Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Glucocorticosteroids are the most commonly used immunosuppressive agents. In the following review important mechanisms of action of glucocorticoids on the immunological network are summarized, the relationship between duration of therapy, daily dose and incidence of infections is analysed, and evidence is presented that in some infectious diseases glucocorticoids may even be beneficial. The association between corticosteroid therapy and subsequent infections was calculated by pooling the data from 73 controlled clinical trials (meta-analysis). The rate of infectious complications was not increased in patients given a daily dose of less than 10 mg or a cumulative dose of less than 700 mg prednisone. With increasing doses the occurrence rate of infectious complications increased in patients given corticosteroids as well as in patients given placebo, a finding which suggests that not only the corticosteroid but also the underlying disease state accounts for the steroid-associated infectious complications observed in clinical practice. To analyze the effect of glucocorticoids prescribed as adjuvants in patients with infectious diseases, an analysis of the controlled trials was performed. Some patients with pulmonary tuberculosis or constrictive pericarditis have a better outcome when they are given prednisone. On the other hand, there is no evidence that patients with septic shock or ARDS derive advantage from glucocorticoid therapy. At present there is controversy as to whether patients with bacterial meningitis should be treated with glucocorticosteroids. Patients with hepatitis B should not be treated with glucocorticoids, whereas elderly patients less frequently show postherpetic neuralgia when given glucocorticosteroids. Patients with cerebral malaria should not be given glucocorticosteroids. Aids patients with pneumocystis carinii pneumonia have a higher survival rate when treated with glucocorticosteroids than with placebo.
 ...
PMID:[Glucocorticoids and infection]. 173 19

Two hundred and seventy patients were studied during a 2 years period in Abbassia and Embaba fever hospitals. The duration of illness before admission was less than 20 days. Suggestive clinical symptoms and/or signs of each disease were stressed. Rapid laboratory investigations include slide typhoid agglutination test (98%) in enteric fevers, slide malta agglutination test (86%) in brucellosis, urine culture (100%) in urinary tract infection, gram stain of C.S.F. in bacterial meningitis (80%), encephalitis (0%) and meningeal irritation (0%), high vaginal swab culture (100%) in puerperal fevers, echocardiogram (100%) in infective endocarditis, high E.S.R. (100%) and positive C.R.P. (71%) and/or high A.S.O. (86%) in rheumatic fever, counterimmunoelectrophoresis (86%) in amoebic liver abscess, chest X-ray in pneumonia (100%), pulmonary tuberculosis (100%) and pleural effusion (100%), ultrasound of lymph nodes (100%) in tuberculous lymphadenitis. Erysipelas and tetanus were diagnosed on clinical grounds only.
 ...
PMID:Rapid diagnosis of non-prolonged febrile illnesses necessitating fever hospital admission. 179 71

The pathogenesis of tuberculous meningitis is still unclear. Recently, vascular endothelial growth factor (VEGF) was found to be associated with inflammatory diseases and we found the increased serum level of VEGF in pulmonary tuberculosis. We hypothesized that VEGF might be associated with the pathogenesis of tuberculous meningitis and measured serum and cerebrospinal fluid (CSF) levels of VEGF in 28 patients with tuberculous meningitis and 31 non-tuberculous infectious meningitis patients (13 bacterial meningitis patients, eight fungal meningitis patients and 10 patients with viral meningitis) before therapy. We examined the CSF VEGF levels 3 months after in 12 tuberculous meningitis patients. The serum and CSF levels of VEGF were significantly higher in tuberculous meningitis than in other meningitis. The decrease in titer of CSF VEGF paralleled the clinical improvement of tuberculous meningitis. Immunohistochemical staining of autopsied brains demonstrated the presence of VEGF in the inflammatory mononuclear cells of the dense fibroconnective tissue both in the subarachnoid space and surrounding the vasculitis lesion. We found the expression of VEGF in tuberculous meningitis and think that VEGF reflects its activity.
 ...
PMID:Expression of vascular endothelial growth factor in tuberculous meningitis. 1141 75

A retrospective review of autopsy findings and medical records in 33 HIV-infected children living in a Kenyan orphanage is described. Their ages ranged from 1 month to 18 years and median age at death was 71 months (range 7-156). Respiratory disorders were probably the primary cause of death in 21 (64%), in 19 (90%) of whom pyogenic parenchymal lung disease was detected. A presumptive clinical diagnosis of pulmonary tuberculosis had been made in 14 (67%); these children also had a history of recurrent acute lower respiratory tract infections (more than four infections/year). At autopsy, however, only one case of tuberculosis was identified (disseminated disease). Pneumocystis carinii pneumonia was not identified. Primary bacterial meningitis was detected in 33%. The associated findings included disseminated Kaposi sarcoma in two children and cryptococcal meningitis in one child. It is concluded that pyogenic infections are common causes of morbidity and mortality in HIV-1-infected African children. Management should include prompt treatment and, if indicated, prophylaxis for recurrent bacterial infections, and early evaluation and treatment of pulmonary tuberculosis.
 ...
PMID:The post-mortem pathology of HIV-1-infected African children. 1207 Sep 47

The numerous extrapulmonary manifestations of tuberculosis have been well described. Intracranial localizations, including brain stem tuberculoma, are very rare. The authors report a case of brain tuberculoma in a patient with a history of primary pulmonary tuberculosis successfully treated more than twenty years earlier. The patient presented with signs of infection, although the fever disappeared temporarily after successive treatments for malaria (confirmed Plasmodium faiciparum), as well as neurological signs with left hemiparesis. Chest radiographs showed no signs of progressive pulmonary tuberculosis, and blood tests, cerebrospinal fluid testing, and HIV serology were all negative. Treatments for maxillary sinusitis, the malaria, bacterial meningitis, and cerebral abscess were equally ineffective. Brain stem tuberculoma was diagnosed only when the patient was transferred to a hospital equipped with neuroimaging equipment and was confirmed after histopathological examination of the intracranial lesion biopsies and the detection of mycobacterium DNA by polymerase chain reaction (PCR) in the cerebrospinal fluid. A review of 147 cases of intracranial tuberculoma reported in Africa between 1985 and 2001 points out the difficulties of both the differential diagnosis (tuberculoma or other intracranial space-occupying lesions) and treatment in African areas where neuroimaging is unavailable. Our patient's brainstem tuberculoma probably resulted from reactivation of latent tuberculosis.
 ...
PMID:[Intracranial tuberculoma in Africa, with no available neuroimaging. Case report and review of the literature]. 1469 80