Wednesday, December 19, 2012
Delayed cerebral thrombosis in bacterial meningitis: a prospective cohort study.
Delayed cerebral thrombosis in bacterial meningitis: a prospective cohort study.
Source
Abstract
PURPOSE:
METHODS:
RESULTS:
CONCLUSION:
Labels: bacterial meningitis, cerebral thrombosis, cerebrospinal fluid, dexamethasone therapy, Listeria monocytogenes, Streptococcus pneumoniae
Friday, November 23, 2012
A Case of Steroid-induced Hyperinfective Strongyloidiasis with Bacterial Meningitis.
A Case of Steroid-induced Hyperinfective Strongyloidiasis with Bacterial Meningitis.
Source
Abstract
Labels: antibiotic, antihelminthic therapy, autoinfection, bacterial meningitis, Hyperinfective Strongyloidiasis, immunocompromized host, immunosuppressive therapy
Thursday, June 11, 2009
Bacterial Meningitis in HIV-1-Infected Patients in the Era of Highly Active Antiretroviral Therapy.
J Acquir Immune Defic Syndr. 2009 Jun
Domingo P, Suarez-Lozano I, Torres F, Pomar V, Ribera E, Galindo MJ, Cosin J, Garcia-Alcalde ML, Vidal F, Lopez-Aldeguer J, Roca B, Gonzalez J, Lozano F, Garrido M; on behalf of the VACH Cohort Study Group.
From the *Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; daggerHospital Infanta Elena, Huelva, Spain; double daggerLaboratori de Bioestadística i Epidemiologia (Universitat Autònoma de Barcelona), IDIBAPS (Hospital Clínic), Barcelona, Spain; section signHospital Vall d'Hebrón, Barcelona, Spain; parallelHospital Clinico, Valencia, Spain; paragraph signHospital Gregorio Marañón, Madrid, Spain; #Hospital de Cabueñes, Gijón, Spain; **Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona; daggerdaggerHospital La Fe, Valencia, Spain; double daggerdouble daggerHospital General, Castellón, Spain; section sign section signHospital La Paz, Madrid, Spain; parallel parallelHospital de Valme, Sevilla, Spain; and paragraph sign paragraph signVACH Data Management Group, Huelva, Spain.
BACKGROUND:
The burden that spontaneous bacterial meningitis (SBM) currently represents among HIV-1-infected patients is poorly known.
METHODS:
We prospectively evaluated 32 episodes of SBM in HIV-1-infected patients from the VACH (VIH-Aplicación de Control Hospitalario) Cohort and compared findings with those of 267 episodes in uninfected persons, matched by age and year of infection. A group of 13,187 HIV-1-infected patients from the VACH Cohort were used to identify predictors for acquiring SBM.
RESULTS:
Between 1997 and 2006, we found 32 episodes of SBM among HIV-1-infected patients for an annual incidence rate of 62.0 cases per 100,000 population compared with 3.2 (3.0 to 3.4) per 100,000 population for uninfected patients (P <>/=200/mm count was the only predictor for developing SBM. Compared with uninfected, HIV-1-infected patients with SBM had a greater prevalence of primary extrameningeal infection, especially pneumonia (P = 0.02), bacteremia (P = 0.02), focal neurologic signs (P = 0.005), seizures (P = 0.06), a lower cerebrospinal fluid to blood glucose ratio (P = 0.02), and a lower prevalence of nuchal rigidity (P = 0.005). Streptococcus pneumoniae was the most frequent etiologic agent among HIV-1-infected patients. HIV-1-infected patients had neurologic complications more frequently (P = 0.02), a higher overall case fatality rate (P = 0.004), and greater incidence of neurologic sequelae (P = 0.001). '
CONCLUSIONS:
Even in the highly active antiretroviral therapy era, the risk of developing SBM is 19 times higher among HIV-1-infected patients than among uninfected ones. It tends to present in severely immunosuppressed patients not previously vaccinated and off antiretroviral therapy, with a concomitant extrameningeal infection, bacteremia, and focal neurologic signs, and is caused by S. pneumoniae. SBM in HIV-1-infected patients carries a worse prognosis than in uninfected ones both in terms of lethality and sequelae.
PMID: 19512939 [PubMed - as supplied by publisher]
Labels: bacteremia, bacterial meningitis, HIV-1-Infection, S. pneumoniae, spontaneous bacterial meningitis
Thursday, November 01, 2007
Differential diagnosis between viral and bacterial meningitis in children.
Differential diagnosis between viral and bacterial meningitis in children.
Eur J Emerg Med. 2007 Dec
De Cauwer HG, Eykens L, Hellinckx J, Mortelmans LJ.aDepartment of Neurology bClinical Laboratory Departments of cPaediatrics dEmergency Medicine, Klina Regional Hospital, Brasschaat, Belgium.
OBJECTIVE: The differential diagnosis between viral meningitis and bacterial meningitis is often very difficult. The results of peripheral blood and spinal fluid analysis are not 100% accurate. We tried to find a useful 'bedside' decision-making tool, based on laboratory results readily available at the emergency department. METHODS: Retrospective study design. Analysis of a consecutive series of all children (age 0-15 years) admitted to the paediatric ward because of a viral or bacterial meningitis, in the period from 1997 to September 2005.
RESULTS: Seventy-one children with viral and 21 with bacterial meningitis were included. Bacterial meningitis occurred at much younger ages than viral meningitis. The paediatrician decided to administer antibiotics in 41 of 71 children with viral meningitis and in all children with bacterial meningitis. We developed a 'bacterial meningitis score' based on C-reactive protein in peripheral blood, as well as glucose and protein in cerebrospinal fluid. Using this score, we could distinguish 54 of 71 patients with viral meningitis from the group with bacterial meningitis. When the dispensing of antibiotics was based on this score, only 16 patients with viral meningitis would receive antibiotics.
CONCLUSION: We present a bedside bacterial meningitis score. Using this bacterial meningitis score as a decision-making tool, we would be able to avoid antibiotics in a large number of children with viral meningitis. As this gives a 100% success rate, thus guaranteeing that bacterial meningitis patients would receive the proper therapy, our bacterial meningitis score could be an accurate decision-support tool.
Emergency Medicine
Labels: bacterial meningitis, differential diagnosis, pediatric, viral meningitis
