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

Based on a review of medical records, we have analysed the outcome after bacterial meningitis among 875 patients admitted during the period 1966-1976. The outcome was evaluated not only by fatality during admission or within 4 weeks after discharge, but also by neurological sequelae at the time of discharge. These two types of outcome were determined and compared in subgroups of patients categorised according to a number of features of prognostic significance. This has allowed us to quantify the clinical conditions and features with regard to the severity of the prognosis. In most subgroups of patients, the frequencies of fatality and sequelae followed the same patterns: High frequencies were associated with pneumococcal meningitis, rare bacterial aetiologies, increasing age, affected consciousness on admission, pneumonia on admission, convulsions during admission, and respiratory problems during admission. For some prognostic features, a correlation could be established with high sequelae rates, but not with high fatality rates. This was the case with increased duration of disease symptoms before admission, with alcoholism and with previous head trauma. Thus, this correlation revealed the importance of early hospitalisation. We find that the analysis of sequelae not only supports, but also adds important prognostic information to the results obtained by an analysis of fatality itself in this large retrospective clinical study.
 ...
PMID:Neurological sequelae and fatality as prognostic measures in 875 cases of bacterial meningitis. 334 49

During the years 1966-1976, 875 patients were treated for bacterial meningitis at the University Clinic for Infectious Diseases, Copenhagen. By about January 1, 1980, all 782 surviving patients had been traced. 87 had died in the observation period of four to 15 years. Mortality in the years following meningitis was studied by means of a comparison with the expected mortality in a matched normal population, using a computer program for the determination of late excess mortality. Late excess mortality was significantly increased during the first two years following discharge after meningitis and was of the same magnitude in the major etiological groups. The cumulative five-year late excess mortality rate was higher in the group of patients between 30 and 60 years, in those transferred from other hospitals, in those in coma or somnolence on admission and in those developing convulsions during hospitalization. In the group of patients aged 30 to 60 years, 11 patients died during the first two years after discharge. In nine of these cases, the main cause or the concomitant causes of death were conditions predisposing to infections or bacterial meningitis. The frequency of the causes of death in the 87 patients who died was not significantly different from that among the general Danish population.
 ...
PMID:Mortality in the years following bacterial meningitis. 371 May 93

Serum creatine kinase was assessed in 94 consecutive patients without convulsions admitted to hospital due to suspicion of infection of the central nervous system. No reliable discrimination between patients with aseptic and those with bacterial meningitis was obtained. Patients with bacterial meningitis and brain oedema, as well as patients with encephalitis, had significantly higher values (P less than 0.01) than patients with meningism, aseptic meningitis and bacterial meningitis without cerebral oedema. Very high values, above 2500 U/1, were encountered in only the most severe cases of bacterial meningitis. The highest serum CK value found in patients with encephalitis was 725 U/l. Reference values for control patients with meningism were 16-269 U/1. In a subset of 9 patients creatine kinase isoenzyme analysis was performed. In all cases only muscle type (MM) isoenzyme was found.
 ...
PMID:Creatine kinase in the serum of patients with acute infections of the central nervous system. 400 61

Brain CT scans of 40 neonates with bacterial meningitis showed that the main lesions consisted of obstacles to CSF flow resulting in hydrocephalus during the second month; single or multiple foci of ischaemia of very early onset appearing as hypodense areas sometimes contrast-enhanced, and abscesses consecutive to haematogenous septic necrosis. The organisms responsible for these abscesses usually were Proteus spp., more rarely other enterobacteria. Attention is drawn to the usefulness of CT in detecting the nature and size of lesions which are often clinically silent, except for convulsions.
 ...
PMID:[Scanography in purulent meningitis in newborn infants]. 622 58

Cerebrospinal fluid prostaglandin F2 alpha (CSF PGF2 alpha) levels were measured by radioimmunoassay in children as follows: Febrile convulsions (31 cases), epilepsies (32 cases), meningitides (31 cases) and non-neurological diseases (20 cases), totaling 114 cases. A 4.5-fold increase in CSF PGF2 alpha levels was seen in simple febrile convulsion, and a 2.5-fold increase in those with complex febrile convulsion as compared to those with non-neurological diseases. On the other hand, no increase in CSF PGF2 alpha levels was seen in children with epilepsy. When the body temperature was normal, the mean CSF PGF2 alpha levels showed no relation with age. When the body temperature was between 37.5 degrees C and 40 degrees C, the CSF PGF2 alpha levels in infants were higher than those in older children. The CSF PGF2 alpha levels in children with meningitis were high. The mean CSF PGF2 alpha levels in bacterial meningitis were not statistically (p greater than 0.05) different from those in viral meningitis. The CSF PGF2 alpha levels in meningitis were high on admission and gradually decreased with therapy. The results of our studies indicate that PGF2 alpha of the central nervous system markedly increased in infants and children with febrile convulsions or meningitis but not in those with epilepsy.
 ...
PMID:Prostaglandin F2 alpha concentrations in the cerebrospinal fluid of children with febrile convulsions, epilepsy and meningitis. 657 59

Acute bacterial meningitis still represents a therapeutic problem. Successful management depends on early administration of large doses of bactericidal antibiotics and adequate treatment of complications, i.e. shock, acute cerebral edema, consumption coagulopathy, convulsions and electrolyte disturbances. Meningitis caused by Neisseria meningitidis or Streptococcus pneumoniae should be treated with benzylpenicillin. If benzylpenicillin cannot be given, chloramphenicol has remained the best substitute. However, cefuroxime or ceftriaxone now seems to offer an alternative to chloramphenicol. The prevalence of beta-lactamase-producing Haemophilus influenzae strains is increasing and chloramphenicol has replaced ampicillin in the treatment of H. influenzae meningitis. Recent studies indicate that cefuroxime, ceftriaxone or moxalactam may be as effective as chloramphenicol in this type of meningitis. In neonatal meningitis, cefotaxime or moxalactam may constitute alternatives to the present regimens with ampicillin-gentamicin, gentamicin-chloramphenicol, cotrimoxazole or gentamicin. Promising results have also been obtained with cefotaxime or moxalactam in elderly patients with meningitis due to Gram-negative enteric bacilli. However, more extensive studies are needed to determine the role of the newer cephalosporins in the treatment of acute bacterial meningitis.
 ...
PMID:Treatment of acute bacterial meningitis with special emphasis on beta-lactam antibiotics. 659 56

During the years 1966-1976, 875 patients with bacterial meningitis were treated at the Department of Infectious Diseases, Rigshospitalet, Denmark. In late 1979 and early 1980 a survey by questionnaire was conducted among survivors concerning the impact of the disease. Replies were received from 667 patients (96.4 per cent). The most common complaints after meningitis were headache (32 per cent) inability to concentrate (31 per cent), altered working capability (33 per cent) and loss of memory (24 per cent). Approximately 20 per cent suffered from impaired hearing, visual disturbances and dizziness. Five per cent had convulsions. Each questionnaire was evaluated for sequelae, and when present these were rated as mild, medium or severe. One-third of the patients had sequelae and in 6 per cent these were severe. Sequelae were most commonly associated with drowsiness, coma, agitation and confusion on admission to hospital.
 ...
PMID:Sequelae from bacterial meningitis and their relation to the clinical condition during acute illness, based on 667 questionnaire returns. Part II of a three part series. 660 3

The ratio of glutamine to homocarnosine (G/H ratio) in CSF of children with meningeal pathology or convulsions was measured and the following results were obtained. 1. The mean G/H ratio of normal subjects was 83.0 +/- 41.4. 2. The mean G/H ratios of the patients with bacterial meningitis and meningeal leukemia were 115.9 +/- 81.9 and 115.2 +/- 49.2, respectively. Significant differences were found between those in normal subjects and these diseases. 3. The mean G/H ratio of the patients with viral meningitis was 80.0 +/- 35.1 and no significant difference was found between normal subjects and these patients. 4. The mean G/H ratios in the patients with controlled versus uncontrolled epilepsy were 130.9 +/- 67.1 and 74.8 +/- 49.4, respectively. A significant difference was found between normal subjects and the patients with controlled epilepsy. 5. The mean G/H ratio in the patients with febrile convulsions was 46.5 +/- 6.3. A significant difference was found between normal subjects and these patients. These data suggest that a high G/H ratio in CSF may indicate the excited state of the brain.
 ...
PMID:Brain function estimated from the ratio of glutamine to homocarnosine levels in cerebrospinal fluid. 666 Apr 25

CSF obtained for clinical purposes from newborn, children and adults has been analysed by high pressure liquid chromatography for hypoxanthine, xanthine, inosine, uridine and urate. Large rises in hypoxanthine and to a lesser extent xanthine occur for about 24 h after hypoxia. High concentrations were associated with later evidence of brain damage or subsequent death. Changes in CSF could be independent of those in plasma. Small or negligible rises were associated with localised and generalised infections including bacterial meningitis, fits, or both. Marked and rapid rises were found after death. These estimations may "predict" the extent of brain damage or brain death.
 ...
PMID:Cerebrospinal fluid concentrations of hypoxanthine, xanthine, uridine and inosine: high concentrations of the ATP metabolite, hypoxanthine, after hypoxia. 668 17

The clinical and laboratory date on 115 pediatric patients with bacterial meningitis are presented. Sixty-one were less than 12 mo of age including 13 less than 1 mo of age. Thirty-nine children were treated prior to admission with antimicrobial agents which obscured accurate bacteriologic diagnosis in eight of them. Gram-negative enteric bacteria, mainly Escherichia coli, were recorded in 9 of 13 neonates. Hemophilus influenzae type B accounted for 56 (52%) of all isolated recorded in those greater than 2 mo of age, of which 35% were resistant to chloramphenicol. Seventy-eight patients (73%) recovered completely following 10 to 14 days of antimicrobial therapy. Fifteen patients died, most of whom were less than 1 yr of age, including five neonates. Major neurologic sequelae included subdural effusions, cerebral abscesses and recurrent convulsions. This study, which documents the infrequency of Streptococcus group B and H. influenzae as etiological agents of neonatal meningitis, indicates that treatment of this disease with ampicillin and an aminoglycoside is efficacious. Chloramphenicol may be the drug of choice in the postnatal period, since H. influenzae is partly resistant to ampicillin.
 ...
PMID:Bacterial meningitis. A follow-up study of 115 children. 692 Nov 77


<< Previous 1 2 3 4 5 6 7 Next >>