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central nervous system infection guidelines

Heng Gee Lee, Timothy William, Jayaram Menon, Anna P Ralph, Eng Eong Ooi, Yan'an Hou, October Sessions, Tsin Wen Yeo
BACKGROUND: Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there may be regional differences due to variation in the socio-economic levels, public health services and vaccination policies. Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections...
2016: BMC Infectious Diseases
M Schmidt-Hieber, G Silling, E Schalk, W Heinz, J Panse, O Penack, M Christopeit, D Buchheidt, U Meyding-Lamadé, S Hähnel, H H Wolf, M Ruhnke, S Schwartz, G Maschmeyer
Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients...
July 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Vugar Nabiyev, Ateş Kara, M Cemalettin Aksoy
BACKGROUND: Congenital insensitivity to pain and anhidrosis (CIPA) is a rare clinical condition characterized by the absence of normal subjective and objective responses to noxious stimuli in patients with intact central and peripheral nervous systems. CASE PRESENTATIONS: Two patients with CIPA are reported. The first patient was a 13-year-old girl who presented to our hospital with multiple joint destructions secondary to osteomyelitis. The second patient was a 10-year-old boy who presented with multiple hand lesions and right leg osteomyelitis...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ha Son Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani, Wade Mueller
BACKGROUND: When wounds are benign, diagnosis of deep brain stimulation (DBS) electrode infection and associated intraparenchymal infection can be challenging. Only a couple, such cases exist in literature. Since infections of the central nervous system can be life-threatening, prompt diagnosis is necessary to prevent neurological injury. Employed within the appropriate context, magnetic resonance imaging (MRI) of the brain, as well as laboratory data and clinical presentation, may help guide diagnosis...
2016: Surgical Neurology International
Rita Castro, Maria João Águas, Teresa Batista, Carlos Araújo, Kamal Mansinho, Filomena da Luz Martins Pereira
BACKGROUND: Laboratory diagnosis of neurosyphilis is complicated especially when it is asymptomatic, no single laboratory test result being appropriate to diagnose central nervous system infectivity caused by Treponema pallidum. Our objective was to evaluate two polymerase chain reaction (PCR) techniques for the detection of T. pallidum DNA in the cerebrospinal fluid (CSF) of patients with syphilis. METHODS: One hundred twenty-four CSF samples from patients with reactive blood tests for syphilis were obtained...
September 2016: Journal of Clinical Laboratory Analysis
A Sebestyén, F Tóth, J Sándor, J Nyárády, I Boncz
PURPOSE: Regarding intracapsular femoral neck fractures, the main focus of research is the correlation between fracture-related complications and prognostic factors. To evaluate the correlation between complications required surgery (fracture-related treatment) and, among others, several less extensively investigated prognostic factors (day of surgery, co-morbidities, hospital type) in a 2-year period following internal fixation in patients under the age of 60 years with intracapsular femoral neck fracture...
October 2011: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Sylviane Defres, Josephine Mayer, Ruth Backman, Rachel Kneen
Lumbar punctures are essential in the management of suspected CNS infections. However, despite clear guidelines their use can be haphazard. This survey investigated the training, knowledge and experience of UK doctors in training in relation to lumbar punctures.
November 2015: British Journal of Hospital Medicine
Miguel J Martínez, Sergio Massora, Inácio Mandomando, Esperança Ussene, Dercio Jordao, Lucilia Lovane, Carmen Muñoz-Almagro, Paola Castillo, Alfredo Mayor, Cristina Rodriguez, Miriam Lopez-Villanueva, Mamudo R Ismail, Carla Carrilho, Cesaltina Lorenzoni, Marcus V G Lacerda, Quique Bassat, Clara Menéndez, Jaume Ordi, Jordi Vila
In developing countries, the knowledge of the microorganisms causing fatal infections is critical and could help designing and implementing more effective preventive interventions and treatment guidelines. We aimed to develop and validate protocols for microbiological analysis in post-mortem samples obtained during minimally invasive autopsy (MIA) procedures and to assess their performance. Thirty MIAs performed in adults at Maputo Central Hospital in Southern Mozambique were included in the analysis. Microbiological tests included a universal screening for HIV, hepatitis B and C viruses, Plasmodium falciparum, and bacterial/fungal culture...
January 2016: Diagnostic Microbiology and Infectious Disease
Antonio Aceti, Laura Gianserra, Lara Lambiase, Alfredo Pennica, Elisabetta Teti
Highly active antiretroviral therapy (HAART) has substantially changed human immunodeficiency virus (HIV) infection from an inexorably fatal condition into a chronic disease with a longer life expectancy. This means that HIV patients should receive antiretroviral drugs lifelong, and the problems concerning with a chronic treatment (tolerability, side effects, adherence to treatment) have now become dominant. In this context, strategies for the treatment personalization have taken a central role in optimizing the therapeutic response and prevention of adverse drug reactions...
August 12, 2015: World Journal of Virology
Victor Asensi, Julio Collazos, Eulalia Valle-Garay
Pharmacogenetics refers to the effect of single nucleotide polymorphisms (SNPs) within human genes on drug therapy outcome. Its study might help clinicians to increase the efficacy of antiretroviral drugs by improving their pharmacokinetics and pharmacodynamics and by decreasing their side effects. HLAB*5701 genotyping to avoid the abacavir-associated hypersensitivity reaction (HSR) is a cost-effective diagnostic tool, with a 100% of negative predictive value, and, therefore, it has been included in the guidelines for treatment of human immunodeficiency virus (HIV) infection...
August 12, 2015: World Journal of Virology
F Tissot, G Prod'hom, O Manuel, G Greub
The impact of round-the-clock cerebrospinal fluid (CSF) Gram stain on overnight empirical therapy for suspected central nervous system (CNS) infections was investigated. All consecutive overnight CSF Gram stains between 2006 and 2011 were included. The impact of a positive or a negative test on empirical therapy was evaluated and compared to other clinical and biological indications based on institutional guidelines. Bacterial CNS infection was documented in 51/241 suspected cases. Overnight CSF Gram stain was positive in 24/51...
September 2015: European Journal of Clinical Microbiology & Infectious Diseases
Padmaja Sudhakar, David M Bachman, Alexander S Mark, Joseph R Berger, Sachin Kedar
BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a severe often fatal opportunistic infection of the central nervous system caused by reactivation of a ubiquitous polyoma virus, JC virus. Although typically characterized by multifocal asymmetric subcortical white matter lesions, it may be monofocal and affect the cortical gray matter. Among the broad spectrum of clinical manifestations that occurs with PML, visual complaints are common. EVIDENCE ACQUISITION: Combination of representative personally observed cases of PML and comprehensive review of case series of PML from 1958 through 2014...
September 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Herman Egberink, Diane D Addie, Corine Boucraut-Baralon, Tadeusz Frymus, Tim Gruffydd-Jones, Katrin Hartmann, Marian C Horzinek, Margaret J Hosie, Fulvio Marsilio, Albert Lloret, Hans Lutz, Maria Grazia Pennisi, Alan D Radford, Etienne Thiry, Uwe Truyen, Karin Möstl
OVERVIEW: West Nile virus (WNV) is a zoonotic mosquito-borne virus with a broad host range that infects mainly birds and mosquitos, but also mammals (including humans), reptiles, amphibians and ticks. It is maintained in a bird-mosquito-bird transmission cycle. The most important vectors are bird-feeding mosquitos of the Culex genus; maintenance and amplification mainly involve passerine birds. WNV can cause disease in humans, horses and several species of birds following infection of the central nervous system...
July 2015: Journal of Feline Medicine and Surgery
Hans Lutz, Diane D Addie, Corine Boucraut-Baralon, Herman Egberink, Tadeusz Frymus, Tim Gruffydd-Jones, Katrin Hartmann, Marian C Horzinek, Margaret J Hosie, Albert Lloret, Fulvio Marsilio, Maria Grazia Pennisi, Alan D Radford, Etienne Thiry, Uwe Truyen, Karin Möstl
OVERVIEW: Borna disease virus (BDV) has a broad host range, affecting primarily horses and sheep, but also cattle, ostriches, cats and dogs. In cats, BDV may cause a non-suppurative meningoencephalomyelitis ('staggering disease'). INFECTION: The mode of transmission is not completely elucidated. Direct and indirect virus transmission is postulated, but BDV is not readily transmitted between cats. Vectors such as ticks may play a role and shrews have been identified as a potential reservoir host...
July 2015: Journal of Feline Medicine and Surgery
G Gifford, K Fay, A Jabbour, D D Ma
Primary central nervous system posttransplantation lymphoproliferative disorder (PCNS-PTLD) is uncommon, especially after heart or lung transplantation. Database analysis from a single heart and lung transplantation centre and a literature review pertaining to PCNS-PTLD was performed. In this study, the prevalence of PCNS-PTLD was 0.18% after heart and/or lung transplants. Of 1674 transplants, three cases of PCNS-PTLD developed 14 months, 9 years and 17 years posttransplant, and all were Epstein-Barr virus driven malignancies...
May 2015: Internal Medicine Journal
Beatriz Larru, Jessica Eby, Elizabeth D Lowenthal
Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI), used for the treatment of human immunodeficiency virus (HIV)-1 infection. Approved by the US Food and Drug Administration in 1998, its indication was recently extended to include children as young as 3 months of age. The World Health Organization and many national guidelines consider efavirenz to be the preferred NNRTI for first-line treatment of children over the age of 3 years. Clinical outcomes of patients on three-drug antiretroviral regimens which include efavirenz are as good as or better than those for patients on all other currently approved HIV medications...
May 29, 2014: Pediatric Health, Medicine and Therapeutics
Ruth Backman, Robbie Foy, Benedict Daniel Michael, Sylviane Defres, Rachel Kneen, Tom Solomon
BACKGROUND: Central nervous system infections can have devastating clinical outcomes if not diagnosed and treated promptly. There is a documented gap between recommended and actual practice and a limited understanding of its causes. We identified and explored the reasons for this gap, focusing on points in the patient pathway most amenable to change and the development of a tailored intervention strategy to improve diagnosis and treatment. METHODS: Using theoretically-informed semi-structured interviews, we explored barriers and enablers to diagnosing and managing patients with suspected encephalitis, specifically performing lumbar punctures and initiating antiviral therapy within 6 h...
2015: Implementation Science: IS
Komi Assogba, Bahoura Balaka, Fidato A Touglo, Kossivi M Apetsè, Damelan Kombaté
BACKGROUND: Convulsive seizures are the common neurological emergencies in developing regions. OBJECTIVES: The aim was to determine the prevalence, causes and outcome of seizures in childhood. PATIENTS AND METHODS: Participants were children aged 1-5 years old, admitted consecutively with a history of febrile convulsions or were presented seizures with fever during hospitalization, in two pediatric university hospitals. The prospective study covered a period from January to December 2013...
January 2015: Journal of Pediatric Neurosciences
Tom Wong, Kevin Fonseca, Max A Chernesky, Richard Garceau, Paul N Levett, Bouchra Serhir
Neurosyphilis refers to infection of the central nervous system by Treponema pallidum, which may occur at any stage. Neurosyphilis has been categorized in many ways including early and late, asymptomatic versus symptomatic and infectious versus non-infectious. Late neurosyphilis primarily affects the central nervous system parenchyma, and occurs beyond early latent syphilis, years to decades after the initial infection. Associated clinical syndromes include general paresis, tabes dorsalis, vision loss, hearing loss and psychiatric manifestations...
January 2015: Canadian Journal of Infectious Diseases & Medical Microbiology
Boqna Pierzchała, Beata Łabuz-Roszak, Ewa Pierzchała, Krystyna Tyrpień
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system occuring in young adults, mainly female. MS dominates in Caucasians living in regions far away from the equator. The coexistence of genetic and environmental factors is considered in its etiopathogenesis. MS mostly occurs in the form of relapses and remissions, leading to the physical disability and cognitive decline. The diagnosis is based on MRI images and cerebrospinal fluid testing. The current guidelines for therapy recommend immunosuppression (steroids during relapses) and immunomodulation...
2014: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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