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steroids meningitis

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
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
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
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
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
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
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
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
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
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
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
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
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
Rashi I Mehta, Rupal I Mehta
Polymer substances are commonly applied as surface coatings on endovascular catheters and vascular devices. Adverse effects related to their use have been reported, although the overall clinical significance and appropriate methods of detection of these complications have been unclear. In this analysis, we systematically reviewed clinical and diagnostic features in 32 patients (age, 36-87years; mean, 59years) in whom intracranial polymer reactions were documented following vascular interventions. Associated neuroradiologic and neuropathologic findings were variable and included cerebral vasculitis or vasculopathy (63%), abscess or granuloma formation (38%), ischemic infarcts (28%), parenchymal hematomas (28%), white matter change (25%), and/or chemical meningitis (22%)...
July 2016: Human Pathology
Mohd Jazman Che Rahim, Wan Syamimee Wan Ghazali
We report a case of a 19-year-old immunocompetent Malay woman who presented with a worsening psychotic disorder of 1-year duration. She initially presented with social isolation with subsequent mutism and stupor. Physical examination revealed a stuporous, emaciated, dehydrated woman with Glasgow Coma Scale of 11/15 (E4V2M5). She had a blank stare, mutism and akinesia. Motor examination revealed upper motor neuron findings. Neck stiffness was present, however, Kernig's and Brudzinski's signs were negative. There were no other findings on other systems...
2016: BMJ Case Reports
Varun R Kshettry, Bjorn Lobo, Joshua Lim, Burak Sade, Soichi Oya, Joung H Lee
OBJECTIVE: Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction. METHODS: We conducted a retrospective review of operations performed by the senior author from 2004-2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations...
January 2016: Journal of Korean Neurosurgical Society
F McGill, R S Heyderman, B D Michael, S Defres, N J Beeching, R Borrow, L Glennie, O Gaillemin, D Wyncoll, E Kaczmarski, S Nadel, G Thwaites, J Cohen, N W S Davies, A Miller, A Rhodes, R C Read, T Solomon
Bacterial meningitis and meningococcal sepsis are rare conditions with high case fatality rates. Early recognition and prompt treatment saves lives. In 1999 the British Infection Society produced a consensus statement for the management of immunocompetent adults with meningitis and meningococcal sepsis. Since 1999 there have been many changes. We therefore set out to produce revised guidelines which provide a standardised evidence-based approach to the management of acute community acquired meningitis and meningococcal sepsis in adults...
April 2016: Journal of Infection
Justin A Wasko, James S Westholder, Pamala A Jacobson
PURPOSE: Patients undergoing hematopoietic cell transplantation are treated with multiple medications, potentially complicated by drug-drug interactions. Drug interactions with sirolimus, voriconazole, and rifampin are particularly difficult because of the complex and simultaneous enzyme inhibition and induction mechanisms. We report a hematopoietic cell transplantation patient receiving sirolimus and voriconazole who was given rifampin while being treated for presumed methicillin-resistant Staphylococcus aureus meningitis...
January 12, 2016: Journal of Oncology Pharmacy Practice
Yoav Y Pikkel, Tamir Ben-Hur, Ruth Eliahou, Asaf Honig
BACKGROUND: Meningitis and meningoencephalitis pose major risks of morbidity and mortality. OBJECTIVES: To describe 20 years of experience treating infections of the central nervous system in Israel Defense Force (IDF) soldiers, including the common presentations, pathogens and sequelae, and to identify risk groups among soldiers. METHODS: All soldiers who were admitted to the Hadassah University Medical Center (both campuses: Ein Kerem and Mt...
November 2015: Israel Medical Association Journal: IMAJ
Alena Meleková, Leona Andrlová, Pavel Král, Leoš Ungermann, Edvard Ehler
INTRODUCTION: The splenium of the corpus callosum has a specific structure of blood supply with a tendency towards blood-brain barrier breakdown, intramyelinic edema, and damage due to hypoxia or toxins. Signs and symptoms of reversible syndrome of the splenium of the corpus callosum typically include disorientation, confusion, impaired consciousness, and epileptic seizures. CASE REPORT: A previously healthy 32-year-old man suffered from weakness, headache, and fever...
2015: Acta Medica (Hradec Králové)
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