Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 19-year-old immunocompetent man was admitted to hospital with diplopia, nausea, vomiting and change in mental status. The patient had a history of tuberculous meningitis that was diagnosed at another hospital 6 months before the present admission, and at that time anti-tuberculosis treatment was initiated using a first-line drug combination. A computed tomography (CT) scan of the brain revealed non-communicating hydrocephalus. A ventriculo-peritoneal shunt was inserted surgically. Two months later, the patient was hospitalized again for fever, dysphagia and left hemiparesis. At that time, his cranial CT findings were within normal limits; however, magnetic resonance imaging (MRI) revealed an irregular multilocular peripheral contrast-enhancing lesion in the posterior fossa. The abscess was surgically drained. The presence of acid-fast bacilli in the abscess material was demonstrated by Ziehl-Neelsen staining. Mycobacterium tuberculosis grew on Lowenstein-Jensen culture medium, and the strain was found to be resistant to isoniazid. One month after the operation, the patient became quadriparetic. Cervical MRI revealed a cervico-thoracic syringomyelitic cavity, after which a syringoperitoneal shunt was placed. Treatment with four drugs was continued for 10 months, and then treatment with three drugs for a total period of 18 months. The patient recovered, with residual quadriparesis. Even though very rare, isoniazid-resistant M. tuberculosis may be the causative agent of progressive tuberculosis.
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PMID:Cerebellar abscess and syringomyelia due to isoniazid-resistant Mycobacterium tuberculosis. 1713 74

Thrombocytopenia is a relatively frequent complication in patients infected by human immunodeficiency virus (HIV). Most frequent mechanisms of thrombopenia are destruction of half-filled platelets by immunocomplex and defects in production. We present two cases of severe thrombocytopenia associated to HIV infection. Case 1: A male patient, 45 years old with fever and diarrhea that lasted for 1 month that presented with thrombopenia of 3,000 platelets/mm3. After beginning zidovudine and lamivudine therapy, he normalized the platelet count in 5 days. Case 2: A male patient of 30 years old, who suffered during one day migraine, nausea, vomits and then seizures. A criptococccal meningitis was confirmed. Concomitantly he had a platelet count of 59,000/mm3. He started antiretroviral therapy with zidovudina and lamivudina, then was changed to didanosine plus stavudine plus nevirapine. After 6 months of severe thrombocytopenia, platelets count was restored to normal values. A literature review is presented.
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PMID:[Severe thrombocytopenia and human immunodeficiency virus infection. Report of two cases and review]. 1736 74

Meropenem is a broad-spectrum carbapenem antibacterial with potent antimicrobial activity against a broad range of Gram-negative, Gram-positive and anaerobic bacteria. The second parenteral carbapenem to be introduced worldwide, meropenem has been in clinical use since 1994. Two previous safety reviews have established that meropenem has a favourable and acceptable safety profile. This new review was conducted after the approval of meropenem in the US in 2005 for the treatment of patients with complicated skin and skin-structure infections, in addition to the previously approved indications of intra-abdominal infections and paediatric bacterial meningitis. The analysis includes the clinical trial data from the previous safety reviews, updated with expanded experience across a number of serious bacterial infections, including a large international study in patients with skin or skin-structure infections and further experience in patients with intra-abdominal infections and bacterial meningitis. A total of 6154 patients with 6308 meropenem exposures were compared with 4483 patients treated with comparator agents (4593 exposures), and the paediatric population base for which safety data are available has doubled to over 1000 patients. The data presented reinforce the favourable safety profile of meropenem. In general, the incidence and pattern of adverse events occurring with meropenem were similar to those of the first carbapenem, imipenem/cilastatin, and to those of the cephalosporin- and clindamycin-based regimens to which it had been compared. The most common adverse events reported for meropenem were diarrhoea (2.5%), rash (1.4%) and nausea/vomiting (1.2%). No adverse event occurred in more than 3% of patient exposures to meropenem, indicating a low overall frequency of adverse events as well as excellent gastrointestinal tolerability. Furthermore, no unexpected adverse events were identified, and the very low incidence of seizures in patients with meningitis was not considered to be drug related. In infections other than meningitis, the incidence of seizures considered by investigators to be related to meropenem treatment was 0.07%. In the new studies that updated the earlier safety data, no new cases of drug-related seizure were reported for any treatment or patient group (meningitis/non-meningitis infections). In conclusion, meropenem is well tolerated and has good CNS and gastrointestinal tolerability when used for the treatment of serious bacterial infections in a wide range of adult and paediatric patient populations.
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PMID:Safety profile of meropenem: an updated review of over 6,000 patients treated with meropenem. 1769 78

A normal component of the flora of the oropharynx, Neisseria sicca was first isolated in 1906 and has since been reported as a rare cause of various human infections including endocarditis, pneumonia, sinusitis, sepsis, and urethritis. We report the case of a 44-year-old African-American female with a history of hypertension who presented with complaints of right frontal headache, nausea, photophobia, and vomiting. A computed tomography scan of the patient's brain showed a large subarachnoid hemorrhage, and an arteriogram confirmed a large posterior communicating artery aneurysm. A ventriculostomy tube was placed, and the patient subsequently developed an elevated temperature and elevated white blood cell count. Cerebrospinal fluid studies showed elevated protein and glucose levels and cultures positive for N. sicca. This is only the seventh reported case of culture-proven meningitis related to N. sicca, and the first reported case associated with intracranial hemorrhage and ventriculostomy tube placement.
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PMID:Neisseria sicca meningitis following intracranial hemorrhage and ventriculostomy tube placement. 1790 82

An outbreak of aseptic meningitis caused by echovirus type 30 (E-30) occurred in the southern area of Fukushima Prefecture from March to September in 2004. The data of 54 patients with E-30 meningitis were analyzed. The median age was 7.3 years and the age range was 4 to 14 years. The male to female ratio was 2.2:1. The major symptoms of fever, headache and nausea/vomiting were observed more than 80% of the patients. The mean cerebrospinal fluid cell count was 104/microL, and polymorphonuclear cells were predominant in 61% of the cases. The clinical characteristics were not remarkably different from those in the outbreak in the middle to southern region of Fukushima Prefecture in 1997. The phylogenetic analysis based on the VP4 structural gene showed that the E-30 strains isolated in 2004 formed different clusters from those isolated during other time periods, suggesting that a variant genotype of E-30 was responsible for the outbreak in Fukushima in 2004.
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PMID:[Epidemiological and virological study of aseptic meningitis in children caused by echovirus type 30 in Fukushima in 2004]. 1854 46

(1) Invasive infections due to serogroup B meningococci can be life-threatening. Antibiotics are not always effective. Vaccines available in France do not protect against serogroup B meningococci. (2) In the French region of Normandy, a vaccine manufactured by the Norwegian National Institute of Public Health and directed against serogroup B meningococci. (2) In the French region of Normandy, a vaccine manufactured by the Norwegian National Institute of Public Health and directed against a meningococcal strain related to the strain circulating in this region has been used since summer 2006 to protect children over one year of age and adolescents. (3) A review of the 16 available immunogenicity studies shows that immunogenicity is similar in children and adults when the vaccine is administered in two doses, six weeks apart. The manufacturing process was modified in 1995, and the new vaccine could be less immunogenic: three doses provided results similar to those obtained with two doses of the older vaccine. This implies that, in epidemic situations, the maximum protection conferred by the vaccine would be reached 3 to 4 months after beginning vaccination. (4) A double-blind placebo-controlled trial conducted between 1988 and 1991 included 171 800 adolescents aged 14 to 16 years who received two doses of the meningitis B vaccine, or placebo injections. During 29 months of follow-up, 12 invasive infections due to serogroup B meningococci occurred in the vaccine group, versus 24 cases in the placebo group. The protection rate was 57% but the confidence interval was very wide (21% to 78%). A correlation was established between the bactericidal antibody titre and clinical protection. (5) In this trial, the adverse events studied in 877 adolescents were infrequent: less than 4% of local adverse events, and about the same proportion of systemic adverse events (headache, nausea, fatigue, malaise), led to taking time off school. (6) Too few data are available for infants. And it is difficult to extrapolate to other countries the results obtained in Norway 10 years ago with a vaccine that was manufactured differently and may be more immunogenic. (7) In practice, vaccination with the Norwegian vaccine is justified in areas where an epidemic strain closely related to the vaccine strain is circulating, even though only about 60% of vaccinees are protected after three doses.
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PMID:Meningococcal B vaccine: new drug. The only vaccine against some serogroup B meningococci. 1862 7

Pseudomonas stutzeri which is an aerobic, non-fermentative gram-negative bacillus frequently found in soil, water and hospital environment, rarely leads to serious community-acquired infections. In this report a case of community-acquired meningitis due to P. stutzeri was presented. A 73-years-old male patient was admitted to the emergency department with the complaints of nausea, vomiting, headache, dizziness, difficulties in walking and speaking and loss of consciousness. There was no history of an underlying disease or immunosuppression. Physical examination revealed nuchal rigidity, however, Kernig and Brudzinski signs were negative. The cerebrospinal fluid (CSF) analysis revealed 0.4 mg/dl glucose (simultaneous blood glucose 145 mg/dl), and 618 mg/dl protein and 640 leucocyte/mm3 (90% PMNL). No bacteria were detected in Gram stained and Ehrlich-Ziehl-Neelsen stained CSF smears. Upon the diagnosis of acute bacterial meningitis, treatment with ceftriaxone and ampicillin was initiated, however, the patient died after 16 hours of hospitalization. CSF culture yielded the growth of gram-negative oxidase-positive bacteria and the isolate was identified as P. stutzeri by Vitek-2 Compact system (bioMerieux, France). The isolate was found to be sensitive to piperacillin/tazobactam, amikacin, gentamycin, ceftazidime, cefepime, ciprofloxacin, imipenem and meropenem. Since the patient was lost due to acute respiratory and cardiac failure, it was not possible to change the therapy to agent specific therapy. In conclusion, it should always be kept in mind that uncommon agents could lead to community-acquired meningitis in elderly patients and empirical treatment protocols might fail in such cases resulting in high morbidity and mortality.
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PMID:[Community-acquired Pseudomonas stutzeri meningitis in an immunocompetent patient]. 1933 94

(1) When oral morphine does not relieve severe pain and when there is no specific treatment for the underlying cause, the first option is to try subcutaneous or intravenous administration. If this standard treatment fails or is poorly tolerated, intrathecal injection is usually preferred as the direct route to the central nervous system. However, one-quarter to one-half of patients still do not achieve adequate pain relief, and adverse effects are relatively frequent; (2) Ziconotide is not an opiate and is not related to the usual classes of drugs that interfere with nervous transmission in the posterior horn of the spinal cord. Marketing authorization has been granted for "severe, chronic pain in patients who require intrathecal analgesia". The Summary of Product Characteristics (SPC) recommends continuous infusion via an intrathecal catheter connected to a pump; (3) Clinical evaluation of ziconotide does not include any trials versus morphine in patients with nociceptive pain, or any trials versus tricyclic or antiepileptic drugs in patients with neurogenic pain; (4) In a trial in 220 patients in whom systemic morphine had failed, the mean pain score on a 100-mm visual analogue scale was 69.8 mm after three weeks on ziconotide, compared to 75.8 mm with placebo. This difference, although statistically significant, is clinically irrelevant. The proportion of "responders" (reduction of at least 30% in the initial pain score) was respectively 16.1% and 12.0% (no statistically significant difference); (5) The two other placebo-controlled trials included 112 patients with pain linked to cancer or HIV infection, and 257 patients with non-cancer pain. After a titration phase lasting 5 to 6 days, a combined analysis of the two trials showed that the mean pain score was 48.8 mm with ziconotide and 68.4 mm with placebo (statistically significant difference). However, many patients did not complete the titration phase. Efficacy also appeared to differ according to the type of pain; ziconotide was more effective on cancer pain than on neurogenic pain; (6) The main adverse effects of ziconotide in clinical trials were cerebellovestibular disorders such as ataxia, dizziness, and gait disorders, as well as confusion, hallucinations (increased in cases of overdose), nausea, vomiting, postural hypotension, and urine retention. About 40% of patients had an elevation in muscle creatine kinase activity, through an unknown mechanism; (7) Intrathecal administration carries a risk of infection (especially meningitis). Some patients might experience a paradoxical increase in pain with ziconotide; (8) In practice, the efficacy of ziconotide in relieving neurogenic pain remains to be established. In cancer pain, the available evidence showing that ziconotide is effective after opiate failure is too weak in view of the potential risks. It is better to re-examine and, if possible, correct the reasons for opiate treatment failure rather than prescribe ziconotide.
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PMID:Ziconotide: new drug. Limited analgesic efficacy, too many adverse effects. 1953 Mar 73

Plectranthus ecklonii Benth. is traditionally used in South Africa for treating stomach aches, nausea, vomiting and meningitis. Bioassay-guided fractionation of the ethyl acetate extract of the plant led to the isolation of two known compounds, parvifloron D and parvifloron F, neither of which has been previously reported for this species. The compounds exhibited minimum inhibitory concentrations of 15.6 and 31.2 microg/mL, respectively against Listeria monocytogenes, whereas the values against a drug-sensitive strain of Mycobacterium tuberculosis were 190 and 95 microg/mL, respectively. The ethyl acetate extract of P. ecklonii and its isolated compounds were tested for their activity on tyrosinase inhibition. The concentration at which half the tyrosinase activity was inhibited (IC50) by the extract was found to be 61.7 +/- 2.7 microg/mL. The antibacterial activity of the extract and its isolated compounds correlates with the traditional use of the plant for various ailments such as stomach aches, diarrhea and skin diseases. The fifty percent inhibitory concentrations of parvifloron D and parvifloron F against vero cell lines were found to be 2.9 microg/mL and 1.6 microg/mL, respectively. This is the first report of the bioactivity of P. ecklonii extract and its constituents.
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PMID:Bioactivities of Plectranthus ecklonii constituents. 1983 Oct 23

To report a case of bilateral endophthalmitis as the initial presentation of bacterial meningitis in a young, immunocompetent Korean patient. A 35-year-old female with a one day history of bilateral swollen eyes, visual disturbance, headache, petechial skin rash, and nausea visited our clinic. She was diagnosed as having endogenous endophthalmitis associated with bacterial meningitis. Intravenous broad spectrum antibiotic therapy was initiated with cefotaxime 3 g and ubacillin 3 g, four times daily. Intravitreal antibiotic (vancomycin 1 mg/0.1 mL and ceftazidime 2 mg/0.1 mL) injections were performed in both eyes. Two weeks post presentation, the best corrected visual acuity in both eyes improved to 0.7, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, intravitreal and intravenous antibiotics should be promptly administered to preserve vision.
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PMID:Bilateral endophthalmitis as the initial presentation of bacterial meningitis. 2004 99


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