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https://www.readbyqxmd.com/read/28428929/treatment-of-posttubercular-syringomyelia-not-responsive-to-antitubercular-therapy-case-report-and-review-of-literature
#1
Giuseppe Canova, Alessandro Boaro, Enrico Giordan, Pierluigi Longatti
Posttubercular adhesive arachnoiditis is a rare, late complication of tubercular meningitis. Syringomyelia can develop as a consequence of intramedullary cystic lesions and cerebrospinal fluid (CSF) flow disturbance around the spinal cord, even after successful chemotherapy. We reviewed the literature related to posttubercular syringomyelia treatment and suggest a new combined surgical approach. A 25-year-old Nigerian male patient presented with legs numbness, urinary disturbance, and legs weakness. Spinal magnetic resonance revealed a T5-T7 syringomyelia, secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis...
April 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28421878/cerebrovascular-injury-in-cryptococcal-meningitis
#2
Ajay Kumar Mishra, Vanjare Harshad Arvind, Divya Muliyil, Cijoy K Kuriakose, Anu Anna George, Reka Karuppusami, Ronald Albert Benton Carey, Sunithi Mani, Samuel George Hansdak
Background Cryptococcal meningitis continues to be one of the common causes of chronic central nervous system infection worldwide. Individuals with cryptococcal meningitis can occasionally present with small vessel vasculitis causing infarcts primarily in the basal ganglia, internal capsule, and thalamus. Literature regarding patterns of cerebrovascular injury among patients with cryptococcal meningitis is scanty, and outcome following these vascular involvements is unknown. Aim To study the clinical profile, imaging findings, and details of vascular territory involved among patients admitted with cryptococcal meningitis and central nervous system infarct in a tertiary care center from India...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28420931/paediatrics-primary-myelofibrosis-and-acute-stroke-a-rare-presentation
#3
Wajida Mazher, Ather Hasan Rizvi, Arsalan Majeed Adam, Muhammad Saad Ali Mallick, Ansab Godil
Idiopathic Myelofibrosis is a rare myeloproliferative disorder. In children, it becomes even rarer. Herein, we report a case of idiopathic myelofibrosis of a 6-year old male patient who presented with complaints of pallor, petechiae and bleeding from gums. Bone marrow aspirate showed afragmented haemodiluted smears with erythroid and myeloid precursors scattered throughout. Trephine biopsy showed increased background fibrotic activity along with clusters of histiocytes. A diagnosis of paediatric primary myelofibrosis was made on biopsy...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28420846/intrathecal-isoniazid-for-refractory-tuberculous-meningitis-with-cerebral-infarction
#4
Yuko Nakatani, Yutaka Suto, Kazuki Fukuma, Mika Yamawaki, Ryoichi Sakata, Shotaro Takahashi, Hiroyuki Nakayasu, Kenji Nakashima
A 30-year-old Vietnamese woman, about 19 weeks pregnant, was admitted for acute cerebral infarction with stenosis of the left middle cerebral artery (LMCA), tuberculous meningitis, and miliary tuberculosis. Treatment with heparin, quadruple anti-tuberculosis therapy, and dexamethasone afforded prompt symptomatic improvement. However, she delivered a stillbirth, after which there was recurrence of acute cerebral infarction with LMCA occlusion, sinus thrombosis, and cranial base inflammation. A thrice-weekly 100 mg dose of intrathecal isoniazid (INH) improved the signs of meningeal inflammation...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28414665/a-case-of-early-neurosyphilis
#5
M Walker, R Wisler, J Simmons, A Johnson
INTRODUCTION: Neurosyphilis is an infection of the central nervous system by Treponema pallidum, which can occur after the initial syphilis infection. Although commonly associated with late stage disease, patients with early neurosyphilis may present with acute syphilitic meningitis, meningovascular syphilis, or uveitis. CASE: A 28 year old man with a past medical history of HIV (CD4 364);, and recent diagnosis of uveitis presented to the Emergency Department with a positive RPR result...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409733/endovascular-management-of-acute-epidural-hematomas-clinical-experience-with-80-cases
#6
Carlos Michel A Peres, Jose Guilherme M P Caldas, Paulo Puglia, Almir F de Andrade, Igor A F da Silva, Manoel J Teixeira, Eberval G Figueiredo
OBJECTIVE Small acute epidural hematomas (EDHs) treated conservatively carry a nonmeasurable risk of late enlargement due to middle meningeal artery (MMA) lesions. Patients with EDHs need to stay hospitalized for several days, with neurological supervision and repeated CT scans. In this study, the authors analyzed the safety and efficacy of the embolization of the involved MMA and associated lesions. METHODS The study group consisted of 80 consecutive patients harboring small- to medium-sized EDHs treated by MMA embolization between January 2010 and December 2014...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28409290/comparison-of-clinical-and-laboratory-characteristics-during-two-major-paediatric-meningitis-outbreaks-of-echovirus-30-and-other-non-polio-enteroviruses-in-germany-in-2008-and-2013
#7
H Rudolph, R Prieto Dernbach, M Walka, P Rey-Hinterkopf, V Melichar, E Muschiol, S Schweitzer-Krantz, J W Richter, C Weiss, S Böttcher, S Diedrich, H Schroten, T Tenenbaum
Viral meningitis is mainly caused by non-polio enteroviruses (NPEV). Large-scale data on the clinical characteristics between different outbreaks within the same region are lacking. This study aimed to analyse a possible influence of the circulating NPEV genotype on the disease outcome of affected children. A retrospective cohort study analysing two major outbreaks of NPEV meningitis in Germany in 2008 and 2013 was conducted in cooperation with the National Reference Centre for Poliomyelitis and Enteroviruses (NRC PE) and five German children's hospitals...
April 13, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28409125/colibactin-contributes-to-the-hypervirulence-of-pks-k1-cc23-klebsiella-pneumoniae-in-mouse-meningitis-infections
#8
Min-Chi Lu, Ying-Tsong Chen, Ming-Ko Chiang, Yao-Chen Wang, Pei-Yi Hsiao, Yi-Jhen Huang, Ching-Ting Lin, Ching-Chang Cheng, Chih-Lung Liang, Yi-Chyi Lai
Klebsiella pneumoniae is the most common pathogen of community-acquired meningitis in Taiwan. However, the lack of a physiologically relevant meningitis model for K. pneumoniae has impeded research into its pathogenesis mechanism. Based on the core genome MLST analyses, the hypervirulent K1 K. pneumoniae strains, which are etiologically implicated in adult meningitis, mostly belong to a single clonal complex, CC23. Some K1 CC23 K. pneumoniae strains carry a gene cluster responsible for colibactin production...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28407706/gas-containing-cervical-epidural-abscess-accompanying-bacterial-meningitis-in-an-adult
#9
Dong Min Kim, Seok Won Kim
Gas-containing spinal epidural abscesses are uncommon. Moreover, acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. Here, we report a rare case of a gas-containing cervical epidural abscess accompanying bacterial meningitis. In spite of aggressive fluid and continuous antibiotic therapy after the isolation of Streptococcus anginosus and Streptococcus constellatus in the cerebrospinal fluid cultures, the patient showed remaining motor dysfunction and bladder involvement. Our experience suggests that the effort to prevent neurologic deterioration by emergent surgical decompression and drainage of pus is mandatory to avoid additional spinal cord dysfunction in patients with spinal epidural abscesses accompanying bacterial meningitis...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28402705/interaction-of-factor-h-binding-protein-of-streptococcus-suis-with-globotriaosylceramide-promotes-the-development-of-meningitis
#10
Decong Kong, Zhe Chen, Junping Wang, Qingyu Lv, Hua Jiang, Yuling Zheng, Maokai Xu, Xuyu Zhou, Huaijie Hao, Yongqiang Jiang
Streptococcus suis is an important emerging zoonotic agent that causes acute bacterial meningitis in humans with high mortality and morbidity. Our previous work showed that factor H-binding protein (Fhb) contributed to virulence of S. suis, but the role of Fhb in the development of S. suis meningitis remained unclear. In this study, we demonstrated for the first time that Fhb contributed to the traversal of S. suis across the human blood-brain barrier by allelic-exchange mutagenesis, complementation and specific antibody blocking studies...
April 12, 2017: Virulence
https://www.readbyqxmd.com/read/28387984/practical-issues-in-using-eculizumab-for-children-with-atypical-hemolytic-uremic-syndrome-in-the-acute-phase-a-review-of-4-patients
#11
Chikako Terano, Kenji Ishikura, Riku Hamada, Yasuhiro Yoshida, Wataru Kubota, Yusuke Okuda, Shunsuke Shinozuka, Ryoko Harada, Sunao Iyoda, Yoshihiro Fujimura, Yuko Hamasaki, Hiroshi Hataya, Masataka Honda
AIM: Recently eculizumab, a monoclonal antibody to C5, was found to improve the disease course of atypical hemolytic uremic syndrome (aHUS) and has been recommended as the first line treatment by an international consensus guideline. However, several practical issues in the use of eculizumab for the acute phase of aHUS have yet to be resolved. METHODS: Children who received eculizumab with diagnosis of aHUS between March 2010 and December 2015 at Tokyo Metropolitan Children's Medical Center were enrolled...
April 7, 2017: Nephrology
https://www.readbyqxmd.com/read/28384999/pathogenesis-of-coxsackievirus-b2-in-mice-characterisation-of-clinical-isolates-of-the-coxsackievirus-b2-from-patients-with-myocarditis-and-aseptic-meningitis-in-korea
#12
JiYoung Hong, BungHak Kang, SangGu Yeo, Youngmee Jee, Jae-Hak Park
Group B coxsackieviruses (CVBs) are a group of common human pathogens causing various clinical symptoms. Although the virology of CVB is well known, there is limited information on viral pathogenesis and the relationship between clinical symptoms and viral phenotype, particularly for CVB type 2 (CVB2). In this study, two CVB2 strains were isolated: CB2/04/279 from a stool of an acute myocarditis patient with heart failure; and CB2/04/243 from an aseptic meningitis patient in 2004 in Korea. A high degree of homology was observed between the CB2/04/279 and CB2/04/243 full genome sequences...
April 6, 2017: Journal of Veterinary Science
https://www.readbyqxmd.com/read/28382572/current-clinical-trials-on-the-use-of-ceftaroline-in-the-pediatric-population
#13
REVIEW
Adam Corey, Tsz-Yin So
The rate of antibiotic resistance in children continues to rise requiring the use of new antibiotics. Ceftaroline fosamil, a newer-generation cephalosporin, was recently approved for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia in children aged >2 months. Ceftaroline provides coverage against staphylococcal and streptococcal infections, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae...
April 5, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28349737/pediatric-acute-otitis-media-in-the-era-of-pneumococcal-vaccination
#14
Kareem O Tawfik, Stacey L Ishman, Mekibib Altaye, Jareen Meinzen-Derr, Daniel I Choo
Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28344163/characterization-of-antibody-response-in-neuroinvasive-infection-caused-by-toscana-virus
#15
Anna Pierro, Sabrina Ficarelli, Nazli Ayhan, Silvia Morini, Luigi Raumer, Michele Bartoletti, Antonio Mastroianni, Francesca Prati, Simona Schivazappa, Patrizia Cenni, Caterina Vocale, Giada Rossini, Paolo Gaibani, Vittorio Sambri, Maria Paola Landini, Russel Edward Lewis, Remi N Charrel, Stefania Varani
OBJECTIVES: Among sandfly-borne pathogens, Toscana virus (TOSV) is a prominent cause of summer meningitis in Mediterranean Europe. Here, we assessed the kinetics of anti-TOSV antibodies over time in 41 patients diagnosed with TOSV-meningitis or meningoencephalitis in North-eastern Italy. METHODS: Acute and follow-up serum samples were collected up to 20 months after diagnosis of TOSV infection and tested for the presence of specific antibody using immunoenzymatic and indirect immunofluorescence assays...
March 23, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28330942/primary-angiitis-of-the-central-nervous-system-magnetic-resonance-imaging-spectrum-of-parenchymal-meningeal-and-vascular-lesions-at-baseline
#16
Grégoire Boulouis, Hubert de Boysson, Mathieu Zuber, Loïc Guillevin, Eric Meary, Vincent Costalat, Christian Pagnoux, Olivier Naggara
BACKGROUND AND PURPOSE: Primary angiitis of the central nervous system remains challenging. To report an overview and pictorial review of brain magnetic resonance imaging findings in adult primary angiitis of the central nervous system and to determine the distribution of parenchymal, meningeal, and vascular lesions in a large multicentric cohort. METHODS: Adult patients from the French COVAC cohort (Cohort of Patients With Primary Vasculitis of the Central Nervous System), with biopsy or angiographically proven primary angiitis of the central nervous system and brain magnetic resonance imaging available at the time of diagnosis were included...
March 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28320704/listeria-monocytogenes-meningitis-preceded-by-acute-cholangitis
#17
Sarah Kyuragi Luthe, Ryota Sato, Tetsuro Maeda, Kuniko Takahashi
Listeria monocytogenes is a well-known cause of meningitis in immunocompromised patients. This organism has a growing significance for community-acquired meningitis, which should have ampicillin added to the usual regimen. We describe a case of L. monocytogenes meningitis preceded by cholangitis. This case suggests gastrointestinal symptoms preceding meningitis may be a clue of listeriosis. It is important for physicians to consider L. monocytogenes as a cause of bacterial meningitis in patients with altered mental status preceded by gastrointestinal symptoms, especially in the immunocompromised population...
March 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28303609/pathological-analysis-of-children-with-childhood-central-nervous-system-infection-based-on-changes-in-chemokines-and-interleukin-17-family-cytokines-in-cerebrospinal-fluid
#18
Shinichiro Morichi, Tomomi Urabe, Natsumi Morishita, Mika Takeshita, Yu Ishida, Shingo Oana, Gaku Yamanaka, Yasuyo Kashiwagi, Hisashi Kawashima
BACKGROUND: In this study, the pathologies of acute meningitis and encephalopathy were investigated, and biomarkers useful as prognostic indices were searched for. METHODS: The subjects were 31 children with meningitis, 30 with encephalopathy, and 12 with convulsions following gastroenteritis. Control group consisted of 24 children with non-central nervous system infection. Cerebrospinal fluid cytokine analysis was performed. RESULTS: Chemokines significantly increased in the bacterial meningitis group compared with those in viral meningitis and encephalopathy groups...
March 17, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28298482/movement-disorder-associated-with-foreign-body-ingestion
#19
Olugbenga Akingbola, Dinesh Singh, Uwe Blecker
We present a case of recurrent bouts of irritability with arching, head extension, and lethargy in a previously healthy 10-month-old girl admitted to the PICU for acute onset of a movement disorder. The patient's vital signs and physical examination were unremarkable but recurrent bouts of abnormal movements persisted for the first 10 hours of admission in the PICU. Possible diagnoses, such as meningitis, status epilepticus, space occupying lesions, and toxic ingestions, were ruled out because of negative cerebrospinal fluid analysis, normal EEG, and negative results of other ancillary tests...
March 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28298047/development-of-a-prediction-rule-for-diagnosing-postoperative-meningitis-a-cross-sectional-study
#20
Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants...
March 10, 2017: Journal of Neurosurgery
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