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)

    ... are caused by viruses ( viral meningitis ) or bacteria ( bacterial meningitis ). Fungi and other organisms can also cause infectious ... can spread through the body to cause meningitis. Bacterial meningitis is a more severe form of the infection. ...

  3. 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 ...

  4. Innervation of the human middle meningeal artery

    DEFF Research Database (Denmark)

    Edvinsson, L; Gulbenkian, S; Barroso, C P; Cunha e Sá, M; Polak, J M; Mortensen, A; Jørgensen, Linda; Jansen-Olesen, I

    1998-01-01

    arteries without endothelium, while the responses to norepinephrine, NPY, VIP, PHM, and CGRP were not changed by endothelium removal. Blockade experiments showed that the vasomotor responses to norepinephrine were blocked by prazosin, to NPY by BIBP 3226, acetylcholine by atropin, substance P by RP 67580...

  5. 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...

  6. 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...

  7. 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...

  8. 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.

  9. 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...

  10. 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.)

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

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

    Science.gov (United States)

    Mojumder, Deb Kumar; Toledo, John De

    2014-04-01

    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. PMID:24966558

  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

    2013-01-01

    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

  18. 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

  19. Innervation of the human middle meningeal artery: immunohistochemistry, ultrastructure, and role of endothelium for vasomotility.

    Science.gov (United States)

    Edvinsson, L; Gulbenkian, S; Barroso, C P; Cunha e Sá, M; Polak, J M; Mortensen, A; Jørgensen, L; Jansen-Olesen, I

    1998-01-01

    The majority of nerve fibers in the middle meningeal artery and branching arterioles are sympathetic, storing norepinephrine and neuropeptide Y (NPY). A sparse supply of fibers contain acetylcholinesterase activity and immunoreactivity toward vasoactive intestinal peptide (VIP), peptidine histidine methionine (PHM), and calcitonin gene-related peptide (CGRP). Only few substance P and neuropeptide K immunoreactive fibers are noted. Electronmicroscopy shows axons and terminals at the adventitial medial border of the human middle meningeal artery, with a fairly large distance to the smooth muscle cells (>500 nM). Several axon profiles contain vesicles of different types, including putative sensory profiles. The perivascularly stored signal substances, norepinephrine and NPY induced vasoconstrictor. Relaxations were induced by acetylcholine and substance P, and these were significantly reduced in arteries without endothelium, while the responses to norepinephrine, NPY, VIP, PHM, and CGRP were not changed by endothelium removal. Blockade experiments showed that the vasomotor responses to norepinephrine were blocked by prazosin, to NPY by BIBP 3226, acetylcholine by atropin, substance P by RP 67580, and the human alpha-CGRP response by human alpha-CGRP(8-37). PMID:9786171

  20. 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.

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

    International Nuclear Information System (INIS)

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

  2. 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

  3. 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 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...

  4. 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

    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......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...

  5. 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.

  6. 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.

  7. 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.

  8. Aneurysm of the Posterior Meningeal Artery Embedded Within a Dorsal Exophytic Medullary Hemangioblastoma: Surgical Management and Review of Literature

    Science.gov (United States)

    Raygor, Kunal P.; Rowland, Nathan C.; Cooke, Daniel L.; Solomon, David A.

    2014-01-01

    Hemangioblastomas are World Health Organization (WHO) Grade I neoplasms of the hindbrain and spinal cord, whose management can be complicated by preoperative hemorrhage. We report on a case of a young female in extremis with posterior fossa hemorrhage following rupture of a fusiform posterior meningeal artery aneurysm embedded within a medullary hemangioblastoma. We discuss management options, including operative staging and embolization, and review similar cases of hemangioblastoma associated with aneurysm. PMID:25340034

  9. 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)

  10. Variability of the Middle Meningeal Artery Subject to the Shape of Skull.

    Science.gov (United States)

    Kornieieva, Maryna; Hadidy, Azmy; Zhuravlova, Iuliia

    2015-12-01

    Objectives?Endovascular embolization of the middle meningeal artery (MMA) is currently considered one of the basic methods to treat acute bleeding and a posttraumatic aneurysm. The present research correlates the morphological characteristics of the MMA with individual skull shape. Design?A prospective cohort study. Setting?Hospital of University of Jordan (Amman, Jordan) from 2012 to 2013. Participants?A total of 50 patients without known vascular pathology in the carotid system underwent routine magnetic resonance angiography examination of the head and neck. Main Outcome Measures?The length and outer diameter of extracranial, intraosseous, and intracranial segments of the MMA were measured in patients with dolichocephalic, mesocephalic, and brachycephalic types of skulls. Results?The brachycephalic patients have the most inauspicious anatomical precondition for endovascular intervention of the MMA due to the narrowest lumen of the vessel, high probability of a tortuous extracranial part, and pronounced inflexion at the transmission of the intraosseous segment to the intracranial one. Conclusions?The morphological characteristics of the MMA have a close correlation with individual skull shape. PMID:26682123

  11. 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

  12. 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...

  13. 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

  14. 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 ...

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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 ...

  1. Treating Meningitis

    Science.gov (United States)

    ... their study, “ Dexamethasone and long-term survival in bacterial meningitis, ” Dr. Fritz and his colleagues carefully evaluated 2 ways to treat bacterial meningitis. 1 They compared steroids (dexamethasone) with pla- cebo. ...

  2. Meningitis - pneumococcal

    Science.gov (United States)

    ... of bacteria is the most common cause of bacterial meningitis in adults. It is the second most common ... Messonnier NE, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl ...

  3. 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

  4. Parasitic Meningitis

    Science.gov (United States)

    ... Resources for Healthcare Professionals Related Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Parasitic Meningitis Recommend on ... Related Page Naegleria fowleri Related Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease File Formats Help: How ...

  5. Viral Meningitis

    Science.gov (United States)

    ... Resources for Healthcare Professionals Related Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Viral Meningitis Recommend on ... Arboviruses Lymphocytic Choriomeningitis Virus Related Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease File Formats Help: How ...

  6. 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 ...

  7. Meningitis - tuberculous

    Science.gov (United States)

    ... Elsevier Churchill Livingstone; 2015:chap 251. Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier ... more questions, still too few answers. Lancet Neurol . ...

  8. 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 ...

  9. Meningitis (For Parents)

    Science.gov (United States)

    ... can be due to certain medications or illnesses. Bacterial meningitis is rare, but is usually serious and can ... around the spinal cord. In some cases of bacterial meningitis, the bacteria spread to the meninges from a ...

  10. 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 ...

  11. 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 ...

  12. 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.

  13. Meningitis - H. influenzae

    Science.gov (United States)

    ... vaccine, H. influenzae was the leading cause of bacterial meningitis in children under age 5. Since the vaccine ... Messonnier NE, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl ...

  14. 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...

  15. 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.

  16. MR angiography in tuberculous meningitis

    International Nuclear Information System (INIS)

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

  17. Bacterial meningitis in children. MR findings

    International Nuclear Information System (INIS)

    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)

  18. 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)

  19. Localized basal meningeal enhancement in tuberculous meningitis

    International Nuclear Information System (INIS)

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

  20. Syringomyelia following tuberculous meningitis

    International Nuclear Information System (INIS)

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

  1. 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.

  2. 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.

  3. 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...

  4. Locations of cerebral infarctions in tuberculous meningitis

    International Nuclear Information System (INIS)

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

  5. 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.

  6. Meningitis and Encephalitis

    Science.gov (United States)

    ... contact with the affected individual should be given preventative antibiotics. Haemophilus meningitis was at one time the ... reduce brain inflammation. If inflammation is severe, pain medicine and sedatives may be prescribed to make the ...

  7. 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.)

  8. 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.

  9. Meningitis del adulto

    OpenAIRE

    Vergara G., Ignacio; Saravia G., Jaime; Toro G., Gabriel; Román C., Gustavo; Navarro C., Lydia Isabel

    2012-01-01

    En Colombia, el problema de las meningitis ha sido estudiado únicamente en la población infantil. No hemos encontrado en la literatura médica colombiana ninguna publicación sobre la Meningitis del Adulto; y a pesar de su frecuencia relativamente alta en nuestros medios hospitalarios, no teníamos datos nacionales acerca de sus características epidemiológicas, clínicas y bacteriológicas, por lo cual decidimos realizar el presente trabajo, que hemos dividido en dos fases: Retrospectiva y Prospec...

  10. 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...

  11. Meningitis bacteriana aguda Acute bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Marcela Castro R

    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.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.

  12. 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.

  13. 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...

  14. 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)

  15. [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

  16. [Pasteurella multocida bacteremic meningitis].

    Science.gov (United States)

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

    2008-01-01

    Human infections by Pasteurella multocida are usually associated with bites or scratches from dogs and cats. Many of them are accompanied by other oropharyngeal microorganisms of these animals. We herein present a case of bacteremic meningitis by P. multocida in an 86-year-old woman who was living with seven cats. Even though no skin or soft tissue infection was recorded, it is possible that a mild infection had gone undetected and a subsequent bacteremia had impacted on the meninges, or that meningitis could have occurred after nasopharyngeal colonization (not demonstrated). The isolates obtained from blood cultures and cerebrospinal fluid were identified as P. multocida by API 20NE, API 20E, and Vitek 1. In agreement with findings in the literature, this strain was susceptible to penicillin, cefotaxime, levofloxacin and tetracyclines. PMID:19213242

  17. Adult bacterial meningitis

    DEFF Research Database (Denmark)

    Meyer, C N; Samuelsson, I S; Galle, M; Bangsborg, Jette Marie

    2004-01-01

    Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin susceptibi......Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin...

  18. 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...

  19. 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.

  20. Cerebrospinal fluid concentration of fibronectin in meningitis.

    OpenAIRE

    Torre, D.; 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.

  1. Adult bacterial meningitis

    DEFF Research Database (Denmark)

    Meyer, C N; Samuelsson, I S; Galle, M; Bangsborg, Jette Marie

    2004-01-01

    Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin susceptibi......Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin...... inappropriate clinical handling, abnormal consciousness, convulsions and nosocomial infection. Overall, the data indicated that neither age alone, community-acquired infection nor absence of identified risk factors can predict susceptibility to penicillin accurately. Recommendations for empirical antibiotic...

  2. 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...

  3. 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.

  4. 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.)

  5. Tuberculous meningitis in children.

    Science.gov (United States)

    Altunba?ak, S; Alhan, E; Baytok, V; Aksaray, N; Yüksel, B; Onenli, N

    1994-10-01

    Between May 1988 and November 1992 the data from 52 patients with tuberculous meningitis (TBM) were noted down for their symptoms and signs, BCG vaccines, PPD tests; clinical, laboratory, radiologic and microbiologic findings. These data were discussed by means of literature knowledge. Cranial computed tomography (CT) demonstrated hydrocephalus (HC) in 98% of the patients. There was a statistically significant difference among the clinical stages on admission in respect to prognosis (P 0.05). PMID:7825446

  6. 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 ...

  7. Locations of cerebral infarctions in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-06-01

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

  8. Chemical meningitis in metrizamide myelography

    International Nuclear Information System (INIS)

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

  9. 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.

  10. 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.

  11. 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...

  12. 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.

  13. Cognitive outcome in adults after bacterial meningitis

    OpenAIRE

    Hoogman, M.; Beek, D. van de; Weisfelt, M.; Gans, J.; Schmand, B.

    2007-01-01

    OBJECTIVE: To evaluate cognitive outcome in adult survivors of bacterial meningitis. METHODS: Data from three prospective multicentre studies were pooled and reanalysed, involving 155 adults surviving bacterial meningitis (79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls. RESULTS: Cognitive impairment was found in 32% of patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Survivors of pneumococcal meningitis ...

  14. Methicillin resistant Staphylococcus aureus meningitis

    Science.gov (United States)

    Pereira, Noella Maria Delia; Shah, Ira; Ohri, Alpana; Shah, Forum

    2015-01-01

    Methicillin resistant Staphylococcus aureus (MRSA) meningitis is rarely known to occur in children. We report an 11-year-old girl with fever, headache and vomiting, right hemiparesis with left-sided upper motor neuron facial nerve palsy and bladder incontinence. On investigation, she was found to have MRSA meningitis with an acute left thalamo-corpuscular infarct. She was treated with vancomycin, linezolid and rifampicin. She recovered successfully with residual right-sided lower limb monoparesis. MRSA meningitis is rare but can occur in children. PMID:26609421

  15. CT in meningitis purulenta

    International Nuclear Information System (INIS)

    Twenty nine infants with meningitis purulenta were classified into 5 groups according to CT findings in the acute stage: cerebral infarction group, subdural hygroma group, ventricular enlargement group, and a group of other diseases. In each group, clinical findings, surgical procedures and prognosis were evaluated. In the cerebral infarction group, although 3 of 4 patients underwent V-P shunt or subdural drainage, remarkable sequelae were found in all the cases. Of 4 subdural hygroma patients, 2 had subdural drainage, and 4 of 8 patients with ventricular enlargement underwent V-P shunt. All the patients of the two groups had favorable prognosis without any sequela. A patient with cerebral herniation in the group of other diseases died in its acute stage. Eleven infants without abnormal CT findings showed normal psychomotor development. (Ueda, J.)

  16. Meningitis tras anestesia espinal Meningitis after a spinal anesthesia

    Directory of Open Access Journals (Sweden)

    A. L. Vázquez-Martínez

    2008-03-01

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

  17. 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....

  18. Spinal perineurial and meningeal cysts

    Science.gov (United States)

    Tarlov, I. M.

    1970-01-01

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

  19. Computed tomography of tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-12-01

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

  20. Computed tomography of tuberculous meningitis

    International Nuclear Information System (INIS)

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

  1. Experimental studies of pneumococcal meningitis.

    Science.gov (United States)

    Brandt, Christian T

    2010-01-01

    This thesis summarizes experimental meningitis research conducted at Statens Serum Institut in collaboration with the Copenhagen HIV programme and the Danish Research Centre for Magnetic Resonance between 2001 and 2007. Previous experimental studies had shown that the host inflammatory response in invasive infections contributed significantly to an extremely poor outcome despite initiation of efficient antimicrobial chemotherapy. Consequently, we aimed to investigate and clarify how the course of disease in pneumococcal meningitis was modulated by local meningeal inflammation and concomitant systemic infection and inflammation. Experimental studies were based on the development of a rat model of pneumococcal meningitis, refined and optimized to closely resemble the human disease, mimicking disease severity, outcome, focal- and global brain injury and brain pathophysiology. These endpoints were evaluated by the development of a clinical score system, definition of outcomes and measurement of hearing loss by otoacoustic emission. The investigation of in-vitro and in-vivo brain pathology with histology and MRI revealed an injury pattern similar to that found clinically. Additionally, MRI enabled the study of parameters closely related to the cerebral pathophysiology of meningitis (brain oedema, blood brain barrier (BBB) permeability, focal brain injury and hydrocephalus). Modulation of the inflammatory host response was achieved by initiation of treatment prior to infection: 1) G-CSF treatment increased the peripheral availability of leukocytes, 2) Selectin blocker fucoidin attenuated meningeal leukocyte accumulation and 3) A serotype specific Ab augmented systemic pneumococcal phagocytosis. The studies revealed a dual role of the inflammatory response in pneumococcal meningitis. Whilst focal brain injury appeared to result from local meningeal infectious processes, clinical disease severity and outcome appeared determined by systemic infection. Furthermore systemic disease contributed significantly to BBB permeability and brain ventricle expansion. Ventricle expansion was also associated with clinical appearance. An augmented systemic host response limited pneumococcal bacteraemia and protected from fatal outcome, but did not reduce occurrence of focal brain injury. Thus, our findings suggest that meningitis sequelae arise from local disease complications whereas fatal outcome is accelerated by systemic infection. Understanding of the relationship and interplay between septicaemia, intracranial pressure, ventricle expansion and brain edema could help optimize the treatment of these disease complications by, for example, improved systemic infection control. New therapeutic approaches to improve survival and neurological outcome from pneumococcal meningitis may be achieved through identification of the pathogen factors that initiate and prolong extensive systemic and local inflammation. Investigation of genomic differences and protein expression between pneumococcal serotypes or between identical serotypes with different virulence are considered crucial to this progress. Future progress may also be achieved by disease prevention with pneumococcal vaccines. Randomized trials of treatment strategies including bacteriostatic agents, antioxidants or more specific anti-inflammatory agents are realistic possibilities in the near future. PMID:20175949

  2. Neonatal meningitis caused by Achromobacter xylosoxidans.

    OpenAIRE

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

    1985-01-01

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

  3. Dynamic CT of tuberculous meningeal reactions

    Energy Technology Data Exchange (ETDEWEB)

    Jinkins, J.R.

    1987-07-01

    The technique of intravenous dynamic cranial computed tomography has been applied to the patient population at this location in Saudi Arabia with meningeal tuberculosis. The various manifestations and sequelae including meningitis, arteritis, infarct, and true meningeal tuberculomata all have characteristic if not specific appearances. The dynamic study enhances an otherwise static examination and reveals a great deal about the pathophysiology of tuberculosis involving the cerebral meningeal surfaces.

  4. Meningitis de Mollaret: reporte de caso

    Directory of Open Access Journals (Sweden)

    Luz Clemencia Zárate C

    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 polimerasa (PCR del líquido cefalorraquídeo y se hace una revisión del tema.

  5. Meningococcal Disease (Bacterial Meningitis) Vaccine and Pregnancy

    Science.gov (United States)

    Meningococcal Disease (Bacterial meningitis) Vaccine and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having a ... treatment differs depending on the type of meningitis. Bacterial meningitis is usually a very severe condition but there ...

  6. 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

  7. Subdural effusion following purulent meningitis

    International Nuclear Information System (INIS)

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

  8. 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.)

  9. 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.

  10. CT scan of bacterial and aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-01-01

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

  11. CT scan of bacterial and aseptic meningitis

    International Nuclear Information System (INIS)

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

  12. 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.

  13. Autosplenectomy Causing Catastrophic Pneumococcal Meningitis in a Patient with Lupus/Antiphospholipid Antibody Syndrome.

    Science.gov (United States)

    Sheth, Khushboo; Snyder, Aaron; Wu, Ulysses; Lahiri, Bimalin; Grover, Prashant

    2016-01-01

    We present the case ofa26-year-old female who presented to the hospital with pneumococcal meningitis. A review of her records showed atrophic spleen, and a hypercoagulable workup was positive for Systemic Lupus Erythematous (SLE)/Antiphospholipid Antibody Syndrome (APS). An autosplenectomy from thrombotic occlusion of the splenic artery made her susceptible to pneumococcal meningitis. Autoimmune conditions, particularly SLE and APS, are important causes of hypercoagulable states in a young population, and earlier detection of these conditions and appropriate treatment helps to decrease morbidity and mortality among these patients. PMID:26882790

  14. 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.)

  15. 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.)

  16. Meningitis due to Fusobacterium necrophorum

    Directory of Open Access Journals (Sweden)

    Luana Coltella

    2010-06-01

    Full Text Available Introduction: Fusobacterium necrophorum is an anaerobic Gram negative bacillus highly virulent, responsible, usually in children or adolescents, of localized abscesses and pharynx, as well as severe systemic infections, called Lemierre syndrome. Methods: A 15 year old child came to the emergency department (ED of Bambino Gesù Children Hospital. Physicians prescribed chemicalphysical examination on blood and liquor, blood cultures for aerobic and anaerobic bacteria and for fungi (BD Ped Plus, lytic Ana, Micosis, microbiological culture on liquor (CSF and on the swab from the right outer ear. Results: On chemical examination, liquor appears cloudy, with 309 mg/dl of total proteins, glucose undetectable,WBC 11,160 mmc, 92% of neutrophils. Hyperleukocytosis was detected also on the emocrome (WBC 21x103/?l, 92% neutrophils. No bacterial antigens were detected. CSF culture resulted negative for aerobic bacteria, even after 48 hours of incubation. After 24 hours of inoculation, the blood culture for anaerobic bacteria resulted positive and, Fusobacterium necrophorum was isolated and identified, by genomic sequencing, after 24 hours growth on Schaedler medium. Microbiological culture of the right outer ear swab, highlighted only Corynebacterium spp. After 6 days from admission, the patient died for meningitis. Conclusion:This event has shown the severity of infection by F. necrophorum and, at the same time, the underestimation of this germ in the spectrum of etiologic agents responsible for meningitis.The only microbiological indication was obtained from the anaerobes bacteria blood culture. Following this episode our working procedures for what concerns liquor samples management was modified, including routinely the investigation for anaerobic bacteria. Presumably this episode of meningitis has originated from a F. necrophorum otitis of the right ear, unfortunately not microbiologically confirmed.The anaerobic bacteria should always be considered as potentially responsible of meningitis, especially when ear infections or pharyngeal abscesses precede or accompany the onset of symptoms.

  17. 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 ...

  18. Endolymphatic sac involvement in bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Brandt, Christian; Østergaard, Christian; 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...

  19. 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 ...

  20. 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.)

  1. 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.)

  2. 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.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-11-15

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

  5. Antibiotikavalg ved purulent meningitis uden bakteriologisk diagnose

    DEFF Research Database (Denmark)

    Krarup, H B

    1989-01-01

    A case of meningitis in a 16 month old boy caused by Hemophilus influenzae resistant to ampicillin is presented. The question is raised whether a third generation cephalosporin such as cefotaxime should be the drug of choice in the treatment of bacterial meningitis with unknown etiology...

  6. Cerebral infarction in childhood bacterial meningitis

    OpenAIRE

    Snyder, R D; Stovring, J; Cushing, A H; Davis, L E; Hardy, T L

    1981-01-01

    Forty-nine children with complicated bacterial meningitis were studied. Thirteen had abnormalities on computed tomography compatible with the diagnosis of brain infarction; one had a brain biopsy with the histological appearance of infarction. Factors exist in childhood bacterial meningitis which are associated with the development of brain infraction.

  7. Personlighedsforandring og hydrocefalus forårsaget af tuberkuløs meningitis

    DEFF Research Database (Denmark)

    von Huth, Sebastian; Pedersen, Court; Johansen, Isik Somuncu

    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...

  8. 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.

  9. 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

  10. MR of childhood tuberculous meningitis

    International Nuclear Information System (INIS)

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

  11. MR of childhood tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-12-01

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

  12. 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.

  13. 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...

  14. 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)

  15. 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.

  16. 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.)

  17. 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.

  18. Climate Change and Cerebrospinal Meningitis in the Ghanaian Meningitis Belt

    Directory of Open Access Journals (Sweden)

    Samuel Nii Ardey Codjoe

    2014-07-01

    Full Text Available Cerebrospinal meningitis (CSM is one of the infectious diseases likely to be affected by climate change. Although there are a few studies on the climate change-CSM nexus, none has considered perceptions of community members. However, understanding public perception in relation to a phenomenon is very significant for the design of effective communication and mitigation strategies as well as coping and adaptation strategies. This paper uses focus group discussions (FGDs to fill this knowledge lacuna. Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits to CSM infections during FGDs, majority of participants rightly linked CSM infections to dry, very hot and dusty conditions experienced during the dry season. Finally, community members use a suite of adaptation options to curb future CSM epidemics.

  19. 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 ).

  20. 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...

  1. 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...

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

    OpenAIRE

    Ali Moghtaderi; Roya Alavi-Naini; Saideh Rashki

    2013-01-01

    Tuberculous meningitis (TBM) and acute bacterial meningitis (ABM) cause substantial mortality and morbidity in both children and adults. Identification of poor prognostic factors at patient’s admission could prepare physicians for more aggressive monitoring of patients with meningitis. The objective of this study was to determine the predictive value of neurological features to differentiate ABM and TBM. A retrospective study was conducted between patients affected with ABM or TBM admitted to...

  4. Computed tomography in suppurative meningitis

    International Nuclear Information System (INIS)

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

  5. Meningeal carcinomatosis in solid tumors

    Directory of Open Access Journals (Sweden)

    Sandro José Martins

    2011-12-01

    Full Text Available 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 frequent 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.

  6. Pyogenic meningitis in Ilesa, Nigeria.

    Science.gov (United States)

    Ogunlesi, T A; Okeniyi, J A O; Oyelami, O A

    2005-10-01

    This study was conducted in 124 children with meningitis to review the etiology, antimicrobial susceptibility and outcome of disease in a Nigerian tertiary health facility. Of these, 97 (78.27%) were culture positive; in the rest 27(21.8%), diagnosis was based on Gram staining of the CSF. Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus and Escherichia coli were isolated in 33.9%, 33.9%, 5.6%, 2.4%, and 2.4% samples respectively. All the isolates had 100 percent; sensitivity to both ceftriaxone and ciprofloxacin while the sensitivities to penicillin and ampicillin were remarkably low. The mortality was 33/124 (26.6%) while 16/ 91 (17.6%) of the survivors had various neurologic sequelae. PMID:16269839

  7. Endolymphatic sac involvement in bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Brandt, Christian; Østergaard, Christian; 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...... 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...

  8. 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.

  9. 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...

  10. Carcinomatous meningitis mimicking Creutzfeldt-Jakob disease

    Directory of Open Access Journals (Sweden)

    Vas C

    2004-07-01

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

  11. 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...

  12. [Neuropsychological findings in patients with aseptic meningitis.

    Science.gov (United States)

    Damsgaard, Jesper; Klostergaard, Kirsten Rose; Leutscher, Peter Derek Christian

    2014-10-20

    Aseptic meningitis is considered to be a benign illness with mild symptoms, and the prognosis is usually good. However, retrospective studies have demonstrated that these patients may experience cognitive sequelae. A neuropsychologist was affiliated to the Department of Infectious Diseases, and neuropsychological findings in patients with aseptic meningitis were assessed. In conclusion, at twelve months of follow-up cognitive dysfunction persist among the majority of patients; 75% had mental fatigue and 45% had changed their work status. PMID:25353677

  13. MRI enhancing patterns of non-meningioma meningeal lesions

    International Nuclear Information System (INIS)

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

  14. 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.

  15. 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.

  16. 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.

  17. Cholinesterase modulations in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Berg, Ronan M G; Ofek, Keren; Qvist, Tavs; Tofteng, Flemming; Soreq, Hermona; Møller, Kirsten

    2011-01-01

    The circulating cholinesterases acetyl- and butyrylcholinesterase may be suppressed and subsequently released from the brain in acute bacterial meningitis.......The circulating cholinesterases acetyl- and butyrylcholinesterase may be suppressed and subsequently released from the brain in acute bacterial meningitis....

  18. Risk of Bacterial Meningitis in Children with Cochlear Implants

    Science.gov (United States)

    ... America Information For... Media Policy Makers Risk of Bacterial Meningitis in Children with Cochlear Implants Language: English Español ( ... Share Compartir 2002 Study of the Risk of Bacterial Meningitis in Children with Cochlear Implants Many people have ...

  19. 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

  20. 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.

  1. An unusual case of chronic meningitis

    Directory of Open Access Journals (Sweden)

    Hinton Anna

    2004-10-01

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

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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...

  7. 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...

  8. Listeria monocytogenes Meningitis in Adults: The Czech Republic Experience

    OpenAIRE

    Olga Dzupova; Hanus Rozsypal; Dita Smiskova; Jiri Benes

    2013-01-01

    Background. Listeria monocytogenes (LM) is currently the third most frequent pathogen of bacterial meningitis in adults. Methods. A prospective study of patients with LM meningitis in a Czech tertiary care hospital, carried out from 1997 to 2012. Results. Thirty-one patients were diagnosed with LM meningitis, which was 7% of a total of 440 adult patients with acute bacterial meningitis (ABM) over a 16-year period. Their median age was 63 years, range 26–80 years. Nineteen patients (61%) had u...

  9. 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.

  10. 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.)

  11. 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.

  12. 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

  13. Surveillance of Bacterial Meningitis, Ethiopia, 2012-2013.

    Science.gov (United States)

    Mihret, Wude; Lema, Tsehaynesh; Merid, Yared; Kassu, Afework; Abebe, Workeabeba; Moges, Beyene; Tenna, Admasu; Woldegebriel, Fitsum; Yidnekachew, Melaku; Mekonnen, Wondale; Ahmed, Arslan; Yamuah, Lawrence; Silamsaw, Mezgebu; Petros, Beyene; Oksnes, Jan; Rosenqvist, Einar; Ayele, Samuel; Aseffa, Abraham; Caugant, Dominique A; Norheim, Gunnstein

    2016-01-01

    Among 139 patients with suspected bacterial meningitis in Ethiopia, 2012-2013, meningococci (19.4%) and pneumococci (12.9%) were the major disease-causing organisms. Meningococcal serogroups detected were A (n = 11), W (n = 7), C (n = 1), and X (n = 1). Affordable, multivalent meningitis vaccines for the African meningitis belt are urgently needed. PMID:26689450

  14. C-reactive protein and bacterial meningitis

    DEFF Research Database (Denmark)

    Gerdes, Lars Ulrik; Jørgensen, P E; Nexø, E; Wang, P

    1998-01-01

    The aim of the study was to review published articles on the diagnostic accuracy of C-reactive protein (CRP) tests with cerebrospinal fluid and serum in diagnosing bacterial meningitis. The literature from 1980 and onwards was searched using the electronic databases of MEDLINE, and we used summary...... receiver operating characteristic curve analyses (SROCs) to describe central tendencies and examine possible sources of inter-study variability in the results. We included data from 35 studies of both children and adults: 21 in which CRP had been measured in cerebrospinal fluid, 10 in which CRP had been...... measured in serum, and 4 in which it had been measured in both cerebrospinal fluid and serum. The odds ratio for bacterial meningitis versus aseptic meningitis for a positive CRP test with cerebrospinal fluid was estimated at 241 (95% confidence interval [CI]: 59-980), and the central tendencies for the...

  15. Emergency Neurologic Life Support: Meningitis and Encephalitis.

    Science.gov (United States)

    Gaieski, David F; Nathan, Barnett R; O'Brien, Nicole F

    2015-12-01

    Bacterial meningitis and viral encephalitis, particularly herpes simplex encephalitis, are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because treatment is more effective if given early, the topic of meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. This protocol provides a practical approach to recognition and urgent treatment of bacterial meningitis and encephalitis. Appropriate imaging, spinal fluid analysis, and early empiric treatment is discussed. Though uncommon in its full form, the typical clinical triad of headache, fever, and neck stiffness should alert the clinical practitioner to the possibility of a central nervous system infection. Early attention to the airway and maintaining normotension is crucial in treatment of these patients, as is rapid treatment with anti-infectives and, in some cases, corticosteroids. PMID:26438456

  16. 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

  17. Counterimmunoelectrophoresis in the diagnosis of bacterial meningitis

    DEFF Research Database (Denmark)

    Colding, H; Lind, I

    1977-01-01

    The aim of the present study was to investigate whether counterimmunoelectrophoresis (CIE) would facilitate the rapid, etiological diagnosis of bacterial meningitis when used in parallel with other routine methods in a medical bacteriological laboratory. Of 3,674 consecutive specimens of...... culture-negative specimens. CSF specimens from 21 patients with bacterial meningitis caused by other species were all negative in CIE, except four, three of which contained Escherichia coli antigen reacting with antiserum to N. meningitidis group B and one E. coli antigen reacting with antiserum to H...

  18. 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.

  19. Neurosonographic findings of bacterial meningitis in Infants

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-02-15

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

  20. Neurosonographic findings of bacterial meningitis in Infants

    International Nuclear Information System (INIS)

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

  1. [Fahr syndrome discovered following a bacterial meningitis].

    Science.gov (United States)

    Sbai, H; Smail, L; Hamdani, S; Essatara, Y; Harrandou, M; Khatouf, M; Kanjaa, N

    2008-05-01

    Fahr's disease refers to a rare syndrome characterized by symmetrical and bilateral intracranial calcifications. The basal ganglia and dentate nucleus are the most common site of involvement and most cases present extrapyramidal symptoms. This disease is mostly associated with a phosphocalcic metabolism disorder, especially to hypoparathyroidism. The authors report a case of Fahr syndrome (FS) discovered when a young patient with hypocalcemia and bacterial meningitis had a cerebral CT scan disclosing intracerebral calcifications. She fully recovered after both meningitis and hypocalcemia were treated. PMID:18329142

  2. 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.

  3. Radioactive bromide partition test in the diagnosis of tuberculous meningitis

    International Nuclear Information System (INIS)

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

  4. Bacteremia causes hippocampal apoptosis in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Andersen, Christian Østergaard; Leib, S.L.; Rowland, Ian J; Brandt, C.T.

    2010-01-01

    -specific pneumococcal antibodies (n=14), and III. uninfected controls (n=6). RESULTS: Pneumococcal meningitis resulted in a significantly higher apoptosis score 0.22 (0.18-0.35) compared to uninfected controls (0.02 (0.00-0.02), Mann Whitney test, P=0.0003). Also, meningitis with an attenuation of bacteremia by...... antibody treatment resulted in significantly reduced apoptosis (0.08 (0.02-0.20), P=0.01) as compared to meningitis. CONCLUSIONS: Our results demonstrate that bacteremia accompanying meningitis plays an important role in the development of hippocampal injury in pneumococcal meningitis....

  5. 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.

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

    DEFF Research Database (Denmark)

    Østergaard, C; O´Reilly, T; Brandt, C; Frimodt-Møller, N; Lundgren, Jens Dilling

    2006-01-01

    blood WBC levels in 153 pneumococcal meningitis patients with and without presence of bacteraemia. RESULTS: As designed, blood bacterial concentrations were significantly different among three experimental groups during the 16 hours study period (Kruskal Wallis test, P < 0.05), whereas no differences in......BACKGROUND: Despite bacteraemia is present in the majority of patients with pneumococcal, little is known about the influence of the systemic infection on the meningeal inflammatory response. METHODS: To explore the role of systemic infection on the meningeal inflammation, experimental meningitis...... for 5 weeks prior to the experiment ("immunized" rabbits", n = 8), or not treated further ("control" rabbits, n = 9). WBC and bacterial concentrations were determined in CSF and blood every second hour during a 16 hours study period together with CSF IL-8 and protein levels. We also studied CSF and...

  7. 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.

  8. Randomized comparison of meropenem with cefotaxime for treatment of bacterial meningitis. Meropenem Meningitis Study Group.

    OpenAIRE

    Klugman, K. P.; DAGAN R.

    1995-01-01

    Broad-spectrum cephalosporins are drugs of choice for the treatment of meningitis in communities which can afford them. The emergence of cephalosporin-resistant pneumococci demands the clinical trial of alternate agents. Carbapenems are active against the bacteria causing meningitis, but the use of imipenem-cilastatin was frustrated by drug-associated seizures. The safety and efficacy of meropenem, a new carbapenem, were compared to those of cefotaxime in a prospective randomized trial of 190...

  9. Differential diagnosis of tuberculous meningitis from partially-treated pyogenic meningitis by cell ELISA

    OpenAIRE

    Purohit Hemant J; Chandak Nitin H; Agarwal Neha P; Satpute Ravindra M; Kainthla Rani P; Kashyap Rajpal S; Taori Girdhar M; Daginawala Hatim F

    2004-01-01

    Abstract Background Tuberculous meningitis (TBM) is a major global health problem, and it is sometimes difficult to perform a differential diagnosis of this disease from other diseases, particularly partially-treated pyogenic meningitis (PTPM). In an earlier study, we demonstrated the presence of a 30-kD protein antigen in cerebrospinal fluid (CSF) of TBM patients. We have also shown that lymphocytes from CSF of TBM patients respond differently to this antigen than do those from PTPM patients...

  10. 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...

  11. 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

  12. 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; Cosić, 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

    , 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 of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release...

  13. 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.

  14. 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

  15. 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

  16. Kleine-Levin syndrome in tubercular meningitis

    OpenAIRE

    Thacker Anup; Aeron Anupam; Haider Jamal; Rao K

    2007-01-01

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

  17. Ophthalmic systems completely supplied from dural arteries indicate the utility of endovascular treatment of cerebral aneurysms.

    Science.gov (United States)

    Kadooka, Keisuke; Tanaka, Michihiro

    2015-12-01

    We report a 67-year-old man who harboured an unruptured left basilar-superior cerebellar artery aneurysm. Cerebral angiography and cone beam computed tomography with diluted contrast medium showed that the bilateral ophthalmic arteries were not supplied from internal carotid arteries but, rather, were supplied from the middle meningeal and accessory meningeal arteries. This meant that the ophthalmic system was predominantly supplied from the dural arteries and, therefore, pterional craniotomy might cause a compromise in blood supply to the retinal artery. To avoid this complication, coil embolization was selected instead of neck clipping, and this endovascular therapy succeeded without neurological deficit. This case report shows the importance of cerebral angiography (including cone beam computed tomography) and consideration of the patterns of ophthalmic artery perfusion when selecting operative procedures for management of aneurysms that require manipulation around the sphenoid ridge. PMID:26472634

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

    DEFF Research Database (Denmark)

    Jansen-Olesen, Inger; Jørgensen, Linda; Engel, Ulla; Edvinsson, Lars

    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...

  19. 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

    of the BK(Ca) channel in rat basilar, middle cerebral, and middle meningeal arteries by reverse transcription polymerase chain reaction (RT-PCR), quantitative real-time PCR, and Western blotting. Distribution patterns were investigated using in situ hybridization and immunofluorescence studies. RT......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......-PCR and quantitative real-time PCR detected the expression of the BK(Ca) channel mRNA transcript in rat basilar, middle cerebral, and middle meningeal arteries, with the transcript being expressed more abundantly in rat basilar arteries than in middle cerebral and middle meningeal arteries. Western...

  20. Intra-arterial chemotherapy for bilateral retinoblastoma via left ophthalmic artery and right anterior deep temporal artery.

    Science.gov (United States)

    Amans, Matthew R; Narvid, Jared; Halbach, Van V

    2014-01-01

    A 12-month-old boy with a history of bilateral retinoblastoma refractory to systemic chemotherapy, laser therapy and cryotherapy, with excellent response to previous intra-arterial melphalan infusion, presents with active tumour deposits in the right eye. Repeat intra-arterial chemotherapy was recommended. Previous bilateral melphalan infusion was uneventful using flow-guided catheterisation technique. Direct catheterisation of the right ophthalmic artery was unsuccessful despite employment of several flow-guided and over-the-wire catheters. Superselective catheterisation of the ipsilateral middle meningeal artery was unable to identify an anastomotic connection to the ophthalmic artery; however, angiography of the anterior deep temporal artery identified an alternate route for chemotherapy infusion. The anterior deep temporal artery was successfully and safely catheterised to infuse chemotherapy into the ophthalmic artery. The anterior deep temporal artery is an important potential anastomotic connection to the ophthalmic artery that can be used safely and effectively for central retinal artery chemotherapy infusion for retinoblastoma treatment. PMID:25240013

  1. 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- γ were elevated, as were brain homogenate levels of KC, MIP-2, IL-6, IL-1β 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.

  2. Diffusion-weighted magnetic resonance imaging of borderzone necrosis in paediatric tuberculous meningitis

    International Nuclear Information System (INIS)

    Tuberculous meningitis (TBM) is associated with borderzone necrosis (BZN) of the brain parenchyma in areas adjacent to meningeal inflammation. Diffusion-weighted MRI (DWI) allows for accurate detection of cytotoxic oedema associated with necrosis. Detection and characterisation of BZN using DWI to explain its pathogenesis in TBM have not been performed previously in children. Our objective was to identify the prevalence and characteristics of BZN using DWI in children with TBM and to correlate it with the presence, degree and distribution of basal meningeal enhancement (BE) in the absence of large-vessel thrombosis. A retrospective descriptive MRI DWI study of 34 children with TBM was conducted. The topography of BZN was compared with the presence and severity of BE on specific MRI sequences. BZN was identified on MRI DWI in 50% of patients of which 82% had involvement of the temporal lobes. The severity and extent of BE in either middle cerebral artery cistern correlated with the presence of BZN (P = 0.02). BZN did not correlate with radiologically detectable vascular occlusion BZN is common in TBM occurring in 50% of children. Detection and confirmation of cytotoxic oedema associated with BZN using DWI, and its clear relation to BE supports existing pathogenetic descriptions. The pathogenesis of BZN differs to that of topographical infarction on the basis of distribution as well as an absent statistical relationship between vascular occlusion and BZN.

  3. 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

  4. 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

  5. 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 of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-? release...... accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic...

  6. MRI of primary meningeal tumours in children

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

  7. MRI of primary meningeal tumours in children

    International Nuclear Information System (INIS)

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

  8. 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...

  9. Group B streptococcal meningitis in a previously healthy man.

    Science.gov (United States)

    Li, Lucy Qian; Cheema, Sanjay; Goel, Nupur

    2016-01-01

    Group B Streptococcus (GBS) is an infrequent cause of meningitis in adults, usually affecting elderly patients and those with serious underlying disease. It is more commonly recognised as one of the leading aetiological agents of neonatal sepsis following maternally derived infection during pregnancy. We report a case of a previously healthy 26-year-old man who presented with fevers, confusion and headache. Lumbar puncture results were consistent with bacterial meningitis, and blood cultures grew GBS. To the best of our knowledge, our patient represents one of the few reported cases of GBS meningitis in a previously healthy young man. Interestingly, our patient had a significant family history of central nervous system infection including a son with herpes simplex virus encephalitis, a sister with meningococcal meningitis and a great-uncle with meningitis of unknown cause. We discuss genetic factors that may predispose certain people to develop meningitis with normally harmless microorganisms such as GBS. PMID:26759446

  10. 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

  11. Oxidative stress and antioxidants in tubercular meningitis

    OpenAIRE

    Sudha, K.; Rao, Ashalatha V.; Rao, S. N.; Rao, Anjali

    2002-01-01

    Oxidative stress is implicated in the etiopathogenesis of a variety of human diseases. Therefore, in the present study, erythrocyte lipid peroxidation, percentage hemolysis, antioxidant enzymes viz., glutathione reductase, glutathione peroxidase, superoxide dismutase and plasma antioxidants viz., ceruloplasmin, vitamins A,E and C have been determined in 19 patients with tubercular meningitis (TBM) and 50 normals. Six patients who were treated with antibiotics were considered for the follow up...

  12. Tuberculous Meningitis: Diagnosis and Treatment Overview

    OpenAIRE

    Grace E. Marx; Chan, Edward D.

    2011-01-01

    Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality. TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Characteristic cerebrospinal fluid (CSF) findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples...

  13. 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...

  14. [Pneumococcal meningitis in a pregnant woman].

    Science.gov (United States)

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

    2014-01-30

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

  15. 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 ...

  16. Optic nerve sheath fenestration in cryptococcal meningitis

    OpenAIRE

    Tatyana Milman; Neena Mirani; Turbin, Roger E

    2008-01-01

    Tatyana Milman1, Neena Mirani1,2, Roger E Turbin11Ophthalmology Department, Institute of Ophthalmology and Visual Science, 2Pathology Department, University Hospital, New Jersey Medical School, Newark, NJ, USAAbstract: A patient with acquired immunodeficiency syndrome (AIDS) developed crytpococcal meningitis, complicated by papilledema and severe progressive visual loss despite medical therapy. Bilateral optic sheath fenestration resulted in significant improvement in vision and resolution of...

  17. 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. ...

  18. Kleine-Levin syndrome in tubercular meningitis

    Directory of Open Access Journals (Sweden)

    Thacker Anup

    2007-01-01

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

  19. 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

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

    OpenAIRE

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

    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 pri...

  1. 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...

  2. 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....

  3. 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. ...

  4. Host-pathogen interactions in bacterial meningitis.

    Science.gov (United States)

    Doran, Kelly S; Fulde, Marcus; Gratz, Nina; Kim, Brandon J; Nau, Roland; Prasadarao, Nemani; Schubert-Unkmeir, Alexandra; Tuomanen, Elaine I; Valentin-Weigand, Peter

    2016-02-01

    Bacterial meningitis is a devastating disease occurring worldwide with up to half of the survivors left with permanent neurological sequelae. Due to intrinsic properties of the meningeal pathogens and the host responses they induce, infection can cause relatively specific lesions and clinical syndromes that result from interference with the function of the affected nervous system tissue. Pathogenesis is based on complex host-pathogen interactions, some of which are specific for certain bacteria, whereas others are shared among different pathogens. In this review, we summarize the recent progress made in understanding the molecular and cellular events involved in these interactions. We focus on selected major pathogens, Streptococcus pneumonia, S. agalactiae (Group B Streptococcus), Neisseria meningitidis, and Escherichia coli K1, and also include a neglected zoonotic pathogen, Streptococcus suis. These neuroinvasive pathogens represent common themes of host-pathogen interactions, such as colonization and invasion of mucosal barriers, survival in the blood stream, entry into the central nervous system by translocation of the blood-brain and blood-cerebrospinal fluid barrier, and induction of meningeal inflammation, affecting pia mater, the arachnoid and subarachnoid spaces. PMID:26744349

  5. 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.

  6. [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

  7. Cerebral blood flow autoregulation in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten

    2001-01-01

    Ph.d. afhandlingen omhandler sammenhængen mellem hjernens blodtilførsel (CBF) og middelarterietrykket (MAP) hos patienter med akut bakteriel meningitis. Hos raske er CBF uafhængig af MAP, hvilket kaldes CBF autoregulation. Svækket autoregulation antages at øge risikoen for cerebral hypoperfusion og...... iskæmi under episoder med lavt MAP, og for cerebral hyperperfusion og vasogent ødem ved højt MAP. CBF autoregulationen undersøgtes hos tyve voksne patienter med akut bakteriel meningitis i den tidlige sygdomsfase (<24 timer efter diagnostisk lumbalpunktur). Idet autoregulationen fandtes svækket hos...... meningitis, men retableres ved klinisk restitution. Autoregulationen kan endvidere delvis retableres ved akut hyperventilation. Fundene har potentiel betydning for valg af supportiv terapi hos patienter med meningitis....

  8. 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

  9. Bacterial meningitis: an update of new treatment options.

    Science.gov (United States)

    Nau, Roland; Djukic, Marija; Spreer, Annette; Ribes, Sandra; Eiffert, Helmut

    2015-11-01

    The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections. PMID:26293166

  10. Meningitis bacteriémica por Pasteurella multocida Pasteurella multocida bacteremic meningitis

    Directory of Open Access Journals (Sweden)

    R. Soloaga

    2008-12-01

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

  11. Predictive Value of Decoy Receptor 3 in Postoperative Nosocomial Bacterial Meningitis

    OpenAIRE

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

    2014-01-01

    Nosocomial bacterial meningitis requires timely treatment, but what is difficult is the prompt and accurate diagnosis of this disease. The aim of this study was to assess the potential role of decoy receptor 3 (DcR3) levels in the differentiation of bacterial meningitis from non-bacterial meningitis. A total of 123 patients were recruited in this study, among them 80 patients being with bacterial meningitis and 43 patients with non-bacterial meningitis. Bacterial meningitis was confirmed by...

  12. 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...

  13. 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

  14. 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.

  15. 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.

  16. Radioactive bromide partition test in early diagnosis of tuberculous meningitis

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

    Ronit, Andreas; Berg, Ronan M G; Bruunsgaard, Helle; Plovsing, Ronni R

    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...

  18. An autopsied case of tuberculous meningitis showing interesting CT findings

    International Nuclear Information System (INIS)

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

  19. Autopsied case of tuberculous meningitis showing interesting CT findings

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-11-01

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

  20. Purulent meningitis with unusual diffusion-weighted MRI findings

    International Nuclear Information System (INIS)

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

  1. Chemical meningitis in metrizamide myelography. A report of seven cases

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-01-01

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

  2. Recent experience of four patients with suppurative meningitis

    International Nuclear Information System (INIS)

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

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. [Tuberculous meningitis presented by altered mental state and hydrocephalus].

    Science.gov (United States)

    von Huth, Sebastian; Pedersen, Court; Johansen, Isik Somuncu

    2015-03-30

    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. PMID:25822950

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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 ...

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Intracerebral tuberculoma in children with tuberculous meningitis.

    Science.gov (United States)

    Altunba?ak, S; Alhan, E; Baytok, V; Aksaray, N; Onenli, N

    1996-01-01

    Not all patients with tuberculosis develop tuberculoma during the disease or antituberculous therapy. Therefore, we compared various parameters in patients with and without tuberculoma and presented the results. We formed two groups from the patients with tuberculous meningitis: Group I consisted of 18 patients with tuberculoma, and Group II consisted of 18 randomly selected patients without tuberculoma. Significant difference between the groups was found with respect to level of consciousness and CSF-glucose level (p < 0.05). The consciousness level was more depressed and the CSF-glucose level more decreased in the group without tuberculoma. These findings were discussed. PMID:8827901

  16. 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

  17. 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.

  18. 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.)

  19. 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

  20. Divided maxillary artery in relation to the lateral pterygoid muscle.

    Science.gov (United States)

    Aland, R Claire; Shaw, Vivien

    2016-03-01

    We describe an anatomical variation of the right maxillary artery. The variation loops deep, giving off a middle meningeal artery with an extremely short extracranial segment, then bifurcates into unequal branches. The smaller branch passes superficial to the lateral pterygoid head and distributes primarily to the masticatory muscles. The larger partially pierces the lateral pterygoid lower head, re-emerges superficially, branches again and passes into the pterygopalatine fossa. The larger lies superficial to the lingual and inferior alveolar nerves and deep to the buccal nerve. An embryonic development origin of the cranial arteries is suggested. PMID:26077959

  1. Experimental bacterial meningitis in rabbit; evaluation with CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jeong Jin; Kang, Heoung Keun; Chu, Sung Nam; Kim, Yun Hyeon; Jeong, Yong Yeon; Chung, Hyon De [Chonnam Univ. Medical School, Kwangju (Korea, Republic of)

    1996-01-01

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

  2. Experimental bacterial meningitis in rabbit; evaluation with CT and MRI

    International Nuclear Information System (INIS)

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

  3. 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)

  4. 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)

  5. 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. PMID:26118835

  6. [Clinical implications of lactic acidosis in purulent meningitis].

    Science.gov (United States)

    Vengerov, Iu Ia; Nagibina, M V; Chentsov, V B; Menushenkova, S A; Molotilova, T N; Migmanov, T E

    2008-01-01

    Lactic acidosis is an integral index of metabolic disturbances and severity of inflammation processes. This study was designed to measure lactate levels in blood and cerebrospinal fluid (CSF), CSF/blood lactate ratio, correlation coefficient between CSF lactate and other CSF parameters in patients with purulent meningitis of different etiology. The study included 112 patients (62 men and 50 women aged 18-70 years) admitted to No2 City Hospital, Moscow, for the treatment of meningococcal and pneumococcal meningitis (40 and 23 respectively), purulent meningitis of unknown etiology (22), staphylococcal sepsis with secondary purulent meningitis (11), serous viral meningitis (9), and non-inflammatory lesions of central nervous system (control group of 7patients). Blood and CSF lactate levels were measured on admittance, days 3- 7and 8-18 after the initiation of therapy. CSF lactate was especially high in patients with primary purulent meningitis having lower blood lactate levels. Patients with sepsis and secondary purulent meningitis had higher lactate levels in plasma than in CSF on admittance and days 8-18 after the onset of therapy; this situation reflects a generalized infectious process. CSF lactate positively correlated with protein content and pleocytosis intensity in the liquor and negatively with the glucose level. Prognosis of the disease depended on the efficiency of antibacterial therapy. PMID:19069459

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Tatiana Barichello

    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 artificial 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.

  9. 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.

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

    International Nuclear Information System (INIS)

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

  11. 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...

  12. 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...

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

    Directory of Open Access Journals (Sweden)

    A. Nagel

    2008-09-01

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

  14. 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...

  15. 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.

  16. 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.

  17. 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

  18. Tuberculous and brucellosis meningitis differential diagnosis

    DEFF Research Database (Denmark)

    Erdem, Hakan; Senbayrak, Seniha; Gencer, Serap; Hasbun, Rodrigo; Karahocagil, Mustafa Kasim; Sengoz, Gonul; Karsen, Hasan; Kaya, Selçuk; Civljak, Rok; Inal, Ay?e Seza; Pekok, Abdullah Umut; Celen, Mustafa Kemal; Deniz, Secil; Ulug, Mehmet; Demirdal, Tuna; Namiduru, Mustafa; Tekin, Recep; Guven, Tumer; Parlak, Emine; Bolukcu, Sibel; Avci, Meltem; Sipahi, O?uz Re?at; Nayman-Alpat, Saygin; Ya?ar, Kadriye; Pehlivano?lu, Filiz; Yilmaz, Emel; Ates-Guler, Selma; Mutlu-Yilmaz, Esmeray; Tosun, Selma; Sirmatel, Fatma; ?ahin-Horasan, Elif; Johansen, Isik Somuncu; Akbulut, Ayhan; Simeon, Soline; Batirel, Ay?e; Öztoprak, Nefise; Cag, Yasemin; Catroux, Melanie; Hansmann, Yves; Kadanali, Ayten; Turgut, Huseyin; Baran, Ali Irfan; Gul, Hanefi Cem; Karaahmetoglu, Gokhan; Sunnetcioglu, Mahmut; Haykir-Solay, Asli; Denk, Affan; Ayaz, Celal; Kose, Sukran; Gorenek, Levent

    2015-01-01

    BACKGROUND: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the...... differential diagnosis of TBM when these two systems suggest the presence of TBM. METHOD: BME and TBM patients from 35 tertiary hospitals were included in this study. Overall 294 adult patients with BME and 190 patients with TBM were enrolled. All patients involved in the study had microbiological confirmation...... for either TBM or BME. Finally, the Thwaites and Lancet scoring systems were assessed in both groups. RESULTS: The Thwaites scoring system more frequently predicted BME cases (n = 292, 99.3%) compared to the TBM group (n = 182, 95.8%) (P = 0.017). According to the Lancet scoring system, the mean...

  19. Meningitis granulomatosa, glomerulonefritis rápidamente progresiva y vasculitis

    Directory of Open Access Journals (Sweden)

    Ana Ludueña

    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 de Wegener que debutó con compromiso de vías aéreas superiores, oídos, órbitas y meningitis granulomatosa asintomática y que posteriormente evolucionó con mononeuritis múltiple y glomerulonefritis crescéntica ANCA positiva. La presencia de ANCA y el compromiso sistémico (vías aéreas superiores, oído, órbitas, nervios periféricos, duramadre y glomerulonefritis rápidamente progresiva permitieron en este caso llegar a un diagnóstico de certeza e iniciar el tratamiento inmunosupresor combinado (corticoides y ciclofosfamida. Evolucionó con remisión clínica y serológica (negativización de ANCA, pero persistiendo leve deterioro secuelar auditivo y de la función renal, sin recidiva de la enfermedad de base.

  20. 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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Stoši?-Opin?al Tatjana

    2005-01-01

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

  3. 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.

  4. 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 ...

  5. 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...

  6. 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...

  7. Meningitis as a primary presentation of dengue infection

    OpenAIRE

    Bhat, Ramesh Y; Chaitanya Varma

    2013-01-01

    Dengue fever is the most prevalent arboviral infection in the world that is transmitted by mosquitoes. It is an acuteillness of sudden onset that usually follows a benign course with symptoms such as headache, fever and rash. Centralnervous system manifestations of dengue infection are usually rare. Here, a Dengue case with meningitis as primarymanifestation has been presented. J Microbiol Infect Dis 2013; 3(1): 39-40Key words: Meningitis, presentation, Dengue

  8. Computed tomography in cases of coccidioidal meningitis, with clinical correlation

    International Nuclear Information System (INIS)

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

  9. 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.

  10. 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...

  11. 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.

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

    OpenAIRE

    Maria Bruna Pasticci; Maurizio Paciaroni; Piero Floridi; Enisia Cecchini; Franco Baldelli

    2013-01-01

    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 ...

  13. Tuberculous meningitis: presenting as isolated complete III nerve palsy

    OpenAIRE

    Laul Rohit S , Avhad Vinod, Laul Abhishek S, Laul Subodh S

    2013-01-01

    Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality. TBM is a subacute disease with symptoms that may persist for weeks before diagnosis. Based on the clinical features alone, the diagnosis of TBM can neither be made nor excluded with certainty. A high clinical suspicion and vigilance is required for early diagnosis of TBM. The present case report demonstrates a patient with TB meningitis, who presented wit...

  14. Diagnostic features of tuberculous meningitis: a cross-sectional study

    OpenAIRE

    Pasco Paul

    2012-01-01

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

  15. 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.

  16. 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.

  17. 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...

  18. Meningitis as a primary presentation of Dengue infection

    Directory of Open Access Journals (Sweden)

    Ramesh Y Bhat

    2013-03-01

    Full Text Available Dengue fever is the most prevalent arboviral infection in the world that is transmitted by mosquitoes. It is an acuteillness of sudden onset that usually follows a benign course with symptoms such as headache, fever and rash. Centralnervous system manifestations of dengue infection are usually rare. Here, a Dengue case with meningitis as primarymanifestation has been presented. J Microbiol Infect Dis 2013; 3(1: 39-40Key words: Meningitis, presentation, Dengue

  19. 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 ...

  20. 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...

  1. 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...

  2. 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...

  3. Ambulant neuropsykologisk opfølgning af patienter indlagt med aseptisk meningitis

    DEFF Research Database (Denmark)

    Damsgaard Gunst, Jesper; Klostergaard, Kirsten Rose; Leutscher, Peter Derek Christian

    2014-01-01

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

  4. 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 ...

  5. 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

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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.

  11. Criteria indicating morbidity in tuberculous meningitis

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-07-01

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

  13. [Responding to Arterial Perforation during Endovascular Neurosurgery].

    Science.gov (United States)

    Muraoka, Kenichiro; Tomita, Yosuke; Kuwahara, Ken; Takahashi, Yu; Okuma, Yu; Tanabe, Tomoyuki; Meguro, Toshinari; Hirotsune, Nobuyuki; Nishino, Shigeki

    2015-11-01

    During endovascular neurosurgery, various devices, such as catheters, are passed through the intracranial arteries to access target vessels;the arteries can thereby be perforated. Even though such incidents are serious and should be dealt with appropriately, few case reports or standard procedures have been published. Herein, we report two cases of arterial perforation that occurred recently in our hospital. In the first case, the patient had been treated preoperatively using feeder occlusion of an arteriovenous malformation;the microcatheter perforated the feeder, which branched from the middle cerebral artery. The feeder and perforation site were occluded by injection of n-butyl 2-cyanoacrylate(NBCA)through the same microcatheter, and complete hemostasis was thereby achieved. The second case occurred during an embolization of the middle meningeal artery(MMA)to treat a refractory chronic subdural hematoma;the microcatheter perforated a branch of the MMA. Both the perforation and the artery were embolized using platinum coils and by injecting NBCA, and hemostasis was achieved. Considering the anatomical and pathological properties of the injured vessels, favorable results were achieved with appropriate intervention. PMID:26549717

  14. [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

  15. 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.

  16. 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.

  17. Diagnosis of tuberculous meningitis: challenges and promises.

    Science.gov (United States)

    Philip, N; William, T; William, D V

    2015-04-01

    Tuberculosis (TB) which is caused by Mycobacterium tuberculosis infects primarily the lungs but it also affects other parts of the body. Tuberculous meningitis (TBM) is the most severe form of TB and has the highest mortality and morbidity rate compared to other forms of TB. It is common in young children and HIV-infected patients, but is also seen in adults. Despite anti-tuberculosis treatment, TBM is still a major cause of death and neurological sequelae as treatment given to the patients is often delayed. Early diagnosis is challenging due to the non-specific symptoms of TBM and the low number of tubercle bacilli in cerebrospinal fluid (CSF). Until now, there is no established diagnostic method that can rapidly detect M. tuberculosis in TBM patients with high sensitivity and specificity. The emergence of drug resistant M. tuberculosis strains further complicates the diagnosis and treatment regimen of TBM. This review summarizes challenges of the currently used diagnostic methods and the potential future use of molecular diagnostic methods for TBM. PMID:25890607

  18. Differential diagnosis of tuberculous meningitis from partially-treated pyogenic meningitis by cell ELISA

    Directory of Open Access Journals (Sweden)

    Purohit Hemant J

    2004-10-01

    Full Text Available Abstract Background Tuberculous meningitis (TBM is a major global health problem, and it is sometimes difficult to perform a differential diagnosis of this disease from other diseases, particularly partially-treated pyogenic meningitis (PTPM. In an earlier study, we demonstrated the presence of a 30-kD protein antigen in cerebrospinal fluid (CSF of TBM patients. We have also shown that lymphocytes from CSF of TBM patients respond differently to this antigen than do those from PTPM patients. The purpose of this study was to develop an assay that can discriminate between TBM and PTPM. Methods We developed a cell enzyme-linked immunosorbant assay (Cell ELISA to quantitatively measure production of antibodies against the 30-kD protein in B cells from CSF of TBM and PTPM patients. Results The cell ELISA yielded 92% (11/12 sensitivity and 92% (11/12 specificity for the differential diagnosis of TBM from PTPM. Conclusion When induced with the 30-kD protein antigen, B cells derived from CSF of TBM patients respond to IgG production within 24 h while those derived from PTPM patients do not respond.

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

    OpenAIRE

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

    1988-01-01

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

  20. Bakteriel meningitis i Danmark 2002 og 2003. Landsdaekkende registrering baseret på laboratoriedata

    DEFF Research Database (Denmark)

    Meyer, Christian N; Schønheyder, Henrik Carl; Bangsborg, Jette Marie; Nielsen, Xiaohui C; Møller, Jens K; Mølbak, Kåre; Korshin, André; Rønneberg, Elisabeth; Køster-Rasmussen, Rasmus; Høiby, Niels

    2007-01-01

    Notification of bacterial meningitis (BM) is likely to be incomplete, and a recent Danish study indicated that unbalanced notification may bias expected aetiology of BM. Therefore the Danish Bacterial Meningitis Group initiated a national registration of culture-positive BM....

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

    International Nuclear Information System (INIS)

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

  2. Long-term mortality in children diagnosed with Haemophilus influenzae meningitis: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

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

    2011-01-01

    The long-term mortality in children diagnosed with Haemophilus influenzae meningitis is poorly documented.......The long-term mortality in children diagnosed with Haemophilus influenzae meningitis is poorly documented....

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

    Science.gov (United States)

    ... gov . Vaccines and Immunizations Share Compartir Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants ... which may increase their risk for meningitis. Pneumococcal Vaccine Recommendations Pneumococcal Vaccination for Cochlear Implant Candidates and ...

  4. 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

  5. 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

  6. MRI features of meningeal metastasis from lung cancer

    International Nuclear Information System (INIS)

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

  7. 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...

  8. 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 ...

  9. 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...

  10. 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...

  11. 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.

  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. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. Epidemiología de la meningitis Una visión socio-epidemiológica

    Directory of Open Access Journals (Sweden)

    Arturo Morales Bedoya

    2006-01-01

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

  20. Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Sarah T. Garber

    2012-01-01

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

  1. Progress towards meningitis prevention in the conjugate vaccines era

    Directory of Open Access Journals (Sweden)

    Cristina Aparecida Borges Laval

    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 conjugate vaccines in the beginning of the 90's, especially type b H. influenzae (Hib, and more recently the heptavalent pneumococcal and the serogroup C meningococcal vaccines, have contributed directly to changes in the epidemiological profile of these invasive diseases (direct effect and of their carriage status (indirect effect. We review the impact of the Hib conjugate vaccine in Latin American countries, where this vaccine has been implemented, and the potential of pneumococcal and meningococcal conjugate vaccines for the reduction of meningitis worldwide. We also address constraints for the development and delivery of these vaccines and review new candidate state-of-the-art vaccines. The greatest challenge, undoubtedly, is to implement these vaccines worldwide, especially in the developing regions.

  2. 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.

  3. Computed tomography of granulomatous basal meningitis caused by pneumococcus

    International Nuclear Information System (INIS)

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

  4. 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.)

  5. Cat scratch disease complicated with aseptic meningitis and neuroretinitis

    Directory of Open Access Journals (Sweden)

    Vitor Laerte Pinto Jr.

    2008-04-01

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

  6. 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

  7. 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.

  8. 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

  9. Meningitis tuberculosa en adultos: Análisis de 53 casos Tuberculous meningitis in adults: review of 53 cases

    Directory of Open Access Journals (Sweden)

    Margarita Enberg G

    2006-06-01

    Full Text Available La meningitis tuberculosa (MTBC es la forma más grave de tuberculosis extrapulmonar. El amplio espectro del cuadro clínico y su poca especificidad difícultan su diagnóstico precoz, relacionándose directamente con mayor letalidad. El objetivo de este estudio es analizar las características clínicas de los pacientes con diagnóstico de MTBC en el Hospital de Enfermedades Infecciosas Dr. Lucio Córdova, de Santiago, Chile, entre 1995 y 2002. Se estudiaron 53 casos de MTBC en adultos, con una edad mediana de 39 años. Al ingreso 66% de los pacientes presentaba algún grado de compromiso de conciencia, pero sólo 30% la tríada sintomática clásica. El LCR mostró aumento de proteínas, glucosa baja y linfocitosis, en la mayoría de los casos. Treinta por ciento de los pacientes presentó co-infección con VIH; la letalidad en este grupo de pacientes fue mayor, 31 vs 17% del total de la muestra. La MTBC continúa siendo una enfermedad vigente. El diagnóstico de certeza precoz de esta patología no es posible con los métodos actuales, por lo que la sospecha clínica es importanteTuberculous Meningitis (TBM is the most severe form of extrapulmonary tuberculosis. The clinical spectrum is broad and may be non-specific making early diagnosis difficult. This increases the incidence of mortality. We decribe the clinical characteristics of patients with TBM in the Dr. Lucio Córdova´s Infectious Disease Hospital in Santiago, Chile, between 1995 and 2002. We review 53 adult cases of TBM, with a median age of 39 years. At admission 66% of the patients had some mental status deterioration, and the classic triad of symptoms of meningeal irritation was present only in 30%. The cerebrospinal fluid (CSF examination showed increased protein level, low glucose level and lymphocytic pleocytosis in most. Thirty percent of the patients were coinfected with HIV. The mortality in the later group was greater than in the TBM population as a whole (31 vs 17%. TBM is still a present diagnostic problem, in spite of the new diagnostic methods. A high index of suspicion is required in order to make an early diagnosis

  10. 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...

  11. Brain CT scanning of children with purulent meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Mishima, M.; Suzuki, M.; Nagata, M.; Kawamura, G.

    1986-12-01

    Nine of 21 children with purulent meningitis showed abnormal findings in brain CT when admitted. All of the abnormal group were less than 12 months of age, but 75 % of the normal group were more than 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 similarly in both groups, it may be difficult to determine the organic changes of the brain clinically. Brain CT scanning is recommended as soon as possible after the onset of purulent meningitis.

  12. 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)

  13. Prevalence and antimicrobial resistance pattern of bacterial meningitis in Egypt

    Directory of Open Access Journals (Sweden)

    Shaban Lamyaa

    2009-09-01

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

  14. 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.

  15. 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.

  16. 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.

  17. 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.).

  18. Group A streptococcal meningitis in a patient with palmoplantar pustulosis.

    Science.gov (United States)

    Hagiya, Hideharu; Otsuka, Fumio

    2013-01-01

    A 64-year-old man with a 10-year history of palmoplantar pustulosis, a recent history of cranial surgery and a persistent upper airway infection presented with a high fever and deep coma. The patient was diagnosed with Group A Streptococcal meningitis and promptly treated with antibiotics. Although his general condition recovered well, sensorineural hearing loss and facial palsy remained. Group A Streptococcal meningitis is a rare condition, and its typical clinical picture and epidemiological features remain poorly understood. Physicians need to be more aware of this infection, which is extremely rare but frequently causes various complications and yields a high mortality. PMID:24292762

  19. Spinal Extradural Meningeal Cyst in Klippel-Trenaunay Syndrome

    OpenAIRE

    Choi, Kyung-Chul; Ahn, Sung Tae; Shin, Yong Hawn; Lee, Sang-Ho

    2011-01-01

    A case of a symptomatic spinal extradural meningeal cyst (SEMC) in Klippel-Trenaunay syndrome (KTS) is introduced. A 38-year-old woman presented with right L2 radiculopathy. She underwent operations for varicose veins in both her lower extremities. She had port-wine nevi on her trunk and extremities. The edematous change in both legs had waxed and waned. Magnetic resonance imaging showed an 11.8×13 mm extradural meningeal cyst growing through the intervertebral foramen in L2-3. Multiple menin...

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

    Directory of Open Access Journals (Sweden)

    Danais Vidal Rosell

    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.BACKGROUND: Lactococcus lactis cremoris is a bacteria from Streptococcaceae family that may usually be isolated as part of transient or residing microbiota in the human gastrointestinal tract. It is considered essential element in the food industry where it is used as milk fermenter to obtain byproducts such as cheese, yoghurt, butter and others. OBJECTIVES: this is the first report of an adult patient with bacterial meningitis by L. lactis, without a previous history of immunosuppresion. METHODS: the evolution of a 73 years-old female patient, who came to the Emergency Department with a very acute clinical picture of behavioural disorders like irritability, immediately evolving into obnulation condition and lack of proper orientation. The conventional identification techniques together with the antimicrobial sensitivity studies allowed making the microbiological diagnosis. RESULTS: bacterial meningitis caused by L. lactis was diagnosed. This bacterium is linked to infectious processes mainly in pediatric and inmmunosuppresed patients. CONCLUSIONS: the mode of transmission is indirect and orally. The primary focus of infection from which the virus disseminated inside the body was not found. It was considered then that it occurred according to the anatomical location of the sites where sepsis signs were found. According to the data provided by the patient´s medical history, not a single antecedent of compromised immunity was found before appearing the above-mentioned clinical picture.

  1. 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.

  2. Using Relative Humidity Forecasts to Manage Meningitis in the Sahel

    Science.gov (United States)

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

    2012-12-01

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

  3. Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis

    DEFF Research Database (Denmark)

    Sporrborn, Janni L; Baunbæk-Knudsen, Gertrud Louise; Sølling, Mette; Seierøe, Karina; Farre, Annette; Lindhardt, Bjarne Ø; Benfield, Thomas; Brandt, Christian T

    2015-01-01

    BACKGROUND: Experimental studies suggest that changes in brain ventricle size are key events in bacterial meningitis. This study investigated the relationship between ventricle size, clinical condition and risk of poor outcome in patients with bacterial meningitis. METHODS: Adult patients diagnosed...... with bacterial meningitis admitted to two departments of infectious diseases from 2003 through 2010 were identified. Clinical and biochemical data as well as cerebral computed tomographic images were collected. The size of the brain ventricles were presented as a Ventricle to Brain Ratio (VBR). Normal...... marked changes in size as a consequence of meningitis. Increased brain ventricle size in the acute phase of bacterial meningitis was associated with increased mortality....

  4. 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

  5. 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.

  6. Arterial embolism

    Science.gov (United States)

    ... the affected artery Shedding (sloughing) of skin Skin erosion ( ulcer ) Tissue death (necrosis; skin is dark and ... of the following tests: Euglobulin lysis time (ELT) Factor VIII assay Isotope study of the affected organ ...

  7. [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

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Variations of relative humidity in relation to meningitis in Africa

    Science.gov (United States)

    Seefeldt, M. W.; Hopson, T. M.

    2011-12-01

    The meningitis belt is a region covering Sub-Saharan Africa from the Sahel of West Africa eastward to western Ethiopia. The region is prone to meningitis epidemics during the dry season extending from approximately January to May, depending on the region. Relative humidity has been found to be a critical environmental factor indicating the susceptibility of a region to meningitis epidemics. This study evaluates the variation of relative humidity across West Africa over 30 dry-seasons (1979 - 2009) using the NASA-MERRA dataset. The method of self-organizing maps is employed to characterize the changes in relative humidity patterns across the region within a given dry season as well as changes over the 30 years. A general pattern of changes in relative humidity is indicated as the rainbelt retreats to the south at the onset of the dry season and then returns to the region at the end of the dry season. Within each dry season there is a unique pattern. The climatological conditions of relative humidity at the onset of the dry season provide an indication of the moisture environment for the entire dry season. Year to year variation in the relative humidity patterns are found to be gradual. Future applications involve using the results from the SOM evaluation to be used for future decisions involving prevention of meningitis epidemics.

  13. 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.

  14. 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.

  15. Diffusion-weighted imaging in acute bacterial meningitis in infancy

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-09-01

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

  16. Diffusion-weighted imaging in acute bacterial meningitis in infancy

    International Nuclear Information System (INIS)

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

  17. Ovarian small cell carcinoma complicated by carcinomatous meningitis

    Directory of Open Access Journals (Sweden)

    Terukazu Ishii

    2012-04-01

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

  18. Streptococcal Meningitis Resulting from Contact with an Infected Horse

    OpenAIRE

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

    2001-01-01

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

  19. Stroke in a Patient with Tuberculous Meningitis and HIV Infection

    OpenAIRE

    Pasticci, Maria Bruna; Paciaroni, Maurizio; Floridi, Piero; Cecchini, Enisia; Baldelli, Franco

    2013-01-01

    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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

    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...

  4. Meningitis due to aeromonas hydrophila

    OpenAIRE

    Seetha K; Jose B; Jasthi A

    2004-01-01

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

  5. 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

  6. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  7. 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.

  8. 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

  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. 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.

  11. 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.

  12. Subdural collections associated with pediatric bacterial meningitis MR imaging

    International Nuclear Information System (INIS)

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

  13. A case of multiple intracranial tuberculomas accompanied by tuberculous meningitis

    International Nuclear Information System (INIS)

    A 63-year-old man was admitted for headache and progressive drowsiness. In spite of negative results from cerebrospinal fluid (CSF) stains and cultures of tuberculosis and other bacteria, CSF findings and tuberculosis-positive sputum culture led to a tentative diagnosis of tuberculous meningitis. Symptoms and neurological test results both improved remarkably during antituberculous chemotherapy. Although the brain CT scan taken on admission showed no abnormal findings, one taken two months later revealed multiple high-density areas after enhancement with a contrast medium, suggesting multiple intracranial tuberculomas accompanied by tuberculous meningitis. The size of the multiple high-density areas gradually decreased during antituberculous chemotherapy. The CT scan can clearly locate lesions, detect complications, and evaluate the effects of treatment in patients with intracranial tuberculosis. (author)

  14. Tuberculoma and Meningitis in a Young Girl: A Case Report

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    Behroz Ahssan

    2012-01-01

    Full Text Available Problem statement: Because of difficulty in early diagnosis and severe consequences of delay in diagnosis and treatment, tuberculosis meningitis is a serious problem for clinicians. Therefore recognizing rare cases of tuberculosis can improve clinician practice and save the patient's life in countries with a high burden of disease. An 18-year-old girl suffered from fever, headache, illness, arthralgia, myalgia, constipation and weight loss for several weeks. On clinical exam, lethargy, Strabismus, neck stiffness, papilledema, bilateral cranial nerve VI palsy and left facial nerve palsy were observed. Pleocytosis in CSF and multiple small nodular enhancements was detected within the cerebellum. The anti-tuberculosis plus corticosteroid were prescribed. Conclusion/Recommendations: In TB high burden regions such as Iran and Middle East, clinical diagnosis is an important tool for making decisions about such cases. Though using corticosteroids in tuberculosis meningitis are still controversial, we recommend it strongly.

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

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    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.

  16. 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.

  17. 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

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

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    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

  19. 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.)

  20. 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.

  1. 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 ...

  2. Meningitis Associated with Brucella abortus in an Aborted Bovine Foetus

    OpenAIRE

    ÇET?N, Cengiz

    2004-01-01

    In this study, the brain and other organs from an aborted bovine foetus were examined histopathologically and microbiologically. In addition, a serum sample from the aborting cow was examined serologically. A granulomatous inflammation, characterised by the infiltration of lymphocytes, plasma cells with some neutrophils and macrophages was observed in the meninges of the brain, liver and kidney. Brucella abortus biovar 1 was isolated in pure culture from the brain and other organs. The serum ...

  3. 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...

  4. 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...

  5. Molecular Detection of Common Bacterial Pathogens Causing Meningitis

    Directory of Open Access Journals (Sweden)

    H Sadighian

    2009-03-01

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

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

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    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. 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...

  8. Characteristics of tuberculous meningitis in HIV-infected patients

    OpenAIRE

    Hristea, A; C Manciuc; E Zaharia-Kezdi; C Dorobat; Arbune, M; Olaru, I; R Jipa; Niculescu, I.; Streinu-Cercel, A.

    2012-01-01

    Background: Tuberculous meningitis (TBM) has a substantial mortality even with anti-tuberculous treatment, in HIV-non-infected patients. Purpose of the study. The objectives were to describe clinical and laboratory differences of TBM in HIV-infected versus HIV non-infected patients and to assess risk factors of death in HIV-infected patients. Methods: We retrospectively analyzed patients admitted to four infectious diseases hospitals in Romania, between 2001 and 2011, with TBM. Patients were ...

  9. Prognostic factors of tuberculous meningitis: a single-center study

    OpenAIRE

    Gu, Jin; Xiao, Heping; Wu, Furong; Ge, Yanping; MA, JUN; Sun, Wenwen

    2015-01-01

    Objective: To investigate the prognostic factors of tuberculous meningitis (TBM) and develop strategies for the improvement of clinical efficacy. Methods: A total of 156 TBM patients were retrospectively reviewed. The demographic characteristics, underlying diseases, clinical features, laboratory findings, bacteriologic test, images, use of steroids, mannitol and anti-TB drugs, surgery or drainage, and clinical outcomes were collected and analyzed. Results: Patients with tubercle bacillus in ...

  10. Tuberculous meningitis in Denmark: a review of 50 cases

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    Andersen Peter H

    2011-02-01

    Full Text Available Abstract Background Tuberculous meningitis is the most severe manifestation of extrapulmonary tuberculosis with a high mortality rate and a high rate of sequelae among survivors. The aim of this study is to assess the current epidemiology, clinical features, diagnostic procedures, treatment and outcome in patients with tuberculous meningitis in Denmark, a country with a low tuberculosis incidence. Methods A nationwide retrospective study was conducted, comprising all patients notified with tuberculous meningitis (TBM in Denmark from 2000-2008. Medical records were reviewed using a standardised protocol. Results Fifty patients, including 12 paediatric patients, were identified. 78% of the patients were immigrants from countries of high tuberculosis endemicity. 64% of all patients had a pre-existing immunosuppressive condition; 10% were HIV positive, 48% were HIV seronegative and 42% had an unknown HIV status. Median symptom duration before admission was 14 days in the Danish patient population and 20 days in the immigrant group. Biochemical analysis of cerebrospinal fluid (CSF samples revealed pleocytosis in 90% with lymphocyte predominance in 66%. Protein levels were elevated in 86%. The most common findings on neuro-radiological imaging were basal meningeal enhancement, tuberculomas and hydrocephalus. Lumbar puncture was performed on 42 patients; 31 of these specimens (74% had a positive CSF culture for mycobacteria and 9.5% were smear positive for acid-fast bacilli. The overall mortality rate was 19% and 48% of the remaining patients had neurological sequelae of varying degree. Conclusion TBM is a rare but severe manifestation of extrapulmonary TB in Denmark. The clinician must be prepared to treat empirically if the suspicion of TBM has arisen to improve treatment outcome.

  11. Tuberculous Meningitis: A Comparison of Scoring Systems for Diagnosis

    OpenAIRE

    Roshan Kurien; Thambu David Sudarsanam; Samantha S; Kurien Thomas

    2013-01-01

    Objectives: Tuberculous meningitis (TBM) is a major clinical and public health problem, both for diagnosis and management. We compare two established scoring systems, Thwaites and the Lancet consensus scoring system for the diagnosis of TB and compare the clinical outcome in a tertiary care setting.Methods: We analyzed 306 patients with central nervous system (CNS) infection over a 5-year period and classified them based on the unit’s diagnosis, the Thwaites classification as well as the newe...

  12. Multi Drug Resistant Tuberculous Meningitis in Pediatric Age Group

    OpenAIRE

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

    2008-01-01

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

  13. Tuberculous meningitis in BCG vaccinated and unvaccinated children

    OpenAIRE

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

    2005-01-01

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

  14. Vascular complications of tuberculous meningitis: An autopsy study

    OpenAIRE

    Debajyoti Chatterjee; Bishan Dass Radotra; Rakesh Kumar Vasishta; Kusum Sharma

    2015-01-01

    Aims: Vascular complications have the most serious consequences in patients with tuberculous meningitis (TBM). Although stroke is seen in approximately 20% of patients with TBM, the underlying vascular damage and infarction are much more extensive. This study has been undertaken to study the pathology at different levels of cerebral vessels and their resultant complications in TBM. Materials and Methods: Fifty-one postmortem TBM brains were examined over a period of 16 years (1997–2012). T...

  15. Immunocytochemical Method for Early Laboratory Diagnosis of Tuberculous Meningitis

    OpenAIRE

    Sumi, M. G.; Mathai, A.; Reuben, S.; Sarada, C.; V V Radhakrishnan

    2002-01-01

    A simple immunocytochemical method was standardized for the direct demonstration of mycobacterial antigen in cerebrospinal fluid (CSF) specimens of patients with tuberculous meningitis (TBM). CSF-cytospin smears were prepared from 22 patients with a clinical diagnosis of TBM and also from an equal number of patients with nontuberculous neurological diseases (disease control). Immunocytological demonstration of mycobacterial antigens in the cytoplasm of monocytoid cells was attempted, by using...

  16. Streptococcus salivarius meningitis after dental care: case report

    OpenAIRE

    Maira Zoppelletto; Dario Cesco; Dina Bonini; Alessandra Dinale; Maria Frizzo; Gilberto Lorenzin; Elide Marcon; Alessandra Vigolo; Francesco Malfa; Giorgio Da Rin

    2012-01-01

    Introduction. Streptococcus salivarius is a common commensal of the oral mucosa, associated with infections in different sites. Meningitis due to this species are described in a few occasions . In this study refer to a case recently diagnosed in our hospital for treatment of a subsequent dental caries. Case report. A man of 35 years, presents to the emergency room with fever, headache, confusion, marked nuchal rigor.Anamnesis is the treatment of dental caries on the previous day.The blood cou...

  17. 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...

  18. 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...

  19. 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

  20. 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 ...

  1. 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. 

  2. 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%...

  3. Bacterial meningitis as a first presentation of pituitary macroprolactinoma

    OpenAIRE

    Margari, Niki; Page, Simon

    2014-01-01

    A 56-year-old man was brought to the Emergency Department after being found collapsed at his office with a reduced level of consciousness. From clinical examination and initial investigations, he was diagnosed as having bacterial meningitis and was promptly commenced on empirical i.v. antibiotics. Computed tomography of the brain revealed a parenchymal mass at the base of the skull and subsequent magnetic resonance imaging of the head 4 days later confirmed a large soft tissue mass, which ext...

  4. 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.

  5. Meningitis due to Stenotrophomonas maltophilia after a Neurosurgical Procedure

    OpenAIRE

    Sood, Smita; Vaid, Vivek Kumar; Bhartiya, Hemant

    2013-01-01

    Stenotrophomonas maltophilia is an aerobic, glucose non- fermentative, gram negative bacillus, which is being increasingly recognized as a cause of serious infections such as bacteraemia, urinary tract infections, respiratory tract infections, skin and soft tissue infections, endocarditis, meningitis and ocular infections in hospitalized patients. The treatment of invasive S. maltophilia infections is difficult, as this pathogen shows high levels of intrinsic or acquired resistance to differe...

  6. Tuberculous Meningitis in Adults: A Review of 160 Cases

    OpenAIRE

    Filiz Pehlivanoglu; Kadriye Kart Yasar; Gonul Sengoz

    2012-01-01

    Objective. This study aimed to evaluate epidemiological, clinical, laboratory, and neuroimaging features of 160 adult patients with tuberculous meningitis (TBM) according to “Thwaites' diagnostic index.” Methods. The subjects of this retrospective study are the patients with TBM who were followed up between years 1998 and 2009 in a tertiary referral hospital. Diagnosis of TBM was based on clinical, laboratory, and neuroimaging signs and Thwaites' diagnostic index. Results. Mycobacterium tuber...

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

    OpenAIRE

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

    2014-01-01

    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 artificial 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:...

  8. Vaccination against meningitis B: is it worth it?

    Directory of Open Access Journals (Sweden)

    Peter English

    2013-01-01

    Full Text Available Summary: when a new vaccine is licensed having passed the tests for efficacy and safety, governments who have to pay for it to be used, as in the UK, will carry out a careful economic appraisal before making it generally available. In this challenging article, Dr Peter English discusses whether or not a new vaccine for meningitis that has just been licensed and that could save lives is actually worth it.

  9. 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...

  10. 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...

  11. Intratympanic steroid prevents long-term spiral ganglion neuron loss in experimental meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Brandt, C.T.; Lund, S.P.; Andersen, Christian Østergaard; Thomsen, J.; Caye-Thomasen, P.

    2010-01-01

    Hypothesis: Intratympanic steroid treatment prevents hearing loss and cochlear damage in a rat model of pneumococcal meningitis. Background: Sensorineural hearing loss is a long-term complication of meningitis affecting up to a third of survivors. Streptococcus pneumoniae is the bacterial species...... betamethasone treatment prevents long-term spiral ganglion neuron loss in experimental pneumococcal meningitis. This finding is clinically relevant in relation to postmeningitic hearing rehabilitation by cochlear implantation. However, the drug instillation in the middle ear induced local fibrosis and a...

  12. Phenotypic Characterization and Antibiogram of CSF Isolates in Acute Bacterial Meningitis

    OpenAIRE

    Modi, Syamal; Anand, Amit Kumar

    2013-01-01

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

  13. Sequelae due to bacterial meningitis among African children: a systematic literature review

    OpenAIRE

    Moïsi Jennifer C; Steinhardt Laura C; Ulland Aaron J; Ramakrishnan Meenakshi; Were Fred; Levine Orin S

    2009-01-01

    Abstract Background African children have some of the highest rates of bacterial meningitis in the world. Bacterial meningitis in Africa is associated with high case fatality and frequent neuropsychological sequelae. The objective of this study is to present a comprehensive review of data on bacterial meningitis sequelae in children from the African continent. Methods We conducted a systematic literature search to identify studies from Africa focusing on children aged between 1 month to 15 ye...

  14. Bacterial meningitis in HIV-infected patients: Case reports and review of the literature

    OpenAIRE

    Tommasini, Robert; Fong, Ignatius W

    1992-01-01

    Meningitis is not an uncommon complication of the acquired immune deficiency syndrome. Purulent meningitis is not a well recognized infection in human immunodeficiency virus (HIV) positive patients. Three cases of bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis and Listeria monocytogenes are presented. These cases illustrate that common community organisms may present in HIV positive patients. An acquired B cell defect may predispose to bacterial infections res...

  15. Streptococcus pneumoniae meningitis in Alberta pre- and postintroduction of the 7-valent pneumococcal conjugate vaccine

    OpenAIRE

    Johnstone, Jennie; Tyrrell, Gregory J; Marrie, Thomas J.; Garg, Sipi; Kellner, James D; the Streptococcus pneumoniae Alberta Team

    2011-01-01

    The objective of this study was to describe the epidemiology, clinical characteristics, microbiology and outcomes of patients of all ages with Streptococcus pneumoniae meningitis between 2000 and 2004; two years pre- and postintroduction of an S pneumoniae 7-valent conjugate vaccine program in Alberta in children younger than two years of age. The high mortality rate associated with S pneumoniae meningitis, despite appropriate therapy, suggests that prevention of S pneumoniae meningitis is cr...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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 ...

  1. 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...

  2. 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

  3. 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

  4. 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.

  5. 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)

  6. 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.)

  7. 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.)

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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.)

  15. Adenosine deaminase levels in cerebrospinal fluid as a diagnostic test for tuberculous meningitis in children

    OpenAIRE

    Rana, Satya Vati; Singhal, Raj Kumar; Singh, Kartar; Kumar, Lata

    2004-01-01

    Adenosine deaminase activity (ADA) was estimated in cerebrospinal fluid (CSF) of 30 patients of tuberculous meningitis (TBM) and 10 patients each of partially treated pyomeningitis (PTM), aseptic meningitis (AM) and pyogenic meningitis (PM). Mean ADA levels in CSF of TBM patients were higher (18.22 U/L) as compared to 6.28 U/L, 3.43 U/L and 7.98 U/L in PTM, AM and PM respectively. This difference of ADA values in CSF between TBM and other types of meningitis was statistically significant (p

  16. 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...

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

    Scientific Electronic Library Online (English)

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

    2001-09-01

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

  18. 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

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

    DEFF Research Database (Denmark)

    Liu, Y.; Broman, J.; Edvinsson, L.

    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....... 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...

  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

    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...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-10-01

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

  3. 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...

  4. 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...

  5. Cryptococcus neoformans meningitis with negative cryptococcal antigen: Evaluation of a new immunochromatographic detection assay

    OpenAIRE

    O. Opota; Desgraz, B.; Kenfak, A.; Jaton, K; Cavassini, M.; Greub, G.; Prod'hom, G; Giulieri, S.

    2014-01-01

    Detection of cryptococcal antigen in serum or cerebrospinal fluid allows cryptococcal meningitis diagnosis within few hours with >90% sensitivity. In an HIV-positive patient with Cryptococcus neoformans meningitis, initial antigen detection by immunoagglutination was negative. We thus evaluated a new immunochromatographic detection assay that exhibited a higher sensitivity.

  6. '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.)

  7. 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

  8. Syringomyelia following tuberculous meningitis. Report of three cases diagnosed by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro; Takeshita, Koji; Makita, Kozo; Furui, Shigeru; Takenaka, Eiichi

    1988-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Gelmers, H.J.

    1984-01-01

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

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

    International Nuclear Information System (INIS)

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

  11. 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.

  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

    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.

  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. Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis

    DEFF Research Database (Denmark)

    Roed, Casper; Omland, Lars Haukali Hvass; Skinhoj, Peter; Rothman, Kenneth J; Sorensen, Henrik Toft; Obel, Niels

    2013-01-01

    To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood.......To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood....

  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. Successful treatment of Stenotrophomonas maltophilia meningitis in a preterm baby boy: a case report

    OpenAIRE

    Rojas Pilar; Garcia Elisa; Calderón Gema M; Ferreira Fernando; Rosso Marisa

    2009-01-01

    Abstract Introduction Stenotrophomonas maltophilia is an important cause of hospital acquired infection particularly among severely debilitated and immunosuppressed patients. Case presentation We report a case of S. maltophilia meningitis in a preterm baby boy after a neurosurgical procedure, successfully treated with trimethoprim-sulfamethoxazole and ciprofloxacin. Conclusion This organism should be considered as a potential cause of meningitis and trimethoprim-sulfamethoxazole and ciproflox...

  17. Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults

    DEFF Research Database (Denmark)

    Bodilsen, Jacob; Schønheyder, Henrik Carl; Nielsen, Henrik I

    2013-01-01

    BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this...

  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. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of blood pressure ...

  20. Coronary artery disease (image)

    Science.gov (United States)

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the coronary arteries narrow, the flow of blood to the ...

  1. [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

  2. 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.)

  3. 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

  4. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis

    International Nuclear Information System (INIS)

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

  5. 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

  6. Listeria monocytogenes meningitis in an elderly, alcoholic male

    Directory of Open Access Journals (Sweden)

    Meena Dias

    2014-01-01

    Full Text Available Listeriosis is a zoonotic infection seen normally in herd animals. Humans can be infected by consumption of raw meat, fish, milk, vegetables or canned refrigerated foods. There are many reports of listeriosis in pregnant females, neonates and immune-compromised individuals. However, due to limited clinical suspicion in India, only a few cases has been reported, most of them in neonates. We report here a case of Listeria meningitis in an elderly alcoholic male who was treated successfully with ampicillin and vancomycin.

  7. 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...

  8. 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 ...

  9. Factors associated with the occurrence of hearing loss after pneumococcal meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.; Thomsen, J.; Andersen, Christian Østergaard

    2010-01-01

    Background. On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including the pneumoco...... common after pneumococcal meningitis, and audiometry should be performed on all those who survive pneumococcal meningitis. Important risk factors for hearing loss are advanced age, female sex, severity of meningitis, and bacterial serotype......Background. On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including the...... pneumococcal serotype) for development of hearing loss. Methods. Results of blood and cerebrospinal fluid (CSF) biochemistry, bacterial serotyping, follow-up audiological examinations, and medical records were collected, and disease-related risk factors for hearing loss were identified. The mean pure...

  10. The risk of acquiring bacterial meningitis following surgery in Denmark, 1996-2009

    DEFF Research Database (Denmark)

    Howitz, M F; Homøe, P

    2014-01-01

    SUMMARY: This paper estimates the risk of bacterial meningitis following surgery between 1996 and 2009 in Denmark. We conducted two retrospective nationwide cohort studies; first by linking notified bacterial meningitis cases to the National Patient Registry to see how many had undergone a surgical...... procedure; second, we scrutinized notified bacterial meningitis cases to see if the clinician suspected a surgical procedure to be the aetiology. We found that ear, nose and throat surgery had an 11-fold, and neurosurgery a sevenfold, increased risk compared to the reference group in the first 10 days...... following surgery. Streptococcus pneumoniae was the pathogen most often involved. Operation procedures involving penetration of dura mater was associated with increased risk for post-operative bacterial meningitis. In absolute numbers we found few bacterial meningitis cases after surgery; however, patients...

  11. 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

  12. Radial Artery Catheterization

    Science.gov (United States)

    ... by Shah, P. B. Related Content Load related Internet Resources information Social Bookmarking ... This Article Top Introduction Advantages of Radial Artery Catheterization The Radial Artery Catheterization ...

  13. Factors associated with mumps meningitis and the possible impact of vaccination

    Science.gov (United States)

    Rhie, Kyuyol; Park, Heung-Keun; Kim, Young-Soo; Park, Ji Sook; Seo, Ji-Hyun; Park, Eun Sil; Lim, Jae-Young; Park, Chan-Hoo; Woo, Hyang-Ok; Youn, Hee-Shang

    2016-01-01

    Purpose Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease. Methods We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea between 2003 and 2013. Patients were divided into groups with and without meningitis, and the clinical features of the 2 groups were compared. Results The study enrolled 119 patients: 19 patients with meningitis and 100 patients without. Univariate analysis showed that older age (median: 15 years vs. 9.5 years, respectively), a longer interval from last vaccination (median: 10.2 years vs. 4.8 years, respectively), and febrile presentation (94.7% vs. 31.0%, respectively) were significantly associated with mumps meningitis. Sex, number of vaccination doses, bilateral parotitis, and the presence of complications other than meningitis did not differ between the 2 groups. In multivariate logistic regression analysis, age (odds ratio, 1.38; 95% confidence interval, 1.01–1.89; P=0.04) and fever (odds ratio, 30.46; 95% confidence interval, 3.27–283.61; P<0.01) remained independent factors for mumps meningitis. Conclusion Clinicians in the postvaccine era should be aware of the possibility of mumps meningitis in febrile cases of mumps in adolescents, regardless of the number of vaccination doses. To establish the role of vaccination in mumps meningitis, further studies will be necessary. PMID:26893600

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. A child case of meningitis tuberculosa showing interesting CT findings

    International Nuclear Information System (INIS)

    A 6-year-old boy is presented in whom plain CT failed to reveal specific findings suggesting inflammation, but enhanced CT revealed noticeably abnormal enhancement along the right middle cerebral artery and linear enhancement at the periphery of the artery. The cause of specific enhancement and its clinical value are discussed. (Namekawa, K.)

  19. 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.

  20. 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.