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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The frequency, course and clinical significance of changes in regional cerebral blood flow (rCBF) during bacterial meningitis were investigated in 14 adult patients. The results of 99mTc-hexamethylpropylene amine oxime (HMPAO) single photon emission computed tomography (SPECT) were compared with the clinical signs and findings using cerebral angiography and conventional CT. HMPAO SPECT was performed 2-15 days (median 4.5 days) after the onset of neurological disease. Decreased HMPAO accumulation was detected in 13 patients. SPECT studies revealed focal hypoperfusion corresponding to the clinical symptoms in 6 patients suffering from hemiparesis or hemiataxia. Conventional cranial CT disclosed brain infarction in only 1 patient. Focal hypoperfusion was also found in 7 of 8 patients without clinical evidence of focal neurological deficits. In 6 patients, HMPAO SPECT findings were abnormal although cerebral angiography was normal. At follow-up examinations 3-45 weeks after the acute disease, abnormalities revealed by HMPAO SPECT had improved or had even disappeared in all patients studied. Our results indicate that reduced rCBF is a frequent finding in bacterial meningitis in the adult. In most patients it probably represents a functional and reversible disorder without structural lesion detectable on CT.
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PMID:Abnormalities of cerebral blood flow in the acute phase of bacterial meningitis in adults. 144 71

Cortical auditory evoked potentials (CAEP) were recorded from scalp electrodes in 47 patients, who survived to bacterial meningitis in their childhood. CAEP were obtained from 1 month to 8 years after recovering from acute disease. Neisseria meningitidis was the microorganism more frequently isolated from CSF (43.5%). Exclusively abnormal values in amplitude of CAEP were registered in 15 cases (32%), mainly at the lower tones explored; 14 of them were subjected to conventional audiometric test, which demonstrated unilateral hearing loss only in 2. No alterations in the latency of P2 wave were seen. We recommend to include CAEP in search of hearing disorders in younger children after recovering from meningitis, since they can detect lesions in cortical-subcortical auditory tracts, which otherwise could go unnoticed.
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PMID:[Cortical evoked auditory evoked potentials in a series of patients who had bacterial meningitis during childhood]. 343 55

We studied 30 patients with infectious sphenoid sinusitis (15 acute cases and 15 chronic cases) in an effort to characterize the clinical presentation, bacteriology, and associated complications of this frequently misdiagnosed infection. Severe frontal, temporal, or retro-orbital headache that radiated to the occipital regions or pain in the trigeminal (V1 to V3) distribution or both were the most prominent presenting symptoms. In acute cases, purulent exudate was frequently seen in the middle and superior nasal turbinates. Computerized axial tomography or sinus tomography and cannulation of the sphenoid sinus proved to be the most useful diagnostic studies. Organisms detected in acute cases included streptococci other than Streptococcus pneumoniae (41 per cent), Staphylococcus aureus (29 per cent), and Str. pneumoniae (17 per cent). In chronic infections, gram-negative bacilli (43 per cent) and staphylococcal species (24 per cent) were the predominant organisms. In acute disease, early diagnosis and aggressive therapy, including surgical drainage, were important. Delay in treatment was always associated with serious morbidity or mortality. Fatal complications included cavernous sinus thrombosis and bacterial meningitis.
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PMID:Sphenoid sinusitis. A review of 30 cases. 662 61

Bacterial meningitis is an acute disease with high mortality that is reduced by early treatment. Identification of the causative microorganism by culture is sensitive but slow. Large volumes of cerebrospinal fluid (CSF) are required to maximise sensitivity and establish a provisional diagnosis. We have utilised nuclear magnetic resonance (NMR) spectroscopy to rapidly characterise the biochemical profile of CSF from normal rats and animals with pneumococcal or cryptococcal meningitis. Use of a miniaturised capillary NMR system overcame limitations caused by small CSF volumes and low metabolite concentrations. The analysis of the complex NMR spectroscopic data by a supervised statistical classification strategy included major, minor and unidentified metabolites. Reproducible spectral profiles were generated within less than three minutes, and revealed differences in the relative amounts of glucose, lactate, citrate, amino acid residues, acetate and polyols in the three groups. Contributions from microbial metabolism and inflammatory cells were evident. The computerised statistical classification strategy is based on both major metabolites and minor, partially unidentified metabolites. This data analysis proved highly specific for diagnosis (100% specificity in the final validation set), provided those with visible blood contamination were excluded from analysis; 6-8% of samples were classified as indeterminate. This proof of principle study suggests that a rapid etiologic diagnosis of meningitis is possible without prior culture. The method can be fully automated and avoids delays due to processing and selective identification of specific pathogens that are inherent in DNA-based techniques.
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PMID:Rapid etiological classification of meningitis by NMR spectroscopy based on metabolite profiles and host response. 1939 Jun 97

Meningitis is defined as inflammation of the meninges, in almost all cases identified by an abnormal number of white blood cells in the cerebrospinal fluid and specific clinical signs/symptoms. Onset may be acute or chronic, and clinical symptoms of acute disease develop over hours to days. This article reviews the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of acute meningitis, and provides a list of key points for primary care practitioners. Aseptic and bacterial meningitis vary significantly and are discussed separately.
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PMID:Meningitis. 2395 65