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

We report a case of focal infection of the brain with cytomegalovirus (CMV) in a 14-year-old boy with metastatic lymphoepithelioma (nasopharyngeal carcinoma). Cytomegalovirus-bearing subependymal glia were only seen in the fourth ventricle, in close proximity to tumor cells, these were associated with an intense inflammatory cell exudate. The latter was due to enterococcal meningitis. There was no evidence of systemic CMV infection, and the typical encephalitis with glial nodules seen in acquired forms of the disease was lacking. We postulate that the infection gained access to the brain either with the tumor cells, which happened to carry CMV genome, or with virus-carrying polymorphonuclear leukocytes migrating to the bacterial meningitis. It is also possible that the proliferating subependymal glia were unduly susceptible to CMV when the host defense mechanisms were compromised.
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PMID:Localized cytomegalovirus encephalitis contiguous to metastatic nasopharyngeal carcinoma. 22 30

Previous studies of the value of the complete blood count (CBC) in distinguishing viral from bacterial infection in young febrile children have failed to exclude children with clinically evident bacterial infection and thus have inflated the positive predictive value of the test for occult focal infection. We prospectively studied 2492 children 3-24 months of age who presented to a children's hospital emergency department between March 1989 and August 1990 with fever (> or = 38.0 degrees C) of acute (< or = 4 days) onset but no evident bacterial focus of infection, 433 (17.4%) of whom received a CBC. We also carried out an 8-year retrospective analysis to estimate prior, or pre-test, probabilities (prevalences) and examine CBC results for rare occult bacterial infections (meningitis, osteomyelitis, and septic arthritis). Estimated prior probabilities for the four most common categories of infection that can be diagnosed at the initial visit were: non-pneumonitic viral infection, 88.6% in boys and 86.0% in girls; pneumonia, 8.5% in both sexes; urinary tract infection (UTI), 3.0% in boys and 5.5% in girls; and bacterial meningitis, 0.0066% in both sexes. The likelihood (sensitivity) of a total white blood cell (WBC) count > or = 15,000/mm3 was 25.5, 64.5, 62.5, and 50.0% for viral infection, pneumonia, UTI, and meningitis, respectively. Among children with a high total white blood cell count, neither a total polymorphonuclear count > or = 10,000/mm3 nor a band count > or = 500/mm3 was associated with significantly elevated likelihoods for occult pneumonia or UTI, a finding confirmed by multiple logistic regression analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of the complete blood count in detecting occult focal bacterial infection in the young febrile child. 848 99

Despite advances in antimicrobial and antiviral therapy, meningitis and brain abscess are infections that result in significant morbidity and mortality. A multidisciplinary approach, including intensive care, is often required in the treatment of these infections. Meningitis is defined by the presence of the inflammation of the meninges, with characteristic changes in cerebrospinal fluid. Brain abscess is a focal infection of the brain parenchyma, commonly caused by bacterial, fungal, and parasitic pathogens. This article reviews the common infectious etiologies of central nervous system infections, especially bacterial meningitis and brain abscess, and their subsequent management in the intensive care unit.
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PMID:Central nervous system infections: meningitis and brain abscess. 1966 86