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

A child developed bacterial meningitis and shunt dysfunction 2 years after the insertion of a ventriculoperitoneal shunt for posttraumatic hydrocephalus. The distal end of the shunt catheter had penetrated the gastric wall. We found no other report of intragastric shunt catheter migration with successful treatment.
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PMID:Intragastric migration of a ventriculoperitoneal shunt catheter. 330 15

The diagnosis on the exclusion of infectious diseases of the central nervous system, especially of bacterial infections still is one of the most important issues in clinical microbiology. In bacterial meningitis, where lethal courses as well as severe sequelae are still frequent, there should be a rapid diagnosis not only with microscopy but also with Limulus test and antigen detection tests because a specific therapy should be initiated as soon as possible. But also viral infections caused by varicella or herpes virus are increasingly susceptible to chemotherapy. The indication for the examination of cerebrospinal fluid, the minimal volume for exhaustive laboratory tests and the possibilities of a stepwise diagnostic procedure are given with reference data from literature for the various techniques. In our experience the synopsis of laboratory results and clinical symptoms yielded in 75% of all cases the exclusion of an infectious etiology of the disease. In 17% a bacterial meningitis or the infection of a hydrocephalus shunt could be diagnosed. Viral infections could be proven in 4% either by antibody or by antigen detection. Only in 1% of all patients the clinical symptoms and the laboratory parameters remained unclear.
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PMID:[Microbiologic-immunologic laboratory diagnosis in suspected meningitis/encephalitis]. 331 73

Serial cranial ultrasound examinations were performed through the anterior fontanel to detect and follow the complications of bacterial meningitis in 16 neonates. The final results included normal findings in 9 patients, and abnormal in the other 7 cases. Among the latter, 5 patients with hydrocephalus were sequentially found after the second week of the disease and the earlier the onset, the larger the ventricular dilation. One ventriculitis showed polycystic loculi with abnormal septa in the advanced stage. Cystic low attenuation lesion with mass effect at a later stage of meningitis specified one patient with brain abscess. Progressive dilatation of ventricular systems without associated growth of head girth disclosed a process of brain atrophy. They had neither obvious neurological signs nor specific CSF findings clinically, but their sonograms showed the abnormal changes which were finally proved by CT scans. The potential value of cranial ultrasound in the detection of post-meningitic complication besides CT scan is stressed.
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PMID:Cranial ultrasound in the detection of postmeningitic complications in the neonates. 351 20

Ninety-two patients with hydrocephalus secondary to cysticercotic meningitis were followed for a mean period of 8 years 11 months. The mortality rate was 50%, with most patients dying within the first 2 years after cerebrospinal fluid (CSF) shunting. The prognosis was worse in females than in males. Multiple surgical procedures for shunt obstruction were necessary in half of the patients. Complications such as bacterial meningitis and shunt obstruction were more frequent in the patients who died than in those who survived. The follow-up data revealed that the clinical status was satisfactory in 78% of survivors and unsatisfactory in 22%. Spontaneous remission of the cysticercotic arachnoiditis, as shown by the CSF findings, occurred in only 18% of the cases. In most patients, arachnoiditis and positive immune reactions persisted unchanged even after several years. The results demonstrate the poor outcome of these patients and indicate the need for better medical and surgical therapy.
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PMID:Hydrocephalus secondary to cysticercotic arachnoiditis. A long-term follow-up review of 92 cases. 357 94

Computed tomography (CT) was performed in 14 cases of tuberculous meningitis (TBM), 12 of which were examined during the acute phase of the disease. CT findings in these cases included internal hydrocephalus (6/12), internal combined with external hydrocephalus (2/12), focal lesions consistent with localized encephalitis (3/12), diffuse brain edema (1/12), and middle cerebral artery infarction (1/12). In comparison to 32 cases of nonspecific bacterial meningitis, internal hydrocephalus was found significantly more often in TBM than in nonspecific meningitis (p less than 0.01) making CT an additional tool for the differentiation of these conditions in doubtful cases. In addition, CT features of 2 cases of cerebral tuberculoma are presented.
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PMID:Computed tomography in CNS tuberculosis. 394 92

This article describes four techniques for the noninvasive measurement of intracranial pressure in the newborn, and discusses common pitfalls in their use, and various pathologic states (for example, intraventricular hemorrhage, perinatal asphyxia, posthemorrhagic hydrocephalus, and bacterial meningitis) in which measurements of ICP have been demonstrated to be or are likely to be of value.
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PMID:Intracranial pressure measurements in the newborn. 397 87

C-reactive protein (C-RP) determinations were performed by using the latex slide agglutination test on cerebrospinal fluid (CSF) from 235 patients. The patients were categorized into the following groups: bacterial meningitis (n = 74); viral meningitis (n = 10); fever without bacterial meningitis (n = 80); neurological symptoms without infection (n = 25); intracranial hemorrhage (n = 10); increased intracranial pressure that was secondary to pseudotumor cerebri or hydrocephalus (n = 16); and malignancies (n = 20). On the initial lumbar puncture, the C-RP was positive in 97% (72 of 74) of the patients in group 1, as compared with 0% (0 of 10), 6% (5 of 80), 20% (5 of 25), 50% (5 of 10), 6% (1 of 16), and 30% (6 of 20) in groups 2-7, respectively (P less than .0001). The C-RP test was able to detect bacterial meningitis with a sensitivity of 97% (72 of 74), a specificity of 86% (139 of 161), a positive predictive value of 77% (72 of 94), and a negative predictive value of 99% (139 of 141). These data indicate that C-RP determinations performed on CSF are useful and rapid clinical tests for the exclusion of the presence of bacterial meningitis in a patient.
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PMID:The use of C-reactive protein from cerebrospinal fluid for differentiating meningitis from other central nervous system diseases. 398 20

Thirteen children with meningitis due to Haemophilus influenzae, beta-haemolytic streptococcus group B, Streptococcus pneumoniae, Staphylococcus epidermidis, Neisseria meningitidis, Escherichia coli, or Pseudomonas aeruginosa and who had been unsuccessfully treated with other antibiotics or had causative organisms which were resistant to available antibiotics were treated with intravenous cefotaxime. Nine children were cured; in one case infection (with a different organism) recurred but a further course of cefotaxime was successful; one child died, with sterile CSF; one child died from his underlying disease (astrocytoma); and one child was cured with sequelae (hydrocephalus). A further child with meningitis caused by E. coli had been treated unsuccessfully by intravenous and intraventricular chloramphenicol and gentamicin; intravenous and intraventricular cefotaxime was successful. The agent was well tolerated. CSF levels were measured in seven children and ranged from 300 to 27 200 microgram/l; published and unpublished in-vitro studies suggest that minimum inhibitory concentrations for cefotaxime against the organisms commonly causing bacterial meningitis are usually well below 250 microgram/l.
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PMID:Intravenous cefotaxime in children with bacterial meningitis. 610 14

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.
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PMID:[Scanography in purulent meningitis in newborn infants]. 622 58

During a five-year period, 24 patients' conditions (age range, 2 to 6 weeks) were diagnosed, and they were treated for bacterial meningitis. Organisms recovered from the CSF included group B Streptococcus (n = 6), Escherichia coli (n = 5), Listeria monocytogenes (n = 5), Hemophilus influenzae (n = 4), Streptococcus pneumoniae (n = 2), and group D and group A Streptococcus (one each). Initial antimicrobial therapy must include antibiotics that are effective across this spectrum of potential pathogens. Symptoms and signs were often subtle. Six children (25%) experienced major neurologic residua, including five patients (21%) in whom hydrocephalus developed. Ultrasound examination of the head at the end of therapy was an effective technique for early assessment of neurologic sequelae.
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PMID:Bacterial meningitis in older neonates. 635 81


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