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https://www.readbyqxmd.com/read/29912262/-cerebral-tuberculosis-without-meningitis-in-a-immunocompetent-child
#1
Mónica Ramírez, Eduardo Cortés, José Betancur, Carlos Garcés
Cerebral tuberculosis TB (tuberculomas) without meningitis is an uncommon disease with a high morbidity and mortality. We report on a case that illustrates the complexity of this clinical presentation. An 11 month old, previously healthy male infant was brought to the clinic due to fever present during the last 1.5 months, associated with loss of neurodevelopmental goals and signs of endocranial hypertension. CT scan of the skull revealed dilatation of the ventricular system with transependimary edema; MRI showed multiple intra- and extra-axial micronodular images and hydrocephalus...
April 2018: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29907737/paradoxical-reaction-in-a-patient-with-co-occurring-tuberculous-meningitis-and-pott-s-disease
#2
Talia Robledo-Gil, Kaoru Harada, Ichiro Ikuta, Merceditas Villanueva
BACKGROUND Paradoxical reactions to tuberculosis (TB) are clinical or radiological worsening of prior tuberculous lesions or the development of new lesions upon treatment with appropriate anti-tuberculosis therapy (ATT). This phenomenon has been described in both HIV-seropositive and HIV-seronegative patients. Although historically estimated to occur in 6-30% of HIV-seronegative patients with TB, the phenomenon is often under-recognized in the current era, particularly in countries of low TB prevalence. We describe a case of a TB paradoxical reaction affecting the CNS and spine in an HIV-seronegative individual who received clinical care in the U...
June 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29901002/cryptococcal-meningitis-in-a-patient-with-giant-cell-arteritis
#3
Jin Lv, Qiankun Zhang
Cryptococcal meningitis is a rare complication of giant cell vasculitis. Because its manifestations are very similar to those of giant cell vasculitis relapse, the diagnosis is often delayed and/or misdiagnosed. In this article, we present the case of a 65-year-old female patient who suffered from cryptococcal meningitis during high-dose steroid therapy for giant cell vasculitis.
December 2017: Archives of Rheumatology
https://www.readbyqxmd.com/read/29895576/central-nervous-system-blast-crisis-of-chronic-myeloid-leukaemia-misdiagnosed-as-tubercular-meningitis
#4
Banshi Lal Kumawat, Chandra Mohan Sharma, Pankaj Kumar Saini, Ankur Garg
Chronic Myeloid Leukaemia (CML) presenting with isolated Central Nervous System (CNS) blast crisis is an uncommon entity. A 22-year-old man, diagnosed with chronic phase CML in 2011 and was in haematological and cytogenetic remission until July 2016, had acute onset headache and vomiting with meningeal signs and was admitted elsewhere, investigated by brain imaging and cerebrospinal fluid (CSF) analysis and suspected to have tubercular meningitis, for which steroids and antitubercular medications were started...
June 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29883820/extensive-spinal-adhesive-arachnoiditis-after-extradural-spinal-infection-spinal-dura-mater-is-no-barrier-to-inflammation
#5
Theresa Krätzig, Marc Dreimann, Klaus Christian Mende, Ingo Königs, Manfred Westphal, Sven Oliver Eicker
BACKGROUND: Spinal adhesive arachnoiditis (SAA) is an inflammatory process of the meninges. Cystic changes and cicatrisation may lead to neurological deficits and immobilization. Therapy is difficult and often unsatisfactory. We describe eight cases of extensive SAA following extradural spinal infection. METHODS: 238 patients with epidural abscess or osteomyelitis were treated at our institution between 2011 and 2018. We identified eight patients who developed extensive SAA on follow-up...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29843630/unusual-presentation-of-a-skull-base-mass-lesion-in-sarcoidosis-mimicking-malignant-neoplasm-a-case-report
#6
Katsunori Shijo, Nobuhiro Moro, Mari Sasano, Mitsuru Watanabe, Hiroshi Yagasaki, Shori Takahashi, Taku Homma, Atsuo Yoshino
BACKGROUND: Sarcoidosis is a multi-organ disease of unknown etiology characterised by the presence of epithelioid granulomas, without caseous necrosis. Systemic sarcoidosis is rare among children, while neurosarcoidosis in children is even rarer whether it is systemic or not. CASE PRESENTATION: We described the case of a 12-year-old boy who presented with monocular vision loss accompanied by unusual MRI features of an extensive meningeal infiltrating mass lesion...
May 29, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29800541/neonatal-outcomes-of-elective-early-term-births-after-demonstrated-fetal-lung-maturity
#7
Alan T N Tita, Kathleen A Jablonski, Jennifer L Bailit, William A Grobman, Ronald J Wapner, Uma M Reddy, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Jay D Iams, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: Studies of early term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early term birth (370 -386 ) even after demonstrated fetal lung maturity when compared with full term birth (390 -406 ). However these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus the increase in adverse outcomes might be due to the indication for early term birth rather than the early term birth itself...
May 22, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29793761/steroids-and-survival-in-critically-ill-adult-patients-a-meta-analysis-of-135-randomized-trials
#8
Enrico A Martino, Martina Baiardo Redaelli, Salvatore Sardo, Rosalba Lembo, Vito F Giordano, Dario Winterton, Laura Ruggeri, Ludhmilla A Hajjar, Alberto Zangrillo, Giovanni Landoni
OBJECTIVE: Corticosteroids have important effects on intermediate outcomes in critically ill patients, but their effect on survival is unknown. The objective of this meta-analysis was to analyze the effect on mortality of corticosteroids in critical and perioperative settings. DESIGN: A meta-analysis of randomized trials. SETTING: PubMed, Embase, BioMed Central, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched to February 1, 2018, for randomized trials comparing corticosteroids with placebo or standard care...
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29746358/delayed-cerebral-injury-in-adults-with-bacterial-meningitis-a-novel-complication-of-adjunctive-steroids
#9
Cinthia Gallegos, Farrell Tobowlosky, Masayuki Nigo, Rodrigo Hasbun
OBJECTIVES: To report the prevalence of delayed cerebral injury in adults with bacterial meningitis and explore its association with adjunctive steroids. DESIGN: Retrospective analysis of adults with bacterial meningitis between 2005 and 2016. SETTING: Ten hospitals in the Greater Houston area. PATIENTS: Consecutive subjects with culture proven community-acquired bacterial meningitis. INTERVENTION: Subjects were categorized as receiving or not adjunctive steroids within 4 hours...
May 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29740507/major-risks-and-complications-of-cervical-epidural-steroid-injections-an-updated-review
#10
REVIEW
Nancy E Epstein
Background: Too many patients, with or without significant cervical disease, unnecessarily undergo cervical epidural steroid injections (CESIs). These include interlaminar (ICESI) and transforaminal ESI (TF-CESI) injections that are not Food and Drug Administration (FDA) approved, have no documented long-term efficacy, and carry severe risks and complications. Methods: Here we reviewed recent reports of morbidity and mortality attributed to the various types of CESIS...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29736618/leptomeningeal-form-of-immunoglobulin-g4-related-hypertrophic-meningitis-with-perivascular-spread-a-case-report-and-review-of-the-literature
#11
Jasmina Boban, Selin Ardalı, Majda M Thurnher
PURPOSE: Immunoglobulin G4 (IgG4)-related disease represents a spectrum of fibro-inflammatory disorders that affects various organ systems, including the central nervous system. METHODS: Here we present the case of lgG4-related hypertrophic meningitis with exclusively leptomeningeal involvement and spread via perivascular spaces. RESULTS: A 58-year-old male patient presented with complex partial seizures. Initial computed tomography examination showed left frontal sulcal hyperdensity...
May 7, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29707591/miliary-tuberculosis-presenting-with-meningitis-in-a-patient-treated-with-mycophenolate-for-lupus-nephritis-challenges-in-diagnosis-and-review-of-the-literature
#12
Precious Macauley, Mark Rapp, Sarah Park, Olaoluwatomi Lamikanra, Pratibha Sharma, Michael Marcelin, Kavita Sharma
Tuberculosis is one of the top 10 causes of death worldwide according to the World Health Organization. Central nervous system involvement is usually the least common presentation of tuberculosis occurring in about 1% of all cases but yet can have very devastating outcomes. Lupus nephritis is one of the most common complications of systemic lupus erythematosus with up to two thirds of patients presenting with some degree of renal dysfunction. The mainstay of treatment is glucocorticoids; however, to sustain remission, steroid sparing agents such as cyclophosphamide, azathioprine and mycophenolate mofetil are used...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29682017/the-organisms-and-factors-affecting-outcomes-of-external-ventricular-drainage-catheter-related-ventriculitis-a-penang-experience
#13
Jo Ee Sam, Chee Loon Lim, Priya Sharda, Nasser Abdul Wahab
Introduction: Ventriculostomy-related infection (VRI) from external ventricular drain (EVD) insertion is a common complication and carries a high mortality rate. Choice of empiric antibiotics depends on the institutions common causative organisms and their susceptibility. We determined risk factors for mortality in patients with VRI, the common organisms causing VRI, and the rate of EVD-related VRI at our institution. Methods: Medical records and operative data of patients with cerebrospinal fluid positive cultures with an EVD inserted from 2012 to 2015 were traced...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29669602/cerebral-vasculitis-and-lateral-rectus-palsy-two-rare-central-nervous-system-complications-of-dengue-fever-two-case-reports-and-review-of-the-literature
#14
H M M Herath, J S Hewavithana, C M De Silva, O A R Kularathna, N P Weerasinghe
BACKGROUND: Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. CASE PRESENTATION: We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy...
April 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29604972/cryptococcal-meningitis-in-aids
#15
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
#16
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
#17
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
#18
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
#19
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...
March 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
#20
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
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