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Sample records for bacterial meningitis clinical

  1. 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, ...

  2. Meningitis bacteriana Bacterial meningitis

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    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

  3. 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

  4. 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...

  5. Seizures Complicating Bacterial Meningitis

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    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.

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

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    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.

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

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    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.

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

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    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.

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

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    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.

  10. Bacterial Meningitis in Infants

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    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.

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

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    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.

  12. 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

  13. 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...

  14. 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 ...

  15. 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

  16. CT scan of bacterial and aseptic meningitis

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    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.

  17. 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...

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

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    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

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

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    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.

  20. 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...

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

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

    1996-01-01

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

  2. 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....

  3. 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

  4. 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...

  5. 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

  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. 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

  8. 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 ...

  9. 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...

  10. 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....

  11. 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 ...

  12. 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

  13. 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.

  14. 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 ...

  15. 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

  16. 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

  17. [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.

  18. Bacterial meningitis in children. MR findings

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-09-01

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

  19. 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.

  20. 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

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

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    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.

  2. 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.

  3. 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.

  4. 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.

  5. Molecular Detection of Common Bacterial Pathogens Causing Meningitis

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    H Sadighian

    2009-03-01

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

  6. 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...

  7. 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

  8. 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.

  9. 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

  10. 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。

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

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    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.

  12. 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

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

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    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

  14. 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 ...

  15. 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.

  16. 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...

  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. 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.

  19. 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...

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

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    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.

  1. 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...

  2. 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...

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

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    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.

  4. 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...

  5. 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.

  6. 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 ...

  7. 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.

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

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    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.

  9. 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

  10. 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

  11. 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

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

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    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.

  13. 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...

  14. 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...

  15. 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.

  16. 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

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

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    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].

  18. 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.)

  19. 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.)

  20. 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...

  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. 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.

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

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    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.

  4. 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

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

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    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.

  6. 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

  7. 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

  8. Pasteurella multocida bacterial meningitis caused by contact with pigs

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    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.

  9. [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.

  10. 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).

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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....

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

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    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.

  17. 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...

  18. 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, ...

  19. Laboratorial diagnosis of lymphocytic meningitis

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    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.

  20. 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.

  1. Clinical and microbiological features of cryptococcal meningitis

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    Lucia Kioko Hasimoto e Souza

    2013-06-01

    Full Text Available Introduction In this study, the clinical features, underlying diseases and clinical outcomes of patients with cryptococcosis were investigated. In addition, a molecular analysis of the Cryptococcus neoformans species complex isolated from these patients was performed. Methods A prospective study of 62 cases of patients with cryptococcal infection was conducted at the Hospital de Doenças Tropicais de Goiás Dr. Anuar Auad from 2009-2010. Cryptococcal meningitis cases were diagnosed by direct examination and cerebrospinal fluid (CSF sample culture. The profiling of these patients was assessed. The CSF samples were submitted to India ink preparation and cultured on Sabouraud dextrose agar, and C. neoformans was identified by the production of urease, a positive phenoloxidase test and assimilation of carbohydrates. C. neoformans and C. gattii isolates were distinguished by growth on L-canavanine-glycine-bromothymol blue medium, and molecular analysis was conducted via PCR fingerprinting reactions using M13 and (GACA4 primers. Results From the 62 patients with cryptococcosis, 71 isolates of CSF were obtained; 67 (94.4% isolates were identified as C. neoformans var. grubii/VNI, and 4 (5.6% were identified as C. gattii/VGII. Of these patients, 53 had an HIV diagnosis. The incidence of cryptococcosis was higher among patients 20-40 years of age, with 74.2% of the cases reported in males. Cryptococcus-related mortality was noted in 48.4% of the patients, and the symptoms were altered sensorium, headache, fever and stiff neck. Conclusions The high morbidity and mortality observed among patients with cryptococcosis demonstrate the importance of obtaining information regarding the epidemiological profile and clinical course of the disease in the State of Goiás, Brazil.

  2. Cryptococcal meningitis: Clinical, diagnostic and therapeutic overviews

    Directory of Open Access Journals (Sweden)

    Satishchandra P

    2007-01-01

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

  3. 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....

  4. 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....

  5. 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.

  6. [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

  7. 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.

  8. 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.

  9. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. 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.

  12. 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.

  13. [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

  14. 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.

  15. 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.

  16. 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...

  17. 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

  18. 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

  19. 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....

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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 ...

  6. 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...

  7. 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...

  8. 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.

  9. 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...

  10. 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.)

  11. 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 ...

  12. 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

  13. 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...

  14. 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...

  15. 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

  16. 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

  17. 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.

  18. [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

  19. 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.

  20. 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...

  1. 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

  2. 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.)

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. "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

  8. 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...

  9. 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

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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

  17. 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.

  18. 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)

  19. 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...

  20. 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.)

  1. 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...

  2. 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.

  3. A CLINICAL AND EPIDEMIOLOGICAL STUDY OF MENINGEAL TUMORS

    Directory of Open Access Journals (Sweden)

    Channappa

    2016-01-01

    Full Text Available INTRODUCTION The meninges surround and protect the central nervous system. They are composed of connective tissue proper and comprise three membranes the dura mater, the arachnoid and the pia mater. These membranes are composed of collagen fibres, a small number of elastic fires and endothelial cells. The incidence of intracranial tumors depends on the sources and methods used to collect the data. The general consensus is that the annual incidence rate of primary intracranial neoplasm is between 10 and 12 per 100,000 and these constitute approximately 9% of all primary cancers. AIMS AND OBJECTIVES The aim is to study the most common signs that the patient presents in the clinic and to study the epidemiology of the disease. The material used in this study was obtained from 100 cases of intracranial tumours in various colleges of South of India, which I have worked. The sample was obtained over a period of 5 years from May 2007 to May 2012. The most common symptoms that were found in the present study was consistent headache and projectile vomiting. There were 9 grade 1 meningiomas, out of which 5 were meningothelial, microscopically composed of meningothelial cells with ovoid large pale nuclei with vacuoles of cytoplasmic invagination and inconspicuous cytoplasmic borders, the cells are arranged concentrically around calcified blood vessels or connective tissue.

  4. 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.

  5. 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

  6. 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

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

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    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. 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

    (r=0. 89, 0.84, respectively; P = 0.046, 0.049, respectively). Conclusions In the treatment of bacterial meningitis, effective and sufficient antibiotics should be used as soon as possible to control the CSF bacterial load and reduce the mortality. The CSF leukocyte count can be used as indicator of CSF bacterial load and guide the antibiotic treatment in clinical bacterial meningitis.

  9. 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

  10. 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

  11. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-10-01

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

  13. 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.

  14. Pneumococcal meningitis: Clinical-pathological correlations (meningene-path)

    OpenAIRE

    Engelen-Lee, Joo-Yeon; Brouwer, Matthijs C.; Aronica, Eleonora; de Beek, Diederik van

    2016-01-01

    Pneumococcal meningitis is associated with substantial mortality and morbidity. We systematically assessed brain histopathology of 31 patients who died of pneumococcal meningitis from a nationwide study (median age 67 years; 21 (67 %) were male) using a pathology score including inflammation and vascular damage. Of the 27 patients with known time from the admission to death, 14 patients died within 7 days of admission and 13 after 7 days of admission. Eleven of 25 (44 %) patients had been tre...

  15. Clinical characteristics of Haemophilus influenzae meningitis in Denmark in the post-vaccination era

    DEFF Research Database (Denmark)

    Pedersen, T.I.; Howitz, Michael Frantz; Andersen, Christian Østergaard

    2010-01-01

    P>The introduction of Haemophilus influenzae type b (Hib) vaccine into the Danish childhood vaccination programme in 1993 may have influenced the epidemiology of H. influenzae meningitis (i.e. increasing frequency of other non-vaccine types; presentation in other age groups). Based on nationwide...... registration, clinical information and laboratory findings were collected from all 65 confirmed cases of H. influenzae meningitis during the period 1994-2005. Twenty-nine patients (45%) were 24 years old [median 62 years (range 25....... The presence of a lung focus was an independent prognostic factor for an unfavourable outcome (p 0.03). In conclusion, meningitis caused by Hib has been infrequent in Denmark after introduction of the Hib vaccine in the childhood vaccination programme, and no increase in meningitis cases due to non-b type H...

  16. Pneumococcal meningitis: clinical-pathological correlations (MeninGene-Path).

    Science.gov (United States)

    Engelen-Lee, Joo-Yeon; Brouwer, Matthijs C; Aronica, Eleonora; van de Beek, Diederik

    2016-01-01

    Pneumococcal meningitis is associated with substantial mortality and morbidity. We systematically assessed brain histopathology of 31 patients who died of pneumococcal meningitis from a nationwide study (median age 67 years; 21 (67 %) were male) using a pathology score including inflammation and vascular damage. Of the 27 patients with known time from the admission to death, 14 patients died within 7 days of admission and 13 after 7 days of admission. Eleven of 25 (44 %) patients had been treated with adjunctive dexamethasone therapy. Observed pathological processes were inflammation of medium-large arteries in 30 brains (97 %), cerebral haemorrhage in 24 (77 %), cerebritis in 24 (77 %), thrombosis in 21 (68 %), infarction in 19 (61 %) and ventriculitis in 19 (of 28 cases, 68 %). Inflammation of medium-large arteries led to obstruction of the vascular lumen in 14 (of 31 cases, 45 %). Vascular inflammation was associated with infarction and thrombosis of brain parenchymal vessels. Hippocampal dentate gyrus apoptosis between patients treated with and without dexamethasone was similar (p = 0.66); however, dexamethasone treated patients had higher total pathology score than non-dexamethasone treated patients (p = 0.003). Our study shows that vascular damage is key in the process of brain damage in pneumococcal meningitis. Data and material of this study will be made open-access for translational research in pneumococcal meningitis (MeninGene-Path). PMID:27001057

  17. [Meningitis and encephalitis in the years 1983-1990. Clinical observations].

    Science.gov (United States)

    Kepa, L; Wilczek, K; Karasińska, M

    1991-01-01

    From 1983 to 1990, at the I Clinic of Infectious Diseases, Silesian Academy of Medicine in Bytom, 995 patients with meningitis and encephalitis were treated; the average age was 17.86 years. After cerebrospinal fluid (CSF) examinations the patients were divided into groups. The first group consisted of patients with suppurative meningitis and encephalitis (202-20.30%), the other group were patients with aseptic meningitis (309-31.06%), a separate group consisted of patients with mumps meningitis (484-48.06% cases). In the group with suppurative meningitis and encephalitis etiological agents were isolated (Gram stain smear and/or culture of CSF) in 50.99% of cases. The most common causes of suppurative neuroinfections were: Neisseria meningitides and Streptococcus pneumoniae (in 23.76% cases). The increasing number of bacteriological tests positive results was observed during the analyzed period. The etiology of aseptic inflammation diseases of the central nervous system was defined with the help of serologic blood tests in 10-15%, and serologic confirmation of mumps meningitis was as high as 80% of cases. In the group of purulent neuroinfections, during the 8-year observation, 36 deaths occurred (17.82% of these patients). The observed tendency of the death rate decrease is concerned to be a result of better microbiological diagnostics and the possibility of an early aimed antibiotic therapy. PMID:1819814

  18. Clinical manifestations of Eosinophilic meningitis due to infection with Angiostrongylus cantonensis in children.

    Science.gov (United States)

    Sawanyawisuth, Kittisak; Chindaprasirt, Jarin; Senthong, Vichai; Limpawattana, Panita; Auvichayapat, Narong; Tassniyom, Sompon; Chotmongkol, Verajit; Maleewong, Wanchai; Intapan, Pewpan M

    2013-12-01

    Eosinophilic meningitis, caused by the nematode Angiostrongylus cantonensis, is prevalent in northeastern Thailand, most commonly in adults. Data regarding clinical manifestations of this condition in children is limited and may be different those in adults. A chart review was done on 19 eosinophilic meningitis patients aged less than 15 years in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Clinical manifestations and outcomes were reported using descriptive statistics. All patients had presented with severe headache. Most patients were males, had fever, nausea or vomiting, stiffness of the neck, and a history of snail ingestion. Six patients had papilledema or cranial nerve palsies. It was shown that the clinical manifestations of eosinophilic meningitis due to A. cantonensis in children are different from those in adult patients. Fever, nausea, vomiting, hepatomegaly, neck stiffness, and cranial nerve palsies were all more common in children than in adults.

  19. 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.

  20. 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.

  1. Clinical applications of bacterial glycoproteins.

    Science.gov (United States)

    Fulton, Kelly M; Smith, Jeffrey C; Twine, Susan M

    2016-01-01

    There is an ongoing race between bacterial evolution and medical advances. Pathogens have the advantages of short generation times and horizontal gene transfer that enable rapid adaptation to new host environments and therapeutics that currently outpaces clinical research. Antibiotic resistance, the growing impact of nosocomial infections, cancer-causing bacteria, the risk of zoonosis, and the possibility of biowarfare all emphasize the increasingly urgent need for medical research focussed on bacterial pathogens. Bacterial glycoproteins are promising targets for alternative therapeutic intervention since they are often surface exposed, involved in host-pathogen interactions, required for virulence, and contain distinctive glycan structures. The potential exists to exploit these unique structures to improve clinical prevention, diagnosis, and treatment strategies. Translation of the potential in this field to actual clinical impact is an exciting prospect for fighting infectious diseases. PMID:26971465

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-10-01

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

  3. 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

  4. 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

  5. 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.).

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

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    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.

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

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    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.

  8. 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

  9. 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。

  10. 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.

  11. THE VALUE OF PROCALCITONIN MEASUREMENT IN MENINGITIS PATIENTS

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    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.

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

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    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.

  13. 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.

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

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    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.

  15. 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.

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

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

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    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.

  18. 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.

  19. 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.

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    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.

  20. Herpes simplex virus type 2-associated recurrent aseptic (Mollaret's meningitis in genitourinary medicine clinic: a case report

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    Abou-Foul AK

    2014-03-01

    Full Text Available Ahmad K Abou-Foul, Thajunisha M Buhary, Sedki L Gayed Department of Genitourinary Medicine, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK Introduction: Cases of idiopathic recurrent benign aseptic meningitis were first described by Mollaret. Today, herpes simplex virus (HSV is considered the cause of most cases of Mollaret's meningitis. Case report: A 40-year-old male was referred to our genitourinary medicine clinic with recurrent genital herpetic lesions. He had HSV-2-positive genital ulcers 8 years earlier. One year after the first infection, he developed severe recurrent attacks of headache associated with meningitis symptoms. The results of all radiological and biochemical tests were normal, but the patient reported a correlation between his attacks and genital herpes flare-ups. We diagnosed the patient with Mollaret's meningitis and started him on continuous suppressive acyclovir therapy, which resulted in marked clinical improvement. Discussion: Mollaret's meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset, short duration, and spontaneous remission with unpredictable recurrence. We believe that the presence of concurrent or recurrent mucocutaneous herpetic lesions can aid its diagnosis, prior to which, affected patients usually have many unnecessary investigations and treatments. Therefore, detailed sexual history should be sought in all patients with aseptic meningitis, and clinicians should also ask about history of recurrent headaches in all patients with recurrent herpetic anogenital lesions. Continuous suppressive acyclovir therapy may reduce the frequency and severity of attacks and can dramatically improve lifestyle. Keywords: HSV-2 virus, acyclovir, Mollaret's meningitis, recurrent aseptic meningitis, HSV-2 virus, viral meningitis, acyclovir

  1. 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.

  2. Clinical aspects of eosinophilic meningitis and meningoencephalitis caused by Angiostrongylus cantonensis, the rat lungworm.

    Science.gov (United States)

    Murphy, Gerald S; Johnson, Stuart

    2013-06-01

    Angiostrongylus Eosinophilic Meningitis is caused by human infection with larvae of the rat lungworm, Angiostrongylus cantonensis. The clinical presentation includes a spectrum of disease, from meningitis through radiculitis, cranial nerve abnormalities, ataxia, encephalitis, coma, and rarely death. The condition is diagnosed by recognizing the triad of: the clinical syndrome, eosinophils in the cerebrospinal fluid or blood, and exposure history. A history of eating raw or poorly cooked snails is classic, but ingestion of other intermediate hosts or unwashed produce (such as lettuce) harboring hosts is not uncommon. Several serologic tests exist but none has yet been fully validated. There is good evidence that a 2 week course of high dose corticosteroids shortens the duration and severity of symptoms. There is somewhat weaker evidence that albendazole reduces symptoms. The combination of prednisolone and albendazole is being used more commonly for treatment. Some suggestions for future research are given.

  3. 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...

  4. Clinical and Laboratory Findings That Differentiate Herpes Simplex Virus Central Nervous System Disease from Enteroviral Meningitis.

    Science.gov (United States)

    Sanaee, Layli; Taljaard, Monica; Karnauchow, Tim; Perry, Jeffrey J

    2016-01-01

    Background. It can be difficult for clinicians to distinguish between the relatively benign enteroviral (EnV) meningitis and potentially lethal herpes simplex virus (HSV) central nervous system (CNS) disease. Very limited evidence currently exists to guide them. Objective. This study sought to identify clinical features and cerebrospinal fluid (CSF) findings associated with HSV CNS disease. Methods. Given that PCR testing often is not immediately available, this chart review study sought to identify clinical and cerebrospinal fluid (CSF) findings associated with HSV meningitis over a 6-year period. In cases where PCR was not performed, HSV and EnV were assigned based on clinical criteria. Results. We enrolled 166 consecutive patients: 40 HSV and 126 EnV patients. HSV patients had a mean 40.4 versus 31.3 years for EnV, p = 0.005, seizures 21.1% versus 1.6% for EnV, p meningitis. HSV cases had lower CSF neutrophils, higher lymphocytes, and higher protein levels. PMID:27563314

  5. 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

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

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    Roberta M.C. Romanelli

    2002-02-01

    cases of meningitis, and 111 (52.9% were caused by bacteria. Actually, 52 were probable bacterial meningitis (with liquor alterations and 59 were confirmed (with culture and/or antigen tests. The main agents were: Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. The initial treatment for children aged between three months and five years consisted of ampicillin and chloramphenicol. Later, the antibiotic was changed to penicillin in cases of Neisseria meningitidis and Streptococcus pneumoniae. and to chloramphenicol in cases of Haemophilus influenzae. Extended spectrum antimicrobial agents were used on clinical or laboratory basis, but resistant microorganisms were not found in cultures.Conclusions: the epidemiology of meningitis should be continuous and should consider local data in order to guide antimicrobial therapy. The continuous monitoring of the prevalent agents in each institution and their resistance is fundamental to the selection of antimicrobial drugs, preserving the antimicrobial agents, and causing less interference with individual colonization, without contributing to the increasing resistance of the agents responsible for meningeal infections.

  7. 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.

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

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    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

  9. Clinical characteristics of Haemophilus influenzae meningitis in Denmark in the post-vaccination era

    DEFF Research Database (Denmark)

    Pedersen, T.I.; Howitz, M.; Andersen, Christian Østergaard

    2010-01-01

    P>The introduction of Haemophilus influenzae type b (Hib) vaccine into the Danish childhood vaccination programme in 1993 may have influenced the epidemiology of H. influenzae meningitis (i.e. increasing frequency of other non-vaccine types; presentation in other age groups). Based on nationwide...... registration, clinical information and laboratory findings were collected from all 65 confirmed cases of H. influenzae meningitis during the period 1994-2005. Twenty-nine patients (45%) were 24 years old [median 62 years (range 25...... infected with Hib, two cases (13%) were identified as true vaccine failures. Six patients (9%) died; one premature infant infected with serotype f and five adults (age 83-96 years) with non-typeable H. influenzae. Hearing loss was reported in 16% of the surviving children and in 10% of the surviving adults...

  10. Correlation of anti-fungal susceptibility with clinical outcomes in patients with cryptococcal meningitis

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    Lee Chen-Hsiang

    2012-12-01

    Full Text Available Abstract Background This study aimed to investigate the correlation of minimum inhibiting concentrations (MICs, obtained by broth micro-dilution, and clinical response in patients with cryptococcal meningitis. Methods Using retrospective analyses covering the period 2001–2010, factors affecting clinical therapeutic cure in patients with cryptococcal meningitis 10 weeks after the start of anti-fungal therapy were identified. Specific emphasis was placed on the role of anti-fungal susceptibility. Results Of 46 patients with cryptococcal meningitis identified, 21 were cured after 10 weeks of treatment. Overall, 12 strains (26.1% were resistant to fluconazole (>8 μg/ml and 8 (17.4% had an MIC >1 μg/ml for amphotericin B. Twenty-three patients received combination amphotericin B and fluconazole as their initial antifungal therapy, 17 were given amphotericin B only, five received fluconazole only, and one received a combination of amphotericin B and flucytosine. After 2 weeks, all patients received fluconazole (400–600 mg daily for 8 weeks at least, then 200 mg daily thereafter. The presence of isolates resistant to fluconazole (MIC >8 μg/ml; 4.8% vs. 44%, p 8 μg/ml, was an independent predictor of therapeutic cure at 10-week evaluation (OR = 15.7; 95% CI: 1.8-135.9; p = 0.01, but higher MIC of amphotericin B (>1 μg/ml was not. Conclusions The MICs of fluconazole, determined by the CLSI method, may be a potential predictor of therapeutic cure in patients with cryptococcal meningitis.

  11. 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

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    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.

  12. Adult Klebsiella pneumoniae meningitis in Qatar:clinical pattern of ten cases

    Institute of Scientific and Technical Information of China (English)

    Fahmi; Yousef; Khan; Mohammed; Abukhattab; Mohanuned; Abukamar; Deshmukh; Anand

    2014-01-01

    Objective:To describe the clinical presentation,underlying diseases,antimicrobial susceptibility,treatment and outcome of Klebsiella pneumoniae meningitis patients.Methods:This retrospective study involved all patients with 15 years of age or older who admit ted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1,2007 to December 31,2012.Results:A total of ten cases were identified mine males and one female).Their mean age was i43.3±12.8) years.Eight patients(80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition.Fever and altered consciousness were the most frequent symptom.Cerebrospinal fluid showed elevated protein and glucose levels.Oram slain showed Gram—negative rods in 50%of cases,while positive cerebrospinal fluid culture results were found in all patients.Multidrug resistance was observed in two cases,and all patients had received appropriate empirical and definitive antibiotic treatments.The mean duration of intravenous antimicrobial treatment was(19.3±7.0) d and all patients with external ventricular drains underwent removal of the device,while in—hospital mortality was 50%.Conclusions:The number of cases was too small to come up with therapeutic and prognostic conclusions.Further large-scale prospective study is needed.

  13. Mesenteric Lymphadenopathy in Childhood Epidemic Aseptic Meningitis: Sonographic Features and Clinical Significance

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    Mun, Sung Hee; Park, Young Chan; Lee, Young Hwan [Catholic University of Daegu, College of Medicine, Daegu (Korea, Republic of)

    2006-09-15

    To evaluate the sonographic features of mesenteric lymphadenopathy in childhood epidemic aseptic meningitis and to assess their clinical significance. Thirty-three patients (25 male, 8 female: mean age, 8.6 years) with a diagnosis of aseptic meningitis were prospectively evaluated with abdominal ultrasonography for the presence of enlarged mesenteric nodes. The size and number of enlarged mesenteric lymph nodes were analyzed in relationship with the patient's age, between the patients with abdominal pain or diarrhea (16 cases, 48%) and asymptomatic patients (17 cases, 52%). Mesenteric lymphadenopathy was seen in 31 patients (94%), all 16 symptomatic and 15 of the 17 asymptomatic patients. The number of enlarged nodes was most prevalent between 6-10, seen in 16 patients (52%) and the largest node ranged in size from 4 to 8 mm. Among the 31 patients with mesenteric lymphadenopathy, the mean size of the largest node was statistically different between the symptomatic (6.0 mm) and asymptomatic (5.0 mm) groups (p = 0.021). The number of enlarged nodes and the patient's age were not statistically different between the two groups. Mesenteric lymphadenopathy was seen in almost all cases of childhood epidemic aseptic meningitis, and may be related to the mesenteric lymphadenitis caused by enterovirus

  14. Adult Klebsiella pneumoniae meningitis in Qatar:clinical pattern of ten cases

    Institute of Scientific and Technical Information of China (English)

    Fahmi Yousef Khan; Mohammed Abukhattab; Mohammed AbuKamar; Deshmukh Anand

    2014-01-01

    Objective: To describe the clinical presentation, underlying diseases, antimicrobial susceptibility, treatment and outcome of Klebsiella pneumoniae meningitis patients. Methods:This retrospective study involved all patients with 15 years of age or older who admitted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1, 2007 to December 31, 2012. Results: A total of ten cases were identified (nine males and one female). Their mean age was (43.3±12.8) years. Eight patients (80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition. Fever and altered consciousness were the most frequent symptom. Cerebrospinal fluid showed elevated protein and glucose levels. Gram stain showed Gram-negative rods in 50%of cases, while positive cerebrospinal fluid culture results were found in all patients. Multidrug resistance was observed in two cases, and all patients had received appropriate empirical and definitive antibiotic treatments. The mean duration of intravenous antimicrobial treatment was (19.3±7.0) d and all patients with external ventricular drains underwent removal of the device, while in-hospital mortality was 50%. Conclusions: The number of cases was too small to come up with therapeutic and prognostic conclusions. Further large-scale prospective study is needed.

  15. Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection

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    Samuelsson Susanne

    2005-10-01

    Full Text Available Abstract Background We conducted a nationwide study in Denmark to identify clinical features and prognostic factors in patients with Streptococcus pneumoniae according to the focus of infection. Methods Based on a nationwide registration, clinical information's was prospectively collected from all reported cases of pneumococcal meningitis during a 2-year period (1999–2000. Clinical and laboratory findings at admission, clinical course and outcome of the disease including follow-up audiological examinations were collected retrospectively. The focus of infection was determined according to the clinical diagnosis made by the physicians and after review of the medical records. Results 187 consecutive cases with S. pneumoniae meningitis were included in the study. The most common focus was ear (30%, followed by lung (18%, sinus (8%, and other (2%. In 42% of cases a primary infection focus could not be determined. On admission, fever and an altered mental status were the most frequent findings (in 93% and 94% of cases, respectively, whereas back rigidity, headache and convulsion were found in 57%, 41% and 11% of cases, respectively. 21% of patients died during hospitalisation (adults: 27% vs. children: 2%, Fisher Exact Test, P P = 0.0005. Prognostic factors associated with fatal outcome in univariate logistic regression analysis were advanced age, presence of an underlying disease, history of headache, presence of a lung focus, absence of an otogenic focus, having a CT-scan prior to lumbar puncture, convulsions, requirement of assisted ventilation, and alterations in various CSF parameters (WBC P P = 0.005. Conclusion These results emphasize the prognostic importance of an early recognition of a predisposing focus to pneumococcal meningitis.

  16. 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.

  17. 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.

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

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    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

  19. Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis

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    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.

  20. 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

  1. 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...

  2. [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.

  3. The enhanced pneumococcal LAMP assay: a clinical tool for the diagnosis of meningitis due to Streptococcus pneumoniae.

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    Dong Wook Kim

    Full Text Available BACKGROUND: Streptococcus pneumoniae is a leading cause of invasive bacterial disease in developed and developing countries. We studied the loop-mediated isothermal amplification (LAMP technique to assess its suitability for detecting S. pneumoniae nucleic acid in cerebrospinal fluid (CSF. METHODOLOGY/PRINCIPAL FINDINGS: We established an improved LAMP assay targeting the lytA gene (Streptococcus pneumoniae [Sp] LAMP. The analytical specificity of the primers was validated by using 32 reference strains (10 Streptococcus and seven non-Streptococcus species plus 25 clinical alpha-hemolytic streptococcal strains, including four S. pneumoniae strains and 21 other strains (3 S. oralis, 17 S. mitis, and one Streptococcus species harboring virulence factor-encoding genes (lytA or ply. Within 30 minutes, the assay could detect as few as 10 copies of both purified DNA and spiked CSF specimens with greater sensitivity than conventional polymerase chain reaction (PCR. The linear determination range for this assay is 10 to 1,000,000 microorganisms per reaction mixture using real-time turbidimetry. We evaluated the clinical sensitivity and specificity of the Sp LAMP assay using 106 randomly selected CSF specimens from children with suspected meningitis in Korea, China and Vietnam. For comparison, CSF specimens were also tested against conventional PCR and culture tests. The detection rate of the LAMP method was substantially higher than the rates of PCR and culture tests. In this small sample, relative to the LAMP assay, the clinical sensitivity of PCR and culture tests was 54.5% and 33.3%, respectively, while clinical specificity of the two tests was 100%. CONCLUSIONS/SIGNIFICANCE: Compared to PCR, Sp LAMP detected S. pneumoniae with higher analytical and clinical sensitivity. This specific and sensitive LAMP method offers significant advantages for screening patients on a population basis and for diagnosis in clinical settings.

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

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    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

  5. Relationship between serial CT findings and clinical course of purulent meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Nakata, Mihoko; Nakata, Hajime; Kawanami, Takashi; Fukuda, Miho

    1984-11-01

    We reviewed the CT examinations and clinical records of 31 patients of purulent meningitis to evaluate the relation of CT findings to pathogenic bacteria and clinical course. The most frequently observed abnormal CT finding was an enlargement of the subarachnoid space and ventricles. There was no relationship between those abnormal CT findings and pathogenic bacteria. Enlargement of ventricles, low density area of the white matter and subdural effusion suggested the necessity of the surgical treatment or poor prognosis. The patients with convulsion or re-elevation of CRP had a tendency to show an exacerbation of such abnormalities. On the contrary, abnormal CT findings improved in the patients without convulsion or with decrease of CRP. We conclude that a follow-up CT examination is indicated in cases developing convulsion or re-elevation of CRP. (author).

  6. Tubercular meningitis in children: Clinical, pathological, and radiological profile and factors associated with mortality

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    Anil V Israni

    2016-01-01

    Full Text Available Context: Childhood tuberculosis is a major public health problem in developing countries with tubercular meningitis being a serious complication with high mortality and morbidity. Aim: To study the clinicopathological as well as radiological profile of childhood tuberculous meningitis (TBM cases. Settings and Design: Prospective, observational study including children <14 years of age with TBM admitted in a tertiary care hospital from Western India. Subjects and Methods: TBM was diagnosed based on predefined criteria. Glassgow coma scale (GCS and intracranial pressure (ICP was recorded. Staging was done as per British Medical Council Staging System. Mantoux test, chest X-ray, cerebrospinal fluid (CSF examination, neuroimaging, and other investigations were done to confirm TB. Statistical Analysis Used: STATA software (version 9.0 was used for data analysis. Various risk factors were determined using Chi-square tests, and a P< 0.05 was considered significant. Results: Forty-seven children were included, of which 11 (24.3% died. Fever was the most common presenting symptom, and meningismus was the most common sign. Twenty-nine (62% children presented with Stage III disease. Stage III disease, low GCS, and raised ICP were predictors of mortality. Findings on neuroimaging or CSF examination did not predict mortality. Conclusions: Childhood TBM presents with nonspecific clinical features. Stage III disease, low GCS, lack of Bacillus Calmette–Gu͹rin vaccination at birth and raised ICP seem to the most important adverse prognostic factors.

  7. 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

  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. 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.

  10. Pattern, Clinical Characteristics, and Outcome of Meningitis among HIV-Infected Adults Admitted in a Tertiary Hospital in North Western Tanzania: A Cross-Sectional Study.

    Science.gov (United States)

    Boaz, Matobogolo M; Kalluvya, Samuel; Downs, Jennifer A; Mpondo, Bonaventura C T; Mshana, Stephen E

    2016-01-01

    Background. Limited information exists on the etiologies, clinical characteristics, and outcomes of meningitis among HIV-infected patients in Africa. We conducted a study to determine the etiology, clinical characteristics, and outcomes of meningitis among HIV-infected adults. Methods. A prospective cross-sectional hospital based study was conducted among HIV-infected patients aged ≥18 years admitted to the medical wards with symptoms and signs of meningitis. Sociodemographic and clinical information were collected using a standardized data collection tool. Lumbar puncture was performed to all patients; cerebrospinal fluid samples were sent for analysis. Results. Among 60 HIV-infected adults clinically diagnosed to have meningitis, 55 had CSF profiles consistent with meningitis. Of these, 14 (25.5%) had a laboratory-confirmed etiology while 41 (74.5%) had no isolate identified. Cryptococcus neoformans was the commonest cause of meningitis occurring in 11 (18.3%) of patients followed by Mycobacterium tuberculosis (6.7%). The in-hospital mortality was 20/55 (36.4%). Independent predictors of mortality were low baseline CD4 count and turbid CSF appearance. Conclusion. Cryptococcal meningitis is the most prevalent laboratory-confirmed etiological agent among adult HIV-infected patients with suspected meningitis admitted to medical wards in Western Tanzania. Mortality rate in this population remains unacceptably high. Improving diagnostic capacity and early treatment may help to decrease the mortality rate. PMID:27651801

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

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    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.

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

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    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

  13. 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.

  14. A Vignette-Based Survey to Assess Clinical Decision Making Regarding Antibiotic Use and Hospitalization of Patients with Probable Aseptic Meningitis

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    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.

  15. Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis

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    Erdem Ilknur

    2008-01-01

    Full Text Available Background: Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality. Aim: The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations. Setting and design: Tertiary care hospital and an observational study. Materials and Methods: The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria. Statistical analysis: It was performed by using Statistical Package for Social Sciences for Windows 10.0 program. Results: The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated. Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8% patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR: 19.419, 95% Confidence Interval (CI; 1.637-230.41, P = 0.001, and low cerebrospinal fluid glucose level (≤ 30 mg/ dL (OR: 10.272, 95% CI; 1.273-82.854, P = 0.002, and presence of concurrent nosocomial infection (OR: 28.744, 95% CI;1.647-501.73, P =0.001 were the independent risk factors associated with mortality. Conclusion: The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.

  16. Meningeal hemangiopericytoma

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    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

  17. 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.

  18. 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....

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

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    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.

  20. Clinical characteristics and treatment of purulent meningitis in adults%成人化脓性脑膜炎临床特点与诊治分析

    Institute of Scientific and Technical Information of China (English)

    薄宇清; 王智勇; 吴景录

    2013-01-01

    目的 分析探讨成人化脓性脑膜炎的临床特点,提高成人化脓性脑膜炎的诊治水平.方法 回顾性分析医院2007年1月—2011年12月收治的26例成人化脓性脑膜炎患者的临床资料.结果 患者入院后根据脑脊液生化检查结果诊断化脓性脑膜炎,脑脊液细菌培养阳性16例,其中肺炎链球菌感染9例,大肠埃希菌及肺炎杆菌感染各2例,金黄色葡萄球菌、肺炎克雷伯菌、表皮葡萄球菌感染各1例;经抗感染治疗后,患者住院3~25 d,平均住院天数12 d;好转23例,死亡3例.结论 成人化脓性脑膜炎的多有明确的病因,临床表现不特异,脑脊液及颅脑影像学检查有助于诊断,根据脑脊液细菌培养及药敏结果给予抗菌药物治疗,可以取得一定效果.%OBJECTIVE To analyze the clinical characteristics of purulent meningitis in adults so as to improve the level of diagnosis and treatment of the purulent meningitis in the adults.METHODS A total of 26 cases of adult patients with purulent meningitis,who were treated in the hospital from Jan 2007 to Dec 2011,were ebrolled in the study,then the clinical data of the patients were retrospectively analyzed.RESULTS The purulent meningitis was diagnosed with cerebral spinal fluid (CSF) biochemical test results after the patient were enrolled,the bacterial culture of cerebrospinal fluid was positive in 16 cases,among which there were 9 cases with Streptococcus pneumoniae infections,2 cases with Escherichia coli infections,2 cases with Pneumobacillus infections,1 case with Staphylococcus aureus infections,1 case with Klebsiella pneumoniae infections,and 1 case with Staphylococcus epidermidis infections.After the anti-infection therapy,the hospitalization duration varied from 3 days to 25 days with the mean time of 12 days,23 cases improved,and 3 cases died.CONCLUSION There are many definite causes of purulent meningitis in the adults,and the clinical manifestations are atypical

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

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    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.

  2. Clinical Response, Outbreak Investigation, and Epidemiology of the Fungal Meningitis Epidemic in the United States: Systematic Review.

    Science.gov (United States)

    Abbas, Kaja M; Dorratoltaj, Nargesalsadat; O'Dell, Margaret L; Bordwine, Paige; Kerkering, Thomas M; Redican, Kerry J

    2016-02-01

    We conducted a systematic review of the 2012-2013 multistate fungal meningitis epidemic in the United States from the perspectives of clinical response, outbreak investigation, and epidemiology. Articles focused on clinical response, outbreak investigation, and epidemiology were included, whereas articles focused on compounding pharmacies, legislation and litigation, diagnostics, microbiology, and pathogenesis were excluded. We reviewed 19 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The source of the fungal meningitis outbreak was traced to the New England Compounding Center in Massachusetts, where injectable methylprednisolone acetate products were contaminated with the predominant pathogen, Exserohilum rostratum. As of October 23, 2013, the final case count stood at 751 patients and 64 deaths, and no additional cases are anticipated. The multisectoral public health response to the fungal meningitis epidemic from the hospitals, clinics, pharmacies, and the public health system at the local, state, and federal levels led to an efficient epidemiological investigation to trace the outbreak source and rapid implementation of multiple response plans. This systematic review reaffirms the effective execution of a multisectoral public health response and efficient delivery of the core functions of public health assessment, policy development, and service assurances to improve population health. PMID:26681583

  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. 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.

  7. 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.

  8. 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

    the control group comprised patients confirmed with non - bacterial meningitis. Statistic data, epidemiological characteristics, clinical manifestations and conventional laboratory indicators of the two groups were collected. multivariate conditional Logistic regression analysis was undertaken to investigate the influencing factors for bacterial meningitis in children. Results The single factor conditional Logistic regression analysis showed that the two groups were significantly different(P <0. 05)in age,onset season,vomit,neck rigidity,neutrophile granulocyte in blood specimen, appearance of cerebrospinal fluid and white blood cell count in cerebrospinal fluid. With the occurrence of bacterial meningitis or not as dependent variables and the indexes that have statistical significance in univariate analysis as independent variables, multivariate conditional Logistic regression analysis showed that age(OR=10. 36,P=0. 003),onset season(OR=0. 06,P=0. 007),neck rigidity(OR=17. 01,P=0. 048),neutrophile granulocyte in blood specimen(OR=12. 43,P=0. 028), appearance of cerebrospinal fluid(OR=2. 59,P=0. 014)and white blood cell count in cerebrospinal fluid(OR=2. 31,P=0. 047) entered the regression equation. Conclusion Being aged 1 to < 5, no summer onset, neck rigidity, score of neutrophile granulocyte in blood specimen,appearance of cerebrospinal fluid and white blood cell count in cerebrospinal fluid are predictors for bacterial meningitis in children,which could be used for the precaution and prevention of the disease in children.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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...

  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. 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.

  16. 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。

  17. 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...

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

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    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

  19. 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

  20. 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.

  1. Transforming clinical microbiology with bacterial genome sequencing

    Science.gov (United States)

    2016-01-01

    Whole genome sequencing of bacteria has recently emerged as a cost-effective and convenient approach for addressing many microbiological questions. Here we review the current status of clinical microbiology and how it has already begun to be transformed by the use of next-generation sequencing. We focus on three essential tasks: identifying the species of an isolate, testing its properties such as resistance to antibiotics and virulence, and monitoring the emergence and spread of bacterial pathogens. The application of next-generation sequencing will soon be sufficiently fast, accurate and cheap to be used in routine clinical microbiology practice, where it could replace many complex current techniques with a single, more efficient workflow. PMID:22868263

  2. Transforming clinical microbiology with bacterial genome sequencing.

    Science.gov (United States)

    Didelot, Xavier; Bowden, Rory; Wilson, Daniel J; Peto, Tim E A; Crook, Derrick W

    2012-09-01

    Whole-genome sequencing of bacteria has recently emerged as a cost-effective and convenient approach for addressing many microbiological questions. Here, we review the current status of clinical microbiology and how it has already begun to be transformed by using next-generation sequencing. We focus on three essential tasks: identifying the species of an isolate, testing its properties, such as resistance to antibiotics and virulence, and monitoring the emergence and spread of bacterial pathogens. We predict that the application of next-generation sequencing will soon be sufficiently fast, accurate and cheap to be used in routine clinical microbiology practice, where it could replace many complex current techniques with a single, more efficient workflow.

  3. Clinical Characteristics and Predictors of Adverse Outcome in Adult and Pediatric Patients With Healthcare-Associated Ventriculitis and Meningitis.

    Science.gov (United States)

    Srihawan, Chanunya; Castelblanco, Rodrigo Lopez; Salazar, Lucrecia; Wootton, Susan H; Aguilera, Elizabeth; Ostrosky-Zeichner, Luis; Sandberg, David I; Choi, HuiMahn A; Lee, Kiwon; Kitigawa, Ryan; Tandon, Nitin; Hasbun, Rodrigo

    2016-04-01

    Background.  Healthcare-associated meningitis or ventriculitis is a serious and life-threatening complication of invasive neurosurgical procedures or penetrating head trauma. Methods.  We performed a retrospective study of adults and children with the diagnosis of healthcare-associated meningitis or ventriculitis, as defined by the 2015 Centers of Disease Control and Prevention case definition, at 2 large tertiary care hospitals in Houston, Texas from July 2003 to November 2014. Patients were identified by infection control practitioners and by screening cerebrospinal fluid samples sent to the central laboratory. We collected data on demographics, clinical presentations, laboratory results, imaging studies, treatments, and outcomes. Results.  A total of 215 patients were included (166 adults and 49 children). A positive cerebrospinal fluid culture was seen in 106 (49%) patients, with the majority of the etiologies being Staphylococcus and Gram-negative rods. An adverse clinical outcome was seen in 167 patients (77.7%) and was defined as death in 20 patients (9.3%), persistent vegetative state in 31 patients (14.4%), severe disability in 77 patients (35.8%), or moderate disability in 39 patients (18.1%). On logistic regression analysis, age >45 years (adjusted odds ratio [OR], 6.47; 95% confidence interval [CI], 2.31-18.11; P ≤ .001), abnormal neurological exam (adjusted OR, 3.04; 95% CI, 1.27-7.29; P = .013), and mechanical ventilation (adjusted OR, 5.34; 95% CI, 1.51-18.92; P = .01) were associated with an adverse outcome. Conclusions.  Healthcare-associated meningitis or ventriculitis is associated with significant morbidity and mortality. PMID:27419154

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

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    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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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

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

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    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.

  11. 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

  12. Listeria monocytogenes meningitis in an immunocompetent 18-year old patient as a possible diagnostic and therapeutical problem

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    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.

  13. 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

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    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

  14. 脑膜癌病9例分析%Clinical analysis of meningeal carcinomatosis

    Institute of Scientific and Technical Information of China (English)

    徐晓伟

    2004-01-01

    脑膜癌病(meningeal careinomatosis,MC)是癌细胞弥漫性侵犯软脑膜和脊膜,而颅内并无占位性病灶的一类具有多种临床表现的疾病。我科自1994年至今共收治9例,分别经MRL脑脊液细胞学证实,现结合病人临床表现,实验室及其影像学检查进行分析。

  15. 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

  16. A case of Staphylococcus aureus meningitis associated with cryoglobulin-related renal failure and clinically mild encephalitis/encephalopathy with a reversible splenial lesion.

    Science.gov (United States)

    Shimozono, Koji; Korenaga, Hideki; Mawatari, Reiko; Tsukishima, Naoki

    2016-05-31

    A 59-years old man, having untreated hypertension and diabetes, was admitted to our hospital because of lumbago and fever. A T2-weighted image of spine showed increased signal intensity of vertebra at L3 and L4. Methicillin-susceptible staphylococcus aureus (MSSA) infection was confirmed by blood culturing. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Diagsosis of pyogenic spondylitis with bacterial meningitis was made. Diffusion-weighted magnetic imaging of the brain disclosed a focal hyperintense lesion in the corpus callosum which showed a low coefficient in the apparent diffusion coefficient mapping. This finding suggests a clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). His symptoms temporarily ameliorated by antibiotic therapy. Two weeks later, however, his conscious level rapidly worsened to comatose state. Concomitantly he developed acute renal failure with severe proteinuria. Serum serology showed a positive cryoglobulin test. Mechanical ventilation, hemodialysis and steroid pulse therapy improved his consciousness with a resultant complete recovery of all symptoms. We emphasize the possible complications in some cases of MERS. PMID:27151224

  17. 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

  18. Características clínico-microbiológicas de la meningitis por Streptococcus pneumoniae resistente a la penicilina Streptococcus pneumoniae meningitis resistant to penicillin clinical and microbiological characteristics

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    Demóstenes Gómez-Barreto

    1999-10-01

    Full Text Available OBJETIVO: Evaluar la susceptibilidad antimicrobiana de Streptococcus pneumoniae aislado del líquido cefalorraquídeo de niños con meningitis, así como describir y comparar las características clínicas y microbiológicas, el tratamiento y la evolución del padecimiento entre niños infectados con cepas sensibles y resistentes a la penicilina y la cefalosporina. MATERIAL Y MÉTODOS: Treinta y ocho niños con meningitis neumocócica fueron incluidos prospectivamente en el Programa Institucional de Vigilancia de las Infecciones Neumocócicas, durante el lapso 1994-1998. Los datos clínicos y de laboratorio se colectaron de cada expediente. RESULTADOS: Del total de niños, 63% era menor de dos años de edad, 28.9% mostró cepas insensibles a la penicilina, 18.4% tenía resistencia intermedia, y 10.5% tenía resistencia elevada. El 2.6% mostró también resistencia a la cefotaxima. La única característica (por la prueba exacta de Fisher asociada con la resistencia fue: enfermedad de base previa al proceso (pOBJECTIVE: To evaluate the susceptibility to antibiotics of Streptococcus pneumoniae isolated from cerebrospinal fluid of children with meningitis. To describe and compare the clinical and microbiological characteristics, treatment and outcome among children infected with strains either susceptible or resistant to penicillin and cephalosporin. MATERIAL AND METHODS: A total of 38 children with pneumococcal meningitis were prospectively enrolled in the Institutional Surveillance Program for Pneumococcal Infections during 1994-1998. Clinical and laboratory data were collected by chart review. RESULTS: Of the 38 children, 24 (63% were less than 2 years of age, 11 (28.9% had drug-resistant S. pneumoniae, 18.4% had intermediate resistance, 10.5% high level resistance and 2.6% also showed high level resistance to cefotaxime. The only associated factors (by Fisher’s exact test associated to resistance were: previous use of antibiotics (p=0

  19. 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....

  20. 结核性脑膜炎患儿脑脊髓液中腺苷脱氨酶活性测定的临床意义%Clinical Significance of Cerebrospinal Fluid Adenosine Deaminase of Children with Tuberculous Meningitis

    Institute of Scientific and Technical Information of China (English)

    程金玲

    2012-01-01

      目的:评价结核性脑膜炎患儿脑脊髓液中腺苷脱氨酶(CSF-ADA)活性对临床诊断意义及疗效判断价值.方法:选择122例住院患儿为研究对象,56例结核性脑膜炎患者为A组;66例非结核性脑膜炎患者为对照组,其中细菌性脑膜炎32例为B组,病毒性脑膜炎34例为C组,采用酶耦联Trinder法测定患儿治疗前CSF-ADA活性,56例结核性脑膜炎患儿于抗结核治疗后2周和6周时分别检测CSF-ADA.结果:A组CSF-ADA活性为(11.8±4.4)U/L,B组为(6.1±2.8)U/L,C组为(4.9±3.1)U/L,与A组比较差异有统计学意义(F=45.150, P=0.000).取CSF-ADA≥8 U/L作为临界值时鉴别结核性脑膜炎与非结核性脑膜炎价值最高,灵敏度为87.72%,特异度为90.77%.随着患儿病情好转,CSF-ADA活性逐渐降低.结论:CSF-ADA活性≥8U/L可作为诊断结核性脑膜炎的一项辅助诊断指标,抗结核治疗后CSF-ADA活性可作为疗效判断的参考指标.%  Objective: Evaluation of tuberculous meningitis with cerebrospinal fluid of adenosine deaminase(CSF-ADA)activity to clinical diagnosis significance and effect of value judgment. Method: To choose 122 cases hospitalized children as the research object,56 cases of tuberculous meningitis was the case group(group A). 66 cases of meningitis of n/med tuberculosis sex as control group,including bacterial meningitis 32 cases(group B),and viral meningitis 34 cases(C group),using enzyme coupling Trinder spectrometry to analyze CSF-ADA activity before treatment. 56 cases of tuberculous meningitis in antitubercular treatment children after 2 weeks and six weeks respectively detection CSF-ADA. Result:The CSF-ADA activity of group A was(11.8±4.4)U/L,compared with group B(6.1±2.8)U/L,group C(4.9±3.1)U/L,there was a significant difference meaning(F=45.150,P=0.000). Taking the CSF-ADA ≥ 8 U/L as critical value in identification of tuberculous meningitis had the highest value,and sensitivity was 87.72% and specificity was 90

  1. Clinical characteristics of tuberculous meningitis and correlated treatment%结核性脑膜炎的临床特点观察与治疗分析

    Institute of Scientific and Technical Information of China (English)

    宋贵军; 尹琳; 曹云鹏; 刘文静

    2012-01-01

    OBJECTIVE To summarize and analyze the clinical manifestations of tuberculous meningitis and related treatments.METHODS The clinical data of 87 patients with tuberculous meningitis were summarized, and the incidence, clinical manifestation, and clinical treatment were analyzed.RESULTS Totally 87 patients with tuberculous meningitis mainly occurred in childhood, youth, and senile patients, among which 57 cases were cured, 2 cases died, the effective rate was 87.36%.CONCLUSION The clinical manifestations of tuberculous meningitis are complex, early diagnosis and standardized treatment can effectively reduce brain edema and complications thus to improve the cure rate of tuberculous meningitis.%目的 对结核性脑膜炎的临床表现和相关治疗进行总结分析.方法 总结87例结核性脑膜炎患者的临床资料,对其发病情况、临床表现、临床治疗进行分析.结果 87例结核性脑膜炎患者主要分布于幼年、青年和老年,其中痊愈57例,死亡2例,有效率为87.36%.结论 结核性脑膜炎的临床表现错综复杂,早期诊断、规范治疗能有效减轻脑水肿,减少并发症,提高结核性脑膜炎治愈率.

  2. 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.

  3. Case Report of Neurological Sequelae and Bilateral Optic Atrophy Developed Due to Tuberculosis Meningitis Treatment - A Rare Clinical Syndrome

    Directory of Open Access Journals (Sweden)

    M. Prasamse

    2016-06-01

    Full Text Available Tuberculosis meningitis (TBM is common CNS infection associated with neurologic sequelae and mortality if untreated. Recommended treatment regimen consists; two months of daily Isoniazide (INH, Rifampin (RIF, Pyrazinamide (PZA and either Streptomycin (SM or Ethambutol (EMB followed by 7–10 months of INH and RIF. Optic atrophy as neurologic complication may develop in TBM patients with anti TB therapy. Infection and/or drugs can be an etiologic factor also. In this case patient was diagnosed with TBM at the age of three years and was on anti TB drugs. At the age of four years he was completely cured from TBM but developed seizure as neurologic sequelae. Provisionally, child was diagnosed as known case of TBM with seizures and visual defect. Ophthalmologist revealed; bilateral optic atrophy and Neurophysician confirmed as Neurological sequelae and bilateral optic atrophy developed due to TBM treatment. A thorough patient history including past medication history is a clinical pearl to identify such rare clinical complication. In this case optic atrophy and neurological sequelae was confirmed only after thorough history and evaluation by various specialists. Not only confirmation of rare clinical syndrome is important, also identification of possible etiology and appropriate management is required for better management. Clinical pharmacists play a crucial role even in identification and reporting of such rare clinical condition as a part of health care system to create awareness among others.

  4. 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.

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

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    Gaurav B Modi

    2012-06-01

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

  6. Aseptic meningitis 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.

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

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    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.

  8. 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...

  9. Clinical analysis of 28 cases with tuberculous meningitis%28例结核性脑膜炎临床分析

    Institute of Scientific and Technical Information of China (English)

    杨燕; 张侠

    2012-01-01

    目的 总结结核性脑膜脑炎的临床特点.方法 分析我院明确诊断的28例结核性脑膜炎患者的临床资料.结果 22例病情好转出院,2例转神经外科,3例自动出院,1例死亡.结论 早就诊、早诊断、早治疗是决定结核性脑膜炎预后的关键因素.%Objective To investigate the clinical features of tuberculous meningitis in order to improve the diagnostic and therapy level for tuberculous meningitis. Methods 28 cases with tuberculous meningitis in our hospital were analyzed, including the clinical manifestation, laboratory examination, treatment and prognosis. Results In the 28 cases, 22 cases improved, 2 cases transferred to neurosur-gery, 3 cases discharged from hospital themselves, and 1 case was dead. Conclusion Early diagnosis and treatment are the important fac-tors to cure TB meningitis

  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. 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.

  12. Clinical analysis of 324 cases of tuberculous meningitis%结核性脑膜炎324例临床分析

    Institute of Scientific and Technical Information of China (English)

    周晓慧

    2013-01-01

    目的 探讨结核性脑膜炎临床特点早期诊断,误诊等问题.方法 对我院收治的结核性脑膜炎324例,就临床特点化疗效果早期诊断,鞘内注药,误诊原因等进行分析.结果 发病早期患者占26.5%,中期占53.7%.平均33天.临床表现主要为发热、头疼,恶心,呕吐.本组病例均给于合理抗结核药治疗,其中有86例鞘内注药治疗,收到较好疗效.结论 早期诊断是治疗的关键,合理标准化用药可提高疗效.重危患者可鞘内注药,疗效甚高.%Objective To investigate the clinical features of early diagnosis of tuberculous meningitis and the causes of misdiagno-sis. Methods 324 patients with tuberculous meningitis from 2006 to 2010 were selected in this study, and their clinical features and mis-diagnosis causes were retrospectively analyzed. Results The early incidence of patients with tuberculous meningitis accounted for 26. 5% , and the interim incidence was 53.1% . The average time was 33 days. The main clinical manifestations included fever, headache, and nausea and vomiting. All patients were given reasonable anti tuberculosis drug therapy, and 86 patients of them were given in-trathecal injection and received a better curative effect. Conclusion Early diagnosis is the key to the treatment of patients with tuberculous meningitis, and reasonable standard chemotherapy can improve its curative effect. Intrathecal injection has a favorable curative effect in the treatment of patients with severe tuberculous meningitis.

  13. Incidence and clinical features of herpes simplex viruses (1 and 2) and varicella-zoster virus infections in an adult Korean population with aseptic meningitis or encephalitis.

    Science.gov (United States)

    Choi, Rihwa; Kim, Gyeong-Moon; Jo, Ik Joon; Sim, Min Seob; Song, Keun Jeong; Kim, Byoung Joon; Na, Duk L; Huh, Hee Jae; Kim, Jong-Won; Ki, Chang-Seok; Lee, Nam Yong

    2014-06-01

    Since there are limited data on the incidence and clinical findings of central nervous system (CNS) infection by three α-herpesviruses including human herpes simplex virus 1 (HSV-1), HSV-2 and varicella-zoster virus (VZV) in Korea, a retrospective analysis of clinical data and polymerase chain reaction (PCR) results was performed in patients who presented with suspicion of acute viral meningitis and/or encephalitis at the emergency department of a tertiary referral hospital in Seoul, Korea. During the 3-year study period, a total of 224 cerebrospinal fluid (CSF) samples from 224 patients were examined. Among the 224 patients, 135 (60.3%) patients were identified as having aseptic meningitis (n = 70, 51.9%), encephalitis (n = 41, 30.4%) or meningoencephalitis (n = 24, 17.8%) at discharge. Twenty-four (17.8%) patients were identified as having VZV meningitis (n = 16, 11.9%), VZV meningoencephalitis (n = 2, 1.5%), HSV-2 meningitis (n = 4, 3.0%), or HSV-1 encephalitis (n = 2, 1.5%). Of the 24 patients infected with the three herpesviruses, immunocompromised patients accounted for 33.3% (n = 8). Skin rashes were observed in half (n = 9) of the patients with VZV, and none with HSV-1 or HSV-2. One patient with VZV meningitis and four patients with brain parenchymal involvement had neurologic sequelae. In conclusion, three herpesviruses are important causative agents of CNS infectious disease with significant morbidity in adults, regardless of the immunologic status. Therefore, CSF should be examined for HSV-1, HSV-2, and VZV using sensitive diagnostic methods in all cases of adult patients with clinical manifestations of CNS disease in order to identify the correct etiology and to determine appropriate therapy.

  14. Clinical importance of the middle meningeal artery: A review of the literature

    Science.gov (United States)

    Yu, Jinlu; Guo, Yunbao; Xu, Baofeng; Xu, Kan

    2016-01-01

    The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases. However, no systematic review describing the importance of MMA has been published. In this study, we used the PUBMED database to perform a review of the literature on the MMA to increase our understanding of its role in neurosurgery. After performing this review, we found that the MMA was commonly used to access DAVFs and meningiomas. Pseudoaneurysms and true aneurysms in the MMA can be effectively treated via endovascular or surgical removal. In MMD, the MMA plays a very important role in the development of collateral circulation and indirect revascularization. For recurrent CDSHs, after burr hole irrigation and drainage have failed, MMA embolization may be attempted. The MMA can also contribute to the occurrence and treatment of migraines. Because the ophthalmic artery can ectopically originate from the MMA, caution must be taken to avoid causing damage to the MMA during operations. PMID:27766029

  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. Clinical analysis of neonatal purulent meningitis caused by group B streptococcus%无乳链球菌致新生儿脑膜炎的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    赵宁; 王萍; 魏谋; 卢伟能; 贺娟; 古锐; 江翠婵

    2015-01-01

    目的 分析新生儿无乳链球菌(Group B Streptococcus,GBS)脑膜炎的临床特点及治疗转归情况,为其早期诊断和科学治疗提供理论依据.方法 对2011年11月至2014年4月广州市妇女儿童医疗中心收治的19例新生儿GBS脑膜炎和22例大肠埃希菌脑膜炎患儿的临床资料、实验室检测结果和治疗转归情况进行回顾性分析.结果 GBS脑膜炎患儿占细菌培养阳性新生儿化脓性脑膜炎病例的24.7% (19/77),早发型6例,平均发病时间(11.80±11.34)h,主要表现为气促呻吟;晚发型13例,平均发病时间(17.85±7.77)d,多以发热为初发临床症状.GBS脑膜炎患儿外周血C反应蛋白浓度显著高于大肠埃希菌脑膜炎患儿[(154.43±88.64) mg/L vs.(67.52±64.23) mg/L,P=0.001].GBS脑膜炎患儿平均住院时间和脑脊液异常恢复时间分别为(44.53±20.48)d和(41.50±17.85)d,均较大肠埃希菌脑膜炎患儿延长了10d,差异均有统计学意义(P均<0.05).结论 GBS脑膜炎临床表现非特异,住院时间和脑脊液恢复耗时长,预后欠佳.产前预防、早期发现、及时足量足疗程的青霉素治疗对新生儿GBS脑膜炎患儿非常重要.%Objective To explore the clinical characteristics and outcome of group B streptococcus (GBS) induced neonatal meningitis and to provide the guide for early diagnosis and appropriate treatment.Methods A retrospective chart review was performed.A total of 19 cases of neonatal purulent meningitis caused by GBS and 22 cases of neonatal purulent meningitis caused by Escherichia coli were identified in the NICU of Guangzhou Women and Children's Medical Center from Nov 1,2011 to Apr 31,2014.The clinical features,treatments and clinical turnover were analysed.Results GBS meningitis accounted for 24.7% (19/77) of total bacterial positive cultures of blood or cerebral spinal fluid.The average time of progression to early-onset GBS meningitis of 6 early-onset cases mainly complaining of anhelation and groan

  17. 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...

  18. 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.

  19. The clinical impact of bacterial biofilms

    DEFF Research Database (Denmark)

    Høiby, Niels; Ciofu, Oana; Johansen, Helle Krogh;

    2011-01-01

    Bacteria survive in nature by forming biofilms on surfaces and probably most, if not all, bacteria (and fungi) are capable of forming biofilms. A biofilm is a structured consortium of bacteria embedded in a self-produced polymer matrix consisting of polysaccharide, protein and extracellular DNA....... Bacterial biofilms are resistant to antibiotics, disinfectant chemicals and to phagocytosis and other components of the innate and adaptive inflammatory defense system of the body. It is known, for example, that persistence of staphylococcal infections related to foreign bodies is due to biofilm formation....... Likewise, chronic Pseudomonas aeruginosa lung infections in cystic fibrosis patients are caused by biofilm growing mucoid strains. Gradients of nutrients and oxygen exist from the top to the bottom of biofilms and the bacterial cells located in nutrient poor areas have decreased metabolic activity...

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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 ...

  6. 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

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    Carmen Varela

    2007-10-01

    and the Minimum Basic Data Set (MBDS. The ESS was evaluated by using the Centers for Disease Control and Prevention (CDC criteria and by estimating the completeness of the system through the capture-recapture technique. Results: 111 cases of nMM were notified (62.2% in males and the mean age was 40.7 years. The largest proportion of cases (16.5% occurred in children under 2 years of age. The clinical presentation was meningitis in 81.1%. Diagnosis was through bacterial culture in 70.3%. Streptococcus sp. was found in 54% (82% due to S. pneumoniae, enterobacteria in 5.4%, Listeria and Staphylococcus in 4.5%, Pseudomonas aeruginosa in 1.8%, and Haemophilus influenzae in 0.9%. The incidence rate per 100,000 inhabitants was 1.6 in 2004 and 2.6 in 2001. The case fatality was 7.3%. The completeness of the mandatory reporting system reached a peak in 2004 at 84.4%. The combined completeness of the MBDS and the mandatory reporting system was above 85% and timeliness of reporting was 2 days. The acceptability of the system was high since 75% of all variables were complete in 97% of the questionnaires. Conclusion: We highlight the importance of evaluation of the ESS, based on its results. nMM due to S. pneumoniae represent an important group of diseases and their case fatality is high. The completeness of the ESS in Saragossa was over 80% when the mandatory reporting system and the MBDS were combined. Incorporating the MBDS into surveillance would facilitate the estimation of the incidence of various diseases subject to mandatory reporting.

  7. Computed tomography of tuberculous meningitis

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    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.

  8. 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

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    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.

  9. 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

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    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.

  10. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases

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    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.

  11. Clinical diagnosis value of immunoglobulin and c-reactive protein in cerebrospinal fluids for infectious meningitis in the aged patients%脑脊液免疫球蛋白与C-反应蛋白对感染性脑膜炎老年患者临床诊断的价值

    Institute of Scientific and Technical Information of China (English)

    沈壮虹; 汪利平; 林红

    2016-01-01

    OBJECTIVE To test the cerebrospinal fluid level of immunoglobulin (Ig) and C-reactive protein (CRP) in elderly patients with infectious meningitis ,so as to explore the clinical diagnostic value of Ig and CRP and pro-vide reference for clinical diagnosis .METHODS Totally 65 elderly cases of infectious meningitis from Jul .2012 to Feb .2015 in our hospital were selected as the observation group which was subdivided into the bacterial suppura-tive meningitis group (n = 20) ,the viral meningitis group (n = 23) and the tuberculous meningitis group (n =22) .Another 65 elderly hospitalized headache patients during the same time in our hospital were selected as the control group .The two groups were compared for immunoglobulin (IgA ,IgM and IgG) and C-reactive protein levels in cerebrospinal fluids .RESULTS Compared with the control group ,each related indicator of immunoglobu-lin and C-reactive protein levels in cerebrospinal fluids were significantly higher in the observation group (P < 0 . 05) .Compared with the bacterial suppurative meningitis patients and the viral meningitis patients ,IgA and IgM levels in patients with tuberculous meningitis were significantly increased (P < 0 .05) .Compared with bacterial suppurative meningitis and tuberculous meningitis patients ,IgG levels in viral meningitis patients were increased significantly (P <0 .05) .In terms of cerebrospinal fluid level of C-reactive protein ,the comparison had significant differences among the patients with 3 types of infecions meningitis ,there was significant difference (P <0 .05) . CONCLUSION In elderly patients with septic meningitis ,immunoglobulin and C-reactive protein levels in cerebro-spinal fluids were significantly elevated .Early detection of immunoglobulin and C-reactive protein in cerebrospinal fluids has an important clinical value for diagnosis of geriatric infectious meningitis .%目的:检测老年感染性脑膜炎患者的脑脊液免疫球蛋白及C-反应蛋白(CRP)水平

  12. 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.

  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. Variáveis clínicas e laboratoriais para o diagnóstico diferencial entre meningites asséptica e piogênica em crianças Laboratorial and clinical variables to the differential diagnosis between aseptic and pyogenic meningitis in children

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    Rita Lucena

    1997-09-01

    Full Text Available Foram estudadas informações obtidas do prontuário de 573 crianças com idade entre 1 mês e 15 anos e diagnóstico de meningite, internadas no Hospital Couto Maia, na cidade de Salvador-Bahia, no período de janeiro-1990 a dezembro-1992. Crises epilépticas, diminuição do nível de consciência e rigidez de nuca foram mais frequentes no grupo com meningite bacteriana. Glicorraquia menor que 45 mg/dL, proteinorraquia igual ou superior a 140 mg/dL e celularidade liquórica superior a 600 cels/mm³ mostraram-se preditores de meningite piogênica. A análise da curva ROC foi utilizada para estabelecer o melhor ponto de corte nas medidas liquóricas de celularidade, proteínas e glicose capaz de predizer meningite bacteriana. Os resultados encontrados enfatizam que informações clínicas, obtidas com a anamnese e o exame neurológico, e liquóricas simples, definidas pelos níveis de proteína, glicose e análise da celularidade, podem ser utilizadas como medidas de grande acurácia para diferenciar meningite piogênica de asséptica em crianças.We reviewed the charts of 573 children with a final diagnosis of pyogenic or aseptic meningitis, who were hospitalized in a large reference hospital for the treatment of infectious disease, from January 1990 to December 1992. Seizures, decreased consciousness, nuchal rigidity were more frequent in bacterial than in aseptic meningitis. A cerebrospinal fluid (CSF glucose level lower than 45 mg/dL, a protein level equal or greater than 140 mg/dL and cell count greater than 600/mm³ were predictors of pyogenic meningitis. Receiver operating characteristic curve analysis was used to assess the best point in CSF measures of leukocytes, glucose and protein that could predict bacterial meningitis. These results suggest that clinicians should differentiate bacterial from aseptic meningitis in children with greater accuracy utilizing only clinical and simple CSF data.

  15. 恶性肿瘤合并隐球菌脑膜炎临床分析%Clinical analysis of cryptococcal meningitis in patients with malignant tumors

    Institute of Scientific and Technical Information of China (English)

    刘晨; 黄赟; 李智文

    2014-01-01

    Objective To analyze the clinical features of cryptococcal meningitis in cancer patients as well as the risk factors for this disease. Methods Clinical data for 32 patients with malignant tumors and cryptococcal meningitis were retrospectively analyzed using single-and multiple-factor logistic regression. Results The most frequent symptoms of cryptococcal meningitis were fever and headache. Other than significantly elevated cerebrospinal fluid pressure,patients with cryptococcal meningitis did not show any specific signs or symptoms based on routine examination of cerebrospinal fluid,biochemical tests,computed tomography or magnetic resonance imaging. Cryptococcal meningitis was able to be confirmed by detecting cryptococcus in cerebrospinal fluid by microscopy or in a culture test. Multifactorial analysis identified the following factors as significant predictors of whether a patient would suffer cryptococcal meningitis (P<0.05):to what extent bone marrow was suppressed,whether broad-spectrum antibiotics were administered quickly after onset of symptoms,whether the patient received both chemotherapy and radiotherapy,whether the patient underwent an invasive operation, and whether the patient had reduced albumin levels or was in poor physical condition. Conclusion Decreasing the rate of cryptococcal infection of patients with malignant tumors involves reducing or eliminating risk factors,strengthening immunity and providing supportive care. Early diagnosis of infection and early antifungal therapy can improve the prognosis of cancer patients with cryptococcal meningitis.%目的:探讨恶性肿瘤合并隐球菌脑膜炎患者的临床特点及相关危险因素。方法采用回顾性分析方法,通过logistic回归模型单因素和多因素分析对32例恶性肿瘤合并隐球菌脑膜炎患者的临床资料进行分析。结果恶性肿瘤合并隐球菌脑膜炎患者以发热、头痛为常见临床表现,脑脊液压力显著升高,脑脊液生化

  16. Outbreak of Enterovirus - 71 Meningitis in Calicut

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    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.

  17. Cryptococcal meningitis

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    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.

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

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    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.

  19. Clinical significance of C-reactive protein and immunoglobulin in cerebrospinal fluid for children infected with meningitis%脑脊液C反应蛋白及免疫球蛋白对儿童感染性脑膜炎的临床诊断意义

    Institute of Scientific and Technical Information of China (English)

    周丽华

    2013-01-01

    Objective To investigate the clinical significance of C-reactive protein and immunoglobulin in cerebrospinal fluid for children infected with meningitis.Methods One hundred and fifty children diagnosed with infectious meningitis and 50 healthy children in the same period were chosen as the study group and the control group respectively.The CRP and immunoglobulins (IgA,IgM,IgG indicators) were detected.Results All the indicators of the study group were higher than those of the control group(P<0.05).The IgA and IgM of the tuberculous meningitis group was higher than those of the bacterial infections and viral infections group (P < 0.05).The IgA of the bacterial purulent meningitis was higher than that of the tuberculosis and viral infections group (P<0.05).And there was no significant difference between the three groups (P >0.05).Conclusion The c-reactive protein and immunoglobulin may be used as effective indicators of the detection of meningitis and be of great clinical value.%目的 探讨C反应蛋白(CRP)及免疫球蛋白检测在儿童感染性脑膜炎临床诊断中的应用价值.方法 选取确诊为感染性脑膜炎的患儿150例作为观察组,选取同期健康患儿50例为对照组,分别检测2组患儿脑脊液CRP和免疫球蛋白(IgA、IgM、IgG)相关指标.结果 观察组临床生化指标检测结果均高于正常对照组,P均<0.05.其中结核性脑膜炎组(观察组2)IgA和IgM高于细菌感染和病毒感染组(观察组1和3),P<0.05;细菌化脓性脑膜炎组(观察组1)IgA高于结核组和病毒感染组,P<0.05;3种感染性脑膜炎患儿CRP间差异无统计学意义,P>0.05.结论 C反应蛋白和免疫球蛋白检测可作为脑膜炎检测的有效指标,具有较大的临床应用价值.

  20. C-REACTIVE PROTEIN AND LACTATE DEHYDROGENASE IN SERUM AND CEREBROSPINAL FLUID IN RAPID AND EARLY DIAGNOSIS OF CHILDHOOD MENINGITIS

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    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.

  1. 结核性脑膜炎与病毒性脑炎临床分析%Clinical analysis of tubercular meningitis and viral encephalitis

    Institute of Scientific and Technical Information of China (English)

    赵二义; 王带媚

    2015-01-01

    Objective To explore the clinical manifestations, cerebrospinal fluid (CSF), electroencephalogram (EEG) and magnetic resonance imaging (MRI) of both tubercular meningitis and viral encephalitis, and to provide clinical evidence for diagnosis and treatment. Methods Clinical data about the clinical manifestations, CSF, EEG and MRI re-sults of 64 tubercular meningitis and 62 viral encephalitis patients in our hospital from February 2008 to March 2014 were retrospectively analyzed. Results Clinical data showed that the incidence of cranial nerves injury and hyponatre-mia in patients with tubercular meningitis was higher than that in patients with viral encephalitis (P<0.05), and the inci-dence of epilepsy, mental disorders and unconsciousness in patients with tubercular meningitis was lower than that in pa-tients with viral encephalitis (P<0.05). There were statistically significant differences of the protein, chloride, ADA and cytological findings in CSF between both groups (P<0.05). And there were also statistically significant differences of the abnormal EEG detection rate and cranial MRI lesions between both groups (P<0.05). Conclusion The clinical manifes-tation, CSF, EEG and cranial MRI of tubercular meningitis and viral encephalitis all showed their characteristics and can play important roles in clinical diagnosis and treatment.%目的 探讨结核性脑膜炎与病毒性脑炎的临床表现、脑脊液、脑电图及头颅MRI特点,为诊断及治疗提供依据.方法 回顾性分析海南省人民医院2008年2月至2014年3月临床诊断为结核性脑膜炎(64例)和病毒性脑炎(62例)的患者的临床表现、脑脊液、脑电图及头颅MR等结果.结果 (1)临床资料显示结脑组患者发生颅神经损害及低钠血症比率高于病脑组,而病脑组发生癫痫、精神障碍及意识障碍的概率高于结脑组,差异均有统计学意义(P<0.05);(2)结脑组脑脊液(CSF)的蛋白、氯化物、腺苷脱氨酶(ADA)及细胞学与

  2. 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.

  3. Neuroimaging in tuberculous meningitis

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    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.

  4. Meningitis tras anestesia espinal Meningitis after a spinal anesthesia

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    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.

  5. 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。

  6. 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

  7. 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.

  8. 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.

  9. 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 ...

  10. 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 ...

  11. 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 ...

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

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

    2012-01-01

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

  13. 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.

  14. Clinical manifestations of AIDS with cryptococcal meningitis%艾滋病合并隐球菌脑膜炎18例临床分析

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To increase the awareness of AIDS with cryptococcal meningitis. Methods Eighteen cases of confirmed AIDS with cryptococcal meningitis in the Bata Regional Hospital, Equatorial Guinea from January 1997 to November 1999 were analyzed. Results The clinical manifestations of the 18 cases were: insidious onset, fever, severe headache, generalized pain, nausea and vomiting, weight loss and dehydration, and enlarged cervical lymph nodes. Boa's and Cullen's signs were positive. The positive rates of cerebrospinal fluid (CSF) India ink stain and the polysaccharide capsule antigen (ELISA) were 77.8% and 99.4%, respectively. The positive rate of CSF culture of cryptococcus was 100%. The mortality rate was 83.3%. Conclusion Cryptococcal meningitis is the most common opportunistic infection and one of the major causes of deaths in AIDS patients. The misdiagnosis and mortality rates were very high and could be explained by a lack of awareness for the occurrence of AIDS with cryptococcal meningitis, late presentation, serious illness and severe complications, and delayed and inadequate therapy.%目的提高对艾滋病(AIDS)合并隐球菌脑膜炎的认识。 方法对赤道几内亚巴塔地区医院1997年1月~1999年11月确诊的18例AIDS合并隐球菌脑膜炎进行分析。 结果 18例患者的临床主要表现为:起病隐匿;发热、剧烈头痛、全身疼痛、恶心呕吐、消瘦脱水、颈淋巴结肿大、布氏征与克氏征阳性、巴彬氏征阳性;脑脊液检查:隐球菌印度墨汁染色及隐球菌多糖荚膜抗原阳性率分别为77.8%,94.4%;脑脊液隐球菌培养均为阳性。病死率为83.3%。 结论隐球菌脑膜炎是AIDS患者最常见的机会感染和致死病因。误诊及病死率高的主要原因系临床医生对本病的认识不足,治疗欠及时合理。

  15. Carcinomatous meningitis mimicking Creutzfeldt-Jakob disease

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    Vas C

    2004-07-01

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

  16. 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.

  17. 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

  18. V-akt murine thymoma viral oncogene homolog 3 (AKT3) contributes to poor disease outcome in humans and mice with pneumococcal meningitis.

    Science.gov (United States)

    Valls Serón, Mercedes; Ferwerda, Bart; Engelen-Lee, JooYeon; Geldhoff, Madelijn; Jaspers, Valery; Zwinderman, Aeilko H; Tanck, Michael W; Baas, Frank; van der Ende, Arie; Brouwer, Matthijs C; van de Beek, Diederik

    2016-05-18

    Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Here, we have performed a prospective nationwide genetic association study using the Human Exome BeadChip and identified gene variants in encoding dynactin 4 (DCTN4), retinoic acid early transcript 1E (RAET1E), and V-akt murine thymoma viral oncogene homolog 3 (AKT3) to be associated with unfavourable outcome in patients with pneumococcal meningitis. No clinical replication cohort is available, so we validated the role of one of these targets, AKT3, in a pneumococcal meningitis mouse model. Akt3 deficient mice had worse survival and increased histopathology scores for parenchymal damage (infiltration) and vascular infiltration (large meningeal artery inflammation) but similar bacterial loads, cytokine responses, compared to wild-type mice. We found no differences in cerebrospinal fluid cytokine levels between patients with risk or non-risk alleles. Patients with the risk genotype (rs10157763, AA) presented with low scores on the Glasgow Coma Scale and high rate of epileptic seizures. Thus, our results show that AKT3 influences outcome of pneumococcal meningitis.

  19. [Bacterial genomics and metagenomics: clinical applications and medical relevance].

    Science.gov (United States)

    Diene, S M; Bertelli, C; Pillonel, T; Schrenzel, J; Greub, G

    2014-11-12

    New sequencing technologies provide in a short time and at low cost high amount of genomic sequences useful for applications such as: a) development of diagnostic PCRs and/or serological tests; b) detection of virulence factors (virulome) or genes/SNPs associated with resistance to antibiotics (resistome) and c) investigation of transmission and dissemination of bacterial pathogens. Thus, bacterial genomics of medical importance is useful to clinical microbiologists, to infectious diseases specialists as well as to epidemiologists. Determining the microbial composition of a sample by metagenomics is another application of new sequencing technologies, useful to understand the impact of bacteria on various non-infectious diseases such as obesity, asthma, or diabetes. Genomics and metagenomics will likely become a specialized diagnostic analysis.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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....

  5. Edaravone attenuates hippocampal damage in an infant mouse model of pneumococcal meningitis by reducing HMGB1 and iNOS expression via the Nrf2/HO-1 pathway

    Science.gov (United States)

    Li, Zheng; Ma, Qian-qian; Yan, Yan; Xu, Feng-dan; Zhang, Xiao-ying; Zhou, Wei-qin; Feng, Zhi-chun

    2016-01-01

    Aim: Edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) is a free radical scavenger that has shown potent antioxidant, anti-inflammatory and neuroprotective effects in variety of disease models. In this study, we investigated whether edaravone produced neuroprotective actions in an infant mouse model of pneumococcal meningitis. Methods: C57BL/6 mice were infected on postnatal d 11 by intracisternal injection of a certain inoculum of Streptococcus pneumoniae. The mice received intracisternal injection of 10 μL of saline containing edaravone (3 mg/kg) once a day for 7 d. The severity of pneumococcal meningitis was assessed with a clinical score. In mice with severe meningitis, the survival rate from the time of infection to d 8 after infection was analyzed using Kaplan-Meier curves. In mice with mild meningitis, the CSF inflammation and cytokine levels in the hippocampus were analyzed d 7 after infection, and the clinical neurological deficit score was evaluated using a neurological scoring system d 14 after infection. The nuclear factor (erythroid-derived 2)-like 2 knockout (Nrf2 KO) mice and heme oxygenase-1 knockout (HO-1 KO) mice were used to confirm the involvement of Nrf2/HO-1 pathway in the neuroprotective actions of edaravone. Results: In mice with severe meningitis, edaravone treatment significantly increased the survival rate (76.4%) compared with the meningitis model group (32.2%). In mice with mild meningitis, edaravone treatment significantly decreased the number of leukocytes and TNF- levels in CSF, as well as the neuronal apoptosis and protein levels of HMGB1 and iNOS in the hippocampus, but did not affect the high levels of IL-10 and IL-6 in the hippocampus. Moreover, edaravone treatment significantly improved the neurological function of mice with mild meningitis. In Nrf2 KO or HO-1 KO mice with the meningitis, edaravone treatment was no longer effective in improving the survival rate of the mice with severe meningitis (20.2% and 53.6%, respectively

  6. 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.

  7. 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.

  8. 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

  9. A Practical Approach to Meningitis and Encephalitis.

    Science.gov (United States)

    Richie, Megan B; Josephson, S Andrew

    2015-12-01

    Meningitis is an inflammatory syndrome involving the meninges that classically manifests with headache and nuchal rigidity and is diagnosed by cerebrospinal fluid examination. In contrast, encephalitis refers to inflammation of the brain parenchyma itself and often results in focal neurologic deficits or seizures. In this article, the authors review the differential diagnosis of meningitis and encephalitis, with an emphasis on infectious etiologies. The recommended practical clinical approach focuses on early high-yield diagnostic testing and empiric antimicrobial administration, given the high morbidity associated with these diseases and the time-sensitive nature of treatment initiation. If the initial workup does not yield a diagnosis, further etiology-specific testing based upon risk factors and clinical characteristics should be pursued. Effective treatment is available for many causes of meningitis and encephalitis, and when possible should address both the primary disease process as well as potential complications.

  10. 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

    -69.Hom J, Medwid K, The low rate of bacterial meningitis in children, ages 6 to 18 months, with simple febrile seizures. AcadEmerg Med 2011; 18(11:1114-1120.Fetveit A. Assessment of febrile seizures in children. Eur J Pediatr 1998; 167(1; 17-27.Subcommittee on Febrile Seizures. Febrile seizures: Guidelines for the neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011; 127(2:389-394.Rosman NP. Evaluation of the child who convulses with fever. Pediatr Drugs 2003; 5(7:457- 461.Dubos F, De la Rocque F, Levy C et al. Sensitivity of the bacterial meningitis score in 889 children with bacterial meningitis. J Pediatr 2008; 152:378-382.Nigrovic LE, Kuppermann N, Macias CG, et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA 2007; 297(1:52-60.American Academy of Pediatrics. Provisional Committee on quality improvement, Subcommittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatrics 1997; 769-772.Najaf-Zadeh A, Dubos F, Hue V, et al. Risk of bacterial meningitis in young children with a first seizure in the context of fever: a systematic review and meta- analysis. PLoS One. 2013; 8(1:e55270. Doi: 10. 1371/journal. pone.0055270.Owusu-Ofori A, Agbenyega T, Ansong D, et al. Routine lumbar puncture in children with febrile seizures in Ghana: should it continue? International Journal of Infectious Diseases 2004; 8:353-361.Kimia AA, Capraro AJ, Hummel D, Johnston P, Harper MB. Utility of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age. Pediatrics 2009; 123(1: 6–12.Shaked O, Pena BM, Linares MY, Baker RL. Simple febrile seizures: are the AAP guidelines regarding lumbar puncture being followed? Pediatr Emerg Care 2009; 25(1:8-11.Seltz LB, Cohen E, Weinstein M. Risk of bacterial or herpes simplex virus meningitis/encephalitis in children with complex

  11. A variant epidemic methicillin resistant Staphylococcus aureus-15 cavernous sinus thrombosis and meningitis: A rare occurrence with unusual presentation

    Directory of Open Access Journals (Sweden)

    Veena Kumari H

    2010-01-01

    Full Text Available Septic cavernous sinus thrombosis (CST is an uncommon clinical syndrome. Although Staphylococcus aureus (S aureus is the most common bacterial pathogen causing CST, it is infrequent as a cause of meningitis. We report the first case of CST and meningitis from Bengaluru, Karnataka, caused by community-acquired epidemic methicillin resistant Staphylococcus aureus-15 (EMRSA-15, in a previously healthy individual without known risk factors; the patient recovered following treatment with vancomycin. The isolate was genotyped as belonging to staphylococcal cassette chromosome mec type IV and sequence type 22 and carried the panton-valentine leucocidin gene. It is the first Indian EMRSA-15 disease isolate from a case of meningitis. EMRSA-15 has been a major problem in hospitals in UK and it is a cause for great concern in Indian hospitals too.

  12. 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.)

  13. 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

  14. 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

    criteria of intracranial infection,they were divided into either a bacterial infection group (n =50) or an aseptic meningitis group (n =128).The cerebrospinal fluid PCT and its changes of the traditional cerebrospinal fluid detection index were compared.The receiver operating characteristic curve (ROC) was used to analyze the values of cerebrospinal fluid PCT for identifying the infection and aseptic meningitis.Results Compared with the aseptic meningitis group,the white blood cell count,polynuclear cell ratio,protein content,and PCT content were all increased in the cerebrospinal fluid of bacterial infection,and the blood glucose was reduced.There were significant differences (all P < 0.01).There was no significant difference in chloride.The median (range) of cerebrospinal fluid PCT in the bacterial infection group was 0.15 ng/ml (0-3.09 ng/ml),and in the aseptic meningitis group was 0 ng/ml (0-0.46 ng/ml).The ROC results showed that the area under curve of the differential diagnosis of intracranial bacterial infection was 0.746.The diagnostic threshold was 0.075 ng/ml,the sensitivity was 68.0%,specificity was 72.7%,positive predictive value was 49.3%,and negative predictive value was 85.3%.The PCT in cerebrospinal fluid was positively correlated with theleukocyte,proportion of multinucleated cells,and protein (r =0.446,0.453,and 0.482,respectively,all P<0.01).It was negatively correlated with glucose (r=-0.201,P=0.007).Conclusion The detection of PCT in cerebrospinal fluid has an important clinical application value for the diagnosis of intracranial bacterial infection after neurosurgical operation.

  15. Review of idiopathic eosinophilic meningitis in dogs and cats, with a detailed description of two recent cases in dogs : review and clinical communication

    Directory of Open Access Journals (Sweden)

    J.H. Williams

    2008-05-01

    Caesarian section after developing a non-responsive inertia 8 days prior to presentation. This animal's clinical signs included status epilepticus seizures unrelated to hypocalcaemia and warranted induction of a barbiturate coma. She died 4 hours later. Post mortem and histopathological findings in the brain were almost identical to those of the Boerboel and she also showed histological evidence of recent active intravascular haemolysis with microcyte formation. Rabies, distemper and Neospora caninum immunohistochemical stains were negative in the brains of both dogs. Immunohistochemical staining of the cerebral and meningeal exudates of the Beagle for T- and B-lymphocyte (CD3 and CD79a markers showed a predominance of T-lymphocytes with fewer scattered B lymphocytes. A possible allergic response to amoxicillin / clavulanate is considered, as this appeared to be the only feature common to the recent history of both animals. An overview of EME in humans, dogs and cats is given and the previously published cases of idiopathic EME in dogs and the single published cat case are briefly reviewed.

  16. 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

  17. 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 ...

  18. 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.

  19. 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

  20. Method for inducing experimental pneumococcal meningitis in outbred mice

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    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.

  1. Interactions between blood-borne Streptococcus pneumoniae and the blood-brain barrier preceding meningitis.

    Directory of Open Access Journals (Sweden)

    Federico Iovino

    Full Text Available 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 preceding immediate disease development. To study the interactions between pneumococci and the vascular endothelium of the blood-brain barrier prior to meningitis we used an established bacteremia-derived meningitis model in combination with immunofluorescent imaging. Brain tissue of mice infected with S. pneumoniae strain TIGR4, a clinical meningitis isolate, was investigated for the location of the bacteria in relation to the brain vasculature in various compartments. We observed that S. pneumoniae adhered preferentially to the subarachnoid vessels, and subsequently, over time, reached the more internal cerebral areas including the cerebral cortex, septum, and choroid plexus. Interestingly, pneumococci were not detected in the choroid plexus till 8 hours-post infection. In contrast to the lungs, little to no leukocyte recruitment to the brain was observed over time, though Iba-1 and GFAP staining showed that microglia and astrocytes were activated as soon as 1 hour post-infection. Our results imply that i the local immune system of the brain is activated immediately upon entry of bacteria into the bloodstream and that ii adhesion to the blood brain barrier is spatiotemporally controlled at different sites throughout the brain. These results provide new information on these two important steps towards the development of pneumococcal meningitis.

  2. 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.

  3. Current and past strategies for bacterial culture in clinical microbiology.

    Science.gov (United States)

    Lagier, Jean-Christophe; Edouard, Sophie; Pagnier, Isabelle; Mediannikov, Oleg; Drancourt, Michel; Raoult, Didier

    2015-01-01

    A pure bacterial culture remains essential for the study of its virulence, its antibiotic susceptibility, and its genome sequence in order to facilitate the understanding and treatment of caused diseases. The first culture conditions empirically varied incubation time, nutrients, atmosphere, and temperature; culture was then gradually abandoned in favor of molecular methods. The rebirth of culture in clinical microbiology was prompted by microbiologists specializing in intracellular bacteria. The shell vial procedure allowed the culture of new species of Rickettsia. The design of axenic media for growing fastidious bacteria such as Tropheryma whipplei and Coxiella burnetii and the ability of amoebal coculture to discover new bacteria constituted major advances. Strong efforts associating optimized culture media, detection methods, and a microaerophilic atmosphere allowed a dramatic decrease of the time of Mycobacterium tuberculosis culture. The use of a new versatile medium allowed an extension of the repertoire of archaea. Finally, to optimize the culture of anaerobes in routine bacteriology laboratories, the addition of antioxidants in culture media under an aerobic atmosphere allowed the growth of strictly anaerobic species. Nevertheless, among usual bacterial pathogens, the development of axenic media for the culture of Treponema pallidum or Mycobacterium leprae remains an important challenge that the patience and innovations of cultivators will enable them to overcome.

  4. [Benign recurring aseptic meningitis. What requires our attention?].

    Science.gov (United States)

    Kruis, T; Kredel, L; Nassir, M; Godbersen, M; Schneider, T

    2016-02-01

    Benign recurrent aseptic meningitis (BRAM) or Mollaret's meningitis is a rare disease characterized by recurrent episodes of aseptic meningitis followed by spontaneous recovery. Disease courses over several years have been reported. In most cases, BRAM is caused by HSV-2, less frequently by other viruses or autoimmune diseases. In up to 10 %, the aetiology remains unclear. We present a case of idiopathic BRAM and discuss clinical findings, diagnosis and therapeutic options of this rare illness.

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

    Science.gov (United States)

    Mrelashvili, Anna; Braksick, Sherri A; Murphy, Lauren L; Morparia, Neha P; Natt, Neena; Kumar, Neeraj

    2014-04-01

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

  6. Clinical, Laboratory and Bacterial Profile of Spontaneous Bacterial Peritonitis in Chronic Liver Disease Patients

    International Nuclear Information System (INIS)

    Objective: To determine the clinical and laboratory features, bacterial profile and antibiotic sensitivity pattern of Spontaneous Bacterial Peritonitis (SBP) in Chronic Liver Disease (CLD) patients presenting at a tertiary care hospital of Karachi. Study Design: Cross-sectional study. Place and Duration of Study: PMRC Centre for Gastroenterology and Hepatology and Jinnah Postgraduate Medical Centre, Karachi, from April 2010 to March 2012. Methodology: CLD patients with ascites were recruited from PMRC Centre for Gastroenterology and Hepatology and Jinnah Postgraduate Medical Centre, Karachi. Basic demographics, symptoms and clinical signs of patients were recorded. Patients with the history of antibiotic use within last 3 days or any intra-abdominal source of infection were excluded. Diagnostic paracentesis was done for ascitic fluid detailed report (D/R) and culture. Blood sample was collected for total leukocyte count, serum proteins and billirubin levels. Results: Out of a total 152 CLD patients, 38 (25%) were diagnosed with SBP. Eight (24.2%) patients presented with classical SBP, 20 (52.6%) had culture negative neutrocytic ascites and 10 (26%) had bacterascites. Fever, abdominal tenderness and constipation were common in SBP patients. Ascitic fluid culture was positive in 19 (50%) patients. E. coli (65%) was the predominant pathogen followed by Enterococcus species (15%). Resistance was high against cephalosporins (78%) and fluoroquinolones (69.6%) and least against amikacin (13%) and meropenem (12%). Conclusion: Ascitic fluid D/R and culture together can lead to the accurate diagnosis of SBP and can guide for the right antibiotic choice as resistance to commonly prescribed antibiotic is common in such patients. (author)

  7. Cryptococcus neoformans meningitis:a clinical analysis of 12 cases%新型隐球菌性脑膜炎12例临床分析

    Institute of Scientific and Technical Information of China (English)

    杜彭; 巩路

    2015-01-01

    ABSTRACT:Objective To improve the understanding of cryptococcus neoformans meningitis (CNM) by analyzing the clinical data of 12 patients with CNM.Methods The clinical manifestations, cerebrospinal fluid characteristics and treatments of 12 patients with CNM were retrospectively analyzed.Results The onset of CNM was insidious,the clinical check and biochemical cerebrospinal fluid examination had a low specificity and a high misdiagnosed rate.Conclusion Repeated cerebrospinal fluid examination for the pathogens may be the key for the definite diagnosis.%目的:分析12例新型隐球菌性脑膜炎临床资料,以提高对本病的认识。方法对12例隐球菌性脑膜炎患者临床表现,脑脊液特点和诊疗进行回顾性分析。结果隐球菌性脑膜炎起病隐匿,临床及脑脊液生化检查特异性不高,误诊率高。结论反复行脑脊液检查以查找病原菌是隐球菌性脑膜炎确诊的关键。

  8. Severe bacterial infections in patients with non-transfusion-dependent thalassemia: prevalence and clinical risk factors

    Directory of Open Access Journals (Sweden)

    Nattiya Teawtrakul

    2015-10-01

    Conclusion: The prevalence of bacterial infection in patients with NTDT was found to be moderate. Time after splenectomy >10 years, deferoxamine therapy, and iron overload may be clinical risk factors for severe bacterial infection in patients with NTDT. Bacterial infection should be recognized in splenectomized patients with NTDT, particularly those who have an iron overload.

  9. Localized basal meningeal enhancement in tuberculous meningitis

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    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.)

  10. Tobacco use increases susceptibility to bacterial infection

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    Demuth Donald R

    2008-12-01

    Full Text Available Abstract Active smokers and those exposed to secondhand smoke are at increased risk of bacterial infection. Tobacco smoke exposure increases susceptibility to respiratory tract infections, including tuberculosis, pneumonia and Legionnaires disease; bacterial vaginosis and sexually transmitted diseases, such as chlamydia and gonorrhoea; Helicobacter pylori infection; periodontitis; meningitis; otitis media; and post-surgical and nosocomial infections. Tobacco smoke compromises the anti-bacterial function of leukocytes, including neutrophils, monocytes, T cells and B cells, providing a mechanistic explanation for increased infection risk. Further epidemiological, clinical and mechanistic research into this important area is warranted.

  11. 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

    目的 研究新生儿细菌性脑膜炎(BM)脑脊液(CSF)中激活素A( ACT A)水平的变化及其对预后判断的意义.方法 对2010年3月-2011年6月在本院新生儿病房住院的48例确诊BM患儿,进行3~18个月的随访及回顾性分析,分为有并发症和后遗症组(A组)和无并发症和后遗症组(B组).另收集同期住院的非颅内疾病患儿作为对照组(C组).应用EHSA法动态监测3组患儿CSF中ACT A水平.结果 A组患儿急性期CSF中ACT A水平为(544.39±149.62) ng·L-1,B组CSF中ACT A水平为(480.82±128.24) ng·L-1,二组间差异无统计学意义,但2组均高于C组[(181.06±45.20) ng·L-1](Pa<0.01).治疗1周,A组CSF中ACT A水平为(315.84±86.35) ng·L-1、B组为(338.25±99.43) ng·L-1,2组较治疗前显著下降(Pa<0.05),但2组间差异无统计学意义(P=0.432).治疗2周,A组CSF中ACT A水平为(188.19±43.38) ng·L-1,B组为(203.86±50.73) ng·L-1,2组差异无统计学意义(P=0.281).治疗3周,A组CSF中ACT A水平为(107.65±17.65)ng·L-1,B组为( 169.36±28.90)ng·L-1,A组明显低于B组(P =0.000).治疗4周,A组CSF中ACT A水平为(98.54±28.54) ng·L-1,B组为(181.84 ±35.01)ng·L-1,A组显著低于B组(P=0.000).结论 ACT A参与新生儿BM的发病过程,动态检测CSF中ACT A水平,对评估新生儿BM的预后,可能具有重要价值.%Abstract; Objective To evaluate the changes of activin A( ACT A) level in cerebrospinal fluid(CSF) in neonatal bacterial meningitis and its clinical value for prognosis evaluation. Methods Forty - eight neonatal bacterial meningitis in Tianjin Children's Hospital from Mar. 2010 to Jun. 2011 were visited for 3-18 months and analyzed retrospectively. All the patients were divided into 2 groups: neonatal bacterial meningitis with the complications and (or) sequelae group (group A) ,without the complications and sequelae group (group B) ,and the children without brain disease were selected as control group (group C). The levels of ACT A in cerebrospinal

  12. [Eosinophllic meningitis, a very rare entity in Europe].

    Science.gov (United States)

    Tudisco, Jean-Blaise; Fumeaux, Christophe; Petignat, Pierre-Auguste

    2013-11-13

    Eosinophilic meningitis is a rare entity, which is a complication of an underlying disease. Its diagnosis and treatment is always a challenge for the hospital practitioner. The aim of this case report and review is to identify the most important aetiologies, and show the diagnostic and therapeutic modalities of Eosinophilic meningitis. The most frequent causes of Eosinophilic meningitis are parasitic and fungal infections. In Europe Eosinophilic meningitis is essentially seen in travellers returning from endemic areas for these agents. The treatment is directed against the underlying disease and can differ depending on the aetiology and severity of the clinical manifestations.

  13. 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.

  14. 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.

  15. Comparison of real time IS6110-PCR, microscopy, and culture for diagnosis of tuberculous meningitis in a cohort of adult patients in Indonesia.

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    Lidya Chaidir

    Full Text Available BACKGROUND: Bacteriological confirmation of tuberculous (TB meningitis is difficult. Culture is slow and microscopy has insufficient sensitivity. We evaluated real time PCR targeting insertion sequence IS6110 among 230 consecutive adult patients with subacute meningitis in a referral hospital in Indonesia. METHODS: Cerebrospinal fluid (CSF samples were examined using microscopy, solid and liquid culture, and real time IS6110-PCR with a fluorescence-labeled probe using DNA extracted from CSF. CSF samples from 40 non-infectious neurology patients were used as negative controls. IS6110-PCR results were linked with clinical and CSF characteristics. RESULTS: Most patients presented with subacute meningitis, after a median of 14 days of symptoms (range 7-30. After exclusion of cryptococcal and bacterial meningitis, 207 patients were classified as definite or probable TB meningitis; 17.9% with HIV infection. Among this group IS6110-PCR gave the highest positivity rate (68%, 95% CI 62-74% compared with microscopy of ZN-stained slides (11%, 95% CI 7-15%, and mycobacterial culture using solid (36%, 95% CI 29-42% and liquid (44%, 95% CI 37-51% media. IS6110-PCR was positive in 92% of patients with culture-positive and 42% of patients with culture-negative probable TB meningitis. Among culture-negative patients, a positive PCR was associated with a history of TB treatment, a longer duration of illness, a higher CSF cell count and protein, and a lower CSF glucose. IS6110-PCR was negative in all CSF samples from non-meningitis control patients. CONCLUSIONS: Real time IS6110-PCR is a quick, sensitive, and specific test for diagnosing of TB meningitis in this setting. Its performance in other (less-developed settings needs further study.

  16. Detection and DNA quantification of Enterococcus casseliflavus in a foal with septic meningitis.

    Science.gov (United States)

    Stefanetti, Valentina; Beccati, Francesca; Passamonti, Fabrizio; Sgariglia, Elisa; Coletti, Mauro; Vuerich, Matteo; Marenzoni, Maria Luisa

    2016-07-01

    CASE DESCRIPTION A 3-month-old 180-kg (396-lb) Hanoverian colt was examined because of fever, lethargy, inappetence, drooping of the left ear, and stiff neck posture. Initial treatment included empirical antimicrobial treatment and NSAIDs. CLINICAL FINDINGS Initial findings were consistent with CNS anomalies. Endoscopy revealed hyperemia, ecchymosis, and some mucopurulent exudate in the right guttural pouch. Hematologic findings were consistent with neutrophilic inflammation. On the third day of hospitalization, severe neurologic signs were observed. Computed tomography of the skull revealed a comminuted fracture of the axial aspect of the right mandibular condyle. Examination of CSF revealed turbidity, xanthochromia, and intracellular and extracellular cocci, consistent with septic meningitis. After DNA extraction from blood and CSF, sequenced products from a PCR assay for the bacterial 16S rRNA gene were 99% identical to Enterococcus casseliflavus. Microbial culture of CSF and blood samples yielded bacteria with Enterococcus spp morphology; antimicrobials were selected on the basis of susceptibility testing that identified the isolate as vancomycin resistant. A quantitative PCR assay was used to estimate Enterococcus DNA concentrations in CSF and blood. TREATMENT AND OUTCOME Treatment for E casseliflavus meningitis, including trimethoprim-sulfadiazine and ampicillin sodium administration, resulted in resolution of clinical signs. Culture of CSF and blood samples after 12 days of the targeted treatment yielded no growth. CLINICAL RELEVANCE To the authors' knowledge, this was the first report of E casseliflavus meningitis in a horse. Treatment was successful; vancomycin-resistant enterococci can be a clinical problem and may potentially be zoonotic.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  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. Experience of Clinical Nursing for Viral Meningitis With Symptomatic Epilepsy%探讨病毒性脑膜炎合并症状性癫痫的临床护理体会

    Institute of Scientific and Technical Information of China (English)

    蒋艳秋

    2015-01-01

    目的:对病毒性脑膜炎合并癫痫患者的临床护理方式进行探讨分析。方法2010~2012年我院对31例病毒性脑膜炎合并癫痫患者进行了研究分析,为患者进行临床护理方式研究,采取腰椎穿刺、特殊用药等护理。结果全部患者中有2例放弃治疗,5例治愈,24例好转。结论病毒性脑膜炎合并癫痫患者接受有效的护理可以对病情起到较好的改善效果。%ObjectiveTo investigated the clinical nursing method in patients with viral meningitis and epilepsy.Methods From 2010 to 2012 31 cases of viral meningitis complicated with epilepsy patients in our hospital were studied, patients for clinical nursing research, take the lumbar puncture, special medication nursing.Results 2 patients gave up, 5 patients were cured, 24 patients improved.ConclusionThe clinical viral meningitis patients with epilepsy received effective nursing can have better improvement effect.

  4. Diffusion Tensor Imaging Study of White Matter Damage in Chronic Meningitis

    OpenAIRE

    Lin, Wei-Che; Chen, Pei-Chin; Wang, Hung-Chen; Tsai, Nai-Wen; Chou, Kun-Hsien; Chen, Hsiu-Ling; Su, Yu-Jih; Lin, Ching-Po; Li, Shau-Hsuan; Chang, Wen-Neng; Lu, Cheng-Hsien

    2014-01-01

    Tuberculous meningitis (TBM) and cryptococcal meningitis (CM) are two of the most common types of chronic meningitis. This study aimed to assess whether chronic neuro-psychological sequelae are associated with micro-structure white matter (WM) damage in HIV-negative chronic meningitis. Nineteen HIV-negative TBM patients, 13 HIV-negative CM patients, and 32 sex- and age-matched healthy volunteers were evaluated and compared. The clinical relevance of WM integrity was studied using voxel-based ...

  5. 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.

  6. Bacterial communities in women with bacterial vaginosis: high resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria.

    Directory of Open Access Journals (Sweden)

    Sujatha Srinivasan

    Full Text Available BACKGROUND: Bacterial vaginosis (BV is a common condition that is associated with numerous adverse health outcomes and is characterized by poorly understood changes in the vaginal microbiota. We sought to describe the composition and diversity of the vaginal bacterial biota in women with BV using deep sequencing of the 16S rRNA gene coupled with species-level taxonomic identification. We investigated the associations between the presence of individual bacterial species and clinical diagnostic characteristics of BV. METHODOLOGY/PRINCIPAL FINDINGS: Broad-range 16S rRNA gene PCR and pyrosequencing were performed on vaginal swabs from 220 women with and without BV. BV was assessed by Amsel's clinical criteria and confirmed by Gram stain. Taxonomic classification was performed using phylogenetic placement tools that assigned 99% of query sequence reads to the species level. Women with BV had heterogeneous vaginal bacterial communities that were usually not dominated by a single taxon. In the absence of BV, vaginal bacterial communities were dominated by either Lactobacillus crispatus or Lactobacillus iners. Leptotrichia amnionii and Eggerthella sp. were the only two BV-associated bacteria (BVABs significantly associated with each of the four Amsel's criteria. Co-occurrence analysis revealed the presence of several sub-groups of BVABs suggesting metabolic co-dependencies. Greater abundance of several BVABs was observed in Black women without BV. CONCLUSIONS/SIGNIFICANCE: The human vaginal bacterial biota is heterogeneous and marked by greater species richness and diversity in women with BV; no species is universally present. Different bacterial species have different associations with the four clinical criteria, which may account for discrepancies often observed between Amsel and Nugent (Gram stain diagnostic criteria. Several BVABs exhibited race-dependent prevalence when analyzed in separate groups by BV status which may contribute to increased

  7. 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。

  8. 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.

  9. 新生儿不典型化脓性脑膜炎26例临床特点回顾性分析%Retrospective Analysis of Clinical Characteristics of 26 Cases with Atypical Purulent Meningitis in Newborns

    Institute of Scientific and Technical Information of China (English)

    张娜娜

    2016-01-01

    目的 探究26例新生儿不典型化脓性脑膜炎临床特点. 方法 整群选取回顾性分析该院2013年2月—2015年4月收治的26例罕见性新生儿不典型化脓性脑膜炎临床资料,分析患儿发病时临床表现、诊断方法、治疗方法及治疗效果等. 结果 新生儿不典型化脓性脑膜炎发病初期临床症状不明显,实验室检查一般难以作出正确的诊断,脑脊液检查结果和典型的化脓性脑膜炎有较大的差异,临床诊断该病难度较大;患儿经抗感染、降颅压、肾上腺素、抗惊厥等对症治疗以后,患儿均治愈出院,无死亡病例,治疗后出现神经系统后遗症3例,其中合并硬膜下积液1例,癫痫1例. 结论 新生儿不典型化脓性脑膜炎临床症状不典型,容易出现误诊、漏诊,研究清楚新生儿不典型化脓性脑膜炎临床特点,可为临床诊断、治疗提供可靠依据,以提升治疗治疗效果,降低死亡率,改善患儿预后.%Objective To discuss the clinical characteristics of 26 cases with Atypical purulent meningitis in newborns. Methods The clinical materials of 26 cases with rare atypical purulent meningitis in newborns treated in our hospital from February 2013 to April 2015 were retrospectively analyzed and the clinical performance, diagnostic method, treatment method and treatment effect of the patients were analyzed. Results The clinical symptoms of atypical purulent meningitis in newborns at the initial stage were not obvious, the correct diagnosis was difficult to be made by laboratory examination, the difference in cerebrospinal fluid examination results between atypical purulent meningitis in newborns and typical purulent meningitis, the difficulty in the clinical diagnosis of the disease was big; after the symptomatic treatments of anti-infection, lowering intracranial pressure, adrenaline and anticonvulsants, all patients were cured and discharged without death cases, after treatment, 3 cases were with

  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. 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. A Bacterial Analysis Platform: An Integrated System for Analysing Bacterial Whole Genome Sequencing Data for Clinical Diagnostics and Surveillance

    DEFF Research Database (Denmark)

    Thomsen, Martin Christen Frølund; Ahrenfeldt, Johanne; Bellod Cisneros, Jose Luis;

    2016-01-01

    and antimicrobial resistance genes. A short printable report for each sample will be provided and an Excel spreadsheet containing all the metadata and a summary of the results for all submitted samples can be downloaded. The pipeline was benchmarked using datasets previously used to test the...... web-based tools we developed a single pipeline for batch uploading of whole genome sequencing data from multiple bacterial isolates. The pipeline will automatically identify the bacterial species and, if applicable, assemble the genome, identify the multilocus sequence type, plasmids, virulence genes...... platform was developed and made publicly available, providing easy-to-use automated analysis of bacterial whole genome sequencing data. The platform may be of immediate relevance as a guide for investigators using whole genome sequencing for clinical diagnostics and surveillance. The platform is freely...

  14. Citrobacter koseri meningitis: another freediving risk?

    Science.gov (United States)

    Pollara, Gabriele; Savy, Lloyd; Cropley, Ian; Hopkins, Susan

    2011-01-01

    We present a rare case of meningitis caused by Citrobacter koseri in an immunocompetent adult who had recently been freediving. Middle ear pressure changes from this recreational activity, and the subsequent inflammatory response, are likely to have provided this environmental organism access to the central nervous system, and thus the ability to cause clinically significant infection. PMID:20933000

  15. 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.

  16. Clinical analysis of 68 cases of pediatric tubercular meningitis%小儿结核性脑膜炎68例临床分析

    Institute of Scientific and Technical Information of China (English)

    李翠萍; 邱薇; 周晓婷; 林兆原

    2015-01-01

    were note extra-CNS TB. 27% children had not received BCG, and 42% cases had exposure to tuberculosis patients. CSF of 62 cases showed abnormalities, which were non-purulent, high classification of lymphocytes, high protein concentrations and low concentrations of glucose as well as chloride. Obvious abnormalities in brain CT or MRI were presented in 62 cases (92%), such as ventriculomegaly, communicating/obstructive hydrocephalus and cerebral in-farction. All isolates had accepted anti-TB treatment. 12 children underwent external ventricular drain, and 11 cases underwent ventriculoperitoneal shunt surgery. 62 cases had good outcome, but 28 children had neurological sequelae. 2 cases of death reported ( 4%) . Conclusion The clinic features of pediatric tubercular meningitis is incomplete and the clinical findings are usually non-distinctive. The diagnosis of pediatric tubercular meningitis depends upon contact history, test of CSF, brain CT/MRI and tuberculin skin test.%目的:探讨小儿结核性脑膜炎的临床特点及早期诊断方法。方法回顾性分析2009年10月至2012年10月在我院确诊或临床诊断为结核性脑膜炎的68例住院患儿的临床资料。结果68例病例中,男36例,女32例,年龄(4±4.35)岁。5例确诊病例,脑脊液结核杆菌培养阳性;63例为临床诊断病例。临床主要表现为:发热64例(94%);头痛和/或呕吐38例(56%);抽搐26例(38%);意识障碍33例(48%);脑膜刺激征阳性38例(56%);偏瘫27例(40%);25例伴颅神经损害,以动眼神经和外展神经受损为主。合并脑外结核47例(69%)。未接种卡介苗18例(27%),有明确肺结核接触史28例(42%)。脑脊液异常62例(92%),呈非化脓性改变,白细胞增高以淋巴细胞为主,蛋白质升高,糖、氯化物降低。头颅影像学有异常发现62例(92%),脑室扩张、交通性(梗阻性)脑积水和脑梗死最常见。全部病例均接受抗结核治疗,12例行侧脑室外引流术,其中11

  17. 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.

  18. 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

  19. Correlation Between the Clinical Diagnosis of Bacterial Vaginosis and the Results of a Proline Aminopeptidase Assay

    Directory of Open Access Journals (Sweden)

    George H. Nelson

    1994-01-01

    Full Text Available Objective: The object of this study was to develop a simple and inexpensive test for detection of bacterial vaginosis (BV in pregnant patients and to test its accuracy in a clinic population.

  20. Viral and atypical bacterial infections in the outpatient pediatric cystic fibrosis clinic

    DEFF Research Database (Denmark)

    Olesen, Hanne Vebert; Nielsen, Lars P; Schiotz, Peter Oluf

    2006-01-01

    BACKGROUND: Respiratory viral and atypical bacterial infections are associated with pulmonary exacerbations and hospitalisations in cystic fibrosis patients. We wanted to study the impact of such infections on children attending the outpatient clinic. METHODS: Seventy-five children were followed...

  1. Clinical analysis of 31 cases of neonatal purulent meningitis caused by Escherichia coli%大肠埃希菌致新生儿化脓性脑膜炎31例临床分析

    Institute of Scientific and Technical Information of China (English)

    朱敏丽; 麦菁芸; 朱将虎; 林振浪

    2012-01-01

    Objective Neonatal-purulent meningitis is a severe infection responsible for high mortality and disabling sequelae. Escherichia coli is the main pathogen of neonatal purulent meningitis. This study explored the clinical characteristics and antibiotic resistance of Escherichia co/i-indueed neonatal meningitis. Methods A retrospective chart review was performed. A total of 31 cases of neonatal purulent meningitis caused by Escherichia coli were identified in the neonatal intensive care unit between January 1, 2001 and December 31, 2011. The clinical characteristics and antibiotic sensitivity test results were analyzed. Results Fever, poor feeding, lethargy and seizure were common clinical signs of neonatal purulent_ meningitis caused by Escherichia coli. Acute complications mainly included hyponatremia (17 cases), hydrocephalus (8 cases) , subdural collection (2 cases) , ventriculitis (2 cases) and cerebral infarction (1 case). Thirty neonates (97% ) had increased CRP levels. Of the 31 patients, 14 cases were cured and 12 had adverse outcomes (5 patients died during hospitaiization). Escherichia coli strains were resistant ( > 50%) to commonly used penicillins and cephalosporins between 2007 and 2011 , presenting significantly higher resistance rates than between 2001 and 2006- The detection rate of extended spectrum |3-lactamases( ESBLs) -producing strains between 2007 and 2011 increased significantly compared with between 2001 and 2006 (57% vs 0). Conclusions The clinical manifestations of neonatal purulent meningitis caused by Escherichia coli are non-specific. The outcome is poor. Monitoring of CRP levels is valuable for the early diagnosis of neonatal purulent meningitis's The antimicrobial resistance rates of Escherichia coli are increasing, especially to cephalosporins. The percentage of ESBLs-producing strains is increasing over the years.%目的 化脓性脑膜炎是导致新生儿死亡、致残的重要病因,大肠埃希菌是最常见的致病菌,通过

  2. Antituberculosis drug resistance patterns in adults with tuberculous meningitis

    DEFF Research Database (Denmark)

    Senbayrak, Seniha; Ozkutuk, Nuri; Erdem, Hakan;

    2015-01-01

    BACKGROUND: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to ...

  3. Cerebral salt wasting syndrome in a patient with tuberculous meningitis.

    Science.gov (United States)

    Ravishankar, B; Mangala; Prakash, G K; Shetty, K J; Ballal, H S

    2006-05-01

    We report a case of a 65 year male with meningitis who had polyuria, severe hyponatremia, volume depletion and very high urinary sodium excretion. He was diagnosed to have cerebral salt wasting syndrome based on clinical and laboratory parameters.

  4. MRI Diagnosis of abnormal meningeal enhancement%脑膜异常强化的MRI诊断

    Institute of Scientific and Technical Information of China (English)

    俞方荣; 王土兴; 方春; 朱翔

    2014-01-01

    目的:分析不同病变的脑膜异常强化MRI表现,探讨脑膜异常强化模式的形态与病因间的关系。方法对资料完整、MRI增强扫描显示脑膜异常强化的27例患者进行回顾性分析。结果27例患者中脑膜癌病11例(其中软脑膜强化模式9例,包括结节样强化4例、线样强化4例、结节样和线样强化并存的混合型强化1例,全脑膜强化模式、混合型强化2例);感染性脑膜炎9例(其中细菌性脑膜炎5例,包括软脑膜强化模式、线样强化4例,全脑膜强化模式、线样强化1例,并伴有硬膜下脓肿、颅骨骨髓炎,结核性脑膜炎3例,均为软脑膜强化模式,2例为线样强化,1例为结节样强化并伴有脑内多发结核结节,病毒性脑膜炎1例,为软脑膜强化模式、局限性线样强化);自发性低颅压综合征2例(硬脑膜强化模式、为弥漫均匀的线样强化);慢性硬膜下血肿4例和慢性硬膜下血肿伴硬膜下积液1例(硬脑膜强化模式、线样强化)。结论不同病变所致脑膜异常强化,其强化模式及形态具有一定的特点,MRI能为疾病的诊断提供重要信息。%Objective To analyze MRI findings of abnormal meningeal enhancement and to evaluate the relation between the patterns and shapes of abnormal meningeal enhancement and the causes of disease. Methods Twenty seven patients with abnormal meningeal enhancement on contrast enhanced MRI were included in the study. The patterns and shapes of abnormal meningeal enhancement on MRI in relation to clinical conditions were retrospectively analyzed. Results The diagnosis of 27 patients were meningeal carcinomatosis in 11 cases, infective meningitis in 9 cases (5 bacterial meningitis, 3 tuberculous menin-gitis and 1 viral meningitis), spontaneous intracranial hypotension syndromein in 2, chronic subdural hematoma in 4 and chronic subdural hematoma with subdural hydroma in 1. Meningeal

  5. 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

  6. 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

  7. 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.

  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......-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...

  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. 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.

  11. 脑膜炎并脑积水临床特点及治疗措施分析%Analysis of clinical characteristics and treatment measures of meningitis complicating with hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    贺晓琴

    2015-01-01

    目的 探讨脑膜炎并脑积水临床特点及治疗措施,为疾病的诊断、治疗及预防提供可靠的参考依据.方法 选取我院2012年1月至2013年1月收治的60例脑膜炎并脑积水患者,通过随机数字表法将其分为对照组和观察组各30例,对照组患者给予甘露醇治疗,观察组患者在此基础上给予甘油果糖治疗,分析脑膜炎并脑积水的临床特点,并探讨两组患者临床治疗效果.结果 观察组患者临床治疗总有效率为93.33%,与对照组治疗总有效率60.00%相比差异有统计学意义(x2=31.0481,P=0.0000).结论 脑积水是脑膜炎常见并发症,临床检查结果可以为临床治疗提供科学有效的治疗方案,应用甘露醇联合甘油果糖治疗脑膜炎并脑积水疗效显著,可明显改善临床症状,减轻患者痛苦,降低死亡率,同时临床应完善治疗脑膜炎并脑积水的方式,积极采取科学合理的治疗措施,最大程度降低疾病的危害,提高患者生活质量.%Objective To explore the clinical characteristics and treatment measures of meningitis complicating with hydrocephalus, and provide reliable reference for the diagnosis, treatment and prevention of the disease.Methods 60 cases of meningitis complicating with hydrocephalus in our hospital from January 2012 to January 2013 were randomly divided into control group (n=30) and observation group (n=30).Control group was treated with mannitol, and observation group was treated with glycerin fructose on the basis of control group.Analyzed the clinical characteristics of meningitis complicating with hydrocephalus and clinical therapeutic effect of two groups.Result The total effective rate in observation group was higher than that in control group (93.33% vs.60.00%;x 2=31.0481, P=0.0000).Conclusions Hydrocephalus is a common kind of complication of meningitis.Clinical examination results can provide reference for scientific and effective clinical treatment.Application of

  12. 88例结核性脑膜炎所致精神障碍临床分析%Clinical Analysis of 88 Cases of Mental Disorders Caused by Tuberculous Meningitis

    Institute of Scientific and Technical Information of China (English)

    张立波; 姚袁媛

    2014-01-01

    目的:探讨分析88例结核性脑膜炎所致精神障碍的临床分析。方法回顾性分析2004年-2012年之间入住我院的88例结核性脑膜炎所导致的精神障碍患者的临床特点。结果88例结核性脑膜炎患者均有不同程度的精神障碍,其中表现为谵妄的患者22例,表现为意识朦胧的患者7例,表现为意识模糊的患者7例,表现为精神恍惚的患者31例,表现为癔症发作症状的患者7例,表现为精神分裂症状的患者7例,表现为性格改变症状的患者7例。所有患者经神经检查均有不同程度的异常,经治疗预后效果良好。结论结核性脑膜炎可导致精神障碍,及时发现脑膜炎导致的精神障碍的前驱症状并给予正确的治疗,可以争取较好的预后。%Objective Investigate the clinical analysis of 88 cases of mental disorders caused by Tuberculous meningitis .Methods Retrospective analyzed the Characteristics of mental disorders caused by Tuberculous meningitis of the patients in our hospital from 2004-2012.Results The 88 cases of patients with Tuberculous meningitis al had different degrees of mental disorder,22 patients with delirium,7patients of consciousness,31patients’ mind is wandering,7 patients of hysterical attack symptoms, 7 patients with symptoms of schizophrenia, 7 cases of personality change symptoms. Al the patients with different degree abnormal neurological after examination, the prognosis was good after the treatment. Conclusion The Tuberculous meningitis can cause mental disorders, if discover the mental disorder caused by meningitis pretrial symptoms and let the patients got timely treatment, can get good prognosis.

  13. 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...

  14. 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.

  15. 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...

  16. Streptococcus suis Meningitis: First Case Reported in Quebec

    Directory of Open Access Journals (Sweden)

    Sophie Michaud

    1996-01-01

    Full Text Available Very few Streptococcus suis infections in humans have been reported in Canada, although the condition is frequent in pigs. Meningitis, often accompanied by severe hearing loss, is the most common clinical manifestation. The disease is an occupational illness affecting persons in contact with pigs and may be underdiagnosed because of misidentification of the responsible bacterium. Since Quebec is the leading province for swine production in Canada, physicians and microbiologists should be aware of this infection, especially when a streptococcal meningitis is diagnosed in swine workers. The first case of S suis type 2 meningitis reported in Quebec is described.

  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. Bacterial resistance to tetracycline: mechanisms, transfer, and clinical significance

    OpenAIRE

    Speer, B S; Shoemaker, N. B.; Salyers, A A

    1992-01-01

    Tetracycline has been a widely used antibiotic because of its low toxicity and broad spectrum of activity. However, its clinical usefulness has been declining because of the appearance of an increasing number of tetracycline-resistant isolates of clinically important bacteria. Two types of resistance mechanisms predominate: tetracycline efflux and ribosomal protection. A third mechanism of resistance, tetracycline modification, has been identified, but its clinical relevance is still unclear....

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

    Directory of Open Access Journals (Sweden)

    Robinson Joan L

    2006-04-01

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

  2. Confirmed viral meningitis with normal CSF findings.

    Science.gov (United States)

    Dawood, Naghum; Desjobert, Edouard; Lumley, Janine; Webster, Daniel; Jacobs, Michael

    2014-07-17

    An 18-year-old woman presented with a progressively worsening headache, photophobia feverishness and vomiting. Three weeks previously she had returned to the UK from a trip to Peru. At presentation, she had clinical signs of meningism. On admission, blood tests showed a mild lymphopenia, with a normal C reactive protein and white cell count. Chest X-ray and CT of the head were normal. Cerebrospinal fluid (CSF) microscopy was normal. CSF protein and glucose were in the normal range. MRI of the head and cerebral angiography were also normal. Subsequent molecular testing of CSF detected enterovirus RNA by reverse transcriptase PCR. The patient's clinical syndrome correlated with her virological diagnosis and no other cause of her symptoms was found. Her symptoms were self-limiting and improved with supportive management. This case illustrates an important example of viral central nervous system infection presenting clinically as meningitis but with normal CSF microscopy.

  3. 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.

  4. 小儿病毒性脑膜炎病原的诊断与临床特点分析%Clinical Analysis and Diagnosis of the Pathogens of Viral Meningitis in Children

    Institute of Scientific and Technical Information of China (English)

    王葆辉; 吴鸿雁

    2013-01-01

    目的:探讨小儿病毒性脑膜炎所感染病原的种类及其临床特点。方法对在2007年1月至2011年6月间在我院进行住院治疗的96例病毒性脑膜炎患儿进行回顾性分析,对其病原学及其临床特点进行统计分析。结果经过病毒抗体的检测得出病毒阳性率为60.4%,共58例,其中埃可病毒(ECHO)、柯萨奇病毒(COX)、单纯疱疹病毒(HSV)、乙型脑炎病毒(JEV)、EB病毒(EBV)及流感病毒(IFV)的感染率分别为25.0%、21.9%、21.9%、3.1%、3.1%、2.1%。结论病毒特异性IgM抗体进行脊椎穿刺所得脑脊液中进行检测可作为病毒性脑膜炎患儿早期病原诊断的有效指标,58例病毒性脑膜炎患儿主要由埃可病毒、柯萨奇病毒感染所致。%Objective Discussion on children with viral meningitis infections by pathogenic species and their clinical characteristic. Methods From January 2007 to June 2011 in the treatment of 96 cases of inpatients in our hospital for retrospective analysis in children with viral meningitis, the statistical analysis of the etiology and clinical characteristics. Results After detection of virus antibody that virus positive rate is 60.4%, a total of 58 cases, Echo virus (ECHO), Coxsackie virus (COX), herpes simplex virus (HSV), with Japanese encephalitis virus (JEV), EB virus (EBV) and influenza a virus (IFV) infection rates respectively, 25%, 21.9%, 3.1%. Conclusion Virus-specific IgM antibody in cerebrospinal fluid of spinal tap have to be detected as a virus effective indicators of the pathogen of meningitis in children with early diagnosis, 58 cases of viral meningitis in children mainly by ECHO virus, Coxsackie virus infection.

  5. Bilateral acute retinal necrosis after herpetic meningitis

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    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

  6. 新生儿B族链球菌脑膜炎13例临床分析和随访%Clinical analysis and follow-up of neonatal purulent meningitis caused by group B streptococcus

    Institute of Scientific and Technical Information of China (English)

    朱敏丽; 朱将虎; 李海静; 留佩宁; 林振浪

    2014-01-01

    Objective To study the clinical characteristics,antibiotics sensitivity and outcome of group B streptococcus (GBS) meningitis in neonates in order to provide the guide for early diagnosis and appropriate treatment.Method A retrospective review was performed and a total of 13 cases of neonatal purulent meningitis caused by GBS were identified in the Neonatal Intensive Care Unit of Yuying Children's Hospital of Wenzhou Medical University from January 1,2005 to May 31,2013.The clinical characteristics,antibiotics sensitivity test results and outcome were analyzed.Result Fever,poor feeding,seizure and lethargy were common clinical signs of neonatal purulent meningitis caused by GBS.Three cases of early onset GBS meningitis received prepartum antibiotics.All 13 cases had abnormal C-reactive protein (CRP) level,and 11 cases had increased CRP within hours after admission.Of the 13 patients,7 were cured,4 discharged with improvement,2 patients died during hospitalization after being given up because of serious complication.The average length of stay for recovered patients was (47 ±21)d.Acute complications mainly included hyponatremia (5 cases),intracranial hemorrhage (3 cases),ventriculomegaly (3 cases),subdural collection (2 cases),hydrocephalus (2 cases),septic shock (2 cases),cerebral hernia (1 case),encephalomalacia (1 case).One preterm patient with early onset GBS meningitis died 1 month after hospital discharge.Among 7 survivors with 10-24 months follow-up,3 were early onset GBS meningitis,2 with normal results of neurologic examination,1 with delayed motor development,4 were late onset GBS meningitis,1 with normal results of neurologic examination,3 were neurologically impaired with manifestations including delayed motor development (2 cases) and seizures (1 case).All the GBS strains were sensitive to penicillin and linezolid (13/13,10/10),the susceptibility to levofloxacin,ampicillin and vancomycin were 11/12,9/10,8/13 respectively.Conclusion The clinical

  7. 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.

  8. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Gelmers, H.J.

    1984-01-01

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

  10. Emerging Bacterial Infection: Identification and Clinical Significance of Kocuria Species.

    Science.gov (United States)

    Kandi, Venkataramana; Palange, Padmavali; Vaish, Ritu; Bhatti, Adnan Bashir; Kale, Vinod; Kandi, Maheshwar Reddy; Bhoomagiri, Mohan Rao

    2016-01-01

    Recently there have been reports of gram-positive cocci which are morphologically similar to both Staphylococci and the Micrococci. These bacteria have been identified as Kocuria species with the help of automated identification system and other molecular methods including 16S rRNA (ribosomal ribonucleic acid) evaluation. Kocuria belongs to the family Micrococcaceae which also includes Staphylococcus species and Micrococcus species. Isolation and clinical significance of these bacteria from human specimens warrant great caution as it does not necessarily confirm infection due to their ubiquitous presence, and as a normal flora of skin and mucous membranes in human and animals. Most clinical microbiology laboratories ignore such bacteria as laboratory and specimen contaminants. With increasing reports of infections associated with these bacteria, it is now important for clinical microbiologists to identify and enumerate the virulence and antibiotic susceptibility patterns of such bacteria and assist clinicians in improving the patient care and management. We review the occurrence and clinical significance of Kocuria species. PMID:27630804

  11. 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 ...

  12. 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

  13. 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

  14. MALDI-TOF mass spectrometry proteomic based identification of clinical bacterial isolates

    Directory of Open Access Journals (Sweden)

    Ashutosh Panda

    2014-01-01

    Full Text Available Background & objectives: Pathogenic bacteria often cause life threatening infections especially in immunocompromised individuals. Therefore, rapid and reliable species identification is essential for a successful treatment and disease management. We evaluated a rapid, proteomic based technique for identification of clinical bacterial isolates by protein profiling using matrix-assisted laser desorption-ionization time - of - flight mass spectrometry (MALDI-TOF MS. Methods: Freshly grown bacterial isolates were selected from culture plates. Ethanol/formic acid extraction procedure was carried out, followed by charging of MALDI target plate with the extract and overlaying with α-cyano-4 hydroxy-cinnamic acid matrix solution. Identification was performed using the MALDI BioTyper 1.1, software for microbial identification (Bruker Daltonik GmbH, Bremen, Germany. Results: A comparative analysis of 82 clinical bacterial isolates using MALDI -TOF MS and conventional techniques was carried out. Amongst the clinical isolates, the accuracy at the species level for clinical isolates was 98.78%. One out of 82 isolates was not in accordance with the conventional assays because MALDI-TOF MS established it as Streptococcus pneumoniae and conventional methods as Streptococcus viridans. Interpretation & conclusions: MALDI - TOF MS was found to be an accurate, rapid, cost-effective and robust system for identification of clinical bacterial isolates. This innovative approach holds promise for earlier therapeutic intervention leading to better patient care.

  15. Fungal-bacterial interactions and their relevance to oral health: linking the clinic and the bench

    Directory of Open Access Journals (Sweden)

    Patricia I Diaz

    2014-07-01

    Full Text Available High throughput sequencing has accelerated knowledge on the oral microbiome. While the bacterial component of oral communities has been extensively characterized, the role of the fungal microbiota in the oral cavity is largely unknown. Interactions among fungi and bacteria are likely to influence oral health as exemplified by the synergistic relationship between Candida albicans and oral streptococci. In this perspective, we discuss the current state of the field of fungal-bacterial interactions in the context of the oral cavity. We highlight the need to conduct longitudinal clinical studies to simultaneously characterize the bacterial and fungal components of the human oral microbiome in health and during disease progression. Such studies need to be coupled with investigations using disease-relevant models to mechanistically test the associations observed in humans and eventually identify fungal-bacterial interactions that could serve as preventive or therapeutic targets for oral diseases.

  16. Detection and DNA quantification of Enterococcus casseliflavus in a foal with septic meningitis.

    Science.gov (United States)

    Stefanetti, Valentina; Beccati, Francesca; Passamonti, Fabrizio; Sgariglia, Elisa; Coletti, Mauro; Vuerich, Matteo; Marenzoni, Maria Luisa

    2016-07-01

    CASE DESCRIPTION A 3-month-old 180-kg (396-lb) Hanoverian colt was examined because of fever, lethargy, inappetence, drooping of the left ear, and stiff neck posture. Initial treatment included empirical antimicrobial treatment and NSAIDs. CLINICAL FINDINGS Initial findings were consistent with CNS anomalies. Endoscopy revealed hyperemia, ecchymosis, and some mucopurulent exudate in the right guttural pouch. Hematologic findings were consistent with neutrophilic inflammation. On the third day of hospitalization, severe neurologic signs were observed. Computed tomography of the skull revealed a comminuted fracture of the axial aspect of the right mandibular condyle. Examination of CSF revealed turbidity, xanthochromia, and intracellular and extracellular cocci, consistent with septic meningitis. After DNA extraction from blood and CSF, sequenced products from a PCR assay for the bacterial 16S rRNA gene were 99% identical to Enterococcus casseliflavus. Microbial culture of CSF and blood samples yielded bacteria with Enterococcus spp morphology; antimicrobials were selected on the basis of susceptibility testing that identified the isolate as vancomycin resistant. A quantitative PCR assay was used to estimate Enterococcus DNA concentrations in CSF and blood. TREATMENT AND OUTCOME Treatment for E casseliflavus meningitis, including trimethoprim-sulfadiazine and ampicillin sodium administration, resulted in resolution of clinical signs. Culture of CSF and blood samples after 12 days of the targeted treatment yielded no growth. CLINICAL RELEVANCE To the authors' knowledge, this was the first report of E casseliflavus meningitis in a horse. Treatment was successful; vancomycin-resistant enterococci can be a clinical problem and may potentially be zoonotic. PMID:27308888

  17. Evaluation of anti-pneumococcal capsular antibodies as adjunctive therapy in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian; Frimodt-Moller, N; Lundgren, Jens Dilling;

    2006-01-01

    OBJECTIVE: Bacteraemia concomitant with meningitis has been shown to greatly affect outcome. Consequently, the efficacy of serotype-specific anti-pneumococcal antiserum (APAS) was investigated in a rat model of pneumococcal meningitis. METHODS: Rats were infected with Streptococcus pneumoniae...... at the time of infection whereas no effect was found when administered 26 h after infection. This work indicates that the clinical value of using APAS in pneumococcal meningitis may be limited...

  18. Eosinophilic meningitis: a case series and review of literature of Angiostrongylus cantonensis and Gnathostoma spinigerum.

    Science.gov (United States)

    Shah, I; Barot, S; Madvariya, M

    2015-01-01

    Eosinophilic meningitis is defined as the presence of >10 eosinophils/μL in cerebrospinal fluid (CSF) or at least 10% eosinophils in the total CSF leukocyte count. Eosinophilic meningitis has been reported in two case series and two case reports in India till date and has not been reported in children below 15 years of age. We present two children with eosinophilic meningitis with peripheral eosinophilia and the proposed etiologic agents based on the clinical setting and their response to antihelminthic agents.

  19. 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

  20. 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.

  1. Extensive heterotopic ossification in patient with tubercular meningitis

    Directory of Open Access Journals (Sweden)

    Vijai Prakash Sharma

    2014-01-01

    Full Text Available Tubercular meningitis is a severe form of central nervous system tuberculosis with high morbidity and mortality. Apart from neurological deficits, musculoskeletal involvement is also seen in very few cases in the form of heterotopic ossification around immobile joints. A 35-year-old male case of tubercular meningitis with left hemiparesis presented with multiple joint restriction of range of motion. On clinical examination, palpable firm masses around multiple joints with painful restriction of movements were seen. X-ray films of multiple joints revealed heterotopic ossification over left shoulder, hip and knee joint with bony ankylosis of left hip and soft tissue contractures. Very few reports have been published in the literature for association of heterotopic ossification with tubercular meningitis with such extensive joint involvement which compels us to report this clinical association of tubercular meningitis. This report is intended to create caution among physicians and other caregivers for this debilitating complication of tubercular meningitis and in face of high prevalence of tuberculosis and tubercular meningitis, employ methods to prevent and treat.

  2. Albumin Administration in Patients With Spontaneous Bacterial Peritonitis at a Tertiary Hospital: A Retrospective Clinical Analysis

    OpenAIRE

    Padmavathi Mali; Rajan Kanth; Sudheer Muduganti

    2015-01-01

    Purpose: Albumin is recommended for the treatment of spontaneous bacterial peritonitis (SBP) in patients at high risk for mortality. We assessed adherence to guidelines for administration of albumin for SBP in clinical practice at a private tertiary care hospital. Methods: A retrospective clinical analysis of all cases of SBP diagnosed at a tertiary referral center from January 1, 2006, to December 31, 2012, was performed. Patients were identified electronically and manually validated. Th...

  3. In vivo study of experimental pneumococcal meningitis using magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Østergaard Christian

    2008-01-01

    Full Text Available Abstract Background Magnetic Resonance Imaging (MRI methods were evaluated as a tool for the study of experimental meningitis. The identification and characterisation of pathophysiological parameters that vary during the course of the disease could be used as markers for future studies of new treatment strategies. Methods Rats infected intracisternally with S. pneumoniae (n = 29 or saline (n = 13 were randomized for imaging at 6, 12, 24, 30, 36, 42 or 48 hours after infection. T1W, T2W, quantitative diffusion, and post contrast T1W images were acquired at 4.7 T. Dynamic MRI (dMRI was used to evaluate blood-brain-barrier (BBB permeability and to obtain a measure of cerebral and muscle perfusion. Clinical- and motor scores, bacterial counts in CSF and blood, and WBC counts in CSF were measured. Results MR images and dMRI revealed the development of a highly significant increase in BBB permeability (P Changes in brain water distribution, assessed by ADC, and categorization of brain 'perfusion' by cortex ΔSI(bolus were subject to increased inter-rat variation as the disease progressed, but without overall differences compared to uninfected rats (P > 0.05. Areas of well-'perfused' muscle decreased with the progression of infection indicative of septicaemia (P = 0.05. Conclusion The evolution of bacterial meningitis was successfully followed in-vivo with MRI. Increasing BBB-breakdown and ventricle size was observed in rats with meningitis whereas changes in brain water distribution were heterogeneous. MRI will be a valuable technique for future studies aiming at evaluating or optimizing adjunctive treatments

  4. Clinical Features and Therapeutic Strategies of Late-onset Streptococcus Agalactiae Meningitis%晚发型无乳链球菌脑膜炎的临床特征及治疗策略

    Institute of Scientific and Technical Information of China (English)

    张胜; 罗序峰; 周涛; 付四毛; 朱建萍

    2015-01-01

    Streptococcus agalactiae is common pathogenic bacteria for infant suppurative meningitis. In recent years, the prevalence of streptococcus agalactiae meningitis is increasing. The paper made a retrospective analysis of the clinical data of 6 children with streptococcus agalactiae meningitis and investigated the clinical features and therapeutic strategies of the disease. The clinical manifestations of the 6 children included fever,convulsion,decreased responsiveness,tensity or swell in bregma and irregular respiration. Subdural effusion,cerebral hemorrhage,liver function damage and hyponatremia as complication also occurred in some of the children. Antibiotic therapy was determined according to the results of drug sensitive test and cerebrospinal fluid examination. One child was cured and 4 children improved after 4 - week to 6 - week treatment. One child died due to the halt of treatment following septic shock.%无乳链球菌是婴儿期化脓性脑膜炎最为常见的致病菌之一,近年来,无乳链球菌脑膜炎发病率呈上升趋势。本研究回顾性分析6例无乳链球菌脑膜炎患儿临床资料,探讨无乳链球菌脑膜炎的临床特点及治疗策略。患儿临床表现为发热、惊厥、反应低下、前囟紧张或膨隆及呼吸不规则,部分患儿伴有硬膜下积液、脑出血、肝功能损害、低钠血症并发症。经药敏试验和脑脊液检查结果确定抗生素治疗方案。治疗4~6周6例患儿中治愈1例、好转4例、因感染性休克放弃治疗死亡1例。

  5. 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

  6. An unusual presentation of carcinomatous meningitis.

    Science.gov (United States)

    Foo, Chuan T; Burrell, Louise M; Johnson, Douglas F

    2016-08-01

    A 67-year old previously well male presented with a 1 week history of confusion on a background of 3 weeks of headache. Past history included two superficial melanomas excised 5 years ago. Treatment for meningoencephalitis was commenced based on lumbar puncture (LP) and non-contrast brain magnetic resonance imaging (MRI) results. Lack of a clinical response to antibiotics resulted in a second LP and contrast brain MRI which demonstrated hydrocephalus and leptomeningeal disease. Ongoing deterioration led to a whole-body computed tomographic and spinal MRI that showed widespread metastatic disease and extensive leptomeningeal involvement of the spinal cord. The diagnosis of metastatic melanoma with carcinomatous meningitis was made based on cytological analysis of cerebrospinal fluid. He died 2 weeks later in a palliative care facility. This case illustrates that the diagnosis of carcinomatous meningitis can be difficult to make as the heterogeneous nature of its presentation often delays the diagnosis. PMID:27574561

  7. An unusual presentation of carcinomatous meningitis

    Science.gov (United States)

    Foo, Chuan T.; Burrell, Louise M.; Johnson, Douglas F.

    2016-01-01

    A 67-year old previously well male presented with a 1 week history of confusion on a background of 3 weeks of headache. Past history included two superficial melanomas excised 5 years ago. Treatment for meningoencephalitis was commenced based on lumbar puncture (LP) and non-contrast brain magnetic resonance imaging (MRI) results. Lack of a clinical response to antibiotics resulted in a second LP and contrast brain MRI which demonstrated hydrocephalus and leptomeningeal disease. Ongoing deterioration led to a whole-body computed tomographic and spinal MRI that showed widespread metastatic disease and extensive leptomeningeal involvement of the spinal cord. The diagnosis of metastatic melanoma with carcinomatous meningitis was made based on cytological analysis of cerebrospinal fluid. He died 2 weeks later in a palliative care facility. This case illustrates that the diagnosis of carcinomatous meningitis can be difficult to make as the heterogeneous nature of its presentation often delays the diagnosis. PMID:27574561

  8. 病毒性脑膜炎合并症状性癫痫的临床护理研究%The study of clinical nursing on viral meningitis with symptomatic epilepsy

    Institute of Scientific and Technical Information of China (English)

    杨玉凤; 周光昱

    2014-01-01

    目的:探讨病毒性脑膜炎合并症状性癫痫患者的临床护理方法。方法:2012年3月-2014年4月收治病毒性脑膜炎合并癫痫症状患者80例,随机分为观察组与对照组,各40例。对照组经围手术期常规护理,观察组在此基础上给予综合护理干预,比较两组疗效。结果:观察组护理总满意度97.5%,对照组85.0%,两组比较差异具有统计学意义(P<0.05)。结论:对病毒性脑膜炎合并症状性癫痫患者治疗同时行综合护理干预,可有效提高预后效果,值得在临床上推广应用。%Objective:To investigate the methods of clinical nursing on viral meningitis with symptomatic epilepsy.Methods:80 patients with viral meningitis complicated with symptomatic epilepsy were selected from March 2012 to April 2014.They were randomly divided into the observation group and the control group with 40 cases in each.The control group were received routine nursing during operation period,and the observation group received comprehensive nursing intervention on the basis of routine nursing.Compare the curative effect of two groups.Results:The total nursing satisfaction of the observation group was 97.5%,and that of the control group was 85% .The difference was statistically significant(P<0.05).Conclusion:Comprehensive nursing intervention treated on patients with viral meningitis complicated with symptomatic epilepsy can improve the prognosis effect effectively,so it is worthy of clinical application.

  9. CNS fungal meningitis to the "Top of the basilar"

    Institute of Scientific and Technical Information of China (English)

    Logan CS; Kirschner RC; Simonds GR

    2013-01-01

    Central nervous system(CNS) infections are a rare complication of epidural steroid injections and without strong clinical suspicion, fungal organisms may be overlooked among the long differential of causes of meningitis.Rare sequela of fungal meningitis is the development of stroke.To our knowledge, we present the first case of post epidural steroid injection(ESI) fungal meningitis leading toa basilar artery stroke, otherwise known as“top of the basilar” syndrome.We present a49-year-old female with a history ofESIs who presented to the emergency department with headache, neck stiffness, and abdominal pain.She was discharged after her labs and symptoms were deemed inconsistent with meningitis.She was eventually admitted and twelve days after her originalED visit, she was diagnosed with meningitis and started on anti-fungal treatment.She was discharged88 days later but was readmitted due to left sided weakness and mental status changes.She quickly lost motor and bulbar functions.AnMRA showed diminished distal flow through the basilar artery, suggesting near complete occlusion.Although appropriate long term anti-fungal treatment was started, the patient still succumbed to a rare vascular event.Physicians who are treating patients forESI meningitis should be aware of the potential for vasculitic and encephalitic complications.

  10. 利福平冻干粉针治疗55例结核性脑膜炎临床分析%Rifabutin freeze-dried needle treatment 55 cases of tuberculous meningitis clinical analysis

    Institute of Scientific and Technical Information of China (English)

    刘利荣; 尹平辉; 陈欣

    2011-01-01

    Objective To evaluate the domestic injectable rifabutin freeze-dried needle (weaver hin) treatment of tuberculous meningitis clinical efficacy and safety , and rifampacin capsule comparison. Methods wil155 patients with tuberculosis patients were randomly divided into rifabutin freeze-dried needle group and rifampacin capsule group contrast, observe thc curative effect. Results rifabutin freeze-dried needle curative effect of exact and more oral rifabutin group gastrointestinal side effects less, the effect - acting faster.Conclusion rifabutin freeze-dried needle in the treatment of tuberculous meningitis with local drug concentration high effect, fast, side effect was small characteristics, has good value of clinical applications.%目的 评价国产注射用利福平冻干粉针(维夫欣)治疗结核性脑膜炎的临床有效性和安全性,并与利福平胶囊比较.方法 将55例肺结核患者随机分为利福平冻干粉针组和利福平胶囊组对照,观察疗效.结果 利福平冻干粉针组疗效确切且较口服利福平组胃肠道副作用少,起效更快.结论 利福平冻干粉针在结核性脑膜炎的治疗中具有局部药物浓度高,作用快,副作用小的特点,有较好的临床应用价值.

  11. Clinical analysis of purulent meningitis caused by streptococcus pneumoniae in 12 children%儿童肺炎链球菌所致化脓性脑膜炎12例临床分析

    Institute of Scientific and Technical Information of China (English)

    彭琴玲; 廖红梅; 唐静文; 陈玫; 杨赛

    2013-01-01

    目的 探讨肺炎链球菌所致的小儿化脓性脑膜炎的临床特点.方法 对我院2007年1月至2011年10月收治的12例肺炎链球菌所致的化脓性脑膜炎患儿的临床资料进行回顾性分析.结果 12例均为青霉素耐药肺炎链球菌,年龄2个月~9岁9个月,其中5岁以下占75% (9/12),2岁以下41.6%(5/12),临床表现均有发热,并伴有神经系统受累症状.12例患儿均有合并症,9例合并脓毒症(75%),8例合并肺炎(66.7%),其中5例同时合并脓毒症及肺炎.实验室检查外周血白细胞计数、C反应蛋白、降钙素原、红细胞沉降率及脑脊液白细胞计数、蛋白多明显增高,脑脊液糖下降明显.12例患儿中有11例患儿最终均使用万古霉素联合三、四代头孢或其他抗生素治疗,8例治愈,2例留有严重后遗症,2例死亡.结论 应重视肺炎链球菌所致的脑膜炎,对临床怀疑肺炎链球菌所致的化脓性脑膜炎,要尽早给予包括万古霉素在内的抗生素联合治疗.%Objective To investigate the clinical characteristics of purulent meningitis caused by streptococcus pneumoniae.Methods We studied clinical features of 12 children with purulent meningitis caused by streptococcus pneumoniae who were hospitalized from Jan 2007 to Oct 2011 in our hospital.Results Twelve children were penicillin-resistant streptococcus pneumoniae.The ages ranged from 2 months to 10 years.Nine cases(75%) were aged less than 5 years,and 5 cases(41.6%) were aged less than 2 years.All cases were with fever,and with the nervous system symptoms involvement.All cases were with complications:9 cases(75%) with septicemia,8 cases (66.7%) with pneumonia.The white blood cells,blood C-reactive protein,peripheral blood procalcitonin,erythrocyte sedimentation rate,white cells and protein in cerebrospinal fluid were mostly significantly high,sugar in cerebrospinal fluid were low significantly.Eleven cases were eventually treatmented by vancomycin plus 3rd

  12. Estudio de 312 niños con meningitis atendidos en un Hospital Universitario en el Sur de Brasil Study of 312 children with meningitis treated at a University Hospital in the South of Brazil

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    Sérgio A. Antoniuk

    2009-01-01

    Hospital de Clínicas of the Federal University of Paraná were evaluated between January 2003 and January 2007. All of them had a probable diagnosis of meningitis based on clinical signs, and on the cytological and biochemical alterations in the cerebrospinal fluid routine examination. Viral meningitis (VM was present in 140 children (45%, 58 had bacterial meningitis (BM - 19% and etiology was undetermined in 114 (36%. In MB, Neisseria meningitidis was the most frequent etiological agent (25 cases. Predominant clinical symptoms were fever, sickness and headache. The cerebrospinal fluid test showed a high number of polymorphonuclear leukocytes, high protein and low glucose level in MB; mononuclear cells were predominant in VM. Neurological complications were more frequent in BM, and convulsion the most common symptom (6/58 patients. Death happened to one case in VM and 3 in BM. Our conclusions were that the classical triad (headache, vomiting and fever was the most common clinical manifestation, the cytological and biochemical abnormalities were typical, helping in the differentiation of MB from VM, although a good number of cases ended up with no etiological definition and, finally, immediate neurological complications and death were rare.

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. Clinical characteristics and prognostic analysis of 15 children with streptococcus pneumoniae meningitis%肺炎链球菌脑膜炎15例临床特征及预后分析

    Institute of Scientific and Technical Information of China (English)

    张赟; 丁明杰; 韩玉玲; 马香

    2014-01-01

    Objective To summmrize the clinical characteristics complications,antimicrobial resistance and prognosis in 15 children with streptococcus pneumoniae meningitis so as to improve the diagnosis and treatment of this disease.Methods A systematic retrospective analysis was carried out in the Qilu Children's Hospital of Shandong University from Jan.2010 to Jan.2013,and clinical data from 15 children with streptococcus pneumococcal meningitis were retrospectively analyzed and followed up for 6 months in order to observe the prognosis.Results Eleven cases of streptococcus pneumoniae meningitis occuned in the winter and spring.And it often occuned in children less than 2 years of age who lived in rural areas (13 cases).The clinical manifestations showed diverse characteristics,severe symptoms,obvious changes in symptoms and cerebrospinal fluid were observed.Severe or death cases had low temperature,low leukopenia or low blood platelet.Common complications of streptococcus pneumoniae meningitis included anemia (10 cases),hypoalbuminemia (9 cases),sepsis (8 cases).Multi-drug resistance and complications in streptococcus pneumoniae meningitis led to the therapeutic difficulties.In this study,3 cases were cured,9 cases had varying degrees of sequences,such as left languages,sports,hydrocephalus and cognitive dysfunction,and 3 cases died,and the main cause of death was multiple organ dysfunction syndrome.Conclusions Streptococcus pneumoniae meningitis mainly occurred in the winter and spring.And the children under 2 years of age who lives in rural areas were often attacked.Clinical characteristics and cerebrospinal fluid changes obviously; severe cases are common with low temperature,low leukopenia or blood platelet.And there aye often diverse complications and multi-sequelae; the problem of multi-drug resistant and complications can lead to great difficulties in the clinical treatment.%目的 探讨儿章肺炎链球菌脑膜炎的临床特征、并发症、耐药性资料及

  18. 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.

  19. Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites.

    Science.gov (United States)

    Butler, T

    2015-07-01

    Newly named in 1989, Capnocytophaga canimorsus is a bacterial pathogen found in the saliva of healthy dogs and cats, and is transmitted to humans principally by dog bites. This review compiled all laboratory-confirmed cases, animal sources, and virulence attributes to describe its epidemiology, clinical features, and pathogenesis. An estimated 484 patients with a median age of 55 years were reported, two-thirds of which were male. The case-fatality rate was about 26%. Its clinical presentations included severe sepsis and fatal septic shock, gangrene of the digits or extremities, high-grade bacteremia, meningitis, endocarditis, and eye infections. Predispositions were prior splenectomy in 59 patients and alcoholism in 58 patients. Dog bites before illness occurred in 60%; additionally, in 27%, there were scratches, licking, or other contact with dogs or cats. Patients with meningitis showed more advanced ages, higher male preponderance, lower mortality, and longer incubation periods after dog bites than patients with sepsis (p dog bites. PMID:25828064

  20. Isolation and identification of bacterial causes of clinical mastitis in cattle in Sulaimania region

    Directory of Open Access Journals (Sweden)

    S. A. Hussein

    2008-01-01

    Full Text Available A total of 51 cases of bovine clinical mastitis in Sulaimani district were investigated for their bacteriological causative agents; 76 milk samples were cultured on primary and selective media and the isolated bacteria were tested for their susceptibility to antimicrobial agents used in commercial intramammary infusion products. Eighty two bacterial isolates were obtained and further identified using biochemical tests. Escherichia coli was the most common bacteria followed by Staphylococcus aureus, Streptococcus agalactia and coagulase–negative staphylococci. Two other bacterial species (Pseudomonas aeruginosa and Streptococcucs uberis were also isolated but in a lower proportion. Antibacterial susceptibility testing showed that the use of florfenicol, cephalexin and gentamicin may be useful for the treatment of clinical mastitis cases in cows.

  1. Clinic-based surveillance for bacterial- and rotavirus-associated diarrhea in Egyptian children.

    Science.gov (United States)

    Wierzba, Thomas F; Abdel-Messih, Ibrahim Adib; Abu-Elyazeed, Remon; Putnam, Shannon D; Kamal, Karim A; Rozmajzl, Patrick; Ahmed, Salwa F; Fatah, Abdel; Zabedy, Khaled; Shaheen, Hind I; Sanders, John; Frenck, Robert

    2006-01-01

    To identify enteropathogens for vaccine development, we implemented clinic-based surveillance for severe pediatric diarrhea in Egypt's Nile River Delta. Over 2 years, a physician clinically evaluated and obtained stool samples for microbiology from patients with diarrhea and less than 6 years of age. In the first (N = 714) and second clinic (N = 561), respectively, 36% (N = 254) and 46% (N = 260) of children were infected with rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter, or Shigella. When excluding mixed rotavirus-bacterial infections, for the first and second clinic, 23% and 10% had rotavirus-associated diarrhea, and 14% and 17% had ETEC-associated diarrhea, respectively. Campylobacter-associated diarrhea was 1% and 3%, and Shigella-associated diarrhea was 2% and 1%, respectively, for the two clinics. Rotavirus-associated diarrhea peaked in late summer to early winter, while bacterial agents were prevalent during summer. Rotavirus-associated cases presented with dehydration, vomiting, and were often hospitalized. Children with Shigella- or Campylobacter-associated diarrhea reported as watery diarrhea and rarely dysentery. ETEC did not have any clinically distinct characteristics. For vaccine development and/or deployment, our study suggests that rotavirus is of principle concern, followed by ETEC, Shigella, and Campylobacter. PMID:16407360

  2. 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...

  3. 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%...

  4. [A meningitis case of Brucella and tuberculosis co-infection].

    Science.gov (United States)

    Karsen, Hasan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Demiröz, Ali Pekcan

    2008-10-01

    Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucella and tuberculosis co-infection has been presented. A 19-years-old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucella meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucella spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14th day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30th day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucella and tuberculosis co-infection, this report emphasizes that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis

  5. Bacterial abundance on hands and its implications for clinical trials of surgical scrubs.

    OpenAIRE

    Spradlin, C T

    1980-01-01

    The numbers of bacteria on the hands of 157 subjects volunteering for a clinical trial of a surgical scrub preparation were evaluated statistically. Differences among the volunteers with respect to day-to-day variability in bacterial counts were the most important source of variation in these counts. Generally, more bacteria were found on the left hand than on the right. The experimental plan, proposed by the U.S. Food and Drug Administration, contained criteria for acceptability of subjects ...

  6. Quantitative analysis of bacterial aerosols in two different dental clinic environments.

    OpenAIRE

    Grenier, D

    1995-01-01

    Microbial aerosols are generated during dental treatments and may represent an important source of infection. This study was designed to quantify bacterial air contamination during dental treatments in both a closed dental operatory and a multichair dental clinic. Air was sampled by using a slit type of biological air sampler. Following air sampling, blood-supplemented Trypticase soy agar plates were incubated at 37 degrees C under anaerobic conditions for 7 days. The maximum levels of air co...

  7. 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.

  8. 脑膜癌病%Meningeal carcinomatosis

    Institute of Scientific and Technical Information of China (English)

    倪伟光

    2001-01-01

    目的探讨脑膜癌病的临床表现、 EEG、 CT、 MRI及脑脊液细胞学检查与诊断之间的关系。进一步提高对脑膜癌病的认识。方法对 4例脑膜癌病的临床资料及 EEG、 CT、 MRI、脑脊液检查进行综合分析。结果脑膜癌病主要病变累及软脑膜、颅神经及脊神经根。临床表现复杂,主要出现脑症状,颅神经症状和脊神经症状。脑脊液检查,多数患者蛋白与细胞数轻-中度增高,葡萄糖及氯化物减少。结论 EEG、 CT、 MRI检查对诊断脑膜癌病有重要参考价值。诊断时需注意与结核性脑膜炎,新型隐球菌性脑膜炎及脑囊虫病相鉴别。脑脊液发现癌细胞是诊断本病的可靠依据。%Objective To improve the knowledge about meningeal carcinomatosis by exploring the relationship between the clinical characteristics、 EEG、 CT、 MRI、 cerebrospinal fluid(CSF) and diagnosis. Methods The clinical materials of 4 patients with meningeal carcinomatosis and EEG、 CT、 MRI、 Cytomorphology in CFS were analysed. Results Meningeal carcinomatosis mainly involve some tissues such as cranial nerves、 pia mater、 spinal nervous roots and appear some symptoms associated with these diseased tissues. In CSF of most patients with this disease there is a slight- middle increase in protein and amount of cells, decrease in glucose and chloride. Conclusion EEG、 CT and MRI play an important role in the diagnosis of meningeal carcinomatosis. There is a necessity to differentiate it from cerebral tuberculosis, cytoccous meningitis and cerebral cysticercosis. It is reliable evidence to find cancer cell in CSF.

  9. Tuberculous meningitis in children: a review of clinical, laboratory, epidemiological, and therapeutic aspects and of the usefulness of BCG vaccination Meningitis tuberculosa en niños: una revisión de aspectos clínicos, de laboratorio, epidemiológicos y terapéuticos y de la utilidad de la vacunación con BCG

    Directory of Open Access Journals (Sweden)

    José William Cornejo Ochoa

    2010-08-01

    Full Text Available

    Tuberculous meningitis is the most frequent extrapulmonary form of tuberculosis in underdeveloped countries, among them Colombia. It is associated with high rates of morbidity and mortality. In this article a review is presented of the following aspects of the disease: clinical, epidemiological, therapeutic, prophylactic by means of BCG vaccination, laboratory diagnosis, and tomographic findings.

    La tuberculosis meníngea (MTB es la enfermedad tuberculosa extrapulmonar más frecuente en los países del tercer mundo, incluida Colombia, y tiene tasas altas de morbilidad y mortalidad. En este artículo se presenta una revisión de la literatura sobre los siguientes aspectos de la enfermedad: clínicos, epidemiológicos, de laboratorio, tomográficos, terapéuticos y de prevención con la vacuna BCG.

  10. Long-term clinical and bacterial effects of xylitol on patients with fixed orthodontic appliances

    OpenAIRE

    Masoud, Mohamed I; Allarakia, Reem; Alamoudi, Najlaa M.; Nalliah, Romesh; Allareddy, Veerasathpurush

    2015-01-01

    Background The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of xylitol per day for 3 months on patients with full fixed orthodontic appliances. Methods The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B received xylitol dissolvable chewable tablets, and Group C served as the control group and...

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

    Science.gov (United States)

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

    2013-06-01

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

  12. 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.

  13. MRSA bacteraemia complicating amphotericin B treatment of cryptococcal meningitis

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    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.

  14. 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.

  15. Clinical analysis on 100 cases of AIDS combined with cryptococcal meningitis%艾滋病合并新型隐球菌性脑膜炎100例临床分析

    Institute of Scientific and Technical Information of China (English)

    关家龙; 李粤平; 蔡卫平

    2014-01-01

    Objective To analyze the clinical features and prognosis of cryptococcal meningitis in patients with AIDS,and to improve the understanding of cryptococcal meningitis.Methods We retrospectively analyzed the clinical data of cryptococcal meningitis in patients with AIDS from January 2008 to December 2012 in Guangzhou 8th People's Hospital.The data of clinical manifestation,laboratory examination,treatment and prognosis were collected.Results Among all 100 cases diagnosed as AIDS associated with cryptococcal meningitis,75 cases were male and 25 cases were female,mean age was (39.5 ± 10.3) years old.Charlson comorbidity index was (6.1 ± 0.7).All patients were not receiving HAART.Fever and headache were the most common clinical symptoms.CD4 cell count was 1~ 139/μ l (median 8.5).98 patients had increased open pressure [mean (21.2 ± 12.4) mmHg].Median CSF WBC count was 2 (1-110) × 106/L,the median protein quantification was 0.41 g/L (0.11-1.43 g/L),median glucose 0.42 g/L (0.05-0.69 g/L).88 patients had positive India ink smear,81 patients were cerebrospinal fluid culture positive,88 cases had positive CSF cryptococcal antigen and 99 patients were serum cryptococcal antigen positive.The median duration was 23 days.There were no significant difference of clinical outcomes among different treatment groups (x 2=4.387,P=0.821).Conclusion Cryptococcal meningitis is the common opportunistic infection in patients with AIDS.The clinical manifestations and laboratory tests lack specificity.The key to reducing mortality is early diagnosis and rational use of antifungal agents.%目的 分析艾滋病合并新型隐球菌性脑膜炎的临床特点、治疗及转归,提高对隐球菌性脑膜炎的认识.方法 回顾性总结2008年1月至2012年12月在广州医科大学附属广州市第八人民医院住院治疗的艾滋病合并隐球菌性脑膜炎的临床表现、实验室检查、治疗及转归.结果 100例确诊患者中,男75例,女25例,平均年龄(39.5±10

  16. Aseptic meningitis in a large MMR vaccine campaign (590,609 people in Curitiba, Paraná, Brazil, 1998

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    ARRUDA Walter Oleschko

    2001-01-01

    Full Text Available The aseptic meningitis after Measles-Mumps-Rubella vaccine (MMR is a well recognized complication, and different incidences have been observed in several studies. We retrospectively analyzed forty cases of aseptic meningitis, during a large public immunization campaign (1998 in Curitiba, Southern Brazil (590,609 people, admitted in our Service. The vaccine utilized was Leningrad-3-Zagreb mumps strain, Edmonston-Zagreb measles strain, and RA 27#3 rubella strain. In all county, a total number of 87 cases were reported, resulting in a incidence of 1.7 cases per 10,000 given doses . The mean age was 23.7 ± 12.8 years. The female:male ratio was 1.35:1. Severe headache with meningismus (92.5%, fever (87.5%, nausea/vomiting (82.5% were the most common clinical findings. Three cases (7.5% developed mild mumps. All patients underwent cerebrospinal fluid (CSF tap with the following findings: mononuclear pleocytosis from 100 to 500 cells/mm³ in 17 cases (42.5%; 257.5 ± 260.6 cells/mm³; increased protein 28 cases (67.5%; 92.1 ± 76.9 mg/dL; glucose was normal in all cases (56.8 ± 11.2 mg/dL except in 4 (10% cases, which presented less than 44 mg/dL. All serological tests (latex to bacterial meningitis, Cryptococcus, cysticercosis, VDRL and bacteriological cultures were negative. Virus identification were also negative in 8 samples. None of the patients had neurological deficits or related symptoms after one year of onset. We believe the benefit of vaccination clearly outweights the incidence of benign vaccine-associated meningitis.

  17. Induction of mouse melioidosis with meningitis by CD11b+ phagocytic cells harboring intracellular B. pseudomallei as a Trojan horse.

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    Pei-Ju Liu

    Full Text Available BACKGROUND: Approximately 3-5% of patients with melioidosis manifest CNS symptoms; however, the clinical data regarding neurological melioidosis are limited. METHODS AND FINDINGS: We established a mouse model of melioidosis with meningitis characterized by neutrophil infiltration into the meninges histologically and B. pseudomallei in the cerebrospinal fluid (CSF by bacteriological culturing methods. As the disease progresses, the bacteria successively colonize the spleen, liver, bone marrow (BM and brain and invade splenic and BM cells by days 2 and 6 post-infection, respectively. The predominant cell types intracellularly infected with B. pseudomallei were splenic and BM CD11b(+ populations. The CD11b(+Ly6C(high inflamed monocytes, CD11b(+Ly6C(low resident monocytes, CD11b(+Ly6G(+ neutrophils, CD11b(+F4/80(+ macrophages and CD11b(+CD19(+ B cells were expanded in the spleen and BM during the progression of melioidosis. After adoptive transfer of CD11b populations harboring B. pseudomallei, the infected CD11b(+ cells induced bacterial colonization in the brain, whereas CD11b(- cells only partially induced colonization; extracellular (free B. pseudomallei were unable to colonize the brain. CD62L (selectin was absent on splenic CD11b(+ cells on day 4 but was expressed on day 10 post-infection. Adoptive transfer of CD11b(+ cells expressing CD62L (harvested on day 10 post-infection resulted in meningitis in the recipients, but transfer of CD11b(+ CD62L-negative cells did not. CONCLUSIONS/SIGNIFICANCE: We suggest that B. pseudomallei-infected CD11b(+ selectin-expressing cells act as a Trojan horse and are able to transmigrate across endothelial cells, resulting in melioidosis with meningitis.

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

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    Yan-yu CHANG

    2014-08-01

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

  19. MR IMAGING OF MENINGEAL CARCINOMATOSIS BY SYSTEMIC MALIGNANCY

    Institute of Scientific and Technical Information of China (English)

    马林; 于生元; 蔡幼铨; 梁丽; 郭行高

    2003-01-01

    Objective.To investigate the magnetic resonance(MR)features of meningeal carcinomatosis,and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings. Methods. Eleven cases with proven meningeal carcinomatosis were studied by conventional and Gd-DTPA enhanced MR imaging. The enhancement patterns and features,as well as the types of meningeal involvement,were retrospectively analyzed. Results. Conventional MR imaging showed no evident meningeal abnormalities. After the administration of Gd-DTPA,abnormal pia mater enhancement was detected in 9 cases,demonstrating as the continuous,thin,and lineal high signal intensity on the brain surface that could descend into the sulci. The abnormal pial enhancement occurred on the cortical surfaces of cerebellum,brainstem,and cerebrum. No abnormal enhancement in the subarach-noid space was found. Abnormal dura-arachnoid enhancement was seen in 3 cases,showing as the continuous,thick,and curvilineal high signal intensity over the convexities or in the tentorium without extension into the cortical sulci. Cerebral dura-arachnoid involvement was found in all 3 cases and one of them also showed abnormal enhancement in cerebellar dura-arachnoid and tentorium. Of the 11 cases,9 with pial involvement had abnormal cerebrospinal fluid(CSF)results,2 involving only the dura-arachnoid had normal CSF results. Conclusion. Meningeal carcinomatosis could be well demonstrated by Gd-DTPA enhanced MR imaging,and its type could be differentiated by the enhancement features. Combined with the clinical information,Gd-enhanced MR imaging may lead to the diagnosis and guide the therapy of meningeal carcinomatosis.

  20. 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.

  1. Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: Diagnostic study

    NARCIS (Netherlands)

    R.G. Nijman (Ruud); Y. Vergouwe (Yvonne); M.J. Thompson (Matthew); M.V. Veen (Mirjam Van); A.H.J. van Meurs (Alfred); J. van der Lei (Johan); E.W. Steyerberg (Ewout); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

    2013-01-01

    textabstractObjective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Design: Prospective observational diagnostic study. Setting: Three paediatric em

  2. Aseptic meningitis in children: analysis of 506 cases.

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    Athanasios G Michos

    Full Text Available BACKGROUND: Non-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. The medical records of children who had as discharge diagnosis aseptic or viral meningitis were reviewed. A total of 506 children, median age 5 years, were identified. The annual incidence rate was estimated to be 17/100,000 children less than 14 years of age. Most of the cases occurred during summer (38% and autumn (24%. The dominant clinical symptoms were fever (98%, headache (94% and vomiting (67%. Neck stiffness was noted in 60%, and irritation in 46% of the patients. The median number of CSF cell count was 201/mm(3 with polymorphonuclear predominance (>50% in 58.3% of the cases. Enterovirus RNA was detected in CSF in 47 of 96 (48.9% children tested. Children with positive enterovirus PCR had shorter hospitalization stay as compared to children who had negative PCR or to children who were not tested (P = 0.01. There were no serious complications or deaths. CONCLUSIONS: Enteroviruses accounted for approximately one half of cases of aseptic meningitis. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis.

  3. Incidence, carriage and case-carrier ratios for meningococcal meningitis in the African meningitis belt: a systematic review and meta-analysis.

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    Thibaut Koutangni

    Full Text Available To facilitate the interpretation of meningococcal meningitis epidemiology in the "African meningitis belt", we aimed at obtaining serogroup-specific pooled estimates of incidence, carriage and case-carrier ratios for meningococcal meningitis in the African meningitis belt and describe their variations across the endemic, hyperendemic and epidemic context.We conducted a systematic review and meta-analysis of studies reporting serogroup-specific meningococcal meningitis monthly incidence and carriage in the same population and time period. Epidemiological contexts were defined as endemic (wet season, no epidemic, hyperendemic (dry season, no epidemic, and epidemic (dry season, epidemic.Eight studies reporting a total of eighty pairs of serogroup-specific meningococcal meningitis incidence and carriage estimates were included in this review. For serogroup A, changes associated with the transition from endemic to hyperendemic incidence and from hyperendemic to epidemic incidence were 15-fold and 120-fold respectively. Changes in carriage prevalence associated with both transitions were 1-fold and 30-fold respectively. 
For serogroup W and X, the transition from endemic to hyperendemic incidence involved a 4-fold and 1•1-fold increase respectively. Increases in carriage prevalence for the later transition were 7-fold and 1•7-fold respectively. No data were available for the hyperendemic-epidemic transition for these serogroups. Our findings suggested that the regular seasonal variation in serogroup A meningococcal meningitis incidence between the rainy and the dry season could be mainly driven by seasonal change in the ratio of clinical cases to subclinical infections. In contrast appearance of epidemic incidences is related to a substantial increase in transmission and colonisation and to lesser extent with changes in the case-carrier ratio.Seasonal change in the rate of progression to disease given carriage together with variations in

  4. Predictors of mortality in patients with meningeal tuberculosis

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    Elizabeth Litta George

    2012-01-01

    Full Text Available Background: Meningeal tuberculosis (TB has higher mortality compared to other forms of central nervous system TB. However, data on predictors of mortality is limited. Aims: To determine the predictors of mortality in patients with meningeal TB. Materials and Methods: This study retrospectively analyzed the data of patients admitted with a diagnosis of meningeal TB between January 2006 and December 2008. Thwaites′ index score of four or less was used for the diagnosis of meningeal TB which is a weighted diagnostic index score for dichotomised clinical variables. Predictors of mortality were analyzed separately for both patients with human immunodeficiency virus (HIV infection and without. Statistical Analysis: Univariate analysis and multinomial logistic regression was done. Results: Univariate analysis showed age >40 years, Glasgow Coma Scale (GCS score 40 years was a risk factor for mortality when HIV patients were included (P=0.049 as well as when they were excluded (P=0.048. CSF protein ͳ 60 mg% was found to be a significant risk factor when both HIV seropositive persons (P=0.011 as well as seronegative persons (P=0.004 were included. HIV seropositivity, steroid treatment or delay in treatment did not affect mortality. Conclusions: Identification of factors predictive of in-hospital mortality will help to prognosticate patients with meningeal TB at the time of admission.

  5. Brain CT scanning of children with purulent meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-12-01

    Nine of 21 children with purulent meningitis showed abnormal findings in brain CT when admitted. All of the abnormal group were less than 12 months of age, but 75 % of the normal group were more than 1 year old. The period of positive CRP was longer and the level of sugar in CSF was lower in abnormal group when compared with normal group. Because convulsion and EEG abnormalities were observed similarly in both groups, it may be difficult to determine the organic changes of the brain clinically. Brain CT scanning is recommended as soon as possible after the onset of purulent meningitis.

  6. 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...

  7. [Clinical burden of multi-cause and pneumococcal pneumonia, meningitis, and septicemia in Hungary. Results of a retrospective study (2006-2011)].

    Science.gov (United States)

    Ludwig, Endre; Jorgensen, Lindsay; Gray, Sharon; Munson, Samantha; Chou, Kathy; Gutterman, Elane M

    2014-09-01

    Bevezetés: Kevés adat áll rendelkezésre a konjugált pneumococcusvakcináknak a pneumonia, meningitis és septikaemia előfordulására gyakorolt hatásáról Magyarországon. Célkitűzés: A szerzők retrospektív vizsgálattal kívánták felmérni a 2006–2011 között Magyarországon minden korosztályban előforduló, kórházi kezelést igénylő, bármely kórokú és pneumococcus okozta pneumonia-, meningitis- és septikaemiaeseteket. Módszer: Összesített adatokat gyűjtöttek az Országos Egészségbiztosítási Pénztár adatbázisából előre meghatározott BNO-10-kódok segítségével. Az összehasonlítás χ2-próba segítségével készült a következők alapján: átlagos arány a védőoltás bevezetését megelőzően (2006–2007) versus átlagos arány a védőoltás bevezetését követően (2010–2011). Eredmények: A 0–4 éves korú gyermekeknél a kórházi kezelést igénylő esetek aránya jelentősen csökkent a bármely kórokú tüdőgyulladás és agyhártyagyulladás esetében, de nőtt a septikaemia esetében. A többi korcsoportnál jelentősen növekedett a bármely kórokú pneumonia- és septikaemiaesetek száma. A kórházi halálozás aránya az életkorral emelkedett. A pneumococcusspecifikus kódok korlátozott alkalmazása miatt nem állapítottak meg egyértelmű eredményeket a pneumococcus okozta betegségeket illetően. Következtetések: A bármely kórokú tüdőgyulladás és agyhártyagyulladás csökkenése a 0–4 éves korosztálynál a konjugált pneumococcusvakcinációnak a kórházi kezelés arányára gyakorolt közvetlen hatására utal. Orv. Hetil., 2014, 155(36), 1426–1436.

  8. Guillain-Barré syndrome following meningococcal meningitis.

    OpenAIRE

    Puri, V.; Khalil, A; Suri, V

    1995-01-01

    A case of Guillain-Barré syndrome following meningococcal meningitis is reported. The diagnosis was made on clinical grounds and the results of electrophysiological studies. The patient recovered spontaneously. Guillain-Barré syndrome following meningococcal infection has not to our knowledge been reported previously.

  9. [Chemotherapy of severe bacterial infections in pediatrics].

    Science.gov (United States)

    Guggenbichler, J P

    1983-01-01

    Bacterial infections are frequent events in premature and newborn infants. The reason is a defective specific and nonspecific defence of bacterial organisms. Some immunoglobulins like IgM and IgA including secretory IgA are absent. Premature infants also show a decreased level of IgG. Cellular immunity is anatomically intact but functionally defective. A number of complement factors are lacking, the activation of the alternative pathway is impaired. Newborn infants with perinatal problems like asphyxia or difficult delivery, show defects of leucocyte function like decreased deformability, defective chemotaxis and defective killing of ingested bacteria. Certain diseases, like hypoxia and malformations of immature organ functions in this age group (decreased acid production in the stomach), facilitate bacterial colonization of surface epithelia and the invasion of tissues. Consequences of these pathogenetic mechanisms are an unimpaired propagation of bacterial organisms into the blood and meninges without localization of the infecting organisms at the entry site. Bacterial meningitis is not considered a separate disease entity but a complication of bacteremia and sepsis. Clinical symptoms are nonspecific at the onset of the infection. Fever is frequently absent; decreased appetite, vomiting, a bloated abdomen, diarrhea, tachycardia, tachypnea are early signs of a bacterial infection, a grey mottled appearance, cyanosis, jaundice, petechiae, apneic spells, seizure activity and a metabolic acidosis are symptoms of advanced infection. Successful treatment at this stage is often not possible. Every sign of a decreased well being of a newborn of premature infant warrants laboratory and bacteriologic work up for septicemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6316669

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

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    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.

  11. Recurrent meningitis associated with complete Currarino triad in an adult--case report.

    Science.gov (United States)

    Haga, Yasushi; Cho, Hiroyuki; Shinoda, Souji; Masuzawa, Toshio

    2003-10-01

    A 58-year-old woman presented with Currarino triad manifesting as recurrent meningitis. Currarino triad is a combination of a presacral mass, a congenital sacral bony abnormality, and an anorectal malformation, which is caused by dorsal-ventral patterning defects during embryonic development. She had a history of treatment for anal stenosis in her childhood. Radiographic examinations demonstrated the characteristic findings of Currarino triad and a complicated mass lesion. The diagnosis was recurrent meningitis related to the anterior sacral meningocele. Neck ligation of the meningocele was performed via a posterior transsacral approach after treatment with antibiotics. At surgery, an epidermoid cyst was observed inside the meningocele. The cyst content was aspirated. She suffered no further episodes of meningitis. The meningitis was probably part of the clinical course of Currarino triad. Radiography of the sacrum and magnetic resonance imaging are recommended for patients with meningitis of unknown origin. The early diagnosis and treatment of this condition are important. PMID:14620204

  12. Atypical meningococcal meningitis with rashless presentation:A case report

    Institute of Scientific and Technical Information of China (English)

    Sunita; Singh Manpreet; Kapoor Dheeraj

    2012-01-01

    Meningococcal disease is the major health problem in developing world. The clinical presentation is varied, ranging from transient fever and bacteraemia to fulminant disease with death ensuing within hours of the onset of clinical symptoms. The classical clinical manifestations of meningococcal disease have been well described, but atypical presentations if unrecognized, may lead to a delay in treatment and fatal outcome. We here report a case presented with atypical presentation of meningococcal meningitis without classical rash, which was diagnosed and managed successfully.

  13. Streptococcus suis Meningitis: A Systematic Review and Meta-analysis.

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    Anusha van Samkar

    Full Text Available Streptococcus suis is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on S. suis meningitis to define the clinical characteristics, predisposing factors and outcome.Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with S. suis meningitis in whom at least one clinical characteristic was described.We identified 913 patients with S. suis meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%. Exposure to pigs or pork was present in 395 of 648 patients (61% while other predisposing factors were less common. 514 of 528 patients presented with fever (97%, 429 of 451 with headache (95%, 462 of 496 with neck stiffness (93% and 78 of 384 patients (20% had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%. Treatment included dexamethasone in 157 of 300 (52% of patients and was associated with reduced hearing loss in S. suis meningitis patients included in a randomized controlled trial.S. suis