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Query: UMLS:C0024530 (malaria)
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Neurologic manifestations of severe infectious complications of drug abuse and chronic alcoholism are reviewed in this article. Portals of entry from cutaneous postinjection infections and multiple vascular injection sites may lead to pyomyositis, tetanus, infective endocarditis, meningitis, brain abscesses, and vertebral osteomyelitis. Chronic intranasal abuse of cocaine may be followed by frontal osteomyelitis, botulism, brain abscess, and visual loss. Problems of hepatitis, malaria, and syphilis in drug abusers are discussed also.
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PMID:Infections other than AIDS. 837 45

In recent supplement of neuroendocrinology letters, first time the authors from West and East, North and South of EU and the "Third World" present data on neuroinfections in high technology society - on nosocomial meningitis and vice versa in low technology and income countries of sub-Saharan Africa. 14 years survey of 171 cases of nosocomial paediatric meningitis is presented by Rudinsky et al. [1] and subpopulations of Acinetobacter baumannii and Pseudomonas aeruginosa [1,2] within last 20 years are briefly analyzed by Huttova et al. [2] and Ondrusova et al. [3]. All cases were complicating high technology procedures, such as neurosurgery, very low birth weight neonates after shunt implants etc. Current problems of management of nosocomial meningitis are reviewed by Bauer et al. [4] and consequence of inappropriate therapy by Huttova et al. [5]. Another high technology associated infection is septic embolisation followed by brain abscess and meningitis in patients with endocarditis after cardiac surgery (Kovac et al.) [6]. Experience from more than 600 cases is discussed in the article by Karvaj et al. [7] who outlines extremely high mortality in patients with endocarditis embolizing to central nervous system - up to 60%. The rest of papers are in contrary to problems of neuroinfections in EU and US focused on meningitis and cerebral malaria as commonest neuroinfections in the third world: 261 cases of cerebral malaria are discussed in a brief research note by Sudanese team of tropical programme in area of famine and civil war in southern Sudan (Bartkovjak and Ianetti et al.) [8]. Fungal neuroinfections complicating AIDS are of decreasing trend as reported by Njambi et al. from Kenya [9] and data from 497 cases from Uganda, Ethiopia and Burundi are presented by Benca et al. [10]. Finally an outbreak of meningococcal meningitis is reported by Benca et al. [11] from meningitis belt in Darfur and southern Sudan. We hope that the supplement may show difference in etiology, risk factors, therapy and outcome of neuroinfections (which is a burning public health and social problem in tropics) in other third world countries versus developed high-tech medical settings of US, EU and other high income countries, as presented by Benca et al. [12].
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PMID:Neuroinfections in developed versus developing countries. 1755 64

Cerebral involvement in parasitoses is an important clinical manifestation of most of the human parasitoses. Parasites that have been described to affect the central nervous system (CNS), either as the dominant or as a collateral feature, include cestodes (Taenia solium (neurocysticerciasis), Echinococcus granulosus (cerebral cystic echinococcosis), E. multilocularis (cerebral alveolar echinococcosis), Spirometra mansoni (neurosparganosis)), nematodes (Toxocara canis and T. cati (neurotoxocariasis), Trichinella spiralis (neurotrichinelliasis), Angiostrongylus cantonensis and A. costaricensis (neuroangiostrongyliasis), Gnathostoma spinigerum (gnathostomiasis)), trematodes (Schistosoma mansoni (cerebral bilharziosis), Paragonimus westermani (neuroparagonimiasis)), or protozoa (Toxoplasma gondii (neurotoxoplasmosis), Acanthamoeba spp. or Balamuthia mandrillaris (granulomatous amoebic encephalitis), Naegleria (primary amoebic meningo-encephalitis), Entamoeba histolytica (brain abscess), Plasmodium falciparum (cerebral malaria), Trypanosoma brucei gambiense/rhodesiense (sleeping sickness) or Trypanosoma cruzi (cerebral Chagas disease)). Adults or larvae of helminths or protozoa enter the CNS and cause meningitis, encephalitis, ventriculitis, myelitis, ischaemic stroke, bleeding, venous thrombosis or cerebral abscess, clinically manifesting as headache, epilepsy, weakness, cognitive decline, impaired consciousness, confusion, coma or focal neurological deficits. Diagnosis of cerebral parasitoses is dependent on the causative agent. Available diagnostic tools include clinical presentation, blood tests (eosinophilia, plasmodia in blood smear, antibodies against the parasite), cerebrospinal fluid (CSF) investigations, imaging findings and occasionally cerebral biopsy. Treatment relies on drugs and sometimes surgery. Outcome of cerebral parasitoses is highly variable, depending on the effect of drugs, whether they are self-limiting (e.g. Angiostrongylus costaricensis) or whether they remain undetected or asymptomatic, like 25% of neurocysticerciasis cases.
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PMID:Parasitoses of the human central nervous system. 2304 8

We report three cases of brain abscess in children admitted to QECH in 2006. All children were HIV-uninfected. One case was associated with staphylococcal empyema, another with chronic suppurative otitis media and mastoiditis, and the third case had no identified extracranial focus of infection. These cases illustrate the difficulties of diagnosis and management of brain abscesses in the resource-poor setting where other causes of infection of the central nervous system are common. The typical clinical presentation of brain abscess of altered mental state and seizures is also characteristic of cerebral malaria and meningitis and it is likely that many cases of brain abscess in Malawian children are not diagnosed. The value of cranial CT scan, ideally with contrast, for diagnosis and management of brain abscess is highlighted by these cases.
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PMID:A case series of brain abscesses in Malawian children. 2387 55

Central nervous system fungal infections can be broadly divided into those that infect a healthy host such as Cryptococcus, Coccidioides, Histoplasma, Blastomyces, Sporothrix spp., and those that cause opportunistic infections in an immunocompromised host such as Candida, Aspergillus, Zygomycetes, Trichosporon spp. The clinical manifestations of central nervous system fungal infections commonly seen in children in clinical practice include a chronic meningitis or meningoencephalitis syndrome, brain abscess, rhino-cerebral syndrome and rarely, a fungal ventriculitis. Fungal central nervous system infections should be suspected in any child with subacute to chronic febrile encephalopathy or meningitis with or without raised intracranial pressure, seizures, orbital pain and/or sero-sanguinous nasal discharge. Diagnosis is corroborated by cerebrospinal fluid analysis, culture and PCR, special stains, serological tests and neuroimaging. Management of fungal central nervous system infections include specific antifungal therapy and supportive measures for associated problems, management of underlying predisposing condition and surgical intervention in cases with localized disease, abscess or presence of simultaneous foreign body such as intracranial shunts. In addition to the fungi, several parasitic infections can cause central nervous system infections in children. Of these, authors briefly discuss cerebral malaria, and amebic meningo-encephalitis.
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PMID:Fungal and Parasitic CNS Infections. 2912 15

Brain abscess is a known complication of cyanotic congenital heart diseases. We report the case of a four-year-old girl whose first presentation in the hospital was because of symptoms referable to the neurological system. These symptoms are similar to those seen in cerebral malaria as well as other infections of the central nervous system, e.g. meningitis and encephalitis. Detailed history, painstaking examination, and investigations will however help in differentiating these conditions. In the index case however, the illness was fatal due to the late presentation, which is not uncommon in this environment. In a resource-poor environment such as Nigeria, this is a reminder that proper history taking, clinical examination, and subsequent investigations will aid in early diagnosis and subsequent management of such cases to reduce childhood mortality. It also underscores the need for increased awareness among primary health care providers. <Learning objective: In developing countries where definitive treatments for most congenital heart diseases are not available, complications such as brain abscesses are not uncommon. Primary health care givers should be aware of these complications in these patients. Symptoms such as headaches, fever, and convulsions are common in children living in malaria endemic regions and may mimic the symptoms seen in brain abscess. A high index of suspicion is required to make prompt diagnosis and give appropriate treatment while treating children with congenital heart disease.>.
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PMID:Meningitis and brain abscess: First but fatal presentation in a child with tetralogy of fallot. 3054 9