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meningitis in emergency

Gaurang S Shah
BACKGROUND Streptococcus acidominimus, which belongs to the viridans streptococci group, is rarely considered pathogenic in humans. However, over the past 10 years, this bacterium has been reported to cause serious infections in humans, particularly among the critically ill. This article is the first case report of pyogenic ventriculitis (PV) and meningitis caused by S. acidominimus in North America. CASE REPORT A 49-year-old Asian male presented to the emergency department with complaints of a headache, fever greater than 37...
March 22, 2018: American Journal of Case Reports
Guojun Zhang, Guanghui Zheng, Yan Zhang, Ruimin Ma, Xixiong Kang
Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections (HAI) worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, which require at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains...
March 17, 2018: International Journal of Infectious Diseases: IJID
Istvan Bodi, Anastasios Giamouriadis, Naomi Sibtain, Ross Laxton, Andrew King, Francesco Vergani
Background: Primary CNS malignant rhabdoid tumors are very rare in adults and much less is known about their biological behavior than in children. Recently, two adult cases of SMARCB1 (also known as INI1)-deficient tumor with rhabdoid cells have been described, suggesting an emerging group of primary meningeal SMARCB1-deficient tumors. We have recently encountered a case of INI1-deficient tumor with similar histology and immunophenotype to the above cases, but with a superficial cerebral, yet apparent intra-axial origin...
2018: Surgical Neurology International
Shraddha Siwakoti, Rinku Sah, Rupa Singh Rajbhandari, Basudha Khanal
Introduction: Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. Case Presentations: A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding...
2018: Case Reports in Pediatrics
Nicole Bertin, Gabriele Brosolo, Fabrizio Pistola, Francesco Pelizzo, Christian Marini, Franco Pertoldi, Olga Vriz
BACKGROUND: Capnocytophaga canimorsus is a bacterium of the normal oral flora of dogs and cats. Human infection is caused by animal bite but is rarely observed, mainly in immunocompromised patients. We present 2 cases of C. canimorsus infection that occurred in immunocompetent patients and caused multiorgan failure and in both cases severe neurologic involvement. CASE REPORT: In the first case, we present a 69-year-old immunocompetent woman with septic shock derived from skin and soft tissue infection after a dog's bite...
March 6, 2018: Journal of Emergency Medicine
Asim Azhar, Qamar Zia, Shakeel Ahmad Ansari, Muhammad Amjad Kamal, Athanasios Alexiou, Nagendra Sastry Yarla, Ghulam Md Ashraf
Nanotechnology exploits materials and devices with a functional organization that has been engineered at the nanometre scale. The application of nanotechnology in neuroscience involves specific interactions with neurons and glial cells. This property is used for delivering drugs and other small molecules (such as genes, oligonucleotides and contrasting agents) across the blood brain barrier (BBB), an important requirement for delivering the drug successfully to the brain. Nanotechnology based approaches (NBA) favoured transcytosis-mediated delivery of nanoparticles to the brain by crossing the BBB...
March 5, 2018: Current Drug Metabolism
Alireza Ala, Farzad Rahmani, Sima Abdollahi, Zahra Parsian
Introduction: The diagnostic value of clinical signs in early diagnosis of meningitis has been evaluated but the existing results are contradicting. The present study aimed to evaluate the accuracy of Kernig, Brudzinski, neck stiffness, and Jolt Accentuation of Headache (JAH) signs in this regard. Methods: In this diagnostic accuracy study, patients with suspected meningitis who were referred to the emergency department were examined regarding presence or absence of the mentioned clinical signs and screening performance characteristics of the signs were calculated...
2018: Emergency (Tehran, Iran)
Pumtiwitt C McCarthy, Abeer Sharyan, Laleh Sheikhi Moghaddam
Neisseria meningitidis causes most cases of bacterial meningitis. Meningococcal meningitis is a public health burden to both developed and developing countries throughout the world. There are a number of vaccines (polysaccharide-based, glycoconjugate, protein-based and combined conjugate vaccines) that are approved to target five of the six disease-causing serogroups of the pathogen. Immunization strategies have been effective at helping to decrease the global incidence of meningococcal meningitis. Researchers continue to enhance these efforts through discovery of new antigen targets that may lead to a broadly protective vaccine and development of new methods of homogenous vaccine production...
February 25, 2018: Vaccines
Angharad Davis, Graeme Meintjes, Robert J Wilkinson
PURPOSE OF REVIEW: Tuberculous meningitis (TBM) is a global health problem. In this review, we systematically evaluate the evidence for current and emerging antimicrobials, host-directed therapies and supportive managements. RECENT FINDINGS: Current antimicrobial regimes do not factor the differing ability of drugs to cross the blood-brain barrier. Rifampicin may be more effective at higher doses yet the most recent clinical trial failed to demonstrate survival benefit at 15 mg/kg/day...
February 28, 2018: Current Treatment Options in Neurology
Asalim Thabet, Tyler Greenfield, Richard M Cantor
Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis...
March 2018: Pediatric Emergency Medicine Practice
Asalim Thabet, Tyler Greenfield, Richard M Cantor, Bryan Wilson
Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis...
March 1, 2018: Pediatric Emergency Medicine Practice
André H Bechara, Raquel O Simões, Marta Júlia Faro, Juberlan S Garcia
Angiostrongylus cantonensis is considered the main etiological agent of eosinophilic meningitis in humans. At present, this zoonosis is considered an emerging disease mainly in the Americas. The aim of this study was to determine the prevalence of Achatina fulica infected by Angiostrongylus cantonensis in restinga areas along beaches in the west zone of Rio de Janeiro city, Brazil. The study areas included the following beaches: Barra da Tijuca, Recreio dos Bandeirantes, Reserva, Prainha and Grumari. Ninety specimens of Achatina fulica were collected...
2018: Revista do Instituto de Medicina Tropical de São Paulo
Santiago Mintegi, Borja Gomez, Alba Carro, Haydee Diaz, Javier Benito
OBJECTIVE: To determine the prevalence of invasive bacterial infections (IBI, pathogenic bacteria in blood or cerebrospinal fluid) in infants less than 90 days old with fever without a source related to the presence or absence of fever on arrival to the emergency department (ED). DESIGN: Prospective registry-based cohort study. SETTING: Paediatric ED of a tertiary teaching hospital. PATIENTS: We included infants less than 90 days old with a history of fever evaluated in the ED from 2003 to 2016...
February 15, 2018: Archives of Disease in Childhood
Andrea L Conroy, Michael T Hawkes, Robyn Elphinstone, Robert O Opoka, Sophie Namasopo, Christopher Miller, Chandy C John, Kevin C Kain
BACKGROUND: Chitinase-3-like 1 (CHI3L1) is a glycoprotein elevated in paediatric severe malaria, and an emerging urinary biomarker of acute kidney injury (AKI). Based on the hypothesis that elevated CHI3L1 levels in malaria are associated with disease severity, the relationship between plasma CHI3L1 levels, AKI and mortality was investigated in Ugandan children enrolled in a clinical trial evaluating inhaled nitric oxide (iNO) as an adjunctive therapy for severe malaria. METHODS: Plasma CHI3L1 levels were measured daily for 4 days in children admitted to hospital with severe malaria and at day 14 follow up...
February 15, 2018: Malaria Journal
Jun Aruga
Zic family proteins have been investigated in various biomedical studies. Here we summarize the contact points between Zic proteins and recent medical research. The topics cover a wide range, reflecting the pleiotropic roles of these proteins in early embryogenesis and organogenesis. Zic1, Zic2, and Zic3 proteins play important roles in the development of axial and limb bones, and of muscles, among the derivatives of the notochord and somites. Zic1 is involved in bone's response to mechanical stress, and it also serves as a marker specific for brown adipocytes...
2018: Advances in Experimental Medicine and Biology
Joanna Thomson, Heidi Sucharew, Andrea T Cruz, Lise E Nigrovic, Stephen B Freedman, Aris C Garro, Fran Balamuth, Rakesh D Mistry, Joseph L Arms, Paul T Ishimine, Dina M Kulik, Mark I Neuman, Samir S Shah
OBJECTIVES: To determine age-specific reference values and quantify age-related changes for cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein and glucose concentrations in infants ≤60 days of age. METHODS: This multicenter, cross-sectional study included infants ≤60 days old with CSF cultures and complete CSF profiles obtained within 24 hours of presentation. Those with conditions suspected or known to cause abnormal CSF parameters (eg, meningitis) and those with a hospital length of stay of >72 hours were excluded...
February 2, 2018: Pediatrics
Tomonobu Yanase, Daiichi Morii, Satoshi Kamio, Ayako Nishimura, Eri Fukao, Yuri Inose, Yutaka Honma, Nobuo Kitahara, Takayuki Yokozawa, Bin Chang, Toshimi Oda
Streptococcus suis, a gram-positive facultative anaerobe commonly found in pigs, is an emerging zoonotic pathogen. Herein, we describe a case of a 45-year-old male Japanese meat wholesaler with S. suis meningitis and pyogenic ventriculitis. S. suis was isolated from his blood and cerebrospinal fluid culture, and sequence type (ST) and serotype were confirmed to be ST1 and serotype 2, respectively, by multilocus sequence typing and the Quellung reaction. Magnetic resonance imaging (MRI) revealed right labyrinthitis and pyogenic ventriculitis...
February 8, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Olumide Ajibola, Semeeh Akinwale Omoleke, Olusola Akintoye Omisakin
INTRODUCTION: Following the significant reduction of Neisseria meningitidis A (NmA) in most parts of northern Nigeria, a new strain of Neisseria meningitidis C (NmC) emerged in 2013 causing outbreaks in the north and recently spreading to southern parts of the Nigeria. This study provides detailed epidemiological investigation in the last four years. METHODS: Analysis of confirmed and suspected cases of meningitis in Kebbi, Nigeria from 2014 to June 2017 detected through Integrated Disease Surveillance and Response...
February 6, 2018: Vaccine
Arnaud Dominati, Liesbeth Sap, Samir Vora
Arbovirus infections are emerging pathogens leading sometimes to severe disease. This virus is transmitted by sandflies in the Mediterranean countries during the summer season. The disease is often asymptomatic but can also cause an influenza-like illness and aseptic meningitis or encephalitis. The treatment is supportive and preventive measures should be taken in order to avoid an infection when travelling to the affected areas. The differential diagnosis of fever in the returning traveler from southern European countries should include Toscana virus...
January 31, 2018: Revue Médicale Suisse
Oxana Semyachkina-Glushkovskaya, Vladimir Chehonin, Ekaterina Borisova, Ivan Fedosov, Anton Namykin, Arkady Abdurashitov, Alexander Shirokov, Boris Khlebtsov, Yelena Lyubun, Nikita Navolokin, Mariya Ulanova, Natalia Shushunova, Alexander Khorovodov, Ilana Agranovich, Anastasia Bodrova, Madina Sagatova, Ali Esmat Shareef, Elena Saranceva, Tatyana Iskra, Mariya Dvoryatkina, Ekaterina Zhinchenko, Olga Sindeeva, Valery Tuchin, Jurgen Kurths
A new application of the photodynamic treatment (PDT) is presented for the opening of blood-brain barrier (BBB) and the brain clearing activation that is associated with it, including the use of gold nanoparticles as emerging photosensitizer carriers in PDT. The obtained results clearly demonstrate two pathways for the brain clearing: 1) using PDT-opening of BBB and intravenous injection of FITC-dextran we showed a clearance of this tracer via the meningeal lymphatic system in the subdural space; 2) using optical coherence tomography and intra-parenchymal injection of gold nanorods we observed their clearance through the exit gate of cerebral spinal fluid from the brain into the deep cervical lymph node, where the gold nanorods were accumulated...
January 30, 2018: Journal of Biophotonics
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