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

In a five year period 142 cases of bacterial meningitis were reported, of which 50 per cent were children under the age of four years and a third of the children were neonates. The commonest organism isolated was Streptococcus pneumoniae, there being 28 cases. The incidence of Klebsiella organism causing meningitis has been on the increase, and 20 cases were reported within this period. There has been a change in pattern of neonatal meningitis, with group B streptococcal infection predominating over the gram negatives.
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PMID:Bacterial meningitis--a five year review 1975--1979. 679 76

On a new dry filled doxycycline derivative for intravenous administration, some clinical studies were performed. The results obtained were summarized as follows; 1. Intravenous administration was effective in three cases of pulmonary abscess, in one case of bronchopneumonia, in one case of urinary tract infection complicated to nephrolithiasis, in one case of Mycoplasma pneumonia and in one case of tsutsugamushi disease. 2. In one case of FUO (fever of unknown origin), in one case of non-bacterial meningitis and in one case of ampicillin induced hemorrhagic colitis, from whom Klebsiella oxytoca was isolated in feces, satisfactory clinical course was observed with the drug administration. However, as it was impossible to give any comments for the causative agent of each disease, the effectiveness of the derivative was not necessarily clear. 3. Neither side effects nor abnormal laboratory finding caused by the derivative were noticed in any cases.
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PMID:[Clinical studies on dry filled doxycycline for intravenous administration; including one case of tsutsugamushi disease (author's transl)]. 724 97

Klebsiella oxytoca meningitis is a rare condition. Nine patients were diagnosed between 1981 and 1993 at our institution. These accounted for 2.3% of 393 patients with blood and/or cerebrospinal fluid culture-proven bacterial meningitis. K. oxytoca was noted in both community-acquired meningitis and nosocomial meningitis. Eight of the nine cases were patients who had undergone neurosurgical procedures. Four were mixed bacterial meningitis. All K. oxytoca isolates were susceptible to third-generation cephalosporins and all but one to chloramphenicol. Antibiotic therapy was successful in eight patients but failed in one.
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PMID:Klebsiella oxytoca meningitis: frequent association with neurosurgical procedures. 749 5

Although the pharmacokinetics of ceftriaxone allows its administration in a single daily dose, this practice is not standard in the treatment of bacterial meningitis. Herein, we review our experience and that of other investigators with this mode of therapy. We used a single daily dose of ceftriaxone (50 mg/[kg.d]; maximum, 4 g/d) for the treatment of bacterial meningitis in 84 adult patients. Meningitis was due to Neisseria meningitidis in 34 cases, to Streptococcus pneumoniae in 25, to Escherichia coli in three, to Klebsiella pneumoniae in two, to Haemophilus influenzae in two, to viridans streptococci in two, and to an unknown agent in 16. Eleven patients died, for an overall mortality of 13%; therapy failed in three additional cases. The mean trough levels of ceftriaxone in cerebrospinal fluid was 3.5 micrograms/mL; the median trough bactericidal titer at this site was 1:128. Both our experience and that in the literature suggest that a single daily dose is optimal when ceftriaxone is used for the treatment of bacterial meningitis.
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PMID:A single daily dose of ceftriaxone for bacterial meningitis in adults: experience with 84 patients and review of the literature. 761 94

Relapsing bacterial meningitis is a rare condition, diagnosed in eight patients between 1981 and 1993 at our institution. These accounted for 3.4% of 234 adult patients with blood and/or cerebrospinal fluid culture-proven bacterial meningitis. A review of the English-language literature from 1966 to the present revealed only five further adult cases of relapsing bacterial meningitis with in-depth case histories. Of these 13 total patients, nine were female and four male, aged 17-61 years. Ten were neurosurgical patients. Gram-negative bacilli, especially Klebsiella species, were the commonest micro-organisms identified for both the initial episode and the relapse of infection. Three patients died in the course of relapse. Four or more weeks of antibiotic therapy may be needed to treat post-surgical patients with Gram-negative bacillary meningitis. Even a normal cerebrospinal fluid study at the end of treatment of bacterial meningitis is not a guarantee of freedom from relapse.
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PMID:Relapsing bacterial meningitis in adults. 789 94

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

During a four-year period from November 1988 to October 1992, 41 cases of bacterial meningitis with a positive cerebrospinal fluid (CSF) culture and/or CSF antigen test were collected at the National Cheng Kung University Hospital. The ages of the subjects ranged from 32 days to 13 years, with a median of seven months. The male to female ratio was 2.4:1. The most common causative agent was Haemophilus influenzae type b (Hib, 29.3%), followed by group B beta-hemolytic streptococci (GBS, 24.4%), Streptococcus pneumoniae (22.0%), Escherichia coli (4.9%), Neisseria meningitidis (4.9%), Salmonella species (4.9%), Klebsiella pneumoniae (4.9%), Pseudomonas aeruginosa (2.6%), and viridans streptococci (2.6%). The onset of GBS meningitis was always prior to four months of age. Of the 41 cases studied, 27 (65.9%) were aged from two months to five years; 12 (44.4%) of these had meningitis caused by Hib. Most of the cases (90.2%) had a fever as the first clinical manifestation. Ampicillin combined with a third-generation cephalosporin was effective against most of the causative pathogens. The most frequently encountered short-term sequelae were seizures (64.7%), subdural effusion (55.9%) and ventriculomegaly (44.1%). Observations on long-term sequelae are ongoing. While the case-fatality rate was as high as 33.3% in S. pneumoniae, and 25% in Hib-infected patients, the overall mortality rate was 17.1%. There is a need for greater emphasis on prevention through the use of available vaccines, including the newly introduced conjugate vaccines against Hib which are capable of eliciting immune responses in infants as young as two months.
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PMID:Bacterial meningitis in infants and children in southern Taiwan: emphasis on Haemophilus influenzae type B infection. 790 69

Citrobacter meningitis is an uncommon infection of neonates and young children. It is rarely seen in adults. We describe a 46-year-old man with a mixed bacterial meningitis caused by C. diversus and Klebsiella oxytoca and a 64-year-old woman with C. freundii meningitis. Review of the English-language literature revealed only 2 adult patients with C. diversus meningitis and another 2, with C. freundii meningitis. The ages of these 6 aforementioned patients ranged from 31 to 84 years. Multiple facial fractures, neurosurgical procedures, alcoholism and diabetes mellitus were predisposing conditions. Among the 5 patients whose outcome was known, antibiotic therapy was successful in 4 but failed in 1. This study emphasizes that almost any of the gram-negative bacilli can cause serious infection of the central nervous system in adults in the proper setting.
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PMID:Citrobacter meningitis in adults. 818 83

All 42 cases of Klebsiella pneumoniae meningitis diagnosed between 1981 and 1991 were evaluated. These accounted for 13% of patients with blood and/or cerebrospinal fluid culture-proven bacterial meningitis. There was an increased incidence of K. pneumoniae meningitis from the first 6 years of study (7%) to the last 5 years (16%). K. pneumoniae became increasingly important not only in community-acquired meningitis but also in nosocomial meningitis. 12/13 nosocomial cases were patients who had undergone neurosurgical procedures. The overall mortality rate was 43%. The mortality rate in patients with spontaneous meningitis was higher than that in patients with post-traumatic or postoperative meningitis. Factors that adversely affected mortality were age over 60, diabetes mellitus, and severe neurological deficits on admission. The use of third-generation cephalosporins did not reduce the mortality rate.
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PMID:Klebsiella pneumoniae meningitis: prognostic factors. 819 Dec 46

A prospective, randomized controlled trial was performed from January 1988 to August 1989 involving 66 (33 in each group) children over 3 months of age diagnosed with bacterial meningitis in the pediatric hospital of the All India Institute of Medical Sciences. Children were administered chloramphenicol alone intravenously at a dose of 100 mg.kg-1.day-1 in 4 divided doses. Those who received chloramphenicol + penicillin were given 100 mg.kg-1.day-1 of chloramphenicol and 300,000-400,000 IU.kg-1.day-1 of crystalline penicillin in 6-hourly doses intravenously. Chloramphenicol was given orally after 3-5-days' treatment, if there was an improvement in sensorium and no vomiting. The antibiotics were prescribed for 10-14 days. The cell count ranged from 525 to 16,000 per mcl, while the protein level varied from 53 to 1000 mg.dl. The CSF glucose level as a proportion of the blood glucose ranged from 0 to 69%. There were 3 deaths (4.5%): all in the chloramphenicol + penicillin group. 1 death occurred within 4 hours of admission from Waterhouse-Friderichsen syndrome; in 1 fatal case, the causative agent was a Klebsiella pneumoniae strain resistant to both chloramphenicol and penicillin. Treatment failure (deaths + change of treatment) was recorded for 3 patients (9%) in the chloramphenicol-alone group and for 4 patients (12%) in the chloramphenicol + penicillin group (P 0.05). Intravenous therapy was continued for 4.27 + or - 1.01 days in the chloramphenicol-alone group, while it was required for 10.3 + 1.99 days in the chloramphenicol + penicillin group )P 0.01). Significant thrombophlebitis occurred in 17 patients (58.6%) in the combination group but only in 1 patient (3.3%) in the chloramphenicol-alone group (P 0.001). Drug fever occurred in 3 patients in the combination group and in 1 patient in the chloramphenicol-alone group. After a week of therapy, none of the patients had a total leukocyte count 4000.
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PMID:Antibiotic therapy for bacterial meningitis in children in developing countries. 849 Sep 81


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