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https://www.readbyqxmd.com/read/29604972/cryptococcal-meningitis-in-aids
#1
Andrej Spec, William G Powderly
Cryptococcal meningitis remains a significant cause of morbidity and mortality amongst patients living with human immunodeficiency virus (HIV). The prevalence in the developed world has decreased as HIV is being diagnosed earlier, but is still significant, and the prevalence in resource-limited settings is exceedingly high. The presenting symptoms usually include a headache, fever, and, less often, cranial nerve abnormalities. Space-occupying lesions do occur, but are rare. Once diagnosed, patients should be treated with a combination of amphotericin and flucytosine, with step-down therapy to fluconazole for a minimum of a year, or until the CD4 count is above 100 cells/μL, whichever is longer...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29560861/can-aspirin-help
#2
Ashwini Kalantri, Shriprakash Kalantri
Using a combination of aspirin, anti-tuberculosis drugs and steroids may help to reduce the number of strokes and deaths in patients with tuberculous meningitis.
March 21, 2018: ELife
https://www.readbyqxmd.com/read/29541156/coptidis-rhizoma-and-its-main-bioactive-components-recent-advances-in-chemical-investigation-quality-evaluation-and-pharmacological-activity
#3
REVIEW
Fan-Cheng Meng, Zheng-Feng Wu, Zhi-Qi Yin, Li-Gen Lin, Ruibing Wang, Qing-Wen Zhang
Background: Coptidis rhizoma (CR) is the dried rhizome of Coptis chinensis Franch., C. deltoidea C. Y. Cheng et Hsiao or C. teeta Wall. (Ranunculaceae) and is commonly used in Traditional Chinese Medicine for the treatment of various diseases including bacillary dysentery, typhoid, tuberculosis, epidemic cerebrospinal meningitis, empyrosis, pertussis, and other illnesses. Methods: A literature survey was conducted via SciFinder, ScieneDirect, PubMed, Springer, and Wiley databases...
2018: Chinese Medicine
https://www.readbyqxmd.com/read/29503961/shingles-as-the-underlying-cause-of-orbital-myositis-in-an-adolescent-a-case-report
#4
Christopher D Conrady, Richard M Feist, Alison Crum
Purpose: Orbital myositis is characterized by pain with eye movements, gaze restriction, diplopia, and enlargement of extraocular muscles on imaging. Varicella zoster virus (VZV) is an extremely rare cause of the disease in the elderly and has never been reported in a patient younger than forty-five years old such as the adolescent described herein. We present this case to raise awareness of an entity that will likely become more prevalent due to current vaccine strategies. Observation: We present the case of a 13-year-old girl with VZV-associated orbital myositis and meningitis that had a quick and complete recovery following IV acyclovir and oral steroids...
April 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29491331/-a-case-of-short-lasting-unilateral-neuralgiform-headache-with-conjunctival-injection-and-tearing-triggered-by-mumps-meningitis-in-a-patient-with-recurrent-primary-stabbing-headache
#5
Yuki Unai, Kenta Sato
A 32-year-old man with a 16-year history of recurrent primary stabbing headache was admitted to our hospital, owing to mumps meningitis. On day 2 of admission, he began experiencing episodes of unbearable intermittent stabbing pain, each lasting few seconds, with conjunctival injection and tearing, on the temporal side of the left orbit. We suspected trigeminal autonomic cephalgias, and administered non-steroidal anti-inflammatory drugs (NSAIDs), oxygen, and sumatriptan; however, the pain episodes persisted...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29487467/empiric-treatment-of-acute-meningitis-syndrome-in-a-resource-limited-setting-clinical-outcomes-and-predictors-of-survival-or-death
#6
Birkneh Tilahun Tadesse, Byron Alexander Foster, Mulugeta Sitot Shibeshi, Henok Tadele Dangiso
Background: Bacterial meningitis is a significant cause of morbidity and mortality in the developing world. However, limited research has focused on the diagnosis and management of meningitis in resource-limited settings. Methods: We designed a prospective case series of children admitted to a large, academic referral hospital with acute meningitis syndrome. Data were collected on age, time of presentation, prior antibiotics, cerebrospinal fluid (CSF) parameters, antibiotic and steroid prescription, and clinical outcome...
November 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29446067/headache-linked-to-intracranial-hypertension-and-hypertrophic-pachymeningitis-as-the-initial-and-dominant-presentation-of-granulomatosis-with-polyangiitis-case-report-and-review-of-the-recent-literature
#7
Marianthi A Arnaoutoglou, Chrysostomos G Xerras, Ioannis K Kalevrosoglou, Vasileios D Rafailidis, Konstantinos P Notas, Thomas I Tegos
OBJECTIVE: The objective of this article is to report a rare case of headache as the initial symptom of granulomatosis with polyangiitis (GPA) and to review the recent literature. BACKGROUND: Granulomatosis with polyangiitis is a rare, systemic, autoimmune disease of unknown etiology. GPA has a wide spectrum of clinical symptomatology, including involvement of the nervous system, even as the initial manifestation. Symptoms of the peripheral nervous system used to dominate the clinical symptomatology...
February 15, 2018: Headache
https://www.readbyqxmd.com/read/29423423/rapid-reversal-of-complete-binocular-blindness-with-high-dose-corticosteroids-and-lumbar-drain-in-a-solid-organ-transplant-recipient-with-cryptococcal-meningitis-and-immune-reconstitution-syndrome-first-case-study-and-literature-review
#8
Zoe Weiss, Nihaal Mehta, Su Nandar Aung, Michael Migliori, Dimitrios Farmakiotis
Blindness is a rare, devastating, usually permanent complication of cryptococcal meningitis (CM). We present the first case of complete vision loss in a solid organ transplant recipient with CM treated with placement of a lumbar drain who had a dramatic visual recovery that started after 3 doses of high-dose steroids.
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29408878/the-endocannabinoid-system-in-canine-steroid-responsive-meningitis-arteritis-and-intraspinal-spirocercosis
#9
Jessica Freundt-Revilla, Franciska Heinrich, Alexander Zoerner, Felix Gesell, Martin Beyerbach, Merav Shamir, Anna Oevermann, Wolfgang Baumgärtner, Andrea Tipold
Endocannabinoids (ECs) are involved in immunomodulation, neuroprotection and control of inflammation in the central nervous system (CNS). Activation of cannabinoid type 2 receptors (CB2) is known to diminish the release of pro-inflammatory factors and enhance the secretion of anti-inflammatory cytokines. Furthermore, the endocannabinoid 2-arachidonoyl glycerol (2-AG) has been proved to induce the migration of eosinophils in a CB2 receptor-dependent manner in peripheral blood and activate neutrophils independent of CB activation in humans...
2018: PloS One
https://www.readbyqxmd.com/read/29405037/osmotic-therapies-added-to-antibiotics-for-acute-bacterial-meningitis
#10
REVIEW
Emma Cb Wall, Katherine Mb Ajdukiewicz, Hanna Bergman, Robert S Heyderman, Paul Garner
BACKGROUND: Every day children and adults die from acute community-acquired bacterial meningitis, particularly in low-income countries, and survivors risk deafness, epilepsy and neurological disabilities. Osmotic therapies may attract extra-vascular fluid and reduce cerebral oedema, and thus reduce death and improve neurological outcomes.This is an update of a Cochrane Review first published in 2013. OBJECTIVES: To evaluate the effects of osmotic therapies added to antibiotics for acute bacterial meningitis in children and adults on mortality, deafness and neurological disability...
February 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29330273/rheumatoid-disease-an-unusual-cause-of-relapsing-meningoencephalitis
#11
Sian K Alexander, Maria Di Cicco, Ute Pohl, Alberto Cifelli
A 73-year-old man presented with three episodes of dysphasia and disinhibited behaviour, a single seizure and transient ischaemic attack-like events characterised by right arm and/or leg weakness. These episodes were separated by month-long asymptomatic intervals. Medical history included rheumatoid arthritis, which was clinically quiescent on leflunomide.Repeated cerebrospinal fluid examination showed a persistent lymphocytosis with mildly reduced glucose and elevated protein; oligoclonal bands and viral PCR were negative...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29321200/bilateral-haemorrhagic-basal-ganglia-infarction-associated-with-early-onset-group-b-streptococcus-meningitis
#12
Rajesh Gupta, Taiwo Maraiyesa, Brendon Conry
A 2-day-old infant presented with poor feeding and grunting. Investigations revealed a raised C reactive protein of 164. Full septic screen was done, which subsequently confirmed a diagnosis of group B streptococcus meningitis. Baby was apyrexial and haemodynamically stable. There were no obvious neurological manifestations, and a routine cranial ultrasound scan was done, which revealed echogenic changes in the basal ganglia and thalami. MRI brain showed extensive haemorrhagic infarction within the lentiform and caudate nuclei with involvement of both posterior limbs of the internal capsule...
January 9, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29301177/iatrogenic-spinal-subarachnoid-hematoma-after-diagnostic-lumbar-puncture
#13
Jung Hyun Park, Jong Yeol Kim
Spinal subarachnoid hematoma (SSH) following diagnostic lumbar puncture is very rare. Generally, SSH is more likely to occur when the patient has coagulopathy or is undergoing anticoagulant therapy. Unlike the usual complications, such as headache, dizziness, and back pain at the needle puncture site, SSH may result in permanent neurologic deficits if not properly treated within a short period of time. An otherwise healthy 43-year-old female with no predisposing factors presented with fever and headache. Diagnostic lumbar puncture was performed under suspicion of acute meningitis...
December 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29299893/response-of-vancomycin-according-to-steroid-dosage-in-pediatric-patients-with-culture-proven-bacterial-meningitis
#14
Shin Ae Lee, Jin Kyu Kim, Dae Sun Jo, Sun Jun Kim
BACKGROUND: This study aimed to evaluate the efficacy of combined vancomycin and steroid therapy for the treatment of culture-proven bacterial meningitis in pediatric patients. MATERIALS AND METHODS: We identified a total of 86 pediatric patients with culture-positive cerebrospinal fluid who were treated at our facility between 2005 and 2015. Ten of these patients (5 boys and 5 girls) received first-line treatment with vancomycin as the initial form of therapy. All cultured bacteria were sensitive to vancomycin...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29277461/intra-cranial-granulomatous-disease-in-common-variable-immunodeficiency-case-series-and-review-of-the-literature
#15
REVIEW
Catherine E Najem, Jason Springer, Richard Prayson, Daniel A Culver, James Fernandez, Jinny Tavee, Rula A Hajj-Ali
BACKGROUND/PURPOSE: Common variable immunodeficiency (CVID) is typically characterized by hypogammaglobulinemia and often but not always recurrent infections. Paradoxically, 8-22% of patients with CVID develop granulomatous disease. Granulomata have been described in many organs including the lungs, skin, liver, spleen, kidneys, eyes, lymph nodes, and intestines. Data about central nervous system (CNS) involvement in CVID are extremely rare. We aim to describe a case series and include an extensive literature review of CNS involvement in CVID to understand the different features and patterns of the disease...
October 20, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29201129/cerebral-vasculitis-in-a-case-of-meningitis
#16
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
#17
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
#18
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
#19
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
#20
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
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