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

Cardiac hemodynamics were assessed by right and left heart catheterizations in nine patients on hemodialysis. Results showed increased stroke work index and left ventricular work indices. Left ventricular end-diastolic pressure was elevated in all patients (markedly so in five) and did not fall with occlusion of arteriovenous communications. Cardiac output was significantly elevated, but fell to normal postocclusion. Myocardial oxygen consumption, indirectly assessed by tension time and pressure rate indices, appeared increased. Six patients died: four from complications attributed to myocardial failure without infarction, one from transplant-related complications, and one from bacterial meningitis. Five had increased cardiac weights at autopsy, but none showed infarction. This study suggests that increased cardiac work is present in chronic renal failure. Myocardial mass increases result in increased myocardial oxygen demand; however, the increased oxygen requirements may not be met because of reduced erythrocyte mass. Persistance of pressure-volume overload and severe anemia are conducive to myocardial failure.
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PMID:Cardiac work demands and left ventricular function in end-stage renal disease. 13 18

We report the first case of Haemolytic-uraemic syndrome (HUS) associated with Streptococcus pneumoniae meningitis. This supports a common pathogenic mechanism in HUS following infections by neuraminidase-producing organisms and in pneumococcal meningitis. We recommend that HUS must be considered in cases of renal failure and/or anaemia associated with pneumococcal meningitis, and that bacterial meningitis be considered in all patients with HUS and central nervous system involvement.
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PMID:Haemolytic-uraemic syndrome associated with Streptococcus pneumoniae meningitis. 274 37

The authors studied in the Paediatric Department of the Leverkusen Municipal Hospital retrospectively the influence of an early dose of antibiotics (broad-spectrum penicillin combined with an aminoglycoside) in respect of the manifestation of bacterial newborn infections in infants with an increased risk of infection, during a period of 3 years (1981-1983). Among the infants born in the Gynaecological Department of the Leverkusen Municipal Hospital (exact data were available on the number of births and referrals) the incidence of bacterial newborn infections was 3.3% referred to the total number of deliveries (n = 3598); 0.7% of these newborn has sepsis. In the total group of children treated for newborn infection, the infection mortality was 5.5%; the mortality of the manifest newborn sepsis was 16.2%, i.e. lower than reported in literature. Early administration of antibiotics proved particularly effective in preventing purulent bacterial meningitis of newborn; this disease did not occur with any of the infants observed during the study period. Diagnosis of newborn infection included discolouration of the skin, respiratory disturbances, fever, shift to the left in the differential blood picture, and anaemia; these signs proved particularly suitable for arriving at a correct diagnosis. Identification of the pathogens was most frequently successful in gastric juice culture and anal smear. The latency period of more than 24 hours between rupture of the amnion and delivery does not represent an increased risk of infection for the newborn, as our results confirm, and this is, therefore, not an indication for initiating prophylaxis with antibiotics if there are no other abnormal findings.
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PMID:[Neonatal septicemia and bacterial neonatal infection. Manifestation and course in early antibiotic therapy]. 395 62

The hematologic values in patients with Haemophilus influenzae meningitis were contrasted with those of patients with other types of bacterial meningitis and aseptic meningitis in an attempt to determine whether anemia is either specific for or more common in patients with H influenzae meningitis. Patients with H influenzae meningitis had significantly lower admission hemoglobin values because they were significantly younger than the other two groups. The H influenzae meningitis patients with the lowest hemoglobin values on admission had been sicker for longer periods prior to diagnosis and had higher initial white cell counts. Patients with H influenzae meningitis, aged 3 to 24 months, developed lower hemoglobin values during hospitalization than did patients with other forms of meningitis. Anemia occurs with all forms of bacterial meningitis but is uncommon in aseptic meningitis. The anemia observed in patients with H influenzae meningitis, particularly those less than 2 years of age, is generally more severe than that observed in other forms of bacterial meningitis.
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PMID:Anemia with Haemophilus influenzae meningitis. 737 33

Children with bacterial meningitis often have a full blood count (FBC) measured urgently on admission. We investigated whether urgent FBC gave results that aided immediate management or predicted outcome in children with meningitis. FBCs were measured on admission during 190 episodes of bacterial meningitis in children admitted between 1984 and 1991. Significant anaemia was found in seven children, but immediate transfusion was only necessary in the three subjects who were in the Paediatric Intensive Care Unit (PICU). A white blood count of less than 5 x 10(9) L-1 was significantly associated with death (P < 0.02), but a Glasgow Coma Score of less than 8 predicted death more accurately (positive predictive value of 40%). FBC yielded immediately useful information only in the 15% of children who were admitted to PICU. Conscious level was a better predictor of outcome than FBC. We recommend that urgent FBC should be performed in children with meningitis admitted to a PICU; in other children with meningitis FBC can be analysed during normal laboratory hours.
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PMID:Urgent full blood count in children over 3 months of age with bacterial meningitis. 758 8

Sixty-one episodes of Salmonella meningitis were identified during a 3-year period from February 1996 to January 1999 inclusive. These accounted for 6.8% of all the acute bacterial meningitis cases seen during this time. In contrast, only two children were admitted with Salmonella meningitis in 1982. The increase may reflect the rise in HIV disease and the associated increase in Salmonella septicaemia. All but one child were under 2 years of age, only six children were well nourished and anaemia was common. The prognosis was poor: 33 (58%) died, 19 made a full recovery and five developed sequelae. Two children relapsed, one of whom died. Patients were routinely treated with chloramphenicol, to which all isolates were sensitive in vitro. The poor outcomes suggest that an alternative antibiotic policy is required.
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PMID:Salmonella meningitis in children in Blantyre, Malawi, 1996-1999. 1082 12

In this study we aimed to investigate the findings in patients with adult-onset Still's disease (AOSD) admitted with fever of unknown origin (FUO) during the last 18 years in our unit, in order to discover the ratio of such patients to all patients with FUO during the same period, and to determine the clinical features of AOSD in FUO. The number and the aetiologies of the patients with FUO diagnosed between 1984 and 2001, and the clinical features of those with AOSD, were taken from the patient files. The diagnosis of AOSD was reanalysed according to the diagnostic criteria of Cush et al. [11]. The presumed diagnoses before a diagnosis of AOSD was established were also noted. The chi(2) and Fisher's exact tests were used for statistical analysis. We studied 130 patients with a diagnosis of FUO, 36 (28%) of whom had collagen vascular diseases. Of these 36 patients, 20 (56%, 12 female, 8 male, mean age 34 years, range 16-65) had AOSD. Clinical and laboratory findings were as follows: fever (100%), arthralgia (90%), rash (85%), sore throat (75%), arthritis (65%), myalgia (60%), splenomegaly (40%), hepatomegaly (25%), lymphadenopathy (15%), anaemia (65%), neutrophilic leukocytosis (90%), increased erythrocyte sedimentation rate (100%), elevated transaminase levels (65%), a negative RF (100%), and a negative FANA (80%). Antibiotics had been prescribed in 18 (90%) of cases. The presumed infectious diagnoses were streptococcal tonsillitis/pharyngitis (50%), infective endocarditis (four patients), sepsis (two patients) and acute bacterial meningitis (two patients). The presumed non-infectious diagnoses were acute rheumatic fever (three patients), seronegative rheumatoid arthritis (two patients) and polymyositis (two patients). Sixteen patients were followed for a mean duration of 30 months (range 2-59). A remission was obtained with indomethacin in three cases (19%), and with prednisolone in the remainder. Relapse was detected in three cases (19%). AOSD is one of the most frequent aetiologies of FUO. During the diagnostic course of a patient with FUO, a maculopapular rash and/or arthralgia and/or sore throat should raise the suspicion of AOSD. Because the disease has heterogeneous clinical findings, certain bacterial infections (e.g. streptococcal pharyngitis and sepsis) are generally considered and the prescribing of antibiotics is common.
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PMID:Fever of unknown origin: a review of 20 patients with adult-onset Still's disease. 1274 Jun 70

Although the roles played by systemic tumour necrosis factor (TNF) and interleukin 1beta (IL-1beta), and their upregulation of intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and E-selectin, in the pathogenesis of human cerebral malaria (CM) are well established, the role of local cytokine release, in the brain, remains unclear. Immunohistochemistry was therefore used to compare the expression of ICAM-1, VCAM-1, E-selectin, IL-1beta, TNF and transforming growth factor beta (TGF-beta) at light-microscope level, in cryostat sections of cerebral, cerebellar and brainstem tissues collected, post-mortem, from Ghanaian children. Among the 21 children investigated were 10 cases of CM, five of severe malarial anemia (SMA), one of purulent bacterial meningitis (PBM), two of non-central-nervous-system infection (NCNSI) and three children who had no infection (NI) when they died. Parasitised erythrocytes were detected in all of the sections from the cases of fatal malaria (CM and SMA), and sequestered leucocytes were present in most of the sections from the CM cases (but none of the sections from the SMA cases). Significantly elevated vascular expression of all three adhesion molecules investigated was detected in the brains of the 15 cases of fatal malaria and one of the cases of NCNSI (a child with Salmonella septicaemia), and in the malaria cases this showed highly significant co-localization with the areas of erythrocyte sequestration. In terms of the levels of expression of ICAM-1, VCAM-1 and E-selectin, there were, however, negligible differences between the CM and SMA cases. Although TGF-beta showed intravascular and perivascular distribution in all the subjects, its expression was most intense in the PBM case and the CM group. Only in the sections from the PBM and CM cases did TNF and IL-1beta show prominent brain parenchymal staining, in addition to the intravascular and perivascular staining seen in all subjects. The highest observed expression of each of the six antigens studied was in the cerebellar sections of the malaria cases. Endothelial activation in the brain therefore appears to be a feature of fatal malaria and Salmonella sepsis, and in cases of fatal malaria is closely associated with leucocyte sequestration. In the present study, IL-1beta and TNF were only up-regulated in the brains of children with neurodegenerative lesions, whereas TGF-beta was present in all cases.
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PMID:High-level cerebellar expression of cytokines and adhesion molecules in fatal, paediatric, cerebral malaria. 1621 98

Although the role of systemic proinflammatory cytokines, IL-1beta and TNF-alpha, and their up-regulation of adhesion molecules, ICAM-1, VCAM-1 and E-Selectin, in the pathogenesis of cerebral malaria (CM) is well established, the role of local cytokine release remain unclear. Immunohistochemistry (IHC) was used to compare the expression of ICAM-1, VCAM-1, E-Selectin, IL-1beta, TNF-a and TGF-beta at light microscopic level in cerebral, cerebellar and brainstem postmortem cryostat sections from 10 CM, 5 severe malarial anemia (SMA), 1 purulent bacterial meningitis (PBM), 2 non-central nervous system infections (NCNSI) and 3 non-infections (NI) deaths in Ghanaian children. Fatal malaria and Salmonella sepsis showed significantly higher vascular expression of all 3 adhesion molecules, with highly significant co-localization with sequestration in the malaria cases. However, there was negligible difference between CM and SMA. TGF-beta showed intravascular and perivascular distribution in all cases, but expression was most intense in the PBM case and CM group. TNF-alpha and IL-1beta showed prominent brain parenchymal staining, in addition to intravascular and perivascular staining, in only the PBM case and CM group. The maximal expression of all 6 antigens studied was in the cerebellar sections of the malaria cases. Endothelial activation is a feature of fatal malaria and Salmonella sepsis, with adhesion molecule expression being highly correlated with sequestration. IL-1beta and TNF-alpha are upregulated in only cases with neurodegenerative lesions, whilst TGF-beta is present in all cases. Both cytokines and adhesion molecules were maximally upregulated in the cerebellar sections of the malaria cases.
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PMID:Cytokines and adhesion molecules expression in the brain in human cerebral malaria. 1670 10

Haemophilus influenzae is a gram-negative bacteria. The capsular form of this bacteria, mainly type b, is responsible for severe bacterial meningitis. In the study course of Haemophilus influenzae meningitis in two children was presented. In one of these children the clinical course of meningitis was particularly serious. The child was unconscious, the generalized swellings, pneumonia, increase and damage of liver, diarrhoea, heavy anaemia as well as disorders of blood coagulation were observed. In second child the beginning of disease was not characteristic, what delayed the proper diagnosis. The duration of children treatment was from 16 to 18 days. The permanent damages of central nervous system were not observed in both children
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PMID:[Haemophilus influenzae infections in children]. 1768 59


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