Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The successful treatment of Candida albicans meningoencephalitis with 5-fluorocytosine (5-FC) is reported. After abdominal surgery with many complications, a 60-year-old man developed severe headache, lumbar pain, mental change. The significance of this was not realized for months. The cerebrospinal fluid (CSF) showed pleocytosis, high protein and low glucose concentration. One CSF culture out of 6 revealed growth of Candida albicans. Serologic tests are also indicated candida infection. After a month of treatment with 5-FC, the severe pain decreased and he improved mentally. After 4 months, the CSF was normal and the 5-FC treatment ended. For the past year, the patient has not shown any signs of relapse.
 ...
PMID:Candida meningoencephalitis treated with 5-fluorocytosine. 84 Dec 84

Echovirus type 7 was isolated from 7 conjunctival scrapings obtained during an epidemic of meningoencephalitis caused by the same virus. The patients suffered from conjunctivitis or keratoconjunctivitis, and also had gastrointestinal symptoms, fever, headache and lymphadenopathy early in their illness. Two characteristics of the isolated strains were not in agreement with those of the standard echovirus type 7: they adapted only slowly to cell cultures, and no viral hemagglutinin for human red blood cells could be demonstrated. Our data suggest an etiologic association of echovirus 7 with eye disease.
 ...
PMID:Echovirus type 7 isolated from conjunctival scrapings. 89 72

A 39-year-old man, who had high grade fever and headache for 4 days was admitted to our hospital because of generalized seizure and disturbance of consciousness. He was pyrexial, but not icteric. Neurological examination revealed disorientation, nuchal rigidity and bilateral Babinski reflexes. Laboratory test results included the following: GOT 1,740 U/l, GPT 2,800 U/l, bilirubin 1.2 mg/dl, serum IgM-HA antibody cut-off index 6.8. CSF was clear, with 10 leukocytes/mm3 and protein level of 108 mg/dl. Head CT and MRI revealed no abnormality. An EEG demonstrated diffuse slowing. During the following 2 days, he had increased obtundation and labored breathing. In the second week of hospitalization his neurological conditions and liver function test results improved. A diagnosis of HA was confirmed by a finding of serum IgM-HA antibody. The neurological findings, CSF findings and clinical course indicated acute meningoencephalitis in association with HA. To our knowledge, there have been only 4 previous case reports of meningoencephalitis associated with serologically confirmed HA infection. HA virus infection might pass unnoticed, as many cases of HA infection remain anicteric or subclinical. Therefore, HA virus should also be considered as one of the etiological agents in meningoencephalitis.
 ...
PMID:[Acute hepatitis A (HA) presenting findings of meningoencephalitis]. 139 33

Several cases of Acanthamoeba encephalitis (ie, granulomatous amebic encephalitis) have been reported in patients with acquired immunodeficiency syndrome from the United States. To our knowledge, none so far has been reported from Europe, and this is the first case of amebic meningoencephalitis due to Acanthamoeba in a patient with acquired immunodeficiency syndrome from Italy. The patient was a 24-year-old, human immunodeficiency virus-positive heterosexual man with a 6-year history of intravenous drug use. He was admitted to the hospital because of severe headache, confusion, nuchal rigidity, jaundice, and ascites. He died 5 days later. At autopsy, the brain showed extensive hemorrhagic necrosis with numerous trophic and cyst forms of Acanthamoeba. The amebas were identified as Acanthamoeba divionensis by the indirect immunofluorescence test.
 ...
PMID:Acanthamoeba meningoencephalitis in a patient with acquired immunodeficiency syndrome. 145 85

A case of tuberculous meningitis, proved by cerebrospinal fluid (CSF) cultures, is reported due to atypical findings in CSF. This 19-year-old man developed subacute headache and fever for 2 weeks, followed by focal seizure and left hemiparesis. Initial CSF study showed hemorrhagic lymphocytic pleocytosis with mildly elevated protein and normal sugar content, mimicking viral or postinfectious meningoencephalitis. Follow-up CSF studies showed polymorphonuclear pleocytosis. A concomitant bacterial meningoencephalitis was suspected, though repeated CSF cultures did not isolate any bacteria. The activity of adenosine deaminase in CSF was 12 U/L, highly suggestive of tuberculous meningitis. Magnetic resonance imaging (MRI) showed only a focal meningoencephalitis in the right lateral frontal cortex. Due to progressive deterioration of the clinical status, umbrella therapy, including antimycobacterial drugs and strong antibiotics were given. At a later time, growth of tubercle bacilli was reported in the CSF cultures. Follow-up study of MRI 4 months later, showed thick abnormal enhancement in the basal cisterns and obstructive hydrocephalus, typical findings of chronic basal meningitis.
 ...
PMID:Atypical presentations of tuberculous meningitis--a case report. 165 88

In the immunocompromised patient, even mild forms of any combination of headache, meningismus, altered mental status, or focal neurologic signs should initiate an evaluation for possible CNS infection. The limited signs and symptoms of acute CNS infection are not due to specific organisms but to pathologic changes at the neuroanatomic site of infection. The initial clinical history, examination, laboratory, and neuroradiographic data will narrow the problem to one of several groups of agents, although it may not be possible to specify a single causative agent. It should be remembered that several concurrent infections (i.e., CMV and toxoplasmosis, aspergillosis, and bacterial sepsis) may be present. Thus, the clinician should rely on broad antibiotic coverage appropriate to the suspected causative agent or agents at the site of infection. It may be necessary to offer broad-spectrum antibiotic coverage for a CSF presentation that is subsequently found to result from a viral illness or from a noninfectious cause. However, one should avoid undertreating those infections for which specific therapy can be offered, and broad-spectrum treatment usually will not be regretted. Uncertainty in diagnosis following noninvasive procedures should lead to a brain biopsy. Although many of the infections discussed in this article have a poor prognosis, some of the most common pathogens, such as Cryptococcus, Listeria, and Toxoplasma, have effective specific therapies to which the patient should have access as rapidly as possible. The clinician who has successfully treated a patient with CNS infection should remain vigilant for late sequelae or recurrence of infection. Chronic treatment of some infections, such as toxoplasmosis or aspergillosis, may be necessary. The reintroduction of steroids for the treatment of an underlying cancer may reactivate previously treated disease, such as cryptococcosis, and periodic CSF surveillance is appropriate under these circumstances. Recurrence of the symptoms should raise the suspicion of recurrent or new infection, and the patient also should be evaluated with CT or MRI for the development of hydrocephalus or for new metastatic disease. In patients who have had varicella-zoster infection, postherpetic neuralgia and delayed arteritis may develop. Seizures, hearing loss, and neuropsychologic sequelae may follow any meningoencephalitis. The patient should always be reevaluated for the possibility of infection with a different opportunistic organism. CNS infections remain a major cause of morbidity and mortality in immunosuppressed patients with malignancies. In one series, 60% of such patients died as a result of their CNS infection, many at a time when the underlying disease had an otherwise good prognosis.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Central nervous system infections in cancer patients. 175 29

A 37-year-old hemophiliac patient with known, asymptomatic human immunodeficiency virus infection and chronic Chagas' disease was admitted to the hospital complaining of fever and headache. A computed tomographic scan revealed multiple ring-enhancing lesions in both cerebral hemispheres. No antibodies to Trypanosoma cruzi were found in the cerebrospinal fluid. Treatment for toxoplasmosis of the central nervous system, which was considered the most likely diagnosis, was instituted, but the patient died after progressive neurologic deterioration. An autopsy revealed severe meningoencephalitis caused by T. cruzi.
 ...
PMID:Acute fatal Trypanosoma cruzi meningoencephalitis in a human immunodeficiency virus-positive hemophiliac patient. 176 99

Angiostrongyliasis cantonensis is a disease commonly seen in Taiwan, especially in children during the summer rainy season. Most of the cases reported in other countries were adults and their clinical manifestations were different from children. Studies on special clinical characteristics of angiostrongyliasis cantonensis among 82 children in Taiwan were performed. Thirty-eight (46.3%) were male and 44 (53.7%) females, and 87% could be traced to a history of contact with the intermediate host, the giant African snail, Achatina fulica, which plays a major role in transmission. The incubation period (average: 13.2 days) was shorter in children than in adults (average: 16.5 days). In about one-third (30.5%) of the total cases, the clinical form was meningoencephalitis, which was higher than in adult cases seen in Thailand (5%). The most common clinical symptom was fever (91.5%), followed by vomiting and headache. The percentages of sixth and seventh cranial neuropathy associated with the disease were 19.5% and 11.0% respectively. Ophthalmologic fundoscopy showed that 25.0% with papilledema which was significantly higher than seen in adults (12%) in Thailand. Most of the cases in this study had peripheral leukocytosis (above 10,000/mm3) and eosinophilia (above 10%); the percentages were 82.9% and 84.1%, respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 82 cases was 41.5%; 141 worms were collected from one female patient using a pumping method. In the recent 2 years, albendazole and levamisole were used clinically with good result.
 ...
PMID:Clinical studies on angiostrongyliasis cantonensis among children in Taiwan. 182 85

We review the 257 patients hospitalized for meningitis in the Cantonal University Hospital, Geneva between 1st January 1980 and 31st December 1986. 104 patients had acute bacterial meningitis (32 Str. pneumoniae, 21 N. meningitidis, 10 Listeria monocytogenes, 8 streptococci, 5 H. influenzae, 5 staphylococci, 4 gram negative bacilli and 19 without identified bacteria), 124 patients had viral meningitis and 29 meningitis of other etiologies (6 tuberculous meningitis, 2 fungal meningitis, 1 leptospiral meningitis, 5 neoplastic meningitis--one already counted because of a meningitis due to Staph. epidermidis--2 meningitis consecutive to a meningeal irritation, 4 already treated meningitis of undetermined etiology, 2 chronic meningitis and 8 meningoencephalitis). The total mortality was 14.4%. It was zero in viral meningitis and 28% in bacterial meningitis (47% in cases of Str. pneumoniae, 5% in cases of N. meningitidis, 20% in cases of Listeria monocytogenes, 38% in cases of streptococci, 0% in cases of H. influenzae, 60% in cases of staphylococci, 50% in cases of gram negative bacilli, 16% in cases of unidentified bacteria). The striking difference in mortality emphasizes the importance of recognizing a bacterial etiology in order to institute antibiotic therapy as soon as possible. The delay between admission and lumbar puncture averaged 15 hours (range 0.25-96 h) in patients with acute bacterial meningitis and 6.3 hours (0.5-80 h) in patients with viral meningitis. The delay between admission and institution of the antibiotics averaged 5.3 hours (1-48 h) in cases of acute bacterial meningitis and 4.8 hours (0.5-48 h) in cases of viral meningitis. A better clinical workup may provide a reliable diagnosis sooner. In the collective with bacterial and viral meningitis headaches, fever or nuchal rigidity were present in over 80% of the cases. The following features were significantly associated with a bacterial etiology: age over 30 years, alcoholism, concomitant neoplasm, cough, coma, pulmonary rales, new neurological signs or petechia. At least one of these 4 latter signs was present in more than 70% of the cases with acute bacterial meningitis compared to 6% in cases of viral meningitis. Thus the clinical presentation alone serves to recognize the meningitis and to differentiate between a bacterial or viral etiology, thus permitting an immediate therapeutic decision without waiting for complementary investigations. The 104 patients with acute bacterial meningitis were treated with antibiotics: 60 with penicillin, 17 with ampicillin and 26 with other antibiotics; one case did not receive antibiotics. More than the half of the cases with viral meningitis have got antibiotics (52%).
 ...
PMID:[Meningitis in adults in Geneva. Review of 257 cases]. 185 79

A fatal case of meningoencephalitis due to a leptomyxid ameba in a patient with the acquired immunodeficiency syndrome is presented. This opportunistic organism has not been previously recognized as a human pathogen. A 36-year-old male intravenous drug abuser died after an 18-day hospital course heralded by fever and headache and followed by nuchal rigidity and hemiparesis. Computed tomography of the head showed multiple hypodense lesions. Neuropathologic examination showed that in addition to human immunodeficiency virus encephalomyelitis, there was multifocal meningoencephalitis with trophozoites and cysts morphologically indistinguishable from those of Acanthamoeba. These organisms were also found in the kidneys and adrenal glands. By immunofluorescence, the parasites showed antigenic identity with a free-living leptomyxid ameba and failed to react with any of a spectrum of antiacanthamoeba antisera. This emphasizes the importance of immunofluorescence identification of morphologically indistinguishable ameba species.
 ...
PMID:Amebic meningoencephalitis in a patient with AIDS caused by a newly recognized opportunistic pathogen. Leptomyxid ameba. 198 9


1 2 3 4 5 6 7 8 9 10 Next >>