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

To investigate the present state and the disadvantages of rapid diagnosis methods in clinical microbiology in Japan, We have conducted a questionnaire survey of 360 medical facilities accredited by the Japanese Association for Rapid Method and Automation in Microbiology (JARMAM). Major rapid diagnosis methods being used in clinical microbiology are, in the order of its use rate, influenza virus, adenovirus, Mycobacterium tuberculosis, Clostridium difficile toxin A, Rotavirus, hepatitis B virus, group A Streptococcus, RS virus, hepatitis C virus antibody. The fact found by this survey is that there is some gap between two groups, as one group views that the result of rapid diagnosis method can be considered as the final, another views that it is a supplementary diagnosis under conventional methods such as culturing. Some problems related to rapid diagnosis methods are also pointed out; how to interpret and report a test result obtained by the rapid diagnosis method when it is different from that of culture method, it can not perform antibiotic sensitivity tests, a problem of non-specific reaction, comparatively higher cost of rapid diagnosis kits. This survey finds that rapid diagnosis methods have greatly contributed to early medical treatment and appropriate therapy with its quickness, such as the use of rapid diagnosis kits for bacterial meningitis or viral infectious diseases requiring clinical urgency is highly necessitated even though some problems mentioned above exist.
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PMID:[Present state and disadvantage of rapid diagnosis method in clinical microbiology--analysis of questionnaire survey]. 1450 45

Candida species, including Candida dubliniensis, are a rare cause of meningitis. Herein, we report the second case of C. dubliniensis meningitis in a 49-year-old man with a history of hepatitis C virus-related cirrhosis, substance use disorder, and recent exposure to intravenous antibiotic therapy, presenting with confusion, abnormal gait, and urinary incontinence. Magnetic resonance imaging (MRI) of the brain showed marked hydrocephalus and leptomeningeal enhancement. Initial cerebrospinal fluid (CSF) studies were concerning for bacterial meningitis, although cultures were negative. Despite empiric treatment with broad-spectrum antibiotics, the patient's mental status declined. The diagnosis of C. dubliniensis meningitis was not made until the third lumbar puncture. The patient was treated with liposomal amphotericin B and flucytosine. Despite improvement of hydrocephalus on MRI of the brain and sterilization of CSF, the patient's mental status declined and he expired. This case highlights the difficulty in the diagnosis of C. dubliniensis meningitis as multiple lumbar punctures may be necessary. C. dubliniensis meningitis should be considered in the differential diagnosis for a patient with risk factors such as end-stage liver disease, human immunodeficiency virus infection, recent chemotherapy, substance use disorders, and recent broad-spectrum antibiotic use. A high index of suspicion is necessary as delay in initiation of therapy is associated with high mortality. The optimal treatment strategy has not been determined.
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PMID:Meningitis Caused by Candida Dubliniensis in a Patient with Cirrhosis: A Case Report and Review of the Literature. 2703 12