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

For the systematic study of the role of inflammation in the morbidity and mortality associated with bacterial meningitis, techniques for quantitation of the inflammatory reaction in the meninges of rabbits with experimental pneumococcal infection were developed. The brains of 19 infected animals were removed intact, and the area of inflammation in microscopic sections was quantitated by an electronic X-Y plotter connected to a computer. Exudate was maximal along the ventral surface of the brain at the level of the cerebellum. Inflammation increased progressively with time and peaked at 72 hr. In a separate group of 29 animals, lactic acid dehydrogenase concentrations in cerebrospinal fluid increased significantly during infection, and the rate of increase wirh time coincided with the increase in inflammation documented histologically. The described method of quantitating inflammation in the meninges during experimental meningitis makes it possible to study the increase in granulocyte involvement with time. The establishment of a direct relation between the concentration of lactic acid dehydrogenase in the cerebrospinal fluid and the inflammatory mass validates the use of lactic acid dehydrogenase as an indicator of inflammation.
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PMID:Experimental pneumococcal meningitis. II. Characterization and quantitation of the inflammatory process. 17 13

Successful therapy of bacterial meningitis is dependent upon achieving adequate antibacterial activity in the CSF. The percent penetration (CSF concentration/serum concentration X 100) of various antimicrobial agents was determined in a rabbit model of bacterial meningitis. The percent penetration of the penicillin and cephalosporin derivatives was found to vary inversely with the protein binding of the respective drugs. Esterification of ampicillin increased its lipid solubility and likewise increased the penetration into the CSF. Probenecid competitively inhibits the active transport efflux of various organic acids from the CSF and increased the CSF concentrations of penicillin and cephalosporin derivatives. The percent penetration of all drugs was increased in the presence of the inflamed meninges.
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PMID:Factors influencing the penetration of antimicrobial agents into the cerebrospinal fluid of experimental animals. 27 68

The pathogenesis of bacterial meningitis was studied in infant rats. Intranasal intoculation of greater than 10(3) Haemophilus influenzae type b resulted in an incidence of bacteremia that was directly related to the size of hte challenge inoculum. The temporal and quantitative relationship of bacteremia to meningitis indicated that bacteria spread to the meninges by the hematogenous route and that the magnitude of bacteremia was a primary determinant in the development of meningitis. In a sparate series of experiments, infant rats that were fed Escherichia coli strain C94 (O7:K1:H-) became colonized and developed bacteremia and meningitis, but invasive disease was rare when rats were fed E. Coli strain Easter (O75:K100:H5). A comparison of intranasal vs. oral challenge indicated that the nasopharynx was the most effective route for inducing H. influenzae bacteremia, whereas the gastrointestinal route was the more effective challenge route for the E. coli K1 serotype.
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PMID:The infant rat as a model of bacterial meningitis. 33 Jul 77

30 children suffering from bacterial meningitis and 2 children suffering from septicemia were treated with 6-((R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetmido(-penicillanic acid sodium salt (mezlocillin, Baypen). The daily dose was 250 mg/kg, divided in three portions. Therapy was successful in all patients. Neither signs of toxicity nor side effects of any kind could be found. Mezlocillin concentrations were measured in serum and cerebrospinal fluid (CSF) mainly on days one and six or seven of therapy. Serum concentrations were in the expected range. CSF concentrations depended on the inflammation of the meninges. On the first day of treatment they ranged from 0.5 to 7.2 to 12.0 microgram/ml. After normalisation of CSF no concentrations of mezlocillin were detectable.
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PMID:Treatment of childhood meningitis with mezlocillin. 54 12

Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections (5), gram-negative bacterial meningitis (2), septic arthritis (1), epidural abscess (1) and isolated septicemia (1). The antibacterial spectrum of cefoxitin was found to be one which included all gram-positive organisms except enterococci, most gram-negative organisms except Pseudomonas aeruginosa, and almost all of the important anaerobic organisms. The only five treatment failures included one patient with empyema and one with septic arthritis, both caused by Serratia marcescens, initially only moderately susceptible to cefoxitin, which subsequently developed increased resistance, two patients with contaminated intravenous catheters, and one patient with epidural abscess and cerebritis, who was treated late in the course. There was one serious clinical superinfection with P. aeruginosa. The drug levels noted in the pus and joint fluid were half to two-thirds of the simultaneous serum level. In inflamed meninges, up to 30% of the serum level was noted in the cerebrospinal fluid, and as the process resolved, 10 to 15% was noted. Toxicity of cefoxitin was mild and constituted skin rash in three patients (7%) and phlebitis in eight (19%).
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PMID:Use of cefoxitin, new cephalosporin-like antibiotic, in the treatment of aerobic and anaerobic infections. 74 74

Lysozyme activity was measured in cerebrospinal fluid (CSF) from 114 patients with inflammatory (bacterial and serous meningitis, polyradiculitis, encephalitis) and non-inflammatory (multiple sclerosis, CNS tumors, cerebral vascular diseases) CNS diseases. Highly elevated values were found consistently in patients with bacterial meningitis. Elevated values were found also in patients with encephalitis, polyradiculitis, multiple sclerosis and CNS tumors, but a considerable overlapping between these groups and normal controls precludes the use of CSF lysozyme measurements as a diagnostic aid in the latter disease groups. Simultaneous measurements of lysozyme, albumin and IgG in CSF and serum suggested that the mechanism for increased CSF lysozyme values in bacterial meningitis is mainly a breakdown of the blood/brain barrier, whereas the increased CSF lysozyme values in the remaining groups of patients are more likely caused by production of lysozyme by cells within the meninges (neutrophilic granulocytes, monocytes?).
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PMID:Lysozyme activity in cerebrospinal fluid. Studies in inflammatory and non-inflammatory CNS disorders. 85 79

Twenty-four infants under 6 months infected with echovirus 19 are described, They were the youngest of the many children admitted to hospitals in Newcastle and Gateshead during an epidemic in the north-east of England in 1974. Generally, the younger the child the more severe the illness, which affected the upper respiratory tract, the gut, the skin, and the meninges, and sometimes caused as state of collapse resembling septicaemic shock. Polymorphonuclear pleocystosis of the cerebrospinal fluid (CSF) sometimes suggested bacterial meningitis, so that antibiotics were given in 38% of cases. The virus was recovered with a high success rate from nasopharyngeal secretions, CSF, and stool.
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PMID:Echovirus 19 infection in infants under six months. 96 74

Albumin, IgG, IgA, IgM, transferrin, and alpha 1-antitrypsin were determined quantitatively in the cerebrospinal fluid (CSF) of 44 healthy children and 37 pediatric patients with central nervous system diseases. Neither IgA nor IgM were found in the CSF of normal children, but they were present in cases of purulent and non-bacterial meningitis. In cases of encephalitis all proteins studied were increased except IgA and IgM, which could not be demonstrated. On the basis of the results it may be concluded that the increase of IgG in the CSF in bacterial and a bacterial meningitis is due to an increased permeability of the blood-CSF barrier. Except in cases with ependymitis, IgG is produced only in small amounts in or near the CSF spaces even in the presence of inflammation of the meninges. The quantitative determination of IgG, IgA, and IgM in case of increased CSF protein content may facilitate the differential diagnosis between purulent and acute viral meningitis and encephalitis.
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PMID:[The quantitative determination of the individual CSF proteins in the diagnosis of inflammatory diseases of the CNS in children (author's transl)]. 108 15

Bacterial meningitis is relatively common, can progress rapidly, and can result in death or permanent debilitation. This infection justifiably elicits strong emotional reactions and, hopefully, immediate medical intervention. This review is a brief presentation of the pathogenesis of bacterial meningitis and a review of current knowledge, literature, and recommendations on the subject of laboratory diagnosis of bacterial meningitis. Those who work in clinical microbiology laboratories should be familiar with the tests used in detecting bacteria and bacterial antigens in cerebrospinal fluid (CSF) and should always have the utmost appreciation for the fact that results of such tests must always be reported immediately. Academic and practical aspects of the laboratory diagnosis of bacterial meningitis presented in this review include the following: anatomy of the meninges; pathogenesis; changes in the composition of CSF; etiological agents; processing CSF; microscopic examination of CSF; culturing CSF; methods of detecting bacterial antigens and bacterial components in CSF (counter-immunoelectrophoresis, coagglutination, latex agglutination, enzyme-linked immunosorbent assay, Limulus amebocyte lysate assay, and gas-liquid chromatography); use of the polymerase chain reaction; and practical considerations for testing CSF for bacterial antigens.
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PMID:Laboratory diagnosis of bacterial meningitis. 157 85

Almost all agents can cause infection within the central nervous system. The extent of infection ranges from diffuse involvement of the meninges, brain, or spinal cord to localized involvement presenting as a space-occupying lesion. Epidemiologic considerations, appreciation of the presenting clinical syndrome (acute bacterial meningitis, acute aseptic meningitis, chronic meningitis, or space-occupying lesion), and cerebrospinal fluid analysis facilitate arrival at a diagnosis.
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PMID:Infective agents in the central nervous system. 163 58


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