WorldWideScience

Sample records for meningitis bacteriana aguda

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

    Directory of Open Access Journals (Sweden)

    Witer Elena Vallejo López

    1991-01-01

    Full Text Available

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

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

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

    Directory of Open Access Journals (Sweden)

    Wallace Andrino da Silva

    2010-08-01

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

  3. Amigdalitis aguda recurrente bacteriana: Estudio prospectivo, comparativo y controlado de sus características clínicas y microbiológicas

    OpenAIRE

    Der M,Carolina; Iñiguez C,Rodrigo; Guzman D,Ana Maria; Jofré P,David; Iñiguez C,Armando; Labarca L,Jaime

    2007-01-01

    Introducción: La amigdalitis aguda recurrente es una patología de frecuente consulta, es una de las indicaciones de amigdalectomía. No se sabe con exactitud el origen de esta patología. Objetivo: Identificar la microbiología y patrones de susceptibilidad de las bacterias en la amigdalitis aguda recurrente bacteriana (AARB) a los antimicrobianos más comúnmente en el medio nacional, usados en su tratamiento. Material y método: Se planificó un estudio prospectivo, controlado y ciego. Se evaluaro...

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

    Directory of Open Access Journals (Sweden)

    Adrián Poblano

    2007-09-01

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

  5. Displasia de Mondini asociada a meningitis bacteriana recurrente, correlación clínico-imagenológica

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa

    Full Text Available Se describe la displasia de Mondini asociada a pérdida auditiva y meningitis bacteriana recurrente. La malformación de Mondini representa el 30 % de las anomalías congénitas del oído interno, puede ser unilateral o bilateral, y su principal característica consiste en el desarrollo coclear incompleto, causante de grados variables de hipoacusia neurosensorial. Se considera que la ocurrencia de esta malformación se produce por disrupción del desarrollo embrionario durante la séptima semana de gestación, en la cual se detiene el desarrollo coclear. Se presenta el caso de una niña de 12 años, atendida en los Servicios de Pediatría y Otorrinolaringología del Hospital Pediátrico Universitario "William Soler", por presentar 3 infecciones meningoencefálicas, en las cuales se aisló Streptococcus pneumoniae serotipo 19F, y se constató hipoacusia neurosensorial severa en el oído izquierdo. La tomografía axial computarizada de alta resolución del oído (cortes axiales y coronales, evidenció la malformación coclear y vestibular, con presencia de tejido en el oído medio que se comunicaba directamente con el oído interno del lado izquierdo a nivel de la ventana oval. Se destaca la importancia de la sospecha clínica de displasia de Mondini, y el impacto científico de la tomografía computarizada del hueso temporal, para el diagnóstico precoz de fístula congénita en el oído interno asociada a meningitis bacteriana recurrente.

  6. 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.

  7. Categorías de riesgo de meningitis bacteriana y tratamiento con antibióticos en neonatos con pleocitosis del líquido cefalorraquídeo

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    Full Text Available Introducción: recientemente se desarrolló y validó el Modelo de Predicción de Meningitis Bacteriana Neonatal, lo cual provee de una herramienta efectiva en la toma de decisiones médicas para la indicación de tratamiento antibiótico ante un neonato con pleocitosis del líquido cefalorraquídeo. Objetivo: conocer cómo se procedió retrospectivamente con la indicación de tratamiento antibiótico en neonatos con pleocitosis del líquido cefalorraquídeo, antes de desarrollar el modelo mencionado, y fortalecer y fundamentar una estrategia del tratamiento antibiótico, basados en nuestro Modelo de Predicción de Meningitis Bacteriana Neonatal, ante un neonato con pleocitosis del líquido cefalorraquídeo. Métodos: estudio retrospectivo y aplicado, que incluyó 290 neonatos evaluados por probable infección, 44 con meningitis bacteriana y 246 con meningitis aséptica, ingresados en el Servicio de Neonatología del Hospital Pediátrico "Juan Manuel Márquez", entre febrero/1992 y diciembre/2009. Se verificó la efectividad del Modelo de Predicción de Meningitis Bacteriana Neonatal, lo que permitió clasificar los pacientes en alto o bajo riesgo de meningitis bacteriana. Se determinó retrospectivamente la indicación y los motivos de tratamiento antibiótico ante un neonato con pleocitosis del líquido cefalorraquídeo, así como análisis de asociación para distintas circunstancias clínicas, entre ellas, la clasificación de riesgo de infección bacteriana severa. Resultados: se precisó que el Modelo de Predicción de Meningitis Bacteriana Neonatal tuvo una sensibilidad y valor predictivo negativo de 100 % para meningitis bacteriana. Hubo concordancia estadísticamente significativa entre la predicción por el modelo y la clasificación de riesgo de infección bacteriana severa. Se comprobó un uso racional del tratamiento antibiótico, pues se utilizó de inmediato al diagnóstico de meningitis bacteriana en 100 % de los casos, y solo en

  8. Meningitis

    Science.gov (United States)

    Meningitis - bacterial; Meningitis - viral; Meningitis - fungal; Meningitis - vaccine ... treatment, meningitis may result in the following: Brain damage Buildup ... that leads to brain swelling ( hydrocephalus ) Seizures Death

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

    Directory of Open Access Journals (Sweden)

    Ellen H. Lee

    2008-09-01

    Full Text Available OBJECTIVES: Widespread use of Haemophilus influenzae type b (Hib vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningitis before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis. METHODS: Meningitis cases among children OBJETIVOS: El uso generalizado de la vacuna contra Haemophilus influenzae tipo b (Hib ha permitido reducir radicalmente la carga de enfermedad por Hib en las Américas. Pocos estudios han evaluado el impacto de la vacunación contra Hib sobre los casos no confirmados mediante cultivo. En este estudio se analizaron las tendencias en el número de casos probables de meningitis bacteriana antes y después de la introducción de la vacuna contra Hib en la República Dominicana y se estimó la eficacia de la vacuna contra la meningitis. MÉTODOS: Se identificaron los casos de meningitis en niños menores de 5 años a partir de los registros de ingreso del principal hospital pediátrico de Santo Domingo entre 1998 y 2004. Los casos de meningitis con probable etiología bacteriana se clasificaron según criterios de laboratorio; los casos confirmados contaban con cultivo bacteriano positivo o detección de antígenos específicos en el líquido cefalorraquídeo. Se calcularon las tasas de incidencia acumulada de casos confirmados y probables de meningitis en los niños que vivían en el Distrito Nacional. Los casos confirmados de meningitis por Hib se incorporaron a un estudio de casos y controles -pareados según la edad y el barrio de residencia- para calcular la eficacia de la vacuna. RESULTADOS: Antes de la introducción de la vacuna, la tasa anual de meningitis de posible etiología bacteriana era de 49 casos por 100 000 niños menores de 5 años; de los casos confirmados de

  10. Cirurgia conservadora da endocardite bacteriana aguda da valva tricúspide Conservative operation for bacterial endocardites of the tricuspide valve

    Directory of Open Access Journals (Sweden)

    Iseu Affonso da Costa

    1988-08-01

    Full Text Available É relatado o caso de 1 paciente que apresentou endocardite aguda da valva tricúspide pós-aborto, cujo agente causal era o S. aureus. Como não houvesse resposta favorável ao tratamento antibiótico (gentamicina, vancomicina e oxacilina, optou-se pela intervenção, vinte dias após a internação. Foi praticada excisão de uma vegetação única e do tecido valvar adjacente, na comissura ântero-posterior e plicatura anular. O resultado foi favorável, com cura clínica. O exame ecocardiográfico confirmou a presença da vegetação no pré-operatório e o funcionamento conservado da valva, após a plastia. O tratamento cirúrgico, com retirada do tecido infectado e preservação da valva constitui uma alternativa aplicável a certos casos de endocardite aguda das valvas atrioventriculares.One case of acute bacterial endocarditis of the tricuspid valve caused by S. aureus and following a septic abortion is presented. Surgical treatment was indicated after failure of antibiotics. Operation consisted of excision of a large vegetation adherent to the anterior and posterior cusps at the commisure and of the affected valvar tissue. Annular plicature at the segment corresponding to the posterior cuspid was employed to maintain competence. Clinical result was very satisfactory with resolution of sepsis. Dopplerecocardiography revealed the presence of the vegetation before the operation and showed a small regurgitation after valvoplasty. Conservative operation upon the atrioventricular valves must be kept in mind as an alternative in the treatment of acute bacterial endocarditis.

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

    Directory of Open Access Journals (Sweden)

    MARIA INÊS VIEIRA COUTO

    1999-09-01

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

  12. Un modelo de predicción de meningitis bacteriana en recién nacidos con pleocitosis del líquido cefalorraquídeo

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    Full Text Available Introducción: se han desarrollado herramientas de predicción de meningitis bacteriana (MB en pacientes pediátricos, pero ellas no incluyen el período neonatal. Objetivo: diseñar y validar un modelo de predicción de MB en pacientes neonatales quienes presentan pleocitosis del líquido cefalorraquídeo (LCR al ser evaluados por variables clínicas y de laboratorio. Pacientes y método: estudio retrospectivo y analítico, que incluyó 320 pacientes neonatales evaluados por probable infección, en quienes se hizo el diagnóstico de meningitis, 45 con MB y 275 con meningitis aséptica, e ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario "Juan M. Márquez", entre Febrero de 1992 y Diciembre del 2009. Se creó un Modelo Predictivo de Meningitis Bacteriana, sobre la base de un conjunto de variables identificadas mediante procedimientos de análisis uni y multivariado. El modelo se diseñó a partir de una población «de derivación», y se contrastó en otro grupo, este "de validación". Resultados: las variables seleccionadas para integrar el modelo predictivo fueron: 1 Apariencia de estado tóxico-infeccioso, 2 Convulsiones en el transcurso de la enfermedad, 3 Tinción de Gram del LCR positiva, 4 Proporción de leucocitos polimorfonucleares en el LCR >80%, y 5 Glucorraquia <1.0 mMol/l. Con estas variables se alcanzaron sensibilidad y valor predictivo negativo de 100.0%. Con el modelo propuesto, en el grupo de derivación no hubo ningún paciente malclasificado con predicción negativa de MB pero portador de este tipo de infección. En el grupo de validación, el modelo tuvo un desempeño similar, lo cual lo acredita como un modelo de predicción validado internamente. Conclusiones: el modelo de predicción diseñado descansa en variables de evaluación rutinarias, y permitió identificar inequívocamente la totalidad de los pacientes neonatales con MB. Su empleo podría ser una herramienta útil en la toma de

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Roberta M.C. Romanelli

    2002-02-01

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

  15. 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

  16. 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

    Full Text Available OBJETIVO: Analisar a melhor evidência disponível nos últimos 15 anos com relação aos benefícios da terapia adjuvante com dexametasona na meningite bacteriana em população pediátrica. FONTES DE DADOS: Das bases de dados Medline, Lilacs e SciELO, foram analisados ensaios clínicos randomizados de 1996 a 2011, os quais comparavam a dexametasona ao placebo e/ou a outra terapia adjuvante em pacientes com meningite bacteriana diagnosticada laboratorialmente por critérios quimiocitológicos e/ou bacteriológicos, na faixa etária de 29 dias aos 18 anos. Os desfechos avaliados foram mortalidade e ocorrência de sequelas neurológicas e/ou auditivas. Foram excluídos estudos relacionados à meningite tuberculosa. SÍNTESE DOS DADOS: Com os critérios utilizados, foram identificadas cinco publicações correspondentes a quatro protocolos de estudo. Nenhum dos estudos mostrou diferenças entre a dexametasona e o placebo para os desfechos avaliados. Os estudos analisados tiveram alta qualidade (escore de Jadad et al=5. CONCLUSÕES: As evidências encontradas na literatura são insuficientes para indicar de forma rotineira o uso da dexametasona como terapia adjuvante para redução de mortalidade, perda auditiva e sequelas neurológicas em pacientes pediátricos com meningite bacteriana não tuberculosa.OBJETIVO: El presente estudio tiene por objetivo el análisis de la mejor evidencia disponible los últimos 15 años respecto a los beneficios de la terapia adyuvante con dexametasona en la meningitis bacteriana en población pediátrica por medio de revisión sistemática. FUENTES DE DATOS: De las bases de datos Medline, Lilacs y ScieLO, se analizaron ensayos clínicos aleatorios de 1996 a 2011 que comparaban la dexametasona al placebo y/u otra terapia adyuvante, en pacientes con meningitis bacteriana diagnosticada laboratorialmente por criterios quimiocitológicos y/o bacteriológicos, en la franja de edad de 29 días a 18 años. Los desenlaces

  17. 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.

  18. Meningitis

    Science.gov (United States)

    ... around. Even more protection is given by the meninges (say: muh-NIN-jeez), which are the membranes ... disease involving inflammation (swelling), or irritation, of the meninges. There are different kinds of meningitis, but most ...

  19. 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

  20. Meningites bacterianas no lactente aspectos neurológicos

    Directory of Open Access Journals (Sweden)

    M. Valeriana L. de Moura-Ribeiro

    1990-06-01

    Full Text Available Aspectos clínicos, neurológicos e laboratoriais das meningites bacterianas agudas no lactente são criticamente analisados em função da experiência da autora. São apresentadas considerações fisiopatológicas sobre os eventos que ocorrem na fase aguda desses processos.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Carmen Varela

    2007-10-01

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

  3. Apendicitis Aguda

    OpenAIRE

    Jorge Fallas González

    2012-01-01

    La apendicitis aguda, descrita desde 1886, es la emergencia quirúrgica más común. Tiene su mayor incidencia durante la adultez joven y su menor incidencia en niños y adultos mayores. Su diagnóstico se basa en una historia clínica completa, un examen físico bien orientado y en una adecuada interpretación de los exámenes de laboratorio y gabinete. A pesar de ser una entidad de resolución quirúrgica, su tratamiento engloba diferentes aspectos médicosAcute appendicitis, described since 1886, is t...

  4. 103. Reparación valvular mitral en un caso de endocarditis trombótica no bacteriana

    Directory of Open Access Journals (Sweden)

    R. Manrique

    2012-04-01

    Conclusiones: La reparación valvular mitral es un procedimiento eficaz y seguro en la insuficiencia mitral aguda en pacientes con endocarditis trombótica no bacteriana. Permite evitar un riesgo adicional asociado al uso de prótesis mecánicas en pacientes con riesgo tromboembólico elevado.

  5. Meningitis - pneumococcal

    Science.gov (United States)

    Pneumococcal meningitis; Pneumococcus - meningitis ... Pneumococcal meningitis is caused by Streptococcus pneumoniae bacteria (also called pneumococcus, or S pneumoniae ). This type of bacteria is the ...

  6. Meningites bacterianas recidivantes

    Directory of Open Access Journals (Sweden)

    Maria Valeriana L. Moura-Ribeiro

    1992-06-01

    Full Text Available O estudo das fístulas liquóricas, envolvendo anormalidades otorrinolaringológicas, deve se basear na procura da causa fundamental que leva às meningites recidivantes. As malformações congênitas, as anormalidades pós-traumáticas e pós-operatórias ou, ainda, associadas a doenças que envolvem ossos cranianos, constituem as causas básicas a serem pesquisadas. Os traumas cranianos podem resultar em fístula liquórica com possibilidade de meningites bacterianas de repetição.

  7. Meningitis - meningococcal

    Science.gov (United States)

    Meningococcal meningitis; Gram negative - meningococcus ... Meningococcal meningitis is caused by the bacteria Neisseria meningitidis (also known as meningococcus). Meningococcus is the most common cause ...

  8. Bacterial meningitis

    NARCIS (Netherlands)

    Roos, Karen L.; van de Beek, Diederik

    2010-01-01

    Bacterial meningitis is a neurological emergency. Empiric antimicrobial and adjunctive therapy should be initiated as soon as a single set of blood cultures has been obtained. Clinical signs suggestive of bacterial meningitis include fever, headache, meningismus, vomiting, photophobia, and an

  9. Fungal Meningitis

    Science.gov (United States)

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

  10. Meningitis - H. influenzae

    Science.gov (United States)

    H. influenzae meningitis; H. flu meningitis; Haemophilus influenzae type b meningitis ... H. influenzae meningitis is caused by Haemophilus influenzae type b bacteria. This illness is not the same ...

  11. Etiology of bacterial meningitis among children aged 2-59 months in Salvador, Northeast Brazil, before and after routine use of Haemophilus influenzae type b vaccine Etiologia da meningite bacteriana em crianças com idade entre 2 e 59 meses em Salvador, Nordeste do Brasil, antes e depois do uso rotineiro da vacina para Haemophilus influenzae tipo b

    Directory of Open Access Journals (Sweden)

    Cristiana M. Nascimento-Carvalho

    2004-06-01

    Full Text Available OBJECTIVE: To describe the frequency of etiologic agents of bacterial meningitis (BM among children aged 2-59 months in a sample of patients in Salvador, Northeast Brazil, with emphasis on the frequency of BM of unknown etiology (BMUE, just before, during and after the implementation of routine immunization of infants with Haemophilus influenzae type b (Hib vaccination. METHOD: Demographic, clinical and cerebrospinal fluid (CSF information was collected from the chart of every patient, aged 2-59 months, whose CSF exam was performed at the CSF Lab - José Silveira Foundation, between January 1989 and December 2001. Every CSF exam was completely performed according to standard methods. The etiologic diagnosis was based on either culture and/or latex-agglutination test. When the agent was only seen on Gram stained smear, the diagnosis was descriptive. BMUE was defined as: glucose 100 mg / dl, white blood cell count > 20 cells / mm³, percentage of neutrophils > 80%. RESULTS: Of 1519 patients, 894 (58.9% had normal exams and BM was diagnosed in 95 (6.2%. Etiologic agents were: Hib (44.2%, meningococcus (13.7%, Gram-negative bacilli (11.6%, Mycobacterium tuberculosis (6.3%, pneumococcus (4.2%, other agents (4.2%; BMUE was diagnosed in 15.8% of cases with BM. By analysing the frequency of BMUE and Hib among all exams performed yearly, the peaks were recorded in 1989 (5.3% and 1990 (16.9%, respectively, decreasing to 0.7% and 0% in 2001. CONCLUSION: It is possible that the implementation of the conjugate Hib vaccine during the 1990's has been decreasing not only the occurrence of Hib meningitis but also of BMUE.OBJETIVO: Descrever a freqüência dos agentes etiológicos de meningite bacteriana (MB em amostra das crianças com idade entre 2 e 59 meses, em Salvador, Nordeste do Brasil, com ênfase na freqüência de MB de etiologia indeterminada (MBEI, antes, durante e após a implementação da imunização rotineira de lactentes com vacina para

  12. Notas sobre apendicitis aguda

    OpenAIRE

    Méndez S., Martín

    2011-01-01

    Hacer un buen diagnóstico, tener el valor de la responsabilidad operando precozmente los enfermos, en los cuales después de minucioso examen se cree o se tiene certeza de una apendicitis aguda, es uno de los méritos de todo buen cirujano. Sin duda tendrá que luchar contra todo, la familia, el enfermo y los allegados; pero si triunfa y vence logrará éxitos y salvará vidas. Parece fácil diagnosticar unaapendicitis aguda y sin embargo, es necesario decirlo claro, nada hay tan complicado y en oca...

  13. Meningitis (For Parents)

    Science.gov (United States)

    ... Is Meningitis? Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal ... of bacterial meningitis, the bacteria spread to the meninges from a severe head trauma or a severe ...

  14. Recurrent Meningitis.

    Science.gov (United States)

    Rosenberg, Jon; Galen, Benjamin T

    2017-07-01

    Recurrent meningitis is a rare clinical scenario that can be self-limiting or life threatening depending on the underlying etiology. This review describes the causes, risk factors, treatment, and prognosis for recurrent meningitis. As a general overview of a broad topic, the aim of this review is to provide clinicians with a comprehensive differential diagnosis to aide in the evaluation and management of a patient with recurrent meningitis. New developments related to understanding the pathophysiology of recurrent meningitis are as scarce as studies evaluating the treatment and prevention of this rare disorder. A trial evaluating oral valacyclovir suppression after HSV-2 meningitis did not demonstrate a benefit in preventing recurrences. The data on prophylactic antibiotics after basilar skull fractures do not support their use. Intrathecal trastuzumab has shown promise in treating leptomeningeal carcinomatosis from HER-2 positive breast cancer. Monoclonal antibodies used to treat cancer and autoimmune diseases are new potential causes of drug-induced aseptic meningitis. Despite their potential for causing recurrent meningitis, the clinical entities reviewed herein are not frequently discussed together given that they are a heterogeneous collection of unrelated, rare diseases. Epidemiologic data on recurrent meningitis are lacking. The syndrome of recurrent benign lymphocytic meningitis described by Mollaret in 1944 was later found to be closely related to HSV-2 reactivation, but HSV-2 is by no means the only etiology of recurrent aseptic meningitis. While the mainstay of treatment for recurrent meningitis is supportive care, it is paramount to ensure that reversible and treatable causes have been addressed for further prevention.

  15. Syphilitic aseptic meningitis

    Science.gov (United States)

    Meningitis - syphilitic; Neurosyphilis - syphilitic meningitis ... Syphilitic meningitis is a form of neurosyphilis . This condition is a life-threatening complication of syphilis infection. Syphilis is ...

  16. Viral Meningitis

    Science.gov (United States)

    ... better from treatment such as an antiviral medicine. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. However, antibiotics do fight bacteria, so they are very important ...

  17. Bacterial Meningitis

    Science.gov (United States)

    ... certain places, such as: The meningitis belt in sub-Saharan Africa, particularly during the dry season Mecca during the ... a serious Hib infection Your doctor or local health department will tell you if you or someone ...

  18. Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children.

    Science.gov (United States)

    Pires, Frederico Ribeiro; Franco, Andréia Christine Bonotto Farias; Gilio, Alfredo Elias; Troster, Eduardo Juan

    2017-01-01

    To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone. Avaliar o papel da pesquisa de enterovírus no líquido cefalorraquidiano em comparação com o Escore de Meningite Bacteriana em crianças com meningite. Coorte retrospectiva, realizada pela análise de prontuários, incluindo pacientes pediátricos, com diagnóstico de meningite e atendidos em um hospital privado e terciário, localizado em São Paulo, entre 2011 e 2014. Foram excluídos os pacientes com doença crítica, púrpura, deriva

  19. Meningitis and Encephalitis

    Science.gov (United States)

    ... Publications Definition Meningitis is an infection of the meninges, the membranes that surround the brain and spinal ... immediately. × Definition Meningitis is an infection of the meninges, the membranes that surround the brain and spinal ...

  20. Insuficiencia respiratoria aguda

    OpenAIRE

    Gutiérrez Muñoz, Fernando R.

    2010-01-01

    La función respiratoria básica es el intercambio gaseoso de oxígeno y dióxido carbono; lo que implica un perfecto equilibrio y control entre los componentes del sistema respiratorio. a insuficiencia respiratoria aguda (IRA) es la incapacidad del sistema respiratorio de cumplir su función básica, que es el intercambio gaseoso de oxígeno y dióxido de carbono. Basic respiratory function is gas exchange of oxygen and carbon dioxide, which implies a perfect balance and control between the compo...

  1. Notas sobre apendicitis aguda

    Directory of Open Access Journals (Sweden)

    Martín Méndez S.

    1933-04-01

    apendicitis aguda y sin embargo, es necesario decirlo claro, nada hay tan complicado y en ocasiones tan oscuro. Sin duda, a medida que los conocimientos clínicos se extienden, se va iluminando el campo, antes inexplorado, de la cirugía apendicular, y hoy día casi todos los médicos y cirujanos tienen un criterio científico muy bien formado para lograr hacer un buen diagnóstico y aconsejar o llevar a cabo una intervención quirúrgica.

  2. Gingivitis ulceronecrosante aguda

    Directory of Open Access Journals (Sweden)

    Eduardo de la Teja-Ángeles

    2015-11-01

    Full Text Available La gingivitis ulcerativa necrosante, conocida por sus siglas en inglés como GUN (anteriormente se le conocía como enfermedad de Vincent o “boca de trinchera” por afectar a soldados en guerra, es una enfermedad poco frecuente.1-6 Se caracteriza por ser una infección aguda y dolorosa en la que las encías sangran, hay necrosis de las papilas interdentales y ataque al estado general.

  3. HELICOBACTER PYLORI EN LA FLORA BACTERIANA ORAL

    OpenAIRE

    Moromi Nakata, Hilda

    2014-01-01

    No hay duda de la relación existente entre enfermedades orales con otras enfermedades sistémicas. En tal contexto, las bacterias de la flora bacteriana oral, que alcanzan alrededor de 350 especies, para la mayoría de tales bacterias no se ha demostrado un rol específico, conociéndose sí una clara relación entre los Estreptococos orales (Streptococcus sanguis, Strecoccus mutans, Streptococcus sobri nus) y Actinobacillus actinomycetencomitans, entre otros, con la endocarditis bacteriana; así co...

  4. Antibióticos vs. resistencia bacteriana

    OpenAIRE

    Elso Manuel Cruz Cruz

    2015-01-01

    La resistencia bacteriana a los antibióticos es un problema de salud mundial que se encuentra en constante evolución. De manera frecuente se reportan nuevos mecanismos de resistencia bacteriana a los antibióticos, tanto en bacterias gram negativas como en gram positivas. La presencia de resistencia en una bacteria causante de infección disminuye las posibilidades de obtener la curación clínica y la erradicación bacteriológica e incrementa los costos del tratamiento, la morbilidad y la mortali...

  5. Treating Meningitis

    Science.gov (United States)

    ... Beek D. Dexamethasone and long-term survival in bacterial meningitis. Neurology 2012; 79:2177 – 2179. e190 © 2012 American Academy of Neurology ª 2012 American Academy of Neurology. Unauthorized reproduction of this article is prohibited. PATIENT PAGE Section ...

  6. Bacterial meningitis

    NARCIS (Netherlands)

    Heckenberg, Sebastiaan G. B.; Brouwer, Matthijs C.; van de Beek, Diederik

    2014-01-01

    Bacterial meningitis is a neurologic emergency. Vaccination against common pathogens has decreased the burden of disease. Early diagnosis and rapid initiation of empiric antimicrobial and adjunctive therapy are vital. Therapy should be initiated as soon as blood cultures have been obtained,

  7. Cryptococcal Meningitis

    African Journals Online (AJOL)

    1974-03-16

    Mar 16, 1974 ... Cryptococcal meningitis occurred in an elderly Coloured woman in the Northern Cape. She presented with symp- toms and signs suggestive of encephalitis 4 weeks after a cholecystectomy. After the administration of cortisone, cryptococcal organisms were isolated in her cerebrospinal fluid. She was first ...

  8. Tuberculous meningitis

    NARCIS (Netherlands)

    Wilkinson, R.J.; Rohlwink, U.; Misra, U.K.; Crevel, R. van; Mai, N.T.H.; Dooley, K.E.; Caws, M.; Figaji, A.; Savic, R.; Solomons, R.; Thwaites, G.E.

    2017-01-01

    Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In

  9. Hepatitis viral aguda

    Directory of Open Access Journals (Sweden)

    Héctor Rubén Hernández Garcés

    1998-10-01

    Full Text Available Se realizó una revisión bibliográfica de las hepatitis virales agudas sobre aspectos vinculados a su etiología. Se tuvieron en cuenta además algunos datos epidemiológicos, las formas clínicas más importantes, los exámenes complementarios con especial énfasis en los marcadores virales y el diagnóstico positivoA bibliographical review of acute viral hepatitis was made taking into account those aspects connected with its etiology. Some epidemiological markers, the most important clinical forms, and the complementary examinations with special emphasis on the viral markers and the positive diagnosis were also considered

  10. Mortalidad por meningitis por Pasteurella canis. Oportunidades de aprendizaje

    Directory of Open Access Journals (Sweden)

    Ana Rosa Ropero Vera

    2016-01-01

    Full Text Available La meningitis bacteriana es una enfermedad importante de distribución mundial, causa mayor y sustancial de mortalidad y morbilidad en países en desarrollo. La Organización Mundial de la Salud (OMS sostiene que la meningitis es una de las diez afecciones principales del ser humano y debe ser considerada como una emergencia infectológica; por eso es fundamental reconocer que esta enfermedad es causa de muerte en niños de todo el mundo, sin distinción de raza, nivel económico o sociocultural. Se realizó una investigación de caso en menor de 53 días de nacido, que cumplía con los criterios clínicos y de laboratorio compatible con meningitis bacteriana, con el propósito de analizar y fortalecer la toma de decisiones en salud pública por parte de la secretaría local de salud del municipio de Valledupar (Colombia. Entre los hallazgos se encontró antecedentes infecciosos en el menor, coloración de Gram y cultivo de LCR, en el que se identificó cocobacilos Gram negativos, que fueron aislados como agente causal Pasteurella canis. Este estudio pretende sensibilizar a los prestadores de salud para que cuenten con personal altamente capacitado para brindar tratamientos adecuados y prevenir complicaciones en la meningitis bacteriana en niños, y así disminuir la posibilidad de secuelas o muerte, tanto en pacientes con compromiso inmunológico o sin este.

  11. Peritonite bacteriana espontânea

    Directory of Open Access Journals (Sweden)

    Strauss Edna

    2003-01-01

    Full Text Available A peritonite bacteriana espontânea ocorre em 30% dos cirróticos com ascite e, neste grupo, apresenta altas taxas de morbidade e mortalidade. Os fatores predisponentes incluem a diminuição da defesa imunológica encontrada no homem nas fases avançadas da cirrose, o supercrescimento da flora intestinal e a translocação bacteriana da luz dos intestinos aos linfonodos mesentéricos. As manifestações clínicas variam de graves a leves ou ausentes, sendo sempre necessária a análise do líquido ascítico. O diagnóstico de peritonite bacteriana espontânea se faz pela contagem de neutrófilos > 250/mm³ no líquido ascítico associado ou não ao crescimento de bactéria na cultura. As enterobactérias predominam como causa da infecção, sendo a Echerichia coli a bactéria mais freqüentemente isolada. O diagnóstico precoce e o tratamento adequado provocaram a queda das taxas de mortalidade nas duas últimas décadas. O uso endovenoso de cefalosporinas de terceira geração mostra-se eficaz em 70% a 95% dos casos. A recorrência de peritonite bacteriana espontânea é comum e pode ser prevenida com norfloxacina oral, de uso contínuo. O surgimento de resistência bacteriana tem estimulado a procura de novas opções para a profilaxia da peritonite bacteriana espontânea; os probióticos constituem nova abordagem promissora, mas que necessita melhor avaliação. Recomenda-se a profilaxia primária de curta duração aos cirróticos com ascite que apresentem episódio de hemorragia digestiva alta.

  12. Meningeal hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    Guang-zhi YANG

    2015-03-01

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

  13. [Carcinomatous meningitis].

    Science.gov (United States)

    Cserni, Gábor; Vágó, Tibor; Török, Norbert; Gaál, Zoltán; Velkei, Tamás; Serényi, Péter; Göczo, Katalin; Tusa, Magdolna; Kovács, Katalin; Szucs, Miklós

    2007-10-01

    Carcinomatous meningitis is a serious complication of advanced stage solid tumours, which may become more common with improved survival. A 53-year-old woman with a recent history of breast cancer (pT2pN2M0) had been treated by mastectomy and adjuvant chemotherapy and radiotherapy. She presented with weakness, diplopia and vertigo raising the possibility of vertebrobasilar ischaemia or an intracranial mass. In another patient, a 62-year-old man with hypertension, a stenotic common bile duct had been diagnosed when examined for abdominal complaints. When he presented with a high blood pressure value accompanied by intensive headache, vomiting and bilateral hearing loss, he was thought to have a hypertensive crisis. The rapidly progressive neurological symptoms and the history of breast cancer and findings suggesting pancreatic head tumour, respectively, led to the clinical diagnosis of carcinomatous meningitis in both cases, despite any evidence on CT scans or a negative MR scan, though of limited value, in the first case. This diagnosis was confirmed by the laboratory and cytological findings of the cerebrospinal fluid, and also by the post mortem examination, since both patients died within a month after the onset of the symptoms. The primary tumour in the second patient proved to be a widely metastasizing diffuse type gastric cancer. Carcinomatous meningitis has a varying but characteristic presentation which generally makes it easy to diagnose, but it can sometimes present differential diagnostic problems. What we can learn from these two cases may help in recognizing this complication.

  14. Manejo hospitalario de la meningoencefalitis bacteriana por S. Neumoniae

    Directory of Open Access Journals (Sweden)

    Roberto Álvarez Fumero

    2003-12-01

    Full Text Available La actitud terapéutica ante la meningitis bacteriana (MEB es uno de los retos más importantes a los que se enfrenta el pediatra, pues de su oportuno y adecuado manejo depende el pronóstico. Los cambios en la epidemiología de los síndromes neurológicos infecciosos bacterianos observados en Cuba a partir del año 2000, promovieron la implementación de modificaciones al régimen terapéutico antibiótico convencional. En este artículo, sin olvidar que el tratamiento ideal es el preventivo, se expone una revisión actualizada del manejo hospitalario de las MEB por S.pneumoniae, que incluye: adopción de medidas generales, instauración temprana de acciones dirigidas a atenuar los efectos perjudiciales de la respuesta inflamatoria sistémica, conducta específica contra el agente (antibioticoterapia y finalmente la identificación precoz e inicio de la rehabilitación de secuelas. Se hace énfasis en las modificaciones al esquema antibiótico adoptadas recientemente por la Comisión Nacional de SNI. Se exponen consideraciones sobre la introducción de la vancomicina en esquema antimicrobiano de las MEB por S.pneumoniae.The therapeutic attitude to face bacterial meningitis (BME is one of the most important challenges for pediatricians, since the prognosis depends on its timely and adequate management The changes in the epidemiology of the bacterial infectious neurological syndromes ocurred in Cuba from 2000 on, promoted the implementation of modifications in the conventional therapeutical antibiotic regimen. In this article, without forgetting that the ideal treatment is the preventive one, it is exposed an updated review of the hospital management of BME due to S.Pneumoniae that includes: adoption of general measures, early establishment of actions directed to alleviate the harmful effects of the systemic inflammatory reponse, specific conduct against the agent (antibiotic therapy and, finally, the identification and beginning of the

  15. Cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    DING Wen-ting

    2013-01-01

    Full Text Available Cryptococcus neoformans is a kind of encapsulated fungal organism that widely exists in the nature. Because of its neurotropic nature, the central nervous system becomes its major target organ. Cryptococcus neoformans can use "transcellular pathway", "paracellular pathway" and "Trojan horse approach" to cross blood-brain barrier, and then make the devastating diffusion. Despite antifungal therapy, the mortality rate remains between 10% and 25% in patients with cryptococcal meningitis (CM and acquired immunodeficiency syndrome (AIDS, and at least one-third of patients have experienced failure of antifungal therapy. Consequently, it is very important for us to understand the pathogenesis of CM, to diagnose as soon as possible and to explore more reasonable treatment.

  16. Otitis media aguda: nuevo enfoque terapéutico

    Directory of Open Access Journals (Sweden)

    Ileana Alvarez Lam

    2004-03-01

    Full Text Available La otitis media aguda continúa siendo una de las enfermedades infecciosas más frecuentes en la infancia. Se hace una revisión del tema haciendo énfasis en la conducta terapéutica actual luego del surgimiento de complejos mecanismos de resistencia bacteriana creados por los microorganismos causantes de la enfermedad. Como toda enfermedad infecciosa las esperanzas están cifradas en el surgimiento de una vacuna que impacte de forma positiva en nuestra población infantil. En tal sentido se hace una reflexión sobre el uso de la vacuna antineumocócica de 7 valencias (Prevnar y su repercusión sobre esta enfermedad.Acute otitis media is still one of the most common infectious diseases among children. A review of the topic is made giving emphasis to the present therapeutic conduct after the appearance of complex mechanisms of bacterial resistance created by the microorganisms causing the disease. As in every infectious disease, we place our hopes on the emergence of a vaccine with a positive impact on our infantile population. In this sense, a reflection is made on the use of the heptavalent antipneumococcic vaccine (Prevnar and its repercussion on this disease.

  17. 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 ...

  18. 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...

  19. CSF LACTATE IN MENINGITIS

    Directory of Open Access Journals (Sweden)

    Anjampakuthikal Aboobekar Haris

    2017-05-01

    Full Text Available BACKGROUND Meningitis is an infection within the subarachnoid space characterised by a CNS inflammatory reaction. It is a serious condition requiring immediate diagnosis and appropriate treatment to be started at the earliest to prevent mortality as well as irreversible neurological deficits. CSF lactate has been found useful in differentiating bacterial meningitis from viral meningitis in many studies in the western population, but studies in Indian population are limited. The aim of the study is to study whether CSF lactate can be used to distinguish bacterial from viral meningitis and to study the levels of CSF lactate in tuberculosis meningitis. MATERIALS AND METHODS This was a descriptive study conducted in a tertiary care hospital. In this study, 78 cases of meningitis were selected. Cases are patients with bacterial, viral or tuberculosis meningitis admitted to the hospital under the Department of Medicine and Neurology. Cases are grouped into bacterial, viral and tuberculosis meningitis based on clinical picture, CSF analysis and imaging characteristics. CSF lactate estimation was done by dry chemistry method. Using appropriate statistical methods and SPSS software, CSF lactate levels were compared among these groups and analysed for any association with the final outcome. RESULTS The levels of CSF lactate in bacterial meningitis were higher than viral meningitis with a statistical significance of p 35 mg/dL for bacterial meningitis in this study was 95% and 100% respectively and the positive predictive value was 100% and the negative predictive value was 96%. The mean CSF lactate values in bacterial, viral and tuberculosis meningitis were 124.40 ± 35.85 mg/dL, 24.34 ± 6.05 mg/dL and 50.13 ± 9.89 mg/dL, respectively. CONCLUSION CSF lactate level was significantly elevated in bacterial meningitis than tuberculosis or viral meningitis and can be used as a marker for differentiating bacterial from viral meningitis.

  20. Ataxias agudas en la infancia

    Directory of Open Access Journals (Sweden)

    Yaline Betancourt Fursow

    2013-09-01

    Full Text Available La ataxia cerebelosa aguda infantil (ACAI es la forma más frecuente de complicación neurológica por el virus de la varicela.Descritas dentro del grupo de las cerebelitis agudas. Los objetivos de este estudio fueron: evaluar la presentación clínica, manejo y seguimiento de niños hospitalizados con ACAI en un hospital pediátrico terciario donde la inmunización para varicela no está disponible (parte I y describir los diagnósticos diferenciales de la cerebelitis aguda (parte II. Estudiamos 95 pacientes. Los criterios diagnósticos de ataxia aguda se basaron en: pérdida aguda de la coordinación o dificultad para la marcha con o sin nistagmo asociado y duración menor de 48 horas, en un niño previamente sano. Estos criterios se cumplían en todos los casos valorados, excepto en las ataxias secundarias a ingesta de tóxicos, en los que la duración debía ser menor de 24 horas para su inclusión en el estudio. Se registraron los datos en una historia clínica pediátrica y neurológica. Entre los pacientes inmunosuprimidos la incidencia mayor fue la complicación por varicela. La mayoría de los pacientes fueron varones. El rango de edad fue la preescolar, 5 años . El intervalo entre la presentación del rash y el ingreso fue de 1 a 3 días. El estudio de LCR se practicó en 59.5% de los casos. La TAC y la resonancia magnética cerebral (RM presentaron edema en el 33.3%. El aciclovir endovenoso fue utilizado en 23 pacientes; pero no hubo diferencias significativas en las manifestaciones clínicas y seguimiento entre tratados y no tratados. La ataxia fue la primera manifestación clínica. La estadía hospitalaria fue de 4 días (rango: 2-11 días.

  1. 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....

  2. Pneumonia aguda fibrinosa e organizante

    Directory of Open Access Journals (Sweden)

    Cláudia Santos

    2010-07-01

    Full Text Available Resumo: O padrão histológico de Pneumonia Aguda Fibrinosa e Organizante (AFOP – Acute Fibrinous And Organizing Pneumonia, descrito por Beasley em 2002, caracteriza-se pela existência de fibrina intra-alveolar sob a forma de bolas de fibrina e pneumonia organizativa difusa. A apresentação clínica desta doença intersticial pulmonar pode ser aguda ou subaguda, diferindo no entanto dos outros padrões histológicos habitualmente associados a lesão pulmonar aguda – Lesão Alveolar Difusa (DAD, Pneumonia Organizativa (OP e Pneumonia Eosinofílica (EP.A propósito deste tema, os autores fazem uma revisão da literatura e descrevem o caso clínico de um doente de 44 anos, com aspectos imagiológicos e evolução pouco habituais. Abstract: The histologic pattern of Acute Fibrinous and Organizing Pneumonia (AFOP, described by Beasley in 2002, is characterized by the existence of intra alveolar fibrin in the form of fibrin “balls” and diffuse organizing pneumonia. Presenting symptoms of this interstitial pulmonary disease can be acute or subacute. However, it differs from the well-recognized histologic patterns of acute pulmonary lesion – Diffuse Alveolar Damage (DAD, Organizing Pneumonia (OP and Eosinophilic Pneumonia (EP.The authors carry out a review of the literature concerning this topic and describe the clinical case of a 44-year-old patient with unusual imaging features and outcome. Palavras-chave: AFOP, bolas de fibrina, pneumonia organizativa, Key-word: AFOP, fibrin balls, organizing pneumonia

  3. 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.

  4. Resistencia bacteriana Bacterial resistance to antimicrobial agents

    Directory of Open Access Journals (Sweden)

    Jesualdo Fuentes

    1993-01-01

    Full Text Available

    Se presenta un panorama de la resistencia bacteriana incluyendo su fisiopatogenia y formas de presentación y se establecen algunas consideraciones generales de tipo clínico como auxiliares para racionalizar el uso de los antimicrobianos y evitar o retardar el problema de la resistencia; éste plantea la necesidad de un reordenamiento definitivo en la prescripción de antimicrobianos. No será tanto la creación o descubrimiento de nuevos antibióticos sino la racionalización del manejo de los existentes lo que permitirá alcanzar victorias sobre estos microorganismos. Es Importante mantener educación continua sobre el uso adecuado de los antimicrobianos desde los puntos de vista epidemiológico, farmacocinético y fisiopatogénico.

    An overview on bacterial resistance to antimicrobial agents is presented. It includes the different genetic mechanisms for Its development and the biochemical phenomena that explain It. Some clinical considerations are proposed in order to rationalize the use of these drugs and to avoid or delay the appearance of resistance.

  5. [Meningitis carcinomatosa (author's transl)].

    Science.gov (United States)

    Steinhäusl, H

    1979-06-20

    On the basis of a case report the clinical picture of meningitis carcinomatosa is discussed. The cerebrospinal fluid is the most important criterion for the diagnosis. All other examinations (EEG, brain-scan, X-ray) yield only imperfect information. The clinical picture of meningitis carcinomatosa is similar above all to meningitis tuberculosa. If cerebrospinal fluid shows inflammatory signs and there is a breakdown of cerebral nerves (blindness, deafness) meningitis carcinomatosa always should be considered, even if thorough examination does not succeed in proving a primary tumour.

  6. Uso de antimicrobianos en la enfermedad diarreica aguda

    Directory of Open Access Journals (Sweden)

    Enrique A. González Corona

    1996-04-01

    Full Text Available Se realizó un estudio sobre el estado actual del uso de antimicrobianos en el Servicio de Enfermedades Diarreicas Agudas del Hospital Infantil Docente Sur de Santiago de Cuba, durante el período comprendido entre marzo y agosto de 1992. El universo estuvo integrado por 427 pacientes ingresados, de los cuales sólo 13,1 % requirió el empleo de estos medicamentos: 9,4 % por infección enteral y 3,7 % por extraenteral bacteriana. Más de la tercera parte de los afectados curaron con alimentación continuada y rehidratación, en su mayoría oral, y fueron las diarreas persistentes y disentéricas las que más frecuentemente condicionaron su administración. El criterio clínico fue determinante en su indicación.A study was carried out on the current state of the use of microbicidals in the Acute Diarrhea Service of the Southern Educational Children's Hospital at Santiago de Cuba, during the period between March and August 1992. The universe was integrated by 427 inpatients, of which only the 13,1 % required the use of these drugs: 9,4 % due to enteral infection, and 3,7 % due to bacterial extraenteral infection. More than the third part of the patients healed with continuous feeding and rehydration, mostly oral, and the persistent and dysenteric diarrheas conditioned most frequently its administration. The clinical criterion was determining in its indication.

  7. Localized basal meningeal enhancement in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

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

  8. Localized basal meningeal enhancement in tuberculous meningitis

    International Nuclear Information System (INIS)

    Theron, Salomine; Andronikou, Savvas; Grobbelaar, Marie; Steyn, Freda; Mapukata, Ayanda; Plessis, Jaco du

    2006-01-01

    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.)

  9. Biofertilizantes no controle da mancha bacteriana (Xanthomonas spp. do tomateiro

    Directory of Open Access Journals (Sweden)

    Vinícius William Borges Rodrigues

    2016-03-01

    Full Text Available RESUMO A mancha bacteriana do tomateiro, causada por quatro espécies de Xanthomonas pode provocar perdas significativas na produção da cultura e a utilização de biofertilizantes na proteção de plantas tende a reduzir a incidência de doenças. O objetivo do trabalho foi avaliar o efeito dos biofertilizantes no controle preventivo e curativo da mancha bacteriana do tomateiro. Para o controle preventivo da doença, plantas de tomate cultivar Santa Cruz Kada, com 3 a 4 folhas foram pulverizadas com os biofertilizantes (Soil-Set, Agro-Mos e Cop-R-Quick e água (testemunha; e dois dias após foram inoculadas por aspersão com a suspensão bacteriana nas concentrações 109 UFC mL-1 (OD550=0,5 e 106UFC mL-1, com o isolado UFU A35 de Xanthomonas sp. Para o controle curativo, as plantas foram inoculadas com a suspensão bacteriana, e dois dias após foram pulverizadas com os biofertilizantes e água. A severidade da mancha bacteriana foi avaliada usando uma escala diagramática; aos 3, 5, 8, 11 e 14 dias após a inoculação e calculada a área abaixo da curva de progresso de doença (AACPD. O controle preventivo foi mais eficiente no manejo da mancha bacteriana do tomateiro, e os diferentes biofertilizantes reduziram a severidade da doença.

  10. Biofertilizantes no controle da mancha bacteriana (Xanthomonas spp.) do tomateiro

    OpenAIRE

    Rodrigues,Vinícius William Borges; Bueno,Thays Vieira; Tebaldi,Nilvanira Donizete

    2016-01-01

    RESUMO A mancha bacteriana do tomateiro, causada por quatro espécies de Xanthomonas pode provocar perdas significativas na produção da cultura e a utilização de biofertilizantes na proteção de plantas tende a reduzir a incidência de doenças. O objetivo do trabalho foi avaliar o efeito dos biofertilizantes no controle preventivo e curativo da mancha bacteriana do tomateiro. Para o controle preventivo da doença, plantas de tomate cultivar Santa Cruz Kada, com 3 a 4 folhas foram pulverizadas com...

  11. Meninges in cancer imaging.

    Science.gov (United States)

    Mahendru, G; Chong, V

    2009-10-02

    Primary malignant tumours arising from the meninges are distinctly uncommon, and when they occur, they are usually sarcomas. In contrast, metastatic meningeal involvement is increasingly seen as advances in cancer therapy have changed the natural history of malignant disease and prolonged the life span of cancer patients. The meninges can either be infiltrated by contiguous extension of primary tumours of the central nervous system, paranasal sinuses and skull base origin or can be diffusely infiltrated from haematogenous dissemination from distant primary malignancies. Imaging in these patients provides crucial information in planning management. This article reviews the pertinent anatomy that underlies imaging findings, discusses the mechanism of meningeal metastasis and highlights different imaging patterns of meningeal carcinomatosis and the pitfalls.

  12. Antibióticos vs. resistencia bacteriana

    Directory of Open Access Journals (Sweden)

    Elso Manuel Cruz Cruz

    2015-02-01

    Full Text Available La resistencia bacteriana a los antibióticos es un problema de salud mundial que se encuentra en constante evolución. De manera frecuente se reportan nuevos mecanismos de resistencia bacteriana a los antibióticos, tanto en bacterias gram negativas como en gram positivas. La presencia de resistencia en una bacteria causante de infección disminuye las posibilidades de obtener la curación clínica y la erradicación bacteriológica e incrementa los costos del tratamiento, la morbilidad y la mortalidad; por lo que es importante seleccionar el tratamiento adecuado. Uno de los aspectos que más preocupa a los médicos en el diagnóstico y tratamiento de una infección es la llamada resistencia adquirida, la cual ocurre en una bacteria inicialmente sensible a los antibióticos, por cambios, mutaciones o la adquisición de genes de resistencia durante el fenómeno de transferencia genética lateral, proceso por medio del cual un organismo transfiere material genético a otra célula que no es descendiente. La resistencia bacteriana adquirida a los antibióticos puede ser de distintos tipos, dependiendo de la presión selectiva, las mutaciones o la transferencia de genes de resistencia. Las definiciones de resistencia se clasifican según el número y clase de antibióticos afectados. La multirresistencia (Multiple Drug Resistance, MDR se define como la ausencia de sensibilidad a, por lo menos, un fármaco en tres o más de las categorías de antibióticos; la resistencia extrema (Extensively Drug-Resistant, XDR se refiere a la ausencia de sensibilidad a, por lo menos, un agente en todas las categorías de antimicrobianos, excepto en dos de ellas o menos, y la resistencia a todos los antimicrobianos se define como resistencia a todas las categorías de antibióticos. (1 Los mecanismos de resistencia dependen del tipo de bacteria que los desarrollen. Las bacterias gram positivas que producen con más frecuencias infecciones en humanos y que por

  13. Laboratorial diagnosis of lymphocytic meningitis

    Directory of Open Access Journals (Sweden)

    Sérgio Monteiro de Almeida

    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.

  14. Pathophysiology of pneumococcal meningitis

    NARCIS (Netherlands)

    Geldhoff, M.

    2016-01-01

    Bacterial meningitis is a serious infectious disease, involving the membranes surrounding the brain and spinal cord, and the subarachnoid space. In the Netherlands most common causative agents are Streptococcus pneumoniae (72%) and Neisseria meningitidis (11%). The incidence of pneumococcal

  15. Cetuximab induced aseptic meningitis

    OpenAIRE

    Ulrich, A; Weiler, S; Weller, M; Rordorf, T; Tarnutzer, A A

    2015-01-01

    We report a 67-year-old man with recurrent advanced oropharyngeal squamous cell carcinoma who developed aseptic meningitis, with first symptoms arising approximately 9hours after the first administration of cetuximab, and review the literature to identify key signs and symptoms of this condition. Cetuximab is a monoclonal antibody targeting the epidermal growth factor receptor which has been rarely associated with aseptic meningitis. Besides the case description, a MEDLINE search was performe...

  16. Leucemia congénita aguda

    Directory of Open Access Journals (Sweden)

    Nilvia Esther González García

    2011-06-01

    Full Text Available La leucemia aguda durante el período neonatal es poco frecuente de evolución rápida y pronóstico sombrío. Sus características clínicas y biológicas difieren de las encontradas en niños de mayor edad, y su inicio se caracteriza por afectación cutánea, hepatoesplenomegalia, hiperleucocitosis e infiltración del sistema nervioso central. Se han observado pacientes con formas tanto mieloides como linfoides, pero la leucemia mieloide aguda parece predominar en esta etapa de la vida. Se presenta el caso de un paciente con leucemia congénita clasificada morfológicamente, con aparición de manifestaciones clínicas de enfermedad hematológica desde el nacimiento y diagnóstico de leucemia linfoblástica aguda congénita.

  17. Pancreatitis aguda grave asociada a gangrena vesicular

    OpenAIRE

    Arroyo-Sánchez, Abel S; Aguirre-Mejía, Rosa Y; Echenique-Martínez, Sergio E

    2014-01-01

    Se presenta el caso un paciente diabético que desarrolló un cuadro de pancreatitis aguda grave asociada a gangrena vesicular, en el que se evaluó la aplicabilidad de los criterios de clasificación y manejo de la hoja de ruta para pancreatitis aguda, así mismo se proponen algunos tópicos que pudieran ser investigados a futuro We present a diabetic patient who developed severe acute pancreatitis associated to gallbladder gangrene, in this case we assessed the applicability of classification ...

  18. Neurological sequelae of bacterial meningitis

    NARCIS (Netherlands)

    Lucas, Marjolein J.; Brouwer, Matthijs C.; van de Beek, Diederik

    2016-01-01

    We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive

  19. Meninges of the brain (image)

    Science.gov (United States)

    ... covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the ... the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. ...

  20. Meninges of the spine (image)

    Science.gov (United States)

    ... by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the ... the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. ...

  1. Bacterial meningitis in immunocompromised patients

    NARCIS (Netherlands)

    van Veen, K.E.B.

    2018-01-01

    Bacterial meningitis is an acute infection of the meninges, in The Netherlands most commonly caused by Streptococcus pneumoniae and Neisseria meningitides. Risk factors for acquiring bacterial meningitis include a decreased function of the immune system. The aim of this thesis was to study

  2. Community-acquired bacterial meningitis

    NARCIS (Netherlands)

    van de Beek, Diederik; Brouwer, Matthijs; Hasbun, Rodrigo; Koedel, Uwe; Whitney, Cynthia G.; Wijdicks, Eelco

    2016-01-01

    Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma

  3. Pneumonia aguda fibrinosa e organizante

    Directory of Open Access Journals (Sweden)

    C. Damas

    2006-09-01

    Full Text Available Resumo: A designação acute fibrinous and organizing pneumonia (AFOP foi proposta por Beasley et al para os casos em que as características histopatológicas das lesões não se enquadravam em outras situações clínicas (agu-das ou subagudas conhecidas. A presença de fibrina intra alveolar e de pneumonia organizativa, com distribuição difusa, é a principal alteração histológica associada a esta entidade.Os autores descrevem o caso de um doente do sexo masculino, com o diagnóstico de AFOP, por bióp-sia pulmonar cirúrgica. O doente teve uma apresentação subaguda, apresentando por queixas principais tosse, dor torácica e febre. TAC torácica mostrou infiltrados bilaterais, difusos. Após início de corticoterapia sistémica e ciclofosfamida, o doente apresentou melhoria clínica significativa. Ao elaborar este caso, os autores esperam acrescentar mais alguns dados sobre esta nova entidade.Rev Port Pneumol 2006; XII (5: 615-620 Abstract: The term Acute Fibrinous and Organizing Pneumonia (AFOP has been proposed by Beasley et al for cases that not fit into the histopathologic criteria of the recognized entities described as acute or subacute clinical presentations. The presence of intra-alveolar fibrin in the form of fibrin ‘balls’ and organizing pneumonia with patchy distribution are the main histological features of this entity. We describe the case of a male patient with the diagnostic of AFOP made by surgical lung biopsy. He had a subacute presentation of symptoms consisting of productive cough, chest pain and fever. Bilateral infiltrates with patchy and diffuse distribution were the predominant features in his chest HRCT scan. The patient had a good clinical course after a treatment with prednisone and cyclophosphamide. Our hope in reporting this case study is to add some more data to the discussion of this new entity.Rev Port Pneumol 2006; XII (5: 615-620 Palavras

  4. Primary Meningeal Rhabdomyosarcoma

    Science.gov (United States)

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

    2011-01-01

    Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance 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. PMID:21772793

  5. 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.

  6. Primary meningeal rhabdomyosarcoma.

    Science.gov (United States)

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

    2011-01-01

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

  7. Bacterial meningitis in children

    International Nuclear Information System (INIS)

    Marji, S.

    2007-01-01

    To demonstrate the epidemiology, clinical manifestations and bacteriological profile of bacterial meningitis in children beyond the neonatal period in our hospital. This was a retrospective descriptive study conducted at Prince Rashid Hospital in Irbid, Jordan. The medical records of 50 children with the diagnosis of bacterial meningitis during 4 years period, were reviewed. The main cause of infection was streptococcus pneumoniae, followed by Haemophilus influenza and Niesseria meningitides. Mortality was higher in infants and meningococcal infection, while complications were more encountered in cases of streptococcus pneumoniae. Cerebrospinal fluid culture was positive in 11 cases and Latex agglutination test in 39. There is a significant reduction of the numbers of bacterial meningitis caused by Haemophilus influenza type B species. (author)

  8. Adult bacterial meningitis

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  9. Drug induced aseptic meningitis

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2013-09-29

    Sep 29, 2013 ... Abstract. Drug-induced aseptic meningitis (DIAM) is a rare but important and often challenging diagnosis for the physician. Intake of antimicrobials, steroids, anal- gesics amongst others has been implicated. Signs and symptoms generally develop within 24-48 hours of drug ingestion. The pa- tient often ...

  10. 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...

  11. VIH: Infeccion aguda, pesquisa y manejo

    Directory of Open Access Journals (Sweden)

    Cortés S. Esteban, Dr.

    2014-05-01

    Si bien existe una relativa facilidad para realizar el diagnóstico de un paciente con la infección crónica por VIH, existe por otro lado una relativa dificultad para realizar el diagnóstico de la infección aguda en etapas tempranas de la infección. Esta situación es de importancia desde el punto de vista de la Salud Pública por cuanto en la infección aguda es cuando se producen las viremias más elevadas y por tanto la mayor facilidad para que el sujeto sea infectante y disemine la infección viral.

  12. Bases moleculares de las leucemias agudas

    Directory of Open Access Journals (Sweden)

    G. Martínez Antuña

    2006-04-01

    Full Text Available El gran desarrollo de la biología molecular en los últimos años ha contribuido a un importante avance en los conocimientos relacionados con las bases moleculares de las leucemias agudas (LA. Ademas de profundizar en la biología de estas enfermedades y conocer las bases moleculares, ha renido también gran impacto en mejorar el resultado de los tratamientos y disminuir la toxicidad de las terapias.

  13. Otomastoidite Aguda em Criança

    Directory of Open Access Journals (Sweden)

    João Araújo

    2017-09-01

    Full Text Available Criança de 2 anos, sexo masculino, diagnóstico de otite média aguda bilateral, medicada inicialmente com amoxicilina + clavulanato 90 mg/kg/dia desde há 7 dias, internada por agravamento do quadro à esquerda, com edema e eritema retroauricular, apagamento do sulco retroauricular [...] Recebido: 07/09/2015 · Aceite: 7/01/2016

  14. Comportamiento de la otitis media aguda

    Directory of Open Access Journals (Sweden)

    Gladys Fuentes Fernández

    Full Text Available Introducción: la otitis media aguda es una complicación de las infecciones respiratorias agudas altas, frecuente en los niños menores de 5 años. Objetivos: caracterizar su comportamiento, según edad y sexo, e identificar algunos factores de riesgo en este grupo de edad. Métodos: se realizó un estudio descriptivo retrospectivo de 554 niños ingresados en el hospital Pediátrico de Centro Habana con el diagnóstico de otitis media aguda, durante los años 2006-2010. Los datos se recogieron de las historias clínicas. Resultados: la otitis media aguda fue más frecuente en el sexo masculino (58,7 % y en los menores de 1 año (53,1 %. El antecedente de bajo peso (33,9 % y la prematuridad (27,5 %, la asistencia a círculos infantiles (43,5 % y el hábito de fumar de los padres (58,4 %, además del antecedente de ingresos hospitalarios por otitis media en el mes previo a la aparición del episodio actual (59,0 %, constituyeron los principales factores de riesgo en el presente estudio. Conclusiones: la otitis media es una causa frecuente de ingresos hospitalarios, y se identifican como principales factores de riesgo la asistencia a círculos infantiles y el tabaquismo de algunos de los padres.

  15. Variabilidad de las meningoencefalitis bacterianas en el Hospital Pediátrico "Pepe Portilla" Variability of the bacterial meningoencephalitis at "Pepe Portilla" Paediatric Hospital

    Directory of Open Access Journals (Sweden)

    Maydelin Fernández González

    2009-03-01

    Full Text Available Se realizó un estudio retrospectivo y prospectivo longitudinal de las Meningoencefalitis Bacterianas diagnosticadas en el Hospital Pediátrico "Pepe Portilla" en el año 2006 y 2007, con el objetivo de determinar los gérmenes que han aislado en dicha patología, comparándose con años anteriores desde 1992, analizando el impacto de la vacunación contra Neisseria meningitidis y Haemophilus influenzae. Los estudios de líquido cefalorraquídeo se realizaron como indican las normativas para estos casos. Se encontró que en el 2006 solo hubo un caso de meningitis a Neisseria meningitidis y en el 2007 dos casos de meningitis por Streptocuccus pneumoneae, y además que la incidencia de Neisseria meningitidis y Haemophilus influenzae disminuyó después de la aplicación de las vacunas VAMENGO BC y Hib de manera ostensible como lo hizo en el país en general, demostrándose la efectividad de dicha vacuna en nuestro medio.A retrospective-prospective and longitudinal study about Bacterial Meningoencephalitis diagnosed at "Pepe Portilla" Paediatric Hopital was carried out during 2006-2007 aimed at determining the isolated germs of this pathology comparing them with previous years (since 1992 and analyzing the impact of vaccination against Neisseria meningitidis y Haemophilus influenzae. The studies about cerebrospinal fluid were conducted as indicated by the rules towards these cases. Results showed that in 2006 only one case of meningitis a Neisseria meningitidis occurred and two cases of meningitis by Streptocuccus pneumoneae in 2007; besides the incidence of Neisseria meningitidis y Haemophilus influenza diminished after the vaccination with VAMENGON BC and Hib observed in all the country, showing the effectiveness of the vaccine in our environment.

  16. Resultados do tratamento da pancreatite aguda grave

    Directory of Open Access Journals (Sweden)

    Franz Robert Apodaca-Torrez

    Full Text Available OBJETIVO: Avaliar os resultados do Protocolo de Atendimento de pacientes com diagnóstico de pancreatite aguda grave. MÉTODOS: Foram analisados, consecutivamente, a partir de janeiro de 2002, idade, sexo, etiologia, tempo de internação, tipo de tratamento e mortalidade de 37 pacientes portadores de pancreatite aguda grave. RESULTADOS: A idade dos pacientes variou de 20 a 88 anos (média de 50 anos; 27% foram do sexo feminino e 73% do masculino. O tempo médio global de internação foi 47 dias. Treze pacientes foram tratados cirurgicamente; a média de operações realizadas foi duas por paciente. Ocorreram seis óbitos dentre os pacientes submetidos ao tratamento cirúrgico (46% e dois óbitos no grupo submetido somente ao tratamento clínico (8,3%. A mortalidade global foi 21% CONCLUSÃO: Após a modificação na forma de abordagem dos pacientes com pancreatite aguda grave, houve diminuição da mortalidade e uma tendência para a conduta expectante.

  17. Endocarditis in adults with bacterial meningitis

    NARCIS (Netherlands)

    Lucas, Marjolein J.; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2013-01-01

    Endocarditis may precede or complicate bacterial meningitis, but the incidence and impact of endocarditis in bacterial meningitis are unknown. We assessed the incidence and clinical characteristics of patients with meningitis and endocarditis from a nationwide cohort study of adults with

  18. Fibrosarcoma of the meninges

    Directory of Open Access Journals (Sweden)

    Ishwar Chand Premsagar

    2010-03-01

    Full Text Available Meningeal fibrosarcomas are rare tumors. Only 41 cases have been reported in the literature to date. Primary central nervous system fibrosarcomas are very aggressive neoplasms and have a poor prognosis. Hence they need to be correctly diagnosed. This is a case of a 13-year old boy with intracranial space occupying lesion. The mass was completely removed and histological examination was characteristic of meningeal fibrosarcoma. The pathological diagnosis is usually made on routine light microscopic examination; however, occasionally these may be difficult to distinguish from other malignant neoplasms such as gliomas, meningiomas and metastases. The diagnosis of fibrosarcoma is based on the identification of a predominant herringbone architectural pattern, the overall uniformity of the spindle cell population, the prominent vimentin positivity, and the presence of pericellular reticulin fibre network. IHC helps to exclude other diagnoses.

  19. 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.

  20. Mondini dysplasia with recurrent meningitis.

    Science.gov (United States)

    Lu, M Y; Lee, P I; Lee, C Y; Hsu, C J

    1996-01-01

    Mondini dysplasia is a congenital malformation of the inner ear, commonly associated with hearing impairment, cerebrospinal fluid otorrhea/rhinorrhea and recurrent meningitis. Two such cases are described, with hearing impairment, cerebrospinal fluid rhinorrhea, and several episodes of meningitis. Diagnosis was confirmed by high-resolution computed tomography. After surgical correction of the malformation, there was no recurrent episode of meningitis at subsequent follow-up. To avoid the suffering and the sequelae of recurrent meningitis, an early diagnosis and prompt surgical intervention are crucial for such patients.

  1. Total antioxidant/oxidant status in meningism and meningitis.

    Science.gov (United States)

    Aycicek, Ali; Iscan, Akin; Erel, Ozcan; Akcali, Mustafa; Selek, Sahbettin

    2006-12-01

    The objective of this study was to investigate the antioxidant/oxidant status of serum and cerebrospinal fluid in children with meningismus and acute bacterial meningitis. Twenty-three children (age range, 0.75 to 9 years) with fever and meningeal signs that required analysis of the cerebrospinal fluid, but no cytologic or biochemical evidence of meningitis in their serum and cerebrospinal fluid, constituted the meningismus group. Thirty-one children (age range, 0.5 to 10 years) with acute bacterial meningitis constituted the meningitis group. Twenty-nine healthy children (age range, 0.5 to 11 years) were recruited as control subjects. Antioxidant status (ascorbic acid, albumin, thiol, uric acid, total bilirubin, total antioxidant capacity, catalase and ceruloplasmin concentrations) and oxidant status (lipid hydroperoxide and total oxidant status) were measured. The serum antioxidant status was lower, and oxidant status levels higher in both meningitis and meningismus subjects than in the control children (P antioxidant status was lower, and serum oxidant status was higher in children in the meningismus and meningitis groups, whereas cerebrospinal fluid oxidant status was higher in the meningismus group than in the meningitis group.

  2. Pituitary apoplexy masquerading as meningitis

    African Journals Online (AJOL)

    meningeal irritation is not considered a classic feature of pituitary apoplexy.2,3 The pathophysiology behind this symptom complex involves leakage of blood into the subarachnoid space, which, in conjunction with the necrotic tissue in the pituitary itself, induces a cytokine response, resulting in meningeal irritation and the.

  3. Chemical meningitis in metrizamide myelography

    International Nuclear Information System (INIS)

    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.)

  4. Bacteriële meningitis

    NARCIS (Netherlands)

    Brouwer, M. C.; van de Beek, D.

    2012-01-01

    Bacterial meningitis is a severe disease which affects 35.000 Europeans each year and has a mortality rate of about 20%. During the past 25 years the epidemiology of bacterial meningitis has changed significantly due to the implementation of vaccination against Haemophilus influenzae, Neisseria

  5. Soporte nutricional en la insuficiencia renal aguda

    Directory of Open Access Journals (Sweden)

    O. Cristina Olivos, Dra.

    2010-07-01

    Full Text Available La insuficiencia renal aguda (IRA se presenta frecuentemente en distintas condiciones clínicas y es especialmente frecuente en unidades de cuidados intensivos. La presencia de IRA se considera como un factor de riesgo independiente de morbilidad y mortalidad hospitalaria. De ahí la importancia de evaluar los diversos factores determinantes de su evolución, entre los que cuenta la desnutrición calórico-proteica. El propósito de esta revisión es analizar la literatura más relevante hasta la actualidad en este tema.

  6. The Meningitis Vaccine Project.

    Science.gov (United States)

    LaForce, F Marc; Konde, Kader; Viviani, Simonetta; Préziosi, Marie-Pierre

    2007-09-03

    Epidemic meningococcal meningitis is an important public health problem in sub-Saharan Africa. Current control measures rely on reactive immunizations with polysaccharide (PS) vaccines that do not induce herd immunity and are of limited effectiveness in those under 2 years of age. Conversely, polysaccharide conjugate vaccines are effective in infants and have consistently shown an important effect on decreasing carriage, two characteristics that facilitate disease control. In 2001 the Meningitis Vaccine Project (MVP) was created as a partnership between PATH and the World Health Organization (WHO) with the goal of eliminating meningococcal epidemics in Africa through the development, licensure, introduction, and widespread use of conjugate meningococcal vaccines. Since group A Neisseria meningitidis (N. meningitidis) is the dominant pathogen causing epidemic meningitis in Africa MVP is developing an affordable (US$ 0.40 per dose) meningococcal A (Men A) conjugate vaccine through an innovative international partnership that saw transfer of a conjugation and fermentation technology to a developing country vaccine manufacturer. A Phase 1 study of the vaccine in India has shown that the product is safe and immunogenic. Phase 2 studies have begun in Africa, and a large demonstration study of the conjugate vaccine is envisioned for 2008-2009. After extensive consultations with African public health officials a vaccine introduction plan has been developed that includes introduction of the Men A conjugate vaccine into standard Expanded Programme on Immunization (EPI) schedules but also emphasizes mass vaccination of 1-29 years old to induce herd immunity, a strategy that has been shown to be highly effective when the meningococcal C (Men C) conjugate vaccine was introduced in several European countries. The MVP model is a clear example of the usefulness of a "push mechanism" to finance the development of a needed vaccine for the developing world.

  7. Meningitis por Streptococcus suis

    OpenAIRE

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

    2001-01-01

    La infección humana por Streptococcus suis (S. suis) es una zoonosis, con un riesgo ocupacional conocido y que suele presentarse como meningitis purulenta, que tiene baja mortalidad y frecuentes secuelas de hipoacusia y ataxia. Se han publicado menos de 150 casos humanos desde el informe original de hace 30 años. Hay una reconocida distribución geográfica viviendo la mayoría de los afectados en el norte de Europa y el sudeste Asiático. En España se han comunicado dos pacientes con enfermedad ...

  8. Intoxicaciones agudas en pediatría

    Directory of Open Access Journals (Sweden)

    Yalena Prado Vizcaíno

    2011-12-01

    Full Text Available Introducción: las intoxicaciones han sido en los últimos años una importante causa de aumento de la morbilidad y mortalidad en edades pediátricas. Objetivo: determinar el comportamiento clínico de las intoxicaciones agudas en la etapa de enero de 2005 a diciembre de 2009 en el Hospital Pediátrico "William Soler". Métodos: el estudio se realizó en el Hospital "William Soler". Se revisaron las historias clínicas, los registros de intoxicaciones agudas y las tarjetas de codificación de egresos hospitalarios por intoxicaciones de los pacientes llegados al hospital en esta etapa. Resultados: se recibieron en el hospital 886 pacientes. El grupo de mayor frecuencia de intoxicaciones fue el de 1 a 5 años, con predominio del sexo masculino, aunque sin diferencias significativas con respecto al sexo femenino. Las intoxicaciones más frecuentes fueron por medicamentos, fundamentalmente psicofármacos y antibióticos, seguido por alimentos y por productos químicos del hogar. El 30,2 % de los casos fueron ingresados. Conclusiones: estos resultados nos hacen pensar en la necesidad de estar alertas y crear acciones encaminadas a proteger o evitar las intoxicaciones en edades tan vulnerables.

  9. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

    Directory of Open Access Journals (Sweden)

    Musso CG

    2006-03-01

    Full Text Available RESUMEN:La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia.En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal. SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one.In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  10. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

    Directory of Open Access Journals (Sweden)

    Musso CG

    2007-04-01

    Full Text Available RESUMENLa insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia. En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one. In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  11. Campylobacter Fetus Meningitis in Adults

    Science.gov (United States)

    van Samkar, Anusha; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2016-01-01

    Abstract The zoonotic pathogen Campylobacter fetus is a rare cause of bacterial meningitis. Little is known about the clinical characteristics, predisposing factors and outcome of C fetus meningitis in adults. We report cases of C fetus meningitis in a nationwide cohort study of adult bacterial meningitis patients in the Netherlands and performed a review of the literature. Two patients with C fetus meningitis were identified from January 2006 through May 2015. The calculated annual incidence was 0.02 per million adults. Combined with the literature, we identified 22 patients with a median age of 48 years. An immunocompromised state was present in 16 patients (73%), mostly due to alcoholism (41%) and diabetes mellitus (27%). The source of infection was identified in 13 out of 19 patients (68%), consisting of regular contact with domestic animals in 5 and working on a farm in 4. Recurrent fever and illness was reported in 4 patients (18%), requiring prolonged antibiotic treatment. Two patients died (9%) and 3 survivors (15%) had neurological sequelae. C fetus is a rare cause of bacterial meningitis and is associated with an immunocompromised state. Based on the apparent slow clinical response seen in this limited number of cases, the authors of this study recommend a prolonged course of antimicrobial therapy when C fetus is identified as a causative agent of bacterial meningitis. Cases appeared to do best with carbapenem therapy. PMID:26937916

  12. Insuficiencia renal aguda con necrosis tubular aguda secundaria a picadura masiva de abejas

    Directory of Open Access Journals (Sweden)

    Gustavo A. Aroca - Martínez

    2006-01-01

    Full Text Available Leñador de 46 años consulta al servicio de nefrología, de la Clínica Renal de la Costa en Barranquilla, con episodio de insuficiencia renal aguda 48 horas después de haber sufrido múltiples picaduras por abejas africanizadas. Durante su estancia hospitalaria presentó incremento de enzimas musculares (AST LDH, y de pruebas de función renal, motivo por el cual fue dializado en varias ocasiones. Con mejoría total, se decide egresar y manejar ambulatoriamente. Se concluye que el caso se trata de una insuficiencia renal por necrosis tubular aguda por rabdomiolisis debida a la picadura múltiple de abejas africanizadas.

  13. CT in meningitis purulenta

    International Nuclear Information System (INIS)

    Yoshida, Akira; Fujiwara, Katsuhiko; Iino, Shigeru; Ochi, Masaharu; Yoshioka, Hiroshi

    1982-01-01

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

  14. Estrategia de atención de niños hospitalizados por infecciones respiratorias agudas bajas

    Directory of Open Access Journals (Sweden)

    Ana M Ferrari

    2002-06-01

    Full Text Available OBJETIVO: Mejorar la calidad de la atención hospitalaria de los niños con infecciones respiratorias agudas bajas, aumentar los conocimientos sobre esa patología y mejorar la eficiencia en el uso de los recursos asistenciales, por medio de una estrategia que se denominó Plan de Invierno.MÉTODOS: La estrategia se basó en la utilización de protocolos de diagnóstico y tratamiento, internación por cuidados progresivos y por enfermedad, adecuación de los recursos asistenciales y creación de un sistema de registro permanente, informatizado. Se incorporó la investigación sistemática de la etiología viral para racionalizar el uso de la medicación y reducir las infecciones intrahospitalarias. RESULTADOS: Durante la aplicación del Plan (19/V-19/IX/99 ingresaron 3.317 niños; 1.347 (40.61% presentaban infecciones respiratorias agudas bajas. Se captaron 1.096 (81%, de los cuales 71% eran menores de un año. Predominaron las infecciones respiratorias virales (68%. Los criterios de ingreso fueron saturación de oxígeno <95%, polipnea, tiraje o derrame pleural en el 92.4% de los niños. La magnitud de la demanda impidió que las pautas de aislamiento individual o en grupo se cumplieran en todos los casos. El uso de la medicación se ajustó a lo recomendado en un elevado porcentaje: no recibieron antibióticos 73% de las bronquiolitis ni 72% de las neumonías virales, y 96% de las neumonias bacterianas los recibieron según pauta; se redujo el uso de broncodilatadores y de corticoides. El gasto en medicamentos disminuyó fundamentalmente en el grupo de los corticoides y tuvo el mayor impacto en el costo por día/cama de antibióticos. CONCLUSIONES: Disminuir la morbimortalidad por infecciones respiratorias agudas bajas requiere continuar mejorando la calidad de la atención hospitalaria y fortalecer los programas de promoción de salud y de control de las enfermedades prevalentes, en el primer nivel de atención.

  15. Estrategia de atención de niños hospitalizados por infecciones respiratorias agudas bajas

    Directory of Open Access Journals (Sweden)

    Ferrari Ana M

    2002-01-01

    Full Text Available OBJETIVO: Mejorar la calidad de la atención hospitalaria de los niños con infecciones respiratorias agudas bajas, aumentar los conocimientos sobre esa patología y mejorar la eficiencia en el uso de los recursos asistenciales, por medio de una estrategia que se denominó Plan de Invierno.MÉTODOS: La estrategia se basó en la utilización de protocolos de diagnóstico y tratamiento, internación por cuidados progresivos y por enfermedad, adecuación de los recursos asistenciales y creación de un sistema de registro permanente, informatizado. Se incorporó la investigación sistemática de la etiología viral para racionalizar el uso de la medicación y reducir las infecciones intrahospitalarias. RESULTADOS: Durante la aplicación del Plan (19/V-19/IX/99 ingresaron 3.317 niños; 1.347 (40.61% presentaban infecciones respiratorias agudas bajas. Se captaron 1.096 (81%, de los cuales 71% eran menores de un año. Predominaron las infecciones respiratorias virales (68%. Los criterios de ingreso fueron saturación de oxígeno <95%, polipnea, tiraje o derrame pleural en el 92.4% de los niños. La magnitud de la demanda impidió que las pautas de aislamiento individual o en grupo se cumplieran en todos los casos. El uso de la medicación se ajustó a lo recomendado en un elevado porcentaje: no recibieron antibióticos 73% de las bronquiolitis ni 72% de las neumonías virales, y 96% de las neumonias bacterianas los recibieron según pauta; se redujo el uso de broncodilatadores y de corticoides. El gasto en medicamentos disminuyó fundamentalmente en el grupo de los corticoides y tuvo el mayor impacto en el costo por día/cama de antibióticos. CONCLUSIONES: Disminuir la morbimortalidad por infecciones respiratorias agudas bajas requiere continuar mejorando la calidad de la atención hospitalaria y fortalecer los programas de promoción de salud y de control de las enfermedades prevalentes, en el primer nivel de atención.

  16. Falla cardíaca aguda

    OpenAIRE

    Sénior Sánchez, Juan Manuel; Gándara Ricardo, Jairo Alfonso

    2015-01-01

    Se presenta el caso clínico de una mujer de 26 años de edad, que acudió al Hospital Universitario San Vicente Fundación (Medellín) con síntomas y signos de falla cardíaca aguda y diagnóstico previo de falla cardíaca crónica con fracción de expulsión disminuida, de origen no claro, tromboembolismo pulmonar y ataque cerebrovascular isquémico, sin modulación neurohormonal óptima. Ingresó a la institución con hallazgos clínicos de sobrecarga hídrica y baja perfusión tisular, con requerimiento de ...

  17. Coréia aguda na gravidez

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1967-12-01

    Full Text Available São apresentados doze casos de coréia aguda observados entre 150.000 gestantes (1/12.500. A maioria dos surtos ocorreu no segundo trimestre da primeira gravidez. A duração média dos sintomas foi de três meses, não tendo sido registrado caso algum de óbito materno. Todos os partos foram espontâneos e normais. Houve apenas um óbito fetal conseqüente a choque hemorrágico. São tecidas considerações a propósito dos aspectos clínico, laboratorial e prognóstico da coréia gravídica, sendo focalizado mais pormenorizadamente o problema fisiopatogênico dessa afecção.

  18. Computed tomography of tuberculous meningitis

    International Nuclear Information System (INIS)

    Sato, Noriko; Sato, Hiromi; Kawaguchi, Tetsuro; Fujita, Katsuzo; Tanaka, Makoto

    1982-01-01

    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. (author)

  19. Anatomy of the Spinal Meninges.

    Science.gov (United States)

    Sakka, Laurent; Gabrillargues, Jean; Coll, Guillaume

    2016-06-01

    The spinal meninges have received less attention than the cranial meninges in the literature, although several points remain debatable and poorly understood, like their phylogenesis, their development, and their interactions with the spinal cord. Their constancy among the chordates shows their crucial importance in central nervous system homeostasis and suggests a role far beyond mechanical protection of the neuraxis. This work provides an extensive study of the spinal meninges, from an overview of their phylogenesis and embryology to a descriptive and topographic anatomy with clinical implications. It examines their involvement in spinal cord development, functioning, and repair. This work is a review of the literature using PubMed as a search engine on Medline. The stages followed by the meninges along the phylogenesis could not be easily compared with their development in vertebrates for methodological aspects and convergence processes throughout evolution. The distinction between arachnoid and pia mater appeared controversial. Several points of descriptive anatomy remain debatable: the functional organization of the arterial network, and the venous and lymphatic drainages, considered differently by classical anatomic and neuroradiological approaches. Spinal meninges are involved in neurodevelopment and neurorepair producing neural stem cells and morphogens, in cerebrospinal fluid dynamics and neuraxis functioning by the synthesis of active molecules, and the elimination of waste products of central nervous system metabolism. The spinal meninges should be considered as dynamic functional formations evolving over a lifetime, with ultrastructural features and functional interactions with the neuraxis remaining not fully understood.

  20. Voriconazole in an infant with cryptococcal meningitis

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Cryptococcus neoformans (C. neoformans) is the most common cause of fungal meningitis worldwide.1 Cryptococcal meningitis is an opportunistic infection commonly found in immunocompromised hosts,especially HIV-infected adults. It also occurs in apparently immunocompetent individuals.

  1. Adjunctive Corticosteroids in Adults with Bacterial Meningitis

    NARCIS (Netherlands)

    van de Beek, Diederik; de Gans, Jan

    2005-01-01

    Bacterial meningitis is a complex disorder in which neurologic injury is caused, in part, by the causative organism and, in part, by the host's own inflammatory response. In studies of experimental bacterial meningitis, adjuvant treatment with corticosteroids, specifically dexamethasone, has

  2. Dynamic CT of tuberculous meningeal reactions

    International Nuclear Information System (INIS)

    Jinkins, J.R.

    1987-01-01

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

  3. Meningeal cysts in the sacral canal

    International Nuclear Information System (INIS)

    Salatkova, A.; Matejka, J.

    1996-01-01

    Meningeal cysts develop from the meningeal cover, contain liquor, are localised in the spinal canal. Clinical demonstration are different, often with no clinical manifestation, or with manifestation from compression surrounding structures. Meningeal cysts is possible diagnostic imaging with perimyelography, CT and MRI. In the paper it was discussed different feature in the diagnosis meningeal cysts with perimyelography and CT of the spine, position and time of the examination.(authors). 7 figs., 11 refs

  4. Meningococcal Disease (Bacterial Meningitis) Vaccine and Pregnancy

    Science.gov (United States)

    Meningococcal Disease (Bacterial Meningitis) Vaccine In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a ... advice from your health care provider. What is meningitis? Meningitis is an infection of the lining around ...

  5. Stroke in tuberculous meningitis.

    Science.gov (United States)

    Misra, Usha Kant; Kalita, Jayantee; Maurya, Pradeep Kumar

    2011-04-15

    Stroke in tuberculous meningitis (TBM) occurs in 15-57% of patients especially in advance stage and severe illness. The majority of strokes may be asymptomatic because of being in a silent area, deep coma or associated pathology such as spinal arachnoiditis or tuberculoma. Methods of evaluation also influence the frequency of stroke. MRI is more sensitive in detecting acute (DWI) and chronic (T2, FLAIR) stroke. Most of the strokes in TBM are multiple, bilateral and located in the basal ganglia especially the 'tubercular zone' which comprises of the caudate, anterior thalamus, anterior limb and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal and thalamostriate arteries which are embedded in exudates and likely to be stretched by a coexistent hydrocephalus. Cortical stroke can also occur due to the involvement of proximal portion of the middle, anterior and posterior cerebral arteries as well as the supraclinoid portion of the internal carotid and basilar arteries which are documented in MRI, angiography and autopsy studies. Arteritis is more common than infarction in autopsy study. The role of cytokines especially tumor necrosis factor (TNFα), vascular endothelial growth factor (VEGF) and matrix metaloproteineases (MMPs) in damaging the blood brain barrier, attracting leucocytes and release of vasoactive autocoids have been suggested. The prothrombotic state may also contribute to stroke in TBM. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in reducing strokes has not been proven. Aspirin also reduces mortality and its role in reducing stroke in TBM needs further studies. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Esofagitis necrotizante aguda: Una entidad inusual

    Directory of Open Access Journals (Sweden)

    Silvana E. Pramparo

    2010-12-01

    Full Text Available La esofagitis necrotizante aguda (ENA, también denominada esófago negro, es una rara enfermedad poco descripta en la literatura médica. Describimos el caso de un hombre de 80 años, con hemorragia digestiva alta quien desarrolló un esófago negro luego de un episodio de hipotensión. La necrosis fue confirmada histológicamente. Los pacientes se presentan con hematemesis y melena en más del 70% de los casos. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica. El diagnóstico se realiza con endoscopia y confirmación histológica. La mortalidad es alta (más del 50% aunque relacionada a las enfermedades de base del paciente. Por último, podemos decir que la sospecha es muy importante en el diagnóstico de ENA, particularmente en pacientes ancianos con enfermedades asociadas y evidencia de hemorragia digestiva alta. En este trabajo describimos las características clínicas, endoscópicas e histopatológicas de un paciente con ENA.

  7. La placa bacteriana: conceptos básicos para el higienista bucodental

    OpenAIRE

    Poyato Ferrera, Manuel María; Segura-Egea, Juan J; Ríos-Santos, J.V.; Bullon, Pedro

    2001-01-01

    La placa bacteriana es el factor etiológico principal de las dos enfermedades bucodentales de mayor prevalencia, la caries y la enfermedad periodontal. El higienista bucodental y colaborador del odontoestomatólogo en la aplicación del programa de control de placa, debe conocer en profundidad la microbiología de la placa bacteriana dental, así como los mecanismos implicados en su patogenicidad cariogénica y periodontal, aspectos que se revisan a continuación. Dental plaque is the main etiol...

  8. Manejo de las infecciones respiratorias bacterianas en pediatría

    Directory of Open Access Journals (Sweden)

    T. Juan Pablo Torres, Dr.

    2014-05-01

    En el manejo de la faringitis estreptocócica destaca el uso de amoxicilina en una dosis diaria por 10 días. En sinusitis aguda, otitis media aguda y neumonía, la recomendación de tratamiento inicial lo constituye la amoxicilina a dosis de 80–100 mg/kg/día. Se discuten algoritmos de manejo para cada una de estas patologías.

  9. CT scan of bacterial and aseptic meningitis

    International Nuclear Information System (INIS)

    Takemoto, Kazumasa; Saiwai, Shigeo; Tamaoka, Koichi

    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 3 patients developed parenchymal inhomogeneous low density and progressive ventricular dilatation which did not improve after ventricular peritoneal shunt surgery. We believe that these changes are most likely due to hypoxic hypoxemia during epileptic seizure and meningitis itself seems to play a little role. (author)

  10. Tratamento ambulatorial da endocardite bacteriana estreptocócica Tratamiento clínico de la endocarditis bacteriana estreptocócica Ambulatory treatment of streptococcal bacterial endocarditis

    Directory of Open Access Journals (Sweden)

    Sirio Hassem Sobrinho

    2010-04-01

    Full Text Available A endocardite bacteriana é uma grave doença infecciosa cujo tratamento é tradicionalmente feito com o paciente internado. recebendo medicação intravenosa. A possibilidade de tratamento domiciliar ou ambulatorial. em casos estritamente selecionados. é atraente tanto do ponto de vista social quanto do econômico. Apresentamos o relato de 6 pacientes com diagnóstico de endocardite bacteriana por Streptococcus. tratados parcial ou integralmente em regime ambulatorial. Todos evoluíram sem complicações e com resolução completa do quadro infeccioso.La endocarditis bacteriana es una severa enfermedad infecciosa cuyo tratamiento se hace tradicionalmente con el paciente internado, recibiendo medicación intravenosa. La posibilidad de tratamiento domiciliar o clínico, en casos estrictamente seleccionados, es atractivo desde el punto de vista social como del económico. Presentamos el caso clínico de 6 pacientes con diagnóstico de endocarditis bacteriana por streptococcus, tratados parcial o integralmente en régimen ambulatorio. Todos evolucionaron sin complicaciones y con resolución completa del cuadro infeccioso.Bacterial endocarditis is a severe infectious disease. of which treatment is traditionally carried out in hospitalized patients through intravenous medication. The possibility of at-home or ambulatory treatment. for stringently selected cases. is attractive from the social as well as from the economic point of view. We report 6 patients with a diagnosis of bacterial endocarditis caused by Streptococcus. treated partially or completely on an outpatient basis. All of them evolved without complications and presented complete resolution of the infection.

  11. Onkologisk behandling af meningeal carcinomatose

    DEFF Research Database (Denmark)

    Sulim, S.; Høyer, Morten

    2005-01-01

    Meningeal carcinomatosis (MC) occurs in 5-8% of cancer patients. In the       majority of cases, MC appears in patients with advanced disease. The       increase in incidence is probably caused by improved survival due to       improvements in systemic therapy and an increased awareness of MC among...

  12. Cochlear implant after bacterial meningitis.

    Science.gov (United States)

    Bille, Jesper; Ovesen, Therese

    2014-06-01

    The aim of this retrospective case study at a tertiary referral center was to investigate the outcome of cochlear implantation (CI) in children with sensorineural hearing loss due to meningitis compared to CI in children with deafness due to other reasons. This post-meningial group (PMG) consisted of 22 children undergoing CI due to deafness induced by meningitis, between December 1996 and January 2012. Five children had bilateral simultaneous implantation. None was excluded and the children were followed for at least 3 years. Operations were carried out by one of two surgeons using similar techniques in all cases. Each patient from the PMG was matched 2:1 with children having implantation for other reasons according to age and follow up (control group). Overall, the median category of auditory performance (CAP) and speech intelligibility rating (SIR) score were not statistically significantly different between the two groups. The presence of additional central nervous system (CNS) disorders (post-meningeal sequelae), however, correlated significantly with poorer outcome CI was a safe procedure without surgical complications in the present study. It is possible to restore auditory capacity and speech performance to a degree comparable to children undergoing implantation for other reasons. A statistically important variable is secondary CNS involvement. The rehabilitation program after CI should be adjusted according to these additional handicaps. It is recommended to screen meningitis patients as fast as possible to identify those with hearing loss and initiate treatment with hearing aids or CI. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  13. Computed tomography in meningeal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, H; Ono, N; Horikoshi, S; Uki, J; Takeda, F [Saitama Cancer Center (Japan)

    1982-04-01

    CT findings of meningeal carcinomatosis were studied in 17 patients (seven with lung cancer, two with breast cancer, one with gastric cancer, one with malignant melanoma, five with leukemia, and one with malignant lymphoma). The diagnosis was confirmed by a cytological survey of the cerebrospinal fluid and/or autopsy. Signs and symptoms caused by meningeal carcinomatosis at the CT examination varied from individual to individual. Those most frequently observed were signs of increased intracranial pressure, often accompanied by cranial nerve palsies, paresthesia, motor weakness, cerebellar signs, and nuchal stiffness, CT scan revealed evidence of meningeal carcinomatosis in ten cases out of the seventeen. CT evidences were obtained in 16.7% of the cases with hematologic malignancy and in 81.8% of those with non-hematologic malignancies. The CT findings of meningeal carcinomatosis may be summarized as follows: I. 1) Obliteration and narrowing of the cisterns and sulci, with contrast enhancement along them. 2) Enhanced spots/areas beneath the brain surface, with contrast enhancement. 3) Diffuse, slightly high density of the brain surface, with contrast enhancement. 4) Enhancement of the ventricular wall. 5) Hydrocephalus. II. 1) No CT abnormalities.

  14. Computed tomography in meningeal carcinomatosis

    International Nuclear Information System (INIS)

    Koizumi, Hidehito; Ono, Nobuo; Horikoshi, Satoru; Uki, Jiro; Takeda, Fumikazu

    1982-01-01

    CT findings of meningeal carcinomatosis were studied in 17 patients (seven with lung cancer, two with breast cancer, one with gastric cancer, one with malignant melanoma, five with leukemia, and one with malignant lymphoma). The diagnosis was confirmed by a cytological survey of the cerebrospinal fluid and/or autopsy. Signs and symptoms caused by meningeal carcinomatosis at the CT examination varied from individual to individual. Those most frequently observed were signs of increased intracranial pressure, often accompanied by cranial nerve palsies, paresthesia, motor weakness, cerebellar signs, and nuchal stiffness, CT scan revealed evidence of meningeal carcinomatosis in ten cases out of the seventeen. CT evidences were obtained in 16.7% of the cases with hematologic malignancy and in 81.8% of those with non-hematologic malignancies. The CT findings of meningeal carcinomatosis may be summarized as follows: I. 1) Obliteration and narrowing of the cisterns and sulci, with contrast enhancement along them. 2) Enhanced spots/areas beneath the brain surface, with contrast enhancement. 3) Diffuse, slightly high density of the brain surface, with contrast enhancement. 4) Enhancement of the ventricular wall. 5) Hydrocephalus. II. 1) No CT abnormalities. (author)

  15. Lesiones periapicales agudas en pacientes adultos

    Directory of Open Access Journals (Sweden)

    María Elena Fernández Collazo

    2012-06-01

    Full Text Available Se realizó un estudio analítico de corte transversal en el área de salud del Policlínico "27 de Noviembre" del municipio Marianao, La Habana, en el periodo correspondiente de enero a diciembre de 2009. Se incluyeron todos los pacientes que acudieron al servicio de urgencia y que presentaron lesiones periapicales agudas. Se recogió información de las variables edad, sexo, grupo dentario, causa de la enfermedad, características clínicas e higiene bucal. Esta última se clasificó en las categorías eficiente y deficiente según el índice simplificado de higiene bucal. Se utilizó el X² para estimar la relación entre las variables, y la comparación de proporciones para contrastar la hipótesis de que existieran diferencias entre las lesiones periapicales para las categorías de las variables grupo dentario, causa de la enfermedad y características clínicas. Se encontró un predominio del absceso periapical agudo en un 84,7 % del grupo de edad de 35 a 59 años y del sexo masculino, aunque no se encontraron diferencias significativas para estas variables, ni en los grupos dentarios con respecto a la enfermedad. La higiene bucal resultó estar relacionada con las lesiones periapicales. Se encontraron diferencias significativas en las lesiones periapicales respecto a todas las causas estudiadas, con excepción de las enfermedades periodontales. Respecto a las características clínicas hubo significación en cuanto al aumento de volumen del fondo del surco vestibular y la movilidad dentaria.

  16. Duchas vaginales y otros riesgos de vaginosis bacteriana

    Directory of Open Access Journals (Sweden)

    Natividad Chávez

    2009-07-01

    Full Text Available La vaginosis bacteriana (VB es una infección caracterizada por el cambio en la microflora de la vagina, se asocia con resultados adversos del embarazo y a la adquisición de infecciones de transmisión sexual (ITS, que incluyen el VIH. Objetivos. Identificar la asociación entre el uso de duchas vaginales y otros factores de riesgo con VB. Materiales y métodos. Se realizó un estudio transversal en 1252 mujeres que asistieron al servicio de planificación familiar de tres hospitales nacionales y un instituto especializado de Lima, durante el año 1997. Se utilizó un cuestionario estructurado donde se registró las variables sociodemográficas y las características del estilo de vida de las participantes. La VB fue diagnosticada mediante el puntaje de Nugent. Se empleó análisis de regresión logística para calcular odds ratio (OR e intervalos de confianza al 95%. Resultados. La edad promedio fue 25,1 ± 4,7 años, el 23,4% tenían más de 11 años de educación. La prevalencia de VB fue 20,1%. Las mujeres que practicaban duchas vaginales (OR: 2,28; IC95%: 1,0- 5,0, que tenían dos o más parejas sexuales (OR: 2,0; IC95%: 1,2-3,5 y que iniciaron una relación sexual a una edad temprana (OR: 1,4; IC95%: 1,0 -1,9 tuvieron mayor probabilidad de adquirir VB. Conclusiones. El uso de duchas vaginales es un factor de riesgo de VB en mujeres peruanas. Los programas destinados a la salud de la mujer deben abordar las repercusiones perjudiciales para la salud asociados con las duchas vaginales.

  17. DUCHAS VAGINALES Y OTROS RIESGOS DE VAGINOSIS BACTERIANA

    Science.gov (United States)

    Chávez, Natividad; Molina, Helfer; Sánchez, Jorge; Gelaye, Bizu; Sánchez, Sixto E.

    2010-01-01

    Vaginosis bacteriana (VB) es una infección caracterizada por el cambio en la microflora de la vagina, asociándose a resultados adversos del embarazo y a la adquisición de infecciones de transmisión sexual (ITS), incluyendo el VIH. En este estudio se buscó la asociación entre el uso de duchas vaginales y otros factores de riesgos con VB. Se usó un diseño observacional descriptivo transversal prospectivo, en 1,252 mujeres que asistieron al servicio de planificación familiar de tres hospitales nacionales (Dos de Mayo, Arzobispo Loayza, San Bartolomé) y el Instituto Materno Perinatal, durante el año 1997. Se utilizó un cuestionario estructurado donde se registraron variables socio demográficas y características del estilo de vida de las participantes. VB fue diagnosticada mediante el puntaje de Nugent. Se empleó análisis de regresión logística para calcular odds ratio (OR) e intervalos de confianza al 95%. La edad promedio de las participantes fue 25.1 ± 4,7 años, el 23.4% tenían más de 11 años de educación. La prevalencía de VB fue 20,1%. Las mujeres que practicaban duchas vaginales tuvieron 2.28 veces (OR = 2.28, IC 95% [1.0–5.0]) mayor probabilidad de tener VB comparado con aquellas que no lo practicaban. Tener dos o más parejas sexuales estuvo asociado con 2.0 veces (OR =2.0, IC 95% [1.2–3.5]) mayor probabilidad de adquirir VB comparado con aquellas que habían tenido solo una pareja sexual. Las participantes que iniciaron una relación sexual a una edad temprana tuvieron 1.4 veces (OR=1.4, IC 95% [1.0 –1.9]) mayor probabilidad de adquirir VB. El uso de duchas vaginales es un factor de riesgo de VB. Los programas destinados a la salud de la mujer deben abordar las repercusiones perjudiciales para la salud asociados con las duchas vaginales. PMID:21132048

  18. Cumplimiento de las recomendaciones internacionales en la lucha contra las resistencias bacterianas

    DEFF Research Database (Denmark)

    Malo, Sara; Jose Rabanaque, Mara; Bjerrum, Lars

    2016-01-01

    Introducción: El aumento de la resistencia a antibióticosrepresenta una amenaza para la salud pública al poner en riesgoel tratamiento futuro de las infecciones bacterianas. Este estudiotiene como objetivo describir el cumplimiento de las recomendaciones del Advisory Group on Integrated Surveilla......Introducción: El aumento de la resistencia a antibióticosrepresenta una amenaza para la salud pública al poner en riesgoel tratamiento futuro de las infecciones bacterianas. Este estudiotiene como objetivo describir el cumplimiento de las recomendaciones del Advisory Group on Integrated...... Surveillance of Antimicrobial Resistance (AGISAR) de la Organización Mundial de la Salud (OMS), en España y Dinamarca, en cuanto al uso ambulatoriode Critically Important Antimicrobials (CIA), así como analizarla relación entre éste y las resistencias bacterianas a ellos. Material y métodos: Los sistemas...... resistencias bacterianas, que son másmoderadas en Dinamarca. Introduction: Increasing antibiotic resistance represents a major public health threat that jeopardises the future treatment of bacterial infections. This study aims to describe the adherence to recommendations proposed by the World Health...

  19. LIXIVIACION BACTERIANA EN REACTORES: RECUPERACION DE COBRE A PARTIR DE CONCENTRADOS SULFURADOS.

    OpenAIRE

    CASAS DE PRADA, JESUS MANUEL

    1991-01-01

    Se estudió la cinética de lixiviación química (estéril) y bacteriana (con Thiobacillus ferrooxidans) de dos concentrados sulfurados de cobre, utilizando como agente oxidante el sulfato férrico en ambos casos. Los concentrados fueron suministrados por las 167p.

  20. La evolución de la resistencia bacteriana en México, 1973-2013

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez-Noriega

    2014-04-01

    Full Text Available Introducción. La resistencia bacteriana a los antibióticos es un problema de salud mundial. Las investigaciones relacionadas con este problema emergente son indispensables para reconocer y desarrollar programas para su vigilancia y control. Objetivo. Revisar y comentar las contribuciones de los investigadores mexicanos en el área de la resistencia bacteriana a los antibióticos. Materiales y métodos. Se realizó una búsqueda de la literatura científica relacionada con la resistencia bacteriana a los antibióticos producida por investigadores mexicanos y registrada en Medline-PubMed entre 1973 y julio de 2013. Resultados. En 66 publicaciones, las contribuciones de investigadores mexicanos incluyeron datos sobre la resistencia de agentes patógenos entéricos como Salmonella Typhi, múltiples contribuciones sobre la producción de betalactamasas de espectro extendido, de metalobetalactamasas y de carbapenemasas, los mecanismos de resistencia en Pseudomonas aeruginosa y la evolución de la resistencia en cocos Gram positivos como Streptococcus pneumoniae, Staphylococcus aureus y Enterococcus spp., entre otros. Conclusiones. Los datos publicados en los últimos 40 años son fuente adecuada para entender la evolución de la resistencia bacteriana a los antibióticos y desarrollar programas para su control.

  1. Meningitis tras anestesia espinal Meningitis after a spinal anesthesia

    OpenAIRE

    A. L. Vázquez-Martínez; F. Castro; G. Illodo; E. Freiré; M. A. Camba

    2008-01-01

    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 favora...

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

    International Nuclear Information System (INIS)

    Trivedi, Richa; Gupta, Rakesh K.; Nath, Kavindra; Malik, Gyanendra K.; Gupta, Amit; Prasad, Kashi N.; Purwar, Ankur; Rathore, Divya; Rathore, Ram K.S.; Narayana, Ponnada A.

    2007-01-01

    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.)

  3. 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.)

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

    Directory of Open Access Journals (Sweden)

    Mónica Zuluaga Quintero

    2010-02-01

    Full Text Available

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

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

  5. 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...... measured in serum, and 4 in which it had been measured in both cerebrospinal fluid and serum. The odds ratio for bacterial meningitis versus aseptic meningitis for a positive CRP test with cerebrospinal fluid was estimated at 241 (95% confidence interval [CI]: 59-980), and the central tendencies.......06-0.08, respectively, the post-test probability of not having bacterial meningitis given a negative test is very high (> or = 97%), in the range of a pre-test probability (prevalence of bacterial meningitis) from 10 to 30%, whereas the post-test probability of bacterial meningitis given a positive test is considerably...

  6. Clinical Case of Listeria Meningitis

    Directory of Open Access Journals (Sweden)

    V.O. Kuzmina

    2014-09-01

    Full Text Available This article describes a case of listeria meningitis in a 41-year-old man. At the time of admission to hospital, the patient complained of fever, headache, vomiting, general weakness. An objective examination revealed cervical lymphadenopathy, meningeal signs (positive Kernig’s sign and doubtful rigidity of occipitals, with no focal symptoms. On the right hand it was revealed an abscess in the stage of healing. In the liquor we have detected: pleocytosis — 222 cells with a predominance of neutrophils — 73 %, рrotein — 0.49 g/l, the sugar level in the liquor is slightly reduced. During the bacteriological study of liquor we have isolated Listeria monocytogenes. Serological survey of blood serum using passive hemagglutination test and indirect hemagglutination test revealed levels of antibodies to Listeria monocytogenes — 1 : 800 and 3 (+, respectively.

  7. Meningitis and pneumonia in Guatemalan children: the importance of Haemophilus influenzae type b and Streptococcus pneumoniae Meningitis y neumonía en niños guatemaltecos: importancia de Haemophilus influenzae tipo b y de Streptococcus pneumoniae

    Directory of Open Access Journals (Sweden)

    Edwin J. Asturias

    2003-12-01

    meningitis and help estimate the burden of bacterial meningitis in Guatemala and other developing countries.OBJETIVO: Determinar las características epidemiológicas de las infecciones invasoras por Haemophilus influenzae tipo b (Hib y Streptococcus pneumoniae en niños hospitalizados en Guatemala. La importancia de este tema radica en que la vacunación contra Hib no ha sido incorporada a los programas de inmunización establecidos en Guatemala y en que los registros hospitalarios de 1995 indicaban una baja incidencia de meningitis e infecciones invasoras causadas por Hib y S. pneumoniae. MÉTODOS: Los niños hospitalizados en la Ciudad de Guatemala con signos clínicos de infección bacteriana se estudiaron en busca de indicios de infección por Hib o S. pneumoniae. Se cultivaron líquidos corporales normalmente estériles y se hicieron pruebas de detección de antígenos en líquidos cefalorraquídeo (LCR y pleural. RESULTADOS: De los 1 203 niños de 1 a 59 meses de edad hospitalizados en un período de 28 meses, 725 (60,3% tenían un diagnóstico primario de neumonía, 357 (29,7% de meningitis, 60 (5,0% de celulitis y 61 (5,1% de sepsis u otras afecciones. En 20,0% de los niños con meningitis se detectó Hib y en 12,9% S. pneumoniae. La incidencia media anual de meningitis por Hib fue de 13,8 casos por 100 000 niños menores de 5 años de edad; 32,4% de los casos de meningitis causados por Hib y 58,7% de los causados por S. pneumoniae ocurrieron en niños menores de 6 meses de edad. La tasa de letalidad fue de 14,1%, 37,0% y 18,0%, respectivamente, para los casos de meningitis por Hib, por S. pneumoniae y con resultados negativos tanto en el cultivo como en las pruebas de detección de antígeno. El tratamiento previo con antibióticos fue frecuente y se vio asociado con una reducción significativa de resultados positivos en el cultivo de LCR en los niños que presentaban otros signos de meningitis por Hib o S. pneumoniae. CONCLUSIONES: El perfeccionamiento de la

  8. Gallium-67 uptake in meningeal sarcoidosis

    International Nuclear Information System (INIS)

    Ayres, J.G.; Hicks, B.H.; Maisey, M.N.

    1986-01-01

    A case of sarcoidosis limited to the central nervous system is described in which the diagnosis was suggested by high Ga-67 uptake in the cranial and spinal meninges. The diagnosis was confirmed by meningeal biopsy. Treatment with oral corticosteroids resulted in clinical improvement and marked reduction in Ga-67 uptake in the meninges. This is the first reported case of the central nervous system sarcoid diagnosed by Ga-67 imaging

  9. Multiple Cranial Nerve Involvement In Cryptococcal Meningitis

    Directory of Open Access Journals (Sweden)

    Mahadevan A

    2000-01-01

    Full Text Available Cryptococcal meningitis is an uncommon cause of multiple cranial nerve palsies. This case report illustrates one such case of cryptococcal meningitis clinically manifesting with extensive cranial nerve involvement in an HIV seronegative individual. Histology revealed infiltration of the cranial nerves by cryptococci causing axonal disruption with secondary demyelination in the absence of any evidence of inflammation or vasculitis. We believe that axonal damage underlies the pathogenesis of cranial nerve involvement in cryptococcal meningitis.

  10. Pediatric bacterial meningitis in French Guiana.

    Science.gov (United States)

    Elenga, N; Sicard, S; Cuadro-Alvarez, E; Long, L; Njuieyon, F; Martin, E; Kom-Tchameni, R; Balcaen, J; Moreau, B; Boukhari, R

    2015-01-01

    Controlling vaccine-preventable infectious diseases is a public health priority in French Guiana but there is currently no epidemiological data on pediatric bacterial meningitis in this overseas department. Our aim was to describe data related to pediatric bacterial meningitis in French Guiana and compare it with that of metropolitan France. We conducted a multicenter retrospective study from 2000 to 2010 to describe the clinical picture, biological data, epidemiology, and outcome of pediatric bacterial meningitis case patients in French Guiana. The median age of bacterial meningitis patients was 6months [0-15] and the sex ratio 1.06. We observed a total of 60 bacterial meningitis case patients. Most presented with pneumococcal meningitis (24 patients; 40%); 11 with Haemophilus influenzae type b meningitis (23%), five with group B streptococcal meningitis (8.5%), and five others (8.5%) with staphylococcal meningitis (three patients presented with coagulase-negative staphylococci and two with Staphylococcus aureus). Only one patient presented with group B meningococcal meningitis, an 18-month-old infant. We recorded 14 deaths (overall case fatality: 23%); eight were due to Streptococcus pneumoniae (case fatality: 33%). The overall sequelae rate was 28%. It was 32% for patients presenting with pneumococcal meningitis. We observed that 38% of children who had never been vaccinated were infected by a vaccine-preventable bacterium. We observed many differences in the distribution of the bacteria and in the patients' prognosis when comparing the French Guiana data with that of metropolitan France. Improving vaccination coverage would decrease the incidence of H. influenzae meningitis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. The bacterial meningitis score to distinguish bacterial from aseptic meningitis in children from Sao Paulo, Brazil.

    Science.gov (United States)

    Mekitarian Filho, Eduardo; Horita, Sérgio Massaru; Gilio, Alfredo Elias; Alves, Anna Cláudia Dominguez; Nigrovic, Lise E

    2013-09-01

    In a retrospective cohort of 494 children with meningitis in Sao Paulo, Brazil, the Bacterial Meningitis Score identified all the children with bacterial meningitis (sensitivity 100%, 95% confidence interval: 92-100% and negative predictive value 100%, 95% confidence interval: 98-100%). Addition of cerebrospinal fluid lactate to the score did not improve clinical prediction rule performance.

  12. Post spinal meningitis and asepsis.

    Science.gov (United States)

    Videira, Rogerio L R; Ruiz-Neto, P P; Brandao Neto, M

    2002-07-01

    Post spinal meningitis (PSM) is a complication still currently being reported. After two PSM cases in our hospital an epidemiological study was initiated, which included a survey of techniques for asepsis that are applied in our department. Cases defined as PSM comprised meningitis within a week after spinal anesthesia. Anesthesia records, anesthesia complication files and the records of the Hospital Commission for Infection Control from 1997 to 2000 were reviewed. Asepsis techniques applied were surveyed by a questionnaire answered by all our department's anesthesiologists. The equipment and procedures for spinal anesthesia were listed. Current anesthesia textbooks were reviewed for recommendations regarding asepsis techniques in conjunction with spinal anesthesia. Three cases of PSM were identified following 38,128 spinal anesthesias whereas none was observed in 12,822 patients subjected to other types of regional or general anesthesia (P>0.05). Culture of cerebrospinal fluid yielded Streptococcus in two patients and was negative in the other patient. The asepsis technique applied by the anesthesiologists varied considerably. The literature review showed that aspects on asepsis for spinal anesthesia are poorly covered. The incidence of meningitis was similar in patients subjected to spinal anesthesia and in those subjected to other anesthetic techniques. Asepsis techniques were found to differ considerably among our staff members, reflecting the lack of well-defined published standards for this procedure. We recommend that asepsis for spinal anesthesia should not be less rigorous than for surgical asepsis.

  13. Purulent Bacterial Meningitis at Birth

    Directory of Open Access Journals (Sweden)

    Babak Karimi

    2015-12-01

    Full Text Available Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, which are known as the meninges. This infection may be caused by Streptococcus pneumonia bacteria. In this study, we presented the case of a female newborn with meningitis secondary to Streptococcus pneumonia. Her birth weight and height were normal. After 24 hours of birth, the neonate was diagnosed with tachypnea, without presenting any signs of fever or respiratory distress. The newborn was referred to Sheikh Children's Hospital, where chest X-ray showed clear lungs with no evidence of abnormality. Furthermore, the cardiothoracic ratio was normal. A complete blood count demonstrated white blood cell (WBC count of 5400/uL. In Blood/Culcture ratio (B/C test, Streptococcus pneumonia was reported, and the results of the cerebrospinal fluid (CSF analysis confirmed this result. Following 14 days of receiving antibiotic therapy, the results of CSF analysis were within the normal range. Her visual and hearing examinations were normal, and demonstrated improved situation. The infant was discharged with exclusive breastfeeding.

  14. Radiation in the treatment of meningeal leukemia

    International Nuclear Information System (INIS)

    Jenkin, R.D.

    1979-01-01

    At the present time, a successful regimen for the eradication of occult meningeal leukemia is the combination of cranial radiotherapy in a dose of 1800 rads in 10 fractions in 12 to 14 days with six doses of intrathecal methotrexate. This regimen, when given with prednisone and vincristine can be expected to give a relapse rate for isolated meningeal leukemia of approximately 5% during the first 2 years of follow-up. A modification of this regimen utilizing craniospinal radiation with prior and concurrent intrathecal methotrexate is given for the treatment of overt meningeal leukemia at diagnosis or for an isolated first relapse with meningeal leukemia. Radiation technique and morbidity are discussed

  15. 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...

  16. Diseño de planta piloto para producción de Celulosa Bacteriana

    OpenAIRE

    Guinea Nava, Maria

    2016-01-01

    El presente trabajo hace referencia al diseño de una planta piloto productiva de 1.350 kilogramos anuales de celulosa por fermentación bacteriana a partir de desperdicios de piña. Se ha hecho un estudio de las propiedades que tiene la celulosa bacteriana, las múltiples aplicaciones que tiene en diferentes industrias y la vía de obtención biológica a través de la bacteria con mejores resultados de producción, G. xylinus. Además, se expone el estado del arte de la producción de celulosa, los me...

  17. Endocarditis in adults with bacterial meningitis.

    Science.gov (United States)

    Lucas, Marjolein J; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

    2013-05-21

    Endocarditis may precede or complicate bacterial meningitis, but the incidence and impact of endocarditis in bacterial meningitis are unknown. We assessed the incidence and clinical characteristics of patients with meningitis and endocarditis from a nationwide cohort study of adults with community-acquired bacterial meningitis in the Netherlands from 2006 to 2012. Endocarditis was identified in 24 of 1025 episodes (2%) of bacterial meningitis. Cultures yielded Streptococcus pneumoniae in 13 patients, Staphylococcus aureus in 8 patients, and Streptococcus agalactiae, Streptococcus pyogenes, and Streptococcus salivarius in 1 patient each. Clues leading to the diagnosis of endocarditis were cardiac murmurs, persistent or recurrent fever, a history of heart valve disease, and S aureus as the causative pathogen of bacterial meningitis. Treatment consisted of prolonged antibiotic therapy in all patients and surgical valve replacement in 10 patients (42%). Two patients were treated with oral anticoagulants, and both developed life-threatening intracerebral hemorrhage. Systemic (70%) and neurological (54%) complications occurred frequently, leading to a high proportion of patients with unfavorable outcome (63%). Seven of 24 patients (29%) with meningitis and endocarditis died. Endocarditis is an uncommon coexisting condition in bacterial meningitis but is associated with a high rate of unfavorable outcome.

  18. MRI of intracranial meningeal malignant fibrous histiocytoma

    International Nuclear Information System (INIS)

    Ogino, A.; Ochi, M.; Hayashi, K.; Hirata, K.; Hayashi, T.; Yasunaga, A.; Shibata, S.

    1996-01-01

    We describe the CT and MRI findings in a patient with primary intracranial meningeal malignant fibrous histiocytoma (MFH). CT delineated the anatomical relations and MRI aided in tissue characterisation. To our knowledge, this is the first report describing the MRI findings in primary intracranial meningeal MFH. (orig.). With 1 fig

  19. 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...

  20. Risk factors for meningitis after transsphenoidal surgery

    NARCIS (Netherlands)

    van Aken, M. O.; de Marie, S.; van der Lely, A. J.; Singh, R.; van den Berge, J. H.; Poublon, R. M.; Fokkens, W. J.; Lamberts, S. W.; de Herder, W. W.

    1997-01-01

    To evaluate possible risk factors for meningitis, we retrospectively reviewed 228 transsphenoidal operations (in which a standard regimen of amoxicillin prophylaxis was used) for sellar pathology. The incidence of meningitis was 3.1% (seven of 228 cases). Cultures of preoperative specimens from the

  1. Effect of vaccines on bacterial meningitis worldwide

    NARCIS (Netherlands)

    McIntyre, Peter B.; O'Brien, Katherine L.; Greenwood, Brian; van de Beek, Diederik

    2012-01-01

    Three bacteria-Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis-account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account

  2. Neonatal Bacterial Meningitis And Dexamethasone Adjunctive ...

    African Journals Online (AJOL)

    Methodology: Babies admitted from1992 to 1995 in the Special Care Baby Unit of the University of Maiduguri Teaching Hospital, Maduguri, Nigeria, with bacterial meningitis were studied prospectively. Neonatal bacterial meningitis was confirmed if the cerebrospinal fluid (CSF) microbiological, chemical, immunological and ...

  3. Streptococcus suis meningitis in the Netherlands

    NARCIS (Netherlands)

    van de Beek, Diederik; Spanjaard, Lodewijk; de Gans, Jan

    2008-01-01

    We present four patients with Streptococcus suis meningitis identified during a 3.5-year prospective surveillance study in the Netherlands. All cases were associated with exposure to pigs. Patients presented with classic symptoms and signs of bacterial meningitis. Outcome was characterized by severe

  4. Outbreak of Enterovirus - 71 Meningitis in Calicut

    Directory of Open Access Journals (Sweden)

    CK Sasidharan

    2016-04-01

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

  5. neonatal bacterial meningitis in Cape Town children

    African Journals Online (AJOL)

    neonatal bacterial meningitis in Cape Town children. Bacterial meningitis is a major cause of childhood morbidity and mortality in South Africa. However, comprehensive regional or national epidemiological data, essential for rational public health interventions, are lacking. The purpose of this 1-year prospective study, from.

  6. Meningitis and encephalitis in Poland in 2014

    Science.gov (United States)

    Paradowska-Stankiewicz, Iwona; Piotrowska, Anna

    The aim of this study was to assess the epidemiology of meningitis and/or encephalitis in Poland in 2014. In the last three years in Poland, about 3000 cases of meningitis and/or encephalitis of viral or bacterial etiology were recorded annually. Assessment of the epidemiological situation of meningitis and/or encephalitis in Poland in 2014, was based on the results of the analysis of epidemiological reports sent to the NIZP-PZH by the Regional Sanitary-Epidemiological Stations published in the annual bulletin “Infectious diseases and poisonings in Poland in 2014” and “Preventive immunizations in Poland in 2014”. In 2014 in Poland 3488 cases of bacterial meningitis and/or encephalitis were recorded. Almost 61.3% of these were viral infections. In 2014, in comparison to 2013, a 1.1% increase in the number of cases of meningitis and/or encephalitis was observed and 91% with viral etiology.

  7. Apendicite aguda isquêmica em coelhos: novo modelo com estudo histopatológico Acute ischaemic appendicitis in rabbits: new model with histopathological study

    Directory of Open Access Journals (Sweden)

    Fernando Costa Nunes

    2005-10-01

    Full Text Available OBJETIVOS: Avaliar a isquemia parcial ou total, através da ligadura com fio inabsorvível dos vasos do mesoapêndice do apêndice vermiforme de coelhos, bem como a obstrução mecânica, através da ligadura com fio inabsorvível da base do apêndice vermiforme, a 1 cm do ceco. Avaliar a histologia do apêndice ( normal e acometido . Estudar a flora bacteriana residente no apêndice vermiforme ( normal e acometido e do exsudato peritoneal. MÉTODOS: Foram utilizados 72 coelhos ( "Oryctogalus cuniculos" , machos da linhagem Nova Zelândia, com peso médio de 3,000 gramas. Foram divididos em grupos: piloto ( A , flora bacteriana ( B , controle ( H e experimento ( C, D, E, F e G com períodos de observação de 96 horas e 192 horas. Fez-se a ligadura dos vasos do mesoapêndice, com fio inabsorvível nos grupos ( D, E, F e G e da base do apêndice vermiforme a 1 cm do ceco, no grupo ( C . No grupo experimento (D,E,F e G foi praticado o modelo isquêmico. No grupo experimento ( C foi realizada a obstrução mecânica e no grupo controle ( H foi feita somente a simulação da cirurgia. RESULTADOS: No grupo controle ( H , não ocorreu apendicite aguda. No grupo experimento ( C,D,E,F, e G ocorreu apendicite aguda. CONCLUSÃO: O procedimento utilizado causa apendicite aguda com alterações anatomopatológicas distintas. A bactéria residente encontrada na flora fisiológica do suco entérico do apêndice vermiforme e no exsudato peritoneal foi a Escherichia coli.PURPOSE: To evaluate partial or total ischemia, through ligature with an unabsorbed thread of vessels from the vermiform appendix of rabbits, as well as the mechanical obstruction, through ligature with an unabsorbed thread at the basis of the vermiform appendix, at 1 cm from the cecum, of the acute appendicitis disease. To evaluate the histology of the appendix ( normal and affected . To study the bacterium flora resident in the vermiform appendix (normal and affected and the exudates

  8. Miopia aguda induzida por topiramato: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Kathy Dadam Sgrott

    2011-06-01

    Full Text Available RESUMO A miopia aguda pode ser desencadeada pelo uso de medicações sistêmicas, dentre elas, o anticonvulsivante topiramato. Este trabalho descreve dois casos de pacientes jovens com quadro agudo bilateral de miopia induzida por terapia com topiramato para controle de síndrome depressiva, fazendo relação com casos semelhantes descritos na literatura e revisão bibliográfica pertinente.

  9. Meningitis due to Xanthomonas maltophilia.

    Directory of Open Access Journals (Sweden)

    Girijaratnakumari T

    1993-07-01

    Full Text Available During 1st week of post-operative period, a 28 year old female patient operated for left cerebellopontine angle tumor, continued to get fever. Lumbar puncture did not reveal any organisms. She responded to ciprofloxacin. Two months later, she was readmitted with signs and symptoms of meningitis. The CSF tapped on lumbar puncture grew Xanthomonas maltophilia, Gram negative bacilli, sensitive to various antibiotics, ciprofloxacin being one of them. The patient was given ciprofloxacin for 3 weeks. On follow up, a year later she was found to be asymptomatic.

  10. Serie de 8 casos de parotiditis supurada aguda neonatal

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    Full Text Available La parotiditis supurada aguda es una infección poco frecuente en la práctica del pediatra y neonatólogo. El objetivo es mostrar nuestra experiencia en la atención de serie de casos con parotiditis supurada aguda en el período neonatal, y describir sus características de presentación. Se presentan los hallazgos clínicos en 8 pacientes con parotiditis supurativa neonatal, quienes estuvieron ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario "Juan Manuel Márquez", durante el período de 22 años (desde el año 1992 hasta el año 2013, y se contrasta con los reportes publicados en la literatura internacional. Las características de presentación de la parotiditis aguda supurada de nuestros casos concuerdan con la literatura revisada en muchos aspectos, y se demuestra que es, además, una infección poco frecuente en el período neonatal. Es la primera publicación sobre esta entidad en neonatos en Cuba, y la mayor serie de casos en el ámbito latinoamericano.

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

    NARCIS (Netherlands)

    Adriani, K.S.

    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

  12. 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. © 2015 Japanese Society of Neuropathology.

  13. In Brief: Forecasting meningitis threats

    Science.gov (United States)

    Showstack, Randy

    2008-12-01

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

  14. Infecção bacteriana no paciente cirrótico

    Directory of Open Access Journals (Sweden)

    Mattos Angelo A. de

    2003-01-01

    Full Text Available RACIONAL: Em torno de 30% dos pacientes com cirrose hepática apresentam infecção bacteriana na admissão hospitalar ou a desenvolvem durante a mesma. As infecções bacterianas são responsáveis por até 25% das mortes nesta população de pacientes. OBJETIVO: Avaliar a prevalência de infecção bacteriana em uma população de pacientes cirróticos internados em hospital geral, bem como correlacionar sua presença com a etiologia alcoólica da hepatopatia, com o grau de comprometimento da função hepática e com a presença de hemorragia digestiva alta. PACIENTES E MÉTODOS: Foram avaliadas retrospectivamente 541 internações hospitalares consecutivas em 426 pacientes com cirrose hepática, internados no período de 1992 a 2000. A média de idade destes pacientes foi de 50,5 anos (15-95, sendo 71,2% do sexo masculino. Etiologia alcoólica da hepatopatia esteve presente em 35,4% dos pacientes. Alta ou óbito do paciente no período da internação hospitalar foi considerado como principal desfecho. O nível de significância considerado na análise estatística foi de 5%. RESULTADOS: As infecções bacterianas ocorreram em 25% dos cirróticos (135 episódios. Destas, as mais freqüentes foram: a infecção do trato urinário em 31,1%, a peritonite bacteriana espontânea em 25,9% e a broncopneumonia em 25,2%. Ocorreu associação de infecção urinária e broncopneumonia em 3,7% e infecção de pele e tecido celular subcutâneo em 11,11%. Bacteremia sem foco definido ocorreu nos quatro casos restantes (2,9%. Houve associação da presença de infecção com a etiologia alcoólica da hepatopatia, com a classificação de Child-Pugh e com a ocorrência de hemorragia digestiva alta. A mortalidade hospitalar foi maior nos pacientes infectados (8,9%, estando a mesma associada ao grau de disfunção hepatocelular. CONCLUSÕES: A ocorrência de infecção bacteriana no paciente cirrótico hospitalizado é freqüente e correlaciona-se com a

  15. Use of tacrolimus in rescue therapy of acute and chronic rejection in liver transplantation Uso de tacrolimus na terapia de resgate de rejeições agudas e crônicas no transplante de fígado

    Directory of Open Access Journals (Sweden)

    Fabricio Ferreira Coelho

    2003-01-01

    de rejeições agudas + sepse bacteriana - 0/1 caso; (2 terapia de resgate de rejeições agudas recorrente - 1/1 caso; (3 terapia de resgate de rejeições agudas resistente a OKT3 - 2/2 casos; (4 terapia de resgate de rejeições agudas resistente a corticóide + doença viral ativa - 3/3 casos; (5 terapia de resgate de rejeições crônicas - 8/11 casos (72,7% de resposta. Os quatro casos sem resposta (22,2% evoluíram para óbito. CONCLUSÃO: O tacrolimus é eficaz na terapia de resgate da maioria dos casos de rejeição celular aguda e crônica no transplante de fígado.

  16. The epidemiology of bacterial meningitis in Kosovo.

    Science.gov (United States)

    Namani, Sadie A; Koci, Remzie A; Qehaja-Buçaj, Emine; Ajazaj-Berisha, Lindita; Mehmeti, Murat

    2014-07-14

    The purpose of this study was to present the epidemiologic features of bacterial meningitis in the developing country of Kosovo. Data were collected from active surveillance of bacterial meningitis cases treated at the University Clinical Center of Kosovo in the years 2000 (first post-war year) and 2010. Meningitis cases in 2000 compared with 2010 showed a 35.5% decline in incidence (from 4.8 to 3.1 cases per 100,000 population) and a decrease in the case fatality rate from 10% to 5%. In children, there was a lower mortality rate (5% versus 2%) and a lower incidence of neurological complications (13% versus 16%) as compared to adults (32% versus 10% and 16% versus 35%, respectively). Neisseria meningitidis was the most common pathogen of bacterial meningitis in both study periods. Bacterial meningitis was most prevalent in the pediatric population, and showed an increase in the median age, from three years in 2000 to seven years in 2010. A steady number of bacterial meningitis cases in adults throughout last decade (around 20 cases per year) was recorded. During the last decade, gradual changes have been observed in the epidemiology of bacterial meningitis that are unrelated to the introduction of new vaccines, but are partly due to the improvement of living conditions.

  17. Meninges: from protective membrane to stem cell niche

    OpenAIRE

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

    2012-01-01

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

  18. Meninges-derived cues control axon guidance.

    Science.gov (United States)

    Suter, Tracey A C S; DeLoughery, Zachary J; Jaworski, Alexander

    2017-10-01

    The axons of developing neurons travel long distances along stereotyped pathways under the direction of extracellular cues sensed by the axonal growth cone. Guidance cues are either secreted proteins that diffuse freely or bind the extracellular matrix, or membrane-anchored proteins. Different populations of axons express distinct sets of receptors for guidance cues, which results in differential responses to specific ligands. The full repertoire of axon guidance cues and receptors and the identity of the tissues producing these cues remain to be elucidated. The meninges are connective tissue layers enveloping the vertebrate brain and spinal cord that serve to protect the central nervous system (CNS). The meninges also instruct nervous system development by regulating the generation and migration of neural progenitors, but it has not been determined whether they help guide axons to their targets. Here, we investigate a possible role for the meninges in neuronal wiring. Using mouse neural tissue explants, we show that developing spinal cord meninges produce secreted attractive and repulsive cues that can guide multiple types of axons in vitro. We find that motor and sensory neurons, which project axons across the CNS-peripheral nervous system (PNS) boundary, are attracted by meninges. Conversely, axons of both ipsi- and contralaterally projecting dorsal spinal cord interneurons are repelled by meninges. The responses of these axonal populations to the meninges are consistent with their trajectories relative to meninges in vivo, suggesting that meningeal guidance factors contribute to nervous system wiring and control which axons are able to traverse the CNS-PNS boundary. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 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.

  20. 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

  1. 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...

  2. ORIGINAL ARTICLES Cryptococcus and lymphocytic meningitis in ...

    African Journals Online (AJOL)

    2008-08-20

    Aug 20, 2008 ... of presumptive meningitis, we reviewed results of CSF cultures and cell .... AIDS patients with cryptococcal CSF infections.3 A third of the culture-positive cases ... is no indication that cryptococcal infection is unlikely. Thirdly,.

  3. Escova dental e dedeira na remoção da placa bacteriana dental em cães

    OpenAIRE

    Lima,Tânia Berbert Ferreira; Eurides,Duvaldo; Rezende,Renata Junqueira; Milken,Vanessa Martins Fayad; Silva,Luiz Antonio Franco da; Fioravanti,Maria Clorinda Soares

    2004-01-01

    A placa bacteriana é fator primário na formação de gengivite, cálculo dentário, halitose e doença periodontal. Objetivou-se avaliar a quantidade de placa bacteriana dental removida pela escova dental e dedeira. Foram utilizados 60 cães machos e fêmeas de diferentes raças, idade e peso, divididos em dois grupos. O índice Logan & Boyce foi utilizados para quantificar a placa bacteriana antes e após a escovação. Observou-se diferença estatística (p0,05) entre a utilização da escova dental e ...

  4. MRI enhancing patterns of non-meningioma meningeal lesions

    International Nuclear Information System (INIS)

    Tao Xiaofeng; Ding Juan; Xiao Xiangsheng; Shi Zengru; Yu Hong; Gu Qian

    2004-01-01

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

  5. Mondini Dysplasia Presenting as Otorrhea without Meningitis

    OpenAIRE

    Chien-Yu Lin; Hung-Ching Lin; Chun-Chih Peng; Kuo-Sheng Lee; Nan-Chang Chiu

    2012-01-01

    Mondini dysplasia is a rare inner ear malformation that is usually only diagnosed after recurrent meningitis. Surgical intervention is mandatory. This report highlights the case of a patient with Mondini dysplasia who presented with hearing impairment and otorrhea and was diagnosed and treated before the occurrence of meningitis, thus preventing morbidity and neurologic sequelae. Hearing impairment may be the only manifestation of Mondini dysplasia, and the benefit of hearing screening is emp...

  6. Multiple Cranial Nerve Involvement In Cryptococcal Meningitis

    OpenAIRE

    Mahadevan A; Kumar A; Santosh V; Satishchandra P; Shankar S.K

    2000-01-01

    Cryptococcal meningitis is an uncommon cause of multiple cranial nerve palsies. This case report illustrates one such case of cryptococcal meningitis clinically manifesting with extensive cranial nerve involvement in an HIV seronegative individual. Histology revealed infiltration of the cranial nerves by cryptococci causing axonal disruption with secondary demyelination in the absence of any evidence of inflammation or vasculitis. We believe that axonal damage underlies the pathogenesis of...

  7. Leucemia congénita aguda Acute congenital leukemia

    Directory of Open Access Journals (Sweden)

    Nilvia Esther González García

    2011-06-01

    Full Text Available La leucemia aguda durante el período neonatal es poco frecuente de evolución rápida y pronóstico sombrío. Sus características clínicas y biológicas difieren de las encontradas en niños de mayor edad, y su inicio se caracteriza por afectación cutánea, hepatoesplenomegalia, hiperleucocitosis e infiltración del sistema nervioso central. Se han observado pacientes con formas tanto mieloides como linfoides, pero la leucemia mieloide aguda parece predominar en esta etapa de la vida. Se presenta el caso de un paciente con leucemia congénita clasificada morfológicamente, con aparición de manifestaciones clínicas de enfermedad hematológica desde el nacimiento y diagnóstico de leucemia linfoblástica aguda congénita.Acute leukemia during neonatal period is not frequent, of a fast course and gloomy prognosis. Its clinical and biological features differ of that present in older children and it onset is characterized by cutaneous affection, hepatosplenomegaly, hyperleukocytosis and infiltration of central nervous system (CNS. There are patients presenting with myeloid and lymphoid types, but the acute leukemia seems to predominate in this stage of life. This is the case of a patient with acute leukemia morphologically classified, with appearance of clinical manifestations of hematologic disease from birth and a diagnosis of congenital acute lymphoblastic leukemia.

  8. Classificação de gravidade na pancreatite aguda

    Directory of Open Access Journals (Sweden)

    Tercio De Campos

    Full Text Available De acordo com a Classificação de Atlanta a pancreatite aguda pode ser dividida, baseado em sua severidade, em uma forma leve ou grave. Uma série de aspectos têm sido discutidos nos últimos anos, tais como, quantas categorias de gravidade devem ser consideradas; se o doente com falência orgânica é igual ao doente com necrose infectada; qual o papel da falência orgânica transitória; e como avaliar a falência orgânica. A reunião de revista"Telemedicina Baseada em Evidência - Cirurgia do Trauma e Emergência" (TBE-CiTE realizou uma avaliação crítica de artigos relacionados a este tema, considerando três artigos recentes que delinearam duas grandes revisões publicadas nos últimos meses. Estes artigos sugerem a classificação de gravidade em três ou quatro categorias, ao invés de pancreatite aguda leve ou grave, além de discutir qual o melhor escore para avaliar a falência orgânica. As seguintes recomendações foram propostas: (1 A pancreatite aguda deve ser classificada em quatro categorias: leve, moderada, grave e crítica, o que permite uma melhor determinação das características dos doentes; (2 Avaliação de falência orgânica com um escore de gravidade, preferencialmente algum que avalie diretamente cada falência orgânica, tais como o SOFA e o MODS (Marshall. O SOFA parece ter maior acurácia, mas o MODS tem melhor aplicabilidade devido à facilidade de uso.

  9. Meningites por Haemophilus influenzae b após a implantação da vacina específica Occurrence of Haemophylus influenzae b meningitis after the implementation of a mass vaccination program

    Directory of Open Access Journals (Sweden)

    Claudete I. Kmetzsch

    2003-11-01

    Full Text Available OBJETIVO: Avaliar a incidência de meningite por Hib antes e após a introdução da vacinação de rotina contra esse agente no Rio Grande do Sul em 1999. MÉTODOS: Este estudo retrospectivo representa todos os dados sobre meningites por Hib investigados pela Coordenação do Controle de Doenças Transmissíveis Agudas (CCDTA - sistema de vigilância da Secretaria da Saúde do Rio Grande do Sul entre 1995 e 2001. Todos os dados foram analisados usando o teste de qui-quadrado, com p OBJECTIVE: To evaluate the incidence of Hib meningitis before and after the implementation of a vaccination program in the state of Rio Grande do Sul State, southern Brazil, in 1999. METHODS: This retrospective study summarizes all data concerning Hib meningitis recorded by the state of Rio Grande do Sul Department of Health/Acute Communicable Disease Surveillance Agency between 1995 and 2001. All data were analyzed using the chi-square test (statistical significance: p < 0.005. RESULTS: The decline in the number of cases of Hib meningitis was associated with the Hib vaccine coverage in children. From 1995 to 2001 the incidence of Hib meningitis decreased 89% (from 1.35 cases/100,000 people in 1995 to 0.15 cases/100,000 in 2001 (p < 0.01, especially in children younger than 1 year (p < 0.005. In the same period, Hib meningitis lethality decreased from 17.8 to 6.7 % (p < 0.01. CONCLUSIONS: The implementation of an Hib meningitis vaccination program has nearly eliminated Hib meningitis in the state of Rio Grande do Sul. These findings underscore the need to maintain the vaccination in children, with a thorough investigation of suspected cases and reporting of confirmed cases.

  10. Spinal cord involvement in tuberculous meningitis.

    Science.gov (United States)

    Garg, R K; Malhotra, H S; Gupta, R

    2015-09-01

    To summarize the incidence and spectrum of spinal cord-related complications in patients of tuberculous meningitis. Reports from multiple countries were included. An extensive review of the literature, published in English, was carried out using Scopus, PubMed and Google Scholar databases. Tuberculous meningitis frequently affects the spinal cord and nerve roots. Initial evidence of spinal cord involvement came from post-mortem examination. Subsequent advancement in neuroimaging like conventional lumbar myelography, computed tomographic myelography and gadolinium-enhanced magnetic resonance-myelography have contributed immensely. Spinal involvement manifests in several forms, like tuberculous radiculomyelitis, spinal tuberculoma, myelitis, syringomyelia, vertebral tuberculosis and very rarely spinal tuberculous abscess. Frequently, tuberculous spinal arachnoiditis develops paradoxically. Infrequently, spinal cord involvement may even be asymptomatic. Spinal cord and spinal nerve involvement is demonstrated by diffuse enhancement of cord parenchyma, nerve roots and meninges on contrast-enhanced magnetic resonance imaging. High cerebrospinal fluid protein content is often a risk factor for arachnoiditis. The most important differential diagnosis of tuberculous arachnoiditis is meningeal carcinomatosis. Anti-tuberculosis therapy is the main stay of treatment for tuberculous meningitis. Higher doses of corticosteroids have been found effective. Surgery should be considered only when pathological confirmation is needed or there is significant spinal cord compression. The outcome in these patients has been unpredictable. Some reports observed excellent recovery and some reported unfavorable outcomes after surgical decompression and debridement. Tuberculous meningitis is frequently associated with disabling spinal cord and radicular complications. Available treatment options are far from satisfactory.

  11. [The meninges, an anatomical point of view].

    Science.gov (United States)

    Sakka, L; Chazal, J

    2005-03-01

    The meninges correspond to an anatomical concept. For the morphologist, the microscopic organization, the hypothetical presence of a subdural space, the nature of the interface between the deep meningeal layer and the nervous parenchyma in the perivascular spaces are the central issues. For the clinician, dynamic aspects of cerebrospinal fluid flow, secretion, and resorption are essential factors with practical consequences in terms of disease and patient management. Comparative anatomy, embryology, and organogenesis provide an interesting perspective for the descriptive and functional anatomy of the meninges. Usually considered as protective membranes, the meninges play a prominent role in the development and maintenance of the central nervous system. The meninges are in constant evolution, from their formation to senescence. The meninges present three layers in children and adults: the dura mater, the arachnoid and the pia mater. The cerebrospinal fluid is secreted by the choroid plexuses, flows through the ventricles and the subarachnoid space, and is absorbed by arachnoid granulations. Other sites of secretion and resorption are suggested by comparative anatomy and human embryology and organogenesis.

  12. Ataxia cerebelar aguda na criança

    Directory of Open Access Journals (Sweden)

    Valeriana Moura Ribeiro

    1968-03-01

    Full Text Available São relatados os casos de 6 crianças com ataxia cerebelar aguda. Admitem os autores a presença de um fator etiológico de caráter viral comum a todos êles, discutindo os mecanismos patogênicos com base nos casos da literatura. A evolução foi favorável em todos os pacientes, com regressão completa da sintomatologia, dentro do período de 6 a 60 dias.

  13. Insuficiencia renal aguda inducida por mordedura de serpiente Bothrops

    Directory of Open Access Journals (Sweden)

    Gustavo A. Aroca Martínez

    2014-01-01

    Full Text Available Mujer de 58 años de edad, remitida a urgencias por presentar cuadro clínico de insuficiencia renal aguda (IRA secundaria a mordedura de serpiente (Bothrops Atrox. Ingresa hipotensa con elevación de azoados e hiperkalemia, ecografía renal dentro de parámetros normales. Se maneja terapia dialítica con lo cual presenta mejoría clínica. En este reporte se detallan aspectos del diagnóstico, manejo clínico y posibles mecanismos fisiopatológicos que explican el daño renal.

  14. A resistência bacteriana no contexto da infecção hospitalar

    OpenAIRE

    Santos, Neusa de Queiroz

    2004-01-01

    Este artigo aborda alguns aspectos do impacto da resistência bacteriana no contexto da infecção hospitalar. Alerta sobre o importante papel dos profissionais de saúde no controle da infecção hospitalar e do grave problema do uso indiscriminado de antibióticos que tem provocado uma pressão seletiva sobre as bactérias do ambiente hospitalar tornando-as multiresistentes This article lays out some aspects of the impact of bacterial resistence in the context of hospital infection. It alerts to ...

  15. Método para prevenir y/o controlar infecciones bacterianas

    OpenAIRE

    Soto, María José; Nogales, Joaquina; Olivares Pascual, José; Sanjuán, Juan

    2012-01-01

    La presente invención se refiere a un método para prevenir y/o controlar infecciones bacterianas en una planta y/o cultivo, así como en productos (alimentos crudos, soluciones de lavado, material de uso hospitalario) e instalaciones susceptibles de contaminación por bacterias, mediante aplicación de metilcetonas alifáticas de cadena larga, fundamentalmente 2-tridecanona pero también 2- undecanona, 2-dodecanona, y 2-pentadecanona, en formas y concentraciones del orde...

  16. Administração endovenosa de antibióticos e resistência bacteriana : responsabilidade da enfermagem

    OpenAIRE

    Hoefel, Heloisa Helena Karnas; Lautert, Liana

    2006-01-01

    O sucesso da terapêutica com antibióticos e o desenvolvimento da resistência bacteriana dependem de diversos fatores, sendo que os relacionados ao cuidado de enfermagem são o seu preparo e a sua administração. Objetivo: realizar uma revisão da literatura sobre falhas na administração de antibióticos analisando sua possível influência na resistência bacteriana. Delineamento: realizada uma pesquisa bibliográfica das fontes do LILACS e Medline. Métodos: realizada revisão bibliográfica sistematiz...

  17. Estudo prospectivo dos fatores de risco para complicações neurológicas na meningite bacteriana infantil

    OpenAIRE

    Namani, Sadie; Milenković, Zvonko; Koci, Bulëza

    2013-01-01

    OBJETIVO: Análise prospectiva de fatores de prognóstico para complicações neurológicas da meningite bacteriana infantil. MÉTODOS: Este estudo prospectivo recrutou 77 crianças de um mês a 16 anos de idade tratadas de meningite bacteriana durante o período de 1/1/2009 a 31/12/2010. Foram escolhidos 16 preditores relevantes para analisar sua associação com a incidência de complicações neurológicas. Valores P abaixo de 0,05 foram considerados estatisticamente significativos. RESULTADOS: Das 77 cr...

  18. O mosaico patogênico da pancreatite aguda grave

    Directory of Open Access Journals (Sweden)

    Márcio Cavalcante Carneiro

    Full Text Available A pancreatite aguda tem sido alvo de grandes discussões que vão desde o entendimento de sua fisiopatologia até a investigação de novas modalidades terapêuticas. Reconhece-se que a necrose pancreática e a falência orgânica múltipla - mormente associadas à infecção - representam os principais fatores determinantes da evolução para o óbito, mas, apesar dos grandes avanços em seu estudo, a doença permanece como um desafio para o clínico e o cirurgião. Deste modo, um melhor conhecimento dos mecanismos envolvidos em sua fisiopatologia pode ser a chave para um tratamento mais eficaz, principalmente em relação às formas graves, cuja letalidade ainda encontra-se substancialmente elevada. Baseado nestas considerações, o presente trabalho tem por objetivo a revisão bibliográfica da fisiopatologia, dos fatores patogênicos envolvidos na história natural da pancreatite aguda grave e dos eventos associados à síndrome da resposta inflamatória sistêmica e à sepse, esboçando-se assim o mosaico patogênico desta importante condição.

  19. Carambola como causa de lesão renal aguda

    Directory of Open Access Journals (Sweden)

    Karilla Lany Scaranello

    2014-04-01

    Full Text Available A carambola pertence à família das Oxalidáceas, espécie Averrhoa carambola. É rica em sais minerais, vitaminas A, C, complexo B e ácido oxálico. Estudos recentes demonstram que a toxicidade da fruta difere entre os indivíduos e pode ser explicada pelas respostas biológicas individuais como idade, quantidade da ingestão, neurotoxinas em cada tipo de fruta. Adicionalmente, a nefrotoxicidade causada pela fruta é dose dependente, podendo levar ao desenvolvimento de lesão renal aguda pela deposição de cristais de oxalato de cálcio intratubular, assim como por lesão direta das células epiteliais tubulares, levando à apoptose das mesmas. Relatamos o caso de uma paciente que, após a ingestão do suco da fruta e fruta in natura, desenvolveu lesão renal aguda, necessitando de terapia dialítica, evoluindo com desfecho favorável e recuperação da função renal.

  20. Respostas cardiovasculares agudas em ambiente virtualmente simulado pelo Nintendo Wii

    Directory of Open Access Journals (Sweden)

    Renato Aparecido de Souza

    2013-01-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n1p60 Recentemente, tem sido verificada a utilização do Nintendo Wii no contexto da saúde. O objetivo do presente estudo foi analisar as respostas cardiovasculares agudas monitoradas por meio do comportamento da frequência cardíaca, pressão arterial sistólica, pressão arterial diastólica e duplo produto, em ambiente virtualmente simulado pelo console Nintendo Wii. A amostra foi composta por 18 universitários saudáveis, com média de idade de 22,07 ± 1,34 anos. As variáveis foram observadas com uso de deltas (valor final - inicial após 25 arremessos de basquetebol em duas situações experimentais: (I com o voluntário sentado e, (II com o voluntário saltando verticalmente. Os resultados sugerem que a prática de atividade física em ambiente virtual emulado pelo Nintendo Wii é capaz de alterar as respostas cardiovasculares agudas, especialmente, quando realizada em associação a saltos verticais. Assim, os resultados sustentam a viabilidade do uso do Nintendo Wii em programas de treinamento e favorecem sua indicação de forma mais segura.

  1. Meningitis and Climate: From Science to Practice

    Science.gov (United States)

    Perez Garcia-Pando, Carlos; Thomson, Madeleine C.; Stanton, Michelle C.; Diggle, Peter J.; Hopson, Thomas; Pandya, Rajul; Miller, Ron L.; Hugonnet, Stephane

    2014-01-01

    Meningococcal meningitis is a climate sensitive infectious disease. The regional extent of the Meningitis Belt in Africa, where the majority of epidemics occur, was originally defined by Lapeysonnie in the 1960s. A combination of climatic and environmental conditions and biological and social factors have been associated to the spatial and temporal patterns of epidemics observed since the disease first emerged in West Africa over a century ago. However, there is still a lack of knowledge and data that would allow disentangling the relative effects of the diverse risk factors upon epidemics. The Meningitis Environmental Risk Information Technologies Initiative (MERIT), a collaborative research-to-practice consortium, seeks to inform national and regional prevention and control strategies across the African Meningitis Belt through the provision of new data and tools that better determine risk factors. In particular MERIT seeks to consolidate a body of knowledge that provides evidence of the contribution of climatic and environmental factors to seasonal and year-to-year variations in meningococcal meningitis incidence at both district and national scales. Here we review recent research and practice seeking to provide useful information for the epidemic response strategy of National Ministries of Health in the Meningitis Belt of Africa. In particular the research and derived tools described in this paper have focused at "getting science into policy and practice" by engaging with practitioner communities under the umbrella of MERIT to ensure the relevance of their work to operational decision-making. We limit our focus to that of reactive vaccination for meningococcal meningitis. Important but external to our discussion is the development and implementation of the new conjugate vaccine, which specifically targets meningococcus A

  2. Microbiota bacteriana asociada al papel moneda de circulación en Colombia

    Directory of Open Access Journals (Sweden)

    Pilar Ximena Lizarazo-Medina

    Full Text Available Resumen Diariamente los seres humanos están en interacción con objetos de uso continuo, como el papel moneda, sin el conocimiento de que estos almacenan microorganismos y de que nos exponemos al contacto con potenciales patógenos. La composición de la comunidad bacteriana en un billete colombiano fue determinada mediante el secuenciamiento profundo de librerías de amplicones 16S. Se encontraron 233 géneros bacterianos; 12 de estos géneros corresponden a especies con potencial patogénico. El género más abundante fue Propionibacterium, seguido de Streptococcus, Staphylococcus Pseudomonas . Este es el primer reporte de la diversidad bacteriana que puede ser alojada en este objeto de alta circulación en Colombia. Pocos estudios en el mundo han mostrado este nivel de detalle de la microbiota en billetes de circulación y ofrece un panorama mucho más amplio de la exposición diaria a microorganismos al utilizar papel moneda en las condiciones en las que se utiliza en Colombia.

  3. A orbifloxacina no tratamento das cistites bacterianas em gatos domésticos

    Directory of Open Access Journals (Sweden)

    Reche Junior Archivaldo

    2005-01-01

    Full Text Available O presente estudo teve como objetivos, avaliar o uso da orbifloxacina nas cistites bacterianas de felinos, e seus possíveis efeitos colaterais, mormente a nefro e/ou hepatotoxicidade. Para tanto, foram colhidas amostras de urina de 53 gatos com históricos variados, mas com predisposição à infecção urinária. A cistite bacteriana foi comprovada, através de exame microbiológico, em 13 pacientes. No entanto, apenas 10 apresentaram infecção por agentes sensíveis a orbifloxacina. Esses 10 pacientes foram então submetidos ao tratamento com orbifloxacina na dose de 2,5mg kg-1 a cada 24 horas por 10 dias. Não houve crescimento bacteriano nas amostras de urina submetidas à cultura, 72 horas após a interrupção do tratamento. Não foram observados sinais de nefro e/ou hepatotoxicidade nesses pacientes, uma vez que os níveis séricos de alanina aminotransferase (ALT, aspartato aminotransferase (AST, fosfatase alcalina (FA, albumina, uréia e creatinina não tiveram variação significativa após o uso do fármaco. Portanto, os resultados apresentados sugerem que a orbifloxacina pode ser usada como agente antimicrobiano nas infecções urinárias de felinos.

  4. Diagnóstico das meningites através de fitas reagentes Diagnosis of meningitis with reagent strips

    Directory of Open Access Journals (Sweden)

    Roberta M.C. Romanelli

    2001-06-01

    Full Text Available OBJETIVO: determinar a utilidade de fitas reagentes para a avaliação liquórica de pleocitose, glicorraquia e proteinorraquia no diagnóstico precoce e rápido de meningites em crianças. MÉTODOS: Foram incluídas no estudo amostras de líquor provenientes de 164 crianças admitidas no ambulatório de doenças infecto-contagiosas do Centro Geral de Pediatria (CGP-FHEMIG, com suspeita clínica de meningite, no período diurno de Maio/97 à Maio/99. A faixa etária dos pacientes variou de um mês a 12 anos (mediana de 12 meses, sendo obtidos resultados da citobioquímica liquórica (celularidade, glicorraquia e proteinorraquia de 154 desses pacientes. Esses achados foram comparados com reações do líquor em fitas reagentes. RESULTADOS: Através da citobioquímica líquórica foram identificados 43 casos de provável meningite bacteriana, 19 provavelmente viróticas e 83 amostras sem alterações. Pelas fitas reagentes, detectaram-se 41 casos de provável meningite bacteriana, dois casos de infecção meníngea provavelmente virótica, e em 71 exames não se verificaram alterações. Comparando os resultados obtidos por meio das fitas reagentes com a citobioquímica convencional, observou-se sensibilidade, especificidade, valores preditivos positivo e negativo e acurácia (90,7; 98,1; 95,1; 96,4; 96,1%, respectivamente. Ademais, a análise estatística pelo teste de Mc Nemar não evidenciou discordância significativa no diagnóstico de meningite bacteriana obtido através de ambos os métodos (p=0,68 e, pela estatística Kappa, verificou-se elevado grau de concordância entre os testes (pOBJECTIVE: to determine the usefulness of reagent strips in the evaluation of pleocytosis, cerebrospinal fluid glucose and protein levels for early and rapid diagnosis of meningitis in children. METHODS: We included cerebrospinal fluid samples of 164 children admitted to the outpatient clinic of Communicable Diseases of the General Pediatric Center (Funda

  5. Escala de Alvarado como herramienta diagnóstica para apendicitis aguda

    Directory of Open Access Journals (Sweden)

    Iván Pimienta Concepción

    2017-06-01

    Full Text Available Introducción: La apendicitis aguda es la enfermedad intrabdominal más frecuente tratada de urgencia. Resulta de interés la utilización de la Escala de Alvarado en el diagnóstico de esta patología por su contribución a la disminución de apendicectomías negativas. Objetivo: Determinar la validez de la Escala de Alvarado como herramienta diagnóstica para apendicitis aguda en pacientes atendidos en el Servicio de Cirugía General del Hospital IESS Ambato. Métodos: Se realizó una investigación observacional, descriptiva y transversal en pacientes hospitalizados con cuadro de dolor abdominal y sospecha de apendicitis aguda, valorados en el Servicio de Cirugía General en el Hospital General IESS Ambato en el período junio 2015 a noviembre del año 2015. Resultados: De acuerdo al resultado histopatológico predominó la apendicitis aguda supurada con (n=83, 54.9%; seguida de apendicitis aguda gangrenosa (n=35, 23.2%; apendicitis aguda precoz (n=15, 9.9%; mientras que el resultado normal y apendicitis aguda gangrenosa perforada se encontraron con los mismos valores (n=9, 5.9%. Conclusiones: Existió un puntaje elevado de la Escala de Alvarado para el diagnóstico de apendicitis aguda según la severidad de los hallazgos descritos en el resultado histopatológico posterior a la apendicectomía. El resultado histopatológico de mayor frecuencia fue la apendicitis aguda supurada, con un riesgo medio en la Escala de Alvarado, la cual es más sensible en periodos de gravedad.

  6. Does antimicrobial usage before meningitis lead to a higher risk of adult postsurgical Acinetobacter baumannii meningitis than that of Enterobacteriaceae meningitis?

    Science.gov (United States)

    Demiraslan, Hayati; Ulutabanca, Halil; Ercal, Baris Derya; Metan, Gokhan; Alp, Emine

    2016-12-01

    Acinetobacter baumannii and Enterobacteriaceae are two pathogens responsible for postneurosurgical meningitis. The aim of this retrospective study was to evaluate the factors that influenced the outcomes in patients with postneurosurgical meningitis caused by A. baumannii and Enterobacteriaceae. Patients with post-surgical meningitis were identified from infection control committee charts between 2007 and 2015. Subjects over 16 years old who had positive cerebral spinal fluid cultures for A. baumannii or Enterobacteriaceae were enrolled in the study. Clinical and laboratory data for 30 patients with A. baumannii meningitis were compared with those of 12 patients with Enterobacteriaceae meningitis. The mean age of patients was 51.9 years and 57.1% were male. Eleven patients had comorbidities, the most common being diabetes mellitus. Most patients were due to intracranial haemorrhage (78.6%). The rate of the patients who received an appropriate antimicrobial therapy was 35.7%, and the crude mortality rate was 64.3%. In univariate analysis, previous antibiotic use, an infection before meningitis and mechanical ventilation had an increased risk of A. baumannii meningitis. Moreover, intrathecal antimicrobial use, inappropriate empirical antimicrobial use, antimicrobial resistance and alanine aminotransferase elevation were significantly higher in patients with A. baumannii meningitis than in those with Enterobacteriaceae meningitis. Antimicrobial use before meningitis (8.84 times) and mechanical ventilation (7.28 times) resulted in an increased risk of A. baumannii meningitis. None of the results affected 30-day mortality. Avoidance of unnecessarily prolonged antimicrobial usage may help to prevent a selection of A. baumannii.

  7. Differential diagnosis of scrub typhus meningitis from tuberculous meningitis using clinical and laboratory features.

    Science.gov (United States)

    Valappil, Ashraf V; Thiruvoth, Sohanlal; Peedikayil, Jabir M; Raghunath, Praveenkumar; Thekkedath, Manojan

    2017-12-01

    The involvement of the central nervous system in the form of meningitis or meningoencephalitis is common in scrub typhus and is an important differential diagnosis of other lymphocytic meningitis like tuberculous meningitis (TBM). The aim of this study was to identify the clinical and laboratory parameters that may be helpful in differentiating scrub typhus meningitis from TBM. We compared of the clinical and laboratory features of 57 patients admitted with scrub typhus meningitis or TBM during a 3-year period. Patients who had abnormal cerebrospinal fluid (CSF) and positive scrub typhus enzyme-linked immunosorbent assay serology (n=28) were included in the scrub typhus meningitis group, while the TBM group included those who satisfied the consensus diagnostic criteria of TBM (n=29). Compared with the TBM group, the mean duration of symptoms was less in patients with scrub typhus meningitis, who also had a lower magnitude of neurological deficits, such as altered mental status and cranial nerve and motor deficits. Patients with scrub typhus meningitis had a lower CSF white blood-cell count (WBC) than the TBM group (130.8±213 195±175 cells/mm 3 , P=0.002), lower CSF protein elevation (125±120 vs. 195.2±108.2mg/dl, P=0.002), and higher CSF sugar (70.1±32.4 vs. 48.7±23.4mg/dl, P=0.006). Features predictive of the diagnosis of scrub typhus meningitis included the absence of neurological impairment at presentation, blood serum glutamic-oxaloacetic transaminase>40 international units (IU)/L, serum glutamic-pyruvic transaminase>60 IU/L, total blood leukocyte count>10,000/mm 3 , CSF protein50mg/dl, CSF WBC<100 cells/mm 3 . All patients with scrub typhus meningitis recovered completely following doxycycline therapy CONCLUSIONS: This study suggests that, clinical features, including duration of fever, neurological deficits at presentation and laboratory parameters such as CSF pleocytosis,CSF protein elevation, CSF sugar levels and liver enzyme values are helpful in

  8. 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....

  9. Bacterial Meningitis in Adults After Splenectomy and Hyposplenic States

    NARCIS (Netherlands)

    Adriani, Kirsten S.; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2013-01-01

    Objective: To examine the occurrence, disease course, prognosis, and vaccination status of patients with community-acquired bacterial meningitis with a history of splenectomy or functional hyposplenia. Patients and Methods: Patients with bacterial meningitis proven by cerebrospinal fluid culture

  10. Cerebral tryptophan metabolism and outcome of tuberculous meningitis

    NARCIS (Netherlands)

    Laarhoven, van Arjan; Dian, Sofiati; Aguirre-Gamboa, Raúl; Avila-Pacheco, Julian; Ricaño-Ponce, Isis; Ruesen, Carolien; Annisa, Jessi; Koeken, Valerie A.C.M.; Chaidir, Lidya; Li, Yang; Achmad, Tri Hanggono; Joosten, Leo A.B.; Notebaart, Richard A.; Ruslami, Rovina; Netea, Mihai G.; Verbeek, Marcel M.; Alisjahbana, Bachti; Kumar, Vinod; Clish, Clary B.; Ganiem, A.R.; Crevel, van Reinout

    2018-01-01

    Background: Immunopathology contributes to the high mortality of tuberculous meningitis, but the biological pathways involved are mostly unknown. We aimed to compare cerebrospinal fluid (CSF) and serum metabolomes of patients with tuberculous meningitis with that of controls without tuberculous

  11. Meningeal enhancement on MRI after craniotomy

    International Nuclear Information System (INIS)

    Nomura, Motohiro; Hasegawa, Mitsuhiro; Yamashima, Tetsumori; Yamashita, Junkoh; Suzuki, Masayuki

    1991-01-01

    Gd-DPTA-enhanced MR images in 94 patients who had undergone craniotomy were studied, with particular attention paid to the meningeal enhancement. Such enhancement was noted in 26 of the 94 (27.6%) in the portion surrounding the craniotomy site. Meningeal enhancement, presumably of the subdural neomembrane, was apparent as a third line of a high signal intensity on T 1 -weighted MR images. The outer two high-intensity lines were derived from fat in the subcutaneous tissues of the scalp and fat in the bone marrow of the calvaria. We designated this characteristic enhancement as a 'triple white line'. Of the 26 patients with meningeal enhancement, 22 cases (23.4%) showed such a 'triple white line', 11 cases (11.7%) showed falx enhancement, and 12 cases (12.8%) showed tentorial enhancement. The intervals between surgery and the appearance of the meningeal enhancement ranged from 4 days to 88 weeks. A small amount of bleeding into the dura-arachnoid interface induced by surgery might result in the subdural neomembrane, as has previously been reported. This neomembrane might be enhanced by the leakage of Gd-DTPA through the proliferating capillaries. As meningeal enhancement occurs in approximately a third of the cases following craniotomy, much care should be taken in the differential diagnosis of the infection, inflammation, and metastasis or dissemination of malignant brain tumors. (author)

  12. MR imaging of the meningeal diseases

    International Nuclear Information System (INIS)

    Schoerner, W.; Henkes, H.; Felix, R.

    1988-01-01

    The value of MR imaging in the diagnosis of meningeal diseases was studied in 22 patients with various meningeal alterations (tumor, inflammation, trauma, radiation). MR studies (0.5 T) included T2-weighted (spin echo [SE] 1,600/70 [repetition time msec/echo time msec]) images in 20 of 22 patients and T1-weighted images (SE 400/30) in all patients, before and after Gd-DTPA enhancement. As compared with a control group (20 cases), 16 of 20 T2-weighted studies of the patient group showed pathologically increased signal intensity of the subarchnoidal space. Whereas only normal findings were seen on T1-weighted images in the patient group, 21 of 22 patients had pathologically increased contrast accumulation of the meninges. In conclusion, pathologic changes of the meninges could be demonstrated on plain T2-weighted and contrast-enhanced T1-weighted images. In selected cases, detection of meningeal disease could be achieved only with Gd-DTPA-enhanced studies

  13. Human Meningitis-Associated Escherichia coli

    Science.gov (United States)

    KIM, KWANG SIK

    2016-01-01

    E. coli is the most common Gram-negative bacillary organism causing meningitis and E. coli meningitis continues to be an important cause of mortality and morbidity throughout the world. Our incomplete knowledge of its pathogenesis contributes to such mortality and morbidity. Recent reports of E. coli strains producing CTX-M-type or TEM-type extended-spectrum β-lactamases create a challenge. Studies using in vitro and in vivo models of the blood-brain barrier have shown that E. coli meningitis follows a high-degree of bacteremia and invasion of the blood-brain barrier. E. coli invasion of the blood-brain barrier, the essentials step in the development of E. coli meningitis, requires specific microbial and host factors as well as microbe- and host-specific signaling molecules. Blockade of such microbial and host factors contributing to E. coli invasion of the blood-brain barrier is shown to be efficient in preventing E. coli penetration into the brain. The basis for requiring a high-degree of bacteremia for E. coli penetration of the blood-brain barrier, however, remains unclear. Continued investigation on the microbial and host factors contributing to a high-degree of bacteremia and E. coli invasion of the blood-brain barrier is likely to identify new targets for prevention and therapy of E. coli meningitis. PMID:27223820

  14. Monitoring of Intracranial Pressure in Meningitis.

    Science.gov (United States)

    Depreitere, Bart; Bruyninckx, Dominike; Güiza, Fabian

    2016-01-01

    The literature on intracranial pressure (ICP) monitoring in meningitis is limited to case reports and a handful of descriptive series. The aim of this study is to investigate relationships among ICP, cerebral perfusion pressure (CPP), and outcome in meningitis and to identify whether ICP affected clinical decisions. Between 1999 and 2011, a total of 17 patients with meningitis underwent ICP monitoring at the University Hospitals Leuven. Charts were reviewed for clinical history, ICP/CPP data, imaging findings, and Glasgow Outcome Scale score. Univariate correlations were computed for outcome and ICP/CPP variables, computed tomography characteristics, and Corticosteroid Randomization After Significant Head Injury outcome model variables. Treatment decisions were assessed regarding whether or not they were based on ICP. At drain placement, Glasgow Coma Scale scores showed a median of 8 (range 3-12). Six of 17 patients had either one or two nonreactive pupils. Significant correlations with outcome were found for the highest documented ICP value (r = -0.70), the number of episodes when CPP meningitis high ICP and low CPP represent secondary insults. The poor condition of the patients illustrates that the level of suspicion for increased ICP in meningitis may not be high enough.

  15. Development and plasticity of meningeal lymphatic vessels.

    Science.gov (United States)

    Antila, Salli; Karaman, Sinem; Nurmi, Harri; Airavaara, Mikko; Voutilainen, Merja H; Mathivet, Thomas; Chilov, Dmitri; Li, Zhilin; Koppinen, Tapani; Park, Jun-Hee; Fang, Shentong; Aspelund, Aleksanteri; Saarma, Mart; Eichmann, Anne; Thomas, Jean-Léon; Alitalo, Kari

    2017-12-04

    The recent discovery of meningeal lymphatic vessels (LVs) has raised interest in their possible involvement in neuropathological processes, yet little is known about their development or maintenance. We show here that meningeal LVs develop postnatally, appearing first around the foramina in the basal parts of the skull and spinal canal, sprouting along the blood vessels and cranial and spinal nerves to various parts of the meninges surrounding the central nervous system (CNS). VEGF-C, expressed mainly in vascular smooth muscle cells, and VEGFR3 in lymphatic endothelial cells were essential for their development, whereas VEGF-D deletion had no effect. Surprisingly, in adult mice, the LVs showed regression after VEGF-C or VEGFR3 deletion, administration of the tyrosine kinase inhibitor sunitinib, or expression of VEGF-C/D trap, which also compromised the lymphatic drainage function. Conversely, an excess of VEGF-C induced meningeal lymphangiogenesis. The plasticity and regenerative potential of meningeal LVs should allow manipulation of cerebrospinal fluid drainage and neuropathological processes in the CNS. © 2017 Antila et al.

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

    International Nuclear Information System (INIS)

    Lee, Dong Hyun; Kim, Ho Kyun; Lee, Young Hwan

    2008-01-01

    The CNS involvement by leukemia may either be meningeal or parenchymal, although meningeal infiltration of leukemic cells, known as leukemic meningitis is more common. We report a case of leukemic meningitis involving the cauda equina in a patient with an acute lymphoblastic crisis which transformed from the chronic phase of chronic myeloid leukemia. An MR image revealed diffuse enlargement and peripheral ring enhancement of the nerve roots of the cauda equina

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-15

    The CNS involvement by leukemia may either be meningeal or parenchymal, although meningeal infiltration of leukemic cells, known as leukemic meningitis is more common. We report a case of leukemic meningitis involving the cauda equina in a patient with an acute lymphoblastic crisis which transformed from the chronic phase of chronic myeloid leukemia. An MR image revealed diffuse enlargement and peripheral ring enhancement of the nerve roots of the cauda equina.

  18. Bacterial pneumonia following bone marrow transplantation: HRCT findings Achados de TCAR nas pneumonias bacterianas após transplante de medula óssea

    Directory of Open Access Journals (Sweden)

    Luiz Otávio de Mattos Coelho

    2009-05-01

    Full Text Available OBJECTIVE: To describe HRCT findings in patients with bacterial pneumonia following bone marrow transplantation (BMT. METHODS: This was a retrospective study involving 30 patients diagnosed with bacterial pneumonia in whom HRCT of the chest was performed within 24 h after the onset of symptoms and the diagnosis was confirmed, based on a positive culture of sputum or bronchial aspirate, together with a positive pleural fluid or blood culture, within one week after symptom onset. There were 20 male patients and 10 female patients. The median age was 21 years (range, 1-41 years. The BMT had been performed for the treatment of the following: chronic myeloid leukemia, in 14 cases; severe aplastic anemia, in 6; acute myeloid leukemia, in 4; Fanconi's anemia, in 3; and acute lymphocytic leukemia, in 3. Two radiologists analyzed the HRCT scans and reached their final decisions by consensus. RESULTS: The most common HRCT findings were air-space consolidation (in 60%, small centrilobular nodules (in 50%, ground-glass opacities (in 40%, bronchial wall thickening (in 20%, large nodules (in 20%, pleural lesions (in 16.7% and tree-in-bud opacities (in 10%. The pulmonary lesions were distributed in the central and peripheral areas in 15 patients, whereas they were exclusively peripheral in 11. Lesions were located in the lower and middle lobes of the lung in 22 and 20 patients, respectively. CONCLUSIONS: The most common HRCT findings in our patient sample were air-space consolidation, small centrilobular nodules and ground-glass opacities, most often in the central and peripheral regions of the middle and lower lung zones.OBJETIVO: Descrever os achados de TCAR em pacientes com pneumonia bacteriana após transplante de medula óssea (TMO. MÉTODOS: Estudo retrospectivo com 30 pacientes diagnosticados com pneumonia bacteriana, documentada com TCAR do tórax realizada em até 24 h do início dos sintomas, e com diagnóstico comprovado com base em cultura positiva

  19. Screening the cytokines for diagnosis of tuberculous meningitis

    Institute of Scientific and Technical Information of China (English)

    王丽豪

    2014-01-01

    Objective To select cytokines for diagnosis of tuber-culous meningitis.Methods One hundred and twenty kinds of cytokines were detected with protein chips among two tuberculous meningitis cases,two viral meningitis cases and two noninfectious neurologic disease cases.The results were compared among different disease groups to select the differential cytokines,which were

  20. Bacterial translocation in an experimental intestinal obstruction model: C-reactive protein reliability? Translocação bacteriana no modelo experimental de obstrução intestinal: A proteína C-reativa é confiável?

    Directory of Open Access Journals (Sweden)

    Saleh Ibrahim El-Awady

    2009-04-01

    Full Text Available BACKGROUND: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction through unclear mechanism. The C-reactive protein is an acute phase reactant and a marker of ischemia. METHODS: 45 albino male rats were divided into 3 groups each 15 rats. GI control, GII simple intestinal-obstruction and GIII strangulated obstruction. Outcome measures were: (1 Bacteriologic count and typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac and portal (2 Histopathologic: mucosal injury score, inflammatory cell infiltrate in the wall, MLN, liver, (3 Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidase-malonyldialdhyde tissue levels. RESULTS: (1 Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence, (2 Bacterial translocation (frequency and density was found higher in strangulated I.O, that was mainly enteric (aerobic and anaerobic and mostly E.coli, (3 The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4 The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT -ve rats. CONCLUSION: Bacterial translocation occurs bi-directional (systemic-portal in intestinal obstruction and the resultant inflammatory response pathogenesis is mostly 3 hit model. The CRP is a non selective marker of suspected I.O cases. However, it is a reliable marker of BT, BT density and vascular compromise during I.O.OBJETIVO: Translocação bacteriana ocorre em condições pré-sépticas como na obstrução intestinal por mecanismo não esclarecido. A proteína C-reativa é um marcador de ischemia em fase aguda. A proposição é investigar os possíveis efeitos da obstrução intestinal no equilíbrio ecológico microbiano. MÉTODOS: 45 ratos machos albinos foram distribuídos em três grupos de 15 ratos. GI

  1. Use of radiologic modalities in coccidioidal meningitis

    International Nuclear Information System (INIS)

    Stadalnik, R.C.; Goldstein, E.; Hoeprich, P.D.; McGahan, J.P.

    1981-01-01

    The diagnostic utility of pentetate indium trisodium CSF studies, technetium Tc 99m brain scans, and computerized tomographic (CT) scans was evaluated in eight patients in whom coccidioidal meningitis developed following a dust storm in the Central Valley of California. The 111In flow studies and the CT scans demonstrated hydrocephalus in five patients with clinical findings suggesting this complication. Ventriculitis has not previously been diagnosed before death in patients with coccidioidal meningitis; however, it was demonstrated in two patients by the technetium Tc 99m brain scan. The finding that communicating hydrocephalus occurs early in meningitis and interferes with CSF flow into infected basilar regions has important therapeutic implications in that antifungal agents injected into the lumbar subarachnoid space may not reach these regions

  2. Meningitis after cochlear implantation in Mondini malformation.

    Science.gov (United States)

    Page, E L; Eby, T L

    1997-01-01

    Although the potential for CSF leakage and subsequent meningitis after cochlear implantation in the malformed cochlea has been recognized, this complication has not been previously reported. We report a case of CSF otorhinorrhea and meningitis after minor head trauma developing 2 years after cochlear implantation in a child with Mondini malformation. Leakage of CSF was identified from the cochleostomy around the electrode of the implant, and this leak was sealed with a temporalis fascia and muscle plug. Although this complication appears to be rare, care must be taken to seal the cochleostomy in children with inner ear malformations at the initial surgery, and any episode of meningitis after surgery must be thoroughly investigated to rule out CSF leakage from the labyrinth.

  3. Counterimmunoelectrophoresis in the diagnosis of bacterial meningitis

    DEFF Research Database (Denmark)

    Colding, H; Lind, I

    1977-01-01

    The aim of the present study was to investigate whether counterimmunoelectrophoresis (CIE) would facilitate the rapid, etiological diagnosis of bacterial meningitis when used in parallel with other routine methods in a medical bacteriological laboratory. Of 3,674 consecutive specimens of cerebros......The aim of the present study was to investigate whether counterimmunoelectrophoresis (CIE) would facilitate the rapid, etiological diagnosis of bacterial meningitis when used in parallel with other routine methods in a medical bacteriological laboratory. Of 3,674 consecutive specimens....../139) of the culture-negative specimens. CSF specimens from 21 patients with bacterial meningitis caused by other species were all negative in CIE, except four, three of which contained Escherichia coli antigen reacting with antiserum to N. meningitidis group B and one E. coli antigen reacting with antiserum to H...

  4. Placa bacteriana dentária em cães Dental bacterial plaque in dogs

    Directory of Open Access Journals (Sweden)

    Duvaldo Eurides

    1996-12-01

    Full Text Available Com objetivo de avaliar a incidência de placa bacteriana dentária, foram utilizados 30 cães, sem raça definida, distribuídos em três grupos iguais, de acordo com a faixa etária, sendo o grupo I de 0 a 2 anos, o grupo II de 3 a 5 anos e o grupo III acima de 6 anos. Os animais foram submetidos a anestesia geral e sobre os dentes foi aplicado cloreto de metilrosanilina, para evidenciar acúmulos bacterianos. As placas encontravam-se distribuídas em 80,99% no grupo I, 71,45% no grupo II e 83,96% no grupo III. Os grupos dentários foram considerados separadamente, apresentando índices de 64,84% nos dentes incisivos, 84,80% nos caninos, 87,23% nos pré-molares e 78,34% nos molares. Nos três grupos de cães observou-se índices semelhantes de placa bacteriana nos diferentes grupos dentários. Os animais do grupo II e o grupo de dentes incisivos apresentaram menores índices de placa bacteriana.To avaliate the incidence of bacterial plaque 30 mogreal dogs were utilizated, distributed among three equal groups. According to age, group I was composed of 0 to 2 years-old dogs, group II was 3 to 5 years-old, and group III over 6 years-old. The animals underwent a general anesthesia and metilrosanilin cloret was applied over the tooth, to evidence the bacterial mass. The plaques were distributed to 80.99% in group I, 71.42% in group II and 83.96% in group III. The dental groups were considerated apart, showing index of 64.84% on the incisar tooth, 84.80% on the canine tooth, 87.23% on the premolar tooth, and 78.34% on the molar tooth. At the dogs groups, similar Índex of bacterial plaque were observed on the diffèrent dental groups. The dogs from group II and the incisive tooth group showed minar bacterial plaque index.

  5. Nefrite Intersticial Aguda Após Exposição a Losartan

    Directory of Open Access Journals (Sweden)

    Letícia Schwerz Weinert

    2007-07-01

    Full Text Available Nefrite intersticial aguda é uma causa comum de perda aguda de função renal. Exposição a drogas é o fator desencadeante mais freqüentemente relatado, porém auto-imunidade e infecções também estão associadas. Os inibidores da enzima de conversão da angiotensina têm sido relatados como possíveis agentes, porém não há relato na literatura de nefrite intersticial com uso de losartan. Descrevemos então, o caso de perda aguda de função renal após exposição a losartan, em paciente com dano renal prévio por nefropatia diabética, cuja biópsia renal diagnosticou nefrite intersticial aguda.

  6. Calcio sérico total y calcio corregido como predictores de severidad en pancreatitis aguda

    Directory of Open Access Journals (Sweden)

    A.A. Gutiérrez-Jiménez

    2014-01-01

    Conclusiones: El CT y CCA tomados en las primeras 24 h son útiles como predictores de severidad en pancreatitis aguda, con valores de S y predictivos comparables o superiores a los de las escalas pronósticas tradicionales.

  7. Características clínicas da fase aguda da infecção experimental de felinos pelo vírus da imunodeficiência felina

    Directory of Open Access Journals (Sweden)

    M.S. Zanutto

    2011-03-01

    Full Text Available A infecção dos felinos pelo Vírus da Imunodeficiência Felina (FIV resulta no desenvolvimento da síndrome de imunodeficiência dos felinos. Gengivite, perda de peso, linfadenomegalia generalizada, anemia, insuficiência renal crônica, complicações neurológicas, diarréia crônica e infecções bacterianas são encontradas frequentemente. A fase aguda da infecção pode ser assintomática, retardando o estabelecimento do diagnóstico e a implantação de medidas profiláticas para restringir o contágio e a transmissão do agente aos felinos suscetíveis. Com a finalidade de estudar as características clínicas da fase aguda da infecção, dez felinos jovens, sem definição racial, com oito meses de idade foram inoculados por via endovenosa com 1mL de sangue venoso de um gato portador do FIV subtipo B. A confirmação da infecção foi obtida através de teste sorológico em quatro e oito semanas pós-inoculação (p.i. e por nested-PCR. Foram realizados hemogramas semanais, exame ultrassonográfico do abdômen quinzenais e exame oftalmológico mensal, durante doze semanas p.i. Discreta tendência a linfopenia na segunda semana p.i. e a neutropenia entre a quinta e sétima semana p.i., febre intermitente em alguns gatos, linfadenomegalia e hepato-esplenomegalia entre a quarta e a 12ª semana p.i. foram as alterações clínicas observadas. Apenas um gato apresentou uveíte unilateral direita. A fase aguda da infecção transcorreu com alterações clínicas inespecíficas. A linfadenomegalia e a hepato-esplenomegalia observadas no decorrer da infecção, refletindo hiperplasia linfóide, sugerem a necessidade de se realizar o teste sorológico para o FIV, em todos os gatos que se apresentarem com essas alterações, o que permitirá o diagnóstico precoce da infecção e a adoção de medidas profiláticas no sentido de minimizar a propagação da infecção.

  8. Embolectomía en una embolia pulmonar aguda masiva

    Directory of Open Access Journals (Sweden)

    Manuel Carnero Alcázar

    2007-07-01

    Full Text Available Presentamos el caso de un varón de 57 años que, en el seno de un meningioma microcítico, padece una tromboembolia pulmonar masiva aguda con inestabilidad hemodinámica. Dado el riesgo de hemorragia por el tumor craneal, se contraindica la terapia fibrinolítica y se procede a practicar embolectomía pulmonar. Ésta se realiza bajo anestesia general, con canulación convencional y bajo hipotermia moderada. Se extrae émbolo en el tronco de la arteria pulmonar y con catéter de Fogarty se extraen émbolos en ramas lobares y segmentarias. Discutimos la asociación de enfermedad tromboembólica con determinadas neoplasias y el tratamiento de la tromboembolia pulmonar

  9. Epidemia de infección respiratoria aguda observaciones hospitalarias

    OpenAIRE

    Chavarría Milanés, José Fernando; Mata, Leonardo; Mohs Villalta, Edgar; Ramírez, Giselle; Lizano, Lucía

    1985-01-01

    artículo -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1985 Se describe la clínica, tratamiento y complicaciones de 81 niños lactantes con infección respiratoria aguda. Los niños provenían del cantón central de San José y fueron admitidos en el Hospital Nacional de Niños del 10 de noviembre al 15 de diciembre de 1983. Se encontró un 57% de varones y un 43% de mujeres; los más afectados fueron los niños menores de 3 meses. Más de la mitad de los niños egresó con el di...

  10. Acidosis láctica severa y leucemia aguda

    Directory of Open Access Journals (Sweden)

    David Loja

    2004-03-01

    Full Text Available Reportamos el caso de una paciente de 27 años de edad con leucemia linfoblástica aguda, quien presentó acidosis láctica severa como complicación metabólica. Ella acudió con desnutrición severa, anemia marcada y síndrome consuntivo. No había compromiso del sistema reticuloendotelial y un mielograma inicial fue normal. Estos factores retardaron el diagnóstico y obligaron a ampliar el diagnóstico diferencial. La sospecha de neoplasia hematológica asociada a acidosis láctica sin causa aparente permitió reevaluar el caso con un nuevo mielograma y establecer el diagnóstico.

  11. Isquemia aguda de miembros inferiores secundaria a ergortismo

    Directory of Open Access Journals (Sweden)

    Franco J. Vallejo, MD

    2011-11-01

    Full Text Available Paciente de género femenino, de 21 años de edad, quien ingresó por dolor progresivo e intenso en miembros inferiores, y refirió antecedente reciente de ingestión de derivados del ergot. Al examen físico se observó ausencia de pulsos en ambos miembros inferiores. Por angiotomografia se documentó disminución severa, generalizada y bilateral, del calibre de los vasos arteriales de miembros inferiores. Se diagnosticó isquemia arterial aguda secundaria a ergotismo y se inició tratamiento con vasodilatadores y calcio-antagonistas, que resolvió los síntomas en su totalidad.

  12. Tuberculous and brucellosis meningitis differential diagnosis

    DEFF Research Database (Denmark)

    Erdem, Hakan; Senbayrak, Seniha; Gencer, Serap

    2015-01-01

    BACKGROUND: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the dif......BACKGROUND: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included...

  13. Innervation of the human middle meningeal artery

    DEFF Research Database (Denmark)

    Edvinsson, L; Gulbenkian, S; Barroso, C P

    1998-01-01

    The majority of nerve fibers in the middle meningeal artery and branching arterioles are sympathetic, storing norepinephrine and neuropeptide Y (NPY). A sparse supply of fibers contain acetylcholinesterase activity and immunoreactivity toward vasoactive intestinal peptide (VIP), peptidine histidine...... methionine (PHM), and calcitonin gene-related peptide (CGRP). Only few substance P and neuropeptide K immunoreactive fibers are noted. Electronmicroscopy shows axons and terminals at the adventitial medial border of the human middle meningeal artery, with a fairly large distance to the smooth muscle cells...

  14. Meningeal involvement in Behcet's disease: MRI

    International Nuclear Information System (INIS)

    Guma, A.; Aguilera, C.; Pons, L.; Acebes, J.; Arruga, J.

    1998-01-01

    Behcet's disease is a multisystem disease that involves the central nervous system up to half of cases. Presentation with neurologic symptoms occurs in 5 % of cases and cerebral venous thrombosis is one of its major manifestations. A feature not previously reported is progressive meningeal thickening with involvement of both optic nerves. We report a patient with cerebral venous thrombosis, meningeal thickening and contrast enhancement on MRI. This patient had two other unusual features: positive antineutrophil cytoplasmic antibodies and later development of central diabetes insipidus. (orig.)

  15. Anthrax Meningitis - Report Of An Autopsied Case

    Directory of Open Access Journals (Sweden)

    Mahadevan A

    1999-01-01

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

  16. The microbiological diagnosis of tuberculous meningitis

    DEFF Research Database (Denmark)

    Erdem, H; Ozturk-Engin, D; Elaldi, N

    2014-01-01

    We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia......, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release.......05). Combination of L-J and ACS was superior to using these tests alone (p

  17. Nasopharyngeal glial heterotopia with delayed postoperative meningitis.

    Science.gov (United States)

    Maeda, Kenichi; Furuno, Kenji; Chong, Pin Fee; Morioka, Takato

    2017-06-22

    A male infant, who underwent radical resection of a large glial heterotopia at the nasopharynx at 8 days, developed delayed postoperative bacterial meningitis at 9 months. Neuroradiological examination clearly demonstrated that meningitis had occurred because of the intracranial and extracranial connections, which were scarcely seen in the perioperative period. A transsphenoidal extension of hypothalamic hamartoma is possible because the connection started from the right optic nerve, running through the transsphenoidal canal in the sphenoid bone and terminating at the recurrent mass in the nasopharyngeal region. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Tuberculosis meningitis presenting as isolated interhemispheric exudates

    International Nuclear Information System (INIS)

    Bharath, R.D.; Vasudev, M.K.; Sinha, S.; Ravishankar, S.; Chandrashekar, N.

    2008-01-01

    Full text: The total number of tuberculosis cases in the world is increasing, and less common forms of tuberculous meningitis (TBM) with varying imaging manifestations are being encountered more often. We describe anterior interhemispheric variety of TBM, which has not been previously described to the best of our knowledge in the literature. Common imaging findings in these five patients include predominant involvement of the meninges in the anterior interhemispheric fissure with relatively little enhancement of the basal cisterns. Knowledge of uncommon radiological findings is vital in early diagnosis and treatment of this common disease.

  19. Mondini Dysplasia Presenting as Otorrhea without Meningitis

    Directory of Open Access Journals (Sweden)

    Chien-Yu Lin

    2012-12-01

    Full Text Available Mondini dysplasia is a rare inner ear malformation that is usually only diagnosed after recurrent meningitis. Surgical intervention is mandatory. This report highlights the case of a patient with Mondini dysplasia who presented with hearing impairment and otorrhea and was diagnosed and treated before the occurrence of meningitis, thus preventing morbidity and neurologic sequelae. Hearing impairment may be the only manifestation of Mondini dysplasia, and the benefit of hearing screening is emphasized. Temporal bone computed tomography should be considered in children with unilateral sensorineural or mixed-type hearing impairment.

  20. Mondini dysplasia presenting as otorrhea without meningitis.

    Science.gov (United States)

    Lin, Chien-Yu; Lin, Hung-Ching; Peng, Chun-Chih; Lee, Kuo-Sheng; Chiu, Nan-Chang

    2012-12-01

    Mondini dysplasia is a rare inner ear malformation that is usually only diagnosed after recurrent meningitis. Surgical intervention is mandatory. This report highlights the case of a patient with Mondini dysplasia who presented with hearing impairment and otorrhea and was diagnosed and treated before the occurrence of meningitis, thus preventing morbidity and neurologic sequelae. Hearing impairment may be the only manifestation of Mondini dysplasia, and the benefit of hearing screening is emphasized. Temporal bone computed tomography should be considered in children with unilateral sensorineural or mixed-type hearing impairment. Copyright © 2012. Published by Elsevier B.V.

  1. Anatomy and imaging of the normal meninges.

    Science.gov (United States)

    Patel, Neel; Kirmi, Olga

    2009-12-01

    The meninges are an important connective tissue envelope investing the brain. Their function is to provide a protective coating to the brain and also participate in the formation of blood-brain barrier. Understanding their anatomy is fundamental to understanding the location and spread of pathologies in relation to the layers. It also provides an insight into the characteristics of such pathologies when imaging them. This review aims to describe the anatomy of the meninges, and to demonstrate the imaging findings of specific features.

  2. MODERN CLINICAL AND LABORATORY FEATURES OF ENTEROVIRAL MENINGITIS

    Directory of Open Access Journals (Sweden)

    O. V. Usacheva

    2014-04-01

    Full Text Available Among numerous viral meningitises from 80% to 90% of cases are accounted for meningitis of enteroviral etiology according to the international data. Despite the favorable disease course, there are forms which are characterized by severe damage of CNS. In order to improve diagnostics of enteroviral meningitis in this article we have made a comparative analysis of clinical and laboratory parameters in 23 patients with enteroviral meningitis and 18 patients with serous meningitis of non-enteroviral etiology. Anamnesis data and the major clinical manifestations of the disease dynamics were analyzed. Particular attention is paid to the comparison of diagnoses, by which patients were sent to infectious hospital, the symptoms that occurred during patients’ admission into hospitals and their severity. The presence and severity of meningeal symptoms and the indices of cerebrospinal fluid in the patients of the comparison group were analyzed in detail. It is shown that enteroviruses are the important factor in the development of meningitis in the children of younger age. The clinical picture of enteroviral meningitis often develops gradually for 2-3 days and includes the typical syndromes: intoxication and meningeal ones. Every third patient with enterovirus infection has diarrhea and catarrhal symptoms, that’s why it is difficult to diagnose meningitis in its early stages, but it allows to assume enteroviral etiology of the disease. The meningitis of enteroviral etiology is characterized by multiple meningeal signs, while the non-enteroviral meningitis is characterized by dissociation with the prevalence of the of Kernig’s and Brudzinski’s symptoms. The analysis of the laboratory data showed that the enteroviral meningitis is characterized by low (over 50-100 cells "mixed" pleocytosis (the ratio of lymphocytes and neutrophils is about 1:1. These data can be used for differential diagnosis between enteroviral meningitis and serous meningitis of

  3. MR demonstration of the meninges: Normal and pathological findings

    International Nuclear Information System (INIS)

    Schoerner, W.; Henkes, H.; Sander, B.; Felix, R.

    1988-01-01

    The MR appearance of normal and pathological meninges was studied in 23 patients. Amongst twelve normals, T 1 -weighted images demonstrated the meninges as slightly hyperintense density structures (compared with CSF) which increased in signal intensity somewhat after the administration of gadolinium-DTPA. On T 2 -weighted images, the subarachnoid space and meninges were isointense. In eleven patients with inflammatory disease or tumourous infiltration of the meninges, abnormal findings were evident in the unenhanced images as well as after administration of gadolinium-DTPA. Compared with CT, MR proved greatly superior in the diagnosis of meningeal abnormalities. (orig.) [de

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

    Directory of Open Access Journals (Sweden)

    AR EMAMI NAEINI

    2001-03-01

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

  5. Endocarditis bacteriana por Kocuria kristinae en paciente inmunocompetente. Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Alirio R. Bastidas, MD

    2013-09-01

    Full Text Available Las infecciones por microorganismos del género Kocuria spp. han sido descritas con mayor frecuencia en pacientes con enfermedades crónicas y estados de inmunosupresión. Comúnmente, no se ha reportado su aislamiento como causa de endocarditis en pacientes jóvenes e inmunocompetentes. Se deben diferenciar de las infecciones producidas por Staphylococcus spp. ya que su evolución clínica puede ser similar y sólo el aislamiento y tipificación en cultivos permite hacer el diagnóstico etiológico definitivo y dirigir la terapia antibiótica adecuada. Se describe el caso de un paciente joven e inmunocompetente que cursó con endocarditis bacteriana, aislándose Kocuria kristinae en hemocultivos.

  6. Endocarditis bacteriana por Kocuria kristinae en paciente inmunocompetente: Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Alirio R Bastidas

    2013-09-01

    Full Text Available Las infecciones por microorganismos del género Kocuria spp. han sido descritas con mayor frecuencia en pacientes con enfermedades crónicas y estados de inmunosupresión. Comúnmente, no se ha reportado su aislamiento como causa de endocarditis en pacientes jóvenes e inmunocompetentes. Se deben diferenciar de las infecciones producidas por Staphylococcus spp. ya que su evolución clínica puede ser similar y sólo el aislamiento y tipifi cación en cultivos permite hacer el diagnóstico etiológico defi nitivo y dirigir la terapia antibiótica adecuada. Se describe el caso de un paciente joven e inmunocompetente que cursó con endocarditis bacteriana, aislándose Kocuria kristinae en hemocultivos.

  7. Placa bacteriana dentária em cães

    OpenAIRE

    Eurides,Duvaldo; Gonçalves,Gentil Ferreira; Mazzanti,Alexandre; Buso,Antônio Mário

    1996-01-01

    Com objetivo de avaliar a incidência de placa bacteriana dentária, foram utilizados 30 cães, sem raça definida, distribuídos em três grupos iguais, de acordo com a faixa etária, sendo o grupo I de 0 a 2 anos, o grupo II de 3 a 5 anos e o grupo III acima de 6 anos. Os animais foram submetidos a anestesia geral e sobre os dentes foi aplicado cloreto de metilrosanilina, para evidenciar acúmulos bacterianos. As placas encontravam-se distribuídas em 80,99% no grupo I, 71,45% no grupo II e 83,96% n...

  8. Nuevos métodos bacteriológicos para detectar y evitar la resistencia bacteriana

    Directory of Open Access Journals (Sweden)

    Margaret Ordoñez-Smith de Danies

    2003-09-01

    Full Text Available

    DEFINICIÓN DE LA RESISTENCIA

    De acuerdo al COC (Centro de Control de Enfermedades de Estados Unidos, la resistencia se da cuando un medicamento deja de inhibir el crecimiento o matar un microorganismo. 

    Hay dos tipos de resistencia la adquirida y la clínica. La adquirida se realiza en el laboratorio a través de las mutaciones o por transferencia de genes, sistemas de conjugación, transducción y transformación.

    La resistencia clínica es la observada en la práctica médica, donde no todos los organismos son igualmente sensibles o resistentes a cierto antibiótico y que requiere la ayuda de técnicas de laboratorio para medir cuantitativamente o cualitativamente dicho proceso.

    MECANISMOS DE LA RESISTENCIA BACTERIANA

    En la detección de la Resistencia Bacteriana se han identificado diferentes mecanismos utilizados por las bacterias: destrucción o inactivación enzimática, cambios en la permeabilidad de la membrana interna, alteraciones de los precursores de la pared celular, de la membrana y de los ribosomas.

    Para los años 90 se dispuso de una serie de antimicrobianos como betalactámicos, aminoglucósidos, macrólidos, sulfonamidas, trimetoprim, cloranfenicol, glicopéptidos, rifampicina, quinolonas, tetraciclinas....

     

  9. Microbiota bacteriana de ovos de jacaré-do-pantanal incubados naturalmente

    Directory of Open Access Journals (Sweden)

    R. Pulcherio

    Full Text Available RESUMO A cadeia produtiva do Caiman yacare tem-se destacado no Mato Grosso com a exportação de 143.386 peles em 2015, cujo sistema de manejo (ranching implica a incubação artificial dos ovos. Nesse processo, a contaminação bacteriana de ovos influencia a taxa de eclosão. O conhecimento da microbiota de ovos incubados naturalmente orienta o manejo sanitário adequado no incubatório. No presente estudo, são apresentadas informações sobre essa microbiota e sua correlação com a de outros crocodilianos, apontando-se as espécies com potencial patogênico. Amostras de 20 ninhos de C. yacare foram coletadas e semeadas em ágar sangue e ágar Mac Conckey. A colônia condizente com Salmonella sp. foi confirmada pela técnica de reação em cadeia de polimerase. Das 22 espécies bacterianas isoladas, 59% pertencem à família Enterobacteriaceae e 41% a outros táxons bacterianos. A semelhança dos achados com as bactérias isoladas na microbiota oral e/ou intestinal/cloacal de crocodilianos foi de 77,27%. As bactérias mais e menos frequentes foram, respectivamente, Bacillus cereus, Flavobacterium multivorum, Citrobacter freundii, Escherichia hermannii, Hafnia alvei, Morganella, morganni, Salmonella sp., Serratia marcescens e Shigella sonnei. Das bactérias isoladas, 86,36% têm potencial patogênico para crocodilianos. A origem materna e a ambiental da microbiota de ovos incubados naturalmente são, respectivamente, de 77,27% e 27,27%.

  10. Suero autólogo al 50 % en las queratitis bacterianas

    Directory of Open Access Journals (Sweden)

    Arelys Ariocha Cambas Andreu

    Full Text Available Objetivo: evaluar el comportamiento de las queratitis bacterianas con el tratamiento coadyuvante de suero autólogo tópico al 50 %. Métodos: estudio comparativo, longitudinal y prospectivo. La muestra estuvo constituida por 60 pacientes, divididos de forma aleatoria en dos grupos: A utilizó tratamiento antibiótico convencional y suero autólogo y B utilizó solo tratamiento antibiótico convencional (cefazolina y amikacina. Los datos almacenados se procesaron utilizando el paquete estadístico SPSS 15. Las variables se expresaron según sus respectivas medidas de resumen y para la comparación de las terapias se aplicaron pruebas de hipótesis, con un nivel de confianza del 95 % y de error inferior al 0,05 %. Resultados: predominaron en los aislamientos microbiológicos Staphylococcus y Pseudomonas; seguidas por los Streptococcus, gonococos y enterobacterias. En cuanto al tiempo de aparición de los signos que favorecen la cicatrización corneal y la respuesta terapéutica, encontramos que con la aplicación tópica del suero autólogo, en casi dos tercios de los pacientes, estos se manifestaron a partir de la segunda semana de tratamiento y se obtuvo una respuesta terapéutica favorable. Conclusiones: El suero autólogo al 50 % resulta ser un complemento terapéutico efectivo en el manejo de las queratitis infecciosas de etiología bacteriana.

  11. Bacteremia causes hippocampal apoptosis in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

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

    2010-01-01

    ABSTRACT: BACKGROUND: Bacteremia and systemic complications both play important roles in brain pathophysiological alterations and the outcome of pneumococcal meningitis. Their individual contributions to the development of brain damage, however, still remain to be defined. METHODS: Using an adult...... rat pneumococcal meningitis model, the impact of bacteremia accompanying meningitis on the development of hippocampal injury was studied. The study comprised of the three groups: I. Meningitis (n=11), II. meningitis with attenuated bacteremia resulting from iv injection of serotype......-specific pneumococcal antibodies (n=14), and III. uninfected controls (n=6). RESULTS: Pneumococcal meningitis resulted in a significantly higher apoptosis score 0.22 (0.18-0.35) compared to uninfected controls (0.02 (0.00-0.02), Mann Whitney test, P=0.0003). Also, meningitis with an attenuation of bacteremia...

  12. Tratamiento sin antibióticos en recién nacidos febriles con pleocitosis del líquido cefalorraquídeo y presunta meningitis viral Treatment without antibiotics in febrile infants presenting with cerebrospinal fluid pleocytosis and supposed viral meningitis

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    2011-03-01

    Full Text Available INTRODUCCIÓN. El objetivo de esta investigación fue presentar la experiencia en antibioticoterapia en recién nacidos (RN febriles con pleocitosis del líquido cefalorraquídeo (LCR y presunción médica de meningitis viral. MÉTODOS. Se realizó un estudio retrospectivo con 310 RN con diagnóstico de meningitis aséptica, ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario «Juan Manuel Márquez» entre 1992 y 2009. Se determinó, utilizando estadística descriptiva, la indicación o no de tratamiento antibiótico, momento y motivos de la indicación. RESULTADOS. Hubo 204 RN (65,8 % con meningitis aséptica que egresaron favorablemente sin haber recibido tratamiento antibiótico. En 106 RN (34,2 % se indicaron antibióticos (en 76 inmediatamente al diagnóstico de meningitis y en 30 casos, mediatamente por diversos motivos. Los motivos para tratamiento inmediato fueron principalmente los resultados del examen citoquímico del LCR muy semejantes a los de una meningitis de causa bacteriana y los antecedentes de fiebre elevada o persistente. En la indicación mediata el principal motivo fue la concurrencia de infección del tracto urinario. En los pacientes que nunca recibieron tratamiento antibiótico, la mediana de estadía hospitalaria fue de 4 días (intervalo intercuartil 3-5 días y para los que sí lo recibieron fue de 5 días (intervalo intercuartil 4-7 días (p INTRODUCTION. The aim of present research was to present the antibiotic-therapy experience in febrile newborn (NB presenting with cerebrospinal fluid pleocytosis (CSFP and supposed viral meningitis. METHODS. A retrospective study was conducted in 310 NB diagnosed with aseptic meningitis admitted in the Neonatology Service of the "Juan Manuel Márquez" Children University Hospital between 1992 and 2009. Using the descriptive statistic method the indication or not of antibiotic treatment, moment and indication reasons were determined. RESULTS. There

  13. Meningeal infiltration in recurrent nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Chong, V.F.H.; Fan, Y.-F.

    2000-01-01

    Permeative infiltration of the meninges appears to be a distinct form of recurrent nasopharyngeal carcinoma (NPC). The present report of eight patients with recurrent NPC illustrates meningeal infiltration following basal foramina extension. Seven of the eight patients (88%) showed jugular foramen involvement. Three patients had concomitant infiltration of the foramen magnum. There was one patient showing spread through the foramen lacerum. Only four (50%) of these patients had clinically detectable tumour in the nasopharynx, while the other half showed deep submucosal recurrence with endoscopically unremarkable findings. Permeative meningeal infiltration appears to be a distinct form of NPC recurrence. It is important to recognize this phenomenon so as to optimize the treatment options. The imaging studies were reviewed and the following features were recorded: local nasopharyngeal recurrence, the manner of intracranial spread and site of meningeal infiltration. Four patients had only MRI, two had only CT and two patients had both CT and MRI. The presence or absence of intracranial tumour before treatment was also recorded. Two observers reviewed the images and results were arrived at by consensus. Copyright (1999) Blackwell Science Pty Ltd

  14. The meningeal sign: a new appraisal

    International Nuclear Information System (INIS)

    Hutzelmann, A.; Palmie, S.; Zimmer, C.; Benz, T.; Leweke, F.; Freund, M.

    1996-01-01

    To evaluate the occurrence of the meningeal sign in meningiomas and metastases. We studied 20 patients with meningiomas and 17 patients with cerebral metastases adjacent to the dura. MRI studies (Siemens, Magnetom 1,5) included axial T 1 -weighted and T 2 -weighted unenhanced as well as gadolinium-DTPA enhanced T 1 -weighted (axial, coronal, sagittal) SE imaging. In all patients the tumours were resected with the attached dura mater. Histopathological examinations were done, which corresponded to the area of marked enhancement by gadolinium-DTPA. There was no correlation between the occurrence of the meningeal sign and the histopathological examinations. In 20 patients with meningiomas adjacent to the dura we found the meningeal sign in 11 cases. Histologically we observed an increase of collagen fibres and fibrocytes. In 5 to 17 cases with superficial cerebral as dura infiltrations and microbleedings. The meningeal sign is not specific for meningiomas and can be observed in a wide variety of pathological entities. (orig.) [de

  15. Communication between Paranasal Sinuses and Meninges after ...

    African Journals Online (AJOL)

    Two cases are presented, both demonstrating the value of the painstaking use of pleuridirectional spiral tomography to map out the exact situation and extent of defects where a communication exists between the paranasal sinuses and the meninges. S. Afr. Med. J., 48, 909 (1974) ...

  16. Prediction of unfavorable outcomes in cryptococcal meningitis

    DEFF Research Database (Denmark)

    Hakyemez, I N; Erdem, H; Beraud, G

    2018-01-01

    Cryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV...

  17. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  18. Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy.

    Science.gov (United States)

    Williamson, Peter R; Jarvis, Joseph N; Panackal, Anil A; Fisher, Matthew C; Molloy, Síle F; Loyse, Angela; Harrison, Thomas S

    2017-01-01

    HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent. Despite therapy, mortality rates in these groups are high. Over the past 5 years, advances have been made in rapid point-of-care diagnosis and early detection of cryptococcal antigen in the blood. These advances have enabled development of screening and pre-emptive treatment strategies aimed at preventing the development of clinical infection in patients with late-stage HIV infection. Progress in optimizing antifungal combinations has been aided by evaluation of the clearance rate of infection by using serial quantitative cultures of cerebrospinal fluid (CSF). Measurement and management of raised CSF pressure, a common complication, is a vital component of care. In addition, we now better understand protective immune responses in HIV-associated cases, immunogenetic predisposition to infection, and the role of immune-mediated pathology in patients with non-HIV associated infection and in the context of HIV-associated immune reconstitution reactions.

  19. Bilateral optic neuropathy in acute cryptococcal meningitis

    Institute of Scientific and Technical Information of China (English)

    Qi Zhe Ngoo; Li Min Evelyn Tai; Wan Hazabbah Wan Hitam; John Tharakan

    2016-01-01

    We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had som-nolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous flu-conazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

  20. a rare complication of tuberculous meningitis

    African Journals Online (AJOL)

    We report one such case of tuberculous meningitis where the patient developed cortical venous thrombosis after 5 days of illness. She was treated empirically, initially, till confirmation of the diagnosis and later was put on antitubercular drugs along with prednisolone therapy and anticoagulation, which led to complete ...

  1. Endophthalmitis in a Child with Meningococcal Meningitis

    African Journals Online (AJOL)

    most obvious abnormality was that the left eye, entirely normal six hours previously, was completely opaque and appeared to be filled with thick white material. A lumbar puncture was performed, yielding cloudy CSF and, based on the microscopy and Gram stain appearance, a diagno- sis of meningococcal meningitis was ...

  2. Childhood bacterial meningitis in Mbarara Hospital, Uganda ...

    African Journals Online (AJOL)

    Background : The recommended antibiotic treatment of bacterial meningitis has come under scrutiny following frequent reports of in-vitro resistance by the common causative organisms to penicillin and chloramphenicol. Objective : The study recorded the causative organisms, antibiotic sensitivity patterns and outcome of ...

  3. Pathogenesis and Pathophysiology of Pneumococcal Meningitis

    Science.gov (United States)

    Mook-Kanamori, Barry B.; Geldhoff, Madelijn; van der Poll, Tom; van de Beek, Diederik

    2011-01-01

    Summary: Pneumococcal meningitis continues to be associated with high rates of mortality and long-term neurological sequelae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae, which must avoid mucosal entrapment and evade the host immune system after local activation. During invasive disease, pneumococcal epithelial adhesion is followed by bloodstream invasion and activation of the complement and coagulation systems. The release of inflammatory mediators facilitates pneumococcal crossing of the blood-brain barrier into the brain, where the bacteria multiply freely and trigger activation of circulating antigen-presenting cells and resident microglial cells. The resulting massive inflammation leads to further neutrophil recruitment and inflammation, resulting in the well-known features of bacterial meningitis, including cerebrospinal fluid pleocytosis, cochlear damage, cerebral edema, hydrocephalus, and cerebrovascular complications. Experimental animal models continue to further our understanding of the pathophysiology of pneumococcal meningitis and provide the platform for the development of new adjuvant treatments and antimicrobial therapy. This review discusses the most recent views on the pathophysiology of pneumococcal meningitis, as well as potential targets for (adjunctive) therapy. PMID:21734248

  4. October 2012 Multistate Fungal Meningitis Outbreak

    Centers for Disease Control (CDC) Podcasts

    2012-10-17

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

  5. Angiostrongylus cantonensis Meningitis and Myelitis, Texas, USA.

    Science.gov (United States)

    Al Hammoud, Roukaya; Nayes, Stacy L; Murphy, James R; Heresi, Gloria P; Butler, Ian J; Pérez, Norma

    2017-06-01

    Infection with Angiostrongylus cantonensis roundworms is endemic in Southeast Asia and the Pacific Basin. A. cantonensis meningitis and myelitis occurred in summer 2013 in a child with no history of travel outside of Texas, USA. Angiostrongyliasis is an emerging neurotropic helminthic disease in Texas and warrants increased awareness among healthcare providers.

  6. Computed Tomography Study Of Complicated Bacterial Meningitis ...

    African Journals Online (AJOL)

    To monitor the structural intracranial complications of bacterial meningitis using computed tomography (CT) scan. Retrospective study of medical and radiological records of patients who underwent CT scan over a 4 year period. AUniversityTeachingHospital in a developing country. Thirty three patients with clinically and ...

  7. Advances in treatment of bacterial meningitis

    NARCIS (Netherlands)

    van de Beek, Diederik; Brouwer, Matthijs C.; Thwaites, Guy E.; Tunkel, Allan R.

    2012-01-01

    Bacterial meningitis kills or maims about a fifth of people with the disease. Early antibiotic treatment improves outcomes, but the effectiveness of widely available antibiotics is threatened by global emergence of multidrug-resistant bacteria. New antibiotics, such as fluoroquinolones, could have a

  8. Clinical and MRI evaluation of tuberculous meningitis

    International Nuclear Information System (INIS)

    Jiang Chunjing; Shu Jiner; Chen Jian; Sheng Sanlan; Lu Jinhua; Cai Xiaoxiao; Li Huimin

    2010-01-01

    Objective: To evaluate the relationship of clinical and magnetic resonance imaging (MRI) findings in patients with tuberculous meningitis (TBM), and to improve the understanding of TBM. Methods: The clinical and MRI findings in 42 patients with confirmed TBM were analyzed retrospectively. MRI examination was performed using a 1 Tesla system, including SE T 1 WI and T 2 WI. Intravenous contrast was injected in 29 patients, and follow-up scans were performed on 17 patients. Results: Of 24 patients with early TBM, MRI was abnormal in 5(21%) with slight Tl-hypointense meningeal (4) or ependymal thickening (1). MRI on 33/35 (94%) patients with late stage TBM was abnormal with T 1 hypointensity and T 2 hyperintensity including meningeal thickening (19), mild surrounding brain edema (10), nodules (11), tuberculoma (5) and abscess (2). There was significant plaque-like, nodular or rim enhancement with surrounding brain edema. Conclusion: Tuberculous meningitis has minimal clinical and MRI findings in the early phase and significant clinical and MRI findings in the late phase. The enhanced scan may help to detect the abnormality. (authors)

  9. Emergency diagnosis and treatment of adult meningitis

    NARCIS (Netherlands)

    Fitch, Michael T.; van de Beek, Diederik

    2007-01-01

    Despite the existence of antibiotic therapies against acute bacterial meningitis, patients with the disease continue to suffer significant morbidity and mortality in both high and low-income countries. Dilemmas exist for emergency medicine and primary-care providers who need to accurately diagnose

  10. Streptococcus suis meningitis, a poacher's risk

    NARCIS (Netherlands)

    Halaby, T.; Hoitsma, E.; Hupperts, R.; Spanjaard, L.; Luirink, M.; Jacobs, J.

    2000-01-01

    Streptococcus suis infection is a zoonosis that has been mainly reported in pig-rearing and pork-consuming countries. The most common disease manifestation is meningitis, often associated with cochleovestibular signs. The causative agent is Streptococcus suis serotype 2, found as a commensal in the

  11. Meninges: from protective membrane to stem cell niche.

    Science.gov (United States)

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

    2012-01-01

    Meninges are a three tissue membrane primarily known as coverings of the brain. More in depth studies on meningeal function and ultrastructure have recently changed the view of meninges as a merely protective membrane. Accurate evaluation of the anatomical distribution in the CNS reveals that meninges largely penetrate inside the neural tissue. Meninges enter the CNS by projecting between structures, in the stroma of choroid plexus and form the perivascular space (Virchow-Robin) of every parenchymal vessel. Thus, meninges may modulate most of the physiological and pathological events of the CNS throughout the life. Meninges are present since the very early embryonic stages of cortical development and appear to be necessary for normal corticogenesis and brain structures formation. In adulthood meninges contribute to neural tissue homeostasis by secreting several trophic factors including FGF2 and SDF-1. Recently, for the first time, we have identified the presence of a stem cell population with neural differentiation potential in meninges. In addition, we and other groups have further described the presence in meninges of injury responsive neural precursors. In this review we will give a comprehensive view of meninges and their multiple roles in the context of a functional network with the neural tissue. We will highlight the current literature on the developmental feature of meninges and their role in cortical development. Moreover, we will elucidate the anatomical distribution of the meninges and their trophic properties in adult CNS. Finally, we will emphasize recent evidences suggesting the potential role of meninges as stem cell niche harbouring endogenous precursors that can be activated by injury and are able to contribute to CNS parenchymal reaction.

  12. 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.

  13. Optimitzación de la biosíntesis de nanocelulosa bacteriana por fermentación

    OpenAIRE

    García González, Alberto

    2017-01-01

    La cel·lulosa bacteriana és un biopolímer obtingut per fermentació amb diversos microorganismes, dels quals l’espècie més eficient en la producció és la Gluconacetobacter xylinus sucrofermentans. La principal diferencia entre la cel·lulosa bacteriana y la resta de cel·luloses que existeixen és la seva puresa, per això, és un del biopolímer més atractius per les seves possibles aplicacions en diverses àrees com són l’alimentació, la farmàcia i la medicina. A més de la seva puresa, les seves...

  14. Insuficiencia renal aguda obstructiva: Estudio de 42 pacientes

    Directory of Open Access Journals (Sweden)

    Isabel Caravia Pubillones

    1997-04-01

    Full Text Available Se revisaron las historias clínicas de 42 pacientes ingresados en el Servicio de Cuidados Intensivos del Instituto de Nefrología con el diagnóstico de insuficiencia renal aguda obstructiva (IRAO, con 1 ó 2 riñones funcionantes. Los pacientes estudiados estaban entre la 5ta y la 7ma década de la vida, con una mayor incidencia en el sexo masculino. La causa más frecuente de IRAO fue la litiasis renal (47,62 %, seguida por las enfermedades tumorales que infiltraban los uréteres (28,57 %. Se empleó tratamiento médico en 9 pacientes y el resto (33 fueron sometidos a tratamiento quirúrgico. Las principales complicaciones fueron sépticas con un franco predominio de las infecciones del tractus urinario (38,5 %. Hubo 3 fallecidos, 2 de ellos por complicaciones cardiovasculares. Del total de insuficiencias renales agudas que se atendieron en nuestro Centro, el 10,6 % correspondió a IRAO. La efectividad del tratamiento quirúrgico empleado fue del 94,4 % de curación en los pacientes atendidosMedical records of 42 patients admitted to the Intensive Care Unit of the Institute of Nephrology diagnosed as having acute obstructive renal failure with 1 or 2 kidneys functioning, were revised. Patients studied ware at the 5th and 7th decade of life with a greater incidence in males. The most frequent cause of acute obstructive renal failure was renal lithiasis (47.62 %, followed by tumor diseases which were infiltrating the ureters (28.57 %. Medical treatment was employed in 9 patients and the remaining (33 were submitted to surgical treatment. The main complications were septic with predominance of urinary tract infections (38.5 %. Three patients died, 2 of them as a result of cardiovascular complications. Of the total number of cases presenting with acute renal failure and treated in our center, 10.6 % had an acute obstructive renal failure. The effectiveness of the surgical treatment performed was 94.4 % of healing in patients treated for this

  15. Administração endovenosa de antibióticos e resistência bacteriana: responsabilidade da enfermagem

    Directory of Open Access Journals (Sweden)

    Heloisa Helena Karnas Hoefel

    2006-12-01

    Full Text Available O sucesso da terapêutica com antibióticos e o desenvolvimento da resistência bacteriana dependem de diversos fatores, sendo que os relacionados ao cuidado de enfermagem são o seu preparo e a sua administração. Objetivo: realizar uma revisão da literatura sobre falhas na administração de antibióticos analisando sua possível influência na resistência bacteriana. Delineamento: realizada uma pesquisa bibliográfica das fontes do LILACS e Medline. Métodos: realizada revisão bibliográfica sistematizada com pesquisa de artigos de 1994 a 2005 na Internet usando-se os seguintes descritores juntamente com enfermagem: resistência bacteriana, controle de antibióticos, infecções hospitalares, administração de medicamentos, erros de medicações e eventos adversos. Foram selecionados 58 artigos que apresentaram correlação com a enfermagem e/ou eram básicos na fundamentação brasileira ou internacional. Resultados: Foram descritos aspectos gerais sobre a resistência bacteriana, antibióticos e custos incluindo estratégias para prevenção da resistência e classificações de erros utilizadas internacionalmente. Conclusões: Baseado nesse conhecimento são recomendadas intervenções para implementação do cuidado de enfermagem prático e seguro.

  16. Linfonodo pulmonar na paracoccidioidomicose aguda infantil (relato de um caso

    Directory of Open Access Journals (Sweden)

    Evanil Pires de Campos

    1992-09-01

    Full Text Available Observou-se a evolução de um linfonodo pulmonar na paracoccidioidomicose (PCM aguda infantil. Doente, masculino, 6 anos, branco, natural de Curitiba (PR, procedente de Guaratinguetá (SP, que há 3 meses desenvolveu quadro gripal, febre diária, bimodal, prolongada, precedida de calafrio, acompanhada de sudorese inodora, cefaléia frontal e anorexia. Diagnosticado e tratado como pneumonia por cinco dias, sem melhora do quadro. Há 2 meses, apresentou dor óssea nos braços e articulações do pé, com edema inflamatório e emagrecimento de 6 kg em 3 meses. Exame físico revelou: peso 20 kg; estatura 120 cm; P. A. 90/60 mmHg; facies atípica, hipoativo, palidez cutâneo-mucosa (+ +, hipotrofia muscular, adenopatiageneralizada, sopro sistólico suave em foco aórtico acessório e hepatesplenomegalia. Imunodifusão com exoantígeno glicoprotéico 43 kdpositiva (1/32. A biópsia de gânglio revelou Paracoccidioides brasiliensis. A radiologia demonstrou na primeira consulta, discreto infiltrado intersticial bilateral com linfoadenomegaliapara-hilar que desaparecu em 30 dias. Observou- se, ainda, massa tumoral mediastínica superior, hiperplasia do sistema fagocítico mononuclear e lesões osteolíticas nos 60 dias iniciais da evolução.

  17. Efeito da hipertermia na pancreatite aguda grave experimental

    Directory of Open Access Journals (Sweden)

    Maurício Gustavo Ieri Yamanari

    Full Text Available OBJETIVO: O objetivo deste estudo é avaliar os efeitos da hipertermia na pancreatite aguda (PA grave experimental induzida por ácido taurocólico. MÉTODO: A PA grave foi induzida pela injeção retrógrada de ácido taurocólico a 2,5% ou 5% no ducto pancreático principal. Após a indução, os animais foram colocados numa gaiola contendo duas lâmpadas de 100 W. A temperatura corporal foi aumentada para 39,5ºC e mantida neste nível por 45 minutos. Foram estudados taxa de mortalidade em 72 horas, permeabilidade vascular no pâncreas, porcentagem de água no tecido pancreático, amilase sérica, histologia (edema, necrose acinar e infiltrado inflamatório e níveis séricos de IL-6 e IL-10. RESULTADOS: Não houve alteração em nenhum dos parâmetros avaliados. CONCLUSÃO: Não há benefício da hipertermia na PA grave experimental induzida por ácido taurocólico.

  18. Meningoencefalite na fase aguda do sarampo : relato de seis casos

    Directory of Open Access Journals (Sweden)

    EL-FAR FABIANE

    2000-01-01

    Full Text Available Apresentamos 6 casos de meningoencefalite aguda por sarampo, diagnosticados durante epidemia na cidade de São Paulo, em 1997. Os prontuários dos 6 pacientes foram analisados retrospectivamente. O diagnóstico de meningoencefalite baseou-se nas alterações clínicas e liquóricas, e foi confirmado por sorologia específica. Dos 467 pacientes com sarampo atendidos no Instituto de Infectologia Emílio Ribas nesse período, estes 6 evoluíram com alterações neurológicas e liquóricas durante a fase exantemática, sendo a sonolência e rigidez de nuca os achados mais frequentes. Os pacientes tinham entre 2 meses e 28 anos de idade. O exame do líquor mostrou pleocitose em todos. Não houve correlação entre a severidade do quadro clínico e liquórico com a evolução. Em 4 casos foi necessária internação na unidade de terapia intensiva; destes, 2 foram intubados. Apenas 2 pacientes apresentaram alterações na tomografia computadorizada de crânio. Todos tiveram boa evolução, sem sequelas.

  19. Extramedullary spinal teratoma presenting with recurrent aseptic meningitis.

    Science.gov (United States)

    Mpayo, Lucy L; Liu, Xiao-Hong; Xu, Man; Wang, Kai; Wang, Jiao; Yang, Li

    2014-06-01

    Spinal teratomas are extremely rare; they constitute meningitis. A 7-year-old boy presented with paroxysmal abdominal pain and a history of recurrent aseptic meningitis. Kernig and Brudzinski signs were present. Lumber puncture revealed pleocytosis with no evidence of bacteria growth. Imaging of the spine revealed a cystic lesion in spinal cord at thoracic level 9-11. Endoscopic excision of the cyst was successfully performed. Surgical and histopathological findings confirmed extramedullary matured teratoma. As the symptomatic attacks of spontaneous rupture of spinal teratoma resemble presentations of Mollaret meningitis, spinal teratoma should be considered in the differential diagnosis of Mollaret meningitis. We describe a rare example of spinal teratoma causing recurrent meningitis. Spine imaging should be considered in individuals with recurrent aseptic meningitis as this promotes earlier diagnosis, more appropriate treatment, and improved neurological outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Epidemiologic and microbiologic characteristics of recurrent bacterial and fungal meningitis in the Netherlands, 1988-2005

    NARCIS (Netherlands)

    van Driel, Joris J.; Bekker, Vincent; Spanjaard, Lodewijk; van der Ende, Arie; Kuijpers, Taco W.

    2008-01-01

    Background. Patients may experience multiple episodes of bacterial meningitis. Information from large studies of recurrent meningitis is limited. We evaluated the incidence of recurrent bacterial meningitis and the distribution of causative organisms in The Netherlands. Methods. Data for patients

  1. Eficacia de cinco desinfectantes para la reducción bacteriana doméstica

    Directory of Open Access Journals (Sweden)

    Julián Stambullian

    2011-06-01

    Full Text Available El uso adecuado de hipoclorito de sodio, sales de amonio cuaternario y triclosán ha demostrado ser eficaz para eliminar gérmenes dentro del hogar. Nuestro objetivo fue evaluar la eficacia inmediata, a la semana y al mes del uso controlado de cinco productos con estos componentes, comparados con otros productos de uso habitual. Se incluyeron 32 hogares de clase media de la Ciudad de Buenos Aires y la periferia en un estudio con intervención, abierto, aleatorizado, y de grupos paralelos, durante 6 meses. La mitad de los hogares fue seleccionada para usar hipoclorito de sodio, sales de amonio cuaternario y triclosán en la cocina y el baño durante un mes. El grupo control mantuvo prácticas habituales de limpieza doméstica. Se tomaron muestras para recuento y tipificación bacteriana de los sitios estudiados: muestras basales (sin discriminación de grupo en cocina, que presentaron recuento bacteriano promedio de 66.0 UFC/cm²; baño: 40.1 UFC/cm². Las muestras inmediatas a la limpieza (sin discriminación de grupo: en cocina: 0.8 UFC/cm²; baño: <1 UFC/cm². A la semana (grupo intervenido vs. grupo control: cocina 18.0 vs. 32.5 UFC/cm²; baño 12.7 vs. 7.7 UFC/cm². Al mes (intervenido vs. control: cocina: 60.1 vs. 62.1 UFC/cm²; baño: 37.0 vs. 42.0 UFC/cm². Se observó una notable disminución de la carga bacteriana en ambos grupos, lo que sugiere que no sólo la calidad de los productos sino también la educación en el uso desempeñan un papel clave en la desinfección del hogar. Este enfoque podría ser una herramienta importante para prevenir infecciones transmitidas por alimentos, dado que los coliformes fecales predominaron ampliamente en todas las muestras tipificadas.

  2. La persistencia bacteriana: una problemática ignorada por una ciencia sin respuestas

    Directory of Open Access Journals (Sweden)

    FORMENTINI E

    2017-09-01

    Full Text Available ARTÍCULO DE OPINIÓN. En nuestra cultura occidental tenemos un concepto triunfalista y mesiánico de la ciencia, ya que se confía que tarde o temprano la misma hallará respuestas y soluciones a los problemas del hombre. Sin embargo, la ciencia tiende a negar sistemáti-camente todo aquello para lo cual no tiene explicación y condena al olvido a todo conocimiento para lo cual no tiene aplicación actual. Las bacterias persistentes son uno de esos problemas olvidados, que recientemente ha despertado interés en la comunidad científica, al tener que enfrentarse a la problemática creciente de la resistencia bacteriana. Este artículo trata dos temas disímiles pero que están estrechamente relacionados. El primero, consiste en explicar el ignorado y olvidado fenómeno de la persistencia bacteriana y su impli-cancia en la progresiva disminución de la vida útil de los antibióticos. El segundo, es un análisis epistémico-ético con el objetivo de dilucidar la responsabilidad de la ciencia respecto de la ignorancia y el olvido de esta problemática. Finalmente se propone una pos-tura epistemológica para la revalorización constante de los conocimientos olvidados. SUMMARY. Bacterial persistence: an ignored problem by a science without answers. In our western culture, we have a triumphalist and messianic conception of science, since it is confided that sooner or later it will find the answers and the solutions to the problems of humanity. However, science tends to systematically ignore everything for which it has no explanation, and condemns to oblivion all knowledge that has not practical application. Persister cells are one of those forgotten problems, although it has recently attracted the attention of the scientific community, as it is associated with the growing problem of bacterial resistance. This article addresses two dissimilar but closely related topics. The first is to explain the forgotten and ignored phenomenon of persister cells

  3. MRI of primary meningeal tumours in children

    International Nuclear Information System (INIS)

    Yoon, H.K.; Na, D.G.; Byun, H.S.; Han, B.K.; Kim, S.S.; Kim, I.O.; Shin, H.J.

    1999-01-01

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

  4. Mumps vaccine virus strains and aseptic meningitis.

    Science.gov (United States)

    Bonnet, Marie-Claude; Dutta, Anil; Weinberger, Clement; Plotkin, Stanley A

    2006-11-30

    Mumps immunization can easily be included in national schedules, particularly if combined with measles or measles and rubella vaccines, but debate continues concerning the relative safety of various licensed mumps vaccine strains. The opportunities for control of mumps are also being affected by differences in the cost of the vaccines prepared with different strains of mumps virus. The present report evaluates available data on the association of the Urabe and other strains of mumps vaccine with the occurrence of aseptic meningitis. We also review the comparative immunogenicity and efficacies of the most widely used mumps vaccines in controlled clinical trials and field evaluations, and briefly examine relative cost as it relates to the implementation of national immunization programs. We conclude that extensive experience with the most widely used mumps vaccine strains in many countries has shown that the risk-benefit ratio of live mumps vaccines is highly favourable for vaccination, despite the occasional occurence of aseptic meningitis.

  5. Transethmoidal intranasal meningoencephalocele in an adult with recurrent meningitis.

    Science.gov (United States)

    Hasegawa, Takafumi; Sugeno, Naoto; Shiga, Yusei; Takeda, Atsushi; Karibe, Hiroshi; Tominaga, Teiji; Itoyama, Yasuto

    2005-08-01

    Intranasal meningoencephalocele is a rarely encountered congenital malformation. We report a case of transethmoidal intranasal meningoencephalocele in a 52-year old man with recurrent purulent meningitis. After treatment of the acute meningitis, frontal craniotomy followed by the removal of the stalk of the meningoencephalocele and repair of the bony defect was successfully performed. He has had no further meningitis or CSF rhinorrhea post-operatively. Detailed neuroradiological examination and appropriate surgical treatment are important to prevent fatal neurological complications of intranasal meningoencephalocele.

  6. Isolated Meningeal Recurrence of Transitional Cell Carcinoma of the Bladder

    Directory of Open Access Journals (Sweden)

    Catherine Butchart

    2010-06-01

    Full Text Available Meningeal carcinomatosis occurs in 1–18% of patients with solid tumours, most commonly carcinomas of the breast and lung or melanomas. There are relatively few reports of meningeal carcinomatosis in transitional cell carcinoma of the bladder. Isolated meningeal recurrence is particularly uncommon, and we present an unusual case of this in a 58-year-old man. The case was further complicated by the somewhat atypical presentation with a confirmed ischaemic stroke. The patient died one month after presentation.

  7. CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII POSTOPERATIVE MENINGITIS

    OpenAIRE

    Laura Ghibu; Egidia Miftode; Olivia Dorneanu; Carmen Dorobat

    2011-01-01

    Acinetobacter baumannii is an opportunistic pathogen of increasing relevance in hospital infections during the last 15 years.This organism causes a wide range of infection .Extensive use of antibiotics within hospitals has contribute to the emergence of multidrug-resistent A.baumannii strains that exhibit resistance to a wide range of antibiotics ,including carbapenems.We report the case of an 37 years old man diagnosed with Acinetobacter multidrug-resistant post-neurosurgical meningitis with...

  8. Congenital malformations of the skull and meninges.

    Science.gov (United States)

    Kanev, Paul M

    2007-02-01

    The surgery and management of children who have congenital malformations of the skull and meninges require multidisciplinary care and long-term follow-up by multiple specialists in birth defects. The high definition of three-dimensional CT and MRI allows precise surgery planning of reconstruction and management of associated malformations. The reconstruction of meningoencephaloceles and craniosynostosis are challenging procedures that transform the child's appearance. The embryology, clinical presentation, and surgical management of these malformations are reviewed.

  9. 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

  10. Viral Oncolytic Therapeutics for Neoplastic Meningitis

    Science.gov (United States)

    2014-09-01

    ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Massachusetts General Hospital RICHARD BRINGHURST, M.D. 55 FRUIT ST BOSTON...Martuza. The cell lines were tested for mycoplasma, Hoechst DNA staining, PCR, and culture testing for contaminant bacteria, yeast, and fungi ...complication of breast cancer affects 5-8% of patients when circulating cancer cells seed in the meninges. Their subsequent growth causes severe

  11. Atrofia mucosa/translocação bacteriana na sepse experimental em ratos Wistar Mucosal atrophy/bacterial translocation in experimental sepsis in Wistar rats

    Directory of Open Access Journals (Sweden)

    Armando José d'Acampora

    2004-10-01

    Full Text Available OBJETIVO: Avalizar a relação entre lesão mucosa e translocação bacteriana. MÉTODO: Utilizou-se 50 ratos distribuídos em 5 grupos: 1.Controle: injeção de inóculo padrão de Pseudomonas aeruginosa, 2.Dreno: injeção do inóculo padrão e drenagem da cavidade abdominal, após 6 horas, 3.Lavado: injeção do inóculo padrão e lavagem da cavidade abdominal, após 6 horas, 4.Lavado + dreno: injeção do inóculo padrão e após 6 horas, drenagem e lavagem da cavidade, 5.Normal: avaliação histológica da parede intestinal normal. Após o óbito, realizou-se hemocultura e cultura peritoneal. Realizou-se medida da espessura total da parede do jejuno e da camada mucosa em vilosidades seccionadas de forma longitudinal. RESULTADOS: Na hemocultura, houve crescimento de Pseudomonas aeruginosa e Escherichia coli em 90% e 52,5% dos animais. Na cultura peritoneal, houve crescimento de P. aeruginosa, E. coli e Klebsiella sp em 87,5%, 85% e 5% dos animais. Quanto a altura da camada mucosa e da parede intestinal, não houve alteração estatisticamente significativa entre os 5 grupos. CONCLUSÃO: A sepse aguda não causou alteração na camada mucosa do intestino delgado e a translocação ocorrida não pode ser considerada como decorrente de uma lesão da mucosa intestinal.PURPOSE: Observe the relation between small intestine's mucosal injury and bacterial translocation. METHODS: 50 adult female rats were distributed in 5 groups: 1. Control: intraperitoneal injection of Pseudomonas aeruginosa, 2. Drainage: intraperitoneal injection of P. aeruginosa and drainage of the abdominal cavity, after 6 hours, 3. Washed: intraperitoneal injection of P. aeruginosa and washing of the abdominal cavity, after 6 hours, 4. Washed + drainage: intraperitoneal injection of P. aeruginosa plus drainage and washing of the cavity, after 6 hours, 5. Normal: evaluation of the normal intestinal wall. After death, blood and peritoneal cultures were performed. Fragments of

  12. Gd-DTPA-enhanced MR imaging in meningitis

    International Nuclear Information System (INIS)

    Han, M.H.; Chang, K.H.; Roh, J.K.; Kim, I.O.; Han, M.C.; Kim, C.W.

    1988-01-01

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

  13. Postoperative meningeal enhancement on MRI in children with brain neoplasms

    International Nuclear Information System (INIS)

    Lee, Min Hee; Han, Bokyung Kim; Yoon, Hye Kyung; Shin, Hyung Jin

    2000-01-01

    The meninges composed of the dura, the arachnoid and the pia are significant sites of blood-brain barrier. Physical disruption of the integrity of the meninges from a variety of causes including surgery results in various patterns of meningeal enhancement on contrast enhanced MR images. It is important to distinguish normal reactive or benign postoperative enhancement from more serious leptomeningeal metastasis or infection, particularly in children with intracranial neoplasms. We present various patterns of meningeal enhancement on MRI in children following surgery for brain neoplasms. (author)

  14. Recurrent meningitis--a review of current literature.

    Science.gov (United States)

    Janocha-Litwin, Justyna; Simon, Krzysztof

    2013-01-01

    The paper discusses epidemiology, aetiology and the most important predisposing factors associated with recurrent meningitis, as well as the possibilities to prevent this particularly challenging clinical problem. The frequency of recurrent meningitis is estimated to be 2-9%. However, the case fatality is lower compared to a single episode of meningitis. The main causes of recurrent meningitis are considered to be: head injury, congenital or acquired (post-traumatic or post-surgical) cranial or spinal defects, chronic intracranial inflammation, complement system dysfunction, as well as congenital and acquired humoral or cellular immunodeficiency.

  15. Pneumococcal meningitis post-cochlear implantation: preventative measures.

    Science.gov (United States)

    Wei, Benjamin P C; Shepherd, Robert K; Robins-Browne, Roy M; Clark, Graeme M; O'Leary, Stephen J

    2010-11-01

    Both clinical data and laboratory studies demonstrated the risk of pneumococcal meningitis post-cochlear implantation. This review examines strategies to prevent post-implant meningitis. Medline/PubMed database; English articles after 1980. Search terms: cochlear implants, pneumococcus meningitis, streptococcus pneumonia, immunization, prevention. Narrative review. All articles relating to post-implant meningitis without any restriction in study designs were assessed and information extracted. The presence of inner ear trauma as a result of surgical technique or cochlear implant electrode array design was associated with a higher risk of post-implant meningitis. Laboratory data demonstrated the effectiveness of pneumococcal vaccination in preventing meningitis induced via the hematogenous route of infection. Fibrous sealing around the electrode array at the cochleostomy site, and the use of antibiotic-coated electrode array reduced the risk of meningitis induced via an otogenic route. The recent scientific data support the U.S. Food and Drug Administration recommendation of pneumococcal vaccination for the prevention of meningitis in implant recipients. Nontraumatic cochlear implant design, surgical technique, and an adequate fibrous seal around the cochleostomy site further reduce the risk of meningitis. Copyright © 2010 American Academy of Otolaryngology–Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  16. Concurrent tubercular and staphylococcus meningitis in a child

    Institute of Scientific and Technical Information of China (English)

    Amit Agrawal

    2009-01-01

    Spontaneous,non-surgical haematogenous Staphylococcus aureus meningitis is rare and associated with high mortality.Mixed infection causing meningitis (pyogenic and tubercular)is further rarer,poses a difficult diag-nostic and management challenge,which warrants early diagnosis and aggressive therapy.We present a case of concurrent pyogenic and tubercular meningitis in a child managed successfully.It seems that in present case initial pyogenic infection resulted in the immunocompromised state for the child that would had lead to the acti-vation of tubercular foci resulting in tubercular meningitis.

  17. Incidental finding of cutaneous meningeal heterotopia in aplasia cutis congenita.

    Science.gov (United States)

    Kenyon, Katharine; Zedek, Daniel; Sayed, Christopher

    2016-07-01

    Aplasia cutis congenita and cutaneous meningeal heterotopia are both rare congenital conditions that most commonly occur on the scalp and may appear clinically and histologically similar. A subtype of aplasia cutis congenita, membranous aplasia cutis congenita, and cutaneous meningeal heterotopia are both proposed to result from neural tube closure errors. However, neither non-membranous nor membranous aplasia cutis congenita are known to occur together with cutaneous meningeal heterotopia in the same lesion. We report the incidental finding of cutaneous meningeal heterotopia within a lesion of aplasia cutis congenita. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Sub-meninges implantation reduces immune response to neural implants.

    Science.gov (United States)

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

    2013-04-15

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

  19. Spinal meningeal uptake of technetium-99m methylene diphosphonate in meningeal seeding by malignant lymphoma

    International Nuclear Information System (INIS)

    Siegal, T.; Or, R.; Matzner, Y.; Samuels, L.D.

    1980-01-01

    Definite diagnosis of meningeal seeding by systemic cancer relies on the presence of malignant cells in the cerebrospinal fluid (CSF). In the absence of such cells in the CSF, only two other tests strongly suggest the diagnosis - a CT scan and a myelogram. This paper reports a case in which the diagnosis was strongly suggested by an unusual uptake of Tc-99m methylene diphosphonate by the leptomeninges during a skeletal scan and later established by the presence of malignant cells in the CSF. The radionuclide scan may be an additional diagnostic test in some cases with meningeal seeding by systemic cancer

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

    Science.gov (United States)

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

    2015-11-15

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

  1. 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.

  2. Lúpus eritematoso sistêmico e pancreatite aguda: relato de dois casos

    OpenAIRE

    Azevedo, Ana Beatriz Cordeiro de; Brito, Fabiano Almeida; Santos, Flávia Patrícia Sena Teixeira; Ferreira, Gilda Aparecida; Carvalho, Marco Antônio Parreiras de

    2003-01-01

    A pancreatite aguda é uma manifestação incomum do lúpus eritematoso sistêmico (LES) e a freqüência desta associação não é conhecida. Contudo, a pancreatite aguda é um diagnóstico diferencial importante na avaliação da dor abdominal em pacientes com LES. Os pacientes, normalmente, apresentam dor de intensidade variável, algumas vezes simulando abdome agudo. Vários fatores têm sido implicados na patogênese desta condição, tais como fenômenos autoimunes, vasculite, anticorpos antifosfolípides e ...

  3. Abdomen agudo ocasionado por apendicitis aguda de probable origen tuberculoso. Informe de un caso

    OpenAIRE

    Montiel-Jarquín, Álvaro José; Alvarado-Ortega, Iván; Romero-Figueroa, María del Socorro; Rodríguez-Pérez, Fabiola; Rodríguez-Lima, Felipe; Loria-Castellanos, Jorge

    2017-01-01

    RESUMEN Antecedentes: la apendicitis aguda tuberculosa es una enfermedad rara, constituye de 0,001 % a 0,01 % de las formas clínicas de tuberculosis. Se presenta un caso de apendicitis aguda probablemente tuberculosa como causa de abdomen agudo quirúrgico. Caso clínico: hombre de 29 años con cuadro de dolor abdominal leve a moderado que se intensificó y localizó en el hemiabdomen derecho, claudicación, febrícula, vómito, mal estado general, leucocitosis de 11 300/µL y neutrofilia de 91 %....

  4. Injúria renal aguda: um alerta global

    Directory of Open Access Journals (Sweden)

    Philip Kam Tao Li

    2013-03-01

    Full Text Available A Injúria Renal Aguda (IRA é cada vez mais prevalente nos países desenvolvidos e nos em desenvolvimento, e está associada com morbidade e mortalidade severas. A maioria das causas da IRA pode ser evitada por meio de intervenções em nível individual, comunitário, regional e intra-hospitalar. Medidas efetivas devem incluir, em toda a comunidade, os esforços para aumentar a consciência dos efeitos devastadores do IRA e fornecer orientações sobre as estratégias de prevenção, bem como o reconhecimento e tratamento precoces. Os esforços devem ser focados em minimizar as causas de IRA, aumentando a consciência da importância de medidas seriadas de creatinina sérica em pacientes de alto risco para IRA, e documentar o volume de urina em pessoas gravemente doentes para obtenção de diagnóstico precoce; até o momento, não há ainda um papel definitivo para outros biomarcadores. Há a necessidade de protocolos para sistematizar a conduta em condições de IRA pré-renal e em infecções específicas. Dados mais precisos sobre a verdadeira incidência e o impacto clínico da IRA ajudarão a melhor conhecer a importância desta doença, a aumentar o conhecimento de IRA por parte dos governantes, dos médicos em geral e de outros profissionais de saúde para ajudar na prevenção da doença. A prevenção é a chave para evitar a pesado ônus de mortalidade e morbidade associada com IRA.

  5. Intoxicación aguda por hidrato de hidracina

    Directory of Open Access Journals (Sweden)

    Santiago Nogué Xarau

    2008-06-01

    Full Text Available Se aporta un caso de exposición aguda, debido a un vertido accidental de unos 25 litros de hidrato de hidracina, que el trabajador estuvo recogiendo sin ningún tipo de equipo de protección individual. El trabajador presentó alteraciones bucales, cutáneas y dolores abdominales difusos. De las pruebas complementarias únicamente se detectó un aumento de la bilirrubina total con predominio de la indirecta. Se le separó de la exposición, se le administró un tratamiento sintomático y en un periodo de un mes se recuperó íntegramente. Se comenta los principales casos de intoxicación por hidracina descritos en la literatura médica y se enfatiza en las medidas preventivas que se deben tomar para evitar casos como éste.We report a case of poisoning by acute exposure to hydrazine hydrate in a worker clearing up an accidental spillage of about 25 litres of the product who had no type of individual protective equipment. The patient presented buccal and cutaneous involvement and diffuse abdominal pain. Complementary tests were unremarkable except for an increase in total bilirubin with a predominance of indirect bilirubin. The patient was removed from the occupational exposure, symptomatic treatment was administered and the patient recovered completely after one month. We review the main reported cases of hydrazine poisoning and emphasize the preventive measures that should be taken to avoid this type of poisoning.

  6. Dacriocistitis aguda neonatal (1996-2005 Acute neonatal dacryocystitis

    Directory of Open Access Journals (Sweden)

    Zoila del S López Díaz

    2006-12-01

    Full Text Available Se realizó un estudio longitudinal y retrospectivo en diez años (1996-2005, de todos los neonatos cuyo motivo de ingreso en nuestra Unidad de Cuidados Intensivos Neonatales fue ser portadores de dacriocistitis aguda. Se obtuvo los siguientes resultados: incidencia 0,04 c/ 100 ingresos. Predominio: edades entre 7-27días (sepsis tardía, sexo femenino 66,6 %, nacidos de embarazos a término y con buen peso al nacer 100 %. Etiología no precisada 83,3 %. Tratamiento utilizado: antibioticoterapia (penicilina + gentacina, 4 pacientes, 66,6 %, (unasyn, 1 paciente, 16,6 %, (amoxicilina + unasyn + gentamicina, 1 paciente, 16,6 %; uso de inmunoglobulina humana en 2 pacientes. Complicaciones: celulitis facial y periorbitaria 66,6 %; absceso periorbitario 33,3 %; fiebre (33,3 % y obstrucción nasal 16,6 %. Evolución satisfactoria con seguimiento por Oftalmología después del egreso hospitalario, en 100 % de los casosA retrospective longitudinal study of all neonates admitted to our Intensive Care Unit because they suffered from acute dacryocystitis was performed for 10 years (1996-2005. The results were as follows: incidence rate of 0,04 per 100 admissions; prevalence: 7-27d age groups (late sepsis, females with 66,6%; neonates born to term pregnancies and with good birthweight in 100%. Inaccurate etiology in 83,3 %. Treatment: antibiotic therapy (penicilline + gentamycin in 4 paients, 66,6%, (unasyn, one patient, 16,6 %, (amoxycillin + unasyn +gentamycin, 1 patient, 16.6 %. Use of human immunoglobulin in 2 patients. Complications: facial and periorbital cellulitis, 66,6%; periorbital abscess 33,3 %; fever (33,3 % and nasal obstruction (16,6 %. Satisfactory recovery with ophtalmological follow-up after discharge from hospital in 100 % of cases

  7. Intoxicação aguda por cobre em ovinos

    Directory of Open Access Journals (Sweden)

    Marcele Bettim Bandinelli

    2013-10-01

    Full Text Available Descrevem-se casos de intoxicação aguda por cobre em ovinos da raça Santa Inês, numa propriedade rural, no Rio Grande do Sul. Três ovelhas recém-paridas, que consumiam ração formulada para bovinos, ingeriram, avidamente, sal mineral comercial para bovinos e apresentaram doença clínica e morte, uma semana após a introdução do sal. Os animais desenvolveram anorexia, permaneceram em decúbito lateral, o qual evoluiu para esternal e apresentaram fasciculação e rigidez muscular generalizada, antes de morrerem. À necropsia de um desses animais, as principais alterações foram hepatomegalia moderada e acentuação do padrão lobular hepático, além de erosões e ulcerações multifocais aleatórias na mucosa abomasal. Na avaliação histológica do fígado, havia necrose hepatocelular centrolobular acentuada e difusa, tumefação de hepatócitos, predominantemente, na região periportal, além de pequena quantidade de células de Kupffer com pigmento granular citoplasmático. O diagnóstico baseou-se na história clínica, nos achados de necropsia e histopatológicos e confirmou-se pelas altas concentrações de cobre detectadas no tecido hepático e nas amostras de ração e sal mineral.

  8. Problemas identificados en el manejo de la enfermedad diarreica aguda

    Directory of Open Access Journals (Sweden)

    Carlos Coronel Carbajal

    2000-08-01

    Full Text Available Se realizó un estudio retrospectivo de corte transversal en el Hospital "Armando E. Cardoso", en el período de 1 año (Mayo 98-Febrero 99. Este estudio consistió en encuestar a 256 madres de niños con diarreas agudas con el objetivo de identificar las costumbres inapropiadas que aún persisten en el manejo ambulatorio de las enfermedades diarreicas. Al concluir el estudio se pudo apreciar cómo en el 56,3 % de los pacientes hubo mal manejo alimentario, además solo el 12,1 % de las madres buscaron orientación médica en las primeras 24 horas. En este estudio se pudo conocer que el 100 % de las madres saben que las soluciones de rehidratación oral (SRO forman parte del tratamiento de la EDA, pero solo el 42 % conoce que previenen la deshidratación, además solo un 25 % conoce de otros líquidos que reemplazan el uso de las soluciones de rehidratación oralA cross-sectional study was conducted at the "Armando E. Cardoso" Hospital from May, 1998, to February,1999. 256 mothers of children with acute diarrhea were surveyed in order to identify the inappropiate costums that still exist in the ambulatory management of diarrheal diseases. A poor food management was observed in 56.3% of the patients and only 12.1% of the mothers looked for medical advice during the first 24 hours. It was possible to know through this study that 100% of the mothers know that oral rehydration solutions (ORS are part of the treatment of ADD, but only 42% know that the drug also prevents dehydration. Just 25% know about other fluids that replace the use of oral rehydration solutions

  9. Diagnosis and antimicrobial therapy of Mycoplasma hominis meningitis in adults

    NARCIS (Netherlands)

    Lee, Elisabeth H. L.; Winter, Heinrich L. J.; van Dijl, Jan Maarten; Metzemaekers, Joannes D. M.; Arends, Jan P.

    2012-01-01

    Meningitis in adults due to infection with Mycoplasma hominis is rarely reported. Here, we document the third case of M. hominis meningitis in an adult individual, developed upon neurosurgery following a subarachnoid haemorrhage. Our findings are noteworthy, because the presence of M. hominis in

  10. Spontaneous methicillin-resistant Staphylococcus aureus (MRSA) meningitis.

    Science.gov (United States)

    Longhurst, William D; Sheele, Johnathan M

    2018-05-01

    Spontaneous methicillin-resistant Staphylococcus aureus (MRSA) meningitis is extremely rare and has a high mortality rate. We report a case of MRSA meningitis in an otherwise healthy young adult female with no recent trauma or neurosurgical interventions. Despite antibiotics she suffered a vasculitis-induced cerebral vascular ischemic event. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Spinal meningeal cyst: analysis with low-field MRI

    International Nuclear Information System (INIS)

    Wu Hongzhou; Chen Yejia; Chen Ronghua; Chen Yanping

    2010-01-01

    Objective: To analyze the characteristics of spinal meningeal cyst in low-field MRI and to discuss its classification, subtype, clinical presentation, and differential diagnosis. Methods: Forty-two patients (20 male, 22 female) were examined with sagittal T 1 -and T 2 -, axial T 2 -weighted MR imaging. Twelve patients were also examined with contrast-enhanced MRI. Results: The cysts were classified using Nakors' classification as type Ia extradural meningeal cysts (4 patients), type Ib sacral meningeal cysts (32), type II extradural meningeal cysts with spinal nerve root fibers (4), and type III spinal intradural meningeal cysts (2). All 42 spinal meningeal cysts had well-defined boundaries with low T 1 and high T 2 signal intensities similar to cerebral spinal fluid. In type Ia, the lesions were often on the dorsum of mid-lower thoracic spinal cord compressing the spinal cord and displacing the extradural fat. In type Ib, the lesions were in the sacral canal with fat plane between the cyst and dural sac. In type II, the lesions contained nerve roots and were lateral to the dural sac. In type III, the lesions were often on the dorsum of spinal cord compressing and displacing the spinal cord anteriorly. Conclusion: Low-field MRI can clearly display the spinal meningeal cyst. Types Ia and Ib spinal meningeal cysts had typical features and can be easily diagnosed. Types II and III should be differentiated from cystic schwannomas and enterogenous cysts, respectively. (authors)

  12. Experimental pneumococcal meningitis in mice: a model of intranasal infection

    NARCIS (Netherlands)

    Zwijnenburg, P. J.; van der Poll, T.; Florquin, S.; van Deventer, S. J.; Roord, J. J.; van Furth, A. M.

    2001-01-01

    Effective laboratory animal models of bacterial meningitis are needed to unravel the pathophysiology of this disease. Previous models have failed to simulate human meningitis by using a directly intracerebral route of infection. Hyaluronidase is a virulence factor of Streptococcus pneumoniae. In

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

    International Nuclear Information System (INIS)

    Abiko, Takashi; Higuchi, Hiroshi; Imada, Ryuichi; Nagai, Kenichi

    1983-01-01

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

  14. Diagnosis and treatment of bacterial meningitis in the newborn

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-05-29

    May 29, 2012 ... Wales has not changed remarkably from the known 0.2. – 0.4 cases/1000 live ... ing world, mortality associated with neonatal meningitis also varies between ... tively, the classic signs of meningeal irritation in the older children ...

  15. 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...

  16. Infectious meningitis and encephalitis in adults in Denmark

    DEFF Research Database (Denmark)

    Bodilsen, Jacob; Storgaard, Merete; Larsen, Lykke

    2018-01-01

    -haemolytic streptococci (n=14). Meningococcal meningitis was rare (n=11). In encephalitis, Herpes simplex virus-1 was most common (n=37) followed by Varicella zoster virus (n=20), while Varicella zoster virus (n=61) was most common in viral meningitis followed by enterovirus (n=50) and Herpes simplex virus-2 (n=46). Case...

  17. An unusual case of neonatal meningococcal meningitis complicated ...

    African Journals Online (AJOL)

    Neisseria meningitidis is a leading cause of pyogenic meningitis worldwide, as well as causing large epidemics in parts of Africa. With the dramatic decline in cases of Haemophilus inuenzae B, N. meningitidis has emerged as one of the most common causes of acute bacterial meningitis in children and adults in South ...

  18. Symptomatic relapse of HIV-associated cryptococcal meningitis in ...

    African Journals Online (AJOL)

    Objectives. Cryptococcal meningitis is the most common cause of adult meningitis in southern Africa. Much of this disease burden is thought to be due to symptomatic relapse of previously treated infection. We studied the contribution of inadequate secondary fluconazole prophylaxis to symptomatic relapses of cryptococcal ...

  19. Empiric Treatment of Acute Meningitis Syndrome in a Resource ...

    African Journals Online (AJOL)

    2017-11-01

    Nov 1, 2017 ... ABSTRACT. BACKGROUND: Bacterial meningitis is a significant cause of morbidity and mortality in the developing world. However, limited research has focused on the diagnosis and management of meningitis in resource-limited settings. METHODS: We designed a prospective case series of children.

  20. Meningitis in a College Student in Connecticut, 2007

    Science.gov (United States)

    Sosa, Lynn E.; Gupta, Shaili; Juthani-Mehta, Manisha; Hadler, James L.

    2009-01-01

    The authors describe a case of aseptic meningitis in a college student that was ultimately attributed to infection with lymphocytic choriomeningitis virus (LCMV). The authors also provide a review of LCMV infection, epidemiology, and public health implications. Providers should be aware of LCMV as a cause of meningitis in college students,…

  1. Unusual Presentation of Meningitis following Stab Neck | Motsitsi ...

    African Journals Online (AJOL)

    Background: A case report of stab neck presenting at Kalafong Hospital, Pretoria, South Africa with atypical meningitis. The objective was to illustrate the challenge of diagnosing this unusual and late presentation of meningitis. Case Report: A 48 year-old male patient presented to us two days after a stab neck. He was ...

  2. Is it possible to differentiate tuberculous and cryptococcal meningitis ...

    African Journals Online (AJOL)

    Background. Tuberculous and cryptococcal meningitis (TBM and CM) are the most common causes of opportunistic meningitis in HIVinfected patients from resource-limited settings, and the differential diagnosis is challenging. Objective. To compare clinical and basic cerebrospinal fluid (CSF) characteristics between TBM ...

  3. outbreak of cerebrospinal meningitis in kebbi state, nigeria

    African Journals Online (AJOL)

    INTRODUCTION. Cerebrospinal meningitis, also called epidemic meningococcal meningitis, is a major public health problem still affecting tropical countries, particularly in sub-Saharan Africa. It is highly contagious and mortality from the disease remains high, despite major achievements in the treatment modalities.

  4. Medical audit of the management of cryptococcal meningitis in HIV ...

    African Journals Online (AJOL)

    Background: Cryptococcal meningitis (CM) has become the most common type of community-acquired meningitis. CM has a poor outcome if the initial in-hospital treatment does not adhere to standard guidelines. The aim of this audit was to improve the quality of the care of human immunodeficiency virus (HIV) positive ...

  5. Diagnosis and treatment of bacterial meningitis in the newborn ...

    African Journals Online (AJOL)

    Background: Bacterial meningitis in the newborn is globally renowned for high mortality. The associated morbidities also include audiologic, motor, visual and mental deficits. Objective: To highlight the peculiarities in the current diagnostic and management strategies in newborn meningitis. Methods: Relevant literature on ...

  6. Dynamics of germs responsible for acute bacterial meningitis in ...

    African Journals Online (AJOL)

    The aim of this study was to analyze ten (10) years of epidemiological surveillance data of meningitis in Burkina Faso for high risk germs patterns identification in order to contribute to the strengthening of prevention strategies. A retrospective study of the past decade (2005- 2014) of cases of acute bacterial meningitis ...

  7. Meningococcal meningitis C in Tamil Nadu, public health perspectives.

    Science.gov (United States)

    David, Kirubah Vasandhi; Pricilla, Ruby Angeline; Thomas, Beeson

    2014-01-01

    Meningococcal meningitis has rarely been reported in Tamil Nadu. We report here two children diagnosed with meningococcal meningitis in Vellore, Tamil Nadu, on May 2014. The causative strain was Neisseria meningitidis serotype C. The role of the primary care physician in early diagnosis, appropriate referral, and preventive measures of this disease to the immediate family and community is stressed.

  8. Bacterial meningitis in adults at the University of Calabar Teaching ...

    African Journals Online (AJOL)

    The common complications associated with adult bacterial meningitis were septicemia, aspiration pneumonia and cranial nerve palsies. Bacterial meningitis still remains an important cause of morbidity and mortality in this environment. Adequate therapeutic coverage, health education, and immunization where available, ...

  9. Streptococcus suis meningitis can require a prolonged treatment course

    Directory of Open Access Journals (Sweden)

    Jean Dejace

    2017-12-01

    Full Text Available We report a case of recrudescent Streptococcus suis meningitis requiring a prolonged treatment course. A few similar cases can be found in the burgeoning literature on what remains a relatively uncommon disease in humans, and these patients should be monitored carefully upon completion of therapy. Keywords: Meningitis, Relapse, Duration, Streptococcus suis

  10. Haemophilus influenzae Type a Meningitis in Immunocompetent Child, Oman, 2015.

    Science.gov (United States)

    Sawardekar, Kiran P

    2017-07-01

    Meningitis caused by Haemophilus influenzae type b (Hib) was eliminated in Oman after the introduction of Hib vaccine in 2001. However, a case of H. influenzae type a meningitis was diagnosed in a child from Oman in 2015, which highlights the need to monitor the incidence of invasive non-Hib H. influenzae disease.

  11. Outcomes of tuberculous meningitis in children: a case review study

    Directory of Open Access Journals (Sweden)

    Yazid Dimyati

    2011-10-01

    Conclusions Tuberculous meningitis starts with nonspecific symptoms and is often only diagnosed when brain damage has already occurred. Outcome is directly associated with age and the stage of tuberculous meningitis. Earlier diagnosis may significantly improve outcomes. [Paediatr Indones. 2011;51:288-93].

  12. Purulent meningitis with unusual diffusion-weighted MRI findings

    International Nuclear Information System (INIS)

    Abe, M.; Takayama, Y.; Yamashita, H.; Noguchi, M.; Sagoh, T.

    2002-01-01

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

  13. Crystals in brain and meninges in primary hyperoxaluria and oxalosis.

    Science.gov (United States)

    Haqqani, M T

    1977-01-01

    A case of primary hyperoxaluria and oxalosis with chronic renal failure, crystalline myocarditis, and disseminated calcium oxalate crystal deposition in various tissues including the brain and meninges is described. Deposition of crystals in brain and meninges is exceptionally rare in primary oxalosis. Images PMID:838867

  14. [Alarm symptoms of meningitis in children with fever].

    NARCIS (Netherlands)

    D.H.F. Geurts (Dorien); H.A. Moll (Henriëtte)

    2011-01-01

    textabstractA 15-year-old girl presented with fever and pain in her legs. A viral infection was suspected, but within 24 hours she became confused and developed meningeal signs, based on which she was diagnosed as having meningitis. Within a few hours a 6-month-old boy developed fever, a grey

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

    NARCIS (Netherlands)

    Engelen-Lee, J.Y.; Brouwer, M.C.; Aronica, E.; van de Beek, D.

    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

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

    NARCIS (Netherlands)

    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

  17. Meningitis following spinal anaesthesia in an obstetric patient.

    Science.gov (United States)

    Celik, Mine; Kizilkaya, Mehmet; Dostbil, Aysenur; Dogan, Nazim; Parlak, Mehmet; Can, Fatma Kesmez; Bayar, Meral

    2014-07-01

    Meningitis following lumbar puncture and spinal anaesthesia is a rare but serious complication. A 19-year-old woman was administered spinal anaesthesia at another centre prior to a Caesarean section. The following day she experienced headaches. On the fourth day, she started vomiting and having convulsions, and became agitated. Meningitis was diagnosed based on a clinical examination and analysis of a lumbar puncture sample. After 21 days of treatment, she was discharged. Meningitis should be considered in the differential diagnosis of a patient presenting with headaches following spinal anaesthesia. The causes of meningitis following spinal anaesthesia are debated, and it is difficult to distinguish between aseptic and bacterial meningitis. It should be compulsory to wear a face mask while performing a dural puncture. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

    International Nuclear Information System (INIS)

    Schuknecht, B.; Nadjmi, M.; Mueller, J.

    1990-01-01

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

  19. Retinoic acid from the meninges regulates cortical neuron generation.

    Science.gov (United States)

    Siegenthaler, Julie A; Ashique, Amir M; Zarbalis, Konstantinos; Patterson, Katelin P; Hecht, Jonathan H; Kane, Maureen A; Folias, Alexandra E; Choe, Youngshik; May, Scott R; Kume, Tsutomu; Napoli, Joseph L; Peterson, Andrew S; Pleasure, Samuel J

    2009-10-30

    Extrinsic signals controlling generation of neocortical neurons during embryonic life have been difficult to identify. In this study we demonstrate that the dorsal forebrain meninges communicate with the adjacent radial glial endfeet and influence cortical development. We took advantage of Foxc1 mutant mice with defects in forebrain meningeal formation. Foxc1 dosage and loss of meninges correlated with a dramatic reduction in both neuron and intermediate progenitor production and elongation of the neuroepithelium. Several types of experiments demonstrate that retinoic acid (RA) is the key component of this secreted activity. In addition, Rdh10- and Raldh2-expressing cells in the dorsal meninges were either reduced or absent in the Foxc1 mutants, and Rdh10 mutants had a cortical phenotype similar to the Foxc1 null mutants. Lastly, in utero RA treatment rescued the cortical phenotype in Foxc1 mutants. These results establish RA as a potent, meningeal-derived cue required for successful corticogenesis.

  20. Intraventricular antibiotics for bacterial meningitis in neonates.

    Science.gov (United States)

    Shah, Sachin S; Ohlsson, Arne; Shah, Vibhuti S

    2012-07-11

    Neonatal meningitis may be caused by bacteria, especially gram-negative bacteria, which are difficult to eradicate from the cerebrospinal fluid (CSF) using safe doses of antibiotics. In theory, intraventricular administration of antibiotics would produce higher antibiotic concentrations in the CSF than intravenous administration alone, and eliminate the bacteria more quickly. However, ventricular taps may cause harm. To assess the effectiveness and safety of intraventricular antibiotics (with or without intravenous antibiotics) in neonates with meningitis (with or without ventriculitis) as compared to treatment with intravenous antibiotics alone. The Cochrane Library, Issue 2, 2007; MEDLINE; EMBASE; CINAHL and Science Citation Index were searched in June 2007. The Oxford Database of Perinatal Trials was searched in June 2004. Pediatric Research (abstracts of proceedings) were searched (1990 to April 2007) as were reference lists of identified trials and personal files. No language restrictions were applied.This search was updated in May 2011. Selection criteria for study inclusion were: randomised or quasi-randomised controlled trials in which intraventricular antibiotics with or without intravenous antibiotics were compared with intravenous antibiotics alone in neonates (antibiotics compared to the group receiving intravenous antibiotics alone (RR 3.43; 95% CI 1.09 to 10.74; RD 0.30; 95% CI 0.08 to 0.53); NNTH 3; 95% CI 2 to 13). Duration of CSF culture positivity did not differ significantly (MD -1.20 days; 95% CI -2.67 to 0.27). In one trial that enrolled infants with gram-negative meningitis and ventriculitis, the use of intraventricular antibiotics in addition to intravenous antibiotics resulted in a three-fold increased RR for mortality compared to standard treatment with intravenous antibiotics alone. Based on this result, intraventricular antibiotics as tested in this trial should be avoided. Further trials comparing these interventions are not justified in

  1. Pneumonia eosinofílica aguda com evolução para síndroma de dificuldade respiratória aguda: caso clínico

    OpenAIRE

    J.P.F. Baptista; P.C. Casanova; J.P.A. Sousa; P.J. Martins; A. Simões; V. Fernandes; J. Souto; J.J. Costa; A. Rebelo; L. Carvalho; J. Pimentel

    2004-01-01

    RESUMO: Os autores apresentam um caso de pneumonia eosinofílica aguda (PEA) associada a síndroma de dificuldade respiratória aguda grave num adolescente previamente saudável, medicado com nitrofurantoína. A PEA deve ser incluída no diagnóstico diferencial da pneumonia adquirida na comunidade, bem como na lista das patologias causadoras de síndroma de dificuldade respiratória aguda, e o seu diagnóstico deve ser sugerido pela presença de alveolite eosinofílica no líquido de lavagem broncoalveol...

  2. CHEMICAL VERSUS SERUM TREATMENT OF EPIDEMIC MENINGITIS.

    Science.gov (United States)

    Flexner, S; Amoss, H L

    1916-05-01

    Claims of efficiency have been made at two widely separated periods for the chemical treatment of epidemic meningitis, in the first instance for lysol and in the second for protargol. The use of lysol was long since abandoned; the recommendation for protargol is based on a single series of cases, small in number. Because of the variable severity of epidemics of meningitis, small reliance can be placed on results of treatment limited in extent to small numbers of cases and to one locality. A more uniform and accurate measure of the value of a method of treatment is provided by animals infected experimentally with pathogenic cultures of meningococci. Young guinea pigs respond in a definite manner to intraperitoneal inoculation of virulent meningococci. Neither protargol nor lysol proved to have any curative action on the experimental infection thus produced in these animals. Monkeys respond in a characteristic manner to the inoculation of virulent cultures into the subarachnoid space. Protargol displayed no curative action on the experimental infection thus produced in these animals. On the contrary, both lysol and protargol exert antileukotactic and antiphagocytic effects, and are also potent protoplasmic poisons, and the leukocytes with which they come in contact are injured and made to degenerate. According to the extent to which these harmful properties are exerted, the chemicals promote the advance rather than restrain the progress of meningococcic infection. Recovery from meningococcic infection in man and animals is accomplished chiefly through the process of phagocytosis. The specific antiserum acts curatively by increasing the emigration of leukocytes, by promoting phagocytosis directly, and by agglutinating the meningococci, and also by neutralizing endotoxin. Any means which interfere with and reduce these essential processes retard or prevent recovery. Both lysol and protargol interfere with and diminish the emigration of leukocytes and the phagocytosis

  3. Hearing Loss in Cryptococcal Meningitis Survivors

    OpenAIRE

    Lofgren, Sarah; Montgomery, Martha; Yueh, Nathan; Namudde, Alice; Rhein, Joshua; Abassi, Mahsa; Musubire, Abdu; Meya, David; Boulware, David

    2017-01-01

    Abstract Background Hearing loss is a known complication cryptococcal meningitis (CM); however, there is a paucity of data. We aimed to describe hearing loss in CM survivors. Methods We assessed hearing via audiometry 8 and 18 weeks after diagnosis of CM in Kampala, Uganda from 2015-2016. We measured at 0.5, 1, 2, 4 Hz. Normal hearing was defined as minimum hearing level at 25 cm H2O 113 24 (71%) 28 (45%) 0.017 Average Opening Pressure >20 cm H20 96 34 (81%) 43 (61%) 0.025 Quantitative Cultur...

  4. Locations of cerebral infarctions in tuberculous meningitis

    International Nuclear Information System (INIS)

    Hsieh, F.Y.; Chia, L.G.; Shen, W.C.

    1992-01-01

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

  5. IDENTIFICACIÓN MOLECULAR DE POBLACIONES BACTERIANAS ASOCIADAS AL CARACOL PALA (Strombus gigas DEL CARIBE COLOMBIANO

    Directory of Open Access Journals (Sweden)

    EDINSON ACOSTA

    2009-05-01

    Full Text Available RESUMEN El caracol Pala, Strombus gigas (Strombidae, es de gran importancia ecológica y socioeconómica en el área caribeña colombiana. Sin embargo, es una especie catalogada como “vulnerable” y existe muy poca información referente a las especies bacterianas asociadas al caracol que puedan ser importantes para el desarrollo, manejo productivo y de seguridad acuícola de estos gastrópodos. En este trabajo, nosotros empleamos un estudio microbiológico y molecular de la región intergénica entre los genes 16S y 23S rDNA, análisis del gen rDNA 16S y secuenciación, para analizar las bacterias asociadas al caracol Pala (S. gigas. La composición de bacterias cultivables asociadas fue evaluada por su capacidad para crecer en agar marino y en medios de cultivos selectivos. De un total de 28 muestras analizadas encontramos que el número de bacterias cultivadas en condiciones aerobias fue de alrededor 106 ufc mL-1 donde las bacterias pertenecientes a la familia Vibrionacea fueron las más abundantes, cerca de >105 ufc mL-1 . El análisis molecular de la región intergénica entre los genes 16S y 23S rDNA de las diferentes muestras, reveló una gran complejidad bacteriana asociada a S. gigas. Las secuencias de los amplificados del gen rDNA 16S identificó Pseudoalteromonas sp., Halomonas sp., Psycrobacter sp., Cobetia sp., Pseudomonas sp. y Vibrios sp. Nuestros resultados podrían sugerir un rol importante de estas bacterias como componentes de la comunidad asociada al S. gigas. Esta información puede complementar los estudios que se están implementando en los procesos para la conservación y repoblamiento de las poblaciones de S. gigas en Colombia. Palabras clave: Strombus gigas, Caracol pala, Bacteria, Región intergénica 16S-23S, rDNA 16S. ABSTRACT The Queen Conch, Strombus gigas (Strombidae, is a species of great ecological and socioeconomic importance in the Caribbean area of Colombia. However, it is currently catalogued as

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

    International Nuclear Information System (INIS)

    Seo, Jeong Jin; Kang, Heoung Keun; Chu, Sung Nam; Kim, Yun Hyeon; Jeong, Yong Yeon; Chung, Hyon De

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-01-01

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

  8. Una nueva ultraestructura de ópalo CT en silcretas. Posible indicador de influencia bacteriana

    Directory of Open Access Journals (Sweden)

    Bustillo, Mª A.

    1995-04-01

    Full Text Available Electron microscope observations of opaline silcretes found in the playa of a Miocene shallow lake reveal new opal CT microstructures. These microstructures are made up of fibres, filaments or rods, which are formed, in tum by coalesced microspheres or microhemispheres (0,1-0,2 µ diameter. They are up to 10 µ in length although larger ones could exist. They are straight, bent, wavy or even hairpin shaped. These microstructures comprise part of the opaline mass of the silcretes and are very similar to both neogenic opaline structures which are formed by bacterial intluence and to silicified biofilms. Therefore microbial mediation could exist in the genesis of this opal CT, although a possible inorganic origin by silicification of sepiolite is also considered.Un estudio mediante MEB de silcretas miocenas opalinas formadas por silicificación de playas en un ambiente de «playa-lake» pone de manifiesto la existencia de una nueva microestructura de ópalo CT. Esta microestructura denominada en general fibrosa, se manifiesta por la presencia de multitud de fibras, filamentos o varillas formadas por la alineación de microesferas o microhemisferas que presentan un diámetro entre 0,1 y 0,2 µ. Las fibras, filamentos o varillas tienen formas variables: rectas, curvadas, onduladas y «en horquilla», y presentan longitudes de hasta 10 µ, aunque podrían existir longitudes mayores. La disposición organizada de las microesferas en filamentos o fibras, constituyendo la masa general del ópalo, y su parecido con microestructuras opalinas que han sido formadas por influencia bacteriana, hacen considerar esta hipótesis, aunque no se puede descartar totalmente un origen inorgánico por silicificación de sepiolita.

  9. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

    Directory of Open Access Journals (Sweden)

    César Palazón Sánchez

    2000-01-01

    Full Text Available Conocer 12 epidemiología de las u~tux~- aciones agudas graves en un servicio de medicina intensiva y evaluar el pronóstico de la PCR y mortalidad asociada a los distintos tóxicos.

  10. Efectividad de la magnetoterapia como tratamiento en pacientes con lumbalgia aguda

    Directory of Open Access Journals (Sweden)

    Raidel González Rodríguez

    2015-05-01

    Full Text Available Son numerosos los pacientes aquejados de algias vertebrales, tanto lumbares como dorsales y cervicales. Se realizó esta investigación con el objetivo de determinar la efectividad de la magnetoterapia como tratamiento en la lumbalgia aguda, en pacientes atendidos en el policlínico universitario “Raúl Sánchez” de la provincia de Pinar del Río, Cuba. Se realizó un estudio descriptivo, prospectivo, de corte transversal en pacientes con lumbalgia aguda, pertenecientes a dicha área de salud. La muestra quedó conformada por 68 pacientes de ambos sexos con lumbalgia aguda, diagnosticados clínicamente y mayores de 17 años de edad. En la investigación predominó el sexo femenino (67,6 % y el rango de edad estuvo entre 40 y 49 años. El esfuerzo físico fue el principal factor desencadenante (47,1 %. Con el tratamiento de la magnetoterapia aplicado a los pacientes se redujeron los estadios del dolor. La mayoría de los pacientes presentaron una respuesta clínica excelente y mejoraron los síntomas entre los siete y diez días (61,8 %. No se reportaron efectos adversos. La magnetoterapia resultó efectiva en el tratamiento de pacientes aquejados de lumbalgia aguda

  11. Incidencia de la enfermedad diarreica aguda en menores de cinco años

    Directory of Open Access Journals (Sweden)

    Mayelín Ávila Labrada

    2015-05-01

    Full Text Available La enfermedad diarreica aguda es motivo frecuente de consulta pediátrica, representando un problema grave de salud pública. Los agentes infecciosos son causa frecuente de diarrea aguda. Se realizó un estudio descriptivo, retrospectivo sobre la prevalencia de la enfermedad diarreica aguda en menores de cinco años, atendidos en la clínica “Simón Bolívar” en la ciudad de Mariara del municipio Diego Ibarra, Carabobo, Venezuela; en el periodo comprendido entre enero de 2008 y diciembre de 2012, lo cual ofreció información de cinco años completos. La prevalencia de la enfermedad diarreica aguda disminuyó significativamente en el intervalo 2009-2011, sin embargo, se caracterizó por tener la mayor prevalencia en los años extremos, 2012 y 2008, por ese orden. Los varones y los del grupo de uno a cuatro años fueron los que más incidieron en cada uno de los años estudiados

  12. Técnicas de fermentación y aplicaciones de la celulosa bacteriana: una revisión

    OpenAIRE

    Carreño Pineda, Luz Dary; Caicedo Mesa, Luis Alfonso; Martínez Riascos, Carlos Arturo

    2012-01-01

    La celulosa bacteriana es un polímero obtenido por fermentación con microrganismos de los géneros Acetobacter, Rhizobium, Agrobacterium y Sarcina, de las cuales la especie más eficiente es la Acetobacter Xylinum. Este polímero presenta la misma estructura química de la celulosa de origen vegetal, pero difiere en su conformación y propiedades fisicoquímicas, lo que lo hace atractivo para diversas aplicaciones, especialmente en las áreas de alimentos, procesos de separación, catálisis y en medi...

  13. Estudo prospectivo dos fatores de risco para complicações neurológicas na meningite bacteriana infantil

    Directory of Open Access Journals (Sweden)

    Sadie Namani

    2013-06-01

    Full Text Available OBJETIVO: Análise prospectiva de fatores de prognóstico para complicações neurológicas da meningite bacteriana infantil. MÉTODOS: Este estudo prospectivo recrutou 77 crianças de um mês a 16 anos de idade tratadas de meningite bacteriana durante o período de 1/1/2009 a 31/12/2010. Foram escolhidos 16 preditores relevantes para analisar sua associação com a incidência de complicações neurológicas. Valores P abaixo de 0,05 foram considerados estatisticamente significativos. RESULTADOS: Das 77 crianças tratadas para meningite bacteriana, desenvolveram-se complicações neurológicas em 33 pacientes (43%, e duas crianças morreram (2,6%. A etiologia dos casos de meningite bacteriana foi comprovada em 57/77 (74% dos casos: foram encontrados 32 isolados de meningococos; 8 de pneumococos; 6 de bacilos gram-negativos; 5 de H. influenzae; 5 de estafilococos e 1 de S. viridans. Os fatores que se mostraram associados a aumento do risco de desenvolvimento de complicações neurológicas foram idade 5.000 células/mm³, pleiocitose > 5.000 células/mm³ depois de 48 horas, baixa relação da glicose no LCS/sangue 48 horas, presença de comorbidade e foco primário de infecção não se associaram a aumento do risco para o desenvolvimento de complicações neurológicas. CONCLUSÃO: Idade inferior a 12 meses e gravidade da apresentação clínica na admissão foram identificadas como os preditores mais fortes de complicações neurológicas e podem ter valor para selecionar pacientes para tratamento mais intensivo.

  14. Biossíntese e caracterização de nanocelulose bacteriana para engenharia de tecidos

    OpenAIRE

    Fischer, Michele Roberta; Garcia, Michele Cristina Formolo; Nogueira, André Lourenço; Porto, Luismar Marques; Schneider, Andréa Lima dos Santos; Pezzin, Ana Paula Testa

    2018-01-01

    RESUMO Queimaduras causam lesões do revestimento epitelial, a partir de um agente externo, podendo variar desde uma pequena bolha flictena até formas mais graves, capazes de desencadear respostas sistêmicas. O uso de curativos contendo substâncias cicatrizantes e antimicrobianas é uma opção para terapia local. Os curativos de nanocelulose bacteriana (BNC) já demonstraram seu grande potencial de aplicação devido às suas propriedades como alto teor de pureza, alto poder de absorção de água e ót...

  15. Fisiopatología de la diarrea aguda

    Directory of Open Access Journals (Sweden)

    Raúl L. Riverón Corteguera

    1999-06-01

    Full Text Available Es un artículo de revisión de los aspectos importantes de la fisiopatología de la diarrea. Se hace una descripción de la fisiopatología intestinal que incluye la anatomía del intestino y de su superficie de absorción y la estructura funcional de la mucosa intestinal. La fisiopatología normal de los líquidos intestinales. Mecanismo de absorción del agua y los electrólitos. Absorción de sodio por difusión electrogénica, unido al ion cloro, intercambio con el ion hidrógeno y unido a sustancias orgánicas como glucosa, aminoácidos y algunos oligopéptidos; secreción intestinal de agua y electrólitos. Control intracelular de la secreción. Mediadores y moduladores extracelulares del transporte intestinal. Factores que aumentan la absorción y reducen la secreción. Factores que estimulan la secreción y reducen la absorción Mecanismo fisiopatológico de la diarrea. Clasificación de la diarrea infecciosa aguda: acuosa secretoria y osmótica; diarrea con sangre invasiva y no invasiva.This a review of some important aspects of the physiopathology of diarrhea. A description is made of the intestinal physiopathology, including the anatomy of the intestine and of its surface of absorption, as well as the functional structure of the intestinal mucosa: the normal physiopathology of the intestinal fluids; the mechanism of absorption of water and electrolites; the absorption of sodium by electrogenic difussion, joined to the chloride ion; the interchange with the hydrogen ion and attached to organic substances, such as glucose, aminoacids and some oligopeptides; the intestinal secretion of water and electrolites; the intracellular control of secretion, the extracellular mediators and modulators of intestinal transport; the factors that increase absorption and reduce secretion; the factors that stimulate secretion and absorption; and the physiopathological mechanism of diarrhea. The classification of acute infectious diarrhea in aqueous

  16. Linfonodo pulmonar na paracoccidioidomicose aguda infantil (relato de um caso

    Directory of Open Access Journals (Sweden)

    Evanil Pires de Campos

    1992-09-01

    Full Text Available Observou-se a evolução de um linfonodo pulmonar na paracoccidioidomicose (PCM aguda infantil. Doente, masculino, 6 anos, branco, natural de Curitiba (PR, procedente de Guaratinguetá (SP, que há 3 meses desenvolveu quadro gripal, febre diária, bimodal, prolongada, precedida de calafrio, acompanhada de sudorese inodora, cefaléia frontal e anorexia. Diagnosticado e tratado como pneumonia por cinco dias, sem melhora do quadro. Há 2 meses, apresentou dor óssea nos braços e articulações do pé, com edema inflamatório e emagrecimento de 6 kg em 3 meses. Exame físico revelou: peso 20 kg; estatura 120 cm; P. A. 90/60 mmHg; facies atípica, hipoativo, palidez cutâneo-mucosa (+ +, hipotrofia muscular, adenopatiageneralizada, sopro sistólico suave em foco aórtico acessório e hepatesplenomegalia. Imunodifusão com exoantígeno glicoprotéico 43 kdpositiva (1/32. A biópsia de gânglio revelou Paracoccidioides brasiliensis. A radiologia demonstrou na primeira consulta, discreto infiltrado intersticial bilateral com linfoadenomegaliapara-hilar que desaparecu em 30 dias. Observou- se, ainda, massa tumoral mediastínica superior, hiperplasia do sistema fagocítico mononuclear e lesões osteolíticas nos 60 dias iniciais da evolução.The primary complex like Ghon was observed in a child's clinical roentgenographic study. C.S., white, male, 6 years old, was born in Curitiba (PR, Brazil and living in Guaratingueta (SP, Brazil, developed "common cold", bimodal diary fever, chills, shake and sweats. Dyspnea, cough with general fymphadenopathy. Foot and right shoulder artralgies. Six months ago visited a cave, equitation practice, dog and cat contacts and notransfusion, frontal sweats, fever (38.4°C. T.A. was 8/6, tachicardia in generalizated fymphadenopathy. Cardiopulmonary system was normal, mesogastric tumoral mass, hepatesplenomegaly and no ascitis. Bone marrow with eosinophilia; nodule demonstred presence of P. brasiliensis; hypoalbuminemia

  17. Validación del método LAL para determinar endotoxinas bacterianas en el inyectable heparina sódica

    OpenAIRE

    Nancy Burguet; Lázaro César Brito

    2012-01-01

    Dentro del control de la calidad de los productos farmacéuticos, la United State Pharmacopeia establece la cuantificación de endotoxinas bacterianas por el método de lisado de amebocito de Limulus , como monitor de pirógenos para más del 90% de los parenterales que regula. Este método se aplicó de forma específica a vacunas bacterianas y virales, agentes antineoplásicos, radiofármacos y parenterales que se producen en la industria médico farmacéutica. En el presente trabajo se mostró la metod...

  18. O uso de antibióticos e as resistências bacterianas: breves notas sobre a sua evolução

    OpenAIRE

    Loureiro, Rui João; Roque, Fátima; Teixeira Rodrigues, António; Herdeiro, Maria Teresa; Ramalheira, Elmano

    2016-01-01

    A resistência bacteriana aos antibióticos é atualmente um dos problemas de saúde pública mais relevantes a nível global, dado que apresenta consequências clínicas e económicas preocupantes, estando associada ao uso inadequado de antibióticos. Portugal é, no contexto europeu, um país com um elevado consumo de antibióticos, apesar de uma diminuic¸ão no consumo destes fármacos nos últimos anos. A resistência bacteriana tem crescido acentuadamente, sendo que as bactérias Gram-posit...

  19. Eficacia del tratamiento homeopático en pacientes con neumonía bacteriana adquirida en la comunidad. Hospital Infantil Norte de Santiago de Cuba

    OpenAIRE

    Yasel Garcia Leyva; Martha María Leyva Anaya; Rebeca María Massieu Cobas; , Yuneska Rodriguez Ochoa

    2017-01-01

    Objetivo: evaluar la efectividad del tratamiento homeopático en los pacientes con neumonía bacteriana adqui-rida en la comunidad. Método: se realizó un estudio clínico controlado en el que se conformó dos grupos con los niños hospitalizados para evaluar la efectividad del tratamiento homeopático en los principales síntomas de 40 pacientes con neu-monía bacteriana adquirida en la comunidad, que ingresaron en la Unidad de Cuidados Intensivos Polivalentes Pediátricos del Hospital Infa...

  20. Frecuencia de aislamientos microbiológicos y perfil de resistencia bacteriana en 13 clínicas y hospitales de alta complejidad en Santiago de Cali - Colombia

    OpenAIRE

    Martínez Buitrago, Ernesto; Hernández, Cristhian; Pallares, Cristhian; Pacheco, Robinson; Hurtado, Kelly; Recalde, Mónica

    2014-01-01

    Introducción: La resistencia bacteriana se consolida como una amenaza para los sistemas de salud en el manejo de las enfermedades infecciosas. La vigilancia epidemiológica de la resistencia bacteriana ha demostrado ser una estrategia efectiva para conocer los patrones de susceptibilidad a los antimicrobianos regionales para el desarrollo de medidas de contención y gestión del uso adecuado de antimicrobianos. Objetivo: Describir los aislamientos microbiológicos y perfiles de resistencia a los ...

  1. Stages of tuberculous meningitis: a clinicoradiologic analysis

    International Nuclear Information System (INIS)

    Sher, K.; Firdaus, A.; Bullo, N.; Kumar, S.; Abbasi, A.

    2013-01-01

    Objective: To determine the frequencies and percentages of various clinicoradiologic variables of tuberculosis meningitis (TBM) with reference to British Medical Research Council (BMRC) staging of the disease. Study Design: A case series. Place and Duration of Study: Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, from October 2010 to September 2011. Methodology: The study included 93 adult patients with the diagnosis of tuberculous meningitis (TBM) at the study place. Patients were divided in three groups according to British Medical Research Council (BMRC) staging of TBM. Different clinical and radiological findings were analyzed at different stages of the disease. Data was analyzed using SPSS (Statistical Package of Social Sciences) version 11.0. Results: A majority of patients were found to be in stage-II disease at the time of admission. History of illness at the time of admission was more than 2 weeks in 50% of stage-I patients but around 80% in stage-II and stage-III patients. Neck stiffness was the most commonly reported finding in all stages. Cranial nerve palsies were higher in stage-III (75%) than in stage-II (43%) and in stage-I (24%) patients. Hydrocephalus and basal enhancement was the most frequently reported radiographic abnormalities. Conclusion: Duration of illness and cranial nerve palsies are important variables in the diagnosis of TBM stages and if TBM is suspected, empiric treatment should be started immediately without bacteriologic proof to prevent morbidity and mortality. (author)

  2. Communicating hydrocephalus subsequent to purulent meningitis

    International Nuclear Information System (INIS)

    Suzuki, Hiroshi; Ogawa, Kimio; Hibio, Shuichi; Goto, Kazuhiko; Shiihara, Hiroaki

    1984-01-01

    Based on CT findings one year after shunting, ventricular dialtion was classified into five degrees for examining prognosis of communicating hydrocephalus subsequent to purulent meningitis. Factors causing and aggravating hydrocephalus were also examined. Patients with hydrocephalus tended to have spasms frequently as the first symptom within one month after birth when there were few characteristic findings. Spasm and disturbance of consciousness occurred frequently during the first week of the occurrence of disease. Large numbers of cells in the spinal fluid and high volume of spinal cord protein were persistent in patients aged one month or less. Chloride transport decreased in patients aged two months or more. The occurrence of syndrome of the pyramidal tract, eye symptoms, movement of head to the left and right, and involuntary movement suggested serious conditions of the disease. Disturbance of movement could be relieved by giving adequate antibiotics as soon as meningitis was discovered within one month after birth and by giving chloramphenicol when symptoms suggesting the development of serious conditions occurred. However, mental retardation and epilepsy could not be prevented. (Namekawa, K.)

  3. 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. © The American Society of Tropical Medicine and Hygiene.

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

    International Nuclear Information System (INIS)

    Jensen, J.I.; Juel Christensen, N.; Marqversen, J.; Esmann, V.

    1977-01-01

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

  5. Distribution of /sup 82/Br between serum and CSF in patients with meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, J I; Juel Christensen, N; Marqversen, J; Esmann, V [Marselisborg hospital, Aarhus, Denmark

    1977-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tatiana Barichello

    2014-12-01

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

  7. Primary cellular meningeal defects cause neocortical dysplasia and dyslamination

    Science.gov (United States)

    Hecht, Jonathan H.; Siegenthaler, Julie A.; Patterson, Katelin P.; Pleasure, Samuel J.

    2010-01-01

    Objective Cortical malformations are important causes of neurological morbidity, but in many cases their etiology is poorly understood. Mice with Foxc1 mutations have cellular defects in meningeal development. We use hypomorphic and null alleles of Foxc1 to study the effect of meningeal defects on neocortical organization. Methods Embryos with loss of Foxc1 activity were generated using the hypomorphic Foxc1hith allele and the null Foxc1lacZ allele. Immunohistologic analysis was used to assess cerebral basement membrane integrity, marginal zone heterotopia formation, neuronal overmigration, meningeal defects, and changes in basement membrane composition. Dysplasia severity was quantified using two measures. Results Cortical dysplasia resembling cobblestone cortex, with basement membrane breakdown and lamination defects, is seen in Foxc1 mutants. As Foxc1 activity was reduced, abnormalities in basement membrane integrity, heterotopia formation, neuronal overmigration, and meningeal development appeared earlier in gestation and were more severe. Surprisingly, the basement membrane appeared intact at early stages of development in the face of severe deficits in meningeal development. Prominent defects in basement membrane integrity appeared as development proceeded. Molecular analysis of basement membrane laminin subunits demonstrated that loss of the meninges led to changes in basement membrane composition. Interpretation Cortical dysplasia can be caused by cellular defects in the meninges. The meninges are not required for basement membrane establishment but are needed for remodeling as the brain expands. Specific changes in basement membrane composition may contribute to subsequent breakdown. Our study raises the possibility that primary meningeal defects may cortical dysplasia in some cases. PMID:20976766

  8. [Recurrent aseptic meningitis secondary to taking ibuprofen and ketorolac].

    Science.gov (United States)

    Cano Vargas-Machuca, E; Mondéjar-Marín, B; Navarro-Muñoz, S; Pérez-Molina, I; Garrido-Robres, J A; Alvarez-Tejerina, A

    Aseptic meningitis is a process that is characterised by an inflammatory reaction of the meninges that is not due to any infectious agent. Its aetiology is varied and is most frequently caused by rheumatologic and/or autoimmune processes, chemical or medication-induced meningitis, the most notable drugs involved being antibiotics and non-steroidal anti-inflammatory drugs (NSAI). We report the case of a 70-year-old male, with no relevant history, who was admitted to hospital five times over a period of 16 months because of acute meningitis with polymorphonuclear pleocytosis, high protein levels in cerebrospinal fluid and normal glucose in cerebrospinal fluid. No evidence of an infectious causation, chemical meningitis, carcinomatosis or autoimmune disease was found and the patient was diagnosed with recurrent aseptic meningitis. It was found that the patient had taken ibuprofen or ketorolac on several occasions, a few hours before the appearance of symptoms. These episodes were quickly resolved after withdrawal of this medication. A number of NSAI have been reported as inducers of aseptic meningitis, one of the most notable being ibuprofen. We report the case of a patient who, as a consequence of taking ibuprofen and ketorolac, presented episodes of recurrent aseptic meningitis. To our knowledge this side effect of ketorolac has not been reported before. Its clinical features are impossible to differentiate from those of infectious meningitis. Diagnosis is reached by exclusion and a careful pharmacological study, including over-the-counter drugs like some of the NSAI, must be performed in patients with this condition, since it is a problem that can easily be solved by withdrawing the drug that causes it.

  9. Giant Leaking Colloid Cyst Presenting with Aseptic Meningitis

    DEFF Research Database (Denmark)

    Bakhtevari, Mehrdad Hosseinzadeh; Sharifi, Guive; Jabbari, Reza

    2015-01-01

    BACKGROUND: Colloid cysts are benign third ventricle lesions that need to be diagnosed correctly because of their association with sudden death. Chemical or aseptic meningitis is a rare presentation of a colloid cyst. METHODS: We present a case of a 69-year-old man with fever, alteration of mental...... status, and meningismus. Microbiological examination of the cerebrospinal fluid revealed aseptic meningitis. Brain imaging revealed a third ventricular colloid cyst with hydrocephalus. RESULTS: The tumor was resected via endoscopic intervention. There were no persistent operative complications related...... to the endoscopic procedure. CONCLUSIONS: Chemical or aseptic meningitis is an unusual clinical manifestation of a colloid cyst, complicating the differential diagnosis, especially in the elderly....

  10. Meningitis and Ventriculitis due to Nocardia araoensis Infection.

    Science.gov (United States)

    Yamamoto, Fumio; Yamashita, Satoshi; Kawano, Hiroyuki; Tanigawa, Tomio; Mihara, Yosuke; Gonoi, Toru; Ando, Yukio

    2017-01-01

    A 73-year-old man was admitted to our hospital with disturbance of consciousness, fever and headache. Cerebrospinal fluid (CSF) analysis revealed pleocytosis with neutrophil predominance, increased protein and low glucose. CSF and blood cultures yielded negative results. Antibiotics and antituberculous drugs were started for meningitis. An antimycotic was also added. The patient died from transtentorial hernia 99 days after admission. Autopsy revealed meningitis, ventriculitis and brain abscess, and Nocardia araoensis was detected in pus from the left lateral ventricle. This appears to represent the first report of N. araoensis meningitis complicated by ventriculitis and brain abscess.

  11. [A case of Mondini dysplasia with bacterial meningitis].

    Science.gov (United States)

    Kajimoto, Madoka; Ichiyama, Takashi; Matsufuji, Hironori; Isumi, Hiroshi; Furukawa, Susumu

    2006-11-01

    A boy with bilateral hearing impairment developed pneumococcal meningitis at 14-month-old. Further examination revealed cerebrospinal fluid leakage due to bilateral Mondini dysplasia. He was cured by treatment with panipenem/betamiprone and dexamethasone, and then, he was performed an operation to fill the inner ear on day 30. He did not have bacterial meningitis 19 months after the operation. Children with congenital hearing impairment should be examined for malformation of the inner ear because the inner ear malformation has cerebrospinal fluid leakage and bacterial meningitis frequently.

  12. A case of Mondini dysplasia with recurrent Streptococcus pneumoniae meningitis.

    Science.gov (United States)

    Yilmaz Ciftdoğan, Dilek; Bayram, Nuri; Ozdemir, Yasemin; Bayraktaroğlu, Selen; Vardar, Fadil

    2009-12-01

    Mondini's dysplasia is a developmental anomaly of the middle ear characterized by cochlear malformation with dilation of the vestibular aquaduct, vestibule, and ampullar ends of the semicircular canals. These deformities may result in a connection between subarachnoid space and the middle ear resulting in recurrent episodes of meningitis. Additionally, it is commonly associated with hearing impairment. We describe here a boy with recurrent meningitis and unilateral sensorineural hearing loss. Mondini dysplasia was demonstrated with computed tomographic scans of the temporal bones in the search for pathogenesis of recurrent meningitis.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Anu Gupta

    2014-01-01

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

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

    OpenAIRE

    Naija, Walid; Matéo, Joaquim; Raskine, Laurent; Timsit, Jean-François; Lukascewicz, Anne-Claire; George, Bernard; Payen, Didier; Mebazaa, Alexandre

    2004-01-01

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

  16. Meningitis in Children: Evaluation of 197 Patients

    Directory of Open Access Journals (Sweden)

    Ali Gunes

    2016-01-01

    Full Text Available Aim: The aim of our study was to evaluate the epidemiologic, clinic and laboratory results and the answers to treatment of meningitis cases. Material and Method: In this study, the epidemiologic, clinic and laboratory results of 197 patients hospitalized with central nervous system infection diagnosis in the Department of Pediatric Health and Diseases of the Faculty of Medicine of Dicle University between 1st of January 2003 and 1st of January 2006 have been studied retrospectively. The files have been studied in details for age, sex, complaints, and results of physical examination, laboratory results, radiological results and treatments applied. Results: 118 of the patients were male, 79 were women and the mean age calculated was 62,2±47,3 months.137, 27 and 33 patients have been respectively considered as ABM, AM and TM. The most frequent complaints of application to hospital were fever (95,4%, vomiting (82,7%, headache (45,6% and change of consciousness (21,3%. The presence of many risks about meningitis has been observed. The most frequent risk factors were head trauma history, parenchymal lung tuberculosis, military tuberculosis, presence of V-P shunt, meningocele, varicella history, having mumps, and the presence of purulent ear discharge. BOS has developed in 7 patients and for five patients, reproduction occurred in blood culture. The most important central nervous system sequels or complications were in order of frequency hydrocephalies requiring the installation of V-P shunt, brain edema, epilepsies, subdural effusions, tuberculoma, retention of head pair, and brain apses. The rate of mortality was (% 13,1. Discussion: During the period of execution of the study, the mortality and morbidity of central nervous system diseases were still at high risk. But this may be associated to the absence of vaccination programs for frequent meningitis factors such as pneumococcus and H. influenza were not in routine vaccination program in our

  17. Prevalencia de vaginosis bacteriana en trabajadoras sexuales chilenas Prevalence of bacterial vaginosis in Chilean sex workers

    Directory of Open Access Journals (Sweden)

    Gloria Venegas

    2011-07-01

    Full Text Available OBJETIVO: Determinar la prevalencia de vaginosis bacteriana (VB en trabajadoras sexuales chilenas y relacionar los hallazgos con variables sociodemográficas, sexuales y clínicas. MÉTODO: Se estudió una muestra de 379 trabajadoras sexuales que asistían para control a Unidades de Atención y Control de Salud Sexual de Chile. A todas se las entrevistó para obtener antecedentes sociodemográficos y sexuales, se les realizó evaluación clínica que incluyó características del flujo vaginal, pH y prueba de aminas, y se les tomó una muestra vaginal para tinción de Gram. Para el diagnóstico de VB se empleó el criterio de Nugent. Los datos fueron analizados con EPI-INFO 3.4.1 y BioStat, utilizándose un grado de significación de P OBJECTIVE: To determine the prevalence of bacterial vaginosis (BV in Chilean sex workers and relate the findings to sociodemographic, sexual, and clinical variables. METHODS: A sample of 379 sex workers seen in Chilean Sexual Health Monitoring and Care Units for check-ups was studied. All of them were interviewed to obtain their sociodemographic and sexual history. A clinical examination was performed that included the characteristics of vaginal discharge, pH, and amine test. A vaginal sample was taken for Gram stain. The Nugent criteria were used for the diagnosis of BV. The data was analyzed with EPI-INFO 3.4.1 and BioStat, using a degree of significance of P < 0.005. RESULTS: BV prevalence was 69.1%. The syndrome was not associated with the sociodemographic variables, age or education. BV was less common in women (married or unmarried who lived with their partners than in single women (P < 0.001. There were no sexual variables associated with BV, whereas use of intrauterine devices was related (P < 0.0001. The presence of vaginal discharge, abnormal vaginal pH, and positive amine test were associated with infection (P < 0.0001. CONCLUSIONS: Like other studies conducted in different countries, this study

  18. Las meningoencefalitis bacterianas en la población infantil cubana: 1998-2000

    Directory of Open Access Journals (Sweden)

    Félix Orlando Dickinson Meneses

    2002-06-01

    Full Text Available Se describen algunos aspectos epidemiológicos de las meningoencefalitis bacterianas (MEB en Cuba entre 1998 y el año 2000, según los datos de la Vigilancia Nacional de las MEB (VNMEB disponibles. Se reportaron un total de 530 casos en menores de 15 años en todo el país durante el período. El grupo de edad más afectado resultó el de menos de 5 años. Los agentes más frecuentemente identificados fueron Haemophilus influenzae tipo b (Hib, Streptococcus pneumoniae (Spn y Neisseria meningitidis (Nm. La incidencia de Hib disminuyó 4 veces por el efecto de la vacunación masiva, especialmente en los menores de 5 años, a partir del año 2000 Spn es el principal agente causante de MEB y el más letal en Cuba. La letalidad general se incrementó de 10,6 a 20,4 %, y fue el grupo de los de menos de 1 año uno de los más afectados. Futuros estudios permitirán profundizar en la epidemiología de estas infecciones y monitorear los cambios que ocurran como consecuencia de intervenciones.Somme epidemiological aspects of bacterial meningoencephalities that occurred in Cuba from 1998-2000 are described according to available data from the National Surveillance Service. A total of 530 cases involving children under 15 years old were reported throughout the country in this period of time. The most affected age group was under 5 years. The most frequent identified agents were Haemophilus influenzae type B(Hib, Streptococcus pneumoniae (Spn and Neisseria meningitidis (Nm. The incidence of Hib decreased by 4 times thanks to massive vaccination program, particularly in under 5 years-old children, from the year 2000 on. Spn is the main causative agent of bacterial meningoencephalities and the most lethal one in Cuba. General lethality rate increased from 10.6 to 20.4% and the under one-year old age group was the most affected. Further studies will allow deepening into the epidemiology of these infections and monitoring the changes that might occur as a

  19. Infecciones por bacterias poco comunes y oncogénesis bacteriana

    Directory of Open Access Journals (Sweden)

    Horacio A. Lopardo

    Full Text Available La recuperación de algunos microorganismos de aislamiento esporádico en el laboratorio de microbiología clínica podría significar la existencia de algún defecto inmunitarioespecial en el paciente. Por ejemplo, se ha descrito una importante correlación entre Clostridium septicum y carcinoma de colon, y se han visto relacionadas con leucemias y linfomas a especies que aparecen casi siempre como contaminantes (Bacillus spp., Corynebacterium spp. y a otras raramente aisladas en otros contextos (Capnocytophaga spp.. Hay bacterias que se aíslan casi exclusivamente de pacientes con sida (Rhodococcus equi. Se ha observado una mayor frecuencia de infecciones por Campylobacter spp., Aeromonas spp. y estreptococos del grupo G y del grupo mitis en individuos con algún tipo de cáncer que en el resto de los pacientes. También hay bacterias que son marcadoras de algún cáncer no detectado o que afectan más a pacientes neutropénicos que a individuos normoinmunes. La alteración de la reacción inflamatoria, la linfoproliferación mediada por antígenos bacterianos y la inducción de hormonas que aumentan la proliferación de las células epiteliales podrían ser causas de la oncogénesis bacteriana. Los ejemplos clásicos son el adenocarcinoma gástrico inducido por Helicobacter pylori, la asociación de la bacteriemia por estreptococos del grupo bovis y el cáncer de colon y los linfomas de tejido linfoide asociado a mucosas (MALT en vinculación con especies de Helicobacter (MALT gástricos y con Chlamydophila spp. (MALT oculares. El aislamiento de alguno de estos patógenos debería ser un llamado de atención para inducir al estudio de alguna enfermedad maligna.

  20. Tratamiento de agrandamiento gingival inducido por fenitoina asociado a placa bacteriana

    Directory of Open Access Journals (Sweden)

    Carmen Julia Rovira

    2013-10-01

    Full Text Available ResumenLa ingesta de algunos medicamentos puede producir un sobre crecimiento de las encías. Se reportan medicamentos tales como los bloqueadores de los canales de calcio, inmunosupresores, anticonvulsivantes que producen estos efectos adversos. Múltiples casos de agrandamientos gingivales están asociados a la ingesta de Fenitoína. El tratamiento de los agrandamientos gingivales inducidos por drogas por lo general es quirúrgico, pero mantener un buen control de placa bacteriana puede evitar en muchos casos que se presente un exagerado aumento de volumen gingival. Se presenta un caso de agrandamiento gingival en paciente masculino de 22 años de edad, bajo tratamiento antiepiléptico con fenitoína. Al examen clínico se observó aumento del volumen gingival de forma generalizada, en maxilar superior e inferior, predominante en sector anterior, produciendo ardor y sangrado durante el cepillado y la ingestión de alimentos. Al sondaje presenta múltiples pseudobolsas en los diferentes cuadrantes. La radiografía panorámica reveló pérdida ósea moderada horizontal, predominante en el sector posterosuperior, posteroinferior y anteroinferior. El plan de tratamiento consistió en fase higiénica, instrucción y motivación en higiene oral a la madre, gingivectomía y gingivoplastía en ambos maxilares. (DUAZARY 2011 No. 2, 226 - 231Abstract The importance of endodontic treatment is to achieve a complete filling and sealing of the root canal to prevent the transport of contaminants to and from root canal, with materials compatible with the surrounding tissues. Occasionally a situation may arise in which the purpose of the maintenance of working length is compromised such as overenlargement. This situation allows the extrusion of filling materials, mainly sealer cements, causing post treatment complications such as inflammatory reactions, injury to adjacent structures (orbital pain, inferior alveolar nerve injury, headache, etc., and infections

  1. Detección molecular de las translocaciones más comunes en Leucemia aguda mediante RT-PCR

    Directory of Open Access Journals (Sweden)

    L. García

    2001-07-01

    Full Text Available Evaluar la incidencia de las translocaciones t(4;11, t(1;19, t(9;22 y t(12;21 en leucemia linfoide aguda (LLA y t(15;17, t(8;21 e Inv.(16 en leucemia mieloide aguda (LMA. Correlacionar los resultados obtenidos con el diagnóstico morfológico y citogenético.

  2. Tiempo libre de enfermedad en infecciones urinarias recurrentes según profilaxis con antibiótico o con vacuna bacteriana

    OpenAIRE

    Santo Bueno, Pedro José

    2014-01-01

    [ES]Estudio comparativo de dos tipos de tratamientos profilacticos, antibioterapia supresiva y vacuna bacteriana, en infecciones urinarias de repetición, para determinar el tiempo libre de enfermedad, entendida como el tiempo transcurrido entre la finalización de la profilaxis y la aparición de un episodio de infeccion urinario.

  3. Esofagitis necrosante aguda: análisis retrospectivo Acute esophageal necrosis: a retrospective case series

    Directory of Open Access Journals (Sweden)

    R. Ramos

    2008-09-01

    Full Text Available Introducción: la esofagitis necrosante aguda es una entidad rara. Se reconoce por el aspecto negro difuso del esófago a la endoscopia. Su incidencia e patogénesis se desconoce. Pacientes y métodos: se analizaron retrospectivamente 11 pacientes con esofagitis necrosante aguda desde el punto de vista de los datos clínicos, de laboratorio y endoscopicos en 2 años. Resultados: se analizaron las endoscopias realizadas a 3.976 pacientes, observándose esofagitis necrosante aguda en 11 pacientes. El estado nutricional era malo en 6 pacientes. La resolución completa de la esofagitis se observó en cuatro pacientes. Durante el seguimiento se observó una estenosis en un paciente y un nuevo episodio de esofagitis necrosante aguda en otro paciente. Siete pacientes fallecieron, pero esta elevada mortalidad parece deberse a las enfermedades de base y no es atribuible a las lesiones de la esofagitis necrosante. Conclusiones: la incidencia de esofagitis necrosante aguda en nuestra serie fue 0,28%. La esofagitis necrosante aguda tiene una elevada mortalidad.Background: acute esophageal necrosis has been considered a rare event. It is defined as the presence of diffuse dark pigmentation of the esophagus on upper endoscopy. Its incidence has not yet been established. The pathogenesis remains unknown. Patients and methods: a retrospective analysis of clinical, laboratory, endoscopic, and histological data, and of the clinical course of 11 patients with acute necrotizing esophagitis was carried out over a 2-year period. Results: among 3,976 patients who underwent upper endoscopy, 11 (0.28% with acute esophageal necrosis were identified. Nutritional status was poor for 6 patients. Complete resolution of acute esophageal necrosis without further recurrence was observed in 4. One stricture appeared during follow-up and other patient developed new-onset acute esophageal necrosis. Seven patients died, but no death was directly related to acute esophageal necrosis

  4. Estado oxidante e antioxidante de crianças com bronquiolite aguda

    Directory of Open Access Journals (Sweden)

    Rusen Dundaroz

    2013-08-01

    Full Text Available OBJETIVO: O estresse oxidativo demonstrou contribuir para a patogênese de doenças pulmonares inflamatórias agudas e crônicas. Nosso objetivo foi avaliar o estado oxidante/antioxidante de crianças com bronquiolite aguda por meio de mensuração da capacidade antioxidante total do plasma, estado oxidante total e índice de estresse oxidativo. MÉTODOS: As crianças com bronquiolite aguda encaminhadas para o Departamento de Emergência Pediátrica do hospital universitário entre janeiro e abril 2012 foram comparadas a controles saudáveis de mesma idade. Os pacientes com bronquiolite aguda tiveram essa doença classificada como leve e moderada. O estado oxidante e antioxidante foi avaliado pela mensuração da capacidade antioxidante total do plasma, estado oxidante total e índice de estresse oxidativo. RESULTADOS: Foram incluídas 31 crianças com bronquiolite aguda com idade de três meses a dois anos e 37 crianças saudáveis. O estado oxidante total (EOT foi maior em pacientes com bronquiolite aguda do que no grupo de controle (5,16±1,99 µmol H2O2 em comparação a 3,78±1,78 µmol H2O2 [p = 0,004]. A capacidade antioxidante total (CAT foi significativamente menor em crianças com bronquiolite que no grupo de controle (2,51±0,37 µmol Trolox equivalente/L em comparação a 2,75±0,39 µmol Trolox Eqv/L (p = 0,013. Os pacientes com bronquiolite moderada apresentaram níveis de EOT mais elevados que os com bronquiolite leve e os do grupo de controle (p = 0,03, p < 0,001. Os pacientes com bronquiolite moderada apresentaram níveis de IEO mais elevados que os do grupo de controle (p = 0,015. O nível de saturação de oxigênio de pacientes com bronquiolite foi inversamente correlacionado ao nível de EOT (r = -0,476, p < 0,05. CONCLUSÃO: O equilíbrio entre os sistemas oxidante e antioxidante é interrompido em crianças com bronquiolite moderada, indicando que o fator de estresse poderá ter um papel na patogênese da doença.

  5. MR myelography of sacral meningeal cysts

    International Nuclear Information System (INIS)

    Tsuchiya, K.; Katase, S.; Hachiya, J.

    1999-01-01

    Purpose: To describe the findings of sacral meningeal cysts (SMCs) on MR myelography and assess its value for the diagnosis of SMCs. Material and Methods: We evaluated the MR images and MR myelograms obtained from 10 patients with SMC. MR myelograms were obtained using a 2D or 3D single-shot fast spin-echo sequence. In 5 patients, X-ray myelograms and postmyelographic CT images were compared with the MR myelograms. Results: A total of 33 SMCs were diagnosed within the spinal canal and/or sacral foramen. MR myelograms clearly revealed each cyst as a well-defined mass showing hyperintensity (10 cysts) or isointensity (23 cysts) compared to cerebrospinal fluid. MR myelograms demonstrated SMCs better than X-ray myelograms and postmyelographic CT images in 3 of the 5 patients. Conclusion: MR myelography can be an adjunct to conventional imaging techniques when surgical treatment is indicated, because it can precisely delineate the extent of SMCs. (orig.)

  6. Carcinomatous Meningitis from Unknown Primary Carcinoma

    Directory of Open Access Journals (Sweden)

    L. Favier

    2009-10-01

    Full Text Available Carcinomatous meningitis (CM occurs in 3 to 8% of cancer patients. Patients present with a focal symptom, and multifocal signs are often found following neurological examination. The gold standard for diagnosis remains the demonstration of carcinomatous cells in the cerebrospinal fluid on cytopathological examination. Despite the poor prognosis, palliative treatment could improve quality of life and, in some cases, overall survival. We report on a patient who presented with vertigo, tinnitus and left-sided hearing loss followed by progressive diffuse facial nerve paralysis. Lumbar cerebrospinal fluid confirmed the diagnosis of CM. However, no primary tumor was discovered, even after multiple invasive investigations. This is the first reported case in the English-language medical literature of CM resulting from a carcinoma of unknown primary origin.

  7. [Acute bacterial meningitis as an occupational disease].

    Science.gov (United States)

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

    2014-01-01

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

  8. Telocytes in meninges and choroid plexus.

    Science.gov (United States)

    Popescu, B O; Gherghiceanu, M; Kostin, S; Ceafalan, L; Popescu, L M

    2012-05-16

    Telocytes (TCs) are a recently identified type of interstitial cells present in a wide variety of organs in humans and mammals (www.telocytes.com). They are characterized by a small cell body, but extremely long cell processes - telopodes (Tp), and a specific phenotype. TCs establish close contacts with blood capillaries, nerve fibers and stem cells. We report here identification of TCs by electron microscopy and immunofluorescence in rat meninges and choroid plexus/subventricular zone, in the vicinity of putative stem cells. The presence of TCs in brain areas involved in adult neurogenesis might indicate that they have a role in modulation of neural stem cell fate. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Mycobacterium bovis meningitis in young Nigerian-born male

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  10. 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...

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

    DEFF Research Database (Denmark)

    Brandt, Christian T; Holm, David; Liptrot, Matthew

    2008-01-01

    BACKGROUND: Bacteremia plays a major role in the outcome of pneumococcal meningitis. This experimental study investigated how bacteremia influences the pathophysiologic profile of the brain. METHODS: Rats with Streptococcus pneumoniae meningitis were randomized to 1 of 3 groups of infected study...... rats: (1) rats with attenuated bacteremia resulting from intravenous injection of serotype-specific pneumococcal antibody, (2) rats with early-onset bacteremia resulting from concomitant intravenous infection, or (3) a meningitis control group. The blood-brain barrier (BBB) breakdown, ventricle size......, brain water distribution, and brain pathologic findings were analyzed using magnetic resonance morphological and functional imaging. Laboratory data and clinical disease scores were obtained. RESULTS: Attenuation of the bacteremic component of pneumococcal meningitis improved clinical disease symptoms...

  12. Chordoma with postoperative subcutaneous implantation and meningeal dissemination: MRI

    International Nuclear Information System (INIS)

    Kinoshita, T.; Okudera, T.; Shimosegawa, E.; Hatazawa, J.; Yoshida, Y.; Yasui, N.; Ogawa, T.

    2001-01-01

    Chordomas are histologically benign tumours which are locally invasive. We present an unusual case of recurrent chordoma with subcutaneous implantation and widespread meningeal dissemination after surgery. Contrast-enhanced MRI was useful for determining the extent of the tumour. (orig.)

  13. 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.

  14. Two Cases of Tuberculous Meningitis after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    This article revealed two valuable case reports about two young females suffered tuberculous meningitis after cesarean section. After antituberculous therapy, the condition of one patient improved and the other one became deteriorated.

  15. Antibiotic resistance in bacterial pathogens causing meningitis in ...

    African Journals Online (AJOL)

    Antibiotic resistance in bacterial pathogens causing meningitis in children at Harare Central Hospital, Zimbabwe. M Gudza-Mugabe, R.T. Mavenyengwa, M.P. Mapingure, S Mtapuri-Zinyowera, A Tarupiwa, V.J. Robertson ...

  16. 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....

  17. Rapid Diagnosis of Bacterial Meningitis Using a Microarray

    Directory of Open Access Journals (Sweden)

    Ren-Jy Ben

    2008-06-01

    Conclusion: The microarray method provides a more accurate and rapid diagnostic tool for bacterial meningitis compared to traditional culture methods. Clinical application of this new technique may reduce the potential risk of delay in treatment.

  18. Chemical Meningitis with Intracranial Tumours | De Klerk | South ...

    African Journals Online (AJOL)

    Two patients with intracranial epidermoid tumours who had a chemical meningitis as part of their clinical course, are described. The importance of recognising this as a presenting complaint is stressed. The pathogenesis and treatment are discussed.

  19. Unrecognised ventriculitis/meningitis presenting as hydrocephalus in infancy.

    Science.gov (United States)

    Udani, Vrajesh; Udani, Soonu; Merani, Rohan; Bavdekar, Manisha

    2003-09-01

    Infantile hydrocephalus due to unrecognized neonatal-onset meningitis/ventriculitis, was studied retrospectively using 1991-1998 chart review. Seventy two patients with hydrocephalus were reviewed. Thirteen infants had hydrocephalus associated with active meningitis/ventriculitis which had remained unrecognized. Active meningitis/ventriculitis was confirmed by the finding of an abnormal lumbar and ventricular CSF with or without positive culture. All had perinatal risk factors and 10/13 had been given antibiotics in the postnatal period. 6/13 infants appeared to be well. The most common presentation was increasing head size. All lumbar and ventricular CSFs were abnormal and 10/13 had positive cultures as well. Imaging revealed hydrocephalus in all. The infants were treated with antibiotics for a mean of 32.8 days before VP shunting. 7/11 were severely disabled. Unrecognized active meningitis/ventriculitis is an important cause of infantile hydrocephalus.

  20. A rare cause of neonatal meningitis: Group A streptecocci

    Directory of Open Access Journals (Sweden)

    Ali Annagür

    2013-03-01

    Full Text Available Group A Streptococci are rare cause of neonatal meningitis.In this case report, we discussed a case of newbornmeningitis caused by Group A beta hemolytic streptococcusunder the light of related literature. Twenty four daysold male baby who was reported to be completely healthybefore was referred to our clinic with symptoms of fever,not sucking and left localized convulsion which were presentfor one day. Lumbar puncture was consistent with purulentmeningitis. Group A beta hemolytic streptococcusgrowth both in blood and Cerebrospinal liquid. Patientwas treated with Penicillin G. In clinical follow-up, tetraventricular hydrocephaly was detected but there was noneed for shunt. Later follow-up revealed hearing loss.Meningitis caused by Group A beta hemolytic streptococcusalthough is quite rare must be kept in mind in casesof newborn meningitis. Group A Streptococcus can alsocause serious neurological sequel as in other newbornmeningitis causes.Key words: Group A streptococci, neonatal meningitis,Streptococcus pyogenes, hydrocephaly

  1. Regulation of radial glial survival by signals from the meninges.

    Science.gov (United States)

    Radakovits, Randor; Barros, Claudia S; Belvindrah, Richard; Patton, Bruce; Müller, Ulrich

    2009-06-17

    Radial glial cells (RGCs) in the developing cerebral cortex are progenitors for neurons and glia, and their processes serve as guideposts for migrating neurons. So far, it has remained unclear whether RGC processes also control the function of RGCs more directly. Here, we show that RGC numbers and cortical size are reduced in mice lacking beta1 integrins in RGCs. TUNEL stainings and time-lapse video recordings demonstrate that beta1-deficient RGCs processes detach from the meningeal basement membrane (BM) followed by apoptotic death of RGCs. Apoptosis is also induced by surgical removal of the meninges. Finally, mice lacking the BM components laminin alpha2 and alpha4 show defects in the attachment of RGC processes at the meninges, a reduction in cortical size, and enhanced apoptosis of RGC cells. Our findings demonstrate that attachment of RGC processes at the meninges is important for RGC survival and the control of cortical size.

  2. Delayed cerebral thrombosis complicating pneumococcal meningitis: an autopsy study

    NARCIS (Netherlands)

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

    2018-01-01

    Background: Delayed cerebral thrombosis (DCT) is a devastating cerebrovascular complication in patients with excellent initial recovery of pneumococcal meningitis. The aetiology is unknown, but direct bacterial invasion, activation of coagulation or post-infectious immunoglobulin deposition has been

  3. Meningococcal carriage in the African meningitis belt

    Science.gov (United States)

    2013-01-01

    A meningococcal serogroup A polysaccharide/tetanus toxoid conjugate vaccine (PsA-TT) (MenAfriVac#x2122;) is being deployed in countries of the African meningitis belt. Experience with other polysaccharide/protein conjugate vaccines has shown that an important part of their success has been their ability to prevent the acquisition of pharyngeal carriage and hence to stop transmission and induce herd immunity. If PsA-TT is to achieve the goal of preventing epidemics, it must be able to prevent the acquisition of pharyngeal carriage as well as invasive meningococcal disease and whether PsA-TT can prevent pharyngeal carriage needs to be determined. To address this issue, a consortium (the African Meningococcal Carriage (MenAfriCar) consortium) was established in 2009 to investigate the pattern of meningococcal carriage in countries of the African meningitis belt prior to and after the introduction of PsA-TT. This article describes how the consortium was established, its objectives and the standardised field and laboratory methods that were used to achieve these objectives. The experience of the MenAfriCar consortium will help in planning future studies on the epidemiology of meningococcal carriage in countries of the African meningitis belt and elsewhere. Un vaccin conjugué contenant un polysaccharide du sérogroupe A méningococcique et une anatoxine du tétanos (PsA-TT) (MenAfriVac™) est en cours de déploiement dans les pays de la ceinture africaine de la méningite. L’ expérience avec d’ autres vaccins conjugués polysaccharide/protéine a montré qu’ une partie importante de leur succès a été leur capacité à empêcher l’ acquisition du portage pharyngé et donc à arrêter la transmission et à induire une immunité de group. Si PsA-TT doit d’ atteindre l’ objectif de prévenir les épidémies, il devrait être en mesure d’ empêcher l’ acquisition du portage pharyngé ainsi que la méningococcie invasive et le fait que PsA-TT puisse emp

  4. Antibioticoterapia ambulatorial como fator de indução da resistência bacteriana: uma abordagem racional para as infecções de vias aéreas Outpatient antibiotic therapy as a predisposing factor for bacterial resistance: a rational approach to airway infections

    Directory of Open Access Journals (Sweden)

    Cristiana M. Nascimento-Carvalho

    2006-11-01

    Full Text Available OBJETIVOS: Apresentar as recomendações baseadas em evidência para uso de antibióticos no tratamento das infecções respiratórias agudas (IRA mais freqüentes e as informações disponíveis sobre a importância desse tipo de conduta. FONTES DOS DADOS: Bases de dados MEDLINE, LILACS, publicações técnicas de organizações internacionais, diretrizes nacionais e internacionais. Foram utilizados os unitermos acute respiratory infection, otitis, sinusitis, tonsillitis, pneumonia, antibiotic, guidelines, bacterial resistance. Artigos citados pelos artigos incluídos foram analisados quanto à apresentação de informação de interesse. SÍNTESE DOS DADOS: A resistência bacteriana tem crescido, sendo atualmente reconhecida como problema mundial de saúde pública. As IRA são a causa mais freqüente para uso de antibiótico na comunidade; grande parte desses casos, tanto nas vias aéreas superiores (otite, sinusite, faringoamidalite como nas inferiores (pneumonia, são decorrente de infecção viral. As recomendações para racionalizar o uso de antibióticos nos pacientes com IRA têm como objetivo comum minimizar o uso desnecessário de antibióticos, visto que a "pressão antibiótica" é um dos fatores desencadeantes da resistência bacteriana. CONCLUSÕES: É de grande importância a distinção, entre os pacientes com IRA, daqueles que podem se beneficiar do uso de antibióticos. O uso das recomendações para a prescrição de antibióticos é uma estratégia para minimizar a freqüência de resistência bacteriana.OBJECTIVES: To present evidence-based recommendations for the use of antibiotics for the treatment of the most common acute respiratory infections (ARI and the available information on the importance of this type of management. SOURCES: MEDLINE and LILACS databases, technical publications by international organizations, national and international directives. The search terms acute respiratory infection, otitis, sinusitis

  5. Use of intracranial pressure monitoring in bacterial meningitis

    DEFF Research Database (Denmark)

    Larsen, Lykke; Rom Poulsen, Frantz; Nielsen, Troels H

    2017-01-01

    BACKGROUND: The aim of this study was to evaluate the clinical outcome of patients with severe bacterial meningitis where intracranial pressure (ICP) monitoring has been performed. METHODS: A retrospective observational study including patients admitted 1st(.) January 2005 to 31st(.) December 2014...... CT scans with signs of elevated ICP. CONCLUSIONS: Patients with severe meningitis should be admitted to intensive care units and evaluated for ICP monitoring regardless of head CT findings....

  6. Streptococcus sanguinis meningitis following endoscopic ligation for oesophageal variceal haemorrhage.

    Science.gov (United States)

    Liu, Yu-Ting; Lin, Chin-Fu; Lee, Ya-Ling

    2013-05-01

    We report a case of acute purulent meningitis caused by Streptococcus sanguinis after endoscopic ligation for oesophageal variceal haemorrhage in a cirrhotic patient without preceding symptoms of meningitis. Initial treatment with flomoxef failed. The patient was cured after 20 days of intravenous penicillin G. This uncommon infection due to S. sanguinis adds to the long list of infectious complications among patients with oesophageal variceal haemorrhage.

  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. Chemical meningitis from a leaking craniopharyngioma: a case report.

    Science.gov (United States)

    Hakizimana, David; Poulsgaard, Lars; Fugleholm, Kåre

    2018-06-01

    Recurrent chemical meningitis from cyclic leakage of cyst content from a craniopharyngioma is a rare phenomenon. Here, we report a case of leaking cystic craniopharyngioma presenting with recurrent episodes of sterile meningitis, depression, and paranoia. The diagnosis after an initial craniotomy and exploration was hypophysitis. Signs and symptoms were not alleviated by puncture and biopsy of the tumour but they disappeared after complete resection with a final histological diagnosis of craniopharyngioma.

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

    LENUS (Irish Health Repository)

    O'Brien, Deirdre

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    O'brien, Deirdre

    2010-12-15

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

  11. Mondini malformation associated with diastematomyelia and presenting with recurrent meningitis.

    Science.gov (United States)

    Masri, Amira; Bakri, Faris G; Birkenhäger, Ralf; Alassaf, Abeer; Musharbash, Awni F; Haroun, Azmy; Zak, Imad

    2011-05-01

    The authors report the case of 5-year-old girl who presented with 4 episodes of recurrent meningitis. Her initial workup revealed a lumbosacral dermoid sinus associated with diastematomyelia and a tethered cord. Therefore, a surgical repair to correct the anomaly was performed. However, another episode of meningitis occurred after surgery, and a subsequent temporal bone scan revealed the presence of left Mondini dysplasia. To the authors' knowledge, this is the first report of Mondini dysplasia in association with diastematomyelia.

  12. Recurrent Bacterial Meningitis in a Child with Mondini Dysplasia

    OpenAIRE

    Kepenekli-Kadayifci, Eda; Karaaslan, Ayşe; Atıcı, Serkan; Binnetoğlu, Adem; Sarı, Murat; Soysal, Ahmet; Altınkanat, Gülşen; Bakır, Mustafa

    2014-01-01

    Mondini dysplasia, also known as Mondini malformation, is a developmental abnormality of the inner and middle ears that can cause hearing loss, cerebrospinal fluid (CSF) leakage, and recurrent bacterial meningitis (RBM), which is defined as two or more episodes of meningitis separated by a period of convalescence and the complete resolution of all signs and symptoms. An accurate diagnosis of the underlying pathology is crucial to prevent further episodes from occurring. Herein, we present a...

  13. Concomitant Bacterial Meningitis in Infants With Urinary Tract Infection.

    Science.gov (United States)

    Thomson, Joanna; Cruz, Andrea T; Nigrovic, Lise E; Freedman, Stephen B; Garro, Aris C; Ishimine, Paul T; Kulik, Dina M; Uspal, Neil G; Grether-Jones, Kendra L; Miller, Aaron S; Schnadower, David; Shah, Samir S; Aronson, Paul L; Balamuth, Fran

    2017-09-01

    To determine age-stratified prevalence of concomitant bacterial meningitis in infants ≤60 days with a urinary tract infection, we performed a 23-center, retrospective study of 1737 infants with urinary tract infection. Concomitant bacterial meningitis was rare, but more common in infants 0-28 days of age [0.9%; 95% confidence interval (CI): 0.4%-1.9%) compared with infants 29-60 days of age (0.2%; 95% CI: 0%-0.8%).

  14. [Congenital skull base defect causing recurrent bacterial meningitis].

    Science.gov (United States)

    Berliner, Elihay; Bar Meir, Maskit; Megged, Orli

    2012-08-01

    Bacterial meningitis is a life threatening disease. Most patients will experience only one episode throughout life. Children who experience bacterial meningitis more than once, require further immunologic or anatomic evaluation. We report a 9 year old child with five episodes of bacterial meningitis due to a congenital defect of the skull base. A two and a half year old boy first presented to our medical center with pneumococcal meningitis. He was treated with antibiotics and fully recovered. Two months later he presented again with a similar clinical picture. Streptococcus pneumoniae grew in cerebrospinal fluid (CSF) culture. CT scan and later MRI of the brain revealed a defect in the anterior middle fossa floor, with protrusion of brain tissue into the sphenoidal sinus. Corrective surgery was recommended but the parents refused. Three months later, a third episode of pneumococcal meningitis occurred. The child again recovered with antibiotics and this time corrective surgery was performed. Five years later, the boy presented once again with clinical signs and symptoms consistent with bacterial meningitis. CSF culture was positive, but the final identification of the bacteria was conducted by broad spectrum 16S ribosomal RNA PCR (16S rRNA PCR) which revealed a sequence of Neisseria lactamica. CT and MRI showed recurrence of the skull base defect with encephalocele in the sphenoid sinus. The parents again refused neurosurgical intervention. A year later the patient presented with bacterial meningitis. CSF culture obtained after initiation of antibiotics was negative, but actinobacillus was identified in the CSF by 16S rRNA PCR. The patient is scheduled for neurosurgical intervention. In patients with recurrent bacterial meningitis caused by organisms colonizing the oropharynx or nasopharynx, an anatomical defect should be carefully sought and surgically repaired.

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

    International Nuclear Information System (INIS)

    Shetter, A.G.; Fischer, D.W.; Flom, R.A.

    1985-01-01

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

  16. 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.

  17. Cerebelite aguda causada por vírus Epstein-Barr: relato de caso

    Directory of Open Access Journals (Sweden)

    Teive Hélio A.G.

    2001-01-01

    Full Text Available A cerebelite aguda pode ocorrer em associação a infecção pelo vírus da varicela-zoster, enterovirus, caxumba, micoplasma e outros agentes infecciosos. A cerebelite aguda é uma complicação rara da infecção pelo vírus Epstein-Barr (EBV. Relatamos o caso de uma mulher de 21 anos com história de 12 dias de evolução com náuseas, vômitos, ataxia de marcha e membros, tremor cefálico e de membros, opsoclono, mioclonias e rash cutâneo. Sorologia para EBV foi positiva. A infecção pelo EBV, com complicações neurológicas, pode não se apresentar com os sinais e sintomas clássicos da mononucleose infeciosa.

  18. Nutrição na pancreatite aguda : monografia : Nutrition in acute pancreatitis

    OpenAIRE

    Oliveira, Joana da Silva

    2009-01-01

    Resumo da tese:A pancreatite aguda (PA) é uma doença inflamatória aguda do pâncreas de etiologia multifactorial e pode ter atingimento local (PA ligeira a moderada) ou sistémico (PA grave). A magnitude da lesão pancreática, a presença e extensão da necrose e de infecção determinam o grau de gravidade. Prever a gravidade é fundamental para direccionar antecipadamente a terapêutica médica e nutricional. Na sua maioria, os episódios de PA são ligeiros a moderados, de resolução espontânea, enquan...

  19. Dor aguda no joelho do paciente idoso Acute knee pain in elderly patients

    Directory of Open Access Journals (Sweden)

    Gilberto Luís Camanho

    2008-09-01

    Full Text Available A dor aguda no joelho de pacientes idosos é freqüente, sendo caracterizada por seu aparecimento súbito, sem causa aparente, com exame radiográfico dentro dos padrões da normalidade, na maioria dos casos. A etiologia da dor aguda no joelho é decorrente de insuficiência das estruturas, e seu quadro clínico difere completamente daquele determinado pela osteoartrose, sendo sempre unilateral e ocorre na grande maioria em pacientes do sexo feminino, após a quinta década de vida, e na região medial do joelho (local de maior carga. Com o propósito de analisar as possíveis etiologias para a dor aguda do joelho de pacientes acima de 60 anos de idade, suas características e tratamento, os autores discutem as etiologias relacionadas à dor aguda: lesão meniscal, fratura por fadiga e osteonecrose idiopática.Acute knee pain in elderly patients is not uncommon, and is characterized by a sudden onset, no apparent cause, and by normal radiographic findings in most cases. The etiology of acute knee pain is the result of insufficient structures, and clinical symptoms are totally different from the symptoms seen in osteoarthrosis. This acute pain in the knee is always unilateral and in the medial region of the knee joint (site with the heaviest load, predominantly in females after the fifth decade of live. In order to consider the possible etiologies for acute knee joint pain in patients older than 60 years, its characteristics and treatment, the authors discuss etiologies related to acute pain: lesion of the meniscus, stress fracture, and idiopathic osteonecrosis.

  20. Perfiles clínicos y hemodinámicos en pacientes con falla cardiaca aguda

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Calderón

    2017-09-01

    Conclusiones: la falla cardíaca aguda descompensada es el perfil de presentación clínica más común en nuestra población con dos tercios del total de casos. El perfil hemodinámico más frecuente fue el “caliente y húmedo” (Stevenson B, resultados que concuerdan con lo observado en estudios locales y registros internacionales.

  1. Primeiro consenso brasileiro do tratamento da fase aguda do acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    2001-01-01

    Full Text Available Este texto apresenta a síntese das conclusões do Iº Consenso Brasileiro do Tratamento da Fase Aguda do Acidente Vascular Cerebral (AVC. Tratou-se de reunião patrocinada e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados nas doenças cerebrovasculares, que analisaram os principais itens da conduta dos AVC.

  2. Relación entre las infecciones respiratorias agudas altas y el asma bronquial

    Directory of Open Access Journals (Sweden)

    Verónica Soler Fonseca

    Full Text Available Introducción: la infección respiratoria es la enfermedad más frecuente en los seres humanos, pues es responsable de la mitad de todas las enfermedades agudas. En Cuba al igual que en el resto del mundo, el asma bronquial constituye un importante problema de salud con incidencia relevante en los niños. Se señala que las infecciones virales están involucradas en la patogénesis del asma, sobre todo en el paciente pediátrico. Objetivo: identificar la influencia de las Infecciones Respiratorias Agudas Altas en la aparición y exacerbación de las crisis de asma bronquial. Métodos: se realizó un estudio descriptivo, transversal y prospectivo de los pacientes ingresados con asma bronquial en el servicio de enfermedades respiratorias del Hospital Pediátrico Docente de San Miguel del Padrón, durante todo el año 2008. Resultados: el tiempo de evolución de la IRAA más frecuente que desencadenó la crisis de asma bronquial fue de más de 7 días, con un 54,8 %. Un total de 188 pacientes presentaron rinofaringitis aguda catarral relacionada con la aparición de la crisis de asma bronquial, lo que representó el 82,4 % del total de la muestra. Conclusiones: predominó el grupo de 1 a 4 años con manifestaciones respiratorias altas de posible etiología viral sin diferencias apreciables en relación con el sexo. La mayoría de los pacientes que participaron en el estudio presentaron IRAA de etiología viral (Rinofaringitis, que precedieron la aparición y exacerbación de las crisis agudas de asma bronquial.

  3. Sertralina e pancreatite aguda: relato de caso Sertraline and acute pancreatitis: a case-report

    Directory of Open Access Journals (Sweden)

    André Malbergier

    2004-03-01

    Full Text Available A pancreatite aguda é uma patologia grave e com considerável morbidade e mortalidade. Vários fatores são apontados como possíveis causas de pancreatite aguda. Neste relato, será apresentado um caso de pancreatite aguda com possível associação causal com um inibidor seletivo de recaptura de serotonina: sertralina. Após um mês de tratamento com sertralina, uma paciente do sexo feminino, 55 anos, desenvolveu forte dor abdominal e elevação da amilase sérica. Após internação e retirada da sertralina, seus sintomas remitiram e os níveis de amilase voltaram ao normal. Pela potencial gravidade do quadro e pelo amplo uso desta medicação, tal associação deve ser lembrada em investigações de casos de pancreatite aguda.Acute pancreatitis is a severe disease with considerable morbidity and mortality. Many risk factors are causally related to acute pancreatitis. In this report, a case of acute pancreatitis with possible causal relationship with the use of a selective serotonin reuptake inhibitor, sertraline, will be discussed. After one month of treatment with sertraline, a female patient, 55 years-old, developed a severe abdominal pain and showed a serum amylase elevation. She was admitted to the hospital and the use of sertraline was interrupted. After that, the symptoms remitted and the serum amylase level returned to normal. Because of the potential severity of this disease and the widespread use of sertraline, this association should be reminded when investigating possible causes for acute pancreatitis.

  4. Necessidades básicas das esposas de pacientes infartados na fase aguda do tratamento

    Directory of Open Access Journals (Sweden)

    Edna Ikumi Umebayashi Takahashi

    1990-12-01

    Full Text Available Trata-se de um estudo exploratório que teve por finalidade as necessidades básicas das esposas de pacientes infartados, na fase aguda do tratamento. Foi utlizado como referencial para análise os conceitos de Nacessidades Básicas de MASLOW. Os resultados permitiram identificar como principais necessidades afetadas das esposas: segurança, amor e gregária, estima.

  5. NECESSIDADES BÁSICAS DAS ESPOSAS DE PACIENTES INFARTADOS, NA FASE AGUDA DO TRATAMENTO

    Directory of Open Access Journals (Sweden)

    Edna Ikumi Umebayashi Takahashi

    Full Text Available Trata-se de um estudo exploratório que teve por finalidade identificar as necessidades básicas das esposas de pacientes infartados, na fase aguda do tratamento. Foi utilizado como referencial para análise os conceitos de Necessidades Básicas de Maslow. Os resultados permitiram identificar como principais necessidades afetadas das esposas: segurança, amor e gregária, estima.

  6. Necessidades básicas das esposas de pacientes infartados na fase aguda do tratamento

    Directory of Open Access Journals (Sweden)

    Edna Ikumi Umebayashi Takahashi

    Full Text Available Trata-se de um estudo exploratório que teve por finalidade as necessidades básicas das esposas de pacientes infartados, na fase aguda do tratamento. Foi utlizado como referencial para análise os conceitos de Nacessidades Básicas de MASLOW. Os resultados permitiram identificar como principais necessidades afetadas das esposas: segurança, amor e gregária, estima.

  7. Algunas observaciones sobre la apendicitis aguda en los niños

    Directory of Open Access Journals (Sweden)

    Luis Piñeros Suárez

    1940-03-01

    Full Text Available La apendicitis aguda en los niños, presenta actitudes particulares que diferencian de la apendicitis aguda del adulto y que vienen a formar grupos clínicos casi exclusivamente de la infancia. De una manera general, las formas más graves, las formas fulminantes de la apendicitis aguda se encuentran especialmente en la infancia y en estas formas graves llama poderosamente la atención, la falta de relación entre los signos clínicos observados y la importancia de las lesiones encontradas en el apéndice y el peritoneo, pues en los niños con signos de intensidad media y sin que se hayan presentado los síntomas que en el adulto caracterizan las formas graves de apendicitis, podemos encontrar en las operaciones practicadas en las primeras 24 a 36 horas, peritonitis generalizadas, formas de apendicitis gangrenosas, que no son frecuentes en el adulto y mucho menos en un lapso de tiempo tan corto.

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

    Directory of Open Access Journals (Sweden)

    A. Nagel

    2008-09-01

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

  9. Infarto esplénico secundario a pancreatitis aguda Splenic infarction secondary to acute pancreatitis

    Directory of Open Access Journals (Sweden)

    J. J. Arenal Vera

    2008-05-01

    Full Text Available Fundamento y objetivo: la estrecha relación anatómica del páncreas con los vasos esplénicos y el bazo es responsable de complicaciones esplénicas en el curso de la pancreatitis aguda. El objetivo es presentar dos casos clínicos de pancreatitis aguda grave que sufrieron infarto esplénico como complicación de la enfermedad pancreática. Pacientes, participantes: en un periodo de tres meses, dos pacientes fueron diagnosticados de infarto esplénico secundario a pancreatitis aguda. En ambos casos el diagnóstico y seguimiento evolutivo del infarto esplénico se hizo a través de tomografía axial computerizada. Resultados: en el primer paciente, las imágenes muestran de forma inequívoca la afectación de la arteria esplénica por el proceso inflamatorio pancreático. En el segundo, no se pudo demostrar afectación de los vasos esplénicos, por lo que la única posible explicación etiológica es un incremento de coagulabilidad intravascular. Conclusiones: sería recomendable añadir las complicaciones esplénicas al conjunto de complicaciones graves extrapancreáticas de la pancreatitis aguda. La tomografía axial computerizada es de gran utilidad para la detección y seguimiento de las complicaciones esplénicas de la pancreatitis aguda.Background and objective: the close anatomic relationship of the pancreas with the splenic vessels and the spleen is responsible for splenic complications in the course of acute pancreatitis. Our objective was to report two cases of severe acute pancreatitis complicated by splenic infarction. Patients: in a three-month period of time two patients were diagnosed with splenic infarction secondary to acute pancreatitis. In both cases splenic infarction diagnosis and follow-up were carried out using computed tomography. Results: in the first case images clearly showed a narrowing of the splenic artery due to the inflammatory pancreatic condition. In the second case no involvement of the splenic vessels could

  10. Tratamiento quirúrgico de las colecciones agudas y crónicas del pericardio

    Directory of Open Access Journals (Sweden)

    Orestes Noel Mederos Curbelo

    Full Text Available Introducción: las colecciones agudas o crónicas del pericardio con frecuencia producen una compresión del corazón que en los casos crónicos conlleva invalidez y, en los agudos, peligro de muerte por taponamiento cardíaco. Objetivo: caracterizar a los pacientes intervenidos quirúrgicamente en el Hospital Universitario "Comandante Manuel Fajardo" entre 1995 y 2012 a causa de colecciones pericárdicas. Métodos: se realizó un estudio descriptivo transversal con los pacientes atendidos quirúrgicamente en dicha institución por colecciones del pericardio. Constituyeron el universo 24 pacientes: 22 con colecciones agudas y 2 con colecciones crónicas. Resultados: la causa más frecuente de los derrames agudos fue la pericarditis aguda idiopática (25 %. Las colecciones crónicas fueron por pericarditis fibrosa de causa idiopática en el 100 % de los enfermos. La intervención realizada fue la resección del pericardio y el drenaje de las colecciones agudas mediante toracotomía izquierda o por vía preperitoneal subxifoidea. En las colecciones de origen maligno se realizó la resección pericárdica con fines paliativos y, en los derrames por lesión traumática del corazón, la sutura de este órgano fue el tratamiento quirúrgico empleado en todos los casos. En las pericarditis constrictivas, la pericardiectomía radical fue el tratamiento empleado en el 100 % de los casos. Conclusiones: el tratamiento quirúrgico en las colecciones agudas y crónicas del pericardio permite drenar el contenido por una ventana pericárdica obtenida por toracoscopia o por vía preperitoneal subxifoidea, mientras que la toracotomía izquierda es útil en las emergencias. En los derrames crónicos con fibrosis y síntomas de insuficiencia cardíaca, la pericardiectomía radical mediante esternotomía media ofrece los mejores resultados.

  11. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

    Directory of Open Access Journals (Sweden)

    Palazón Sánchez C

    2000-01-01

    Full Text Available Fundamento: Conocer la epidemiología de las intoxicaciones agudas graves en un servicio de medicina intensiva y evaluar el pronóstico de la PCR y mortalidad asociada a los distintos tóxicos Métodos: Estudio retrospectivo realizado en el servicio de medicina intensiva polivalente de 10 camas, ubicado en un Hospital General de adultos. Período de estudio 12 años. Revisión de las historias clínicas de las personas ingresadas en el servicio de medicina intensiva por intoxicaciones agudas graves. Se recogieron datos demográficos, existencia de PCR al ingreso, necesidad de VM, complicaciones de las intoxicaciones agudas graves y mortalidad de la serie. Se realizó un análisis global y por año de estudio. El tratamiento estadístico de los datos se realizó con el paquete SPSS mediante la "t" de Student o la "chi" cuadrado, considerando valores significativos si p<0,05 Resultados: Se han incluido 233 sujetos, de los que 130 fueron varones. La estancia media fue de 4 días. El 63% de los pacientes fueron menores de 40 años (p<0,05. La intoxicación más frecuente fue la medicamentosa debida a un solo producto (72%. La supervivencia tras la PCR fue del 40% (4/10. La mortalidad global se situó en el 5,6% (n=13, habiendo precisado el 92% de los sujetos que posteriormente murieron, VM en algún momento de su ingreso en la unidad de cuidados intensivos. Conclusiones: En nuestro medio, la intoxicación más frecuente es la medicamentosa. La mortalidad se muestra dependiente del carácter de voluntariedad, pero independiente del tipo de tóxico (medicamentoso o no. La PCR asociada a las intoxicaciones agudas graves tiene, en nuestra serie, un mejor pronostico que la asociada a otras patologías. La VM asociada a las intoxicaciones agudas graves tiene una mortalidad baja (15,7%

  12. FDG PET in the diagnosis of meningeal carcinomatosis

    International Nuclear Information System (INIS)

    Guan, Y. H.; Zuo, C.T.; Zhao, J.; Hua, F.C.; Lin, X.T.

    2002-01-01

    Objective: Meningeal involvement is frequent in metastatic lymphoma, leukemia, and other metastatic tumor. Functional signs may be misleading and the neurological examination may be normal or non-specific. Certain diagnosis requires identification of tumor cells in the cerebrospinal fluid. CSF cytology is however sometimes negative and MRI maybe help in providing the diagnosis. The aim of our retrospective study was to assess the role of FDG PET in the diagnosis of meningeal carcinomatosis. Patients and Methods: The diagnosis of meningeal carcinomatosis was made in 5 patients between 1999 and 2001. Two of the patients were suffer from lymphoma, two were lung cancer patients, and another was a breast cancer patient. Cytology examination of the cerebrospinal fluid provided the diagnosis of meningeal carcinomatosis in these 5 patients. All the patients had signs of neurological function impairment, but the neurological examination cannot demonstrate the site of lesions. Therefore, All the patients had MRI examination, but only 1 case was diagnosis correctly (the MRI showing meningeal enhancement). 3 patients' MRI results show normal .Another MRI was suspicious of ischemic change. Results: A brain FDG PET using an ECAT HR + PET examined all the 5 patients. All the FDG PET results show the hypermetabolic foci respectively. The foci were diffused on the brain meninges. Their size is bigger than the foci detected by MRI . 3 of the patients repeated the FDG PET scan after treatment (chemotherapy and radiotherapy). The therapeutic effect can be reflecting by FDG PET (the foci dismissed as the neurological symptoms disappeared), although the simultaneity MRI shows no change before and after treatment. Conclusion: 5 patients proven meningeal carcinomatosis FDG PET has better sensitivity than brain MRI scans and other anatomic modality. The patients who suffer from metastatic lymphoma, leukemia, and other metastatic tumor with nonspecific neurological signs should be explored

  13. 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.

  14. Serratia marcescens meningitis: epidemiology, prognostic factors and treatment outcomes.

    Science.gov (United States)

    Wu, Yen-Mu; Hsu, Po-Chang; Yang, Chien-Chang; Chang, Hong-Jyun; Ye, Jung-Jr; Huang, Ching-Tai; Lee, Ming-Hsun

    2013-08-01

    Serratia marcescens is a rare pathogen of central nervous system infections. This study was to investigate the epidemiology, prognostic factors, and treatment outcomes of S. marcescens meningitis. This retrospective analysis included 33 patients with culture-proven S. marcescens meningitis hospitalized between January 2000 and June 2011. Of the 33 patients enrolled, only one did not receive neurosurgery before the onset of S. marcescens meningitis. Patients with S. marcescens meningitis had higher ratios of brain solid tumors (54.5%) and neurosurgery (97.0%) with a mortality rate of 15.2%. The mean interval between the first neurosurgical procedure and the diagnosis of meningitis was 17.1 days (range, 4-51 days). Only one third-generation cephalosporin-resistant S. marcescens isolate was recovered from the patients' cerebrospinal fluid (CSF) specimens. Compared with the favorable outcome group (n = 20), the unfavorable outcome group (n = 13) had a higher percentage of brain solid tumors, more intensive care unit stays, and higher Sequential Organ Failure Assessment score, CSF lactate and serum C-reactive protein concentrations at diagnosis of meningitis. Under the multiple regression analysis, CSF lactate concentration ≥2-fold the upper limit of normal (ULN) was independently associated with unfavorable outcomes (odds ratio, 7.20; 95% confidence interval, 1.08-47.96; p = 0.041). S. marcescens meningitis is highly associated with neurosurgical procedures for brain solid tumors. CSF lactate concentration ≥2x ULN may predict an unfavorable outcome. Its mortality is not high and empiric treatment with parenteral third-generation cephalosporins may have a satisfactory clinical response. Copyright © 2012. Published by Elsevier B.V.

  15. Effect of hyperthermia on experimental acute pancreatitis Efeito da hipertermia na pancreatite aguda experimental

    Directory of Open Access Journals (Sweden)

    José Luiz Jesus de Almeida

    2006-12-01

    Full Text Available BACKGROUD: Recent studies indicate that hyperthermia can change inflammatory mechanisms and protect experimental animals from deleterious effects of secretagogue-induced acute pancreatitis AIM: To evaluate the effects of hyperthermia post-treatment on cerulein-induced acute pancreatitis in rats METHODS: Twenty animals were divided in two groups: group I (n = 10, rats with cerulein-induced acute pancreatitis undergone hyperthermia, and group II (n = 10, animals with cerulein-induced acute pancreatitis that were kept normothermic. In all groups, amylase serum levels, histologic damage, vascular permeability and pancreatic water content were assessed. Acute pancreatitis was induced by administration of two cerulein injections (20 mcg/kg. A single dose of Evans' blue dye was administered along with the second dose of cerulein. All animals also received a subcutaneous injection of saline solution. After this process, animals undergone hyperthermia were heated in a cage with two 100 W lamps. Body temperature was increased to 39.5ºC and maintained at that level for 45 minutes. Normothermia rats were kept at room temperature in a second cage RESULTS: Control animals had typical edema, serum amylase activity and morphologic changes of this acute pancreatitis model. Hyperthermia post-treatment ameliorated the pancreatic edema, whereas the histologic damage and the serum amylase level remained unchanged CONCLUSIONS: The findings suggest a beneficial effect of the thermal stress on inflammatory edema in experimental acute pancreatitis.RACIONAL: Estudos recentes indicam que a hipertermia pode modificar mecanismos inflamatórios e proteger animais experimentais dos efeitos deletérios da pancreatite aguda induzida por secretagogos OBJETIVO: Avaliar a eficácia da hipertermia como tratamento da pancreatite aguda induzida por ceruleína em ratos MÉTODOS: Vinte animais foram divididos em dois grupos: grupo I (n = 10, ratos com pancreatite aguda induzida por

  16. [Mondini dysplasia: recurrent bacterial meningitis in adolescence].

    Science.gov (United States)

    Vargas-Dĭaz, J; Garófalo-Gómez, N; Rodríguez, U; Parra, M; Barroso-García, E; Novoa-López, L; Rojas-Massipe, E; Sardiñas-Hernández, N L

    Episodes of recurrent bacterial meningitis can occur in patients due to either congenital or acquired disorders. Congenital deformity of the bony labyrinth can be linked to a fistulous tract communicating it with the intracranial subarachnoid space. Mondini deformity is a frequent malformation in congenitally deaf patients. We report the case of an adolescent with a history of being unable to hear in one ear who, from the age of 10 years, began to suffer repeated bacterial meningoencephalitis with microbiological recovery of Streptococcus pneumoniae on three occasions. The type of germ recovered in the cerebrospinal fluid (CSF) and the history of congenital deafness that was detected when the patient was 3 years old were the diagnostic clues to the possible anomaly of the inner ear with a CSF fistula. The clinically proven CSF rhinorrhea contributed to the diagnosis of an ear anomaly with a fistula. Computerised axial tomography and magnetic resonance studies of the petrous portion of the temporal bone revealed the malformation that was later found and closed during the surgical intervention on the affected ear. The clinical absence of rhinorrhea, a year's progression without new infections after operating on the patient and post-surgery imaging studies were all proof that the fistula had closed. Mondini dysplasia with CSF fistula must be included as a possible diagnosis when faced with a patient with recurrent bacterial meningoencephalitis. Imaging studies, especially magnetic resonance, enable the clinician to check the diagnosis and the CSF fistula can be closed with ear surgery.

  17. Tuberculous Meningitis: Diagnosis and Treatment Overview

    Directory of Open Access Journals (Sweden)

    Grace E. Marx

    2011-01-01

    Full Text Available Tuberculous meningitis (TBM is the most common form of central nervous system tuberculosis (TB and has very high morbidity and mortality. TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Characteristic cerebrospinal fluid (CSF findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples. Nucleic acid amplification of the CSF by PCR is highly specific but suboptimal sensitivity precludes ruling out TBM with a negative test. Treatment for TBM should be initiated as soon as clinical suspicion is supported by initial CSF studies. Empiric treatment should include at least four first-line drugs, preferably isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol; the role of fluoroquinolones remains to be determined. Adjunctive treatment with corticosteroids has been shown to improve mortality with TBM. In HIV-positive individuals with TBM, important treatment considerations include drug interactions, development of immune reconstitution inflammatory syndrome, unclear benefit of adjunctive corticosteroids, and higher rates of drug-resistant TB. Testing the efficacy of second-line and new anti-TB drugs in animal models of experimental TBM is needed to help determine the optimal regimen for drug-resistant TB.

  18. Microcristais biliares na pancreatite aguda idiopática: indício para etiologia biliar oculta subjacente

    Directory of Open Access Journals (Sweden)

    CHEBLI Júlio Maria Fonseca

    2000-01-01

    Full Text Available As principais causas de inflamação pancreática no mundo são a litíase biliar e o alcoolismo crônico. Admite-se que 10 a 30% das pancreatites agudas sejam idiopáticas. Sugere-se que parte destas são causadas por microlitíase ou barro biliar, identificados pela presença de microcristais no sedimento biliar. Neste estudo, realizou-se análise microscópica da bile obtida por colangiopancreatografia endoscópica, em pacientes com pancreatite aguda idiopática, pancreatite aguda biliar e pancreatite crônica alcoólica - 20 em cada grupo. Pacientes com pancreatite aguda idiopática e microcristais na bile foram submetidos a colecistectomia. Naqueles inaptos à cirurgia efetuou-se esfincterotomia endoscópica ou tratamento com ácido ursodesoxicólico. Pacientes com pancreatite aguda idiopática sem cristais não receberam tratamento específico. A prevalência de microcristais biliares em pacientes com pancreatite aguda idiopática (75% e pancreatite aguda biliar (90% foi significativamente maior que naqueles com pancreatite crônica alcoólica (15%. A detecção de microcristais apresentou sensibilidade de 90%, especificidade de 85%, valor preditivo positivo de 85,7%, valor preditivo negativo de 89,4% e acurácia de 87,5% em identificar pancreatite de origem biliar. Nos pacientes com pancreatite aguda idiopática recurrente, cursando com microcristais, houve redução significante dos episódios de pancreatite após tratamento específico. No seguimento deste grupo durante 23,3 meses, recidiva ocorreu apenas naqueles que apresentavam "fator biliar persistente" (coledocolitíase ou microcristais. Todos os pacientes com pancreatite aguda idiopática submetidos a colecistectomia apresentavam colecistite crônica, e microlitíase foi observada em um paciente. No seguimento ultra-sonográfico, colelitíase foi detectada em um dos casos. No subgrupo de cinco pacientes com pancreatite aguda idiopática sem microcristais houve uma recidiva. Estudo

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

    International Nuclear Information System (INIS)

    Good, C.D.; Jaeger, H.R.

    2000-01-01

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

  20. Cerebrospinal fluid leakage during transsphenoidal surgery: postoperative external lumbar drainage reduces the risk for meningitis

    NARCIS (Netherlands)

    van Aken, M. O.; Feelders, R. A.; de Marie, S.; van de Berge, J. H.; Dallenga, A. H. G.; Delwel, E. J.; Poublon, R. M. L.; Romijn, J. A.; van der Lely, A. J.; Lamberts, S. W. J.; de Herder, W. W.

    2004-01-01

    Postoperative meningitis is a well known complication of transsphenoidal surgery (TSS). The objective of this study was to evaluate whether postoperative external cerobrospinal fluid (CSF) drainage in case of intraoperative CSF-leakage, reduces the risk of postoperative meningitis. We

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

    NARCIS (Netherlands)

    van Samkar, A.

    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

  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 diagnos...

  3. CSF ADA Determination in Early Diagnosis of Tuberculous Meningitis in HIV-Infected Patients.

    Science.gov (United States)

    Ghosh, Gopal Chandra; Sharma, Brijesh; Gupta, B B

    2016-01-01

    Tuberculous and Cryptococcal meningitis are common in HIV patients. A highly specific and sensitive rapid test for diagnosis of Tuberculous meningitis especially in setting of HIV is not available in developing countries where the burden of disease is high. We measured ADA (adenosine deaminase) levels using spectrophotometric method in the CSF of HIV patients with meningitis to differentiate Tuberculous meningitis from meningitis due to other causes. Kruskal-Wallis test was used to compare ADA values between tuberculous meningitis (TBM) and nontuberculous (non-TB) meningitis patients and a receiver-operating characteristic (ROC) analysis curve was drawn from these values. Levels of ADA in the CSF of patients with TBM were significantly higher than those in patients with meningitis due to other causes. CSF ADA level determination with a cut-off value of 6 IU/L was found to be highly specific and fairly sensitive test for the diagnosis of TBM in HIV positive patients.

  4. Procoagulant and fibrinolytic activity in cerebrospinal fluid from adults with bacterial meningitis

    NARCIS (Netherlands)

    Weisfelt, Martijn; Determann, Rogier M.; de Gans, Jan; van der Ende, Arie; Levi, Marcel; van de Beek, Diederik; Schultz, Marcus J.

    2007-01-01

    OBJECTIVES: This study investigated levels of coagulation and fibrinolysis factors in cerebrospinal fluid (CSF) from adults with bacterial meningitis in relation to development of brain infarction. METHODS: CSF was collected from 92 adults with community-acquired bacterial meningitis, who

  5. Meningeal carcinomatosis: a retrospective analysis of seventy-seven cases

    Institute of Scientific and Technical Information of China (English)

    Feng-Na Chu; Yue Lang; Xiao-Min Sun; Li Cui

    2017-01-01

    Aim:Meningeal carcinomatosis is a special type of malignant tumor characterized by short survival and poor prognosis.In the present study,the authors aim to analyze the clinical,laboratory data and prognosis of meningeal carcinomatosis patients.Methods:The authors enrolled 77 cases of meningeal carcinomatosis from 2003 to 2013 in the First Hospital of Jilin University.The clinical data including age,gender,symptoms at onset,clinical manifestations,primary tumors and the laboratory data including cerebrospinal fluid (CSF),tumor markers as well as the imaging data were analyzed.The interval between the onset of primary tumor and the onset of central nervous symptoms,treatments and survival time were also analyzed.Results:The onset of meningeal carcinomatosis was usually acute (46.2%) or subacute (39.0%).The most frequent symptom at onset was intracranial hypertension (70.1%).Symptoms such as headache,vomit and high lumbar puncture intracranial pressure was observed in 56% of cases during the course of the disease.CSF abnormalities such as higher protein concentration (73.4%),more CSF pleocitosis (57.1%) and lower glucose levels (48.4%) were found in 95.3% of meningeal carcinomatosis patients.Non-contrast enhanced cerebral magnetic resonance imaging (MRI) showed that 13.2% patients had abnormal meningeal changes while in the enhancement scan 35.3% patients showed changes.The serum tumor markers increased in 84% of the patients.There were no differences regarding the mean survival between patients who received intrathecal chemotherapy and those who received brain radiotherapy or supportive treatment.Conclusion:The most common clinical manifestation of meningeal carcinomatosis is intracranial hypertension.The most common primary tumor is lung cancer,followed by gastric cancer and breast cancer.The linear enhancement of meningeal on the MRI scan is of great importance for the diagnosis of meningeal carcinomatosis.

  6. 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.

  7. MRI features of meningeal metastasis from lung cancer

    International Nuclear Information System (INIS)

    Luo Xuemao; Long Wansheng; Jin Zhifa; Hu Maoqing; Mai Xuyu

    2009-01-01

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

  8. The meninges: new therapeutic targets for multiple sclerosis.

    Science.gov (United States)

    Russi, Abigail E; Brown, Melissa A

    2015-02-01

    The central nervous system (CNS) largely comprises nonregenerating cells, including neurons and myelin-producing oligodendrocytes, which are particularly vulnerable to immune cell-mediated damage. To protect the CNS, mechanisms exist that normally restrict the transit of peripheral immune cells into the brain and spinal cord, conferring an "immune-specialized" status. Thus, there has been a long-standing debate as to how these restrictions are overcome in several inflammatory diseases of the CNS, including multiple sclerosis (MS). In this review, we highlight the role of the meninges, tissues that surround and protect the CNS and enclose the cerebral spinal fluid, in promoting chronic inflammation that leads to neuronal damage. Although the meninges have traditionally been considered structures that provide physical protection for the brain and spinal cord, new data have established these tissues as sites of active immunity. It has been hypothesized that the meninges are important players in normal immunosurveillance of the CNS but also serve as initial sites of anti-myelin immune responses. The resulting robust meningeal inflammation elicits loss of localized blood-brain barrier (BBB) integrity and facilitates a large-scale influx of immune cells into the CNS parenchyma. We propose that targeting the cells and molecules mediating these inflammatory responses within the meninges offers promising therapies for MS that are free from the constraints imposed by the BBB. Importantly, such therapies may avoid the systemic immunosuppression often associated with the existing treatments. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. A Rare Case of Salmonella typhi Meningitis in an Eleven Month Old ...

    African Journals Online (AJOL)

    Non-typhoidal Salmonella are infrequent causes of childhood meningitis. Most reports of Salmonella typhi meningeal infections are confined to neonates. A rare instance of S. typhi in an otherwise healthy eleven month old infant is being reported. Keywords: Salmonella typhi, meningitis, infant.

  10. Interleukin-18 gene-deficient mice show enhanced defense and reduced inflammation during pneumococcal meningitis

    NARCIS (Netherlands)

    Zwijnenburg, Petra J. G.; van der Poll, Tom; Florquin, Sandrine; Akira, Shizuo; Takeda, Kiyoshi; Roord, John J.; van Furth, A. Marceline

    2003-01-01

    To determine the role of endogenous interleukin-18 (IL-18) in pneumococcal meningitis, meningitis was induced in IL-18 gene-deficient (IL-18(-/-)) and wild-type (WT) mice by intranasal inoculation of Streptococcus pneumoniae with hyaluronidase. Induction of meningitis resulted in an upregulation of

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

    International Nuclear Information System (INIS)

    Sakamoto, S.; Kitagaki, H.; Ishii, K.; Yamaji, S.; Ikejiri, Y.; Mori, E.

    1997-01-01

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

  12. Severe aseptic meningitis with hydrocephalus following iotrolan myelography: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hyoung; Ha, Choong Kun; Ahn, In Oak [Gyeongsang National University College of Medicine, Jinju (Korea, Republic of)

    1993-05-15

    A case of severe aseptic meningitis with communicating hydrocephalus following iotrolan myelography is presented. The patient's condition improved very quickly after corticosteroid therapy. Rapid improvement and absence of pathogenic organisms in the CSF culture strongly favor an aseptic meningitis. This is the first reported case of aseptic meningitis with the secondary development of hydrocephalus caused by iotrolan myelography.

  13. Pitfalls Associated With the Use of Molecular Diagnostic Panels in the Diagnosis of Cryptococcal Meningitis.

    Science.gov (United States)

    O'Halloran, Jane A; Franklin, Alexander; Lainhart, William; Burnham, Carey-Ann; Powderly, William; Dubberke, Erik

    2017-01-01

    We report the case of a kidney transplantation patient on chronic immunosuppressive therapy presenting with subacute meningitis. The final diagnosis of cryptococcal meningitis was delayed due to 2 false-negative cryptococcal results on a molecular diagnostic panel. Caution with such platforms in suspected cryptococcal meningitis is needed.

  14. Severe aseptic meningitis with hydrocephalus following iotrolan myelography: A case report

    International Nuclear Information System (INIS)

    Kim, Jae Hyoung; Ha, Choong Kun; Ahn, In Oak

    1993-01-01

    A case of severe aseptic meningitis with communicating hydrocephalus following iotrolan myelography is presented. The patient's condition improved very quickly after corticosteroid therapy. Rapid improvement and absence of pathogenic organisms in the CSF culture strongly favor an aseptic meningitis. This is the first reported case of aseptic meningitis with the secondary development of hydrocephalus caused by iotrolan myelography

  15. Interleukin-18 gene-deficient mice show enhanced defense and reduced inflammation during pneumococcal meningitis.

    NARCIS (Netherlands)

    Zwijnenburg, P.J.G.; Poll, van der T.; Florquin, S; Akira, S; Takeda, K; Roord, J.J.; Furth, van A.M.

    2003-01-01

    To determine the role of endogenous interleukin-18 (IL-18) in pneumococcal meningitis, meningitis was induced in IL-18 gene-deficient (IL-18(-/-)) and wild-type (WT) mice by intranasal inoculation of Streptococcus pneumoniae with hyaluronidase. Induction of meningitis resulted in an upregulation of

  16. Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children

    Science.gov (United States)

    Pires, Frederico Ribeiro; Franco, Andréia Christine Bonotto Farias; Gilio, Alfredo Elias; Troster, Eduardo Juan

    2017-01-01

    ABSTRACT Objective To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. Results The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Conclusion Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone. PMID:28767914

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

    Directory of Open Access Journals (Sweden)

    Syriopoulou Vassiliki P

    2007-08-01

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

  18. 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.

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

    International Nuclear Information System (INIS)

    Suh, Dae Chul; Park, Young Seo

    1991-01-01

    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

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

    International Nuclear Information System (INIS)

    Trautmann, M.; Loddenkemper, R.; Hoffmann, H.G.; Krankenhaus Zehlendorf, Berlin; Allgemeines Krankenhaus Altona

    1982-01-01

    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. (orig.) [de

  1. Evaluation of meningeal enhancement with Gd-DTPA

    International Nuclear Information System (INIS)

    Phillips, M.; Ryals, T.J.; Yuh, W.T.C.; Kambho, S.

    1989-01-01

    Forty-three consecutive patients (16 with tumor, 11 with inflammation, 16 postoperative) with abnormal meningeal enhancement were studied. Positive pathology was obtained in 75% of tumors and 100% of inflammatory conditions. Pial enhancement was demonstrated in seven of 11 patients with inflammation, four of 16 with tumor, and two of 16 postoperative patients. Diffuse meningeal enhancement was most commonly present with neoplastic and inflammatory etiologies. Localized enhancement predominated in the postoperative population, unless complicated by a subdural hematoma. A nodular appearance was present in two patients with tumor. In conclusion, Gd-DTPA MR imaging is sensitive to but not specific of meningeal pathology. MR imaging is better in inflammatory than in neoplastic conditions

  2. Cerebral oxygenation and energy metabolism in bacterial meningitis

    DEFF Research Database (Denmark)

    Larsen, Lykke

    Introduction: In a recent retrospective study of patients with severe bacterial meningitis we demonstrated that cerebral oxidative metabolism was affected in approximately 50% of the cases. An increase of lactate/pyruvate (LP) ratio above the upper normal limit, defined according to according...... bacterial meningitis; secondly to examine whether it is correct to separate the diagnosis of cerebral ischemia from mitochondrial dysfunction based exclusively on the biochemical pattern obtained during intracerebral microdialysis. Method: A prospective clinical study including patients with severe...... community acquired bacterial meningitis admitted to the Department of Infectious Diseases, Odense University Hospital, during the period January 2014 to June 2016. We relate data from measurements of brain tissue oxygen tension (PbtO2) to simultaneously recorded data reflecting cerebral cytoplasmic redox...

  3. Meningeal carcinomatosis as first manifestation of gastric carcinoma

    International Nuclear Information System (INIS)

    Romero R, Alfredo E; Mantilla H, Julio C; Melo U, Mario A; Barajas S, Paula A; Chinchilla O Sandra

    2009-01-01

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

  4. Meningitis and Pneumocephalus. A rare complication of external dacryocystorhinostomy.

    Science.gov (United States)

    Usul, Haydar; Kuzeyli, Kayhan; Cakir, Ertugrul; Caylan, Refik; Imamoglu, H Ibrahim; Yazar, Ugur; Arslan, Erhan; Sayin, O Caglar; Arslan, Selcuk

    2004-11-01

    Meningitis due to fracture of the fovea ethmoidalis during external dacryocystorhinostomy is a rare complication. We report a case of pneumocephalus and meningitis in a 51-year-old female who underwent an external dacryocystorhinostomy (DCR). Although extracranial complications during or after external DCR have been well-described, only one case of meningitis has been reported in the literature. Physical examination, computerised tomography, lumbar puncture, and bacteriologic cultures were used to make the diagnosis. The patient responded well to antibiotic therapy. Her symptoms resolved immediately and she was discharged on the 21st post-operative day. This complication emphasises the importance of careful surgical technique and a thorough knowledge of regional anatomy, during DCR and similar procedures.

  5. Role of surgery in the management of otogenic meningitis.

    Science.gov (United States)

    Slovik, Y; Kraus, M; Leiberman, A; Kaplan, D M

    2007-09-01

    Meningitis is a life-threatening complication of otitis media. The appropriate management and the role of surgical intervention are still controversial, and there are no evidence-based guidelines in this regard. We report three cases of otogenic meningitis, initially treated with parenteral antibiotics and myringotomy, followed by surgery. Two patients had an emergency mastoidectomy and one patient underwent surgery one month post-recovery due to the suspicion of bone erosion on a computed tomography scan. In two cases, a canal wall up procedure was performed, and one patient underwent revision of a radical mastoidectomy. In all cases, no pus or granulations were seen in the mastoid. Two patients fully recovered and one patient died. We review the literature and critically discuss the role, timing and preferred type of surgery for otogenic meningitis.

  6. 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.

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

    Science.gov (United States)

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

    2015-06-01

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

  8. Meningitis associated with Vancomycin resistant Enterococcus casseliflavus: First report

    Directory of Open Access Journals (Sweden)

    Nilay Sefa Uçar

    2011-12-01

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

  9. Computed tomography of granulomatous basal meningitis caused by pneumococcus

    Energy Technology Data Exchange (ETDEWEB)

    Sonobe, Makoto; Takahashi, Shinichiro (Mito National Hospital, Ibaraki (Japan)); Ohara, Kazuo

    1983-07-01

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

  10. Early versus late diagnosis in community-acquired bacterial meningitis

    DEFF Research Database (Denmark)

    Bodilsen, J; Brandt, C T; Sharew, A

    2018-01-01

    OBJECTIVES: To examine clinical characteristics and outcome of patients with late diagnosis of community-acquired bacterial meningitis (CABM). METHODS: We conducted a chart review of all adults with proven CABM in three centres in Denmark from 1998 through to 2014. Patients were categorized...... as early diagnosis of CABM immediately on admission, or late diagnosis if CABM was not listed in referral or admission records and neither lumbar puncture nor antibiotic therapy for meningitis was considered immediately on admission. We used modified Poisson regression analysis to compute adjusted relative...... differences (p 65 years (56/113, 50% versus 67/245, 27%), neck stiffness (35/97, 36% versus 183/234, 78%), concomitant pneumonia (26/113, 23% versus 26/245, 11%), and meningococcal meningitis (6/113, 5% versus 52/245, 21%). These variables...

  11. 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.

  12. Progress towards meningitis prevention in the conjugate vaccines era

    Directory of Open Access Journals (Sweden)

    Cristina Aparecida Borges Laval

    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.

  13. Cat scratch disease complicated with aseptic meningitis and neuroretinitis

    Directory of Open Access Journals (Sweden)

    Vitor Laerte Pinto Jr.

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

  14. [Streptococcus suis meningitis in a meat factory employee].

    Science.gov (United States)

    de Ceuster, Laura M E; van Dillen, Jeroen J; Wever, Peter C; Rozemeijer, Wouter; Louwerse, Elisabeth S

    2012-01-01

    In the Netherlands, Streptococcus suis is a rare cause of meningitis. Over the past few years, the number of reported cases worldwide has increased. The bacterium is mainly isolated in pigs, but humans can also become infected. At the Emergency Department, a 60-year-old man presented with headache, confusion, fever and nuchal rigidity. He worked at a meat factory. Laboratory testing showed abnormalities linked to bacterial meningitis. S. suis was cultured from blood and cerebrospinal fluid. The patient was treated with dexamethasone, ceftriaxone and later benzylpenicillin intravenously. He recovered well, but had bilateral perceptive hearing loss as a sequela. Particularly people who are in close contact with pigs have an increased risk of S. suis infection. S. suis meningitis can be very severe and lead to serious complications and even death. Rapid diagnosis and adequate treatment are critical. Permanent hearing loss is the most frequent sequela.

  15. Early blindness and coma during intrathecal chemotherapy for meningeal carcinomatosis.

    Science.gov (United States)

    Boogerd, W; Moffie, D; Smets, L A

    1990-02-01

    A 35-year-old woman was treated with intraventricular methotrexate (MTX) with a total dose of 70 mg followed by cytosine arabinoside (Ara-C) with a total dose of 80 mg for meningeal metastasis of breast carcinoma. Radiation therapy was not given. Despite a response of the meningeal tumor the patient developed in the third week of MTX treatment a progressive visual loss and loss of consciousness which worsened during subsequent Ara-C treatment and led to death within 3 weeks. Postmortem examination revealed only minimal neoplastic infiltration of the meninges. Multiple foci of axonal degeneration and demyelination were found in the optic nerves and chiasm, the superficial layers of the brainstem, and spinal cord and to some extent in other cranial nerves and spinal nerve roots. The possible causes of this previously unreported early complication are discussed.

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

    Directory of Open Access Journals (Sweden)

    Vikram

    2016-05-01

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

  17. Validación del método LAL para determinar endotoxinas bacterianas en el inyectable heparina sódica

    Directory of Open Access Journals (Sweden)

    Nancy Burguet

    2012-12-01

    Full Text Available Dentro del control de la calidad de los productos farmacéuticos, la United State Pharmacopeia establece la cuantificación de endotoxinas bacterianas por el método de lisado de amebocito de Limulus , como monitor de pirógenos para más del 90% de los parenterales que regula. Este método se aplicó de forma específica a vacunas bacterianas y virales, agentes antineoplásicos, radiofármacos y parenterales que se producen en la industria médico farmacéutica. En el presente trabajo se mostró la metodología a seguir para realizar la validación de la técnica de determinación de endotoxinas bacterianas por el método de gelificación. Para ello se confirmó la sensibilidad del reactivo utilizado (0,03125 UE/mL y la validez de los analistas para poder obtener resultados confiables. Las pruebas preliminares para el producto ensayado, heparina sódica 5000 UI/mL, demostraron que este producto no potencia ni inhibe la reacción del reactivo. Se escogió la dilución de trabajo (1/128 para la validación del método. De esta manera quedaron estandarizadas las condiciones para la validación del test de lisado de amebocito de Limulus por gelificación en este producto parenteral, método que se hace extensivo a la determinación de endotoxinas bacterianas en vacunas y en otros medicamentos por vía de administración intravenosa.

  18. El uso de la radiografía de tórax para la vigilancia de neumonías bacterianas en niños latinoamericanos

    Directory of Open Access Journals (Sweden)

    Lagos Rosanna

    2003-01-01

    Full Text Available La División de Vacunas e Inmunización de la Organización Panamericana de la Salud (OPS está promoviendo la vigilancia epidemiológica de neumonías bacterianas en niños latinoamericanos, con el objetivo de generar pruebas científicas que sustenten futuras decisiones de control mediante vacunas en los países de la Región. Como es poco frecuente que el diagnóstico de estas enfermedades abarque la documentación bacteriológica del agente causal, los estudios de este tipo que se realizan en el mundo aceptan la imagen radiológica de consolidación alveolar como criterio confirmatorio de una neumonía presuntamente bacteriana. En este informe se examinan la racionalidad teórica y los requisitos necesarios para utilizar la radiología de tórax como instrumento para la vigilancia epidemiológica de neumonías bacterianas. Además, se ofrece un resumen de las actividades realizadas en dos años de trabajo conjunto entre el Centro para Vacunas en Desarrollo, en Chile, y la División de Vacunas e Inmunización de la OPS. Durante ese período se fomentó el estudio epidemiológico de las neumonías bacterianas en niños latinoamericanos utilizando los criterios y definiciones acordados a escala internacional, así como herramientas y soluciones prácticas ajustadas a la realidad de la Región. Las actividades desarrolladas hasta ahora evidencian la necesidad y factibilidad de estandarizar la interpretación de las radiografías de tórax para utilizarlas en estudios epidemiológicos.

  19. Frecuencia de aislamientos microbiológicos y perfil de resistencia bacteriana en 13 clínicas y hospitales de alta complejidad en Santiago de Cali - Colombia

    Directory of Open Access Journals (Sweden)

    Ernesto Martínez Buitrago

    Full Text Available Introducción: La resistencia bacteriana se consolida como una amenaza para los sistemas de salud en el manejo de las enfermedades infecciosas. La vigilancia epidemiológica de la resistencia bacteriana ha demostrado ser una estrategia efectiva para conocer los patrones de susceptibilidad a los antimicrobianos regionales para el desarrollo de medidas de contención y gestión del uso adecuado de antimicrobianos. Objetivo: Describir los aislamientos microbiológicos y perfiles de resistencia a los antimicrobianos de las principales bacterias gram-negativas y gram-positivas en clínicas y hospitales de alta complejidad de Santiago de Cali, Colombia. Metodología: Estudio descriptivo enmarcado en la estrategia de vigilancia epidemiológica de la resistencia bacteriana desarrollado entre el año 2010 al 2012 en 13 instituciones de alta complejidad. Se recolectaron archivos mensualmente en formato WHONET, se realizaron pruebas de calidad de datos. El análisis fue estratificado por tipos de localización hospitalaria, además de análisis de tendencia a través de los 3 años de seguimiento. Resultados: El 65% de los aislamientos son bacterias de la familia enterobacteriaceae y el 11,4% corresponden a Staphylococcus spp., Escherichia coli presenta hasta un 17% de resistencia a cefalosporinas de 3.ª generación mientras que Klebsiella pneumoniae ha incrementado su perfil de resistencia a carbapenémicos hasta un 2,7% en las UCI; Pseudomonas aeruginosa presenta un perfil MDR de hasta el 21% en UCI y salas de hospitalización general. Conclusiones: Existen altas prevalencias de resistencia a los antimicrobianos en la región; se requiere fortalecer estrategias de vigilancia, prevención y control de la resistencia bacteriana en ambientes hospitalarios y de la comunidad.

  20. Clinical and microbiological features of cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Lucia Kioko Hasimoto e Souza

    2013-06-01

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

  1. The Evolution of the Meningitis Vaccine Project.

    Science.gov (United States)

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

    2015-11-15

    In 2001, the Meningitis Vaccine Project (MVP) was tasked to develop, test, license, and introduce a group A meningococcal (MenA) conjugate vaccine for sub-Saharan Africa. African public health officials emphasized that a vaccine price of less than US$0.50 per dose was necessary to ensure introduction and sustained use of this new vaccine. Initially, MVP envisioned partnering with a multinational vaccine manufacturer, but the target price and opportunity costs were problematic and formal negotiations ended in 2002. MVP chose to become a "virtual vaccine company," and over the next decade managed a network of public-private and public-public partnerships for pharmaceutical development, clinical development, and regulatory submission. MVP supported the transfer of key know-how for the production of group A polysaccharide and a new conjugation method to the Serum Institute of India, Ltd, based in Pune, India. A robust staff structure supported by technical consultants and overseen by advisory groups in Europe and Africa ensured that the MenA conjugate vaccine would meet all international standards. A robust project structure including a team of technical consultants and 3 advisory groups in Europe and Africa ensured that the MenA conjugate vaccine (PsA-TT, MenAfriVac) was licensed by the Drug Controller General of India and prequalified by the World Health Organization in June 2010. The vaccine was introduced in Burkina Faso, Mali, and Niger in December 2010. The development, through a public-private partnership, of a safe, effective, and affordable vaccine for sub-Saharan Africa, PsA-TT, offers a new paradigm for the development of vaccines specifically targeting populations in resource-poor countries. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

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

    Science.gov (United States)

    van Samkar, Anusha; Brouwer, Matthijs C.; Schultsz, Constance; van der Ende, Arie; van de Beek, Diederik

    2015-01-01

    Background 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. Methodology 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. Findings 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. Conclusion S. suis meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss. PMID:26505485

  3. Community-acquired bacterial meningitis in alcoholic patients.

    Directory of Open Access Journals (Sweden)

    Martijn Weisfelt

    2010-02-01

    Full Text Available Alcoholism is associated with susceptibility to infectious disease, particularly bacterial pneumonia. In the present study we described characteristics in alcoholic patients with bacterial meningitis and delineate the differences with findings in non-alcoholic adults with bacterial meningitis.This was a prospective nationwide observational cohort study including patients aged >16 years who had bacterial meningitis confirmed by culture of cerebrospinal fluid (696 episodes of bacterial meningitis occurring in 671 patients. Alcoholism was present in 27 of 686 recorded episodes of bacterial meningitis (4% and alcoholics were more often male than non-alcoholics (82% vs 48%, P = 0.001. A higher proportion of alcoholics had underlying pneumonia (41% vs 11% P<0.001. Alcoholics were more likely to have meningitis due to infection with Streptococcus pneumoniae (70% vs 50%, P = 0.01 and Listeria monocytogenes (19% vs 4%, P = 0.005, whereas Neisseria meningitidis was more common in non-alcoholic patients (39% vs 4%, P = 0.01. A large proportion of alcoholics developed complications during clinical course (82% vs 62%, as compared with non-alcoholics; P = 0.04, often cardiorespiratory failure (52% vs 28%, as compared with non-alcoholics; P = 0.01. Alcoholic patients were at risk for unfavourable outcome (67% vs 33%, as compared with non-alcoholics; P<0.001.Alcoholic patients are at high risk for complications resulting in high morbidity and mortality. They are especially at risk for cardiorespiratory failure due to underlying pneumonia, and therefore, aggressive supportive care may be crucial in the treatment of these patients.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Comportamento da síndrome coronariana aguda: resultados de um registro brasileiro

    Directory of Open Access Journals (Sweden)

    Leopoldo Soares Piegas

    2013-06-01

    Full Text Available FUNDAMENTO: O Brasil carece de registros multicêntricos publicados de síndrome coronariana aguda. OBJETIVO: O Registro Brasileiro de Síndrome Coronariana Aguda é um estudo multicêntrico nacional com objetivo de apresentar dados representativos das características clínicas, e manejo e evolução hospitalares dessa síndrome. MÉTODOS: Participaram 23 hospitais de 14 cidades. Foram elegíveis pacientes que se apresentaram com suspeita de síndrome coronariana aguda nas primeiras 24 horas, com quadro clínico sugestivo, associado a alterações eletrocardiográficas compatíveis e/ou marcadores de necrose. O seguimento foi realizado até o óbito ou a alta hospitalar. RESULTADOS: Entre os anos de 2003 e 2008, foram incluídos 2.693 pacientes com diagnóstico de síndrome coronariana aguda, sendo 864 (32,1% mulheres. O diagnóstico final foi de angina instável para 1.141 (42,4% pacientes, com mortalidade de 3,06% deles; de infarto agudo do miocárdio sem supradesnível de ST para 529 (19,6% pacientes, com mortalidade de 6,8% deles; e de infarto agudo do miocárdio com supradesnível de ST para 950 (35,3% pacientes, com mortalidade de 8,1% deles; tiveram diagnóstico não confirmado 73 (2,7% pacientes, com mortalidade de 1,36% deles. A mortalidade global foi de 5,53%. O modelo de regressão logística múltipla identificou o gênero feminino (OR=1,45, o diabetes melito (OR=1,59, o índice de massa corporal (OR=1,27 e a intervenção coronariana percutânea (OR=0,70 como fatores de risco de óbito, para demografia e intervenções. Um modelo para óbito por complicações maiores identificou choque cardiogênico/Edema Agudo de Pulmão (OR=4,57, reinfarto (OR=3,48, acidente vascular cerebral (OR=21,56, sangramento grave (OR=3,33, parada cardiorrespiratória (OR=40,27 e classe funcional de Killip (OR=3,37. CONCLUSÃO: Os dados do Registro Brasileiro de Síndrome Coronariana Aguda não diferem de outros coletados fora do país. Seus achados poder

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

    Directory of Open Access Journals (Sweden)

    Ana Ludueña

    2011-08-01

    Full Text Available El compromiso meníngeo es una manifestación infrecuente de la granulomatosis de Wegener. Puede manifestarse como cefalea con hiperproteinorraquia y engrosamiento de la duramadre con aspecto granulomatoso, que se observa en la resonancia magnética. Presentamos un varón de 57 años con granulomatosis de Wegener que debutó con compromiso de vías aéreas superiores, oídos, órbitas y meningitis granulomatosa asintomática y que posteriormente evolucionó con mononeuritis múltiple y glomerulonefritis crescéntica ANCA positiva. La presencia de ANCA y el compromiso sistémico (vías aéreas superiores, oído, órbitas, nervios periféricos, duramadre y glomerulonefritis rápidamente progresiva permitieron en este caso llegar a un diagnóstico de certeza e iniciar el tratamiento inmunosupresor combinado (corticoides y ciclofosfamida. Evolucionó con remisión clínica y serológica (negativización de ANCA, pero persistiendo leve deterioro secuelar auditivo y de la función renal, sin recidiva de la enfermedad de base.Meningeal involvement is an infrequent manifestation of Wegener's granulomatosis. Clinical manifestations can be headache with high protein level in the cerebrospinal fluid and an enhanced MRI signal of granulomatous thickening of the duramater in the brain. We report a 57 year-old male with Wegener granulomatosis with onset manifestations of asymptomatic granulomatous meningitis, upper respiratory tract, ears and orbits involvement. He progressively developed ANCA positive multiple mononeuritis and crescentic glomerulonephritis. The diagnostic confirmation of Wegener's granulomatosis based on a positive ANCA test and on the evidence of systemic disease (crescentic glomerulonephritis and involvement of the upper respiratory tract, ears, orbits, peripheral nerves and duramater allowed a prompt initiation of aggressive immunosuppressive treatment with systemic cyclophosphamide and high - dosis corticosteroids. The patient entered

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

    Directory of Open Access Journals (Sweden)

    Shaban Lamyaa

    2009-09-01

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

  8. Mortality from bacterial meningitis in children in Kosovo.

    Science.gov (United States)

    Namani, Sadie; Milenkovic, Zvonko; Kuchar, Ernest; Koci, Remzie; Mehmeti, Murat

    2012-01-01

    Bacterial meningitis is a severe infection responsible for high mortality. This prospective study of 277 pediatric bacterial meningitis cases was done to identify factors predicting death in children 24 hours after admission (RR = 11.5), age <1 month (RR = 19.3), the use of inotropic agents (RR = 11.5), and admission after 5 days' duration of illness (P < .001). The mortality rate in children in Kosovo is similar to those reported from developing countries, and this is most likely due to the unfavorable living conditions.

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

    Directory of Open Access Journals (Sweden)

    Shinde R

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Naseer A Choh

    2013-01-01

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

  11. Spontaneous Escherichia coli Meningitis Associated with Hemophagocytic Lymphohistiocytosis

    Directory of Open Access Journals (Sweden)

    Kuo-Hsuan Chang

    2006-01-01

    Full Text Available Spontaneous Escherichia coli meningitis has not been previously reported in association with hemophago-cytic lymphohistiocytosis (HLH. A previously healthy 72-year-old woman was admitted due to fever, nuchal rigidity, disturbed consciousness and splenomegaly. Anemia, thrombocytopenia and hyperfer-ritinemia developed on the 8th day of hospitalization. Cultures of cerebrospinal fluid and blood grew E. coli. Abundant macrophages overwhelmed erythrocytes in the bone marrow aspirate, confirming the presence of hemophagocytosis. E. coli meningitis was managed with a 40-day course of antibiotic treatment. However, the severity of anemia and thrombocytopenia progressed despite intensive transfusion therapy. The patient died of HLH on the 60th day of hospitalization.

  12. [THE NATIONAL NUTRIENT MEDIUM FOR DIAGNOSTIC OF PURULENT BACTERIAL MENINGITIS].

    Science.gov (United States)

    Podkopaev, Ya V; Domotenko, L V; Morozova, T P; Khramov, M K; Shepelin, A P

    2015-05-01

    The national growth mediums were developed for isolating and cultivating of main agents of purulent bacterial meningitis--haemophilus agar, chocolate agar, PBM-agar. The growing and selective characteristics of developed growth mediums are examined. The haemophilus agar ensures growth of Haemophilus influenzae. The chocolate agar, PBM-agar ensure growth of Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. By growing characteristics, the national growth mediums match foreign analogues. Under application of growth mediums with selective additions it is possible to achieve selective isolation of main agents of purulent bacterial meningitis with inhibition of growth of microbes-associates.

  13. Increase of Meningitis Risk in Stroke Patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Chie-Hong Wang

    2018-03-01

    Full Text Available Background and purposeThe blood–brain barrier (BBB not only provides a physical obstruction but also recruits and activates neutrophils in cases of infection. Hemorrhagic or ischemic stroke reportedly induces the disruption of the BBB. However, few studies have reported a correlation between the incidence of meningitis in patients with a history of stroke. This study tested the hypothesis that patients with a history of stroke may be more vulnerable to meningitis.MethodsStroke and age-matched comparison (n = 29,436 and 87,951, respectively cohorts were recruited from the Taiwan National Health Insurance database (2000–2011. Correlations between the two cohorts were evaluated by Cox proportional hazard regression model, Kaplan–Meier curve, and log-rank tests.ResultsThe incidence of meningitis was higher in the stroke cohort compared to that in the comparison cohort [hazard ratio (HR, 2.89; 95% confidence interval (CI, 2.23–3.74, p < 0.001]. After adjusting for age, sex, and comorbidities, the estimated HR in the stroke cohort was 2.55-fold higher than that in the comparison cohort (CI, 1.94–3.37; p < 0.001. Notably, patients who had experienced hemorrhagic stroke had a higher incidence rate of meningitis than those with a history of ischemic stroke, except for patients older than 75 years (incidence rates in hemorrhagic/ischemic stroke patients, 3.14/1.48 in patients younger than 45 years, 1.52/0.41 in 45- to 64-year group, 1.15/0.90 in 65- to 74-year group, 0.74/0.93 in patients older than 75 years. Moreover, stroke patients who had undergone head surgery had the highest meningitis risk (adjusted HR, 8.66; 95% CI, 5.55–13.5; p < 0.001 followed by stroke patients who had not undergone head surgery (adjusted HR, 2.11; 95% CI, 1.57–2.82; p < 0.001.ConclusionOur results indicated that stroke patients have higher risks of meningitis. Compromised BBB integrity in stroke patients may lead to increased

  14. TOXICIDAD AGUDA DE Aleurites moluccana POR VIA ORAL EN RATAS SPRAGUE-DAWLEY

    Directory of Open Access Journals (Sweden)

    Laura Rocío Orellana-Cuéllar

    2014-12-01

    Full Text Available Objetivo: Determinar la toxicidad aguda por Aleurites moluccana por administración oral en ratas Sprague-Dawley. Metodología: Estudio experimental realizado en el Instituto de Patología de la Facultad de Medicina-UNMSM. Se usaron treinta ratas Sprague-Dawley, hembras y machos, de 6 semanas de edad. Se formaron aleatoriamente tres grupos de diez ratas: grupo A1, recibió 8,2 mg/Kg de peso de A. moluccana; grupo  A2, recibió 2000 mg/Kg de peso de A. moluccana; grupo control, recibió agua ad libitum. Se evaluaron los signos clínicos de toxicidad, los pesos, variables bioquímicas y las características histopatológicas de hígado, riñón, corazón, intestino, bazo y gónadas. Se consideró significativo un p0,05. Los grupos  A1 y A2 presentaron signos clínicos de toxicidad y la muerte de tres ratas; células hepáticas binucleadas y regenerativas en el hígado; y hemorragia glomerular en el riñón. Conclusiones: Las variables clínicas e histopatológicas en hígado y riñón demostraron que la Aleurites moluccana produce toxicidad aguda, las variables bioquímicas no demostraron este efecto. Palabras Claves: Aleurites moluccana, Toxicidad aguda, Ratas Sprague-Dawley.

  15. Síndrome coronariana aguda em paciente jovem com sintomas atípicos

    Directory of Open Access Journals (Sweden)

    Gustavo Daher

    2012-08-01

    Full Text Available O diagnóstico da dor torácica aguda no setor de emergência pode ser difícil e desafiador, incluindo diversos diagnósticos diferenciais, dentre eles: causas benignas a causas potencialmente fatais. O diagnóstico na maioria das vezesé estabelecido através do quadro clínico e de exames complementares como: marcadores de necrose miocárdica, eletrocardiograma e radiografia de tórax.A angiotomografia coronariana tem sido utilizada nos casos de dor torácica aguda com baixa ou intermediária probabilidade de síndrome coronariana aguda, permitindo sua exclusão e conseqüente alta precoce dos pacientes. Apresentamosrelato de caso de uma paciente jovem com dor precordial atípica e marcadores de necrose miocárdica discretamente elevados. Considerando-se a epidemiologia e o quadro clínico da paciente, foi feita hipótese diagnóstica inicial de miocardite. A angiotomografia cardíaca com pesquisa de realce tardiofoi solicitada. Apesar do escore de cálcio ter sido zero, foi diagnosticada lesão estenosante grave no terço médio da artéria coronária descendente anterior com realce tardio na parede anterior do ventrículo esquerdo, compatível comnecrose miocárdica. A paciente foi submetida a cateterismo com angioplastia da lesão.

  16. Infección bacteriana severa en niños febriles: Parámetros predictivos

    Directory of Open Access Journals (Sweden)

    Alicia Álvarez Rodríguez

    1997-12-01

    Full Text Available Diferentes investigadores han realizado estudios sobre el manejo del niño febril y plantean que es un dilema al que se enfrenta a diario el médico que atiende niños. Motivados por este tema se efectuó un estudio descriptivo retrospectivo de los niños febriles, sin causa aparente en su valoración inicial, que asistieron al servicio de urgencias en un período de 9 meses, con el objetivo de identificar el diagnóstico definitivo al egreso y se precisó el tipo de infección bacteriana severa y relacionó la presencia de éstos con parámetros clínicos y de laboratorios. El mayor número de niños febriles valorados e ingresados mostraron edades desde 91 días hasta 36 meses. El menor porcenaje de ellos ingresaron y desarrollaron alguna infección bacteriana severa principalmente neumonía, y fue mayor el porcentaje de niños con esta patología a menos edad con predominio del aspecto tóxico y de la temperatura 39 EC. Resultó el manejo ambulatorio del niño febril mayor de 90 días y bajo riesgo de infección bacteriana severa un ahorro en vidas y dinero, por lo que se recomienda generalizar el flujograma propuesto para la evaluación y manejo del niño febril de 3 a 36 meses de edad.Different researches have performed studies on the management of the febrile infant and they point out that this is a dilemma faced by every physician who takes care of children. Motivated by this subject, a descriptive and retrospective study of febrile infants was conducted. The study was carried out to evaluate febrile infants without evident cause at the baseline evaluation who attended the emergency service during a period of 9 months with the objective of identifying the definite diagnosis at admission. The type of bacterial infection was accurately assessed and the presence of this was related to clinical and laboratory parameters. The greatest number of febrile infants evaluated and admitted to hospital were 91 days-36 months old. The lowest percentage

  17. Pancreatitis aguda por hipertrigliceridemia severa: reporte de caso y revisión de la literatura

    OpenAIRE

    Herrera Del Águila, Dwight Denis; Garavito Rentería, Jorge; Linarez Medina, Karen; Lizarzaburu Rodríguez, Víctor

    2015-01-01

    La pancreatitis aguda por hipertrigliceridemia se presenta en aproximadamente 1-4 % de los casos, es la tercera causa de pancreatitis luego de la etiología biliar y alcohólica. La hipertrigliceridemia puede ser producida por causas primarias asociadas a trastornos genéticos en el metabolismo de los lípidos, y por casusas secundarias. Se presenta el caso de un paciente varón de 32 años de edad, natural de Huancayo, con antecedentes de diabetes mellitus tipo 2, dislipidemia mixta severa con hip...

  18. Sarcoidosis aguda: Variante de Síndrome de Löfgren sin eritema nodoso

    OpenAIRE

    Pérez, Gerardo; Facal, Jorge

    2014-01-01

    El síndrome de Löfgren, es una variante aguda de la sarcoidosis, que se caracteriza por fiebre, eritema nodoso, adenomegalias hiliares pulmonares y artritis. En general, tiene un curso benigno y autolimitado, que contrasta con las formas crónicas que requieren uso de corticoides y tienen tendencia a la recidiva. Se describe aquí el caso clínico de un paciente joven, de sexo masculino, con artritis pero sin eritema nodoso, lo que dificultó el planteo diagnóstico de síndrome de Löfgren. Se real...

  19. Inmunofenotipos aberrantes en leucemias agudas en una población hospitalaria de Buenos Aires

    Directory of Open Access Journals (Sweden)

    Viviana Novoa

    2013-02-01

    Full Text Available La citometría de flujo multiparamétrica es el método de elección para la caracterización inmunofenotípica de las células hematopoyéticas clonales presentes en los distintos procesos leucémicos agudos. El objetivo fue analizar la expresión de antígenos de membrana y evaluar la presencia de fenotipos aberrantes en los blastos de pacientes con diagnóstico de leucemia aguda, que permiten el monitoreo de la respuesta al tratamiento. Se revisaron los inmunofenotipos de 364 muestras de pacientes adultos derivadas a nuestro laboratorio en un período de 7 años. El inmunofenotipo se realizó por citometría de flujo con un amplio panel de anticuerpos monoclonales con el que se evaluó la expresión de antígenos de linaje linfoide, mieloide y también antígenos de maduración. De las 364 muestras estudiadas, 60.2% presentaron un fenotipo compatible con leucemia mieloide aguda (LMA, 28.8% con leucemia linfoblástica B (LLA-B, 6.6% con leucemia linfoblástica T (LLA-T y 4.4% con leucemias agudas poco frecuentes. La presencia de fenotipos aberrantes se observó en 89% de los casos, los fenotipos aberrantes identificados fueron: 1 infidelidad de linaje: LMA (54%, LLA-B (40%, LLA-T (29%; 2 ausencia de expresión antigénica: LMA (21%, LLA-B (35%, LLA-T (70%; 3 alteración de la expresión antigénica: LMA (67%, LLA-B (66%, LLA-T (84%; 4 asincronismo madurativo: LMA (26%, LLA-B (37% y 5 fenotipo ectópico: LLA-T 96%. El análisis por citometría de flujo multiparamétrica de las leucemias agudas permitió la identificación de fenotipos aberrantes en la mayoría de nuestros pacientes, que son de utilidad para el monitoreo de la respuesta al tratamiento.

  20. Infecciones respiratorias agudas en los niños. Posibles medidas de control

    OpenAIRE

    Mohs Villalta, Edgar

    1985-01-01

    Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1985 Las infecciones respiratorias agudas que representan el 50% aproximadamente, de los casos de enfermedades que deben notificarse a las autoridades y de las consultas pediátricas de pacientes ambulatorios en los países en desarrollo, son también una de las principales causas de las enfermedades contraídas en los hospitales y de mortalidad por enfermedades nosocomiales. En 1982, por *mph:), fueron la...