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https://www.readbyqxmd.com/read/28916998/emergency-neurologic-life-support-meningitis-and-encephalitis
#1
David F Gaieski, Nicole F O'Brien, Ricardo Hernandez
Bacterial meningitis and viral encephalitis, particularly herpes simplex encephalitis, are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because of the value of early recognition and treatment, meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. This protocol provides a practical approach to recognition and urgent treatment of bacterial meningitis and encephalitis. Appropriate imaging, spinal fluid analysis, and early empiric treatment are discussed...
September 15, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28889017/mycoplasmas-brain-invaders
#2
REVIEW
Rubén S Rosales, Roberto Puleio, Guido R Loria, Salvatore Catania, Robin A J Nicholas
Mycoplasmas of humans and animals are usually associated with respiratory, autoimmune, genital and joint diseases. Human mycoplasmas have also been known to affect the brain. Severe central nervous system (CNS) diseases, such as encephalitis, have been linked to Mycoplasma pneumoniae and ureaplasma infections. Less well known is the sheep and goat pathogen, Mycoplasma agalactiae, which has been found in large quantities in the brain where it may be responsible for non-purulent encephalitis as well as ataxia in young animals...
September 5, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28885354/acute-versus-subacute-community-acquired-meningitis-analysis-of-611-patients
#3
Tarek Sulaiman, Lucrecia Salazar, Rodrigo Hasbun
Community-acquired meningitis can be classified into acute and subacute presentations by the duration of illness of ≤ or >5 days, respectively. There are currently no studies comparing the clinical features, management decisions, etiologies, and outcomes between acute and subacute presentations.It is a retrospective study of adults with community-acquired meningitis hospitalized in Houston, TX between January 2005 and January 2010. An adverse clinical outcome was defined as a Glasgow Outcome Scale score of ≤4...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28882017/utility-of-rapid-microbiological-techniques-for-the-diagnosis-of-severe-infections
#4
REVIEW
E Cercenado
Rapid diagnostic microbiological techniques and antimicrobial susceptibility testing are necessary for early and adequate treatment. The utility of old (Gram stain, antigen detection, direct antimicrobial susceptibility testing, chromogenic media) and new techniques (molecular assays, MALDI-TOF) is summarized for the rapid diagnosis of bacteraemia and fungaemia, catheter-related bloodstream infections, pneumonia, meningitis, skin and soft-tissue infections, urinary tract infection, Clostridium difficile infection, viral infections, and tuberculosis...
September 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28879886/a-study-on-the-clinical-outcomes-and-management-of-meningitis-at-a-tertiary-care-centre
#5
Aparna Yerramilli, Priya Mangapati, Subhashini Prabhakar, Harish Sirimulla, Shravani Vanam, Yashaswini Voora
BACKGROUND: Meningitis is a life threatening central nervous system infection that is prevalent worldwide. Many studies have been conducted on bacterial meningitis, but the information is inadequate on the other types of meningitis, especially prevalent in India. Regional information regarding trends, in terms of etiology and microbiological susceptibility, are essential for timely and adequate management of meningitis. AIMS: The present study was undertaken to evaluate the changing epidemiology of meningitis by reviewing the causative agents, the available laboratory methods for making the etiological diagnosis, the risk factors and the clinical outcomes, and the management of meningitis in our patient population...
September 2017: Neurology India
https://www.readbyqxmd.com/read/28866321/cerebrospinal-fluid-lactate-a-differential-biomarker-for-bacterial-and-viral-meningitis-in-children
#6
Mudasir Nazir, Wasim Ahmad Wani, Muzaffar Ahmad Malik, Mohd Rafiq Mir, Younis Ashraf, Khalid Kawoosa, Syed Wajid Ali
OBJECTIVE: To assess the performance of cerebrospinal fluid (CSF) lactate as a biomarker to differentiate bacterial meningitis (BM) from viral meningitis (VM) in children, and to define an optimal CSF lactate concentration that can be called significant for the differentiation. METHODS: Children with clinical findings compatible with meningitis were studied. CSF lactate and other conventional CSF parameters were recorded. RESULTS: At a cut-off value of 3mmol/L, CSF lactate had a sensitivity of 0...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28866263/use-of-multiplex-pcr-based-molecular-diagnostics-in-diagnosis-of-suspected-cns-infections-in-tertiary-care-setting-a-retrospective-study
#7
Mahendra Javali, Purushottam Acharya, Aneesh Mehta, Aju Abraham John, Rohan Mahale, R Srinivasa
OBJECTIVES: CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections...
August 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28859668/cerebrospinal-fluid-cxcl13-as-a-diagnostic-marker-of-neuroborreliosis-in-children-a-retrospective-case-control-study
#8
M M Remy, N Schöbi, L Kottanattu, S Pfister, A Duppenthaler, F Suter-Riniker
BACKGROUND: Lyme neuroborreliosis (LNB) is a frequent manifestation of Lyme disease in children and its current diagnosis has limitations. The elevation of the chemokine CXCL13 in the cerebrospinal fluid (CSF) of adult patients with LNB has been demonstrated and suggested as a new diagnostic marker. Our aim was to evaluate this marker in the CSF of children with suspected LNB and to determine a CXCL13 cut-off concentration that would discriminate between LNB and other central nervous system (CNS) infections...
August 31, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28858084/diagnostic-value-of-lactate-procalcitonin-ferritin-serum-c-reactive-protein-and-other-biomarkers-in-bacterial-and-viral-meningitis-a-cross-sectional-study
#9
Anahita Sanaei Dashti, Shekoofan Alizadeh, Abdullah Karimi, Masoomeh Khalifeh, Seyed Abdolmajid Shoja
There are many difficulties distinguishing bacterial from viral meningitis that could be reasonably solved using biomarkers. The aim of this study was to evaluate lactate, procalcitonin (PCT), ferritin, serum-CRP (C-reactive protein), and other known biomarkers in differentiating bacterial meningitis from viral meningitis in children.All children aged 28 days to 14 years with suspected meningitis who were admitted to Mofid Children's Hospital, Tehran, between October 2012 and November 2013, were enrolled in this prospective cross-sectional study...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28851278/toscana-virus-meningo-encephalitis-an-important-differential-diagnosis-for-elderly-travellers-returning-from-mediterranean-countries
#10
James Veater, Farhan Mehedi, Chee Kay Cheung, Laura Nabarro, Jane Osborne, Nicholas Wong, Martin Wiselka, Julian W Tang
BACKGROUND: Elderly patients have a long list of differentials for causes of acute confusion and altered consciousness levels, including infectious agents. In addition, elderly, retired patients often have more time to travel for tourism, particularly to exotic, warmer locations. Mediterranean countries such as Spain and Italy are popular holiday destinations for British and other tourists, especially during the winter months. However, these warm climates allow insect vectors to proliferate, increasing the risk of exposure to endemic vectorborne viral infections whilst on vacation...
August 29, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28837564/impact-of-meningitis-on-intelligence-and-development-a-systematic-review-and-meta-analysis
#11
Deborah Christie, Harunor Rashid, Haitham El-Bashir, Faye Sweeney, Tim Shore, Robert Booy, Russell M Viner
BACKGROUND: We undertook a systematic review and meta-analysis to address the question "what is the impact of meningitis on IQ and development." METHODS: Search: conducted using standardized search terms across Medline, PsychInfo and EMBASE to 06/2014. Eligibility: human studies of any infectious aetiology of meningitis reporting IQ or infant developmental age or stage outcomes. Quality: Centre for Evidence Based Medicine, Oxford, quality tools. Analysis: random effects meta-analysis by organism...
2017: PloS One
https://www.readbyqxmd.com/read/28831299/west-nile-virus-meningitis-in-a-patient-with-human-immunodeficiency-virus-type-1-infection
#12
D Pilalas, L Skoura, A Margariti, D Chatzidimitriou, A Sarantopoulos, O Tsachouridou, A Papa, S Metallidis
The emergence of West Nile virus lineage 2 in central Macedonia, Greece, in 2010 resulted in large outbreaks for 5 consecutive years. We report a case of viral meningitis in an individual infected with human immunodeficiency virus type 1, which preceded the recognition of the outbreak and was confirmed retrospectively as West Nile virus neuroinvasive disease.
September 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/28831257/encephalitis-with-reversible-splenial-and-deep-cerebral-white-matter-lesions-associated-with-epstein-barr-virus-infection-in-adults
#13
Yanjun Guo, Shuhui Wang, Bin Jiang, Jianle Li, Lei Liu, Jiawei Wang, Weiqin Zhao, Jianping Jia
BACKGROUND: Approximately 200 cases of mild encephalitis with reversible splenial (MERS) and deep cerebral white matter lesions have been reported since MERS was first defined in 2004. MERS occurs more frequently in children; in adults, only ~60 cases have been reported. Until now, only four cases of MERS in adults have been associated with Epstein-Barr virus (EBV). CASE PRESENTATION: We report three adult cases of MERS associated with EBV infection in China. For all three patients, cranial magnetic resonance imaging (MRI) indicated solitary reversible splenial and/or perilateral ventricle white matter lesions with reduced diffusion...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28816034/cerebrospinal-fluid-cytology-in-nonmalignant-aseptic-meningeal-disorders
#14
REVIEW
Rafael Martínez-Girón, Liron Pantanowitz
Cerebrospinal fluid cytology examination is a common and reliable primary and/or complementary procedure for the diagnosis of central nervous system (CNS) disorders. This review provides an update of aseptic meningeal disorders that may be encountered in cytopathology practice. The article covers the cytological findings and helpful ancillary studies needed of nonmalignant aseptic CNS disorders such as viral, bacterial, fungal and parasitic infections, and other noninfectious diseases, such as Mollaret´s meningitis (recurrent benign lymphocytic meningitis), Guillain-Barré syndrome, multiple Sclerosis, subarachnoid haemorrhage, and drug-induced disorders...
August 16, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28814255/current-evidence-on-the-evaluation-and-management-of-fever-without-a-source-in-infants-aged-0-90-days-a-review
#15
Joyee G Vachani, Kenya McNeal-Trice, Sowdhamini S Wallace
BACKGROUND: Despite development of risk stratification tools decades ago, the best strategy for evaluation and management of young infants with fever without a clear source remains uncertain. OBJECTIVE: To describe the variability in current practice and review recently published evidence in three key areas: inflammatory markers as a tool for risk stratification, impact of viral testing, and optimal observation time on antibiotics. METHODS: Articles were identified using PubMed, Scopus, and Cochrane databases and via experts...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28813773/a-case-of-ivig-induced-aseptic-chemical-meningitis
#16
Anish Patel, Kalyan Chakravarthy Potu, Tamera Sturm
Intravenous immunoglobulin (IVIG) is a commonly used and generally well-tolerated medication. Common side effects include flu-like symptoms such as fevers, headaches, myalgia, fatigue, and nausea. One of the more rare side effects is aseptic meningitis, with a reported incidence rate of around 0.067 percent of all IVIG infusions. In this paper, we describe a 47-year-old female patient with a history of myasthenia gravis who presented with a headache, neck pain, and neck stiffness while undergoing IVIG infusions for a myasthenia crisis...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28804111/an-adult-case-of-group-a-streptococcus-meningitis-associated-with-steroid-responsive-meningoencephalitis
#17
Koji Shimozono, Yoshiko Hayashi, Tokuji Nishinaka, Sayaka Kobayashi
A previously healthy 80-year-old woman presented to our service in a comatose state. On examination the patient had fever and neck stiffness. Laboratory investigation showed polymorphonuclear pleocytosis in cerebro-spinal fluid (CSF). These findings prompted us to a diagnosis of bacterial or viral meningitis and combination therapy consisting of ceftriaxone, vancomycin and acyclovir was started immediately. Two days later, culture of blood yielded Streptococcus pyogenes (group A streptococcus; GAS). The antibiotic therapy was converted to intravenous ampicillin for 14 days...
August 11, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28799299/a-comparative-study-of-csf-viral-rna-loads-between-hiv-positive-patients-with-neurological-manifestations-and-neurologically-asymptomatic-hiv-patients
#18
A D Mathur, S Devesh
INTRODUCTION: There are conflicting reports in literature about correlation of CSF viral RNA levels with neurological manifestations in HIV positive patients. Many studies in animals and human subjects have shown that CSF HIV-1 RNA can be useful as a specific marker of HIV induced neuropathology. To the contrary there are studies which show that neurological disease states can occur in absence of significant increase of CSF HIV RNA. MATERIALS AND METHODS: This was a prospective study conducted at Base hospital Delhi Cantt, New Delhi, a tertiary care hospitals for HIV patients...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28796045/with-a-little-help-from-a-computer-discriminating-between-bacterial-and-viral-meningitis-based-on-dominance-based-rough-set-approach-analysis
#19
Ewelina Gowin, Danuta Januszkiewicz-Lewandowska, Roman Słowiński, Jerzy Błaszczyński, Michał Michalak, Jacek Wysocki
Differential Diagnosis of bacterial and viral meningitis remains an important clinical problem. A number of methods to assist in the diagnoses of meningitis have been developed, but none of them have been found to have high specificity with 100% sensitivity.We conducted a retrospective analysis of the medical records of 148 children hospitalized in St. Joseph Children's Hospital in Poznań. In this study, we applied for the first time the original methodology of dominance-based rough set approach (DRSA) to diagnostic patterns of meningitis data and represented them by decision rules useful in discriminating between bacterial and viral meningitis...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28775082/disseminated-cryptococcal-infection-in-a-patient-who-had-kidney-transplant-discrepancy-between-clinical-symptoms-and-microbiological-findings
#20
Suzan Dahdal, Robert Kalicki, Niklaus Von Steiger, Parham Sendi
A 29-year-old man complained of a 2-day history of frontal headache and new-onset fever but no other symptoms. Two months prior to admission, he underwent his third kidney transplantation. Clinical and laboratory examinations were unremarkable. Brain MRI showed a meningeal irritation consistent with viral meningitis. A diagnosis of cryptococcal meningitis and fungaemia was made after detection of a remarkably high and visible load of Cryptococcus neoformans in the cerebrospinal fluid.
August 3, 2017: BMJ Case Reports
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