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https://www.readbyqxmd.com/read/29201129/cerebral-vasculitis-in-a-case-of-meningitis
#1
Devdeep Mukherjee, Agnisekhar Saha
Cerebral vasculitis is a serious complication of meningitis with Streptococcus pneumoniae. We report a 5 yr old girl who was admitted in May 2015 at Fortis Hospital, Kolkata, India and was diagnosed to have pneumococcal meningitis with vasculitis on DWMRI within a week of onset of fever. She was given high dose of methyl-prednisolone simultaneously with antibiotics and successfully treated without any neuro-sequelae. Although vasculitis has been documented to develop as sequelae to bacterial meningitis usually in the second week, our patient had an early presentation...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/29199500/management-of-a-rare-case-of-posterior-condylar-canal-dural-arteriovenous-fistula-presenting-with-subarachnoid-haemorrhage-a-case-report-and-review-of-literature
#2
Somorendra Singh Shambanduram, Leve Joseph Devarajan Sebastian, Nishchint Jain, Ajay Garg, Shailesh B Gaikwad
Posterior condylar canal dural arteriovenous fistula (PCC dAVF) is a rare entity with only three cases having been reported so far in the English literature. We describe the clinical presentation, imaging, and endovascular management of an elderly man with left PCC dAVF presenting with subarachnoid haemorrhage (SAH). Endovascular management of such cases requires thorough understanding of the vascular anatomy around the craniovertebral junction (CVJ) and variable bridging vein draining patterns. The fistula in our case was fed by the posterior meningeal branch of the left vertebral artery and was draining through a dilated and tortuous medullary bridging vein into the antero-lateral pontomedullary venous system...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29123908/a-case-of-disseminated-cryptococcosis-with-necrotizing-fasciitis-in-a-non-hiv-patient
#3
Tetsuya Hoshino, Kazuya Omura, Shinichi Kimura, Hiroyuki Takahashi, Katsuhiko Kamei, Misako Ohkusu
Case: Disseminated cryptococcosis is a well-recognized condition among HIV patients, but it also occurs in non-HIV patients. Necrotizing fasciitis caused by cryptococcus is rare. An 81-year-old man who had received steroid therapy presented with erythema and pain in his right thigh. After the rapid progression of symptoms and a failure to respond to antibiotic therapy, a clinical diagnosis of necrotizing fasciitis was made. We performed debridement, and yeasts were detected using a Gram stain of the fascia...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118502/bilateral-sensorineural-hearing-loss-secondary-to-sympathetic-ophthalmia-in-a-human-leukocyte-antigen-a2-positive-patient
#4
Konstantinos T Tsaousis, Vasileios E Konidaris, Theodoros Empeslidis
We report a case of sympathetic ophthalmia 1 month following trauma in a 71-year-old immunocompetent female patient of Indian origin. The patient was hospitalized with signs and symptoms of meningism, ataxia, and neurosensory deafness. We explore and provide further clinical evidence in supporting the hypothesis of antigen cross-reactivity derived from tissues with common neural crest embryological background such as the uvea and cells of the labyrinth. The patient was human leukocyte antigen-A2 positive and treatment with oral steroids and cyclosporine has managed to have favorable results and control the inflammation...
September 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/29061245/neurosarcoidosis
#5
REVIEW
Patompong Ungprasert, Eric L Matteson
Neurosarcoidosis occurs in 3% to 10% of patients with sarcoidosis. Cranial neuropathy and meningeal involvement are the most common manifestations, but any part of the nervous system can be affected. Definite diagnosis requires the presence of noncaseating granuloma in the nervous system, although histopathologic confirmation is often not obtainable. Moderate to high dose of glucocorticoids is the main therapy for neurosarcoidosis. Relapse often occurs after the dose of glucocorticoids is tapered down, often necessitating the use of steroid-sparing immunosuppressive agents...
November 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29050838/three-children-of-meningoencephalitis-with-kikuchi-necrotizing-lymphadenitis
#6
Joung-Hee Byun, Su Eun Park, Sang Ook Nam, Young A Kim, Young Mi Kim, Gyu Min Yeon, Yun-Jin Lee
BACKGROUND: Kikuchi necrotizing lymphadenitis (KNL) is a rare and benign cause of lymphadenopathy, most often cervical. The etiology of KNL remains unknown. Central nervous system (CNS) involvement, such as in meningoencephalitis, is a very rare clinical manifestation of KNL, especially in children. CASE REPORTS: A 12-year-old boy presented with unilateral cervical lymphadenopathy and fever. Histopathological findings led to the diagnosis of KNL. He revisited due to severe headache and vomiting one week later...
October 16, 2017: Brain & Development
https://www.readbyqxmd.com/read/29050399/diagnostic-criteria-for-chronic-lymphocytic-inflammation-with-pontine-perivascular-enhancement-responsive-to-steroids-clippers
#7
W Oliver Tobin, Yong Guo, Karl N Krecke, Joseph E Parisi, Claudia F Lucchinetti, Sean J Pittock, Jay Mandrekar, Divyanshu Dubey, Jan Debruyne, B Mark Keegan
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a central nervous system inflammatory syndrome predominantly affecting the brainstem, cerebellum, and spinal cord. Following its initial description, the salient features of CLIPPERS have been confirmed and expanded upon, but the lack of formalized diagnostic criteria has led to reports of patients with dissimilar features purported to have CLIPPERS. We evaluated clinical, radiological and pathological features of patients referred for suspected CLIPPERS and propose diagnostic criteria to discriminate CLIPPERS from non-CLIPPERS aetiologies...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29021984/mri-findings-of-early-stage-hyperacute-hemorrhage-causing-extramedullary-compression-of-the-cervical-spinal-cord-in-a-dog-with-suspected-steroid-responsive-meningitis-arteritis
#8
Adriano Wang-Leandro, Enrice-Ina Huenerfauth, Katharina Heissl, Andrea Tipold
A 9-month-old female Weimaraner was presented to the emergency service due to episodes of fever and neck pain. Physical examination revealed a stiff neck posture and elevated body temperature. Shortly after clinical examination was performed, the dog developed peracute onset of non-ambulatory tetraparesis compatible with a C1-C5 spinal cord (SC) lesion. Immediately thereafter (<1 h), MRI of the cervical SC was performed with a 3-T scanner. A left ventrolateral intradural-extramedullary SC compression caused by a round-shaped structure at the level of C3--C4 was evidenced...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28956537/epidemiology-and-treatment-of-the-commonest-form-of-listeriosis-meningitis-and-bacteraemia
#9
Pasquale Pagliano, Ferhat Arslan, Tiziana Ascione
Listeria monocytogenes is a Gram-positive bacillus and facultative intracellular bacterium whose transmission occurs mainly through the consumption of contaminated food. Listeriosis has an incidence estimated at around three-six cases per million per year and the most common forms of the infection are neurolisteriosis, bacteraemia, and maternal-neonatal infection. Those affected by listeriosis are at the extremes age of the life or report specific risk factors, such as malignancies, causing a defect of cellular immunity...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28921665/effects-of-oral-prednisone-administration-on-serum-cystatin-c-in-dogs
#10
J Muñoz, P Soblechero, F J Duque, B Macías-García, P Ruiz, C Zaragoza, R Barrera
BACKGROUND: Oral administration of glucocorticoid alters serum cystatin C (sCysC) concentration in humans. OBJECTIVE: To determine if oral administration of prednisone alters sCysC in dogs without pre-existing renal disease. ANIMALS: Forty six dogs were included: 10 dogs diagnosed with steroid responsive meningitis arteritis (SRMA; group A), 20 dogs diagnosed of pituitary-dependent hyperadrenocorticism (PDH; group B), and 16 healthy control dogs (group C)...
September 18, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28895024/tuberculosis-meningitis
#11
REVIEW
Kassem Bourgi, Christina Fiske, Timothy R Sterling
PURPOSE OF REVIEW: As the most severe form of tuberculosis (TB), TB meningitis disproportionately affects developing countries and results in significant morbidity and mortality. In this report, we review recent updates in the epidemiology, diagnosis, and management of TB meningitis. RECENT FINDINGS: Young children and people living with HIV continue to be at highest risk for TB meningitis. Early diagnosis remains challenging, especially since conventional diagnostic tests have sub-optimal sensitivity and specificity...
September 11, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28843114/clinical-and-radiological-predictors-of-outcome-in-tubercular-meningitis-a-prospective-study-of-209-patients
#12
M Modi, K Sharma, S Prabhakar, M K Goyal, A Takkar, N Sharma, A Garg, S Faisal, N Khandelwal, P Singh, J Sachdeva, R Shree, V Rishi, V Lal
OBJECTIVES: The predictors of poor outcome in tuberculous meningitis (TBM) remain to be delineated. We determined role of various clinical, radiological and cerebrospinal fluid (CSF) parameters in prediction of outcome in TBM. PATIENTS AND METHODS: Current study was a prospective observational study including 209 patients of TBM. All patients underwent detailed evaluation including Gadolinium enhanced Magnetic resonance imaging (GdMRI) of brain as well as tests to detect evidence of tuberculosis elsewhere in body...
October 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28804111/an-adult-case-of-group-a-streptococcus-meningitis-associated-with-steroid-responsive-meningoencephalitis
#13
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...
September 30, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28736347/efficacy-of-closed-continuous-lumbar-drainage-on-the-treatment-of-postcraniotomy-meningitis-a-retrospective-analysis-of-1062-cases
#14
Yanming Ren, Xuesong Liu, Chao You, Yuekang Zhang, Liang Du, Xuhui Hui, Wenke Liu, Lu Ma, Jiagang Liu
BACKGROUND: Postcraniotomy meningitis is a severe complication in neurosurgery, and can result in high morbidity and mortality. Closed continuous lumbar drainage (CCLD) as an adjuvant method for treating postcraniotomy meningitis in adults is rarely assessed. This study aimed to evaluate the efficacy of CCLD in the treatment of postcraniotomy meningitis. METHODS: A total of 1062 patients older than 16 years with postcraniotomy meningitis were included, between January 2000 and December 2015...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28720215/autoimmune-meningitis-and-encephalitis-in-adult-onset-still-disease-case-report
#15
Milena Bożek, Magdalena Konopko, Teresa Wierzba-Bobrowicz, Grzegorz Witkowski, Grzegorz Makowicz, Halina Sienkiewicz-Jarosz
INTRODUCTION: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown cause. Its symptoms usually include persistent fever, fugitive salmon-colored rash, arthritis, sore throat (not specific), but it may also lead to internal organs' involvement, which presents with enlargement of the liver and spleen, swollen lymph nodes, carditis or pleuritis - potentially life-threatening complications. In rare cases, AOSD can cause aseptic meningitis or/and encephalitis...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28710237/focal-neurological-presentation-in-hashimoto-s-encephalopathy-mimicking-a-vascular-occlusion-of-the-middle-cerebral-artery
#16
Ahmad Alazzeh, Sarah Jaroudi, Matthew Gooch, Alan N Peiris
Hashimoto's encephalopathy is a rare form of autoimmune encephalopathy. It is likely an underdiagnosed entity especially in the setting of focal neurological defects. We report a case of a 49-year-old man who presented with "strange behavior"of a day's duration. Examination was significant only for lethargy, poor attention span and agitation. Routine labs revealed leucocytosis. Head CT scan was unremarkable. Lumbar puncture showed high white blood cells with lymphocytosis and elevated protein level. The patient was empirically treated for meningitis without improvement...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28699429/the-order-of-administration-of-macrolides-and-beta-lactams-may-impact-the-outcomes-of-hospitalized-patients-with-community-acquired-pneumonia-results-from-the-community-acquired-pneumonia-organization
#17
Paula Peyrani, Timothy L Wiemken, Mark L Metersky, Forest W Arnold, William A Mattingly, Charles Feldman, Rodrigo Cavallazzi, Rafael Fernandez-Botran, Jose Bordon, Julio A Ramirez
BACKGROUND: The beneficial effect of macrolides for the treatment of community-acquired pneumonia (CAP) in combination with beta-lactams may be due to their anti-inflammatory activity. In patients with pneumococcal meningitis, the use of steroids improves outcomes only if they are administered before beta-lactams. The objective of this study was to compare outcomes in hospitalized patients with CAP when macrolides were administered before, simultaneously with, or after beta-lactams. METHODS: Secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study database...
July 12, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28694636/delayed-facial-palsy-after-microvascular-decompression-report-of-two-cases
#18
G Lakshmi Prasad, Vinod Kumar, Girish Menon
Microvascular decompression (MVD) is a novel surgical procedure predominantly performed for treating trigeminal neuralgia (TN) and hemifacial spasm (HS). Multiple studies have proven the long-term success of MVD for both these conditions. The most common complications of MVD reported include chemical meningitis, facial hypesthesia, cerebrospinal fluid leak, facial paresis, and hearing loss. Delayed facial palsy (DFP) is an uncommon complication mostly noted in MVD for HS and after the removal of acoustic tumors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28671774/-management-of-suspected-meningitis-in-the-emergency-department
#19
Anaïs Degraeve, Marc Clemente, Benedikt Huttner, Olivier Rutschmann
Febrile meningeal syndrome is a medical emergency. Lumbar puncture keeps its gold-standard status as clinical findings are neither sensitive nor specific enough. Antibiotics and steroids are ideally administered within the first 30 minutes after admission when bacterial meningitis is suspected. A cerebral CT-scan before lumbar puncture is mandatory for selected patients only. PCR for viruses in the cerebrospinal fluid can inform diagnosis and treatment. Meningitis caused by enterovirus can usually be managed at home...
August 10, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28601860/characteristics-and-long-term-outcome-of-neurosarcoidosis-a-population-based-study-from-1976-2013
#20
Patompong Ungprasert, Cynthia S Crowson, Eric L Matteson
BACKGROUND/AIMS: Neurosarcoidosis is a rare condition with serious health consequences. However, little is known about clinical characteristics and outcome of neurosarcoidosis in the community setting. METHODS: Patients with neurosarcoidosis were identified from a previously described cohort of patients with incident sarcoidosis from Olmsted County, Minnesota, United States from 1976 to 2013 using individual medical record review. Data on clinical characteristics, treatment, and outcome were collected...
2017: Neuroepidemiology
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