that cannot be detected by routine microbiological testing. It is imperative to do complete cerebrospinal fluid (CSF workup before implicating the symptoms to disease activity or drugs, as untreated infections cause significant mortality in SLE. We present a case of young female with SLE who presented with chronic meningitis of an uncommon etiology.

  8. A Case Report on Eosinophilic Meningitis Caused by Angiostrongylus cantonensis

    Directory of Open Access Journals (Sweden)

    Jingyao Liu, Jiguo Gao, Chunkui Zhou

    2011-01-01

    Full Text Available Angiostrongylus cantonensis is the most common cause of eosinophilic meningitis in humans. It is usually caused by ingestion of raw or inadequately cooked intermediate hosts or food contaminated with infective third-stage larvae. We describe a case of eosinophilic meningitis caused by A. cantonensis in a male Chinese patient. The patient had a history of eating raw fish and snail. We describe the clinical features of the patient, the diagnostic process and treatments. We also provide a brief update for physicians on the characteristics, diagnosis and treatment of eosinophilic meningitis caused by A. cantonensis, with particular emphasis on the update of prevalence and treatment of the disease in China.

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

    OpenAIRE

    Gull, Sadaf; Badawy, Ayman; Chaudhuri, Arindam

    2009-01-01

    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...

  10. Meningococcal carriage in the African meningitis belt

    Science.gov (United States)

    2013-01-01

    A meningococcal serogroup A polysaccharide/tetanus toxoid conjugate vaccine (PsA-TT) (MenAfriVac#x2122;) is being deployed in countries of the African meningitis belt. Experience with other polysaccharide/protein conjugate vaccines has shown that an important part of their success has been their ability to prevent the acquisition of pharyngeal carriage and hence to stop transmission and induce herd immunity. If PsA-TT is to achieve the goal of preventing epidemics, it must be able to prevent the acquisition of pharyngeal carriage as well as invasive meningococcal disease and whether PsA-TT can prevent pharyngeal carriage needs to be determined. To address this issue, a consortium (the African Meningococcal Carriage (MenAfriCar) consortium) was established in 2009 to investigate the pattern of meningococcal carriage in countries of the African meningitis belt prior to and after the introduction of PsA-TT. This article describes how the consortium was established, its objectives and the standardised field and laboratory methods that were used to achieve these objectives. The experience of the MenAfriCar consortium will help in planning future studies on the epidemiology of meningococcal carriage in countries of the African meningitis belt and elsewhere. Un vaccin conjugué contenant un polysaccharide du sérogroupe A méningococcique et une anatoxine du tétanos (PsA-TT) (MenAfriVac™) est en cours de déploiement dans les pays de la ceinture africaine de la méningite. L’ expérience avec d’ autres vaccins conjugués polysaccharide/protéine a montré qu’ une partie importante de leur succès a été leur capacité à empêcher l’ acquisition du portage pharyngé et donc à arrêter la transmission et à induire une immunité de group. Si PsA-TT doit d’ atteindre l’ objectif de prévenir les épidémies, il devrait être en mesure d’ empêcher l’ acquisition du portage pharyngé ainsi que la méningococcie invasive et le fait que PsA-TT puisse empêcher le portage pharyngé devrait être déterminé. Pour résoudre ce problème, le consortium MenAfriCar (Consortium Africain du Portage Méningococcique) a été établi en 2009 pour étudier le mode de portage du méningocoque dans les pays de la ceinture africaine de la méningite avant et après l’ introduction de PsA-TT. Cet article décrit comment le consortium a été établi, ses objectifs et les méthodes de laboratoire et de terrain standardisées qui ont été utilisées pour atteindre ces objectifs. L’ expérience du consortium MenAfriCar aidera à planifier les futures études sur l’ épidémiologie du portage du méningocoque dans les pays de la ceinture africaine de la méningite et d’ ailleurs. Se está utilizando una vacuna meningocócica conjugada (MenAfriVac™) de polisacárido del serogrupo A / tétano toxoide (PsA-TT) en países del cinturón Africano de meningitis. Las experiencias obtenidas con otras vacunas conjugadas polisacárido/proteína han demostrado que una parte importante de su éxito se debe a su habilidad para prevenir la colonización faríngea de los portadores, acabando por lo tanto con la transmisión, y a la de inducir la protección de rebaño. Si PsA-TT ha de cumplir el objetivo de prevenir epidemias, debe ser capaz de prevenir el estado de portador faríngeo, al igual que la enfermedad invasiva por meningococo, y para ello es necesario determinar si la PsA-TT puede prevenir la colonización faríngea. Con el fin de abordar esta cuestión se estableció un consorcio africano en el 2009 - el MenAfriCar (African Meningococcal Carriage Consortium) – para investigar los patrones del estado de portador de meningococo en paí

  11. Five cases of recurrent meningitis associated with chronic strongyloidiasis.

    Science.gov (United States)

    Shimasaki, Teppei; Chung, Heath; Shiiki, Soichi

    2015-03-01

    Although meningitis secondary to chronic strongyloidiasis is a rare complication, it is associated with a high mortality rate. Recurrent meningitis can occur if the underlying parasitic infection is left untreated. We report five cases of recurrent meningitis related to chronic strongyloidiasis that were associated with human T-lymphotropic virus type 1 (HTLV-1) infection. Common causative organisms are Escherichia coli, Streptococcus bovis, and Klebsiella pneumonia. One patient died during the second episode of meningitis. Three patients showed significant gastrointestinal and respiratory symptoms before developing headache and fever. In four cases, patients developed multiple recurrences even with the treatment of thiabendazol. Ivermectin seems to be a better agent compared with thiabendazol to achieve eradication of strongyloidiasis. PMID:25548379

  12. Mycobacterium bovis meningitis in young Nigerian-born male

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Daniel; Lillebaek, Troels

    2014-01-01

    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.

  13. Positive bromide partition test in the absence of tuberculous meningitis.

    OpenAIRE

    Weinberg, J. R.; Coppack, S P

    1985-01-01

    Five cases of lymphocytic meningitis are described where a Bromide Partition Test was performed and proved positive at levels usually considered consistent with tuberculous meningitis. Three of these cases were ultimately shown to have herpes simplex viral encephalitis, one had Listeria monocytogenes in the CSF and the fifth patient recovered without treatment and was thought to have had a viral encephalitis. The Bromide Partition Test may not be as good a discriminant as has previously been ...

  14. Chronic meningitis in systemic lupus erythematosus: An unusual etiology

    OpenAIRE

    Gupta, Anu; Jogi, Vishal; Goyal, Manoj Kumar; Modi, Manish; Khurana, Dheeraj

    2014-01-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus (SLE). Apart from immunological causes and drugs, the aseptic meningitis group can include some unidentified viral infections that cannot be detected by routine microbiological testing. It is imperative to do complete cerebrospinal fluid (CSF) workup before implicating the symptoms to disease activity or drugs, as untreated infections cause significant mortality in SLE. We present a case of young female with SL...

  15. Tumour necrosis factor-alpha in infectious meningitis.

    OpenAIRE

    Nadal, D; LEPPERT, D; Frei, K; Gallo, P.; Lamche, H; Fontana, A.

    1989-01-01

    During a one year period tumour necrosis factor-alpha (TNF-alpha) was prospectively determined in the cerebrospinal fluid of 49 patients with infectious meningitis. TNF-alpha was found in the cerebrospinal fluid of 15 of 18 patients with bacterial meningitis. In 11 patients who had cerebrospinal fluid positive for TNF-alpha it was detected in only one serum (in low concentration). There was no significant correlation between the concentration of TNF-alpha in cerebrospinal fluid and the patien...

  16. Sensitive enzyme immunoassay for early diagnosis of tuberculous meningitis.

    OpenAIRE

    Hernández, R; Muñoz, O.; Guiscafre, H.

    1984-01-01

    Cerebrospinal fluid from patients with tuberculous, pyogenic, and viral meningitis, as well as from appropriate control individuals, were assayed for immunoglobulin G and immunoglobulin M antibody activity to Mycobacterium bovis BCG by an enzyme-linked immunosorbent assay. BCG linked covalently to plastic disks served as the antigen in a classical indirect enzyme-linked immunosorbent assay. A significant difference was found between the tuberculous meningitis group and the nontuberculous meni...

  17. Salmonella enterica Serotype Arizonae Meningitis in a Neonate

    OpenAIRE

    Wubishet Lakew; Abayneh Girma; Elizabeth Triche

    2013-01-01

    Typhoidal and nontyphoidal salmonella infections are common causes of gastroenteritis in the community. However, salmonella only rarely causes invasive infections like meningitis. We report a 13-day-old female neonate with signs and symptoms of meningitis whose cerebrospinal fluid (CSF) culture showed Salmonella enterica serotype Arizonae that was sensitive to ceftriaxone. She presented with fever and failure to feed for 2 days. Despite prompt treatment with ampicillin, gentamicin, and ceftri...

  18. Climate Drives the Meningitis Epidemics Onset in West Africa

    OpenAIRE

    Sultan Benjamin; Labadi Karima; Guégan Jean-François; Janicot Serge

    2005-01-01

    Background Every year West African countries within the Sahelo-Sudanian band are afflicted with major meningococcal meningitis (MCM) disease outbreaks, which affect up to 200,000 people, mainly young children, in one of the world's poorest regions. The timing of the epidemic year, which starts in February and ends in late May, and the spatial distribution of disease cases throughout the "Meningitis Belt" strongly indicate a close linkage between the life cycle of the causative agent of MCM a...

  19. A Case Report on Eosinophilic Meningitis Caused by Angiostrongylus cantonensis

    OpenAIRE

    Jingyao Liu, Jiguo Gao, Chunkui Zhou

    2011-01-01

    Angiostrongylus cantonensis is the most common cause of eosinophilic meningitis in humans. It is usually caused by ingestion of raw or inadequately cooked intermediate hosts or food contaminated with infective third-stage larvae. We describe a case of eosinophilic meningitis caused by A. cantonensis in a male Chinese patient. The patient had a history of eating raw fish and snail. We describe the clinical features of the patient, the diagnostic process and treatments. We also provide a brief ...

  20. Fatal Cryptococcal Meningitis in a Patient With Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Oguzhan S?tk? Dizdar

    2012-01-01

    Full Text Available

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

  1. Antibiotic therapy for bacterial meningitis in children in developing countries.

    OpenAIRE

    KUMAR, P; Verma, I. C.

    1993-01-01

    We carried out a study to investigate the effectiveness of chloramphenicol alone as a treatment for bacterial meningitis. A total of 70 consecutive children aged > 3 months with bacterial meningitis, who had been admitted to the paediatric hospital of the All India Institute of Medical Sciences, were randomized to receive chloramphenicol alone or chloramphenicol + penicillin. The two groups were matched with each other. Treatment failure occurred with three (9%) patients in the chloramphenico...

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

    LENUS (Irish Health Repository)

    O'Brien, Deirdre

    2012-02-01

    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.

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

    LENUS (Irish Health Repository)

    O'brien, Deirdre

    2010-12-15

    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.

  4. Presumed Group B Streptococcal Meningitis After Epidural Blood Patch.

    Science.gov (United States)

    Beilin, Yaakov; Spitzer, Yelena

    2015-06-15

    Bacterial meningitis after epidural catheter placement is rare. We describe a case in which a parturient received labor epidural analgesia for vaginal delivery complicated by dural puncture. The patient developed postdural puncture headache and underwent 2 separate epidural blood patch procedures. She subsequently developed a headache with fever and focal neurologic deficits. She was treated with broad spectrum antibiotics for presumed meningitis, and she made a full recovery. Blood cultures subsequently grew group B streptococcus. PMID:26050248

  5. Spectrum of Meningitis in Adult at the Douala General Hospital

    OpenAIRE

    Yacouba N. Mapoure; Luma, Henry N; Dieudonné Gnonlonfoun; Paul M. Ossou-Guiet; Xaverie Biloa; Jacques N. Doumbe; Hugo Bertrand N. Mbatchou; Benjamin Clet N. Tchaleu; Fonsah, Julius Y; Albert S. Mouelle; Njamnshi, Alfred K

    2014-01-01

    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 yea...

  6. Epidemiology of infectious meningitis in the State of Amazonas, Brazil

    Directory of Open Access Journals (Sweden)

    Maria das Graças Gomes Saraiva

    2015-06-01

    Full Text Available INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV and varicella zoster virus (VZV prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS, cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

  7. Streptococcus suis Meningitis with Bilateral Sensorineural Hearing Loss

    OpenAIRE

    Huh, Hee Jae; Park, Kyoung-Jin; Jang, Ja-Hyun; Lee, Mina; Lee, Jang Ho; Ahn, Yoon Hee; Kang, Cheol-In; Ki, Chang-Seok; Lee, Nam Yong

    2011-01-01

    Streptococcus suis infection is an emerging zoonosis in Asia. The most common disease manifestation is meningitis, which is often associated with hearing loss and cochleovestibular signs. S. suis infection in humans mainly occurs among risk groups that have frequent exposure to pigs or raw pork. Here, we report a case of S. suis meningitis in a 67-yr-old pig carcass handler, who presented with dizziness and sensorineural hearing loss followed by headaches. Gram-positive diplococci were isolat...

  8. Human Parasitic Meningitis Caused by Angiostrongylus cantonensis Infection in Taiwan

    OpenAIRE

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

    2013-01-01

    The major cause of eosinophilic meningitis in Taiwan is Angiostrongylus cantonensis. Humans are infected by ingesting terrestrial and freshwater snails and slugs. In 1998 and 1999, two outbreaks of eosinophilic meningitis caused by A. cantonensis infection were reported among 17 adult male immigrant Thai laborers who had eaten raw golden apple snails (Pomacea canaliculata). Another outbreak associated with consuming a health drink consisting of raw vegetable juice was reported in 2001. These ...

  9. Epidemiology of infectious meningitis in the State of Amazonas, Brazil

    Scientific Electronic Library Online (English)

    Maria das Graças Gomes, Saraiva; Eyde Cristianne Saraiva, Santos; Valéria, Saraceni; Lívia Laura dos Santos, Rocha; Rossicléia Lins, Monte; Bernardino Cláudio de, Albuquerque; Michele de Souza, Bastos; Marcelo Cordeiro dos, Santos; Wuelton Marcelo, Monteiro; Maria Paula Gomes, Mourão; Marcus Vinitius de Farias, Guerra; Marcus Vinícius Guimarães de, Lacerda.

    2015-06-01

    Full Text Available INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present s [...] tudy reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

  10. The cochlear lesion in experimental bacterial meningitis of the rabbit.

    OpenAIRE

    Osborne, M. P.; Comis, S D; Tarlow, M. J.; Stephen, J.

    1995-01-01

    Sensorineural hearing loss was studied in a rabbit model of experimental bacterial meningitis using electrophysiological and ultrastructural techniques. Hearing impairment was monitored by auditory brain-stem evoked responses (ABERs) and concomitant structural lesions were identified by both transmission (TEM) and scanning (SEM) electron microscopy. Meningitis was induced by intra-cerebrospinal fluid injection of either Escherichia coli (strain 2073 and type K-12) or Haemophilus influenzae ty...

  11. Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, C.T.; Holm, D.; Liptrot, Matthew George; Østergaard, C.; Lundgren, J.D.; Frimodt-Møller, N.; Skovsted, I.C.; Rowland, I.J.

    2008-01-01

    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 infe...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  13. 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.

  14. BURDEN OF BACTERIAL MENINGITIS: A RETROSPECTIVE REVIEW ON LABORATORY PARAMETERS AND FACTORS ASSOCIATED WITH DEATH IN MENINGITIS, KELANTAN MALAYSIA

    OpenAIRE

    BASRI, REHANA; ZUETER, ABDEL RAHMAN; MOHAMED, ZEEHAIDA; Alam, Mohammad Khursheed; NORSA’ADAH, Bachok; HASAN, SITI ASMA; Hasan, Habsah; AHMAD, FADZILAH

    2015-01-01

    To describe the clinical characteristics and the risk factors associated with mortality in patients with meningitis. This is a retrospective review of patients diagnosed to have meningitis with positive culture of the cerebrospinal fluid (CSF) specimen. All cases aged 19 > years who were admitted to Hospital USM between January 2004 and December 2011 were included in the study. The CSF results database were obtained from the Department of Medical Microbiology and Parasitology, Hospital USM, K...

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

    Scientific Electronic Library Online (English)

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

    2013-12-01

    Full Text Available 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.

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

    Scientific Electronic Library Online (English)

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

    2011-08-01

    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 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.

  17. [Epidemiology of acute bacterial meningitis in adult patients in France].

    Science.gov (United States)

    Varon, E

    2009-01-01

    In 2006, the number of bacterial meningitis cases was estimated at 1375 (2.23/100,000). The leading pathogens involved in adult meningitis were, according to frequency, Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, Streptococcus agalactiae, and Haemophilus influenzae. The overall mortality rate averaged 20%, higher among patients with pneumococcal meningitis or in individuals over 65 years of age. Sequels were observed in 30% of cases and more frequent after pneumococcal meningitis. A decrease in susceptibility to antibiotics was reported for N. meningitidis, S. pneumoniae and H. influenzae. Generalized vaccination of children less than two years of age with H. influenzae type b conjugate vaccine has lead to a dramatic decrease in adult H. influenza meningitis. The few cases involved almost exclusively non-typeable strains, presenting in 12% of cases, a modified penicillin binding protein leading to a decreased susceptibility to aminopenicillins. Decreased susceptibility to amoxicillin was observed in 30% of meningococcal isolates, but all strains remained susceptible to parenteral third generation cephalosporins. Resistances to rifampicin or to ciprofloxacin, recommended in meningococcal meningitis prophylaxis, were unusual, but had to be documented. Finally, the proportion of pneumococcal strains with decreased susceptibility to beta-lactams has decreased since 2002. In adult meningitis, pneumococcal isolates with decreased susceptibility to penicillin, amoxicillin, and cefotaxime or ceftriaxone accounted for 37, 18, and 4% of cases respectively. It should be noted that for these isolates, no parenteral third generation cephalosporins MIC was above 2mg/l. Resistance to rifampin was very unusual and all pneumococcal isolates were fully susceptible to glycopeptides. PMID:19395209

  18. Meningite neofatal: aspectos associados Neonatal meningitis: related features

    Directory of Open Access Journals (Sweden)

    Diogo C. Haussen

    2005-09-01

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

  19. K ATP channels in pig and human intracranial arteries

    DEFF Research Database (Denmark)

    Ploug, Kenneth Beri; SØrensen, Mette Aaskov

    2008-01-01

    Clinical trials suggest that synthetic ATP-sensitive K(+) (K(ATP)) channel openers may cause headache and migraine by dilating cerebral and meningeal arteries. We studied the mRNA expression profile of K(ATP) channel subunits in the pig and human middle meningeal artery (MMA) and in the pig middle cerebral artery (MCA). We determined the order of potency of four K(ATP) channel openers when applied to isolated pig MMA and MCA, and we examined the potential inhibitory effects of the Kir6.1 subunit specific K(ATP) channel blocker PNU-37883A on K(ATP) channel opener-induced relaxation of the isolated pig MMA and MCA. Using conventional RT-PCR, we detected the mRNA transcripts of the K(ATP) channel subunits Kir6.1 and SUR2B in all the examined pig and human intracranial arteries. Application of K(ATP) channel openers to isolated pig MMA and MCA in myographs caused a concentration-dependent vasodilatation with an order of potency that supports the presence of functional SUR2B K(ATP) channel subunits. 10(-7) M PNU-37883A significantly inhibited the in vitro dilatory responses of the potent K(ATP) channel opener P-1075 in both pig MMA and MCA. In conclusion, our combined mRNA expression and pharmacological studies indicate that Kir6.1/SUR2B is the major functional K(ATP) channel complex in the pig MMA and MCA, and mRNA expression studies suggest that the human MMA shares this K(ATP) channel subunit profile. Specific blocking of Kir6.1 or SUR2B K(ATP) channel subunits in large cerebral and meningeal arteries may be a future anti-migraine strategy.

  20. Specificity of immunoblotting analyses in eosinophilic meningitis

    Scientific Electronic Library Online (English)

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

    2011-08-01

    Full Text Available 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.

  1. Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants

    Science.gov (United States)

    ... Vaccines to Prevent Meningitis in Persons with Cochlear Implants FACT SHEET On this Page What You Should ... References What You Should Know Children with cochlear implants are more likely to get bacterial meningitis than ...

  2. Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis.

    DEFF Research Database (Denmark)

    Brandt, Christian T; Holm, David

    2008-01-01

    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. Udgivelsesdato: 2008-Jan-15

  3. Human parasitic meningitis caused by Angiostrongylus cantonensis infection in Taiwan.

    Science.gov (United States)

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

    2013-06-01

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

  4. [Arterial heterogeneity].

    Science.gov (United States)

    Gouëffic, Y; Davaine, J-M; Merlini, T; Rimbert, A; Hérisson, F; Heymann, M-F; Heymann, D; Steenman, M; Lambert, G

    2013-01-01

    More and more clinical observations and trials support the concept of heterogeneity of atheroma according to the arterial bed. In a pilot study named "Étude Comparative des Lésions Athéromateuses" (ECLA), we have shown that carotid and femoral plaques possess different characteristics. Carotid arteries display increased lipid content compared to femoral arteries whereas femoral arteries are more prone to calcify and to develop osteoid metaplasia. These observations should lead the researcher and the clinician to look at the cellular and molecular mechanisms governing the heterogeneity of atheromas. At last, a better understanding of the characteristics of plaques should help us to determine plaque stability, to prevent cardiovascular events and to choose the best medical, endovascular or surgical option. PMID:23159822

  5. Imaging of Dual Ophthalmic Arteries: Identification of the Central Retinal Artery

    Directory of Open Access Journals (Sweden)

    Louise Louw

    2014-01-01

    Full Text Available Identification of the origin of the central retinal artery (CRA is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs, characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA and internal carotid artery (ICA origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA anomaly via the ECA, marked by a middle meningeal artery (MMA (origin: Maxillary artery; course: Through foramen spinosum with normal branches (i.e. anterior and posterior branches, and an OA variant (course: Through superior orbital fissure with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen with a distinct ocular branching pattern presented with the central retinal artery (CRA. The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.

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

    OpenAIRE

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

    2010-01-01

    Problem statement: Acute bacterial meningitis is one of the most important causes of medical emergency diseases, which can cause high mortality and morbidity rates. Early antibiotic therapy is life saving in bacterial meningitis. One of the most common etiologies of acute meningitis is viral. Differentiation between bacterial and Aseptic meningitis is mandatory, which leads to avoid useless administration of antibiotics. Various diagnostic tests are available for diagnosis of acute bacterial ...

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

    OpenAIRE

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

    2012-01-01

    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 meningitis-related clinical manifesta...

  8. Alpha-interferon responses in cerebrospinal fluid of patients with suspected meningitis.

    OpenAIRE

    Ho-Yen, D. O.; Carrington, D

    1987-01-01

    Cerebrospinal fluid from 100 patients with clinically diagnosed meningitis was examined for alpha-interferon. In the laboratory four patient groups were identified: bacterial meningitis (n = 12), viral meningitis (n = 15), normal cerebrospinal fluid (n = 57) and abnormal cerebrospinal fluid (n = 16). A further 14 patients with cerebrospinal fluid shunts but no abnormality in the cerebrospinal fluid provided a control group for alpha-interferon determinations. The group with viral meningitis a...

  9. Role of CSF-CRP as a bedside diagnostic test in children with meningitis.

    OpenAIRE

    Piyush Sadat; Snehal Patel; Kruti Shah

    2013-01-01

    Meningitis is a formidable illness with high mortality and morbidity in India. Delay in distinguishing pyogenic meningitis from tuberculous and viral meningitis and delay in starting therapy on one hand and irrational use of antibiotics on the other hand may have irrevocable consequences, so, early diagnosis and appropriate treatment of pyogenic meningitis is very vital to prevent permanent neurological deficits. Detection of C-reative protein in CSF is a bed side rapid diagnostic test to dis...

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

    DEFF Research Database (Denmark)

    Parner, Erik T; Reefhuis, Jennita

    2007-01-01

    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.

  11. De Novo meningitis caused by Propionibacterium acnes in a patient with metastatic melanoma.

    Science.gov (United States)

    Burnham, Jason P; Thomas, Benjamin S; Trevino, Sergio E; McElvania Tekippe, Erin; Burnham, Carey-Ann D; Kuhlmann, F Matthew

    2014-04-01

    Propionibacterium acnes is a known cause of postneurosurgical meningitis; however, it is rarely implicated in de novo meningitis. Herein we report a case of a 49-year-old male with de novo meningitis caused by P. acnes with metastatic melanoma as the only identified risk factor for his infection. PMID:24478417

  12. 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

  13. Clinical and microbiological features of cryptococcal meningitis

    Scientific Electronic Library Online (English)

    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

    Full Text Available 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.

  14. Clinical and microbiological features of cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Lucia Kioko Hasimoto e Souza

    2013-06-01

    Full Text Available 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 (GACA4 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.

  15. The Evolution of the Meningitis Vaccine Project

    Science.gov (United States)

    Tiffay, Kathleen; Jodar, Luis; Kieny, Marie-Paule; Socquet, Muriel; LaForce, F. Marc

    2015-01-01

    Background.?In 2001, the Meningitis Vaccine Project (MVP) was tasked to develop, test, license, and introduce a group A meningococcal (MenA) conjugate vaccine for sub-Saharan Africa. African public health officials emphasized that a vaccine price of less than US$0.50 per dose was necessary to ensure introduction and sustained use of this new vaccine. Methods.?Initially, MVP envisioned partnering with a multinational vaccine manufacturer, but the target price and opportunity costs were problematic and formal negotiations ended in 2002. MVP chose to become a “virtual vaccine company,” and over the next decade managed a network of public–private and public–public partnerships for pharmaceutical development, clinical development, and regulatory submission. MVP supported the transfer of key know-how for the production of group A polysaccharide and a new conjugation method to the Serum Institute of India, Ltd, based in Pune, India. A robust staff structure supported by technical consultants and overseen by advisory groups in Europe and Africa ensured that the MenA conjugate vaccine would meet all international standards. Results.?A robust project structure including a team of technical consultants and 3 advisory groups in Europe and Africa ensured that the MenA conjugate vaccine (PsA-TT, MenAfriVac) was licensed by the Drug Controller General of India and prequalified by the World Health Organization in June 2010. The vaccine was introduced in Burkina Faso, Mali, and Niger in December 2010. Conclusions.?The development, through a public–private partnership, of a safe, effective, and affordable vaccine for sub-Saharan Africa, PsA-TT, offers a new paradigm for the development of vaccines specifically targeting populations in resource-poor countries. PMID:26553666

  16. 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.

  17. Meningitis tuberculosa: Clinical findings and results of cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-10-01

    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.

  18. 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.)

  19. Vaccine preventable meningitis in Malaysia: epidemiology and management.

    Science.gov (United States)

    McNeil, Hannah C; Jefferies, Johanna M C; Clarke, Stuart C

    2015-06-01

    Worldwide bacterial meningitis accounts for more than one million cases and 135,000 deaths annually. Profound, lasting neurological complications occur in 9-25% of cases. This review confirms the greatest risk from bacterial meningitis is in early life in Malaysia. Much of the disease burden can be avoided by immunization, particularly against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae. Despite inclusion of the Hib vaccine in the National Immunisation Programme and the licensure of pneumococcal vaccines, these two species are the main contributors to bacterial meningitis in Malaysia, with Neisseria meningitidis and Mycobacterium tuberculosis, causing a smaller proportion of disease. The high Hib prevalence may partly be due to dated, small-scale studies limiting the understanding of the current epidemiological situation. This highlights the need for larger, better quality surveillance from Malaysia to evaluate the success of Hib immunization and to help guide immunization policy for vaccines against S. pneumoniae and N. meningitidis. PMID:25962101

  20. Streptococcus group C meningitis with cavernous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Clarke M

    2013-08-01

    Full Text Available Mattew Clarke,1 Hilary Enuh,1 Jessie Saverimuttu,2 Jay Nfonoyim31Department of Medicine, 2Division of Infectious Disease, 3Critical Care Unit, Richmond University Medical Center, Staten Island, NY, USAAbstract: Group C Streptococcus (GCS is a rare cause of bacteremia in humans. It is mostly associated with zoonological infections. Although GCS can be part of the normal oral, skin, and genitourinary flora, an infection with this pathogen can be highly virulent, causing rapid, disseminating disease. With a mortality of about 25%, the poor prognosis is linked to the severity of illness and the high level of virulence of the organism. Only a few cases of GCS meningitis have been reported. We present the first case of GCS meningitis with cavernous sinus thrombosis.Keyword: streptococcus group C, cavernous sinus thrombosis, meningitis

  1. Brain CT scanning of children with purulent meningitis

    International Nuclear Information System (INIS)

    Nine of 21 children with purulent meningitis showed abnormal findings in brain CT when admitted. All of abnormal group were less than 12 months of age, but 75 % of normal group were after 1 year old. The period of positive CRP was longer and the level of sugar in CSF was lower in abnormal group when compared with normal group. Because convulsion and EEG abnormalities were observed similary in both groups, it may be hard to suggest the organic changes of brain by clinically. It will be better to perform brain CT scanning as soon as possible on the beginning of purulent meningitis. (author)

  2. Haemophilus influenzae type f meningitis in a previously healthy boy

    DEFF Research Database (Denmark)

    Ronit, Andreas; Berg, Ronan M G

    2013-01-01

    Non-serotype b strains of Haemophilus influenzae are extremely rare causes of acute bacterial meningitis in immunocompetent individuals. We report a case of acute bacterial meningitis in a 14-year-old boy, who was previously healthy and had been immunised against H influenzae serotype b (Hib). The causative pathogen was identified as H influenzae serotype f (Hif), and was successfully treated with ceftriaxone. An immunological evaluation revealed transient low levels of immunoglobulins but no apparent immunodeficiency was found 2 years after the clinical insult.

  3. Are mothers always right? When acute meningitis is something more.

    Science.gov (United States)

    Gomes, Catarina; Romão, Patrícia; Miguens, Jose; Mouzinho, Ana

    2015-01-01

    A 22-month-old girl with a history of a congenital occipital cutaneous cyst was brought to the paediatric emergency department for lethargy and occipital headache. She had been discharged 5?days before for acute meningitis without bacterial isolates. At physical observation, she presented with irritability and neck hyperextension, with negative meningeal signs. CT scan revealed a vermian cyst and hydrocephalus. She was submitted to neurosurgery with removal of an infected midline dermoid cyst with a fistulous track to the skin. Surgery was successful and without complications. During follow-up, the child was asymptomatic with normal psychomotor development. PMID:26464408

  4. Ceftriaxone diffusion into cerebrospinal fluid of children with meningitis.

    OpenAIRE

    Latif, R; Dajani, A S

    1983-01-01

    We evaluated the diffusion of ceftriaxone into the cerebrospinal fluid of 27 infants and children with meningitis who were receiving conventional antimicrobic therapy. Ceftriaxone was administered as a single 75 mg/kg dose and was given early or late or both in the course of the illness. Three hours after a dose, the mean cerebrospinal fluid ceftriaxone level was 5.7 micrograms/ml in patients studied early in the course of meningitis and 2.1 micrograms/ml in patients studied later in the illn...

  5. Intracranial neurenteric cyst: A rare cause of chemical meningitis

    Directory of Open Access Journals (Sweden)

    Naseer A Choh

    2013-01-01

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

  6. Meningeal melanocytes in the mouse: Distribution and dependence on Mitf

    Directory of Open Access Journals (Sweden)

    Stefan Arni Hafsteinsson Gudjohnsen

    2015-11-01

    Full Text Available Melanocytes are pigment producing cells derived from the neural crest. They are primarily found in the skin and hair follicles, but can also be found in other tissues including the eye, ear and heart. Here we describe the distribution of pigmented cells in C57BL/6J mouse meninges, the membranes that envelope the brain. These cells contain melanosomes of all four stages of development and they depend on MITF, the master regulator of melanocyte development, suggesting that they are bona-fide melanocytes. The location of these pigmented cells is consistent with the location of meningeal melanomas in humans and animal models.

  7. Meningeal metastasing of malignant melanomas. Meningeale Metastasierung maligner Melanome

    Energy Technology Data Exchange (ETDEWEB)

    Gogoll, M.; Langer, M.; Hosten, N. (Klinikum Rudolf Virchow, Berlin (Germany, F.R.). Radiologische Klinik und Poliklinik)

    1989-08-01

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

  8. Meningitis due to Rhodotorula glutinis in an HIV infected patient

    Directory of Open Access Journals (Sweden)

    Shinde R

    2008-01-01

    Full Text Available Rhodotorula spp, though considered a common saprophyte, recently has been reported as causative agent of opportunistic mycoses. We present a case of meningitis in an immunocompromised human immunodeficiency virus infected patient who presented with longstanding fever. He was diagnosed as a case of chronic meningitis. Diagnosis was confirmed by cell cytology, India ink preparation, Gram staining and culture of cerebrospinal fluid (CSF sample. CSF culture grew Rhodotorula glutinis . Therapy with amphotericin B was successful in eliminating the yeast from CSF and the patient was discharged after recovery.

  9. Imaging of Unilateral Meningo-ophthalmic Artery Anomaly in a Patient with Bilateral Nasopharyngeal Angiofibroma

    Directory of Open Access Journals (Sweden)

    Louise Louw

    2014-01-01

    Full Text Available A 12-year-old boy with epistaxis presented with a rare midline nasopharyngeal angiofibroma that extended lateral into the pterygoid and infratemporal fossae. Pre-operative angiography revealed bilateral prominent feeder arteries and two major anastomotic connections, and a rare left meningo-ophthalmic artery (M-OA anomaly that was the sole path of supply to the eye. A literature search using Pubmed and Medline was conducted. For imaging, a six-vessel study (i.e. external and internal carotid and vertebral arteries on both sides was selected. Embolization of prominent tumor feeder arteries was unsafe for tumor extirpation, but super-selective embolization of both sphenopalatine arteries was performed to control epistaxis. The M-OA anomaly that originated from the maxillary artery (MA was marked by an ophthalmic artery (OA variant with orbital and ocular divisions that coursed through the superior orbital fissure and optic foramen, respectively, each with distinct branching patterns, a middle meningeal artery (MMA with normal branches (i.e. anterior and posterior branches, and two branch variations (i.e. lacrimal and meningeal branches that originated from the anterior branch of the MMA. The lacrimal branch coursed through a cranio-orbital foramen, but the meningeal branch remained outside the orbit. The anatomy of the right OA was normal. The left M-OA anomaly was considered incidental and not tumor-related since the tumor was more prominent on the right side, and no intra-orbital infiltrations occurred. Of clinical significance is that proximal embolization of MA or MMA carries a high risk of visual impairment in cases where M-OA anomalies are the sole mode of supply to the eye.

  10. Eosinophilic meningitis caused by Angiostrongylus cantonensis--a neglected disease with escalating importance.

    Science.gov (United States)

    Eamsobhana, P

    2014-12-01

    The rat lungworm Angiostrongylus cantonensis, a food-borne zoonotic parasite, has been recognized as the primary pathogen associated with human eosinophilic meningitis or eosinophilic meningoencephalitis. This neurotropic nematode has a definitive rodent host and a molluscan intermediate host. The adult worms live in the pulmonary arteries of rats. Human is a non-permissive, accidental host. Transmission to humans is by eating of infected raw or undercooked snails, poorly cleaned contaminated vegetables or other infected paratenic hosts such as freshwater prawns, crabs, frogs or monitor lizards. Thousands of diagnosed cases of eosinophilic meningitis caused by A. cantonensis have been reported worldwide. Angiostrongyliasis is of increasing public health importance as globalization contributes to the geographical spread and more international travelers encounter the disease. The parasite is on the move. It has spread from its traditional endemic areas of Asia and the Pacific Basin to the American continent including the USA, Brazil and Caribbean islands. Recently, the incidence of human infections has increased rapidly. Most reports of the disease are from Thailand and Taiwan with increasing reports from mainland China. The rapid global spread of the parasite and the emerging occurrence of the infection pose challenges in clinical and laboratory diagnosis, and in epidemiology and basic biology. Enhanced understanding of the epidemiology of angiostrongyliasis, increased public awareness about the risks associated with eating raw or undercooked food, and enhanced food safety measures are needed. Therefore, current knowledge on various aspects of the parasite and the disease it causes, as well as recent epidemiological status together with significant progress in laboratory investigation of A. cantonensis infection, are overviewed to promote understanding and awareness of this emerging neglected disease. PMID:25776582

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

    Scientific Electronic Library Online (English)

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

    2008-12-01

    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. 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.

  12. Long-term neuropsychiatric consequences of aseptic meningitis in adult patients.

    Science.gov (United States)

    Damsgaard, Jesper; Hjerrild, Simon; Andersen, Henning; Leutscher, Peter Derek Christian

    2015-06-01

    Aseptic meningitis is considered a benign and self-limiting clinical condition. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. The existing literature is scarce on the potential long-term neuropsychiatric consequences of aseptic meningitis. Previous studies have primarily been retrospective and differences in methodologies make it difficult to draw conclusions regarding the prevalence and nature of neuropsychiatric manifestations. However, studies have reported decreased psychomotor speed and impaired executive and visuo-constructive functions following aseptic meningitis. Larger controlled prospective studies are urgently needed to elucidate the neuropsychiatric complications of aseptic meningitis. PMID:25738613

  13. Long-term neuropsychiatric consequences of aseptic meningitis in adult patients

    DEFF Research Database (Denmark)

    Damsgaard Gunst, Jesper; Hjerrild, Simon

    2015-01-01

    Aseptic meningitis is considered a benign and self-limiting clinical condition. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. The existing literature is scarce on the potential long-term neuropsychiatric consequences of aseptic meningitis. Previous studies have primarily been retrospective and differences in methodologies make it difficult to draw conclusions regarding the prevalence and nature of neuropsychiatric manifestations. However, studies have reported decreased psychomotor speed and impaired executive and visuo-constructive functions following aseptic meningitis. Larger controlled prospective studies are urgently needed to elucidate the neuropsychiatric complications of aseptic meningitis.

  14. Costs for households and community perception of meningitis epidemics in burkina faso.

    Science.gov (United States)

    Colombini, Anaïs; Bationo, Fernand; Zongo, Sylvie; Ouattara, Fatoumata; Badolo, Ousmane; Jaillard, Philippe; Seini, Emmanuel; Gessner, Bradford D; Da Silva, Alfred

    2009-11-15

    Bacterial meningitis in the African meningitis belt remains 1 of the most serious threats to health. The perceptions regarding meningitis in local populations and the cost of illness for households are not well described. We conducted an anthropologic and economic study in Burkina Faso, in the heart of the meningitis belt. Respondents reported combining traditional and modern beliefs regarding disease etiology, which in turn influenced therapeutic care-seeking behavior. Households spent US $90 per meningitis case, or 34% of the annual gross domestic product per capita, and up to US $154 more when meningitis sequelae occurred. Much of this cost was attributable to direct medical expenses, which in theory are paid by the government. Preventive immunization against meningitis will overcome limitations imposed by traditional beliefs and contribute to poverty reduction goals. PMID:19842972

  15. Características clínicas y epidemiológicas de la meningitis aséptica en recién nacidos / Clinical and epidemiological features of aseptic meningitis in newborns

    Scientific Electronic Library Online (English)

    Manuel, Díaz Álvarez; Teresa, Medina González; Adilén, Sánchez Jiménez; Libertad, Rivera Alés; Orlando, Rodríguez Castillo.

    2012-03-01

    Full Text Available Objetivo: exponer las características clínicas y epidemiológicas de la meningitis aséptica, probablemente enteroviral, en recién nacidos atendidos en nuestro servicio de neonatología. Métodos: estudio retrospectivo de 291 pacientes recién nacidos ingresados en el servicio de neonatología del Hospita [...] l Pediátrico Universitario "Juan M. Márquez", entre los años 1992-2009, con el diagnóstico de meningitis aséptica. La información se obtuvo de una base de datos creada para una investigación sobre meningitis neonatal. Se analizaron diversas variables clínicas y epidemiológicas de presentación de esta enfermedad. Resultados: ocurrieron picos de incremento de la incidencia de la meningitis aséptica, con una tendencia estadísticamente significativa a disminuir en el transcurso de los 18 años (p= 0,00027). La frecuencia de presentación mostró una agrupación de casos hacia los meses de junio a noviembre. La fiebre estuvo presente en todos los pacientes, seguida por la irritabilidad y la presencia de diversas manifestaciones del aparato respiratorio. La apariencia de niño enfermo y las convulsiones fueron manifestaciones poco frecuentes. Exceptuando la pleocitosis, los indicadores convencionales en el líquido cefalorraquídeo y la relación glucosa líquido cefalorraquídeo/sangre tuvieron una mediana dentro de los límites normales para el período neonatal, sin embargo, los rangos fueron amplios. Hubo pacientes con pleocitosis importante, otros con predominio de los polimorfonucleares en una proporción mayor del 50 % y también con relación glucosa líquido cefalorraquídeo/sangre baja. La evolución clínica de todos los pacientes fue favorable sin secuelas neurológicas inmediatas aparentes. Conclusiones: los episodios de meningitis aséptica ocurridos siguen un patrón característico de las infecciones enterovirales con agrupación de casos estacional y picos epidémicos periódicos. La expresión clínica de la infección y los resultados en los exámenes de biometría hemática y del examen citoquímico del líquido cefalorraquídeo, aunque característicos de una infección de esta índole, tienen amplia variabilidad, pues puede haber pacientes que presenten hallazgos que se asemejan a los observados en pacientes con meningitis bacteriana, lo cual puede crear incertidumbre clínica al médico que evalúa el paciente. Abstract in english Objective: to show the clinical and epidemiological features of the aseptic meningitis, potentially by enterovirus in newborns seen in our service of Neonatology. Methods: a retrospective study was conducted in 291 neonatal patients admitted in the Neonatology service of the "Juan Manuel Márquez" Ch [...] ildren Hospital from 1992 to 2009, diagnosed with aseptic meningitis. Information was collected from a database created for a research on neonatal meningitis. Different clinical and epidemiological variables of presentation of this disease were analyzed. Results: there were peaks of increase in the incidence of the aseptic meningitis with a statistically significant trend to decrease within the 18 years old (p= 0.00027). The frequency of presentation showed a grouping of cases towards June to November. The fever was present in all patients, followed by irritability and presence of different manifestations of respiratory tract. The appearance of the sick child and the convulsions were no more frequent manifestations. Excepting for the pleocytosis, the conventional indicators in the cerebrospinal fluid/blood had a mean within the normal limits for the neonatal period, however, the ranks were wide. There were patients presenting with a significant pleocytosis, other with predominance of polimorphonuclear ones in a ratio higher than 50 % and also a low relation of glucose-cerebrospinal fluid/blood. The natural history of all patients was favorable without neurological immediate obvious sequelae. Conclusions: the episodes of aseptic meningitis occurred have a pattern characteristic of the enterovirus infections with seasonal grouping of ca

  16. Características clínicas y epidemiológicas de la meningitis aséptica en recién nacidos Clinical and epidemiological features of aseptic meningitis in newborns

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    2012-03-01

    Full Text Available Objetivo: exponer las características clínicas y epidemiológicas de la meningitis aséptica, probablemente enteroviral, en recién nacidos atendidos en nuestro servicio de neonatología. Métodos: estudio retrospectivo de 291 pacientes recién nacidos ingresados en el servicio de neonatología del Hospital Pediátrico Universitario "Juan M. Márquez", entre los años 1992-2009, con el diagnóstico de meningitis aséptica. La información se obtuvo de una base de datos creada para una investigación sobre meningitis neonatal. Se analizaron diversas variables clínicas y epidemiológicas de presentación de esta enfermedad. Resultados: ocurrieron picos de incremento de la incidencia de la meningitis aséptica, con una tendencia estadísticamente significativa a disminuir en el transcurso de los 18 años (p= 0,00027. La frecuencia de presentación mostró una agrupación de casos hacia los meses de junio a noviembre. La fiebre estuvo presente en todos los pacientes, seguida por la irritabilidad y la presencia de diversas manifestaciones del aparato respiratorio. La apariencia de niño enfermo y las convulsiones fueron manifestaciones poco frecuentes. Exceptuando la pleocitosis, los indicadores convencionales en el líquido cefalorraquídeo y la relación glucosa líquido cefalorraquídeo/sangre tuvieron una mediana dentro de los límites normales para el período neonatal, sin embargo, los rangos fueron amplios. Hubo pacientes con pleocitosis importante, otros con predominio de los polimorfonucleares en una proporción mayor del 50 % y también con relación glucosa líquido cefalorraquídeo/sangre baja. La evolución clínica de todos los pacientes fue favorable sin secuelas neurológicas inmediatas aparentes. Conclusiones: los episodios de meningitis aséptica ocurridos siguen un patrón característico de las infecciones enterovirales con agrupación de casos estacional y picos epidémicos periódicos. La expresión clínica de la infección y los resultados en los exámenes de biometría hemática y del examen citoquímico del líquido cefalorraquídeo, aunque característicos de una infección de esta índole, tienen amplia variabilidad, pues puede haber pacientes que presenten hallazgos que se asemejan a los observados en pacientes con meningitis bacteriana, lo cual puede crear incertidumbre clínica al médico que evalúa el paciente.Objective: to show the clinical and epidemiological features of the aseptic meningitis, potentially by enterovirus in newborns seen in our service of Neonatology. Methods: a retrospective study was conducted in 291 neonatal patients admitted in the Neonatology service of the "Juan Manuel Márquez" Children Hospital from 1992 to 2009, diagnosed with aseptic meningitis. Information was collected from a database created for a research on neonatal meningitis. Different clinical and epidemiological variables of presentation of this disease were analyzed. Results: there were peaks of increase in the incidence of the aseptic meningitis with a statistically significant trend to decrease within the 18 years old (p= 0.00027. The frequency of presentation showed a grouping of cases towards June to November. The fever was present in all patients, followed by irritability and presence of different manifestations of respiratory tract. The appearance of the sick child and the convulsions were no more frequent manifestations. Excepting for the pleocytosis, the conventional indicators in the cerebrospinal fluid/blood had a mean within the normal limits for the neonatal period, however, the ranks were wide. There were patients presenting with a significant pleocytosis, other with predominance of polimorphonuclear ones in a ratio higher than 50 % and also a low relation of glucose-cerebrospinal fluid/blood. The natural history of all patients was favorable without neurological immediate obvious sequelae. Conclusions: the episodes of aseptic meningitis occurred have a pattern characteristic of the enterovirus infections with seasonal grouping of cases and periodical epidemic peaks. Th

  17. Tuberkuløs meningitis med svær hyponatriæmi på grund af cerebralt salttab

    DEFF Research Database (Denmark)

    Tinggaard, Jeanette; Schmidt, Ida Maria

    2011-01-01

    We describe two children, who were admitted with severe hyponatraemia and dehydration. In both children the hyponatraemia was due to cerebral salt wasting caused by tubercular meningitis. Differential diagnosis and pathophysiology is discussed. It is important to discriminate between cerebral salt wasting and inappropriate secretion of antidiuretic hormone since the therapy required is completely different in the two conditions.

  18. Herpes simplex virus meningitis complicated by ascending paralysis

    OpenAIRE

    Benjamin, Mina M.; Gummelt, Kyle L.; Zaki, Rabeea; Afzal, Aasim; Sloan, Louis; Shamim, Sadat

    2013-01-01

    A case of herpes simplex virus (HSV) meningitis complicated by ascending paralysis with almost complete recovery following antiviral treatment is reported. We present this case to illustrate the importance of including HSV-induced neuropathy in the differential diagnosis of acute neurologic symptoms following the viral illness.

  19. Meningitis Due to a “Bartonella washoensis”-Like Human Pathogen?

    OpenAIRE

    Probert, Will; Louie, Janice K.; Tucker, James R.; Longoria, Rose; Hogue, Robin; Moler, Silvia; Graves, Margot; Palmer, Heather J.; Cassady, Joseph; Fritz, Curtis L

    2009-01-01

    We report the second human case of infection caused by an organism identified as the proposed Bartonella species, “B. washoensis.” The organism was isolated from a blood sample from a patient presenting with meningitis and early sepsis. Oropsylla montana fleas were implicated as the vector for disease transmission in this case.

  20. Recent advances in management of cryptococcal meningitis: commentary

    OpenAIRE

    Sorrell, Tania C.; Chen, Sharon C-A

    2010-01-01

    Cryptococcal meningitis remains a substantial health burden with high morbidity, particularly in developing countries. Antifungal treatment regimens are guided by host factors, severity of illness (including presence of complications), and causative cryptococcal species. Recent clinical studies indicate the need for rapidly fungicidal induction therapy regimens using amphotericin B in combination with flucytosine for optimal outcomes. Maintenance therapy with fluconazole is necessary until re...

  1. Pulmonary cryptococcosis with cryptococcal meningitis in an immunocompetent host

    OpenAIRE

    Panigrahi, Manoj Kumar; Kumar, Narahari Narendra; Jaganathan, Venugopal; Kumar, Saka Vinod

    2014-01-01

    Cryptococcosis is a systemic fungal infection associated with significant morbidity and mortality. It predominantly affects people with immunosuppresion and human immunodeficiency virus infection. Extrapulmonary dissemination is rare in immunocompetent hosts. We present here a case of disseminated cryptococcosis in an immunocompetent patient who presented with an unusually large pulmonary mass and meningitis and successfully managed with medical therapy.

  2. Acute serous meningitis in a patient with erythema infectiosum

    Directory of Open Access Journals (Sweden)

    ?anovi? Predrag

    2006-01-01

    Full Text Available Bacground. Clinical manifestations caused by parvovirus B19 (PVB19 are various and depend on the age and immunity of an infected person. In children, the most frequent clinical manifestation of parvovirus B19 primary infection is erythema infectiosum (EI. Case report. In this case report we presented a 12-year-old patient with 2 clinical syndromes: erythema infectiosum and serous meningitis. Erythema infectiosum was manifested as fever, typical skin lesions (“slapped cheeks”, erythematous macules and papules confluent with reticular appearance on the extremities and the trunk. Serous meningitis had a mild course with an increased number of lymphocytes (120/ mm³ and the mildly increased level of proteins (0.75 g/l. The serological examination showed the presence of IgM and IgG antibodies against parvovirus B19 in serum, as well as in cerebrospinal fluid (CSF. The reduction of serum/CSF ratio of IgG antibodies was present. The symptomatic therapy was used in the treatment. The course and the prognosis were benign. Conclusion. Human PVB19, although non-specifically associated with CNS diseases could be an etiological factor that might cause serous meningitis. So, it should be considered in different diagnosis in patients with aseptic meningitis, especially during the outbreaks of erythema infectiosum.

  3. Folic acid prevented cognitive impairment in experimental pneumococcal meningitis.

    Science.gov (United States)

    Barichello, Tatiana; Generoso, Jaqueline S; Simões, Lutiana R; Steckert, Amanda V; Moreira, Ana Paula; Dominguini, Diogo; Ferrari, Pâmela; Gubert, Carolina; Kapczinski, Flávio; Jornada, Luciano K; Danielski, Lucineia G; Petronilho, Fabricia; Budni, Josiane; Quevedo, João

    2015-05-01

    Streptococcus pneumoniae is a common cause of bacterial meningitis, with a high mortality rate and neurological sequelae. In contrast, folic acid plays an important role in neuroplasticity and the preservation of neuronal integrity. In the present study, we evaluated the influence of folic acid on memory, oxidative damage, enzymatic defence, and brain-derived neurotrophic factor (BDNF) expression in experimental pneumococcal meningitis. In animals that received folic acid at a dose of 10 or 50 mg, there was a reduction in both crossing and rearing during an open-field task compared with the training session, demonstrating habituation memory. During a step-down inhibitory avoidance task, there was a difference between the training and the test sessions, demonstrating aversive memory. In the hippocampus, BDNF expression decreased in the meningitis group; however, adjuvant treatment with 10 mg of folic acid increased BDNF expression, decreased lipid peroxidation, protein carbonylation, nitrate/nitrite levels, and myeloperoxidase activity and increased superoxide dismutase activity. In frontal cortex adjuvant treatment with 10 mg of folic acid decreased lipid peroxidation and protein carbonylation. There is substantial interest in the role of folic acid and related pathways in nervous system function and in folic acid's potential therapeutic effects. Here, adjuvant treatment with vitamin B9 prevented memory impairment in experimental pneumococcal meningitis. PMID:25233798

  4. Prognostic indicators in bacterial meningitis: a case-control study

    Scientific Electronic Library Online (English)

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

    2013-10-01

    Full Text Available 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.

  5. Bacteriological Profile of Pyogenic Meningitis in Tertiary Care Hospital, Ahmedabad

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    Gaurav B Modi

    2012-06-01

    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

  6. ASEPTIC MENINGITIS IN PEDIATRICS: EPIDEMIOLOGIC EVALUATION AND CEREBROSPINAL FLUID CHANGES

    Directory of Open Access Journals (Sweden)

    B. Hatamian

    2009-08-01

    Full Text Available AbstractObjectiveThis study aimed at investigating seasonal variation, clinical symptoms, and cerebrospinal fluid (CSF changes in patients with aseptic meningitis admitted in Mofid hospital between 1995 and 1996.Materials & MethodsA total of 63 children with aseptic meningitis were enrolled in the study. Their age, gender, season of the disease, etiology, clinical symptoms, CSF changes, and treatment were evaluated and  documented. Data were analyzed using SPSS 11.5.ResultsThe male to female ratio of the patients was 2.5 to 1, mean age being 6.5 years. The disease occurrence was most common in spring and summer, and the most common symptoms observed were fever (92.6%, followed by nausea and vomiting (88.88% and 68.25%, neck stiffness, neck stiffness (54%, seizure (19%, kernig sign (14.28%, Brudzinski's sign (11.11%, and 1.58% of the patients had history of head injury. Mean white blood cell count for CSF was 165/mm3 (range, 6 to 850/mm3, the common cells being mononuclear cells; mean red blood cell count was 538 (range, 0 to 8100/mm3; protein and glucose levels were within the normal ranges. Blood and CSF culture and CSF smear were negative. Prognosis was excellent and mean duration of recovery was 5 days (range, 2 to 18 days.ConclusionAlthough the clinical symptoms of aseptic meningitis are similar to those of bacterial meningitis, its prognosis is excellent. The CSF features can be used to diagnose the disease.Keywords:Aseptic meningitis, CSF features, clinical symptoms

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

    Scientific Electronic Library Online (English)

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

    2008-10-01

    Full Text Available 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

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

    Directory of Open Access Journals (Sweden)

    Mónica Zuluaga Quintero

    2010-02-01

    Full Text Available

    Recurrent meningitis is an uncommon condition with the capability of causing important midand long-term sequelae. Its clinical presentation depends on the etiologic agent, although most patients exhibit at least one of the classical symptoms of acute meningitis (intense headache, fever and neck stiffness. Due to the clinical variability of the disease, a high level of suspicion and an adequate use of laboratory tests are required in order to establish a timely diagnosis. This article contains a literature review regarding epidemiology, etiology, clinical presentation, diagnosis and management of recurrent meningitis.

    La meningitis recurrente no es una entidad común pero tiene el potencial de generar secuelas importantes a mediano y largo plazo. Su cuadro clínico depende del agente causal aunque en la mayoría de los pacientes se conserva al menos uno de los síntomas clásicos de la meningitis aguda (cefalea intensa, fiebre y rigidez de nuca. Debido a su variabilidad clínica se requieren un alto nivel de sospecha y usar bien las pruebas de laboratorio para llegar oportunamente al diagnóstico. El presente artículo contiene una revisión de la literatura sobre la epidemiología, la etiología, el cuadro clínico, el diagnóstico y el tratamiento de esta enfermedad.

  9. Neonatal Meningitis: Risk Factors, Causes, and Neurologic Complications

    Directory of Open Access Journals (Sweden)

    Nasrin KHALESSI

    2014-12-01

    Full Text Available How to Cite This Article: Khalessi N, Afsharkhas L. Neonatal Meningitis: Risk Factors, Causes and Neurologic Complications.Iran J Child Neurol. 2014 Autumn;8(4: 46-50.AbstractObjectiveNeonates are at greater risk for sepsis and meningitis than other ages and in spite of rapid diagnoses of pathogens and treatments, they still contribute to complications and mortality. This study determines risk factors, causes, andneurologic complications of neonatal meningitis in  ospitalized neonates.Material & MethodsIn this descriptive, cross sectional study, we evaluated 415 neonates with sepsis and meningitis admitted to the neonatal intensive care unit at our center between 2008 and 2012. The data that was recorded was age, sex, birth weight, prenatalrisk factors, clinical features, blood and cerebrospinal fluid analysis, and brain sonographic findings and outcomes.Results Twenty patients had meningitis. Eleven cases (55% were male. The mean age was 8. 41 days and mean birth weight was 2891.5±766 grams. Poor feeding, seizures, and tachypnea were detected in 12 (60%, 11 (55%, and 6 (30%patients, respectively. Prenatal risk factors were prolonged rupture of membranes, maternal vaginitis, asymptomatic bacteriuria, prematurity, low birth weights, and asphyxia. Four patients had positive cerebrospinal fluid cultures with klebsiella pneumoniae 2 (50%, Enterococcus spp. 1 (25%, and Group B streptococcus 1 (25% cases, respectively. Two cases had positive blood cultures with klebsiella pneumoniae. Neurologic complications were brain edema, subdural effusion,and brain abscesses with hydrocephaly. One neonate (5% died.ConclusionOur study provides some information about risk factors, pathogens, and neurologic complications for neonatal meningitis. Prenatal assessments help to diagnose and reduce risk factors of this hazardous disease. ReferencesVolpe JJ. Bacterial and fungal intracranial infections. In:Neurology of the Newborn. 5th. Edition. Philadelphia, Pa: Saunders Elsevier.2008. Pp:916-56.Aletayeb M, Farajzadeh S, Dehdashtian M. Eleven-year study of causes of neonatal bacterial meningitis in Ahvaz, Iran Pediatrics International 2010; 52, 463–466.Edwards MS, Baker CJ. Sepsis in the newborn. In:  Gershon A, Hotez PJ, Katz SL, editors. Krugman’s Infectious Diseases of Children, 11th edition. Philadelphia: Mosby. 2004. Pp: 545-561Hristeva L, Booy R, Bowler I, Wilkinson AR. Prospective surveillance of neonatal meningitis. Arch. Dis. Child. 1993; 69: 14–8.Klein JO. Bacterial meningitis and sepsis. In: Remington JS, Klein JO (eds.. Infectious Diseases of the Fetus and Newborn Infant. 4th edition WB Saunders, Philadelphia, PA. 2006.Pp: 943–98.Klinger G, Chin CN, Beyene J, et al. Predicting the outcome of neonatal bacterial meningitis. Pediatrics. Sep 2000; 106(3:477-82.Tiskumara R, Fakharee SH, Liu C-Q, Nuntnarumit P, Lui K-M, Hammoud M, et al. Neonatal infections in Asia. Arch Dis Child Fetal Neonatal Ed. March 2009; 94: 144-8.Zaidi AK, Thaver D, Ali SA, Khan TA. Pathogens associated with sepsis in newborns and young infants in developing countries. Pediatr Infect Dis J. 2009 Jan; 28(1Suppl:S10-8.Muhe L, Tilahun M, Lulseged S et al. Etiology of pneumonia, sepsis, and meningitis in infants younger than three months of age in Ethiopia. Pediatric. Infect. Dis. J. 1999; 18(Suppl. 1: 56–61.Garges HP, Moody MA, Cotten CM, et al. Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? Pediatrics. Apr 2006; 117(4:1094-100.Edwards MS. Neonatal sepsis. In Martin RJ, Fanaroff AA, Walsh MC, editors. Fanaroff and Martin’s Neonatal-Perinatal Medicine. Diseases of the fetus and infant, 9th edition. Philadelphia: Elsevier Mosby.2010. Pp:806- 09.Laving AM, Musoke RN, Wasunna AO, Revathi G. Neonatal bacterial meningitis at the newborn unit of Kenyatta National Hospital. East Afr. Med. J. 2003; 80:456–62.Chang Chien HY, Chiu NC, Li WC, Huang FY. Characteristics of neonatal bacterial meningitis in a teaching hospital in Taiwan from 1984

  10. Etiology of aseptic meningitis and clinical characteristics in immune-competent adults.

    Science.gov (United States)

    Han, Su-Hyun; Choi, Hye-Yeon; Kim, Jeong-Min; Park, Kwang-Ryul; Youn, Young Chul; Shin, Hae-Won

    2016-01-01

    Viral meningitis is the most common cause of aseptic meningitis. Use of the polymerase chain reaction (PCR) has increased the ability to determine the etiology of viral meningitis. This study used PCR analysis to evaluate the etiology of aseptic meningitis in 177 previously healthy adults over a 5-year period, as well as analyzing the clinical characteristics, cerebrospinal fluid (CSF) findings, and prognosis according to each etiology. The most frequent cause of aseptic meningitis was enterovirus (EV), followed by varicella zoster virus (VZV). Patients with EV meningitis were significantly younger than those with VZV meningitis. The percentage of lymphocytes in white blood cell counts and protein concentrations in the CSF differed significantly among patients with EV, VZV and meningitis of undetermined etiology. Younger age and lower percentage of lymphocyte and protein level in CSF analysis may be suggestive of EV meningitis. Further prospective studies are warranted to identify the correlations between the clinical characteristics and the etiologies of meningitis. J. Med. Virol. 88:175-179, 2016. © 2015 Wiley Periodicals, Inc. PMID:26118835

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

    DEFF Research Database (Denmark)

    Johansson, Helle Wulf; Hay-Schmidt, Anders; Poulsen, Asser Nyander; Klærke, Dan Arne; Olesen, Jes; Jansen-Olesen, Inger

    2008-01-01

    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. Dist...

  12. Molecular studies of BKCa channels in intracranial arteries

    DEFF Research Database (Denmark)

    Wulf, Helle; Hay-Schmidt, Anders; Poulsen, Asser Nyander; Klærke, Dan Arne; Olesen, Jes; Jansen-Olesen, Inger

    2008-01-01

      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. Di...

  13. Uso de una escala clínica predictiva para el diagnóstico de meningitis bacteriana en pediatría

    Scientific Electronic Library Online (English)

    Karla, Ruiz; Yanina, Soave; Mary, Torres; Nelson, Alcalá.

    2010-03-01

    Full Text Available Introducción: La difícil interpretación de los hallazgos sugestivos de meningitis bacteriana y viral en el líquido cefalorraquídeo con frecuencia imposibilita su diferenciación. Por décadas, los investigadores han intentado crear escalas predictivas que permitan resolver tal disyuntiva. El objetivo [...] del presente trabajo es determinar la validez y seguridad de una escala clínica predictiva para el diagnóstico de meningitis bacteriana en Pediatría. Métodos: Realizamos un estudio retrospectivo, transversal, de evaluación de una prueba diagnóstica en una muestra de pacientes con edades entre 29 días y 12 años, egresados con diagnóstico de meningitis entre enero de 1992 y diciembre de 2006, del Departamento de Pediatría del Hospital “Dr. Jesús Yerena”, ubicado en Caracas, Venezuela. Aplicamos una escala clínica predictiva y calculamos su sensibilidad, especificidad, valores predictivos y razones de verosimilitud para el diagnóstico de meningitis bacteriana. Resultados: La muestra estuvo conformada por 41 pacientes. Predominó el sexo masculino (n=29; 70,73 %). El grupo etareo más afectado fue el de los lactantes menores (n=26; 63,41 %). Se identificaron 14 meningitis bacterianas y 27 asépticas. Mediante la escala clínica predictiva se clasificaron 31 meningitis como de alto riesgo de meningitis bacteriana y 10 como de bajo riesgo. La sensibilidad y valor predictivo negativo fueron de 100 %. Conclusiones: La escala clínica predictiva aplicada resultó ser válida y segura para descartar meningitis bacteriana. Abstract in english Introduction: The overlapping of findings suggestive of bacterial or viral meningitis in cerebrospinal fluid makes it difficult to differentiate one of another. For decades, investigators have attempted to create clinical prediction scores to resolve such disjunctive. The objective of this investiga [...] tion was to determine the validity and safety of a clinical prediction score for the diagnosis of bacterial meningitis in childhood. Methods: We performed a retrospective, transversal, diagnostic test evaluation study of a sample of patients between 29 days to 12 years of age, discharged from January 1992 to December 2006, with diagnosis of meningitis, from the Pediatrics Department of Dr. Jesús Yerena Hospital, in Caracas, Venezuela. The clinical prediction score was applied. We evaluated its validity and safety with the calculation of sensibility, specificity, predictive values and likelihood ratios for the diagnosis of bacterial meningitis. Results: A total of 41 patients were included. Male gender was more common (n= 29; 70,73 %). The infant age group was predominant (n=26 ; 63,41 %). We identified 14 bacterial meningitis and 27 aseptic meningitis. With the clinical prediction score, 31 meningitis were classified as high risk of bacterial meningitis and 10 as low risk. The sensibility and the negative predictive value were 100 %. Conclusions: The clinical prediction score applied resulted to be valid and safe for identifying patients without bacterial meningitis.

  14. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC study of aseptic meningitis

    Directory of Open Access Journals (Sweden)

    Robinson Joan L

    2006-04-01

    Full Text Available Abstract Background The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results There were 233 cases of proven enteroviral (EV meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ? 5 years of age, while rash, diarrhea and cough were more common in children Conclusion The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants

  15. 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.)

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

    Scientific Electronic Library Online (English)

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

    2013-01-01

    Full Text Available 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.

  17. Improving Decision-Making Activities for Meningitis and Malaria

    Science.gov (United States)

    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

    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.

  18. ENTEROBACTER SPECIES CAUSING MENINGITIS IN PATIENT ADMITTED WITH FEBRILE ENCEPHALOPATHY

    Directory of Open Access Journals (Sweden)

    Shadma

    2013-01-01

    Full Text Available ABSTRACT: Enterobacte r species are increasingly a cause of nosocomial meni ngitis among neurosurgery patients, but risk factors for these in fections are not well defined. It was found that external cerebrospinal fluid (CSF drainage de vices, isolation of Enterobacter species from a non-CSF culture, prolonged administration of antimi crobial drugs before the diagnosis of meningitis that were inactive in vitro against Enterobacter species, immunosuppression and advanced age are also independent risk factors for E nterobacter Meningitis. Despite favourable treatment outcomes, EM is a serious infection assoc iated with Enterobacter species colonization or infection at other surgical sites, with selectiv e antimicrobial pressure, and with invasive CNS devices. The treatment is difficult because of inab ility of many of the antibiotics that are active against these bacteria to achieve adequate concentr ation in CSF. However third generation cephalosporins are active against gram negative bacil li and also achieved high concentration in CSF.

  19. Pasteurella multocida bacterial meningitis caused by contact with pigs

    Scientific Electronic Library Online (English)

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

    Full Text Available 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.

  20. Meningite neofatal: aspectos associados / Neonatal meningitis: related features

    Scientific Electronic Library Online (English)

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

    2005-09-01

    Full Text Available INTRODUÇÃO: O objetivo deste estudo foi identificar e analisar fatores relacionados à meningite neonatal. MÉTODO: Em estudo de caso-controle, foram examinados neonatos com meningite no período de agosto/2002 a dezembro/2003 na Unidade de Tratamento Intensivo Neonatal (UTIN) e alocados recém-nascidos [...] hígidos como grupo controle (GC). Foram relatados dados referentes à gestação, ao parto e ao neonato. Os resultados foram considerados significativos quando p (alfa) Abstract in english OBJECTIVE: The goal of this study was to identify and to analyze the features related to the occurrence of neonatal meningitis. METHOD: In a case-control study we examined all newborns presenting meningitis between August/2002 and December/2003 in the neonatal Intensive Care Unit. Healthy newborns w [...] ere enrolled as a Control Group (CG). Data related to pregnancy, labor and the neonate itself were collected. The results with p

  1. Thrombopoietin Contributes to Neuronal Damage in Experimental Bacterial Meningitis ?

    OpenAIRE

    Hoffmann, Olaf; Rung, Olga; Im, Ae-Rie; Freyer, Dorette; ZHANG Juan; Held, Josephin; Stenzel, Werner; Dame, Christof

    2010-01-01

    Thrombopoietin (Tpo), which primarily regulates megakaryopoiesis, and its receptor (c-Mpl) are expressed in the brain, where Tpo exhibits proapototic effects on neurons. In the present study, we investigated the implication of Tpo in experimental pneumococcal meningitis. Following intrathecal infection with the encapsulated Streptococcus pneumoniae strain D39, we observed upregulation of Tpo mRNA expression at 12 h and 24 h in brain homogenates of wild-type C57BL/6 mice. c-Mpl mRNA expression...

  2. Evaluation of aztreonam in experimental bacterial meningitis and cerebritis.

    OpenAIRE

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

    1983-01-01

    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 ...

  3. Surveillance and control of meningococcal meningitis epidemics in refugee populations.

    OpenAIRE

    Moore, P. S.; Toole, M J; Nieburg, P.; Waldman, R. J.; Broome, C V

    1990-01-01

    Epidemics of communicable diseases pose a direct threat to refugee and internally displaced populations, and could lead to high mortality rates and a disruption of basic health care services. Several large refugee populations live in regions of high meningococcal disease endemicity and their camps are at risk for outbreaks of meningococcal meningitis. Surveillance in these camps allows early detection and control of impending outbreaks. Confirmation of meningococcal disease can be performed u...

  4. Role of Oxidative Stress in the Pathophysiology of Pneumococcal Meningitis

    OpenAIRE

    Barichello, Tatiana; Generoso, Jaqueline S.; Simões, Lutiana R.; Elias, Samuel G.; Quevedo, João

    2013-01-01

    Pneumococcal meningitis is a life-threatening disease characterized by an acute purulent infection affecting the pia mater, the arachnoid, and the subarachnoid spaces. Streptococcus pneumoniae crosses the blood-brain barrier (BBB) by both transcellular traversal and disruption of the intraepithelial tight junctions to allow intercellular traversal. During multiplication, pneumococci release their bacterial products, which are highly immunogenic and may lead to an increased inflammatory respon...

  5. Computed tomography. CT and prognosis of hemophilus influenza meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, H.; Ogawa, K.; Shiihara, H.; Ohkubo, O.; Utsumi, Y. (Nihon Univ., Tokyo. School of Medicine)

    1981-06-01

    CT scanning was performed on 18 patients with hemophilus influenza meningitis. These findings were classified into 4 groups, i.e., focal cortical necrosis (F.C.N.), subdural effusion (S.Ef.), ventricular dilatation (V.D.), and subdural empyema (S.Em.). These findings reflect the process developing encephalopathy, and can be graded mild, moderate, and severe concerning the prognosis. Therefore, follow-up CT scanning is of value in elucidating the mechanism of encephalopathy and predicting the prognosis.

  6. Gene expression in cortex and hippocampus during acute pneumococcal meningitis

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2006-06-01

    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.

  7. Comparison of ceftriaxone and traditional therapy of bacterial meningitis.

    OpenAIRE

    Congeni, B L

    1984-01-01

    Forty-five children (aged 1 day to 15 years) with bacterial meningitis were randomized to receive either traditional therapy (ampicillin and chloramphenicol or gentamicin, pending sensitivity) or ceftriaxone (100 mg/kg per day in two doses for a minimum of 10 days). The etiological agents involved were similar for the two groups and included Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, and group B streptococcus. Repeat spinal taps were carried out 24 to 48 ...

  8. ASEPTIC MENINGITIS IN PEDIATRICS: EPIDEMIOLOGIC EVALUATION AND CEREBROSPINAL FLUID CHANGES

    Directory of Open Access Journals (Sweden)

    A. Fahimzad

    2009-06-01

    Full Text Available ObjectiveThis study aimed at investigating seasonal variation, clinical symptoms, and cerebrospinal fluid (CSF changes in patients with aseptic meningitis admitted in Mofid hospital between 1995 and 1996.Materials & MethodsA total of 63 children with aseptic meningitis were enrolled in the study. Their age, gender, season of the disease, etiology, clinical symptoms, CSF changes, and treatment were evaluated and documented. Data were analyzed using SPSS 11.5.ResultsThe male to female ratio of the patients was 2.5 to 1, mean age being 6.5 years. The disease occurrence was most common in spring and summer, and the most common symptoms observed were fever (92.6%, followed by nausea and vomiting (88.88% and 68.25%, neck stiffness, neck stiffness (54%, seizure (19%, kernig sign (14.28%, Brudzinski's sign (11.11%, and 1.58% of the patients had history of head injury. Mean white blood cell count for CSF was 165/mm3 (range, 6 to 850/mm3, the common cells being mononuclear cells; mean red blood cell count was 538 (range, 0 to 8100/mm3; protein and glucose levels were within the normal ranges. Blood and CSF culture and CSF smear were negative. Prognosis was excellent and mean duration of recovery was 5 days (range, 2 to 18 days.ConclusionAlthough the clinical symptoms of aseptic meningitis are similar to those of bacterial meningitis, its prognosis is excellent. The CSF features can be used to diagnose the disease.

  9. Meningitis by Toxocara canis after Ingestion of Raw Ostrich Liver

    OpenAIRE

    Noh, Young; Hong, Sung-Tae; Yun, Ji Young; Park, Hong-Kyun; Oh, Jung-Hwan; Kim, Young Eun; Jeon, Beom S

    2012-01-01

    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...

  10. Management of Paradoxical Response in Pediatric Tubercular Meningitis with Methylprednisolone

    OpenAIRE

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

    2014-01-01

    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...

  11. Antituberculosis drug resistance patterns in adults with tuberculous meningitis

    DEFF Research Database (Denmark)

    Senbayrak, Seniha; Ozkutuk, Nuri; Erdem, Hakan; Johansen, Isik Somuncu; Civljak, Rok; Inal, Ayse Seza; Kayabas, Uner; Kursun, Ebru; Elaldi, Nazif; Savic, Branislava; Simeon, Soline; Yilmaz, Emel; Dulovic, Olga; Ozturk-Engin, Derya; Ceran, Nurgul; Lakatos, Botond; Sipahi, Oguz Resat; Sunbul, Mustafa; Yemisen, Mucahit; Alabay, Selma; Beovic, Bojana; Ulu-Kilic, Aysegul; Cag, Yasemin; Catroux, Melanie; Inan, Asuman; Dragovac, Gorana; Deveci, Ozcan; Tekin, Recep; Gul, Hanefi Cem; Sengoz, Gonul; Andre, Katell; Harxhi, Arjan; Hansmann, Yves; Oncu, Serkan; Kose, Sukran; Oncul, Oral; Parlak, Emine; Sener, Alper; Yilmaz, Gulden; Savasci, Umit; Vahaboglu, Haluk

    2015-01-01

    BACKGROUND: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. METHODS: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line anti...

  12. Primary granulocytic sarcoma of meninges and mediastinum as diagnostic dilemma.

    Science.gov (United States)

    Samanta, Dipti Rani; Mohanty, Kirti Ranjan; Roopesh, K; Senapati, Surendra Nath

    2013-06-01

    Granulocytic sarcoma is a rare hematological neoplasm which is often misdiagnosed. We report two patients of primary granulocytic sarcoma, one at meninges who was diagnosed radiologically as meningioma and on histopathology as langerhans cell histiocytosis. The second patient presented with an ulcerated chest wall swelling, who on histopathology revealed malignant round cell tumour. Both the patients subsequently proved as primary granulocytic sarcoma on immunohistochemistry. These two cases are reported here due to their rarity. PMID:24426349

  13. Primary Granulocytic Sarcoma of Meninges and Mediastinum as Diagnostic Dilemma

    OpenAIRE

    Samanta, Dipti Rani; Mohanty, Kirti Ranjan; Roopesh, K.; Senapati, Surendra Nath

    2012-01-01

    Granulocytic sarcoma is a rare hematological neoplasm which is often misdiagnosed. We report two patients of primary granulocytic sarcoma, one at meninges who was diagnosed radiologically as meningioma and on histopathology as langerhans cell histiocytosis. The second patient presented with an ulcerated chest wall swelling, who on histopathology revealed malignant round cell tumour. Both the patients subsequently proved as primary granulocytic sarcoma on immunohistochemistry. These two cases ...

  14. A Case with Pituitary Abscess Presented with Acute Purulent Meningitis

    OpenAIRE

    ?lkay Çak?r; Züleyha Karaca; Emine Alp; Halil Dönmez; Fatih Tanr?verdi; Gül?ah Elbüken; Ahmet Selçuklu; Kür?ad Ünlüh?zarc?; Fahrettin Kele?timur

    2009-01-01

    Pituitary abscess is a rare and potentially life-threatening disease. Misdiagnosis is extremely frequent, until the drainage of purulent material during surgery because of the non-spesific clinical signs and laboratory findings. The diagnosis can be made preoperatively with awareness of the disease and careful assessment of radiological investigations, especially magnetic resonance imaging (MRI). We report a 43-year-old man who presented with acute purulent meningitis. Control MRI scans, perf...

  15. Epidemiology of Cryptococcal Meningitis in the US: 1997–2009

    OpenAIRE

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

    2013-01-01

    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%...

  16. Climate Drives the Meningitis Epidemics Onset in West Africa

    Directory of Open Access Journals (Sweden)

    Sultan Benjamin

    2005-01-01

    Full Text Available Background Every year West African countries within the Sahelo-Sudanian band are afflicted with major meningococcal meningitis (MCM disease outbreaks, which affect up to 200,000 people, mainly young children, in one of the world's poorest regions. The timing of the epidemic year, which starts in February and ends in late May, and the spatial distribution of disease cases throughout the "Meningitis Belt" strongly indicate a close linkage between the life cycle of the causative agent of MCM and climate variability. However, mechanisms responsible for the observed patterns are still not clearly identified. Methods and Findings By comparing the information on cases and deaths of MCM from World Health Organization weekly reports with atmospheric datasets, we quantified the relationship between the seasonal occurrence of MCM in Mali, a West African country, and large-scale atmospheric circulation. Regional atmospheric indexes based on surface wind speed show a clear link between population dynamics of the disease and climate: the onset of epidemics and the winter maximum defined by the atmospheric index share the same mean week (sixth week of the year; standard deviation, 2 wk and are highly correlated. Conclusions This study is the first that provides a clear, quantitative demonstration of the connections that exist between MCM epidemics and regional climate variability in Africa. Moreover, this statistically robust explanation of the MCM dynamics enables the development of an Early Warning Index for meningitis epidemic onset in West Africa. The development of such an index will undoubtedly help nationwide and international public health institutions and policy makers to better control MCM disease within the so-called westward-eastward pan-African Meningitis Belt.

  17. Plasma cell pleocytosis in HSV-2 aseptic meningitis

    OpenAIRE

    Rohit Kalia; Karen Hennessey

    2013-01-01

    Plasma cell pleocytosis has been seen in cerebrospinal fluid (CSF) analysis of patients with multiple myeloma, multiple sclerosis, leukemia, west nile encephalitis and lymphoma. There also have been some anecdotal reports suggesting the presence of plasma cells in CSF as possible early indicator of WNV encephalitis. We describe a case of plasma cell pleocytosis in CSF due to HSV-2 meningitis, adding it to the list of possible etiologies for the same. 

  18. Meningococcal Meningitis Control in Iran: Five Year Comparative Study 2000-2004

    OpenAIRE

    A Mehrabi Tavana; R.A. Ataee

    2009-01-01

    The aim of this study was to compare the incidence and death rate of meningococcal meningitis among military and non military population in Iran from 2000 to 2004. All patients with clinical sign and symptoms of meningitis and para clinical findings were entered to the study from 21st March 2000 to 21st March 2004. Meningococcal meningitis was diagnosed on the basis isolation of the Neisseria meningitidis in culture. CSF samples were provided at admission before commencing antibiotic th...

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

    OpenAIRE

    Pomar, Virginia

    2013-01-01

    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...

  20. Childhood meningitis in the conjugate vaccine era: a prospective cohort study.

    OpenAIRE

    Sadarangani, M; Willis, L; Kadambari, S; Gormley, S; Young, Z; Beckley, R; Gantlett, K; Orf, K; Blakey, S.; Martin, NG; Kelly, DF; Heath, PT; Nadel, S; Pollard, AJ

    2014-01-01

    Bacterial conjugate vaccines have dramatically changed the epidemiology of childhood meningitis; viral causes are increasingly predominant, but the current UK epidemiology is unknown. This prospective study recruited children under 16?years of age admitted to 3 UK hospitals with suspected meningitis. 70/388 children had meningitis-13 bacterial, 26 viral and 29 with no pathogen identified. Group B Streptococcus was the most common bacterial pathogen. Infants under 3?months of age with bacteria...

  1. Bacterial meningitis in Swaziland: an 18 month prospective study of its impact.

    OpenAIRE

    Ford, H.; Wright, J.

    1994-01-01

    STUDY OBJECTIVE--To describe the epidemiology, clinical features, and outcome of bacterial meningitis in Swaziland. DESIGN--Prospective study of patients diagnosed as having meningitis of nonviral aetiology during an 18 month period from February 1991 to July 1992. SETTING--Four regional hospitals covering the population of the four districts in Swaziland. SUBJECTS--All patients with non-viral meningitis admitted to hospital within the study period. MAIN RESULTS--Altogether 85 patients were r...

  2. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis

    OpenAIRE

    Robinson Joan L; Strong James; Husain Entesar; Baerg Krista; Al-Hosni Mohammed; Forgie Sarah E; Langley Joanne M; Chawla Rupesh; Lee Bonita E; Allen Upton; Law Barbara J; Dobson Simon; Davies H Dele

    2006-01-01

    Abstract Background The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinica...

  3. Laboratory surveillance of viral meningitis by examination of cerebrospinal fluid in Cape Town, 1981-9.

    OpenAIRE

    McIntyre, J P; Keen, G. A.

    1993-01-01

    Nine years accumulated laboratory data derived from the culture of the cerebrospinal fluid of 11,360 aseptic meningitis cases were retrospectively reviewed to establish the epidemiology of viral meningitis in Cape Town. Virus was isolated from 3406 of the cases (91% enteroviruses and 9% mumps). Five major summer viral meningitis episodes were documented: two of echovirus 4 (706 and 445 cases), echovirus 9 (223), coxsackie A9 (104) and one of unidentified enterovirus (324 cases--probably echo ...

  4. Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis

    OpenAIRE

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

    2004-01-01

    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...

  5. Persistent Strongyloidiasis Complicated by Recurrent Meningitis in an HTLV Seropositive Peruvian Migrant Resettled in Italy

    OpenAIRE

    Zammarchi, Lorenzo; Montagnani, Francesca; Tordini, Giacinta; Gotuzzo, Eduardo; Bisoffi, Zeno; Bartoloni, Alessandro; Luca, Andrea De

    2015-01-01

    We describe a case of persistent strongyloidiasis complicated by recurrent meningitis, in a human T cell lymphotropic virus type 1 (HTLV-1) seropositive Peruvian migrant adult resettled in Italy. He was admitted with signs and symptoms of acute bacterial meningitis, reporting four other meningitis episodes in the past 6 years, with an etiological diagnosis of Escherichia coli and Enterococcus faecium in two cases. He had been previously treated with several antihelmintic regimens not includin...

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

    OpenAIRE

    M. Aligholi; B Pourakbari; SR Tabatabaei; FB Hashemi; A. Siadati; Noorbakhsh, S; S Mamaishi; AR Fahimzad; M. Abedini

    2006-01-01

    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...

  7. Cryptococcal meningitis in HIV infected: Experience from a North Indian tertiary center

    OpenAIRE

    Kumar Susheel; Wanchu Ajay; Chakrabarti Arunaloke; Sharma Aman; Bambery Pradeep; Singh Surjit

    2008-01-01

    Background: Cryptococcal meningitis is a common opportunistic infection in Human Immunodeficiency Virus (HIV)-infected individuals. There is little information specifically addressing cryptococcal meningitis in HIV-infected patients from North India. Aims: To determine clinical presentation, hospital course, response to treatment, complications developed, in-hospital mortality, any recurrence of cryptococcal meningitis and reasons of recurrence during follow-up. Settings and Design: A re...

  8. Levels of antibody to defined antigens of Mycobacterium tuberculosis in tuberculous meningitis.

    OpenAIRE

    Chandramuki, A; Bothamley, G H; Brennan, P. J.; Ivanyi, J.

    1989-01-01

    The aim of the study was to develop an antibody immunoassay for tuberculous meningitis with a sensitivity greater than that of the initial bacterial smear while maintaining a 100% specificity. Antibody titers to five purified antigens of Mycobacterium tuberculosis were measured in cerebrospinal fluid by using an enzyme-linked immunosorbent assay technique. Seventy-four patients with tuberculous meningitis (26 culture positive) were compared with 26 patients with purulent meningitis, 69 patien...

  9. Role of CSF-CRP as a bedside diagnostic test in children with meningitis.

    Directory of Open Access Journals (Sweden)

    Piyush Sadat

    2013-01-01

    Full Text Available Meningitis is a formidable illness with high mortality and morbidity in India. Delay in distinguishing pyogenic meningitis from tuberculous and viral meningitis and delay in starting therapy on one hand and irrational use of antibiotics on the other hand may have irrevocable consequences, so, early diagnosis and appropriate treatment of pyogenic meningitis is very vital to prevent permanent neurological deficits. Detection of C-reative protein in CSF is a bed side rapid diagnostic test to distinguish pyogenic from tuberculous and viral meningitis. So, present study was undertaken to study the usefulness of c-reactive protein in CSF as a rapid diagnostic test in differentiating pyogenic from tuberculous and viral meningitis.This study was conducted at Smt Shardaben Hospital from Sept-2008 to Nov-2010. Total 150 cases admitted in paediatric department and neonates admitted to the sick nursery suspected of having meningitis were included. Samples of CSF were taken for bed side diagnostic test of CSF-CRP. The major advantage of this method is rapid two minute reaction time. Our study revealed that out of 150 cases of suspected meningitis 64 (42.66% patient were having meningitis out of which 18 (12% patients were diagnosed as pyogenic meningitis and CSF CRP was positive in 10 (55.55 % patients out of 18 pyogenic meningitis patients and CSF-CRP was negative in all other groups Applying chisquare test, correlation between CSF-CRP positivity and pyoganic meningitis was highly significant (x2 = 31(i.e.> 3.84

  10. Spinal meningeal melanocytoma and hydrocephalus and intracranial superficial siderosis

    International Nuclear Information System (INIS)

    Meningeal melanocytomas are uncommon tumours of the central nervous system; fewer than 50 cases have been reported in the English literature. We review the unique clinical presentation, radiological appearance and histological features of a rare case of meningeal melanocytoma. The patient was a 50-year-old man with a history of hypertension who presented with complaints of severe headache, nausea, vomiting and blurry vision for 2 days. Clinical examination revealed no hyperpigmentation marks and he had no history of regressed skin melanocytic lesions. Apart from mild terminal neck stiffness, his general medical examination was unremarkable. On funduscopic examination he had marked bilateral papilloedema and the blind spots were enlarged bilaterally. His neurological examination was otherwise unremarkable. A magnetic resonance imaging scan (MRI) of the brain showed hydrocephalus. On the precontrast T2-weighted images, there was hyperintensity of the meninges with little change after administration of gadolinium, which was suggestive of blood. On the T2-weighted sequences, there was evidence of hypo-i intensity on the surface of the pons and medulla, which was indicative of superficial siderosis

  11. 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)

  12. Carcinomatous meningitis appearing as acoustic neuromas. Two cases

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  13. Distribution of meningeal worm (Parelaphostrongylus tenuis) in South Dakota.

    Science.gov (United States)

    Jacques, Christopher N; Jenks, Jonathan A

    2004-01-01

    Heads of hunter-harvested deer (Odocoileus sp.) and elk (Cervus elaphus) were collected from meat processing plants throughout South Dakota (USA) from 1997 through 1999 to determine distribution of meningeal worm (Parelaphostrongylus tenuis) in eastern and western South Dakota. A total of 2,848 white-tailed deer (WTD) were examined for P. tenuis, of which 578 (20.3%) were infected with the parasite. Of 578 deer infected, 570 (98.6%) were harvested east of the Missouri River. Our results indicate that P. tenuis is widely distributed throughout eastern South Dakota and limited to the southcentral region of western South Dakota. Infected WTD were documented in 37 of 44 counties in eastern South Dakota and three of 22 counties in western South Dakota. No meningeal worms were found on the meninges or cranial surfaces of 215 mule deer ( Odocoileus hemionus) or 344 elk examined. These findings further define the distribution of the parasite throughout the state. We suggest that the Missouri River acts, in part, as a physical barrier to the westward expansion of P. tenuis to the grasslands of western South Dakota. PMID:15137501

  14. Progress towards meningitis prevention in the conjugate vaccines era

    Scientific Electronic Library Online (English)

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

    2003-10-01

    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 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.

  15. Classification of electrophoretic registers from meningitis contaminated rats

    Directory of Open Access Journals (Sweden)

    Luis E Mendoza

    2015-10-01

    Full Text Available This paper proposes a new method for classification of Capillary Electrophoretic Registers (CER retrieved from cerebrospinal fluid sample taken from meningitis contaminated rats. The proposed approach applies several signal processing tools such as, wavelet analysis (WA, dynamic programming, principal component analysis (PCA and support vector machines (SVM, for data pre-processing, feature extraction and CER classification. Furthermore, an algorithm is developed that detects zones in the CER where local energy variations between study groups (meningitis group and control group are observed. This algorithm help us to identify the effects that Kliebsella Pneumonie (KP bacteria produce in certain substances (aminoacids that are part of the cerebrospinal fluid samples. It is shown that Meningitis disease can be effectively detected, analyzing the CER with the proposed methods. Futhermore, we show that exploiting the information related to the local energy variation improves the classification correctness rate up to 97.3%. This classification performance is obtained using least square SVM (LS-SVM as classification tools and the parameterized CER representation proposed in this paper.

  16. 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 symptoms where carcinomatous meningitis has to be taken into account. (orig.)

  17. Spontaneous pneumorrhachis and transverse myelitis complicating purulent meningitis

    Directory of Open Access Journals (Sweden)

    Bouchra Amara

    2013-01-01

    Full Text Available Pneumorrhachis is the presence of air in the spinal canal; mostly, it has an iatrogenic origin. The association of this entity with spontaneous pneumomediastinum without any pneumothorax is rarely reported in the literature. The spontaneous resorption is the usual evolution. The association to acute transverse myelitis is discussed by the authors. The patient is a 21-year-old male with pneumorrhachis associated to a spontaneous pneumomediastinum was admitted at the emergency department for bacterial meningitis. The antibiotherapy has marked the clinical profile by disappearance of the meningeal signs in the 48 h after admission. In contrast, the neurological symptoms were of marked aggravation by appearance of a tetraparesis with a respiratory distress syndrome having required artificial ventilation. The computed tomography (CT scan showed a typical hypodensity corresponding to paramedullary air extending to several thoracic segments. The spinal magnetic resonance imaging (MRI showed a high cervical medullary edema without signs of compression. The patient died within 15 days with a profile of vasoparalysis resistant to vasoactive drugs. Pneumomediastinum associated to pneumorrhachis and transverse myelitis complicating purulent meningitis is a rare entity. Although the usual evolution is favorable, the occurrence of serious complications is possible.

  18. Mesenteric artery ischemia

    Science.gov (United States)

    ... ischemia is often seen in people who have hardening of the arteries in other parts of the ... long-term (chronic) mesenteric artery ischemia caused by hardening of the arteries ( atherosclerosis ): Abdominal pain after eating ...

  19. Hardening of the arteries

    Science.gov (United States)

    Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in ... the arteries and cause problems throughout the body. Hardening of the arteries is a common disorder.

  20. The contribution of MRI to the diagnosis of diffuse meningeal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kreuzberg, B.; Kastner, J.; Ferda, J. [Department of Diagnostic Radiology, Faculty Hospital Pilsen, Alej Svobody 80, 30460, Pilsen (Czech Republic)

    2004-03-01

    We analysed MRI findings in patients in whom a diffuse abnormality of the meninges was revealed by MRI. We looked at T1 and T2-weighted spin-echo or fast spin-echo images and contrast-enhanced T1-weighted images. There were 15 patients with abnormalities on MRI, clinically suspected in ten. Four had meningoencephalitis, one meningeal and subcortical sarcoidosis nodules, four meningeal malignancies - one disseminated oligodendroglioma, one with meningeal infiltration around an adenocarcinoma, three meningeal infiltration by a haematological malignancy, and one a chronic subdural haematoma without a history of injury. We excluded patients with primary meningeal tumours and typical injury-related meningeal bleeding. The relatively small number of patients is due to both the infrequency of diffuse meningeal disease and to the low frequency of suspected meningeal pathology as an indication for MRI. The latter's diagnostic contribution is greatest in infectious disease and neoplastic infiltration, and less obvious in haematological malignancies. Contrast-enhanced T1-weighted images are most useful. (orig.)

  1. Meningitis in HIV-positive patients in sub-Saharan Africa: a review

    Directory of Open Access Journals (Sweden)

    Jennifer A Veltman

    2014-10-01

    Full Text Available Introduction: Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. There is no widespread tracking of the incidence rates of causative agents among patients living with HIV, yet the aetiologies of meningitis are different than those of the general population. Methods: We reviewed the scientific literature published in PubMed to determine the incidence rates of meningitis among hospitalized people living with HIV in sub-Saharan Africa and report our findings from seven studies across sub-Saharan Africa. Results: We found high rates of cryptococcal meningitis (19–68%. Tuberculous meningitis was lower (1–36%, although some centres included possible cases as “other” meningitis; therefore, this may not be a true representation of the total cases. Pyogenic meningitis ranged from 6 to 30% and “other” meningitis ranged from 7 to 28% of all reported cases of meningitis. Mortality rates ranged from 25 to 68%. This review describes the most common aetiologies and provides practical diagnostic, treatment and prevention considerations as they apply to the individual living with HIV in sub-Saharan Africa. Conclusions: Diagnosis is often limited, and wider availability of accurate and low-cost laboratory diagnostics is desperately needed for prompt diagnosis and initiation of appropriate treatment. Wider acceptance and adoption of available preventative modalities can decrease the incidence of potentially fatal central nervous system infections in African patients living with HIV.

  2. Carga de la meningitis bacteriana en Cuba, año 2000 / Burden of bacterial meningitis in Cuba in 2000

    Scientific Electronic Library Online (English)

    Armando H, Seuc; Antonio, Pérez; Félix, Dickinson; Daily, Ortiz; Emma, Domínguez.

    2008-06-01

    Full Text Available Introducción La meningitis bacteriana es una de las enfermedades infecciosas de mayor impacto social en Cuba, en particular en la población infantil y joven. Estimar su carga mediante los Años de Vida Ajustados por Discapacidad resulta importante para monitorear su comportamiento y evaluar el impact [...] o de distintas acciones para prevenirla y tratarla. Objetivos Estimar las cargas por morbilidad y por mortalidad de la meningitis bacteriana en el país para el año 2000, y comparar estas estimaciones con las obtenidas de forma preliminar por la OMS. Métodos Los procedimientos de estimación fueron los empleados por la OMS en sus estudios de Carga Global de Enfermedades. Los datos de mortalidad y de incidencia se tomaron de fuentes nacionales. Se trabajó sin descuento en el tiempo y sin ponderación por edad. La carga por morbilidad se obtuvo para tres variantes distintas, a partir del uso o no de un programa de computación desarrollado para validar los indicadores epidemiológicos necesarios para el cálculo de las cargas, y a partir de la inclusión o no de las secuelas. Resultados La carga por mortalidad fue cerca de 1,4 veces la carga por morbilidad. Dentro de esta última, la carga por secuelas fue más de 80 veces mayor que la carga por tipo de meningitis. Los resultados fueron similares a las estimaciones preliminares de la OMS para Cuba en el 2000. Conclusiones Se pone de manifiesto la importancia de crear y mantener registros de incidencia y duración de las secuelas de la meningitis bacteriana. Este trabajo es el primero en Cuba que estima la carga de esta enfermedad, y crea las condiciones para valorar esta carga para otros años, desglosada por provincia, sexo y edad Abstract in english Introduction Bacterial meningitis is one of the infectious diseases with higher social impact in Cuba, mainly in the child and young populations. Estimating the burden of this disease based on disability-adjusted years of life is important to monitor its behaviour and to evaluate the impact of sever [...] al actions to prevent and treat it. Objectives To estimate the morbidity and mortality burdens of bacterial meningitis in the country in 2000, and to compare these estimations with the preliminary estimations by WHO. Methods WHO estimation procedures for Global Burden of Diseases studies were used. Mortality and incidence data were taken from domestic sources. Time discount and age weighing were not considered in this paper. Morbidity burden was obtained for three different variants, based on the use or non use of a software to validate epidemiological indicators for burden calculations and on the inclusion or exclusion of the disease sequelae. Results The mortality burden was almost 1.4 times that of morbidity. In this latter, the burden of sequelae was eighty times higher than the burden by type of meningitis. The achieved results were similar to the preliminary estimations for Cuba made by WHO in the year 2000. Conclusions It was evident that creating and keeping records of incidence and duration of bacterial meningitis sequelae is fundamental. This paper is the first conducted in Cuba that estimated the burden of this disease and created the conditions for estimating the burden for coming years, broken down by province, sex and age

  3. Carga de la meningitis bacteriana en Cuba, año 2000 / Burden of bacterial meningitis in Cuba in 2000

    Scientific Electronic Library Online (English)

    Armando H., Seuc; Antonio, Pérez; Félix, Dickinson; Daily, Ortiz; Emma, Domínguez.

    Full Text Available Introducción: La meningitis bacteriana es una de las enfermedades infecciosas de mayor impacto social en Cuba, en particular en la población infantil y joven. Estimar su carga mediante los Años de Vida Ajustados por Discapacidad resulta importante para monitorear su comportamiento y evaluar el impac [...] to de distintas acciones para prevenirla y tratarla. Objetivos: Estimar las cargas por morbilidad y por mortalidad de la meningitis bacteriana en el país para el año 2000, y comparar estas estimaciones con las obtenidas de forma preliminar por la OMS. Métodos: Los procedimientos de estimación fueron los empleados por la OMS en sus estudios de Carga Global de Enfermedades. Los datos de mortalidad y de incidencia se tomaron de fuentes nacionales. Se trabajó sin descuento en el tiempo y sin ponderación por edad. La carga por morbilidad se obtuvo para tres variantes distintas, a partir del uso o no de un programa de computación desarrollado para validar los indicadores epidemiológicos necesarios para el cálculo de las cargas, y a partir de la inclusión o no de las secuelas. Resultados: La carga por mortalidad fue cerca de 1,4 veces la carga por morbilidad. Dentro de esta última, la carga por secuelas fue más de 80 veces mayor que la carga por tipo de meningitis. Los resultados fueron similares a las estimaciones preliminares de la OMS para Cuba en el 2000. Conclusiones: Se pone de manifiesto la importancia de crear y mantener registros de incidencia y duración de las secuelas de la meningitis bacteriana. Este trabajo es el primero en Cuba que estima la carga de esta enfermedad, y crea las condiciones para valorar esta carga para otros años, desglosada por provincia, sexo y edad. Abstract in english Introduction: Bacterial meningitis is one of the infectious diseases with higher social impact in Cuba, mainly in the child and young populations. Estimating the burden of this disease based on disability-adjusted years of life is important to monitor its behaviour and to evaluate the impact of seve [...] ral actions to prevent and treat it. Objectives: To estimate the morbidity and mortality burdens of bacterial meningitis in the country in 2000, and to compare these estimations with the preliminary estimations by WHO. Methods: WHO estimation procedures for Global Burden of Diseases studies were used. Mortality and incidence data were taken from domestic sources. Time discount and age weighing were not considered in this paper. Morbidity burden was obtained for three different variants, based on the use or non use of a software to validate epidemiological indicators for burden calculations and on the inclusion or exclusion of the disease sequelae. Results: The mortality burden was almost 1.4 times that of morbidity. In this latter, the burden of sequelae was eighty times higher than the burden by type of meningitis. The achieved results were similar to the preliminary estimations for Cuba made by WHO in the year 2000. Conclusions: It was evident that creating and keeping records of incidence and duration of bacterial meningitis sequelae is fundamental. This paper is the first conducted in Cuba that estimated the burden of this disease and created the conditions for estimating the burden for coming years, broken down by province, sex and age.

  4. Carga de la meningitis bacteriana en Cuba, año 2000 Burden of bacterial meningitis in Cuba in 2000

    Directory of Open Access Journals (Sweden)

    Armando H Seuc

    2008-06-01

    Full Text Available Introducción La meningitis bacteriana es una de las enfermedades infecciosas de mayor impacto social en Cuba, en particular en la población infantil y joven. Estimar su carga mediante los Años de Vida Ajustados por Discapacidad resulta importante para monitorear su comportamiento y evaluar el impacto de distintas acciones para prevenirla y tratarla. Objetivos Estimar las cargas por morbilidad y por mortalidad de la meningitis bacteriana en el país para el año 2000, y comparar estas estimaciones con las obtenidas de forma preliminar por la OMS. Métodos Los procedimientos de estimación fueron los empleados por la OMS en sus estudios de Carga Global de Enfermedades. Los datos de mortalidad y de incidencia se tomaron de fuentes nacionales. Se trabajó sin descuento en el tiempo y sin ponderación por edad. La carga por morbilidad se obtuvo para tres variantes distintas, a partir del uso o no de un programa de computación desarrollado para validar los indicadores epidemiológicos necesarios para el cálculo de las cargas, y a partir de la inclusión o no de las secuelas. Resultados La carga por mortalidad fue cerca de 1,4 veces la carga por morbilidad. Dentro de esta última, la carga por secuelas fue más de 80 veces mayor que la carga por tipo de meningitis. Los resultados fueron similares a las estimaciones preliminares de la OMS para Cuba en el 2000. Conclusiones Se pone de manifiesto la importancia de crear y mantener registros de incidencia y duración de las secuelas de la meningitis bacteriana. Este trabajo es el primero en Cuba que estima la carga de esta enfermedad, y crea las condiciones para valorar esta carga para otros años, desglosada por provincia, sexo y edadIntroduction Bacterial meningitis is one of the infectious diseases with higher social impact in Cuba, mainly in the child and young populations. Estimating the burden of this disease based on disability-adjusted years of life is important to monitor its behaviour and to evaluate the impact of several actions to prevent and treat it. Objectives To estimate the morbidity and mortality burdens of bacterial meningitis in the country in 2000, and to compare these estimations with the preliminary estimations by WHO. Methods WHO estimation procedures for Global Burden of Diseases studies were used. Mortality and incidence data were taken from domestic sources. Time discount and age weighing were not considered in this paper. Morbidity burden was obtained for three different variants, based on the use or non use of a software to validate epidemiological indicators for burden calculations and on the inclusion or exclusion of the disease sequelae. Results The mortality burden was almost 1.4 times that of morbidity. In this latter, the burden of sequelae was eighty times higher than the burden by type of meningitis. The achieved results were similar to the preliminary estimations for Cuba made by WHO in the year 2000. Conclusions It was evident that creating and keeping records of incidence and duration of bacterial meningitis sequelae is fundamental. This paper is the first conducted in Cuba that estimated the burden of this disease and created the conditions for estimating the burden for coming years, broken down by province, sex and age

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

    OpenAIRE

    Prasad, Kameshwar; Sahu, Jitendra Kumar

    2011-01-01

    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...

  6. Burden of bacterial meningitis: a retrospective review on laboratory parameters and factors associated with death in meningitis, kelantan malaysia.

    Science.gov (United States)

    Basri, Rehana; Zueter, Abdel Rahman; Mohamed, Zeehaida; Alam, Mohammad Khursheed; Norsa'adah, Bachok; Hasan, Siti Asma; Hasan, Habsah; Ahmad, Fadzilah

    2015-02-01

    To describe the clinical characteristics and the risk factors associated with mortality in patients with meningitis. This is a retrospective review of patients diagnosed to have meningitis with positive culture of the cerebrospinal fluid (CSF) specimen. All cases aged 19 > years who were admitted to Hospital USM between January 2004 and December 2011 were included in the study. The CSF results database were obtained from the Department of Medical Microbiology and Parasitology, Hospital USM, Kelantan. A checklist was used to record the clinical characteristics. A total of 125 cases met the inclusion criteria. The age of patients ranged between newborn and 19 years old (Mean±SD, 74.5±80.6 months). The majority of them were males (65.6%). Fever was the most common presentation (73.6%) followed by poor oral intake (48.0%), seizure (36.0%) and headache (24.8%). The mortality rate was 31.2%. Coagulase negative staphylococcus was the most frequent pathogens isolated (21.6%), followed by Acinetobacter spp. (17.6%), Staphylococcus aureus (13.6%), Streptococcus spp. (11.2%) and Klebsiella pneumoniae (6.4%). There were significant association of in-hospital death with age (p=0.020) and conscious level (p=0.001). Infectious meningitis is a big health concern, especially among children. We found that coagulase negative staphylococcus, Acinetobacter species, S. aureus, Streptococcus spp and K. pneumoniae were prevalent in our hospital. These microorganisms were hospital associated pathogens. The 31% mortality linked to hospital acquired meningitis specifies the need for focused physician attention especially among younger aged patients. PMID:25797971

  7. Arterial stenosis following radiotherapy

    International Nuclear Information System (INIS)

    Published reports of arterial stenosis following radiotherapy are reviewed. In oncological practice, this complication is rare but experimental studies have demonstrated the role of irradiation in producing arterial lesions. The histological specificity and the mechanisms of radiation and related arterial lesions are discussed. Atherosclerosis risk factors and chemotherapy could have a synergic role on artery stenosis. Cases reported of arterial stenosis after radiotherapy include subclavicular artery after breast cancer, carotid artery after head and neck cancer, coronary artery and abdominal aorta or its trunks after pelvic and abdominal irradiation. The radiotherapy parameters described are not unusual. Therapeutical modalities and their indications are presented

  8. Coronary arteries

    International Nuclear Information System (INIS)

    Coronary angiography (CA) is presently considered the gold standard for the assessment of the coronary arteries. However, the presence of ionizing radiation, its invasiveness and the small associated risk of morbidity prompted long ago the development of more patient-friendly imaging modalities. A promising technique, magnetic resonance imaging (MRI), has been regarded as the major modality in the coming decade. Although still in its infancy qualitatively, its flexibility and non-invasiveness opens the door for a comprehensive evaluation of the heart and the coronary arteries in one single sitting with high anatomical definition and excellent soft tissue contrast capabilities, double-oblique tomographic sections and the possibility to quantify an innumerable number of cardiovascular physiological parameters. Numerous ideas have been assessed, comprising breath-hold and free-breathing two-dimensional and three-dimensional measurements. New ongoing trials with intravascular contrast agents may provide for all these techniques the long-awaited essential boost for reliable magnetic resonance coronary angiography (MRCA). Introduction of parallel MRI acquisition techniques, such as simultaneous acquisition of spatial harmonics (SMASH) and sensitivity encoding (SENSE) may provide the speed enhancement required to shorten imaging time for all techniques explored to date. (orig.)

  9. Sensitivity and specificity of enzyme-linked immunosorbent assay in the detection of antigen in tuberculous meningitis cerebrospinal fluids.

    OpenAIRE

    Kadival, G.V.; Mazarelo, T B; Chaparas, S D

    1986-01-01

    A sandwich enzyme-linked immunosorbent assay was developed for its potential utility in the detection of antigen in the cerebrospinal fluid of patients with tuberculous meningitis. Cerebrospinal fluids examined included those from untreated (group Ia) and treated (group Ib) Mycobacterium tuberculosis meningitis, nonseptic central nervous conditions (group II) such as epilepsy, viral meningitis, and tetany, and nonmycobacterial septic meningitis (group III). The average levels of antigens dete...

  10. Levels of soluble delta-like ligand 1 in the serum and cerebrospinal fluid of tuberculous meningitis patients?

    OpenAIRE

    Li, Jinghong; Li, Jinyi; Jia, Yanjie

    2012-01-01

    In this study, the levels of soluble delta-like ligand 1 in cerebrospinal fluid and serum of 50 patients with tuberculous meningitis, 30 patients with viral meningitis, 20 patients with purulent meningitis and 40 subjects without central nervous system disease were determined using an enzyme-linked immunosorbent assay. The mean levels of soluble delta-like ligand 1 in both cerebrospinal fluid and serum from patients with tuberculous meningitis were significantly higher compared with those fro...

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

    Directory of Open Access Journals (Sweden)

    Mohammad Ahangarzadeh Rezaee

    2012-03-01

    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.

  12. Cerebrospinal Fluid Stem Cell Factor Concentrations in the Children with Meningitis

    Directory of Open Access Journals (Sweden)

    Farhad Mashayekhi

    2007-01-01

    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.

  13. Rapid and sensitive detection of enteroviruses in specimens from patients with aseptic meningitis.

    OpenAIRE

    Yerly, S.; Gervaix, A; Simonet, V; Caflisch, M; Perrin, L; Wunderli, W

    1996-01-01

    A 5-h PCR assay (Amplicor enterovirus test) was compared with viral culture for the detection of enteroviruses in cerebrospinal fluid. Of the cerebrospinal fluid specimens collected during a summer outbreak of aseptic meningitis, 34% were positive by viral culture whereas 66% were positive by the Amplicor PCR, suggesting that this technique improves the diagnosis of enteroviral meningitis.

  14. A Fuzzy Expert System for Distinguishing between Bacterial and Aseptic Meningitis

    Directory of Open Access Journals (Sweden)

    Mostafa Langarizadeh

    2015-05-01

    Data were extracted from 106 records of patients with meningitis (42 cases with bacterial meningitis in order to evaluate the proposed system. The system accuracy, specificity, and sensitivity were 89%, 92 %, and 97%, respectively. The area under the ROC curve was 0.93, and Kappa test revealed a good level of agreement (k=0.84, P

  15. Polymerase Chain Reaction Assay and Bacterial Meningitis Surveillance in Remote Areas, Niger

    OpenAIRE

    Sidikou, Fati; Djibo, Saacou; Taha, Muhamed Kheir; Alonso, Jean Michel; Djibo, Ali; Kairo, Kiari Kaka; Chanteau, Suzanne; Boisier, Pascal

    2003-01-01

    To compensate for the lack of laboratories in remote areas, the national reference laboratory for meningitis in Niger used polymerase chain reaction (PCR) to enhance the surveillance of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. PCR effectively documented the wide geographic spread of N. meningitidis serogroup W135.

  16. Increase in hippocampal water diffusion and volume during experimental pneumococcal meningitis is aggravated by bacteremia

    DEFF Research Database (Denmark)

    Holler, Jon G; Brandt, Christian T

    2014-01-01

    BACKGROUND: The hippocampus undergoes apoptosis in experimental pneumococcal meningitis leading to neurofunctional deficits in learning and memory function. The aim of the present study was 1) to investigate hippocampal apparent diffusion coefficient (ADC) and volume with MRI during the course of experimental pneumococcal meningitis, 2) to explore the influence of accompanying bacteremia on hippocampal water distribution and volume, 3) and to correlate these findings to the extent of apoptosis in the hippocampus. METHODS: Experimental meningitis in rats was induced by intracisternal injection of live pneumococci. The study comprised of four experimental groups. I. Uninfected controls (n?=?8); II. Meningitis (n?=?11); III. Meningitis with early onset bacteremia by additional i.v. injection of live pneumococci (n?=?10); IV. Meningitis with attenuated bacteremia by treatment with serotype-specific anti-pneumococcal antibodies (n?=?14). T2 and diffusion weighted MR images were used to analyze changes in hippocampus volume and water diffusion (ADC). The results were correlated to ADC of the cortex, to ventricular volume, and to the extent of hippocampal apoptosis. RESULTS: Both ADC and the volume of hippocampus were significantly increased in meningitis rats compared to uninfected controls (Kruskal-Wallis test, p?=?0.0001, Dunns Post Test, p??0.05). CONCLUSIONS: In experimental meningitis increase in volume and water diffusion of the hippocampus are significantly associated with accompanying bacteremia.

  17. Streptococcus pyogenes meningitis in children: report of two cases and literature review

    Directory of Open Access Journals (Sweden)

    Mariana V. Arnoni

    2007-06-01

    Full Text Available Streptococcus pyogenes meningitis (SPM occurs sporadically, even with the increase of invasive streptococcal disease observed in the past years. We reported two cases of SPM in infants to alert pediatricians for the possibility of this agent as a cause of meningitis in previously healthy children.

  18. Streptococcus pyogenes meningitis in children: report of two cases and literature review

    Scientific Electronic Library Online (English)

    Mariana V., Arnoni; Eitan N., Berezin; Marco A.P., Sáfadi; Flávia J., Almeida; Cláudia R.C., Lopes.

    2007-06-01

    Full Text Available Streptococcus pyogenes meningitis (SPM) occurs sporadically, even with the increase of invasive streptococcal disease observed in the past years. We reported two cases of SPM in infants to alert pediatricians for the possibility of this agent as a cause of meningitis in previously healthy children. [...

  19. 'Meningeal sign': A characteristic finding of meningiomas on contrast-enhanced MR images

    International Nuclear Information System (INIS)

    In meningiomas, a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on Gadolinium-DTPA enhanced MR images. This so called 'meningeal sign' was evaluated with respect to the differential diagnosis of meningiomas in MR imaging. The study included 29 patients with intracranial meningiomas and 24 patients with non-meningeal brain tumors. In all meningiomas, MR studies included T2-weighted as well as unenhanced and Gadolinium-DTPA-enhanced T1-weighted images. In all non-meningeal tumors, Gd-DTPA-enhanced MR images were available. All images were evaluated with respect to the presence of the 'meningeal sign'. In meningiomas, a 'meningeal sign' was seen in 15/29 cases on Gadolinium-DTPA-enhanced images. No abnormalities corresponding to the areas of contrast enhancement were found on unenhanced T2- and T1-weighted MR images. In non-meningeal tumors only 2/24 cases showed a 'meningeal sign'. In conclusion, with a sensitivity of 52% and a specificity of 92%, the demonstration of the 'meningeal sign' improved the differential diagnosis of intracranial meningiomas in contrast-enhanced MR imaging. (orig.)

  20. Vaccine-Induced Waning of Haemophilus influenzae Empyema and Meningitis, Angola

    OpenAIRE

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

    2014-01-01

    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.

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

    Science.gov (United States)

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

    2014-11-01

    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

  2. [Cerebral artery bypass surgery].

    Science.gov (United States)

    Kivipelto, Leena; Lehecka, Martin; Niemelä, Mika; Hernesniemi, Juha

    2014-01-01

    Cerebral artery bypass surgery makes it possible to improve or replace cerebral circulation by bringing blood flow from extracranial arteries into the cerebral arteries or by creating new flow routes between cerebral arteries. Cerebral artery bypass operations play an important role in the treatment of the rare moyamoya disease causing cerebral artery stenosis and disturbances of the cerebral circulation and in the treatment of cerebral aneurysms that are unamenable to treatment with traditional microsurgical or endovascular techniques. Compared with conservative therapy, bypass surgery does, however, not seem beneficial in the prevention of strokes and hemodynamic disturbances of the cerebral circulation associated with atherosclerotic occlusion of the carotid artery. PMID:25158582

  3. [Childhood bacterial meningitis trends in Japan from 2009 to 2010].

    Science.gov (United States)

    Shinjoh, Masayoshi; Iwata, Satoshi; Sato, Yoshitake; Akita, Hironobu; Sunakawa, Keisuke

    2012-09-01

    We conducted a pediatric survey of bacterial meningitis epidemiology from January 2009 to December 2010 in Japan, and obtained the following results for 314 cases (186 boys, 124 girls, and 4 with gender not reported). Children younger than one year old accounted for the majority of cases (51.2%, 161/314), and the incidence decreased with increasing age. Haemophilus influenzae (in children aged 1 month to 5 years old) was the most common cause of infection (53.2%), followed by Streptococcus pneumoniae (1 month to 12 years, 24.2%), Streptococcus agalactiae (0-4 months, 7.6%), and Escherichia coli (0-3 months, 3.2%). Susceptibility tests showed that 50.1% (78/153) of the H. influenzae isolates and 63.0% (46/73) of the S. pneumoniae isolates were drug-resistant. Combinations of ampicillin and cephem or carbapenem and other beta-lactams were mainly used as the initial antibiotics for patients under 4 months of age (77.8%, 42/54), and a carbapenem and other beta-lactam combination was used for patients aged 4 months and older (76.4%, 198/259). The final antibiotics for H. influenzae and S. pneumoniae were mainly cefotaxime (CTX) or ceftriaxone (CTRX) and carbapenem, respectively. The overall fatality rate was 2.0% (6/305). Since the Haemophilus influenzae type b vaccine (Hib vaccine) and the 7 valent pneumococcal conjugate vaccine (PCV7) are not widely used in Japan, only 5 patients in our cohort (all with meningitis not caused by H. influenzae) had been immunized with the Hib vaccine, and none had been immunized with the PCV7 vaccine. No remarkable changes in the characteristics of pediatric meningitis have been observed for several years in Japan. PMID:23198578

  4. A Syrian patient diagnosed with meningococcal meningitis serogroup B.

    Science.gov (United States)

    Tezer, Hasan; Ozkaya-Parlakay, Aslinur; Kanik-Yuksek, Saliha; Gülhan, Belgin; Güldemir, Dilek

    2014-01-01

    Meningococcal infection is an important health problem in children, with significant mortality and morbidity. In this infection, early recognition and aggressive treatment can reduce mortality. Herein we report an 11-year-old-Syrian refugee girl living in Turkey for 3 months admitting with fever, headache, and vomiting diagnosed as meningococcal meningitis type B who was cured with intravenous ceftriaxone therapy. Infections in refugee populations constitute major importance for highlighting importance of investigation of endemic diseases in their own country and contagious diseases in their present place. PMID:25424959

  5. Moxalactam penetration into cerebrospinal fluid in patients with bacterial meningitis.

    OpenAIRE

    Modai, J; Wolff, M.; Lebas, J; Meulemans, A; Manuel, C.

    1982-01-01

    Penetration of moxalactam into the cerebrospinal fluid was studied in 11 patients with bacterial meningitis undergoing treatment with other antibiotics. Moxalactam at a dose of 20 mg/kg was administered as three 30- to 45- min infusions at 8-h intervals, once between days 2 and 4 and a second time between days 11 and 20 of treatment with the other antibiotics. Serum and cerebrospinal fluid were sampled 60, 90, or 120 min after the third moxalactam dose for measurement of the concentration of ...

  6. Cefoxitin penetration into cerebrospinal fluid in patients with purulent meningitis.

    OpenAIRE

    Galvao, P A; Lomar, A V; Francisco, W; de Godoy, C V; Norrby, R

    1980-01-01

    The penetration of cefoxitin into cerebrospinal fluid (CSF) was studied in 25 patients with purulent meningitis treated with antibiotics other than cefoxitin. Each patient received three 2-g doses of cefoxitin at 6-h intervals. Blood and CSF samples were obtained before and at 2, 4, or 6 h after the first and third doses. CSF cefoxitin concentrations were found in all patients and varied between 1.2 and 22.0 microgram/ml, with a majority of the concentrations falling within a range from 1.2 t...

  7. Effect of contrast media and chymopapain on the spinal meninges

    International Nuclear Information System (INIS)

    Cases of paralysis following diskography and chemonucleolysis have been reported. The relationship between paralysis and the procedure has not been explained in previous experimental investigations. Therefore, we tested chymopapain and renografin in an experimental animal model used extensively for studying the toxic effect of drugs on the meninges. In four cynomolgus monkeys, renografin was injected into the epidural space, and in four other monkeys, chymopapain was used. The animals were killed 12 weeks later, and the dural sac was removed for histologic examination. The severity of arachnoid and dural fibrosis in the two groups was compared. Vascular thrombosis, foreign body reaction, and subarachnoid hemorrhage were assessed

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

    Directory of Open Access Journals (Sweden)

    Yan-yu CHANG

    2014-08-01

    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

  9. Action for child survival: elimination of Haemophilus influenzae type b meningitis in Uganda

    Directory of Open Access Journals (Sweden)

    Rosamund F Lewis

    2008-04-01

    Full Text Available OBJECTIVE: To guide immunization policy, we determined the public health benefit of introducing Haemophilus influenzae type b (Hib vaccine in Uganda and estimated the vaccine effectiveness. METHODS: Surveillance data for acute bacterial meningitis among children aged 0-59 months were reviewed from three hospital sentinel sites, for July 2001 to June 2007, to determine the incidence of Hib meningitis, the effectiveness of Hib vaccine with a case-control design, and the number of vaccine-preventable cases and deaths of Hib disease in Uganda. FINDINGS: Of the 13 978 children from 17 districts with suspected bacterial meningitis, 269 had confirmed Hib meningitis, declining from 69 patients in the prevaccine year (2001-2002 to three in 2006-2007. Hib meningitis incidence dropped from 88 cases per 100 000 children aged < 5 years in the year before vaccine introduction to 13 within 4 years, and to near zero in the fifth year. Vaccine effectiveness for 2 or more doses was 93% (95% confidence interval, CI: 69-99 against confirmed Hib meningitis and 53% (95% CI: 11-68 against purulent meningitis of unknown cause. In Uganda, Hib vaccine prevents an estimated 28 000 cases of pneumonia and meningitis, 5000 deaths and 1000 severe meningitis sequelae each year. CONCLUSION: Infant immunization with Hib vaccine has virtually eliminated Hib meningitis in Uganda within 5 years. Ensuring long-term benefits of Hib vaccine urgently requires sustainable vaccine financing, high-quality ongoing surveillance, and a health sector able to deliver a robust immunization programme.

  10. Caso clínico de una meningitis por reactivación del virus varicela zóster en un paciente inmunocompetente / Case report of an inmunocompetent patient with reactivation of varicela zoster as meningitis

    Scientific Electronic Library Online (English)

    Felipe, Vial U; Sofía, González T-K; Mirta Javiera, López G.

    2013-09-01

    Full Text Available En este reporte presentamos el caso de un niño de 15 años sin antecedentes mórbidos, que consulta por un cuadro de cefalea febril, erupción cutánea de características herpéticas en tórax, en quien finalmente se confirma el diagnóstico de meningitis por varicela zóster. La literatura nos muestra que [...] la reactivación del virus varicela zóster en forma de meningitis es rara y en general afecta a la población inmunocomprometida, sin embargo, existen algunos reportes de casos similares al que se presenta, por lo que se debiese considerar como germen causal de meningitis, en la población inmunocompetente. Abstract in english This is a case report about a 15-year-old boy with no other previous medical history than chicken pox. His symptoms were headache, fever and a rash with vesicles in the dermatome that corresponds to T8. He was diagnosed with meningitis by the varicella-zoster virus. The information in the literature [...] is scarce and shows that reactivation of the varicella-zoster virus as meningitis is rare and generally affects immunodeficient patients; however, there are some case reports similar to this case in which the varicella-zoster virus is the agent involved, so it should also be considered in immunocompetent patients diagnosed with meningitis.

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

    Directory of Open Access Journals (Sweden)

    Andreya Fonseca Cardoso

    2013-01-01

    Full Text Available 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.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.

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

    Scientific Electronic Library Online (English)

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

    2013-01-01

    Full Text Available 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.

  13. The diagnosis and medical management of tuberculous meningitis in adults

    Scientific Electronic Library Online (English)

    S, Marais; R J, Wilkinson.

    2014-12-01

    Full Text Available 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.

  14. Stroke in a patient with tuberculous meningitis and HIV infection

    Directory of Open Access Journals (Sweden)

    Maria Bruna Pasticci

    2013-02-01

    Full Text Available Abstract. Tuberculous meningitis (TBM is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

  15. Meningitis y artritis por Haemophilus influenzae en un adulto

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    Javier Molina

    1988-02-01

    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.

  16. Unusual Tonsillar Herniation in Meningeal Melanocytoma: A Case Report

    International Nuclear Information System (INIS)

    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 these varied lesions. In appropriate clinical settings, certain radiologic findings, especially both T1 and T2 shortening in nodular CNS lesions should propose meningeal melanocytoma

  17. Unusual Tonsillar Herniation in Meningeal Melanocytoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Kaveh Samimi

    2012-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Aydin Mehmet

    2005-01-01

    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.

  19. Prediction of bacterial meningitis based on cerebrospinal fluid pleocytosis in children

    Scientific Electronic Library Online (English)

    Sofia, Águeda; Teresa, Campos; Ana, Maia.

    2013-08-01

    Full Text Available Children with cerebrospinal fluid pleocytosis are frequently treated with parenteral antibiotics, but only a few have bacterial meningitis. Although some clinical prediction rules, such as bacterial meningitis score, are of well-known value, the cerebrospinal fluid white blood cells count can be the [...] initial available information. Our aim was to establish a cutoff point of cerebrospinal fluid white blood cell count that could distinguish bacterial from viral and aseptic meningitis. A retrospective study of children aged 29 days to 17 years who were admitted between January 1st and December 31th, 2009, with cerebrospinal fluid pleocytosis (white blood cell > 7 µL-1) was conducted. The cases of traumatic lumbar puncture and of antibiotic treatment before lumbar puncture were excluded. There were 295 patients with cerebrospinal fluid pleocytosis, 60.3% females, medium age 5.0 ± 4.3 years distributed as: 12.2% 1-3 months; 10.5% 3-12 months; 29.8% 12 months to 5 years; 47.5% >5 years. Thirty one children (10.5%) were diagnosed with bacterial meningitis, 156 (52.9%) viral meningitis and 108 (36.6%) aseptic meningitis. Bacterial meningitis was caused by Neisseria meningi tidis (48.4%), Streptococcus pneumoniae (32.3%), other Streptococcus species (9.7%), and other agents (9.7%). cerebrospinal fluid white blood cell count was significantly higher in patients with bacterial meningitis (mean, 4839 cells/µL) compared to patients with aseptic meningitis (mean, 159 cells/µL, p

  20. Cryptococcal meningitis in HIV infected: Experience from a North Indian tertiary center

    Directory of Open Access Journals (Sweden)

    Kumar Susheel

    2008-01-01

    Full Text Available Background: Cryptococcal meningitis is a common opportunistic infection in Human Immunodeficiency Virus (HIV-infected individuals. There is little information specifically addressing cryptococcal meningitis in HIV-infected patients from North India. Aims: To determine clinical presentation, hospital course, response to treatment, complications developed, in-hospital mortality, any recurrence of cryptococcal meningitis and reasons of recurrence during follow-up. Settings and Design: A retrospective observational study undertaken in a large tertiary care center. Materials and Methods: Patient?s demographic data, presenting clinical symptomatology, physical findings, laboratory parameters, cerebrospinal fluid (CSF examination findings, side-effects of treatment, development of any complications and hospital outcome were analyzed. During follow-up any recurrence of cryptococcal meningitis, possible reasons of recurrence, type of treatment received, complications developed and outcome was recorded as well. Results: Forty patients diagnosed to have cryptococcal meningitis were analyzed. Twenty-two (55% patients had acute/ subacute presentation. Thirty-six (90% patients presented with headache and 18 (45% had altered sensorium. Twenty (50% patients had no cells in the CSF. Hypoglycorrhchia was seen in 30 (75% patients. Cryptococcal meningitis was the first acquired immune deficiency syndrome (AIDS-defining illness in 30 (75% patients. Thirty-five patients developed some adverse effects to amphotericin-B. Thirty-three patients improved with treatment while three patients died. Four patients had recurrence of cryptococcal meningitis within six months of first episode. Non-compliance of fluconazole therapy was the reason for recurrence in all of these patients. Conclusions: Cryptococcal meningitis is a common initial AIDS-defining illness. Acute and/or subacute presentation of cryptococcal meningitis is not uncommon in HIV-infected individuals. An early diagnosis of HIV infection might reduce the incidence of this infection.

  1. Traumatic Axillary Artery Dissection with Radial Artery Embolism

    International Nuclear Information System (INIS)

    This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram

  2. Cerebrospinal Fluid Stem Cell Factor Concentrations in the Children with Meningitis

    OpenAIRE

    Farhad Mashayekhi; Zivar Salehi

    2007-01-01

    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 C...

  3. Vertebral artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Ravi Kumar C

    2000-04-01

    Full Text Available Vertebral artery (VA aneurysms are rare. We present our experience with three cases of VA aneurysms. Two aneurysms were located close to the origin of basilar artery while the third patient had a giant posterior inferior cerebellar artery aneurysm. These aneurysms were operated by the far lateral inferior suboccipital approach with good results.

  4. Neonatal Meningitis: Clinical and Bacteriologic Findings in 120 Patients

    Directory of Open Access Journals (Sweden)

    SH Behjati

    2000-07-01

    Full Text Available 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 observed as follows: Convulsions in 45 patients (37%, bulged fontanel 17 (14%, opisthotonous 5 (4% and coma 17 (14%. Blood culture was in only 28 cases positive. CSF culture was positive in 56 cases and the isolated microorganisms consisted of salmonella spp in 22 cases (39%, klebsiella 15 (27%, e coli 10 (18%, pneumococcus 2 (3.5%, staph aureus 2 (3.5%. 64 (53% neonates survived, of whom 31 (48% showed sequelae, hydrocephalus being the most frequently encountered one.

  5. Prolonged incubation period in neonatal Pasteurella multocida meningitis and bacteremia.

    Science.gov (United States)

    Yamaguchi, Hiroshi; Tamura, Takuya; Abe, Michiko; Ogiwara, Shigetoshi; Sai, Shuji; Kosugiyama, Kiyotaka; Sugihara, Akemi; Nagumo, Kiyoshi; Iwata, Seido; Kinugawa, Yoshikazu

    2014-12-01

    Pasteurella multocida, often found as part of the human oral flora and in finger/toenails, also exists in many animals, especially cats, dogs, and pigs. Although rare, pasteurella infection in neonates can cause serious systemic disease, such as meningitis. In this article, a 23-day-old girl presented with decreased appetite and irritability for >2?days. Eighteen?days previously her pet cat had jumped onto the left side of her head while she was sleeping. On laboratory data C-reactive protein was high, and on cerebrospinal fluid (CSF) analysis leukocyte count was extremely high, with low glucose and high protein. P.?multocida grew out of the blood and CSF cultures, and she was successfully treated with antibiotics for 3?weeks. Although pasteurellosis rarely occurs, it can sometimes lead to life-threatening situations, so parents should exercise caution when having pets around their children. PMID:25521988

  6. Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient

    Directory of Open Access Journals (Sweden)

    Quesne Gilles

    2003-11-01

    Full Text Available Abstract Background Streptococcus pneumoniae is a major cause of human disease, especially in pre-school children and elderly people, as well as in special risk groups such as asplenic, antibody deficient patients, or presenting disruption of natural barriers. The occurrence of pneumococcal disease has increased with the onset of the HIV epidemic and the emergence of drug-resistance. Case presentation We report the case of an HIV-1-infected patient who experienced three episodes of recurrent pneumococcal meningitis over a 4-year period, despite chemoprophylaxis and capsular vaccination. Conclusions Efficacy of anti-pneumococcal chemoprophylaxis and vaccination in HIV-infected patients are discussed in the light of this particular case.

  7. Modeling tuberculous meningitis in zebrafish using Mycobacterium marinum.

    Science.gov (United States)

    van Leeuwen, Lisanne M; van der Kuip, Martijn; Youssef, Sameh A; de Bruin, Alain; Bitter, Wilbert; van Furth, A Marceline; van der Sar, Astrid M

    2014-09-01

    Tuberculous meningitis (TBM) is one of the most severe extrapulmonary manifestations of tuberculosis, with a high morbidity and mortality. Characteristic pathological features of TBM are Rich foci, i.e. brain- and spinal-cord-specific granulomas formed after hematogenous spread of pulmonary tuberculosis. Little is known about the early pathogenesis of TBM and the role of Rich foci. We have adapted the zebrafish model of Mycobacterium marinum infection (zebrafish-M. marinum model) to study TBM. First, we analyzed whether TBM occurs in adult zebrafish and showed that intraperitoneal infection resulted in granuloma formation in the meninges in 20% of the cases, with occasional brain parenchyma involvement. In zebrafish embryos, bacterial infiltration and clustering of infected phagocytes was observed after infection at three different inoculation sites: parenchyma, hindbrain ventricle and caudal vein. Infection via the bloodstream resulted in the formation of early granulomas in brain tissue in 70% of the cases. In these zebrafish embryos, infiltrates were located in the proximity of blood vessels. Interestingly, no differences were observed when embryos were infected before or after early formation of the blood-brain barrier (BBB), indicating that bacteria are able to cross this barrier with relatively high efficiency. In agreement with this observation, infected zebrafish larvae also showed infiltration of the brain tissue. Upon infection of embryos with an M. marinum ESX-1 mutant, only small clusters and scattered isolated phagocytes with high bacterial loads were present in the brain tissue. In conclusion, our adapted zebrafish-M. marinum infection model for studying granuloma formation in the brain will allow for the detailed analysis of both bacterial and host factors involved in TBM. It will help solve longstanding questions on the role of Rich foci and potentially contribute to the development of better diagnostic tools and therapeutics. PMID:24997190

  8. MRI demonstration of unsuspected intraventricular rupture of pyogenic cerebral abscesses in patients being treated for meningitis

    International Nuclear Information System (INIS)

    We report three patients with pyogenic meningitis who showed a partial response to medical treatment. MRI demonstrated an unsuspected brain abscess with intraventricular rupture, a possible cause of the partial response to treatment. (orig.)

  9. Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis

    Directory of Open Access Journals (Sweden)

    A. Denizmen Aygun

    1992-01-01

    Full Text Available 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.

  10. The 2012 Fungal Meningitis Outbreak in the United States: Connections Between Soils and Human Health

    Science.gov (United States)

    Burgess, Lynn; Brevik, Eric

    2013-04-01

    In September of 2012 the United States found itself facing a fungal meningitis outbreak that was traced back to contaminated steroid injections. The fungus Exserohilium rostratum, which is found in soil, among other locations in the environment, was identified as the main cause of the health issues created by the contaminated steroids. As of November 7, 2012 419 cases of fungal meningitis, stroke due to presumed fungal meningitis, or other central nervous system-related infections, 10 cases of peripheral joint infections, and 31 deaths linked to the contaminated steroids had been documented. However, the life cycle and soil ecology of E. rostratum is not well understood, and such knowledge would aid human health professionals in understanding the pathogenic potential of E. rostratum. Therefore, soil scientists have a role to play in developing the most effective ways to combat human health challenges such as the 2012 fungal meningitis outbreak.

  11. Spontaneous adult Gram-negative bacillary meningitis in Soweto, South Africa

    Directory of Open Access Journals (Sweden)

    Gloria Teckie

    2015-01-01

    Conclusions: A disproportionate burden of GNB meningitis fell on the HIV-infected, among whom absent or low CSF white cells was common. Management was complicated by high rates of resistance to third-generation cephalosporins.

  12. Popliteal artery entrapment syndrome

    International Nuclear Information System (INIS)

    Popliteal artery entrapment syndrome is an uncommon cause of intermittent claudication in young athletic persons. A 32 years old soldier presented with 14 months history of intermittent claudication. On the basis of history, physical examination and angiographic findings a diagnosis of popliteal artery entrapment was made. Exploration revealed a fibrous band tightly compressing popliteal artery and irreversibly damaged popliteal artery. Short saphenous vein graft was used to bypass the occluded segment of popliteal artery. This led to complete resolution of symptoms and continuation of active service. (author)

  13. Direct molecular testing to assess the incidence of meningococcal and other bacterial causes of meningitis among persons reported with unspecified bacterial meningitis.

    Science.gov (United States)

    Ramautar, Arianne E; Halse, Tanya A; Arakaki, Lola; Antwi, Mike; Del Rosso, Paula; Dorsinville, Marie; Nazarian, Elizabeth; Steiner-Sichel, Linda; Lee, Lillian; Dickinson, Michelle; Wroblewski, Danielle; Dumas, Nellie; Musser, Kimberlee; Isaac, Beth; Rakeman, Jennifer; Weiss, Don

    2015-11-01

    Confirmed and probable cases of invasive Neisseria meningitidis (Nm) infection are reportable in New York City. We conducted a study to identify Nm among culture-negative reports of bacterial and viral meningitis. During the study period, 262 reports of suspected meningitis were eligible. Cerebrospinal fluid (CSF) specimens from 138 patients were obtained for testing. No Nm cases were detected. Results from real-time polymerase chain reaction and 16S on CSF specimens were concordant with hospital microbiology findings in 80%; however, other pathogenic organisms were detected in 14 culture-negative specimens. New York City's surveillance system appears to be effective at capturing cases of Nm meningitis. Nucleic acid testing is useful for detecting the presence of bacterial DNA when antibiotic therapy precedes lumbar puncture or bacterial cultures are negative. It remains unanswered whether culture-negative cases of Nm bacteremia are being missed by reportable disease surveillance. PMID:26341704

  14. Group B Streptococcus Meningitis Following Elective Termination of Pregnancy: Two Case Reports

    OpenAIRE

    Walker, Mark A.; McNeeley, S. Gene

    1995-01-01

    Background: Although maternal group B streptococcus (GBS) infections are common, serious infections are rare with prompt diagnosis and treatment. We present 2 cases of GBS meningitis occurring 3 and 10 days after elective abortion. In the first patient, GBS meningitis was definitely related to the elective termination. In the second patient, however, no evidence for a causal relationship could be established and can only be presumed.

  15. Bacterial Pore-Forming Cytolysins Induce Neuronal Damage in a Rat Model of Neonatal Meningitis

    OpenAIRE

    Reiß, Anja; Braun, Johann S.; Jäger, Katja; Freyer, Dorette; Laube, Gregor; Bührer, Christoph; Felderhoff-Müser, Ursula; Stadelmann, Christine; Nizet, Victor; Weber, Joerg R.

    2011-01-01

    Background.?Group B Streptococcus (GBS) and Streptococcus pneumoniae (SP) are leading causes of bacterial meningitis in neonates and children. Each pathogen produces a pore-forming cytolytic toxin, ?-hemolysin/cytolysin (?-h/c) by GBS and pneumolysin by SP. The aim of this study was to understand the role of these pore-forming cytotoxins, in particular of the GBS ?-h/c, as potential neurotoxins in experimental neonatal meningitis.

  16. Fulminant citrobacter meningitis with multiple periventricular abscesses in a three-month-old infant

    Directory of Open Access Journals (Sweden)

    P. Anoop

    2003-12-01

    Full Text Available Citrobacter, a Gram-negative enteric bacillus, is a rare cause of septicemia and meningitis, seldom reported beyond the neonatal period. It is characterized by a fulminant clinical course and a high incidence of complications, including brain abscesses. We studied a three-month-old infant with Citrobacter meningitis, who developed acute communicating hydrocephalus and multiple periventricular brain abscesses while on treatment. The patient died, despite intensive antibiotic treatment directed towards the causative organism, C. diversus.

  17. Fulminant citrobacter meningitis with multiple periventricular abscesses in a three-month-old infant

    Scientific Electronic Library Online (English)

    P., Anoop; M. A., Anjay; Johny, Vincent; B., Girija.

    2003-12-01

    Full Text Available Citrobacter, a Gram-negative enteric bacillus, is a rare cause of septicemia and meningitis, seldom reported beyond the neonatal period. It is characterized by a fulminant clinical course and a high incidence of complications, including brain abscesses. We studied a three-month-old infant with Citro [...] bacter meningitis, who developed acute communicating hydrocephalus and multiple periventricular brain abscesses while on treatment. The patient died, despite intensive antibiotic treatment directed towards the causative organism, C. diversus.

  18. A fatal case of JC virus meningitis presenting with hydrocephalus in an HIV-seronegative patient

    OpenAIRE

    Agnihotri, Shruti P.; Wuthrich, Christian; Dang, Xin; Nauen, David; Karimi, Reza; Viscidi, Raphael; Bord, Evelyn; Batson, Stephanie; Troncoso, Juan; Koralnik, Igor J.

    2014-01-01

    JC virus (JCV) is the etiologic agent of progressive multifocal leukoencephalopathy, JCV granule cell neuronopathy and JCV encephalopathy. Whether JCV can also cause meningitis, has not yet been demonstrated. We report a case of aseptic meningitis resulting in symptomatic hydrocephalus in an HIV-seronegative patient. Brain imaging showed enlargement of ventricles but no parenchymal lesion. She had a very high JC viral load in the CSF and developed progressive cognitive dysfunction despite ven...

  19. Lipocalin 2 in cerebrospinal fluid as a marker of acute bacterial meningitis.

    OpenAIRE

    Guiddir, Tamazoust; Deghmane, Ala-Eddine; Giorgini, Dario; Taha, Muhamed-Kheir

    2014-01-01

    BACKGROUND: Early differential diagnosis between acute bacterial and viral meningitis is problematic. We aimed to investigate whether the detection of lipocalin 2, a protein of the acute innate immunity response, may be used as a marker for acute bacterial meningitis. METHODS: Transgenic mice expressing the human transferrin were infected by intraperitoneal route and were imaged. Cerebrospinal fluid (CSF) was sampled up to 48hours post- infection to measure lipocalin 2. We also tested a colle...

  20. Aseptic meningitis in a patient taking etanercept for rheumatoid arthritis: a case report

    OpenAIRE

    Booker, Matthew J; Flint, Julia; Saravana, Shanmugam

    2008-01-01

    Background We report a case of a 53 year old lady recently commenced on etanercept, an anti-TNF (tumour necrosis factor) therapy for rheumatoid arthritis presenting with confusion, pyrexia and an erythematous rash. Case presentation A lumbar puncture was highly suggestive of bacterial meningitis, but CSF cultures produced no growth, and polymerase chain reactions (PCR) for all previously reported bacterial, fungal and viral causes of meningitis were negative. Co...

  1. Analysis of the surveillance situation for viral encephalitis and meningitis in Europe

    OpenAIRE

    Donoso Mantke, Oliver; Vaheri, A.; AMBROSE, H; Koopmans, Marion; de Ory, F; Zeller, Hervé; Beyrer, K.; Windorfer, Adolf; Niedrig, Matthias

    2008-01-01

    Infective processes in the brain, spinal cord and meninges are considered to be the main causes of encephalitis, myelitis and meningitis. However, most cases remain unexplained. The incidence of different viral aetiologies (zoonotic and non-zoonotic) is especially poorly estimated, due to the lack of a standard case definition and of agreed diagnostic algorithms, including harmonised diagnostic methods and sample collection. It is important to clarify the incidence of viral encephaliti...

  2. Mobile laboratory to improve response to meningitis epidemics, Burkina Faso epidemic season 2004

    OpenAIRE

    Ouedraogo, R. T.; B.-M. Njanpop-Lafourcade; P. Jaillard; Y. Traoré; J. E. Mueller; J.-F. Aguilera; M. Dabal; S. R. Tiendrébéogo; W. Goehde; Da Silva, A.; B. D. Gessner; P. Stoecke

    2009-01-01

    A Mobile Laboratory was developed for use primarily during the epidemic meningitis season in Burkina Faso. This report describes the Mobile Laboratory characteristics, its use to date, problems encountered and their resolution, and future directions. During 2004, the mobile laboratory intervention in three remote Burkina Faso districts experiencing meningitis epidemics led to more speci?c case management and led directly to vaccination of one district. However, in a second district, the inter...

  3. Haematogenous Staphylococcus aureus meningitis. A 10-year nationwide study of 96 consecutive cases

    DEFF Research Database (Denmark)

    Pedersen, Michael; Benfield, Thomas L; Skinhoej, Peter; Jensen, Allan G; Benfield, Thomas

    2006-01-01

    BACKGROUND: Haematogenous Staphylococcus aureus meningitis is rare but associated with high mortality. Knowledge about the disease is still limited. The objective of this study was to evaluate demographic and clinical prognostic features of bacteraemic S. aureus meningitis. METHODS: Nationwide surveillance in Denmark from 1991 to 2000 with clinical and bacteriological data. Risks of death were estimated by Cox proportional hazards regression analysis. RESULTS: Among 12480 cases of S. aureus bact...

  4. Listeria meningitis and resultant symptomatic hydrocephalus complicating infliximab treatment for ulcerative colitis

    OpenAIRE

    Rana, Fahd; Shaikh, Muddassir Muhammad; Bowles, Jane

    2014-01-01

    Listeria monocytogenes, an uncommon pathogen, should be considered by clinicians as a source of sepsis and meningitis in the immunocompromised individuals, including those on anti-TNF alpha agents. Immunosuppressant agents including biologic therapies have transformed the management of various rheumatological and dermatological conditions.1 We report a case of life-threatening L. monocytogenes sepsis and meningitis in a 75-year-old man receiving infliximab for severe ulcerative colitis (UC).

  5. HSV-1 as a novel therapy for breast cancer meningeal metastases.

    Science.gov (United States)

    Kuruppu, D; Tanabe, K K

    2015-10-01

    Meningeal metastasis is a fatal complication of breast cancer that affects 5-8% of patients. When cancer cells seed in the meninges, their subsequent growth results in severe neurological complications involving the cranial nerves, cerebrum and spinal cord, limiting life expectancy to less than 4 months. The incidences of meningeal metastases increase with prolonged lifespan resulting from treatment advances for primary breast cancer and their metastases. Currently, there is no cure. Aggressive multimodal therapies such as radiation and chemotherapy (intra-cerebrospinal fluid (CSF) and systemic) are ineffective. Therapeutic agents are often quickly cleared from the CSF, while higher doses that can achieve a therapeutic response are highly toxic. The secure guarding of the subarachnoid space by the blood-brain barrier on one side and the blood-CSF barrier on the other prevents chemotherapy from reaching cancer cells in the meninges. These challenges with treating meningeal metastases highlight the urgent need for a new therapeutic modality. An ideal treatment would be an agent that avoids rapid clearance, remains within the CSF, reaches the meninges and selectively destroys tumor cells. Replication conditional oncolytic herpes simplex virus type 1 (HSV-1) may be effective in this regard. Viral oncolysis, the destruction of cancer cells by replicating virus, is under clinical investigation for cancers that are unresponsive to current therapies. It is based on the model of multiple cycles of lytic virus replication in cancer cells that amplify the injected dose. The therapeutic potential of oncolytic HSV-1 for breast cancer meningeal metastases is discussed here. HSV-1 could be a potential novel treatment for meningeal metastases that can be translated to the clinic. PMID:26384139

  6. Primary Diffuse Leptomeningeal Gliomatosis: Report of a Case Presenting with Chronic Meningitis

    OpenAIRE

    Kim, Sung-Hun; Jun, Dong-Chul; Park, Jin Se; Heo, Jae-Hyeok; KIM, SUNG-MIN; Kim, Juhan; Paek, Sun Ha; Kim, Manho

    2006-01-01

    Neoplastic meningitis occurs in approximately 5% of patients with cancer. Primary diffuse leptomeningeal gliomatosis is a rare condition whereby a glioma arises from heterotopic cell nests in the leptomeninges. We report here a case presenting with clinical features similar to those of chronic infectious meningitis without positive cerebrospinal fluid cytology. Neurological signs in our patient deteriorated progressively without responding to antitubercular, antiviral, or antibiotic therapy. ...

  7. Primary Diffuse Leptomeningeal Gliomatosis: Report of a Case Presenting with Chronic Meningitis

    Science.gov (United States)

    Kim, Sung-Hun; Jun, Dong-Chul; Park, Jin Se; Heo, Jae-Hyeok; Kim, Sung-Min; Kim, Juhan; Paek, Sun Ha

    2006-01-01

    Neoplastic meningitis occurs in approximately 5% of patients with cancer. Primary diffuse leptomeningeal gliomatosis is a rare condition whereby a glioma arises from heterotopic cell nests in the leptomeninges. We report here a case presenting with clinical features similar to those of chronic infectious meningitis without positive cerebrospinal fluid cytology. Neurological signs in our patient deteriorated progressively without responding to antitubercular, antiviral, or antibiotic therapy. Leptomeningeal biopsy sampling revealed the condition to be primary diffuse leptomeningeal gliomatosis. PMID:20396508

  8. The diagnosis and management of acute bacterial meningitis in resource-poor settings.

    OpenAIRE

    Scarborough, M; Thwaites, GE

    2008-01-01

    Acute bacterial meningitis is more common in resource-poor than resource-rich settings. Survival is dependent on rapid diagnosis and early treatment, both of which are difficult to achieve when laboratory support and antibiotics are scarce. Diagnostic algorithms that use basic clinic and laboratory features to distinguish bacterial meningitis from other diseases can be useful. Analysis of the CSF is essential, and simple techniques can enhance the yield of diagnostic microbiology. Penicillin-...

  9. Comparison of ceftriaxone and ampicillin plus chloramphenicol for the therapy of acute bacterial meningitis.

    OpenAIRE

    Bryan, J. P.; Rocha, H., da; da Silva, H R; Taveres, A; Sande, M A; Scheld, W. M.

    1985-01-01

    Ceftriaxone, a new third-generation cephalosporin, appears to be promising for the therapy of acute bacterial meningitis. The 90% MBCs of ceftriaxone against 54 recent cerebrospinal fluid isolates of Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae were less than or equal to 0.06 to 0.25 micrograms/ml. We examined the efficacy and safety of ceftriaxone therapy of meningitis in Bahia, Brazil. The study was conducted in two phases; in phase A, ceftriaxone was coadmin...

  10. Management of cryptococcal meningitis in HIV-infected patients: Experience from western India

    OpenAIRE

    Patel Atul; Patel Ketan; Ranjan Rajiv; Shah Shalin; Patel Jagdish

    2010-01-01

    Introduction: Cryptococcal meningitis is one of the acquired immunodeficiency syndrome defining infections with high mortality. Amphotericin B is the preferred drug for induction therapy. Despite advances in human immunodeficiency virus (HIV) treatment, Antiretroviral Treatment (ART) roll-out programs and availability of amphotericin B, cryptococcal meningitis remains an important cause of mortality in the African and other developing countries. Materials and Methods: We carried out a prospec...

  11. Bacterial invasion of the inner ear in association with pneumococcal meningitis

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Brandt, Christian; Andersen, Christian Østergaard; Caye-Thomasen, Per

    2014-01-01

    OBJECTIVE: To examine the pathways of bacterial invasion and subsequent spreading in the inner ear during pneumococcal meningitis. STUDY DESIGN: A well-established adult rat model of Streptococcus pneumoniae meningitis was used. METHODS: Thirty rats were inoculated intrathecally with S. pneumoniae serotype 1, 3 or 9 V and received no additional treatment. The rats were sacrificed when reaching terminal illness or on Day 7 and then prepared for serial sectioning and PAS-Alcian blue staining for l...

  12. Increase in hippocampal water diffusion and volume during experimental pneumococcal meningitis is aggravated by bacteremia

    DEFF Research Database (Denmark)

    Holler, Jon G; Brandt, Christian T; Leib, Stephen L; Rowland, Ian J; Andersen, Christian Østergaard

    2014-01-01

    BACKGROUND: The hippocampus undergoes apoptosis in experimental pneumococcal meningitis leading to neurofunctional deficits in learning and memory function. The aim of the present study was 1) to investigate hippocampal apparent diffusion coefficient (ADC) and volume with MRI during the course of experimental pneumococcal meningitis, 2) to explore the influence of accompanying bacteremia on hippocampal water distribution and volume, 3) and to correlate these findings to the extent of apoptosis i...

  13. Diagnosis of Streptococcus pneumoniae meningitis by polymerase chain reaction amplification of the gene for pneumolysin

    OpenAIRE

    Juliana A. Matos; Danielle J Madureira; Maria C Rebelo; Cristina B Hofer; David E Barroso

    2006-01-01

    Diagnosis of bacterial meningitis has long been based on classical methods of Gram stain, serological tests, and culture of cerebrospinal fluid (CSF). The performance of these methods, especially culture and direct smear, is thwarted by failure to detect bacteria following administration of antimicrobial agents and reluctance to performance lumbar punctures at admission. Indeed, patients with meningitis frequently receive antibiotics orally or by injection before the diagnosis is suspected or...

  14. Enzootic Angiostrongylus cantonensis in Rats and Snails after an Outbreak of Human Eosinophilic Meningitis, Jamaica

    OpenAIRE

    Lindo, John F; Waugh, Cecilia; Hall, John; Cunningham-Myrie, Colette; Ashley, Deanna; Eberhard, Mark L; Sullivan, James J.; Bishop, Henry S.; Robinson, David G.; Holtz, Timothy; Robinson, Ralph D

    2002-01-01

    After an outbreak in 2000 of eosinophilic meningitis in tourists to Jamaica, we looked for Angiostrongylus cantonensis in rats and snails on the island. Overall, 22% (24/109) of rats harbored adult worms, and 8% (4/48) of snails harbored A. cantonensis larvae. This report is the first of enzootic A. cantonensis infection in Jamaica, providing evidence that this parasite is likely to cause human cases of eosinophilic meningitis.

  15. Long-term mortality in patients diagnosed with Listeria monocytogenes meningitis: A Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Roed, Casper; Engsig, Frederik Neess; Omland, Lars Haukali; Skinhøj, Peter; Obel, Niels

    2012-01-01

    OBJECTIVES: To determine the long-term mortality, the causes of death and the incidence of cancer in listeria meningitis patients. METHODS: Nationwide, population-based cohort study including all adult patients diagnosed with listeria meningitis from 1977 to 2006 and alive 1 year after diagnosis, and an age-and gender-matched, population control cohort. Kaplan-Meier tables, Cox regression analysis and cumulative incidence function were used as outcome analyses. RESULTS: We identified 114 listeri...

  16. Kikuchi-Fujimoto Disease Associated with Aseptic Meningitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Murat Sumer

    2011-06-01

    Full Text Available Kikuchi-Fujimoto Disease is usually a rare, self limiting, benign disease causing fever, neutropenia and cervical lymphadenopathy. It is especially seen in young Asian women, rarely in children. A case of Kikuchi-Fujimoto Disease in a female Bangladeshian child with aseptic meningitis is presented from Turkey. She was admitted with fever but had no pathological lymphadenopathies. Her complicated aseptic meningitis was treated successfully with short term steroid therapy.

  17. Bacterial Invasion of the Inner Ear in Association With Pneumococcal Meningitis

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Brandt, Christian; Østergaard, Christian; Caye-Thomasen, Per

    2014-01-01

    OBJECTIVE: To examine the pathways of bacterial invasion and subsequent spreading in the inner ear during pneumococcal meningitis. STUDY DESIGN: A well-established adult rat model of Streptococcus pneumoniae meningitis was used. METHODS: Thirty rats were inoculated intrathecally with S. pneumoniae serotype 1, 3 or 9 V and received no additional treatment. The rats were sacrificed when reaching terminal illness or on Day 7 and then prepared for serial sectioning and PAS-Alcian blue staining for l...

  18. Non-Polio Enteroviruses Aseptic Meningitis:Embaba Fever Hospital Admissions 2010-2011

    OpenAIRE

    Raafat A. Abdel-Twab¹, Kouka S. Abdel-Wahab2. Ahmed O. El-Kafrawi3, Moustafa A. Aly3, Laila A. EL-Bassiony4, May EL-Maamoun4, Caroline Fayez5

    2013-01-01

    Human enteroviruses (EV) cause a wide spectrum of both common and uncommon illnesses among all age groups. Enterically transmitted. The objective of this study was to identify non-poliovirus EV as a cause of viral aseptic meningitis (VAM) by two methods (cell culture and Real time PCR). From October 2010 to August 2011 cerebrospinal fluid (CSF) samples were collected from 85 patients Embaba fever hospital admitted with symptoms of aseptic meningitis of any age and both sexes. The 85 CSF sampl...

  19. Identification of the serotypes of bacterial meningitis agents; implication for vaccine usage.

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Attarpour-Yazdi

    2014-08-01

    Full Text Available Bacterial meningitis is one of the most serious infections and should be treated as emergency. As it has significant morbidity and mortality throughout the world, every country should have precise information regarding the etiological agents of disease and populations at risk to design public health prevention strategy. In the present study in addition of evaluation of common etiological agents (Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae in bacterial meningitis cases, we sero-grouped or serotyped the obtained agents in order to predict the usefulness of existing vaccines against bacterial meningitis.Cerebrospinal fluid of 182 suspected meningitis patients were collected, from which 114 cases were approved by biochemical, microbiological and molecular tests as bacterial meningitis. The isolated bacteria were serogrouped or serotyped to determine the dominant serotypes.Streptococcus pneumoniae accounted for 36%, Haemophilus influenza for 26% and Neisseria meningitidis for 14% of cases. From 13 serogroups of N. meningitides the most frequent serogroups, were meningococcus group B (51%, C(24% A (18%, Z(2%, W135 (1% and 3% was not identified. In H. influenzae group only serotype b (100% have been identified and in pneumococcal meningitis the most common serotype among our cases were 18C (44% followed by14 (17%, 19A (13%, 6A (9%, 7F (4%, 4(3%, 3 (3%, 9V (2%, 8 (2%, 23f (2%, 5 (1%.Since there is no nationwide mass immunization program for common agents of bacterial meningitis in Iran, the result of this study can be used to improve the existing vaccines to cover the detected serotypes and consequently reduce the incidence of bacterial meningitis.

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

    Directory of Open Access Journals (Sweden)

    Lee Mi-Hee

    2005-11-01

    Full Text Available 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 Outbreaks of aseptic meningitis were observed in 1990, 1993, 1996, 1997, 2001 and 2002. The age distribution of cases was relatively uniform, with a higher incidence in those aged P = 0.001. Neurologic sequelae were observed in 0.7% of the patients. Conclusion Aseptic meningitis, rare before the 1980s in Korea, has since become a common clinical entity. Since 1990, outbreaks of aseptic meningitis have occurred every 1 to 3 years in Daejeon in keeping with Korea-wide epidemics. The frequency of disease affecting children less than one year of age may reflect herd immunity to the epidemic strain.

  1. The diagnostic value of c-reactive protein estimation in differentiating bacterial from viral meningitis

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of serum and CSF C-reactive protein (C-rp) in differentiating bacterial from viral meningitis. Design: An observational, respective hospital-based study. Place and duration of study: It was conducted at the Department of Medicine and Department of Pediatrics, Shaikh Zayed Postgraduate Medical Institute Lahore, Over a Period of one year between march, 1999 and March, 2000. Subject and Methods: A randomized group of thirty patients, who presented with clinical features, suggestive of meningitis, were included in the study. C-reactive protein determinations were performed by latex agglutination method on the serum and cerebrospinal fluid (CSF) of these patients. Results: In the present study, c-reactive protein was found to be a more sensitive test for differentiating bacterial from non-bacterial meningitis on initial examination than the usual conventional methods used to diagnose bacterial meningitis. CSF C-reactive protein had a greater sensitivity (92% as compared to serum C-reactive protein (71%). Conclusion: C-reactive protein determination in CSF was found to be a useful indicator of bacterial meningitis that can be used to distinguish it from viral meningitis. (author)

  2. CSF lactate for accurate diagnosis of community-acquired bacterial meningitis.

    Science.gov (United States)

    Giulieri, S; Chapuis-Taillard, C; Jaton, K; Cometta, A; Chuard, C; Hugli, O; Du Pasquier, R; Bille, J; Meylan, P; Manuel, O; Marchetti, O

    2015-10-01

    CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74 %) had a documented bacterial (n?=?18; S. pneumoniae, 11; N. meningitidis, 5; other, 2) or viral (n?=?27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively (p?viral meningitis, with a cutoff set at 3.5 mmol/l providing 100 % sensitivity, specificity, PPV, NPV, and efficiency. CSF lactate had the best accuracy for discriminating bacterial from viral meningitis and should be included in the initial diagnostic workup of this condition. PMID:26282789

  3. Study on isolates of acute meningitis in a tertiary care centre in Assam

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    Gitali Bhagawati

    2014-10-01

    Full Text Available Background: Meningitis is an inflammatory affection of the membranes surrounding the brain and spinal cord, which occurs as either a primary disease or secondarily to disease in some other part of the body. The epidemiological trend of acute meningitis varies with time and geography. Objective: To isolate the various agents of acute meningitis in all age group patients and to know the antimicrobial susceptibility pattern of bacterial isolates. Materials and Mathods: In this prospective study, a total of 316 cerebrospinal fluid (CSF specimens were collected from patients showing signs and symptoms of acute meningitis and processed by standard microbiological methods in a tertiary care hospital in Guwahati, Assam over a period of one year, from August 2009 to July 2010. Results: Out of 316 CSF samples, bacterial and fungal culture positivity rate was found to be 16.13%. The most common bacterial isolate was Staphylococcus aureus, 29.41%. Isolation rate of Cryptococcus neoformans was 8%. All the Gram positive isolates were 100% sensitive to linezolid and vancomycin, whereas Gram negative isolates were 92% sensitive to polymyxin B. Conclusion: This study gives an idea about the changing trend of acute meningitis along with the changing in vitro antimicrobial susceptibility pattern of the bacterial isolates, which can help the clinicians to formulate the initial empiric therapy for patients of acute meningitis.

  4. Persistent strongyloidiasis complicated by recurrent meningitis in an HTLV seropositive Peruvian migrant resettled in Italy.

    Science.gov (United States)

    Zammarchi, Lorenzo; Montagnani, Francesca; Tordini, Giacinta; Gotuzzo, Eduardo; Bisoffi, Zeno; Bartoloni, Alessandro; De Luca, Andrea

    2015-06-01

    We describe a case of persistent strongyloidiasis complicated by recurrent meningitis, in a human T cell lymphotropic virus type 1 (HTLV-1) seropositive Peruvian migrant adult resettled in Italy. He was admitted with signs and symptoms of acute bacterial meningitis, reporting four other meningitis episodes in the past 6 years, with an etiological diagnosis of Escherichia coli and Enterococcus faecium in two cases. He had been previously treated with several antihelmintic regimens not including ivermectin, without eradication of strongyloidiasis, and he had never been tested for HTLV before. During the described episode, the patient was treated for meningitis with broad-spectrum antibiotic therapy and 200 ?g/kg/dose oral ivermectin once daily on day 1, 2, 15 and 16 with full recovery and no further episodes of meningitis. The presented case underlines several critical points concerning the management of poorly known neglected diseases such as strongyloidiasis and HTLV infection in low-endemic areas. Despite several admissions for meningitis and strongyloidiasis, the parasitic infection was not adequately treated and the patient was not previously tested for HTLV. The supply of ivermectin and the choice of treatment scheme was challenging since ivermectin is not approved in Italy and there are no standardized guidelines for the treatment of severe strongyloidiasis in HTLV seropositive subjects. PMID:25846292

  5. Clinical indicators of bacterial meningitis among neonates and young infants in rural Kenya

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    Were Eugene

    2011-11-01

    Full Text Available Abstract Background Meningitis is notoriously difficult to diagnose in infancy because its clinical features are non-specific. World Health Organization (WHO guidelines suggest several indicative signs, based on limited data. We aimed to identify indicators of bacterial meningitis in young infants in Kenya, and compared their performance to the WHO guidelines. We also examined the feasibility of developing a scoring system for meningitis. Methods We studied all admissions aged Results We studied 2,411 and 1,512 young infants during the derivation and validation periods respectively. During derivation, 31/1,031 (3.0% neonates aged Conclusion Simple clinical signs at admission identify two thirds of meningitis cases in neonates and young infants. Lumbar puncture is essential to diagnosis and avoidance of unnecessary treatment, and is worthwhile without CSF biochemistry or bacterial culture. The signs of Meningitis suggested by the WHO perform poorly in the first week of life. A scoring system for meningitis in this age group is not helpful.

  6. Myeloid-Related Protein 14 Promotes Inflammation and Injury in Meningitis

    DEFF Research Database (Denmark)

    Wache, Christina; Klein, Matthias

    2015-01-01

    BACKGROUND: ?Neutrophilic inflammation often persists for days despite effective antibiotic treatment and contributes to brain damage in bacterial meningitis. We propose here that myeloid-related protein 14 (MRP14), an abundant cytosolic protein in myeloid cells, acts as an endogenous danger signal, driving inflammation and aggravating tissue injury. METHODS: ?The release pattern of MRP14 was analyzed in human and murine cerebrospinal fluid (CSF), as well as in isolated neutrophils. Its functional role was assessed in a mouse meningitis model, using MRP14-deficient mice. RESULTS: ?We detected large quantities of MRP14 in CSF specimens from patients and mice with pneumococcal meningitis. Immunohistochemical analyses and a cell-depletion approach indicated neutrophils as the major source of MRP14. In a meningitis model, MRP14-deficient mice showed a better resolution of inflammation during antibiotic therapy, which was accompanied by reduced disease severity. Intrathecal administration of MRP14 before infection reverted the phenotype of MRP14-deficient mice back to wild type. Moreover, intrathecal injection of MRP14 alone was sufficient to induce meningitis in a Toll-like receptor 4 (TLR4)-CXCL2-dependent manner. Finally, treatment with the MRP14 antagonist paquinimod reduced inflammation and disease severity significantly, reaching levels comparable to those achieved after genetic depletion of MRP14. CONCLUSIONS: ?The present study implicates MRP14 as an essential propagator of inflammation and potential therapeutic target in pneumococcal meningitis.

  7. Long-term mortality in patients diagnosed with Listeria monocytogenes meningitis: A Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Roed, Casper; Engsig, Frederik Neess

    2012-01-01

    OBJECTIVES: To determine the long-term mortality, the causes of death and the incidence of cancer in listeria meningitis patients. METHODS: Nationwide, population-based cohort study including all adult patients diagnosed with listeria meningitis from 1977 to 2006 and alive 1 year after diagnosis, and an age-and gender-matched, population control cohort. Kaplan-Meier tables, Cox regression analysis and cumulative incidence function were used as outcome analyses. RESULTS: We identified 114 listeria meningitis patients and 1026 population controls. The adjusted mortality rate ratio (MRR) for listeria meningitis patients the first 5 years of follow-up was 2.35(95% confidence interval (CI) 1.60-3.45) thereafter the MRR was 0.93(95% CI: 0.56-1.55). Listeria meningitis patients had an increased risk of death due to cancer the first 5 years of follow-up, and in the same period patients above 50 years of age had a 2-fold increased risk of being diagnosed with cancer, thereafter the risks declined to that of the background population. CONCLUSIONS: The long-term mortality in adult patients diagnosed with listeria meningitis was increased the first 5 years of follow-up, mainly due to death from cancer, thereafter the mortality did not differ from the background population. To improve survival this patient population should be meticulously screened for predisposing conditions, mainly underlying malignant diseases.

  8. Acelularidad del líquido cefalorraquídeo como factor pronóstico adverso en meningitis criptocóccica / Acellularity of cerebrospinal fluid as adverse prognostic factor in cryptococcal meningitis

    Scientific Electronic Library Online (English)

    Roberto Radamés, Larrea Fabra; Lizet, Sánchez Valdés.

    2013-12-01

    Full Text Available Introducción: las enfermedades oportunistas, y dentro de ellas la meningitis criptocóccica en pacientes inmunodeprimidos, constituyen causa mayor de letalidad en países en vías de desarrollo. Objetivo: identificar factores de mal pronóstico como la acelularidad del líquido cefalorraquídeo (LCR) para [...] individualizar medidas terapéuticas encaminadas al logro de una mayor supervivencia y calidad de vida de estos pacientes. Métodos: se estudió la celularidad de todos los LCR de los 170 casos de Bojanala, North West, ingresados en el Hospital Provincial de Rustenburg, South África por meningitis criptocóccica desde mayo de 2001 hasta abril de 2004. Se interrelacionó el número de células blancas del LCR con la letalidad intrahospitalaria, seropositividad al virus de inmunodeficiencia humana (VIH) y nivel de linfocitos T4. Resultados: se detectó una asociación altamente significativa entre acelularidad basal del LCR y riesgo a morir, y significativa con progresión lineal de mayor mortalidad en los casos con descenso evolutivo del número de células blancas en sucesivos LCR. Se constató un alto índice de letalidad (36,5 %) por meningitis criptocóccica. No hubo diferencias significativas entre acelularidad y letalidad en pruebas de comparación de grupos acorde al nivel de linfocitos T4 y a la confirmación o no de la seropositividad al VIH. Conclusiones: tanto la acelularidad basal como la progresión descendente evolutiva del número de células blancas del LCR constituyen herramientas útiles para la predicción del riesgo a morir por meningitis criptocóccica. Abstract in english Introduction: opportunistic diseases, and among them, cryptococcal meningitis in immune-compromised patients, are a major cause of lethality in developing countries Objective: to identify mal prognostic factors such as acellularity of cerebrospinal fluid (CSF) to identify therapeutic measures aimed [...] to achieve improved survival and quality of life of these patients. Methods: cellularity was studied in all CSF of the 170 cases in Bojanala, North West, who were admitted to the Rustenburg Provincial Hospital, South Africa for cryptococcal meningitis from May 2001 to April 2004. The number of CSF white cell with hospital mortality, seropositive human immunodeficiency virus (HIV) and level of T4 lymphocytes were interrelated. Results: a highly significant association was found between baseline CSF acellularity and risk of death, and significant linear progression of increased mortality in patients with developmental decline in the number of white cells in successive CSF. A high fatality rate (36.5 %) for cryptococcal meningitis was also found. No significant differences was found between acellularity and lethality tests comparing groups according to the level of T4 lymphocytes and the confirmation or otherwise of HIV seropositivity. Conclusions: both basal acellularity and evolutionary downward progression of the number of CSF white cells are useful tools for predicting the risk of death for cryptococcal meningitis.

  9. Colagenopatía y meningitis aséptica recurrente en una paciente de 88 años / Colagenopathy and recurrent aseptic meningitis in an 88 year old patient

    Scientific Electronic Library Online (English)

    Fernando J., VAzquez; Yuqueri, BeguelIn; Natalia, Schutz; Luis M., Mayorga.

    2004-02-01

    Full Text Available La meningitis aséptica recurrente (MAR) en ancianos es rara y generalmente es secundaria a drogas. Su asociación a colagenopatías en ancianos ha sido raramente informada. El Síndrome de Sjögren (SS) en ocasiones afecta el sistema nervioso central, pero la MAR asociada a SS es rara en este grupo etar [...] io. Se presenta una paciente de 88 años, autoválida, con antecedentes de xerostomía, xeroftalmos, Raynaud, disfagia y agrandamiento parotídeo recurrente autolimitado. En el año 2001 cursó una meningitis linfocítica y evolucionó con recuperación completa. Un año después volvió a presentar una meningitis linfocítica aséptica. Se descartaron causas infecciosas. Se demostró FAN 1/160 con patrón nucleolar moteado, Ac anti Ro y anti RNP positivos y anticoagulante lúpico positivo. Se confirmó sequedad ocular y la biopsia de labio fue compatible con SS. Evolucionó con resolución completa en 10 días sin tratamiento. Se interpretó como una enfermedad mixta del tejido conectivo (EMTC) con síntomas predominantemente de SS, que cursó una MAR en su forma pura. La EMTC y el SS deberían ser considerados entre los diagnósticos diferenciales de la MAR, inclusive en ancianos. Abstract in english Recurrent aseptic meningitis (RAM) infrequent in elderly patients and generally secondary to drugs. Its association with rheumatologic diseases is also seldom reported in the elderly. Sjögren Syndrome (SS) sometimes affects the central nevous system, but the association between recurrent meningitis [...] and SS is rare, specially in this age-group. We present an 88 year-old autovalid patient, with a history of xerostomia, xerophthalmia, Raynaud, dysphagia, and recurrent parotid enlargement. In 2001 she developed a lymphocytic meningitis with a complete remission. A year later, she developed again an aseptic lymphocytic meningitis. We ruled out infeccious causes. We found a FAN titer 1/160 with a nucleolar-mottled pattern, positive anti Ro and anti RNP antibodies and a positive lupus anticoagulant. We confirmed the ocular dryness and the lip biopsy was compatible with the diagnosis of SS. She had a good outcome with a complete remission without treatment in 10 days. We believe that this is a case of mixed connective tissue disease (MCTD) with predominant symptoms of SS, that developed a recurrent meningitis in its pure form. MCTD and SS should be considered in the differential diagnoses of RAM, also in the elderly.

  10. Impact of Haemophilus influenzae type b conjugate vaccine on bacterial meningitis in the Dominican Republic Impacto de la vacuna conjugada contra Haemophilus influenzae tipo b sobre la meningitis bacteriana en la República Dominicana

    OpenAIRE

    Ellen H. Lee; Miriam Corcino; Arelis Moore; Zacarias Garib; Chabela Peña; Jacqueline Sánchez; Josefina Fernández; Jesús M. Feris-Iglesias; Brendan Flannery

    2008-01-01

    OBJECTIVES: Widespread use of Haemophilus influenzae type b (Hib) vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningitis before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis. METHODS: Meningitis cases among children < 5 years of age we...

  11. CLINICO - BACTERIOLOGICAL STUDY OF PYOGENIC MENINGITIS WITH SPECIAL REFFERANCE TO C - REACTIVE PROTEIN IN CEREBRO SPINAL FLUID

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    Koteswara Rao

    2015-09-01

    Full Text Available Pyogenic meningitis is one of the most acute dramatic disease which can occur at all ages and is a potentially curable one. 80% of pyogenic meningitis cases occur in children . 1 it is 100% fatal if untreated and survivors are left with major intellectual, psychiatric and neurological handicap. The present stud y was undertaken in order to find out the age and sex distribution, incidence of presenting features, rapid and confirmatory diagnosis of pyogenic meningitis. We are frequently posed with problems in differentiating between tuberculous meningitis and parti ally treated pyogenic meningitis, because of the negative results of Gram's staining and culture . 2 The estimation of C - reactive protein in CSF, a rapid and highly sensitive tool, has been used to differentiate them . 3 The specificity of CRP test was found o ut by estimating CRP in CSF of twenty patients with various neurological disorders other than pyogenic meningitis.

  12. POOR CLINICAL OUTCOME FOR MENINGITIS CAUSED BY H. INFLUENZAE SEROTYPE A STRAINS CONTAINING THE IS1016-BEXA DELETION

    OpenAIRE

    Lima, Josilene B. T.; Ribeiro, Guilherme S.; Cordeiro, Soraia M; Gouveia, Edilane L.; Salgado, Kátia; Spratt, Brian G.; Godoy, Daniel; Mitermayer G. Reis; Ko, Albert I; Reis, Joice N.

    2010-01-01

    Following introduction of Haemophilus influenzae type b (Hib) conjugate vaccines, meningitis caused by serotypes other than Hib has gained importance. We conducted active hospital-based surveillance for meningitis over an 11-year period in Salvador, Brazil. H. influenzae isolates were serotyped and analyzed by PCR, pulsed-field gel electrophoresis and DNA sequencing to identify strains with a specific deletion (IS1016) in the bexA gene (IS1016-bexA). We identified 43 meningitis cases caused b...

  13. Diagnosis of Cryptococcosis and Prevention of Cryptococcal Meningitis Using a Novel Point-of-Care Lateral Flow Assay

    OpenAIRE

    Ashar Dhana

    2013-01-01

    Despite access to antiretroviral therapy, mortality from cryptococcal meningitis (CM) is high among persons with advanced HIV infection in sub-Saharan Africa. Cryptococcal antigen (CrAg) is present several weeks to months before the onset of symptoms of meningitis and can be screened to prevent life threatening meningitis. Recently, the World Health Organisation recommended that a new rapid CrAg lateral flow ‘‘dipstick” assay (LFA) is to be used to screen HIV-infected persons with CD4 counts ...

  14. Ruptured visceral artery aneurysms.

    Science.gov (United States)

    Chiaradia, M; Novelli, L; Deux, J-F; Tacher, V; Mayer, J; You, K; Djabbari, M; Luciani, A; Rahmouni, A; Kobeiter, H

    2015-01-01

    Visceral artery aneurysms are rare but their estimated mortality due to rupture ranges between 25 and 70%. Treatment of visceral artery aneurysm rupture is usually managed by interventional radiology. Specific embolization techniques depend on the location, affected organ, locoregional arterial anatomy, and interventional radiologist skill. The success rate following treatment by interventional radiology is greater than 90%. The main complication is recanalization of the aneurysm, showing the importance of post-therapeutic monitoring, which should preferably be performed using MR imaging. PMID:26054246

  15. Duplicated middle cerebral artery

    OpenAIRE

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an i...

  16. The use of technetium-99m-DTPA in the diagnosis of tuberculous meningitis

    International Nuclear Information System (INIS)

    As 82Br is not available locally in South West Africa on a daily basis a technetium preparation, 99mTc-DTPA, was used in the diagnosis of patients with tuberculous meningitis. The 99mTc-DTPA partition test was compared with the 82Br partition test on 22 trial subjects. The trial subjects varied in age (0,8-57 years), sex and race. There were 7 patients diagnosed by the clinicians as having tuberculous meningitis. All patients were placed on anti-tuberculous meningitis treatment and all, except 2, one of whom regressed and 1 who died 7 days later, improved slowly. The 9 patients with viral meningitis received no antibiotics and recovered rapidly on symptomatic treatment only. With all 5 the septic meningitis cases, the organism was identified and there was thus no diagnostic uncertainty. One normal control subject was also examined. It would appear from the results that both 82Br, as well as 99mTc-DTPA, cross the blood-brain barrier to a greater extent in the case of tuberculous meningitis, compared to viral meningitis. Although the accuracy of the 82Br test, if a critical ratio value of 1,3 was chosen, is 90,6% compared to 86,9% of the 99mTc-DTPA partition test if a critical ratio value of 3 was chosen, there are still advantages to the use of the technetium preparation. These include the availability, cost and lower radiation dose per MBq as well as the possibility of brain imaging. 10 figs., 58 refs., 9 tabs

  17. [Acquired bacterial meningitis in Monastir region, Tunisia (1999-2006): bacteriological aspects and susceptibility patterns].

    Science.gov (United States)

    Khalifa, A Ben Haj; Mastouri, M; Abdallah, H Ben; Noomen, S; Kheder, M

    2011-02-01

    The aim of this study was to analyze the distribution of bacteria responsible for purulent meningitis and the pattern of resistance of common species in the University Hospital of Monastir (Tunisia). All bacteriologically confirmed cases of bacterial meningitis were recorded between 1999 and 2006, and have been analyzed by classic bacterial methods advocate for meningitis. Two hundred fifty three strains have been isolated. The most frequent species were Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae, followed by Escherichia coli and Neisseria meningitides with 19.4, 13.8, 13.8, 7.1, and 6.3% of cases, respectively. Their distribution with regard to age was in accordance with literature data. The yearly distribution of these bacteria did not show any epidemic peak. Enterobacteriaceae and group B Streptococcus were the most frequently identified pathogens in neonatal meningitis. H. Influenzae was the predominant microorganism in children between three month and five years of age (36.3%), followed by S. Pneumoniae (28.8%). S. Pneumoniae was the predominant bacteria responsible for 47% of the cases over five years of age. 38.8% of S. Pneumoniae strains were less susceptible to penicillin. Resistance rates for amoxicillin and cefotaxime were 4.1%, respectively. Only one strain of N. meningitidis (6.2%) presented a decreased susceptibility to penicillin. 22.9% of H. Influenzae strains produced ?-lactamase. The resistance rates of Enterobacteriaceae to third generation cephalosporins were 25%. In our study, nosocomial meningitis have shown a rate of 24.4%. The most affected service was neurosurgery, pediatrics, and intensive care units. The increasing prevalence of pneumococci meningitis with reduced sensitivity to penicillin G strains isolated from meningitis makes adequate therapeutic management difficult. PMID:20835902

  18. Epidemiology of bacterial meningitis among children in Brazil, 1997-1998

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    Débora PL Weiss

    2001-06-01

    Full Text Available OBJECTIVE: To document the incidence and the descriptive epidemiology of bacterial meningitis among individuals under age 20 in a geographically defined region in Brazil during the two-year period immediately preceding the introduction of Haemophilus influenzae type b (Hib vaccines into the national immunization program of Brazil. METHODS: Population-based epidemiological study of all cases of bacterial meningitis reported among residents of Campinas, Brazil, under age 20 (n=316,570 during the period of 1997-98, using comprehensive surveillance records compiled by the Campinas Health Department from cases reported among hospital inpatients, outpatients, emergency room visits, death certificates, and autopsy reports. RESULTS: The incidence of bacterial meningitis (n=274 was 334.9, 115 and 43.5 cases/10(5 person-years (pys for residents of Campinas under age 1, 5 and 20, respectively. All cases were hospitalized, with an average length of stay of 12 days. Documented prior antibiotic use was 4.0%. The case-fatality rate of bacterial meningitis in individuals under age 20 was 9% (24/274 with 75% of deaths occurring in children under the age of five. The incidence of Hib meningitis (n=26 was 62.8 and 17 cases/10(5 pys in children age <1 and <5, respectively. CONCLUSIONS: The incidence of Hib meningitis in children under the age of 5 in Campinas during 1997-98 was similar to that reported in the US, Western Europe, and Israel prior to widespread Hib vaccine use in those regions. This study provides a baseline for later studies to evaluate changes in the etiology and incidence of bacterial meningitis in children after introduction of routine Hib vaccination in Brazil.

  19. Patterns of complications of neonatal and infant meningitis on MRI by organism: A 10 year review

    International Nuclear Information System (INIS)

    Introduction: Imaging of meningitis in neonates and infants is not routine, but is frequent for complications. Aside from tuberculosis and herpesvirus, imaging findings related to most responsible pathogens are thought to be nonspecific, but few studies exist. We reviewed the imaging features of complicated meningitis in infants and neonates at our hospital in the past decade, hypothesizing that patterns of complications might be more specific than previously recognized. Methods: 10 yr retrospective review of magnetic resonance imaging (MRI) and microbiology data for all neonates (age <30 d) and infants (age <1 yr) imaged for possible complications of meningitis at a tertiary children's hospital. Results: We had 63 patients (25 neonates, 38 infants). The 3 most common pathogens were streptococcal species (n = 32, mean age 4.7 mo), E. coli (n = 9, mean 1.2 mo), and herpes simplex virus (n = 4). The most common findings were meningeal enhancement (78% of those given IV contrast), infarct (52%), subdural collection (35%), and ventriculomegaly (32%). E. coli presented much more frequently with ventriculomegaly (64% vs. 22%) than streptococcal species. Extensive infarcts were typical of streptococcal meningitis (13/32, 41%) and rarely seen with other organisms (2/31, 6%, p = 0.001). All 3 cases of Serratia meningitis had large parenchymal abscesses, and 2/4 cases of meningococcus had occipital cortical necrosis. Conclusion: Although overlap was present, each organism responsible for neonatal/infant meningitis produced an identifiable pattern of complications on MRI. Recognising these patterns can help the radiologist suggest possible diagnosis and influence early management.

  20. Recurrent meningitis and persistence of craniopharyngeal canal: case report / Meningitis de repetición y canal craneofaríngeo persistente: a propósito de un caso

    Scientific Electronic Library Online (English)

    D., Pinilla-Arias; J., Hinojosa; J., Esparza; A., Muñoz.

    2009-02-01

    Full Text Available Objetivos. El Canal Craneofaríngeo es una rara malformación del esfenoides que ha sido descrito hasta en el 0,42% de la población asintomática. Se le ha relacionado con la formación de la Bolsa de Rathke durante el desarrollo embrionario aunque existen autores que opinan que se trata de un vestigio [...] de un canal vascular primitivo. Métodos. Presentamos el caso de un niño de cuatro años y medio que desarrolló un cuadro de meningitis de repetición asociado a esta anomalía. Revisamos la literatura para discutir su formación, manifestaciones clínicas y opciones de tratamiento. Conclusión. Dada su baja incidencia y las dificultades diagnósticas es necesario un alto índice de sospecha durante el estudio de un caso de meningitis de repetición o fístula espontánea de líquido cefalorraquídeo. Existe una gran controversia en lo referente al abordaje quirúrgico idóneo. Abstract in english Objects. Craniopharyngeal Canal is a rare malformation of the sphenoid bone described in up to 0.42% of the asymptomatic population. It's been related to the development of the Rathke's pouch during embrionary period although some authors think it's a vestige of a former vascular channel. Methods. T [...] his report details a case of a four and a half years old child that developed recurrent meningitis associated with this anomaly. Its origin, clinical manifestations and treatment options are discussed. Conclusion. Due to its low incidence and diagnostic difficulties, a high suspicion index is required while studying a case of recurrent meningitis or CSF leakage. Surgical approach is still controversial.

  1. Arterial waveform analysis.

    Science.gov (United States)

    Esper, Stephen A; Pinsky, Michael R

    2014-12-01

    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration. PMID:25480767

  2. Niveles de lactato en líquido cefalorraquídeo y su relación con meningitis bacteriana en pediatría / Lactate levels in cerebrospinal fluid and its relationship with bacterial meningitis in children

    Scientific Electronic Library Online (English)

    Daniel Andrés, Gennero.

    2009-09-01

    Full Text Available El líquido cefalorraquídeo (LCR) proporciona un sostén mecánico y contribuye al control del medio químico cerebral. La meningitis es la más común de las infecciones que afectan el sistema nervioso central (SNC) y puede progresar rápidamente produciendo un daño cerebral importante. En la meningitis b [...] acteriana (MB) se produce una disminución de la irrigación cerebral, seguida de hipoxia, catabolismo anaeróbico con formación de ácido láctico (AL) y aumento de su nivel en LCR. Con el fin de realizar un diagnóstico precoz se estudiaron los niveles de AL intentando demostrar la importancia de la determinación de este parámetro, correlacionar sus niveles con los de otros componentes y obtener valores límite para diferenciar los distintos grupos en la población pediátrica. Se realizó un estudio prospectivo en el cual se procesaron muestras de pacientes internados y/o atendidos en el servicio de emergencia del Hospital de Niños de Córdoba, Argentina, con sospecha de meningitis. El aumento de los niveles de lactato fue uno de los datos más confiables en el diagnóstico de meningitis bacteriana al ser comparado con el resto de los parámetros estudiados, diferenciándose del grupo control o con encefalitis viral. Los niveles de AL y lactato dehidrogenasa (LD) permitieron observar subpoblaciones según la virulencia del agente causal e intensidad del cuadro patológico en el grupo con MB. Abstract in english Cerebrospinal fluid (CSF) provides mechanical support and contributes to the control of the cerebral chemical environment. Meningitis is the most common of the infections that affect the nervous central system and can progress rapidly producing important brain damage. Bacterial meningitis gives rise [...] to a reduction in the irrigation of the brain, followed by hypoxia, anaerobic catabolism with the formation of lactic acid (LA) and increase in its level in cerebrospinal fluid. In order to carry out an earlier diagnosis, lactic acid levels were studied, trying to demonstrate the importance of the determination of this parameter, correlate the levels with those of other components, and obtain limit values to differentiate the different groups in the paediatric population. A prospective study was performed in which samples of patients suspected of having meningitis, who were admitted into hospital and/or attending the emergency service of the Children's Hospital of Cordoba, Argentina were analysed. The increase in the levels of lactate was one of the most reliable pieces of information in the diagnosis of BM, comparing it with the rest of the parameters studied and differentiating it from the control group or with viral encephalitis. The levels of LA and lactate dehydrogenase (LD) enabled the observation of subpopulations according to the virulence of the causal agent and the intensity of the pathological manifestations in the BM group.

  3. Niveles de lactato en líquido cefalorraquídeo y su relación con meningitis bacteriana en pediatría Lactate levels in cerebrospinal fluid and its relationship with bacterial meningitis in children

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    Daniel Andrés Gennero

    2009-09-01

    Full Text Available El líquido cefalorraquídeo (LCR proporciona un sostén mecánico y contribuye al control del medio químico cerebral. La meningitis es la más común de las infecciones que afectan el sistema nervioso central (SNC y puede progresar rápidamente produciendo un daño cerebral importante. En la meningitis bacteriana (MB se produce una disminución de la irrigación cerebral, seguida de hipoxia, catabolismo anaeróbico con formación de ácido láctico (AL y aumento de su nivel en LCR. Con el fin de realizar un diagnóstico precoz se estudiaron los niveles de AL intentando demostrar la importancia de la determinación de este parámetro, correlacionar sus niveles con los de otros componentes y obtener valores límite para diferenciar los distintos grupos en la población pediátrica. Se realizó un estudio prospectivo en el cual se procesaron muestras de pacientes internados y/o atendidos en el servicio de emergencia del Hospital de Niños de Córdoba, Argentina, con sospecha de meningitis. El aumento de los niveles de lactato fue uno de los datos más confiables en el diagnóstico de meningitis bacteriana al ser comparado con el resto de los parámetros estudiados, diferenciándose del grupo control o con encefalitis viral. Los niveles de AL y lactato dehidrogenasa (LD permitieron observar subpoblaciones según la virulencia del agente causal e intensidad del cuadro patológico en el grupo con MB.Cerebrospinal fluid (CSF provides mechanical support and contributes to the control of the cerebral chemical environment. Meningitis is the most common of the infections that affect the nervous central system and can progress rapidly producing important brain damage. Bacterial meningitis gives rise to a reduction in the irrigation of the brain, followed by hypoxia, anaerobic catabolism with the formation of lactic acid (LA and increase in its level in cerebrospinal fluid. In order to carry out an earlier diagnosis, lactic acid levels were studied, trying to demonstrate the importance of the determination of this parameter, correlate the levels with those of other components, and obtain limit values to differentiate the different groups in the paediatric population. A prospective study was performed in which samples of patients suspected of having meningitis, who were admitted into hospital and/or attending the emergency service of the Children's Hospital of Cordoba, Argentina were analysed. The increase in the levels of lactate was one of the most reliable pieces of information in the diagnosis of BM, comparing it with the rest of the parameters studied and differentiating it from the control group or with viral encephalitis. The levels of LA and lactate dehydrogenase (LD enabled the observation of subpopulations according to the virulence of the causal agent and the intensity of the pathological manifestations in the BM group.

  4. Un modelo de predicción de meningitis bacteriana en recién nacidos con pleocitosis del líquido cefalorraquídeo / A bacterial meningitis predictive model for newborns with cerebrospinal fluid pleocytosis

    Scientific Electronic Library Online (English)

    Manuel, Díaz Álvarez.

    2013-09-01

    Full Text Available Introducción: se han desarrollado herramientas de predicción de meningitis bacteriana (MB) en pacientes pediátricos, pero ellas no incluyen el período neonatal. Objetivo: diseñar y validar un modelo de predicción de MB en pacientes neonatales quienes presentan pleocitosis del líquido cefalorraquídeo [...] (LCR) al ser evaluados por variables clínicas y de laboratorio. Pacientes y método: estudio retrospectivo y analítico, que incluyó 320 pacientes neonatales evaluados por probable infección, en quienes se hizo el diagnóstico de meningitis, 45 con MB y 275 con meningitis aséptica, e ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario "Juan M. Márquez", entre Febrero de 1992 y Diciembre del 2009. Se creó un Modelo Predictivo de Meningitis Bacteriana, sobre la base de un conjunto de variables identificadas mediante procedimientos de análisis uni y multivariado. El modelo se diseñó a partir de una población «de derivación», y se contrastó en otro grupo, este "de validación". Resultados: las variables seleccionadas para integrar el modelo predictivo fueron: 1) Apariencia de estado tóxico-infeccioso, 2) Convulsiones en el transcurso de la enfermedad, 3) Tinción de Gram del LCR positiva, 4) Proporción de leucocitos polimorfonucleares en el LCR >80%, y 5) Glucorraquia Abstract in english Introduction: there were developed a prediction tools for bacterial meningitis (BM) in pediatric patients, but those do not include the neonatal period. Objetive: to develop and validate a prediction model for BM in neonatal patients who present pleocytosis of the cerebrospinal fluid (CF) when they [...] were evaluated by clinical and laboratory variables. Patients and method: retrospective and analytic study, which included 320 neonatal patients evaluated for probable infection, with the diagnosis of meningitis, 45 with BM and 275 with aseptic meningitis, and who were admitted in the Neonatology Ward at the Universitary Pediatric Hospital «Juan M. Márquez», from february of 1992 up to december of 2009. There was developed a Predictive Model for BM, owing to some variables identified in uni and multivariate analysis. This model was developed from a «derivation group» and it was contrasted in the «validation group». Results: the variables selected to be included at the predictive model were: 1) Toxic appearance, 2) Seizures in the course of the illness, 3) positive CF Gram stain, 4) Polymorphonuclear leukocytes proportion in CF >80%, and 5) CF glucose concentration

  5. [Childhood bacterial meningitis trends in Japan from 2007 to 2008].

    Science.gov (United States)

    Sunakawa, Keisuke; Sakai, Fuminori; Hirao, Yuriko; Hanaki, Hideaki; Nonoyama, Masato; Iwata, Satoshi; Akita, Hironobu; Sato, Yoshitake

    2010-01-01

    We surveyed pediatrics bacterial meningitis epidemiology from January 2007 to December 2008 in Japan, with the following results: Cases numbered 287-160 male and 127 female-equivalent to 1.54-1.62 of 1,000 pediatric hospitalization per year. Children under 1-year-old accounted for the highest number of cases, which decreased with increasing age. Haemophilus influenzae was the most common cause of infection, followed by Streptococcus pneumoniae, group B streptococcus (GBS), and Escherichia coli. GBS and E. coli were major pathogens in children under 4 months of age, while H. influenzae and S. pneumoniae mainly accounted for those over 4 months of age. Susceptibility tests showed that 51% of H. influenzae isolates and 56.5% of S. pneumoniae isolates in 2008 were drug-resistant. Ampicillin combined with cephem antibiotics effective against GBS, E. coli, and Listeria, were mainly used to initially treat those under 4 months of age. In those over 4 months of age, carbapenem antibiotics are effective against PRSP and cephem antibiotics against H. influenza. PMID:20170012

  6. Management of hydrocephalus in patients with tuberculous meningitis

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    Rajshekhar Vedantam

    2009-01-01

    Full Text Available Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM occurring in up to 85% of children with the disease. It is more severe in children than in adults. It could be either of the communicating type or the obstructive type with the former being more frequently seen. The Vellore grading system for clinical grading of patients with TBM and hydrocephalus with grade I being the best grade and grade IV being the worst grade has been validated by several authors. The management of hydrocephalus can include medical therapy with dehydrating agents and steroids for patients in good grades and those with communicating hydrocephalus. However, surgery is required for patients with obstructive hydrocephalus and those in poor grades. Surgery can involve either a ventriculo-peritoneal shunt or endoscopic third ventriculostomy (ETV. Complications of shunt surgery in patients with TBM and hydrocephalus are high with frequent shunt obstructions and shunt infections requiring repeated revisions. ETV has variable success in these patients and is generally not advisable in patients in the acute stages of the disease. Mortality on long-term follow up has been reported to vary from 10.5% to 57.1% in those with altered sensorium prior to surgery and 0 to 12.5% in patients with normal sensorium. Surgery for patients in Vellore grade IV is usually associated with a poor outcome and high mortality and therefore, its utility in these patients is debatable

  7. Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis

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    Heda Melinda D. Nataprawira

    2014-10-01

    Full Text Available Perinatal tuberculosis (TB is rarely reported, because the clinical manifestations are not specific and there is a problem in its laboratory and radiology examination which caused undiagnosed. Perinatal TB is the preferred description that encompasses TB acquired either intra uterine, during or post delivery in early newborn period. A-3- month old baby was transferred to Pediatric Emergency Hasan Sadikin Hospital because of prolong fever and unable to breastfeed. There was no problem with delivery. Lethargic, fever, tachypnea, and hepatosphlenomegali were found on physical examination. Ziehl Neelsen smear of gastric lavage yielded positive acid fast bacilli. Tuberculine test was non reactive, chest x-ray showed a miliary pattern, and cerebral spinal fluid analysis gave tuberculous meningitis interpretation. By active finding, his father and grandfather were detected as a source of TB transmission. In additon to oral antituberculosis regimen, antibiotics and prednison were also given. Septic shock and disseminated intravascular coagulation were occurred during his illness and the baby died. Staphylococcus haemolyticus was identified from blood culture. In conclusion, although there were no problems during labor, active investigation of perinatal TB possibility is required on the family with a source of TB. Caution on TB in pregnant women is necessary at developing country with high rates of TB.

  8. Meningitis aséptica concurrente con infección del tracto urinario en recién nacidos Aseptic meningitis concomitant with urinary tract infection in newborns

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    Manuel Díaz Álvarez

    2011-06-01

    Full Text Available INTRODUCCIÓN. Trabajos publicados recientemente han destacado el hallazgo de meningitis aséptica (MA en lactantes pequeños, concomitante con infección del tracto urinario (ITU. El objetivo de esta investigación fue determinar la frecuencia de tal presentación. MÉTODOS. Se realizó un estudio descriptivo, retrospectivo que incluyó a 626 recién nacidos con ITU, ingresados en el Hospital Pediátrico Universitario «Juan Manuel Márquez» entre febrero de 1992 y diciembre de 2008, y a quienes se les realizó una punción lumbar. Se comparó la frecuencia de MA e ITU con los informes documentados en la literatura médica. RESULTADOS. La frecuencia de MA concomitante con ITU fue del 7,0 % (IC 95 %: 4,9-9,1 %. Los resultados promedio del examen citoquímico del líquido cefalorraquídeo mostraron que la pleocitosis fue el indicador más notable entre los que comúnmente se miden. La frecuencia encontrada fue similar a la de los informes internacionales. CONCLUSIONES. Es llamativa la incidencia de MA concomitante con ITU en los recién nacidos y en concordancia con lo reportado internacionalmente. La concomitancia de MA e ITU puede ser multifactorial, y es posible que se presenten factores causales en algunos pacientes, o casuales en otros casos.INTRODUCTION. Papers recently published have emphasized the finding of the aseptic meningitis (AM in small infants, concomitant with a urinary tract infection (UTI. The aim of present research was to determine the frequency of this type of presentation. METHODS. A retrospective and descriptive study was conducted including 626 newborns presenting with UTI, admitted in the "Juan Manuel Márquez" University Children Hospital between February, 1992 and December, 2008 who underwent a lumbar puncture. The AM and UTI frequency was compared with informed reports in medical literature. RESULTS. The frequency of AM concomitant with UTI was of 7.0% (95% CI. 4,9-9,1%. The mean results of cytochemical examination of cerebrospinal fluid (CSF showed that pleocytosis was the more remarkable indicator among those usually measured. The frequency found was similar to that of international reports. CONCLUSIONS. It is interesting the incidence of AM concomitant with UTI in newborns and in concordance with that reported at international level. The AM and UTI concomitant feature may be multifactor, and it is possible the presence of causal factors in some patients or casual in other cases.

  9. Reacción paradojal en meningitis tuberculosa: presentación de un caso / Paradoxical reaction in tuberculous meningitis: a case report

    Scientific Electronic Library Online (English)

    Norma E, González; Silvia, Álvarez Ponte.

    2014-12-01

    Full Text Available La afectación del sistema nervioso central es una de las localizaciones extrapulmonares de la tuberculosis con peor pronóstico. El retraso en el diagnóstico y tratamiento es uno de los factores relacionados con mayor tasa de mortalidad y secuelas. Se describe la "reacción paradojal" como un deterior [...] o sintomático de grado variable, durante el tratamiento efectivo de la tuberculosis. El aumento de la resistencia del Mycobacterium tuberculosis a fármacos observado en los últimos años genera mayor preocupación ante la aparición de una reacción paradojal durante el tratamiento. Se presenta el caso de un niño con meningitis tuberculosa que, luego de un mes de tratamiento, presentó empeoramiento clínico y nuevas lesiones en la tomografía y resonancia magnética nuclear de cerebro. Se excluyeron patologías asociadas, se verificó que la toma de medicamentos haya sido supervisada, y la sensibilidad del bacilo a fármacos antituberculosos de primera línea fue confirmada. El paciente no requirió cambios en el esquema de tratamiento antituberculoso y se administraron esteroides para el alivio sintomático. La reacción paradojal durante el tratamiento antituberculoso es infrecuente y debida a una reacción de hipersensibilidad entre el huésped y el bacilo tuberculoso. Cuando aparece, se debe asegurar la efectividad y el cumplimiento del tratamiento administrado. Abstract in english The central nervous system is one of the locations of extrapulmonary tuberculosis with worse prognosis. The delay in diagnosis and treatment is one of the factors associated with higher mortality and sequelae. The "paradoxical reaction" is described as a variable degree of symptomatic deterioration [...] during the effective treatment of tuberculosis. The increased resistance of Mycobacterium tuberculosis to drugs observed in recent years generates greater concern about the emergence of a paradoxical reaction during treatment. The case of a child with tuberculous meningitis that after one month of treatment presented clinical worsening and new lesions in CT and MRI images of the brain is presented. Comorbidities were excluded, it was verified that taking drugs has been monitored, and the sensitivity of the bacillus to first-line antituberculosis drugs was confirmed. The patient required no change in the pattern of tuberculosis treatment and steroids were administered for symptomatic relief. The paradoxical reaction during antituberculosis treatment is rare and due to a hypersensitivity reaction between the host and the tuberculous bacillus. When it appears you must ensure the effectiveness and compliance of the treatment.

  10. Meningitis aséptica concurrente con infección del tracto urinario en recién nacidos / Aseptic meningitis concomitant with urinary tract infection in newborns

    Scientific Electronic Library Online (English)

    Manuel, Díaz Álvarez; Luena, Cárdenas González.

    2011-06-01

    Full Text Available INTRODUCCIÓN. Trabajos publicados recientemente han destacado el hallazgo de meningitis aséptica (MA) en lactantes pequeños, concomitante con infección del tracto urinario (ITU). El objetivo de esta investigación fue determinar la frecuencia de tal presentación. MÉTODOS. Se realizó un estudio descri [...] ptivo, retrospectivo que incluyó a 626 recién nacidos con ITU, ingresados en el Hospital Pediátrico Universitario «Juan Manuel Márquez» entre febrero de 1992 y diciembre de 2008, y a quienes se les realizó una punción lumbar. Se comparó la frecuencia de MA e ITU con los informes documentados en la literatura médica. RESULTADOS. La frecuencia de MA concomitante con ITU fue del 7,0 % (IC 95 %: 4,9-9,1 %). Los resultados promedio del examen citoquímico del líquido cefalorraquídeo mostraron que la pleocitosis fue el indicador más notable entre los que comúnmente se miden. La frecuencia encontrada fue similar a la de los informes internacionales. CONCLUSIONES. Es llamativa la incidencia de MA concomitante con ITU en los recién nacidos y en concordancia con lo reportado internacionalmente. La concomitancia de MA e ITU puede ser multifactorial, y es posible que se presenten factores causales en algunos pacientes, o casuales en otros casos. Abstract in english INTRODUCTION. Papers recently published have emphasized the finding of the aseptic meningitis (AM) in small infants, concomitant with a urinary tract infection (UTI). The aim of present research was to determine the frequency of this type of presentation. METHODS. A retrospective and descriptive stu [...] dy was conducted including 626 newborns presenting with UTI, admitted in the "Juan Manuel Márquez" University Children Hospital between February, 1992 and December, 2008 who underwent a lumbar puncture. The AM and UTI frequency was compared with informed reports in medical literature. RESULTS. The frequency of AM concomitant with UTI was of 7.0% (95% CI. 4,9-9,1%). The mean results of cytochemical examination of cerebrospinal fluid (CSF) showed that pleocytosis was the more remarkable indicator among those usually measured. The frequency found was similar to that of international reports. CONCLUSIONS. It is interesting the incidence of AM concomitant with UTI in newborns and in concordance with that reported at international level. The AM and UTI concomitant feature may be multifactor, and it is possible the presence of causal factors in some patients or casual in other cases.

  11. Adhesion molecule levels in serum and cerebrospinal fluid in children with bacterial meningitis and sepsis

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    Jaber Soad

    2009-01-01

    Full Text Available Background : Adhesion molecules play a role in leukocyte recruitment during central nervous system (CNS inflammation. Aim: This study was designed to compare serum, cerebrospinal fluid (CSF concentrations of adhesion molecules in children with meningitis and sepsis, and to evaluate their sources. Setting : This study was carried out at Pediatric Department, King Abdulaziz University Hospital from January 2007 to June 2008. Design: Serum and CSF samples were collected on admission from meningitis (n = 40, sepsis (n = 20 patients, and sera from controls (n = 20. Materials and Methods : Endothelial (E, leukocyte (L, platelet (P selectins intercellular cell adhesion molecule-1 (ICAM-1, and vascular cell adhesion molecules-1 (VCAM-1 were measured using ELISA. Statistics : ANOVA and Spearman?s correlations were used. Adhesion molecules with albumin concentration were estimated in CSF/serum to calculate concentration quotients. Results : In meningitis, serum sE-, sL-, sP-selectins sICAM-1, sVCAM-1 levels were higher than controls. Compared to sepsis, serum sE-selectin, sL-selectin, sVCAM-1, CSF-sL-selectin, CSF-sVCAM-1, VCAM-1 ratio and index were higher, while serum sP-selectin was lower than meningitis. sE-selectin ratio, CSF sICAM-1 were higher in meningitis with positive than negative culture. The sE-selectin index was higher in meningitis with neurological complication than those without it. In meningitis, correlation was found between CSF protein and CSF white blood cell counts (WBCs, CSF sICAM-1, CSF sVCAM-1 and between CSF sE-selectin and CSF sICAM-1. Conclusions : This study supports the role of adhesion molecules especially sL-selectin, sVCAM-1 in meningitis and suggests further research to determine their use as biomarkers for meningitis and use of their antagonists as therapeutic for CNS inflammation. The presence of discrepancy of CSF/serum ratios for molecules of same molecular weight suggest intrathecal shedding in addition to diffusion through the blood-CSF barrier.

  12. BILATERAL DUPLICATION OF RENAL ARTERIES

    OpenAIRE

    Prajkta A Thete; Mehera Bhoir; M. V. Ambiye

    2014-01-01

    Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, su...

  13. Meningitis caused by mumps virus in children admitted to Gorgan’s

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    Meningitis caused by mumps virus in children admitted to Gorgan’s

    2012-01-01

    Full Text Available Background and objectives: Mumps virus is one of the first knowncausative agents of meningitis in children. On-time diagnosis is the firststep in treating meningitis. We aimed to evaluate Mumps virus meningitisin children in Gorgan, IranMaterial and Methods: CSF and blood samples were taken fromchildren with meningitis, Jun 2008 till Sep 2010. For 40 samples withnegative bacterial culture, Extraction of viral RNA was carried out andReal-time PCR was performed for detection of Mumps virus.Demographic, clinical, biochemical and cytological data were collected.We run SPSS version 18 to analyze the data, using Chi Square (p<0.05Results: three (7.5 % samples have Mumps virus, two boys and one girl.All three positive cases have 0.5-1 degrees Celsius fever and vomiting butno bulging fontanel. They have not Kernig, Rodor, Brudzinski’s sign,hepatosplenomegaly, lymphadenopathy, pharyngitis and rash. ESR ishigher than normal in all positive cases and CRP is positive in two cases.Protein of CSF in one case is higher than normal range.Conclusion: meningitis is an emergency condition; therefore, moleculardiagnostic techniques are recommended for early diagnosis andintervention.Key words: meningitis, mumps virus, cerebrospinal fluid, Real-TimePCR

  14. Clinico-radiological features of subarachnoid hyperintensity on diffusion-weighted images in patients with meningitis

    International Nuclear Information System (INIS)

    Aim: To investigate the clinical and radiological features of meningitis with subarachnoid diffusion-weighted imaging (DWI) hyperintensity. Materials and methods: The clinical features, laboratory data, and radiological findings, including the number and distribution of subarachnoid DWI hyperintense lesions and other radiological abnormalities, of 18 patients seen at five institutions were evaluated. Results: The patients consisted of eight males and 10 females, whose ages ranged from 4 months to 82 years (median 65 years). Causative organisms were bacteria in 15 patients, including Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus agalactiae, Staphylococcus aureus, Klebsiella pneumoniae, and Listeria monocytogenes. The remaining three were fungal meningitis caused by Cryptococcus neoformans. Subarachnoid DWI hyperintense lesions were multiple in 16 of the 18 cases (89%) and predominantly distributed around the frontal lobe in 16 of the 18 cases (89%). In addition to subarachnoid abnormality, subdural empyema, cerebral infarction, and intraventricular empyema were found in 50, 39, and 39%, respectively. Compared with paediatric patients, adult patients with bacterial meningitis tended to have poor prognoses (7/10 versus 1/5; p = 0.1). Conclusion: Both bacterial and fungal meningitis could cause subarachnoid hyperintensity on DWI, predominantly around the frontal lobe. This finding is often associated with poor prognosis in adult bacterial meningitis.

  15. Computational modeling of tuberculous meningitis reveals an important role for tumor necrosis factor-?

    Science.gov (United States)

    El-Kebir, M.; van der Kuip, M.; van Furth, A.M.; Kirschner, D.E.

    2013-01-01

    Tuberculosis is a global health issue with annually about 1.5 million deaths and 2 billion infected people worldwide. Extra pulmonary tuberculosis comprises 13% of all cases of which tuberculous meningitis is the most severe. It has a high mortality and is often diagnosed once irreversible neurological damage has already occurred. Development of diagnostic and treatment strategies requires a thorough understanding of the pathogenesis of tuberculous meningitis. This disease is characterized by the formation of a cerebral granuloma, which is a collection of immune cells that attempt to immunologically restrain, and physically contain bacteria. The cytokine tumor necrosis factor-? is known for its important role in granuloma formation. Because traditional experimental animal studies exploring tuberculous meningitis are difficult and expensive, another approach is needed to begin to address this important and significant disease outcome. Here, we present an in silico model capturing the unique immunological environment of the brain that allows us to study the key mechanisms driving granuloma formation in time. Uncertainty and sensitivity analysis reveal a dose-dependent effect of tumor necrosis factor-? on bacterial load and immune cell numbers thereby influencing the onset of tuberculous meningitis. Insufficient levels result in bacterial overgrowth, whereas high levels lead to uncontrolled inflammation being detrimental to the host. These findings have important implications for the development of immuno-modulating treatment strategies for tuberculous meningitis. PMID:23542051

  16. Streptococcus gallolyticus meningitis in adults: report of five cases and review of the literature.

    Science.gov (United States)

    van Samkar, A; Brouwer, M C; Pannekoek, Y; van der Ende, A; van de Beek, D

    2015-12-01

    We describe the incidence and patient characteristics of Streptococcus gallolyticus meningitis. We identified S. gallolyticus meningitis in a nationwide cohort of patients with community-acquired bacterial meningitis, and performed a systematic review and meta-analysis of all reported adult cases in the literature. Five cases were identified (0.3%) in a cohort of 1561 episodes of bacterial meningitis. In one patient, bowel disease (colon polyps) was identified as a predisposing condition for S. gallolyticus infection, whereas no patients were diagnosed with endocarditis. In a combined analysis of our patients and 37 reported in the literature, we found that the median age was 59 years. Predisposing factors were present in 21 of 42 patients (50%), and mainly consisted of immunosuppressive therapy (seven patients), cancer (four patients), and alcoholism (four patients). Colon disease was identified in 15 of 24 patients (63%) and endocarditis in five of 27 patients (18%). Co-infection with Strongyloides stercoralis was identified in 14 of 34 patients (41%), ten of whom were infected with human immunodeficiency virus or human T-lymphotropic virus. Outcomes were described for 37 patients; eight died (22%) and one (3%) had neurological sequelae. S. gallolyticus is an uncommon cause of bacterial meningitis, with specific predisposing conditions. When it is identified, consultation with a cardiologist and gastroenterologist is warranted to rule out underlying endocarditis or colon disease. Stool examinations for Strongyloides stercoralis should be performed in patients who have travelled to or originate from endemic areas. PMID:26314916

  17. Diagnosis of Streptococcus pneumoniae meningitis by polymerase chain reaction amplification of the gene for pneumolysin

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    Juliana de A Matos

    2006-08-01

    Full Text Available Diagnosis of bacterial meningitis has long been based on classical methods of Gram stain, serological tests, and culture of cerebrospinal fluid (CSF. The performance of these methods, especially culture and direct smear, is thwarted by failure to detect bacteria following administration of antimicrobial agents and reluctance to performance lumbar punctures at admission. Indeed, patients with meningitis frequently receive antibiotics orally or by injection before the diagnosis is suspected or established. Thus an alternative method has become necessary to help clinicians and epidemiologists to management and control of bacterial meningitis. We evaluate the application of a polymerase chain reaction-based (PCR assay for amplification of pneumolysin gene (ply to diagnosis of Streptococcus pneumoniae meningitis. The PCR assay sensitivity for CSF was 96% (95% confidence interval, CI, 90-99% compared to a sensitivity of 59% for culture (95% CI 49-69%, 66% for Gram stain (95% CI 56-74%, and 78% for latex agglutination test (95% CI 69-86%; PCR specificity was 100% (95% CI 83-100%. PCR results were available within 4 h of the start of the assay. This molecular approach proved to be reliable and useful to identify this bacterium compared with other classical laboratory methods for identification of bacterial meningitis pathogens.

  18. Influence of ecologic factors on prevalence of meningeal worm (Parelaphostrongylus tenuis) infection in South Dakota, USA.

    Science.gov (United States)

    Jacques, Christopher N; Jenks, Jonathan A; Grovenburg, Troy W; Klaver, Robert W; Dubay, Shelli A

    2015-04-01

    The meningeal worm (Parelaphostrongylus tenuis) is a nematode parasite that commonly infects white-tailed deer (Odocoileus virginianus; WTD) throughout the deciduous forest biome and deciduous-coniferous ecotone of eastern and central North America; the species is not known to occur west of the grassland biome of central North America. We used county-specific prevalence data to evaluate potential effects of landscape and climatologic factors on the spatial distribution of meningeal worm infection in South Dakota, US. Probability of infection increased 4-fold between eastern and western South Dakota and 1.3-fold for each 1-cm increase in summer precipitation. Sixty-three percent of WTD had only a single worm in the cranium. Expansion of meningeal worm infection across western South Dakota may be inherently low due to the combined effects of arid climate and potential attributes of the Missouri River that limit regional movements by infected WTD. Use of landscape genetic analyses to identify potential relationships between landscape features and population genetic structure of infected deer and parasites may contribute to a greater understanding of regional heterogeneity in meningeal worm infection rates across South Dakota, particularly in counties adjacent to the Missouri River. Future research evaluating heterogeneity in prevalence and intensity of infection between fawn and yearling deer, and the potential role of yearling male deer as dispersal agents of meningeal worms across the Missouri River, also is warranted. PMID:25588013

  19. Oxidative stress and S-100B protein in children with bacterial meningitis

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    Hamed Enas A

    2009-10-01

    Full Text Available Abstract Background Bacterial meningitis is often associated with cerebral compromise which may be responsible for neurological sequelae in nearly half of the survivors. Little is known about the mechanisms of CNS involvement in bacterial meningitis. Several studies have provided substantial evidence for the key role of nitric oxide (NO and reactive oxygen species in the complex pathophysiology of bacterial meningitis. Methods In the present study, serum and CSF levels of NO, lipid peroxide (LPO (mediators for oxidative stress and lipid peroxidation; total thiol, superoxide dismutase (SOD (antioxidant mediators and S-100B protein (mediator of astrocytes activation and injury, were investigated in children with bacterial meningitis (n = 40. Albumin ratio (CSF/serum is a marker of blood-CSF barriers integrity, while mediator index (mediator ratio/albumin ratio is indicative of intrathecal synthesis. Results Compared to normal children (n = 20, patients had lower serum albumin but higher NO, LPO, total thiol, SOD and S-100B. The ratios and indices of NO and LPO indicate blood-CSF barriers dysfunction, while the ratio of S-100B indicates intrathecal synthesis. Changes were marked among patients with positive culture and those with neurological complications. Positive correlation was found between NO index with CSF WBCs (r = 0.319, p Conclusion This study suggests that loss of integrity of brain-CSF barriers, oxidative stress and S-100B may contribute to the severity and neurological complications of bacterial meningitis.

  20. The value of the tuberculin skin test in patients with tuberculous meningitis.

    Science.gov (United States)

    Kilpatrick, M E; Girgis, N I; Tribble, D; Farid, Z

    1996-01-01

    To determine the clinical utility of the tuberculin purified protein derivative (PPD) skin test in patients suspected of having tuberculous meningitis (TBM), the test was applied on admission to 180 patients suspected of having tuberculous meningitis and to 50 patients with proven bacterial meningitis admitted to the Abbassia Fever Hospital, Cairo, Egypt, during the period 1987 to 1989. Admission tuberculin positivity in evaluated groups revealed the following: overall suspect TBM cases--17% (31/180), culture-confirmed TBM cases--19% (16/83), and culture-confirmed acute bacterial meningitis cases--14% (7/50). Repeat PPD skin test at 60 days in surviving presumptive/confirmed TBM cases revealed a significant increase in tuberculin positivity to 62% (58/93) from admission (p management of tuberculous meningitis is of limited utility in our study population because of the high prevalence of tuberculin positivity in the Egyptian population (potential false positive correlation with the acute presentation) and the advanced stage of TBM at presentation to Egyptian public hospitals (potential false negative correlation). PMID:17216998

  1. Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis : Journal of Infectious Diseases

    DEFF Research Database (Denmark)

    Brandt, C.T.; Holm, D.

    2008-01-01

    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. © 2008 by the Infectious Diseases Society of America. All rights reserved.

  2. Diagnosis of Streptococcus pneumoniae meningitis by polymerase chain reaction amplification of the gene for pneumolysin

    Scientific Electronic Library Online (English)

    Juliana de A, Matos; Danielle J, Madureira; Maria C, Rebelo; Cristina B, Hofer; David E, Barroso.

    2006-08-01

    Full Text Available Diagnosis of bacterial meningitis has long been based on classical methods of Gram stain, serological tests, and culture of cerebrospinal fluid (CSF). The performance of these methods, especially culture and direct smear, is thwarted by failure to detect bacteria following administration of antimicr [...] obial agents and reluctance to performance lumbar punctures at admission. Indeed, patients with meningitis frequently receive antibiotics orally or by injection before the diagnosis is suspected or established. Thus an alternative method has become necessary to help clinicians and epidemiologists to management and control of bacterial meningitis. We evaluate the application of a polymerase chain reaction-based (PCR) assay for amplification of pneumolysin gene (ply) to diagnosis of Streptococcus pneumoniae meningitis. The PCR assay sensitivity for CSF was 96% (95% confidence interval, CI, 90-99%) compared to a sensitivity of 59% for culture (95% CI 49-69%), 66% for Gram stain (95% CI 56-74%), and 78% for latex agglutination test (95% CI 69-86%); PCR specificity was 100% (95% CI 83-100%). PCR results were available within 4 h of the start of the assay. This molecular approach proved to be reliable and useful to identify this bacterium compared with other classical laboratory methods for identification of bacterial meningitis pathogens.

  3. Clinico-radiological features of subarachnoid hyperintensity on diffusion-weighted images in patients with meningitis

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    Kawaguchi, T., E-mail: madarafuebuki@yahoo.co.jp [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Sakurai, K.; Hara, M. [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Muto, M. [Department of Radiology, Okazaki City Hospital, Okazaki, Aichi (Japan); Nakagawa, M. [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Tohyama, J. [Department of Radiology, Toyota-kai Medical Corporation Kariya Toyota General Hospital, Kariya, Aichi (Japan); Oguri, T. [Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Mitake, S. [Department of Neurology, Tosei General Hospital, Seto-shi, Aichi (Japan); Maeda, M. [Department of Radiology, Mie University School of Medicine, Tsu, Mie (Japan); Matsukawa, N.; Ojika, K. [Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Shibamoto, Y. [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan)

    2012-04-15

    Aim: To investigate the clinical and radiological features of meningitis with subarachnoid diffusion-weighted imaging (DWI) hyperintensity. Materials and methods: The clinical features, laboratory data, and radiological findings, including the number and distribution of subarachnoid DWI hyperintense lesions and other radiological abnormalities, of 18 patients seen at five institutions were evaluated. Results: The patients consisted of eight males and 10 females, whose ages ranged from 4 months to 82 years (median 65 years). Causative organisms were bacteria in 15 patients, including Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus agalactiae, Staphylococcus aureus, Klebsiella pneumoniae, and Listeria monocytogenes. The remaining three were fungal meningitis caused by Cryptococcus neoformans. Subarachnoid DWI hyperintense lesions were multiple in 16 of the 18 cases (89%) and predominantly distributed around the frontal lobe in 16 of the 18 cases (89%). In addition to subarachnoid abnormality, subdural empyema, cerebral infarction, and intraventricular empyema were found in 50, 39, and 39%, respectively. Compared with paediatric patients, adult patients with bacterial meningitis tended to have poor prognoses (7/10 versus 1/5; p = 0.1). Conclusion: Both bacterial and fungal meningitis could cause subarachnoid hyperintensity on DWI, predominantly around the frontal lobe. This finding is often associated with poor prognosis in adult bacterial meningitis.

  4. Prevalence of newborn bacterial meningitis and sepsis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil

    OpenAIRE

    Luzia Poliana Anjos da Silva; Laura Giotto Cavalheiro; Fernanda Queirós; Camila Vila Nova; Rita Lucena

    2007-01-01

    Bacterial meningitis is still a major public health threat inside developing countries. In Brazil, the Department of Public Health estimates that the prevalence of bacterial meningitis is 22 cases per 100,000 persons. During the neonatal period, the bacterial meningitis develops special characteristics that can result in hearing problems and movement loss due to neurological and psychological damages. This study had the aim to analyze the prevalence of bacterial meningitis and sepsis in newbo...

  5. [Transposition of Great Artery].

    Science.gov (United States)

    Konuma, Takeshi; Shimpo, Hideto

    2015-07-01

    Transposition of the great artery is one of common congenital cardiac disease resulting cyanosis. Death occurs easily in untreated patients with transposition and intact ventricular septal defect (VSD) in infancy at a few days of age when posterior descending coronary artery (PDA) closed. Since there are 2 parallel circulations, flow from pulmonary to systemic circulation is necessary for systemic oxygenation, and Balloon atrial septostomy or prostaglandin infusion should be performed especially if patient do not have VSD. Although the advent of fetal echocardiography, it is difficult to diagnose the transposition of the great arteries (TGA) as abnormality of great vessels is relatively undistinguishable. The diagnosis of transposition is in itself an indication for surgery, and arterial switch procedure is performed in the case the left ventricle pressure remains more than 2/3 of systemic pressure. Preoperative diagnosis is important as associated anomalies and coronary artery branching patterns are important to decide the operative indication and timing of surgery. PMID:26197905

  6. Categorías de riesgo de meningitis bacteriana y tratamiento con antibióticos en neonatos con pleocitosis del líquido cefalorraquídeo / Categories of bacterial meningitis risk and antibiotic treatment for neonates with cerebrospinal fluid pleocytosis

    Scientific Electronic Library Online (English)

    Manuel, Díaz Álvarez.

    2014-06-01

    Full Text Available Introducción: recientemente se desarrolló y validó el Modelo de Predicción de Meningitis Bacteriana Neonatal, lo cual provee de una herramienta efectiva en la toma de decisiones médicas para la indicación de tratamiento antibiótico ante un neonato con pleocitosis del líquido cefalorraquídeo. Objetiv [...] o: conocer cómo se procedió retrospectivamente con la indicación de tratamiento antibiótico en neonatos con pleocitosis del líquido cefalorraquídeo, antes de desarrollar el modelo mencionado, y fortalecer y fundamentar una estrategia del tratamiento antibiótico, basados en nuestro Modelo de Predicción de Meningitis Bacteriana Neonatal, ante un neonato con pleocitosis del líquido cefalorraquídeo. Métodos: estudio retrospectivo y aplicado, que incluyó 290 neonatos evaluados por probable infección, 44 con meningitis bacteriana y 246 con meningitis aséptica, ingresados en el Servicio de Neonatología del Hospital Pediátrico "Juan Manuel Márquez", entre febrero/1992 y diciembre/2009. Se verificó la efectividad del Modelo de Predicción de Meningitis Bacteriana Neonatal, lo que permitió clasificar los pacientes en alto o bajo riesgo de meningitis bacteriana. Se determinó retrospectivamente la indicación y los motivos de tratamiento antibiótico ante un neonato con pleocitosis del líquido cefalorraquídeo, así como análisis de asociación para distintas circunstancias clínicas, entre ellas, la clasificación de riesgo de infección bacteriana severa. Resultados: se precisó que el Modelo de Predicción de Meningitis Bacteriana Neonatal tuvo una sensibilidad y valor predictivo negativo de 100 % para meningitis bacteriana. Hubo concordancia estadísticamente significativa entre la predicción por el modelo y la clasificación de riesgo de infección bacteriana severa. Se comprobó un uso racional del tratamiento antibiótico, pues se utilizó de inmediato al diagnóstico de meningitis bacteriana en 100 % de los casos, y solo en una cuarta parte de los neonatos con meningitis aséptica, identificando como causas principales de indicación en estos casos con meningitis aséptica, tener resultados del examen del líquido cefalorraquídeo sospechosos de meningitis bacteriana sin calificar como positivos por el modelo, y hallazgos positivos para alto riesgo por los criterios de riesgo de infección bacteriana severa. Conclusiones: la indicación de tratamiento antibiótico ha sido bastante racional, pero en algunos casos innecesario. El modelo propuesto facilita y fundamenta la indicación de tratamiento antibiótico solo cuando existe un alto riesgo de meningitis bacteriana, y también limitar con confianza su uso cuando la predicción es de bajo riesgo de meningitis bacteriana, aunque puede haber situaciones clínicas excepcionales que lo justifiquen de manera transitoria. Abstract in english Introduction: recently, the neonatal bacterial meningitis predicting model was developed and validated, which provides an effective tool in medical decision-making to prescribe antibiotic treatment to neonates with cerebrospinal fluid pleocytosis. Objective: to find out retrospectively the procedure [...] to indicate the antibiotic treatment for neonates with cerebrospinal fluid pleocytosis prior to the development of the stated model, and to strengthen and substantiate an antibiotic treatment strategy, based on our neonatal bacterial meningitis prediction model of a newborn with cerebrospinal fluid pleocytosis. Methods: retrospective and implemented study of 290 neonates with probable infection; 44 had bacterial meningitis and 246 aseptic meningitis. They were all admitted to the neonatology service of "Juan Manuel Marquez" pediatric hospital from February 1992 to December 2009. The effectiveness of the neonatal bacterial meningitis prediction model was verified, which allowed classifying the patients into high or low bacterial meningitis risk. The indication and the reasons for antibiotic treatment of a neonate with cerebrospinal fluid pleocytosis were retrospectively determined, as well a

  7. Clinical outcome of pneumococcal meningitis during the emergence of pencillin-resistant Streptococcus pneumoniae: an observational study

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    Gouveia Edilane L

    2011-11-01

    Full Text Available Abstract Background Prior to the availability of generic third-generation cephalosporins, penicillins were widely used for treatment of pneumococcal meningitis in developing countries despite concerns about rising levels of penicillin resistance among pneumococcal isolates. We examined the impact of penicillin resistance on outcomes of pneumococcal meningitis over a ten year period in an infectious diseases hospital in Brazil. Methods Clinical presentation, antimicrobial therapy and outcomes were reviewed for 548 patients with culture-confirmed pneumococcal meningitis from December, 1995, to November, 2005. Pneumococcal isolates from meningitis patients were defined as penicillin-resistant if Minimum Inhibitory Concentrations for penicillin were greater than 0.06 ?g/ml. Proportional hazards regression was used to identify risk factors for fatal outcomes. Results During the ten-year period, ceftriaxone replaced ampicillin as first-line therapy for suspected bacterial meningitis. In hospital case-fatality for pneumococcal meningitis was 37%. Of 548 pneumococcal isolates from meningitis cases, 92 (17% were resistant to penicillin. After controlling for age and severity of disease at admission, penicillin resistance was associated with higher case-fatality (Hazard Ratio [HR], 1.62; 95% Confidence Interval [CI], 1.08-2.43. Penicillin-resistance remained associated with higher case-fatality when initial therapy included ceftriaxone (HR, 1.68; 95% CI 1.02-2.76. Conclusions Findings support the use of third generation cephalosporin antibiotics for treatment of suspected pneumococcal meningitis even at low prevalence of pneumococcal resistance to penicillins.

  8. Frequency of Meningitis in Children Presenting with Febrile Seizures at Ali- Asghar Children’s Hospital

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    Azita TAVASOLI

    2014-12-01

    Full Text Available How to Cite This Article: Tavasoli A, Afsharkhas L, Edraki A. Frequency of Meningitis in Children Presenting with Febrile Seizure in Ali-Asghar Children’s Hospital. Iran J Child Neurol. 2014 Autumn; 8(4:51-56.AbstractObjectiveFebrile seizures (FS are the most common type of childhood seizures, affecting 2–5% of children. As the seizure may be the sole presentation of bacterial meningitis in febrile infants, it is mandatory to exclude underlying meningitis in children presenting with fever and seizure. To determine the frequency of meningitis in children with FS and related risk factors, the present study was conducted at Ali-Asghar Children’s Hospital.Materials & MethodsThe records of children aged from 1-month–6 years of age with fever and seizure admitted to the hospital from October 2000–2010 were studied. The charts of patients who had undergone a lumbar puncture were studied and cases of meningitis were selected. The related data was collected and analyzed with SPSS version 16.ResultsA total of 681 patients with FS were known from which 422 (62% lumbar punctures (LP were done. Meningitis (bacterial or aseptic was identified in 19 cases (4.5%, 95% CI 2.9–6.9 by Wilson- Score internal and bacterial meningitis in 7 (1.65%, 95% CI 0.8–3.3. None of the patients with bacterial meningitis had meningeal irritation signs. Complex FS, first attack of FS, and impaired consciousness were more common in patients with meningitis when compared to non- meningitis patients.ConclusionMeningitis is more common in patients less than 18 months presenting with FS; however, complex features of seizures, first attack of FS, or impaired consciousness seem significant risk factors for meningitis in these children and an LP should be considered in this situation. ReferencesKimia A, Ben-Joseph EP, Rudleo T, et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics.2010; 126: 62-69.Hom J, Medwid K, The low rate of bacterial meningitis in children, ages 6 to 18 months, with simple febrile seizures. AcadEmerg Med 2011; 18(11:1114-1120.Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr 1998; 167(1; 17-27.Subcommittee on Febrile Seizures. Febrile seizures: Guidelines for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011; 127(2:389-394.Rosman NP. Evaluation of the child who convulses with fever. Pediatr Drugs 2003; 5(7:457- 461.Dubos F, De la Rocque F, Levy C et al. Sensitivity of the bacterial meningitis score in 889 children with bacterial meningitis. J Pediatr 2008; 152:378-382.Nigrovic LE, Kuppermann N, Macias CG, et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA 2007; 297(1:52-60.American Academy of Pediatrics. Provisional Committee on quality improvement, Subcommittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatrics 1997; 769-772.Najaf-Zadeh A, Dubos F, Hue V, et al. Risk of bacterial meningitis in young children with a first seizure in the context of fever: a systematic review and meta- analysis. PLoS One. 2013; 8(1:e55270. Doi: 10. 1371/journal. pone.0055270.Owusu-Ofori A, Agbenyega T, Ansong D, et al. Routine lumbar puncture in children with febrile seizures in Ghana: should it continue? International Journal of Infectious Diseases 2004; 8:353-361.Kimia AA, Capraro AJ, Hummel D, Johnston P, Harper MB. Utility of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age. Pediatrics 2009; 123(1: 6–12.Shaked O, Pena BM, Linares MY, Baker RL. Simple febrile seizures: are the AAP guidelines regarding lumbar puncture being followed? Pediatr Emerg Care 2009; 25(1:8-11.Seltz LB, Cohen E, Weinstein M. Risk of bacterial or herpes simplex virus meningitis/encephalitis in children with complex febrile seizures. Pediatr Emerg Care 2009;25(8: 494–497.Casasoprana A, Hachon Le Camus C, Clau

  9. Meningeal carcinomatosis in solid tumors / Carcinomatose meníngea em tumores sólidos

    Scientific Electronic Library Online (English)

    Sandro José, Martins; Carla Rameri Alexandre Silva de, Azevedo; Ludmilla Thomé Domingos, Chinen; Marcelo Rocha Sousa, Cruz; Marcos Aurélio, Peterlevitz; Daniel Luiz, Gimenes.

    2011-12-01

    Full Text Available O acometimento leptomeníngeo por metástases tumorais pode ocorrer em tumores sólidos, sendo chamado de carcinomatose meníngea (CM), e também em doenças linfoproliferativas. Tumores de mama, pulmão e melanoma são os principais responsáveis pelos casos, e adenocarcinoma é a histologia mais frequenteme [...] nte encontrada. A CM é um evento tardio na evolução da doença e caracteriza-se por sinais e sintomas neurológicos multifocais. O diagnóstico se faz pela avaliação conjunta do quadro clínico, neuroimagem e estudo do líquido cefalorraquidiano. O maior controle da doença sistêmica obtido com as novas modalidades terapêuticas e a baixa penetração de drogas no sistema nervoso central, aliados ao desenvolvimento nos métodos de neuroimagem observado nas últimas décadas, são fatores que respondem por um aumento na incidência desta apresentação. A quimioterapia intratecal é o tratamento de escolha, porém, frequentemente paliativo. O prognóstico é reservado, sendo que o melhor performance status pode selecionar um subgrupo de pacientes com melhor evolução. Abstract in english The involvement of the leptomeninges by metastatic tumors can be observed in solid tumors, in which case it is termed meningeal carcinomatosis (MC), and in lymphoproliferative malignant disease. It is more common in breast and lung cancer, as well as melanoma, with adenocarcinoma being the most freq [...] uent histological type. MC is usually a late event, with disseminated and progressive disease already present and, it is characterized by multifocal neurological signs and symptoms. Diagnosis is based on the evaluation of clinical presentation, cerebrospinal fluid and neuroimaging studies. The better systemic disease control is observed with new therapeutic agents, and the development of neuroimaging methods is responsible for the increasing incidence of such metastatic evolution. Intrathecal chemotherapy is generally the treatment of choice, although frequently palliative. Prognosis is guarded, although a higher performance status may indicate a subgroup of patients with a more favorable outcome.

  10. Factors influencing shunt malfunction in patients with tuberculous meningitis

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    Sudheer Ambekar

    2013-01-01

    Full Text Available Background: Hydrocephalus secondary to tuberculous meningitis (TBM is a challenging condition to treat. Though ventriculo-peritoneal (VP shunt is an accepted modality of treatment for hydrocephalus in TBM, there is a high rate of complications associated with the same. Objective: The study was planned to evaluate various factors associated with shunt malfunction in patients undergoing VP shunt surgery for hydrocephalus due to TBM. Materials and Methods: A retrospective review of all the patients undergoing VP shunt and shunt revision for TBM between 2004 and 2008 was performed. 449 VP shunt surgeries were performed in 432 patients for hydrocephalus due to TBM. Among these 70 shunt revisions were performed in 53 patients. Results: Shunt malfunction rate in our series was 16.2%. High cerebrospinal fluid (CSF protein concentration (>200 mg/dL was associated with 5 times increased incidence of shunt malfunction. Patients with hyponatremia (Na + <130 mEq/dL prior to surgery had a 3 times increased incidence of shunt malfunction (P < 0.05. Other factors such as duration of symptoms, presence of neurological deficits, Evan?s index, third ventricular diameter, thickness of exudates, presence of infarcts, anemia, CSF cellularity and CSF glucose concentration were not associated with increased incidence of shunt malfunction. Analysis showed that shunt viability was longest in patients with normal serum sodium levels and CSF protein concentration less than 200 mg/dL and shortest in patients with low serum sodium and CSF protein concentration more than 200 mg/dL. Conclusions: Patients with pre-operative hyponatremia and high CSF protein concentration have a higher incidence of shunt malfunction and need to be followed-up closely.

  11. A fatal case of JC virus meningitis presenting with hydrocephalus in an HIV-seronegative patient

    Science.gov (United States)

    Agnihotri, Shruti P.; Wuthrich, Christian; Dang, Xin; Nauen, David; Karimi, Reza; Viscidi, Raphael; Bord, Evelyn; Batson, Stephanie; Troncoso, Juan; Koralnik, Igor J.

    2014-01-01

    JC virus (JCV) is the etiologic agent of progressive multifocal leukoencephalopathy, JCV granule cell neuronopathy and JCV encephalopathy. Whether JCV can also cause meningitis, has not yet been demonstrated. We report a case of aseptic meningitis resulting in symptomatic hydrocephalus in an HIV-seronegative patient. Brain imaging showed enlargement of ventricles but no parenchymal lesion. She had a very high JC viral load in the CSF and developed progressive cognitive dysfunction despite ventricular drainage. She was diagnosed with pancytopenia and passed away after 5 ½ months. Post-mortem exam revealed productive JCV infection of leptomeningeal and choroid plexus cells, and limited parenchymal involvement. Sequencing of JCV CSF strain showed an archetype-like regulatory region. Further studies of the role of JCV in aseptic meningitis and in idiopathic hydrocephalus are warranted. PMID:24895208

  12. Detección precoz de afectación neurosensorial en niños convalecientes de meningitis bacteriana

    Scientific Electronic Library Online (English)

    Eric, Martínez Torres; Bárbara, Bertot Acosta; María Cecilia, Pérez Avalos; Maritza, Perera González; Martha, Moroño Guerrero.

    1995-04-01

    Full Text Available Se estudiaron 100 pacientes entre 2 meses y 2 años de edad que sufrieron meningitis bacteriana aguda. Se les realizó examen neuropediátrico, pruebas psicométricas y potenciales evocados auditivos de tallo cerebral. Treinta y siete niños tuvieron resultados anormales. Se encontró pérdida auditiva sen [...] sorineural en 15, conductiva en 11 y otra afectación neurológica (retardo psicomotor, espasticidad, paresias) en 11. La incidencia de exámenes anormales fue significativamente más allá en el grupo de convalecientes de meningitis, con respecto a otros egresados de terapia intensiva. La edad menor de 6 meses fue el factor (considerado en forma aislada) que se asoció con mayor frecuencia a afectación residual. El germen causal, el sexo y las complicaciones durante la meningitis no fueron significativas. La combinación de métodos clínicos con métodos de laboratorio de neurofisiología permitió identificar a un grupo de niños en riesgo de secuela neurosensorial, mucho mayor que el obtenido por cada uno por separado.

  13. Enterovirus and herpesviridae family as etiologic agents of lymphomonocytary meningitis, Southern Brazil

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    Luine Rosele Renaud Vidal

    2011-06-01

    Full Text Available Viral meningitis is a common infectious disease of the central nervous system (CNS that occurs worldwide. The aim of this study was to identify the etiologic agent of lymphomonocytary meningitis in Curitiba, PR, Brazil. During the period of July 2005 to December 2006, 460 cerebrospinal fluid (CSF samples with lymphomonocytary meningitis were analyzed by PCR methodologies. Fifty nine (12.8% samples were positive. Enteroviruses was present in 49 (83% samples and herpes virus family in 10 (17%, of these 6 (10% herpes simplex virus, 1 (2% Epstein Barr virus, 2 (3% human herpes virus type 6 and 1 (2% mixed infection of enterovirus and Epstein Barr virus. As conclusion enterovirus was the most frequent virus, with circulation during summer and was observed with higher frequency between 4 to 17 years of age. PCR methodology is an important method for rapid detection of RNA enterovirus and DNA herpesvirus in CSF.

  14. A paradoxical decline: intracranial lesions in two HIV-positive patients recovering from cryptococcal meningitis.

    Science.gov (United States)

    Pettersen, Kenneth D; Pappas, Peter G; Chin-Hong, Peter; Baxi, Sanjiv M

    2015-01-01

    Cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) is an increasingly important manifestation among patients with HIV/AIDS, especially as the use of antiretroviral therapy (ART) is expanding worldwide. Cryptococcus and associated C-IRIS are common causes of meningitis. While intracranial lesions are common in HIV/AIDS, they are rarely due to cryptococcosis or C-IRIS. We describe two cases of paradoxical C-IRIS associated with the development of intracranial cryptococcomas in HIV/AIDS. Both patients had an initial episode of cryptococcal meningitis treated with antifungal therapy. At the time, they had initiated or modified ART with subsequent evidence of immune reconstitution. Two months later, they developed aseptic meningitis with intracranial lesions. After exhaustive work ups, both patients were diagnosed with paradoxical C-IRIS and biopsy confirmed intracranial cryptococcomas. We review the important clinical, diagnostic and therapeutic features of cryptococcomas associated with C-IRIS in HIV/AIDS. PMID:26475880

  15. Evaluation of anti-pneumococcal capsular antibodies as adjunctive therapy in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian; Frimodt-Moller, N

    2006-01-01

    OBJECTIVE: Bacteraemia concomitant with meningitis has been shown to greatly affect outcome. Consequently, the efficacy of serotype-specific anti-pneumococcal antiserum (APAS) was investigated in a rat model of pneumococcal meningitis. METHODS: Rats were infected with Streptococcus pneumoniae serotype 3. All rats received ceftriaxone starting 26 h post-infection. APAS was administered either at the time of infection or 26 h post-infection and effects were compared with rats treated with antibiotics only. RESULTS AND CONCLUSION: A significant clinical benefit was found when APAS was given at the time of infection whereas no effect was found when administered 26 h after infection. This work indicates that the clinical value of using APAS in pneumococcal meningitis may be limited

  16. Recurrent aseptic meningitis in association with Kikuchi-Fujimoto disease: case report and literature review

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    Komagamine Tomoko

    2012-09-01

    Full Text Available Abstract Background Kikuchi Fujimoto disease (KFD, or histiocytic necrotising lymphadenitis, is a benign and self-limiting condition characterised by primarily affecting the cervical lymph nodes. Recurrent aseptic meningitis in association with KFD is extremely rare and remains a diagnostic challenge. Case presentation We report a 28-year-old man who presented 7 episodes of aseptic meningitis associated with KFD over the course of 7 years. Histopathological findings of enlarged lymph nodes led to the diagnosis of KFD. The patient’s headache and lymphadenopathy spontaneously resolved without any sequelae. Conclusions A diagnosis of KFD should be considered when enlarged cervical lymph nodes are observed in patients with recurrent aseptic meningitis. A long-term prognosis remains uncertain, and careful follow-up is preferred.

  17. Detección precoz de afectación neurosensorial en niños convalecientes de meningitis bacteriana

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    Eric Martínez Torres

    1995-04-01

    Full Text Available Se estudiaron 100 pacientes entre 2 meses y 2 años de edad que sufrieron meningitis bacteriana aguda. Se les realizó examen neuropediátrico, pruebas psicométricas y potenciales evocados auditivos de tallo cerebral. Treinta y siete niños tuvieron resultados anormales. Se encontró pérdida auditiva sensorineural en 15, conductiva en 11 y otra afectación neurológica (retardo psicomotor, espasticidad, paresias en 11. La incidencia de exámenes anormales fue significativamente más allá en el grupo de convalecientes de meningitis, con respecto a otros egresados de terapia intensiva. La edad menor de 6 meses fue el factor (considerado en forma aislada que se asoció con mayor frecuencia a afectación residual. El germen causal, el sexo y las complicaciones durante la meningitis no fueron significativas. La combinación de métodos clínicos con métodos de laboratorio de neurofisiología permitió identificar a un grupo de niños en riesgo de secuela neurosensorial, mucho mayor que el obtenido por cada uno por separado.

  18. Which clinical parameters predict a CSF diagnosis of meningitis in a population with high HIV prevalence?

    Scientific Electronic Library Online (English)

    W, Loughborough; M, Abouyannis; L, Jones; S, Garach.

    2014-02-01

    Full Text Available BACKGROUND: The HIV epidemic has changed the aetiology of meningitis in sub-Saharan Africa, and frontline clinicians are faced with a variety of meningitic presentations. Doctors working in resource-limited settings have the challenge of appropriately selecting patients for lumbar puncture (LP), a p [...] otentially risky procedure that requires laboratory analysis. METHODS: In a rural South African hospital, the practice of performing LPs was audited against local guidelines. Data were collected retrospectively between February and June 2013. Symptoms and signs of meningitis, HIV status, investigations performed prior to LP and cerebrospinal fluid (CSF) results were recorded. With the aim of determining statistically significant clinical predictors of meningitis, parameters were explored using univariate and multivariate logistic regression analyses RESULTS: A total of 107 patients were included, of whom 43% had an abnormal CSF result. The majority (76%) of patients were HIV-positive (CD4+ cell count

  19. Incidence of tuberculous meningitis in the State of Santa Catarina, Brazil

    Scientific Electronic Library Online (English)

    Cíntia Helena, de Souza; Ayaka, Yamane; Jeison Cleiton, Pandini; Luciane Bisognin, Ceretta; Fabiane, Ferraz; Glauco Duarte, da Luz; Priscyla Waleska, Simões.

    2014-07-01

    Full Text Available Introduction The aim of this study was to estimate the incidence of tuberculous meningitis in the State of Santa Catarina (SC), Brazil, during the period from 2001 to 2010. Methods Ecological, temporal, and descriptive methods were employed using data obtained from the Information System on Diseas [...] e Notification (Sistema de Informação de Agravos de Notificação). Results One hundred sixteen reported cases of tuberculous meningitis occurred from 2001 to 2010, corresponding to 1.2% (0.2 cases/100,000 inhabitants) of all meningitis cases reported in SC. There was a predominance of new cases in males, corresponding to 56.9% of new cases (0.2 cases/100,000 inhabitants; males vs. females; p=0.374), in patients aged 20-39 years, corresponding to 52.6% of new cases (0.5 cases/100,000 inhabitants; 20-39 years versus others; p

  20. A Rare Coronary Artery Anomaly; Double Right Coronary Artery

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    Orhan Önalan

    2010-12-01

    Full Text Available A double right coronary artery is an extremely rare coronary artery anomaly. Difficulties in diagnosis might cause underestimation of the incidence of double right coronary artery. Interestingly, most of the cases about this anomaly were reported from Turkey. In this case report, we aimed to present double right coronary artery in a patient who was admitted with atypic chest pain.

  1. Non-Polio Enteroviruses Aseptic Meningitis:Embaba Fever Hospital Admissions 2010-2011

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    Raafat A. Abdel-Twab¹, Kouka S. Abdel-Wahab2. Ahmed O. El-Kafrawi3, Moustafa A. Aly3, Laila A. EL-Bassiony4, May EL-Maamoun4, Caroline Fayez5

    2013-07-01

    Full Text Available Human enteroviruses (EV cause a wide spectrum of both common and uncommon illnesses among all age groups. Enterically transmitted. The objective of this study was to identify non-poliovirus EV as a cause of viral aseptic meningitis (VAM by two methods (cell culture and Real time PCR. From October 2010 to August 2011 cerebrospinal fluid (CSF samples were collected from 85 patients Embaba fever hospital admitted with symptoms of aseptic meningitis of any age and both sexes. The 85 CSF samples were inoculated into RD (human rhabdomyosarcoma cell line in three blind passages to amplify isolates producing EV-like CPE. A total of 14 (16.5% out of 85 CSF samples showed EV-like CPE. By Real time PCR 11 out of the 14 culture positive samples and 5 out of the 14 source of virus isolation original CSF were non polio EV positive. The frequency of non-polio EV meningitis hospital admissions was in the summer season (50%, spring (25%, late autumn (16.6% and least frequency in winter (8.4%. non-polio EV meningitis was detected in 6 out of 41 male patients (14.5% and in 6 out of 44 female patients (13.5%. Also non-polio EV meningitis was detected in all ages with marked increase of incidence in young children (41.6% and old age (50% and less in adult (8.4%. . In conclusionOur data showed that the non-polioviruses EV was associated with the majority of VAM during 2010 – 2011 at the Embaba fever hospital which serves Embaba, Shoubra Elkheema, Qualyba and neighbors localities in Egypt. Rapid detection of non-polio EV meningitis is essential for making decisions about patient management and treatment

  2. Tratamiento sin antibióticos en recién nacidos febriles con pleocitosis del líquido cefalorraquídeo y presunta meningitis viral

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    Manuel Díaz Álvarez

    2011-03-01

    Full Text Available INTRODUCCIÓN. El objetivo de esta investigación fue presentar la experiencia en antibioticoterapia en recién nacidos (RN febriles con pleocitosis del líquido cefalorraquídeo (LCR y presunción médica de meningitis viral. MÉTODOS. Se realizó un estudio retrospectivo con 310 RN con diagnóstico de meningitis aséptica, ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario «Juan Manuel Márquez» entre 1992 y 2009. Se determinó, utilizando estadística descriptiva, la indicación o no de tratamiento antibiótico, momento y motivos de la indicación. RESULTADOS. Hubo 204 RN (65,8 % con meningitis aséptica que egresaron favorablemente sin haber recibido tratamiento antibiótico. En 106 RN (34,2 % se indicaron antibióticos (en 76 inmediatamente al diagnóstico de meningitis y en 30 casos, mediatamente por diversos motivos. Los motivos para tratamiento inmediato fueron principalmente los resultados del examen citoquímico del LCR muy semejantes a los de una meningitis de causa bacteriana y los antecedentes de fiebre elevada o persistente. En la indicación mediata el principal motivo fue la concurrencia de infección del tracto urinario. En los pacientes que nunca recibieron tratamiento antibiótico, la mediana de estadía hospitalaria fue de 4 días (intervalo intercuartil 3-5 días y para los que sí lo recibieron fue de 5 días (intervalo intercuartil 4-7 días (p < 0,0001. CONCLUSIONES. Es aconsejable revisar el enfoque de utilizar tratamiento antibiótico ante todo RN proveniente de la comunidad cuando se encuentra pleocitosis del LCR y se presume la existencia de una meningitis viral, siempre y cuando existan condiciones de vigilancia profesional calificada y continua, y un laboratorio de microbiología con recursos suficientes para respaldar una estrategia de tratamiento con uso racional de la antibioticoterapia.

  3. Management of cryptococcal meningitis in HIV-infected patients: Experience from western India

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    Patel Atul

    2010-01-01

    Full Text Available Introduction: Cryptococcal meningitis is one of the acquired immunodeficiency syndrome defining infections with high mortality. Amphotericin B is the preferred drug for induction therapy. Despite advances in human immunodeficiency virus (HIV treatment, Antiretroviral Treatment (ART roll-out programs and availability of amphotericin B, cryptococcal meningitis remains an important cause of mortality in the African and other developing countries. Materials and Methods: We carried out a prospective observational study to determine the treatment response rate, tolerability and outcome of patients with cryptococcal meningitis in HIV treated with amphotericin B. Descriptive statistic was used to analyze the data. Results: A total of 27 patients were diagnosed with cryptococcal meningitis during the study period. Headache (96.29% was the single most common presenting symptom of cryptococcal meningitis in HIV-infected patients, followed by vomiting (77.77% and fever (66.66%. Cerebrospinal fluid (CSF routine and microscopic examination was within normal limits in six patients. CSF became sterile on the 12th day of Amphotericin B in 55.55% of the patients while 33.33% had positive CSF cultures. Patients were started with ART after achieving sterile CSF and tolerated at least 2 weeks of fluconazole consolidation treatment and were free from symptoms. Median time for antiretroviral treatment initiation was 35 (14-90 days after completion of Amphotericin B treatment. One patient developed immune reconstitution inflammatory syndrome (IRIS after ART. Conclusions: We found that the recommended 2 weeks induction treatment with Amphotericin B monotherapy for HIV patients with cryptococcal meningitis in resource-limited settings may be suboptimal for at least one-third of the patients. Extending the therapy to 3 weeks is likely to result in sterilization of the CSF in a majority of these patients. This finding requires confirmation by a larger sample size in appropriately powered studies. Delaying ART initiation by at least 2 weeks after amphotericin B treatment may decrease the incidence of IRIS.

  4. Mortality of Rocky Mountain elk in Michigan due to meningeal worm.

    Science.gov (United States)

    Bender, Louis C; Schmitt, Stephen M; Carlson, Elaine; Haufler, Jonathan B; Beyer, Dean E

    2005-01-01

    Mortality from cerebrospinal parelaphostrongylosis caused by the meningeal worm (Parelaphostrongylus tenuis) has been hypothesized to limit elk (Cervus elaphus nelsoni) populations in areas where elk are conspecific with white-tailed deer (Odocoileus virginianus). Elk were reintroduced into Michigan (USA) in the early 1900s and subsequently greatly increased population size and distribution despite sympatric high-density (>or=12/km2) white-tailed deer populations. We monitored 100 radio-collared elk of all age and sex classes from 1981-94, during which time we documented 76 mortalities. Meningeal worm was a minor mortality factor for elk in Michigan and accounted for only 3% of mortalities, fewer than legal harvest (58%), illegal kills (22%), other diseases (7%), and malnutrition (4%). Across years, annual cause-specific mortality rates due to cerebrospinal parelaphostrongylosis were 0.033 (SE=0.006), 0.029 (SE=0.005), 0.000 (SE=0.000), and 0.000 (SE=0.000) for calves, 1-yr-old, 2-yr-old, and >or=3-yr-old, respectively. The overall population-level mortality rate due to cerebrospinal parelaphostrongylosis was 0.009 (SE=0.001). Thus, meningeal worm had little impact on elk in Michigan during our study despite greater than normal precipitation (favoring gastropods) and record (>or=14 km2) deer densities. Further, elk in Michigan have shown sustained population rates-of-increase of >or=18%/yr and among the highest levels of juvenile production and survival recorded for elk in North America, indicating that elk can persist in areas with meningeal worm at high levels of population productivity. It is likely that local ecologic characteristics among elk, white-tailed deer, and gastropods, and degree of exposure, age of elk, individual and population experience with meningeal worm, overall population vigor, and moisture determine the effects of meningeal worm on elk populations. PMID:15827219

  5. Relative Frequency of Echovirus 30 in Patients Suffering From Enterovirus Meningitis in Ahvaz

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    Ali Samarbaf-Zadeh

    2013-04-01

    Full Text Available Background: Human enteroviruses are members of Picornaviridae family; they are non-enveloped, icosahedral viruses with positive RNA as genome. Echovirus 30 is an important member of enteroviruses that is recognized in outbreaks of enterovirus meningitis..Objectives: The aim of this study was to determine relative frequency of echovirus 30 as an important agent of aseptic meningitis among children referred to Aboozar hospital, Ahvaz, Iran..Patients and Methods: 34 cerebrospinal fluid samples from patients with enterovirus aseptic meningitis, negative bacterial culture, WBC (white blood cell count > 5x106/mm3, and aseptic meningitis symptoms were entered in the study. These samples were collected in a year between May 2010 and May 2011. RNA of enteroviruses were extracted and investigated for echovirus 30 infection with RT-PCR (reverse transcription polymerase chain reaction test. Samples also were cultured in RD (rhabdomyosarcoma cell and positive results were approved by RT-PCR test with enterovirus specific primers. To recognize PCR-product, 440 bp RT-PCR product was sequenced and phylogenic tree was drawn based on Neighbor Joining method with 1000 replication bootstrap..Results: Echovirus 30 infection was not detected in any case. Just one CSF sample grew in RD cell culture. This sample was approved by RT-PCR and sequencing. Positive sample was recognized as coxsackie virus B3. .Conclusions: There was no echovirus 30 in Ahvaz because of diverse nature of enteroviruses and several serotypes with various distribution patterns in different geographical regions, and the fact that echovirus 30 is mostly detected in outbreaks rather than endemism. Coxsackie virus B3 was responsible for aseptic meningitis of a child in this study. Based on another study conducted in Tehran, it seems that Coxsackie B viruses are among current agents causing enterovirus aseptic meningitis in Iran. Of course we need to conduct more studies in Ahvaz and other parts of the country to approve this hypothesis.

  6. Características clínicas y epidemiológicas de la meningitis aséptica en recién nacidos

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    Manuel Díaz Álvarez

    2012-03-01

    Full Text Available Objetivo: exponer las características clínicas y epidemiológicas de la meningitis aséptica, probablemente enteroviral, en recién nacidos atendidos en nuestro servicio de neonatología. Métodos: estudio retrospectivo de 291 pacientes recién nacidos ingresados en el servicio de neonatología del Hospital Pediátrico Universitario "Juan M. Márquez", entre los años 1992-2009, con el diagnóstico de meningitis aséptica. La información se obtuvo de una base de datos creada para una investigación sobre meningitis neonatal. Se analizaron diversas variables clínicas y epidemiológicas de presentación de esta enfermedad. Resultados: ocurrieron picos de incremento de la incidencia de la meningitis aséptica, con una tendencia estadísticamente significativa a disminuir en el transcurso de los 18 años (p= 0,00027. La frecuencia de presentación mostró una agrupación de casos hacia los meses de junio a noviembre. La fiebre estuvo presente en todos los pacientes, seguida por la irritabilidad y la presencia de diversas manifestaciones del aparato respiratorio. La apariencia de niño enfermo y las convulsiones fueron manifestaciones poco frecuentes. Exceptuando la pleocitosis, los indicadores convencionales en el líquido cefalorraquídeo y la relación glucosa líquido cefalorraquídeo/sangre tuvieron una mediana dentro de los límites normales para el período neonatal, sin embargo, los rangos fueron amplios. Hubo pacientes con pleocitosis importante, otros con predominio de los polimorfonucleares en una proporción mayor del 50 % y también con relación glucosa líquido cefalorraquídeo/sangre baja. La evolución clínica de todos los pacientes fue favorable sin secuelas neurológicas inmediatas aparentes. Conclusiones: los episodios de meningitis aséptica ocurridos siguen un patrón característico de las infecciones enterovirales con agrupación de casos estacional y picos epidémicos periódicos. La expresión clínica de la infección y los resultados en los exámenes de biometría hemática y del examen citoquímico del líquido cefalorraquídeo, aunque característicos de una infección de esta índole, tienen amplia variabilidad, pues puede haber pacientes que presenten hallazgos que se asemejan a los observados en pacientes con meningitis bacteriana, lo cual puede crear incertidumbre clínica al médico que evalúa el paciente.

  7. Chronic fatigue and minor psychiatric morbidity after viral meningitis: a controlled study.

    OpenAIRE

    Hotopf, M.; Noah, N.; Wessely, S.

    1996-01-01

    OBJECTIVE--To test the hypotheses that patients exposed to viral meningitis would be at an increased risk of developing chronic fatigue syndrome and would have an excess of neurological symptoms and physical impairment. METHODS--Eighty three patients were followed up 6-24 months after viral meningitis and a postal questionnaire was used to compare outcome with 76 controls who had had non-enteroviral, non-CNS viral infections. RESULTS--For the 159 patients and controls the prevalence of chroni...

  8. Intrathecal synthesis of immunoglobulin G and Mycobacterium tuberculosis-specific humoral immune response in tuberculous meningitis.

    OpenAIRE

    Cho, T Y; Park, S C; Cho, S N; Lee, H.R.; Kim, S.K.; Lee, B I

    1995-01-01

    Local synthesis of immunoglobulin G (IgG) in the central nervous system was investigated in 10 patients with tuberculous meningitis (TBM), 15 patients with aseptic meningitis (AM), and 15 patients with pulmonary tuberculosis only (PTBO). The IgG synthesis rate for patients with TBM was 56.4 +/- 18.9 mg/day (mean +/- standard deviation), which was significantly higher than that for patients with AM (8.0 +/- 6.7 mg/day, P < 0.001) and that for patients with PTBO (7.5 +/- 4.4 mg/day, P < 0.001)....

  9. Recurrent meningitis due to Salmonella enteritidis: a case report from Kashmir India.

    Science.gov (United States)

    Fomda, B A; Charoo, B A; Bhat, J A; Reyaz, N; Maroof, P; Naik, M I

    2012-01-01

    Recurrent bacterial meningitis in children is potentially life-threatening and induces psychological trauma to the patients through repeated hospitalization. Here we report a case of recurrent meningitis in a one month old baby. The CSF and blood culture grew Salmonella enteritidis. Injection ciprofloxacin and ceftriaxone were given for 3 weeks. Baby became symptomatically better and was afebrile at discharge. Twenty eight days after discharge baby got readmitted with complaints of fever and refusal of feeds. Blood and CSF culture again showed growth of Salmonella enteritidis. Physicians should be educated about the possibility of recurrence which may occur days or even weeks after apparent successful antibiotic treatment. PMID:23183477

  10. Tumor necrosis factor in mediating experimental Haemophilus influenzae type B meningitis.

    OpenAIRE

    Mustafa, M. M.; Ramilo, O; Olsen, K D; Franklin, P S; Hansen, E. J.; Beutler, B.; McCracken, G. H.

    1989-01-01

    Tumor necrosis factor (TNF) could possibly be instrumental in mediating injury to the CNS during bacterial meningitis. In CSF of rabbits with meningitis induced with Haemophilus influenzae type b (Hib) lipooligosaccharide (LOS), TNF activity was first detected 45 min after intracisternal (IC) injection of 20 ng Hib LOS and white blood cells (WBC) first appeared 75 min later. The peak TNF activity (45 ng/ml) was observed at 120 min after IC and persisted for 5 h. When 1-2 X 10(7) CFU of Hib wa...

  11. Chronic meningitis by histoplasmosis: report of a child with acute myeloid leukemia

    Scientific Electronic Library Online (English)

    G.H., Pereira; S.S., Pádua; M.V.F., Park; R.P., Muller; R.M.A., Passos; Y., Menezes.

    2008-12-01

    Full Text Available Meningitis is a common evolution in progressive disseminated histoplasmosis in children, and is asymptomatic in many cases. In leukemia, the impaired of the T cells function can predispose to the disseminated form. The attributed mortality rate in this case is 20%-40% and the relapse rate is as high [...] as 50%; therefore, prolonged treatment may be emphasized. We have described a child with acute myeloid leukemia (AML), that developed skin lesions and asymptomatic chronic meningitis, with a good evolution after prolonged treatment with amphotericin B deoxycholate followed by fluconazole.

  12. Herpes simplex virus type 2-associated recurrent aseptic (Mollaret's meningitis in genitourinary medicine clinic: a case report

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    Abou-Foul AK

    2014-03-01

    Full Text Available Ahmad K Abou-Foul, Thajunisha M Buhary, Sedki L Gayed Department of Genitourinary Medicine, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK Introduction: Cases of idiopathic recurrent benign aseptic meningitis were first described by Mollaret. Today, herpes simplex virus (HSV is considered the cause of most cases of Mollaret's meningitis. Case report: A 40-year-old male was referred to our genitourinary medicine clinic with recurrent genital herpetic lesions. He had HSV-2-positive genital ulcers 8 years earlier. One year after the first infection, he developed severe recurrent attacks of headache associated with meningitis symptoms. The results of all radiological and biochemical tests were normal, but the patient reported a correlation between his attacks and genital herpes flare-ups. We diagnosed the patient with Mollaret's meningitis and started him on continuous suppressive acyclovir therapy, which resulted in marked clinical improvement. Discussion: Mollaret's meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset, short duration, and spontaneous remission with unpredictable recurrence. We believe that the presence of concurrent or recurrent mucocutaneous herpetic lesions can aid its diagnosis, prior to which, affected patients usually have many unnecessary investigations and treatments. Therefore, detailed sexual history should be sought in all patients with aseptic meningitis, and clinicians should also ask about history of recurrent headaches in all patients with recurrent herpetic anogenital lesions. Continuous suppressive acyclovir therapy may reduce the frequency and severity of attacks and can dramatically improve lifestyle. Keywords: HSV-2 virus, acyclovir, Mollaret's meningitis, recurrent aseptic meningitis, HSV-2 virus, viral meningitis, acyclovir

  13. Meningitis tuberculosa: claves para su diagnóstico y propuestas terapéuticas Tuberculous meningitis: tips for diagnosis and proposals for treatment

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    Martín Lasso B

    2011-06-01

    Full Text Available El diagnóstico de la meningitis tuberculosa (MTBC es siempre un desafío. Debemos dar importancia a las manifestaciones clínicas y su duración. El análisis citoquímico del LCR tiene características propias y debe ser controlado varias veces durante el tratamiento. La adenosin deami-nasa con punto de corte > 15 UI/mL y la RPC para M. tuberculosis en LCR son las pruebas más relevantes. Las imágenes aportan elementos valiosos pero no establecen el diagnóstico por si solas. A futuro se puede estructurar un puntaje con todos estos elementos para apoyar al clínico en el proceso diagnóstico. El tratamiento de la MTBC, dada su alta morbilidad y mortalidad, necesariamente debe ser más intensivo y prolongado, y debemos seleccionar fármacos con buena penetración en el SNC. Se propone un esquema de 12 meses. La fase diaria debería durar tres meses e incluir isoniacida, rifampicina, pirazinamida y etambutol o moxifloxacina. Estreptomicina no debería ser incluida dada su mala penetración en el SNC y reconocida toxicidad. La fase de mantención debería ser trisemanal e incluir isoniacida, rifampicina y pirazinamida. Dexa-metasona debe administrarse durante las primeras seis semanas de tratamiento. En el caso de pacientes con infección por VIH que requieran iniciar TARV ésta debe ser aplazada para después de la fase diaria y no debería incluir inhibidores de proteasa e integrasa.Diagnosis of tuberculous meningitis (TBM is always a challenge. We must give importance for duration of clinical manifestations. Cerebrospinal fluid (CSF has own characteristic and it have to be control several times during the treatment. Adenosin deaminase with cut off more than 15 UI/mL and M. tuberculosis polymerase chain reaction in CSF are the most relevant diagnostic tests. Radiologic test gives diagnostic clues but do not confirm the diagnosis. In the future we can structure a score with all these elements to support the clinician in the diagnostic process. The treatment of TBM because of its high morbidity and high mortality has to be necessarily more intensive and prolonged and we must select drugs with a good penetration into the central nervous system (SNC. A therapeutic scheme with duration of 12 months with two phases is proposed, the diary phase during the first three months of treatment includes isoniacid, rifampicin, pirazinamid and ethambutol or moxifloxacin. Streptomycin must not be included due to own erratic SNC penetration and its known toxicity. The second twice a week phase has to be changed by a three times per week phase during 9 months and it must include isoniacid, rifampicin and pirazinamide. Dexamethasone is added during the first 6 weeks of treatment. Patients with HIV infection than required treatment with antiretroviral drugs have to start ART treatment when diary phase has finished and must not include protease or integrase inhibitors.

  14. Meningitis tuberculosa: claves para su diagnóstico y propuestas terapéuticas / Tuberculous meningitis: tips for diagnosis and proposals for treatment

    Scientific Electronic Library Online (English)

    Martín, Lasso B.

    2011-06-01

    Full Text Available El diagnóstico de la meningitis tuberculosa (MTBC) es siempre un desafío. Debemos dar importancia a las manifestaciones clínicas y su duración. El análisis citoquímico del LCR tiene características propias y debe ser controlado varias veces durante el tratamiento. La adenosin deami-nasa con punto de [...] corte > 15 UI/mL y la RPC para M. tuberculosis en LCR son las pruebas más relevantes. Las imágenes aportan elementos valiosos pero no establecen el diagnóstico por si solas. A futuro se puede estructurar un puntaje con todos estos elementos para apoyar al clínico en el proceso diagnóstico. El tratamiento de la MTBC, dada su alta morbilidad y mortalidad, necesariamente debe ser más intensivo y prolongado, y debemos seleccionar fármacos con buena penetración en el SNC. Se propone un esquema de 12 meses. La fase diaria debería durar tres meses e incluir isoniacida, rifampicina, pirazinamida y etambutol o moxifloxacina. Estreptomicina no debería ser incluida dada su mala penetración en el SNC y reconocida toxicidad. La fase de mantención debería ser trisemanal e incluir isoniacida, rifampicina y pirazinamida. Dexa-metasona debe administrarse durante las primeras seis semanas de tratamiento. En el caso de pacientes con infección por VIH que requieran iniciar TARV ésta debe ser aplazada para después de la fase diaria y no debería incluir inhibidores de proteasa e integrasa. Abstract in english Diagnosis of tuberculous meningitis (TBM) is always a challenge. We must give importance for duration of clinical manifestations. Cerebrospinal fluid (CSF) has own characteristic and it have to be control several times during the treatment. Adenosin deaminase with cut off more than 15 UI/mL and M. t [...] uberculosis polymerase chain reaction in CSF are the most relevant diagnostic tests. Radiologic test gives diagnostic clues but do not confirm the diagnosis. In the future we can structure a score with all these elements to support the clinician in the diagnostic process. The treatment of TBM because of its high morbidity and high mortality has to be necessarily more intensive and prolonged and we must select drugs with a good penetration into the central nervous system (SNC). A therapeutic scheme with duration of 12 months with two phases is proposed, the diary phase during the first three months of treatment includes isoniacid, rifampicin, pirazinamid and ethambutol or moxifloxacin. Streptomycin must not be included due to own erratic SNC penetration and its known toxicity. The second twice a week phase has to be changed by a three times per week phase during 9 months and it must include isoniacid, rifampicin and pirazinamide. Dexamethasone is added during the first 6 weeks of treatment. Patients with HIV infection than required treatment with antiretroviral drugs have to start ART treatment when diary phase has finished and must not include protease or integrase inhibitors.

  15. Bacterial meningitis Meningitis bacateriana aguda en niños: estudio clínico y bacteriológico en el Hospital Infantil de Medellín

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    Daniel Hoyos

    1988-02-01

    Full Text Available

     

    Between aprl13, 1984 and march 31,1986,95  children with acute bacterial meningitis (ABM were admitted to Hospital lnfantil, Medellín, Colombia. 68 (71.6% were under two years old. Haemophifus influenza  type B was the predominant microorganism (41%, followed by Streptococcus pneumoniae (27.4%, enterobacteriaceae (15.8%, Neisseria meningitidis (4.2%, Staphylococcus aureus (3.2% and betahemolytlc streptococci (2.1%. One case produced by Streptococcus agalactiae was the first one in our Hospital and another one due to Shigella was the first one in Colombia. Bacterial origin was confirmed in 93.7% of the cases, employing direct examination, cultures and counter immuno electrophoresis. The most frequent clinical manifestations were: fever, vomit, irritability, meningeai irritation and seizures; the younger the patient the most severe the clinical picture. Those with persistent focal seizures showed cerebral infarction, subdural effusion, ventricular dilatation or a combination of them. Mortality was 19%; sequelae were observed in 26% (seizure, motor deficit and deafness; Haemophilus influenzae resistance to ampicilin was observed for the first time in this institution. We suggest modifications in the initial therapeutic approach and recommend the suppression of the routine pre-discharge lumbar puncture.

    Entre abril 3 de 1984 y marzo 31 de 1986, se estudiaron 95 niños que ingresaron al Hospital Infantil de Medellín con el diagnóstico de meningitis bacteriana aguda (MBA; 68 de ellos fueron menores de 2 años (71.6%; el HaemophiIus influenzae tipo e fue el germen predominante (41.0%; le siguieron el Streptococcus pneumoniae (27.4%, las enterobacterias (15.8%, la Neisseriameningitidis (4.2%, el Staphylococcus aureus (3.2% y estreptococos beta hemoifticos (2.1%; uno de éstos fue Streptococcus agalactiae y correspondió al primer caso de MBA descrito en Medellín por tal microorganismo; igualmente, se halló el primer caso colombiano de MBA por Shigella La fiebre, el vómito, la irritabilidad, los signos de irritación meníngea y las convulsiones, fueron las manifestaciones más frecuentes; en general el cuadro clínico fue más severo y mayores las complicaciones mientras menor fuera el paciente; los pacientes con convulsiones persistentes de predominio focal tenían, por lo general, infarto cerebral, derrame subdural, dilatación ventricular o una combinación de los mismos. El origen bacteriano del padecimiento se pudo comprobar en 89 pacientes (93.7% mediante una combinación de exámenes directos, cultivos y contra inmunoelectroforesis. La mortalidad general fue de 19.0%; de otro lado el 26.0% de los pacientes quedó con secuelas tales como convulsiones, déficit motor y sordera. Por primera vez se comprobó en este Hospital resistencia del H. influenza a la ampicilina (3 de las 26 cepas estudiadas. Con base en éste y los demás hallazgos se recomiendan modificaciones al esquema terapéutico Inicial de la MBA y la supresión de la punción lumbar final rutinaria.

  16. Impact of Haemophilus influenzae type b conjugate vaccine on bacterial meningitis in the Dominican Republic / Impacto de la vacuna conjugada contra Haemophilus influenzae tipo b sobre la meningitis bacteriana en la República Dominicana

    Scientific Electronic Library Online (English)

    Ellen H., Lee; Miriam, Corcino; Arelis, Moore; Zacarias, Garib; Chabela, Peña; Jacqueline, Sánchez; Josefina, Fernández; Jesús M., Feris-Iglesias; Brendan, Flannery.

    2008-09-01

    Full Text Available OBJETIVOS: El uso generalizado de la vacuna contra Haemophilus influenzae tipo b (Hib) ha permitido reducir radicalmente la carga de enfermedad por Hib en las Américas. Pocos estudios han evaluado el impacto de la vacunación contra Hib sobre los casos no confirmados mediante cultivo. En este estudio [...] se analizaron las tendencias en el número de casos probables de meningitis bacteriana antes y después de la introducción de la vacuna contra Hib en la República Dominicana y se estimó la eficacia de la vacuna contra la meningitis. MÉTODOS: Se identificaron los casos de meningitis en niños menores de 5 años a partir de los registros de ingreso del principal hospital pediátrico de Santo Domingo entre 1998 y 2004. Los casos de meningitis con probable etiología bacteriana se clasificaron según criterios de laboratorio; los casos confirmados contaban con cultivo bacteriano positivo o detección de antígenos específicos en el líquido cefalorraquídeo. Se calcularon las tasas de incidencia acumulada de casos confirmados y probables de meningitis en los niños que vivían en el Distrito Nacional. Los casos confirmados de meningitis por Hib se incorporaron a un estudio de casos y controles -pareados según la edad y el barrio de residencia- para calcular la eficacia de la vacuna. RESULTADOS: Antes de la introducción de la vacuna, la tasa anual de meningitis de posible etiología bacteriana era de 49 casos por 100 000 niños menores de 5 años; de los casos confirmados de origen bacteriano, 60% fue por Hib. En el período 2002-2004, después de la introducción de la vacuna, la tasa anual de meningitis de posible etiología bacteriana fue de 16 casos por 100 000, es decir 65% más baja, y 26% de los casos confirmados correspondieron a Hib. Las tasas de meningitis por Hib y de posible origen bacteriano de etiología desconocida se redujeron en 13 y 17 casos por 100 000, respectivamente. CONCLUSIONES: La introducción de la vacuna contra Hib redujo sustancialmente la incidencia de casos de meningitis confirmados y probables en la República Dominicana. El impacto estimado de la vacunación contra Hib fue dos veces mayor cuando se consideraron los casos no confirmados mediante cultivo. Abstract in english OBJECTIVES: Widespread use of Haemophilus influenzae type b (Hib) vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningiti [...] s before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis. METHODS: Meningitis cases among children

  17. Impact of Haemophilus influenzae type b conjugate vaccine on bacterial meningitis in the Dominican Republic Impacto de la vacuna conjugada contra Haemophilus influenzae tipo b sobre la meningitis bacteriana en la República Dominicana

    Directory of Open Access Journals (Sweden)

    Ellen H. Lee

    2008-09-01

    Full Text Available OBJECTIVES: Widespread use of Haemophilus influenzae type b (Hib vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningitis before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis. METHODS: Meningitis cases among children OBJETIVOS: El uso generalizado de la vacuna contra Haemophilus influenzae tipo b (Hib ha permitido reducir radicalmente la carga de enfermedad por Hib en las Américas. Pocos estudios han evaluado el impacto de la vacunación contra Hib sobre los casos no confirmados mediante cultivo. En este estudio se analizaron las tendencias en el número de casos probables de meningitis bacteriana antes y después de la introducción de la vacuna contra Hib en la República Dominicana y se estimó la eficacia de la vacuna contra la meningitis. MÉTODOS: Se identificaron los casos de meningitis en niños menores de 5 años a partir de los registros de ingreso del principal hospital pediátrico de Santo Domingo entre 1998 y 2004. Los casos de meningitis con probable etiología bacteriana se clasificaron según criterios de laboratorio; los casos confirmados contaban con cultivo bacteriano positivo o detección de antígenos específicos en el líquido cefalorraquídeo. Se calcularon las tasas de incidencia acumulada de casos confirmados y probables de meningitis en los niños que vivían en el Distrito Nacional. Los casos confirmados de meningitis por Hib se incorporaron a un estudio de casos y controles -pareados según la edad y el barrio de residencia- para calcular la eficacia de la vacuna. RESULTADOS: Antes de la introducción de la vacuna, la tasa anual de meningitis de posible etiología bacteriana era de 49 casos por 100 000 niños menores de 5 años; de los casos confirmados de origen bacteriano, 60% fue por Hib. En el período 2002-2004, después de la introducción de la vacuna, la tasa anual de meningitis de posible etiología bacteriana fue de 16 casos por 100 000, es decir 65% más baja, y 26% de los casos confirmados correspondieron a Hib. Las tasas de meningitis por Hib y de posible origen bacteriano de etiología desconocida se redujeron en 13 y 17 casos por 100 000, respectivamente. CONCLUSIONES: La introducción de la vacuna contra Hib redujo sustancialmente la incidencia de casos de meningitis confirmados y probables en la República Dominicana. El impacto estimado de la vacunación contra Hib fue dos veces mayor cuando se consideraron los casos no confirmados mediante cultivo.

  18. Renal artery stenosis

    International Nuclear Information System (INIS)

    Renal artery disease is a potentially correctable cause of hypertension. Previous studies have suggested the utility of duplex sonography in accurately detecting and grading the severity of renal artery stenosis. The purpose of this paper is to evaluate color flow Doppler for this use. Forty-three kidneys were examined by color-flow Doppler and conventional duplex sampling in patients with suspected renovascular hypertension or those undergoing aortography for unrelated reasons. Doppler tracings were obtained from the renal arteries and aorta with calculation of the renal aortic ratio (RAR) and resistive index (RI). Results of Doppler sampling with color flow guidance were compared with aortograms in a blinded fashion

  19. Factores asociados con la mortalidad por meningitis neumocócica en hospitales de La Habana / Factors associated with mortality due to pneumococcal meningitis in Havana hospitals

    Scientific Electronic Library Online (English)

    Gabriel E, Lobo Ramírez; Félix O, Dickinson Meneses; Antonio E, Pérez Rodríguez; Beatriz, Vega Riverón; Misladys, Rodríguez Ortega.

    2013-09-01

    Full Text Available Introducción: la meningitis neumocócica constituye un serio problema de salud por su alta morbilidad, letalidad y graves secuelas. Objetivos: identificar algunos factores de riesgo asociados con la mortalidad por meningitis neumocócica. Métodos: se realizó un estudio de caso-control en 7 hospitales [...] de La Habana (enero de 2002-diciembre de 2011) de 45 pacientes (0-86 años de edad), con meningitis neumocócica confirmada: 15 fallecidos (casos) y 30 sobrevivientes (controles), a partir de la vigilancia nacional de síndromes neurológicos bacterianos, historias clínicas, movimientos hospitalarios, tarjetas de enfermedades de declaración obligatoria y registros de laboratorio. Se midió la asociación (análisis bivariado y multivariado) de algunos factores con la muerte a través de la oportunidad relativa y su intervalo de confianza a 95 %, considerando asociación cuando fue mayor o igual que 2. Resultados: la letalidad general resultó de 33,3 %. La media entre el inicio de los síntomas y la consulta médica fue de 2,4 días; entre la consulta y el ingreso 0,5 días; entre el ingreso y el diagnóstico 0,4 días, y entre el diagnóstico y el tratamiento 0,2 días. La estadía hospitalaria media fue de 12,2 días. El análisis bivariado y multivariado mostró asociación significativa de la inconsciencia al ingreso, con la muerte. Otras variables se asociaron con el desenlace fatal pero no fueron significativas. Conclusiones: estar inconsciente al momento del ingreso es un factor de riesgo para la muerte por meningitis neumocócica, en los pacientes con esta enfermedad de los hospitales investigados en La Habana. Abstract in english Introduction: pneumococcal meningitis is a critical public health problem with a high rate of morbidity and mortality and serious sequelae. Objectives: identify some risk factors associated with mortality due to pneumococcal meningitis. Methods: a case-control study was conducted of 45 patients aged [...] 0-86 with confirmed pneumococcal meningitis cared for in seven Havana hospitals from January 2002 to December 2011. Of the 45 patients studied, 15 had died (cases) and 30 had survived (controls). The study was based on national bacterial neurological syndrome surveillance data, medical records, hospital movements, notifiable disease cards and laboratory records. Association (bivariate and multivariate analysis) of some factors with death was measured through odds ratio with a confidence interval of 95 %, considering it an association if greater than or equal to 2. Results: overall case-fatality rate was 33.3 %. Mean time between the onset of symptoms and medical consultation was 2.4 days; between consultation and admission 0.5 day; between admission and diagnosis 0.4 day; and between diagnosis and treatment 0.2 day. Mean hospital stay was 12.2 days. Bivariate and multivariate analysis revealed a significant association between unconsciousness at admission and death. Other variables were associated with death as well, but they were not significant. Conclusions: being unconscious at admission is a risk factor for death due to pneumococcal meningitis in patients with this disease in the Havana hospitals studied.

  20. Spontaneous remission of acromegaly: apoplexy mimicking meningitis or meningitis as a cause of apoplexy? / Remissão espontânea da acromegalia: meningite simulando apoplexia ou meningite como causa da apoplexia?

    Scientific Electronic Library Online (English)

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

    2014-02-01

    Full Text Available A apoplexia é uma síndrome clínica rara, mas potencialmente fatal, caracterizada por infarto isquêmico ou hemorragia em um tumor pituitário. O diagnóstico de apoplexia de tumor pituitário é frequentemente complicado pela natureza inespecífica dos seus sinais e sintomas, que podem simular diferentes [...] processos neurológicos, incluindo a meningite. Vários fatores estão associados com a apoplexia, como o uso de agonistas dopaminérgicos, radioterapia ou trauma da cabeça, mas a meningite foi raramente relatada. Descrevemos o caso de uma mulher de 51 anos de idade com acromegalia por um macroadenoma pituitário. Antes do tratamento cirúrgico, ela foi trazida ao pronto-socorro com febre, náusea, vômitos e meningismo. Os sintomas e análises laboratoriais sugeriram meningite bacteriana e o tratamento com antibióticos foi iniciado, com melhora rápida dos sintomas. Uma tomografia computadorizada (CT) na admissão ao hospital não revelou nenhuma alteração no adenoma pituitário, mas algumas semanas depois uma ressonância magnética (MRI) mostrou informações de apoplexia pituitária, com desaparecimento completo do adenoma. Atualmente, a acromegalia está curada, mas ela desenvolveu hipopituitarismo e diabetes insipidus depois da apoplexia. Questionamo-nos se a paciente realmente apresentou meningite que levou à apoplexia ou se a apoplexia foi mal interpretada como sendo meningite. A relação entre a meningite e a apoplexia pode ser bidirecional. A apoplexia pode simular a meningite viral ou bacteriana, mas a meningite também pode causar apoplexia. Esse fato enfatiza a importância do diagnóstico diferencial ao se avaliar pacientes com adenomas pituitários e sintomas neurológicos. Abstract in english 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.

  1. Primer caso de meningitis por Streptococcus equi subsp. zooepidemicus en Cuba / First case of meningitis from Streptococcus equi subsp. zooepidemicus in Cuba

    Scientific Electronic Library Online (English)

    Gilda, Toraño Peraza; Itciar, Arias Portales; Ariadna, Castillo Marshall; Gardenia, Brossard Alejo.

    2015-03-01

    Full Text Available La meningitis en humanos es posiblemente la entidad clínica más rara de infección por Streptococcus Grupo C. Esta bacteria se considera un patógeno de animales en particular de equinos. La intención de este trabajo es notificar un caso fatal de meningitis por Streptococcus equi subsp. zooepidemicus [...] (Streptococcus ß-hemolítico Grupo C) en Cuba. Se trata de un individuo masculino inmunocompetente de 50 años de edad, de piel negra, que aunque profesionalmente no estaba expuesto a animales, gustaba cabalgar frecuentemente en una propiedad familiar donde había otros animales. El paciente residía en Santiago de Cuba e ingresó en la Unidad de Cuidados Intensivos Emergentes del hospital regional en mayo de 2014. Al momento de la admisión presentaba rigidez de nuca, cefalea intensa, antecedente de fiebre sostenida de 39,5 °C durante cuatro días, lenguaje incoherente, dificultad para la marcha, obnubilación y vómitos. Este cuadro clínico y los resultados del estudio del líquido cefalorraquídeo, llevaron al diagnóstico de una meningitis bacteriana. Se administró tratamiento en correspondencia. El individuo evolucionó desfavorablemente hasta fallecer el mismo día de su admisión, apenas siete horas después. Se sugirió la transmisión de la infección a partir del contacto del paciente. Este trabajo constituye el primer registro de meningitis por Streptococcus equi subsp. zooepidemicus en Cuba. Su notificación contribuye a fundamentar la tesis de que se trata de una zoonosis emergente cuyo control se hace imprescindible en el país. Abstract in english Meningitis in human beings is possibly the rarest clinical illness caused by Group C Streptococcus infection. This bacterium is regarded as an animal pathogen, particularly echinus. The objective of this paper was to present a fatal meningitis case in Cuba caused by Streptoccus equi subsp. zooepidem [...] icus (Streptococcus ß-hemolytic C). It was a Black 50 years-old male immunocompetent patient, who did not work directly with animals but used to frequently ride horses in a family farm where there were other animals. The patient lived in Santiago de Cuba province and was admitted to the Intensive Care Unit of the regional hospital on May, 2014. At the time of hospitalization, he presented with stiff neck, headache, continuous fever of 39.5 oC for four days, incoherent speech, difficulties to walk, obnubilation and vomiting. This clinical picture and the results of the cerebrospinal fluid analysis yielded a diagnosis of bacterial meningitis. He received the corresponding treatment. However, the patient progressed into death just seven hours after his hospitalization. It was suggested that the patient was infected from some contact with any animal. This paper is the first record of meningitis from Streptococcus equi subsp. zooepidemicus in Cuba and contributes to support the thesis that this is an emerging zoonosis and it is necessary to have it under control nationwide.

  2. Análisis de un brote de meningitis viral en la provincia de Tucumán, Argentina Analysis of an outbreak of viral meningitis in the province of Tucuman, Argentina

    OpenAIRE

    María Cecilia Freire; Daniel Marcelo Cisterna; Karina Rivero; Gustavo Fabián Palacios; Inmaculada Casas; Antonio Tenorio; Jorge Alberto Gómez

    2003-01-01

    OBJETIVO: Confirmar la existencia de un brote de meningitis viral en 1996 en la provincia de Tucumán, Argentina, y estudiar sus características epidemiológicas. MÉTODOS: Se analizó información obtenida del Sistema Nacional de Vigilancia Epidemiológica (SINAVE) del Ministerio de Salud de Argentina para el período de 1994-1998, la cual fue provista por la Dirección de Epidemiología de dicho ministerio. Para el cálculo de incidencias se usaron estimaciones poblacionales para los años 1994-1998 r...

  3. Lagochilascariasis leading to severe involvement of ocular globes, ears and meninges Infecção humana por Lagochilascaris minor com envolvimento ocular, auditivo e das meninges

    OpenAIRE

    Renata T.R. Aquino; Maria E.R. Magliari; José Vital Filho; Maria A.L.G. Silva; Carlos A. da Conceição Lima; Antonio J. Rocha; Carlos J. Silva; Jonathan A. Rewin; Nahas, Tatiana R.; Pedro Paulo Chieffi

    2008-01-01

    A case report of a 31 year-old woman from Paraíba State (North-Eastern Brazil) that presented severe involvement of ocular globes, ears and meninges. Diagnosis was established after enucleation of her left eye, when adult worms were seen in the midst of a granulomatous inflammatory process. Her response to the initial treatment with levamisole and cambendazole was good, but there was a relapse after the fifth month of treatment even with maintenance doses of both medications. She later receiv...

  4. Meningitis y diseminación tuberculosa en paciente con el síndrome de inumodeficiencia adquirida (sida) / Meningitis and tuberculosis dissemination in acquired immunodeficiency syndrome (AIDS) patients

    Scientific Electronic Library Online (English)

    Lilian María, Mederos Cuervo; Juan Francisco, Bandera Tirado; Lidunka, Valdés Alonso; Virginia, Capó de Paz; Gilberto, Fleites González; María Rosarys, Martínez; Ernesto Hilario, Montoro Cardoso.

    2010-06-01

    Full Text Available Las meningoencefalitis por gérmenes oportunistas ocupan un lugar importante dentro de la patología neurológica del paciente sida, Treponema pallidum y Mycobacterium tuberculosis dentro de las bacterias, Cryptococcus neoformans dentro de los hongos, Toxoplasma gondii dentro de los protozoos y el Papo [...] virus JC dentro de los virus, son de los gérmenes mas frecuentes dentro de cada grupo. También en los pacientes inmunodeprimidos en general y en particular en el paciente sida, se han encontrado con cierta frecuencia infecciones mixtas, precisamente por el gran deterioro en su barrera inmunológica. La meningitis tuberculosa (MTB) es la forma mas grave en que se manifiesta la tuberculosis extrapulmonar, pues la inespecificidad de sus síntomas, la lentitud en el diagnóstico etiológico y las severas secuelas neurológicas que puede producir sobre todo en este tipo de paciente, hacen de esta enfermedad un importante problema de salud, tanto en países desarrollados como en los que están en vías de desarrollo. En este estudio se describe el ¨primer caso¨ meningitis e infección diseminada por Mycobacterium tuberculosis en paciente cubano infectado por el virus de inmunodeficiencia humana. Abstract in english Meningoencephalitis due to opportunistic germs has an important place among the neurological diseases in AIDS patient. Treponema pallidum and Mycobacterium tuberculosis (bacteria), Cryptococcus neoformans (fungi), Toxoplasma gondii (protozoa), and Papovirus JC (virus) are the most frequently germs f [...] ound in each group. Likewise, in immunodepressed patients in general and in HIV/AIDS patients in particular, mixed infections have been frequently found, basically as a consequence of the patient’s deteriorated immunological barrier. Tuberculosis meningitis (TBM) is the most severe form of presentation of the extrapulmonary tuberculosis. Its unspecific symptoms, the delay in the etiological diagnosis, and the severe neurological sequelae that can appear in this specific type of patient make of this disease an important health problem, in both developed and developing countries. This study describes the "first case" of meningitis and disseminated infection by Mycobacterium tuberculosis in a Cuban patient infected by the human immunodeficiency virus.

  5. Carotid artery surgery - discharge

    Science.gov (United States)

    ... Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. J. Am. Coll. Cardiol . 2011;124:e54-e130. Eisenhauer AC, White CJ, Bhatt DL. Endovascular treatment of noncoronary obstructive vascular disease. In: Bonow ...

  6. Carotid Artery Disease

    Science.gov (United States)

    ... normal activities without any restrictions. A new “nonsurgical” endovascular treatment uses angio- plasty and stents to open blocked carotid arteries. This procedure’s safety and efficacy continues to ...

  7. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  8. Neonatal pulmonary artery thrombosis

    OpenAIRE

    Jadhav, Mangesh; Sapre, Ashish; Garekar, Swati; Kulkarni, Snehal

    2012-01-01

    Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

  9. Neonatal pulmonary artery thrombosis

    Directory of Open Access Journals (Sweden)

    Mangesh Jadhav

    2012-01-01

    Full Text Available Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

  10. The clinical and cerebrospinal fluid cytological features of tuberculous meningitis

    Directory of Open Access Journals (Sweden)

    YANG Xiao

    2012-04-01

    Full Text Available Objective To analyze the clinical and cerebrospinal fluid (CSF cytological features of patients with tuberculous meningitis (TBM, to improve early diagnostic accuracy and treatment of TBM. Methods Clinical presentations, etiology and biochemical and cytological features of CSF were analyzed retrospectively among 60 adult cases with TBM hospitalized at Neurology Department of General Hospital of Ningxia Medical University from January 2005 to May 2011. Results Most patients (58/60, 96.67% had fever and headache at onset. In some patients, disturbance of consciousness (9/60, 15.00%, seizure (5/60, 8.33% occurred in 1 week and focal neurological signs developed during the course. Forty?four patients (73.33% had pulmonary tuberculosis history. In CSF examination, acid?fast bacillus positive was found in 8 patients. Positive acid ? fast myobacterium tuberculous culture was detected in 5 patients and positive myobacterium tuberculosis DNA were seen in 5 patients. The main changes of CSF were intracranial hypertension, increase of protein, and decrease of glucose. CSF presented mixed cellular response with predominace in the increasing of leucocytes. During early stage the mean percentage of neutrophil in CSF was less than 40%. After short term (as long as 2 months of regular antituberculotic therapy no significant changes in total cell count and the proportion of neutrophils were seen. In 60 patients, 44 patients were ameliorated, 11 were not healed or were discharged or transferred to other hospital and 5 were dead. Prognosis of patients treated within 3 weeks after onsets was superiorly to those treated at more than 3 weeks after onset. Conclusion There are no specific clinical features in TBM and it is hard to perform early diagnosis for TBM, particularly, existing of low efficiency in pathogenic detection, but pulmonary tuberculosis is of accessary value to diagnose TBM. Whereas mixed cellular response may complementarily provide the diagnosis of TBM in early stage. Cytologic changes of CSF can be very slow even after therapy. Therefore persistent mixed cellular response in CSF cannot exclude TBM. The time of treatment will determine the therapeutic effectiveness in a great degree.

  11. Definitive neuroradiological diagnostic features of tuberculous meningitis in children

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas; Smith, Bruce; Douis, Hassan [University of Cape Town, Department of Pediatric Radiology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); Hatherhill, Mark [University of Cape Town, Department of Intensive Care, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); Wilmshurst, Jo [University of Cape Town, Department of Neurology, Red Cross War Memorial Children' s Hospital School of Child and Adolescent Health, Cape Town (South Africa)

    2004-11-01

    Although CT scanning is used widely for making the diagnosis and detecting the complications of tuberculous meningitis (TBM) in children, the radiological features are considered non-specific. CT is particularly suggestive of the diagnosis when there is a combination of basal enhancement, hydrocephalus and infarction, and even then the diagnosis may be in doubt. In this paper we introduce a new CT feature for making the diagnosis of TBM, namely, hyperdensity in the basal cisterns on non-contrast scans, and we assess which of the recognized CT features is most sensitive and specific. To determine the sensitivity and specificity of the presence of high-density exudates in the basal cisterns (on non-contrast CT) and basal enhancement (on contrast-enhanced CT) for the diagnosis of TBM in children, and to correlate these with the complications of infarction and hydrocephalus. Retrospective review of CT scans with readers blinded to the diagnosis, which was based on a definitive culture of cerebrospinal fluid (CSF) for TBM or other bacteria. Computer-aided conversion of hard-copy film density to Hounsfield units was employed as well as a density threshold technique for determining abnormally high densities. The most specific feature for TBM is hyperdensity in the basal cisterns prior to IV contrast medium administration (100%). The most sensitive feature of TBM is basal enhancement (89%). A combination of features (hydrocephalus, infarction and basal enhancement) is as specific as pre-contrast hyperdensity, but has a lower sensitivity (41%). There were statistically significant differences in the presence of hydrocephalus (p=0.0016), infarcts (P=0.0014), basal enhancement (P<0.0001) and pre-contrast density (P<0.0001) between the negative and positive TBM patient groups. The presence of granulomas was not statistically significant between the two groups (P=0.44). The presence of high density within the basal cisterns on non-contrast CT scans is a very specific sign for TBM in children. This will enhance diagnostic confidence, allow early institution of therapy and could reduce expenditure on contrast medium, scan time and radiation exposure. With the use of threshold techniques we believe that the pre-contrast hyperdensity may be detectable by a computer program that will facilitate diagnosis, and may also be modified to detect abnormal enhancement. Basal enhancement is a sensitive sign for the diagnosis of TBM and should be sought after contrast medium administration when no hyperdensity is seen in the basal cisterns or when this finding needs to be confirmed. The CT scan feature of hyperdense exudates on pre-contrast scans should be added to the inclusion criteria for the diagnosis of TBM in children. (orig.)

  12. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E; Henriksen, J H

    1998-01-01

    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic characteristics. PATIENTS: One hundred and forty two patients with cirrhosis without significant hepatic encephalopathy (grades 0-I) (41 patients in Child class A, 57 in class B, and 44 in class C) and 21 patien...

  13. Temperature Variability and Outbreak of Meningitis and Measles in Zaria, Northern Nigeria

    Directory of Open Access Journals (Sweden)

    B.A. Sawa

    2011-05-01

    Full Text Available Monthly maximum and minimum temperature records and reported cases of Meningitis and Measles in Zaria, Kaduna State for 10 years (1999-2008 were used to determine the influence of temperature on the outbreak of these two diseases. The results show that the reported cases of Meningitis and Measles are highest between March and April when the temperatures are also high. Results of the correlation analysis indicate that the reported cases of these two diseases have positive and significant relationship with temperature. Regression analyses show that about 78.4 and 84.5% of the variations in the occurrence of Meningitis and Measles respectively are accounted for by variations in temperature. The study revealed that the cases of Meningitis and Measles would increase by 6 and 19 persons, respectively for every 1ºC increase in temperature. It was found out that the traditional architectural setting of Zaria city also aggravates the effect of temperature in that part of Zaria.

  14. Frequency and clinical significance of CAT findings in purulent and lymphocytic meningitis

    International Nuclear Information System (INIS)

    From 1974-1980, computerized tomography was carried out on 34 patients with purulent and on 17 patients with lymphocytic meningitis. 25 out of the patients with purulent meningitis resp. meningoencephalitis could be examined in the acute stage. For all patients with already attenuated clinical symptoms normal results were obtained, while for the remainder findings were in part highly pathological consisting, e.g. in dilatations or narviowings of the ventricula system, failure to make the outer liquor cavities roentgenoparens, accumulation of pas in the subarachnoidal and subdur spaces including the interhemispheric clefs, cerebral medulla and periventricular edemas, abscesses and signs of ependymitis. Various findings could only be classified as pathological upon serial examination. Correlation statistics showed that all patients with marked pathological CT findings also suffered from distinct pertubations of consciousness. Out of 14 patients with pathological CT findings, 12 died. No connexions could be established between the level of liquor cell counts and CT alterations. Among 17 patients with a lymphocytic meningitis, CT findings were pathological with a mean dilatation of the ventricular system in only one case of chronic course and predominantly basal localization. The patient decreased. Phathological CT findings in purulent and lymphocytic meningitis point to an unfavourable prognosis. (orig.)

  15. Assessing pneumococcal meningitis association with viral respiratory infections and antibiotics: insights from statistical and mathematical models

    OpenAIRE

    Opatowski, Lulla; Varon, Emmanuelle; Dupont, Claire; Temime, Laura; Van Der Werf, Sylvie; Gutmann, Laurent; Boëlle, Pierre-Yves; Watier, Laurence; GUILLEMOT, DIDIER

    2013-01-01

    Pneumococcus is an important human pathogen, highly antibiotic resistant and a major cause of bacterial meningitis worldwide. Better prevention requires understanding the drivers of pneumococcal infection incidence and antibiotic susceptibility. Although respiratory viruses (including influenza) have been suggested to influence pneumococcal infections, the underlying mechanisms are still unknown, and viruses are rarely considered when studying pneumococcus epidemiology. Here, we propose a nov...

  16. Vogt-Koyanagi-Harada syndrome: A rare but important differential diagnosis of viral meningitis

    DEFF Research Database (Denmark)

    Smit, Jesper; Berman, Dalia Cecilia

    2012-01-01

    Abstract Vogt-Koyanagi-Harada syndrome (VKHS) is an inflammatory syndrome affecting melanocyte-containing organs. The clinical onset is often acute with neurological and ophthalmological symptoms and there is considerable risk of sequelae if the condition is not promptly diagnosed and treated. We present a case illustrating that VKHS is a rare but important differential diagnosis of viral meningitis.

  17. The technetium-99m DTPA partition test in the diagnosis of tuberculous meningitis

    International Nuclear Information System (INIS)

    Although the blood/cerebrospinal fluid (CSF) bromide concentration ratio is sensitive and specific in the diagnosis of tuberculous meningitis (TBM), bromide-82 is not always available since it is not generally used in nuclear medicine. The use of technetium-99m diethylenetriamine penta-acetic acid (DTPA) for a partition test was compared with that of 82Br in 22 cases. Seven patients were diagnosed as having TBM, 9 patients had viral meningitis and 5 patients had septic meningitis. One normal control subject was also studied. Although the mechanism of transfer of substances across the blood-brain barrier as well as the factors affecting it are still unclear, both 82Br and 99mTc-DTPA cross the blood-brain barrier to a greater extent in TBM than in viral meningitis. Both tracers thus yield decreased serum/CSF concentration ratios in TBM. The accuracy of the 82 Br partition test was found to be 90,9% if a critical serum/CSF ratio of 1,3 was chosen, compared with 86,9% for the 99mTc-DTPA partition test if a critical value of 3 was chosen. The use of 99mTcDTPA offers various advantages, including general availability, lower cost and radiation dose per MBq, as well as the possibility of concomitant brain scintigraphy. 1 tab., 9 refs

  18. Primary meningeal melanocytoma of the anterior cranial fossa: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lin Bowen

    2012-07-01

    Full Text Available Abstract Background Primary meningeal melanocytoma is a rare neurological disorder. Although it may occur at the base of the brain, it is extremely rare at the anterior cranial fossa. Case presentation A 27-year-old man presented with headache and diplopia at our department. Fundoscopy showed left optic nerve atrophy and right papilledema consistent with Foster-Kennedy syndrome. Neurological exams were otherwise normal. A left frontal irregular space-occupying lesion was seen on magnetic resonance imaging (MRI, and enhancement was shown on contrast-enhanced computed tomography (CT scan. CT angiography (CTA revealed vascular compression around the lesion. Prior to surgery, meningioma was diagnosed and gross tumor removal was performed. On postoperative pathohistological exam, the tumor proved to be a meningeal melanocytoma, WHO grade I. No skin melanoma was found. After surgery, the patient received radiation therapy. No tumor was seen on follow-up MR images six months after surgery. The patient was well after two and a half years, and there was no tumor recurrence on the follow-up CT. Conclusions This case of primary meningeal melanocytoma located at the anterior cranial fossa is very rare. Although primary meningeal melanocytoma is benign, it may behave aggressively. Complete surgical resection is curative for most cases. Radiation therapy is important to prevent relapse of the tumor, especially in cases of incomplete surgical resection.

  19. HIV infection associated with Strongyloides stercoralis colitis resulting in Streptococcus bovis bacteraemia and meningitis

    OpenAIRE

    Silva, T; Raychaudhuri, M; Poulton, M.

    2005-01-01

    We report the case of an HIV infected patient with Streptococcus bovis bacteraemia and meningitis associated with gastrointestinal Strongyloides stercoralis infection. To our knowledge, this has been reported once previously and serves as a reminder to actively exclude asymptomatic S stercoralis infection in HIV infected individuals presenting with bacteraemia.

  20. Cryptococcal infection in patients with clinically diagnosed meningitis in a tertiary care center

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    Prasad K

    2003-07-01

    Full Text Available A retrospective analysis of 326 clinically diagnosed cases with meningitis over a period of five-and-a-half years was carried out to determine the prevalence of cryptococcal infection, its associated risk factors and therapeutic outcome. Fifty-four (16.6% patients with cryptococcal meningitis were identified by smear examination, culture and/or cryptococcal antigen latex agglutination test. Records of 45 cryptococcal meningitis patients were available; 18 (40% of them were apparently healthy immunocompetent individuals, 13 (28.9% had human immunodeficiency virus (HIV infection, 9 (20% were renal transplant recipients, 4 (8.9% were diabetic and 1 (2.2% had systemic lupus erythematosus. Ten (22.2% patients died and 11 (24.4% patients (all HIV-positive left against medical advice. The present study indicates that cryptococcal infection is associated with high mortality. Presenting symptoms being indistinguishable from other causes of central nervous system infection, all patients with a clinical diagnosis of meningitis, irrespective of their immune status should be investigated for cryptococcal infection.