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

All patients who present with severe headaches merit careful medical and neurologic evaluation, and many require neuroimaging studies or lumbar puncture. To avoid missing the occasional seriously ill patient among the large number of patients with relatively benign headaches, physicians must maintain a high index of suspicion and a familiarity with the differential diagnosis. Patients with severe acute headaches must be evaluated for subarachnoid hemorrhage and bacterial meningitis. Temporal arteritis must be excluded in all older patients with recurrent headaches of recent onset. Trigeminal neuralgia and cluster headache usually do not signify serious underlying disease, but the severity of the pain mandates rapid diagnosis and institution of therapy. Migraines are extremely common and often mislabeled as tension or sinus headaches. All primary care physicians should be able to recognize the many faces of migraine and be familiar with symptomatic and prophylactic therapy. Difficult cases should be referred to a neurologist for ongoing care.
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PMID:Severe headaches. When to worry, what to do. 231 44

Serial tests for serum C-reactive protein (CRP) and C4 levels were carried out on 20 patients undergoing microvascular decompression (MVD) for trigeminal neuralgia with interposition of synthetic material (Teflon +/- Dacron). These proteins represent important elements of host defense mechanisms against invading pathogens and their serum levels might be of value in distinguishing bacterial meningitis from tissue reaction to synthetic material. According to post-operative pyrexia, patients were classified into three groups: gr 1 (n = 4): apyrexia, gr 2 (n = 11): pyrexia from 38 degrees C to 39 degrees C, gr 3 (n = 5): pyrexia upper 39 degrees C. Such frequent hyperpyrexia provides a clinical dilemma about meningitis. In 2 patients high CRP levels, 4 days after surgery, indicated the presence of meningitis. In all other patients, CRP levels were decreasing rapidly and normal levels were reached by day 8. All C4 levels were normal values. Measurements of CRP contributed to diagnose common meningitis reactions. These reactions seemed more frequent with Dacron and Teflon than with Teflon alone. Though non significative this difference deserves confirmation by fuller investigations.
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PMID:[Levels of C-reactive protein and complement 4 fraction in hyperthermia secondary to microsurgical vascular decompression for trigeminal neuralgia]. 857 54

Seven patients are reported with meningitis due to viridans streptococci. These patients represented 5% of culture-proven cases of bacterial meningitis in adults participating in a prospective multicentre clinical trial evaluating the use of dexamethasone. Meningitis was iatrogenic in three patients: one patient had been treated with endoscopic sclerotherapy for oesophageal varices, and two patients had undergone thermocoagulation of the gasserian ganglion for trigeminal neuralgia in the previous days.
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PMID:Meningitis due to viridans streptococci in adults. 926 62

We report here two cases of patients complicated with aseptic meningitis after microvascular decompression (MVD). The first case, a 56-year-old female complained of headache with high fever 18 days after the MVD for right trigeminal neuralgia. The amount of cells in cerebrospinal fluid (CSF) had so much increased that bacterial meningitis was suspected. However, there was no improvement after antibiotics therapy, so immune globulin was injected and the meningitis gradually improved. Eosinophilia remained in peripheral blood and the symptoms improved rapidly after the steroid therapy. Because of this, we suspected that meningitis was caused by an abnormal allergic reaction. The second case, a 30-year-old male complained of headache with mild fever 15 days after MVD for left hemifacial spasm. The amount of cells in CSF increased, so bacterial meningitis was suspected. Eosinophilia remained in peripheral blood and the steroid therapy proved very effective for the meningitis. Because of this, we suspected that meningitis was caused by an abnormal allergic reaction. We suspected that the two patients suffered from aseptic meningitis caused by allergic reaction, and the antigen for this abnormal allergic reaction was the foreign materials used for MVD. The materials were Dacron for prostesis, Goatex or Lyodula for dural plasty, fibrin glue for preventing CSF leakage. We ascertained that the abnormal allergic reaction was caused by human fibrinogen in the second case. It is important to be aware of such allergic reaction to fibrin glue in the post-operative stage after MVD.
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PMID:[Aseptic meningitis as a complication caused by an allergic reaction after microvascular decompression: two case reports]. 1249 85