WorldWideScience

Sample records for acute bacterial meningitis

  1. Cholinesterase modulations in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Berg, Ronan M G; Ofek, Keren; Qvist, Tavs;

    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....

  2. Corticosteroids for acute adult bacterial meningitis

    NARCIS (Netherlands)

    D. van de Beek

    2009-01-01

    Bacterial meningitis in adults is a severe disease, with high fatality and morbidity rates. Experimental studies showed that the inflammatory response in the subarachnoid space is associated with unfavorable outcome. In these experiments, corticosteroids, and in particular dexamethasone, were able t

  3. Bacterial Meningitis

    Science.gov (United States)

    ... Schedules Preteen & Teen Vaccines Meningococcal Disease Sepsis Bacterial Meningitis Recommend on Facebook Tweet Share Compartir On this ... serious disease. Laboratory Methods for the Diagnosis of Meningitis This manual summarizes laboratory methods used to isolate, ...

  4. Meningitis bacteriana Bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Ana Teresa Alvarado Guevara

    2006-03-01

    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

  5. Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

    NARCIS (Netherlands)

    M.C. Brouwer; A.R. Tunkel; D. van de Beek

    2010-01-01

    The epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the i

  6. Regional cerebral blood flow during mechanical hyperventilation in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Høgh, Peter; Larsen, Fin Stolze;

    2000-01-01

    Mechanical hyperventilation is often instituted in patients with acute bacterial meningitis when increased intracranial pressure is suspected. However, the effect on regional cerebral blood flow (CBF) is unknown. In this study, we measured regional CBF (rCBF) in patients with acute bacterial...... meningitis before and during short-term hyperventilation. In 17 patients with acute bacterial meningitis, absolute rCBF (in ml/100 g min-1) was measured during baseline ventilation and hyperventilation by single-photon emission computed tomography (SPECT) using intravenous 133Xe bolus injection. Intravenous...... in the frontal and parietal cortex as well as in the basal ganglia. Focal perfusion abnormalities were present in 10 of 12 patients. Regional cerebral blood flow abnormalities are frequent in patients with acute bacterial meningitis. Short-term hyperventilation does not enhance these abnormalities....

  7. 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.)

  8. 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

  9. Cerebral blood flow, oxidative metabolism and cerebrovascular carbon dioxide reactivity in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Strauss, Gitte Irene; Thomsen, Gerda;

    2002-01-01

    BACKGROUND: The optimal arterial carbon dioxide tension (P(a)CO(2)) in patients with acute bacterial meningitis (ABM) is unknown and controversial. The objective of this study was to measure global cerebral blood flow (CBF), cerebrovascular CO(2) reactivity (CO(2)R), and cerebral metabolic rates...... to baseline ventilation, whereas CMR(glu) increased. CONCLUSION: In patients with acute bacterial meningitis, we found variable levels of CBF and cerebrovascular CO(2) reactivity, a low a-v DO(2), low cerebral metabolic rates of oxygen and glucose, and a cerebral lactate efflux. In these patients...

  10. Meningitis bacteriana Bacterial meningitis

    OpenAIRE

    Ana Teresa Alvarado Guevara; Lizzie Marie Castillo Solano

    2006-01-01

    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 pleoc...

  11. Circulating levels of vasoactive peptides in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Berg, Ronan Martin Griffen; Strauss, Gitte Irene; Tofteng, Flemming;

    2009-01-01

    PURPOSE: The underlying mechanisms for cerebral blood flow (CBF) abnormalities in acute bacterial meningitis (ABM) are largely unknown. Putative mediators include vasoactive peptides, e.g. calcitonin-gene related peptide (CGRP), vasoactive intestinal peptide (VIP), and endothelin-1 (ET-1), all...

  12. Cerebral blood flow and metabolism in adults with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten

    2007-01-01

    The intense intrathecal inflammation observed in acute bacterial meningitis (ABM) is associated with pronounced changes in cerebral blood flow (CBF) and metabolism. In seven substudies, CBF and metabolism were measured in adults with ABM as well as healthy volunteers during various interventions...

  13. 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 (... 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....

  14. Dependency of cerebral blood flow upon mean arterial pressure in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Larsen, Fin Stolze; Qvist, Jesper;

    2000-01-01

    patients undergoing serial examination after 7 (range, 2-10) days. Six of these patients had an uncomplicated course, one had a protracted recovery, and one died. Autoregulation was not restored in two patients; one died and one had a protracted recovery. CONCLUSION: In patients in the early phase of acute......OBJECTIVE: Patients with acute bacterial meningitis are often treated with sympathomimetics to maintain an adequate mean arterial pressure (MAP). We studied the influence of such therapy on cerebral blood flow (CBF). DESIGN: Prospective physiologic trial. SETTING: The Department of Infectious...... Diseases, Copenhagen University Hospital, Denmark. PATIENTS: Sixteen adult patients with acute bacterial meningitis. INTERVENTION: Infusion of norepinephrine to increase MAP. MEASUREMENTS: During a rise in MAP induced by norepinephrine infusion, we measured relative changes in CBF by transcranial Doppler...

  15. Role of imaging in the diagnosis of acute bacterial meningitis and its complications.

    Science.gov (United States)

    Hughes, D C; Raghavan, A; Mordekar, S R; Griffiths, P D; Connolly, D J A

    2010-08-01

    Acute bacterial meningitis is a common neurological emergency and a leading cause of death and neurological disability worldwide. Diagnosis is based on clinical and microbiological findings with neuroimaging in the form of CT reserved for those with specific adverse clinical features or when an underlying cause such as mastoiditis is suspected. MRI is extremely useful for detecting and monitoring the complications of meningitis. These can be remembered by the mnemonic HACTIVE (hydrocephalus, abscess, cerebritis/cranial nerve lesion, thrombosis, infarct, ventriculitis/vasculopathy and extra-axial collection). Diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) are useful to distinguish abscess from other ring enhancing lesions. PMID:20709770

  16. Repeat Lumbar Puncture: CSF Lactic Acid Levels are Predictive of Cure with Acute Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    Burke A. Cunha

    2013-12-01

    Full Text Available A common clinical problem concerns the utility of repeat lumbar puncture (LP in adults with acute bacterial meningitis (ABM, e.g., pneumococcal meningitis [1]. An LP is initially done for diagnostic purposes in patients with suspected ABM, i.e., diagnostic lumbar puncture (DLP. A repeat LP (RLP may be done 1–3 days after the initial DLP, if the patient shows no improvement. If a patient with ABM is not doing well after three days, adequacy of antimicrobial therapy is the main concern. Other reasons for RLP is to detect possible intracranial complications of ABM unrelated to adequacy of therapy [1–2].

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

    Directory of Open Access Journals (Sweden)

    Farag HF

    2005-01-01

    Full Text Available Purpose: To address the epidemiological characteristics and clinical indices that may predict the prognostic profile of meningitis among children. Methods: Children admitted to Alexandria fever hospital with clinical diagnosis of meningitis/meningoencephalitis during the period 2002-2003 were recruited for the study. They were subjected to clinical examination as well as CSF bacteriological and serological investigations Results: Three hundred and ten patients (195 males and 115 females were included. About 65.2% of them were infected with acute bacterial meningitis (ABM and 34.8% were infected with aseptic meningitis. In this study, ABM was caused by Haemophilus influenzae (21%, Streptococcus pneumoniae (13.9%, Neisseria meningitidis (14.2% and other undetermined bacteria (16.1%. ABM showed significant association with age group 1-9 years (66.3%, low socio-economic class (96%, working mother (83.2%, more than two smokers in the family (62.9% and cold seasons(fall 35.1% and winter 48.5%. Aseptic meningitis showed significant association with age group 3-15 months (100% and previous immunization(81.5%. The overall case fatality rate was 10.3%; 13.9% for ABM and 3.4% for aseptic meningitis. 7.1% of all survivors developed epileptic attacks. Predictors for death or epilepsy events were high WHO meningitis score (> 9, decreased CSF glucose level (Conclusion: This study highlights the importance of several predictors of the outcome of meningitis in children. It is concluded that quick and simple scoring scales, such as the WHO scale, are not only applicable but valuable prognostic tools for meningitis in children.

  18. [Autochthonous acute viral and bacterial infections of the central nervous system (meningitis and encephalitis)].

    Science.gov (United States)

    Pérez-Ruiz, Mercedes; Vicente, Diego; Navarro-Marí, José María

    2008-07-01

    Rapid diagnosis of acute viral and bacterial infections of the central nervous system (meningitis and encephalitis) is highly important for the clinical management of the patient and helps to establish early therapy that may solve life-threatening situations, to avoid unnecessary empirical treatments, to reduce hospital stay, and to facilitate appropriate interventions in the context of public health. Molecular techniques, especially real-time polymerase chain reaction, have become the fastest and most sensitive diagnostic procedures for autochthonous viral meningitis and encephalitis, and their role is becoming increasingly important for the diagnosis and control of most frequent acute bacterial meningitides. Automatic and closed systems may encourage the widespread and systematic use of molecular techniques for the diagnosis of these neurological syndromes in most laboratories.

  19. Diagnostic value of latex agglutination test in diagnosis of acute bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Syeda Fasiha Mohammadi

    2013-01-01

    Full Text Available Objectives: To know the incidence of bacterial meningitis in children below five years of age. To compare conventional culture and antigen detection methods ( Latex agglutination test. Materials and Methods: 100 CSF samples of clinically suspected meningitis cases in children below 5 years of age were included. The samples were subjected to cell count, Gram stain, culture and LAT. The organisms isolated in the study were characterized according to standard procedures. Results: Of the 100 cases studied, 31 cases were diagnosed as ABM by Gram stain, culture and latex agglutination test as per WHO criteria. The hospital frequency of ABM was 1.7%. 15 (48.38 cases were culture positive. Gram stain was positive in 22(70.96 cases and LAT in 17(54.83 cases. Haemophilus influenzae was the most common causative agent of acute bacterial meningitis followed by S.pneumoniae. Case fatality rate was 45.16%.The sensitivity and specificity of LAT was 66.66% and 87.91% respectively. Conclusion : Bacterial meningitis is a medical emergency and early diagnosis and treatment is life saving and reduces chronic morbidity. LAT was more sensitive compared to conventional Gram stain and Culture technique in identifying the fastidious organisms like H.influenzae, S.pneumoniae and Group B Streptococcus. However, the combination of Gram stain, Culture and LAT proved to be more productive than any of the single tests alone.

  20. Effect of short-term hyperventilation on cerebral blood flow autoregulation in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten

    2000-01-01

    BACKGROUND AND PURPOSE: Cerebral blood flow (CBF) autoregulation is impaired in patients with acute bacterial meningitis: this may be caused by cerebral arteriolar dilatation. We tested the hypothesis that CBF autoregulation is recovered by acute mechanical hyperventilation in 9 adult patients...... with acute bacterial meningitis. METHODS: Norepinephrine was infused to increase mean arterial pressure (MAP) 30 mm Hg from baseline. Relative changes in CBF were concomitantly recorded by transcranial Doppler ultrasonography of the middle cerebral artery, measuring mean flow velocity (V...... completely during hyperventilation. The slope of the autoregulation curve decreased during hyperventilation compared with normoventilation (Pmeningitis, indicating...

  1. Bacterial Meningitis in Infants

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-04-01

    Full Text Available A retrospective study of 80 infantile patients (ages 30-365 days; 47 male, 33 female with culture-proven bacterial meningitis seen over a 16 year period (1986-2001 is reported from Taiwan.

  2. Acute phase proteins in serum and cerebrospinal fluid in the course of bacterial meningitis.

    Science.gov (United States)

    Paradowski, M; Lobos, M; Kuydowicz, J; Krakowiak, M; Kubasiewicz-Ujma, B

    1995-08-01

    We carried out estimations of the following acute phase proteins: C-reactive protein (CRP), alpha-1-antitrypsin (AAT), alpha-1-acid glycoprotein (AAG), alpha-2-ceruloplasmin (CER), and alpha-2-haptoglobin (HPT) in serum and in cerebrospinal fluid (CSF) in patients with bacterial meningitis (BM, n = 30) and viral meningitis (VM, n = 30). We have shown that determinations of concentrations of AAG and CRP in serum and CER in CSF are useful in differentiation between BM and VM. The diagnostic power of these three tests (the areas under their ROC curves equal 0.942, 0.929, and 0.931, respectively) is bigger, though statistically not significantly, than that of traditional parameters of BM in CSF, i.e., total protein concentration and white blood cell count. Determination of AAG, CRP, and AAT in serum is a valuable monitoring marker in the course of BM treatment. Convenience of serum sampling constitutes an advantage over traditional BM parameters in CSF. PMID:8521602

  3. Seizures Complicating Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-09-01

    Full Text Available The clinical data of 116 patients, 1 month to <5 years of age, admitted for bacterial meningitis, and grouped according to those with and without seizures during hospitalization, were compared in a study at Buddhist Dalin Tzu Chi General Hospital, Chang Gung Memorial Hospital and other centers in Taiwan.

  4. Chronic Meningitis

    Science.gov (United States)

    ... School Lunch Lines FDA Cracks Down on Antibacterial Soaps Health Tip: Schedule a Back-to-School Dental ... the Professional Version Meningitis Introduction to Meningitis Acute Bacterial Meningitis Viral Meningitis Noninfectious Meningitis Recurrent Meningitis Chronic ...

  5. Epidemiological, clinical and prognostic profile of childhood acute bacterial meningitis in a resource poor setting

    Directory of Open Access Journals (Sweden)

    Bankole Peter Kuti

    2015-01-01

    Full Text Available Background: Childhood bacterial meningitis is a neurologic emergency that continues to kill and maims children particularly in developing countries with poor immunization coverage. Objective: This study set out to assess the hospital incidence, pattern of presentation, etiologic agents, outcome and determinants of mortality among the children admitted with bacterial meningitis at the Wesley Guild Hospital (WGH, Ilesa. Patients and Methods: We carried out a retrospective review of admitted cases of bacterial meningitis in children aged one month to 15 years at the WGH, Ilesa over a three year period by looking at the hospital records. Factors in the history and examinations were compared among survivors and those that died to determine factors significantly associated with mortality in these children. Results: Eighty-one (5.5% of the 1470 childhood admissions during the study period had bacterial meningitis. Male preponderance was observed and two-thirds of the children were infants. More cases were admitted during the wet rainy season than during the dry harmattan season. Haemophilus influenzae type B and Streptococcus pneumoniae were the leading etiologic agents and ciprofloxacin and ceftriaxone adequately cover for these organisms. Twenty-two (27.2% of the 81 children died, while 34 (42.0% survived with neurologic deficits. Children with multiple seizures, coma, neck retraction, hyponatremia, hypoglycorrhachia, turbid CSF as well as Gram positive meningitis at presentation were found to more likely to die (P < 0.05. None of these factors however independently predict mortality. Conclusion: Childhood bacterial meningitis often results in death and neurologic deficit among infants and young children admitted at the WGH, Ilesa. Children diagnosed with meningitis who in addition had multiple seizures, neck retraction and coma at presentation are at increased risk of dying.

  6. Cognitive outcome in adults after bacterial meningitis.

    NARCIS (Netherlands)

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

  7. Clinical, Paraclinical, and Antimicrobial Resistance Features of Community-Acquired Acute Bacterial Meningitis at a Large Infectious Diseases Ward in Tehran, Iran.

    Science.gov (United States)

    Heydari, Behrooz; Khalili, Hossein; Karimzadeh, Iman; Emadi-Kochak, Hamid

    2016-01-01

    In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients' medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected. Kirby-Bauer disc diffusion method was used to determine their antimicrobial susceptibility profile. Details of medical management including antibiotic regimen, duration, patients' outcome, and possible sequelae of meningitis were recorded. The most commonly isolated microorganism from CSF or blood of patients was Streptococcus pneumonia (33.33%) followed by Neisseria meningitidis (27.78%) and Haemophilus influenza (16.67%). The most common antimicrobial regimen was ceftriaxone plus vancomycin (69.44%) followed by ceftriaxone plus vancomycin plus ampicillin (11.11%). Neurological sequelae of meningitis including cranial nerve palsy, deafness, and hemiparesis were identified in 4 (11.11%), 2 (5.56%), and 1 (2.78%) subjects, respectively. Regarding mortality, only 3 (8.33%) patients died from bacterial meningitis and the remaining 33 individuals discharged from the hospital. In conclusion, findings of the current study demonstrated that the mean incidence of acute bacterial meningitis in a referral infectious diseases ward in Iran was 9 episodes per year. The majority cases of community-acquired acute bacterial meningitis admitted to our center had negative CSF culture and classic triad of meningitis was absent in them. PMID:27610176

  8. 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.

  9. Integration of Rule Based Expert Systems and Case Based Reasoning in an Acute Bacterial Meningitis Clinical Decision Support System

    CERN Document Server

    Cabrera, Mariana Maceiras

    2010-01-01

    This article presents the results of the research carried out on the development of a medical diagnostic system applied to the Acute Bacterial Meningitis, using the Case Based Reasoning methodology. The research was focused on the implementation of the adaptation stage, from the integration of Case Based Reasoning and Rule Based Expert Systems. In this adaptation stage we use a higher level RBC that stores and allows reutilizing change experiences, combined with a classic rule-based inference engine. In order to take into account the most evident clinical situation, a pre-diagnosis stage is implemented using a rule engine that, given an evident situation, emits the corresponding diagnosis and avoids the complete process.

  10. Bacterial meningitis by streptococcus agalactiae

    OpenAIRE

    Villarreal-Velásquez Tatiana Paola; Cortés-Daza César Camilo

    2012-01-01

    Introduction: bacterial meningitis is an infectious disease considered a medicalemergency. The timely management has an important impact on the evolution of thedisease. Streptococcus agalactiae, a major causative agent of severe infections innewborns can colonize different tissues, including the central nervous system.Case report: Male patient 47 years old from rural areas, with work activity as amilker of cattle, referred to tertiary care, with disorientation, neck stiffness, and grandmal se...

  11. 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 baby ... advice from your health care provider. What is meningitis? Meningitis is an infection of the lining that ...

  12. 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.

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

    DEFF Research Database (Denmark)

    Sporrborn, Janni L; Knudsen, Gertrud B; Sølling, Mette;

    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 range...... changes in size as a consequence of meningitis. Increased brain ventricle size in the acute phase of bacterial meningitis was associated with increased mortality....

  14. Aspectos clínicos e laboratoriais de meningite piogênica em lactentes Clinical and laboratorial aspects of acute bacterial meningitis in infants

    Directory of Open Access Journals (Sweden)

    Rita Lucena

    2002-06-01

    Full Text Available OBJETIVO: descrever as características clínicas e laboratoriais da meningite piogênica em lactentes. MÉTODO: informações obtidas a partir do acompanhamento prospectivo dos lactentes com meningite piogênica, admitidos no Hospital Couto Maia no período de março a dezembro de 1997, foram inseridas em um banco de dados e analisadas com auxílio de programas estatísticos. RESULTADOS: meningite piogênica foi mais prevalente em lactentes com idade entre 6 meses e 1 ano, sendo o agente etiológico mais freqüente o Haemophilus influenzae. A letalidade global foi de 25,9% e, entre os sobreviventes, 39,3% deixaram o hospital apresentando alguma anormalidade compatível com envolvimento encefálico ao exame neurológico. CONCLUSÃO: meningite piogênica em lactentes se constitui em enfermidade com taxa de letalidade elevada, sendo, na maioria dos casos, passível de prevenção. Consideramos de grande relevância a adoção de medidas profiláticas de saúde visando redução da incidência desta enfermidade.OBJECTIVE: to describe clinical and laboratorial characteristics of acute bacterial meningitis in infants. METHOD: data from the prospective follow-up of infants with acute bacterial meningitis, admitted at the Hospital Couto Maia between March and December 1997, were analyzed with specific statistical software. RESULTS: acute bacterial meningitis was more prevalent in infants with ages varying from 6 months to 1 year. The most frequent etiologic agent was Haemophilus influenzae. The global lethality was 25.9% and among the survivors 39.3% left the hospital with some abnormality in the neurological exam compatible with the brain involvement. CONCLUSION: acute bacterial meningitis in infants is a high lethality disease that in the majority of cases can be prevented. We consider of great relevance the adoption of health prevention strategies in order to reduce the incidence of this disease.

  15. Acute Disseminated Encephalomyelitis Following Pneumococcal Meningitis Infection

    Directory of Open Access Journals (Sweden)

    Majzoobi

    2014-10-01

    Full Text Available Introduction Acute disseminated encephalomyelitis (ADEM is an acute inflammatory and demyelinating disease of the central nervous system, resulting in various neurological symptoms. Usually, the disease appears following vaccination or systemic viral infections. In rare cases, the disease appears following pneumococcal infections. Case Presentation The patient was a 27 year-old man who was referred to the clinic following a few days of fever and cold with consciousness deficit and right hemiplegia. Based on the analysis of cerebrospinal fluid (CSF and diagnosis of pneumococcal meningitis, he received suitable antibiotic treatment. Despite complete return of consciousness, good general condition, and negative smear and culture of CSF, fever continued and no considerable improvement was observed in the hemiplegia. Therefore, brain magnetic resonance imaging (MRI was performed and according to the findings, treatment was started with the diagnosis of acute disseminated encephalomyelitis. Treatment with prednisolone at first obviated the fever and after a month brought about a complete hemiplegia cure. Following the status of the patient after three months, his MRI clearly showed considerable reduction in lesions. Discussion There is possible occurrence of ADEM following pneumococcal meningitis. Regarding the occurrence of neurological symptoms such as visual disturbance, hemiparesis or hemiplegia following bacterial meningitis, ADEM can be considered as one of the differential diagnoses to be accompanied by MRI. Acute disseminated encephalomyelitis should be treated using suitable dose of corticosteroids.

  16. Endolymphatic sac involvement in bacterial meningitis

    DEFF Research Database (Denmark)

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

  17. Clinical characteristics and prognosis of acute bacterial meningitis in elderly patients over 65: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Lai Wei-An

    2011-12-01

    Full Text Available Abstract Background To examine the clinical characteristics of bacterial meningitis in elderly patients. Methods 261 patients with adult bacterial meningitis (ABM, collected during a study period of 11 years (2000-2010, were included for study. Among them, 87 patients aged ≥ 65 years and were classified as the elderly group. The clinical and laboratory characteristics and prognostic factors were analyzed, and a clinical comparison with those of non-elderly ABM patients was also made. Results The 87 elderly ABM patients were composed of 53 males and 34 females, aged 65-87 years old (median = 71 years. Diabetes mellitus (DM was the most common underlying condition (34%, followed by end stage renal disease (7%, alcoholism (4% and malignancies (4%. Fever was the most common clinical manifestation (86%, followed by altered consciousness (62%, leukocytosis (53%, hydrocephalus (38%, seizure (30%, bacteremia (21% and shock (11%. Thirty-nine of these 87 elderly ABM patients had spontaneous infection, while the other 48 had post-neurosurgical infection. Forty-four patients contracted ABM in a community-acquired state, while the other 43, a nosocomial state. The therapeutic results of the 87 elderly ABM patients were that 34 patients expired and 53 patients survived. The comparative results of the clinical and laboratory characteristics between the elderly and non-elderly ABM patients showed that only peripheral blood leukocytosis was significant. Presence of shock and seizure were significant prognostic factors of elderly ABM patients. Conclusions Elderly ABM patients accounted for 34.8% of the overall ABM cases, and this relatively high incidence rate may signify the future burden of ABM in the elderly population in Taiwan. The relative frequency of implicated pathogens of elderly ABM is similar to that of non-elderly ABM. Compared with non-elderly patients, the elderly ABM patients have a significantly lower incidence of peripheral blood leukocytosis

  18. Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes Meningite bacteriana aguda por Streptococcus pneumoniae resistente aos antimicrobianos e seus sorotipos

    Directory of Open Access Journals (Sweden)

    Andrea Maciel de Oliveira Rossoni

    2008-09-01

    Full Text Available The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from April 2001 to august 2002 have been evaluated. One hundred S. pneumoniae have been isolated, of which 15% were resistant to penicillin, 1% to cephalosporin and 0% to vancomycin. The serotypes most found were 14 (19%, 3 and 23F (10% each. When only the resistant serotypes were analyzed, the most prevalent was the 14 with 44%. The risk factors found in relation to the S. pneumoniae resistance were: age under one year old (p=0.01 and previous use of antibiotic (p=0.046. The resistance rates found, which were moderate to penicillin, low to cephalosporin and neutral to vancomycin, suggest the isolated use of a 3rd generation cephalosporin as an initial empirical therapy for the treatment of acute bacterial meningitis with a communitarian background.Este estudo teve como objetivo avaliar as taxas de resistência de Streptococcus pneumoniae, isolados de pacientes com meningite, à penicilina G, ceftriaxona e vancomicina; avaliar possíveis fatores de risco para resistência antimicrobiana; descrever os sorotipos encontrados e sugerir a terapêutica empírica inicial para meningite. Foram isoladas 100 amostras de S. pneumoniae, encontrando-se 15% de resistência à penicilina, 1% à cefalosporina e 0% à vancomicina. Os sorotipos mais encontrados foram 14 (19%, 3 e 23F (10% cada. Analisando-se os resistentes, o sorotipo 14 (44% também foi o mais freqüente. Os fatores de risco para resistência de S. pneumoniae encontrados foram: idade menor que um ano (p=0,01 e o uso

  19. Spontaneous coronary artery dissection in a patient with bacterial meningitis

    OpenAIRE

    Kinoshita, Kensuke; TSUNODA, YOSHIYA; Watanabe, Shigeyuki; Tokuda, Yasuharu

    2013-01-01

    A 40-year-old man was admitted to our hospital because of the acute onset of fever and headache, which were attributed to bacterial meningitis. Antibiotic treatment was initiated and his condition gradually improved. On day 5 after admission, immediately after masturbation, he developed abrupt onset of severe chest pain and cold sweat and the ECG suggested acute anterior myocardial infarction. Immediate coronary angiography revealed spontaneous dissection of the left anterior descending arter...

  20. Risk factors for community-acquired bacterial meningitis in adults

    NARCIS (Netherlands)

    K.S. Adriani

    2015-01-01

    Bacterial meningitis is an inflammation of the meninges and occurs when bacteria invade the subarachnoid space. The meninges are the protective membranes that surround the brain and the spinal cord. Bacterial meningitis is a life-threatening disease because the proximity of the infection to the brai

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

    Science.gov (United States)

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

    2012-12-01

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

  2. Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis

    OpenAIRE

    Wei, Ting-Ting; Hu, Zhi-De; Qin, Bao-Dong; Ma, Ning; Tang, Qing-Qin; Wang, Li-li; ZHOU, Lin; Zhong, Ren-Qian

    2016-01-01

    Abstract Several studies have investigated the diagnostic accuracy of procalcitonin (PCT) levels in blood or cerebrospinal fluid (CSF) in bacterial meningitis (BM), but the results were heterogeneous. The aim of the present study was to ascertain the diagnostic accuracy of PCT as a marker for BM detection. A systematic search of the EMBASE, Scopus, Web of Science, and PubMed databases was performed to identify studies published before December 7, 2015 investigating the diagnostic accuracy of ...

  3. 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 cerebros......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....../139) of the 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...

  4. Risk of Bacterial Meningitis in Children with Cochlear Implants

    Science.gov (United States)

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

  5. Hyperglycemia in bacterial meningitis: a prospective cohort study

    NARCIS (Netherlands)

    E.S. Schut; W.F. Westendorp; J. de Gans; N.D. Kruyt; L. Spanjaard; J.B. Reitsma; D. van de Beek

    2009-01-01

    ABSTRACT: BACKGROUND: Hyperglycemia has been associated with unfavorable outcome in several disorders, but few data are available in bacterial meningitis. We assessed the incidence and significance of hyperglycemia in adults with bacterial meningitis. METHODS: We collected data prospectively between

  6. [Indication of neuro-imaging for the initial management and the follow-up of acute community-acquired bacterial meningitis].

    Science.gov (United States)

    Béquet, D; de Broucker, T

    2009-01-01

    Lumbar puncture is the best way to prove bacterial meningitis. It should be performed without any delay if the diagnosis is suspected. Herniation is a rare complication of LP. CT is normal in most cases of purulent meningitis, including those complicated by a subsequent herniation; normal CT results does not mean that performing a LP is safe. Three main clinical features can help determine which patient is at risk of herniation and should have a CT before LP. This risk has to be determined rapidly in the emergency ward while assessing anamnestic data, localization signs or symptoms, and level of consciousness. Cranial imaging (mainly MRI) is useful in the course of bacterial meningitis. Patients who do not respond well to treatment or with atypical presentation, persistence of fever, or new neurological signs should undergo brain imaging; MRI and CT may identify subdural effusions, brain abscesses, empyemas, hydrocephaly, or brain parenchymal changes (cerebritis, infarction, hemorrhage). CT and MRI are useful to screen for an ENT cause of bacterial meningitis, and mandatory in case of pneumococcal meningitis. Numerous MRI sequences are useful to identify bacterial meningitis complications: SE T1 without and with gadolinium injection, SE T2, FLAIR, gradient-echo T2, diffusion weighted imaging, MR angiography. PMID:19398288

  7. Predictors of acute bacterial meningitis among children with a first episode of febrile convulsion from Northern India: A prospective study

    Directory of Open Access Journals (Sweden)

    Amiraj Singh

    2014-01-01

    Full Text Available Context: There is limited data to support need of lumbar puncture among Indian children aged less than 5 years presenting with a first episode of fever and seizure. Aims: To determine the incidence and clinical predictors of meningitis among children aged 6-60 months presenting with a first episode of febrile convulsion. Settings and Designs: A prospective study was conducted on 35 children (6-60 months with a first episode of febrile convulsion subjected to lumbar puncture in a tertiary care teaching hospital of North India. Materials and Methods: Clinical characteristics were compared between the two groups: Children with meningitis (n = 17 and children without meningitis (n = 18. Statistical Methods: Multivariate logistic regression was applied to assess the independent predictors of meningitis. Results: A total of 120 children were screened; 35 children subjected to lumbar puncture were finally enrolled. The mean (SD age of enrolled children was 18.49 (10.79 months. The incidence of meningitis was 48.6% (17/35. Children with meningitis significantly had a higher proportion of children with high grade (temperature >104°F fever (P = 0.005, received prior antibiotics (P = 0. 041, had lower hemoglobin levels (P = 0.04 and lower blood sugar levels (P = 0.03 as compared to children with no meningitis. On multivariate logistic regression, it was observed that high-grade fever was an independent predictor of meningitis (odds ratio: 0.03 [0.001-0.86] [P = 0.04]. Conclusion: We found that the presence of high-grade fever was an important predictor of meningitis among children aged 6-60 months presenting with a first episode of febrile convulsion.

  8. Meningitis

    Science.gov (United States)

    The most common causes of meningitis are viral infections. These infections usually get better without treatment. But, bacterial meningitis infections are very serious. They may result in death or ...

  9. Proposal for a New Score-Based Approach To Improve Efficiency of Diagnostic Laboratory Workflow for Acute Bacterial Meningitis in Adults.

    Science.gov (United States)

    Lagi, Filippo; Bartalesi, Filippo; Pecile, Patrizia; Biagioli, Tiziana; Caldini, Anna Lucia; Fanelli, Alessandra; Giannazzo, Giuseppe; Grifoni, Stefano; Massacesi, Luca; Bartoloni, Alessandro; Rossolini, Gian Maria

    2016-07-01

    Microbiological tests on cerebrospinal fluid (CSF) utilize a common urgent-care procedure that does not take into account the chemical and cytological characteristics of the CSF, resulting sometimes in an unnecessary use of human and diagnostic resources. The aim of this study was to retrospectively validate a simple scoring system (bacterial meningitis-Careggi score [BM-CASCO]) based on blood and CSF sample chemical/cytological parameters for evaluating the probability of acute bacterial meningitis (ABM) in adults. BM-CASCO (range, 0 to 6) was defined by the following parameters: CSF cell count, CSF protein levels, CSF lactate levels, CSF glucose-to-serum glucose ratio, and peripheral neutrophil count. BM-CASCO was retrospectively calculated for 784 cases of suspected ABM in adult subjects observed during a four-and-a-half-year-period (2010 to 2014) at the emergency department (ED) of a large tertiary-care teaching hospital in Italy. Among the 28 confirmed ABM cases (3.5%), Streptococcus pneumoniae was the most frequent cause (16 cases). All ABM cases showed a BM-CASCO value of ≥3. Most negative cases (591/756) exhibited a BM-CASCO value of ≤1, which was adopted in our laboratory as a cutoff to not proceed with urgent microbiological analysis of CSF in cases of suspected ABM in adults. During a subsequent 1-year follow-up, the introduction of the BM-CASCO in the diagnostic workflow of ABM in adults resulted in a significant decrease in unnecessary microbiological analysis, with no false negatives. In conclusion, BM-CASCO appears to be an accurate and simple scoring system for optimization of the microbiological diagnostic workflow of ABM in adults. PMID:27170017

  10. Bacterial meningitis: Mechanisms of disease and therapy

    NARCIS (Netherlands)

    R.F. Kornelisse (René); R. de Groot (Ronald); H.J. Neijens (Herman)

    1995-01-01

    textabstractBacterial meningitis continues to be a serious infectious disease with a high morbidity and mortality in young children. Early recognition and initiation of adequate treatment are the major determinants for a good outcome. Recent advances in our understanding of the host inflammatory res

  11. [Cerebral salt wasting syndrome in bacterial meningitis].

    Science.gov (United States)

    Attout, H; Guez, S; Seriès, C

    2007-10-01

    Subarachnoid hemorrhage is the most common cause of cerebral salt wasting syndrome. There are few reports of this condition in infectious meningitis. We describe a patient with hyponatremia and bacterial meningitis. Hyponatremia rapidly improved after administration of sodium chloride. The purpose of this report is to alert clinicians to the fact that hyponatremic patients with central nervous system disease do not necessarily have a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but may have cerebral salt wasting syndrome. By contrast with SIADH, the treatment requires saline administration.

  12. 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)

  13. Latex agglutination vs. counterimmunoelectrophoresis in the diagnosis of acute bacterial meningitis Aglutinación de partículas de látex vs. contrainmunoelectroforesis en meningitis bacteriana aguda

    Directory of Open Access Journals (Sweden)

    Witer Elena Vallejo López

    1991-01-01

    Full Text Available

    A comparison was made between latex particles agglutination (LPA and counterimmunoelectrophoresis (CIE in the diagnosis of 57 children with acute bacterial meningitis; reagents were utllized to detect infection by Haemophilus influenzae, Streptococcus pneumoniae and Neísseria meningitídís. Results of both tests were similar for diagnosis of H. ínfluenzae and S. pneumoniae; in contrast only 30.0% of cases due to N. meningitidis gave a positive result with LP A and none was detected with CIE.in 12 patients (21.0% LPA and CIE were the only tests that allowed a precise determination ot the etiology of the disease. The authors recommend LPA for the particular situation of limited availability of funds since it is more economic than CIE and the quality of the results is similar.

    Se estudiaron 57 pacientes con meningitis aguda, de etiología bacteriana comprobada; 47.4% (27 casos fueron causados por Haemophilus influenzae tipo b; 21.0% (12 casos por Streptococcus pneumoniae; 17.5% (10 casos por Neisseria meningitidis; 5.3% (3 casos por Staphylococcus aureus,. 5.3% (3 casos por enterobacterias y 3.5% (2 casos por gérmenes no Identificados por cultivos. Se comparó la aglutinación de partículas de látex (APL con la contralnmunoelectroforesis (CIE en los pacientes con cultivo positivo. La exactitud de ambas fue similar para el H. influenzae tipo b y el S. pneumoniae. Tres de los 10 casos con cultivo positivo para N. meningítidis fueron positivos en la APL pero ninguno lo fue en la CIE. Se presentó un falso positivo para H. ínfluenzae con la APL que correspondió a meningitis por Salmonella typhí, Las pruebas inmunológicas estuvieron plenamente justificadas en 12 de los 57 pacientes (21.0%, previamente tratados, en quienes la bacteriología tradicional fue negativa o se quería identificar el germen porque lo único positivo era el gram y se justificaba utilizar el

  14. Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitis.

    Science.gov (United States)

    Beleza, Pedro; Ribeiro, Manuel; Pereira, João; Ferreira, Carla; Jordão, Maria José; Almeida, Fátima

    2008-05-01

    We report the case of a 17-year-old male on long-term steroid therapy for minimal lesion glomerulopathy who, after an upper respiratory infection, presented with Haemophilus influenzae type b meningitis. Twenty-four hours later he developed depression of consciousness which progressed to coma and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple lesions (hyperintense on T2 and slightly hypointense on Tl) involving mainly white matter suggestive of inflammation. MRI features were compatible with acute disseminated encephalomyelitis (ADEM), although a differential diagnosis included cerebritis or vasculitis, secondary to bacterial meningitis. The patient was treated with high-dose steroids which resulted in a gradual improvement followed by complete clinical recovery. We propose a diagnosis of ADEM was the best diagnosis because of the radiological features and response to steroids. The occurrence of ADEM associated with acute meningitis, however rare, represents an important diagnostic challenge for the clinician. PMID:18355336

  15. 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.

  16. Predictors of acute bacterial meningitis among children with a first episode of febrile convulsion from Northern India: A prospective study

    OpenAIRE

    Amiraj Singh; Joginder Silayach; Geeta Gathwala; Jaya Shankar Kaushik

    2014-01-01

    Context: There is limited data to support need of lumbar puncture among Indian children aged less than 5 years presenting with a first episode of fever and seizure. Aims: To determine the incidence and clinical predictors of meningitis among children aged 6-60 months presenting with a first episode of febrile convulsion. Settings and Designs: A prospective study was conducted on 35 children (6-60 months) with a first episode of febrile convulsion subjected to lumbar puncture in a tertiary car...

  17. Cerebrospinal fluid ferritin in children with viral and bacterial meningitis.

    Science.gov (United States)

    Rezaei, M; Mamishi, S; Mahmoudi, S; Pourakbari, B; Khotaei, G; Daneshjou, K; Hashemi, N

    2013-01-01

    Despite the fact that the prognosis of bacterial meningitis has been improved by the influence of antibiotics, this disease is still one of the significant causes of morbidity and mortality in children. Rapid differentiation between bacterial and aseptic meningitis, and the need for immediate antibiotic treatment in the former, is crucial in the prognosis of these patients. Ferritin is one of the most sensitive biochemical markers investigated in cerebrospinal fluid (CSF) for the early diagnosis of bacterial meningitis. The present study aims to evaluate the diagnostic capability of CSF ferritin in differentiating bacterial and viral meningitis in the paediatric setting. A cross-sectional study was carried out in the referral Children's Medical Center Hospital, Tehran, during 2008 and 2009. According to the inclusion criteria, CSF samples from 42 patients with suspected meningitis were obtained and divided into two meningitis groups, bacterial (n = 18) and viral (n = 24). Ferritin and other routine determinants (i.e., leucocytes, protein and glucose) were compared between the two groups. Ferritin concentration in the bacterial meningitis group was 106.39 +/- 86.96 ng/dL, which was considerably higher than in the viral meningitis group (10.17 +/- 14.09, P meningitis group and showed a positive correlation with CSF ferritin. In conclusion, this study suggests that CSF ferritin concentration is an accurate test for the early differentiation of bacterial and aseptic meningitis; however, further investigation on a larger cohort of patients is required to confirm this finding.

  18. ANTIBIOTIC SUSCEPTIBILITY PATTERN FROM PATHOGENS CAUSING ACUTE PYOGENIC MENINGITIS IN A TEACHING HOSPITAL, SOUTH INDIA.

    Directory of Open Access Journals (Sweden)

    Kavyashree CV

    2014-11-01

    Full Text Available Background and Objectives: Acute pyogenic meningitis is one of the most serious infections in infants and children. It is associated with serious complications and risk of morbidity and mortality. The purpose of present study was to identify the pathogen in acute pyogenic meningitis and to determine its antibiotic susceptibility pattern. Methods: Present study was undertaken for a period of one year from July 2009 to June 2010 included 100 CSF samples of clinically suspected acute pyogenic meningitis cases in children below 12 years. The samples were subjected to Gram’s stain, culture and antibiotic sensitivity test. The cases positive in either of Gram stain or culture were diagnosed as acute bacterial meningitis cases. Results were tabulated and antibiotic sensitivity pattern was compared. Results: Of the 100 cases studied, 26 cases were diagnosed as acute bacterial meningitis. Gram’s stain positivity was 73% (19/26 cases, culture positivity was 100%. The most common organism isolated in the study was Streptococcus pneumoniae, followed by Haemophilus influenzae, Escherichia coli and Klebsiella pneumoniae. Aminoglycosides, cefotaxime and cotrimoxazole showed high sensitivity. Interpretation and conclusion: Though Gram stain is very essential in diagnosis of meningitis, it may miss some cases. Culture and latex agglutination tests overcome this disadvantage. Streptococcus pyogenes still remains predominant pathogen. Antibiogram of the bacteria causing meningitis is also slowly undergoing a change. This calls for change in the empirical therapy for bacterial meningitis cases.

  19. Acute bacterial meningitis in HIV, pacients in southern Brazil: Curitiba, Paraná, Brazil Meningite bacteriana aguda em portadores de HIV, no sul do Brasil: Curitiba, Paraná, Brasil

    Directory of Open Access Journals (Sweden)

    Sérgio M. de Almeida

    2007-06-01

    Full Text Available Acute communitarian bacterial meningitis and AIDS are prevalent infectious disease in Brazil. The objective of this study was to evaluate the frequency of acute communitarian bacterial meningitis in AIDS patients, the clinical and cerebrospinal fluid (CSF characteristics. It was reviewed the Health Department data from city of Curitiba, Southern Brazil, from 1996 to 2002. During this period, 32 patients with AIDS fulfilled criteria for acute bacterial meningitis, representing 0.84% of the AIDS cases and 1.85% of the cases of bacterial meningitis. S. pneumoniae was the most frequent bacteria isolated. The number of white blood cells and the percentage of neutrophils were higher and CSF glucose was lower in the group with no HIV co-infection (p 0.12; 0.008; 0.04 respectively. Bacteria not so common causing meningitis can occur among HIV infected patients. The high mortality rate among pneumococcus meningitis patients makes pneumococcus vaccination important.A meningite bacteriana aguda comunitária e a AIDS são doenças prevalentes no Brasil. O objetivo desse estudo foi avaliar a freqüência de meningite bacteriana aguda comunitária entre os pacientes com AIDS e as características clínicas e do líquido cefalorraquidiano (LCR. Foram revistos os dados da Secretaria Municipal da Saúde, Curitiba, Paraná, Brasil, nos anos de 1996 a 2002. Nesse período, 32 pacientes com AIDS preencheram os critérios para meningite bacteriana aguda, representando 0,84% dos casos com AIDS e 1,85% dos casos com meningite bacteriana aguda. A bactéria mais freqüentemente isolada foi S. pneumoniae. A celularidade total e a porcentagem de neutrófilos no LCR foi mais elevada e a glicose foi mais baixa no grupo sem co-infecção (p 0,12; 0,008; 0,04 respectivamente. Bactérias menos freqüentes como agentes etiológicos de meningite podem ocorrer. A taxa de mortalidade elevada entre pacientes com meningite por pneumococo torna a vacinação importante.

  20. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-03-15

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

  2. 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

  3. The early prognosis at the bacterial meningitis

    OpenAIRE

    Yu. V. Lobzin; V. V. Pilipenko; M. V. Rezvansev

    2011-01-01

    On the basis of the studying of clinical and laboratory sings of 150 cases of bacterial meningitis (BM) with the use of various statistical methods, including multivariate logistical regression analysis, the early prognostic criteria of the maximum risk and the relation of chances of the maximum risk of an acyclic (severe, complicated, including lethal) variant of a diseases were estimated. These criteria are: age of the patient ≥ 55 years, late hospitalisation (≥3 days of disease), the expre...

  4. 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;

    2006-01-01

    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...... 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 ... to the two other groups between 12-16 hours from time of infection (P meningitis, no significant difference in CSF WBC was observed between patients with or without bacteraemia at admission (n = 103, 1740...

  5. Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis

    Science.gov (United States)

    Wei, Ting-Ting; Hu, Zhi-De; Qin, Bao-Dong; Ma, Ning; Tang, Qing-Qin; Wang, Li-Li; Zhou, Lin; Zhong, Ren-Qian

    2016-01-01

    Abstract Several studies have investigated the diagnostic accuracy of procalcitonin (PCT) levels in blood or cerebrospinal fluid (CSF) in bacterial meningitis (BM), but the results were heterogeneous. The aim of the present study was to ascertain the diagnostic accuracy of PCT as a marker for BM detection. A systematic search of the EMBASE, Scopus, Web of Science, and PubMed databases was performed to identify studies published before December 7, 2015 investigating the diagnostic accuracy of PCT for BM. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy method. The overall diagnostic accuracy of PCT detection in CSF or blood was pooled using the bivariate model. Twenty-two studies involving 2058 subjects were included in this systematic review and meta-analysis. The overall specificities and sensitivities were 0.86 and 0.80 for CSF PCT, and 0.97 and 0.95 for blood PCT, respectively. Areas under the summary receiver operating characteristic curves were 0.90 and 0.98 for CSF PCT and blood PCT, respectively. The major limitation of this systematic review and meta-analysis was the small number of studies included and the heterogeneous diagnostic thresholds adopted by eligible studies. Our meta-analysis shows that PCT is a useful biomarker for BM diagnosis. PMID:26986140

  6. C-reactive protein and bacterial meningitis

    DEFF Research Database (Denmark)

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

    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...... lower. Hence, only a negative test is highly informative in a typical clinical setting. This, as well as the absence of analyses to show if CRP tests contribute independent diagnostic information, relatively to the information held in the traditionally used clinical and biochemical variables, makes...... 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...

  7. 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.

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

    Science.gov (United States)

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

    2015-10-01

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

  9. Brain sonography in African infants with complicated sporadic bacterial meningitis

    OpenAIRE

    Kenneth C Eze; Sam U Enukegwu; Odike, Angela I.

    2013-01-01

    Background: To determine the structural findings in brain sonography of African infants with complicated sporadic bacterial meningitis. Materials and Methods: Retrospective assessment of medical records of patients who underwent brain sonography on account of complicated bacterial meningitis. The brain sonography was carried out over a 4-year period (between September 15, 2004 and September 14, 2008). Result : A total of 86 infants were studied (40 boys and 46 girls in a ratio of 1:1.1); more...

  10. Management of Community -Acquired Acute Bacterial Meningitis in Children%社区获得性急性细菌性脑膜炎患儿的管理

    Institute of Scientific and Technical Information of China (English)

    郭虎; 郑帼

    2011-01-01

    Bacterial meningitis(BM) is a common pediatric infectious disease of the nervous system,which often affect the psychomotor development of children, the correct diagnosis and treatment had always been a challenge. The United States, Europe, Canada, France, England had issued guidelines for the management of BM in 2004 - 2010, which were important reference value for guiding clinicians dealing with BM.%细菌性脑膜炎(BM)是小儿常见的神经系统感染性疾病之一,常影响小儿精神运动发育,其正确的诊断和治疗一直是个挑战;美国、欧洲、加拿大、法国、英国先后于2004 - 2010年发布了BM治疗指南,对于指导临床医师处理BM有重要的参考价值.

  11. Improved outcome of bacterial meningitis associated with use of corticosteroid treatment

    DEFF Research Database (Denmark)

    Baunbæk-Knudsen, Gertrud; Sølling, Mette; Farre, Annette;

    2016-01-01

    BACKGROUND: The aim of this study was to evaluate the clinical outcome of patients with bacterial meningitis following the introduction of dexamethasone treatment in Denmark. METHODS: Adult patients with bacterial meningitis, admitted from 2003-2010 to two different university hospitals, were...... (RR = 1.06; 95% CI = 1.04-1.09). Long-term mortality was influenced by age (RR = 1.06; 95% CI = 1.03-1.08) and female sex (RR = 1.81; 95% CI = 1.05-3.14). CONCLUSION: This study indicated that adjuvant corticosteroid treatment in acute bacterial meningitis improves the outcome and can safely...

  12. 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;

    2006-01-01

    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 ...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...... weeks prior to the experiment ("immunized" rabbits", n = 8), or not treated further ("control" rabbits, n = 9). WBC and bacterial concentrations were determined in CSF and blood every second hour during a 16 hours study period together with CSF IL-8 and protein levels. We also studied CSF and blood WBC...

  13. Sonographic Findings in Bacterial Meningitis in Neonates and Young Infants

    OpenAIRE

    Yikilmaz, Ali; Taylor, George Anthony

    2007-01-01

    Cranial sonography plays an important role in the initial evaluation of infants with suspected bacterial meningitis and in monitoring for complications of the disease. Echogenic widening of the brain sulci, meningeal thickening and hyperemia suggest the diagnosis in an at-risk population. Sonography can identify the presence of extra-axial fluid collections, and color Doppler sonography can be very helpful in differentiating benign enlargement of subarachnoid spaces from subdural effusions. I...

  14. Dexamethasone therapy for bacterial meningitis: Better never than late?

    OpenAIRE

    King, Susan M.; Law, Barbara; Langley, Joanne M.; Heurter, Helen; Bremner, Diane; Wang, Elaine E; Gold, Ronald

    1994-01-01

    A multicentre randomized controlled trial was conducted in children with bacterial meningitis using dexamethasone or placebo for four days within 24 h of starting antibiotics. Primary outcomes were hearing loss and neurological abnormalities at 12 months after meningitis. The dexamethasone (n=50) and placebo (n=51) groups were similar in age, severity of illness and etiological agent. Hearing loss occurred in 10% and 11% of the dexamethasone and placebo groups and neurological deficits occurr...

  15. The utility of the polymerase chain reaction assay for aetiologic definition of unspecified bacterial meningitis cases

    Directory of Open Access Journals (Sweden)

    Mari Tuyama

    2008-03-01

    Full Text Available Most patients with acute suppurative meningitis are otherwise healthy individuals with regard to immune mechanisms against invasive bacterial disease. This medical emergency is among the most dramatic and potentially ravaging diseases that affect humans, particularly young children. The illness often strikes suddenly, and can either result in death or leave the survivors with significant neurological dysfunctions. The demonstration of a bacterial aetiology is necessary for decisions regarding treatment and prophylaxis. Conventional bacteriological methods frequently fail to identify an agent, as a result of administration of antibiotics or delayed lumbar punctures. We investigated the major aetiologic sources of unspecified bacterial meningitis cases (G00.9, ISCD-10 by polymerase chain reaction (PCR-based identification of Neisseria meningitidis (crgA, Streptococcus pneumoniae (ply and Haemophilus influenzae (bexA in cerebrospinal fluid samples. The multiplex PCR detected N. meningitidis in 92%, S. pneumoniae in 4% and H. influenzae in 1% of the 192 clinical samples assayed; 3% were negative for all three DNA targets. Bacterial DNA detection was found to be a valuable adjunct to enhance bacterial meningitis surveillance when the yield of specimens by culture is reduced. The implementation of PCR assays as a diagnostic procedure in Public Health Laboratories is perceived to be a significant advance in the investigation of bacterial meningitis.

  16. Diagnostic clinical and laboratory findings in response to predetermining bacterial pathogen: data from the Meningitis Registry.

    Directory of Open Access Journals (Sweden)

    Maria Karanika

    Full Text Available BACKGROUND: Childhood meningitis continues to be an important cause of mortality in many countries. The search for rapid diagnosis of acute bacterial meningitis has lead to the further exploration of prognostic factors. This study was scheduled in an attempt to analyze various clinical symptoms as well as rapid laboratory results and provide an algorithm for the prediction of specific bacterial aetiology of childhood bacterial meningitis. METHODOLOGY AND PRINCIPAL FINDINGS: During the 32 year period, 2477 cases of probable bacterial meningitis (BM were collected from the Meningitis Registry (MR. Analysis was performed on a total of 1331 confirmed bacterial meningitis cases of patients aged 1 month to 14 years. Data was analysed using EPI INFO (version 3.4.3-CDC-Atlanta and SPSS (version 15.0-Chicago software. Statistically significant (p or = 15000/microL (OR 2.19 with a PPV of 77.8% (95%CI 40.0-97.2. For the diagnosis of Haemophilus influenzae, the most significant group of diagnostic criteria included, absence of haemorrhagic rash (OR 13.61, age > or = 1 year (OR 2.04, absence of headache (OR 3.01, CSF Glu < 40 mg/dL (OR 3.62 and peripheral WBC < 15,000/microL (OR 1.74 with a PPV of 58.5% (95%CI 42.1-73.7. CONCLUSIONS: The use of clinical and laboratory predictors for the assessment of the causative bacterial pathogen rather than just for predicting outcome of mortality seems to be a useful tool in the clinical management and specific treatment of BM. These findings should be further explored and studied.

  17. Acute meningitis caused by Cladosporium sphaerospermum.

    Science.gov (United States)

    Chen, Chi-Yu; Lu, Po-Liang; Lee, Kun-Mu; Chang, Tsung Chain; Lai, Chung-Chih; Chang, Ko; Lin, Wei-Ru; Lin, Chun-Yu; Chen, Yen-Hsu

    2013-12-01

    Phaeohyphomycosis of the central nervous system is rare but typically associated with high mortality. Treatment has not been standardized, but the combination of antifungal chemotherapy with surgical debridement is recommended. We report a 73-year-old, retired, male timber merchant with acute meningitis caused by Cladosporium sphaerospermum. The patient, who had well-controlled type 2 diabetes mellitus, presented with fever and weakness of the lower limbs. No brain abscess was apparent by cranial computed tomography. C. sphaerospermum was isolated from the cerebral spinal fluid and identified based on both morphology and DNA sequencing. He was treated with combination antifungal chemotherapy with amphotericin B and voriconazole for 28 days, followed by voriconazole monotherapy for 46 days. To date, the patient has recovered without significant sequelae. This patient represents the first reported case of cerebral phaeohyphomycosis caused by C. sphaerospermum. Moreover, the therapy was successful for totally less than 3 months of treatment duration.

  18. Pneumococcal-meningitis associated acute disseminated encephalomyelitis (ADEM) – case report of effective early immunotherapy

    OpenAIRE

    Huhn, Konstantin; Lee, De-Hyung; Linker, Ralf A.; Kloska, Stephan; Huttner, Hagen B.

    2014-01-01

    Introduction Unvaccinated patients with history of splenectomy are prone to fulminant courses of Streptococcus pneumoniae-associated bacterial meningitis. Besides direct brain damage those patients may additionally suffer from parainfectious syndromes, notably vasculitis and acute disseminated encephalomyelitis (ADEM). Differentiation and treatment of these immunological reactions is challenging. Methods Case report. Results A 61 year-old woman with history of splenectomy without vaccination ...

  19. [Cognitive Impairment in Patients with Bacterial Meningitis and Encephalitides].

    Science.gov (United States)

    Kamei, Satoshi

    2016-04-01

    Cognitive impairments, including dementia, can present as first symptoms at the acute stage, and/or as sequelae in the chronic stages, in some patients with bacterial meningitis (BM) or encephalitides. BM and encephalitides are lifethreatening neurological emergencies, and early recognition, efficient decision-making, and rapid commencement of therapy can be lifesaving. Empirical therapy should be initiated promptly whenever BM or encephalitides are a probable diagnosis. In this article cognitive impairments, including dementia, presenting in patients with BM, Herpes simplex virus encephalitis (HSVE), Human herpesvirus-6 (HHV-6) encephalitis, and Anti N-methyl-d-aspartate (NMDA) receptor encephalitis are reviewed. In the above mentioned diseases, cognitive impairment without fever might be observed at the time of disease onset. cognitive impairment has been also noted in some aged or immunocompromised patients at the onset of BM. Immediate memory disturbance as one of the first symptoms of HHV-6 encephalitis presented in 74% of patients with this disease. Cognitive impairment, including dementia as sequela, was also found in 10-27% of patients with BM, 54-69% of patients with HSVE, 33% of HHV-6 encephalitis patients, and 39% of patients with anti-NMDA receptor encephalitis. Suitable therapeutic management of these diseases at the acute stage is thus required in order to avoid these sequelae. PMID:27056850

  20. Predictive value of decoy receptor 3 in postoperative nosocomial bacterial meningitis.

    Science.gov (United States)

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

    2014-11-03

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

  1. Meningococcal Meningitis

    Science.gov (United States)

    ... Fact sheets Features Commentaries 2014 Multimedia Contacts Meningococcal meningitis Fact sheet N°141 Updated November 2015 Key facts Meningococcal meningitis is a bacterial form of meningitis, a serious ...

  2. Evaluation Of Sensitivity And Spesicity Of CSF Procalcitonin Levels In Differentiation Of Bacterial And Viral Meningitis,In Children Older Than Two Months

    Directory of Open Access Journals (Sweden)

    Rahimi H

    2005-06-01

    Full Text Available Background: Bacterial meningitis is a fatal disease with high mortality and morbidity that needs emergency management. But due to nonspecific signs and symptoms it's diagnosis in children is difficult. Recently procalcitonin has been used for diagnosis of serious bacterial infections like bacterial meningitis. We conducted a prospective study in children for evaluation of procalcitonin in differential diagnosis of acute bacterial and viral meningitis. Materials and Methods: In a prospective process research, we measured CSF procalcitonin levels in 43 children older than two months referred to Markaz Tebbi hospital. According to the results of universal PCR the patients were divided into two groups: bacterial meningitis (n=11 and nonbacterial meningitis (n=32. To analysis the results, Mann-Whitney test was used. Results: CSF procalcitonin level in bacterial meningitis was significantly higher than viral meningitis (1.72±0.9 ng/ml and 0.71±0.04ng/ml respectively,Pvalue= 0.00. A serum procalcitonin level >0.5 ng/ml had high sensitivity and specificity ( 90.1% and 97.1% respectively in the diagnosis of bacterial meningitis. Conclusion: CSF procalcitonin level seems to be a valuable marker in differentiating between bacterial and viral meningitis.

  3. 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.)

  4. Bacterial cytolysin during meningitis disrupts the regulation of glutamate in the brain, leading to synaptic damage.

    Directory of Open Access Journals (Sweden)

    Carolin Wippel

    Full Text Available Streptococcus pneumoniae (pneumococcal meningitis is a common bacterial infection of the brain. The cholesterol-dependent cytolysin pneumolysin represents a key factor, determining the neuropathogenic potential of the pneumococci. Here, we demonstrate selective synaptic loss within the superficial layers of the frontal neocortex of post-mortem brain samples from individuals with pneumococcal meningitis. A similar effect was observed in mice with pneumococcal meningitis only when the bacteria expressed the pore-forming cholesterol-dependent cytolysin pneumolysin. Exposure of acute mouse brain slices to only pore-competent pneumolysin at disease-relevant, non-lytic concentrations caused permanent dendritic swelling, dendritic spine elimination and synaptic loss. The NMDA glutamate receptor antagonists MK801 and D-AP5 reduced this pathology. Pneumolysin increased glutamate levels within the mouse brain slices. In mouse astrocytes, pneumolysin initiated the release of glutamate in a calcium-dependent manner. We propose that pneumolysin plays a significant synapto- and dendritotoxic role in pneumococcal meningitis by initiating glutamate release from astrocytes, leading to subsequent glutamate-dependent synaptic damage. We outline for the first time the occurrence of synaptic pathology in pneumococcal meningitis and demonstrate that a bacterial cytolysin can dysregulate the control of glutamate in the brain, inducing excitotoxic damage.

  5. Hydrocephalus in adults with community-acquired bacterial meningitis

    NARCIS (Netherlands)

    E. Soemirien Kasanmoentalib; M.C. Brouwer; A. van der Ende; D. van de Beek

    2010-01-01

    Objective: To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults. Methods: Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009. Results: Hydrocephalus was diagnosed in 26 of 577 epi

  6. Dexamethasone in adults with community-acquired bacterial meningitis

    NARCIS (Netherlands)

    D. van de Beek; J. de Gans

    2006-01-01

    Bacterial meningitis in adults is a severe disease with high fatality and morbidity rates. Experimental studies have shown that the inflammatory response in the subarachnoid space is associated with an unfavourable outcome. In these experiments, corticosteroids, and in particular dexamethasone, were

  7. Pasteurella multocida bacterial meningitis caused by contact with pigs

    OpenAIRE

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

    2013-01-01

    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 present 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 c...

  8. Dexamethasone Therapy for Bacterial Meningitis: Better Never Than Late?

    Directory of Open Access Journals (Sweden)

    Susan M King

    1994-01-01

    Full Text Available A multicentre randomized controlled trial was conducted in children with bacterial meningitis using dexamethasone or placebo for four days within 24 h of starting antibiotics. Primary outcomes were hearing loss and neurological abnormalities at 12 months after meningitis. The dexamethasone (n=50 and placebo (n=51 groups were similar in age, severity of illness and etiological agent. Hearing loss occurred in 10% and 11% of the dexamethasone and placebo groups and neurological deficits occurred in 20% and 18% of patients, respectively. Duodenal perforation occurred in one dexamethasone-treated child. In conclusion, there was no significant benefit in those receiving dexamethasone. The lack of benefit may have been due to the delay in administration of dexamethasone (median delay of 11 h after antibiotics. Therefore, if dexamethasone is used for meningitis it should be given immediately with the antibiotic.

  9. Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome

    NARCIS (Netherlands)

    A. van Samkar

    2016-01-01

    In this thesis, we describe the clinical characteristics, etiology, treatment and outcome of zoonotic bacterial meningitis. Each chapter describes meningitis patients infected by a specific zoonotic pathogen, such as Streptococcus equi, Streptococcuis suis, Capnocytophaga canimorsus, Campylobacter f

  10. 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.

  11. Cerebral function assessment in the acute phase of neonatal bacterial meningitis caused by different pathogens%不同病原所致新生儿细菌性脑膜炎急性期脑功能评估

    Institute of Scientific and Technical Information of China (English)

    陈敏霞; 周伟; 唐娟; 王萍; 陈晓文

    2016-01-01

    目的 探讨近5年新生儿细菌性脑膜炎常见病原菌,并通过振幅整合脑电图(aEEG)、脑干听觉诱发电位(BAEP)、头颅MRI评估其急性期脑功能.方法 选取2011年3月至2015年3月广州市妇女儿童医疗中心新生儿科收治的60例细菌性脑膜炎患儿为研究对象,按照病原学培养结果分为无乳链球菌组(14例)、大肠埃希菌组(10例)、其他阳性菌组(11例)及培养阴性组(25例),通过aEEG、BAEP及头颅MRI检查对4组患儿进行急性期脑功能比较研究.结果 60例患儿中29例(48.3%)血培养阳性;14例(23.3%)脑脊液培养阳性,无乳链球菌和大肠埃希菌为引起新生儿细菌性脑膜炎最常见病原.对其中57例患儿进行急性期脑功能评估,结果显示:aEEG总异常率为61.4%,大肠埃希菌组异常率80.0%,且以中重度损害为主,大肠埃希菌组与培养阴性组异常率比较差异有统计学意义(x2=3.941,P=0.047);BAEP异常48例,总异常率84.2%,大肠埃希菌及无乳链球菌所致的细菌性脑膜炎患儿重度听力损伤比例明显升高,大肠埃希菌组与培养阴性组异常率比较差异有统计学意义(x2=4.399,P=0.036),且大肠埃希菌组所致听力损伤较其他细菌组严重;57例患儿中MRI总异常率为77.2%,其中脑积水为最常见并发症,44例异常患儿中有16例并脑积水,其中大肠埃希菌占6例,其次为硬膜下积液,另有5例患儿合并脑软化,大肠埃希菌占3例.结论 新生儿细菌性脑膜炎病原主要为无乳链球菌和大肠埃希菌,大肠埃希菌所致新生儿细菌性脑膜炎急性期脑功能损伤较其他病原严重.%Objective To investigate the common pathogens of neonatal bacterial meningitis in the past 5 years,and to evaluate the brain injury in the acute phase through amplitude-integrated electroencephalogram (aEEG),brainstem auditory evoked potential (BAEP) and brain MRI.Methods Sixty children were selected from the past 5 years who were treated in

  12. Epidemiology and Risk Factors Associated with Developing Bacterial Meningitis among Children in Gaza Strip.

    Directory of Open Access Journals (Sweden)

    Abdel Moat Al Jarousha

    2014-09-01

    Full Text Available Bacterial meningitis is still the leading cause of high morbidity and mortality among the children. The present study was conducted to determine the epidemiology, clinical characteristics of bacterial meningitis and to evaluate the risk factors associated with developing the infection.This cross sectional study was conducted in three hospitals of Gaza strip -Palestine during the period 2009. All the children with clinical diagnosis of meningitis /meningoencephalitis admitted to these hospitals were included in the study. They were subjected to clinical examination as well as CSF bacteriological and serological investigations.During the period (2009, 1853 patients were admitted to the hospitals with suspect of meningitis by pediatricians, 73 (3.9% proved by culture to be acute bacterial meningitis, of these patients 62% were males and 38% were females. The common isolated pathogens were Neisseria meningitides (47.9%, Streptococcus pneumonia (15.1%, Haemophilus influenza (13.7%, E. coli (11.0%, Enterobacter spp. (6.8%, Citrobacter spp. (2.7%, Providencia spp. (1.4%, and Pseudomonas aeruginosa (1.4%. The common recorded symptoms were fever (78%, neck stiffness (47%, vomiting (37%, poor feeding (19%, and irritability (16%. Statistical analysis showed that there was statistical significance associated developing of infection with malnutrition (low hemoglobin level, high house crowdness and irritability (P-value <0.05. The ANOVA statistical analysis showed that S. pneumonia has an impact on developing low hemoglobin level and leukocytosis.N. meningitides is still dominant and needs vaccination. The risk factors should be taken into consideration in any future plan.

  13. An Acute Ibuprofen Overdose Masking a Severe Staphylococcus aureus Meningitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Matthew Smetana

    2013-01-01

    Full Text Available Acute bacterial meningitis has a low incidence (3/100,000 in the United States and yet high fatality rate (approximately 14–16% and classically presents as a triad of fever, neck stiffness, and altered mental status. However, less than half of patients with meningitis present with this classic triad. We present the clinical course of a patient who initially presented to the emergency department after overdosing on ibuprofen for what he described as back pain secondary to mechanical injury. However, the patient's condition quickly deteriorated: he developed tachycardia, mental status changes, was intubated due to respiratory distress, and then suffered an 8-minute PEA arrest before return of spontaneous circulation was achieved. After the patient was stabilized, in addition to the nonsteroidal anti-inflammatory drug (NSAID overdose Staphylococcus aureus meningitis, bacteremia, and pneumonia were diagnosed. We report this case to illustrate that the initial presentation of meningitis may be extremely unusual especially in the setting of NSAID overdose and the acutely decompensating patient. As the risk of adverse clinical outcomes increases with delays in appropriate antibiotic therapy, it is therefore crucial to recognize the many signs and symptoms of meningitis, typical and atypical, and quickly begin appropriate treatment.

  14. Contrast-enhanced MR imaging in bacterial meningitis in children. Temporal profile and correlation with the prognosis

    International Nuclear Information System (INIS)

    Treatment periods for bacterial meningitis are often very long, and often this prolonged treatment is based on the judgment of its effectiveness by the degree of enhancement on brain magnetic resonance imaging (MRI). In this study, we analyzed the contrast MRI in the acute and recovery phases of bacterial meningitis in twelve patients, and graded the contrast level of the subdural space and subarachnoid space separately. While the contrast level of the subarachnoid space increased with time in 4 cases, that of the subdural space increased in 10 cases, and 9 of them revealed a good prognosis without continuation of the treatment. These findings indicate that increased contrast level of the subdural space is common in the recovery phase of bacterial meningitis, and that repetitive MRI investigation is not valuable to determine the duration of treatment. (author)

  15. [Neuropsychiatric sequelae of viral meningitis in adults].

    Science.gov (United States)

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

    2011-10-10

    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.

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

    Directory of Open Access Journals (Sweden)

    Yong-Juan Liu

    2014-11-01

    Full Text Available Nosocomial bacterial meningitis requires timely treatment, but what is difficult is the prompt and accurate diagnosis of this disease. The aim of this study was to assess the potential role of decoy receptor 3 (DcR3 levels in the differentiation of bacterial meningitis from non-bacterial meningitis. A total of 123 patients were recruited in this study, among them 80 patients being with bacterial meningitis and 43 patients with non-bacterial meningitis. Bacterial meningitis was confirmed by bacterial culture of cerebrospinal fluid (CSF culture and enzyme-linked immunosorbent assay (ELISA was used to detect the level of DcR3 in CSF. CSF levels of DcR3 were statistically significant between patients with bacterial meningitis and those with non-bacterial meningitis (p < 0.001. A total of 48.75% of patients with bacterial meningitis received antibiotic >24 h before CSF sampling, which was much higher than that of non-bacterial meningitis. CSF leucocyte count yielded the highest diagnostic value, with an area under the receiver operating characteristic curve (ROC of 0.928, followed by DcR3. At a critical value of 0.201 ng/mL for DcR3, the sensitivity and specificity were 78.75% and 81.40% respectively. DcR3 in CSF may be a valuable predictor for differentiating patients with bacterial meningitis from those with non-bacterial meningitis. Further studies are needed for the validation of this study.

  17. 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.

  18. A proteomic approach for the diagnosis of bacterial meningitis.

    Directory of Open Access Journals (Sweden)

    Sarah Jesse

    Full Text Available BACKGROUND: The discrimination of bacterial meningitis (BM versus viral meningitis (VM shapes up as a problem, when laboratory data are not equivocal, in particular, when Gram stain is negative. METHODOLOGY/PRINCIPAL FINDINGS: With the aim to determine reliable marker for bacterial or viral meningitis, we subjected cerebrospinal fluid (CSF to a quantitative proteomic screening. By using a recently established 2D-DIGE protocol which was adapted to the individual CSF flow, we compared a small set of patients with proven BM and VM. Thereby, we identified six potential biomarkers out of which Prostaglandin-H2 D-isomerase was already described in BM, showing proof of concept. In the subsequent validation phase on a more comprehensive collective of 80 patients, we could validate that in BM high levels of glial fibrillary acidic protein (GFAP and low levels of soluble amyloid precursor protein alpha/beta (sAPPalpha/beta are present as possible binding partner of Fibulin-1. CONCLUSIONS/SIGNIFICANCE: We conclude that our CSF flow-adapted 2D-DIGE protocol is valid especially in comparing samples with high differences in total protein and suppose that GFAP and sAPPalpha/beta have a high potential as additional diagnostic markers for differentiation of BM from VM. In the clinical setting, this might lead to an improved early diagnosis and to an individual therapy.

  19. Sonographic findings in bacterial meningitis in neonates and young infants.

    Science.gov (United States)

    Yikilmaz, Ali; Taylor, George A

    2008-02-01

    Cranial sonography plays an important role in the initial evaluation of infants with suspected bacterial meningitis and in monitoring for complications of the disease. Echogenic widening of the brain sulci, meningeal thickening and hyperemia suggest the diagnosis in an at-risk population. Sonography can identify the presence of extra-axial fluid collections, and color Doppler sonography can be very helpful in differentiating benign enlargement of subarachnoid spaces from subdural effusions. Intraventricular debris and stranding, and an irregular and echogenic ependyma are highly suggestive findings associated with ventriculitis. Sonography can play an important role in the detection of postinfectious hydrocephalus, in the determination of the level of obstruction, and in the evaluation of intracranial compliance. Focal or diffuse parenchymal involvement can represent parenchymal involvement by cerebritis, infarction, secondary hemorrhage or early abscess. PMID:17611750

  20. Pasteurella multocida bacterial meningitis caused by contact with pigs

    Directory of Open Access Journals (Sweden)

    C. López

    2013-01-01

    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 present 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.

  1. 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.)

  2. Epidemiological profile of acute bacterial meningitis in the state of Rio Grande do Norte, Brazil Perfil epidemiológico da meningite bacteriana aguda no estado do Rio Grande do Norte, Brasil

    Directory of Open Access Journals (Sweden)

    Wallace Andrino da Silva

    2010-08-01

    Full Text Available INTRODUCTION: Acute bacterial meningitis (ABM remains a public health problem in Brazil. To evaluate the epidemiology of ABM cases at Giselda Trigueiro Hospital, Rio Grande do Norte, a descriptive retrospective survey was conducted covering 2005 to 2008. METHODS: Clinical and laboratory data were collected from the epidemiology department of the hospital and analyzed. RESULTS: Out of 168 ABM cases, 24.4%, 10.7%, and 2.4% were, respectively, caused by Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenza b, and 5.4% by other bacteria. The mean age was 22.48 ± 18.7 years old. CONCLUSIONS: Streptococcus pneumoniae was the main causative pathogen in the young urban population.INTRODUÇÃO: Meningite bacteriana aguda (MBA permanece um problema de saúde pública no Brasil. Para avaliar a epidemiologia da MBA atendida no Hospital Giselda Trigueiro, Rio Grande do Norte, um estudo retrospectivo-descritivo foi realizado de 2005 a 2008. MÉTODOS: Dados clínicos e laboratoriais foram coletados do departamento de epidemiologia hospitalar e analisados. RESULTADOS: Dos 168 casos de MBA, 24,4%, 10,7% e 2,4% foram, respectivamente, causados por Streptococcus pneumoniae, Neisseria meningitidis e Haemophilus influenzae b e 5,4% por outras bactérias. A média da idade foi 22,48 ± 18,7 anos. CONCLUSÕES: Streptococcus pneumoniae foi o principal patógeno causador na população urbana jovem.

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

    DEFF Research Database (Denmark)

    Roed-Petersen, Casper; Omland, Lars Haukali; Skinhoj, Peter;

    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....

  4. Recurrent Bacterial Meningitis in a Child with Hearing Impairment, Mondini Dysplasia: A Case Report

    Directory of Open Access Journals (Sweden)

    Narges Mazloomi Nobandegani

    2012-12-01

    Full Text Available Recurrent bacterial meningitis is not a common disease and makes physicians seek underlying predisposing factors which can result from anatomic anomalies or immunodeficiency. In this paper we present a boy with recurrent bacterial meningitis with the history of trauma and sensorineural hearing loss. Mondini dysplasia was demonstrated with computed homographic scans (CT-Scan of temporal bones.

  5. Brain sonography in African infants with complicated sporadic bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Kenneth C Eze

    2013-01-01

    Full Text Available Background: To determine the structural findings in brain sonography of African infants with complicated sporadic bacterial meningitis. Materials and Methods: Retrospective assessment of medical records of patients who underwent brain sonography on account of complicated bacterial meningitis. The brain sonography was carried out over a 4-year period (between September 15, 2004 and September 14, 2008. Result : A total of 86 infants were studied (40 boys and 46 girls in a ratio of 1:1.1; more than 70% of the patients were aged below 6 months. Presenting complaint included convulsion with fever in 34 (39.53%, persistent fever 20 (23.26%, bulging fontanelles 8 (9.30%, coma 7 (8.14% and sepsis with convulsion 6 (6.98%, among others. Patients′ place of previous treatment included specialist hospitals 33 (38.37%, private hospitals 21 (24.42%, herbal home centres 12 (13.95%, nursing homes 8 (9.30%, patent medicine stores 7 (8.14% and other non-doctor attended clinics 5 (5.81% infants. The sonographic findings included hydrocephalus 36 (41.86%, cerebral infarction 12 (13.95%, encephalocoele 9 (10.49% and intracerebral abscess 7 (8.14% infants. Cerebritis 5 (5.81%, intracerebral hemorrhage 3 (3.49%, porocephalic cysts 2 (2.33%, cerebral oedema 2 (2.33%, intraventricular haemorrhage 1 (1.16% and subdural collection 1 (1.16% infants; 8 patients (9.30% had normal findings. Conclusion: Hydrocephalus, cerebral infarction and intracerebral abscess were the most common complications elicited by sonography in this study. Early and adequate treatment with antibiotics in patients with persistent fever and convulsion with fever will reduce the complications of meningitis and its long-term neurological sequelae.

  6. 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...

  7. Meningitis - pneumococcal

    Science.gov (United States)

    ... and older People at high risk for pneumococcus infection Alternative Names Pneumococcal meningitis Images Pneumococci organism Pneumococcal pneumonia References Swartz MN. Meningitis: bacterial, ...

  8. BACTERIOLOGICAL PROFILE OF PATIENTS WITH ACUTE PYOGENIC MENINGITIS - A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Arnab

    2016-03-01

    Full Text Available BACKGROUND Pyogenic meningitis is one of the most common infectious disease emergencies involving the central nervous system with higher incidence in developing countries than developed nations. Despite the large number of pathogens that have been reported to cause acute pyogenic meningitis, certain microorganisms are isolated with higher frequency depending on patient’s age, immune status and geography. Present study was aimed to determine the trends in aetiology and spectrum of the bacteriological profile in adult patients with suspected pyogenic meningitis in North-East India. MATERIALS 50 CSF samples from as many patients of Acute Bacterial Meningitis over a period of one year were processed for cell counts, biochemical analysis, gram staining, culture, antigen detection by latex agglutination test and antibiotic susceptibility tests, as per standard techniques. OBSERVATION CSF cell counts showed neutrophilic predominance in all cases along with high protein and low sugar levels. 44% of the cases were culture positive and latex agglutination test was positive in 46.4% of the cases where culture was negative. S. pneumonia was the predominant pathogen identified in the present study in 12(24% cases, followed by Pseudomonas and E. coli in 5(10% cases each. Gram stain indicated the causative organisms in 68.2% of the culture positive cases. Among the culture negative patients gram stain indicated the causative organism in 3(10.7% cases and these three cases were positive by LAT also. CONCLUSION Simple, rapid, inexpensive tests like gram staining remain significant means for diagnosis of acute pyogenic meningitis in developing countries. LAT goes a long way in identifying the organisms where the cultures are negative. This study thus paves the way for larger studies in this region for better recognition of the predominant organisms and the empirical antibiotic regimens.

  9. Acute Disseminated Encephalomyelitis Following Pneumococcal Meningitis Infection

    OpenAIRE

    Majzoobi; Mamani; Ghiasian; Abdoli

    2014-01-01

    Introduction Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory and demyelinating disease of the central nervous system, resulting in various neurological symptoms. Usually, the disease appears following vaccination or systemic viral infections. In rare cases, the disease appears following pneumococcal infections. Case Presentation The patient was a 27 year-old man who was referred to the clinic following a few d...

  10. LYMPHOCYTE SUBSETS AND CYTOKINES IN BLOOD AND CEREBROSPINAL FLUID IN CHILDREN WITH VIRAL AND BACTERIAL MENINGITIS

    Directory of Open Access Journals (Sweden)

    L. A. Alekseeva

    2016-01-01

    Full Text Available Introduction of flow cytometry caused an increase in the investigation of liquor lymphocyte pool phenotype in the case of different brain disorders, including viral and bacterial meningitis, however this type of research in children has been relatively rare. Phenotype and lymphocyte functions are under cytokine control system, therefore detection of interconnections between lymphocyte pool subpopulation composition and cytokine level in blood and liquor of the patients concerns a great interest. The purpose of this research was to study lymphocyte subpopulation composition and the level of cytokines IL-1β, IL-6, IL-8, IL-10, IFNα, IFNγ and IL-4, and also IgG in liquor and blood of children with viral and bacterial meningitis. There was performed blood and liquor investigation in 46 children aged from 1 to 16 years old with viral (n = 35 and bacterial (n = 11 meningitis. Immunophenotyping of blood and liquor cells was performed by the method of flow cytometry with the use of monoclonal antibodies to CD3, CD4, CD8, CD19, CD16, CD56, CD25 and CD95. The content of cytokines was detected in ELISA, and that of IgG — by the method of quantitative immunoturbodimetry. During an acute period of viral meningitis there was detected a decrease in NK portion and activated CD25+ cells in the blood of patients accompanied by the increase in B-lymphocytes number, along with cytokine IFNγ, IL-8 and IL-10 serum level rise. There was determined T-lymphocytes accumulation in liquor with the prevalence of CD4+ Т-cells and, to a lesser degree, CD25+ and CD95+ cells, NK and B-lymphocytes. Intrathecally there was noted the predominance of IL-6 response accompanied by the growth of IL-8 and IL-10 concentration as well. During an acute period of bacterial meningitis there was noted a decrease in percentage of CD3+, CD4+, CD8+ Т-lymphocytes, NK, CD25+ and CD95+ cells, along with, on the contrary, sharp increase in B-cells pool, simultaneously with

  11. Factors influencing neurological outcome of children with bacterial meningitis at the emergency department.

    Science.gov (United States)

    Bargui, Fatiha; D'Agostino, Irene; Mariani-Kurkdjian, Patricia; Alberti, Corinne; Doit, Catherine; Bellier, Nathalie; Morin, Laurence; Galli Gibertini, Giuliano; Smail, Assia; Zanin, Anna; Lorrot, Mathie; Dauger, Stéphane; Neve, Mathieu; Faye, Albert; Armoogum, Priscilla; Bourrillon, Antoine; Bingen, Edouard; Mercier, Jean-Christophe; Bonacorsi, Stéphane; Nigrovic, Lise E; Titomanlio, Luigi

    2012-09-01

    We performed a cohort study of children who survived bacterial meningitis after the neonatal period at a single pediatric center in France over a 10-year period (1995-2004) to identify predictors of death and long-term neurological deficits in children with bacterial meningitis. We performed multivariate regression to determine independent predictors of death and neurologic deficits. We identified 101 children with bacterial meningitis of which 19 died during initial hospitalization. Need for mechanical ventilation [hazard ratio (HR) 11.5, 95 % confidence interval (CI) 2.4-55.5)] and thrombocytopenia defined as a platelet count highest risk.

  12. Diagnosis and Management of Bacterial Meningitis in the Paediatric Population: A Review

    Directory of Open Access Journals (Sweden)

    Catherine L. Tacon

    2012-01-01

    Full Text Available Paediatric bacterial meningitis is a neurological emergency which, despite advances in medical management, still has a significant morbidity and mortality. Over recent decades new vaccines have led to a change in epidemiology of the disease; however, it remains a condition that requires a high index of suspicion, prompt diagnosis, and early management in the emergency department. New laboratory techniques and clinical tools are aiding the diagnosis of bacterial meningitis, yet some controversies still exist in its management. This paper outlines the changing epidemiology of the disease, current diagnostic techniques as well as controversies and advances in the management of bacterial meningitis in the paediatric population.

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

    Directory of Open Access Journals (Sweden)

    Sofia Águeda

    2013-08-01

    Full Text Available Children with cerebrospinal fluid pleocytosis are frequently treated with parenteral antibiotics, but only a few have bacterial meningitis. Although some clinical prediction rules, such as bacterial meningitis score, are of well-known value, the cerebrospinal fluid white blood cells count can be the initial available information. Our aim was to establish a cutoff point of cerebrospinal fluid white blood cell count that could distinguish bacterial from viral and aseptic meningitis. A retrospective study of children aged 29 days to 17 years who were admitted between January 1st and December 31th, 2009, with cerebrospinal fluid pleocytosis (white blood cell > 7 µL-1 was conducted. The cases of traumatic lumbar puncture and of antibiotic treatment before lumbar puncture were excluded. There were 295 patients with cerebrospinal fluid pleocytosis, 60.3% females, medium age 5.0 ± 4.3 years distributed as: 12.2% 1-3 months; 10.5% 3-12 months; 29.8% 12 months to 5 years; 47.5% >5 years. Thirty one children (10.5% were diagnosed with bacterial meningitis, 156 (52.9% viral meningitis and 108 (36.6% aseptic meningitis. Bacterial meningitis was caused by Neisseria meningi tidis (48.4%, Streptococcus pneumoniae (32.3%, other Streptococcus species (9.7%, and other agents (9.7%. cerebrospinal fluid white blood cell count was significantly higher in patients with bacterial meningitis (mean, 4839 cells/µL compared to patients with aseptic meningitis (mean, 159 cells/µL, p < 0.001, with those with aseptic meningitis (mean, 577 cells/µL, p < 0.001 and with all non-bacterial meningitis cases together (p < 0.001. A cutoff value of 321 white blood cell/µL showed the best combination of sensitivity (80.6% and specificity (81.4% for the diagnosis of bacterial meningitis (area under receiver operating characteristic curve 0.837. Therefore, the value of cerebrospinal fluid white blood cell count was found to be a useful and rapid diagnostic test to distinguish

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

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2006-06-01

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

  15. Cochlear ossification in patients with profound hearing loss following bacterial meningitis

    DEFF Research Database (Denmark)

    Caye-Thomasen, Per; Dam, Mikkel Seidelin; Omland, Silje Haukali;

    2012-01-01

    Cochlear ossification following bacterial meningitis is related to causative pathogen, but not age at disease or time point of evaluation. However, progression may occur over time, especially in case of primary signs of ossification.......Cochlear ossification following bacterial meningitis is related to causative pathogen, but not age at disease or time point of evaluation. However, progression may occur over time, especially in case of primary signs of ossification....

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

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Attarpour-Yazdi

    2014-08-01

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

  17. 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)

    Stošić-Opinćal 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

  18. 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.

  19. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    The use of cochlear implants is increasingly common, particularly in children younger than 3 years. Bacterial meningitis, often with associated acute otitis media, is more common in children with cochlear implants than in groups of control children. Children with profound deafness who are candidates for cochlear implants should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza. In addition, starting at 24 months of age, a single dose of 23-valent pneumococcal polysaccharide vaccine should be administered. Before implant surgery, primary care providers and cochlear implant teams should ensure that immunizations are up-to-date, preferably with completion of indicated vaccines at least 2 weeks before implant surgery. Imaging of the temporal bone/inner ear should be performed before cochlear implantation in all children with congenital deafness and all patients with profound hearing impairment and a history of bacterial meningitis to identify those with inner-ear malformations/cerebrospinal fluid fistulas or ossification of the cochlea. During the initial months after cochlear implantation, the risk of complications of acute otitis media may be higher than during subsequent time periods. Therefore, it is recommended that acute otitis media diagnosed during the first 2 months after implantation be initially treated with a parenteral antibiotic (eg, ceftriaxone or cefotaxime). Episodes occurring 2 months or longer after implantation can be treated with a trial of an oral antimicrobial agent (eg, amoxicillin or amoxicillin/clavulanate at a dose of approximately 90 mg/kg per day of amoxicillin component), provided the child does not appear toxic and the implant does not have a spacer/positioner, a wedge that rests in the cochlea next to the electrodes present in certain implant models available between 1999 and 2002. "Watchful waiting" without antimicrobial

  20. Bacterial Meningitis in the Absence of Cerebrospinal Fluid Pleocytosis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ryota Hase

    2014-01-01

    Full Text Available Elevation of cerebrospinal fluid (CSF cell count is a key sign in the diagnosis of bacterial meningitis. However, there have been reports of bacterial meningitis with no abnormalities in initial CSF testing. This type of presentation is extremely rare in adult patients. Here, a case involving an 83-year-old woman who was later diagnosed with bacterial meningitis caused by Neisseria meningitidis is described, in whom CSF at initial and second lumbar puncture did not show elevation of cell counts. Twenty-six non-neutropenic adult cases of bacterial meningitis in the absence of CSF pleocytosis were reviewed. The frequent causative organisms were Streptococcus pneumoniae and N meningitidis. Nineteen cases had bacteremia and seven died. The authors conclude that normal CSF at lumbar puncture at an early stage cannot rule out bacterial meningitis. Therefore, repeat CSF analysis should be considered, and antimicrobial therapy must be started immediately if there are any signs of sepsis or meningitis.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Ahangarzadeh Rezaee

    2012-03-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: To examine the pathways of bacterial invasion and subsequent spreading in the inner ear during pneumococcal meningitis. STUDY DESIGN: A well-established adult rat model of Streptococcus pneumoniae meningitis was used. METHODS: Thirty rats were inoculated intrathecally with S. pneumoniae...... spreading were found within the inner ear. Bacterial elimination was evidenced by engulfment by macrophages within the inner ear. CONCLUSION: From the meninges, pneumococci invade the inner ear through the cochlear aqueduct during the first days of infection, whereas hematogenous invasion via the spiral...... scala vestibuli of the basal turn of the cochlea, hematogenous spreading occurred to the spiral ligament and into the cochlear endolymph, subsequently to the vestibular endolymph. We found no evidence of alternative routes for bacterial invasion in the inner ear. Several internal barriers to bacterial...

  3. Swiftly Decreasing Cerebrospinal Fluid Cathelicidin Concentration Predicts Improved Outcome in Childhood Bacterial Meningitis.

    Science.gov (United States)

    Savonius, Okko; Helve, Otto; Roine, Irmeli; Andersson, Sture; Fernández, Josefina; Peltola, Heikki; Pelkonen, Tuula

    2016-06-01

    We investigated cerebrospinal fluid (CSF) cathelicidin concentrations in childhood bacterial meningitis on admission and during antimicrobial treatment. CSF cathelicidin concentrations on admission correlated with CSF white cell counts and protein levels but not with bacterial etiology. A greater decrease in the concentration in response to treatment was associated with a better outcome. Since the CSF cathelicidin concentration reflects the degree of central nervous system (CNS) inflammation, it may be used as a novel biomarker in childhood bacterial meningitis. An early decrease during treatment likely signals more rapid mitigation of the disease process and thus a better outcome. PMID:27008883

  4. Bedside Evaluation of Cerebral Energy Metabolism in Severe Community-Acquired Bacterial Meningitis

    DEFF Research Database (Denmark)

    Rom Poulsen, Frantz; Schulz, Mette; Jacobsen, Anne;

    2015-01-01

    BACKGROUND: Mortality and morbidity have remained high in bacterial meningitis. Impairment of cerebral energy metabolism probably contributes to unfavorable outcome. Intracerebral microdialysis is routinely used to monitor cerebral energy metabolism, and recent experimental studies indicate...... that this technique may separate ischemia and non-ischemic mitochondrial dysfunction. The present study is a retrospective interpretation of biochemical data obtained in a series of patients with severe community-acquired meningitis. METHODS: Cerebral energy metabolism was monitored in 15 patients with severe...... community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as lactate/pyruvate (LP) ratio >30 with intracerebral pyruvate level

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Weiss Débora PL

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Débora PL Weiss

    2001-06-01

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

  8. CSF markers for diagnosis of bacterial meningitis in neurosurgical postoperative patients

    Directory of Open Access Journals (Sweden)

    Tavares Wagner Malagó

    2006-01-01

    Full Text Available OBJECTIVE: To evaluate the diagnostic usefulness of cerebral spinal fluid (CSF cellularity, protein, neutrophils, glucose and lactate for detection of postoperative bacterial meningitis. METHOD: This prospective study was conducted in 28 postoperative neurosurgical patients from 2002 to 2005 at University of São Paulo. The CSF markers were plotted in a receiver operating characteristic (ROC curve to evaluate their accuracy. RESULTS: Based on the area under ROC curve CSF glucose, cellularity, and lactate were considered good tests. Polymorphonuclear and protein did not achieve enough accuracy to be used clinically. CONCLUSION: The CSF glucose, lactate, and cellularity can be used for the diagnosis of bacterial meningitis. Moreover, it can be helpful to differentiate bacterial from aseptic meningitis.

  9. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

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

    Directory of Open Access Journals (Sweden)

    Mostafa Langarizadeh

    2015-05-01

    Full Text Available Introduction Bacterial meningitis is a known infectious disease which occurs at early ages and should be promptly diagnosed and treated. Bacterial and aseptic meningitis are hard to be distinguished. Therefore, physicians should be highly informed and experienced in this area. The main aim of this study was to suggest a system for distinguishing between bacterial and aseptic meningitis, using fuzzy logic.    Materials and Methods In the first step, proper attributes were selected using Weka 3.6.7 software. Six attributes were selected using Attribute Evaluator, InfoGainAttributeEval, and Ranker search method items. Then, a fuzzy inference engine was designed using MATLAB software, based on Mamdani’s fuzzy logic method with max-min composition, prod-probor, and centroid defuzzification. The rule base consisted of eight rules, based on the experience of three specialists and information extracted from textbooks. Results 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

  11. Treating Meningitis

    Science.gov (United States)

    ... David C. Spencer, MD Steven Karceski, MD Treating meningitis Steven Karceski, MD WHAT DID THE AUTHORS STUDY? ... study, “ Dexamethasone and long-term survival in bacterial meningitis, ” Dr. Fritz and his colleagues carefully evaluated 2 ...

  12. Rarity of bacterial and viral meningitis in areas of Western Greece with fewer than 2,000 inhabitants.

    Science.gov (United States)

    Giannakopoulos, Ioannis; Leotsinidis, Michael; Diamantopoulos, Stavros; Makrakis, Konstantinos; Ellina, Aikaterini; Giannakopoulos, Agelos; Papanastasiou, Dimitris A

    2008-01-01

    The purpose of the present study was to compare the incidence of childhood meningitis in regions with fewer than 2,000 inhabitants (rural regions) and regions with more than 2,000 inhabitants (urban regions) in the prefecture of Achaia in Western Greece during 1991-2005. Included were all 555 children hospitalized for meningitis. The criteria for bacterial meningitis were (i) positive blood/cerebralspinal fluid (CSF) culture, Gram stain, or latex agglutination and/or (ii) increased beta-glucuronidase in CSF. In case of suspected bacterial meningitis, the following findings were considered: compatible clinical and laboratory findings, and whether or not a cure was achieved with antibiotic treatment and finally resulted in negative cultures. In cases of suspected viral meningitis, compatible clinical and laboratory findings were considered, together with observation of a cure without antibiotic treatment. Only 28 of 555 meningitis patients were from rural regions. The incidence per 10,000 children in rural and urban regions, respectively, was as follows: meningitis, 1.13 and 8.99; bacterial meningitis, 0.16 and 2.40; suspected bacterial meningitis, 0.52 and 3.00; and viral meningitis, 0.44 and 3.58. The incidence ratio for bacterial, suspected bacterial, and viral meningitis in urban versus rural regions was 14.85, 5.72, and 8.10, respectively. Only 2 of the 79 cases with a confirmed causative pathogen came from rural regions. In conclusion, compared to those living in urban regions, children living in rural regions are relatively spared from bacterial and viral meningitis.

  13. 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 ......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 field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region. METHODS: We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13......-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded...

  14. Epidemiology and antibiotic resistance of bacterial meningitis in Dapaong, northern Togo

    Institute of Scientific and Technical Information of China (English)

    Simplice D Karou; Abago Balaka; Mitiname Bamok; Damhan Tchelougou; Malki Assih; Kokou Anani; Kodjo Agbonoko; Jacques Simpore; Comlan de Souza

    2012-01-01

    Objective:To assess the seasonality of the bacterial meningitis and the antibiotic resistance of incriminated bacteria over the last three years in the northern Togo. Methods: From January 2007 to January 2010, 533 cerebrospinal fluids (CSF) samples were collected from patients suspected of meningitis in the Regional Hospital of Dapaong (northern Togo). After microscopic examination, samples were cultured for bacterial identification and antibiotic susceptibility. Results:The study included 533 patients (306 male and 227 female) aged from 1 day to 55 years [average age (13.00±2.07) years]. Bacterial isolation and identification were attempted for 254/533 (47.65%) samples. The bacterial species identified were:Neisseria meningitidis A (N. meningitidis A) (58.27%), Neisseria meningitidis W135 (N. meningitidis W135) (7.09%), Streptococcus pneumoniae (S. pneumoniae) (26.77%), Haemophilus influenza B (H. influenza B) (6.30%) and Enterobacteriaceae (1.57%). The results indicated that bacterial meningitis occur from November to May with a peak in February for H. influenzae and S. pneumoniae and March for Neisseriaceae. The distribution of positive CSF with regards to the age showed that subjects between 6 and 12 years followed by subjects of 0 to 5 years were most affected with respective frequencies of 67.82% and 56.52% (P20%for both bacterial strains), macrolides (resistance rate> 30%for H. influenzae) quinolones (resistance rate>15%for H. influenzae and N. meningitidis W135). Over three years, the prevalence of S. pneumoniae significantly increased from 8.48%to 73.33%(P<0.001), while the changes in the prevalence of H. influenzae B were not statistically significant: 4.24%, vs. 8.89%, (P= 0.233). Conclusions:Our results indicate that data in African countries differ depending on geographical location in relation to the African meningitis belt. This underlines the importance of epidemiological surveillance of bacterial meningitis.

  15. The role of dexamethasone in the treatment of bacterial meningitis - a systematic review

    DEFF Research Database (Denmark)

    Borchorst, S; Møller, K

    2012-01-01

    Corticosteroids are used as an adjunct to antibiotics in the treatment of bacterial meningitis in an attempt to attenuate the intrathecal inflammatory response and thereby reduce mortality and morbidity. The purpose of the present paper is to provide a review of clinical studies of corticosteroids...... in the treatment of bacterial meningitis. Relevant literature was found in PubMed, the Cochrane databases, and references in studies. Forty-four publications of relevance were identified, comprising 29 publications of randomised studies, 10 publications reporting either non- or quasi-randomised studies, and five...... reporting retrospective studies, and nine meta-analyses. Taken together, dexamethasone treatment may be associated with a lower mortality in adults and fewer neurological and auditory sequelae in adults and children from high-income countries, in particular in adults suffering from pneumococcal meningitis...

  16. Genome-wide identification of Streptococcus pneumoniae genes essential for bacterial replication during experimental meningitis

    DEFF Research Database (Denmark)

    Molzen, T E; Burghout, P; Bootsma, H J;

    2010-01-01

    Meningitis is the most serious of invasive infections caused by the Gram-positive bacterium Streptococcus pneumoniae. Vaccines protect only against a limited number of serotypes, and evolving bacterial resistance to antimicrobials impedes treatment. Further insight into the molecular pathogenesis...... genes mutants of which had become attenuated or enriched, respectively, during infection. The results point to essential roles for capsular polysaccharides, nutrient uptake, and amino acid biosynthesis in bacterial replication during experimental meningitis. The GAF phenotype of a subset of identified...... of invasive pneumococcal disease is required in order to enable the development of new or adjunctive treatments and/or pneumococcal vaccines that are efficient across serotypes. We applied genomic array footprinting (GAF) in the search for S. pneumoniae genes that are essential during experimental meningitis...

  17. Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.

    Directory of Open Access Journals (Sweden)

    Nguyen Tien Huy

    Full Text Available BACKGROUND AND PURPOSE: Successful outcomes from bacterial meningitis require rapid antibiotic treatment; however, unnecessary treatment of viral meningitis may lead to increased toxicities and expense. Thus, improved diagnostics are required to maximize treatment and minimize side effects and cost. Thirteen clinical decision rules have been reported to identify bacterial from viral meningitis. However, few rules have been tested and compared in a single study, while several rules are yet to be tested by independent researchers or in pediatric populations. Thus, simultaneous test and comparison of these rules are required to enable clinicians to select an optimal diagnostic rule for bacterial meningitis in settings and populations similar to ours. METHODS: A retrospective cross-sectional study was conducted at the Infectious Department of Pediatric Hospital Number 1, Ho Chi Minh City, Vietnam. The performance of the clinical rules was evaluated by area under a receiver operating characteristic curve (ROC-AUC using the method of DeLong and McNemar test for specificity comparison. RESULTS: Our study included 129 patients, of whom 80 had bacterial meningitis and 49 had presumed viral meningitis. Spanos's rule had the highest AUC at 0.938 but was not significantly greater than other rules. No rule provided 100% sensitivity with a specificity higher than 50%. Based on our calculation of theoretical sensitivity and specificity, we suggest that a perfect rule requires at least four independent variables that posses both sensitivity and specificity higher than 85-90%. CONCLUSIONS: No clinical decision rules provided an acceptable specificity (>50% with 100% sensitivity when applying our data set in children. More studies in Vietnam and developing countries are required to develop and/or validate clinical rules and more very good biomarkers are required to develop such a perfect rule.

  18. 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.).

  19. 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.)

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

    OpenAIRE

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

    1983-01-01

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

  1. Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies

    NARCIS (Netherlands)

    R.C.J. de Jonge; A.M. van Furth; M. Wassenaar; R.J.B.J. Gemke; C.B. Terwee

    2010-01-01

    Background: Bacterial meningitis (BM) is a severe infection responsible for high mortality and disabling sequelae. Early identification of patients at high risk of these outcomes is necessary to prevent their occurrence by adequate treatment as much as possible. For this reason, several prognostic m

  2. Soluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis

    NARCIS (Netherlands)

    R.M. Determann; M. Weisfelt; J. de Gans; A. van der Ende; M.J. Schultz; D. van de Beek

    2006-01-01

    Objective: To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease. Design: Retrospective study of diagnostic accuracy. Setting and patients: CSF was coll

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

    NARCIS (Netherlands)

    M. Weisfelt; D. van de Beek; L. Spanjaard; J. de Gans

    2006-01-01

    Background: Although the coexistence of bacterial meningitis and arthritis has been noted in several studies, it remains unclear how often both conditions occur simultaneously. Methods: We evaluated the presence of arthritis in a prospective nationwide cohort of 696 episodes of community-acquired ba

  4. [Pediatric Patient with anaerobic Bacterial Meningitis Who was Infected through a Spinal Congenital Dermal Sinus Route].

    Science.gov (United States)

    Okui, Hideyuki; Fukasawa, Chie; Tokutake, Shoko; Takei, Haruka; Sato, Junichi; Hoshino, Tadashi

    2016-05-01

    We report the case of a pediatric patient in whom a spinal congenital dermal sinus was detected after the onset of anaerobic bacterial meningitis. The patient was a 4-month-old boy. He had a recurrent fever for 2 weeks before admission. On admission, he presented with a convulsive status and a bulging anterior fontanel. The previously consulted physician had made a diagnosis of bacterial meningitis. Spinal fluid cultures tested positive for Peptoniphilus asaccharolyticus. Magnetic resonance imaging (MRI) showed a spinal subdural abscess and cranial subdural hydrops; therefore, the patient was transported to our hospital for surgical treatment. A sacral dimple was noted on his lower back, and an MRI showed a spinal congenital dermal sinus. Antimicrobial therapy, cranial subdural aspiration, dermal sinus excision, and drainage were performed. He was discharged on the 60th hospital day. When pathogens such as Staphylococcus aureus or Escherichia coli, Proteus sp. or anaerobic bacteria invade through a dermal sinus, it can result in meningitis. Involvement of a dermal sinus should be suspected when meningitis is caused by these pathogens or when recurrent meningitis occurs. PMID:27529968

  5. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis.

    Science.gov (United States)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M A; Hoving, Eelco W

    2014-06-01

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. During ventriculoscopy, the cyst had all aspects of an arachnoid cyst. An endoscopic fenestration and partial removal of the cyst was performed, combined with a ventriculocisternostomy. The coincidental finding of viral meningitis and a third ventricle arachnoid cyst in a patient with acute hydrocephalus has, to our knowledge, not been described in literature before. If there is a relation between the enteroviral meningitis, the arachnoid cyst (possibly causing a pre-existing subclinical hydrocephalus) and the rapidly evolving neurological deterioration, remains speculative. Proposed mechanisms, by which the viral meningitis could accelerate the disease process, are slight brain swelling or increased CSF production. This rare combination of diagnoses could also be coincidental.

  6. Determination Of Appropriate Antibiotic In Bacterial Meningitis Of Children Based On MIC

    OpenAIRE

    Noorbakhsh S; SA Siadati; Rimaz S; Mamishi S.; Haghi Ashtiani T

    2005-01-01

    Background: Bacterial meningitis is one of the most serious infections in infants and children. Three organisms include S.Pneumo;N.mening;H.Influ are the most common cause of meningitis in children between 2M-14y age.Etest is a new method for determination the MIC of some antimicrobial drugs in agarose .This method is useful for some organisms like as S .Pneumo; N.mening; H.Influ;sensitive Streptococcus and anaerobic ;aerobic gram negative. Materials and Methods: In this descriptive cross sec...

  7. 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.

  8. Sonographic nomogram of the leptomeninges (pia-glial plate) and its usefulness for evaluating bacterial meningitis in infants

    OpenAIRE

    Jequier, Sigrid; Jéquier, J C

    1999-01-01

    To our knowledge, the upper limits of the thickness of normal meninges on neurosonograms are not known. We therefore established a nomogram for sonographic measurements of the leptomeninges (pia-glial plate) and assessed its usefulness in neurosonographic examinations of children with bacterial meningitis.

  9. PATTERN AND ANTIBIOTIC SUSCEPTIBILITY OF BACTERIA ISOLATED IN CLINICALLY SUSPECTED CASES OF ACUTE PYOGENIC MENINGITIS IN CHILDREN IN KRH, GWALIOR

    Directory of Open Access Journals (Sweden)

    Dutt

    2014-05-01

    Full Text Available This study was conducted in Department of Pediatrics, Kamla Raja Hospital Gwalior, (MP, during a period of a year September 2011 to August 2012. It was prospective and investigational study. Two hundred cases were enrolled for the study confirmed by either CSF r/m and or CSF c/s. Their history, complete physical examination and investigation like CSF, RBS, Blood c/s and Urine c/s were sent. Out of 200, male were 66% and female were 34% making a ratio of 1.9:1. Maximum cases were below the age group of 6year (80%. About 60% cases were from the rural area and 40% from urban area. More cases found in the months of May, Jun and July (45%. Commonest manifestations were fever (96%, irritability/ lethargy (88%, vomiting (80%, convulsion (75%, unconsciousness (53% and headache (31%. Signs of meningeal irritation were neck rigidity (57%; kerning’s sign (51%, brudzinki’s sign (45% and photophobia (28%. Anterior fontanel Bulging were found in (30% cases. Sensitivity of gram stain of the CSF was 88%. Culture was found positive in 35%. Out of 70 cases of culture positive 52 cases were gram negative and 18 cases were gram positive. Bacteria isolated from CSF were common below 3 years age group and there was very less difference in sex distribution. The bacteria isolated from the CSF culture were pseudomonas, Klebsiella, Acinetobacter, Streptococci pneumonia, Staph. Aureus, E.coli, Gm –ve bacilli, Citrobacter, Proteus, Enterobacter. Overall sensitivity pattern were for meropenem (90%, vancomycin (87.5%, ceftriaxone (85.7%, Amikacin (85.7%, Ceftazidime (82.2%, Piperacillin-Tazobactam (81.4%, Amoxyclav (77.1%, Cefotaxime (70%, Gentamicin (70%, and Netilmicin (70%. Blood and urine culture were positive 5% and 2% respectively. Case fatality rate was 11.5%. Acute bacterial meningitis in children has a considerable mortality, morbidity and serious long term sequelae therefore neurodevelopmental follow up and therapy should begin early. The study concluded that

  10. Pre-infection physical exercise decreases mortality and stimulates neurogenesis in bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Liebetanz David

    2012-07-01

    Full Text Available Abstract Physical exercise has been shown to increase neurogenesis, to decrease neuronal injury and to improve memory in animal models of stroke and head trauma. Therefore, we investigated the effect of voluntary wheel running on survival, neuronal damage and cell proliferation in a mouse model of pneumococcal meningitis. Mice were housed in cages equipped with voluntary running wheels or in standard cages before induction of bacterial meningitis by a subarachnoid injection of a Streptococcus pneumoniae type 3 strain. 24 hours later antibiotic treatment was initiated with ceftriaxone (100 mg/kg twice daily. Experiments were terminated either 30 hours or 4 days (short-term or 7 weeks (long-term after infection, and the survival time, inflammatory cytokines and corticosterone levels, neurogenesis in the dentate gyrus of the hippocampal formation and the cognitive function were evaluated in surviving mice. Survival time was significantly increased in running mice compared to control animals (p = 0.0087 in short-term and p = 0.016 in long-term experiments, log-rank test. At the end of the long-term experiment, mortality was lower in trained than in sedentary animals (p = 0.031, Fisher’s Exact test. Hippocampal neurogenesis – assessed by the density of doublecortin-, TUC-4- and BrdU + NeuN-colabeled cells - was significantly increased in running mice in comparison to the sedentary group after meningitis. However, Morris water maze performance of both groups 6 weeks after bacterial meningitis did not reveal differences in learning ability. In conclusion, physical exercise prior to infection increased survival in a mouse model of bacterial meningitis and stimulated neurogenesis in the dentate gyrus of the hippocampal formation.

  11. A Case of Fatal Bacterial Meningitis Caused by Enterococcus Faecalis: Postmortem Diagnosis

    Directory of Open Access Journals (Sweden)

    Gülhan Yağmur

    2015-10-01

    Full Text Available Enterococcus species rarely cause bacterial meningitis without predisposing factors such as trauma, brain surgery, etc. In this study, we present a bacterial meningitis case caused by Enterococcus faecalis (E. faecalis in a 13-year-old male who was found dead at home. One hundred and forty two cm tall, 37 kg weight male had admitted to hospital two days after the beginning of complaints such as weakness, headache, swelling of left eye, nausea and vomiting. Body temperature was 37.3 oC, leucocyte count 22100/ mm3, and CRP 71 g/dl at the hospital admission. Antibiotic treatment with amoxicillin/clavulanic acid (625 mg was given to the patient but he was found dead in his house the day after. In autopsy; yellow-green purulant liquid in left frontoparietal zone, fullness of meningeal vessels and oedema was seen in brain. Isolated bacteria in cerebrospinal fluid (CSF was identificated as E. faecalis by mini API 32 Strep®. Postmortem microbiological sampling in autopsy and defining etiologic agents is important for rare meningitis cases in which antemortem identification could not be done before death.

  12. Bacterial Meningitis: a five year retrospective study among patients who had attended at University of Gondar Teaching Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Birehanemeskel Tegene

    2015-05-01

    Full Text Available Acute Bacterial Meningitis (ABM is an important cause of death and long-term neurological disability. Recent Information on the relative frequency of the isolation and antibiotic susceptibility patterns of these pathogens is scarce in Ethiopia. This study was to document the microbial characteristics, the antibacterial sensitivity pattern, and seasonal variation of community acquired acute bacterial meningitis. The study was retrospective, conducted at university of Gondar referral hospital, serving the rural population of the northwest parts of Ethiopia. A total of three thousand and eighty five cerebrospinal fluid specimens submitted to the bacteriology laboratory for culture and antibiotic susceptibility patterns in a period between January 2006 and December 2010. Analysis of extracted data was performed using SPSS statistical software (Version 17. The etiological agent had been identified in 120 (3.8% of the total 3,085 CSF samples by culture. Thirty-nine (32.5% of them were infants below the age of 12 months. S. pneumoniae was the predominant pathogen accounting for 52 (43.3% of the cases. Whereas N. meningitidis and H. influenzae accounted for 27(22.5%, and 12(10%, respectively. Other gram negative bacilli and S. aureus were isolated from 21(17.2%, and 11(9.2% cases, respectively. Among gram positive organisms S.pneumoniae showed a high level of drug resistance against co-trimoxazole 44(84.3%. Among gram negative bacteria, N.meningitidis was found to be resistant to co-trimoxazole in 25(92.5%. E. coli and salmonella spp. were found to be resistant to most antibiotics except ciprofloxacin. Multiple drug resistance was observed in 58.3% of the isolates. S. pneumoniae remains the major etiological agent of Community Acquired Acute Bacterial Meningitis (CAABM both in adults and children in the study area. 5.7% of S. pneumoniae were resistances to penicillin. Further research should focus on preventable aspects CAABM of, especially pneumococcal

  13. "Bacterial Meningitis in children and adolescents: an observational study based on the national surveillance system"

    Directory of Open Access Journals (Sweden)

    Dickinson Félix O

    2005-11-01

    Full Text Available Abstract Background Bacterial meningitis is a group of life threatening infections that mostly affect children and adolescents, and may be the cause of severe neurological sequelae. Cuba has implemented massive vaccination programmes against both Neisseria meningitidis (serogroup C in 1979 and B in 1987, and Haemophilus influenzae type b (1999, two of the main causal pathogens. We described and discussed some epidemiological aspects of the current status of bacterial meningitis to learn from the Cuban experience. Methods A nationwide observational study on children and adolescents from 1 to 18 years old was carried out from 1998 to 2003, estimating the incidence and case-fatality rate by age group and causal pathogens, as well as the seasonality and frequency of overcrowded dormitories. The association between disease and attendance to day care centres or boarding schools was estimated by using relative risk (Chi-squared test and Fisher Exact Test. Results The overall number of cases was 1023; the incidence ranged from 3.4 to 8.5 per 100 000 population, with the higher figures in children 1–5 years old (16.8 per 100 000 population. Streptococcus pneumoniae, Haemophilus influenzae type b and Neisseria meningitidis serogroup B were the main identified agents. The average case-fatality rate was 10.5% and the most lethal agents were Streptococcus pneumoniae (27% and Haemophilus influenzae type b (10.7%. Overall percentage of cases who slept in overcrowded dormitories was 15%, reaching 30.6% in adolescents. Seasonality was only evident among meningococcal meningitis cases between September–October. The attendance to boarding high school showed an association with disease only in 1998 and 1999 (RR = 2.1; p > 0.05. Conclusion The highest incidence of bacterial meningitis was observed among children from 1–5 years old. Pneumococcus was both the leading causal and the most lethal agent. Sleeping in overcrowded dormitories was more frequent among

  14. Brillouin spectroscopy as a new method of screening for increased CSF total protein during bacterial meningitis.

    Science.gov (United States)

    Steelman, Zachary; Meng, Zhaokai; Traverso, Andrew J; Yakovlev, Vladislav V

    2015-05-01

    Bacterial meningitis is a disease of pronounced clinical significance, especially in the developing world. Immediate treatment with antibiotics is essential, and no single test can provide a conclusive diagnosis. It is well established that elevated total protein in cerebrospinal fluid (CSF) is associated with bacterial meningitis. Brillouin spectroscopy is a widely used optical technique for noninvasive determination of the elastic moduli of materials. We found that elevated protein levels in CSF alter the fluid elasticity sufficiently to be measurable by Brillouin spectroscopy, with model healthy and diseased fluids distinguishable to marked significance (P = 0.014), which increases with sample concentration by dialysis. Typical raw output of a 2-stage VIPA Brillouin spectrometer: inelastically scattered Brillouin peaks (arrows) and elastically scattered incident radiation (center cross).

  15. Association between Toll-like receptor 9 gene polymorphisms and risk of bacterial meningitis in a Chinese population.

    Science.gov (United States)

    Wang, X H; Shi, H P; Li, F J

    2016-01-01

    We determined whether two common single nucleotide polymorphisms (SNPs) in the Toll-like receptor 9 gene (TLR9) (TLR9+2848 rs352140 and TLR9-1237 rs5743836) influenced susceptibility to bacterial meningitis in a Chinese population. The study comprised 126 patients with bacterial meningitis and 252 control subjects, all of whom were recruited from the Tuberculosis Hospital of Shanxi Province. Genotyping of TLR9+2848 rs352140 and TLR9-1237 rs5743836 was performed by polymerase chain reaction coupled with restriction fragment length polymorphism. Using logistic regression analysis, we found that individuals with the AA genotype were associated with an increased risk of bacterial meningitis compared with those with the GG genotype (OR = 0.43, 95%CI = 0.19-0.95; P = 0.03). In a recessive model, the AA genotype was correlated with an elevated risk of bacterial meningitis compared with the GG+GA genotype (OR = 0.49, 95%CI = 0.22-0.99; P = 0.04). However, no significant differences were observed in the association between the TLR9-1237 rs5743836 polymorphism and the risk of bacterial meningitis in the codominant, dominant, or recessive models. In conclusion, the results of our study suggest an association between the TLR9+2848 polymorphism and a reduced risk of bacterial meningitis in the codominant and recessive models. PMID:27525854

  16. Analysis on the risk factors of bacterial meningitis complicated with subdural effusion

    Directory of Open Access Journals (Sweden)

    Zhi JIANG

    2015-08-01

    Full Text Available Objective To investigate the risk factors of bacterial meningitis complicated with subdural effusion.  Methods The clinical data of children with bacterial meningitis in our hospital were collected and analyzed retrospectively. Logistic regression analysis was used to investigate the risk factors for subdural effusion.  Results A total of 128 cases were divided into control group (N = 64 and subdural effusion group (N = 64. There was no significant difference on serum erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and white blood cell (WBC between 2 groups (P > 0.05, for all. Compared with control group, cerebrospinal fluid (CSF WBC (Z = 3.126, P = 0.003, CSF protein (Z = 4.928, P = 0.000 and serum procalcitonin (PCT; Z = 2.823, P = 0.007 in subdural effusion group were significantly higher, while CSF glucose (t = 2.166, P = 0.033 was significantly lower. After treatment, CSF WBC (Z = 2.467, P = 0.012 in subdural effusion group was still significantly higher than that of control group, and CSF glucose (t = 4.938, P = 0.000 was still significantly lower. Logistic regression analysis showed that WBC in CSF (P = 0.027, CSF protein (P = 0.002 and serum PCT (P = 0.014 were independent risk factors for bacterial meningitis complicated with subdural effusion.  Conclusions CSF examination of children with bacterial meningitis reveals significant increase of CSF WBC, CSF protein and serum PCT, suggesting concurrent subdural effusion is easily occurred. DOI: 10.3969/j.issn.1672-6731.2015.08.012

  17. A randomised comparison of meropenem with cefotaxime or ceftriaxone for the treatment of bacterial meningitis in adults. Meropenem Meningitis Study Group.

    Science.gov (United States)

    Schmutzhard, E; Williams, K J; Vukmirovits, G; Chmelik, V; Pfausler, B; Featherstone, A

    1995-07-01

    Third-generation cephalosporins are presently the agents of choice for the empirical antimicrobial therapy of bacterial meningitis. However, a number of factors associated with these agents, namely the development of resistance by pneumococci, limited activity against some Enterobacteriaceae and Pseudomonas spp., and the possible adverse effects of their bacteriolytic mode of action, indicate that newer classes of antimicrobial agents be evaluated for the treatment of bacterial meningitis. Meropenem is a carbapenem antibiotic which is highly active against the major bacterial pathogens causing meningitis, and penetrates well into the cerebrospinal fluid. Two prospective randomised studies in 56 adult bacterial meningitis patients have compared meropenem 40 mg/kg 8-hourly, up to a maximum of 6 g/day (n = 28) with cephalosporin treatment, i.e. cefotaxime (n = 17) or ceftriaxone (n = 11). Patients were assessed by neurological examination, Glasgow Coma Score and Herson-Todd score. Clinical cure was observed in all 23 evaluable patients treated with meropenem (100%) and with 17 of the 22 evaluable cephalosporin-treated patients (77%). All pre-treatment isolates were eradicated except one isolate of Staphylococcus aureus in a cefotaxime-treated patient. Neurological sequelae were noted in three meropenem and four cephalosporin-treated patients. No patients in either treatment group experienced seizures after the start of therapy. This was despite the fact that a patient in each group had experienced seizures before therapy, several had underlying CNS disorders, and that doses of 6 g/day of meropenem were given. Hearing impairment was recorded in 11 meropenem and nine cephalosporin treated patients. Three patients in the meropenem group and one in the cephalosporin group died during treatment for reasons unrelated to study therapy. Overall, the results of this study indicate that meropenem is an effective and well-tolerated antibiotic for the treatment of bacterial

  18. Bacterial Meningitis in Brazil: Baseline Epidemiologic Assessment of the Decade Prior to the Introduction of Pneumococcal and Meningococcal Vaccines.

    Directory of Open Access Journals (Sweden)

    Luciano Cesar Pontes Azevedo

    Full Text Available Bacterial meningitis is associated with significant burden in Brazil. In 2010, both 10-valent pneumococcal conjugate vaccine and meningococcal capsular group C conjugate vaccine were introduced into the routine vaccination schedule. Haemophilus influenzae type b vaccine was previously introduced in 1999. This study presents trends in demographics, microbiological characteristics and seasonality patterns of bacterial meningitis cases in Brazil from 2000 to 2010.All meningitis cases confirmed by clinical and/or laboratory criteria notified to the national information system for notifiable diseases between 2000 and 2010 were analyzed. Proportions of bacterial meningitis cases by demographic characteristics, criteria used for confirmation and etiology were calculated. We estimated disease rates per 100,000 population and trends for the study period, with emphasis on H. influenzae, N. meningitidis and S. pneumoniae cases. In the decade, 341,805 cases of meningitis were notified in Brazil. Of the 251,853 cases with defined etiology, 110,264 (43.8% were due to bacterial meningitis (excluding tuberculosis. Of these, 34,997 (31.7% were due to meningococcal disease. The incidence of bacterial meningitis significantly decreased from 3.1/100,000 population in 2000-2002 to 2.14/100,000 in 2009-2010 (p<0.01. Among cases of meningococcal disease, the proportion of those associated with group C increased from 41% in 2007 to 61.7% in 2010, while the proportion of group B disease progressively declined. Throughout the study period, an increased number of cases occurred during winter.Despite the reduction in bacterial meningitis incidence during the last decade, it remains a significant healthcare issue in Brazil. Meningococcal disease is responsible for the majority of the cases with group C the most common capsular type. Our study demonstrates the appropriateness of introduction of meningococcal vaccination in Brazil. Furthermore, this study provides a baseline

  19. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis

    NARCIS (Netherlands)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M. A.; Hoving, Eelco W.

    2014-01-01

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. Duri

  20. Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitis

    OpenAIRE

    Beleza, P; M. Ribeiro; Pereira, J.; Jordão, MJ; Almeida, F.

    2008-01-01

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

  1. Some pathogenetic aspects of experimental pneumococcal meningitis in acute period

    Directory of Open Access Journals (Sweden)

    V. V. Pilipenko

    2011-01-01

    Full Text Available Morphological displays of cerebral microcirculation derangements in a brain cortex with their semiquantitative estimation have been studied in experimental mice model of the first 24-72 hours period of pneumococcal meningitis.Also displays oxidative stress and activity antioxidative protectional system by means of definition of markers of these processes – malondialdehide, reduced glutathione and glucose-6-phosphate-dehydrogenase activity have been investigated. The received results testify to morphological signs of the expressed derangements of cerebral microcirculation in a brain cortex already by first 24 hour of an experimental meningitis. The maximum expressiveness oxidative stress and activity antioxidative protectional system of reduced glutathione with the max activity of glucose-6-phosphatedehydrogenase in a mice brain cortex was noted at first 48hour durations of experimental disease. Signs of irreversible changes of mice cortex neurons are not revealed at 24–72-hour duration of experimental pneumococcal meningitis.

  2. The role of adjunctive dexamethasone in the treatment of bacterial meningitis: an updated systematic meta-analysis

    Science.gov (United States)

    Shao, Mei; Xu, Peng; Liu, Jun; Liu, Wenyun; Wu, Xiujie

    2016-01-01

    Background Bacterial meningitis is a serious infection in children and adults worldwide, with considerable morbidity, mortality, and severe neurological sequelae. Dexamethasone is often used before antibiotics in cases of this disease, and improves outcomes. Objective Although several studies have identified the role of adjunctive dexamethasone therapy in the treatment of bacterial meningitis, the results are still inconclusive. The aim of this study was to systematically evaluate the therapeutic and adverse effect of adjunctive dexa-methasone in patients with bacterial meningitis. Materials and methods Relevant randomized, double-blind, placebo-controlled trials of dexamethasone in bacterial meningitis published between 2000 and 2016 were retrieved from the common electronic databases. The odds ratio (OR) and risk ratio (RR) with their 95% confidence interval (CI) were employed to calculate the effect. Results A total of ten articles including 2,459 bacterial meningitis patients (1,245 in the dex-amethasone group and 1,214 in the placebo group) were included in this meta-analysis. Our result found that dexamethasone was not associated with a significant reduction in follow-up mortality (292 of 1,245 on dexamethasone versus 314 of 1,214 on placebo; OR =0.91, 95% CI =0.80–1.03, P=0.14) and severe neurological sequelae (22.4% versus 24.1%, OR =0.84, 95% CI =0.54–1.29, P=0.42). However, dexamethasone seemed to reduce hearing loss among survivors (21.2% versus 26.1%; OR =0.76, 95% CI =0.59–0.98, P=0.03). No significant difference was found between these two groups in adverse events. Conclusion Our results suggested that adjunctive dexamethasone might not be beneficial in the treatment of bacterial meningitis. Future studies with more data are needed to further prove the role of dexamethasone in bacterial meningitis.

  3. Cerebrospinal fluid analysis, predictors of bacterial meningitis: a study in 312 patients with suspected meningial infection

    Institute of Scientific and Technical Information of China (English)

    Seyed Mohammad Alavi; Naser Moshiri

    2009-01-01

    Objective:Patients with cerebrospinal fluid (CSF) pleocytosis are routinely admitted to the hospital and treated with parenteral antibiotics, although few have bacterial meningitis (BM). The aim of this study was to evaluate predictors to dif-ferentiate BM from aseptic meningitis (ASM). Methods:The study was conducted in Razi hospital, a training center affiliated to Ahvaz Joundishapoor University of Medical Sciences in Iran. And all patients were 18 years old or above and were treated in the hospital between 2003 and 2007. Data of those who had meningitis, tested as CSF pleocytosis but had not received antibiotic treatment before lumbar puncture were retrospectively analyzed. Results: Among 312 patients with CSF pleocytosis, two hundred fifteen (68.9%) had BM and ninety seven (31.1%) had ASM. The mean age for patients with BM was (34.7±17.7) years (P=0.22, NS). Sixty percent of the BM cases and 61.2% of the ASM cases occurred in men (P=0.70, NS). We identified the following predictors of BM:CSF-WBC count > 100 per micro liter, CSF-glucose level 80 mg/dL. Sensitivity, specificity, PPV, NPV of these predictors, and LR for BM are 86.5% ,52.6% ,80.2%, 63.7% and 104. 1 for CSF-WBC count and 72.1%, 83.5%, 90.6% ,57.4% and 164.2% for CSF glucose, and 49.7%, 91.8%, 93.4% ,45. 2% and 104.5% for CSF protein. Conclusion:The CSF WBC count should not be used alone to rule out bacterial meningitis. When it is combined with other factors such as CSF glucose and protein improved decision making in patients with suspected BM may occur.

  4. Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction

    DEFF Research Database (Denmark)

    Deutch, Susanna; Dahlberg, Daniel; Hedegaard, Jesper;

    2007-01-01

    OBJECTIVE: To compare a broad-range real-time polymerase chain reaction (PCR) diagnostic strategy with culture to evaluate additional effects on the etiological diagnosis and the quantification of the bacterial load during the course of ventricular drainage-related bacterial meningitis (VR...

  5. Prognosis of bacterial meningitis in children Prognóstico de meningite bacteriana em crianças

    Directory of Open Access Journals (Sweden)

    Irenio Gomes

    1996-09-01

    Full Text Available We studied the incidence and prognosis of acute neurologic complications in 281 children under 13 years of age with a diagnosis of acute bacterial meningitis. All the patients were examined daily by the same group of neurologists, using a standardized neurological examination. Patients with signs of encephalic lesions, unsatisfactory response to antibiotics or decreased level of consciousness were submitted to brain computer tomography. The overall lethality rate was 20.3% and cases whose causative agent was identified presented a higher lethality rate (23.7% than those in which the agent was not found. The most important neurological abnormalities were meningeal signs (88.3% followed by decreased consciousness (47.7%, irritability (35.2%, seizures (22.4%, fontanel bulging (20.6% and cranial nerve palsy (14.2%. Seizures, cranial nerve palsy and the absence of meningeal signs were related to higher rates of lethality. Diminished consciousness, seizures, subdural effusion, abscess and hydrocephalus were the most important complications, respectively. We can conclude that acute bacterial meningitis continues to be an important health problem in developing countries and that public health measures will be necessary to minimize the impact of sequelae and reduce the mortality rate in children with that pathology.Para estudar os fatores prognósticos e incidência de complicações em meningite bacteriana, 281 crianças (idade abaixo de 13 anos com quadro clínico e do LCR compatíveis com esse diagnóstico foram acompanhadas, durante o internamente, através de ficha de avaliação padrão. Aquelas que apresentaram sinais de lesão encefálica, resposta inadequada ao tratamento ou diminuição do nível de consciência, com Glasgow < 7, foram submetidas a tomografia computadorizada de crânio. A taxa de letalidade global foi 20,3%, sendo maior quando o agente etiológico foi identificado (23,7%. As alterações neurológicas mais encontradas foram

  6. Prevalence of Gram-negative Pathogens and their antimicrobial susceptibility in bacterial meningitis in pediatric cases

    Directory of Open Access Journals (Sweden)

    Yash Pal Chugh

    2012-07-01

    Full Text Available The present study was conducted to find out the prevalence and spectrum of Gram negative pathogens causing bacterial meningitis and their antimicrobial susceptibility pattern in a tertiary care hospital. The cerebrospinal fluid (CSF (3-5 ml was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and antimicrobial susceptibility was assessed by the Kirby-Bauer disk diffusion method. Of the 638 samples tested 102 (15.99% were culture positive. Male to female (M:F ratio was 1.62:1. The maximum incidence of 45 (44.12% cases was found in children (1-12 yrs; in institutional deliveries the incidence was 58 (56.86% cases. Further, the incidence of 51 cases was found from May to August. Escherichia coli (E. coli were commonest, seen in 9 (25% cases followed by Acinetobacter spp., Citrobacter spp. and Klebsiella spp. with 6 (16.67% cases each. Enterobacter spp., Neisseria spp. and Pseudomonas aeruginosa were isolated in 3 (8.33% cases each. E. coli, Acinetobacter spp, Citrobacter spp and Klebsiella spp isolates were 100% susceptible to meropenem, piperacillin-tazobactam and cefoperazone-sulbactam and 100% resistant to cotrimoxazole and tetracycline. All strains of Neisseria spp, Enterobacter spp and Pseudomonas spp. were 100% susceptible to meropenem followed by gatifloxacin. These were 100% resistant to tetracycline and cotrimoxazole. Neisseria spp. were also 100% susceptible to pristinamycin. In septic meningitis Gram negative organisms are less common (35.29%. Of the isolates, more common Gram negative isolates included E. coli, Acinetobacter Spp., Citrobacter Spp., and Klebsiella spp. and these isolates were 100% susceptible to meropenem, piperacillin-tazobacatam and cefoperazone-sulbactam. Hence, empirical therapy should be formulated according to antimicrobial susceptibility patterns.

  7. Usefulness of {sup 99m}Tc-HMPAO-SPECT in evaluation of bacterial meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Kentaro; Ando, Hiroshi; Sueyoshi, Keiko; Matsuyuki, Makado; Hashimoto, Nobuo; Ono, Eiichiro; Katsuragi, Makoto [St. Maria Hospital, Kurume, Fukuoka (Japan)

    1997-03-01

    {sup 99m}Tc-HMPAO SPECT was performed to detect the periodical changes of blood flow distribution in 6 infants (average age 5.5 months) with bacterial meningitis and was compared with findings by CT and MRI imaging, by DQ (developmental quotient) and by neurological examinations. SPECT was done with Shimadzu HEADTOME SET 70 for 20 min at 5 min after intravenous administration of {sup 99m}Tc-HMPAO (111 MBq) at the stage of 16-26 days (SPECT I) after hospitalization, of 39-105 days (II) and/or of 138-197 days (III). The region of interest was set in both cerebellar hemispheres to calculate the mean pixel count c1 and in other 16 areas for the count c2. SPECT image was evaluated together with c2/c1 ratios. Head CT was performed at hospitalization or at the period around the SPECT I, and head MRI, at 39-183 days. At 3-5 months after crisis, evaluation was done for DQ and neurological signs. Periodical brain SPECT was found useful for the precise evaluation of bacterial meningitis and for prediction of its prognosis. (K.H.)

  8. Comparative study of bacteriological culture and real-time fluorescence quantitative PCR (RT-PCR) and multiplex PCR-based reverse line blot (mPCR/RLB) hybridization assay in the diagnosis of bacterial neonatal meningitis

    OpenAIRE

    Wang, Yajuan; Guo, Gaili; Wang, Huixin; Yang, Xuefang; Shao, Fang; Yang, Caiyun; Gao, Wei; Shao, Zhujun; Zhang, Jinjing; Luo, Jie; Yang, Yonghong; Kong, Fanrong; Zhu, Bingqing

    2014-01-01

    Background Bacterial meningitis is more common in the neonatal period than any other time in life; however, it is still a challenge for the evidence based diagnosis. Strategy for identification of neonatal bacterial meningitis pathogens is presented by evaluating three different available methods to establish evidence-based diagnosis for neonatal bacterial meningitis. Methods The cerebrospinal fluid samples from 56 neonates diagnosed as bacterial meningitis in 2009 in Beijing Children’s Hospi...

  9. Fatores de risco para meningite bacteriana no recém-nascido Risk factors for bacterial meningitis in the newborn

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Jornada Krebs

    2004-09-01

    Full Text Available O objetivo do estudo é descrever os fatores de risco para meningite bacteriana em recém-nascidos e analisar a prevalência destes fatores, considerando-se a presença ou não de baixo peso ao nascimento. Foram analisados 50 recém-nascidos com meningite bacteriana, excluindo-se aqueles com meningomielocele ou infecção congênita. Na análise estatística utilizou-se o teste exato de Fisher, considerando-se significantes os valores de p The aim of this study is to describe the risk factors for bacterial meningitis in newborns, and to analyze the prevalence of these factors, considering or not the low birth weight presence. Fifty newborns with bacterial meningitis were analyzed, excluding the ones with meningomyelocele or congenital infection. In the statistical analysis, the Fisher's exact test was used, considering significant the p < 0.05 values. This study has shown that prematurity, low birth weight and presence of previous infectious diseases in the newborn or in the mother were important risk factors for meningitis. Among low birth weight newborns, invasive procedures, especially tracheal intubation, use of central venous catheter and previous use of antibiotics, were significantly associated to the meningitis occurrence. These results indicate that the improvement in the prenatal care and in the hospital infection control are measures of high importance in the decrease of the incidence of neonatal bacterial meningitis.

  10. Procalcitonin as a Serum Biomarker for Differentiation of Bacterial Meningitis From Viral Meningitis in Children: Evidence From a Meta-Analysis.

    Science.gov (United States)

    Henry, Brandon Michael; Roy, Joyeeta; Ramakrishnan, Piravin Kumar; Vikse, Jens; Tomaszewski, Krzysztof A; Walocha, Jerzy A

    2016-07-01

    Several studies have explored the use of serum procalcitonin (PCT) in differentiating between bacterial and viral etiologies in children with suspected meningitis. We pooled these studies into a meta-analysis to determine the PCT diagnostic accuracy. All major databases were searched through March 2015. No date or language restrictions were applied. Eight studies (n = 616 pediatric patients) were included. Serum PCT assay was found to be very accurate for differentiating the etiology of pediatric meningitis with pooled sensitivity and specificity of 0.96 (95% CI = 0.92-0.98) and 0.89 (95% CI = 0.86-0.92), respectively. The pooled positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) for PCT were 7.5 (95% CI = 5.6-10.1), 0.08(95% CI = 0.04-0.14), 142.3 (95% CI = 59.5-340.4), and 0.97 (SE = 0.01), respectively. In 6 studies, PCT was found to be superior than CRP, whose DOR was only 16.7 (95%CI = 8.8-31.7). Our meta-analysis demonstrates that serum PCT assay is a highly accurate and powerful test for rapidly differentiating between bacterial and viral meningitis in children.

  11. Procalcitonin as a Serum Biomarker for Differentiation of Bacterial Meningitis From Viral Meningitis in Children: Evidence From a Meta-Analysis.

    Science.gov (United States)

    Henry, Brandon Michael; Roy, Joyeeta; Ramakrishnan, Piravin Kumar; Vikse, Jens; Tomaszewski, Krzysztof A; Walocha, Jerzy A

    2016-07-01

    Several studies have explored the use of serum procalcitonin (PCT) in differentiating between bacterial and viral etiologies in children with suspected meningitis. We pooled these studies into a meta-analysis to determine the PCT diagnostic accuracy. All major databases were searched through March 2015. No date or language restrictions were applied. Eight studies (n = 616 pediatric patients) were included. Serum PCT assay was found to be very accurate for differentiating the etiology of pediatric meningitis with pooled sensitivity and specificity of 0.96 (95% CI = 0.92-0.98) and 0.89 (95% CI = 0.86-0.92), respectively. The pooled positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) for PCT were 7.5 (95% CI = 5.6-10.1), 0.08(95% CI = 0.04-0.14), 142.3 (95% CI = 59.5-340.4), and 0.97 (SE = 0.01), respectively. In 6 studies, PCT was found to be superior than CRP, whose DOR was only 16.7 (95%CI = 8.8-31.7). Our meta-analysis demonstrates that serum PCT assay is a highly accurate and powerful test for rapidly differentiating between bacterial and viral meningitis in children. PMID:26378091

  12. Acute hyponatraemia secondary to cerebral salt wasting syndrome in a patient with tuberculous meningitis.

    Science.gov (United States)

    Ti, L K; Kang, S C; Cheong, K F

    1998-08-01

    A 30-year-old HIV-positive man presented with acute hydrocephalus secondary to tuberculous meningitis, for which an external ventricular drain was inserted. He developed marked natriuresis in the postoperative period, which resulted in acute hyponatraemia (131 to 122 mmol/l) and a contraction of his intravascular volume. A diagnosis of cerebral salt wasting syndrome was made, and he responded to sodium and fluid loading. This case highlights the differentiation of cerebral salt wasting syndrome from the more commonly occurring syndrome of inappropriate anti-diuretic hormone secretion as the aetiology of the hyponatraemia.

  13. Case of acute meningitis with clear cerebrospinal fluid: value of computed tomography for the diagnosis of central nervous system tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Cesari, V.

    1986-11-06

    The author reports a case of acute meningitis with clear cerebrospinal fluid in which extensive bacteriologic investigations were negative making the etiologic diagnosis exceedingly difficult. Initiation of empiric antituberculous therapy was rapidly followed by clinical and biological improvement, without complications, and by resolution of abnormal findings on computed tomography of the brain. On these grounds, meningitis secondary to a tuberculoma in the temporal lobe was diagnosed. The author points out that tuberculous meningitis is still a severe, potentially fatal condition; this, together with the fact that tubercle bacilli are often very scarce or absent, requires that tuberculous meningitis be routinely considered in every patient with clear cerebrospinal fluid meningitis whose condition deteriorates. Computed tomography of the brain is essential to ensure rapid diagnosis and prompt initiation of antituberculous therapy. Lastly, the author points out that nowadays herpes simplex virus encephalopathy should also be considered.

  14. Determination Of Appropriate Antibiotic In Bacterial Meningitis Of Children Based On MIC

    Directory of Open Access Journals (Sweden)

    Noorbakhsh S

    2005-05-01

    Full Text Available Background: Bacterial meningitis is one of the most serious infections in infants and children. Three organisms include S.Pneumo;N.mening;H.Influ are the most common cause of meningitis in children between 2M-14y age.Etest is a new method for determination the MIC of some antimicrobial drugs in agarose .This method is useful for some organisms like as S .Pneumo; N.mening; H.Influ;sensitive Streptococcus and anaerobic ;aerobic gram negative. Materials and Methods: In this descriptive cross sectional study; In 57 suspected meningitis children ; organisms isolated from blood; CSF or other sterile boy fluid after culturing and antibiogram;. .MIC of someorganisms detected by Etest method. Results: Streptococcuswas the most prevalent ( 70% and S.pneumon( 90% of all Streptococcus; H.infl 2%;N.mening 4%and L.monocyt 6%(more than expected;Gram negative (Ecoli; Klebsiella; entrobacter and psudomona 18%. There was significant difference (P =0.01in type of organisms between age groups. S.pneumonia was more frequent in children > 2 year ;N.meningitis in>4yr old .Site of isolation :blood; CSF (35.8*;28.3%other sterile site 18.4%;concomitant positive culture in two site:17%.Mean age in Streptococcus was significantly different with Listeria (p=0.05; N.meningitis (p=0.04;H.influ (p=0.04;.but no difference with Staphylococcus;Klebsiella and E.coli Two type of H.inf were sensitive to Ampici or chloram ;both of them were sensitive to ceftiaxon. GBS were sensitive to PNC or Ampici Strep.nonAnonBnon- Cotrimoxazol>32mic/ml /PNC >256mic/ml/ Vanco>256mic/ml Strep.D: Cotrimoxazol>0.062mg/ml/ /PNC >0.016mic/ml/Imipenem>0.032mic/ml. Strep Pneumonia: All fo them were sensitive except 3 cases /Cotrimoxazol>2ic/ml /PNC =0.01mic/ml/Vanco>0.125mic/ m Vanco>0. 25mic/ ml/.Cotrimoxazol>2ic/ml / PNC =0.01mg/ml Vanco>0.125mic/ ml / Cotrimoxazol>2mic/ml /MIC-PNC >0.016mic/ml Therefore high dose of PNC is adequate for S.pneu ;because of Interm resistance to PNC All 3 N.menin were

  15. Lack of value of routine analysis of cerebrospinal fluid for prediction and diagnosis of external drainage-related bacterial meningitis

    NARCIS (Netherlands)

    Schade, RP; Schinkel, J; Roelandse, FWC; Geskus, RB; Visser, L.G.; van Dijk, J.M.C.; Voormolen, JHC; van Pelt, H; Kuijper, EJ

    2006-01-01

    Object. Routine microbiological and chemical analysis of cerebrospinal fluid (CSF) is often performed to diagnose external drainage-related bacterial meningitis (ED-BM) at an early stage. A cohort study was performed to investigate the value of several commonly used CSF parameters For the prediction

  16. Lack of value of routine analysis of cerebrospinal fluid for prediction and diagnosis of external drainage-related bacterial meningitis.

    NARCIS (Netherlands)

    Schade, R.P.; Schinkel, J.; Roelandse, F.W.; Geskus, R.B.; Visser, L.G.; Dijk, M.C.R.F. van; Voormolen, J.H.; Pelt, H. van; Kuijper, E.J.

    2006-01-01

    OBJECT: Routine microbiological and chemical analysis of cerebrospinal fluid (CSF) is often performed to diagnose external drainage-related bacterial meningitis (ED-BM) at an early stage. A cohort study was performed to investigate the value of several commonly used CSF parameters for the prediction

  17. Correlation between the neonatal EEG and the neurological examination in the first year of life in infants with bacterial meningitis Correlación entre el EEG neonatal y el examen neurológico en el primer año de vida en recién nacidos con meningitis bacteriana

    Directory of Open Access Journals (Sweden)

    Adrián Poblano

    2007-09-01

    Full Text Available OBJECTIVE: To assess the contribution of neonatal electroencephalogram (EEG and its correlation with the neurological examination at age of 9 months in newborns with bacterial neonatal meningitis. METHOD: Twenty seven infants were studied with positive cerebrospinal fluid (CSF culture for bacteria. We used the worse EEG result during acute phase of meningitis, and performed neurologic follow-up after discharge from hospital. Background cerebral activity was classified as normal or mildly, moderately, or markedly abnormal. Neurologic examination outcomes was classified normal, mild abnormalities, moderate abnormalities and severe abnormalities. RESULTS: EEG performed in the neonatal period during acute bacterial meningitis predicts adverse outcome early at age of 9 months, and had a significant correlation with cephalic perimeter and active tone alterations. CONCLUSION: Neonatal EEG is useful for predicting abnormal outcomes, especially cephalic perimeter and active tone abnormalities at 9 months of age in infants with bacterial neonatal meningitis.OBJETIVO: Medir la contribución del electroencefalograma (EEG neonatal y su correlación con el examen neurológico a la edad de 9 meses en recién nacidos con meningitis neonatal bacteriana. MÉTODO: Se estudió a 27 neonatos con cultivos positivos de líquido cefalorraquídeo a bacterias. Se uso el peor resultado del EEG obtenido durante el periodo agudo de la meningitis. El seguimiento neurológico se efectuó tras el egreso hospitalario. La actividad de fondo del EEG se clasificó en normal y anormal leve, moderada y severa. El examen neurológico se clasificó en normal, y anormal leve moderado y severo. RESULTADOS: El EEG realizado durante el periodo neonatal durante la fase aguda de la meningitis bacteriana predice bien un resultado adverso a la edad de 9 meses, con correlaciones significativas con el perímetro cefálico y con las alteraciones del tono activo. CONCLUSION: El EEG neonatal es

  18. Acute Bacterial Prostatitis: Diagnosis and Management.

    Science.gov (United States)

    Coker, Timothy J; Dierfeldt, Daniel M

    2016-01-15

    Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy. PMID:26926407

  19. Evolution of a FLT3-TKD mutated subclone at meningeal relapse in acute promyelocytic leukemia.

    Science.gov (United States)

    Bochtler, Tilmann; Fröhling, Stefan; Weichert, Wilko; Endris, Volker; Thiede, Christian; Hutter, Barbara; Hundemer, Michael; Ho, Anthony D; Krämer, Alwin

    2016-09-01

    Here, we report the case of an acute promyelocytic leukemia (APL) patient who-although negative for FLT3 mutations at diagnosis-developed isolated FLT3 tyrosine kinase II domain (FLT3-TKD)-positive meningeal relapse, which, in retrospect, could be traced back to a minute bone marrow subclone present at first diagnosis. Initially, the 48-yr-old female diagnosed with high-risk APL had achieved complete molecular remission after standard treatment with all-trans retinoic acid (ATRA) and chemotherapy according to the AIDA (ATRA plus idarubicin) protocol. Thirteen months after the start of ATRA maintenance, the patient suffered clinically overt meningeal relapse along with minute molecular traces of PML/RARA (promyelocytic leukemia/retinoic acid receptor alpha) in the bone marrow. Following treatment with arsenic trioxide and ATRA in combination with intrathecal cytarabine and methotrexate, the patient achieved a complete molecular remission in both cerebrospinal fluid (CSF) and bone marrow, which currently lasts for 2 yr after completion of therapy. Whole-exome sequencing and subsequent ultradeep targeted resequencing revealed a heterozygous FLT3-TKD mutation in CSF leukemic cells (p.D835Y, c.2503G>T, 1000/1961 reads [51%]), which was undetectable in the concurrent bone marrow sample. Interestingly, the FLT3-TKD mutated meningeal clone originated from a small bone marrow subclone present in a variant allele frequency of 0.4% (6/1553 reads) at initial diagnosis. This case highlights the concept of clonal evolution with a subclone harboring an additional mutation being selected as the "fittest" and leading to meningeal relapse. It also further supports earlier suggestions that FLT3 mutations may play a role for migration and clonal expansion in the CSF sanctuary site. PMID:27626069

  20. 血清降钙素原在细菌性脑膜炎诊断中的应用%The significance of serum procalcitonin in diagnosis of bacterial meningitis

    Institute of Scientific and Technical Information of China (English)

    田玉峰; 王家安

    2015-01-01

    Objective:To evaluate the clinical significance of serum procalcitonin in identification and diagnosis of bacterial meningitis.Methods:Among the 22 children bacterial meningitis and 15 children bacterial meningitis,serum procalcitonin(PCT)、C-reactive protein(CRP) concentration levels were measured. And 20 outpatients were measured as normal control.Results:The level of PCT and CRP was significantly higher in the bacterial meningitis group than the viral meningitis group and normal control, there were significant differences in the two groups(P6 ng/ ml as a threshold for the diagnosis of children bacterial meningitis, the sensitivity is 95% and specificity is 99%. However, take serum CRP >25mg/L as a threshold for the diagnosis of children bacterial meningitis, the sensitivity is 83% and specificity is 87%. Conclusions:It suggested that serum procalcitonin can be useful in identification and diagnosis of severe acute pancreatitis,better than CRP.%目的:评价血清降钙素原在细菌性脑膜炎鉴别诊断中的临床意义。方法:对22例儿童细菌性脑膜炎和15例儿童病毒性脑膜炎进行血清降钙素原、C-反应蛋白检测,同时以20例正常体检人群做对照。结果:细菌性脑膜炎组血清降钙素原和C-反应蛋白明显高于病毒性脑膜炎组和对照组,差异均具有统计学差异(P<0.05),PCT能显著区分开细菌性和病毒性脑膜炎,CRP在两组间存在浓度重叠,无法完全区分开细菌性和病毒性脑膜炎。PCT诊断细菌性脑膜炎的灵敏度和特异性为95%,99%,CRP诊断细菌性脑膜炎的灵敏度和特异性为83%,87%。结论:血清降钙素原对于细菌性脑膜炎具有优异的鉴别和诊断效果,优于C-反应蛋白。

  1. Evolution of bacterial meningitis diagnosis in Sao Paulo State-Brazil and future challenges

    Directory of Open Access Journals (Sweden)

    Maristela Marques Salgado

    2013-09-01

    Full Text Available Bacterial meningitis (BM is a severe disease and still represents a serious public health problem with high rates of morbidity and mortality. The most common cases of BM around the world, mainly in Brazil, have been caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b. Bacterial culture is the gold-standard technique for BM confirmation, but approximately 50% of suspected cases are not culture-confirmed, due to problems related to improper transportation and seeding or previous antibiotic treatment. Immunological methods present low sensitivity and have possibility of cross-reactions. Real time PCR (qPCR is a molecular technique and has been successful used for BM diagnosis at Instituto Adolfo Lutz in São Paulo State, Brazil, since 2007. The incorporation of qPCR in the Public Health surveillance routine in our state resulted in diminishing 50% of undetermined BM cases. Our efforts are focused on qPCR implementation in the BM diagnostic routine throughout Brazil.

  2. Validation of a Dutch risk score predicting poor outcome in adults with bacterial meningitis in Vietnam and Malawi.

    Directory of Open Access Journals (Sweden)

    Ewout S Schut

    Full Text Available We have previously developed and validated a prognostic model to predict the risk for unfavorable outcome in Dutch adults with bacterial meningitis. The aim of the current study was to validate this model in adults with bacterial meningitis from two developing countries, Vietnam and Malawi. Demographic and clinical characteristics of Vietnamese (n = 426, Malawian patients (n = 465 differed substantially from those of Dutch patients (n = 696. The Dutch model underestimated the risk of poor outcome in both Malawi and Vietnam. The discrimination of the original model (c-statistic [c] 0.84; 95% confidence interval 0.81 to 0.86 fell considerably when re-estimated in the Vietnam cohort (c = 0.70 or in the Malawian cohort (c = 0.68. Our validation study shows that new prognostic models have to be developed for these countries in a sufficiently large series of unselected patients.

  3. High creatinine clearance in critically ill patients with community-acquired acute infectious meningitis

    Directory of Open Access Journals (Sweden)

    Lautrette Alexandre

    2012-09-01

    Full Text Available Abstract Background A high dose of anti-infective agents is recommended when treating infectious meningitis. High creatinine clearance (CrCl may affect the pharmacokinetic / pharmacodynamic relationships of anti-infective drugs eliminated by the kidneys. We recorded the incidence of high CrCl in intensive care unit (ICU patients admitted with meningitis and assessed the diagnostic accuracy of two common methods used to identify high CrCl. Methods Observational study performed in consecutive patients admitted with community-acquired acute infectious meningitis (defined by >7 white blood cells/mm3 in cerebral spinal fluid between January 2006 and December 2009 to one medical ICU. During the first 7 days following ICU admission, CrCl was measured from 24-hr urine samples (24-hr-UV/P creatinine and estimated according to Cockcroft-Gault formula and the simplified Modification of Diet in Renal Disease (MDRD equation. High CrCl was defined as CrCl >140 ml/min/1.73 m2 by 24-hr-UV/P creatinine. Diagnostic accuracy was performed with ROC curves analysis. Results Thirty two patients were included. High CrCl was present in 8 patients (25% on ICU admission and in 15 patients (47% during the first 7 ICU days for a median duration of 3 (1-4 days. For the Cockcroft-Gault formula, the best threshold to predict high CrCl was 101 ml/min/1.73 m2 (sensitivity: 0.96, specificity: 0.75, AUC = 0.90 ± 0.03 with a negative likelihood ratio of 0.06. For the simplified MDRD equation, the best threshold to predict high CrCl was 108 ml/min/1.73 m2 (sensitivity: 0.91, specificity: 0.80, AUC = 0.88 ± 0.03 with a negative likelihood ratio of 0.11. There was no difference between the estimated methods in the diagnostic accuracy of identifying high CrCl (p = 0.30. Conclusions High CrCl is frequently observed in ICU patients admitted with community-acquired acute infectious meningitis. The estimated methods of CrCl could be used as a screening tool to

  4. Streptococcus suis, an important cause of adult bacterial meningitis in northern Vietnam.

    Directory of Open Access Journals (Sweden)

    Heiman F L Wertheim

    Full Text Available BACKGROUND: Streptococcus suis can cause severe systemic infection in adults exposed to infected pigs or after consumption of undercooked pig products. S. suis is often misdiagnosed, due to lack of awareness and improper testing. Here we report the first fifty cases diagnosed with S. suis infection in northern Viet Nam. METHODOLOGY/PRINCIPAL FINDINGS: In 2007, diagnostics for S. suis were set up at a national hospital in Hanoi. That year there were 43 S. suis positive cerebrospinal fluid samples, of which S. suis could be cultured in 32 cases and 11 cases were only positive by PCR. Seven patients were blood culture positive for S. suis but CSF culture and PCR negative; making a total of 50 patients with laboratory confirmed S. suis infection in 2007. The number of S. suis cases peaked during the warmer months. CONCLUSIONS/SIGNIFICANCE: S. suis was commonly diagnosed as a cause of bacterial meningitis in adults in northern Viet Nam. In countries where there is intense and widespread exposure of humans to pigs, S. suis can be an important human pathogen.

  5. Streptococcus suis, an Important Cause of Adult Bacterial Meningitis in Northern Vietnam

    Science.gov (United States)

    Wertheim, Heiman F. L.; Nguyen, Huyen Nguyen; Taylor, Walter; Lien, Trinh Thi Minh; Ngo, Hoa Thi; Nguyen, Thai Quoc; Nguyen, Bich Ngoc Thi; Nguyen, Ha Hong; Nguyen, Ha Minh; Nguyen, Cap Trung; Dao, Trinh Tuyet; Nguyen, Trung Vu; Fox, Annette; Farrar, Jeremy; Schultsz, Constance; Nguyen, Hien Duc; Nguyen, Kinh Van; Horby, Peter

    2009-01-01

    Background Streptococcus suis can cause severe systemic infection in adults exposed to infected pigs or after consumption of undercooked pig products. S. suis is often misdiagnosed, due to lack of awareness and improper testing. Here we report the first fifty cases diagnosed with S. suis infection in northern Viet Nam. Methodology/Principal Findings In 2007, diagnostics for S. suis were set up at a national hospital in Hanoi. That year there were 43 S. suis positive cerebrospinal fluid samples, of which S. suis could be cultured in 32 cases and 11 cases were only positive by PCR. Seven patients were blood culture positive for S. suis but CSF culture and PCR negative; making a total of 50 patients with laboratory confirmed S. suis infection in 2007. The number of S. suis cases peaked during the warmer months. Conclusions/Significance S. suis was commonly diagnosed as a cause of bacterial meningitis in adults in northern Viet Nam. In countries where there is intense and widespread exposure of humans to pigs, S. suis can be an important human pathogen. PMID:19543404

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

    Science.gov (United States)

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

    2014-02-01

    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.

  7. Neuro-intensive treatment targeting intracranial hypertension improves outcome in severe bacterial meningitis: an intervention-control study.

    Directory of Open Access Journals (Sweden)

    Martin Glimåker

    Full Text Available OBJECTIVE: To evaluate the efficacy of early intracranial pressure (ICP-targeted treatment, compared to standard intensive care, in adults with community acquired acute bacterial meningitis (ABM and severely impaired consciousness. DESIGN: A prospectively designed intervention-control comparison study of adult cases from September 2004 to January 2012. PATIENTS: Included patients were confirmed ABM-cases, aged 16-75 years, with severely impaired mental status on admission. Fifty-two patients, given ICP-targeted treatment at the neuro-intensive care unit, and 53 control cases, treated with conventional intensive care, were included. All the patients received intensive care with mechanical ventilation, sedation, antibiotics and corticosteroids according to current guidelines. Additional ICP-treatment in the intervention group included cerebrospinal fluid drainage using external ventricular catheters (n = 48, osmotherapy (n = 21, hyperventilation (n = 13, external cooling (n = 9, gram-doses of methylprednisolone (n = 3 and deep barbiturate sedation (n = 2 aiming at ICP 50 mmHg. MEASUREMENTS: The primary endpoint was mortality at two months and secondary endpoint was Glasgow outcome score and hearing ability at follow-up at 2-6 months. OUTCOMES: The mortality was significantly lower in the intervention group compared to controls, 5/52 (10% versus 16/53 (30%; relative risk reduction 68%; p<0.05. Furthermore, only 17 patients (32% in the control group fully recovered compared to 28 (54% in the intervention group (relative risk reduction 40%; p<0.05. CONCLUSIONS: Early neuro-intensive care using ICP-targeted therapy, mainly cerebrospinal fluid drainage, reduces mortality and improves the overall outcome in adult patients with ABM and severely impaired mental status on admission.

  8. Comparison of 16S rDNA-PCR Amplification and Culture of Cerebrospinal Fluid for Diagnosis of Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    Farshad Foroughi

    2010-12-01

    Full Text Available Objective:Early and accurate diagnosis of bacterial meningitis is of critical concern. Optimum and rapid laboratory facilities are not routinely available for detecting the etiologic agents of meningitis. The objective of this study was to compare polymerase chain reaction (PCR assay with culture for detection of bacteria in central nervous system (CNS samples from patients suspected to have meningitis. Methods: One-hundred CSF samples were obtained and divided into two parts. One part of samples was used for standard bacterial culture and gram staining. The remaining was used for DNA extraction. PCR assay was performed with universal primers for 16S rDNA gene of bacteria. Performance characteristics of the test were determined. Findings:The PCR method was able to detect bacteria in all 36 culture-positive and in 38 of 64 culture-negative cases showing sensitivity and specificity of 100% and 40.6% respectively. Positive predictive value was 48.6% and negative predictive value 100%, however, Kappa coefficient showed the correlation of the 2 methods to be at 0.33. Conclusion:There are advantages and disadvantages in performance characteristics of the conventional CSF culture and universal CSF 16S rDNA PCR. Therefore, it is recommended to use both methods in clinical practice, particularly in suspicious contaminated samples, with presumable presence of fastidious or slow growing bacteria because of antibiotic consumption.

  9. Computed tomography in suppurative meningitis. CT and clinical findings in the acute stage

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Akira; Fujiwara, Katsuhiko; Iino, Shigeru (Kyoto Prefectural Univ. of Medicine (Japan))

    1982-06-01

    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.

  10. Prevalence of newborn bacterial meningitis and sepsis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil.

    Science.gov (United States)

    da Silva, Luzia Poliana Anjos; Cavalheiro, Laura Giotto; Queirós, Fernanda; Nova, Camila Vila; Lucena, Rita

    2007-04-01

    Bacterial meningitis is still a major public health threat inside developing countries. In Brazil, the Department of Public Health estimates that the prevalence of bacterial meningitis is 22 cases per 100,000 persons. During the neonatal period, the bacterial meningitis develops special characteristics that can result in hearing problems and movement loss due to neurological and psychological damages. This study had the aim to analyze the prevalence of bacterial meningitis and sepsis in newborns during the pregnancy period for those using the public health care system in Salvador-Bahia. One of the goal was to describe the risk factors of bacterial meningitis and sepsis in newborns. A second goal was to identify, based on newborn health records, the difficulties to predict issues with the hearing, neurological and psychological problems. This study has a cross-sectional design. The newborns that were included in this study had bacterial meningitis or sepsis within 0-28 days of life. They were admitted in the maternity wards between June-December 2005 at the newborn intensive unit care. We analyzed 72 reports of newborns and only 11 (17%) were bacterial meningitis or sepsis newborn cases. These cases were associated to high intake of ototoxic drugs that can cause oto and nephrotoxicity, and cause serious sequels on the child development. Nervous system infection is one of the 2 major problems in clinical practice, especially during the first month after birth. During this first month, the nervous system infection develops special characteristics, which are different from regular symptoms and it requires treatment due to the increased risk to develop complications. It is strongly recommended to monitor ototoxic drugs use to prevent effects on the hearing system.

  11. Protecting the herd: the remarkable effectiveness of the bacterial meningitis polysaccharide-protein conjugate vaccines in altering transmission dynamics.

    Science.gov (United States)

    Stephens, David S

    2011-01-01

    Interrupting human-to-human transmission of the agents (Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae) of bacterial meningitis by new capsular polysaccharide-protein conjugate vaccines (PPCVs) has proven to be a remarkable (and unanticipated) contributor to vaccine effectiveness. Herd immunity accounts for ∼50% of the protection by meningococcal serogroup C PPCVs, pneumococcal PPCV7, and H. influenzae b PPCVs. Nasopharyngeal carriage can be reduced ≥75% for vaccine serotypes; the decrease in carriage is correlated with disease reduction in unvaccinated individuals, and the impact of herd immunity lasts for years. Based on these data, models for using herd immunity in vaccine-based prevention strategies are underway for control of meningitis in sub-Saharan Africa. Although the immunologic basis of herd immunity and impact on microbial biology need more study, protecting the unvaccinated by altering pathogen transmission dynamics is a powerful effect of PPCVs and increasingly important in vaccine introduction, implementation, and evaluation strategies.

  12. Pathogenic triad in bacterial meningitis: pathogen invasion, NF-κB activation and leukocyte transmigration that occur at the Blood-Brain Barrier

    Directory of Open Access Journals (Sweden)

    Sheng-He eHuang

    2016-02-01

    Full Text Available Bacterial meningitis remains the leading cause of disabilities worldwide. This life-threatening disease has a high mortality rate despite the availability of antibiotics and improved critical care. The interactions between bacterial surface components and host defense systems that initiate bacterial meningitis have been studied in molecular and cellular detail over the past several decades. Bacterial meningitis commonly exhibits triad hallmark features (THFs: pathogen penetration, nuclear factor-kappaB (NF-B activation in coordination with type 1 interferon (IFN signaling and leukocyte transmigration that occur at the blood-brain barrier (BBB, which consists mainly of brain microvascular endothelial cells (BMEC. This review outlines the progression of these early inter-correlated events contributing to the central nervous system (CNS inflammation and injury during the pathogenesis of bacterial meningitis. A better understanding of these issues is not only imperative to elucidating the pathogenic mechanism of bacterial meningitis, but may also provide the in-depth insight into the development of novel therapeutic interventions against this disease.

  13. Pathogenic Triad in Bacterial Meningitis: Pathogen Invasion, NF-κB Activation, and Leukocyte Transmigration that Occur at the Blood-Brain Barrier.

    Science.gov (United States)

    Wang, Shifu; Peng, Liang; Gai, Zhongtao; Zhang, Lehai; Jong, Ambrose; Cao, Hong; Huang, Sheng-He

    2016-01-01

    Bacterial meningitis remains the leading cause of disabilities worldwide. This life-threatening disease has a high mortality rate despite the availability of antibiotics and improved critical care. The interactions between bacterial surface components and host defense systems that initiate bacterial meningitis have been studied in molecular and cellular detail over the past several decades. Bacterial meningitis commonly exhibits triad hallmark features (THFs): pathogen penetration, nuclear factor-kappaB (NF-κB) activation in coordination with type 1 interferon (IFN) signaling and leukocyte transmigration that occur at the blood-brain barrier (BBB), which consists mainly of brain microvascular endothelial cells (BMEC). This review outlines the progression of these early inter-correlated events contributing to the central nervous system (CNS) inflammation and injury during the pathogenesis of bacterial meningitis. A better understanding of these issues is not only imperative to elucidating the pathogenic mechanism of bacterial meningitis, but may also provide the in-depth insight into the development of novel therapeutic interventions against this disease.

  14. Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies

    Directory of Open Access Journals (Sweden)

    Gemke Reinoud JBJ

    2010-08-01

    Full Text Available Abstract Background Bacterial meningitis (BM is a severe infection responsible for high mortality and disabling sequelae. Early identification of patients at high risk of these outcomes is necessary to prevent their occurrence by adequate treatment as much as possible. For this reason, several prognostic models have been developed. The objective of this study is to summarize the evidence regarding prognostic factors predicting death or sequelae due to BM in children 0-18 years of age. Methods A search in MEDLINE and EMBASE was conducted to identify prognostic studies on risk factors for mortality and sequelae after BM in children. Selection of abstracts, full-text articles and assessment of methodological quality using the QUIPS checklist was performed by two reviewers independently. Data on prognostic factors per outcome were summarized. Results Of the 31 studies identified, 15 were of moderate to high quality. Due to substantial heterogeneity in study characteristics and evaluated prognostic factors, no quantitative analysis was performed. Prognostic factors found to be statistically significant in more than one study of moderate or high quality are: complaints >48 hours before admission, coma/impaired consciousness, (prolonged duration of seizures, (prolonged fever, shock, peripheral circulatory failure, respiratory distress, absence of petechiae, causative pathogen Streptococcus pneumoniae, young age, male gender, several cerebrospinal fluid (CSF parameters and white blood cell (WBC count. Conclusions Although several important prognostic factors for the prediction of mortality or sequelae after BM were identified, the inability to perform a pooled analysis makes the exact (independent predictive value of these factors uncertain. This emphasizes the need for additional well-conducted prognostic studies.

  15. Immunohistochemical analysis of MMP-9, MMP-2 and TIMP-1, TIMP-2 expression in the central nervous system following infection with viral and bacterial meningitis.

    Science.gov (United States)

    Sulik, Artur; Chyczewski, Lech

    2008-01-01

    Matrix metalloproteinases (MMPs) are capable of degrading components of the basal lamina of cerebral vessels, thereby disrupting the blood-brain barrier and inducing leukocyte recruitment. This study provides comprehensive information regarding the cell specificity of matrix metalloproteinases (MMP-2, MMP-9) and their binding tissue inhibitors (TIMP-1, TIMP-2) in the central nervous system during viral and bacterial meningitis. Specifically, we evaluated the immunoreactivity of MMPs and TIMPs in various cell types in brain parenchyma and meninges obtained from autopsy tissues. We found that a higher proportion of endothelial cells were positive for MMP-9 during meningitis when compared to controls. In addition, the immunoreactivity of MMP-9 decreased and the immunoreactivity of TIMP-1 increased in astrocytes upon infection. Furthermore, the results of this study revealed that mononuclear cells were highly immunoreactive for TIMP-1, TIMP-2 and MMP-9 during viral meningitis and that the expression of TIMPs in polymorphonuclear cells was even higher during bacterial meningitis. Taken together the results of this study indicated that the central nervous system resident cells and inflammatory infiltrates contribute to MMPs activity and that the expression patterns vary between cell types and in response to viral and bacterial meningitis.

  16. Immunohistochemical analysis of MMP-9, MMP-2 and TIMP-1, TIMP-2 expression in the central nervous system following infection with viral and bacterial meningitis.

    Directory of Open Access Journals (Sweden)

    Lech Chyczewski

    2009-01-01

    Full Text Available Matrix metalloproteinases (MMPs are capable of degrading components of the basal lamina of cerebral vessels, thereby disrupting the blood-brain barrier and inducing leukocyte recruitment. This study provides comprehensive information regarding the cell specificity of matrix metalloproteinases (MMP-2, MMP-9 and their binding tissue inhibitors (TIMP-1, TIMP-2 in the central nervous system during viral and bacterial meningitis. Specifically, we evaluated the immunoreactivity of MMPs and TIMPs in various cell types in brain parenchyma and meninges obtained from autopsy tissues. We found that a higher proportion of endothelial cells were positive for MMP-9 during meningitis when compared to controls. In addition, the immunoreactivity of MMP-9 decreased and the immunoreactivity of TIMP-1 increased in astrocytes upon infection. Furthermore, the results of this study revealed that mononuclear cells were highly immunoreactive for TIMP-1, TIMP-2 and MMP-9 during viral meningitis and that the expression of TIMPs in polymorphonuclear cells was even higher during bacterial meningitis. Taken together the results of this study indicated that the central nervous system resident cells and inflammatory infiltrates contribute to MMPs activity and that the expression patterns vary between cell types and in response to viral and bacterial meningitis.

  17. Clinical and laboratorial characteristics of bacterial meningitis in children Características clínicas e laboratoriais de meningites bacterianas em crianças

    Directory of Open Access Journals (Sweden)

    Rita Lucena

    1996-12-01

    Full Text Available Data from the records of 528 children under 15 years old with diagnosis of acute bacterial meningitis, admitted at the Hospital Couto Maia between 1990 and 1992 were analyzed. Bacterial meningitis was more frequent in children under the age of 1 year (37.8%. The most common etiologic agent was H. influenzae (42.2%. The global letality was 20.9%. Individual predictors of poor outcome were: absence of the "classic triad", CSF cell count under 1000 /mm³, age under 2 years, presence of seizures, depressed sensorium, and S. pneumoniae as causal agent.Foram analisados dados de prontuário de 528 crianças com faixa etária entre 1 mês e 15 anos e diagnóstico de meningite bacteriana aguda, admitidas no Hospital Couto Maia entre 1990 e 1992. Meningite bacteriana foi mais frequente em crianças com idade inferior a 1 ano (37,8%. O agente etiológico mais comum foi H. influenzae (42,2%. A letalidade global foi 20,9% e os fatores preditivos de pior prognóstico foram: ausência da "tríade clássica" (febre, vômitos e rigidez de nuca, celularidade do líquido cefalorraquidiano inferior a 1000 /mm³, idade inferior a 2 anos, presença de convulsões, alteração do nível de consciência e S. pneumoniae como agente causal.

  18. Matrix metalloproteinase-9 deficiency impairs host defense mechanisms against Streptococcus pneumoniae in a mouse model of bacterial meningitis.

    Science.gov (United States)

    Böttcher, Tobias; Spreer, Annette; Azeh, Ivo; Nau, Roland; Gerber, Joachim

    2003-03-01

    Matrix metalloproteinase-9 (MMP-9) appears to contribute to blood-brain barrier damage and neuronal injury in bacterial meningitis. To further explore the function of MMP-9 in meningeal inflammation, we injected 10(4) colony forming units (CFU) of a Streptoccocus pneumoniae type 3 strain into the right forebrain of MMP-9 deficient mice (MMP-9(-/-), n=16) and wild-type controls (129 x B6, n=15). The clinical course of the disease, leukocyte recruitment into the subarachnoid space and bacterial titers in the brain did not differ. Yet, clearance of the bacteria from blood (log CFU/ml 4.7 [3.8/5.4] vs. 3.6 [3.0/4.0]; P=0.005) and spleen homogenates (log CFU/ml 5.3 [4.8/5.5] vs. 4.0 [2.8/4.7]; P=0.01) was reduced in MMP-9 deficient mice. A reduced systemic bacterial clearance of MMP-9(-/-) mice was confirmed in experimental S. pneumoniae peritonitis/sepsis. This implies a compromised systemic, but not intracerebral host response against S. pneumoniae in MMP-9 deficiency. PMID:12581831

  19. Comparative analysis of clinical characters between acute focal bacterial nephritis and acute pylonephritis

    Institute of Scientific and Technical Information of China (English)

    李湛

    2013-01-01

    Objective To improve standards of diagnosis and therapy for acute focal bacterial nephritis by comparing the characters of acute focal bacterial nephritis and acute pylonephritis.Methods Thirty-five patients of upper urinary tract infection whoever accepted ultrasongraphic and computed tomographic (CT) examinations in Beijing Hospital from January 2007 to January 2013 were studied retrospectively.Eighteen patients were diagnosed as acute focal bacterial nephritis (AFBN) according to CT imaging features,the other 17 patients were diagnosed as acute

  20. Identification of Common Bacterial Pathogens Causing Meningitis in Culture-Negative Cerebrospinal Fluid Samples Using Real-Time Polymerase Chain Reaction.

    Science.gov (United States)

    Khater, Walaa Shawky; Elabd, Safia Hamed

    2016-01-01

    Background. Meningitis is a serious communicable disease with high morbidity and mortality rates. It is an endemic disease in Egypt caused mainly by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. In some settings, bacterial meningitis is documented depending mainly on positive cerebrospinal fluid (CSF) culture results or CSF positive latex agglutination test, missing the important role of prior antimicrobial intake which can yield negative culture and latex agglutination test results. This study aimed to utilize molecular technology in order to diagnose bacterial meningitis in culture-negative CSF samples. Materials and Methods. Forty culture-negative CSF samples from suspected cases of bacterial meningitis were examined by real-time polymerase chain reaction (real-time PCR) for the presence of lytA, bexA, and ctrA genes specific for Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, respectively. Results. Positive real-time PCR results for Streptococcus pneumoniae were detected in 36 (90%) of culture-negative CSF samples while no positive results for Haemophilus influenzae or Neisseria meningitidis were detected. Four (10%) samples were negative by real-time PCR for all tested organisms. Conclusion. The use of molecular techniques as real-time PCR can provide a valuable addition to the proportion of diagnosed cases of bacterial meningitis especially in settings with high rates of culture-negative results. PMID:27563310

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

    DEFF Research Database (Denmark)

    Ronit, Andreas; Berg, Ronan M G; Bruunsgaard, Helle;

    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). Th......). The causative pathogen was identified as H influenzae serotype f (Hif), and was successfully treated with ceftriaxone. An immunological evaluation revealed transient low levels of immunoglobulins but no apparent immunodeficiency was found 2 years after the clinical insult....

  2. The formyl peptide receptor like-1 and scavenger receptor MARCO are involved in glial cell activation in bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Jansen Sandra

    2011-02-01

    Full Text Available Abstract Background Recent studies have suggested that the scavenger receptor MARCO (macrophage receptor with collagenous structure mediates activation of the immune response in bacterial infection of the central nervous system (CNS. The chemotactic G-protein-coupled receptor (GPCR formyl-peptide-receptor like-1 (FPRL1 plays an essential role in the inflammatory responses of host defence mechanisms and neurodegenerative disorders such as Alzheimer's disease (AD. Expression of the antimicrobial peptide cathelicidin CRAMP/LL-37 is up-regulated in bacterial meningitis, but the mechanisms underlying CRAMP expression are far from clear. Methods Using a rat meningitis model, we investigated the influence of MARCO and FPRL1 on rCRAMP (rat cathelin-related antimicrobial peptide expression after infection with bacterial supernatants of Streptococcus pneumoniae (SP and Neisseria meningitides (NM. Expression of FPRL1 and MARCO was analyzed by immunofluorescence and real-time RT-PCR in a rat meningitis model. Furthermore, we examined the receptor involvement by real-time RT-PCR, extracellular-signal regulated kinases 1/2 (ERK1/2 phosphorylation and cAMP level measurement in glial cells (astrocytes and microglia and transfected HEK293 cells using receptor deactivation by antagonists. Receptors were inhibited by small interference RNA and the consequences in NM- and SP-induced Camp (rCRAMP gene expression and signal transduction were determined. Results We show an NM-induced increase of MARCO expression by immunofluorescence and real-time RT-PCR in glial and meningeal cells. Receptor deactivation by antagonists and small interfering RNA (siRNA verified the importance of FPRL1 and MARCO for NM- and SP-induced Camp and interleukin-1β expression in glial cells. Furthermore, we demonstrated a functional interaction between FPRL1 and MARCO in NM-induced signalling by real-time RT-PCR, ERK1/2 phosphorylation and cAMP level measurement and show differences between

  3. A case of acute meningitis with clear cerebrospinal fluid: value of computed tomography for the diagnosis of central nervous system tuberculosis

    International Nuclear Information System (INIS)

    The author reports a case of acute meningitis with clear cerebrospinal fluid in which extensive bacteriologic investigations were negative making the etiologic diagnosis exceedingly difficult. Initiation of empiric antituberculous therapy was rapidly followed by clinical and biological improvement, without complications, and by resolution of abnormal findings on computed tomography of the brain. On these grounds, meningitis secondary to a tuberculoma in the temporal lobe was diagnosed. The author points out that tuberculous meningitis is still a severe, potentially fatal condition; this, together with the fact that tubercle bacilli are often very scarce or absent, requires that tuberculous meningitis be routinely considered in every patient with clear cerebrospinal fluid meningitis whose condition deteriorates. Computed tomography of the brain is essential to ensure rapid diagnosis and prompt initiation of antituberculous therapy. Lastly, the author points out that nowadays herpes simplex virus encephalopathy should also be considered

  4. A Fatal Case of Acute Steroid Responsive Meningitis Arteritis in a Dog

    Directory of Open Access Journals (Sweden)

    Kwiatkowska Miłosława*, Andrzej Pomianowski and Zbigniew Adamiak1

    2013-04-01

    Full Text Available Nine years old female boxer was evaluated for progressive tetraparesis, cranial nerve deficits, lethargy and stupor. Serum biochemistry revealed elevated liver enzymes alanine aminotransferase (ALT 379 u/l, asparaginian aminotransferase (AST 55 u/l, alkaline phosphatase (ALP 685 u/l and creatinine kinase (CK 511 u/l, and elevated acute phase proteins C-reactive protein (CRP 70 mg/ml. The cerebrospinal fluid examination revealed a mixed pleocytosis, protein content elevation (315 mg/dl and positive Pandy reaction. Immunoglobulin A (IgA in CSF was elevated (357 µg/ml, CRP was characteristic for a presentation period of disease (70 mg/ml. MRI examination revealed multifocal, diffused lesions in grey matter of frontal, occipital lobes. The white matter lesions were detected in cranial fossa region, thalamus, medulla oblongata and pons. The lesions were enhanced after contrast administration. Ventricular system was compressed; sediment was present in both of them. The biochemistry CSF results and MRI image were characteristic for steroid responsive meningitis arteritis (SRMA.

  5. 细菌性脑膜炎评分在儿科的应用%Application of bacterial meningitis score in department of pediatrics

    Institute of Scientific and Technical Information of China (English)

    高建生; 于依湘; 张则玮

    2012-01-01

    在发达国家细菌性脑膜炎(BM)仅占急性脑膜炎的4%~6%,但延误诊治有引起死亡或严重神经后遗症的风险.鉴别儿童BM与病毒性脑膜炎(VM),有助于减少抗菌药物使用和/或住院.已发表鉴别儿童BM和VM的临床决策规则中,只有BM评分(BMS)经来自同一中心的内部验证和多中心的外部验证,具有敏感性高、特异性好、易于使用的特点.BMS由5个易于获得、客观的参数组成:脑脊液(CSF)革兰染色阳性、CSF蛋白质>0.8g/L、外周血中性粒细胞绝对计数(ANC)>10×109/L、惊厥、CSF ANC>1000 ×106/L.革兰染色阳性评2分,其余每个参数阳性评1分.BMS可以准确鉴别BM极低风险(BMS=0)和高风险(BMS≥2),预测BM敏感性为98.3%~100%、特异性为52%~73%.极低风险患儿可不用抗菌药物门诊管理.%Bacterial meningitis (BM) accounts for 4%-6% of acute meningitis, and is at risk of death or severeneurologic sequelae, especially when the diagnosis and antibiotic administrationare are delayed. Distinguishing between bacterial and viral meningitis (VM) inchildren could contribute to limiting unnecessary antibioticuse and/or hospital admissions. Published clinical decision rules have beenproposed to distinguish between BM and VM in children. Only the bacterial meningitis score (BMS) are internally and externally validatedandcould distinguish between BM and VM with high sensitivity andspecificity andeasierto use in practice. BMS is based solely on five parameterthat are objective and readily available at the time ofpresentation: Gram stain of cerebrospinal fluid (CSF) showing bacteria, CSF protein > 0.8g/L, peripheral absolute neutrophilcount (ANC) > 10x10' cells/L, eclampsia, and CSF ANC > 1 000×106 cells/L BMSwas developedby attributing 2 points for a positive gram stain and 1 point for each of the othervariables. It accurately identifies childrenat very low (BMS = 0) or high (BMS≥2) risk of BM and could predict BM with high

  6. Post-infective transverse myelitis following Streptococcus pneumoniae meningitis with radiological features of acute disseminated encephalomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Williams Thomas

    2012-09-01

    Full Text Available Abstract Introduction Post-infectious autoimmune demyelination of the central nervous system is a rare neurological disorder typically associated with exanthematous viral infections. We report an unusual presentation of the condition and a previously undocumented association with Streptococcus pneumonia meningitis. Case presentation A 50-year-old Caucasian woman presented to our facility with an acute myelopathy three days after discharge following acute Streptococcus pneumoniae meningitis. Imaging studies of the spine ruled out an infective focus and no other lesions were seen within the cord. Diffuse, bilateral white matter lesions were seen within the cerebral hemispheres, and our patient was diagnosed as having a post-infective demyelination syndrome that met the diagnostic criteria for an acute transverse myelitis. Our patient clinically and radiologically improved following treatment with steroids. Conclusions The novel association of a Streptococcus pneumoniae infection with post-infectious autoimmune central nervous system demyelination should alert the reader to the potentially causative role of this common organism, and gives insights into the pathogenesis. The unusual dissociation between the clinical presentation and the location of the radiological lesions should also highlight the potential for the condition to mimic the presentation of others, and stimulates debate on the definitions of acute transverse myelitis and acute disseminated encephalomyelitis, and their potential overlap.

  7. The clinical utility of Procalcitionin in differentiating Bacterial meningitis from Viral meningitis%降钙素原在鉴别细菌性脑膜炎和病毒性脑炎的临床应用

    Institute of Scientific and Technical Information of China (English)

    林联韵; 高丽丹; 吴莉春

    2013-01-01

    Objective:The aim of this work was to study the clinical utility of Procalcitonin in differentiating Bacterial meningitis from Viral meningitis,we also compared PCT to C-reactive protein (CRP)and White blood count.Methods:Forty one childre with clinically suspected meningitis wenr studied.Lumbar Punctures were done for cases before starting initial antibiotic treatment.According to the result of bacterial cultres and cerebrospital fluid (CSF)cytochemical profile,we classified the children patients into two groups:The Bacterial meningitis group and The Viral meningitis group.PCT、CRPand Leukocyte count were measured individually at the time of admission and after treatment. Results :PCT levels were significantly higher in patients with bacterial miningitis compared to patients with viral meningitis (P<0.05), PCT levels in bacterial meningitis group significantly decreased after antibiotic treatment (P<0.05), Conclusion:Procalcitonin level has a better diagnostic and prognostic value in distinguish between bacterial and viral meningitis,it is also a good indicator of the eefficacy of treatment of bacterial meningitis.%  目的:研究降钙素原(Procalcitonin,PCT)在鉴别细菌性脑膜炎和病毒性脑膜炎的临床应用,同时将PCT与外周血CRP、血常规白细胞计数、脑脊液(CSF)细胞学检查等进行比较.方法:41名中枢神经系统感染患儿在进行抗生素治疗之前进行腰穿,根据细菌培养和脑脊液细胞学检查结果,将患者分成两组:细菌性脑膜炎组和病毒性脑炎组.PCT、CRP和血常规白细胞计数在入院和治疗后分别测定.结果:细菌性脑膜炎组患儿血清PCT和脑脊液PCT浓度明显高于病毒性脑炎组(P<0.05),差异均有统计学意义,且细菌性脑膜炎组患儿外周血PCT在经过抗生素治疗后较入院时明显下降,两者比较有统计学意义(P<0.05).结论:PCT对早期鉴别儿童细菌性脑膜炎和病毒性脑炎具有重要临床价值,同时也

  8. Isolated Torticollis May Present as an Atypical Presentation of Meningitis

    Directory of Open Access Journals (Sweden)

    Roger Chirurgi

    2012-01-01

    Full Text Available Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient. Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis. Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

  9. Prevention of meningeal relapses in acute lymphoblastic leukemia; Zapobieganie wznowom oponowym w ostrej bialaczce limfoblastycznej

    Energy Technology Data Exchange (ETDEWEB)

    Armata, J. [Polsko-Amerykanski Instytut Pediatrii, Collegium Medicum, Uniwersytet Jagiellonski, Cracow (Poland)

    1993-12-31

    The paper describes modern methods of preventing meningeal leukemia which, in view of the noxiousness of skull radiotherapy, increasingly restrict the use of this method in a growing number of children.(author) 25 refs, 3 tabs

  10. Perfil etiológico das meningites bacterianas em crianças Etiological profile of bacterial meningitis in children

    Directory of Open Access Journals (Sweden)

    Orlando C. Mantese

    2002-12-01

    meningite bacteriana continua tendo uma importante mortalidade entre as crianças, principalmente quando causada pelo pneumococo.Objective: To determine the etiologic profile and analyze some epidemiological aspects of children with bacterial meningitis admitted to a public teaching hospital. Methods: A prospective study was conducted on children with clinical and laboratory diagnosis of bacterial meningitis, admitted to Hospital das Clínicas da Universidade Federal de Uberlândia, from January 1987 to January 2001. Patients with meningitis associated with trauma, intracranial devices or malformations of the neural tube, and tuberculosis, were not included in the study. Results: From a total of 415 children with bacterial meningitis, the etiologic agent was detected in 315 (75.9%: Haemophilus influenzae b in 54.2%, meningococci in 20.6%, pneumococci in 18.1% and other agents, in 6.9%. Previous antibiotic treatment, observed in 47.2% of the cases, led to a significant decrease in positive blood cultures (from 50.8% to 38.7% and in cerebrospinal fluid cultures (from 71.7% to 57.6%. Among children younger than 48 months Haemophilus influenzae b was predominant, particularly when compared to meningococci. The overall mortality was 10.1%, with a significant difference between the rates of pneumococcal (17.5% and meningococcal meningitis (4.6%. Conclusions: Children affected by Haemophilus influenzae b and by pneumococci were younger than those with meningitis caused by meningococci. The blood and/or cerebrospinal fluid culture remains an important laboratory tool for etiologic diagnosis, despite the negative impact caused by antibiotic previous treatment. The agents most commonly detected were Haemophilus influenzae b, meningococci and pneumococci. Bacterial meningitis continues to present an important mortality among children, particularly when caused by pneumococci.

  11. Attenuation of the bacterial load in blood by pretreatment with granulocyte-colony-stimulating factor protects rats from fatal outcome and brain damage during Streptococcus pneumoniae meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian T; Lundgren, Jens D; Lund, Søren Peter;

    2004-01-01

    A model of pneumococcal meningitis in young adult rats receiving antibiotics once the infection was established was developed. The intent was to mimic clinical and histopathological features of pneumococcal meningitis in humans. The primary aim of the present study was to evaluate whether medical...... boosting of the peripheral neutrophil count affected the outcome of the meningitis. The risk of terminal illness over the first 7 days after infection was significantly reduced for rats who had elevated peripheral white blood cell counts after receiving granulocyte-colony-stimulating factor (G-CSF) prior...... to the infection compared to that for untreated rats (P = 0.039 by the log rank test). The improved outcome was associated with reduced signs of cerebral cortical damage (P = 0.008). Furthermore, the beneficial effects of G-CSF were associated with reduced bacterial loads in the cerebrospinal fluid (median, 1.1 x...

  12. Non-Type B Haemophilus Influenzae Meningitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Fatma Deniz Aygun

    2016-02-01

    Full Text Available Haemophilus influenza is one of the most common cause of bacterial meningitis in children. H.influenzae, especially type b (Hib serotype causes invasive infections in children under five years of age. The widespread use of Hib conjugate vaccines has led to a dramatic decline in the incidence of invasive Hib infections. But, the invasive diseases are still reported, particularly nontypeable H. influenzae (noncapsulated remain as an important pathogen. However, there is no evidence that nontypeable H. influenzae infections have increased in frequency. Nontypeable H. Ižnfluenzae serotype is encountered as a cause of acute bacterial meningitis among all ages. In this paper, we present to draw attention to the causative bacterium, in a case of bacterial meningitis caused by nontypeable H. influenzae infection in a child immunized with Hib vaccine.

  13. Meningitis Meningococcus

    OpenAIRE

    Iskandar Japardi

    2002-01-01

    Meningitis pyogenic akut merupakan suatu respon inflamasi terhadap infeksi bakteria yang mengenai pria dan arakhnoid. Tiga organisme utama yang dapat menyebabkan meningitis pyogenic adalah Diplococcus pneumonia, Neisseria meningitis dan Haemophilus influenzae bedah-iskandar japardi23

  14. Enterobacteriaceae meningitis in adults: a review of 20 consecutive cases 1977-1997

    DEFF Research Database (Denmark)

    Harder, Eva; Møller, Kirsten; Skinhøj, Peter

    1999-01-01

    consecutive cases of Enterobacteriaceae meningitis admitted to the Department of Infectious Diseases, Rigshospitalet, Copenhagen, during the years 1977-97. They comprised 1.5% of all cases of acute bacterial meningitis admitted to the department. All of the patients were either elderly and/or had 1 or more...... underlying diseases and predisposing factors. The clinical presentation and cerebrospinal fluid findings were not different from that of acute bacterial meningitis in general. The mortality rate was 40% and correlated with simultaneous bacteraemia. Complications were seen in a further 30% of patients and 25......Enterobacteriaceae are not a frequent cause of meningitis in adults and are seen mainly in neurosurgical patients and on occasion in elderly and debilitated patients. Consequently, most series studied have been small and selected. In order to obtain a clearer clinical picture, we reviewed 20...

  15. 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.

  16. Development of internally controlled duplex real-time NASBA diagnostics assays for the detection of microorganisms associated with bacterial meningitis.

    Science.gov (United States)

    Clancy, Eoin; Coughlan, Helena; Higgins, Owen; Boo, Teck Wee; Cormican, Martin; Barrett, Louise; Smith, Terry J; Reddington, Kate; Barry, Thomas

    2016-08-01

    Three duplex molecular beacon based real-time Nucleic Acid Sequence Based Amplification (NASBA) assays have been designed and experimentally validated targeting RNA transcripts for the detection and identification of Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae respectively. Each real-time NASBA diagnostics assay includes an endogenous non-competitive Internal Amplification Control (IAC) to amplify the splice variant 1 mRNA of the Homo sapiens TBP gene from human total RNA. All three duplex real-time NASBA diagnostics assays were determined to be 100% specific for the target species tested for. Also the Limits of Detection (LODs) for the H. influenzae, N. meningitidis and S. pneumoniae duplex real-time NASBA assays were 55.36, 0.99, and 57.24 Cell Equivalents (CE) respectively. These robust duplex real-time NASBA diagnostics assays have the potential to be used in a clinical setting for the rapid (<60min) specific detection and identification of the most prominent microorganisms associated with bacterial meningitis in humans. PMID:27319375

  17. 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.

  18. The early dynamics study of cerebrospinal fluid bacterial in a rabbit model of bacterial meningitis%细菌性脑膜炎动物模型的脑脊液早期细菌动力学变化

    Institute of Scientific and Technical Information of China (English)

    徐凯进; 王华英; (居)红珍; 陈云波; 魏泽庆; 李永涛; 盛吉芳; 李兰娟

    2010-01-01

    目的 建立细菌性脑膜炎动物模型,了解细菌感染后48 h内脑脊液(CSF)细菌载量变化规律,为疾病的诊疗及预后判断提供参考依据.方法 以新西兰大白兔作为研究对象,通过小脑延髓池穿刺建立细菌性脑膜炎动物模型,观察不同菌量的大肠埃希菌和金黄色葡萄球菌(金葡菌)建立模型时动物的死亡情况.明确CSF感染菌量与动物死亡率间的对应关系.选择合适的接种菌量,进行脑膜炎CSF细菌载量观察实验.将实验动物分为4组(每组12只):大肠埃希菌脑膜炎模型组,大肠埃希菌脑膜炎+头孢曲松治疗组、金葡菌脑膜炎模型组、金葡菌脑膜炎+万古霉素治疗组,在建立模型后0、12、24、36和48 h分别进行CSF细菌定量培养、CSF及外周血WBC计数,进而分析细菌性脑膜炎CSF细菌载量的变化规律,及其与动物早期死亡率、抗菌药物治疗、CSF的WBC计数间的关系.CSF细菌载量、WBC计数曲线的显著性检验采用协方差分析,相关性检验采用偏相关分析.结果 CSF感染菌量与动物死亡率间呈现S型曲线关系,CSF细菌载量在蛛网膜下腔接种细菌12~24 h达到高峰,而后逐步下降,有效的抗菌药物治疗可显著加快下降过程,大肠埃希菌脑膜炎模型组与大肠埃希菌脑膜炎+头孢曲松治疗组相比(F=27.10,P<0.01),金葡菌脑膜炎模型组与金葡菌脑膜炎+万古霉素治疗组相比(F=5.97,P=0.016),差异均有统计学意义.大肠埃希菌脑膜炎模型组和金葡菌脑膜炎模型组中的CSF的WBC计数与CSF细菌载量之间存在正相关性(r=0.89、0.84;P=0.046、0.049).结论 在细菌性脑膜炎的治疗中,应早期,足量地使用有效抗生素,以控制CSF细菌载量,降低死亡率.CSF的WBC计数可作为反映CSF细菌载量的指标,指导临床治疗.%Objective To study the dynamics changes of cerebrospinal fluid (CSF) bacterial load within 48 h after infection in a rabbit meningitis model, and

  19. Development of Real-Time PCR Methods for the Detection of Bacterial Meningitis Pathogens without DNA Extraction.

    Directory of Open Access Journals (Sweden)

    Jeni Vuong

    Full Text Available Neisseria meningitidis (Nm, Haemophilus influenzae (Hi, and Streptococcus pneumoniae (Sp are the lead causes of bacterial meningitis. Detection of these pathogens from clinical specimens using traditional real-time PCR (rt-PCR requires DNA extraction to remove the PCR inhibitors prior to testing, which is time consuming and labor intensive. In this study, five species-specific (Nm-sodC and -ctrA, Hi-hpd#1 and -hpd#3 and Sp-lytA and six serogroup-specific rt-PCR tests (A, B, C, W, X, Y targeting Nm capsular genes were evaluated in the two direct rt-PCR methods using PerfeCTa and 5x Omni that do not require DNA extraction. The sensitivity and specify of the two direct rt-PCR methods were compared to TaqMan traditional rt-PCR, the current standard rt-PCR method for the detection of meningitis pathogens. The LLD for all 11 rt-PCR tests ranged from 6,227 to 272,229 CFU/ml for TaqMan, 1,824-135,982 for 5x Omni, and 168-6,836 CFU/ml for PerfeCTa. The diagnostic sensitivity using TaqMan ranged from 89.2%-99.6%, except for NmB-csb, which was 69.7%. For 5x Omni, the sensitivity varied from 67.1% to 99.8%, with three tests below 90%. The sensitivity of these tests using PerfeCTa varied from 89.4% to 99.8%. The specificity ranges of the 11 tests were 98.0-99.9%, 97.5-99.9%, and 92.9-99.9% for TaqMan, 5x Omni, and PerfeCTa, respectively. PerfeCTa direct rt-PCR demonstrated similar or better sensitivity compared to 5x Omni direct rt-PCR or TaqMan traditional rt-PCR. Since the direct rt-PCR method does not require DNA extraction, it reduces the time and cost for processing CSF specimens, increases testing throughput, decreases the risk of cross-contamination, and conserves precious CSF. The direct rt-PCR method will be beneficial to laboratories with high testing volume.

  20. Recognising early meningitis: a missed opportunity to diagnose meningitis.

    Science.gov (United States)

    Ponnampalam, Anusha; de Sousa, Paula; Carroll, Will

    2016-01-01

    There are ∼250 cases of neonatal bacterial meningitis each year in the UK. Clinical evaluation of signs and symptoms of meningitis is challenging, particularly, during the neonatal period. Although uncommon, it is recognised that bacterial meningitis can be present in a child with an apparently normal cerebrospinal fluid (CSF) initially.We report the case of a newborn baby girl who was admitted with concerns regarding 2 dusky episodes. She underwent blood tests, a lumbar puncture and was started on intravenous antibiotics. With negative cultures, normal blood results and following a significant clinical improvement, antibiotics were discontinued after 48 hours and the baby was discharged home. She re-presented to the children's emergency department 7 hours later with a history of an apnoeic episode. A second CSF sample was suggestive of bacterial meningitis. We will discuss the published literature and the potential drawbacks of lumbar punctures and ways to diagnose meningitis early. PMID:27516108

  1. Discriminant analysis on clinical characteristics of Japanese encephalitis and bacterial meningitis%乙型脑炎与细菌性脑膜炎临床指征判别分析

    Institute of Scientific and Technical Information of China (English)

    朱宇佳; 覃琼芬; 许超宇; 邓星超; 谢艺红; 吴兴华

    2011-01-01

    目的 分析乙型脑炎与细菌性脑膜炎病例实验室诊断与临床指征的特征,为提高疾病监测质量提供依据.方法 在广西贵港市进行症候群监测,捕获乙型脑炎、细菌性脑膜炎实验室确诊病例,进行临床体征、实验室常规监测等19项指标的单因素分析和判别分析.结果 监测疑似病例535例,捕获实验室确诊乙型脑炎38例和细菌性脑膜炎23例;判别分析结果显示,乙型脑炎预测符合率为84.21%(32/38),细菌性脑膜炎预测符合率为60.87%(14/23),总体预测符合率为75.41%(46/61);抽搐、脑脊液外观改变、脑脊液蛋白升高和葡萄糖减低等是细菌性脑膜炎的特征性临床指征,乙型脑炎则以抽搐为特异性临床指征;血常规白细胞计数和中性粒细胞比例等无明显诊断价值.结论 急性脑炎脑膜炎症候群的临床诊断准确率不高,存在一定程度漏报.%Objective To analyze clinical characteristics of bacterial meningitis and Japanese encephalitis(JE) for promoting the quality of the disease surveillance. Methods A surveillance system was established to capture the confirmed cases. Single factor analysis and discriminant analysis were conducted for 19 related indexes. Results A total of 535 suspected cases were evaluated in the surveillance, among which 38 and 23 cases were confirmed for JE and bacterial meningitis. Discriminant analyses yielded a JE confirrnation rate of 84. 21% ( 32/38 ) and a bacterial meningitis confirmation rate of 60. 87% ( 14/23 ) with a total validation accuracy rate of 75.41%. Convulsion, change of cerebrospinal fluid appearance, elevated cerebrospinal fluid protein, and glucose reduction were clinical indicators of bacterial meningitis. Blood leukocyte count and neutrophil ratio in peripheral blood were of no significant diagnostic value. Conclusion The clinical diagnostic accuracy was not high and there were unreported cases for acute encephalitis syndrome and meningitis.

  2. 儿童细菌性脑膜炎预警指标的病例对照研究%Predictors of Bacterial Meningitis in Children:A Case -control Study

    Institute of Scientific and Technical Information of China (English)

    郭建花; 张欣; 张世勇; 李静; 周吉坤; 孙印旗

    2015-01-01

    目的:探讨儿童细菌性脑膜炎的预警因素,为其诊治与防控提供依据。方法选取2007—2013年石家庄市急性脑膜炎脑炎监测项目EpiData数据库,采用1:2配对病例对照研究探讨儿童细菌性脑膜炎预警信息。研究组为实验室确诊细菌性脑膜炎病例,对照组为实验室确诊非细菌性病原体脑膜炎病例。收集两组人口统计学信息、流行病学特征、临床表现、实验室常规检测结果。并采用多因素条件Logistic回归分析影响儿童细菌性脑膜炎的因素。结果单因素条件Logistic回归分析结果显示,研究组和对照组年龄、发病季节、呕吐、颈项强直、血标本中性粒细胞分数、脑脊液外观、脑脊液白细胞计数比较,差异均有统计学意义( P<0.05)。以是否发生细菌性脑膜炎为因变量,以单因素分析有统计学意义的指标为自变量,多因素条件Logistic回归分析结果显示,年龄( OR=10.36,P=0.003)、发病季节(OR=0.06,P=0.007)、颈项强直(OR=17.01,P=0.048)、血标本中性粒细胞分数(OR=12.43,P=0.028)、脑脊液外观(OR=2.59,P=0.014)和脑脊液白细胞计数(OR=2.31,P=0.047)进入回归方程。结论患儿1~<5岁、非夏季发病、颈项强直、血标本中性粒细胞分数增高、脑脊液外观混浊及脑脊液白细胞计数增高是儿童细菌性脑膜炎早期预警指标,可用于病例预警和人群防控。%Objective To explore predictors of bacterial meningitis in children in order to provide references for diagnosis,treatment and prevention. Methods We selected information from EpiData,a data base of Shijiazhuang monitoring project of acute meningitis and encephalitis. The time range of selected data was from 2007 to 2013. A 1:2 case-control study was conducted to investigate the predictors for bacterial meningitis in children. The case group comprised patients confirmed with bacterial meningitis, and

  3. Meningitis (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Meningitis KidsHealth > For Parents > Meningitis Print A A A ... to Call the Doctor en español Meningitis About Meningitis Meningitis is an inflammation of the meninges, the ...

  4. 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 ...

  5. Fungal Meningitis

    Science.gov (United States)

    ... Schedules Preteen & Teen Vaccines Meningococcal Disease Sepsis Fungal Meningitis Language: English Español (Spanish) Recommend on Facebook Tweet ... the brain or spinal cord. Investigation of Fungal Meningitis, 2012 In September 2012, the Centers for Disease ...

  6. Bacterial meningitis Meningitis bacateriana aguda en niños: estudio clínico y bacteriológico en el Hospital Infantil de Medellín

    Directory of Open Access Journals (Sweden)

    Daniel Hoyos

    1988-02-01

    Full Text Available

     

    Between aprl13, 1984 and march 31,1986,95  children with acute bacterial meningitis (ABM were admitted to Hospital lnfantil, Medellín, Colombia. 68 (71.6% were under two years old. Haemophifus influenza  type B was the predominant microorganism (41%, followed by Streptococcus pneumoniae (27.4%, enterobacteriaceae (15.8%, Neisseria meningitidis (4.2%, Staphylococcus aureus (3.2% and betahemolytlc streptococci (2.1%. One case produced by Streptococcus agalactiae was the first one in our Hospital and another one due to Shigella was the first one in Colombia. Bacterial origin was confirmed in 93.7% of the cases, employing direct examination, cultures and counter immuno electrophoresis. The most frequent clinical manifestations were: fever, vomit, irritability, meningeai irritation and seizures; the younger the patient the most severe the clinical picture. Those with persistent focal seizures showed cerebral infarction, subdural effusion, ventricular dilatation or a combination of them. Mortality was 19%; sequelae were observed in 26% (seizure, motor deficit and deafness; Haemophilus influenzae resistance to ampicilin was observed for the first time in this institution. We suggest modifications in the initial therapeutic approach and recommend the suppression of the routine pre-discharge lumbar puncture.

    Entre abril 3 de 1984 y marzo 31 de 1986, se estudiaron 95 niños que ingresaron al Hospital Infantil de Medellín con el diagnóstico de meningitis bacteriana aguda (MBA; 68 de ellos fueron menores de 2 años (71.6%; el HaemophiIus influenzae tipo e fue el germen predominante (41.0%; le

  7. Viral-bacterial interactions in acute otitis media.

    Science.gov (United States)

    Marom, Tal; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee

    2012-12-01

    Acute otitis media (AOM) is a polymicrobial disease, which usually occurs as a complication of viral upper respiratory tract infection (URI). While respiratory viruses alone may cause viral AOM, they increase the risk of bacterial middle ear infection and worsen clinical outcomes of bacterial AOM. URI viruses alter Eustachian tube (ET) function via decreased mucociliary action, altered mucus secretion and increased expression of inflammatory mediators among other mechanisms. Transient reduction in protective functions of the ET allows colonizing bacteria of the nasopharynx to ascend into the middle ear and cause AOM. Advances in research help us to better understand the host responses to viral URI, the mechanisms of viral-bacterial interactions in the nasopharynx and the development of AOM. In this review, we present current knowledge regarding viral-bacterial interactions in the pathogenesis and clinical course of AOM. We focus on the common respiratory viruses and their established role in AOM.

  8. Clinical analysis of 16 cases with adult atypical bacterial meningitis%成人不典型细菌性脑膜炎16例临床分析

    Institute of Scientific and Technical Information of China (English)

    唐宇凤; 段劲峰; 冯由军

    2013-01-01

    Objective To study the clinical characteristics of cases with adults bacterial meningitis. Methods Clinical data of 16 cases with adult bacterial meningitis were retrospectively analyzed. Results Only one case showed typical meningitis triad syndrome, while cerebrospinal fluid physicochemical properties of other 15 cases were inconformity with typical bacterial meningitis change. All cases were diagnosed as bacterial meningitis by cerebrospinal fluid culture. In these cases,5 cases(31. 25% )were infected by Staphylococcus epidermidis,4 cases(25% ) by Streptococcus pneumoniae,4 cases(25% ) by Single kernel Lester bacteria,2 cases ( 12. 5 % ) by escherichia coli, and 1 case ( 6. 25 % ) by staphylococcus aureus. After treatment with combination of antibiotics with short-term of hormone, 14 cases were cured and 2 cases died. Conclusion Adults with atypical bacterial meningitis are easy to be misdiag-nosed. Thus, cerebrospinal fluid culture and drug sensitivity test must be done as early as possible. The risk factors of unfavorable outcome are infections with drug resistance bacteria,advanced age,early impairment of consciousness,and positive results of blood cultivation.%目的 探讨成人不典型细菌性脑膜炎的临床表现、治疗和预后.方法 回顾性分析我院16例成人细菌性脑膜炎患者的临床资料.结果 16例患者中仅有1例患者出现了典型的脑膜炎三联征,所有患者的脑脊液理化性状均不符合典型细菌性脑膜炎改变.16例患者均经脑脊液培养确诊为细菌性脑膜炎:表皮葡萄球菌感染5例(31.25%),肺炎链球菌感染4例(25%),单核李斯特菌感染4例(25%),大肠杆菌感染2例(12.5%),金黄色葡萄球菌感染1例(6.25%).经抗生素联合短期激素治疗,14例痊愈,2例死亡.结论 临床表现不典型的成人细菌性脑膜炎容易误诊,必须早期行脑脊液培养及药敏试验进行诊断.患者预后不佳的原因可能与耐药菌感染、高龄、早期意识障碍和血培养阳性有关.

  9. Clinical and laboratory features of Streptococcus salivarius meningitis: a case report and literature review.

    Science.gov (United States)

    Wilson, Megan; Martin, Ryan; Walk, Seth T; Young, Carol; Grossman, Sylvia; McKean, Erin Lin; Aronoff, David M

    2012-02-01

    Streptococcus salivarius is a normal member of the human oral microbiome that is an uncommon cause of invasive infections. Meningitis is a rare but increasingly reported infection caused by S. salivarius. Despite the growing number of reported cases, a comprehensive review of the literature on S. salivarius meningitis is lacking. We sought to gain a better understanding of the clinical presentation, evaluation, management, and outcome of S. salivarius meningitis by analyzing previously reported cases. In addition to a single case reported here, 64 previously published cases of meningitis were identified for this review. The collected data confirm that most patients presented with classical signs and symptoms of bacterial meningitis with a predominance of neutrophils in the cerebrospinal fluid (CSF) and hypoglycorrhachia. The majority of cases followed iatrogenic or traumatic CSF contamination. Most cases were diagnosed by CSF culture within one day of symptom onset. There was no clear evidence of predisposing co-morbid conditions in patients with meningitis, although in most case reports, limited information was given on the medical history of each patient. Outcomes were generally favorable with antibiotic management. Clinicians should suspect S. salivarius meningitis in patients presenting acutely after medical or surgical procedures involving the meninges. PMID:21817122

  10. Protocolo de actuación forense ante la sospecha de meningitis bacteriana y shock séptico fulminante Protocol for the forensic action with regard to the suspicion of bacterial meningitis and fulminant septicemia

    Directory of Open Access Journals (Sweden)

    A. Fernández-Rodríguez

    2004-07-01

    meningoceal infection, wich can progress rapidly and fataly, causing sudden death. In such cases, it is urgent to identify "Neisseria meningitidis" urgently in order to assure the appropiate treatment of people who have come into contact. This agent is a leading cause of bacterial meningitis and septicemia in children and young adults. Due to the rapid development of such infections, ante-mortem cultures sometimes are not taken, making the forensic diagnosis essential. Although post-mortem findings are often typical of the Waterhouse-Friderichsen syndrome, they may sometimes be overlooked or caused by other organisms. For these reasons, a microbiological forensic diagnosis is crucial. This article presents a forensic procedure to diagnose the etiology of fulminant bacterial meningitis or septic shock. The aseptic sampling should include blood, sera, LCR, pleural effusions, urine and fresh tissues. These samples can be submitted to the Instituto Nacional de Toxicología y Ciencias Forenses for their early analyses. Antigenic tests are performed as screening techniques, and real-time PCR assays are also done to detect meningococcus and identify its serogroup. The results of these analyses are reported in 3 hours. Bacterial cultures are also performed. Additional PCR may be performed to diagnose other fragile bacteria that are difficult to recover post-mortem. The collaboration within all legal institutions and between those and health authorities is essential to best deal with this issue.

  11. Polymorphisms in Toll-like receptors 2, 4, and 9 are highly associated with hearing loss in survivors of bacterial meningitis.

    Directory of Open Access Journals (Sweden)

    Gijs Th J van Well

    Full Text Available Genetic variation in innate immune response genes contributes to inter-individual differences in disease manifestation and degree of complications upon infection. We recently described an association of single nucleotide polymorphisms (SNPs in TLR9 with susceptibility to meningococcal meningitis (MM. In this study, we investigate the association of SNPs in multiple pathogen recognition and immune response genes with clinical features that determine severity and outcome (especially hearing loss of childhood MM and pneumococcal meningitis (PM. Eleven SNPs in seven genes (TLR2, TLR4, TLR9, NOD1, NOD2, CASP1, and TRAIL were genotyped in 393 survivors of childhood bacterial meningitis (BM (327 MM patients and 66 PM patients. Genotype distributions of single SNPs and combination of SNPs were compared between thirteen clinical characteristics associated with severity of BM. After correction for multiple testing, TLR4+896 mutant alleles were highly associated with post-meningitis hearing loss, especially MM (p= 0.001, OR 4.0 for BM, p= 0.0004, OR 6.2 for MM. In a multigene analysis, combined carriership of the TLR2+2477 wild type (WT with TLR4+896 mutant alleles increases the risk of hearing loss (p<0.0001, OR 5.7 in BM and p= 0.0001, OR 7.6 in MM. Carriage of one or both mutant alleles in TLR4+896 and TLR9 -1237 increases the risk for hearing loss (p = 0.0006, OR 4.1 in BM. SNPs in immune response genes contribute to differences in clinical severity and outcome of BM. The TLR system seems to play an important role in the immune response to BM and subsequent neuronal damage as well as in cochlear inflammation. Genetic markers may be used for identification of high-risk patients by creating prediction rules for post-meningitis hearing loss and other sequelae, and provide more insight in the complex immune response in the CNS possibly resulting in new therapeutic interventions.

  12. Adult bacterial meningitis

    DEFF Research Database (Denmark)

    Meyer, C N; Samuelsson, I S; Galle, M;

    2004-01-01

    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...

  13. Update on immunology associated with bacterial meningitis%细菌性脑膜炎的免疫学研究进展

    Institute of Scientific and Technical Information of China (English)

    毛丹丹

    2015-01-01

    细菌性脑膜炎是小儿时期最常见的中枢神经系统感染性疾病之一,尽管给予积极治疗,其病死率及致残率仍居高不下.研究表明,病原感染后导致宿主免疫失调是该病高致残率的主要因素.补体C3沉积细菌表面并活化是补体介导的细菌清除的关键步骤.脑脊液中C3或C5水平明显变化提示预后不良.致病菌穿过血脑屏障后,细菌细胞组分被模式识别受体识别,刺激机体产生过量细胞因子,介导白细胞募集及氧化应激反应,最终导致神经元不可逆损伤.该文以肺炎链球菌感染为例,综述细菌性脑膜炎的免疫学研究进展.%Bacterial meningitis is one of the most common infectious diseases of the central nervous system in childhood,with high mortality and disability rate despite available treatment.Studies have shown that the host's immunity dysfunction after the infection plays a central role in neurological sequelae.The deposition and activation of complement component C3 on the bacterial surface is a key step in the complement cascade leading to elimination of the microbe,and the level of complement component C3 or C5 in cerebrospinal fluid may predict outcome of bacterial meningitis.After the microorganisms cross the blood-brain barrier,bacterial compounds are recognized by pattern recognition receptors,triggering the production of excessive cytokines,attracting leukocytes and generating oxidative stress,which contributes to neuron injury irreversibly.This review focuses on current research progress on immunology associated with pneumococcal meningitis.

  14. 脑脊液血管内皮生长因子(VEGF)检测在鉴别诊断细菌性脑膜炎和病毒性脑膜炎中的意义%Significance on VEGF in cerebrospinal fluid for differentiating bacterial meningitis and viral meningitis

    Institute of Scientific and Technical Information of China (English)

    程大也; 梁彬

    2013-01-01

    OBJECTIVE To study the value of VEGF in the differential diagnosis of bacterial and viral meningitis. METHODS A total of 26 patients with bacterial meningitis, 29 patients with viral meningitis and 22 patients without bacterial meningitis and viral meningitis were analyzed. The level of VEGF was measured by ELJSA method. The optimal cut-offs of VEGF was identified by ROC curve. The correlation of VEGF and WBC count was evaluated with linear regression. RESULTS VEGF level in cere-brospinal fluid in bacterial meningitis was higher than those in viral meningitis and the control (P 0.05). The diagnostic accuracy of VEGF combined with WBC count was higher than those alone. The correlation of VEGF and WBC count was 0.5122 (P < 0.01). CONCLUSION VEGF in cerebrospinal fluid in the differential diagnosis of bacterial and viral meningitis has clinical application value.%目的 探讨脑脊液VEGF水平在细菌性脑膜炎和病毒性脑膜炎中的诊断价值.方法 对26例细菌性脑膜炎,29例病毒性脑膜炎和22例排除细菌性和病毒性脑膜炎的脑脊液VEGF水平进行检测.应用受试者工作特征曲线(ROC)进行评价,并采用直线回归方法进行相关性分析.结果 细菌性脑膜炎组脑脊液VEGF水平明显高于病毒性脑膜炎组和对照组(P<0.01),病毒性脑膜炎组和对照组脑脊液VEGF水平无统计学差异.VEGF和白细胞计数联合诊断的灵敏度和特异度高于单项指标诊断.脑脊液VEGF和白细胞计数水平呈明显正相关,相关系数为0.5122 (P< 0.01).结论 脑脊液VEGF的检测可以用于对细菌性脑膜炎的鉴别诊断,可将其作为细菌性脑膜炎诊断的有益补充.

  15. Etiologia e evolução das meningites bacterianas em centro de pediatria Etiology and evolution of bacterial meningitis in a pediatric center

    Directory of Open Access Journals (Sweden)

    Roberta M.C. Romanelli

    2002-02-01

    Full Text Available Objetivo: determinar a prevalência dos agentes etiológicos das meningites bacterianas em serviço de referência, no atendimento de doenças infecciosas para o estado de Minas Gerais, e verificar a resposta ao tratamento utilizado.Métodos: estudo descritivo em que foram incluídas todas as crianças com diagnóstico provável de meningite, admitidas na instituição no período de junho a novembro/99.Resultados: obteve-se 210 casos de meningite, sendo 111 casos de etiologia bacteriana (52,9%. Destes, 52 casos foram diagnósticos prováveis (por alteração do liquor rotina e 59 com diagnósticos de certeza (por cultura e/ou isolamento de antígeno. Os principais agentes isolados foram, em ordem decrescente, H. influenzae, N. meningitidis e S. pneumoniae. O tratamento inicial para a faixa etária de três meses a cinco anos foi ampicilina e cloranfenicol, sendo posteriormente restrito para penicilina em casos de meningococo e pneumococo, e para cloranfenicol nos casos de H. influenzae. A mudança para antimicrobiano de maior espectro foi realizada com base em dados clínicos ou laboratoriais, não havendo isolamento de microorganismo resistente.Conclusões: o acompanhamento do perfil epidemiológico das meningites deve ser contínuo, e cada serviço deve se basear em dados locais para direcionar a terapia antimicrobiana. A monitorização contínua dos agentes prevalentes em cada instituição e de sua resistência é fundamental para a escolha antimicrobiana, atuando com menor interferência na colonização individual, sem contribuir para a crescente resistência dos agentes responsáveis pelas infecções meníngeas.Objective: to establish the prevalence of the etiological agents of bacterial meningitis in a reference center for the treatment of infectious diseases in the state of Minas Gerais. Methods: descriptive study including all children with probable diagnosis of meningitis between June/1999 and November/1999.Results: there were 210

  16. Blockade of NMDA receptor subtype NR2B prevents seizures but not apoptosis of dentate gyrus neurons in bacterial meningitis in infant rats

    Directory of Open Access Journals (Sweden)

    Täuber Martin G

    2003-09-01

    Full Text Available Abstract Background Excitotoxic neuronal injury by action of the glutamate receptors of the N-methyl-d-aspartate (NMDA subtype have been implicated in the pathogenesis of brain damage as a consequence of bacterial meningitis. The most potent and selective blocker of NMDA receptors containing the NR2B subunit is (R,S-alpha-(4-hydroxyphenyl-beta-methyl-4-(phenylmethyl-1-piperid inepropanol (RO 25-6981. Here we evaluated the effect of RO 25-6981 on hippocampal neuronal apoptosis in an infant rat model of meningitis due to Streptococcus pneumoniae. Animals were randomized for treatment with RO 25-6981 at a dosage of either 0.375 mg (15 mg/kg; n = 28 or 3.75 mg (150 mg/kg; n = 15 every 3 h or an equal volume of sterile saline (250 μl; n = 40 starting at 12 h after infection. Eighteen hours after infection, animals were assessed clinically and seizures were observed for a period of 2 h. At 24 h after infection animals were sacrificed and brains were examined for apoptotic injury to the dentate granule cell layer of the hippocampus. Results Treatment with RO 25-6981 had no effect on clinical scores, but the incidence of seizures was reduced (P Conclusions Treatment with a highly selective blocker of NMDA receptors containing the NR2B subunit failed to protect hippocampal neurons from injury in this model of pneumococcal meningitis, while it had some beneficial effect on the incidence of seizures.

  17. 77 FR 59929 - Guidance for Industry on Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With...

    Science.gov (United States)

    2012-10-01

    ... August 22, 2008 (73 FR 49684), which in turn revised the draft guidance for industry entitled ``Acute... ``Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With Chronic Obstructive Pulmonary... treatment of acute bacterial exacerbations of chronic bronchitis in patients with chronic...

  18. CSF ADENOSINE DEAMINASE (ADA ACTIVITY IN PATIENTS WITH MENINGITIS

    Directory of Open Access Journals (Sweden)

    Justin

    2016-05-01

    Full Text Available Meningitis is inflammation of the meninges (pia, arachnoid and dura mater covering the brain and the spinal cord. ADA is an enzyme in the purine salvage pathway which is found in abundance in active T-lymphocytes. Hence, an attempt was made to estimate the CSF ADA level in patients with suspected meningitis and throw light on its use in differentiating the various types of meningitis. AIMS AND OBJECTIVES To estimate the level of CSF adenosine deaminase level in different types of meningitis. To assess its usefulness in differentiating the various types (bacterial, viral and tuberculous of meningitis. MATERIALS AND METHODS The study was conducted at the medical wards of Govt. Rajaji Hospital, Madurai, a prospective analytical study from a period of April 2012 to September 2012. OBSERVATION AND RESULTS Tuberculous meningitis occurred more in the age group of 21–40 years. Bacterial meningitis was seen mainly in patients < 20 years of age. Viral meningitis was seen in all age groups. CSF ADA level was highest in tuberculous meningitis, the mean value being 24.5 U/L. The mean value of ADA in bacterial meningitis was 4.54 U/L and viral meningitis patients had lowest mean ADA value of 2.65 U/L. CONCLUSION In our study, 50 patients with meningitis admitted in Government Rajaji Hospital from April 2012 to September 2012 were evaluated. Meningitis predominantly affected people in the age group of 20-40 years in our study with a male: female ratio of 1.9:1. Cases of tuberculous meningitis constituted 48% of the study group and bacterial and viral meningitis were 26% each. CSF protein values were higher and sugar values lower in patients with tuberculous and bacterial meningitis. CSF cell counts were higher in patients with bacterial meningitis.

  19. 细菌性脑炎/脑膜炎266例流行病学分析%Epidemic Analysis of 266 Cases With Bacterial Meningitis or Encephalitis

    Institute of Scientific and Technical Information of China (English)

    李静; 张振国; 孙印旗; 郭建花; 甄素娟; 王颖童; 贾肇一; 尹遵栋

    2012-01-01

    Objective To provide scientific evidence for the similar nationwide study by understanding the epidemic characteristics and pathogeny spectrum of bacterial meningitis and encephalitis. Methods Cases with bacterial meningitis and encephalitis were investigated, with the blood samples and/ or CSF samples from surveillance cases were collected for laboratory testing. Results From the May, 2007 to December, 2010, 266 cases was reported and investigated. The male - to - female ratio was 1. 56 : 1, the average age of cases was 8. 7 years old, and 73. 7% of cases were children under 10 years old. Cases occurred all the year round, with no obvious seasonal peak. 19. 9% of cases had been vaccinated at least one of vaccines among encephalitis vaccine , meningococcal vaccine and rlib vaccine. 92.4% of cases used the antibiotics before the collection of samples. The main bacterial pathogeny spectrum of laboratory - confirmed bacterial meningitis/encephalitis cases were Streptococcus pneumoniae, Cryptococcus neoformans, Neisseria catarrhalis and Hib. Conclusion The epidemic characteristics and pathogeny spectrum is preliminary understood. It may provide the experience for the national surveillance of bacterial meningitis or encephalitis and other syndrome.%目的 了解急性细菌性脑炎/脑膜脑炎的流行特征与病原谱,为全国范围内开展类似研究提供科学依据.方法 对监测到的细菌性脑炎/脑膜炎开展个案调查并采集血清和或脑脊液标本,开展实验室检测工作.结果 2007 - 05/2010 -12报告的出院诊断为细菌性脑炎/脑膜脑炎患者266例,男女性别比为1.56∶1,平均年龄8.7岁,73.7%的病例集中在10岁以下儿童,各月都有病例发生,无明显发病季节高峰.19.9%病例接种过乙脑、流脑、Hib疫苗中的一种或一种以上,92.4%的病例在标本采集前使用了抗生素.实验室确诊的细菌性脑炎/脑膜脑炎病例的主要病原为肺炎链球菌、脑膜炎奈瑟菌、新

  20. Evolução do comportamento auditivo após meningite bacteriana: relato de caso Auditory behaviour monitoring after bacterial meningitis: case report

    Directory of Open Access Journals (Sweden)

    Ida Lichtig

    1997-06-01

    Full Text Available A deficiência auditiva adquirida tem nas meningites bacterianas a sua principal etiologia e pouco tem-se dito a respeito da evolução para melhora ou piora do comportamento auditivo após a alta hospitalar. O presente estudo descreve o caso de um menino que teve meningite por Haemophilus influenzae aos 5 meses de vida e que entre outras complicações apresentou diminuição da acuidade auditiva detectada na evolução imediata, com melhora significativa posteriormente, confirmada por testes qualitativos e quantitativos. Discute-se a importância e a necessidade do seguimento fonoaudiológico de tais indivíduos para estabelecer orientação adequada.Bacterial meningitis is the main cause for acquired hearing loss. Nevertheless very little has been written about the development of the auditory behaviour either for improvement or for deterioration, after hospital release. The present study describes the case of a five month old boy with Haemophilus influenzae meningitis. Amongst various complications, a decrement in the auditory acuity was detected in the immediate evolution, with significant improvement later on by qualitative and quantitative tests.

  1. Aseptic meningitis and viral myelitis.

    Science.gov (United States)

    Irani, David N

    2008-08-01

    Meningitis and myelitis represent common and very infrequent viral infections of the central nervous system, respectively. The number of cases of viral meningitis that occurs annually exceeds the total number of meningitis cases caused by all other etiologies combined. Focal central nervous system infections, such as occur in the spinal cord with viral myelitis, are much less common and may be confused with noninfectious disorders that cause acute flaccid paralysis. This article reviews some of the important clinical features, epidemiology, diagnostic approaches, and management strategies for patients with aseptic meningitis and viral myelitis. Particular focus is placed on the diseases caused by enteroviruses, which as a group account for most aseptic meningitis cases and many focal infections of the spinal cord.

  2. Expressions of brain-derived neurotrophic factor (BDNF) in cerebrospinal fluid and plasma of children with meningitis and encephalitis/encephalopathy.

    Science.gov (United States)

    Morichi, Shinichiro; Kashiwagi, Yasuyo; Takekuma, Koji; Hoshika, Akinori; Kawashima, Hisashi

    2013-01-01

    Many reports in the field of childhood brain disorders have documented that brain-derived neurotrophic factor (BDNF) affects central nervous system (CNS) functions. In this clinical study, BDNF levels were evaluated in association with pediatric CNS infections. BDNF levels in the serum and cerebrospinal fluid (CSF) of 42 patients admitted during 5-year period, due to CNS infections, were measured by enzyme-linked immunosorbent assays (ELISAs). Control samples were collected from 108 patients with non-CNS infections (urinary tract infection, acute upper respiratory infection, acute gastroenteritis, etc.). Mean values of BDNF levels, at various ages, were determined and compared. BDNF levels were below the sensitivity of the ELISA in most CSF samples from the control group, but were significantly elevated in the patients with bacterial meningitis. The serum BDNF levels were elevated in all subgroups of patients with CNS infections, and the elevation was particularly notable in those with bacterial meningitis. BDNF expression in the CSF was correlated with CSF interleukin (IL)-6 levels as well as with blood platelet counts and neurological prognoses in those with bacterial meningitis. No correlation was found between BDNF levels and serum leukocyte numbers or C-reactive protein (CRP) levels. BDNF levels were found to be elevated in the serum and CSF of pediatric patients with CNS infections, particularly those with bacterial meningitis. Monitoring the changes in serum and CSF levels of BDNF may facilitate the diagnosis of acute meningitis and acute encephalopathy and allow the differential diagnosis of specific CNS infections.

  3. Avaliação e acompanhamento audiológico após meningite bacteriana Audiological assessment and follow-up post bacterial meningitis

    Directory of Open Access Journals (Sweden)

    MARIA INÊS VIEIRA COUTO

    1999-09-01

    Full Text Available A deficiência auditiva é uma das sequelas da meningite bacteriana que ocorre com maior frequência em crianças. Este estudo descreve o perfil audiológico (periférico e central de crianças internadas com diagnóstico de meningite bacteriana. Nas 89 crianças que compareceram ao seguimento audiológico após a alta hospitalar e foram submetidas aos testes audiológicos, os resultados evidenciaram que 85,4% apresentaram acuidade auditiva normal em ambas orelhas, 10,1% apresentaram deficiência auditiva neurossensorial bilateral e 4,5% apresentaram deficiência auditiva neurossensorial unilateral. Nos testes que avaliaram as habilidades de processamento auditivo, os resultados mostraram que 10% dessas crianças apresentaram alteração no desempenho de localização auditiva e de reconhecimento de sentenças com mensagem competitiva ipsilateral.Hearing loss is the more frequent sequel of bacterial meningitis in children. This study describes the audiological profile (peripheric and central of 89 children admitted to the hospital wards with the diagnosis of bacterial meningitis. Those children attended audiological follow up, after their hospital descharge, and were submitted to audiological tests. The results showed that 85.4% among them presented normal hearing in both ears 10.1% presented bilateral neurosensorial hearing loss and 4.5% presented unilateral neurosensorial hearing loss. The results from the auditory processing skills assessment showed that 10% of those children presented auditory localization and recognition of sentences with competitive messages (Paediatric Sentences Identification - ipsilateral disorders.

  4. Ventricular Pneumocephalus with Meningitis after Lumbar Nerve Root Block

    Directory of Open Access Journals (Sweden)

    Shin Ahn

    2013-01-01

    Full Text Available Lumbar nerve root block is a common modality used in the management of radiculopathy. Its complications are rare and usually minor. Despite its low morbidity, significant acute events can occur. Pneumocephalus is an accumulation of air in the intracranial space. It indicates a violation of the dura or the presence of infection. The object of this report is to describe the case of a patient with intraventricular pneumocephalus and bacterial meningitis after lumbar nerve root block. A 70-year-old female was brought into emergency department with severe headache and vomiting which developed during her sleep. She had received lumbar nerve block for her radiculopathy one day before her presentation. Cranial computed tomography scan revealed a few hypodense lesions in her left lateral ventricle frontal horn and basal cistern indicating ventricular pneumocephalus. Five hours later, she developed sudden hearing loss. Cerebrospinal fluid analysis showed bacterial meningitis, and she was treated with high dose steroid and antibiotics. However, her impaired hearing as a sequela from meningitis was persistent, and she is still in follow-up. Intracranial complications of lumbar nerve root block including meningitis and pneumocephalus can occur and should be considered as high-risk conditions that require prompt intervention.

  5. Escherichia coli Meningitis after Rotavirus Gastroenteritis in an Infant

    Science.gov (United States)

    Vermezoglu, Oznur; Ocal Topcu, Didem; Karbuz, Adem; Hacihamdioglu, Bulent

    2016-01-01

    Although rotavirus gastroenteritis is quite common in the pediatric population, secondary bacterial sepsis following rotavirus infection is a rare clinical entity. Gram-negative bacilli are the fifth most common cause of meningitis in infants but this infection rarely occurs after gastroenteritis. Here, we report a 2.5-month-old infant who developed Escherichia coli (E. coli) meningitis after acute rotavirus gastroenteritis. The 2.5-month-old male infant with fever, vomiting, and watery diarrhea that started 1 day earlier was admitted to the hospital. Rotavirus antigen in stool sample was positive. He was hospitalized, and fever was measured at 39.5°C on the second day. Lumbar puncture was done for suspicion of meningitis, and cerebrospinal fluid (CSF) findings suggested meningitis. Intravenous vancomycin and cefotaxime were started empirically. Since E. coli reproduction was seen in blood culture and CSF culture, treatment was continued with cefotaxime. The patient was discharged with minimal midlevel hydrocephalus findings in cranial ultrasonography and magnetic resonance imaging following 21 days of antibiotics treatment. Septicemia development following rotavirus gastroenteritis is an extremely rare clinical condition. It is vital to start prompt antibiotic treatment as soon as the diagnosis of secondary bacterial infection is made because of high mortality and morbidity rates.

  6. 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;

    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....

  7. Clinical Experience of Bacterial Meningitis Treated by Latamoxef Sodium%拉氧头孢钠治疗细菌性脑膜炎的临床体会

    Institute of Scientific and Technical Information of China (English)

    谷祥富

    2011-01-01

    Objective: To observe the clinical efficacy and safety of bacterial meningitis treated by latamoxef sodium.Methods: Retrospective investigation to the bacterial mengitis cases in our hospital in the past 5 years was taken.Forty cases were randomly selected and divided into the latamoxef sodium 50 mg/kg treatment group(group A) and the cefepime 50 mg/kg control group(group B),each with 20 cases.Then the clinical efficacy,bacteriological changes and adverse reactions were compared between the two groups.Results: The clinical efficacy of group A and B was 95.00% and 90.00% respectively,without significant difference(P0.05).Conclusion: Latamoxef sodium treating bacterial meningitis,which had higher efficacy,safety and less adverse reaction,could reach a win-win situation for both the medical institutions and the patients under the system of new rural cooperative medicare scheme and urban health insurance.It is wealthy of clinical application.%目的:观察拉氧头孢钠治疗细菌性脑膜炎的临床疗效和安全性。方法:回顾性调查分析近5年我院治疗细菌性脑膜炎的病历,随即抽取拉氧头孢钠50mg/kg治疗组20例(A组)和头孢吡肟50 mg/kg对照组20例(B组),1次/12 h,疗程均为5~14 d。比较两组临床疗效、细菌学改变及不良反应情况。结果:A、B两组的临床痊愈率分别为90.00%、85.00%,A、B两组的临床有效率分别为95.00%、90.00%,二者比较差异无统计学意义(P〉0.05)。结论:拉氧头孢钠治疗细菌性脑膜炎的疗效满意,不良反应少,药物安全性高,在新农合和城镇医保范围,可对医疗机构及患者取得双赢,值得在临床推广应用。

  8. The Strategy of Prevention and Treatment for Bacterial Meningitis after Craniotomy%开颅术后细菌性脑膜炎的防治策略

    Institute of Scientific and Technical Information of China (English)

    杜家钱; 朱忠民; 梁支兵; 戴立国

    2014-01-01

    目的探讨开颅手术后并发细菌性脑膜炎的危险因素和治疗措施。方法回顾性分析2008年10月~2013年10月开颅手术后发生细菌性脑膜炎患者的临床资料。结果术后细菌性脑膜炎的发生率为3.6%,年龄大于50岁、手术时间大于4H、幕下部位手术、术后引流管留置超过3d、合并脑脊液漏以及开放性颅脑损伤患者均较平均感染率明显升高(P50 year old), longer duration of operation group, and patients who underwent infratentorial craniotomy, prolonged drainage, cerebrospinofluid leakage and open craniocerebral injury ( <0.05). Conclusion The risk factors of bacterial meningitis after craniotomy include age, duration of operation and postoperative drainage, operative site, CSF leakage and open brain injury. Avoiding CSF leakage and using antibiotics based on bacterial-sensitive test as early as possible can improve curative effect.

  9. 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...

  10. Epidemiology of bacterial meningitis among children in Brazil, 1997-1998 Epidemiologia de meningites bacterianas entre crianças no Brasil, 1997 a 1998

    Directory of Open Access Journals (Sweden)

    Débora PL Weiss

    2001-06-01

    Full Text Available OBJECTIVE: To document the incidence and the descriptive epidemiology of bacterial meningitis among individuals under age 20 in a geographically defined region in Brazil during the two-year period immediately preceding the introduction of Haemophilus influenzae type b (Hib vaccines into the national immunization program of Brazil. METHODS: Population-based epidemiological study of all cases of bacterial meningitis reported among residents of Campinas, Brazil, under age 20 (n=316,570 during the period of 1997-98, using comprehensive surveillance records compiled by the Campinas Health Department from cases reported among hospital inpatients, outpatients, emergency room visits, death certificates, and autopsy reports. RESULTS: The incidence of bacterial meningitis (n=274 was 334.9, 115 and 43.5 cases/10(5 person-years (pys for residents of Campinas under age 1, 5 and 20, respectively. All cases were hospitalized, with an average length of stay of 12 days. Documented prior antibiotic use was 4.0%. The case-fatality rate of bacterial meningitis in individuals under age 20 was 9% (24/274 with 75% of deaths occurring in children under the age of five. The incidence of Hib meningitis (n=26 was 62.8 and 17 cases/10(5 pys in children age OBJETIVO: Documentar a incidência e a epidemiologia descritiva de meningites bacterianas entre pessoas com idade inferior a 20 anos em uma região geográfica definida do Brasil. O período foi de dois anos, imediatamente anterior à introdução da vacina contra Haemophilus influenzae tipo b (Hib, no Programa Nacional de Imunização do Brasil. MÉTODOS: Estudo epidemiológico populacional dos casos de meningites bacterianas notificados entre residentes em Campinas, SP, Brasil, com idade inferior a 20 anos (n=316.570, entre 1997 e 1998. Baseia-se em dados de notificação da vigilância epidemiológica da Secretaria Municipal de Saúde de Campinas, relatados entre casos provenientes de pacientes hospitalizados

  11. Meningitis caused by human herpesvirus-6.

    OpenAIRE

    Huang, L M; Lee, C Y; Lee, P I; J. M. Chen; Wang, P.J.

    1991-01-01

    Since the discovery of human herpesvirus-6 (HHV-6) the illnesses associated with it have increased steadily. Two infants with meningitis are reported: both suffered a mild meningitis and serological studies confirmed an acute HHV-6 infection. This report supports a role of HHV-6 in nervous system disease.

  12. Eosinophilic meningitis.

    Science.gov (United States)

    Sawanyawisuth, Kittisak; Chotmongkol, Verajit

    2013-01-01

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

  13. Advances on dexamethasone and glycerol as adjunctive therapy in bacterial meningitis%地塞米松和甘油在细菌性脑膜炎中的应用

    Institute of Scientific and Technical Information of China (English)

    周仲松; 李家斌

    2015-01-01

    尽管使用高效的抗菌药物,但细菌性脑膜炎至今仍有较高的发病率和病死率.研究显示其不良预后与蛛网膜下腔的炎症反应有关,因此阻止脑膜炎早期瀑布样炎症反应将有助于改善细菌性脑膜炎的临床预后.此文就地塞米松和甘油作为细菌性脑膜炎的辅助治疗进展作一综述.%Bacterial meningitis is associated with high morbidity and mortality despite the availability of effective antibiotics.Experimental studies showed that the inflammatory response in the subarachnoid space is associated with unfavorable outcome.The use of adjuvant therapy in bacterial meningitis draws its rationale from the notion of arresting the inflammatory cascade at an early stage of the disease to improve clinical outcome.This paper reviews advances in dexamethasone and glycerol as adjunctive therapy in bacterial meningitis.

  14. 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.

  15. Attenuation of the bacterial load in blood by pretreatment with granulocyte-colony-stimulating factor protects rats from fatal outcome and brain damage during Streptococcus pneumoniae meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian T; Lundgren, Jens D; Lund, Søren Peter;

    2004-01-01

    boosting of the peripheral neutrophil count affected the outcome of the meningitis. The risk of terminal illness over the first 7 days after infection was significantly reduced for rats who had elevated peripheral white blood cell counts after receiving granulocyte-colony-stimulating factor (G-CSF) prior...... to the infection compared to that for untreated rats (P = 0.039 by the log rank test). The improved outcome was associated with reduced signs of cerebral cortical damage (P = 0.008). Furthermore, the beneficial effects of G-CSF were associated with reduced bacterial loads in the cerebrospinal fluid (median, 1.1 x...... 10(5) versus 2.9 x 10(5) CFU/ml; P = 0.023) and in blood (median, 2.9 x 10(2) versus 6.3 x 10(2) CFU/ml; P = 0.024), as well as attenuated pleocytosis (median, 800 x 10(6) versus 1,231 x 10(6) cells/liter; P = 0.025), 24 h after the infection. Conversely, initiation of G-CSF therapy 28 h...

  16. Bacterial Meningitis after Cochlear Implantation among Children without Polyvalent Conjugate Vaccine: A Brief Report of an Iranian Cohort Study on 371 Cases

    Directory of Open Access Journals (Sweden)

    Shahla Afsharpaiman

    2014-01-01

    Full Text Available Background: Regarding risk of bacterial meningitis (BM after Cochlear implantation (CI, it was suggested to receive polyvalent conjugate vaccine. We aimed to estimate the prevalence of BM post CI in child recipients who do not receive polyvalent vaccine. Methods: We enrolled 371 children who had received cochlear implants from 2007 to 2010. None of them received pre or post implantation polyvalent conjugate vaccine for BM. We followed all of them for BM for 2 years after implantation. Results: We detected only one female case of BM (0.3% of patients with the age of 24 months. The mean age of noninfected children was 36.7 ± 23.2 months. The education level of parents was "college level or higher" in less than half of them, and about 65% of patients were products of consanguineous marriage. Conclusions: Our findings indicated that the incidence of BM was not higher in our cochlear implanted children who did not receive immunization than patients from countries in which routine vaccination is done. We suggest that although proper immunization is recommended before surgery, this procedure could be performed without vaccination, especially in developing countries that face financial problems for preparing vaccines.

  17. 新生儿细菌性脑膜炎90例临床分析%Clinical Analysis of 90 Cases With Neonatal Bacterial Meningitis

    Institute of Scientific and Technical Information of China (English)

    袁进海

    2015-01-01

    Objective To study the clinical characteristics of neonatal bacterial meningitis. Methods Selected 90 cases with neonatal bacterial meningitis February 2014 to March 2015 in admitted to our hospital, according to the age of children into early onset neonatal group(≤7 days), late neonatal group(≤7days)in two groups of 45 patients were analyzed retrospectively for children with clinical data. Results The two groups of children in the group of early neonatal neurologic symptoms more atypical;incidence of complications between the two groups of children, P>0.05, had no difference statistically signiifcance. Increased white blood cell count(56 cases, 62.2%), cerebrospinal fluid white blood cell count was significantly higher (87 cases, 96.7%), CSF glucose concentration decreased(15 cases, 16.7%), cerebrospinal lfuid protein increased(42 cases, 46.7%), blood culture The positive rate was 27.8%(25 cases), cerebrospinal fluid culture positive rate was 16.7% (15 cases), early neonatal bacterial culture positive group was signiifcantly lower than late neonatal group, P<0.05, had difference statistically signiifcance. Hearing damage occurs in two groups of children were 6 cases of children belonging to late neonatal group. Conclusion The clinical features of neonatal bacterial meningitis is more a lack of early neonatal characteristics more obvious, the lower rate of positive cultures of bacteria, meningitis in children need early treatment, complications may arise in children respond to intervene.%目的:研究新生儿细菌性脑膜炎的临床特征。方法选取2014年2月~2015年3月我院收治的新生儿细菌性脑膜炎患儿90例对患儿临床资料、治疗方法进行回顾性分析,根据患儿发病日龄分为早期新生儿组(≤7 d)、晚期新生儿组(>7 d)两组,每组45例。结果两组患儿中的早期新生儿组的神经系统症状更加不典型;两组患儿的合并症发生率对比,P>0.05,差异不具有统计

  18. Significance of Creatine Kinase Brain Isoenzyme Concentration in Cerebrospinal Fluid with bacterial meningitis%小儿神经系统感染中测定激酸磷酸激酶的意义

    Institute of Scientific and Technical Information of China (English)

    熊顺军; 王红玲; 张渝侯

    2001-01-01

    测定了怀疑为中枢神经系统感染的85例患儿脑脊液中CK-BB浓度。其中,经确诊无中枢神经系统感染患儿17例,病毒性脑膜脑炎患儿36例,细菌性脑膜炎患儿32例。以上病例均常规作脑脊液检查,同时留取3毫升脑脊液作CK-BB浓度测定。结果显示,脑脊液中CK-BB可作为鉴别细菌性脑膜炎和病毒性脑膜脑炎的一项可靠指标。%Activity of CK-BB in cerebrospinal was determined in 85 children as soon as CNS infection was suspected. 17 cases was normal 36 cases with viral meningitis was diagnosed 32 cases was diagnosed with bacterial meningitis. Routine analysis of CSF was performed. When 3ml CSF was available for analysis of CK-BB activity. The data suggest the possibility of utilizing CSF CK-BB activity to differentiate between bacterial and viral meningitis in situations where a routine CSF examination is inconclusive.

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

    Science.gov (United States)

    Sadarangani, Manish; Willis, Louise; Kadambari, Seilesh; Gormley, Stuart; Young, Zoe; Beckley, Rebecca; Gantlett, Katherine; Orf, Katharine; Blakey, Sarah; Martin, Natalie G; Kelly, Dominic F; Heath, Paul T; Nadel, Simon; Pollard, Andrew J

    2015-03-01

    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 bacterial meningitis were more likely to have a reduced Glasgow Coma Score and respiratory distress than those with viral meningitis or other infections. There were no discriminatory clinical features in older children. Cerebrospinal fluid (CSF) white blood cell count and plasma C-reactive protein at all ages, and CSF protein in infants meningitis and viral meningitis or other infections. Improved diagnosis of non-bacterial meningitis is urgently needed to reduce antibiotic use and hospital stay.

  20. Meningeal hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    Guang-zhi YANG

    2015-03-01

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

  1. 二性霉素B治疗隐球菌脑膜炎引起急性肾功能不全的临床分析及护理%Clinical Analysis and Nursing of Treating Acute Renal Functional Failure Caused by Cryptococcus Meningitis with B (AMB)

    Institute of Scientific and Technical Information of China (English)

    朱婉丽; 邹玲; 邝静霞; 邓云珍; 郑小燕

    2002-01-01

    B (AMB) is the most favorite medicine for cryptococcus meningitis with much side effect. Clinical nursesshould master the pharmacological function and the side effect and be alert for emergent acute reaction.

  2. Investigation of pathogen in children with bacterial meningitis%儿童细菌性脑膜炎病原学及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    谢永强; 邓秋连; 虢艳; 黄勇; 钟玉葵

    2011-01-01

    目的 了解广州地区儿童细菌性脑膜炎的病原菌分布特点及其耐药状况,为临床进行及时有效治疗提供实验室依据.方法 回顾分析2005年1月-2009年12月广州妇女儿童医疗中心细菌性脑膜炎病例的脑脊液病原菌分离培养结果及其药敏试验情况.结果 5年来共从细菌性脑膜炎患儿的脑脊液标本中检出病原菌335株,其中革兰阳性菌215株(64.18%),革兰阴性菌109株(32.54%),真菌11株(3.28%).主要是凝固酶阴性葡萄球菌(115株,占34.33%)和肺炎链球菌(81株,占24.18%).新生儿及婴儿早期的病原菌主要是凝固酶阴性葡萄球菌.耐甲氧西林凝固酶阴性葡萄球菌发生率达55.65%.葡萄球菌对青霉素、红霉素、克林霉素耐药率超过70%,对万古霉素和利奈唑烷敏感;肺炎链球菌对青霉素耐药率为8.64%,对红霉素和克林霉素耐药率较高(>60%);革兰阴性杆菌对亚胺培南、头孢哌酮/舒巴坦及阿米卡星敏感率较高,但大肠埃希菌和肺炎克雷伯菌超广谱β内酰胺酶发生率为22.86%和27.59%.结论 儿童细菌性脑膜炎主要病原菌是凝固酶阴性葡萄球菌和肺炎链球菌,早期准确的病原学诊断和及时采用敏感的抗菌药物治疗是降低后遗症发生率和病死率的重要手段.%Objective To determine the distribution and drug resistance of bacteria isolated from children with bacterial meningitis in Guangzhou; as a benchmark rationale for the use of antibiotics. Methods Bacterial sensitive data of children with bacterial meningitis admitted in Guangzhou Women and Children's Medical Center from January 2005 to December 2009 were analyzed. Results A total of 335 organisms were detected from cerebrospinal fluid, including 215 (64.18%) Gram-positive strains, 109 (32.54%) Gram-negative strains and 11 (3.28%) fungal strains. 115 strains (34.33%) of coagulase negative staphylococci (CNS) and 81 (24.18%) strains of Streptococcus pneumoniae were the most common

  3. Rapid diagnosis of bacteric meningitis

    Directory of Open Access Journals (Sweden)

    Sara Giordana Rimoldi

    2010-09-01

    Full Text Available Gram stain and bacterial antigen detection are economic and rapid tests for the identification of the bacteria in cerebrospinal fluid (CSF for the diagnosis of meningitis. Even if culture is the gold standard of these diagnosis, it requires long time (growth time. The purpose of our study was to compare in the laboratory diagnosis of meningitis real time PCR (Eurospital, Italy. with standard methods. Samples were collected in patients referred to L. Sacco Universital Hospital (range of age: 16 to 70 years from September 2008 to July 2009. 9 out of 130 CFS samples investigated were positive in PCR but they produced different results to the other methods used.

  4. Naegleria meningitis : a rare survival.

    Directory of Open Access Journals (Sweden)

    Jain R

    2002-10-01

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

  5. Meningitis, Clinical Presentation of Tetanus

    Directory of Open Access Journals (Sweden)

    Anna Moniuszko

    2015-01-01

    Full Text Available Background. Tetanus is an acute disease caused by a neurotoxin produced by Clostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals. Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays. Why Should Physician Be Aware of This? Even in developed countries the differential diagnosis of meningitis, especially in the elderly, should include tetanus. Treatment in intensive care unit is required. General population might benefit from vaccine boosters and education on this potentially fatal disease.

  6. Meningitis, Clinical Presentation of Tetanus

    Science.gov (United States)

    Moniuszko, Anna; Zajkowska, Agata; Tumiel, Ewa; Rutkowski, Krzysztof; Pancewicz, Sławomir; Rutkowski, Ryszard; Zdrodowska, Agnieszka; Zajkowska, Joanna

    2015-01-01

    Background. Tetanus is an acute disease caused by a neurotoxin produced by Clostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals. Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays. Why Should Physician Be Aware of This? Even in developed countries the differential diagnosis of meningitis, especially in the elderly, should include tetanus. Treatment in intensive care unit is required. General population might benefit from vaccine boosters and education on this potentially fatal disease. PMID:25789186

  7. Elevated soluble urokinase receptor values in CSF, age and bacterial meningitis infection are independent and additive risk factors of fatal outcome

    DEFF Research Database (Denmark)

    Tzanakaki, G; Paparoupa, M; Kyprianou, M;

    2012-01-01

    The aim of the present study was to evaluate the potential role of cerebrospinal fluid soluble urokinase receptor (suPAR) level, infection and age as risk factors for fatal outcome in patients suspected of having meningitis and/or bacteraemia on admission to hospital. A total of 545 cerebrospinal...... fluid samples from patients with clinically suspected meningitis were sent to the Hellenic National Meningitis Reference Laboratory. Ten of 545 (1.83%) patients died. Analysis by receiver operating characteristics (ROC) curve revealed that both suPAR and age were significant for prediction of fatal...... outcome. Patients with levels of suPAR above the cut-off values and age ≥51 years, or patients in which either Neisseria meningitis or Streptococcus pneumoniae were detected were categorized as high risk patients. The combination of the above three predictors (suPAR, age and infectious agent...

  8. Diagnostic Value of IL-17 and IL-23 in Cerebrospinal Fluid in Bacterial Meningitis%脑脊液IL-17和IL-23检测在诊断细菌性脑膜炎中的意义

    Institute of Scientific and Technical Information of China (English)

    卜跃华; 解芳

    2012-01-01

    Objective To study IL-17 and IL-23 in the differentia] diagnosis of bacterial and viral meningitis. Methods The levels of IL-17 and IL-23 in cerebrospinal fluid of 64 cases were measured by ELISA method. The optimal cut-ofls of IL-17 and IL-23 were identified by using ROC curve. The correlation among IL-17,IL-23 and WBC count were evaluated using linear regression. Results The levels of IL-17 and IL-23 in cerebrospinal fluid were higher in bacterial meningitis than in viral meningitis and the control (P< 0.01),and the levels of IL-17 and IL-23 were higher in viral meningitis than the control (P< 0.01). The correlations of IL-17 and IL-23,IL-17 and WBC count, IL-23 and WBC count were 0.4980,0.5351 and 0.5810,respectively. Conclusion IL-17 and IL-23 in cerebrospinal fluid in the differential diagnosis of bacterial and other meningitis has clinical application value.%目的 探讨脑脊液IL-17和IL-23检测在细菌性脑膜炎中的诊断价值.方法 对64份脑脊液进行白细胞计数和IL-17、IL-23的检测.应用受试者工作特征曲线(ROC)对其诊断价值进行评价,并采用直线回归方法进行相关性分析.结果 细菌性脑膜炎组脑脊液IL-17和IL-23水平明显高于病毒性脑膜炎组和对照组(P<0.01),病毒性脑膜炎组IL-17和IL-23水平高于对照组(P<0.01).脑脊液IL-17与IL-23、IL-17与白细胞计数、IL-23与白细胞计数呈明显正相关,相关系数分别为04980、0.5551和0.5810.结论 脑脊液IL-17和IL-23的检测可以用于对细菌性脑膜炎的鉴别诊断.

  9. [Bacterial flora in children with recurrent acute otitis media].

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-02-01

    The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from middle ear in children with recurrent acute otitis media and acute otitis media. The study comprised 83 children--42 with recurrent acute otitis media and 41 with acute otitis emdia classified for paracentesis. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clinadamycin and trimethoprim/sulfamethoxazole. 217 organisms from middle ear in children with recurrent acute otitis media and 131 organisms from middle ear in children with acute otitis media were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--71.4% in recurrent acute otitis media and 47.3% in acute otitis media. We observed statistically significant (p acute otitis media older than 2 years. The best susceptibility was observed to amoxicillin/clavulanate (79.7% of bacteria in children with recurrent acute otitis media and 83.2% of bacteria in children with acute otitis media). The most of organisms presented resistance to trimethoprim/sulfamethoxazole--65.9% of bacteria in children with recurrent acute otitis media and 62.6% of bacteria in children with acute otitis media. Our investigation showed that resistance to bacteria increase in children with recurrent acute otitis media, most frequent appear in children older than 2 years and depend on number of episodes of acute otitis media and day care.

  10. Severe renal failure in acute bacterial pyelonephritis: Do not forget corticosteroids

    Directory of Open Access Journals (Sweden)

    Sqalli Tarik

    2010-01-01

    Full Text Available Acute renal failure (ARF is a rare complication of acute pyelonephritis in adult immunocompetent patients. Recovery of renal function usually occurs if antibiotics are promptly initiated. However, long-term consequences of renal scarring due to acute pyelonephritis are probably underestimated, and some patients present with prolonged renal failure despite adequate antibiotic therapy. We report two cases of severe ARF complicating bacterial pyelonephritis successfully treated with corticosteroids in association with conventional antibiotics.

  11. 河北省2009-2010年细菌性脑膜炎哨点监测病例分析%Analysis of bacterial meningitis cases in sentinel points of Hebei province during 2009 to 2010

    Institute of Scientific and Technical Information of China (English)

    孙印旗; 王颖童; 贾肇一; 李静; 甄素娟; 郭建花; 周吉坤; 马洪生; 陈素良

    2011-01-01

    Objective To preliminary understand the epidemic characteristics and etiology of bacterial meningitis in Hebei province. Method 6 hospitals were selected as bacterial meningitis surveillance sentinel point, and developed cases epidemiological sunrey and etiology detection. Results 134 bacterial meningitis cases were reported during 2009 to 2010 and 1 case died. The patients were mainly scattered children and students under 15 years old, males were more than females , and half cases were natives. The peak times of the disease were winter, spring and July to August. Clinical symptom of majority cases was not serious. 1 Sp, 1 Hib and 5 other bacterial strains were isolated from 96 cerebrospinal fluid ( CSF) 8amples. Detected by real time PCR, 4 cases were Sp positive, 2 cases were Hib positive and 90 cases were negative. Conclusions Reported bacterial meningitis cases in sentinel hospitals were less and the positive result of etiology detection were low too, and need to analyze and find out the reasons.%目的 初步了解河北省细菌性脑膜炎流行病学特征和病原情况.方法 选择6家哨点医院,开展细菌性脑膜炎病例流行病学调查和实验室病原检测.结果 2009-2010年哨点医院共报告细菌性脑膜炎病例134例,死亡1例.发病以15岁以下散居儿童和学生为主,男性多于女性,本地病例占1/2左右,冬春季节和7~8月为发病高峰,病例以轻型和不典型为主.从96例病例脑脊液标本中分离出sp 1株,Hib 1株,其他菌5株.96例病例标本的Real-time PCR检测Sp阳性4例,Hib阳性2例,阴性90例.结论 哨点医院报告病例数较少,病原检测阳性率低,需进一步分析查找原因.

  12. Dexamethasone treatment in adults with pneumococcal meningitis: risk factors for death

    NARCIS (Netherlands)

    M. Weisfelt; D. van de Beek; J. de Gans

    2006-01-01

    In experimental meningitis, adjunctive treatment with steroids reduces cerebrospinal fluid inflammation and thereby improves neurological outcome. On the basis of these findings, several clinical trials have assessed treatment with adjunctive steroids in bacterial meningitis, with conflicting result

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

    Science.gov (United States)

    ... conjugate vaccine=MenACWY Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants Recommend on Facebook ... cochlear implants are more likely to get bacterial meningitis than children without cochlear implants. In addition, some ...

  14. Eficácia da associação de dexametasona à antibioticoterapia em pacientes pediátricos com meningite bacteriana Effectiveness of the association of dexamethasone with antibiotic therapy in pediatric patients with bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Wanderley Marques Bernardo

    2012-06-01

    Full Text Available OBJETIVO: Avaliar a eficácia da associação de corticoide ao tratamento padrão da meningite bacteriana em pacientes pediátricos. MÉTODOS: Realizou-se revisão sistemática da literatura através da base de dados MEDLINE. Foram incluídos apenas ensaios clínicos controlados e randomizados que comparassem a dexametasona ao placebo no tratamento de pacientes pediátricos com meningite bacteriana. RESULTADOS: Oito artigos preencheram os critérios de inclusão e foram selecionados para análise. Não houve diferença nas taxas de mortalidade (p = 0,86 ou de incidências de sequelas neurológicas (p = 0,41 e audiológicas (p = 0,48 entre os grupos. CONCLUSÃO: Não existem benefícios na associação de corticoide ao tratamento da meningite bacteriana em pacientes pediátricos.OBJECTIVE: To evaluate the efficacy of the association of corticosteroids and the standard treatment of bacterial meningitis in pediatric patients. METHODS: A systematic review of the literature was conducted through the MEDLINE database. Only randomized controlled trials comparing dexamethasone with placebo in the treatment of pediatric patients with bacterial meningitis were included. RESULTS: Eight articles met the inclusion criteria and were selected for analysis. There were no difference in mortality (p = 0.86, and incidence of neurological (p = 0.41 and auditory (p = 0.48 sequelae between the groups. CONCLUSION: There are no benefits in associating corticosteroids with the standard treatment of bacterial meningitis in pediatric patients.

  15. Estimating costs of care for meningitis infections in low- and middle-income countries.

    Science.gov (United States)

    Portnoy, Allison; Jit, Mark; Lauer, Jeremy; Blommaert, Adriaan; Ozawa, Sachiko; Stack, Meghan; Murray, Jillian; Hutubessy, Raymond

    2015-05-01

    Meningitis infections are often associated with high mortality and risk of sequelae. The costs of treatment and care for meningitis are a great burden on health care systems, particularly in resource-limited settings. The objective of this study is to review data on the costs of care for meningitis in low- and middle-income countries, as well as to show how results could be extrapolated to countries without sound data. We conducted a systematic review of the literature from six databases to identify studies examining the cost of care in low- and middle-income countries for all age groups with suspected, probable, or confirmed meningitis. We extracted data on treatment costs and sequelae by infectious agent and/or pathogen, where possible. Using multiple regression analysis, a relationship between hospital costs and associated determinants was investigated in order to predict costs in countries with missing data. This relationship was used to predict treatment costs for all 144 low- and middle-income countries. The methodology of conducting a systematic review, extrapolating, and setting up a standard database can be used as a tool to inform cost-effectiveness analyses in situations where cost of care data are poor. Both acute and long-term costs of meningitis could be extrapolated to countries without reliable data. Although only bacterial causes of meningitis can be vaccine-preventable, a better understanding of the treatment costs for meningitis is crucial for low- and middle-income countries to assess the cost-effectiveness of proposed interventions in their country. This cost information will be important as inputs in future cost-effectiveness studies, particularly for vaccines.

  16. THE VALUE OF PROCALCITONIN MEASUREMENT IN MENINGITIS PATIENTS

    Directory of Open Access Journals (Sweden)

    SHAIMAA A. HAMEED

    2015-04-01

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

  17. 联合检测血清降钙素原、高敏C反应蛋白和全血白细胞在鉴别小儿细菌性和病毒性脑膜炎病中的重大意义%The Great Significance of Combined Detection of Serum Procalcitonin(PCT), High-sensitivity c-reactive Protein(hs - CRP) and White Blood Cells in Whole Blood in the Identification of Children with Bacterial Meningitis and Viral Meningitis

    Institute of Scientific and Technical Information of China (English)

    张保珍

    2016-01-01

    Objective To evaluate the significance of serum procalcitonin(PCT), high-sensitivity c-reactive protein(hs-CRP) and white blood cells in whole blood in identifying children with bacterial meningitis and viral meningitis.Methods To detecte PCT, hs-CRP and whole blood WBC taken from 42 children with bacterial meningitis, 56 children with viral meningitis and 40 healthy controls children.Results ①The level of PCT, hs-CRP and whole blood WBC in children with bacterial meningitis were significantly higher than that in control group. There was significant difference between the two groups(P0.05).②The combined detection of the three indicators in the identification of bacterial meningitis and viral encephalicis in accuracy, sensitivity and specificity was significantly higher than on an individual detection. There was significant difference between the two ways(P0.05).②三项指标联合检测鉴别细菌性和病毒性脑膜炎病在准确度,灵敏度和特异性上明显高于单独检测任一项指标,差异有统计学意义(P<0.05).结论 联合检测血清降钙素原、高敏C反应蛋白和全血白细胞有助于鉴别小儿细菌性和病毒性脑膜炎.

  18. Clinical Features and Risk Factors of Hydrocephalus in Children with Bacterial Meningitis%细菌性脑膜炎并脑积水的临床特点及危险因素

    Institute of Scientific and Technical Information of China (English)

    刘敏; 庞玉生; 石靖

    2012-01-01

    Objective To explore the clinical characteristics and correlated risk factors of hydrocephalus secondary to bacterial meningitis in children,in order to reduce its incidence and improve the outcome of hacterial meningitis. Methods The study was retrospectively performed on 111 patients at the First Affiliated Hospital of Guangxi Medical University, from Jan. 2004 to Jun. 2010,with the diagnosis of bacterial meningitis. All cases were divided into bacterial meningitis with hydrocephalus group and without hydrocephalus group according to neu-roimaging findings. The clinical and laboratory data of patients with and without hydroce phalus were analyzed and compared by SPSS 17.0 software. Results Hydrocephalus patients accounted for 14.4% (16/111 cases) of bacterial meningitis cases. A total of 75% (12/16 cases) hydrocephalus manifested itself within 4 weeks following the disease's onset. Fourteen cases (14/16 cases,87. 5%) were obstructive hydrocephalus. One to three times repeated CT/MRI were performed when hydrocephalus was diagnosed. Two cases with hydrocephalus required ventriculoperitoneal shunt al 2 months after bacterial meningitis was onset. Two patients with hydrocephalus were died. There were significant differences between the both groups at admission included young age,prolonged fever > 10 d,the presence of seizures,impaired consciousness, empirical treatment failure, cerebral infarction,low haemoglobin level,high cerebrospinal fluid(CSF) protein level and low CSF glucose level. The Logistic regression analysis showed that impaired consciousness,empirical treatment failure and low haemoglobin level were independent risk factors of hydrocephalus secondary to bacterial meningitis. Conclusions Hydrocephalus was one of the severe sequelaes of bacterial meningitis. Certain clinical parameters and laboratory findings in blood and CSF at the lime of admission can be used as predictors for hydrocephalus in bacterial meningitis.%目的 探讨细菌性脑膜炎并

  19. Outbreak of Enterovirus - 71 Meningitis in Calicut

    Directory of Open Access Journals (Sweden)

    CK Sasidharan

    2016-04-01

    Full Text Available Objective: Enterovirus 71(EV 71 causes wide spectrum of infections ranging from asymptomatic conditions to clinical syndromes like diarrhea, rash, hand-foot-and mouth disease (HFMD, herpangina, aseptic meningitis, encephalitis, myocarditis, acute flaccid paralysis, bulbar and brainstem encephalitis Guillain Barre syndrome, pulmonary haemorrhage. This study deals with an outbreak of aseptic meningitis in children caused by EV 71 virus. Methods: The authors report an outbreak of aseptic meningitis in children in and around Calicut in June 2008. Clinical and laboratory study was done in collaboration with National Centre for Disease Control, New Delhi. 149 children with aseptic meningitis were studied and followed up from June 2008 to May 2009. Result: All children had clinical features suggestive of aseptic meningitis and serology showed the rising antibody titre against EV 71 virus infection. CSF analysis also showed four fold rise in antibodies in one and ≥ 1:2 neutralising antibodies titer against EV- 71 in four samples indicating meningitis due to EV-71. Conclusion: EV 71 was identified as the causative agent of the outbreak of aseptic meningitis in the study and the fact that the EV 71 infection has evolved from minor illness like HFMD to major illness like aseptic meningitis from the same locality is truly alarming.

  20. 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.

  1. Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection.

    Science.gov (United States)

    Pettigrew, Melinda M; Gent, Janneane F; Pyles, Richard B; Miller, Aaron L; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee

    2011-11-01

    Acute otitis media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute otitis media associated with specific combinations of respiratory viruses and acute otitis media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute otitis media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute otitis media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute otitis media. In adjusted models controlling for the presence of key viruses, bacteria, and acute otitis media risk factors, acute otitis media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute otitis media risk differs by the specific viruses and bacteria involved. Acute otitis media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute otitis media bacterial pathogens.

  2. 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.

  3. Meningite bacteriana neonatal: estudo prospectivo da evolução a longo prazo de 55 crianças Neonatal bacterial meningitis: prospective study of the long term outcome of 55 children

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Jornada Krebs

    1996-03-01

    Full Text Available Foram estudadas prospectivamente 55 crianças que apresentaram meningite bacteriana no período neonatal, com o objetivo da analisar a frequência e o tipo de sequelas neurológicas. Todas as crianças nasceram a termo, sendo 38 do sexo masculino e 17 do feminino; a idade de início da doença variou de 3 a 28 dias. Os principais agentes etiológicos foram as enterobactérias. O tempo médio de seguimento foi 5 anos. A frequência de sequelas neurológicas foi 67,3%, representadas principalmente pelo atraso do desenvolvimento neuropsicomotor (58,2%, hidrocefalia (45,5% e convulsões (34,5%. As alterações motoras graves ocorreram em 23,6% dos pacientes (tetraplegia, diplegia, hemiparesia e ataxia. As convulsões na fase aguda da doença e a cultura positiva do líquido cefalorraqueano estiveram associadas significativamente com a presença de sequelas. Na avaliação do desempenho escolar, realizada em 25 crianças, observaram-se dificuldades na aprendizagem em 48% dos casos, associadas significativamente à deficiência mental.Fifty-five infants who presented bacterial neonatal meningitis were prospectively studied to analyze the frequency and the type of sequelae. All the infants were full term newborns.There were 38 boys and 17 girls; the age of disease onset varied from 3 to 28 days. The causative organism was represented mainly by enterobacteriae. The median time of follow-up was 5 years. The frequency of neurologic sequelae was 63.7%, represented mainly by neuropsychomotor development delay (58.2%, hydrocephaly (45.5% and convulsions (34.5%. Severe motor abnormalities ocurred in 23.6% of children (quadriplegia, diplegia, hemiparesia and ataxia. Convulsions in the acute phase of the disease and the positive cerebrospinal fluid culture were highly associated to sequelae. The school performance, obtained in 25 children, showed presence of disabilities in 48% of cases, which were significantly associated to mental retardation.

  4. Prevention of bacterial infection and sepsis in acute severe pancreatitis.

    OpenAIRE

    McClelland, P.; Murray, A; Yaqoob, M.; Van Saene, H. K.; Bone, J M; Mostafa, S. M.

    1992-01-01

    Between 1984 and 1986 six patients with acute respiratory failure (requiring ventilation for at least 3 days) complicating acute pancreatitis were managed on the intensive care unit (median ventilation period 6 days; range 3-41 days). Between 1987 and 1989 nine similar patients were managed (median ventilation period 35 days, range 4-69 days), and a regimen of enteral tobramycin, polymyxin and amphotericin to selectively decontaminate the digestive tract (SDD) was introduced. Five of six pati...

  5. Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

    OpenAIRE

    Asli Gorek Dilektasli; Ezgi Demirdogen Cetinoglu; Nilufer Aylin Acet Ozturk; Funda Coskun; Guven Ozkaya; Ahmet Ursavas; Cuneyt Ozakin; Mehmet Karadag; Esra Uzaslan

    2016-01-01

    Introduction. The most common cause of acute COPD exacerbation (AECOPD) is the respiratory tract infections. We sought to determine the bacteriological etiology of hospitalized acute exacerbations of COPD requiring hospitalization in consecutive two years. Methods. We aimed to determine the bacteriological etiology underlying in patients whom admitted to Uludag University Faculty of Medicine, Department of Pulmonary Medicine and hospitalized with AECOPD in the last two years. Medical records ...

  6. Clinical efficacy of dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI)

    OpenAIRE

    Leuthner KD; Buechler KA; Kogan D; Saguros A; Lee HS

    2016-01-01

    Kimberly D Leuthner,1 Kristin A Buechler,1 David Kogan,1 Agafe Saguros,1 H Stephen Lee2 1Department of Pharmaceutical Services, University Medical Center of Southern Nevada, Las Vegas, NV, USA; 2Roseman University of Health Sciences College of Pharmacy, Henderson, NV, USA Abstract: Acute bacterial skin and skin structure infections (ABSSSI) are a common disease causing patients to seek treatment through the health care system. With the continued increase of drug-resistant bacterial pathogen...

  7. Mechanisms of the Hepatic Acute-Phase Response during Bacterial Pneumonia▿

    OpenAIRE

    Quinton, Lee J.; Jones, Matthew R.; Robson, Bryanne E.; Mizgerd, Joseph P.

    2009-01-01

    The acute-phase response is characterized by increased circulating levels of acute-phase proteins (APPs) generated by the liver. During bacterial pneumonia, APPs correlate with the severity of disease, serve as biomarkers, and are functionally significant. The kinetics and regulatory mechanisms of APP induction in the liver during lung infection have yet to be defined. Here we show that APP mRNA transcription is induced in the livers of mice whose lungs are infected with either Escherichia co...

  8. Diagnostic Value of Neutrophil CD64 Using ROC Curve in bacterial meningitis%应用ROC曲线评价中性粒细胞CD64诊断儿童化脓性脑膜炎的价值

    Institute of Scientific and Technical Information of China (English)

    穆文娟; 李亚蕊; 韩虹

    2013-01-01

      目的应用受试者工作特征曲线(ROC曲线)评价中性粒细胞CD64诊断儿童化脓性脑膜炎的价值。方法选取40例经脑脊液证实的化脓性脑膜炎儿童患者,所有患者均检测中性粒细胞的CD64、CD11b及血常规。选取20例健康体检患儿,并测试中性粒细胞的CD64、CD11b。结果 CD64、CD11b诊断化脓性脑膜炎的ROC曲线下面积分别是0.880,0.853;CD64、CD11b诊断化脓性脑膜炎的最佳阈值为1.30,15.85;CD64、CD11b诊断化脓性脑膜炎的灵敏度分别为88.3%、70.4%、特异度分别为90.4%、75.9%;化脓性脑膜炎患者中性粒细胞CD64、CD11b与白细胞计数无相关性(P>0.05)。结论 ROC曲线评价显示中性粒细胞CD64对化脓性脑膜炎具有较高的诊断准确度,CD64是诊断化脓性脑膜炎理想的敏感指标。%Objective To evaluate the value Neutrophil CD64 in the diagnosis of bacterial meningitis by Receiver Operating Characteristic curves(ROC). Methods 40 patients with bacterial meningitis(confirmed by cerebrospinal fluid) were obtained for CD64 and CD11b, measurement, blood routin test. 20 non-infected, healthy children cases were seted as control group. Their blood samples were obtained for CD64 and CD11b. Results Draw the ROC curve of the levels of CD64, CD11b in diagnosing bacterial meningitis. The area under the ROC curve were 0.880, 0.853; The best cutoff value of CD64, CD11b were 1.30, 15.85; the sensitivity were 88.3%, 70.4%; the specificity were 90.4%, 75.9%; The coefficients between CD64 and WBC, CD11b and WBC were 0.284, 0.293(P>0.05), no liner correlation. Conclusion ROC analysis showed that Neutrophil CD64 for the bacterial meningitis diagnosis has higher diagnostic accuracy, CD64 is an ideal diagnostic marker to early identify bacterial meningitis.

  9. Neuroimaging in tuberculous meningitis

    Directory of Open Access Journals (Sweden)

    Ravindra Kumar Garg

    2016-01-01

    Full Text Available Tuberculous meningitis is a serious infection caused by Mycobacterium tuberculosis. Early diagnosis is the key to success of treatment. Neuroimaging plays a crucial role in the early and accurate diagnosis of tuberculous meningitis and its disabling complications. Magnetic resonance imaging is considered superior to computed tomography. Neuroimaging characteristics include leptomeningeal and basal cisternal enhancement, hydrocephalus, periventricular infarcts, and tuberculoma. Partially treated pyogenic meningitis, cryptococcal meningitis, viral encephalitis, carcinomatous, and lymphomatous meningitis may have many similar neuroimaging characteristics, and differentiation from tuberculous meningitis at times on the basis of neuroimaging characteristics becomes difficult.

  10. 细菌性脑膜炎与病毒性脑膜炎患者 脑脊液 TNFα、G-CSF、SIL-2R的检测与分析%Determination and analysis of TNF-α,G-CSF and SIL-2 receptor bacterial meningitis and viral meningitis or encephlitis

    Institute of Scientific and Technical Information of China (English)

    王小冬; 吴祖舜; 李述庭; 高俊风; 冯美江; 许宏兵

    2001-01-01

    Objective  To evaluated the levels of tumor necrosis factor-alpha(TNFa), granulocyte colony stimulating factor(G-CSF)and soluble interleukin-2 recepotor(SIL-2R)in cerebrospinal fluid, and analysized their value in differential diagnosis between bacterial meningitis and viral meningitis or encephlitis. Method  The patients were classified into two groups:1. BM. bacterial meningitis (including: PM. pyogenous meningitis; TM. tuberculous meningitis) and 2.VME. Viral meningitis or encephlitis. The levels of TNFα were determined by RIA; The levels of G-CSF and SIL-2R were determined by ELISA. Results  The levels of cerebrospinal fluid TNFα and G-CSF in BM were significantly higher than those in control group(P<0.01)and elevated level were not found in VEM(P<0.05). In addition, the TNFα and G-CSF in BM(PM,TM) were higher than in VME group(P<0.05). The levels of SIL-2R in BM and VME groups were significantly higher than that in control group(P<0.01). Conclusion  All above shows: the disorder in immunity of the patients with BM and VME. We found concentration of cerebrospinal fluid TNFα and G-CSF can be a discriminating index between BM(PM,TM) and VME.%目的研究细菌性脑膜炎(BM)包括化脓性脑膜炎(PM)和结核性脑膜炎(TM)与病毒性脑膜炎(VME)患者急性期脑脊液中肿瘤坏死因子 ( TNFα)、粒细胞集落刺激因子(G-CSF)和可溶性白介素-2受体(SIL-2R)的变化,结合文献探讨它们的临床意义。方法 TNFα用放免法(RIA),G-CSF和SIL-2R用ELISA法,检测25例PM、19例TM、22例VME脑脊液中 TNFα、G-CSF、IL-2R的含量,并与对照组对照。结果脑脊液中 TNFα和G-CSF含量在BM中较对照组显著增高(P<0.01),同时BM较VME组亦明显升高(P<0.05)。 SIL-2R的含量在BM和VME组与对照组相比均增高(P<0.01)。结论说明BM和VME均引起免疫紊乱、免疫参与炎症反应中。 TNFα和G-CSF的改变可以作为BM和VEM早期鉴别诊断的指标之一。

  11. Management of acute bacterial keratitis: Fortified antibiotics or fluoroquinolones?

    Directory of Open Access Journals (Sweden)

    Ana Luisa Hofling-Lima

    2014-10-01

    Full Text Available Bacterial keratitis (BK is one of the most frequent causes for emergency hospital admissions.1 Identifying the causative microorganism promptly and properly is mandatory to achieve acceptable outcomes. Nevertheless, appropriate initial management of these cases requires laboratory-based diagnosis and even a modest laboratory set may not always be available at some clinical settings.

  12. Host Biomarkers for Distinguishing Bacterial from Non-Bacterial Causes of Acute Febrile Illness: A Comprehensive Review

    Science.gov (United States)

    Kapasi, Anokhi J.; Dittrich, Sabine; González, Iveth J.; Rodwell, Timothy C.

    2016-01-01

    Background In resource limited settings acute febrile illnesses are often treated empirically due to a lack of reliable, rapid point-of-care diagnostics. This contributes to the indiscriminate use of antimicrobial drugs and poor treatment outcomes. The aim of this comprehensive review was to summarize the diagnostic performance of host biomarkers capable of differentiating bacterial from non-bacterial infections to guide the use of antibiotics. Methods Online databases of published literature were searched from January 2010 through April 2015. English language studies that evaluated the performance of one or more host biomarker in differentiating bacterial from non-bacterial infection in patients were included. Key information extracted included author information, study methods, population, pathogens, clinical information, and biomarker performance data. Study quality was assessed using a combination of validated criteria from the QUADAS and Lijmer checklists. Biomarkers were categorized as hematologic factors, inflammatory molecules, cytokines, cell surface or metabolic markers, other host biomarkers, host transcripts, clinical biometrics, and combinations of markers. Findings Of the 193 citations identified, 59 studies that evaluated over 112 host biomarkers were selected. Most studies involved patient populations from high-income countries, while 19% involved populations from low- and middle-income countries. The most frequently evaluated host biomarkers were C-reactive protein (61%), white blood cell count (44%) and procalcitonin (34%). Study quality scores ranged from 23.1% to 92.3%. There were 9 high performance host biomarkers or combinations, with sensitivity and specificity of ≥85% or either sensitivity or specificity was reported to be 100%. Five host biomarkers were considered weak markers as they lacked statistically significant performance in discriminating between bacterial and non-bacterial infections. Discussion This manuscript provides a summary

  13. Successful treatment of a patient with ventriculoperitoneal shunt-associated meningitis caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae.

    Science.gov (United States)

    Tseng, Yu-Chen; Kan, Li-Ping; Huang, Li-Yueh; Yin, Ti; Yang, Ya-Sung; Lin, Jung-Chung; Siu, L Kristopher

    2014-01-01

    Bacterial meningitis is responsible for significant morbidity and mortality worldwide, despite that modern antibiotics effectively penetrate cerebrospinal fluid to eradicate bacteria. A clinical suspicion of bacterial meningitis should be recognized early for the rapid diagnostic workup. Bacterial meningitis associated with ventriculoperitoneal shunt (VPS) is not uncommon and infrequently presents as abdominal symptoms and signs. Infections of the central nervous system caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) are extremely rare, and such multiple drug-resistant pathogens frequently cause inappropriate treatments and mortality. β-Lactamases are bacterial enzymes that inactivate β-lactam antimicrobial agents. The increased prevalence of ESBL-producing organism infections has become a worldwide problem. Timely and appropriate treatment is important to reduce mortality and morbidity of infections caused by ESBL-producing organisms. Here, we report a 61-year-old male patient who underwent VPS implantation for consequent hydrocephalus following spontaneous intracranial hemorrhage six months before this presentation. He was admitted for intermittent fever and right lower quadrant abdominal pain, and he was initially managed as acute appendicitis with its typical presentation. Finally, he was diagnosed VPS-associated meningitis caused by ESBL-KP. This patient was successfully treated with the combination of meropenem, a carbapenem antibiotic that is the drug of choice for treating ESBL-producing organisms, and high-dose fosfomycin, a phosphonic acid derivative antibiotic that is effective in treating some drug-resistant pathogens. In the present report, we emphasize the clinical presentations of catheter-related meningitis and risk factors for infections caused by ESBL-producing pathogens. Antibiotic combination therapy can provide synergistic effect and maximize anti-bacterial activity in ESBL-KP meningitis.

  14. Risk factors for bacterial meningitis after major craniotomy in adults%成人开颅术后并发细菌性脑膜炎的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    张冰琰; 陈晨; 虞胜镭; 邵凌云; 张文宏; 陈澍

    2014-01-01

    Objective To investigate the incidence,bacterial pathogen and risk factors of bacterial meningitis after major craniotomy.Methods Clinical data of patients who underwent at least one craniotomy in Huashan Hospital Affiliated to Fudan University in 2008 were collected.All subjects were ≥ 18 years old,and survived at least 7 days after surgery.Patients with only cerebrospinal fluid drainage,burr holes,cranioplasty,vascular interventional surgery,transsphenoidal or spinal surgery were excluded.Risk factors for bacterial meningitis after major craniotomy were analyzed by Logistic regression.Results A total of 691 patients were enrolled,in 60 of whom (8.68%) bacterial meningitis was identified.Among 44 samples,5 were positive in culture with 2 of Acinetobacter baumannii,1 of Enterococcus faecalis,1 of Streptococcus intermedius and 1 of Klebsiella pneumonia.Diabetes (OR =5.79,95% CI:1.40-23.93,P =0.02),Glasgow Coma Scale score < 12 (OR =6.56,95% CI:1.17-36.80,P =0.03),external ventricular drainage (OR =4.31,95% CI:1.57-11.82,P =0.01),and continuous lumbar cistern drainage (OR =22.82,95% CI:10.31-50.52,P =0.00) were independent risk factors for bacterial meningitis after major craniotomy.Patients with external ventricular drainage > 7 d were 11.82 times more likely to develop bacterial meningitis,and those with continuous lumbar cistern drainage > 10 d were 25.50 times more likely to develop bacterial meningitis.Conclusions Bacterial meningitis remains a common complication after major craniotomy,and most are induced by Gram-negative bacilli.Diabetes,Glasgow Coma Scale score,external ventricular drainage and continuous lumbar cistern drainage may increase its incidence.%目的 探讨开颅术后细菌性脑膜炎的发生率、常见病原菌及危险因素.方法 连续收集复旦大学附属华山医院2008年至少接受过一次颅脑手术病例的资料.纳入年龄≥18岁,且术后至少存活7d的病例,排除仅行脑脊髓液引流术、颅

  15. Meningitis and Encephalitis

    Science.gov (United States)

    ... Career Awards Enhancing Diversity Find People About NINDS Meningitis and Encephalitis Fact Sheet See a list of ... Where can I get more information? What is meningitis? What is encephalitis? Infections, and less commonly other ...

  16. Meningitis Myths and Facts

    Science.gov (United States)

    ... Diseases Infographic Prevention and Control of Meningococcal Disease Meningitis Myths and Facts Myth: Meningococcal disease is easy ... infected person, such as shaking hands. Fact: Meningococcal meningitis is spread through air droplets and direct contact ...

  17. Meningitis - H. influenzae

    Science.gov (United States)

    ... antibiotics may be considered. Always use good hygiene habits, such as washing hands before and after changing a diaper, and after using the bathroom. Alternative Names H. influenzae meningitis; H. flu meningitis ...

  18. Acute bacterial infections of the lower respiratory tract in children from low-income countries

    NARCIS (Netherlands)

    Fleer, A; Wolf, B.H.M.

    2000-01-01

    Acute bacterial infection of the lower respiratory tract is a major cause of morbidity and mortality in children and is responsible for 4 million childhood deaths each year. Most of these deaths are caused by pneumonia and occur in the youngest children in the poorest parts of the world. Severe pneu

  19. Effects of subtotal colectomy on bacterial translocation during experimental acute pancreatitis

    NARCIS (Netherlands)

    van Minnen, LP; Nieuwenhuijs, VB; de Bruijn, MT; Verheem, A; Visser, MR; van Dijk, JE; Akkermans, LMA; Gooszen, HG

    2006-01-01

    Objectives: The colon is considered a major source of bacteria causing infection of pancreatic necrosis in acute pancreatitis (AP). Subtotal colectomy before AP in rats reduces mortality, but its role in affecting small bowel flora, bacterial translocation, and infection of pancreatic necrosis is un

  20. 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.

  1. Exome Array Analysis of Susceptibility to Pneumococcal Meningitis

    Science.gov (United States)

    Kloek, Anne T.; van Setten, Jessica; van der Ende, Arie; Bots, Michiel L.; Asselbergs, Folkert W.; Serón, Mercedes Valls; Brouwer, Matthijs C.; van de Beek, Diederik; Ferwerda, Bart

    2016-01-01

    Host genetic variability may contribute to susceptibility of bacterial meningitis, but which genes contribute to the susceptibility to this complex disease remains undefined. We performed a genetic association study in 469 community-acquired pneumococcal meningitis cases and 2072 population-based controls from the Utrecht Health Project in order to find genetic variants associated with pneumococcal meningitis susceptibility. A HumanExome BeadChip was used to genotype 102,097 SNPs in the collected DNA samples. Associations were tested with the Fisher exact test. None of the genetic variants tested reached Bonferroni corrected significance (p-value pathophysiology of pneumococcal meningitis. PMID:27389768

  2. 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.

  3. Purulent meningitis with unusual diffusion-weighted MRI findings

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-10-01

    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.

  4. An 0bservation on the curative effects of meropenem in the treatment of bacterial meningitis%美罗培南治疗细菌性脑膜炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘见民

    2014-01-01

    Objective To observe the clinical effects of meropenem in the treatment of bacterial meningitis. Methods 56 adult patients with bacterial meningitis who were admitted to our hospital from June 2010 to June 2013 were selected and randomLy assigned to two groups, with 28 patients in each group. The control group received intravenous drip of ceftriaxone sodium, while the observation group received intravenous drip of meropenem based on ceftriaxone sodium. The curative effects were compared between the two groups. Results Total effective rate for one week of treatment in the observation group was 67.9%, and 92.9%for two weeks, which were significantly higher than those of 21.4%and 53.6%respectively (P<0.01);bacteria eliminating rate in the observation group was 92.9%, significantly higher than that of 67.2%in the control group (P<0.01). Conclusion A proper use of meropenem treatment based on the results of drug sensitive test in early stages helps improve the curative effects of bacterial meningitis.%目的:观察美罗培南治疗细菌性脑膜炎的临床疗效。方法选取2010年6月~2013年6月我院确诊为细菌性脑膜炎的成人患者56例,随机分为两组,每组28例,对照组用头孢曲松钠静脉滴注;观察组在对照组的基础上加用美罗培南静脉滴注治疗,对比两组疗效。结果观察组治疗1周总有效率为67.9%、2周为92.9%,显著高于对照组的21.4%、53.6%(P<0.01);观察组细菌清除率(92.9%)显著高于对照组(67.2%)(P<0.01)。结论早期根据药敏试验结果合理使用美罗培南治疗方案能有助于提高细菌性脑膜炎的治疗效果。

  5. Revisão sistemática do uso da dexametasona como terapia adjuvante na meningite bacteriana em crianças Revisión sistemática del uso de la dexametasona como terapia adyuvante en la meningitis bacteriana en niños Systematic review of dexamethasone as an adjuvant therapy for bacterial meningitis in children

    Directory of Open Access Journals (Sweden)

    João Antonio G. G. Prats

    2012-12-01

    evaluados fueron mortalidad y ocurrencia de secuelas neurológicas y/o auditivas. Se excluyeron estudios con meningitis tuberculosa. SÍNTESIS DE LOS DATOS: Con los criterios utilizados, se identificaron cinco publicaciones correspondientes a cuatro protocolos de estudio. Ninguno de los estudios mostró diferencias entre la dexametasona y el placebo para los desenlaces evaluados. Todos los estudios analizados tuvieron alta calidad (escore Jadad=5. CONCLUSIÓN: Las evidencias encontradas en la literatura son insuficientes para indicar, de modo rutinario, el uso de la dexametasona como terapia adyuvante para reducción de la mortalidad, pérdida auditiva y secuelas neurológicas, en pacientes pediátricos con meningitis bacteriana no tuberculosa.OBJECTIVE: To analyze the best available evidence from the last 15 years on the benefits of adjuvant therapy with dexamethasone for bacterial meningitis in children. DATA SOURCES: Randomized controlled trials comparing dexamethasone to placebo and/or other adjuvant therapies in patients with bacterial meningitis diagnosed by biochemical, cytological and/or microbiological data. Studies with patients from 29 days to 18 years of age, from 1996 to 2011, were searched at Medline, Lilacs and SciELO databases. The evaluated outcomes were mortality and development of neurological and/or hearing impairment. Studies related to tuberculous meningitis were excluded. DATA SYNTHESIS: With the specified criteria, five published studies were identified corresponding to four study protocols. None of the studies showed differences between dexamethasone and placebo for the evaluated outcomes. All analyzed studies had high methodological quality (Jadad et al score=5. CONCLUSIONS: Current evidence is insufficient to support routine adjuvant therapy with dexamethasone to reduce mortality, hearing impairment, or neurological sequelae in pediatric patients with non-tuberculous bacterial meningitis.

  6. 颅脑术后并发细菌性脑膜炎79例回顾性分析%Postoperative bacterial meningitis in intracranial neurosurgery: a retrospective analysis of 79 cases

    Institute of Scientific and Technical Information of China (English)

    陈晨; 徐婷; 邹鹤娟; 张文宏; 翁心华; 陈澍

    2012-01-01

    Objective To investigate the incidence of bacterial meningitis in patients who underwent intracranial neurosurgery and to explore the pathogen distribution and related risk factors.Methods The patients were selected by cluster systematic sampling method from the patient population who underwent intracranial neurosurgery for at least one time in Huashan Hospital affiliated to Fudan University in 2008.Chi-square test and Logistic regression model were used to analyze the data.Results A total of 1165 patients were included in this study.Seventy-nine of them were diagnosed with bacterial meningitis,while eight of them bad positive results for bacterial culture,including 3 cases of Acinetobacter baumannii,and 1 case each of Acinetobacter lwoffii,Klebsiella pneumoniae,Staphylococcus epidermidis,Enterococcus and Streptococcus intermedius. The common neurosurgical diseases with high incidence of postoperative bacterial meningitis were neurilemmoma 15.85%(13/82),glioma 12.21% (21/172) and hydrocephalus 10.34% (3/29).Logistic regression analysis identified male,implant,enteral nutrition,external ventricular drainage and wound negative pressure drainage as independent risk factors for postoperative bacterial meningitis.Conclusions Postoperative central nervous system infection is the most common and severe complication after the intracranial neurosurgery.The results highlight the importance of improving pathogen detection rate and enhancing the prevention in high risk patient populations.%目的 了解颅脑术后细菌性脑膜炎的发病率,常见的感染病原体以及相关危险因素.方法 对复旦大学附属华山医院2008年间所有神经外科出院病例行等距离整群抽样,查阅其中接受至少一次颅脑手术的病例资料.统计学处理采用x2检验及Logistic回归分析.结果 共抽取1165例病例,其中术后细菌性脑膜炎79例,占6.78%;仅有8例细菌培养阳性,分别为鲍曼不动杆菌3株,鲁氏不动杆菌、肺炎

  7. Medicininduceret aseptisk meningitis

    DEFF Research Database (Denmark)

    Farr, Katherina Podlekareva; Backer Mogensen, Christian

    2010-01-01

    Drug-induced aseptic meningitis is a rare adverse effect of some drugs. We report a patient with four episodes of meningitis caused by ibuprofen. In all episodes the patient had taken ibuprofen for pain, and subsequently developed fever and cerebrovascular symptoms. Drug-induced meningitis cannot...... be distinguished from meningitis caused by other agents. Diagnosis is therefore based on close association between drug administration and onset of symptoms, as well as negative microbiology tests results, especially if previous episodes of drug-induced meningitis have occurred....

  8. 新生儿细菌性脑膜炎99例临床特点分析%Clinical Characteristics of Neonatal Bacterial Meningitis:An Analysis of 99 Cases

    Institute of Scientific and Technical Information of China (English)

    曾丽春; 何玲; 陈丽萍

    2015-01-01

    目的:研究新生儿细菌性脑膜炎的发病人群、临床表现、实验室检查及转归的特点。方法采用回顾性分析法分析99例确诊为新生儿细菌性脑膜炎患儿的临床病历资料,对其临床表现、实验室检查结果、头颅影像学检查情况及临床转归进行分析。结果99例患儿中,<7 d 发病占29.29%,农村患儿占62.63%,早产儿占17.17%;临床表现为反应差的患儿占82.83%,体温大于38.5℃占67.68%,肌张力改变占44.44%,惊厥占29.29%,原始反射减弱占40.40%。初次外周血感染指标检查结果和脑脊液(CSF)检查阳性率均不高,其中外周血 C-反应蛋白(CRP)异常率稍高于外周血白细胞计数异常率,但差异无统计学意义(45.46%比38.38%,P >0.05);外周血降钙素原(PCT)与 CRP 异常率有明显差异(70.00%比50.50%,P <0.05)。从血液和 CSF 培养出的各种致病菌中, G-菌稍多于 G+菌,血培养阳性率为26.26%,G-菌占53.85%,其中10例(38.46%)为多重耐药菌。脑脊液培养阳性率为11.11%,G-菌占54.55%,其中5例(45.45%)为多重耐药菌。80例患儿行头颅 CT 或 MRI 检查,异常头颅 CT 及 MRI 患儿占28.75%(23/80)。结论新生儿细菌性脑膜炎的临床表现无特异性,早期诊断较困难。对该病的早期诊断依赖于临床 PCT、CRP、血培养以及脑脊液等多项检验的联合判定。%ABSTRACT:Objective To study the onset population,clinical manifestations,laboratory tests and outcomes of neonatal bacterial meningitis.Methods Clinical data of 99 newborns with bacte-rial meningitis were analyzed retrospectively.Clinical manifestations,laboratory examinations, cranial imaging findings and clinical outcomes were analyzed.Results Among the 99 newborns, 29.29% had bacterial meningitis within 7 days after birth,62.63% came from

  9. Recurrent meningitis in a child with IgG3 subclass deficiency.

    Science.gov (United States)

    Vehapoglu, Aysel; Ozgurhan, Gamze; Demir, Aysegul Dogan; Uzuner, Selcuk; Nursoy, Mustafa Atilla; Turkmen, Serdar

    2014-08-01

    Recurrent meningitis is an uncommon life-threatening condition. Here, the case of a 6-year-old boy is reported who had two episodes of meningitis with an IgG3 subclass deficiency. The boy had aseptic meningitis at the age of 3 years, followed by bacterial meningitis at the age of 4 years. Primary immunoglobulin deficiencies are a group of disorders associated with an increased incidence and/or severity of infection. Recurrent infections, sinusitis, bronchitis, and pneumonia are the most frequently observed illnesses in patients with IgG subclass deficiencies, of which an IgG3 subclass deficiency is the most common, especially in adults. Although cases of recurrent viral or bacterial meningitis have been reported, herein a patient is presented with recurrence of aseptic and bacterial meningitis 1 year after the initial episode. Some researchers recommend that all children with episodes of recurrent meningitis should be screened for primary immunoglobulin or complement deficiencies.

  10. Oral infection of mice with Salmonella enterica serovar Typhimurium causes meningitis and infection of the brain

    Directory of Open Access Journals (Sweden)

    Provias John

    2007-06-01

    Full Text Available Abstract Background Salmonella meningitis is a rare and serious infection of the central nervous system following acute Salmonella enterica sepsis. For this pathogen, no appropriate model has been reported in which to examine infection kinetics and natural dissemination to the brain. Methods Five mouse lines including C57BL/6, Balb/c, 129S6-Slc11a1tm1Mcg, 129S1/SvImJ, B6.129-Inpp5dtm1Rkh were used in the murine typhoid model to examine the dissemination of systemic Salmonella enterica serovar Typhimurium following oral infection. Results We report data on spontaneous meningitis and brain infection following oral infection of mice with Salmonella enterica serovar Typhimurium. Conclusion This model may provide a system in which dissemination of bacteria through the central nervous system and the influence of host and bacterial genetics can be queried.

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

    Science.gov (United States)

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

    2012-07-01

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

  12. 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.

  13. Significance study of SHP2 Expression in brain tissue of bacterial meningitis rat%细菌性脑膜炎大鼠脑组织中蛋白络氨酸磷酸酶表达及意义

    Institute of Scientific and Technical Information of China (English)

    王强; 谷席娟

    2015-01-01

    目的:研究细菌性脑膜炎中蛋白络氨酸磷酸酶(SHP2)的表达意义。方法依据随机数字表法将90只大鼠分为脑膜炎组(72只)和健康对照组(18只)两组,用反转录(RT)-PCR、Western印迹法、免疫组织化法对脑膜炎组和健康对照组大鼠不同时间点脑组织SHP2表达进行检测,然后对SHP2蛋白表达和肿瘤坏死因子-α(TNF-α)、白细胞(WBC)计数的关系进行观察分析。结果脑膜炎组大鼠皮层SHP2 mRNA表达(0.035±0.020)、(0.200±0.049)、(0.129±0.032)、(0.057±0.039)均明显比健康对照组(0.031±0.028)高(F=12.74,P<0.05);第三脑室周围 SHP2阳性染色细胞明显比健康对照组多(χ2=5.02,P<0.05);皮层SHP2蛋白表达与脑脊液TNF-α浓度、WBC计数的相关系数分别为0.08(P>0.05)和0.77(t=4.303,P<0.05)。结论细菌性脑膜炎的病理生理过程有中SHP2参与,主要作用可能是抑制炎症、修复炎性反应,可作为病情变化的参考指标。%Objective To study the significance of protein tyrosine phosphatase (SHP2)expression in bac-terial meningitis.Methods 90 rats were divided into meningitis group (72)and healthy controls (18)two groups based on the random number table,The SHP2 expression in rat brain tissue at different time points of meningitis group and healthy control group were tested by reverse transcription (RT)a PCR,Western blotting,immunohistochemical methods,then the relationship between SHP2 protein expression and tumor necrosis factor-α(TNF-α),white blood cell (WBC)counts were observed and analyzed.Results The cortical SHP2 mRNA expression of meningitis rat in-cluding (0.035 ±0.020),(0.200 ±0.049),(0.129 ±0.032)and (0.057 ±0.039),were significantly higher than those of the healthy control group (0.031 ±0.028)(F=12.74,P0.05)and 0.77 (t=4.303,P<0.05).Conclusion SHP2 participates in pathophysiology of

  14. Clinical features and imaging examination analysis of bacterial meningitis in children%儿童细菌性脑膜炎临床特征和影像学分析

    Institute of Scientific and Technical Information of China (English)

    高媛媛; 杨思达; 刘鸿圣; 郑可鲁; 李小晶; 陈文雄; 麦坚凝

    2015-01-01

    目的:探讨不同年龄阶段细菌性脑膜炎患儿临床特征的变化和影像学改变,为临床诊断提供依据。方法以广州市妇女儿童医疗中心2011年1月至2013年6月收治的89例细菌性脑膜炎患儿为研究对象,其中男58例,女31例。足月新生儿组34例、婴儿组41例、1岁以上年龄组14例。比较3组间的临床特征、辅助检查结果和影像学异常特点及差异。结果1.非特异性表现:54例有高热,44例有呼吸道症状,12例有消化道症状。1岁以上年龄组高热的发生率显著高于新生儿组和婴儿组(χ2=10.093,P0.05)。40例脑脊液改变不典型的患儿中,脑脊液葡萄糖/血清葡萄糖比值≤0.4的23例和血细菌培养阳性的15例。4.影像学结果:头颅MRI检查75例,51例异常。头颅CT检查30例,15例异常。婴儿组头颅CT/MRI总异常率、头颅MRI的异常率和头颅MRI呈现脑膜炎改变的比例均较新生儿组、1岁以上年龄组高,差异均有统计学意义(χ2=11.768、9.047、7.674,P均<0.05)。头颅MRI显示脑膜炎、硬膜下积液的异常率显著高于头颅CT,差异有统计学意义(χ2=7.430、5.291,P均<0.05)。结论新生儿和婴儿细菌性脑膜炎临床表现不典型,宜早实施腰椎穿刺检查。脑脊液改变不典型时,脑脊液/血清糖比值≤0.4、头颅MRI序列检查和血细菌培养三者之间,两两联合对识别细菌感染较为重要。头颅MRI序列识别患儿脑膜病变明显优于CT。%Objective To investigate the clinical features and the imaging examination changes of bacterial meningitis in children of different age groups,and to offer theoretical basis for the clinic diagnosis of bacterial meningi-tis. Methods The sick children with bacterial meningitis treated in Guangzhou Women and Children′s Medical Center from January 2011 to June 2013,were recruited and divided into three groups according to the age,including newborns group,infants group and more than 1 year group

  15. Chest physiotherapy in children with acute bacterial pneumonia

    Directory of Open Access Journals (Sweden)

    Lieselotte Corten

    2015-04-01

    Full Text Available Background: Pneumonia is the single leading cause of death in children younger than 5 years of age. Chest physiotherapy is often prescribed as an additional therapy in children with pneumonia. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. However, it is unclear if these techniques are effective in this population.Objective: The present review aimed to determine the efficacy of different chest physiotherapy techniques compared with no physiotherapy or other chest physiotherapy treatments in hospitalised children with bacterial pneumonia.Method: Six electronic databases (PubMed, Medline, Cochrane Library, PEDro, CINAHL and Africa-wide information, clinicaltrials.gov and pactr.org were searched for eligible studies.Results: Two randomised controlled trials and one ongoing study were identified. Neither completed trial reported differences between the control and intervention groups, although one study reported a longer duration of coughing (p = 0.04 and rhonchi (p = 0.03 in the intervention group.Conclusion: Because of the limited number of included articles and different presentations of outcome measures, we could not reject or accept chest physiotherapy as either an effective or harmful treatment option in this population.

  16. Extraction of Bacterial Genomic DNA from Cerebrospinal Fluid of Bacterial Meningitis Patients and Identification of 16S rDNA%细菌性脑膜炎患者脑脊液细菌基因组DNA的提取及16SrDNA的鉴定

    Institute of Scientific and Technical Information of China (English)

    梁志娟; 侯晓霖; 王振海; 刘爱翠

    2013-01-01

    Objective To investigate the application of 16S rDNA as a diagnostic tool for bacterial meningitis . Methods The cerebrospinal fluid (CSF) samples were harvested from patients clinically suspected of bacterial meningitis . Bacterial genomic DNA in the CSF was extracted after bacterial enrichment by high-speed centrifugation. Then PCR amplification of 16S rDNA fragment was performed. The results of PCR amplification were compared with those of bacterial culture. Results Twenty-three of the 58 (39.7% ) cases were positive for 16S rDNA in PCR amplification ,which was significantly higher than the positive rate of bacterial culture with only 10 positive cases (17. 2% )(P<0. 05 ). Conclusion The DNA extraction and 16S rDNA PCR detection are simple procedures with short time consumption and high sensitivity suggesting their good application prospect in etio-logical diagnosis of bacterial meningitis.%目的 探讨16S rDNA聚合酶链式反应(PCR)在细菌性脑脊液病原菌检查中的应用价值.方法 收集临床疑诊为细菌性脑膜炎的患者脑脊液标本,高速离心富集细菌后,进行脑脊液中细菌基因组DNA的提取,再进行16S rDNA PCR扩增和琼脂糖凝胶电泳.将检测结果与传统的细菌培养结果进行比较.结果 58例患者脑脊液样本中,23例16S rDNA PCR阳性,阳性率为39.7%;58例脑脊液样本中细菌培养阳性为10例,阳性率为17.2%.PCR检测阳性率明显高于传统的细菌分离培养法(P<0.05).结论 脑脊液细菌基因组DNA提取及16S rDNA PCR鉴定技术操作简单,耗时短,灵敏度高,在细菌性脑膜炎病原学诊断方面具有良好的应用前景.

  17. 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.)

  18. The clinical features and meningeal histochemistry of meningeal malignant melanosis

    Institute of Scientific and Technical Information of China (English)

    LIU Xue-wu; CHI Zhao-fu; ZHAO Xiu-he; WU Wei

    2008-01-01

    @@ Meningeal malignant melanosis is a meninges tumor that can produce melanin.Primary intracranial neurocutaneous melanosis is rare.It grows fast with a high degree of malignancy and is associated with earlier intracranial hypertension and meningeal irritation.

  19. Microbial study of meningitis and encephalitis cases.

    Science.gov (United States)

    Selim, Heba S; El-Barrawy, Mohamed A; Rakha, Magda E; Yingst, Samuel L; Baskharoun, Magda F

    2007-01-01

    Meningitis and/or encephalitis can pose a serious public health problem especially during outbreaks. A rapid and accurate diagnosis is important for effective earlier treatment. This study aimed to identify the possible microbial causes of meningitis and/or encephalitis cases. CSF and serum samples were collected from 322 patients who had signs and symptoms suggestive of meningitis and/or encephalitis. Out of 250 cases with confirmed clinical diagnosis, 83 (33.2%) were definitely diagnosed as bacterial meningitis and/or encephalitis cases (by using CSF culture, biochemical tests, latex agglutination test, and CSF stain), 17 (6.8%) were definitely diagnosed as having viral causes ( by viral isolation on tissue culture, PCR and ELISA), and one (0.4%) was diagnosed as fungal meningitis case (by India ink stain, culture, and biochemical tests). Also, there was one encephalitis case with positive serum ELISA IgM antibodies against Sandfly scilian virus. N. meningitidis, S. pneumonia and M. tuberculosis were the most frequently detected bacterial agents, while Enteroviruses, herpes simplex viruses and varicella zoster viruses were the most common viral agents encountered. Further studies are needed to assess the role of different microbial agents in CNS infections and their effective methods of diagnosis.

  20. Rapid and widely disseminated acute phase protein response after experimental bacterial infection of pigs

    OpenAIRE

    Skovgaard, Kerstin; Mortensen, Shila; Boye, Mette; Poulsen, Karin T.; Campbell, Fiona M; Eckersall, P. David; Heegaard, Peter M.H.

    2009-01-01

    International audience The acute phase protein response is a well-described generalized early host response to tissue injury, inflammation and infection, observed as pronounced changes in the concentrations of a number of circulating serum proteins. The biological function of this response and its interplay with other parts of innate host defence reactions remain somewhat elusive. In order to gain new insight into this early host defence response in the context of bacterial infection we st...

  1. 激活素A在细菌性脑膜炎新生儿脑脊液中的变化及其对预后评估的价值%Change of Activin A in Cerebrospinal Fluid of Neonates with Bacterial Meningitis and Its Value for Prognosis Evaluation

    Institute of Scientific and Technical Information of China (English)

    郝丽红; 王琳; 郭静; 周颖; 巴爽; 林书祥

    2012-01-01

    fluid of children in 3 groups were monitored by enzyme - linked immunosorbent assay. Results The level of CSF ACT A was (554.39 ± 149- 62) ng · L-1 in the acute phase of group A,and the level of the CSF ACT A was (480. 82 ± 128.24) ng · L-1 in group B,there was no significant difference between the 2 groups. The level of the CSF ACT A in the group A and group B were higher than that in group C[ (181.06 ±45.20) ng · L-1 ] (Pa <0.05). Afterl week treatment, ACT A level in CSF was (315.84 ±86.35) ng · L-1 in group A,meanwhile(338.25 ±99.43) ng · L-1 in group B. After 1 week treatment, the level of ACT A in group A and group B had declined than those before treatment (Pa <0.05) ,but there was no difference between the 2 groups(P =0.432). After 2 weeks treatment,the same conclusions[ (188. 19 ±43. 38) ng · L-1 and (203- 86 ± 50. 73) ng · L-1]as that of the 1 week treatment had been received. After 3 weeks treatment .the level of ACT A in group A[ ( 107- 65 ± 17. 65 ) ng · L-1 ] was lower than that in group B[ ( 169.36 ± 28.90) ng· L-1(P=0.000 ) ]. After 4 weeks treatment, the same conclusions [(98. 54 ±28.54) ng · L-1 and (211.95 ± 15.53) ng · L-1 ] as that of the 3 weeks treatment had been received( P = 0.000). Conclusions ACT A is involved in the pathogenesis of bacterial meningitis in neonates. The level of ACT A can evaluate the severity and prognosis of bacterial meningitis.

  2. Mechanism Underlying Protective Effect of Danbiqing Granule on Experimental Acute Bacterial Cholangitis in Rabbits

    Institute of Scientific and Technical Information of China (English)

    LINXiu-zhen; GONGYan-ling; WANGHong-bo

    2003-01-01

    Aim To study the mechanism of protective effects of Danbiqing granule (DBQ) on experimental acute bacterial cholangitis in rabbits. Methods The acute bacterial cholangitis was induced by injecting 1 mL of 1 × l03 cuf·mL-1 Escherchia coli suspension into common bile duit. The serum nitrous oxide (NO) levels were measured using nitric acid reductase kit. Phospholipase A2 (PLA2) activity was assayed by a method of acid titration (microassay). Serum tumor necrosis factor-α (TNF-α), inferleukin-6 (IL-6) and plasma thromboxane B2 ( TXB2 ), 6-keto-platelet growth factor 1(PGF1α) were determined by radioimmunoassay. Results Compared with control group, serum NO, PLA2, TNF-α, IL-6 and plasma TXB2 levels increased significantly in model group ( P < 0.01) while those of DBQ groutm decreased significantly( P < 0.01). Conclusion DBQ dramatically inhibits the overproduction of pro-inflammatory factor PLA2 and inflammatory cytokine. Hence, the mechanism of DBQ underlying anti-inflammatory and protective effect against acute bacterial cholangitis in rabbits has been revealed.

  3. TRPA1 channels mediate acute neurogenic inflammation and pain produced by bacterial endotoxins

    Science.gov (United States)

    Meseguer, Victor; Alpizar, Yeranddy A.; Luis, Enoch; Tajada, Sendoa; Denlinger, Bristol; Fajardo, Otto; Manenschijn, Jan-Albert; Fernández-Peña, Carlos; Talavera, Arturo; Kichko, Tatiana; Navia, Belén; Sánchez, Alicia; Señarís, Rosa; Reeh, Peter; Pérez-García, María Teresa; López-López, José Ramón; Voets, Thomas; Belmonte, Carlos; Talavera, Karel; Viana, Félix

    2014-01-01

    Gram-negative bacterial infections are accompanied by inflammation and somatic or visceral pain. These symptoms are generally attributed to sensitization of nociceptors by inflammatory mediators released by immune cells. Nociceptor sensitization during inflammation occurs through activation of the Toll-like receptor 4 (TLR4) signalling pathway by lipopolysaccharide (LPS), a toxic by-product of bacterial lysis. Here we show that LPS exerts fast, membrane delimited, excitatory actions via TRPA1, a transient receptor potential cation channel that is critical for transducing environmental irritant stimuli into nociceptor activity. Moreover, we find that pain and acute vascular reactions, including neurogenic inflammation (CGRP release) caused by LPS are primarily dependent on TRPA1 channel activation in nociceptive sensory neurons, and develop independently of TLR4 activation. The identification of TRPA1 as a molecular determinant of direct LPS effects on nociceptors offers new insights into the pathogenesis of pain and neurovascular responses during bacterial infections and opens novel avenues for their treatment.

  4. Antibiotic induced meningitis.

    OpenAIRE

    1994-01-01

    Three patients with antibiotic induced meningitis, one following penicillin with seven episodes, are reported on--the first well documented description of penicillin induced meningitis. In this patient episodes of headache and nuchal rigidity appeared with and without CSF pleocytosis. Two patients had a total of five episodes of antibiotic induced meningitis after trimethoprim-sulphamethoxazole (co-trimoxazole) administration. The features common to all three patients were myalgia, confusion ...

  5. Cytotoxic Necrotizing Factor 1 Contributes to Escherichia coli Meningitis

    Directory of Open Access Journals (Sweden)

    Ming-Hsien Wang

    2013-11-01

    Full Text Available E. coli is the most common Gram-negative bacteria causing neonatal meningitis, and E. coli meningitis continues to be an important cause of mortality and morbidity throughout the world. Recent reports of E. coli meningitis caused by antimicrobial resistant strains are a particular concern. These findings indicate that a novel strategy is needed to identify new targets for prevention and therapy of E. coli meningitis. Cytotoxic necrotizing factor 1 (CNF1 is a bacterial virulence factor associated principally with E. coli strains causing urinary tract infection and meningitis. We have shown that CNF1 contributes to E. coli invasion of the blood-brain barrier and penetration into the brain, the essential step in the development of E. coli meningitis, and identified the host receptor for CNF1, 37-kDa laminin receptor precursor (37LRP. CNF1, however, is a cytoplasmic protein and its contribution to E. coli invasion of the blood-brain barrier requires its secretion from the bacterial cytoplasm. No signal peptide is found in the CNF1 sequence. CNF1 secretion is, therefore, a strategy utilized by meningitis-causing E. coli to invade the blood-brain barrier. Elucidation of the mechanisms involved in CNF1 secretion, as shown in this report with the involvement of Fdx and YgfZ provides the novel information on potential targets for prevention and therapy of E. coli meningitis by virtue of targeting the secretion of CNF1.

  6. Aseptic Meningitis with Craniopharyngioma Resection: Consideration after Endoscopic Surgery

    Science.gov (United States)

    Chen, Jenny X.; Alkire, Blake C.; Lam, Allen C.; Curry, William T.; Holbrook, Eric H.

    2016-01-01

    Objectives While bacterial meningitis is a concerning complication after endoscopic skull base surgery, the diagnosis can be made without consideration for aseptic meningitis. This article aims to (1) present a patient with recurrent craniopharyngioma and multiple postoperative episodes of aseptic meningitis and (2) discuss the diagnosis and management of aseptic meningitis. Design Case report and literature review. Results A 65-year-old female patient with a symptomatic craniopharyngioma underwent transsphenoidal resection. She returned postoperatively with symptoms concerning for cerebrospinal fluid (CSF) leak and bacterial meningitis. Lumbar puncture demonstrated mildly elevated leukocytes with normal glucose levels. Cultures were sterile and she was discharged on antibiotics. She returned 18 days postoperatively with altered mental status and fever. Again, negative CSF cultures suggested aseptic meningitis. Radiological and intraoperative findings were now concerning for widespread cerebrovascular vasospasm due to leaked craniopharyngioma fluids. In the following months, her craniopharyngioma recurred and required multiple surgical resections. Days after her last operation, she returned with mental status changes and a sterile CSF culture. She was diagnosed with recurrent aseptic meningitis and antibiotics were discontinued. The patient experienced near complete resolution of symptoms. Conclusions Consideration of aseptic meningitis following craniopharyngioma resection is critical to avoid unnecessary surgical re-exploration and prolonged courses of antibiotics. PMID:27722072

  7. 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.

  8. Bacterial species and their associations with acute and chronic mastitis in suckler ewes.

    Science.gov (United States)

    Smith, E M; Willis, Z N; Blakeley, M; Lovatt, F; Purdy, K J; Green, L E

    2015-10-01

    Acute mastitis in suckler ewes is often detected because of systemic signs such as anorexia or lameness, whereas chronic mastitis, characterized by intramammary abscesses with no systemic disease, is typically detected when ewes are inspected before mating. The aims of the current study were to identify the species and strains of culturable bacteria associated with acutely diseased, chronically diseased, and unaffected mammary glands to investigate whether species and strains vary by state. To investigate acute mastitis, 28 milk samples were obtained from both glands of 14 ewes with acute mastitis in one gland only. To investigate chronic mastitis, 16 ovine udders were obtained from 2 abattoirs; milk was aspirated from the 32 glands where possible, and the udders were sectioned to expose intramammary abscesses, which were swab sampled. All milk and swab samples were cultured aerobically. In total, 37 bacterial species were identified, 4 from acute mastitis, 26 from chronic mastitis, and 8 from apparently healthy glands. In chronic mastitis, the overall coincidence index of overlap of species detected in intramammary abscesses and milk was 0.60, reducing to 0.36 within individual glands, indicating a high degree of species overlap in milk and abscesses overall, but less overlap within specific glands. Staphylococcus aureus was detected frequently in all sample types; it was isolated from 10/14 glands with acute mastitis. In 5 ewes, closely related strains were present in both affected and unaffected glands. In chronic mastitis, closely related Staphylococcus aureus strains were detected in milk and abscesses from the same gland.

  9. Mollaret meningitis: case report with a familial association.

    Science.gov (United States)

    Jones, Christopher W; Snyder, Graham E

    2011-09-01

    Mollaret meningitis is a syndrome characterized by recurrent bouts of meningitis that occur over a period of several years in an affected patient. Also known as recurrent lymphocytic meningitis, this entity involves repeated episodes of headache, stiff neck, fever, and cerebrospinal fluid pleocytosis. Herpes simplex virus type 2 is the most frequently implicated causative agent, and treatment involves the use of antiviral medications. We describe a case of Mollaret meningitis in a 47-year-old man who presented to the emergency department with his eighth episode of meningitis during a period of 20 years. Cerebrospinal fluid polymerase chain reaction testing for herpes simplex virus type 2 was positive, and further testing excluded other common viral, bacterial, and inflammatory causes of meningeal irritation. The patient's family history was significant for a brother who also had multiple episodes of aseptic meningitis during a period of several years. This represents the first published report of a possible familial association involving Mollaret meningitis. It is likely that Mollaret meningitis is underrecognized among emergency physicians, and improved recognition of this entity may limit unwarranted antibiotic use and shorten or eliminate unnecessary hospital admission.

  10. Neurocisticercose com quadro clínico inicial de meningite aguda Twenty seven cases of neurocysticercosis with clinical picture of acute meningitis

    Directory of Open Access Journals (Sweden)

    Ana Maria Bonametti

    1994-02-01

    Full Text Available São apresentados 27 casos de neurocisticercose, com quadro clínico inicial de meningite aguda, atendidos no Hospital Universitário Regional do Norte do Paraná (HURNP - Universidade Estadual de Londrina. Vinte (74,1% pacientes eram do sexo masculino; a idade variou de 4 a 52 anos (23,6 ± 11,7 anos; 11 tinham menos de 20 anos, 10 tinham entre 21 e 30 anos e 6, mais de 30 anos. O diagnóstico etiológico foi estabelecido pela reatividade no líquido cefalorraquidiano (LCR do teste de fixação do complemento (Weinberg em 17 pacientes e pelo imunoenzimático (ELISA para cisticercose em 10. Em 6 pacientes foi realizada tomografia computadorizada de crânio, todas com alterações sugestivas de neurocisticercose. No LCR colhido na admissão, em 21 (77,78% pacientes havia predomínio de linfócitos/monócitos e em 6 (22,2%, predomínio de neutrófilos. A presença de eosinófilos, possibilitando a suspeita de neurocisticercose, só ocorreu na primeira amostra de LCR em 7 casos; desses, 4 casos a pleocitose era linfomonocitária e 3 era neutrofilica. Hiperproteinorraquia e hipoglicorraquia no LCR colhido na admissão foram observadas em 18 (66,6% e 6 (22,2% pacientes, respectivamente. Nos doentes em que não havia eosinófilos no LCR colhido na admissão, o diagnóstico inicial foi de meningite linfomonocitária de etiología presumivelmente viral ou de meningite purulenta. O tratamento da meningite aguda por neurocisticercose foi realizado com dexametasona e houve desaparecimento dos sintomas e sinais. Não houve óbito em nenhum caso. Os autores ressaltam a importância de incluir a neurocisticercose no diagnóstico diferencial das meningites agudas, em áreas endêmicas para essa doença, assim como realizar rotineiramente em todas as amostras de LCR colhidas de pacientes atendidos o teste ELISA para cisticercose.Twenty seven cases of neurocysticercosis, with clinical picture of acute meningitis, are described. Twenty (74.1% patients are male

  11. Antibody-induced neutrophil depletion prior to the onset of pneumococcal meningitis influences long-term neurological complications in mice.

    Science.gov (United States)

    Too, Lay Khoon; Mitchell, Andrew J; McGregor, Iain S; Hunt, Nicholas H

    2016-08-01

    During pneumococcal meningitis, clearance of bacteria by recruited neutrophils is crucial for host protection. However, these innate immune mechanisms are often insufficient and treatment with antibiotics is necessary to prevent death. Despite this antibiotic treatment, approximately half of all survivors suffer lifelong neurological problems. There is growing evidence indicating the harmful effects of neutrophils on CNS integrity. Therefore, the present study investigated the roles of neutrophils in the acute inflammatory response and the resulting long-term neuropsychological effects in murine pneumococcal meningitis. Long-term behavioural and cognitive functions in mice were measured using an automated IntelliCage system. Neutrophil depletion with antibody 1A8 as adjunctive therapy was shown to remarkably impair survival in meningitic C57BL/6J mice despite antibiotic (ceftriaxone) treatment. This was accompanied by increased bacterial load in the cerebrospinal fluid (CSF) and an increase in IL-1β, but decrease in TNF, within the CSF at 20h after bacterial inoculation. In the longer term, the surviving neutrophil-depleted post-meningitic (PM) mice displayed reduced diurnal hypolocomotion compared to PM mice treated with an isotype antibody. However, they showed nocturnal hyperactivity, and greater learning impairment in a patrolling task that is believed to depend upon an intact hippocampus. The data thus demonstrate two important mechanisms: 1. Neutrophil extravasation into the CNS during pneumococcal meningitis influences the pro-inflammatory response and is central to control of the bacterial load, an increase in which may lead to death. 2. Neutrophil-mediated changes in the acute inflammatory response modulate the neuropsychological sequelae in mice that survive pneumococcal meningitis. PMID:26965652

  12. Streptococcus pneumoniae arginine synthesis genes promote growth and virulence in pneumococcal meningitis

    NARCIS (Netherlands)

    J.R. Piet; M. Geldhoff; B.D.C. van Schaik; M.C. Brouwer; M. Valls Seron; M.E. Jakobs; K. Schipper; Y. Pannekoek; A.H. Zwinderman; T. van der Poll; A.H.C. van Kampen; F. Baas; A van der Ende; D. van de Beek

    2014-01-01

    Streptococcus pneumoniae (pneumococcus) is a major human pathogen causing pneumonia, sepsis and bacterial meningitis. Using a clinical phenotype based approach with bacterial whole-genome sequencing we identified pneumococcal arginine biosynthesis genes to be associated with outcome in patients with

  13. Localized basal meningeal enhancement in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

    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.)

  14. Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2010-03-01

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

  15. Profile of oritavancin and its potential in the treatment of acute bacterial skin structure infections

    Science.gov (United States)

    Mitra, Subhashis; Saeed, Usman; Havlichek, Daniel H; Stein, Gary E

    2015-01-01

    Oritavancin, a semisynthetic derivative of the glycopeptide antibiotic chloroeremomycin, received the US Food and Drug Administration approval for the treatment of acute bacterial skin and skin structure infections caused by susceptible Gram-positive bacteria in adults in August 2014. This novel second-generation semisynthetic lipoglycopeptide antibiotic has activity against a broad spectrum of Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate S. aureus (VISA), and vancomycin-resistant Enterococcus. Oritavancin inhibits bacterial cell wall synthesis and is rapidly bactericidal against many Gram-positive pathogens. The long half-life of this drug enables a single-dose administration. Oritavancin is not metabolized in the body, and the unchanged drug is slowly excreted by the kidneys. In two large Phase III randomized, double-blind, clinical trials, oritavancin was found to be non-inferior to vancomycin in achieving the primary composite end point in the treatment of acute Gram-positive skin and skin structure infections. Adverse effects noted were mostly mild with nausea, headache, and vomiting being the most common reported side effects. Oritavancin has emerged as another useful antimicrobial agent for treatment of acute Gram-positive skin and skin structure infections, including those caused by MRSA and VISA. PMID:26185459

  16. Profile of oritavancin and its potential in the treatment of acute bacterial skin structure infections

    Directory of Open Access Journals (Sweden)

    Mitra S

    2015-07-01

    Full Text Available Subhashis Mitra, Usman Saeed, Daniel H Havlichek, Gary E Stein Department of Infectious Diseases, Michigan State University, East Lansing, MI, USA Abstract: Oritavancin, a semisynthetic derivative of the glycopeptide antibiotic chloroeremomycin, received the US Food and Drug Administration approval for the treatment of acute bacterial skin and skin structure infections caused by susceptible Gram-positive bacteria in adults in August 2014. This novel second-generation semisynthetic lipoglycopeptide antibiotic has activity against a broad spectrum of Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA, vancomycin-intermediate S. aureus (VISA, and vancomycin-resistant Enterococcus. Oritavancin inhibits bacterial cell wall synthesis and is rapidly bactericidal against many Gram-positive pathogens. The long half-life of this drug enables a single-dose administration. Oritavancin is not metabolized in the body, and the unchanged drug is slowly excreted by the kidneys. In two large Phase III randomized, double-blind, clinical trials, oritavancin was found to be non-inferior to vancomycin in achieving the primary composite end point in the treatment of acute Gram-positive skin and skin structure infections. Adverse effects noted were mostly mild with nausea, headache, and vomiting being the most common reported side effects. Oritavancin has emerged as another useful antimicrobial agent for treatment of acute Gram-positive skin and skin structure infections, including those caused by MRSA and VISA. Keywords: antibiotic, Gram-positive bacteria, MRSA, VRSA, vancomycin, MIC

  17. Corticosteroids for managing tuberculous meningitis

    Science.gov (United States)

    Prasad, Kameshwar; Singh, Mamta B; Ryan, Hannah

    2016-01-01

    effect on this outcome (RR 0.92, 95% CI 0.71 to 1.20; eight trials, 1314 participants, low quality evidence). There was no difference between groups in the incidence of adverse events, which included gastrointestinal bleeding, invasive bacterial infections, hyperglycaemia, and liver dysfunction. One trial followed up participants for five years. The effect on death was no longer apparent at this time-point (RR 0.93, 95% CI 0.78 to 1.12; one trial, 545 participants, moderate quality evidence); and there was no difference in disabling neurological deficit detected (RR 0.91, 95% CI 0.49 to 1.69; one trial, 545 participants, low quality evidence). One trial included human immunodeficiency virus (HIV)-positive people. The stratified analysis by HIV status in this trial showed no heterogeneity, with point estimates for death (RR 0.90, 95% CI 0.67 to 1.20; one trial, 98 participants) and disability (RR 1.23, 95% CI 0.08 to 19.07; one trial, 98 participants) similar to HIV-negative participants in the same trial. Authors' conclusions Corticosteroids reduce mortality from tuberculous meningitis, at least in the short term. Corticosteroids may have no effect on the number of people who survive tuberculous meningitis with disabling neurological deficit, but this outcome is less common than death, and the CI for the relative effect includes possible harm. However, this small possible harm is unlikely to be quantitatively important when compared to the reduction in mortality. The number of HIV-positive people included in the review is small, so we are not sure if the benefits in terms of reduced mortality are preserved in this group of patients. PLAIN LANGUAGE SUMMARY Corticosteroids for managing people with tuberculous meningitis What is tuberculous meningitis and how might corticosteroids work? Tuberculous meningitis is a serious form of tuberculosis that affects the meninges that cover the brain and spinal cord, causing headache, coma and death. The clinical outcome is often poor

  18. Procalcitonin Identifies Cell Injury, Not Bacterial Infection, in Acute Liver Failure.

    Directory of Open Access Journals (Sweden)

    Jody A Rule

    Full Text Available Because acute liver failure (ALF patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF.Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD subjects served as controls.Procalcitonin concentrations in most samples were elevated, with median values for all ALF groups near or above a 2.0 ng/mL cut-off that generally indicates severe sepsis. While PCT concentrations increased somewhat with apparent liver injury severity, there were no differences in PCT levels between the pre-defined severity groups-non-SIRS and SIRS groups with no documented infections and Severe Sepsis and Septic Shock groups with documented infections, (p = 0.169. PCT values from CLD patients differed from all ALF groups (median CLD PCT value 0.104 ng/mL, (p ≤0.001. Subjects with acetaminophen (APAP toxicity, many without evidence of infection, demonstrated median PCT >2.0 ng/mL, regardless of SIRS features, while some culture positive subjects had PCT values <2.0 ng/mL.While PCT appears to be a robust assay for detecting bacterial infection in the general population, there was poor discrimination between ALF patients with or without bacterial infection presumably because of the massive inflammation observed. Severe hepatocyte necrosis with inflammation results in elevated PCT levels, rendering this biomarker unreliable in the ALF setting.

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

    Science.gov (United States)

    Harrell, Travis; Hammes, John S

    2012-10-01

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

  20. Epidemiology of meningitis in an HIV-infected Ugandan cohort.

    Science.gov (United States)

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

    2015-02-01

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

  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. 可溶性髓系细胞触发受体-1在细菌性脑膜炎诊断中的意义%Value of soluble triggering receptor expressed on myeloid cells-1 in the diagnosis of bacterial meningitis

    Institute of Scientific and Technical Information of China (English)

    郭光辉; 蒋巧雅; 束振华

    2011-01-01

    Objective To investigate the value of soluble triggering receptor expressed on myeloid cells-1(sTRFM-1) in the diagnosis of bacterial meningitis. Methods The levels of sTREM-1 in cerebrospinal fluid ( CSF) were determined by quantitative FlISA assay. The serum levels of PCT and CRP were measured by using immunolumtnometrte assay and immunonephelometry method respectively. The diagnostic value of sTRFM-1 was assessed by receiver operating characteristic(ROC) curve analysis. Results The levels of CSF sTRFM-1 was significantly higher in bacterial meningitis group than in viral meningitis group and control group. There was no obvious difference in CSF sTRFM-1 between viral meningitis group and control group. According to ROC curve, when the cutoff value of CSF sTRFM-1 was set as 25 ng/L,the sensitivity and specificity of it in the diagnosis of bacterial meningitis were 90. 0% and 93. 5% ,accuracy was 93. 8 % . Conclusion Detection of CSF sTRFM-1 would have certain diagnostic value of bacterial meningitis.%目的 探讨脑脊液中可溶性髓系细胞触发受体-1(sTREM-1)在细菌性脑膜炎中的诊断意义.方法 应用定量酶联免疫吸附法(ELISA)检测脑脊液sTREM-1水平,应用免疫发光法和免疫浊度法分别检测血液中降钙素原(PCT)、C反应蛋白(CRP)水平.应用受试者工作特征 ROC 曲线研究sTREM-1的诊断效能.结果 细菌性脑膜炎组脑脊液sTREM-1 水平较病毒性脑膜炎组和对照组显著升高(P0.05).根据 ROC曲线,取sTREM-1>25 ng/L 为临界值,其曲线下面积为 0.930,诊断细菌性脑膜炎的灵敏度为 90.0%、特异度为93.5%、准确率为93.8%,诊断效能好.结论 测定脑脊液 sTREM-1 水平对于细菌性脑膜炎的诊断有一定价值.

  3. Viral meningitis and encephalitis.

    Science.gov (United States)

    Tuppeny, Misti

    2013-09-01

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

  4. Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: a rare case report.

    Science.gov (United States)

    Sood, A; Chauhan, S; Chandel, L; Jaryal, S C

    2014-01-01

    Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6-year-old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a "kuhl" (diversion channels of water). Wet mount of cerebrospinal fluid (CSF) revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non-nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the "kuhl" from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

  5. Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: A rare case report

    Directory of Open Access Journals (Sweden)

    A Sood

    2014-01-01

    Full Text Available Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6-year-old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a "kuhl" (diversion channels of water. Wet mount of cerebrospinal fluid (CSF revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non-nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the "kuhl" from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

  6. Assessing pneumococcal meningitis association with viral respiratory infections and antibiotics: insights from statistical and mathematical models.

    Science.gov (United States)

    Opatowski, Lulla; Varon, Emmanuelle; Dupont, Claire; Temime, Laura; van der Werf, Sylvie; Gutmann, Laurent; Boëlle, Pierre-Yves; Watier, Laurence; Guillemot, Didier

    2013-08-01

    Pneumococcus is an important human pathogen, highly antibiotic resistant and a major cause of bacterial meningitis worldwide. Better prevention requires understanding the drivers of pneumococcal infection incidence and antibiotic susceptibility. Although respiratory viruses (including influenza) have been suggested to influence pneumococcal infections, the underlying mechanisms are still unknown, and viruses are rarely considered when studying pneumococcus epidemiology. Here, we propose a novel mathematical model to examine hypothetical relationships between Streptococcus pneumoniae meningitis incidence (SPMI), acute viral respiratory infections (AVRIs) and antibiotic exposure. French time series of SPMI, AVRI and penicillin consumption over 2001-2004 are analysed and used to assess four distinct virus-bacteria interaction submodels, ascribing the interaction on pneumococcus transmissibility and/or pathogenicity. The statistical analysis reveals strong associations between time series: SPMI increases shortly after AVRI incidence and decreases overall as the antibiotic-prescription rate rises. Model simulations require a combined impact of AVRI on both pneumococcal transmissibility (up to 1.3-fold increase at the population level) and pathogenicity (up to threefold increase) to reproduce the data accurately, along with diminished epidemic fitness of resistant pneumococcal strains causing meningitis (0.97 (0.96-0.97)). Overall, our findings suggest that AVRI and antibiotics strongly influence SPMI trends. Consequently, vaccination protecting against respiratory virus could have unexpected benefits to limit invasive pneumococcal infections.

  7. Rapid etiological classification of meningitis by NMR spectroscopy based on metabolite profiles and host response.

    Directory of Open Access Journals (Sweden)

    Uwe Himmelreich

    Full Text Available Bacterial meningitis is an acute disease with high mortality that is reduced by early treatment. Identification of the causative microorganism by culture is sensitive but slow. Large volumes of cerebrospinal fluid (CSF are required to maximise sensitivity and establish a provisional diagnosis. We have utilised nuclear magnetic resonance (NMR spectroscopy to rapidly characterise the biochemical profile of CSF from normal rats and animals with pneumococcal or cryptococcal meningitis. Use of a miniaturised capillary NMR system overcame limitations caused by small CSF volumes and low metabolite concentrations. The analysis of the complex NMR spectroscopic data by a supervised statistical classification strategy included major, minor and unidentified metabolites. Reproducible spectral profiles were generated within less than three minutes, and revealed differences in the relative amounts of glucose, lactate, citrate, amino acid residues, acetate and polyols in the three groups. Contributions from microbial metabolism and inflammatory cells were evident. The computerised statistical classification strategy is based on both major metabolites and minor, partially unidentified metabolites. This data analysis proved highly specific for diagnosis (100% specificity in the final validation set, provided those with visible blood contamination were excluded from analysis; 6-8% of samples were classified as indeterminate. This proof of principle study suggests that a rapid etiologic diagnosis of meningitis is possible without prior culture. The method can be fully automated and avoids delays due to processing and selective identification of specific pathogens that are inherent in DNA-based techniques.

  8. Treatment progress of nosocomial bacterial meningitis in neurosurgery%神经外科院内获得性细菌性脑膜炎的治疗进展

    Institute of Scientific and Technical Information of China (English)

    王柯; 高亮

    2015-01-01

    With high morbidity and mortality,nosocomial bacterial meningitis(NBM)is a kind of serious nosocomial infection.Post-neurosurgical patients are at a high risk of this infection andNBM in-creases hospital stay and medical expense obviously.In this article,we reviewed recent studiesonpathogen-esis,treatment,and research progress of NBM in neurosurgical patients,and presented unresolved ques-tions and research direction in the future.%院内获得性细菌性脑膜炎是一类严重的院内感染,具有高死亡率和致残率的特点。神经外科术后患者是院内获得性细菌性脑膜炎的高危人群,这一院内感染使得患者住院时间和医疗费用显著增加。本文回顾了近年来神经外科患者院内获得性细菌性脑膜炎的病因、治疗方案和研究进展,提出了尚未解决的问题和今后的研究方向。

  9. Common pathogens and risk factors of hospital-acquired bacterial meningitis%医院获得性细菌性脑膜炎常见病原体及危险因素

    Institute of Scientific and Technical Information of China (English)

    田叶红; 陈佰义

    2012-01-01

    细菌性脑膜炎是常见的中枢神经系统感染,它分为社区和医院获得性细菌性脑膜炎( nosocomial bacterial meningitis,NBM),在发达国家成人中发病率为4/10万~6/10万[1].常见的感染原因是婴幼儿感染、局部流行和继发于中耳炎、肺炎、外伤、腰椎穿刺、脑脊液引流、神经外科手术.其中NBM是严重的医院感染,病死率高达35%[2],正严重威胁着人类的健康.NBM与社区获得性脑膜炎相比较有诸多不同点,如其起病更隐匿、病程更长、病原体更有可能是由耐药病原体引起[3-4].下面对NBM常见的病原体、危险因素等予以综述,希望给予医疗工作者关于NBM的治疗和医院感染控制提供参考.

  10. Syphilitic aseptic meningitis

    Science.gov (United States)

    ... done to confirm the diagnosis. Tests include: FTA-ABS MHA-TP TP-PA TP-EIA Treatment The ... syphilis . Alternative Names Meningitis - syphilitic Images Central nervous system and peripheral nervous system References Hook EW III. ...

  11. 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

  12. Epidemiología descriptiva de meningitis no meningocócicas bacterianas de la provincia de Zaragoza (1999-2004: evaluación de su sistema de vigilancia Descriptive epidemiology of non-meningococcal bacterial meningitis in the province of Saragossa [Spain] from 1999 to 2004: evaluation of the Epidemiological Surveillance System

    Directory of Open Access Journals (Sweden)

    Carmen Varela

    2007-10-01

    Full Text Available Objetivos: Describir las meningitis no meningocócicas bacterianas (MnMB y evaluar el Sistema de Vigilancia Epidemiológica (SVE en la provincia de Zaragoza entre 1999 y 2004. Métodos: Se utilizó el registro de enfermedades de declaración obligatoria (EDO y el conjunto mínimo básico de datos (CMBD. Se evaluó el SVE utilizando criterios de los Centers for Disease Control and Prevention, estimando la exhaustividad mediante captura-recaptura. Resultados: Se notificaron 111 casos de MnMB (62,2% en hombres. La edad media fue de 40,7 años. La mayor proporción de casos (16,5% fue en niños menores de 2 años. La forma clínica en el 81,1% de los casos fue la meningitis; el 70,3% fue diagnosticada por cultivo. Aparecieron Streptococcus en el 54% de los casos (el 82% por S. pneumoniae, enterobacterias en el 5,4%, Lysteria y Staphylococcus en el 4,5%, Pseudomona aeruginosa en el 1,8%, y Haemophilus influenzae en el 0,9%. La incidencia por 100.000 habitantes fue entre 1,6 en 2004 y 2,6 en 2001. La letalidad fue del 7,3%. La exhaustividad del sistema EDO fue máxima en el año 2001 (del 84,4%. La exhaustividad conjunta con CMBD fue superior al 85% y la oportunidad fue de 2 días. La aceptabilidad del sistema fue buena, ya que el 75% de las variables estaban cumplimentadas en el 97% de las encuestas. Conclusiones: Se destaca la relevancia de la evaluación del SVE en función de sus resultados. Las MnMB debidas a S. pneumoniae representan un grupo significativo y su letalidad es elevada. La exhaustividad del SVE en Zaragoza supera el 80%, al considerar EDO y CMBD. La incorporación del CMBD en la vigilancia facilitaría una aproximación a la incidencia real de algunas EDO.Objectives: To describe non-meningococcal bacterial meningitis (nMM and to evaluate the Epidemiological Surveillance System (ESS in the province of Saragossa (Spain between 1999 and 2004. Methods: Information was obtained from the register of diseases subject to mandatory reporting

  13. Inhaled hyaluronic acid as ancillary treatment in children with bacterial acute rhinopharyngitis.

    Science.gov (United States)

    Varricchio, A; Capasso, M; Avvisati, F; Varricchio, A M; De Lucia, A; Brunese, F P; Ciprandi, G

    2014-01-01

    Acute rhinopharyngitis (ARP) is the most common upper respiratory infection in children and represents a social problem for both the pharmaco-economic impact and a burden for the family. Topical antibiotic therapy is usually effective in bacterial ARP, but ancillary treatment might improve its efficacy. Hyaluronic acid (HA) is a promising molecule that has been recently proposed in upper respiratory disorders. Therefore, the purpose of this study was to evaluate the effects of ancillary HA treatment in children with bacterial ARP. Globally, 51 children (27 males, mean age 5.9 ± 2.1 years) with bacterial ARP were enrolled in the study. At baseline, children were randomly assigned to the treatment with: 125 mg of thiamphenicol diluted in 4 mL of saline isotonic solution twice daily (group A) or with 125 mg of thiamphenicol plus 4 ml of sodium hyaluronate 0.2% plus xylitol 5% (Aluneb, Sakura Italia) twice daily (group B) administered by the nasal device Rinowash (Airliquide Medical System, Italy) and connected to an aerosol nebulizer with pneumatic compressor (1.5 bar per 5 L/min) Nebula (Airliquide Medical System, Italy), for 10 days. sVAS, nasopharyngeal spotting, neutrophils and bacteria were assessed at baseline and after the treatment. Both treatments induced significant reduction of symptom perception, spotting, neutrophil and bacteria count. However, thiamphenicol plus HA was able to significantly induce a greater effect on sVAS (p=0.006), neutrophil count (p=0.01), and bacteria count (p=0.0003) than thiamphenicol alone. In conclusion, this study provides the first evidence that intranasal HA, as ancillary treatment, may be able to improve topical antibiotic efficacy in children with bacterial ARP. PMID:25316142

  14. Tamsulosin alters levofloxacin pharmacokinetics in prostates derived from rats with acute bacterial prostatitis

    Institute of Scientific and Technical Information of China (English)

    Guo-Dong Qin; Ming-Zhao Xiao; Yuan-Da Zhou; Jing Yang; Hai-Xia He; Yue He; Yang Zeng

    2013-01-01

    The combination of levofloxacin and α1 adrenergic antagonist treatment is the current preferred choice for both bacterial and non-bacterial prostatitis.The aim of this study is to explore the influence of α1 adrenergic antagonists on the pharmacokinetics of levofloxacin using rat models with acute bacterial prostatitis (ABP) induced by direct injection with Escherichia coli(ATCC25922).A total of 96 model rats were randomly assigned into two groups:the experimental group (treated with both tamsulosin and levofloxacin,n=48) and the control group (treated with levofloxacin and solvents,n=48).Six rats from each group were euthanized to collect blood,liver,kidney and prostate samples at the time points of 0.125,0.25,0.5,1,2,4,8 and 12 h after drug administration.The levofloxacin concentrations were detected by high performance liquid chromatography (HPLC),and the pharmacokinetic parameters were calculated using the 3p97 software program.There were no obvious differences (P>0.05) between the experimental and control groups in the major pharmacokinetic parameters of levofloxacin,including the halftime (t1/2),time to peak (tpeak),clearance rate (CL),maximum concentration (Cmax) and area under the curve (AUC0~12),in the plasma or in the hepatic and kidney tissues of the model rats.However,in the prostatic tissues,tamsulosin increased the Cmax,prolonged the t1/2 and decreased the CL of levofloxacin (P<0.05).These results indicate that tamsulosin may enhance the effect of levofloxacin in the treatment of bacterial prostatitis without changing the drug concentration in the liver and kidney.

  15. Role of acute-phase proteins in interleukin-1-induced nonspecific resistance to bacterial infections in mice.

    OpenAIRE

    Vogels, M.T.E.; L. Cantoni; Carelli, M.; Sironi, M; Ghezzi, P; van der Meer, J. W M

    1993-01-01

    Treatment with a single low dose (80 to 800 ng) of interleukin-1 (IL-1) 24 h before a lethal bacterial challenge of granulocytopenic and normal mice enhances nonspecific resistance. Since IL-1 induces secretion of acute-phase proteins, liver proteins which possess several detoxifying effects, we investigated the role of these proteins in the IL-1-induced protection. Inhibition of liver protein synthesis with D-galactosamine (GALN) completely inhibited the IL-1-induced synthesis of acute-phase...

  16. 应用荧光定量PCR检测细菌性脑膜炎病原体DNA的研究%Studies using fluorescence quantitative PCR to detect DNA of pathogens responsible for bacterial meningitis pathogen

    Institute of Scientific and Technical Information of China (English)

    杨红梅; 吕静; 邹文菁; 徐军强; 占建波; 江永忠; 朱兵清

    2012-01-01

    目的 应用荧光定量PCR检测细菌性脑膜炎病原体DNA,并对脑膜炎奈瑟菌进行基因分群. 方法 提取脑膜炎患者脑脊液和血标本中待检菌DNA,采用荧光定量PCR扩增ctrA、bexA、lytA基因,对ctrA扩增阳性标本及部分流脑菌株进行基因分群. 结果 685份脑脊液标本中19份检出脑膜炎奈瑟菌、8份检出肺炎链球菌、2份检出b型流感嗜血杆菌DNA基因片段;2份血清标本脑膜炎奈瑟菌DNA基因检测均为阳性.对ctrA基因扩增阳性标本进行A、B、C、W135、X及Y分群,有18份为C群,3份为B群;部分健康人群携带的流脑菌株有14份为B群,2份为C群,1份为X群. 结论 荧光定量PCR灵敏性高,检测快速,可用于细菌性脑膜炎病原体的检测、鉴别及对脑膜炎奈瑟菌的分群.%Objectives To use real-time fluorescence quantitative PCR to detect the pathogens responsible for bacterial meningitis and to identify the serogroups of Neisseria rneningitidis. Methods Bacterial DNA was extracted from 685 samples of cerebral spinal fluid (CSF) and 2 blood samples. Species-specific genes {ctrA for N. meningitidis, bex A for Haemophilus influenzae , and lytA for Streptococcus pneumoniae} were detected from the extracted DNA with real-time PCR, and ctrA-positive specimens were serogrouped. Results Of the 685 CSF samples, 19 were positive for ctrA,, 8 were positive for lytA, and 2 were positive for hex A. Both of the two blood samples were positive for ctrA. Of the 21 samples positive for ctrA,18 were serogroup C and 3 were serogroup B. Of the 17 N. rneningitidis strains isolated from healthy carriers, 14 were serogroup B, 2 were serogroup C, and lwas serogroup X. Conclusion Real-time PCR was sensitive and rapid. This method can be used to detect pathogens in clinical specimens of bacterial meningitis and identify the serogroup of N. meningitides.

  17. Acute bacterial prostatitis: heterogeneity in diagnostic criteria and management. Retrospective multicentric analysis of 371 patients diagnosed with acute prostatitis

    Directory of Open Access Journals (Sweden)

    Doucet Jean

    2008-01-01

    Full Text Available Abstract Background There is currently a lack of consensus for the diagnosis, investigations and treatments of acute bacterial prostatitis (AP. Methods The symptoms, investigations and treatments of 371 inpatients diagnosed with AP were analyzed through a retrospective study conducted in four departments – Urology (U, Infectious Diseases (ID, Internal Medicine (IM, Geriatrics (G – of two French university hospitals. Results The cause of admission, symptoms, investigations and treatments depended markedly on the department of admission but not on the hospital. In U, patients commonly presented with a bladder outlet obstruction, they had a large imaging and functional check-up, and received alpha-blockers and anti-inflammatory drugs. In ID, patients were febrile and received longer and more appropriate antibiotic treatments. In G, patients presented with cognitive disorders and commonly had post-void urine volume measurements. In IM, patients presented with a wide range of symptoms, and had very diverse investigations and antibiotic regimen. Overall, a 3:1 ratio of community-acquired AP (CA-AP to nosocomial AP (N-AP was observed. Urine culture isolated mainly E. coli (58% of AP, 68% of CA-AP, with venereal agents constituting less than 1%. The probabilistic antibiotic treatments were similar for N-AP and CA-AP (58% bi-therapy; 63% fluoroquinolone-based regimen. For N-AP, these treatments were more likely to be inadequate (42% vs. 8%, p vs. 19%, p Clinical failure at follow-up was more common than bacteriological failure (75% versus 24%, p Conclusion This study highlights the difficulties encountered on a daily basis by the physicians regarding the diagnosis and management of acute prostatitis.

  18. Diagnostical meaning acute phase proteins in cerebrospinal liquid in children with neuroinfections

    Directory of Open Access Journals (Sweden)

    L. A. Alekseeva

    2010-01-01

    Full Text Available In the article presented results of the examination of acute phase proteins in cerebrospinal liquid in 237 children with meningitis and encephalitis viral and bacterial etiology. The dependence between the level of acute phase proteins in cerebrospinal liquid and etiology of neuroinfectional process, the severity of brain damage and the process stage was determined. Diagnostic and prognostic efficiency of the acute phase proteins (C-reactive protein, albumin, alpha-1-antitripsin, alpha-2-macroglobulin, gaptoglobin examination in children with neuroinfections was specified. Developed method of express diagnostics of the severity of inflammatory damage of the brain in bacterial meningitis in children by determination in cerebrospinal liquid alpha-2-macroglobulin is described.

  19. EDA-containing fibronectin levels in the cerebrospinal fluid of children with meningitis.

    Science.gov (United States)

    Pupek, Małgorzata; Jasonek, Jolanta; Kątnik-Prastowska, Iwona

    2013-01-01

    Fibronectin containing an alternatively spliced extra domain A (EDA-FN) participates in diverse biological cell functions, being also directly or indirectly engaged during an inflammatory response to brain injury and/or neuron regeneration. We analyzed FN and EDA-FN isoform levels by ELISA in 85 cerebrospinal fluid samples and 67 plasma samples obtained from children suffering from bacterial or viral meningitis and non-meningitis peripheral inflammation. We have found that the cerebrospinal level of EDA-FN was significantly lower in the bacterial meningitis group than in the viral- and non-meningitis groups. In the patients' plasma, EDA-FN was almost undetectable. The determination of fibronectin containing the EDA segment might be considered as an additional diagnostic marker of bacterial meningitis in children.

  20. EDA-containing fibronectin levels in the cerebrospinal fluid of children with meningitis.

    Science.gov (United States)

    Pupek, Małgorzata; Jasonek, Jolanta; Kątnik-Prastowska, Iwona

    2013-01-01

    Fibronectin containing an alternatively spliced extra domain A (EDA-FN) participates in diverse biological cell functions, being also directly or indirectly engaged during an inflammatory response to brain injury and/or neuron regeneration. We analyzed FN and EDA-FN isoform levels by ELISA in 85 cerebrospinal fluid samples and 67 plasma samples obtained from children suffering from bacterial or viral meningitis and non-meningitis peripheral inflammation. We have found that the cerebrospinal level of EDA-FN was significantly lower in the bacterial meningitis group than in the viral- and non-meningitis groups. In the patients' plasma, EDA-FN was almost undetectable. The determination of fibronectin containing the EDA segment might be considered as an additional diagnostic marker of bacterial meningitis in children. PMID:23884219

  1. Diagnosing viral and bacterial respiratory infections in acute COPD exacerbations by an electronic nose: a pilot study.

    Science.gov (United States)

    van Geffen, Wouter H; Bruins, Marcel; Kerstjens, Huib A M

    2016-01-01

    Respiratory infections, viral or bacterial, are a common cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). A rapid, point-of-care, and easy-to-use tool distinguishing viral and bacterial from other causes would be valuable in routine clinical care. An electronic nose (e-nose) could fit this profile but has never been tested in this setting before. In a single-center registered trial (NTR 4601) patients admitted with AECOPD were tested with the Aeonose(®) electronic nose, and a diagnosis of viral or bacterial infection was obtained by bacterial culture on sputa and viral PCR on nose swabs. A neural network with leave-10%-out cross-validation was used to assess the e-nose data. Forty three patients were included. In the bacterial infection model, 22 positive cases were tested versus the negatives; and similarly 18 positive cases were tested in the viral infection model. The Aeonose was able to distinguish between COPD-subjects suffering from a viral infection and COPD patients without infection, showing an area under the curve (AUC) of 0.74. Similarly, for bacterial infections, an AUC of 0.72 was obtained. The Aeonose e-nose yields promising results in 'smelling' the presence or absence of a viral or bacterial respiratory infection during an acute exacerbation of COPD. Validation of these results using a new and large cohort is required before introduction into clinical practice. PMID:27310311

  2. Viral etiology of aseptic meningitis among children in southern Iran.

    Science.gov (United States)

    Hosseininasab, Ali; Alborzi, Abdolvahab; Ziyaeyan, Mazyar; Jamalidoust, Marzieh; Moeini, Mahsa; Pouladfar, Gholamreza; Abbasian, Amin; Kadivar, Mohamad Rahim

    2011-05-01

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

  3. Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs.

    Science.gov (United States)

    Falcone, Marco; Concia, Ercole; Giusti, Massimo; Mazzone, Antonino; Santini, Claudio; Stefani, Stefania; Violi, Francesco

    2016-08-01

    Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed. PMID:27084183

  4. A first meningococcal meningitis case caused by serogroup Ⅹ Neisseria meningitidis strains in China

    Institute of Scientific and Technical Information of China (English)

    CHEN Chao; UANG Ying-chun; ZHANG Tie-gang; HE Jing-guo; WU Jiang; CHEN Li-juan; LIU Jun-feng; PANG Xing-huo; YANG Jie; SHAO Zhu-jun

    2008-01-01

    @@ Neisseria meningitidis is the leading cause of bacterial meningitis and classified into 13 serogroups based on the immunological reactivity of the capsular polysaccharide.1 Serogroups A,B,C,W135 and Y are the most common causes of meningitis.2

  5. Interactions between Blood-Borne Streptococcus pneumoniae and the Blood-Brain Barrier Preceding Meningitis

    NARCIS (Netherlands)

    Iovino, Federico; Orihuela, Carlos J.; Moorlag, Henk E.; Molema, Grietje; Bijlsma, Jetta J. E.

    2013-01-01

    Streptococcus pneumoniae (the pneumococcus) is a Gram-positive bacterium and the predominant cause of bacterial meningitis. Meningitis is thought to occur as the result of pneumococci crossing the blood-brain barrier to invade the Central Nervous System (CNS); yet little is known about the steps pre

  6. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Reinshagen Max

    2009-07-01

    Full Text Available Abstract Background Small intestinal bacterial overgrowth (SIBO is characterized by excessive proliferation of colonic bacterial species in the small bowel. Potential causes of SIBO include fistulae, strictures or motility disturbances. Hence, patients with Crohn's Disease (CD are especially predisposed to develop SIBO. As result, CD patients may experience malabsorption and report symptoms such as weight loss, watery diarrhea, meteorism, flatulence and abdominal pain, mimicking acute flare in these patients. Methods One-hundred-fifty patients with CD reporting increased stool frequency, meteorism and/or abdominal pain were prospectively evaluated for SIBO with the Hydrogen Glucose Breath Test (HGBT. Results Thirty-eight patients (25.3% were diagnosed with SIBO based on positive findings at HGBT. SIBO patients reported a higher rate of abdominal complaints and exhibited increased stool frequency (5.9 vs. 3.7 bowel movements/day, p = 0.003 and lower body weight (63.6 vs 70.4 kg, p = 0.014. There was no correlation with the Crohn's Disease Activity Index. SIBO was significantly more frequent in patients with partial resection of the colon or multiple intestinal surgeries; there was also a clear trend in patients with ileocecal resection that did not reach statistical significance. SIBO rate was also higher in patients with affection of both the colon and small bowel, while inflammation of the (neoterminal ileum again showed only tendential association with the development of SIBO. Conclusion SIBO represents a frequently ignored yet clinically relevant complication in CD, often mimicking acute flare. Because symptoms of SIBO are often difficult to differentiate from those caused by the underlying disease, targeted work-up is recommended in patients with corresponding clinical signs and predisposing factors.

  7. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk;

    2007-01-01

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected......-operating characteristic AUCs (areas under curves). Patients were classified by 2 sets of diagnostic criteria into: A) purulent meningitis, serous meningitis or non-meningitis, and B) systemic bacterial infection, local bacterial infection or non-bacterial disease. An elevated serum level of sCD163 was the most specific...... infection, the AUC of sCD163 (0.83) did not differ significantly from those of CRP or PCT. All markers had AUCs meningitis and other conditions. In conclusion, CRP and PCT had high diagnostic value and were superior as markers of bacterial infection compared to s...

  8. Acute bacterial gastroenteritis: a study of adult patients with positive stool cultures treated in the emergency department

    OpenAIRE

    Chan, S.; Ng, K; Lyon, D.; Cheung, W; Cheng, A.; Rainer, T

    2003-01-01

    Objectives: To investigate the presenting clinical features of acute bacterial gastroenteritis in adult patients treated as outpatients in the emergency department (ED), and the pathogens responsible in this setting and population; and to identify the frequency with which positive stool culture result changes management.

  9. Molecular mechanisms of cryptococcal meningitis

    OpenAIRE

    Liu, Tong-Bao; Perlin, David; Xue, Chaoyang

    2012-01-01

    Fungal meningitis is a serious disease caused by a fungal infection of the central nervous system (CNS) mostly in individuals with immune system deficiencies. Fungal meningitis is often fatal without proper treatment, and the mortality rate remains unacceptably high even with antifungal drug interventions. Currently, cryptococcal meningitis is the most common fungal meningitis in HIV-1/AIDS, and its disease mechanism has been extensively studied. The key steps for fungi to infect brain and ca...

  10. Clinical outcome of neonatal bacterial meningitis according to birth weight Evolução clínica da meningite bacteriana neonatal de acordo com o peso de nascimento

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Jornada Krebs

    2007-12-01

    Full Text Available OBJECTIVE: To describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. METHOD: Eighty-seven newborns were studied. Thirty-four infants were low birth weight newborn and 53 presented birth weight > " 2500 g. The clinical data were obtained through the analysis of patients’ files. Fisher’s exact test, the c² and the Mann-Whitney test were applied. RESULTS: Neurological symptoms were more common in infants weighed > " 2500 g (pOBJETIVO: Descrever a evolução clínica e as complicações da meningite bacteriana de acordo com o peso de nascimento em recém-nascidos admitidos em unidade de terapia intensiva externa durante o período de 11 anos. MÉTODO: Foram estudados 87 neonatos, dos quais 34 foram recém-nascidos de baixo peso e 53 apresentaram peso > " 2500 g. Os dados clínicos foram obtidos por análise dos prontuários médicos. Foram realizados teste exato de Fisher, teste do c² e teste de Mann-Whitney. RESULTADOS: Os sintomas neurológicos foram mais comuns em neonatos com peso > " 2500 g (p<0,05 . As complicações ocorreram na metade dos casos em ambos os grupos, com mortalidade global de 11.5%. CONCLUSÃO: A freqüência de complicações foi alta em ambos os grupos, independentemente do peso de nascimento. Não houve associação entre óbito e peso de nascimento. Os neonatos com cultura de líquor positiva apresentaram pior prognóstico.

  11. Antibiofilm Activity, Compound Characterization, and Acute Toxicity of Extract from a Novel Bacterial Species of Paenibacillus

    Directory of Open Access Journals (Sweden)

    Saad Musbah Alasil

    2014-01-01

    Full Text Available The effectiveness of many antimicrobial agents is currently decreasing; therefore, it is important to search for alternative therapeutics. Our study was carried out to assess the in vitro antibiofilm activity using microtiter plate assay, to characterize the bioactive compounds using Ultra Performance Liquid Chromatography-Diode Array Detection and Liquid Chromatography-Mass Spectrometry and to test the oral acute toxicity on Sprague Dawley rats of extract derived from a novel bacterial species of Paenibacillus strain 139SI. Our results indicate that the crude extract and its three identified compounds exhibit strong antibiofilm activity against a broad range of clinically important pathogens. Three potential compounds were identified including an amino acid antibiotic C8H20N3O4P (MW 253.237, phospholipase A2 inhibitor C21H36O5 (MW 368.512, and an antibacterial agent C14H11N3O2 (MW 253.260. The acute toxicity test indicates that the mortality rate among all rats was low and that the biochemical parameters, hematological profile, and histopathology examination of liver and kidneys showed no significant differences between experimental groups P>0.05. Overall, our findings suggest that the extract and its purified compounds derived from novel Paenibacillus sp. are nontoxic exhibiting strong antibiofilm activity against Gram-positive and Gram-negative pathogens that can be useful towards new therapeutic management of biofilm-associated infections.

  12. Primary Meningeal Rhabdomyosarcoma

    Directory of Open Access Journals (Sweden)

    Manisha Palta

    2011-01-01

    Full Text Available 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 imaging (MRI demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13. Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC systemic therapy.

  13. Eosinophilic meningitis caused by infection of Angiostrongylus cantonensis in a traveler

    Institute of Scientific and Technical Information of China (English)

    GUAN Hongzhi; HOI Chupeng; CUI Liying; CHEN Lin

    2013-01-01

    A 55 - year - old female traveler returning from South China with acute onset of meningitis, presenting with eosinophilic pleocytosis in the cerebrospinal fluid was reported. The etiological diagnosis of angiostrongyliasis was confirmed by detection of specific serum antibody against Angiostrongylus cantonensis. Angiostrongyliasis should be considered as a major differential diagnosis for eosinophilic meningitis in the travelers to endemic regions.

  14. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence

    Directory of Open Access Journals (Sweden)

    Keneuoe Hycianth Thinyane

    2015-01-01

    Full Text Available Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise data; association between variables was analysed using Fisher’s exact test. 56 patients were enrolled; the HIV coinfection rate was 79%. The most common presenting symptoms were altered mental status, neck stiffness, headache, and fever. TB meningitis was the most frequent diagnosis (39%, followed by bacterial (27%, viral (18%, and cryptococcal meningitis (16%. In-hospital mortality was 43% with case fatalities of 23%, 40%, 44%, and 90% for TB, bacterial, cryptococcal, and viral meningitis, respectively. Severe renal impairment was significantly associated with mortality. In conclusion, the causes of meningitis in this study reflect the high prevalence of HIV and TB in our setting. Strategies to reduce morbidity and mortality due to meningitis should include improving diagnostic services to facilitate early detection and treatment of meningitis and timely initiation of antiretroviral therapy in HIV-infected patients.

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

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.;

    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......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...... hearing loss, and another 16 (7%) had bilateral profound hearing loss. Significant risk factors for hearing loss were advanced age, the presence of comorbidity, severity of meningitis, a low CSF glucose level, a high CSF protein level, and a certain pneumococcal serotype (P ... is 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...

  16. Scrub typhus meningitis or meningoencephalitis.

    Science.gov (United States)

    Kim, Dong-Min; Chung, Jong-Hoon; Yun, Na-Ra; Kim, Seok Won; Lee, Jun-Young; Han, Mi Ah; Lee, Yong-Bok

    2013-12-01

    Orientia tsutsugamushi induces vasculitis leading to symptoms of systemic organ invasion including meningitis and meningoencephalitis. We conducted a retrospective case-control study of scrub typhus patients to investigate the clinical and laboratory features of patients with scrub typhus meningitis or meningoencephalitis, and the therapeutic outcomes, and to determine the predictor factors. Cases were 22 patients with scrub typhus meningitis or meningoencephalitis, and controls were 303 patients without meningitis or meningoencephalitis. Multivariate analysis showed that the presence of pneumonitis was associated with the occurrence of scrub typhus meningitis and meningoencephalitis (odds ratio [OR] 8.9; P meningitis or meningoencephalitis still occurred in some cases. Physicians should be aware that meningitis or meningoencephalitis may develop during appropriate drug therapy such as doxycycline. Close observation and great care are essential for patients with risk factors, particularly pneumonitis.

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

    Directory of Open Access Journals (Sweden)

    Erdal Taskın

    2004-01-01

    Full Text Available Aims: To determine the level of serum procalcitonin and cerebrospinal fluid cytokines in children with bacterial or viral meningitis and to document the use of these parameters in differential diagnosis.

  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. 脑脊液乳酸和β2微球蛋白对细菌性脑膜炎的诊断价值%The value of cerebrospinal fluid lactic acid and beta-2-microglobulin in the diagnosis of bacterial meningitis

    Institute of Scientific and Technical Information of China (English)

    赵娜; 李冬梅; 贺恒鹏; 周霞

    2014-01-01

    Objective To explore the significance of cerebrospinal fluid lactic acid (LA) and beta2-microglobulin (β2-MG) on the diagnosis of bacterial meningitis,and study their values compared with white blood cell (WBC) or protein in cerebrospinal fluid.Methods Thirty patients with bacterial meningitis were selected as bacterial meningitis group,and 30 surgical patients requiring spinal anesthesia were as control group.The level of cerebrospinal fluid LA was detected by Vitros950 automatic analyzer,and the level of cerebrospinal fluid β2-MG was detected by automatic AIA1800 enzyme immune analyzer.SPSS 13.0 and receiver operating characteristic curve (ROC curve) was used to analyze the data.Results The cerebrospinal fluid LA level in bacterial meningitis group was 1.53 (0.50) mmol/L,in control group was 1.11 (0.34) mmol/L,and there was statistical difference (P < 0.05).The cerebrospinal fluid β 2-MG level in bacterial meningitis group was 2.61 (1.00) mg/L,in control group was 0.83 (0.45) mg/L,and there was statistical difference (P < 0.01).For bacterial meningitis diagnosis,the areas under the ROC curve of cerebrospinal fluid WBC,protein,LA and β2-MG were 0.760,0.936,0.705 and 0.960.The best boundary value of LA in bacterial meningitis diagnosis was 1.78 mmol/L with a sensitivity of 68.0% and specificity of 88.9%.The best boundary value of β2-MG in bacterial meningitis diagnosis was 1.756 mg/L,with a sensitivity of 92.0% and specificity of 99.4%.Conclusions Both cerebrospinal fluid LA and β 2-MG is valuable in the diagnosis of bacterial meningitis.But for the diagnostic value,cerebrospinal fluid LA is not as good as WBC or protein in cerebrospinal fluid,but β2-MG is better than them.It has high sensitivity and specificity.%目的 探讨脑脊液(CSF)乳酸(LA)和β2微球蛋白(β2-MG)是否有助于细菌性脑膜炎(BM)的诊断,以及与CSF白细胞(WBC)、蛋白相比较,二者是否诊断价值更高.方法 选取BM患者30例作为BM组,外科手术

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

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.;

    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...... is 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...

  1. Clinical efficacy of dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI

    Directory of Open Access Journals (Sweden)

    Leuthner KD

    2016-06-01

    Full Text Available Kimberly D Leuthner,1 Kristin A Buechler,1 David Kogan,1 Agafe Saguros,1 H Stephen Lee2 1Department of Pharmaceutical Services, University Medical Center of Southern Nevada, Las Vegas, NV, USA; 2Roseman University of Health Sciences College of Pharmacy, Henderson, NV, USA Abstract: Acute bacterial skin and skin structure infections (ABSSSI are a common disease causing patients to seek treatment through the health care system. With the continued increase of drug-resistant bacterial pathogens, these infections are becoming more difficult to successfully cure. Lipoglycopeptides have unique properties that allow the drug to remain active toward both common and challenging pathogens at the infected site for lengthy periods of time. Dalbavancin, a new lipoglycopeptide, provides two unique dosing regimens for the treatment of ABSSSI. The original regimen of 1,000 mg intravenous infusion followed by a 500 mg intravenous infusion after a week has been shown as safe and effective in multiple, randomized noninferiority trials. These studies also demonstrated that dalbavancin was similar to standard regimens in terms of both safety and tolerability. Recently a single 1,500 mg dose was demonstrated to be equivalent to the dalbavancin two-dose regimen for treating ABSSSI. With the introduction of dalbavancin, clinicians have the option to provide an intravenous antimicrobial agent shown to be as effective as traditional therapies, without requiring admission into the hospitals or prescribing a medication which may not be utilized optimally. Further understanding of dalbavancin and its unusual properties can provide unique treatment situations with potential benefits for both the patient and the overall health care system, which should be further explored. Keywords: dalbavancin, lipoglycopeptide, ABSSSI, skin and skin structure infection, dosing schedule, Gram-positive resistance

  2. Changes in the bacterial microbiota in gut, blood, and lungs following acute LPS instillation into mice lungs.

    Directory of Open Access Journals (Sweden)

    Marc A Sze

    Full Text Available Previous reports have shown that the gastrointestinal (GI bacterial microbiota can have profound effects on the lungs, which has been described as the "gut-lung axis". However, whether a "lung-gut" axis exists wherein acute lung inflammation perturbs the gut and blood microbiota is unknown.Adult C57/Bl6 mice were exposed to one dose of LPS or PBS instillation (n=3 for each group directly into lungs. Bacterial microbiota of the bronchoalveolar lavage fluid, blood, and cecum were determined using 454 pyrotag sequencing and quantitative polymerase chain reaction (qPCR at 4 through 168 hours post-instillation. We then investigated the effects of oral neomycin and streptomycin (n=8 on the microbiota at 4 and 24 hours post LPS instillation versus control treatment (n=5 at baseline and 4 hours, n=7 at 24 hours.At 24 hours post LPS instillation, the total bacterial count was significantly increased in the cecum (P<0.05; whereas the total bacterial count in blood was increased at 4, 48, and 72 hours (P<0.05. Antibiotic treatment reduced the total bacteria in blood but not in the cecum. The increase in total bacteria in the blood correlated with Phyllobacteriaceae OTU 40 and was significantly reduced in the blood for both antibiotic groups (P<0.05.LPS instillation in lungs leads to acute changes in the bacterial microbiota in the blood and cecum, which can be modulated with antibiotics.

  3. ATYPICAL CSF PICTURE IN VIRAL MENINGITIS HSV- TYPE-2

    Directory of Open Access Journals (Sweden)

    Vikram

    2016-05-01

    Full Text Available INTRODUCTION Acute infections of nervous system are among the most important problems in medicine because early recognition, efficient decision making and rapid institution of therapy can be lifesaving. Making a clinical diagnosis of acute meningitis depends on the cornerstone of cerebrospinal fluid (CSF examination. We present a case with the above-mentioned difficulty and the approach involved in establishing the exact diagnosis and institution of appropriate treatment. CONCLUSION About findings in viral meningitis one should be careful while evaluating a CSF report so as to not make a mistaken diagnosis and delay treatment. The most important analysis in patients whose symptoms are consistent with herpes simplex meningitis is the detection of Herpes simplex Virus deoxy-ribo-nucleic acid (HSV-DNA in CSF with Polymerase Chain Reaction (PCR.

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

    Directory of Open Access Journals (Sweden)

    Fida A. Khan

    2004-10-01

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

  5. Bacterial translocation in acute rejection after small bowel transplantation in rats.

    Science.gov (United States)

    Zou, Y; Hernandez, F; Burgos, E; Martinez, L; Gonzalez-Reyes, S; Fernandez-Dumont, V; Lopez, G; Romero, M; Lopez-Santamaria, M; Tovar, J A

    2005-03-01

    Acute rejection after small bowel transplantation (SBTx) may facilitate bacterial translocation (BT) and subsequent changes in the liver, spleen, and lungs. This study investigated whether BT occurs after acute rejection and whether this is followed by changes in the structure of the intestine and the phagocytic organs interposed between the gut and the general circulation. Orthotopic SBTx was performed in allogeneic (ALLO) rat-strain combinations (BN-Wistar, n=5). For comparison we used syngeneic SBTx (SYN) (BN-BN, n=6) controls. Animals were sacrificed on postoperative day 7. Mesenteric lymph nodes and portal and caval blood were cultured for aerobes and anaerobes. Escherichia coli beta-galactosidase DNA was assessed by polymerase chain reaction in the blood samples. Intestine, liver, spleen, and lung protein and DNA contents were measured. Histologic changes were graded according to standard criteria of acute rejection. For comparisons we used chi(2) and nonparametric Mann-Whitney test with a threshold of significance of p<0.05. ALLO rats lost more weight after SBTx than SYN rats (-13.02+/-4.39% vs. -8.04+/-5.08% of preoperative weight), although the difference was not significant (ns). A variable degree of graft rejection was histologically demonstrated in all ALLO rats, and DNA/protein content in the graft was significantly higher in this group (0.245+/-0.85 vs. 0.134+/-0.21, p<0.05). Gram-negative enteric bacteria were found in 4/5 ALLO and 4/6 SYN rats (ns), and aerobic Gram-positive bacteria in 2/5 and 3/6 (ns), respectively. Anaerobic growth occurred in mesenteric lymph nodes in one ALLO rat and in the bloodstream in another one. E. coli DNA was isolated in none of the ALLO but in two SYN rats (ns). BT was frequent after SBTx in both syngeneic and allogeneic strain combinations. Contrary to our expectations, BT after SBTx was not higher in ALLO group rats. However, anaerobic germs were isolated only in this group.

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

    Directory of Open Access Journals (Sweden)

    Maria das Graças Gomes Saraiva

    2015-06-01

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

  7. Study progress of sequelaes and risk factors of bacterial meningitis in children%儿童细菌性脑膜炎的后遗症及其危险因素研究进展

    Institute of Scientific and Technical Information of China (English)

    张金晶; 王亚娟

    2013-01-01

    儿童细菌性脑膜炎仍是导致儿童死亡的重要原因,而细菌性脑膜炎所致后遗症也并不少见,细菌性脑膜炎患者出院后至少发生1种后遗症的平均概率为19.9%,包括听力障碍、认知障碍、运动障碍、癫(癎)、视力障碍等,其中听力障碍是最常见的后遗症,多种后遗症可同时存在.入院时患儿的意识水平、惊厥、起病时间>48 h、外周循环衰竭、致病菌为肺炎链球菌是细菌性脑膜炎发生后遗症的公认危险因素.外周血白细胞计数、脑脊液糖及蛋白水平亦与细菌性脑膜炎预后密切相关.入院时低钠血症提示预后不良.男童及激素的应用对细菌性脑膜炎后遗症影响尚无定论.%Bacterial meningitis in children is still a life-threatening disease which causes a serious of sequelaes,the median risk of at least 1 major or minor sequelae after hospital discharge is 19.9%,including hearing impairment,cognitive impairment,motor disorders,seizures,visual impairment and so on.Of all these sequelaes,hearing impairment is the most common type.Multiple sequelae is recognized.Prognostic factors are found to be statistically significant:coma/impaired consciousness,complaints > 48 hours before admission,seizures at admission,peripheral circulatory failure,respiratory distress,Streptococcus pneumonia as causative pathogen were recognized as the risk factors for sequeales.And cerebrospinal fluid parameters and white blood cell count were closely related to sequelaes.Hypokaliemia at admission also indicate poor prognosis,but need independent validation in clinical works.Male gender and corticoids were still in discussion.

  8. Importância do exame do liquor de controle em meningite bacteriana como critério de alta Importance of cerebrospinal fluid control tests in bacterial meningitis cases as a discharge criterion

    Directory of Open Access Journals (Sweden)

    Diogo Buarque Cordeiro Cabral

    2008-04-01

    Full Text Available Há controvérsias sobre indicação do exame do liquor de controle em pacientes recuperados clinicamente de meningite bacteriana como critério de cura. Alguns autores defendem alta hospitalar após normalização clínica e liqüórica, outros que a análise do liquor não se justifica em todos os pacientes. Esta série de casos com comparação de grupos investiga alterações no exame liqüórico de controle e avalia a importância do exame na decisão da alta. De 297 pacientes estudados, em 89,9%, o liquor de controle não mudou a intenção de alta (liquor resolutivo, já em 10,1% a alta foi suspensa (liquor não-resolutivo. Destes, o esquema antibiótico foi trocado em 30%. Entre as variáveis que pudessem ser preditivas de liquor não-resolutivo, à admissão, proteinorraquia maior que 100mg/dL (p=0,04 e glicorraquia menor ou igual a 20mg/dL (p=0,03 associaram-se a chance 2,5 vezes maior, podendo ser úteis como critérios para indicar exame do liquor como controle de cura para alta.There is controversy regarding indications for cerebrospinal fluid control tests on patients who have clinically recovered from bacterial meningitis, as a cure criterion. Some authors advocate discharge after confirmation of clinical and cerebrospinal fluid normalization, while others maintain that cerebrospinal fluid analysis is not justified in all cases. This case series with group comparisons investigated changes seen in cerebrospinal fluid control tests and evaluated the importance of this for the discharge decision. Out of 297 patients studied, the cerebrospinal fluid control test did not change the discharge intention in 89.9% of the cases (healed cerebrospinal fluid, while in 10.1%, the discharge was suspended (non-healed cerebrospinal fluid. Of these, the antibiotic scheme was changed in 30%. Among the variables that might predict the presence of non-healed cerebrospinal fluid on admission, cerebrospinal fluid protein levels higher than 100mg/dl (p

  9. Adenoviral augmentation of elafin protects the lung against acute injury mediated by activated neutrophils and bacterial infection.

    Science.gov (United States)

    Simpson, A J; Wallace, W A; Marsden, M E; Govan, J R; Porteous, D J; Haslett, C; Sallenave, J M

    2001-08-01

    During acute pulmonary infection, tissue injury may be secondary to the effects of bacterial products or to the effects of the host inflammatory response. An attractive strategy for tissue protection in this setting would combine antimicrobial activity with inhibition of human neutrophil elastase (HNE), a key effector of neutrophil-mediated tissue injury. We postulated that genetic augmentation of elafin (an endogenous inhibitor of HNE with intrinsic antimicrobial activity) could protect the lung against acute inflammatory injury without detriment to host defense. A replication-deficient adenovirus encoding elafin cDNA significantly protected A549 cells against the injurious effects of both HNE and whole activated human neutrophils in vitro. Intratracheal replication-deficient adenovirus encoding elafin cDNA significantly protected murine lungs against injury mediated by Pseudomonas aeruginosa in vivo. Genetic augmentation of elafin therefore has the capacity to protect the lung against the injurious effects of both bacterial pathogens resistant to conventional antibiotics and activated neutrophils. PMID:11466403

  10. Testing for meningitis in children with bronchiolitis.

    Science.gov (United States)

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

    2014-01-01

    Viral bronchiolitis accounts for almost 20% of all-cause hospitalizations of infants (ie, children younger than age 1 year). The annual incidence of fever in viral bronchiolitis has been documented at 23% to 31%. However the incidence of concurrent serious bacterial infections is low (1%-7%), with meningitis occurring in less than 1% to 2% of cases, but lumbar puncture is performed in up to 9% of viral bronchiolitis cases. To our knowledge, no study has examined clinical factors that influence a physician’s decision to perform a lumbar puncture in the setting of viral bronchiolitis. We present a retrospective, case-control study of hospitalized infants younger than one year diagnosed with viral bronchiolitis who underwent lumbar puncture as part of an evaluation for meningitis. The objective of the study was to determine clinical factors that influence a physician’s decision to perform a lumbar puncture in the setting of viral bronchiolitis. Although 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 multivariable regression; no other demographic, clinical, laboratory, or radiologic variables were found to be significant.

  11. Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria.

    Science.gov (United States)

    Muñoz-Gómez, Sigridh; Wirkowski, Elizabeth; Cunha, Burke A

    2015-01-01

    Because external ventricular drains (EVDs) provide access to cerebrospinal fluid (CSF), there is potential for EVD associated acute bacterial meningitis (EVD-AM). Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50 WBCs/mm(3)), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen (same morphology as Gram stained organism). We reviewed 22 adults with EVDs to determine if our four CSF parameters combined accurately identified EVD-AM. No single or combination of <4 CSF parameters correctly diagnosed or ruled out EVD-AM. Combined our four CSF parameters clearly differentiated EVD-AM from one case of pseudomeningitis due to E. cloacae. We conclude that our four CSF criteria combined are useful in diagnosing EVD-AM in adults.

  12. Corticosteroids for managing tuberculous meningitis

    OpenAIRE

    Prasad, Kameshwar; Singh, Mamta B.; Ryan, Hannah

    2016-01-01

    Background Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person's brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their role has been controversial. Objectives To evaluate the effects of corticosteroids as an adjunct to antituberculous treatment on death and severe ...

  13. Management of neoplastic meningitis.

    Science.gov (United States)

    Roth, Patrick; Weller, Michael

    2015-06-01

    Leptomeningeal dissemination of tumor cells, also referred to as neoplastic meningitis, is most frequently seen in patients with late-stage cancer and mostly associated with a poor prognosis. Basically, neoplastic meningitis may affect all patients with a malignant tumor but is most common in patients affected by lung cancer, breast carcinoma, melanoma or hematologic neoplasms such as lymphoma and leukemia. Controlled clinical trials are largely lacking which results in various non-standardized treatment regimens. The presence of solid tumor manifestations in the CNS as well as the extracranial tumor load defines the most appropriate treatment approach. Radiation therapy, systemic chemotherapy and intrathecal treatment must be considered. For each patient, the individual situation needs to be carefully evaluated to determine the potential benefit as well as putative side effects associated with any therapy. A moderate survival benefit and particularly relief from pain and neurological deficits are the main treatment goals. Here, we summarize the management of patients with neoplastic meningitis and review the available treatment options.

  14. Significance of cerebrospinal fluid lactate level in diagnosing neonatal bacterial meningitis%脑脊液乳酸水平对新生儿细菌性脑膜炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    赵翠; 张澜; 刘宁; 张鹏; 梅枚; 胡黎园; 周文浩; 曹云; 程国强

    2016-01-01

    目的:探讨脑脊液乳酸水平在新生儿细菌性脑膜炎诊断中的价值。方法收集2014年1月至2015年3月复旦大学附属儿科医院新生儿科住院患儿脑脊液。采用血气分析仪检测脑脊液乳酸、葡萄糖水平。采用纸片法检测血糖水平及脑脊液葡萄糖水平。根据脑脊液培养、细胞数及临床表现将纳入患儿分为细菌性脑膜炎组(观察组)与非细菌性脑膜炎组(对照组),利用 Stata 12.0软件对数据进行统计学分析。结果共纳入93例患者,其中观察组16例,对照组77例。观察组脑脊液乳酸、脑脊液乳酸/脑脊液糖比值中位数分别为4.2 mmol/ L、2.32,高于对照组的1.3 mmol/ L、0.52,差异有统计学意(Z =-6.19、5.92,P 均﹤0.05);观察组脑脊液糖、脑脊液糖/血糖比值中位数分别为1.25 mmol/ L、0.44,较对照组(2.50 mmol/ L、0.81)明显低,差异有统计学意义(Z =4.97、4.43,P 均﹤0.05)。作为诊断细菌性脑膜炎指标时,脑脊液乳酸最佳界值2.2 mmol/ L,其阳性预测值(PPV)为72.7%、阴性预测值(NPV)为100.0%;脑脊液乳酸/脑脊液糖最佳界值1.24,PPV 为94.1%、NPV 为100.0%;脑脊液糖最佳界值2.0 mmol/ L,其 PPV 为65.0%、NPV 为96.9%;脑脊液糖/血糖比值最佳界值0.6,其 PPV 为60.0%、NPV 为96.9%。结论脑脊液乳酸可作为新生儿细菌性脑膜炎诊断指标之一。%Objective To study the significance of the cerebrospinal fluid(CSF)lactate level in diagnosing neonatal bacterial meningitis(BM). Methods The CSF samples were collected from neonates admitted to Neonatal Ward of Children's Hospital of Fudan University between January 2014 and March 2015. CSF lactate and glucose con-centrations were measured with blood - gas analyzer. CSF and serum glucose levels were measured with glucometer. The enrolled neonates were divided into 2 groups based on CSF culture,CSF white blood cells(WBCs)and clinical

  15. Outbreak of meningitis due to Serratia marcescens after spinal anaesthesia.

    Science.gov (United States)

    Ersoz, G; Uguz, M; Aslan, G; Horasan, E S; Kaya, A

    2014-06-01

    This article describes an outbreak of meningitis caused by Serratia marcescens in patients who had undergone spinal anaesthesia for caesarean section. Bacterial meningitis was diagnosed in 12 of the 46 patients who underwent a caesarean section under spinal anaesthesia in a 75-bed private hospital between 6(th) and 14(th) March 2011. S. marcescens was isolated from samples taken from four prefilled syringes and one bag containing 5% dextrose with norepinephrine, suggesting that medications used in spinal anaesthesia were contaminated extrinsically. Strategies for prevention of anaesthesia-associated infections in operating theatres are discussed.

  16. Características clínicas e laboratoriais de meningites piogênicas em adultos Clinical and laboratorial characteristics of pyogenic meningitis in adults

    Directory of Open Access Journals (Sweden)

    Irênio Gomes

    1997-09-01

    Full Text Available Foram analisados dados do prontuário de 176 pacientes com idade igual ou superior a 15 anos, internados no Hospital Couto Maia, no período de janeiro de 1990 a dezembro de 1992, em Salvador-BA, com o diagnóstico de meningite piogênica. Observamos, em ordem decrescente, maior percentagem de pacientes com N. meningitidis (56,7%, S. pneumoniae (37,5% e E.coli. (3,3%. A letalidade foi maior no grupo com meningite pneumocócica. No grupo de indivíduos com meningite por pneumococo verificamos que a média etária e de leucócitos no sangue periférico foram superiores quando comparadas com o grupo de portadores de meningite meningocócica. Por outro lado, neste último grupo a média de glicorraquia foi maior. A presença de lesões cutâneas hemorrágicas mostrou-se preditora da etiologia meningocócica.We reviewed the charts of 176 adult patients, admitted with a diagnosis of acute bacterial meningitis, in the Hospital Couto Maia, from January 1990 to December 1992. All the patients had community-acquired meningitis. In 120 patients we could identify the causative agent on Gram's staining and culture. The most common pathogens were N. meningitidis (56.7% S. pneumoniae (37.5% and E. coli (3.3%. The overall lethality rate was 19.8% and the lethality was greater in the group with streptococcus meningitis (31.8%. The mean age and the leukocyte in the peripheral blood were greater in the group with S. pneumoniae meningitis than in the meningococal group. Cutaneous hemorrhagic lesions was an excellent predictor meningococcal meningitis.

  17. Differential effects of kidney-lung cross-talk during acute kidney injury and bacterial pneumonia

    OpenAIRE

    Singbartl, Kai; Bishop, Jeffery; Wen, Xiaoyan; Murugan, Raghavan; Chandra, Saurabh; Filippi, Marie-Dominique; John A Kellum

    2011-01-01

    Acute kidney injury (AKI) and acute lung injury (ALI) represent serious, complex clinical problems. The combination of AKI and ALI drastically decreases survival. However, detailed knowledge about the interactions between these two organs is scarce.

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

    Directory of Open Access Journals (Sweden)

    Gaurav B Modi

    2012-06-01

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

  19. 中性粒细胞CD64 CD11b在儿童化脓性脑膜炎早期诊断中的价值%Values of neutrophil CD64, CD11b in early diagnosis of bacterial meningitis in children

    Institute of Scientific and Technical Information of China (English)

    廖洪彬; 明怀志; 鲜安福

    2015-01-01

    目的 探讨中性粒细胞CD64、CD11b在儿童化脓性脑膜炎早期诊断中的价值.方法 选取35例化脓性脑膜炎患儿作为观察组,儿童保健门诊行健康体检的30例儿童作为对照组,比较两组患者治疗前后中性粒细胞CD64、CD11b表达情况,绘制CD64、CD11b诊断儿童化脓性脑膜炎的ROC曲线,确定最佳阀值后计算两者诊断化脓性脑膜炎的敏感度和特异度.结果 观察组患者治疗后CD64与CD11b表达水平显著低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗前及治疗后CD64与CD11b表达水平均显著高于对照组,差异有统计学意义(P<0.05);CD64 与CD11b ROC曲线下面积均>0.5,且因CD64 ROC曲线下面积>CD11b ROC曲线下面积,CD64诊断效能>CD11b;CD64诊断化脓性脑膜炎敏感度和特异度均优于CD11b,差异有统计学意义(P<0.05).结论 中性粒细胞CD64、CD11b表达情况可作为早期诊断儿童化脓性脑膜炎的参考指标,其中CD64诊断效能、敏感度和特异度更高.%Objective To explore the values of neutrophil CD64, CD11b in the early diagnosis of bacterial meningitis in children. Methods Thirty-five cases of children with bacterial meningitis were researched as the observation group, and 30 cases who underwent phys-ical examination as the control group. The expression of CD64, CD11b was compared, the ROC curves of CD64, CD11b for the patients with bacterial meningitis were drawn, and after the best threshold calculation both the sensitivity of the diagnosis of suppurative meningitis and spe-cific degrees were researched. Results The levels of CD64, CD11b posttreatment in the observation group were lower than those prior to treatment(P<0. 05); the levels of CD64, CD11b posttreatment in the observation group were lower than those in the control group(P<0. 05);the area under ROC curve for CD64, CD11b was higher than 0. 5;the sensitivity and specificity for CD64 were better than those for CD11b(P<0

  20. MR features in patients with residual paralysis following aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-01-15

    MR studies were performed in three patients with paralysis in the lower extremities. Poliomyelitis-like paralysis can be caused by neurovirulent strains of nonpolioenteroviruses. Entervirus 71 (EV 71) is documented as one of the potentially neurovirulent strains and a causative agent of some epidemics (1-7). The clinical manifestations associated with the EV 71 infection include aseptic meningitis, hand-food-mouth disease (HFMD), acute respiratory illness and gastrointestinal disease(6). Although rarely fatal, flaccidparalysis can be followed by EV 71 induced aseptic meningitis. Anterior horn cell necrosis was suggested on MR in two patients with residual paralysis (7). MR features, however, have not yet been described in detail. In this report we present three cases of patients with clinical evidence of EV 71 induced aseptic meningitis whose MR studies showed residual changes in spinal cord.

  1. Pathogenic bacteria distribution and drug resistance in one hundred children of bacterial meningitis%儿童细菌性脑膜炎100例病原分布及耐药分析

    Institute of Scientific and Technical Information of China (English)

    林罗娜; 林立; 温顺航; 陈秀珍; 尚燕萍; 李昌崇

    2016-01-01

    Objective To investigate the pathogenic bacteria distribution, antibiotics resistance, and clinical features of childhood bacterial meningitis (BM). Methods Clinical data from BM children with positive cerebrospinal lfuid culture were retrospectively analyzed from March 2004 to March 2015. According to age, the BM children were divided into neonates group (0-28 days), infants group (—1 year), and children group (≥1 year). According to the onset time, the BM children were divided into the early group (March 2004 to March 2010) and the late group (April 2010 to March 2015). According to the clinical situation, the BM children were divided into the trauma and surgery secondary infection group and the control group. Results A total of 100 BM children were recruited. One hundred and two strains of pathogens were detected, 62 (60.8%) strains of Gram positive bacteria and 40 (39.2%) strains of Gram negative bacteria. The main pathogens were Streptococcus pneumoniae (33 strains), Escherichia coli (22 strains), and Streptococcus agalactiae (10 strains). The proportion of Streptococcus agalactiae was higher in the late group (18.8%(9 cases)) than that in the early group (1.9%(1 case)) (χ2=6.406, P=0.011). The proportion of coagulase-negative staphylococci was higher in the trauma and surgery secondary infection group than that in the control group (χ2=6.631, P=0.010). Drug sensitivity analysis found that 60.0%of Escherichia coli produced extended-spectrumβ-lactamases (ESBLs) in the control group, while the only one strain of Escherichia coli in the trauma and surgery secondary infection group was ESBLs negative. Streptococcus pneumoniae were sensitive to vancomycin and linezolid. Streptococcus agalactiae were all found in the control group, which were all sensitive to penicillin and linezolid. The sensitive rate to vancomycin was only 70%. The incidence of complications in neonates group, infants group, and children group was 55.0%(22/40), 78.6%(33/42), and 33

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

    Directory of Open Access Journals (Sweden)

    Owusu Michael

    2012-10-01

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

  3. Detection of single bacteria - causative agents of meningitis using raman microscopy

    Science.gov (United States)

    Baikova, T. V.; Minaeva, S. A.; Sundukov, A. V.; Svistunova, T. S.; Bagratashvili, V. N.; Alushin, M. V.; Gonchukov, S. A.

    2015-03-01

    Early diagnostics of meningitis is a very topical problem as it is a fulminant disease with a high level of mortality. The progress of this disease is, as a rule, accompanied by the appearance of bacteria in the cerebrospinal fluid (CSF) composition. The examination of the CSF is well known to be the only reliable approach to the identification of meningitis. However, the traditional biochemical analyses are time consuming and not always reliable, simple, and inexpensive, whereas the optical methods are poorly developed. This work is devoted to the study of Raman spectra of several bacterial cultures which are mainly present during meningitis. Raman microscopy is a prompt and noninvasive technique capable of providing reliable information about molecular-level alterations of biological objects at their minimal quantity and size. It was shown that there are characteristic lines in Raman spectra which can be the reliable markers for determination of bacterial form of meningitis at a level of a single bacterium.

  4. Cooperation between Monocyte-Derived Cells and Lymphoid Cells in the Acute Response to a Bacterial Lung Pathogen.

    Directory of Open Access Journals (Sweden)

    Andrew S Brown

    2016-06-01

    Full Text Available Legionella pneumophila is the causative agent of Legionnaires' disease, a potentially fatal lung infection. Alveolar macrophages support intracellular replication of L. pneumophila, however the contributions of other immune cell types to bacterial killing during infection are unclear. Here, we used recently described methods to characterise the major inflammatory cells in lung after acute respiratory infection of mice with L. pneumophila. We observed that the numbers of alveolar macrophages rapidly decreased after infection coincident with a rapid infiltration of the lung by monocyte-derived cells (MC, which, together with neutrophils, became the dominant inflammatory cells associated with the bacteria. Using mice in which the ability of MC to infiltrate tissues is impaired it was found that MC were required for bacterial clearance and were the major source of IL12. IL12 was needed to induce IFNγ production by lymphoid cells including NK cells, memory T cells, NKT cells and γδ T cells. Memory T cells that produced IFNγ appeared to be circulating effector/memory T cells that infiltrated the lung after infection. IFNγ production by memory T cells was stimulated in an antigen-independent fashion and could effectively clear bacteria from the lung indicating that memory T cells are an important contributor to innate bacterial defence. We also determined that a major function of IFNγ was to stimulate bactericidal activity of MC. On the other hand, neutrophils did not require IFNγ to kill bacteria and alveolar macrophages remained poorly bactericidal even in the presence of IFNγ. This work has revealed a cooperative innate immune circuit between lymphoid cells and MC that combats acute L. pneumophila infection and defines a specific role for IFNγ in anti-bacterial immunity.

  5. Single Nucleotide Polymorphisms in Pathogen Recognition Receptor Genes Are Associated with Susceptibility to Meningococcal Meningitis in a Pediatric Cohort

    NARCIS (Netherlands)

    van Well, Gijs Th J.; Sanders, Marieke S.; Ouburg, Sander; Kumar, Vinod; van Furth, A. Marceline; Morre, Servaas A.

    2013-01-01

    Bacterial meningitis (BM) is a serious infection of the central nervous system, frequently occurring in childhood and often resulting in hearing loss, learning disabilities, and encephalopathy. Previous studies showed that genetic variation in innate immune response genes affects susceptibility, sev

  6. Genetic and metabolic signals during acute enteric bacterial infection alter the microbiota and drive progression to chronic inflammatory disease

    Energy Technology Data Exchange (ETDEWEB)

    Kamdar, Karishma; Khakpour, Samira; Chen, Jingyu; Leone, Vanessa; Brulc, Jennifer; Mangatu, Thomas; Antonopoulos, Dionysios A.; Chang, Eugene B; Kahn, Stacy A.; Kirschner, Barbara S; Young, Glenn; DePaolo, R. William

    2016-01-13

    Chronic inflammatory disorders are thought to arise due to an interplay between predisposing host genetics and environmental factors. For example, the onset of inflammatory bowel disease is associated with enteric proteobacterial infection, yet the mechanistic basis for this association is unclear. We have shown previously that genetic defiency in TLR1 promotes acute enteric infection by the proteobacteria Yersinia enterocolitica. Examining that model further, we uncovered an altered cellular immune response that promotes the recruitment of neutrophils which in turn increases metabolism of the respiratory electron acceptor tetrathionate by Yersinia. These events drive permanent alterations in anti-commensal immunity, microbiota composition, and chronic inflammation, which persist long after Yersinia clearence. Deletion of the bacterial genes involved in tetrathionate respiration or treatment using targeted probiotics could prevent microbiota alterations and inflammation. Thus, acute infection can drive long term immune and microbiota alterations leading to chronic inflammatory disease in genetically predisposed individuals.

  7. Protective effect of a bacterial extract against acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    李靖; 郑劲平; 袁锦屏; 曾广翘; 钟南山; 林材元

    2004-01-01

    Background Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infections results from the stimulation of the nonspecific component of the immune system. The present study investigated the effect of the oral immunostimulant Broncho-Vaxom, which includes material from eight different species of bacteria that are frequently present in the lower respiratory tract, on the frequency and severity of acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease (COPD). Methods Ninety patients with chronic bronchitis complicated with COPD were randomly divided into groups A and B. Forty-nine subjects in group A received oral capsules containing 7mg Broncho-Vaxom, while 41 patients in group B received similar placebo capsules. Both groups took one capsule daily for the first 10 days of each month for 3 consecutive months. The frequency of acute exacerbation, symptom scores, and lung function were recorded for the following one year period.Results There was a significant decrease in the incidence, duration, and severity of acute exacerbation, as well as a reduction in the course of antibiotics administered and in the dosage of bronchodilator and mucolytic agent in group A, as compared to group B (P<0.05, respectively). Symptom scores for cough, sputum, dyspnea, as well as symptoms observed upon auscultation of the chest also improved significantly in group A as compared to group B (P<0.05, respectively). The bacterial clearance rate in sputum cultures from patients who received no antibiotics for the first 3 months was also significantly higher in group A compared to group B (P<0.01).Conclusions Orally administered Broncho-Vaxom is associated with a decrease in the incidence of acute exacerbation and a decrease in the need for antibiotics and symptomatic relief medications in patients

  8. Streptococcus gallolyticus (bovis): a rare presentation of meningitis in the ED.

    Science.gov (United States)

    Gray, Joshua D; Wilson, Christopher J

    2016-03-01

    Bacterial meningitis is a fairly common and often deadly manifestation of altered mental status in the elderly, carrying a mortality rate of greater than 20% despite antibiotic therapy. Most commonly caused by Streptococcus pneumoniae, Listeria monocytogenes, Escherichia coli, and Klebsiella pneumoniae. We present a case of meningitis caused by Streptococcus gallolyticus in an elderly, otherwise healthy woman. There have been no reports in the emergency medicine literature and only a few reports in the literature of S gallolyticus as a cause of altered mental status and meningitis, specifically of immunocompetent patients.

  9. 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.;

    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...... 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 concurrent low...

  10. Focus on JNJ-Q2, a novel fluoroquinolone, for the management of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections.

    Science.gov (United States)

    Jones, Travis M; Johnson, Steven W; DiMondi, V Paul; Wilson, Dustin T

    2016-01-01

    JNJ-Q2 is a novel, fifth-generation fluoroquinolone that has excellent in vitro and in vivo activity against a variety of Gram-positive and Gram-negative organisms. In vitro studies indicate that JNJ-Q2 has potent activity against pathogens responsible for acute bacterial skin and skin structure infections (ABSSSI) and community-acquired bacterial pneumonia (CABP), such as Staphylococcus aureus and Streptococcus pneumoniae. JNJ-Q2 also has been shown to have a higher barrier to resistance compared to other agents in the class and it remains highly active against drug-resistant organisms, including methicillin-resistant S. aureus, ciprofloxacin-resistant methicillin-resistant S. aureus, and drug-resistant S. pneumoniae. In two Phase II studies, the efficacy of JNJ-Q2 was comparable to linezolid for ABSSSI and moxifloxacin for CABP. Furthermore, JNJ-Q2 was well tolerated, with adverse event rates similar to or less than other fluoroquinolones. With an expanded spectrum of activity and low potential for resistance, JNJ-Q2 shows promise as an effective treatment option for ABSSSI and CABP. Considering its early stage of development, the definitive role of JNJ-Q2 against these infections and its safety profile will be determined in future Phase III studies. PMID:27354817

  11. The relationship between prior antimicrobial prescription and meningitis: a case–control study

    Science.gov (United States)

    Armstrong, David; Ashworth, Mark; Dregan, Alex; White, Patrick

    2016-01-01

    Background Recent research into the role of the human microbiome in maintaining health has identified the potentially harmful impact of antimicrobials. Aim The association with bacterial and viral meningitis following antimicrobial prescription during the previous year was investigated to determine whether antimicrobials have a deleterious effect on the nasopharyngeal microbiome. Design and setting A case-control study (1:4 cases to controls) was conducted examining the rate of previous antimicrobial exposure in cases of meningitis and in a matched control group. Data from a UK primary care clinical database were analysed using conditional logistic regression. Results A total of 7346 cases of meningitis were identified, 3307 (45%) viral, 1812 (25%) bacterial, and 2227 (30%) unspecified. The risks of viral (adjusted odds ratio [AOR] 2.45; 95% confidence interval [CI] = 2.24 to 2.68) or bacterial (AOR 1.98; 95% CI = 1.71 to 2.30) meningitis were both increased following antimicrobial prescription in the preceding year. Patients who received ≥4 antimicrobial prescriptions in the preceding year were at significantly increased risk of all types of meningitis (AOR 2.85; 95% CI = 2.44 to 3.34), bacterial meningitis (AOR 3.06; 95% CI = 2.26 to 4.15) and viral meningitis (AOR 3.23; 95% CI = 2.55 to 4.08) compared to their matched controls. Conclusion There was an increased risk of meningitis following antimicrobial prescription in the previous year. It is possible that this increase was due to an effect of antimicrobials on the microbiome or reflected an increased general susceptibility to infections in these patients. PMID:26965030

  12. A Review of the Impact of Pneumococcal Polysaccharide Conjugate Vaccine (7-valent) on Pneumococcal Meningitis

    OpenAIRE

    Tin Tin Htar, Myint; Madhava, Harish; Balmer, Paul; Christopoulou, Dina; Menegas, Damianos; Bonnet, Eric

    2013-01-01

    Introduction Streptococcus pneumoniae is the leading cause of bacterial meningitis. Young children, the elderly and those who are immunocompromised or who suffer from chronic diseases have the highest risk of developing pneumococcal meningitis. A 7-valent pneumococcal conjugate vaccine (PCV7) was licensed in 2000 in the US and in 2001 in Europe. Methods A literature search was performed in PubMed to identify studies assessing the impact of routine childhood PCV7 vaccination on pneumococcal di...

  13. Epidemiología descriptiva de meningitis no meningocócicas bacterianas de la provincia de Zaragoza (1999-2004): evaluación de su sistema de vigilancia Descriptive epidemiology of non-meningococcal bacterial meningitis in the province of Saragossa [Spain] from 1999 to 2004: evaluation of the Epidemiological Surveillance System

    OpenAIRE

    Carmen Varela; Alberto Vergara; Joaquín Guimbao; María Pilar Rodrigo Val; Salvador de Mateo; Dionisio Herrera

    2007-01-01

    Objetivos: Describir las meningitis no meningocócicas bacterianas (MnMB) y evaluar el Sistema de Vigilancia Epidemiológica (SVE) en la provincia de Zaragoza entre 1999 y 2004. Métodos: Se utilizó el registro de enfermedades de declaración obligatoria (EDO) y el conjunto mínimo básico de datos (CMBD). Se evaluó el SVE utilizando criterios de los Centers for Disease Control and Prevention, estimando la exhaustividad mediante captura-recaptura. Resultados: Se notificaron 111 casos de MnMB (62,2%...

  14. Local and disseminated acute phase response during bacterial respiratory infection in pigs

    DEFF Research Database (Denmark)

    Skovgaard, Kerstin; Mortensen, Shila; Heegaard, Peter M. H.

    2010-01-01

    The acute phase response is playing an important role, aiming to restore the healthy state after tissue injury, inflammation and infection. The biological function of this response and its interplay with other parts of innate defense reactions remain somewhat elusive. Expression of acute phase...... proteins (APP) outside the liver is increasingly recognized, still little is known of extra-hepatic production of APP in pigs. 14-18 h after experimental infection with Actinobacillus pleuropneumoniae, causing acute pleuropneumonia in pigs, we studied local APP gene expression changes in different...... differentially expressed between infected and control animals. We demonstrated that acute pleuropneumonia caused by A. pleuropneumoniae leads to a rapid disseminated local intra-lung APP response, also in apparently unaffected areas of the infected lung. Further extrahepatic expression of several acute-phase...

  15. Evaluation of acute bacterial rhino sinusitis in asthma patients based on clinical parameters and imaging studies, together with ear, nose and throat examination

    International Nuclear Information System (INIS)

    Objective: To evaluate paranasal sinuses in patients with stable or acute asthma in order to determine the prevalence of acute bacterial rhinosinusitis. Methods: A cross-sectional study including 30 patients with acute asthma (73% females) treated in the emergency room and 30 patients with stable asthma (80% females) regularly monitored as outpatients. All patients completed a questionnaire on respiratory signs and symptoms and were submitted to ear, nose and throat (ENT) examination, as well as to X-ray and computed tomography (CT) imaging of the sinuses. Results: Based on the clinical diagnosis, the prevalence of acute bacterial rhinosinusitis was 40% in the patients with acute asthma and 3% in those with stable asthma. The ENT examination findings and the imaging findings in isolation were not useful to confirm the diagnosis. Conclusions: In themselves, ENT examination findings, X-ray findings and CT findings were not useful for the diagnosis of acute bacterial rhinosinusitis. Our results provide further evidence that a clinical diagnosis of bacterial rhinosinusitis should be made with caution. (author)

  16. Possible implication of bacterial infection in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Shigeo eFuji

    2014-04-01

    Full Text Available Graft-versus-host disease (GVHD is still one of the major causes of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (HSCT. In the pathogenesis of acute GVHD, it has been established that donor-derived T cells activated in the recipient play a major role in GVHD in initiation and maintenance within an inflammatory cascade. To reduce the risk of GVHD, intensification of GVHD prophylaxis like T cell depletion is effective, but it inevitably increases the risk of infectious diseases and abrogates beneficial graft-versus-leukemia effects. Although various cytokines are considered to play an important role in the pathogenesis of GVHD, GVHD initiation is such a complex process that cannot be prevented by means of single inflammatory cytokine inhibition. Thus, efficient methods to control the whole inflammatory milieu both on cellular and humoral view are needed. In this context, infectious diseases can theoretically contribute to an elevation of inflammatory cytokines after allogeneic HSCT and activation of various subtypes of immune effector cells, which might in summary lead to an aggravation of acute GVHD. The appropriate treatments or prophylaxis of bacterial infection during the early phase after allogeneic HSCT might be beneficial to reduce not only infectious-related but also GVHD-related mortality. Here, we aim to review the literature addressing the interactions of bacterial infections and GVHD after allogeneic HSCT.

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

    Directory of Open Access Journals (Sweden)

    P. Anoop

    2003-12-01

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

  18. Treatment Complications of Lyme Meningitis

    OpenAIRE

    J Gordon Millichap

    2012-01-01

    Researchers at Alfred I duPont Hospital for Children, Wilmington, DE, and other Centers in Lyme endemic areas determined the frequency and type of all treatment complications at return visits within 30 days of an initial Lyme meningitis diagnosis.

  19. MRSA bacteraemia complicating amphotericin B treatment of cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    J Scriven

    2013-09-01

    Full Text Available Intravenous amphotericin B is a key component of the antifungal therapy for cryptococcal meningitis recommended in South African and international guidelines. Unfortunately, its use is associated with significant toxicity including deterioration in renal function, electrolyte disturbance, anaemia and infusion reactions. Chemical phlebitis is common following administration via peripheral cannulae. This can be complicated by bacterial infection, resulting in localised cellulitis or bacterial sepsis. Here we describe two patients with cryptococcal meningitis who developed methicillin-resistant Staphylococcus aureus (MRSA bacteraemia during, or shortly after treatment with amphotericin B. These cases illustrate the dangers of line-related sepsis in hospitalised individuals and some of the difficulties encountered during treatment of this condition.

  20. Expressions and significance of TNF-α and IL-1 β in the serum and cerebrospinal fluid of children with bacterial meningitis%细菌性脑膜炎患儿脑脊液和血清中TNF-α和IL-1β的表达及其临床意义

    Institute of Scientific and Technical Information of China (English)

    夏明万; 李青

    2013-01-01

    目的 观察急性期细菌性脑膜炎(BM)和病毒性脑膜炎(VM)患儿血清和脑脊液中肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)的水平变化,探讨其临床意义.方法 收集在本院治疗的BM患儿22 例、VM患儿18 例的急性期脑脊液和血清.采用双抗体酶联免疫吸附法(ELISA) 检测两组对象血清和脑脊液中TNF-α和IL-1β的表达水平.结果 BM组脑脊液TNF-α及IL-1β水平明显高于VM组(P0.05).BM脑脊液TNF-α及IL-1β水平呈明显正相关(r=0.635).结论 脑脊液和血清TNF-α与IL-1β的联合检测可以用于对BM患儿的鉴别诊断.%Objective To evaluate the levels of TNF-α and IL-1β in the serum and cerebrospinal fluid of children with bacterial meningitis (BM) and those with virus meningitis (VM). Methods Serum and cerebrospinal fluid samples were collected from 22 children with BM (BM group) and 18 children with VM (VM group). The levels of TNF-α and IL-1β in the samples were evaluated by ELISA. Results The levels of B7-H3 and IL-1β in cerebrospinal fluid of BM group were significantly higher than those of VM group (P0.05). The levels of TNF-α and IL-1β in cerebrospinal fluid of BM group were positively correlated (r=0635, P<0.05). Conclusion Combined test of TNF-α and IL-1β could be used for the differential diagnosis of children with bacterial meningitis.

  1. Rapid and widely disseminated acute phase protein response after experimental bacterial infection of pigs

    DEFF Research Database (Denmark)

    Skovgaard, Kerstin; Mortensen, Shila; Boye, Mette;

    2009-01-01

    infection in pigs. The lung infection was established with the pig specific respiratory pathogen Actinobacillus pleuropneumoniae. Quantitative real-time PCR based expression analysis were performed on samples from liver, tracheobronchial lymph node, tonsils, spleen and on blood leukocytes, supplemented......The acute phase protein response is a well-described generalized early host response to tissue injury, inflammation and infection, observed as pronounced changes in the concentrations of a number of circulating serum proteins. The biological function of this response and its interplay with other...... with measurements of interleukin-6 and selected acute phase proteins in serum. C-reactive protein and serum amyloid A were clearly induced 14-18 h after infection. Extrahepatic expression of acute phase proteins was found to be dramatically altered as a result of the lung infection with an extrahepatic acute phase...

  2. 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.

  3. Life-threatening meningitis resulting from transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Zhou-Jun Shen; Shan-Wen Chen; Hua Wang; Xie-Lai Zhou; Ju-Ping Zhao

    2005-01-01

    After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma.Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.

  4. Effect of comprehensive pain intervention in the acute meningitis children%综合疼痛干预在急性脑膜炎患儿中应用效果

    Institute of Scientific and Technical Information of China (English)

    杨晓莹; 杨松; 唐丽敏; 李晓娟

    2014-01-01

    目的:探讨综合疼痛干预在儿科重症监护病房( PICU)急性脑膜炎患儿疼痛管理中的应用效果。方法选取在PICU住院的急性脑膜炎患儿及家属各140例,采用随机数字表法随机分为两组,每组70例,在干预开始前应用幼儿面部编码系统( NFCS)评分,比较两组患儿疼痛分度,入院当日分别进行疼痛干预,对照组患儿家属学习PICU护理手册,观察组患儿家属学习疼痛信息手册、幼儿缓解疼痛相关方法及PICU护理手册。两组患儿分别在入院当天、脑脊液穿刺时、入院后第3、5、7天对患儿疼痛程度进行评估,入院第7天对家属满意度进行评估。结果疼痛缓解程度上,入院第3天时观察组患儿轻度疼痛28.57%,中度疼痛42.86%,重度疼痛25.71%;对照组轻度疼痛11.43%,中度疼痛54.29%,重度疼痛34.29%,两组差异有统计学意义(χ2=6.91,P=0.03)。入院时,两组患儿间心理状态差异无统计学意义(P>0.05);入院第7天,对照组患儿心理状态较观察组不稳定,不愉悦居多,差异有统计学意义(P<0.05)。入院第7天观察组和对照组患儿家长对疼痛管理的平均满意度分别为(87.42±6.88)%,(73.10±10.12)%,两组差异有统计学意义(t=8.21,P<0.01)。结论综合疼痛干预可帮助PICU急性脑膜炎患儿更好地缓解脑脊液穿刺及疾病本身带来的疼痛。%Objective To investigate the efficacy of comprehensive pain intervention in the pain management of child in the pediatric intensive care unit with Acute Meningitis .Methods A total of 280 parents and children at the PICU of Maternal and Child Care Service Centre of Tangshan were enrolled in the study .All the parents and children were randomly divided into observation group and control group ( child was in same group with his/her parents ) , with 70 parents/children in

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

    Directory of Open Access Journals (Sweden)

    Kumar Susheel

    2008-01-01

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

  6. Focus on JNJ-Q2, a novel fluoroquinolone, for the management of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections

    Directory of Open Access Journals (Sweden)

    Jones TM

    2016-06-01

    Full Text Available Travis M Jones,1,2 Steven W Johnson,1,3 V Paul DiMondi,1,4 Dustin T Wilson,1,2 1Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, 2Department of Pharmacy, Duke University Hospital, Durham, 3Department of Pharmacy, Forsyth Medical Center, Novant Health, Winston-Salem, 4Department of Pharmacy, Durham VA Medical Center, Durham, NC, USA Abstract: JNJ-Q2 is a novel, fifth-generation fluoroquinolone that has excellent in vitro and in vivo activity against a variety of Gram-positive and Gram-negative organisms. In vitro studies indicate that JNJ-Q2 has potent activity against pathogens responsible for acute bacterial skin and skin structure infections (ABSSSI and community-acquired bacterial pneumonia (CABP, such as Staphylococcus aureus and Streptococcus pneumoniae. JNJ-Q2 also has been shown to have a higher barrier to resistance compared to other agents in the class and it remains highly active against drug-resistant organisms, including methicillin-resistant S. aureus, ciprofloxacin-resistant methicillin-resistant S. aureus, and drug-resistant S. pneumoniae. In two Phase II studies, the efficacy of JNJ-Q2 was comparable to linezolid for ABSSSI and moxifloxacin for CABP. Furthermore, JNJ-Q2 was well tolerated, with adverse event rates similar to or less than other fluoroquinolones. With an expanded spectrum of activity and low potential for resistance, JNJ-Q2 shows promise as an effective treatment option for ABSSSI and CABP. Considering its early stage of development, the definitive role of JNJ-Q2 against these infections and its safety profile will be determined in future Phase III studies. Keywords: JNJ-Q2, fluoroquinolone, ABSSSI, CABP, MRSA

  7. Role of cerebrospinal fluid procalcitonin in identification of intracranial bacterial infection and aseptic meningitis%脑脊液降钙素原在鉴别颅内细菌性感染与无菌性脑膜炎中的作用

    Institute of Scientific and Technical Information of China (English)

    李幽然; 张国军; 高之宪; 季楠; 张力伟; 张扬; 王丽娟; 张洪欣; 康熙雄

    2015-01-01

    目的 探讨脑脊液降钙素原(PCT)在鉴别成人颅内细菌性感染与无菌性脑膜炎中的作用.方法 回顾性分析2013年10月至2014年3月首都医科大学附属北京天坛医院神经外科脑肿瘤术后48 ~ 72 h出现疑似细菌性颅内感染症状的患者178例.行脑脊液常规、生化及PCT的检测.按照颅内感染的诊断标准,将其分为细菌性感染组(50例)和无菌性脑膜炎组(128例).比较两组脑脊液PCT及传统脑脊液检测指标的变化情况,应用受试者工作特征曲线(ROC)分析脑脊液PCT对鉴别感染及无菌性脑膜炎的价值.结果 与无菌性脑膜炎组比较,细菌性感染组脑脊液中白细胞数量、多核细胞比例、蛋白质含量、PCT含量均增高,糖降低,差异均有统计学意义(均P<0.01);氯化物差异无统计学意义.其中感染组脑脊液PCT中位数(范围)为0.15 ng/ml(0 ~3.09 ng/ml),无菌性脑膜炎组为0 ng/ml(0 ~0.46 ng/ml).ROC结果显示,PCT鉴别诊断细菌性颅内感染曲线下面积为0.746,诊断阈值为0.075 ng/ml,敏感性为68.0%,特异性为72.7%,阳性预测值为49.3%,阴性预测值85.3%.脑脊液PCT与白细胞、多核细胞比例、蛋白含量呈正相关(r分别为0.446、0.453、0.482,均P<0.01;与糖呈负相关(r=-0.201,P=0.007).结论 脑脊液PCT检测对诊断神经外科术后细菌性颅内感染具有重要的临床应用价值.%Objective To investigate the role of the cerebrospinal fluid procalcitonin (PCT) in the identification of intracranial bacterial infection and aseptic meningitis in adults.Methods A total of 178 patients with the suspected symptom of intracranial bacterial infection at 48 to 72 h after neurosurgical brain tumor surgery at the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from October 2013 to March 2014 were analyzed retrospectively.The cerebrospinal fluid routine,biochemical and procalcitonin tests were performed.According to the diagnostic

  8. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk;

    2007-01-01

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected of meningi......The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected...... of meningitis on admission to a 27-bed infectious disease department at a Danish university hospital. Biomarker serum levels on admission were measured. Sensitivity and specificity were evaluated at pre-specified cut-off values and overall diagnostic accuracies were compared using receiver......-operating characteristic AUCs (areas under curves). Patients were classified by 2 sets of diagnostic criteria into: A) purulent meningitis, serous meningitis or non-meningitis, and B) systemic bacterial infection, local bacterial infection or non-bacterial disease. An elevated serum level of sCD163 was the most specific...

  9. Voriconazole in an infant with cryptococcal meningitis

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Cryptococcus neoformans (C. neoformans) is the most common cause of fungal meningitis worldwide.1 Cryptococcal meningitis is an opportunistic infection commonly found in immunocompromised hosts,especially HIV-infected adults. It also occurs in apparently immunocompetent individuals.

  10. Meningitis B Vaccine Falls Short of Expectations

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159976.html Meningitis B Vaccine Falls Short of Expectations 1 in ... University students given a vaccine to combat a meningitis B outbreak on campus in 2013 didn't ...

  11. Ten years experience with 497 cases of neuroinfections in tropic: in limited laboratory infrastructure initially treat both, cerebral malaria and meningitis.

    Science.gov (United States)

    Benca, J; Ondrusova, A; Adamcova, J; Takacova, M; Polonova, J; Taziarova, M

    2007-06-01

    Review of 497 cases of neuroinfections in 7 tropical clinics in Ethiopia, Uganda, Burundi, Kenya, Sudan within 2000-2007 was performed. 97.5% of all cases was cerebral malaria (40.1%) and bacterial meningitis (56.4%). TB meningitis, cerebral cryptococcosis and sleeping sickness were very rare.

  12. 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.

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

    DEFF Research Database (Denmark)

    Wache, Christina; Klein, Matthias; Andersen, Christian Østergaard;

    2015-01-01

    BACKGROUND:  Neutrophilic inflammation often persists for days despite effective antibiotic treatment and contributes to brain damage in bacterial meningitis. We propose here that myeloid-related protein 14 (MRP14), an abundant cytosolic protein in myeloid cells, acts as an endogenous danger signal......, driving inflammation and aggravating tissue injury. METHODS:  The release pattern of MRP14 was analyzed in human and murine cerebrospinal fluid (CSF), as well as in isolated neutrophils. Its functional role was assessed in a mouse meningitis model, using MRP14-deficient mice. RESULTS:  We detected large...... quantities of MRP14 in CSF specimens from patients and mice with pneumococcal meningitis. Immunohistochemical analyses and a cell-depletion approach indicated neutrophils as the major source of MRP14. In a meningitis model, MRP14-deficient mice showed a better resolution of inflammation during antibiotic...

  14. [Meningitis and encephalitis in Poland in 2005].

    Science.gov (United States)

    Stefanoff, Paweł; Rosińska, Magdalena

    2007-01-01

    In Poland, 2 806 cases of neuroinfections were reported in 2005, of which 998 had bacterial aetiology, 1469 viral, and 339 cases had other or unknown origin. Incidence of bacterial neuroin-fections increased in 2003-2005, following a decreasing trend observed during the past decade. Etiological factor was determined in 486 (49%) cases of bacterial neuroinfections. Among them Neisseria meningitidis was found in 135 cases, Haemophilus influenzae in 59 cases and Streptococ-cus pneumoniae in 111 cases. Unlike previously in 2005 serogroup B was no longer the predominant type of N. meningitidis cultured from patients. Both types B and C constituted similar proportions of all strains serotyped in 2005. Viral neuroinfections incidence in 2005 remained on the same level as in 2004. Etiological factor of central nervous system aseptic infections were established only in minor proportion of cases--3% of meningitis and 20% of encephalitis. Among confirmed cases, there were 177 cases of tick-borne encephalitis and 13 cases of herpetic encephalitis. Tick borne encephalitis incidence decreased in 2005 (0.46), compared to 2003-2004. Most of the cases were reported from endemic areas of northeastern part of the country.

  15. 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.

  16. The role of prophylaxis of bacterial infections in children with acute leukemia/non-Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Elio Castagnola

    2014-06-01

    Full Text Available Infections represent a well-known complication of antineoplastic chemotherapy that may cause delay of treatment, with alteration of the antineoplastic program and dose-intensity, or even the death of a patient that could heal from his/her neoplasia. Bacterial infections are a major cause of morbidity and mortality in patients who are neutropenic following chemotherapy for malignancy. Therefore a program of antibiotic prophylaxis for febrile neutropenia may be considered in the management strategy of cancer patients.

  17. The Role of Prophylaxis of Bacterial Infections in Children With Acute Leukemia/Non-Hodgkin Lymphoma

    OpenAIRE

    Elio Castagnola

    2014-01-01

    Infections represent a well-known complication of antineoplastic chemotherapy that may cause delay of treatment, with alteration of the antineoplastic program and dose-intensity, or even the death of a patient that could heal from his/her neoplasia. Bacterial infections are a major cause of morbidity and mortality in patients who are neutropenic following chemotherapy for malignancy. Therefore a program of antibiotic prophylaxis for febrile neutropenia may be considered in the management stra...

  18. Feline cholecystitis and acute neutrophilic cholangitis: clinical findings, bacterial isolates and response to treatment in six cases.

    Science.gov (United States)

    Brain, Philip H; Barrs, Vanessa R; Martin, Patricia; Baral, Randolph; White, Joanna D; Beatty, Julia A

    2006-04-01

    Clinicopathological findings from six cats with confirmed cholecystitis or acute neutrophilic cholangitis are presented. Historical findings included lethargy and anorexia or inappetence of up to five days duration. On physical examination all cats were pyrexic and four out of six were jaundiced and had cranial abdominal pain. Bile samples were obtained by cholecystocentesis at exploratory coeliotomy (two cases) or by percutaneous, ultrasound-guided cholecystocentesis (four cases). Gall bladder rupture and bile peritonitis occurred subsequent to ultrasound-guided cholecystocentesis in one case. The most common bacterial isolate was Escherichia coli (four cases); E coli was isolated alone in two cases, in combination with a Streptococcus species (one case) and in combination with a Clostridium species (one case). Streptococcus species alone was isolated from one case, as was Salmonella enterica serovar Typhimurium. The latter is the first reported case of Salmonella-associated cholecystitis in a cat. Concurrent pancreatic or intestinal disease was detected histologically in three cases. All cases were treated with antimicrobials based on in vitro susceptibility results. Treatment was successful in five cases. One cat with concurrent diffuse epitheliotropic intestinal lymphoma was euthanased. Percutaneous ultrasound-guided cholecystocentesis is an effective, minimally-invasive technique enabling identification of bacterial isolates in cats with inflammatory hepatobiliary disease.

  19. Co-trimoxazole induced aseptic meningitis.

    OpenAIRE

    PASHANKAR, D.; McArdle, M.; A. Robinson

    1995-01-01

    A 15 year old boy presented with two episodes of aseptic meningitis-like reactions after ingestion of co-trimoxazole. The diagnosis of co-trimoxazole induced aseptic meningitis was made. This syndrome should be considered in the differential diagnosis of aseptic meningitis.

  20. 流行性脑脊髓膜炎疾病负担研究综述%Review of researches on disease burden due to epidemic cerebrospinal meningitis

    Institute of Scientific and Technical Information of China (English)

    王萌

    2012-01-01

    Epidemic cerebrospinal meningitis (ECM)is an infectious disease which attacks acutely,and makes progression rapidly. It will lead to death if improper treatment or not in time. Of the survivors, about 10-15% are with long-term sequelae,such as nerve deafness,blindness,oculomotor nerve palsy,paralysis of limbs,intellectual and emotional change,mental abnormality and so on. For the single ECM,there are not many researches of long-term sequelae. But the ECM is belonging to purulent meningitis,and it is a common type of bacterial meningitis. The research data of purulent meningitis or bacterial meningitis has important significance to understand the harm of the ECM deeply. There are lack of long-term follow-up data of ECM, and its mortality, morbidity or occurrence rate of sequelae is unknown; meanwhile, there is lack of the economic burden data of specific ECM of domestic and international.%流行性脑脊髓膜炎发病急,进展快,若救治不当或不及时易导致死亡.幸存者中,大约有10%~15%的人伴有长期的后遗症,如神经性耳聋、失明、动眼神经麻痹、四肢瘫痪、智力和情志改变、精神异常等.就流脑此单病种而言,长期后遗症方面的研究数据不多.但流脑属于化脓性脑膜炎,同时也是细菌性脑膜炎中常见的一种.参考化脓性脑膜炎或细菌性脑膜炎的研究数据对加深认识流脑的危害有重要意义.流脑缺乏长期随诊资料,病死率、致残率或后遗症发生率情况不详;同时,国内外缺乏针对流脑这一具体病种的经济负担数据.

  1. Creatine kinase in the serum of patients with acute infections of the central nervous system

    DEFF Research Database (Denmark)

    Peterslund, N A; Heinsvig, E M; Christensen, K D

    1985-01-01

    Serum creatine kinase was assessed in 94 consecutive patients without convulsions admitted to hospital due to suspicion of infection of the central nervous system. No reliable discrimination between patients with aseptic and those with bacterial meningitis was obtained. Patients with bacterial...... meningitis and brain oedema, as well as patients with encephalitis, had significantly higher values (P less than 0.01) than patients with meningism, aseptic meningitis and bacterial meningitis without cerebral oedema. Very high values, above 2500 U/1, were encountered in only the most severe cases...... of bacterial meningitis. The highest serum CK value found in patients with encephalitis was 725 U/l. Reference values for control patients with meningism were 16-269 U/1. In a subset of 9 patients creatine kinase isoenzyme analysis was performed. In all cases only muscle type (MM) isoenzyme was found...

  2. Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae.

    Science.gov (United States)

    O'Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

    2015-01-01

    Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni. PMID:25715048

  3. Viral and Bacterial Etiology of Acute Diarrhea among Children under 5 Years of Age in Wuhan, China

    Science.gov (United States)

    Zhu, Xu-Hui; Tian, Lei; Cheng, Zhong-Ju; Liu, Wei-Yong; Li, Song; Yu, Wei-Ting; Zhang, Wen-Qian; Xiang, Xu; Sun, Zi-Yong

    2016-01-01

    Background: Acute diarrhea remains the serious problem in developing countries, especially among children under 5 years of age. Currently, only two or three common diarrhea pathogens were screened at most hospitals in China. The aim of this study was to provide a wide variety of diarrhea pathogens and their antimicrobial resistance patterns in children under 5 years of age. Methods: Totally 381 stool samples collected from Tongji Hospital between July 1, 2014 and June 30, 2015 were tested by culture and/or polymerase chain reaction for eight kinds of bacteria and five kinds of viruses. An antimicrobial sensitivity test was performed using dilution method recommended by the Clinical and Laboratory Standards Institute. Results: Viral infections were mainly identified in infants (0–11 months), whereas bacterial infections were more prevalent in the age of 24–59 months. About 69.8% of samples were positive for at least one pathogen, 51.7% of samples were virus positive, followed by bacteria positive cases (19.4%), and 12.6% of cases displayed co-infections with two viruses or a virus and a bacterium. Rotavirus was the most prevalent pathogen, followed closely by norovirus, while Salmonella was the most commonly isolated bacteria, followed by diarrheagenic Escherichia coli (DEC) and Campylobacter. More than 40% of Salmonella spp. and DEC isolates were resistant to first-line antibiotics (ampicillin, trimethoprim-sulfamethoxazole, and tetracycline). Around 10% of Salmonella spp. isolates were resistant to ceftriaxone and ciprofloxacin simultaneously. Campylobacter spp. displayed high resistance to ciprofloxacin but kept low resistance to azithromycin and doxycycline. Conclusions: The etiology of acute diarrhea varies in children of different age groups. The high frequency of infection with viruses suggests the urgent demand for new viral vaccine development. Proper use of antibiotics in the treatment of acute diarrhea is crucial due to the high level of antibiotic

  4. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, T., E-mail: madarafuebuki@yahoo.co.jp [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Sakurai, K.; Hara, M. [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Muto, M. [Department of Radiology, Okazaki City Hospital, Okazaki, Aichi (Japan); Nakagawa, M. [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Tohyama, J. [Department of Radiology, Toyota-kai Medical Corporation Kariya Toyota General Hospital, Kariya, Aichi (Japan); Oguri, T. [Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Mitake, S. [Department of Neurology, Tosei General Hospital, Seto-shi, Aichi (Japan); Maeda, M. [Department of Radiology, Mie University School of Medicine, Tsu, Mie (Japan); Matsukawa, N.; Ojika, K. [Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan); Shibamoto, Y. [Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya (Japan)

    2012-04-15

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

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

    Directory of Open Access Journals (Sweden)

    Juliana de A Matos

    2006-08-01

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

  7. Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

    Directory of Open Access Journals (Sweden)

    Chao-Chih Lai

    2016-04-01

    Full Text Available Background: The causative pathogen is rarely identified in the emergency department (ED, since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods: We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results: Viruses (41.3% were the leading cause of gastroenteritis, with noroviruses (32.2% being the most prevalent, followed by bacteria (26.8% and Giardia lamblia (12.4%. Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53, household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96, attending a banquet (aOR 2.29; 95% CI, 1.64–3.20, dining out (aOR 1.70; 95% CI, 1.13–2.54, and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94 were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05, those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62, or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62 or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77 were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41, abdominal pain (TR 1.20; 95% CI, 1.07–1.41, and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98 were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05, winter season (aOR 0.45; 95% CI, 0.28–0.74, frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83, and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23 were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63. Conclusions: Acute bacterial gastroenteritis was highly associated with

  8. ClinicValueofProcalcitonininEarlyDiagnosisofPediatricBacterialMeningitisandViralEncephalitis%小儿急性细菌性脑炎与病毒性脑炎降钙素原检测的临床早期诊断价值

    Institute of Scientific and Technical Information of China (English)

    杨芳

    2013-01-01

    目的探讨血清降钙素原(PCT)在小儿急性细菌性脑炎与病毒性脑炎早期诊断中的价值。方法采用降钙素原(PCT)免疫荧光法,测定54例急性细菌性脑炎患儿及48例病毒性脑炎患儿的PCT。结果在54例急性细菌性脑炎患儿,血清PCT质量浓度显著升高(P<0.01)。PCT>0.5ng/mL作为细菌感染的诊断依据,其敏感度为100%。结论 PCT是一个较好的早期鉴别诊断小儿急性细菌性脑炎与病毒性脑炎的指标。%Objective To search Clinic value of procalcitonin in early diagnosis of pediatric bacterial meningitis and viral encephalitis. Methods PCT serum levels were measured with a special immunoluminometric assay of 54 cases in acute pediatric bacterial meningitis and 48 cases in pediatric viral encephalitis. Results Increased levels of serum PCT were found in 54 cases in acute pediatric bacterial meningitis(P0.5ng/mL is evidence in diagnosis of bacterial infection, its sensitivity was 100%. Conclusion PCT is a good indicator in the early differential diagnosis of children with acute bacterial meningitis and viral encephalitis.

  9. Listeria monocytogenes meningitis in an immunocompetent 18-year old patient as a possible diagnostic and therapeutical problem

    Directory of Open Access Journals (Sweden)

    Vrbić Miodrag

    2013-01-01

    Full Text Available Introduction. Listeria monocytogenes is the third most frequent cause of bacterial meningitis in adults. It commonly affects persons with defective cell-mediated immunity or advanced age, and only a few patients with no underlying predisposition have been reported. Case report. We presented an previously healthy, 18-year-old man with typical clinical features of meningitis. On the account of earlier treatment with ceftriaxone and cerebrospinal fluid finding, an assumption of partially treated bacterial meningitis was made. The initial treatment with vancomycin and ceftriaxone, substituted on day 4 with meropenem, did not produce any clinical effect. On day 6 Listeria monocytogenes was isolated and, even as late as that, the administration of ampicillin was followed by complete recovery of the patient. Conclusion. In younger, immunocompetent individuals, in spite of the existent diagnostic and therapeutic problems, the subacute course of Listeria monocytogenes meningitis provides enough time for appropriate treatment and favorable disease outcome.

  10. Clinical outcome of pneumococcal meningitis during the emergence of pencillin-resistant Streptococcus pneumoniae: an observational study

    Directory of Open Access Journals (Sweden)

    Gouveia Edilane L

    2011-11-01

    Full Text Available Abstract Background Prior to the availability of generic third-generation cephalosporins, penicillins were widely used for treatment of pneumococcal meningitis in developing countries despite concerns about rising levels of penicillin resistance among pneumococcal isolates. We examined the impact of penicillin resistance on outcomes of pneumococcal meningitis over a ten year period in an infectious diseases hospital in Brazil. Methods Clinical presentation, antimicrobial therapy and outcomes were reviewed for 548 patients with culture-confirmed pneumococcal meningitis from December, 1995, to November, 2005. Pneumococcal isolates from meningitis patients were defined as penicillin-resistant if Minimum Inhibitory Concentrations for penicillin were greater than 0.06 μg/ml. Proportional hazards regression was used to identify risk factors for fatal outcomes. Results During the ten-year period, ceftriaxone replaced ampicillin as first-line therapy for suspected bacterial meningitis. In hospital case-fatality for pneumococcal meningitis was 37%. Of 548 pneumococcal isolates from meningitis cases, 92 (17% were resistant to penicillin. After controlling for age and severity of disease at admission, penicillin resistance was associated with higher case-fatality (Hazard Ratio [HR], 1.62; 95% Confidence Interval [CI], 1.08-2.43. Penicillin-resistance remained associated with higher case-fatality when initial therapy included ceftriaxone (HR, 1.68; 95% CI 1.02-2.76. Conclusions Findings support the use of third generation cephalosporin antibiotics for treatment of suspected pneumococcal meningitis even at low prevalence of pneumococcal resistance to penicillins.

  11. Characterisation of patients receiving moxifloxacin for acute bacterial rhinosinusitis in clinical practice: results from an international, observational cohort study.

    Directory of Open Access Journals (Sweden)

    Ralph Mösges

    Full Text Available We conducted a prospective, non-controlled, multi-centre Phase IV observational cohort study of patients with acute bacterial rhinosinusitis who were treated with moxifloxacin in clinical practice in 19 countries in Asia Pacific, Europe and the Middle East. With the data collected we evaluated the presentation and course of the current disease episode, particularly in terms of the principal clinical signs and symptoms of acute rhinosinusitis and diagnostic procedures. A final assessment of moxifloxacin therapy was made to evaluate the impact of the sinusitis episode on activities of daily life and on sleep disturbance, and to evaluate the clinical outcome of treatment. A total of 7,090 patients were enrolled, of whom 3909 (57.6% were included in the valid for clinical outcome and safety population. Regional differences were observed in the main symptoms of acute rhinosinusitis and, according to several characteristics, disease episodes appeared to be more severe in patients in Europe than in the Asia Pacific or Middle East regions. The sinusitis episode impacted on daily living for mean (SD periods of 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 days and disturbed sleep for 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 nights in the Asia Pacific, Europe and Middle East regions, respectively. With moxifloxacin treatment, the mean (SD time to improvement of symptoms was 3.0 (1.5, 3.4 (1.6 and 3.2 (1.5 days, and the time to resolution of symptoms was 4.8 (2.6 days, 5.7 (2.4 days and 5.5 (2.5 days, in the Asia Pacific, Europe and Middle East regions, respectively. In conclusion, acute rhinosinusitis remains a substantial health burden with significant impact on patients' quality of life, and there are differences between global regions in the clinical presentation, diagnosis and clinical course of disease episodes. Moxifloxacin was an effective and well-tolerated treatment option in the overall population.ClinicalTrials.gov Identifier: NCT00930488.

  12. 血清降钙素原在鉴别小儿不典型化脓性脑膜炎和病毒性脑炎的作用%Value of serum procalcitonin in differential diagnosis of atypical bacterial meningitis and viral encephalitis in children

    Institute of Scientific and Technical Information of China (English)

    马燕丽; 徐凯丽

    2012-01-01

    目的 对比血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞数(WBC)在鉴别不典型化脓性脑膜炎和病毒性脑炎中的价值.方法 把研究对象分为3组,分别为病毒性脑炎组(viral encephalitis)、不典型化脓性脑膜炎组(atypical bacterial meningitis)和典型化脓性脑膜炎组(typical bacterial meningitis),另选20名性别年龄匹配的正常儿童作为正常对照组(normal control group),分别测PCT值、CRP值和WBC值,各组指标比较应用独立样本t检验及卡方检验,并应用ROC曲线比较三者在鉴别病毒性脑炎和不典型化脓性脑膜炎的敏感性和特异性.结果 血清PCT在不典型化脓性脑膜炎、化脓性脑膜炎组与病毒性脑膜炎组、正常对照组之间差异有统计学意义;血清CRP在病毒性脑炎与化脓性脑膜炎之间差异有统计学意义,但在不典型化脓性脑膜炎与病毒性脑膜炎组之间差异无统计学意义;血清WBC在病毒性脑炎组和不典型化脓性脑膜炎组之间差异无统计学意义,但在典型化脓性脑膜炎组与病毒性脑膜炎组差异有统计学意义.不典型化脓性脑膜炎组与病毒性脑炎组中,PCT对不典型化脓性脑膜炎诊断的ROC曲线下面积93.9%,大于WBC和CRP.结论 不典型化脓性脑膜炎时,PCT升高,病毒性脑炎时PCT升高不明显.PCT在鉴别不典型化脓性脑膜炎和病毒性脑炎时有一定临床应用价值.

  13. Onkologisk behandling af meningeal carcinomatose

    DEFF Research Database (Denmark)

    Sulim, S.; Høyer, Morten

    2005-01-01

    Meningeal carcinomatosis (MC) occurs in 5-8% of cancer patients. In the       majority of cases, MC appears in patients with advanced disease. The       increase in incidence is probably caused by improved survival due to       improvements in systemic therapy and an increased awareness of MC among...

  14. Computed tomography in meningeal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, H.; Ono, N.; Horikoshi, S.; Uki, J.; Takeda, F. (Saitama Cancer Center (Japan))

    1982-04-01

    CT findings of meningeal carcinomatosis were studied in 17 patients (seven with lung cancer, two with breast cancer, one with gastric cancer, one with malignant melanoma, five with leukemia, and one with malignant lymphoma). The diagnosis was confirmed by a cytological survey of the cerebrospinal fluid and/or autopsy. Signs and symptoms caused by meningeal carcinomatosis at the CT examination varied from individual to individual. Those most frequently observed were signs of increased intracranial pressure, often accompanied by cranial nerve palsies, paresthesia, motor weakness, cerebellar signs, and nuchal stiffness, CT scan revealed evidence of meningeal carcinomatosis in ten cases out of the seventeen. CT evidences were obtained in 16.7% of the cases with hematologic malignancy and in 81.8% of those with non-hematologic malignancies. The CT findings of meningeal carcinomatosis may be summarized as follows: I. 1) Obliteration and narrowing of the cisterns and sulci, with contrast enhancement along them. 2) Enhanced spots/areas beneath the brain surface, with contrast enhancement. 3) Diffuse, slightly high density of the brain surface, with contrast enhancement. 4) Enhancement of the ventricular wall. 5) Hydrocephalus. II. 1) No CT abnormalities.

  15. Toll-like receptors 4 and 9 are responsible for the maintenance of the inflammatory reaction in canine steroid-responsive meningitis-arteritis, a large animal model for neutrophilic meningitis

    Directory of Open Access Journals (Sweden)

    Maiolini Arianna

    2012-09-01

    Full Text Available Abstract Background Steroid-responsive meningitis-arteritis (SRMA is a systemic inflammatory disease affecting young adult dogs and a potential large animal model for neutrophilic meningitis. Similarities between SRMA and infectious central nervous system (CNS diseases in lymphocyte subsets suggest an infectious origin. Toll-like receptors (TLRs are pattern recognition receptors playing an important role in innate immunity. Due to their ability to recognize both self and non-self antigens, we hypothesize that TLRs are among the key factors for the induction of the inflammatory process in SRMA and provide an indirect hint on the etiology of the disease. Methods The expression profile of cell surface TLRs (TLR2, TLR4 and TLR5 and intracellular TLRs (TLR3 and TLR9 of canine leukocytes was analyzed by immunophenotyping and subsequent flow cytometric measurements. Experiments were performed on cerebrospinal fluid (CSF and peripheral blood (PB samples of dogs affected with SRMA during the acute phase (n = 14 as well as during treatment (n = 23 and compared with those of dogs with bacterial meningitis (n = 3, meningoencephalitis of unknown etiology (n = 6, neoplasia of the central nervous system (n = 6 and a group of dogs with miscellaneous neurological diseases (n = 9. Two additional control groups consisted of dogs with pyogenic infections (n = 13 and of healthy dogs (n = 6. Results All examined groups showed a high percentage of TLR2, TLR4 and TLR5 positive PB polymorphonuclear cells (PMNs in comparison to healthy dogs. Very high values of TLR9 positive PB PMNs were detected in acute SRMA. Only a few similarities were found between SRMA patients and dogs with pyogenic infections, both groups were characterized by high expression of TLR4 positive PB monocytes. Glucocorticosteroid therapy reduced TLR2, TLR4 and TLR9 expression in PB monocytes. Conclusions A relatively high expression of TLR4 and TLR9 in acute SRMA

  16. Inflammatory markers following acute fuel oil exposure or bacterial lipopolysaccharide in mallard ducks (Anas platyrhynchos).

    Science.gov (United States)

    Lee, Kelly A; Tell, Lisa A; Mohr, F Charles

    2012-12-01

    Adult mallard ducks (Anas platyrhynchos) were orally dosed with bunker C fuel oil for 5 days, and five different inflammatory markers (haptoglobin, mannan-binding lectin, ceruloplasmin, unsaturated iron-binding capacity, and plasma iron) were measured in blood plasma prior to and 8, 24, 48, and 72 hr following exposure. In order to contrast the response to fuel oil with that of a systemic inflammatory response, an additional five ducks were injected intramuscularly with bacterial lipopolysaccharide (LPS). Oil-treated birds had an inflammatory marker profile that was significantly different from control and LPS-treated birds, showing decreases in mannan-binding lectin-dependent hemolysis and unsaturated iron-binding capacity, but no changes in any of the other inflammatory markers. Birds treated with oil also exhibited increased liver weights, decreased body and splenic weights, and decreased packed cell volume.

  17. Comparing Cerumen Bacterial Flora in Acute Otitis Externa Patients and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Keyvan Kiakojori

    2010-07-01

    Full Text Available Introduction: In spite of the fact that acute otitis media is a systemic and symptomatic disease with sever otalgia, otitis media with effusion (OME is an asymptomatic and silent disease. OME is the most common cause of conductive hearing loss in children and has adverse effects on speech development and cognitive skills. Results: Among 1001 children under study, 57 subjects (5.7% were diagnosed with OME, more than 50% of which were asymptomatic. Periodic otalgia and turning up television volume were the most common symptoms. Conclusion: Regarding the improved knowledge on diagnosis and treatment of OME especially in younger children, hearing problems or cognitive and linguistic skills retardation may be avoided by promoting general information.

  18. [Meningitis and encephalitis in Poland in 2006].

    Science.gov (United States)

    Kicman-Gawłowska, Agnieszka; Chrześcijańska, Irena; Stefanoff, Paweł

    2008-01-01

    In Poland, 3 693 cases of neuroinfections were reported in 2006, of which 989 had bacterial aetiology, 1 874--viral aetiology, and 512--other or unknown origin. The etiological agent was determined in 455 (46%) cases of bacterial neuroinfections. Among them Neisseria meningitidis was found in 148 cases, Haemophilus influenzae type B (Hib) in 39 cases and Streptococcus pneumoniae in 119 cases. An increasing trend in meningococcal infections incidence has been observed in 2006, and a substantial decrease of Hib incidence, related to increasing vaccination coverage. Viral neuroinfections incidence in 2006 increased compared to year 2005. Etiological factors of central nervous system aseptic infections were established only in minor proportion of cases--3% of meningitis and 20% of encephalitis. Among confirmed cases, there were 317 cases of tick-borne encephalitis and 31 cases of herpetic encephalitis. Tick borne encephalitis incidence increased in 2006 (0.83), compared to 2004 - 2005. Most of the cases were reported from endemic areas of north-eastern part of the country.

  19. Bacterial Superantigens Promote Acute Nasopharyngeal Infection by Streptococcus pyogenes in a Human MHC Class II-Dependent Manner

    Science.gov (United States)

    Kasper, Katherine J.; Zeppa, Joseph J.; Wakabayashi, Adrienne T.; Xu, Stacey X.; Mazzuca, Delfina M.; Welch, Ian; Baroja, Miren L.; Kotb, Malak; Cairns, Ewa; Cleary, P. Patrick; Haeryfar, S. M. Mansour; McCormick, John K.

    2014-01-01

    Establishing the genetic determinants of niche adaptation by microbial pathogens to specific hosts is important for the management and control of infectious disease. Streptococcus pyogenes is a globally prominent human-specific bacterial pathogen that secretes superantigens (SAgs) as ‘trademark’ virulence factors. SAgs function to force the activation of T lymphocytes through direct binding to lateral surfaces of T cell receptors and class II major histocompatibility complex (MHC-II) molecules. S. pyogenes invariably encodes multiple SAgs, often within putative mobile genetic elements, and although SAgs are documented virulence factors for diseases such as scarlet fever and the streptococcal toxic shock syndrome (STSS), how these exotoxins contribute to the fitness and evolution of S. pyogenes is unknown. Here we show that acute infection in the nasopharynx is dependent upon both bacterial SAgs and host MHC-II molecules. S. pyogenes was rapidly cleared from the nasal cavity of wild-type C57BL/6 (B6) mice, whereas infection was enhanced up to ∼10,000-fold in B6 mice that express human MHC-II. This phenotype required the SpeA superantigen, and vaccination with an MHC –II binding mutant toxoid of SpeA dramatically inhibited infection. Our findings indicate that streptococcal SAgs are critical for the establishment of nasopharyngeal infection, thus providing an explanation as to why S. pyogenes produces these potent toxins. This work also highlights that SAg redundancy exists to avoid host anti-SAg humoral immune responses and to potentially overcome host MHC-II polymorphisms. PMID:24875883

  20. Decompressive craniectomy and early cranioplasty in a 15-year-old boy with N. meningitidis meningitis

    Directory of Open Access Journals (Sweden)

    Julius Hoehne

    2015-01-01

    Conclusions: This unique report shows that decompressive craniotomy with duroplasty may be a crucial therapeutic approach in bacterial meningitis with refractory increased intracranial pressure and brainstem compression. Early cranioplasty with a patient-specific implant allowed the early and full reintegration of the patient.

  1. A Rare Complication of Trimethoprim-Sulfamethoxazole: Drug Induced Aseptic Meningitis.

    Science.gov (United States)

    Jha, Pinky; Stromich, Jeremiah; Cohen, Mallory; Wainaina, Jane Njeri

    2016-01-01

    Drug induced aseptic meningitis is a rare but challenging diagnosis, most commonly reported with nonsteroidal anti-inflammatory drugs and antibiotics. Trimethoprim/sulfamethoxazole is a sulfonamide that is widely used in clinical practice for the treatment and prophylaxis of various infections. Drug induced aseptic meningitis, when seen with trimethoprim/sulfamethoxazole, occurs predominantly in patients with some degree of immune compromise and is less commonly seen in immune competent individuals. The patient often exhibits the classic symptoms of meningitis. Early diagnosis is important, since the cessation of the antibiotic leads to rapid clinical improvement. Trimethoprim/sulfamethoxazole induced aseptic meningitis has been underreported to FDA/MED-WATCH program. Here we report two cases of trimethoprim/sulfamethoxazole: an immune competent individual and immune compromised individual, both of which presented with signs of meningitis and a negative infectious workup. Trimethoprim/sulfamethoxazole is an uncommon and mysterious adverse reaction to a commonly used antibiotic. It should be considered in the differential diagnosis of patients presenting with acute signs and symptoms of meningitis especially after infectious causes have been ruled out. PMID:27579194

  2. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases

    Directory of Open Access Journals (Sweden)

    Meintjes Graeme

    2010-03-01

    Full Text Available Abstract Background The presentation and causes of adult meningitis in South Africa have changed substantially as a result of HIV. Knowledge of aetiology and laboratory findings in patients presenting with meningitis are important in guiding management. We performed a retrospective study to determine these findings in a setting of high HIV and TB prevalence in Cape Town. Methods Patients undergoing lumbar punctures between 1st January 2006 and 31st December 2008 at a public sector referral hospital were studied. Cases were classified by microbiological diagnosis, or in the absence of definitive microbiology as 1 normal CSF (neutrophils ≤ 1 × 106/L, lymphocytes ≤ 5 × 106/L, protein ≤ 0.5 g/dL, glucose ≥1.5 mmol/L, 2 minor abnormalities (neutrophils 2-5, lymphocytes 6-20, protein 0.51-1.0, glucose 1.0-1.49 or 3 markedly abnormal (neutrophils>5, lymphocytes>20, protein>1.0, glucose Results 5578 LPs were performed on 4549 patients, representing 4961 clinical episodes. Of these, 2293 had normal CSF and 931 had minor abnormalities and no aetiology identified. Of the remaining 1737, microbiological diagnoses were obtained in 820 (47%. Cryptococcus accounted for 63% (514 of microbiological diagnoses, TB for 28% (227, bacterial meningitis for 8% (68. Of the remaining 917 who had marked abnormalities, the majority (59% had a sterile lymphocytic CSF. Of note 16% (81 patients with confirmed Cryptococcus, 5% (12 with TB and 4% (3 with bacterial meningitis had normal CSF cell-counts and biochemistry. Conclusions Cryptococcal and tuberculous meningitis are now the commonest causes of adult meningitis in this setting. TB meningitis is probably underdiagnosed by laboratory investigation, as evidence by the large numbers presenting with sterile lymphocytic markedly abnormal CSFs.

  3. Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the Literature.

    Science.gov (United States)

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

    2016-09-01

    Bacterial meningitis is a disease with a high morbidity and mortality. It may be caused by the zoonotic pathogen Capnocytophaga canimorsus, which is part of the commensal oral flora in dogs and cats. We report three cases of C. canimorsus meningitis in a nationwide cohort study of bacterial meningitis patients and performed a review of the literature. Three episodes of C. canimorsus meningitis were identified in three patients included in a nationwide cohort study from 2006 through 2014. The calculated annual incidence was 0.03 per million adults. When combined with the literature, 33 patients were identified of which 28 were male (85%). The median age was 63 years, and 13 (42%) were immunocompromised, which consisted of alcoholism in 7 (21%). Animal contact could be established in 29 of 30 patients (93%) and consisted of dog bites in 22 of 29 (76%). One patient died (3%) and 8 had neurological sequelae upon discharge (25%), most often hearing loss (n = 6, 19%). Capnocytophaga canimorsus meningitis is associated with dog bites. Although mortality is relatively low, survivors often have neurological sequelae. PMID:26693951

  4. Scrub typhus meningitis: An under-recognized cause of aseptic meningitis in India

    Directory of Open Access Journals (Sweden)

    Kundavaram Paul Prabhakar Abhilash

    2015-01-01

    Conclusions: In endemic regions, scrub typhus should be considered in the differential diagnosis of aseptic meningitis. Modest elevation of cells in the CSF with lymphocytic pleocytosis and multi-organ involvement may indicate scrub typhus meningitis/meningo-encephalitis.

  5. Complex Role of the Mitochondrial Targeting Signal in the Function of Steroidogenic Acute Regulatory Protein Revealed by Bacterial Artificial Chromosome Transgenesis in Vivo

    OpenAIRE

    Sasaki, Goro; Ishii, Tomohiro; Jeyasuria, Pancharatnam; Jo, Youngah; Bahat, Assaf; Orly, Joseph; Hasegawa, Tomonobu; Parker, Keith L.

    2008-01-01

    The steroidogenic acute regulatory protein (StAR) stimulates the regulated production of steroid hormones in the adrenal cortex and gonads by facilitating the delivery of cholesterol to the inner mitochondrial membrane. To explore key aspects of StAR function within bona fide steroidogenic cells, we used a transgenic mouse model to explore the function of StAR proteins in vivo. We first validated this transgenic bacterial artificial chromosome reconstitution system by targeting enhanced green...

  6. Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.

    Science.gov (United States)

    Jarrin, Irène; Sellier, Pierre; Lopes, Amanda; Morgand, Marjolaine; Makovec, Tamara; Delcey, Veronique; Champion, Karine; Simoneau, Guy; Green, Andrew; Mouly, Stéphane; Bergmann, Jean-François; Lloret-Linares, Célia

    2016-01-01

    Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or

  7. Mouse meninges isolation for FACS

    OpenAIRE

    sprotocols

    2014-01-01

    Authors: Noel Derecki & Jonathan Kipnis ### Abstract Presented is a method for removal of meninges from the brain and interior skull of the mouse yielding tissue suitable for preparing a single-cell suspension amenable to downstream applications such as flow cytometric analysis or short-term cell culture. ### Materials 1. Nembutal (or similar, as approved by your governing body) - Perfusion apparatus suitable for transcardial mouse perfusion - Perfusion Buffer (0.1M...

  8. Bacterial flora in the sputum and comorbidity in patients with acute exacerbations of COPD

    Directory of Open Access Journals (Sweden)

    Boixeda R

    2015-12-01

    Full Text Available Ramon Boixeda,1 Pere Almagro,2,3 Jesús Díez-Manglano,4 Francisco Javier Cabrera,5 Jesús Recio,6 Isabel Martin-Garrido,7 Joan B Soriano8On behalf of the COPD and Pluripathological Patients Groups of the Spanish Internal Medicine Society 1Internal Medicine Department, Hospital de Mataró – CSDM, Universitat Autònoma de Barcelona, Mataró, Barcelona, Spain; 2Internal Medicine Department, Hospital Mútua de Terrassa, Terrassa, 3Universitat de Barcelona, Barcelona, Spain; 4Internal Medicine Department, Hospital Royo Villanova, Zaragoza, Zaragoza, Spain; 5Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain; 6Internal Medicine Department, Hospital Vall d’Hebrón, Barcelona, Barcelona, Spain; 7Internal Medicine Department, Hospital Quirón San Camilo, Madrid, Madrid, Spain; 8Instituto de Investigación Hospital Universitario de la Princesa (IISP, Universidad Autónoma de Madrid, Cátedra UAM-Lindel, Madrid, Spain Objective: To determine in patients admitted with an acute exacerbation of chronic obstructive pulmonary disease (AE-COPD the association between the isolation of potential pathogens in a conventional sputum culture and comorbidities.Patients and methods: The ESMI study is a multicenter observational study. Patients with AE-COPD admitted to the Internal Medicine departments of 70 hospitals were included. The clinical characteristics, treatments, and comorbidities were gathered. The results of conventional sputum cultures were recorded.Results: A total of 536 patients were included, of which 161 produced valid sputum and a potentially pathogenic microorganism was isolated from 88 subjects (16.4%. The isolation of Pseudomonas aeruginosa (30.7% was associated with a greater severity of the lung disease (previous admissions [P= 0.026], dyspnea scale [P=0.047], post-broncodilator forced expiratory volume in 1 second (FEV1 [P=0.005], and the BODEx index [P=0.009]; also with

  9. Echovirus 18 meningitis in southern Taiwan.

    Science.gov (United States)

    Wang, Shih-Min; Ho, Tzong-Shiann; Shen, Ching-Fen; Wang, Jen-Ren; Liu, Ching-Chuan

    2011-03-01

    Eighty cases of echovirus 18 infection among young children during an outbreak in 2006 in Taiwan were enrolled. Twenty percent of the patients had a comorbid condition. Twenty-five cases (31%) were complicated by aseptic meningitis. The most frequent diagnoses in children without meningitis were pharyngitis/tonsillitis (35%) and vesicular viral exanthem (33%). The case-fatality rate among the children with meningitis was 4%. Echovirus 18 was isolated from the cerebrospinal fluid of 68% of the children.

  10. Functional polymorphisms of macrophage migration inhibitory factor as predictors of morbidity and mortality of pneumococcal meningitis

    Science.gov (United States)

    Savva, Athina; Brouwer, Matthijs C.; Valls Serón, Mercedes; Le Roy, Didier; Ferwerda, Bart; van der Ende, Arie; Bochud, Pierre-Yves; van de Beek, Diederik; Calandra, Thierry

    2016-01-01

    Pneumococcal meningitis is the most frequent and critical type of bacterial meningitis. Because cytokines play an important role in the pathogenesis of bacterial meningitis, we examined whether functional polymorphisms of the proinflammatory cytokine macrophage migration inhibitory factor (MIF) were associated with morbidity and mortality of pneumococcal meningitis. Two functional MIF promoter polymorphisms, a microsatellite (−794 CATT5–8; rs5844572) and a single-nucleotide polymorphism (−173 G/C; rs755622) were genotyped in a prospective, nationwide cohort of 405 patients with pneumococcal meningitis and in 329 controls matched for age, gender, and ethnicity. Carriages of the CATT7 and −173 C high-expression MIF alleles were associated with unfavorable outcome (P = 0.005 and 0.003) and death (P = 0.03 and 0.01). In a multivariate logistic regression model, shock [odds ratio (OR) 26.0, P = 0.02] and carriage of the CATT7 allele (OR 5.12, P = 0.04) were the main predictors of mortality. MIF levels in the cerebrospinal fluid were associated with systemic complications and death (P = 0.0002). Streptococcus pneumoniae strongly up-regulated MIF production in whole blood and transcription activity of high-expression MIF promoter Luciferase reporter constructs in THP-1 monocytes. Consistent with these findings, treatment with anti-MIF immunoglogulin G (IgG) antibodies reduced bacterial loads and improved survival in a mouse model of pneumococcal pneumonia and sepsis. The present study provides strong evidence that carriage of high-expression MIF alleles is a genetic marker of morbidity and mortality of pneumococcal meningitis and also suggests a potential role for MIF as a target of immune-modulating adjunctive therapy. PMID:26976591

  11. 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.)

  12. Recurrent meningitis due to Salmonella enteritidis: A case report from Kashmir India

    Directory of Open Access Journals (Sweden)

    B A Fomda

    2012-01-01

    Full Text Available Recurrent bacterial meningitis in children is potentially life-threatening and induces psychological trauma to the patients through repeated hospitalization. Here we report a case of recurrent meningitis in a one month old baby. The CSF and blood culture grew Salmonella enteritidis. Injection ciprofloxacin and ceftriaxone were given for 3 weeks. Baby became symptomatically better and was afebrile at discharge. Twenty eight days after discharge baby got readmitted with complaints of fever and refusal of feeds. Blood and CSF culture again showed growth of Salmonella enteritidis. Physicians should be educated about the possibility of recurrence which may occur days or even weeks after apparent successful antibiotic treatment.

  13. From suspected Creutzfeldt-Jakob disease to confirmed histoplasma meningitis.

    Science.gov (United States)

    Batra, Vivek; Khararjian, Armen; Wheat, Joseph; Zhang, Sean X; Crain, Barbara; Baras, Alexander

    2016-01-01

    A 77-year-old man with chronic obstructive lung disease who was on steroids, presented to the hospital after a fall with subacute headaches and ataxia. During the patient's hospital course, his clinical condition deteriorated with myoclonic jerks, fevers and severe encephalopathy. An extensive workup, including EEG, brain MRI and lumbar puncture, revealed possible Creutzfeldt-Jakob disease. Unfortunately, the patient failed to improve and died 12 days after admission. A brain-only autopsy revealed he had acute histoplasma meningitis with patchy superficial cerebritis. PMID:27389723

  14. Salmonella Enterica Serotype Enteritidis Vertebral Osteomyelitis and Epidural Abscess Complicated with Meningitis.

    Science.gov (United States)

    Oki, Masayuki; Ueda, Akihiro; Tsuda, Ayumi; Yanagi, Hidetaka; Ozawa, Hideki; Takagi, Atsushi

    2016-01-01

    Infection with non-typhoidal Salmonella often results in a self-limited acute gastroenteritis. Extra-intestinal Salmonella infection is relatively rare and occurs predominantly in infants and adults with significant underlying conditions. We describe a 54-year-old Japanese man with a history of heavy alcohol consumption and daily contact with a dog, who developed bacteremia complicated by vertebral osteomyelitis, spinal epidural abscess, and meningitis, due to Salmonella enterica serotype Enteritidis. This case suggests that Salmonella should be considered as an etiologic pathogen in adult patients with perivertebral infection or meningitis. PMID:27628612

  15. Development of a real-time PCR method for the detection of bacterial colonization in rat models of severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    PENG Jun-sheng; LIU Zhong-hui; LI Chu-jun; WU Xiao-bin; DIAO De-chang; DU Yan-ping; CHEN Jun-rong; LI Yun; WANG Hua-she

    2010-01-01

    Background Techniques for the fast and accurate detection of bacterial infection are critical for early diagnosis, prevention and treatment of bacterial translocation in clinical severe acute pancreatitis (SAP). In this study, the availability of a real-time PCR method in detection of bacterial colonization in SAP rat models was investigated.Methods Samples of blood, mesenteric lymph nodes (MLN), pancreas and liver from 24 specific pathogen-free rats (8 in a control group, 16 in a SAP group) were detected for bacterial infection rates both by agar plate culture and a real-time PCR method, and the results were made contrast.Results Bacterial infection rates of the blood, MLN, pancreas and liver in the SAP group and the control group by the two different methods were almost the same, which were 5/16, 12/16, 15/16, 12/16 in the SAP group compared with 0/8, 1/8, 0/8, 0/8 in the control group by agar plate culture, while 5/16, 10/16, 13/16, 12/16 and 0/8, 1/8, 0/8, 0/8 respectively by a real-time PCR method. Bacterial number was estimated by real-time PCR, which showed that in the same mass of tissues, the pancreas contained more bacteria than the other three kinds of organs in SAP rats (P <0.01), that may be due to the edema, necrosis and hemorrhage existing in the pancreas, making it easier for bacteria to invade and breed.Conclusion Fast and accurate detection of bacterial translocation in SAP rat models could be carried out by a real-time PCR procedure.

  16. Refractory status epilepticus due to pneumococcal meningitis in an infant with congenital immunodeficiency.

    Science.gov (United States)

    Prasanth, Sudhakaran; Shaji, Velayudhan Cheruvallil; Lyla, Chacko; Jayalakshmi, Vasudevapanicker

    2016-01-01

    Pneumococcal meningitis remains a life-threatening infection, with varied presentations. A 3 month-old-baby with pneumococcal meningitis presented with clusters of seizures evolving into refractory status epilepticus despite standard antibiotic and aggressive anticonvulsant therapy. Progressive illness despite antibiotic initially suggested possible antibiotic resistance and resulted in addition of another antibiotic. Nonresponse to standard treatment and previous history of abscess in the back of neck pointed to some underlying congenital immunodeficiency. Further evaluation showed a deficiency of complement factor C3. This case underlines the need to consider underlying immunodeficiency in cases of refractory status epilepticus due to bacterial meningitis. Gram-staining of cerebrospinal fluid sample showing plenty of Gram-positive bacteria and comparatively fewer pus cells is a clue regarding some underlying immunodeficiency. PMID:27606021

  17. Refractory status epilepticus due to pneumococcal meningitis in an infant with congenital immunodeficiency

    Directory of Open Access Journals (Sweden)

    Sudhakaran Prasanth

    2016-01-01

    Full Text Available Pneumococcal meningitis remains a life-threatening infection, with varied presentations. A 3 month-old-baby with pneumococcal meningitis presented with clusters of seizures evolving into refractory status epilepticus despite standard antibiotic and aggressive anticonvulsant therapy. Progressive illness despite antibiotic initially suggested possible antibiotic resistance and resulted in addition of another antibiotic. Nonresponse to standard treatment and previous history of abscess in the back of neck pointed to some underlying congenital immunodeficiency. Further evaluation showed a deficiency of complement factor C3. This case underlines the need to consider underlying immunodeficiency in cases of refractory status epilepticus due to bacterial meningitis. Gram-staining of cerebrospinal fluid sample showing plenty of Gram-positive bacteria and comparatively fewer pus cells is a clue regarding some underlying immunodeficiency.

  18. Refractory status epilepticus due to pneumococcal meningitis in an infant with congenital immunodeficiency

    Science.gov (United States)

    Prasanth, Sudhakaran; Shaji, Velayudhan Cheruvallil; Lyla, Chacko; Jayalakshmi, Vasudevapanicker

    2016-01-01

    Pneumococcal meningitis remains a life-threatening infection, with varied presentations. A 3 month-old-baby with pneumococcal meningitis presented with clusters of seizures evolving into refractory status epilepticus despite standard antibiotic and aggressive anticonvulsant therapy. Progressive illness despite antibiotic initially suggested possible antibiotic resistance and resulted in addition of another antibiotic. Nonresponse to standard treatment and previous history of abscess in the back of neck pointed to some underlying congenital immunodeficiency. Further evaluation showed a deficiency of complement factor C3. This case underlines the need to consider underlying immunodeficiency in cases of refractory status epilepticus due to bacterial meningitis. Gram-staining of cerebrospinal fluid sample showing plenty of Gram-positive bacteria and comparatively fewer pus cells is a clue regarding some underlying immunodeficiency.

  19. Severe hyponatremia and MRI point to diagnosis of tuberculous meningitis in the Southwest USA.

    Science.gov (United States)

    Benson, Stephanie Michelle; Narasimhamurthy, Rashmi

    2013-01-01

    A 21-year-old woman presented to the hospital with 3 days of headache, fever, mood disturbance and nausea. She had recently emigrated from India, and was noted to have a positive screening purified protein derivative tuberculosis skin test with normal chest x-ray. Meningeal signs were noted prompting lumbar puncture and initiation of presumptive treatment for bacterial meningitis. While tuberculous meningitis (TM) was entertained at admission, diagnosis was clouded by the rapid onset of symptoms and recent major psychosocial stressors. She developed severe hyponatremia. Brain MRI revealed tuberculomas, and she was started on treatment for TM, a diagnosis confirmed by culture. On review, several lessons were learned: (1) globalisation of society makes uncommon diagnoses present in unlikely locations, (2) hyponatremia is a common complication of TM, (3) MRI can aid in diagnosis of TM and (4) cognitive and mood changes can be prodromal symptoms of TM.

  20. Japanese Encephalitis Virus in Meningitis Patients, Japan

    OpenAIRE

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

    2005-01-01

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

  1. Meteorological influences on the interannual variability of meningitis incidence in northwest Nigeria.

    Science.gov (United States)

    Abdussalam, Auwal; Monaghan, Andrew; Dukic, Vanja; Hayden, Mary; Hopson, Thomas; Leckebusch, Gregor

    2013-04-01

    Northwest Nigeria is a region with high risk of bacterial meningitis. Since the first documented epidemic of meningitis in Nigeria in 1905, the disease has been endemic in the northern part of the country, with epidemics occurring regularly. In this study we examine the influence of climate on the interannual variability of meningitis incidence and epidemics. Monthly aggregate counts of clinically confirmed hospital-reported cases of meningitis were collected in northwest Nigeria for the 22-year period spanning 1990-2011. Several generalized linear statistical models were fit to the monthly meningitis counts, including generalized additive models. Explanatory variables included monthly records of temperatures, humidity, rainfall, wind speed, sunshine and dustiness from weather stations nearest to the hospitals, and a time series of polysaccharide vaccination efficacy. The effects of other confounding factors -- i.e., mainly non-climatic factors for which records were not available -- were estimated as a smooth, monthly-varying function of time in the generalized additive models. Results reveal that the most important explanatory climatic variables are mean maximum monthly temperature, relative humidity and dustiness. Accounting for confounding factors (e.g., social processes) in the generalized additive models explains more of the year-to-year variation of meningococcal disease compared to those generalized linear models that do not account for such factors. Promising results from several models that included only explanatory variables that preceded the meningitis case data by 1-month suggest there may be potential for prediction of meningitis in northwest Nigeria to aid decision makers on this time scale.

  2. 石家庄地区急性细菌性结膜炎致病菌分析%ANALYSIS ABOUT BACTERIAL SPECTRUM IN ACUTE BACTERIAL CONJUNCTIVITIS OF SHIJIAZHUANG DISTRICT

    Institute of Scientific and Technical Information of China (English)

    张荣霞; 史素恩; 孙鹏; 吴静; 郭春莲

    2014-01-01

    ABSTRACT:Objective To provide reasonable clinical treatments for acute bacterial conjunctivitis by exploring the bacterial spectrum and sensitive changes in Shijiazhuang district. Methods Secretion specimens were cultured before treatment in all 358 eyes of 358 patients with acute bacterial conjunctivitis.The sensitivity test was done at the same time.Other papers about this subject were also searched to enhance this analysis.Results The top five bacteria tested were below: Staphylococcus epidermidais,Staphylococcus saprophyticus,Staphylococcus aureus, Klebsierlla penmoniae and Escherchia Coli.They are the primary bacteria leading to acute bacteria conjunctivitis in Shijiazhuang district.Most bacteria were sensitive to Gatifloxacin,Levofloxacin and Ciprofloxacin but resistant to Chloromycetin,Erythromycin and Tobramycin.Conclusion Staphylococcus epidermidais is the leading bacteria to acute bacterial conjunctivitis in Shijiazhuang district currently.Selecting availably antibiotics drops is important in clinical work.%目的:了解石家庄地区急性细菌性结膜炎致病菌种类及耐药情况,探索本地区急性细菌性结膜炎致病菌演变过程,为该疾病的合理用药提供依据。方法对358例(358眼)急性细菌性结膜炎患者结膜囊分泌物进行细菌培养和药敏试验,并结合其他关于本地区急性细菌性结膜炎的文献加以分析。结果石家庄地区急性细菌性结膜炎致病菌前5位依次为表皮葡萄球菌、金黄色葡萄球菌、腐生葡萄球菌、肺炎克雷伯杆菌、大肠埃希菌。大多数致病菌对加替沙星、左氧氟沙星、环丙沙星敏感,对氯霉素、红霉素、妥布霉素耐药。结论表皮葡萄球菌已成为石家庄地区急性细菌性结膜炎的首要致病菌,在临床工作中应有针对性选择有效抗生素进行治疗。

  3. 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.

  4. C-REACTIVE PROTEIN AND LACTATE DEHYDROGENASE IN SERUM AND CEREBROSPINAL FLUID IN RAPID AND EARLY DIAGNOSIS OF CHILDHOOD MENINGITIS

    Directory of Open Access Journals (Sweden)

    F. Jadali MD,

    2007-08-01

    Full Text Available ObjectiveBacterial meningitis is still a life threatening epidemiological problem especiallyin many developing countries; considering its dire consequences, its promptand accurate diagnosis has become a priority for clinicians. Because of thevarious limitations of conventionally used laboratory techniques, we evaluatedand compared the diagnostic utility of C-reactive protein(CRP and lactatedehydrogenase (LDHin serum and cerebrospinal fluid (CSFin the diagnosisof bacterial meningitis and its effectivity in distinguishing it from asepticmeningitis (AP.Material and MethodsA total of 125 pediatric cases, aged between 1 month and 12 years, includingpatients with bacterial meningitis (n=45, aseptic meningitis (n=42 and acontrol group (n=38, were retrospectively analyzed on the basis of datafrom the initial clinical examinations. Cultures, smears and other commonserum and CSF indices were compared with serum and CSF CRP levels andLDH activity.ResultsCompared with each of the other variables, there were significant differencesin the mean values of serum-CRP, CSF-glucose, CSF-LDH and CSF/serumLDH ratio between the bacterial and aseptic meningitis groups (p<0.001.Of all the tests applied, the highest sensitivity (95% and negative predictivevalue (95% belonged to CSF-LDH activity and the most specific (100% testwith the highest positive predictive value (100% was CSF-CRP titration aswell as smear and culture. Combination of CSF-CRP serum-CRP, and CSFLDHyielded the highest sensitivity (100% and negative predictive value butthe combined application of CSF-LDH and CSF-CRP proved to be the mostspecific and efficient.ConclusionIn the presence of a normal CRP titration and low glucose level in CSF,bacterial meningitis is excluded, whereas elevated level of CSF-LDH activityis a valid confirmatory predictor of BM. In addition, combination of thesethree tests with serum CRP is far more effective than the separate determinationof any of these parameters.

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

    Directory of Open Access Journals (Sweden)

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

    2012-01-01

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

  6. Clinical aspects of acute inflammatory diseases of the brain; Klinisch-neurologische Aspekte akut-entzuendlicher Hirnerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Block, F.; Nolden-Koch, M. [RWTH Aachen (Germany). Neurologische Klinik

    2000-11-01

    Despite the progress, which has been made in diagnosis and therapy of encephalitis and bacterial meningitis, these acute inflammatory diseases of the brain still display a certain amount of morbidity and mortality. History, physical examination, analysis of serum and cerebrospinal fluid and radiological examination are the mainstay for the diagnosis of these diseases. With respect to the acute inflammatory diseases of the brain computed tomography and magnetic resonance imaging fulfil three purposes: 1. They can be used to clarify the diagnosis and to rule out other diseases. 2. They can identify the focus from which a bacterial meningitis can evolve. 3. Complications like edema, cerebral vasculitis, septic sinus thrombosis, hydrocephalus or abscess can be visualized. If the diagnosis is made early, the possible complications are recognized in good time and the appropriate therapy is started immediately, then morbidity and mortality can be kept at a minimum. (orig.) [German] Die bakterielle Meningitis und die Enzephalitis sind akut-entzuendliche Hirnerkrankungen, die trotz aller Fortschritte in der Diagnostik und Therapie mit einer nicht unerheblichen Morbiditaet und Mortalitaet behaftet sind. Die Anamnese, die koerperliche Untersuchung, die laborchemische Diagnostik von Blut und Liquor und die Bildgebung sind die wesentlichen Saeulen in der Diagnostik akut-entzuendlicher Hirnerkrankungen. Die Bildgebung, die mittels Computertomographie bzw. Kernspintomographie erfolgt, hat in diesem Zusammenhang 3 Aufgaben: 1. Sie kann dazu beitragen, die Diagnose zu sichern bzw. differentialdiagnostisch in Erwaegung zu ziehende Erkrankungen auszuschliessen oder nachzuweisen. 2. Sie kann bei der bakteriellen Meningitis entzuendliche Foci im Bereich der Nasennebenhoehlen, des Mastoids oder des Mittelohrs erkennen, die sofort operativ saniert werden muessen. 3. Komplikationen akut-entzuendlicher Hirnerkrankungen koennen bei entsprechendem klinischem Verdacht mittels Bildgebung

  7. In Brief: Forecasting meningitis threats

    Science.gov (United States)

    Showstack, Randy

    2008-12-01

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

  8. Two cases of rheumatoid meningitis.

    Science.gov (United States)

    Magaki, Shino; Chang, Edward; Hammond, Robert R; Yang, Isaac; Mackenzie, Ian R A; Chou, Benedict T; Choi, Soo I; Jen, Joanna C; Pope, Whitney B; Bell, David A; Vinters, Harry V

    2016-02-01

    Central nervous system (CNS) involvement by rheumatoid arthritis (RA) in the form of rheumatoid meningitis (RM) is rare and most commonly occurs in the setting of longstanding severe RA. Due to a wide range of clinical presentations and nonspecific laboratory findings, it presents a diagnostic challenge often requiring brain biopsy. Only a few histopathologically confirmed cases have been described in the literature. Our aim is to describe two cases of RM and review the literature. The first case is of a previously healthy 37-year-old man who presented with severe headaches and focal neurologic deficits. Magnetic resonance imaging demonstrated abnormal leptomeningeal enhancement in the left frontal and parietal sulci. The second case is of a 62-year-old woman with a history of mild chronic joint pain who presented with confusion, personality changes and seizures. Both patients ultimately underwent brain biopsy which demonstrated RM on pathologic examination. Administration of corticosteroids resulted in significant clinical improvement in both cases. To our knowledge, our unusual case of RM in the young man is the fifth reported case of rheumatoid meningitis in a patient with no prior history of RA. Such an atypical presentation makes diagnosis even more difficult and highlights the need for awareness of this entity in the diagnostic consideration of a patient presenting with unexplained neurologic symptoms. Our literature review underscores the clinical and pathologic heterogeneity of CNS involvement in RA.

  9. Frequency of Meningitis in Children Presenting with Febrile Seizures at Ali- Asghar Children’s Hospital

    Directory of Open Access Journals (Sweden)

    Azita TAVASOLI

    2014-12-01

    Full Text Available How to Cite This Article: Tavasoli A, Afsharkhas L, Edraki A. Frequency of Meningitis in Children Presenting with Febrile Seizure in Ali-Asghar Children’s Hospital. Iran J Child Neurol. 2014 Autumn; 8(4:51-56.AbstractObjectiveFebrile seizures (FS are the most common type of childhood seizures, affecting 2–5% of children. As the seizure may be the sole presentation of bacterial meningitis in febrile infants, it is mandatory to exclude underlying meningitis in children presenting with fever and seizure. To determine the frequency of meningitis in children with FS and related risk factors, the present study was conducted at Ali-Asghar Children’s Hospital.Materials & MethodsThe records of children aged from 1-month–6 years of age with fever and seizure admitted to the hospital from October 2000–2010 were studied. The charts of patients who had undergone a lumbar puncture were studied and cases of meningitis were selected. The related data was collected and analyzed with SPSS version 16.ResultsA total of 681 patients with FS were known from which 422 (62% lumbar punctures (LP were done. Meningitis (bacterial or aseptic was identified in 19 cases (4.5%, 95% CI 2.9–6.9 by Wilson- Score internal and bacterial meningitis in 7 (1.65%, 95% CI 0.8–3.3. None of the patients with bacterial meningitis had meningeal irritation signs. Complex FS, first attack of FS, and impaired consciousness were more common in patients with meningitis when compared to non- meningitis patients.ConclusionMeningitis is more common in patients less than 18 months presenting with FS; however, complex features of seizures, first attack of FS, or impaired consciousness seem significant risk factors for meningitis in these children and an LP should be considered in this situation. ReferencesKimia A, Ben-Joseph EP, Rudleo T, et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics.2010; 126: 62

  10. Eradication of common pathogens at days 2, 3 and 4 of moxifloxacin therapy in patients with acute bacterial sinusitis

    Directory of Open Access Journals (Sweden)

    Benson Alice

    2006-04-01

    Full Text Available Abstract Background Acute bacterial sinusitis (ABS is a common infection in clinical practice. Data on time to bacteriologic eradication after antimicrobial therapy are lacking for most agents, but are necessary in order to optimize therapy. This was a prospective, single-arm, open-label, multicenter study to determine the time to bacteriologic eradication in ABS patients (maxillary sinusitis treated with moxifloxacin. Methods Adult patients with radiologically and clinically confirmed ABS received once-daily moxifloxacin 400 mg for 10 days. Middle meatus secretion sampling was performed using nasal endoscopy pre-therapy, and repeated on 3 consecutive days during treatment. Target enrollment was 30 bacteriologically evaluable patients (pre-therapy culture positive for Streptococcus pneumoniae, Haemophilus influenzae or Moraxella catarrhalis and evaluable cultures for at least Day 2 and Day 3 during therapy visits, including at least 10 each with S. pneumoniae or H. influenzae. Results Of 192 patients enrolled, 42 were bacteriologically evaluable, with 48 pathogens isolated. Moxifloxacin was started on Day 1. Baseline bacteria were eradicated in 35/42 (83.3% patients by day 2, 42/42 (100% patients by day 3, and 41/42 (97.6% patients by day 4. In terms of individual pathogens, 12/18 S. pneumoniae, 22/23 H. influenzae and 7/7 M. catarrhalis were eradicated by day 2 (total 41/48; 85.4%, and 18/18 S. pneumoniae and 23/23 H. influenzae were eradicated by day 3. On Day 4, S. pneumoniae was isolated from a patient who had negative cultures on Days 2 and 3. Thus, the Day 4 eradication rate was 47/48 (97.9%. Clinical success was achieved in 36/38 (94.7% patients at the test of cure visit. Conclusion In patients with ABS (maxillary sinusitis, moxifloxacin 400 mg once daily for 10 days resulted in eradication of baseline bacteria in 83.3% of patients by Day 2, 100% by Day 3 and 97.6% by Day 4.

  11. Blocking of leukocyte accumulation in the cerebrospinal fluid augments bacteremia and increases lethality in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian T; Lundgren, Jens D; Frimodt-Møller, Niels;

    2005-01-01

    The role of leukocyte accumulation in the cerebrospinal fluid (CSF) in the evolution of the pathophysiological changes that occur in bacterial meningitis is unclear. Here, we investigate how leukocyte recruitment to the CSF, modulated by the leukocyte blocker fucoidin, affects the extent of brain......, blocking leukocyte entry to the central nervous system in experimental pneumococcal meningitis compromises the survival prognosis but does not affect the risk of brain damage or level of infection in this compartment. Conversely, poorer prognosis was associated with an increase in bacterial load in blood...... damage and outcome in pneumococcal meningitis in rats treated with ceftriaxone from 28 h after infection. Rats treated with fucoidin from time of infection had an excess risk of a fatal outcome compared to rats not receiving fucoidin (25/63 versus 5/34, p=0.012), whereas the risk of cortical damage...

  12. [Empirical therapeutic approach to infection by resistant gram positive (acute bacterial skin and skin structure infections and health care pneumonia). Value of risk factors].

    Science.gov (United States)

    González-DelCastillo, J; Núñez-Orantos, M J; Candel, F J; Martín-Sánchez, F J

    2016-09-01

    Antibiotic treatment inadequacy is common in these sites of infection and may have implications for the patient's prognosis. In acute bacterial skin and skin structure infections, the document states that for the establishment of an adequate treatment it must be assessed the severity, the patient comorbidity and the risk factors for multidrug-resistant microorganism. The concept of health care-associated pneumonia is discussed and leads to errors in the etiologic diagnosis and therefore in the selection of antibiotic treatment. This paper discusses how to perform this approach to the possible etiology to guide empirical treatment. PMID:27608306

  13. 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.

  14. 人造电子耳蜗植入者有患脑膜炎的危险%Cochlear implant recipients at risk for meningitis

    Institute of Scientific and Technical Information of China (English)

    Eric Wooltorton; 农东晓

    2004-01-01

    Cochlear implants are electronic devices that allow sound perception in some people with profound sensorineural deafhess. The US Food and Drug Administration (FDA) recently identified a possible association between cochlear implants and bacterial meningitis in 52 people worldwide. The meningitis occurred in children and adults aged 21 months to 72 years and included 12 deaths. The onset of meningitis symptoms ranged from less than 24 hours to more than 5 years after insertion of the implant, and most of the organisms isolated in 14 cases were Streptococcus pneuraoniae. Vaccination histories against pneumococcus were known for 6 of the individuals, and none had been vaccinated.

  15. Chronic Meningitis: Simplifying a Diagnostic Challenge.

    Science.gov (United States)

    Baldwin, Kelly; Whiting, Chris

    2016-03-01

    Chronic meningitis can be a diagnostic dilemma for even the most experienced clinician. Many times, the differential diagnosis is broad and encompasses autoimmune, neoplastic, and infectious etiologies. This review will focus on a general approach to chronic meningitis to simplify the diagnostic challenges many clinicians face. The article will also review the most common etiologies of chronic meningitis in some detail including clinical presentation, diagnostic testing, treatment, and outcomes. By using a case-based approach, we will focus on the key elements of clinical presentation and laboratory analysis that will yield the most rapid and accurate diagnosis in these complicated cases.

  16. A Vignette-Based Survey to Assess Clinical Decision Making Regarding Antibiotic Use and Hospitalization of Patients with Probable Aseptic Meningitis

    Directory of Open Access Journals (Sweden)

    Glenn Patriquin

    2012-01-01

    Full Text Available BACKGROUND: The many etiologies of meningitis influence disease severity – most viral causes are self-limiting, while bacterial etiologies require antibiotics and hospitalization. Aided by laboratory findings, the physician judges whether to admit and empirically treat the patient (presuming a bacterial cause, or to treat supportively as if it were viral.

  17. Meningitis Caused by Candida Dubliniensis in a Patient with Cirrhosis: A Case Report and Review of the Literature.

    Science.gov (United States)

    Yamahiro, Atsuko; Lau, K H Vincent; Peaper, David R; Villanueva, Merceditas

    2016-08-01

    Candida species, including Candida dubliniensis, are a rare cause of meningitis. Herein, we report the second case of C. dubliniensis meningitis in a 49-year-old man with a history of hepatitis C virus-related cirrhosis, substance use disorder, and recent exposure to intravenous antibiotic therapy, presenting with confusion, abnormal gait, and urinary incontinence. Magnetic resonance imaging (MRI) of the brain showed marked hydrocephalus and leptomeningeal enhancement. Initial cerebrospinal fluid (CSF) studies were concerning for bacterial meningitis, although cultures were negative. Despite empiric treatment with broad-spectrum antibiotics, the patient's mental status declined. The diagnosis of C. dubliniensis meningitis was not made until the third lumbar puncture. The patient was treated with liposomal amphotericin B and flucytosine. Despite improvement of hydrocephalus on MRI of the brain and sterilization of CSF, the patient's mental status declined and he expired. This case highlights the difficulty in the diagnosis of C. dubliniensis meningitis as multiple lumbar punctures may be necessary. C. dubliniensis meningitis should be considered in the differential diagnosis for a patient with risk factors such as end-stage liver disease, human immunodeficiency virus infection, recent chemotherapy, substance use disorders, and recent broad-spectrum antibiotic use. A high index of suspicion is necessary as delay in initiation of therapy is associated with high mortality. The optimal treatment strategy has not been determined. PMID:27038312

  18. MR angiography in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-15

    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

  19. Meningitis caused by Neisseria Meningitidis, Hemophilus Influenzae Type B and Streptococcus Pneumoniae during 2005–2012 in Turkey

    Science.gov (United States)

    Ceyhan, Mehmet; Gürler, Nezahat; Ozsurekci, Yasemin; Keser, Melike; Aycan, Ahmet Emre; Gurbuz, Venhar; Salman, Nuran; Camcioglu, Yildiz; Dinleyici, Ener Cagri; Ozkan, Sengul; Sensoy, Gulnar; Belet, Nursen; Alhan, Emre; Hacimustafaoglu, Mustafa; Celebi, Solmaz; Uzun, Hakan; Faik Oner, Ahmet; Kurugol, Zafer; Ali Tas, Mehmet; Aygun, Denizmen; Oncel, Eda Karadag; Celik, Melda; Yasa, Olcay; Akin, Fatih; Coşkun, Yavuz

    2014-01-01

    Successful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. Cerebrospinal fluid (CSF) samples were obtained prospectively from children from 1 month to ≤ 18 years of age hospitalized with suspected meningitis, in order to determine the etiology of meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Hemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total, 1452 CSF samples were evaluated and bacterial etiology was determined in 645 (44.4%) cases between 2005 and 2012; N. meningitidis was detected in 333 (51.6%), S. pneumoniae in 195 (30.2%), and Hib in 117 (18.1%) of the PCR positive samples. Of the 333 N. meningitidis positive samples 127 (38.1%) were identified as serogroup W-135, 87 (26.1%) serogroup B, 28 (8.4%) serogroup A and 3 (0.9%) serogroup Y; 88 (26.4%) were non-groupable. As vaccines against the most frequent bacterial isolates in this study are available and licensed, these results highlight the need for broad based protection against meningococcal disease in Turkey. PMID:25483487

  20. Blocking of leukocyte accumulation in the cerebrospinal fluid augments bacteremia and increases lethality in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian T; Lundgren, Jens D; Frimodt-Møller, Niels;

    2005-01-01

    The role of leukocyte accumulation in the cerebrospinal fluid (CSF) in the evolution of the pathophysiological changes that occur in bacterial meningitis is unclear. Here, we investigate how leukocyte recruitment to the CSF, modulated by the leukocyte blocker fucoidin, affects the extent of brain...