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https://www.readbyqxmd.com/read/27913223/hepatitis-e-virus-infection-beyond-the-liver
#1
REVIEW
S Pischke, J Hartl, S D Pas, A W Lohse, B C Jacobs, A A van der Eijk
Hepatitis E virus (HEV) infections are not limited to the liver but may also affect other organs. Several diseases, including Guillain-Barré syndrome, neuralgic amyotrophy, glomerulonephritis, cryoglobulinemia, pancreatitis, lymphoma, thrombopenia, meningitis, thyreoiditis and myocarditis have been observed in the context of hepatitis E. To date the definite pathophysiological links between HEV and extrahepatic manifestations are not yet established. However, it is suggested that HEV-infection might be causative based on serological studies, case series, in vitro data and animal models...
November 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27878586/-parainfectious-optic-neuritis-with-macular-infiltrate-in-neisseria-meningitidis-b-meningitis
#2
A Chronopoulos, F Hoogewoud, H Steffen, G Thumann
OBJECTIVE: We report on the case of a young immunocompetent female patient with parainfectious optic neuritis and macular inflitrate due to Neisseria meningitidis B meningitis. METHOD: Case report RESULTS: A 22-year-old female patient was admitted to the emergency department for intensive care treatment with a strong suspicion of meningitis. Clinical and serological parameters were indicative of a bacterial genesis of the meningitis. By analysis of the cerebrospinal fluid (CSF) Neisseria meningitidis type B could be detected...
November 23, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/27857783/hyponatremia-in-children-with-tuberculous-meningitis-a-hospital-based-cohort-study
#3
Prithi Inamdar, Sanjeevani Masavkar, Preeti Shanbag
BACKGROUND: Hyponatremia has long been recognized as a potentially serious metabolic consequence of tuberculous meningitis (TBM) occurring in 35-65% of children with the disease. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has for long been believed to be responsible for the majority of cases of hyponatremia in TBM. Cerebral salt wasting syndrome (CSWS) is being increasingly reported as a cause of hyponatremia in some of these children. AIM: This study was done to determine the frequency and causes of hyponatremia in children with TBM...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27856137/therapeutic-hypothermia-and-inhalation-anesthesia-in-a-patient-with-severe-pneumococcal-meningitis-and-secondary-cardiac-arrest
#4
Nejc Bukovnik, Andrej Markota, Tomaž Velnar, Janez Rebol, Andreja Sinkovič
Therapeutic hypothermia was associated with increased mortality in patients with severe bacterial meningitis in a large randomized trial. It still remains a treatment strategy for comatose survivors of cardiac arrest. There are several potential advantages of inhalational anesthetics as long-term sedation agents compared to intravenous sedation, however, uncontrollable increases of intracranial pressure were observed in neurocritical patients. Here we present a patient with severe bacterial meningitis and secondary cardiac arrest where therapeutic hypothermia and inhalational anesthesia were successfully used...
November 2, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27819416/neurological-manifestations-of-acute-posterior-multifocal-placoid-pigment-epitheliopathy
#5
Hussein Algahtani, Ashjan Alkhotani, Bader Shirah
BACKGROUND AND PURPOSE: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an immune-mediated chorioretinal disease that causes acute visual symptoms with characteristic ophthalmoscopic findings. Neurological complications are rarely reported in the literature. Here we report two new cases of APMPPE that presented with neurological manifestations, one of which was associated with peripheral neuropathy, which has not been described before. METHODS: A retrospective database review of all patients with a diagnosis of APMPPE was performed...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27818191/corticosteroids-for-the-management-of-severe-intracranial-hypertension-in-meningoencephalitis-caused-by-cryptococcus-gattii-a-case-report-and-review
#6
R-A Maciel, L-S Ferreira, F Wirth, P-D Rosa, M Aves, E Turra, L-Z Goldani
Immune reconstitution inflammatory syndrome in meningitis caused by Cryptococcus gattii in immunocompetent patients after initiation of antifungal therapy appears to be the result of paradoxical antifungal treatment-induced clinical deterioration due to improved local immune responses to cryptococcal organisms. Recent anecdotal reports have suggested a favorable clinical response to corticosteroids in select patients with C. gattii central nervous system (CNS) infections. In this report, we describe a 65-year-old patient with meningoencephalitis caused by C...
November 3, 2016: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/27807490/a-case-of-tuberculous-meningitis-with-paradoxical-response-in-a-14-year-old-boy
#7
Murat Özer, Yasemin Özsürekci, Ali Bülent Cengiz, Nagehan Emiralioğlu, Deniz Doğru, Kader Karlı Oğuz, Onur Akça, Özgür Özkayar
A clinical or radiological worsening of already existing lesions or an emergence of new lesions after beginning treatment in patients with tuberculosis (TB) is referred to as the paradoxical response. This has aroused suspicion regarding the accuracy of diagnosis, the possibilities of treatment failure, or the presence of another underlying disease, and thus it is an important topic for clinicians to understand. In this article, the development of a paradox reaction in a 14-year-old male patient diagnosed with and treated for tuberculosis meningitis is reported...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27756232/acute-vision-loss-in-post-partum-period-as-presenting-symptom-of-hiv-associated-cryptococcal-meningitis-an-unusual-case-report
#8
Aniruddha More, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Ravi Uniyal
BACKGROUND: Acute vision loss in the post-partum period can occur due to many reasons. Eclampsia, posterior reversible encephalopathy syndrome (PRES), pituitary apoplexy, and central serous retinopathy are some of the important causes. Cryptococcal meningitis as a cause of acute vision loss in the post-partum period has not been mentioned in literature. CASE PRESENTATION: A 25-year-old female presented to us with acute bilateral complete vision loss in the post-partum period...
October 19, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27709866/relapsing-polychondritis-with-central-nervous-system-involvement-experience-of-three-different-cases-in-a-single-center
#9
Chan Hong Jeon
Relapsing polychondritis (RP) is an autoimmune disorder characterized by inflammation in cartilaginous structures including the ears, noses, peripheral joints, and tracheobronchial tree. It rarely involves the central nervous system (CNS) but diagnosis of CNS complication of RP is challenging because it can present with varying clinical features. Herein we report 3 cases of relapsing polychondritis involving CNS with distinct manifestations and clinical courses. The first patient presented with rhombencephalitis resulting in brain edema and death...
November 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27677285/-clinical-aspects-and-diagnostics-of-cerebral-vasculitis
#10
W Reith, C Kraus, N Harsch
CLINICAL/METHODICAL ISSUE: Vasculitis is a rare cause of diseases of the central nervous system (CNS). Vasculitis can be divided into primary and secondary forms, of which the vast majority can be manifested in various organ systems, including the CNS. Isolated vasculitis of the CNS is limited to the CNS and clinical neurological symptoms as with the other forms of vasculitis, are headaches, encephalopathy, focal deficits and seizures. A criterion of isolated CNS vasculitis is the clinical and laboratory diagnostic exclusion of other forms of vasculitis and the involvement of other organ systems...
October 2016: Der Radiologe
https://www.readbyqxmd.com/read/27412018/-central-nervous-system-in-igg4-related-disease-case-report-and-literature-review
#11
A L Vanegas-Garcia, Y Calle-Lopez, C H Zapata, D M Alvarez-Espinal, Y A Saavedra-Gonzalez, J C Arango-Viana
INTRODUCTION: IgG4-related disease is a recently described multisystemic clinical entity that can occur with different clinical manifestations. The most often affected organs are the pancreas, bile duct and salivary glands, with unusual central nervous system affection. CASE REPORT: A 33 year old woman who presented with cognitive impairment, hallucinations, headache, convulsive syndrome, maxillary sinus inflammation with bone involvement and evidence of pachymeningitis and panhypopytuirarism with meningeal biopsy that confirmed IgG4-related disease, after ruling out secondary causes...
August 1, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27389723/from-suspected-creutzfeldt-jakob-disease-to-confirmed-histoplasma-meningitis
#12
Vivek Batra, Armen Khararjian, Joseph Wheat, Sean X Zhang, Barbara Crain, Alexander Baras
A 77-year-old man with chronic obstructive lung disease who was on steroids, presented to the hospital after a fall with subacute headaches and ataxia. During the patient's hospital course, his clinical condition deteriorated with myoclonic jerks, fevers and severe encephalopathy. An extensive workup, including EEG, brain MRI and lumbar puncture, revealed possible Creutzfeldt-Jakob disease. Unfortunately, the patient failed to improve and died 12 days after admission. A brain-only autopsy revealed he had acute histoplasma meningitis with patchy superficial cerebritis...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27381953/epidural-steroid-injection-complicated-by-intrathecal-entry-pneumocephalus-and-chemical-meningitis
#13
Aakash Kaushik Shah, Andrey Bilko, James Kimo Takayesu
BACKGROUND: Epidural steroid injections are frequently used to treat back and extremity pain. The procedure is generally safe, with a low rate of adverse events, including intrathecal entry, pneumocephalus, and chemical meningitis. CASE REPORT: We report a case of a 45-year-old woman who presented to the emergency department (ED) with headache, nausea, vomiting, and photophobia after a lumbar epidural steroid injection. She was afebrile and had an elevated white blood cell count...
September 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27371330/predicting-postoperative-fever-and-bacterial-colonization-on-packing-material-following-endoscopic-endonasal-surgery
#14
Kazuhiro Nomura, Yurika Yamanaka, Yasuhiro Sekine, Hiroki Yamamoto, Yoshihiko Esu, Mariko Hara, Masayo Hasegawa, Akihiro Shinnabe, Hiromi Kanazawa, Risako Kakuta, Daiki Ozawa, Hiroshi Hidaka, Yukio Katori, Naohiro Yoshida
Postoperative fever following endoscopic endonasal surgery is a rare occurrence of concern to surgeons. To elucidate preoperative and operative predictors of postoperative fever, we analyzed the characteristics of patients and their perioperative background in association with postoperative fever. A retrospective review of 371 patients who had undergone endoscopic endonasal surgery was conducted. Predictors, including intake of antibiotics, steroids, history of asthma, preoperative nasal bacterial culture, duration of operation, duration of packing and intraoperative intravenous antibiotics on the occurrence of postoperative fever, and bacterial colonization on the packing material, were analyzed retrospectively...
July 1, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27227303/fungal-infections-associated-with-contaminated-steroid-injections
#15
Carol A Kauffman, Anurag N Malani
In mid-September 2012, the largest healthcare-associated outbreak in U.S. history began. Before it was over, 751 patients were reported with fungal meningitis, stroke, spinal or paraspinal infection, or peripheral osteoarticular infection, and 64 (8.5%) died. Most patients had undergone epidural injection, and a few osteoarticular injection, of methylprednisolone acetate that had been manufactured at the New England Compounding Center (NECC). The offending pathogen in most cases was Exserohilum rostratum, a brown-black soil organism that previously was a rare cause of human infection...
April 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/27195042/distal-cord-predominant-longitudinally-extensive-myelitis-with-diffuse-spinal-meningitis-and-dural-abscesses-due-to-occult-tuberculosis-a-rare-occurrence
#16
Gaurav M Kasundra, Isha Sood, Bharat Bhushan, Amita Narendra Bhargava, Khichar Shubhkaran
Tuberculous myelitis usually involves thoracic and only rarely, distal cord. Longitudinal lesions more than three spinal segments long in tuberculosis (TB) are usually due to intramedullary tuberculomas and not infectious myelitis. We report a 17-year-old male with acute myelitis from D7 to conus medullaris, diffuse spinal meningitis, subdural and epidural abscesses, normal vertebrae, intervertebral discs, and brain imaging. Cerebrospinal fluid (CSF) showed raised proteins, lymphocytosis, hypoglycorrhagia, and positive TB-polymerase chain reaction...
January 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27169300/rheumatoid-meningitis-diagnostic-and-therapeutic-observations
#17
Christoph Stretz, Xianyuan Song, Brendan D Killory, Martin D Ollenschleger, Amre M Nouh
A 75-year-old female with untreated rheumatoid arthritis presented with two weeks of behavioral changes and cognitive decline. A neurologic examination showed severe encephalopathy, brisk reflexes, and bilateral Babinski sign. A contrast-enhanced brain MRI demonstrated right meningeal enhancement and periventricular white matter disease. A computed tomographic angiogram (CTA) of the head and neck was negative for vasculitis. The cerebrospinal fluid (CSF) demonstrated lymphocytic pleocytosis. The patient's serum rheumatoid factor levels were elevated...
March 2016: Connecticut Medicine
https://www.readbyqxmd.com/read/27151224/a-case-of-staphylococcus-aureus-meningitis-associated-with-cryoglobulin-related-renal-failure-and-clinically-mild-encephalitis-encephalopathy-with-a-reversible-splenial-lesion
#18
Koji Shimozono, Hideki Korenaga, Reiko Mawatari, Naoki Tsukishima
A 59-years old man, having untreated hypertension and diabetes, was admitted to our hospital because of lumbago and fever. A T2-weighted image of spine showed increased signal intensity of vertebra at L3 and L4. Methicillin-susceptible staphylococcus aureus (MSSA) infection was confirmed by blood culturing. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Diagsosis of pyogenic spondylitis with bacterial meningitis was made. Diffusion-weighted magnetic imaging of the brain disclosed a focal hyperintense lesion in the corpus callosum which showed a low coefficient in the apparent diffusion coefficient mapping...
May 31, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27121755/corticosteroids-for-managing-tuberculous-meningitis
#19
REVIEW
Kameshwar Prasad, Mamta B Singh, Hannah Ryan
BACKGROUND: Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person's brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their role has been controversial. OBJECTIVES: To evaluate the effects of corticosteroids as an adjunct to antituberculous treatment on death and severe disability in people with tuberculous meningitis...
April 28, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27104279/delayed-cerebral-ischaemic-injury-following-apparent-recovery-from-streptococcus-pneumoniae-meningitis
#20
Xavier Wittebole, Thierry Duprez, Philippe Hantson
Two patients were admitted to the Emergency Department with fever and altered consciousness. The diagnosis of Streptococcus pneumoniae meningitis was rapidly obtained from cerebrospinal fluid (CSF) culture. Their neurological condition rapidly improved after the introduction of antimicrobial therapy plus dexamethasone. The brain's computed tomography on admission did not reveal any specific lesion. By the second week of treatment, while CSF was sterile, their neurological condition gradually worsened and both died from extensive brain ischaemic lesions...
April 22, 2016: Acta Clinica Belgica
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