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

Patients infected with HIV demonstrate increased susceptibility to serious infections with non-typhoidal salmonellae. However, no cases of salmonella meningitis have been reported in this population. We now report three cases of salmonella meningitis which occurred in a population of 1800 patients with AIDS or AIDS-related complex at our hospitals. The incidence of meningitis complicating salmonella infection in our HIV-infected population appears to be much higher than that reported in non-AIDS patients (7.5 versus 0.15%). All had cerebrospinal fluid parameters consistent with bacterial meningitis, and two of three revealed organisms on cerebrospinal fluid Gram stain. Two presented with a fulminant illness and died despite therapy; the third developed a brain abscess associated with a relapse of meningitis. Salmonella meningitis should be considered as a cause of acute neurological deterioration in patients at risk for HIV-related disease. Relapses may occur, and mortality is high.
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PMID:Salmonella meningitis and infection with HIV. 208 4

In an eight year period (1972-1979), 158 cases of enteric gram-negative bacillary meningitis and 53 cases of Listeria meningitis were reported to the New York City Health Department. These two forms of bacterial meningitis were the fourth and fifth most common ones reported to the Department, respectively. The cumulative total of reported cases of gram-negative rod meningitis over this less than the reported cases due to Neisseria meningitis over this period. In contrast to most previous studies of Listeria and enteric gram-negative meningitides, the majority of cases occurred in adults. Listeria meningitis occurred more often in immunosuppressed hosts and the elderly than in the newborn; gram-negative bacillary meningitides were seen more often in elderly septic patients and in patients with traumatic skull fracture than in infants during the first months of life. The over-all mortality of Listeria meningitis was 62 percent; that of the combined gram-negative meningitides 71.3 percent. The mortality in adults with Escherichia coli and Klebsiella meningitis who were treated with chloramphenicol as the major antibiotic was 83 percent. In comparison, the only appreciable survival rates noted were in those with Listeria, Escherichia coli, Proteus mirabilis and Salmonella meningitis who were treated with ampicillin alone in whom the over-all mortality was 51 percent.
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PMID:Listeria and gram-negative bacillary meningitis in New York City, 1972-1979. Frequent causes of meningitis in adults. 702 Apr 16

During the period January 1980 to December 1990 (11 years) a retrospective study of patients with bacterial meningitis who were admitted to Bangkok Children's Hospital was carried out. There were 618 patients with 77 cases (12.5%) occurring below the age of one month (neonatal meningitis), and 541 cases (87.5%) between one month to 15 years (childhood meningitis). Pseudomonas aeruginosa was the most common pathogenic organism (16.9%) in neonatal meningitis; other causative agents in this age group included Klebsiella pneumoniae (13.0%), group B Streptococcus (11.7%), Escherichia coli and Enterobacter sp (10.4% each). In childhood meningitis, Haemophilus influenzae was the most common causative organism (42.3%), and followed by Streptococcus pneumoniae (22.2%) and Salmonella sp (12.4%). Excluding a 13 year-old leukemic patient, Salmonella meningitis occurred exclusively in infants, 87% of them were under six months, and 13% of them developed relapsing meningitis. Presenting symptoms and signs on admission of neonatal meningitis such as fever (81.8%), convulsions (45.4%), neck stiffness (22.5%), bulging fontanelle (33.3%) and Brudzinski sign (11.5%) were significantly less frequent than in the patients beyond the neonatal period (p < 0.05). The overall fatalities during 1980-1990 were 45.4% and 17.3% for neonatal meningitis and childhood meningitis, respectively. The fatalities of the two age groups declined significantly during 1987-1990 to 26.3% and 11.4% respectively.
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PMID:Bacterial meningitis in children: etiology and clinical features, an 11-year review of 618 cases. 782 99

A retrospective study was carried out at Dayanand Medical College & Hospital, Ludhiana (Pb.) during the period from January 1985 to December 1990 to know the incidence of Salmonella meningitis. Salmonella etiology was established in 8 (3.43%) cases out of 233 cases of bacterial meningitis. Out of 8 cases, 7 were children under the age of 2 years. 4 Patients yielded S. typhimurium, 3, S. typhi and 1 S. senftenberg from cerebrospinal fluid samples. No Salmonella organism was isolated from blood cultures except one in which S. typhi was isolated. S. typhimurium was the predominant isolate showing multi drug resistance to commonly used drugs such as ampicillin, chloramphenicol, streptomycin, tetracycline and kanamycin. S. senftenberg also showed similar drug resistance pattern. S. typhi, on the other hand was sensitive to above antibiotics.
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PMID:Incidence of salmonella meningitis in Ludhiana (Punjab). 835 47

Two cases of neonatal Salmonella meningitis are reported. Both infants were seriously ill: one died 6 days after admittance to the hospital; the other required artificial ventilation for 4 days and recovered without sequelae. In both cases close relatives had shown signs of gastrointestinal infection just prior to the reported cases. The symptoms, the outcome and antibiotic treatment are discussed. In view of the increasing incidence of salmonella infections in Denmark and the serious prognosis of neonatal meningitis, it is important to consider the diagnosis in all cases of bacterial meningitis in infancy.
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PMID:Neonatal Salmonella meningitis: two case reports. 882 14

Sixty-one episodes of Salmonella meningitis were identified during a 3-year period from February 1996 to January 1999 inclusive. These accounted for 6.8% of all the acute bacterial meningitis cases seen during this time. In contrast, only two children were admitted with Salmonella meningitis in 1982. The increase may reflect the rise in HIV disease and the associated increase in Salmonella septicaemia. All but one child were under 2 years of age, only six children were well nourished and anaemia was common. The prognosis was poor: 33 (58%) died, 19 made a full recovery and five developed sequelae. Two children relapsed, one of whom died. Patients were routinely treated with chloramphenicol, to which all isolates were sensitive in vitro. The poor outcomes suggest that an alternative antibiotic policy is required.
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PMID:Salmonella meningitis in children in Blantyre, Malawi, 1996-1999. 1082 12

This 16-year (1986-2001) retrospective study enrolled 80 infantile patients (aged, 30-365 days old) with culture-proven bacterial meningitis. The most prevalent pathogens were Salmonellaspecies, Streptococcus (S.) agalactiae, Escherichia (E.) coli, and Haemophilus (H.) influenzae, accounting for about 59% of the episodes. Meningitis caused by Salmonella species, E. coli and H. influenzae occurs more often in the older infants, while that caused by S. agalactiae occurs more often in young infants. Our study revealed a decrease in the proportion of Salmonella meningitis from 27% in the first 8 years to 9% in the second 8 years with E. coli replacing Salmonella species as the leading pathogen of this disease during the second period. Overall mortality rate for both periods of time was 11%. However, if we take those with undesirable poor outcomes into account, 43% of patients could be considered treatment failures. The study also reveals a high prevalence of neurological complications when this disease is caused by H. influenzae, S. pneumoniae, and Salmonella species. Stepwise logistic regression analysis revealed that only initial changing levels of consciousness (P = 0.006) were independently associated with treatment failure. The most frequent neurological complications associated with this disease included subdural empyema, hydrocephalus, cerebral infarctions, and seizures. Because therapeutic regimens may require attention to the eradication of bacterial pathogen but also the neurological complications, early diagnosis and choice of appropriate antibiotics are essential to increasing the possibility of survival.
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PMID:Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors. 1503 Sep 5

Meningitis caused by Salmonella species is not uncommon in many developing countries. Patients suspected of bacterial meningitis who were admitted to Siriraj Hospital were enrolled in this study during 1986-2001. There were only 19 cases of Salmonella meningitis. Salmonella serogroup D ranked first, followed by serogroup C, serogroup B and then serogroup H. Most patients were children under 1 year of age. The antimicrobial susceptibility pattern for Salmonella meningitis may provide a guideline for the selection of appropriate drug treatment.
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PMID:Salmonella meningitis and antimicrobial susceptibilities. 1591 35

Recurrence of bacterial meningitis in children is not only potentially life-threatening, but also involves or induces psychological trauma to the patients through repeated hospitalization and multiple invasive investigations if the underlying cause remains undetected. Bacteria migration, along congenital or acquired pathways from the skull or spinal dural defects, gains entrance into the central nervous system (CNS) and should be taken into consideration when children face recurrent bacterial meningitis, however, symptoms and signs of cerebrospinal fluid (CSF) rhinorrhea or otorrhea are rare in such patients. Without evidence of CSF leakage, a cranial symptom/sign or coccygeal cutaneous stigmata may suggest the approximate lesion site, diagnosis and detection remains difficult. To detect an occult dural lesion along the craniospinal axis, such as basal encephalocele, dermal sinus tract, or neurenteric cyst, a detailed clinical evaluation and the use of the modern diagnostic imaging methods is necessary. Because of the possibility of concomitant occurrence of more than one malformation, both the frontal and the lateral skull base should be carefully evaluated. Precise localization of the dural lesion is a prerequisite for successful surgical repair. In addition, the bacteria specificity could leave significant clues: Pneumoccocus or Hemophilus suggests cranial dural defects, E. coli or other gram negative bacilli suggests spinal dural defects, and meningococci suggest immunologic deficiency. Asplenia or immunodeficiency such as complement or immunoglobulin deficiency rarely causes recurrent meningitis without a history of frequent infection of non-CNS areas. Salmonella meningitis or brain abscess should not be treated incompletely or inadequately and could lead to recrudescence, relapse or recurrence of bacterial meningitis. Antibiotic (penicillin or trimethoprim-sulfamethoxazole) induced meningitis may repetitively occur on occasion.
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PMID:Diagnostic approach to recurrent bacterial meningitis in children. 1623 27

Non-enteric salmonella infections in immunocompetent adults are exceedingly rare in the United States, and meningitis is one of the least common extra-intestinal sites. In addition, it is very unusual for a patient with bacterial meningitis to present with classic meningitis signs and symptoms of > 72 h duration. The objective of this work is to describe a rare case of salmonella meningitis in an immunocompetent adult and, in the context of previously published case reports, describe the frequently atypical clinical course of salmonella meningitis along with the potential pitfalls encountered during its evaluation and treatment. An otherwise healthy 45-year-old man presented to our Emergency Department with frontal headache, fever, and stiff neck of 7 days duration. He was alert and oriented in triage, where he was noted to be afebrile, mildly tachycardic, with a normal blood pressure and respiratory rate; shortly after triage he developed a high fever, severe tachycardia, hypotension, and a change in mental status. He was resuscitated according to our severe sepsis protocol and treated empirically for bacterial meningitis. Blood and cerebrospinal fluid cultures grew group D Salmonella berta. An evaluation for underlying immunodeficiency was unrevealing. The patient was discharged home on hospital day 7 in good condition. Salmonella meningitis can present with an indolent course and can mimic, in many misleading ways, the less serious diagnosis of aseptic meningitis. This case highlights the need for an unbiased clinical assessment, aggressive management of critical illness, and point-for-point correspondence between clinical data and assigned diagnosis.
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PMID:Salmonella meningitis in an immunocompetent adult. 1853 5


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