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Pyogenic Meningitis treatment in adults

Clémence Demerle, Vadim Ivanov, Cédric Mercier, Régis Costello, Michel Drancourt
INTRODUCTION: Community-acquired meningitis is a monomicrobial infection caused by either viruses or bacteria in the vast majority of patients. We report here one exceptional case of a patient with mixed bacterial meningitis due to Streptococcus pneumoniae and Streptococcus pyogenes. CASE PRESENTATION: We report the case of a 68-year-old immunocompromised Caucasian man suffering from otitis and then meningitis caused by Streptococcus pneumoniae and Streptococcus pyogenes...
2015: Journal of Medical Case Reports
Marjolein J Lucas, Matthijs C Brouwer, Arie van der Ende, Diederik van de Beek
BACKGROUND: Endocarditis may precede or complicate bacterial meningitis, but the incidence and impact of endocarditis in bacterial meningitis are unknown. METHODS AND RESULTS: 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...
May 21, 2013: Circulation
Carsten Stüer, Michael Stoffel, Judith Hecker, Florian Ringel, Bernhard Meyer
BACKGROUND AND STUDY AIM: Spinal pyogenic infections occur frequently in today's neurosurgical routine. Conservative therapy often proves to be insufficient against an aggressive disease that affects patients who tend to be elderly and debilitated with complex comorbidity. Treatment, or lack of treatment, carries risks of persistent disability, sepsis, and death. In this study, we propose a tailored and staged algorithm for treating such spinal infections and present results of this approach...
March 2013: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Kin K Jim, Matthijs C Brouwer, Arie van der Ende, Diederik van de Beek
OBJECTIVE: To evaluate the occurrence, treatment, and outcome of subdural empyema complicating community-acquired bacterial meningitis in adults. METHODS: Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2011. RESULTS: Subdural empyema was diagnosed in 28 of 1,034 episodes (2.7%), and was present on admission in 10 episodes and diagnosed during admission in 18. Predisposing conditions were present in 26 patients (93%), and consisted of otitis or sinusitis in 21 patients (75%)...
November 20, 2012: Neurology
Arianna Maiolini, Regina Carlson, Andrea Tipold
BACKGROUND: Steroid-responsive meningitis-arteritis (SRMA) is a systemic inflammatory disease affecting young adult dogs and a potential large animal model for neutrophilic meningitis. Similarities between SRMA and infectious central nervous system (CNS) diseases in lymphocyte subsets suggest an infectious origin.Toll-like receptors (TLRs) are pattern recognition receptors playing an important role in innate immunity. Due to their ability to recognize both self and non-self antigens, we hypothesize that TLRs are among the key factors for the induction of the inflammatory process in SRMA and provide an indirect hint on the etiology of the disease...
2012: Journal of Neuroinflammation
A L Pattullo, E J Bow
Group A streptococci are an important cause of soft tissue infections but have rarely been reported as the cause of pyogenic meningitis since the advent of antibiotics. A case of group A streptococcal meningitis in an adult is presented along with a review of similar cases reported in the literature. This case serves to illustrate the virulent nature of this pathogen in infections of the meninges, the potential for associated complications, and the need for rapid diagnosis and appropriate treatment. The source of infection in this and many other cases in the literature is the upper respiratory tract...
July 1993: Canadian Journal of Infectious Diseases, Journal Canadien des Maladies Infectieuses
T Siljander, O Lyytikäinen, S Vähäkuopus, M Snellman, J Jalava, J Vuopio
In 2006, Finnish nationwide surveillance showed an increase of invasive group A streptococcal (iGAS) disease and clinicians were alarmed by severe disease manifestations, prompting the investigation of recent trends and outcome for iGAS. A case of iGAS was defined as Streptococcus pyogenes isolated from blood or cerebrospinal fluid. Cases during 1998-2007 and isolates during 2004-2007 were included. Case-patients' 7-day outcome was available for 2004-2007. Isolates were emm typed. A total of 1,318 cases of iGAS were identified...
October 2010: European Journal of Clinical Microbiology & Infectious Diseases
Ritika Sud, M K Bhatnagar, Alok Sud, Akshay Tiwari
Meningococcal outbreaks are a major health concern in Delhi and adjoining regions. Besides acute pyogenic meningitis, meningococcal disease can also manifest as vasculitis, dermatitis and arthritis. To study the frequency, characteristics and long-term outcome of joint involvement in May 2005 meningococcal outbreak in New Delhi, 24 patients with proven meningococcal disease admitted to the hospital from May, 2005 through August, 2005 were studied for occurrence and outcome of joint involvement, and were followed up and evaluated for any complications...
March 2009: Journal of the Indian Medical Association
Mehmet Ulug, Nuray Can Ulug, Mustafa Kemal Celen, Mehmet Faruk Geyik, Celal Ayaz
BACKGROUND: Streptococcus pyogenes is a well-known cause of a variety of clinical infections including local symptoms such as tonsillopharyngitis, cervical lymphadenitis, otitis media, cellulites, erysipelas, as well as more severe diseases such as scarlet fever, osteomyelitis, necrotizing fasciitis, sepsis, and toxic shock syndrome. However, acute bacterial meningitis caused by this pathogen is unusual. OBJECTIVE: We report a case of group A streptococcus (GAS) meningitis in a previously healthy woman with a dramatically rapid course and fatal outcome...
2009: Journal of Infection in Developing Countries
Por-Wen Yang, Hong-Da Lin, Lee-Min Wang
BACKGROUND: Septic pulmonary embolism (SPE) is one of the metastatic foci of pyogenic liver abscess. The purpose of this study was to investigate the clinical presentations of, and management options for patients with pyogenic liver abscess complicated with SPE. METHODS: A retrospective chart review was conducted from January 1, 1999 to December 31, 2005 inclusively, in a medical center in northern Taiwan. We collected and analyzed the clinical presentations, diagnostic modalities, treatment programs and prognoses for all pyogenic liver abscess patients with SPE...
September 2008: Journal of the Chinese Medical Association: JCMA
Clara Menéndez, Cleofé Romagosa, Mamudo R Ismail, Carla Carrilho, Francisco Saute, Nafissa Osman, Fernanda Machungo, Azucena Bardaji, Llorenç Quintó, Alfredo Mayor, Denise Naniche, Carlota Dobaño, Pedro L Alonso, Jaume Ordi
BACKGROUND: Maternal mortality is a major health problem concentrated in resource-poor regions. Accurate data on its causes using rigorous methods is lacking, but is essential to guide policy-makers and health professionals to reduce this intolerable burden. The aim of this study was to accurately describe the causes of maternal death in order to contribute to its reduction, in one of the regions of the world with the highest maternal mortality ratios. METHODS AND FINDINGS: We conducted a prospective study between October 2002 and December 2004 on the causes of maternal death in a tertiary-level referral hospital in Maputo, Mozambique, using complete autopsies with histological examination...
February 2008: PLoS Medicine
Paolo Persichetti, Marika Langella, Giovanni Francesco Marangi, Ettore Vulcano, Giovanni Gherardi, Giordano Dicuonzo
We present a case of a 32-year-old white women, affected by breast cancer and treated with mastectomy, who underwent immediate breast reconstruction with a tissue expander. She presented a periprosthetic infection from Streptococcus pyogenes (group A streptococcus, GAS) after scarlet fever. S. pyogenes may be responsible for suppurative complications of the respiratory system and a variety of metastatic foci of infection such as suppurative arthritic, endocarditis, meningitis, or brain abscess. Even though, in the literature, several cases and types of infection associated with breast implantation have been described, to our knowledge this is the first case report of periprosthetic infection after scarlet fever...
January 2008: Annals of Plastic Surgery
R Mani, A Mahadevan, S Pradhan, S Nagarathna, N S Srikanth, M Dias, A Chandramuki
Despite the recent resurgence in reports of invasive Group A Streptococcal (GAS) infections worldwide, it remains a rare cause of pyogenic meningitis both in children and adults. We report a case of fatal GAS meningitis in a healthy adult emphasizing the need for clinicians to be aware of its fulminant course, prompting early diagnosis and treatment. There is also a need to consider postexposure chemoprophylaxis in close contacts of such cases.
April 2007: Indian Journal of Medical Microbiology
Chang-Sue Yang, Hsien-Yang Tsai, Chun-Sung Sung, Keng-Hung Lin, Fenq-Lih Lee, Wen-Ming Hsu
OBJECTIVE: To study risk factors, clinical features, treatment, and visual outcomes in patients with endogenous Klebsiella pneumoniae endophthalmitis (EKE) associated with K. pneumoniae-induced pyogenic liver abscess, and to investigate contributing factors in successfully treated cases. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Review of medical records of 22 consecutive patients with EKE and pyogenic liver abscess...
May 2007: Ophthalmology
Jeannette Guarner, Michelle M Packard, Kurt B Nolte, Christopher D Paddock, Wun-Ju Shieh, Maria L Tondella, Lesley McGee, Sherif R Zaki
Streptococcus pneumoniae is the most frequent cause of pneumonia and meningitis. Because S pneumoniae can colonize the upper respiratory tract and antibiotic treatment may inhibit growth, culture-based diagnosis can be problematic. An immunohistochemical assay using a polyclonal antibody against pneumococci was used to test formalin-fixed, paraffin-embedded tissue samples from 46 patients for whom bacterial culture results were available. Samples from 26 patients demonstrated pneumococcal antigens in areas of pneumonia, meningitis, or osteomyelitis or within circulating inflammatory cells...
April 2007: American Journal of Clinical Pathology
Oral Oncul, Orhan Baylan, Hakan Mutlu, Saban Cavuslu, Levent Doganci
Central nervous system (CNS) tuberculosis (TB), the most dangerous form of TB, remains a public health problem, particularly in developing countries. In the differential diagnosis of intracranial tuberculomas (ICTs), images on radiological findings should be differentiated from other causes of space-occupying lesions. These lesions include malignant diseases such as glioma or lymphoma, pyogenic abscess, toxoplasmosis, neurocysticercosis (NC), sarcoidosis, hydatidosis and late syphilitic involvement of CNS. We present a case with multiple ICTs mimicking NC with similar clinical and imaging manifestations in a young immunocompetent patient...
December 2005: Japanese Journal of Infectious Diseases
Wolfram Schummer, Claudia Schummer
BACKGROUND: Puerperal sepsis due to group A beta-hemolytic streptococcal (GAS) toxic shock syndrome is associated with very high morbidity and mortality. Luckily it is now rare, but diagnosis is not always easy. This report demonstrates the problem of recognizing this disease, and summarizes the current knowledge on the pathomechanism and management of streptococcal toxic shock syndrome. CASE: Two cases of postpartum streptococcal toxic shock syndrome due to GAS are described...
2002: Infectious Diseases in Obstetrics and Gynecology
Santiago Palacio, Robert G Hart, Dennis G Vollmer, Kathleen Kagan-Hallet
BACKGROUND: Although vasculopathy is a recognized complication during acute meningitis, to our knowledge, no previous reports have been published of this phenomenon developing months after successful treatment. OBJECTIVE: To report a unique case of a late-developing vasculopathy after pyogenic meningitis in an adult. REPORT OF A CASE: A 51-year-old woman was seen with severe headache 2 months after treatment of Haemophilus influenzae type C meningitis...
March 2003: Archives of Neurology
R Jain, S Prabhakar, M Modi, R Bhatia, R Sehgal
Acute amebic meningoencephalitis caused by free-living amebae naegleria fowleri is extremely rare and uniformly fatal with only seven survivals reported till date. An interesting case of naegleria meningitis diagnosed by wet mount cytology of cerebrospinal fluid (CSF) and treated with amphoterecin B, rifampicin and ornidazole with complete recovery is presented. In cases of suspected pyogenic meningitis, if CSF staining, antigen detection or culture is negative for bacteria, a wet mount cytology of CSF for naegleria is suggested...
December 2002: Neurology India
I Saliba, A Moukheiber, G Wanna, N Moukarzel, A Nehme, S Mansour
In pyogenic meningitis resulting from a life-threatening ear infection, mastoidectomy is performed as part of the management of the disorder. A dilemma arises when the active ear is the only hearing ear. An active unsafe ear can lead to sensorineural hearing loss whereas ear surgery carries the risk of inner ear damage. We present the case of a 40-year-old woman admitted for severe purulent meningitis and sub-coma secondary to a left mastoiditis with mixed hearing loss on the left side and complete deafness on the right side...
September 2000: Le Journal Médical Libanais. the Lebanese Medical Journal
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