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meningitis in emergency

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https://www.readbyqxmd.com/read/29160002/a-randomized-double-blind-trial-of-needle-free-injected-lidocaine-versus-topical-anesthesia-for-infant-lumbar-puncture
#1
Ryan Caltagirone, Vidya R Raghavan, Kathleen Adelgais, Genie E Roosevelt
OBJECTIVES: Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection which may be painful or topical application which is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative to these modalities. We compared a needle-free jet-injection system (J-Tip(™) ) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29131135/interhemispheric-and-infratentorial-subdural-empyema-with-preseptal-cellulitis-as-complications-of-sinusitis-a-case-report
#2
Muhammad Reza Arifianto, Achmad Zuhro Ma'ruf, Arie Ibrahim, Abdul Hafid Bajamal
Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29122409/understanding-the-virulence-of-streptococcus-suis-a-veterinary-medical-and-economic-challenge
#3
REVIEW
B Haas, D Grenier
Streptococcus suis is a major swine pathogen worldwide and causes considerable economic losses in the swine industry. S. suis is also an emerging zoonotic agent, mainly in Asia. In pigs and humans, S. suis can cause septicemia, pneumonia, endocarditis, arthritis, and meningitis with irreversible sequelae. Identification and characterization of the virulence factors produced by S. suis are major advances in the understanding of the pathogenesis of S. suis infections and has therefore opened promising avenues for vaccine development against this pathogen...
November 6, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29116307/cryptococcoma-mimicking-a-brain-tumor-in-an-immunocompetent-patient-case-report-of-an-extremely-rare-presentation
#4
Aline Lariessy Campos Paiva, Guilherme Brasileiro de Aguiar, Renan Maximilian Lovato, Arthus Vilar Deolindo Zanetti, Alexandros Theodoros Panagopoulos, José Carlos Esteves Veiga
CONTEXT: Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients...
November 6, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/29112767/fast-and-reliable-diagnosis-of-xdr-acinetobacter-baumannii-meningitis-by-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry
#5
Grazia Brunetti, Giancarlo Ceccarelli, Alessandra Giordano, Anna Sara Navazio, Pietro Vittozzi, Mario Venditti, Giammarco Raponi
Bacterial meningitis is a medical emergency needing quick and timely diagnosis. Even though meningitis caused by Acinetobacter baumannii is relatively rare, it is associated with high mortality rates especially in neurosurgery patients and represents a serious therapeutic problem due to the limited penetration of effective antibiotics into the cerebrospinal fluid. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) has been effectively used as a rapid method for microbial identification...
November 7, 2017: New Microbiologica
https://www.readbyqxmd.com/read/29102094/early-disseminated-lyme-disease-masquerading-as-mononucleosis-a%C3%A2-case-report
#6
Richard Tumminello, Lindsey Glaspey, Anita Bhamidipati, Patrick Sheehan, Sundip Patel
BACKGROUND: Disseminated Lyme disease can be difficult to diagnose, as it begins with nonspecific signs and symptoms, which, if not treated correctly, can lead to atrioventricular conduction blocks and meningitis. In addition, the diagnosis can be further complicated by potentially false-positive test results. CASE REPORT: We report a case of early-disseminated Lyme disease presenting with Borrelia meningitis and concomitant Lyme carditis, which was misdiagnosed as mononucleosis...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29080894/posttraumatic-intralaminar-hematoma-developing-between-cranial-dural-layers-a-case-report
#7
Biji Bahuleyan, Vineetkumar Thakorbhai Patel, Prashanth Usurumarthi, Girish Kuranjiyoor Madhavan, Santhosh George Thomas
We present a case of post-traumatic hematoma developing between the 2 layers of the cranial dura in a 2-year-old child following head injury. This child presented with history of fall from a height in altered sensorium with paucity of movements on the left side. Computerized tomography scan of the brain showed a right parietal linear fracture with an underlying hyperdense biconvex hematoma. Emergency evacuation of the hematoma was done. On elevation of the scalp flap, a fibrous membrane was seen protruding between the fracture lines...
October 28, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29077720/goal-directed-therapy-for-suspected-acute-bacterial-meningitis-in-adults-and-adolescents-in-sub-saharan-africa
#8
Emma C Wall, Mavuto Mukaka, Brigitte Denis, Veronica S Mlozowa, Malango Msukwa, Khumbo Kasambala, Mulinda Nyrienda, Theresa J Allain, Brian Faragher, Robert S Heyderman, David G Lalloo
BACKGROUND: Mortality from acute bacterial meningitis (ABM) in sub-Saharan African adults and adolescents exceeds 50%. We tested if Goal Directed Therapy (GDT) was feasible for adults and adolescents with clinically suspected ABM in Malawi. MATERIALS AND METHODS: Sequential patient cohorts of adults and adolescents with clinically suspected ABM were recruited in the emergency department of a teaching hospital in Malawi using a before/after design. Routine care was monitored in year one (P1)...
2017: PloS One
https://www.readbyqxmd.com/read/29062896/copper-chaperone-cupa-and-zinc-control-copy-regulation-of-the-pneumococcal-cop-operon
#9
Miranda J Neubert, Elizabeth A Dahlmann, Andrew Ambrose, Michael D L Johnson
Any metal in excess can be toxic; therefore, metal homeostasis is critical to bacterial survival. Bacteria have developed specialized metal import and export systems for this purpose. For broadly toxic metals such as copper, bacteria have evolved only export systems. The copper export system (cop operon) usually consists of the operon repressor, the copper chaperone, and the copper exporter. In Streptococcus pneumoniae, the causative agent of pneumonia, otitis media, sepsis, and meningitis, little is known about operon regulation...
September 2017: MSphere
https://www.readbyqxmd.com/read/29059358/daptomycin
#10
Mohsen Heidary, Azar Dohkt Khosravi, Saeed Khoshnood, Mohammad Javad Nasiri, Saleh Soleimani, Mehdi Goudarzi
Daptomycin is a cyclic lipopeptide antibiotic used for the treatment of Gram-positive infections including complicated skin and skin structure infections, right-sided infective endocarditis, bacteraemia, meningitis, sepsis and urinary tract infections. Daptomycin has distinct mechanisms of action, disrupting multiple aspects of cell membrane function and inhibiting protein, DNA and RNA synthesis. Although daptomycin resistance in Gram-positive bacteria is uncommon, there are increasing reports of daptomycin resistance in Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis...
October 20, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29049002/cost-effectiveness-of-the-haemophilus-influenzae-type-b-vaccine-for-infants-in-mainland-china
#11
Guijun Ning, Zundong Yin, Yixing Li, Huaqing Wang, Weizhong Yang
OBJECTIVE: The aims of this study were to estimate the cost-effectiveness of the Haemophilus influenzae type b (Hib) vaccine for the prevention of childhood pneumonia, meningitis and other vaccine-preventable diseases in mainland China from a societal perspective and to provide information about the addition of the Hib vaccine to Chinese immunization programs. METHODS: A decision tree and the Markov model were used to estimate the costs and effectiveness of the Hib vaccine versus no Hib vaccine for a birth cohort of 100,000 children in 2016...
October 19, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29037978/expected-immunizations-and-health-protection-for-hajj-and-umrah-2018-an-overview
#12
REVIEW
Jaffar A Al-Tawfiq, Philippe Gautret, Ziad A Memish
BACKGROUND: The annual Hajj and Umrah are one of the largest recurring religious mass gatherings across the globe drawing pilgrims from more than 185 countries. The living circumstances and activities of the pilgrims may create an environment for the occurrence and spread of communicable diseases. Each year, the Health authority of the Kingdom of Saudi Arabia, in coordination with international health authorities, updates health requirements for pilgrims. The Hajj for 2017 took place from August 24 to September 5, 2017...
October 14, 2017: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/29028957/long-term-mortality-and-disability-in-cryptococcal-meningitis-a-systematic-literature-review
#13
Estelle Pasquier, John Kunda, Pierre De Beaudrap, Angela Loyse, Elvis Temfack, Síle F Molloy, Thomas S Harrison, Olivier Lortholary
Cryptococcal meningitis (CM) is the primary cause of meningitis in HIV-infected adults and an emerging disease in HIV-seronegative individuals. No literature review has studied the long-term outcome of CM. We performed a systematic review on the long-term (≥3 months) impact of CM (C. neoformans and C. gattii) on mortality and disability in HIV-infected and non-HIV-infected adults. Though the quality of current evidence is limited, the long-term impact of CM on survival and disability appears to be high. One-year mortality ranged from 13% in an Australian non-HIV C...
October 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29026659/emergence-and-genomic-diversification-of-a-virulent-serogroup-w-st-2881-cc175-neisseria-meningitidis-clone-in-the-african-meningitis-belt
#14
Araceli Lamelas, Julia Hauser, Jean-Pierre Dangy, Abdul-Wahab M Hamid, Katharina Röltgen, Mohamad R Abdul Sater, Abraham Hodgson, Ali Sie, Thomas Junghanss, Simon R Harris, Julian Parkhill, Stephen D Bentley, Gerd Pluschke
Countries of the African 'meningitis belt' are susceptible to meningococcal meningitis outbreaks. While in the past major epidemics have been primarily caused by serogroup A meningococci, W strains are currently responsible for most of the cases. After an epidemic in Mecca in 2000, W:ST-11 strains have caused many outbreaks worldwide. An unrelated W:ST-2881 clone was described for the first time in 2002, with the first meningitis cases caused by these bacteria reported in 2003. Here we describe results of a comparative whole-genome analysis of 74 W:ST-2881 strains isolated within the framework of two longitudinal colonization and disease studies conducted in Ghana and Burkina Faso...
August 2017: Microbial Genomics
https://www.readbyqxmd.com/read/29022854/single-center-mid-term-experience-with-chimney-graft-technique-for-the-preservation-of-flow-to-the-supra-aortic-branches
#15
Robert Shahverdyan, Spyridon Mylonas, Michael Gawenda, Jan Brunkwall
Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29021984/mri-findings-of-early-stage-hyperacute-hemorrhage-causing-extramedullary-compression-of-the-cervical-spinal-cord-in-a-dog-with-suspected-steroid-responsive-meningitis-arteritis
#16
Adriano Wang-Leandro, Enrice-Ina Huenerfauth, Katharina Heissl, Andrea Tipold
A 9-month-old female Weimaraner was presented to the emergency service due to episodes of fever and neck pain. Physical examination revealed a stiff neck posture and elevated body temperature. Shortly after clinical examination was performed, the dog developed peracute onset of non-ambulatory tetraparesis compatible with a C1-C5 spinal cord (SC) lesion. Immediately thereafter (<1 h), MRI of the cervical SC was performed with a 3-T scanner. A left ventrolateral intradural-extramedullary SC compression caused by a round-shaped structure at the level of C3--C4 was evidenced...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28988964/epidemiology-of-bacteremia-in-febrile-infants-aged-60-days-and-younger
#17
Elizabeth C Powell, Prashant V Mahajan, Genie Roosevelt, John D Hoyle, Rajender Gattu, Andrea T Cruz, Alexander J Rogers, Shireen M Atabaki, David M Jaffe, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
STUDY OBJECTIVE: To describe the current epidemiology of bacteremia in febrile infants 60 days of age and younger in the Pediatric Emergency Care Applied Research Network (PECARN). METHODS: We conducted a planned secondary analysis of a prospective observational study of febrile infants 60 days of age and younger presenting to any of 26 PECARN emergency departments (2008 to 2013) who had blood cultures obtained. We excluded infants with significant comorbidities or critically ill appearance...
October 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28988442/dramatic-response-to-nivolumab-in-xeroderma-pigmentosum-skin-tumor
#18
Fanny Chambon, Sophie Osdoit, Kelly Bagny, Anne Moro, Jacqueline Nguyen, Yves Réguerre
We report the case of a 6-year-old female with xeroderma pigmentosum (XP) who developed a nonoperable scalp tumor, treated with anti-programmed cell death protein 1 (anti-PD-1) therapy (nivolumab). She presented with a sarcomatoid carcinoma of the scalp with bone lysis as well as vascular and meningeal contact. Nivolumab was initiated because it has emerged as a promising immunotherapy. We observed a dramatic tumor response with excellent tolerance. However, while on nivolumab therapy she developed two large skin melanomas and several squamous cell carcinomas, which have been resected...
October 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28975470/infections-of-the-central-nervous-system-in-returning-travelers-and-immigrants
#19
REVIEW
Haley Thompson, Kiran Thakur
PURPOSE OF REVIEW: This review highlights current knowledge in travel-related neuroinfectious diseases, providing insight on approaches to prevention, diagnosis, and treatment of infections of the central nervous system (CNS) in travelers and immigrants. RECENT FINDINGS: Updates on travel vaccine recommendations including vaccine-specific interactions with immunosuppressive agents, advances in Zika virus and dengue virus vaccine development, new diagnostic criteria for neurocysticercosis, updates on treatment approaches for tuberculosis meningitis...
October 3, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28965695/-evaluating-a-child-after-a-febrile-seizure-insights-on-three-important-issues
#20
S Auvin, M Antonios, G Benoist, M-A Dommergues, F Corrard, V Gajdos, C Gras Leguen, E Launay, A Salaün, L Titomanlio, L Vallée, M Milh
Febrile seizures (FS) are the most common seizures seen in the paediatric population in the out-of-hospital and emergency department settings, and they account for the majority of seizures seen in children younger than 5 years old. An FS is a seizure accompanied by fever, without central nervous system infection, occurring in children between 6 months and 5 years old. Five criteria have been used and taught to classify any FS as simple or complex FS. These factors do not bear the same significance for clinical practice, in particular, the decision to perform a lumbar puncture for cerebrospinal fluid analysis to rule out an intracranial infection...
November 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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