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

Countercurrent immunoelectrophoresis was utilized in the study of 621 specimens of cerebrospinal fluid to determine the correlation of detection of viral antigens with the clinical diagnosis of aseptic meningitis and related viral infections. A panel of viral antisera was immunoelectrophoresed against 119 specimens from patients with suspected viral infections of the central nervous system (group I), 32 from patients with bacterial meningitis (group 2), and 470 from patients with no suspected infection of the nervous system (group 3). One or more precipitin bands were detected in 79% of specimens from group 1, 19% from group 2, and 4% from group 3. Paired acute- and convalescent-phase sera from 32 (78%) of 41 patients with precipitin bands detected by countercurrent immunoelectrophoresis demonstrated a fourfold or greater change in complement-fixing antibodies to the detected antigen. With refinements in antisera, countercurrent immunoelectrophoresis may become useful in the rapid laboratory diagnosis of viral infection of the central nervous system.
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PMID:Countercurrent immunoelectrophoresis in the diagnosis of viral infections of the central nervous system. 21 55

The growth of parent influenza viruses A/England/939/69 and A/PR/8/34, and clones 6, 7, and 64C, derived by recombination, was studied in newborn rats. Using an inoculum of 10(4.0) EID50, influenza virus A/England/939/69 produced the highest titres of virus in rat turbinates at 48 hours after inoculation; clones 6 and 7 and A/PR/8/34 grew to lower titres; and clone 64C grew to the lowest titre. These differences were less apparent when 10(2.0) EID50 of virus was used as an inoculum, and rats were not infected by smaller inoculum of any of the virus strains. Infection with 10(4.0) EID50 of all viruses produced lung infection; at 48 hours after infection, the highest titres were recovered from rats infected with A/PR/8/34 and A/England/939/69 virus. Prior infection with A/England/939/69 or A/PR/8/34 increased the incidence of bacteraemia and meningitis following intranasal inoculation of Haemophilus influenzae type b; infection with clone 64C did not enhance bacterial meningitis, while infection with clone 6 gave an intermediate result. Volunteer studies with these viruses have shown that influenza virus A/England/939/69 was virulent, clones 6 and 7 were attenuated, clone 64C was over-attenuated, and A/PR/8/34 virus was noninfective for man. The relative titres of virus recovered from turbinates taken 48 hours after infection with 10(4.0) EID50 of virus and the ability of virus infection to enhance bacterial infection correlated with the property of virus attenuation for man for four of the five strains tested; however, no correlation was seen for A/PR/8/34 virus, which is a result also found in other laboratory tests designed to measure virulence for man.
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PMID:Influenza virus infection in newborn rats: a possible marker of attenuation for man. 30 96

In order to clarify the role of natural killer cell in the central nervous system (CNS) infection, we examined Leu7 positive cells in peripheral blood of aseptic meningitis by flow cytometry. We studied 10 patients with aseptic meningitis (5 echo virus type 6 and 5 suspected viral meningitis). Also 3 patients with Japanese encephalitis, 3 with fungal meningitis, each one with bacterial meningitis, tuberculous meningitis and brainstem encephalitis were analyzed. Blood samples of acute phase and after recovery were obtained by the first examination on admission and the latest examination after normalization of cerebrospinal fluid findings, respectively. All aseptic meningitis patients showed decrease of Leu7 positive cells in acute phase (mean +/- SD = 6.8 +/- 3.12%, from 3 to 25 days of illness) and continued after recovery (8.3 +/- 4.27%, from 35 to 503 days of illness) in all but one. The number of the cells found in the aseptic meningitis patients during the acute phase and after recovery was significantly lower than in normal subjects (p less than 0.01). The change did not differ statistically between the acute phase and post recovery. The date suggest that decreased Leu7 positive cells is present before infection. As concerning other CNS infections, the positive cells decreased from acute phase to after recovery in two Japanese encephalitis and one tuberculous patients. But because of small number, it was not decided whether the decrease significantly was low value or not. Since natural killer cells is related to defence mechanism of viral infection in acute phase, it seems that low natural killer activity may develop the viral infection. Therefore the date raises the possibility that the people who has originally less the natural killer cells tend to be susceptible, as far as viral meningitis.
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PMID:[Decrease of Leu7 positive cells in peripheral blood from patients with aseptic meningitis]. 169 32

The CSF of 57 infants and children with bacterial or enterovirus meningitis was analyzed for the presence of interferon (IFN). CSF was collected when the diagnosis of meningitis was made; a bacterium or enterovirus was isolated in all cases. IFN was detectable in CSF in 24% of cases of bacterial meningitis and in 75% of cases of viral meningitis. Titers of IFN were generally lower in cases of bacterial meningitis. Neither the presence of IFN nor the level of IFN titers correlated with the patient's age or number of white blood cells or mononuclear cells in the CSF. Coxsackievirus induced production of IFN more consistently and in higher titers than did echovirus. None of 35 control patients had detectable IFN in CSF. A literature review and our data indicate that the presence of IFN in CSF suggests infection of the CNS but does not differentiate bacterial from viral infection. The finding of IFN in the CSF of children with bacterial meningitis supports evidence that bacteria and other nonviral microorganisms induce IFN production. The protective role of IFN in nonviral infections deserves further investigation.
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PMID:Bacteria and viruses induce production of interferon in the cerebrospinal fluid of children with acute meningitis: a study of 57 cases and review. 172 15

We analyzed data from the records of 422 patients with acute bacterial or viral meningitis. A cerebrospinal fluid (CSF) glucose level less than 1.9 mmol/L, a CSF-blood glucose ratio less than 0.23, a CSF protein level greater than 2.2 g/L, more than 2000 x 10(6)/L CSF leukocytes, or more than 1180 x 10(6)/L CSF polymorphonuclear leukocytes were individual predictors of bacterial infection with 99% certainty or better. Although any one of these tests could rule in bacterial meningitis with high probability, none could rule it out. To better predict whether a patient has bacterial vs viral infection, we developed a logistic multiple regression model using CSF-blood glucose ratio, total polymorphonuclear leukocyte count in CSF, age, and month of onset. This proved highly reliable when validated in an independent test sample, with an area under receiver operating characteristic curve of 0.97. The model should allow physicians to differentiate between acute viral and acute bacterial meningitis with greater accuracy.
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PMID:Differential diagnosis of acute meningitis. An analysis of the predictive value of initial observations. 281 Jun 3

A highly sensitive and specific immunoradiometric assay, based upon a monoclonal antibody, was used to measure interferon-alpha (IFN-alpha) in the cerebrospinal fluid (CSF) of patients with central nervous system infections and in controls with non-infectious neurological disorders. IFN-alpha was detected in all 21 patients with viral meningitis but in only one of four patients with non-viral aseptic meningitis. It was also present in the CSF of three of four patients with herpes encephalitis and five of seven patients with acute bacterial meningitis. By contrast, IFN-alpha was present in the CSF in low concentrations in only five (7%) of 71 neurological controls. This rapid test is positive in viral meningitis and may help in distinguishing viral infection from other causes of aseptic meningitis. It is usually negative in non-infective disorders but will not distinguish between viral and bacterial infections.
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PMID:Assessment of an immunoassay for interferon-alpha in cerebrospinal fluid as a diagnostic aid in infections of the central nervous system. 366 70

All types of central nervous system (CNS) infections were investigated in a 1966 birth cohort of 12,000 children from Northern Finland followed up from birth to the age of 14. 174 CNS infections occurred in 167 children, 110 boys and 64 girls. The annual incidence of bacterial CNS infections was 36.3/100,000 and that of viral infections 688.0/100 000. It is concluded that bacterial CNS infections were recorded very fully but only 2/3 of the viral infections could be traced, even though the more severe cases were quite well documented. 8/55 children (14.5%) with bacterial meningitis died; the corresponding figure for viral encephalitis and meningitis (excluding mumps) was 3/67 (4.5%). 17/55 (30.9%) developed mental retardation, epilepsy, cerebral palsy or hearing defect or some combination of these after bacterial CNS infection, and 9 (8.1%) after viral infection. The difference with respect to the children who had not experienced CNS infection was statistically significant only for the bacterial infection cases. CNS infections explained 7.6% of all deaths from 28 days to 14 years, 3% of the handicapping cases of cerebral palsy, mental retardation and epilepsy or some combination of these, and 6.6% of the hearing defects.
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PMID:Incidence and prognosis of central nervous system infections in a birth cohort of 12,000 children. 376 48

The presence of viral infection was evaluated in 160 children older than three months with bacterial meningitis who were admitted to Children's Medical Center or Parkland Memorial Hospital, Dallas, TX, between October 1979 and March 1982. Results were compared with a single serologic specimen in 138 children without meningitis. A recent history of upper respiratory infection was obtained from 60% of patients, including 10/13 with pneumococcal, 9/16 with meningococcal, and 77/131 with Haemophilus influenzae meningitis. Viral infection was documented by serologic response (23.8%) or viral isolation (13.2%) in 63/160 (40%) of patients with meningitis. There were 23 positive cultures (one patient with both adenovirus and respiratory syncytial virus). Picornaviruses, including two rhinoviruses, were isolated from six of the 24 subjects without meningitis who had viral cultures. There were 69 serologic conversions in meningitis patients, with 12 patients converting to two organisms and four patients converting to three organisms. Viral diagnoses included: adenovirus, 32 children; respiratory syncytial virus, 14; influenza A, 8; influenza B, 4; parainfluenza (1, 2, and 3), 12; picornaviruses, 9; herpes simplex virus, 1; and cytomegalovirus, 1. Additionally, 6/15 seroconverted to Mycoplasma pneumoniae. The acute geometric mean serum antibody titers of meningitis patients were lower than those of the comparison group for adenovirus (3.5 vs. 6.6, p less than or equal to 0.001) and influenza B (1.2 vs. 1.6, p less than or equal to 0.05). Twenty nine of 131 patients with H. influenzae had evidence of recent adenovirus infection. Primary infection with adenoviruses and possibly influenza B or mycoplasma precedes development of bacterial meningitis in some patients and may be a predisposing factor.
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PMID:Possible association of mycoplasma and viral respiratory infections with bacterial meningitis. 381 56

Cerebrospinal fluid from 100 patients with clinically diagnosed meningitis was examined for alpha-interferon. In the laboratory four patient groups were identified: bacterial meningitis (n = 12), viral meningitis (n = 15), normal cerebrospinal fluid (n = 57) and abnormal cerebrospinal fluid (n = 16). A further 14 patients with cerebrospinal fluid shunts but no abnormality in the cerebrospinal fluid provided a control group for alpha-interferon determinations. The group with viral meningitis and the group with abnormal cerebrospinal fluid had significantly higher alpha-interferon concentrations (p less than 0.001) when compared with those of the three other groups. This assay had great predictive value in determining those patients with abnormal cerebrospinal fluid who did not have a bacterial cause of meningitis. As the groups with abnormal cerebrospinal fluid and viral meningitis had a similar spread in alpha-interferon values it is likely that both reflect viral infection of the central nervous system.
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PMID:Alpha-interferon responses in cerebrospinal fluid of patients with suspected meningitis. 381 74

Viral meningitis is part of the aseptic meningitis syndrome but must be distinguished from bacterial meningitis on the basis of a careful examination of the CSF and sound clinical judgment. Enteroviruses probably account for the bulk of cases of aseptic meningitis that occur in the United States and which are reported to the Centers for Disease Control each year. The seasonal pattern in the incidence of aseptic meningitis is largely due to the seasonal variation of enteroviral infections. Early on, the CSF in patients with viral meningitis frequently contains a predominance of polymorphonuclear leukocytes and may even have a low glucose level. The presence of neutrophils in the initial CSF sample is especially common in patients with enteroviral infections. A CSF glucose level lower than 50 per cent of a simultaneously drawn blood glucose determination is not uncommon in patients with viral meningitis due to mumps, LCM, and herpes simplex. In a patient with a predominance of polymorphonuclear leukocytes in the initial CSF specimen and in whom a viral infection is suspected, antibiotics may be withheld if a spinal tap is repeated within 12 hours. A shift from polymorphonuclear leukocytes to mononuclear cells makes viral meningitis the likely diagnosis. Both herpes simplex and varicella-zoster may infect the meninges by means of spread from cervical and dorsal root ganglia in a retrograde fashion much the way they spread in an antegrade fashion to the skin. HSV-2 is more likely to cause the clinical syndrome of viral meningitis, while HSV-1 is more likely to cause a meningoencephalitis with serious brain dysfunction. The identification of a specific viral agent in body fluids, especially the CSF, in a patient with aseptic meningitis is of more than academic interest, since it can shorten duration of hospital stay and eliminate unnecessary antimicrobial therapy. The diagnosis of enteroviral infections depends upon the isolation of a virus from CSF, stool, or throat plus a fourfold antibody response in the serum to the viral isolate. The 60-odd serotypes of enterovirus, each with different antigenic determinants, preclude serologic testing alone as a useful diagnostic test to identify the patient infected with coxsackievirus or echovirus. For infections, due to herpes simplex, varicella-zoster, LCM, and arboviruses, a serologic test alone can be useful.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Viral meningitis. 399 Apr 41


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