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

During 1977 the state of Washington maintained a surveillance system for reporting cases of bacterial meningitis. Hemophilus influenzae meningitis was the most common etiologic agent causing bacterial meningitis. A high incidence rate for H. influenzae meningitis was found among American Indians less than five years ago. A focus of ampicillin-resistant H. influenzae meningitis was found in Pierce County among military dependents or persons who had family members or relatives working or attending school with Fort Lewis Army Base personnel. Although relationships between the individual cases were not detected, the surveillance system continues to seek some association.
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PMID:Bacterial meningitis in Washington state. 50 27

The Limulus amoebocyte lysate endotoxin assay was evaluated as a method for rapid diagnosis of acute bacterial meningitis in a series of 305 patients. The results of Limulus assays on cerebrospinal fluid (CSF) samples from these patients were compared with the results for each patient of routine bacterial cultures and Gram stains. Positive Limulus tests were obtained on initial CSF specimens from 84% of patients with culture-proven bacterial meningitis, including all patients with meningitis due to gram-negative organisms. Initial Gram-stained smears revealed the presence of organisms in 68% of the patients. One patient with pneumococcal meningitis had a weakly positive Limulus assay, whereas patients with meningitis due to other gram-positive organisms, those with aseptic meningitis, or patients without meningitis had negative CSF Limulus tests. The Limulus assay also demonstrated the persistence of endotoxin in the CSF of certain patients during antibiotic therapy, especially patients with Haemophilus influenzae meningitis. The Limulus test proved to be a rapid, reliable indicator of the presence of gram-negative organisms in the CSF of patients suspected of acute bacterial meningitis.
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PMID:Rapid diagnosis of gram-negative bacterial meningitis by the Limulus endotoxin assay. 62 69

Serum levels of 5 immunoglobulins (IgG, IgA, IgM, IgD and IgE) were determined at frequent intervals in the course of bacterial meningitis in children. 59 patients were examined; 27 with Haemophilus influenzae meningitis, 23 with meningococcal and 9 with pneumococcal meningitis. All 5 immunoglobulins increased during the 2-week course of bacterial meningitis. IgM was the immunoglobulin class responding most rapidly, regularly and intensively. IgG increased moderately. However, practically no rise of the IgG level was observed in children with H. influenzae meningitis. The elevation of the IgA and IgE levels possibly suggests that meningitis may also cause synthesis of IgA and IgE antibodies. The results of the study indicate that antibodies of all the 5 immunoglobulin classes are probably involved in the defense against the causative microbes in bacterial meningitis.
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PMID:Serum immunoglobulin levels in the course of bacterial meningitis in children. 84 Dec 76

The limulus lysate on cerebrospinal fluid was evaluated in 335 infants and children as a method for the rapid diagnosis of Gram-negative bacterial meningitis. Positive limulus tests were obtained within one hour in 33 of 34 cases of Hemophilus influenzae meningitis; four additional patients with Gram-negative meningitis also showed positive limulus lysate tests. Conversely, 13 patients with Gram-positive bacterial meningitis all yielded negative limulus assays. All 48 cases of aseptic meningitis and 236 children with no meningitis showed negative limulus assays. Antibiotic therapy prior to hospitalization did not vitiate the validity of the test. A bedside adaptation of the limulus test, performed by house officers and medical students, showed approximately 98% agreement with the laboratory assay.
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PMID:Limulus lysate test for gram-negative bacterial meningitis. Bedside application. 109 58

Persistent pleocytosis of greater than 60 white blood cells/mm3 was commonly seen in children adequately treated for bacterial meningitis. It occurred in 13 of 21 (62%) children with Hemophilus influenzae meningitis and in 2 of 9 (22%) with pneumococcal meningitis. Pleocytosis alone cannot be used as an indication of prolonging therapy; significance of persistent pleocytosis is not known.
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PMID:Persistent pleocytosis in bacterial meningitis. 124 52

The diagnosis of bacterial meningitis depends on a lumbar puncture (LP). Sometimes, antibiotics are administered before a LP that is delayed owing to prior need for computerized tomography (CT) scan, technical problems, inability to obtain consent, or an unstable patient. We examined the accuracy of blood culture, cerebrospinal fluid (CSF) Gram's stain, and antigen detection by latex for organism identification of meningitis. All patients admitted to the Children's Hospital of Buffalo between January 1, 1984 and December 31, 1989 and having a CSF culture diagnosis of bacterial meningitis had their charts retrospectively reviewed. Patients excluded from the study were those with neural tube defects or CSF catheters, those admitted directly to the Intensive Care Nursery (ICN), those whose positive CSF cultures were determined to be a contaminant, those whose medical records were not found, or those older than 16 years. We analyzed a total of 178 patients with positive CSF cultures and the confirmed diagnosis of bacterial meningitis. Of 169 patients who had a blood culture performed, 86% had the organism responsible for meningitis recovered by this test, with the highest yield of 91% occurring in the 2.5-month to 24-month age group. Blood culture identified the bacteria in 94% of those patients with Haemophilus influenzae meningitis, and this yield increased to 100% when patients who had been pretreated with antibiotics were excluded. The combination of blood culture, CSF Gram's stain, and/or latex agglutination identified the causative bacteria in 92% of patients with meningitis. Blood culture, CSF Gram's stain, and latex agglutination are useful in identifying the organism causing pediatric meningitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Blood culture results as determinants in the organism identification of bacterial meningitis. 138 Oct 91

Bacterial meningitis mortality largely results from the intense host inflammation response to infection. Lysis of bacteria releases bacterial components that stimulate production of cytokines. Cerebrospinal fluid concentrations of these cytokines have been shown to correlate with the severity of the meningitis in both experimental and clinical situations. Dexamethasone has an antiinflammatory effect superior to methylprednisolone. It is the only agent with which significant clinical studies have yet been performed. A recent study recommends the routine use of dexamethasone with Haemophilus influenzae meningitis. The immediate and long-term clinical profiles indicate significantly better outcomes for the dexamethasone group. It is prudent to administer dexamethasone before the first parenteral dose of antibiotic to prevent the release of bacterial components induced by bacterial lysis. The search for agents that down modulate inflammation more strongly continues. Some monoclonal antibodies are superior to dexamethasone in experimental meningitis without modification of antibiotic pharmacokinetics.
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PMID:[Value of corticosteroids in bacterial meningitis]. 140 65

Precise quantity of fever was determined in 191 cases of childhood bacterial meningitis by calculating the areas between the line indicating 37.8 degrees C or 39.5 degrees C temperature and the line connecting all individual temperature values. Temperature measurements were performed rectally one to four times a day throughout the hospitalization. The obtained areas under the curves (AUC), expressed as degree-hours, proved to be a sensitive index for delineating each individual fever pattern and reflected the magnitude of fever more precisely than the traditional fever curves. Children under five had significantly (p less than 0.05) greater AUC than those at five to 15 years; similarly, patients with Haemophilus influenzae meningitis showed greater AUC (i.e., had more fever) than those with meningococcal disease (p less than 0.05). The overall rates of secondary (14%), persistent (16%), and prolonged fever (8%) were virtually identical to previous reports; no drug fever was reported in this study. In cases with prolonged fever, a significantly higher rate (40%) of neurological complications was found compared to those who became afebrile earlier. This method is potentially utilizable in other diseases and conditions where precise measurement of fever is of clinical or scientific relevance.
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PMID:Precise quantification of fever in childhood bacterial meningitis. 156 95

Rapid diagnosis of childhood bacterial meningitis (BM) is generally believed to be essential to avoid poor outcome. To see whether duration of illness before admission to hospital was related to the severity of illness, data from children with BM diagnosed in 18 paediatric hospitals in Finland from 1984 to 1989 were collected prospectively. We divided 286 cases with culture-positive cerebrospinal fluid (CSF) into three groups: BM with a history of up to 24 h (short-history group, n = 141), of more than 24 h and up to 48 h (intermediate-history group, n = 75), and of more than 48 h (long-history group, n = 70). The longer the history, the better the clinical condition of the child. If symptoms or signs of BM lasted 48 h or less, the child did significantly worse, as judged by seven variables, than if the history was longer than 48 h (level of consciousness, p less than 0.001; seizures, p less than 0.01; CSF protein concentration, p less than 0.001; positive CSF gram-stain, p less than 0.01; positive blood culture, p less than 0.05 in Haemophilus influenzae meningitis; serum C-reactive protein, p less than 0.01 between intermediate-history and long-history groups; and urine sodium concentration, p less than 0.001). The differences were not affected by causative organism, sex, age, or preadmission oral antimicrobial agents. The findings show that if BM follows an insidious pattern of disease, diagnostic delay may be unavoidable, which may have medicolegal implications.
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PMID:Severity of childhood bacterial meningitis and duration of illness before diagnosis. 167 83

The search for new antimicrobial agents in the treatment of bacterial meningitis is justified by a rate of mortality that currently remains unacceptably high and by the emergence of bacterial resistance. Because of their excellent in vitro activity against gram-negative organisms and good penetration into the cerebrospinal fluid, the new fluoroquinolones may have a potential role in the treatment of central nervous system (CNS) infections. Although there are few reports on the use of fluoroquinolones in treatment of patients with CNS infections, experience to date indicates that pefloxacin, the most intensively studied agent, and ciprofloxacin provide effective treatment for patients with meningitis caused by susceptible pathogens. Since they cannot be used in patients whose skeletal growth is incomplete, the place of the fluoroquinolones in the treatment of Haemophilus influenzae meningitis is obviously very limited. Neisseria meningitidis is still exquisitely sensitive to penicillin G and ampicillin, and there is thus no reason to replace these agents by fluoroquinolones, except when patients are allergic to beta-lactam agents, or when parental administration is impossible. A potential use of the new fluoroquinolones would be in the treatment of meningitis due to gram-negative bacilli, including Pseudomonas aeruginosa, and Acinetobacter.
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PMID:Potential role of fluoroquinolones in the treatment of bacterial meningitis. 186 89


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