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

In 26 infants and children with septicemia or bacterial meningitis, significantly elevated plasma levels of elastase-alpha 1-proteinase inhibitor (E-alpha 1-PI) were present at time of recognition of infection, even in those patients with neutropenia (range of reference values: 25 to 190 micrograms/L, n = 142; patients: 444 to 2049 micrograms/L, n = 26). After initiation of therapy, normalization of E-alpha 1-PI levels was observed in all patients who recovered from infection. In addition, 18 of 19 children with bacterial meningitis had increased cerebrospinal fluid concentrations of E-alpha 1-PI above the range of normal (range of reference values: 0 to 39 micrograms/L, n = 62; patients: 30 to 3490 micrograms/L, n = 19); concentrations of E-alpha 1-PI in bacterial meningitis were significantly increased when compared with those in aseptic meningitis (range 25 to 194 micrograms/L; n = 15). In 30 patients with local bacterial infections (pneumonia, urinary tract infections, etc.), E-alpha 1-PI was also elevated. These data suggest that E-alpha 1-PI is a sensitive indicator of systemic and local bacterial infection in childhood.
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PMID:Elastase-alpha 1-proteinase inhibitor: an early indicator of septicemia and bacterial meningitis in children. 349

Ceftazidime was prospectively evaluated in the treatment of bacterial meningitis in 19 pediatric patients. Haemophilus influenzae type b (HIB) was the etiologic agent in 17 patients, and Streptococcus pneumonia and Neisseria meningitidis were the etiologic agents in one patient each. Ceftazidime was administered intravenously in a dosage of 150 mg/kg/day divided into eight hourly doses for a mean of 15 days (range, 14 to 22 days) for H. influenzae type b meningitis. The clinical and microbiologic response was appropriate in all cases. The mean ceftazidime CSF concentration was 6.7 micrograms/ml at approximately 2 hours following iv infusions. This concentration was 16- to greater than 100-fold the minimal bactericidal concentration determined for the isolated pathogens. These preliminary observations support ceftazidime as a candidate cephalosporin for the treatment of bacterial meningitis caused by H. influenzae. Additional study is required to further define its role in meningitis caused by S. pneumoniae and N. meningitidis.
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PMID:Treatment of bacterial meningitis with ceftazidime. 352 58

Cefuzoname (CZON, L-105) a newly developed cephalosporin, has broad spectrum on Gram-positive or -negative bacteria and may also be effective against Staphylococcus aureus against which third generation cephalosporins are largely ineffective. We studied the pharmacokinetics and clinical effects of CZON on infectious disease of children. The diseases we studied included 2 cases of bacterial meningitis and 1 case each of viral meningitis, enterocolitis, upper respiratory infection, pneumonia, and mycoplasmal pneumonia. CZON was administered by drip infusion. Dose levels were 20-53 mg/kg/30-60 minutes, 3 times a day. For 5 cases, was studied time course of concentrations of CZON in plasma. Median T 1/2 was 0.96 hour. Concentrations in cerebrospinal fluid (CSF) were studied in cases of pneumonia and bacterial meningitis. In the case of pneumonia the CSF concentration of CZON was 0.272 microgram/ml after 45 minutes, in the case of meningitis they were 0.155 microgram/ml after 5 hours. Both of these values were higher than MIC of 0.025 microgram/ml against Haemophilus influenzae which was isolated from a case of bacterial meningitis. This MIC was lower than that of cefotiam and cefazolin, as well as of cefmenoxime. Clinical effects were excellent on pneumonia, good on upper respiratory infection, fair on mycoplasmal pneumonia. CZON, however, was ineffective in the treatment of a case of bacterial meningitis from which a susceptible strain of H. influenzae was isolated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Studies on cefuzoname in the field of pediatrics]. 361 97

Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age less than 1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear greater than or equal to 10,000/mm3 and band count greater than or equal to 500/mm3) were correlated with bacterial infection by step-wise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.
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PMID:Fever in infants less than two months of age: spectrum of disease and predictors of outcome. 384 82

From 1977 to 1981, 18,642 cases of bacterial meningitis were reported to the Centers for Disease Control. We analyzed data from 27 states with full participation from 1978 through 1981. Hemophilus influenzae was the most frequent cause of bacterial meningitis (48.3%), followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%). Overall attack rates for males were greater than for females (3.3 v 2.6 cases per 10(5) population per year). Attack rates were highest in children under 1 year of age (76.7 per 10(5) population per year). Case-fatality ratios were highest for gram-negative and miscellaneous causes of bacterial meningitis (33.7%) and lowest for meningitis caused by H influenzae (6.0%). Neisseria meningitidis and S pneumonia meningitis occurred preponderantly during the winter, while H influenzae meningitis had peak activity in the spring and fall. Ampicillin resistance among H influenzae increased from 18.7% in 1978, to 23.9% in 1981. Serogroup B Neisseria meningitidis was the most common serogroup identified during the reporting period (51.1%), followed by serogroup C (22.3%), serogroup Y (5.8%), and serogroup A (4.7%) infections.
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PMID:Bacterial meningitis in the United States, 1978 through 1981. The National Bacterial Meningitis Surveillance Study. 387 69

In a 9-month prospective study conducted in an urban emergency room, 15 children with rectal temperature greater than 41.1 degrees C (106 degrees F) were evaluated. Seven of the 15 patients were admitted to the hospital. Two children who were discharged home required subsequent admission, and six were managed on an ambulatory basis. Eight (53.3%) children had serious disease: two bacterial meningitis, two bacteremia without meningitis, two pneumonia, one pericarditis with effusion, and one Kawasaki disease. In four, the final diagnosis indicated a much more serious illness than was considered initially. The laboratory studies did not correlate reliably with the final diagnosis or need for admission. Children with a rectal temperature greater than 41.1 degrees C are at high risk for a life-threatening illness and should be evaluated for sepsis and meningitis.
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PMID:Association of temperature greater than 41.1 degrees C (106 degrees F) with serious illness. 396 27

Cerebrospinal fluid lymphocytosis (more than 50 percent lymphocytes or mononuclear cells) occurred in 14 of 103 cases of bacteriologically proved acute bacterial meningitis. Patients with cerebrospinal fluid lymphocytosis accounted for 32 percent (13 of 41) of all patients with bacterial meningitis with a cerebrospinal fluid white blood cell concentration of 1,000/mm3 or less. Cerebrospinal fluid lymphocytosis was significantly more common in neonates and in those without meningismus, but occurred in all ages and without any clear identifying clinical characteristics. The most common etiologic organisms were Streptococcus pneumonia (five), Neisseria meningitidis (two), and Hemophilus influenzae (two). Cerebrospinal fluid lymphocytosis is common in acute bacterial meningitis when the cerebrospinal fluid white blood cell concentration is below 1,000/mm3. It is therefore of little value in differentiating bacterial meningitis from viral, fungal, and tuberculous meningitis.
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PMID:Cerebrospinal fluid lymphocytosis in acute bacterial meningitis. 402 75

Serum sodium concentrations were measured in 93 children with pneumonia or bacterial meningitis on their admission to hospital. Hyponatraemia (sodium value 134 mmol/l or less) was present in 33 (45%) of the 73 children with pneumonia, and in 10 (50%) of the 20 children with bacterial meningitis. Increased secretion of antidiuretic hormone is common in children with pneumonia, as well as in children with meningitis. The maintenance fluid requirement in these children is usually about 50 ml/kg/per day, and children with hyponatraemia caused by water overload need even lower fluid intakes. In developing countries, most children with pneumonia and meningitis should be managed without intravenous fluid treatment.
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PMID:Hyponatraemia associated with pneumonia or bacterial meningitis. 406 47

Six common clinical situations in infants and children are discussed from the point of view of standard therapeutic regimens: neonatal sepsis and meningitis; febrile episodes in neutropenia; bacterial meningitis; acute pulmonary exacerbations of cystic fibrosis; pneumonia, bone and joint infections, and cellulitis in patients less than four years of age; and intra-abdominal sepsis. Potential or actual problems with these therapeutic regimens and newer therapeutic options are outlined.
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PMID:Current needs for new beta-lactam antibiotics in pediatrics. 407 87

Thirty pediatric and young adult patients with bacterial meningitis were treated with ceftriaxone or "standard therapy" in a comparative trial; 41 other patients with severe bacterial infections were treated with ceftriaxone in an open protocol. Meningitis and brain abscesses were treated successfully with 50 mg/kg of ceftriaxone every 12 hours. In children, other infections were treated with 25 to 37.5 mg/kg of ceftriaxone every 12 hours. Young adults with pneumonia received 1 g of the antibiotic every 12 hours, whereas those with soft tissue infections were treated every 24 hours. All patients responded to therapy, and in all but one was the infectious process sterilized. No significant toxicity was observed. Ceftriaxone appears to be an excellent single agent for the treatment of most severe bacterial infections in pediatric and young adult patients and need not be administered more frequently than once every 12 hours.
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PMID:Ceftriaxone therapy of meningitis and serious infections. 609 19


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