Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 36-month period 83 cases of bacterial meningitis were seen, giving an overall annual incidence rate of 134 per 10(5) population. The highest incidence was seen in infants (930 per 10(5) infants) and 59% of the patients were 0-5 years of age (incidence rate 207 per 10(5) children). Pathogens were successfully identified in 80% of the cases, by employing a combination of microscopy and antigen detection using a commercially available latex agglutination kit. Neisseria meningitidis was identified in 58%, Streptococcus pneumoniae in 29%, Haemophilus influenzae type b in 11% and dual infection with H. influenzae type b and S. pneumoniae in 3% of the cases. Serogrouping was successfully performed on cerebrospinal fluid (CSF) deposits from 8 cases of meningococcal meningitis; 7 belonged to serogroup C and 1 to serogroup Y. There was a significant difference in the geometric mean age of meningitis caused by the three organisms. There was no seasonal or geographical clustering of cases caused by N. meningitidis. Although admissions for severe pneumonia in children less than 5 years of age peaked during the cold dry season (July-October), this was not associated with a similar peak in meningitis admissions caused by H. influenzae or S. pneumoniae. The overall case fatality rate was 15.7%, and the highest case fatality rate was found in infants (28%). Meningitis caused by H. influenzae was associated with the highest case fatality rate (29%) and N. meningitidis with the lowest (8%), but the difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The epidemiology of bacterial meningitis occurring in a Pacific Island population. 805 50

There is scant information about the etiology and epidemiology of bacterial diseases of infants and children in China because of very little success with bacterial culture. This study describes the severity of abuse of antibiotics among Chinese pediatricians and this abuse's potential interference in determining the etiology of bacterial diseases. According to a survey in Beijing Children's Hospital more than 98% of the patients in the Outpatient Department who were diagnosed with common cold were given antibiotics by physicians. More than one-third of the patients had been taking antibiotics before coming to the hospital. Using a sensitive Staphylococcus aureus assay we found that 70% of blood samples and 43% of cerebrospinal fluid samples from the patients with bacterial meningitis and pneumonia contained antibacterial activity. Bacteria were recovered significantly less often from the samples with antibacterial activity than from those who did not from which antibiotic was not recovered, both in blood (5.3% vs. 12.5%) and in cerebrospinal fluid (2.5% vs. 14.8%). This study indicates that antibiotic abuse is a severe problem in China and that judicious use of antibiotics is urgently needed.
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PMID:Abuse of antibiotics in China and its potential interference in determining the etiology of pediatric bacterial diseases. 810 25

Sudden, explosive headache is rather rare. Though dramatic for the patient and the physician, it does not necessarily herald an intracranial catastrophe. Benign and dangerous thunderclap headaches cannot be distinguished from the features of headache itself, but rather on the basis of the situation, the additional symptoms and the findings. This means that every sudden headache should be considered potentially dangerous and be investigated immediately. The dangerous forms comprise intermittent hydrocephalus, acute bacterial meningitis and above all vascular complications. Subarachnoid hemorrhage frequently must be ruled out by computed tomography and lumbar puncture. Intracerebral, especially cerebellar hemorrhage, as well as hypertensive crisis require immediate treatment. Fatal cerebral embolism complicating spontaneous dissection of craniocervical arteries (carotid or vertebral arteries) can be prevented by early anticoagulant therapy. To confirm diagnosis, additional investigations such as CT, lumbar puncture or cerebrovascular ultrasound, and in rare cases MRI, should be performed early as the available time for effective therapy in many situations is short. Many of the benign forms of sudden headache can be diagnosed with a focused interview (cold or drug induced and food dependent headaches, sinusitis, glaucoma). Others, such as neuralgia, cough and coital headache, can be diagnosed as benign only when additional investigations have ruled out symptomatic forms.
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PMID:[Acute headache]. 848 83

Here we report a case of pneumococcal meningitis with bilateral sensorineural hearing loss at the onset. The patient was a 60-year-old man who a few days before visiting our hospital experienced common cold-like symptoms, and then he suddenly developed bilateral hearing loss. Examination of the cerebrospinal fluid (CSF) on the day of admission revealed pleocytosis and his CSF culture demonstrated pneumococci. Otorhinolaryngological examinations disclosed bilateral severe sensorineural hearing loss due to cochlear impairment. Many cases of bacterial meningitis concomitant with hearing loss have been reported, but a case of meningitis starting with sudden hearing loss is rare.
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PMID:[A case of adult meningitis with bilateral sensorineural hearing loss at the onset]. 939 67

Increased vascular permeability causing vasogenic brain edema is characteristic for many acute neurological diseases such as stroke, brain trauma, and meningitis. Src family kinases, especially c-Src, play an important role in regulating blood-brain barrier permeability in response to VEGF, but also mediate leukocyte function and cytokine signalling. Here we demonstrate that pharmacological inhibition of Src or c-Src deficiency does not influence cerebrospinal fluid (CSF) pleocytosis, brain edema formation, and bacterial outgrowth during experimental pneumococcal meningitis despite the increased cerebral expression of inflammatory chemokines, such as IL-6, CCL-9, CXCL-1, CXCL-2 and G-CSF as determined by protein array analysis. In contrast, inhibition of Src significantly reduced brain edema formation, lesion volume, and clinical worsening in cold-induced brain injury without decreasing cytokine/chemokine expression. While brain trauma was associated with increased cerebral VEGF formation, VEGF levels significantly declined during pneumococcal meningitis. Therefore, we conclude that in brain trauma blood-brain barrier tightness is regulated by the VEGF/Src pathway whereas c-Src does not influence brain edema formation and leukocyte function during bacterial meningitis.
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PMID:Differential regulation of blood-brain barrier permeability in brain trauma and pneumococcal meningitis-role of Src kinases. 1701 Mar 40

In September 2008, the Austrian Agency for Health and Food Safety (AGES) learned of an outbreak of diarrheal illness that included a 71-year-old patient hospitalized for gastroenteritis with a blood culture positive for Listeria monocytogenes. Three stool specimens provided by seven of 19 persons attending a day trip to a foreign city, including a final break at an Austrian tavern, yielded L. monocytogenes. All isolates were of serovar 4b and had fingerprints indistinguishable from each other. A cohort study revealed that the outbreak of gastroenteritis occurred among 16 persons who had eaten dinner at the wine tavern on September 6. Of the 15 persons who ate from platters of mixed cold-cuts, 12 (80%) developed symptoms of febrile gastroenteritis within 24-48 h. The median age of those who became ill was 62 years. A 72-year-old patient recovered from gastroenteritis but was hospitalized with bacterial meningitis on day 19 after the dinner. The epidemiological investigation identified the consumption of mixed cold-cuts (including jellied pork) at the wine tavern as the most likely vehicle of the foodborne outbreak (P = 0.0015). This hypothesis was confirmed by microbiological investigation of jellied pork produced by the tavern owner on September 3. L. monocytogenes was isolated from leftover food in numbers of 3 x 10(3)-3 x 10(4) colony forming units/g and was indistinguishable from the clinical outbreak isolates. Symptoms reported by the 12 patients included unspecified fever (12x), diarrhea (9x), headache (5x), vomiting (4x), body aches (2x) and sore throat (1x). Active case finding identified one case of rhombencephalitis (female, age 48) among another group of four guests, among whom only the patient and her asymptomatic husband had eaten jellied pork on September 6. This is the first outbreak of L. monocytogenes-associated gastroenteritis reported in Austria. The occurrence of a secondary case of meningitis (diagnosed on day 19 after consumption of jellied pork) indicates a significant risk of systemic listeriosis among elderly patients with febrile gastroenteritis caused by L. monocytogenes; antibiotic therapy should therefore be considered in such cases of documented listerial gastroenteritis.
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PMID:An outbreak of febrile gastroenteritis associated with jellied pork contaminated with Listeria monocytogenes. 1928 Jan 42

Bacterial meningitis is a medical emergency requiring prompt recognition and evaluation and urgent initiation of appropriate antibacterial therapy. However, early recognition of severe bacterial infection including bacterial meningitis is a challenge in infants. Two clinical forms are basically observed in infants and young children: firstly, clinical meningitis which is characterized by fever, usually greater than 39 degrees C, and poorly specific gastrointestinal signs such as refusal of feeding and/or vomiting; irritability, abnormal crying, bulging fontanel, unusual generalized seizures occurring before six months of age and lasting more than 10 min should draw the clinician's attention and lead him/her to perform a lumbar puncture and initiate antibiotics; secondly, severe sepsis which is characterized by tachycardia, cold and/or mottled limbs and sometimes leg pain which should suggest a meningococcal disease; it is quite urgent to administer rapid fluid loading and antibiotic treatment while postponing lumbar puncture before the septic cascade evolves towards septic shock, extensive hemorrhagic rash, and ischemic limbs. Given the relative frequency of viral self-limiting diseases and rarity of serious bacterial infections, guidelines were published to guide the clinician's decision when dealing with a febrile infant. However, an alternative to these guidelines was recently suggested with a more clinically oriented decision-making attitude appearing as efficient while limiting hospitalizations.
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PMID:[Clinical signs suggestive of bacterial meningitis in infants]. 1940 42

In the acute setting, the primary objective is to decide whether the headache is primary, secondary but benign (for example a headache associated with a cold), or secondary to a potentially life-threatening cause (subarachnoid hemorrhage (SAH), bacterial meningitis, intracranial hypertension). The cornerstone of headache diagnosis is the interview with the patient, followed by a thorough physical examination. These two first clinical steps determine the need for investigation, immediate with inpatient care or on an outpatient basis, and the treatment to recommend, acutely and for future attacks in the case of primary headache. The indication for referral to a neurologist for long-term follow-up is assessed. Headaches can be separated into four groups: (1) recent onset and thunderclap; (2) recent onset with progressive installation: (3) well known to the patient and episodic (attacks with headache-free periods, as in episodic migraine or cluster headache); and (4) chronic daily headaches (more than 3 months, more than 15 days of headache per month). Headaches with a recent onset and judged unusual or worrisome by the patient (even one with frequent headaches) must raise the suspicion of a secondary cause and need to be investigated. Headaches that continue for months or years are more often primary, but secondary causes need to be ruled out in certain cases.
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PMID:Acute headache in the emergency department. 2081 19

Laparoscopic donor nephrectomy has the advantages of less pain, early ambulation and shorter hospitalization compared to open donor nephrectomy. Kidney recipient surgery is, however, traditionally performed by open surgery. Our aim was to study feasibility and safety of laparoscopic kidney transplantation (LKT). After permission from Internal Review Board, LKT was performed in four patients. All kidneys were procured from deceased donors. Left kidney was used for LKT and transplanted in left iliac fossa while right kidney was used for standard open kidney transplantation (OKT). All transplantation procedures were performed successfully. Cold ischemia time varied between 4 h and 14 h. For LKT, mean time for anastomosis was 65 (range 62-72) min, mean operative time was 3.97 (range 3.5-5) h, mean blood loss was 131.25 mL (range 45-350) mL. Mean wound length was 7 cm in LKT group and 18.4 cm in OKT group. Delayed graft function was observed in one patient in each group. One patient was lost in OKT group due to posttransplant bacterial meningitis. At 6 months, both groups have comparable value of serum creatinine. In conclusion, LKT is technically feasible and safe. Long term outcome needs to be evaluated in a larger study.
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PMID:Laparoscopic kidney transplantation: an initial experience. 2223 53

Neisseria meningitidis is responsible for two major diseases: cerebrospinal meningitis and/or septicemia. The latter can lead to a purpura fulminans, an often-fatal condition owing to the associated septic shock. These two clinical aspects of the meningococcal infection are consequences of a tight interaction of meningococci with host endothelial cells. This interaction, mediated by the type IV pili, is responsible for the formation of microcolonies on the apical surface of the cells. This interaction is followed by the activation of signaling pathways in the host cells leading to the formation of a microbiological synapse. A low level of bacteremia is likely to favor the colonization of brain vessels, leading to bacterial meningitis, whereas the colonization of a large number of vessels by a high number of bacteria is responsible for one of the most severe forms of septic shock observed.
Cold Spring Harb Perspect Med 2013 Jun 01
PMID:Pathogenesis of meningococcemia. 2373 56


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