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

Hemophilus influenza type b (Hib), Neisseria meningitides (Mnc), and Streptococcus pneumonia (Pnc) cause more than three-quarters of all cases of acute bacterial meningitis in developing countries. A controlled clinical trial was carried out to compare the efficacy at day 4 of a double intramuscular injection of long-acting chloramphenicol 100 mg/kg with that of ampicillin administered intravenously for 8 days at 200 mg/kg (4 times a day). The study was conducted from May 1989 to May 1990 in the pediatric ward of Hopital Gabriel Toure in Bamako, Mali, and from March 1989 to May 1990 in the infectious diseases ward of the Hopital National in Niamey, Niger. Patients assigned to the ampicillin group received a solution of isotonic sodium chloride intravenously for 8 days. The final series consisted of 528 cases (274 in the ampicillin group and 254 in the chloramphenicol group). In 44.9% (123) of those who received ampicillin, the drug was injected intramuscularly. Among children aged 3 years, 48.5% (128) of the cases were caused by Hib, 27.3% (72) by Pnc, 10.6% (28) by Mnc, and 4.5% (12) by other agents. Among patients aged or = 3 years, 50.4% (133) of the cases were caused by Mnc, 1.9% (5) by Hib; 16.3% (43) by Pnc, and 1.9% (5) by other agents. The cumulative case fatality rate (CFR) at day 4 was 28% for the chloramphenicol group vs. 24.5% for the ampicillin group. The germ- specific hospital CFR and rate of major neurological sequelae, respectively were as follows: 13% (21/161) and 4.9% (7/140) for N. meningitides; 36.1% (48/133) and 28.2% (24/85) for H. influenza; 67% (77/115) and 21% (8/38) for S. pneumonia; and 64.7% (11/17) and 0% (0/6) for the other agents (8 deaths out of 10 cases of salmonella). The very high hospital CFR, (42%), irrespective of the treatment given, was noteworthy. These results are indicative of an endemic, since no outbreak of meningococcal meningitis occurred in either place during the study.
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PMID:Long-acting chloramphenicol for bacterial meningitis. 844 31

Etiologic agents of meningitis were prospectively investigated among patients admitted to Usman Danfodio University Teaching Hospital, Sokoto. Of 1097 cerebrospinal fluid (CSF) samples submitted to the microbiology laboratory from various wards of the hospital, 289 (26%) were microscopically, culturally and/or serologically proven to be bacterial meningitis. The etiologic spectrum was as follows: Neisseria meningitidis (61%), Streptococcus pneumoniae (18%), Haemophilus influenzae (10%), Staphylococcus aureus (6%), Coliform bacilli (3%), Escherichia coli (0.7%), Mycobacterium tuberculosis (0.7%), Listeria monocytogenes (0.4%), Flavobacterium meningosepticum (0.4%) and Pseudomonas putrifasciens (0.4%). Bacterial meningitis was most prevalent (195 or 68%) among children aged 1-9 y, while adults and neonates were least affected. Coliform bacilli caused five of eight neonatal cases. Males were more frequently affected than females (chi2 = 12.50; p < 0.05). Culture and microscopy were comparatively less efficient than the search for bacterial antigens, especially in the diagnosis of Haemophilus meningitis. Antimicrobial susceptibility of N. meningitidis to ampicillin and benzyl penicillin reduced progressively over the years (F = 406.98; p < 0.001). Nineteen (11%) of the isolates (5 Meningococci, 7 Staph. aureus, 1 Haem. influenza and 6 others) showed simultaneous resistance to chloramphenicol, ampicillin and benzyl penicillin.
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PMID:Etiologic spectrum and pattern of antimicrobial drug susceptibility in bacterial meningitis in Sokoto, Nigeria. 1097 35

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

Thirteen children in whom electroencephalography revealed periodic lateralized epileptiform discharges in the acute phase of cerebral involvement were included in this study. Four were diagnosed as having influenza-associated encephalopathy, two nonherpetic limbic encephalitis, two theophylline-associated seizures, one Mycoplasma pneumoniae encephalitis, one acute encephalopathy, and one bacterial meningitis. All patients developed seizures; six developed hemiconvulsions. As to prognosis, two died, six had some neurologic sequelae, and five had no neurologic sequelae. Although periodic lateralized epileptiform discharges are not disease specific, the importance of these disorders had not been focused on as a cause of periodic lateralized epileptiform discharges.
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PMID:Periodic lateralized epileptiform discharges in children. 1469 11

An outbreak of an upper respiratory tract illness at a secondary school, which led to the hospitalisation of 23 cases, occurred in Ireland at the beginning of September 2003. Medical and laboratory examinations, initially for suspected meningitis, were carried out on the hospitalised cases and bacterial meningitis was ruled out. One hundred and seventy-nine students and teachers were interviewed and a retrospective cohort study was conducted among the sixth year students. One hundred and seven respondents met the case definition, but no associations were found between the environmental exposures investigated and illness. As it was before the expected influenza season, initial samples were not tested for influenza, but one month later the new influenza A/Fujian/411/2002 (H3N2)-like strain was confirmed and implicated in the outbreak. It was the first reported outbreak of influenza in Europe in the 2003 'winter' season and it demonstrated the need for vigilance for early and unexpected occurrence of influenza. It also provided valuable lessons for laboratory and epidemiological investigation and management of pre-season influenza.
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PMID:Lessons from a pre-season influenza outbreak in a day school. 1548 Dec 9

The hypothesis that brain damage during infancy causes pathological left-handedness was tested by assessing handedness in 182 survivors of childhood non-Hemophilus influenza type b bacterial meningitis in the Netherlands (mean age of 9.7 years). These children were selected randomly after clustering them into those with or without parental report on academic and behavioural problems. Medical records were obtained from the hospitals, while handedness and neurodevelopmental outcome were assessed at school age. Logistic regression analysis was used to study the relationship between a severity score of bacterial meningitis and handedness. Fifteen percent were left-handed. Severity of childhood bacterial meningitis was related to left-handedness (Odds ratio (OR) 6.2, 95% confidence interval (CI) 2.0-18.6 for those with a total severity score above the median as compared to those below). Compared to non-left-handed children, left-handed children had lower IQ (mean difference -6.6, 95% CI -12 to -1.2), tended to have lower vocabulary scores on WISC-r (-1.0, -2.1 to 0), and lower Beery scores on visual-motor integration (-4.9, -10.1 to 0.4). Left-handed children also tended to have more combined academic and behavioural limitations (OR 2.7, 95% CI 0.9-8.6), lower manual speed of the dominant hand (mean difference -9 taps, p < 0.05) and better manual steadiness in the non-dominant hand (mean difference of contact's time -2.7 s, p < 0.05). Left-handed post-meningitic children generally have worse neurodevelopmental outcome than non-left-handed survivors. Our results support the role of early life brain damage in left-handedness.
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PMID:Increased occurrence of left-handedness after severe childhood bacterial meningitis: support for the pathological left-handedness hypothesis. 1664 66

The aim of this study was to assess if differences in etiology and risk factors among 372 cases of bacterial meningitis acquired after surgery (PM) or in community (CBM) have impact on outcome of infected patients. Among 372 cases of bacterial meningitis within last 17 years from 10 major Slovak hospitals, 171 were PM and 201 CBM. Etiology, risk factors such as underlying disease, cancer, diabetes alcoholism, surgery, VLBW, ENT infections, trauma, sepsis were recorded and mortality, survival with sequellae, therapy failure were compared in both groups. Significant differences in etiology and risk factors between both groups were reported. Those after neurosurgery had more frequently Coagulase negative staphylococci (p<0.001), Enterobacteriaceae (p=0.01) and Acinetobacter baumannii (p=0.0008) isolated from CSF and vice versa Streptococcus pneumoniae (p<0.001), Neisseria meningitis (p<0.001) and Haemophillus influenza (p=0.0009) were more commonly isolated from CSF in CBM. Neurosurgery (p<0.001), sepsis (p=0.006), VLBW neonates (p=0.00002) and cancer (p=0.0007) were more common in PM and alcohol abuse (p<0.001) as well as otitis/sinusitis (p<0.001) and Roma ethnic group (p=0.001) in CAM. Initial treatment success was significantly more frequently observed among CAM (p<0.001) but cure after modification was more common in PM (p=0.002). Therefore outcome in both groups was similar (14.6% vs. 12.4%, p=NS).
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PMID:Comparison of postsurgical and community acquired bacterial meningitis--analysis of 372 cases within a nationwide survey. 1803 Feb 63

Fever with seizure, a common presentation with which a child may present to the emergency is mainly due to febrile seizure, but it may also be due to meningitis. This study was done to find out the incidence of meningitis and to find out whether lumbar puncture is necessary in different age groups of children presenting with first episode of fever with seizure. A prospective study was conducted in the emergency department of Kanti Children's Hospital. Children who presented with first episode of fever and seizure in the age group of 6 months to 5 years were included. Meningitis was diagnosed on the basis of either cytological and biochemical criteria or if a bacterial pathogen was isolated. Of the 175 children included, 17% were diagnosed to have meningitis. Cerebrospinal fluid was positive for a bacterial pathogen in 4.5% of the cases. In the age group of 6 months to 12 months, 30% of the children had meningitis as compared to 20 % and 5% in other age groups of 12- 18 months and above 18 months respectively. All children with culture proven bacterial meningitis were in the age group of 6-12 months and had no evidence of meningeal irritation. Signs of meningeal irritation had high specificity in diagnosing meningitis. Organisms grown were Haemophilus influenza in three cases, Streptococcus pneumoniae in two cases and Staphylococcus aureus in three cases. In conclusion, incidence of meningitis was found to be high in children presenting with first episode of fever and seizure. Lumbar puncture to rule out meningitis should especially be considered in children in the younger age group even without evidence of meningeal irritation.
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PMID:Children with first episode of fever with seizure: is lumbar puncture necessary? 1907 73

Pneumococcal disease in young children has not been as well characterized in East Africa as it has been in industrialized countries. Although pneumococci are likely to cause substantial mortality and morbidity, universal diagnostic challenges plus the rudimentary nature of public health surveillance make the true epidemiological characteristics of these diseases difficult to ascertain with these methods alone. However, local data are critical to inform the debate on vaccine deployment and assess vaccine impact. The Network for Surveillance of Pneumococcal Disease in the East African Region has worked to expand the World Health Organization Paediatric Bacterial Meningitis Surveillance Network-initiated surveillance process aimed at Haemophilus influenza type b to perform surveillance on pneumococcal diseases. A total of 119 H. influenzae isolates from children aged >2 years but <5 years of age have been confirmed. Eighty-three isolates (69.75%) were serotype b, 19 belonged to other capsular antigen groups, and 17 were nontypable. For Streptococcus pneumoniae, a total of 442 isolates were confirmed to be pneumococci; 302 isolates were from blood cultures, and 140 were from cultures of cerebrospinal fluid. Most of the isolates were obtained from patients in the 6-29-month age group; in this age group, overall coverage by the heptavalent vaccine was 56% (increasing to 67% with the addition of cross-protection due to serotype 6A). S. pneumoniae isolates are susceptible to most commonly used antibiotics, with the exception of trimethoprim-sulfamethoxazole, and have exhibited no resistance to penicillin. A surveillance network is in place to provide local data on the importance of S. pneumoniae as a cause of both meningitis and bacteremia. Serotypes in the currently available heptavalent conjugate pneumococcal vaccine and related serotypes account for two-thirds of invasive pneumococcal disease among children aged 6-29 months.
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PMID:Report on invasive disease and meningitis due to Haemophilus influenzae and Streptococcus pneumonia from the Network for Surveillance of Pneumococcal Disease in the East African Region. 1919 10

In 2006, the number of bacterial meningitis cases was estimated at 1375 (2.23/100,000). The leading pathogens involved in adult meningitis were, according to frequency, Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, Streptococcus agalactiae, and Haemophilus influenzae. The overall mortality rate averaged 20%, higher among patients with pneumococcal meningitis or in individuals over 65 years of age. Sequels were observed in 30% of cases and more frequent after pneumococcal meningitis. A decrease in susceptibility to antibiotics was reported for N. meningitidis, S. pneumoniae and H. influenzae. Generalized vaccination of children less than two years of age with H. influenzae type b conjugate vaccine has lead to a dramatic decrease in adult H. influenza meningitis. The few cases involved almost exclusively non-typeable strains, presenting in 12% of cases, a modified penicillin binding protein leading to a decreased susceptibility to aminopenicillins. Decreased susceptibility to amoxicillin was observed in 30% of meningococcal isolates, but all strains remained susceptible to parenteral third generation cephalosporins. Resistances to rifampicin or to ciprofloxacin, recommended in meningococcal meningitis prophylaxis, were unusual, but had to be documented. Finally, the proportion of pneumococcal strains with decreased susceptibility to beta-lactams has decreased since 2002. In adult meningitis, pneumococcal isolates with decreased susceptibility to penicillin, amoxicillin, and cefotaxime or ceftriaxone accounted for 37, 18, and 4% of cases respectively. It should be noted that for these isolates, no parenteral third generation cephalosporins MIC was above 2mg/l. Resistance to rifampin was very unusual and all pneumococcal isolates were fully susceptible to glycopeptides.
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PMID:[Epidemiology of acute bacterial meningitis in adult patients in France]. 1939 9


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