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CNS infections guidelines

Milena M McLaughlin, Sarah H Sutton, Ashley O Jensen, John S Esterly
INTRODUCTION: In late 2011, a shortage of IV acyclovir led to the need to empirically substitute high-dose oral valacyclovir (HDVA) to conserve IV acyclovir for patients with confirmed herpes simplex virus (HSV) meningitis or encephalitis. This report describes the management of the most recent national IV acyclovir shortage by the Antimicrobial Stewardship Program (ASP) at Northwestern Memorial Hospital (NMH), Chicago, IL, USA, and the use of HDVA. Secondarily, we assessed the safety and tolerability of HDVA as an alternate to IV acyclovir during this shortage...
April 17, 2017: Infectious Diseases and Therapy
Alla Guekht, Nazira Zharkinbekova, Alexander Shpak, W Allen Hauser
PURPOSE: There are no data in the English literature about the epidemiology of epilepsy in the large countries in the Asian region of the former Soviet Union. This paper presents the results of epidemiological studies of active epilepsy in the population 14years of age and older in the Province of South Kazakhstan. METHODS: The study population consisted of 306.44 thousand persons: 139.42 in the urban Enbekshinskiy district of the city of Shymkent and 167.02 in the rural Sairam district...
February 2017: Epilepsy & Behavior: E&B
Talia Mahony, Douglas Sidell, Hayley Gans, Kayla Brown, Bahare Farhadian, Melissa Gustafson, Janell Sherr, Margo Thienemann, Jennifer Frankovich
INTRODUCTION: Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. METHODS: We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines...
January 2017: International Journal of Pediatric Otorhinolaryngology
Elizabeth A Mazzio, David Bauer, Patricia Mendonca, Equar Taka, Karam F A Soliman
Chronic and acute central nervous system (CNS) inflammation are contributors toward neurological injury associated with head trauma, stroke, infection, Parkinsons or Alzheimers disease. CNS inflammatory illnesses can also contribute toward risk of developing glioblastoma multiforme (GBM). With growing public interest in complementary and alternative medicines (CAMs), we conduct a high throughput (HTP) screening of >1400 natural herbs, plants and over the counter (OTC) products for anti-inflammatory effects on lipopolysaccharide (LPS)/interferon gamma (IFNγ) activated C6 glioma cells...
January 15, 2017: Journal of Neuroimmunology
Uroosa Ibrahim, Amina Saqib, Farhan Mohammad, Terenig Terjanian
Nocardiosis is a rare cause of opportunistic infection post hematopoietic stem cell transplant (HSCT) occurring in about 0.3% of patients. The risk factors include delayed immune reconstitution, prolonged neutropenia, and graft-versus-host disease. The most common site of infection is the lung, followed by the brain and the skin. Concomitant pulmonary and central nervous system (CNS) nocardiosis is an extremely rare entity as presented in our case. We present the case of a 72-year-old male at 137 days post transplant presenting with complaints of headache and slurred speech...
October 17, 2016: Curēus
Lisa Van de Wijer, Arnt F A Schellekens, David M Burger, Judith R Homberg, Quirijn de Mast, Andre J A M van der Ven
The non-nucleoside reverse transcriptase inhibitor efavirenz is part of the WHO guidelines for preferred first-line treatment of HIV-1-infected adults, pregnant and lactating women, and children. Efavirenz is well known to cause CNS toxicity. Although good data for CNS toxicity are available for adults, the opposite is true for children. Paediatric studies on this topic frequently suffer from small sample sizes or absence of thorough neuropsychiatric assessments. In this Personal View, we focus on two knowledge gaps of CNS toxicity of efavirenz in children...
May 2016: Lancet Infectious Diseases
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
E Firlag-Burkacka, P Swiecki, I Cielniak, E Siwak, J Gizinska, E Bakowska, J Kubicka, P Pulik, J Kowalski, R Podlasin, A Horban
BACKGROUND: Syphilis is an infection frequently seen with HIV, and European guidelines on the management of syphilis suggest that HIV-infected patients may have an increased risk of early neurological involvement, sometimes asymptomatic. Recent study shows a relationship between neurosyphilis and cerebrospinal fluid (CSF) HIV viral load (VL), which in turn may be associated with subsequent neurocognitive decline. OBJECTIVES AND METHODS: The aim of the study was estimation of the frequency of neurosyphilis among HIV-positive patients with early syphilis...
May 2016: HIV Medicine
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
Desiderio Passali, Anna Crisanti, Luisa Maria Bellussi
Acute rhinosinusitis (ARS) is a very common/disease faced more often by general practitioners than ear, nose and throat specialists, pneumologists or allergologists. In an outpatients setting, upper respiratory tract infection is the third most common cause of a primary care consultation, one third of which is attributable to ARS, diagnosed upon clinical presentation. In some cases however, signs and symptoms do not allow clear differentiation from viral, post-viral or bacterial infection. This compels GPs and family doctors to make a careful choice and first use the best antimicrobial treatment to avoid recurrences or complications and the rise of antibiotic resistance...
December 2015: Le Infezioni in Medicina
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
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
Kamga Hortense Gonsu, Etienne Guenou, Michel Toukam, Valantine Ngum Ndze, Calixte Didier Mbakop, Dongmo Norbert Tankeu, Francois Xavier Mbopi-Keou, Samuel Takongmo
INTRODUCTION: Many studies still show significant numbers of surgical patients contracting nosocomial infections each year globally with high morbidity and mortality. The aim of this study was to identify potential bacteria reservoirs that may be responsible for nosocomial infection in surgical services in the Yaoundé University Teaching Hospital (YUTH) and the Central Hospital Yaoundé (CHY). METHODS: A cross sectional descriptive study was conducted from June to August 2012...
2015: Pan African Medical Journal
Francesco Chiappelli, Silvana Maria Eloi Santos, Xenia Maria Caldeira Brant, Andre Bakhordarian, April D Thames, Carl A Maida, Angela M Du, Allison L Jan, Melissa Nahcivan, Mia T Nguyen, Nateli Sama
UNLABELLED: Dengue, a leading cause of illness and death in the tropics and subtropics since the 1950׳s, is fast spreading in the Western hemisphere. Over 30% of the world׳s population is at risk for the mosquitoes that transmit any one of four related Dengue viruses (DENV). Infection induces lifetime protection to a particular serotype, but successive exposure to a different DENV increases the likelihood of severe form of dengue fever (DF), dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS)...
2014: Bioinformation
Choi Younghwan, Song Changmin, Park Eunok, Hyunjin Oh
INTRODUCTION: Safe and reliable vascular access is essential for the treatment and care of burn patients. Peripherally inserted central catheters (PICCs) are widely used for various groups of critically and chronically ill patients. However, the information about PICC use and management for burn patients is limited. METHODS: The Institutional Review Board approved retrospective cohort chart review included all burn patients at a single center who received one or more PICCs (n=106)...
September 2015: Burns: Journal of the International Society for Burn Injuries
Jon F Watchko, M Jeffrey Maisels
Low bilirubin kernicterus in preterm neonates, though rare, remains an unpredictable and refractory form of brain injury. Hypoalbuminemia, co-morbid CNS insult(s), infection, and inflammation are contributing causes that, in many cases, appear to interact in potentiating bilirubin neurotoxicity. Despite compulsive attention to serum bilirubin levels, and clinical and laboratory indices of neurotoxicity risk, low bilirubin kernicterus continues to be seen in contemporary NICUs. While efforts to refine and improve current treatment guidelines are certainly needed, such revision(s) will also have to take into account the risks and benefits of any intervention, including phototherapy...
November 2014: Seminars in Perinatology
Rekha Mittal
Febrile seizures are the most common seizures of childhood. A family history of febrile seizures is common, and the disorder is genetically heterogenous. While guidelines are available for management of simple febrile seizures, the management of complex febrile seizures is individualised. After a febrile seizure, it is important to rule out CNS infection and the decision to perform a lumbar puncture should be based on the clinical condition of the child. Neuroimaging and EEG are not required immediately in workup for simple or complex febrile seizures...
September 2014: Indian Journal of Pediatrics
Kala Yadhav Ml
CONTEXT: Bacterial meningitis is one of the most serious infections seen in infants and children, which is associated with acute complications and chronic morbidity. Infections of Central Nervous System (CNS) still dominate the scene of childhood neurological disorders in most of the developing tropical countries. AIMS: To isolate, identify and determine the antibiotic susceptibility patterns of pathogens associated with bacterial meningitis. We also aimed to comparatively evaluate of Gram staining, culture and bacterial antigen detection in cerebrospinal fluid samples...
April 2014: Journal of Clinical and Diagnostic Research: JCDR
X Kostaras, F Cusano, G A Kline, W Roa, J Easaw
BACKGROUND: Dexamethasone is the corticosteroid most commonly used for the management of vasogenic edema and increased intracranial pressure in patients with brain tumours. It is also used after surgery (before embarking on radiotherapy), particularly in patients whose tumours exert significant mass effect. Few prospective clinical trials have set out to determine the optimal dose and schedule for dexamethasone in patients with primary brain tumours, and subsequently, fewer clinical practice guideline recommendations have been formulated...
June 2014: Current Oncology
Rajeev Desai, James Neuberger
Cancers in solid organ recipients may be classified as donor transmitted, donor derived, de novo or recurrent. The risk of donor-transmitted cancer is very low and can be reduced by careful screening of the donor but cannot be abolished and, in the United Kingdom series is less than 0.03%. For donors with a known history of cancer, the risks will depend on the nature of the cancer, the interventions given and the interval between diagnosis and organ donation. The risks of cancer transmission must be balanced against the risks of death awaiting a new graft and strict adherence to current guidelines may result increased patient death...
May 28, 2014: World Journal of Gastroenterology: WJG
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