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

All cases of unusual types of gram-negative bacillary meningitis in a university hospital over a five year period were retrospectively analyzed. These patients comprised 4.2 per cent of cases of bacterial meningitis among all patients, 69 per cent of neurosurgical cases and 42 per cent of neonatal cases. The over-all mortality was 40.3 per cent. The two most common bacterial isolates were Escherichia coli in patients younger than one year and Klebsiella species in patients above that age. Infection may be acquired at birth or at the time of surgery, or may be secondary to spread of infection from other body sites. Gram-negative bacillary meningitis is a nosocomial infection and this diagnosis should be suspected in patients in whom central nervous system infection develops in the hospital.
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PMID:Gram-negative bacillary meningitis. 110 20

High levels of cerebrospinal fluid (CSF) lactic acid dehydrogenase (LDH) activity were found in 23 cases of bacterial meningitis, but significantly lower levels of CSF LDH activity were observed in 11 patients with viral meningitis and in 13 patients with no central nervous system infection. No correlation was found between levels of CSF LDH activity and specific agents or the amounts of CSF white blood cell, protein, and glucose. The number of meningitis cases of unknown cause that could be classified as probably bacterial or viral was increased by determination of the level of CSF LDH activity. The level of CSH LDH activity is useful in differentiating bacterial from viral meningitis and, along with determination of the CSF blood cell counts and protein and glucose levels, aids in classification of meningitis before culture results are available.
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PMID:Cerebrospinal fluid lactic acid dehydrogenase activity. Levels in untreated and partially antibiotic-treated meningitis. 116 86

Haemophilus influenzae type b is a human bacterial pathogen that causes approximately 12,000 cases of H influenzae type b meningitis and 7500 cases of other forms of invasive disease annually in the United States. This organism is the leading cause of bacterial meningitis in the United States. The cause of meningitis can be established more accurately than that of other forms of invasive bacterial disease because the isolation of the bacterium from the cerebrospinal fluid or blood and/or the detection of bacterial antigen can correctly attribute the infection to a specific bacterial agent and dictate appropriate antimicrobial therapy. In children, more than 95% of all invasive diseases attributable to Haemophilus species, including septicemia, pneumonia, epiglottis, cellulitis, arthritis, osteomyelitis, and pericarditis, are due to H influenzae type b. It has been estimated that systemic disease caused by H influenzae type b occurs in approximately 1 in 200 children in the United States before the age of five. The case fatality rate for H influenzae type b meningitis is approximately 5%, and substantial morbidity has also been documented to result from central nervous system infection with this agent. Of surviving children reported in a 1969 paper, 40% had significant neurologic sequelae after meningitis. A more recent study demonstrated substantial neurologic improvement during the first few months after hospitalization, but at 1 year of age 8% of the children had neurologic or intellectual sequelae of their meningitis. Milder defects with an array of developmental problems have been reported in as many as one third to one half of all survivors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiology of Haemophilus influenzae type b infections. 217 52

Bacterial meningitis remains the most common type of central nervous system infection in both developing and developed countries. Despite modern antimicrobial chemotherapy, the incidence of severe neurological sequelae remains high. We review the pathogenesis of these sequelae and correlate them with computed tomography (CT) appearances. Early diagnosis and appropriate chemotherapy remain the cornerstones of management. Early and accurate diagnosis of complicating space-occupying lesions with the aid of CT and appropriate aggressive therapy are suggested if the prognosis is to be improved.
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PMID:Severe neurological sequelae of childhood bacterial meningitis. 286 46

A prospective study to determine the value of cerebrospinal fluid analysis in the differential diagnosis of meningitis was performed in 710 consecutively observed patients, both children and adults, who underwent lumbar puncture due to suspected central nervous system infection. Diagnoses included acute or presumed bacterial meningitis (n = 79), acute or presumed viral meningoencephalitis (n = 218), acute unclassified meningitis (n = 6), other infections of the central nervous system (n = 37), non-infectious neurological diseases (n = 76) and control patients (n = 294). The sensitivity, specificity and predictive values were determined for cerebrospinal fluid white blood cell count, total protein, lactate, glucose and C-reactive protein levels as well as the blood/cerebrospinal fluid glucose ratio. Determination of cerebrospinal fluid levels of lactate (greater than or equal to 3.5 mmol/l) was found to be superior to the other tests. The C-reactive protein level gave no additional diagnostic information when the lactate level was determined. The white blood cell count, and total protein and glucose levels were often unreliable tools for differential diagnosis, largely due to low sensitivity at realistic discriminatory limits. The study confirms that no cerebrospinal fluid test is fully reliable in distinguishing bacterial meningitis from other forms of meningitis.
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PMID:Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis: a study in 710 patients with suspected central nervous system infection. 313 38

Prompt and accurate diagnosis of acute central nervous system infections is of vital importance to the emergency physician. With the advent of modern antimicrobial therapy, the nearly uniformly fatal outcome of untreated bacterial meningitis can be reduced substantially. Proper test selection is crucial in arriving at a correct and timely diagnosis. A variety of tests are currently available for evaluation of the patient with an acute central nervous system infection. We review the current state of the art in central nervous system testing. Cost considerations and an algorithm for efficient selection of appropriate tests are presented.
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PMID:Cerebrospinal fluid cultures and analysis. 351 94

Cerebrospinal fluid lactate (CSF) was measured by a rapid enzymatic method in 230 patients admitted with a suspected diagnosis of central nervous system infection. In all untreated cases of bacterial meningitis the levels exceeded 4.3 mmol/l and fell below 3.9 mmol/l in most patients with virus meningitis. We believe values of 3.9-4.3 mmol/l should be considered borderline as occasional CSF samples in cases of virus meningitis yield values in this range. However, distinction between untreated pyogenic meningitis and virus meningitis is rarely problematic in clinical practice, so routine use of the test as an emergency procedure offers no extra advantage. The test is unlikely to be of much help in differentiating partly treated bacterial meningitis from virus meningitis, but it is a valuable additional procedure for differentiating tuberculous meningitis from virus meningitis, highly modified bacterial meningitis and parameningeal septic states.
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PMID:How useful is cerebrospinal fluid lactate estimation in differential diagnosis of meningitis? 688 54

A retrospective chart review was performed to evaluate the effect that positive results of cerebrospinal fluid bacterial antigen tests had on the care of patients with presumed bacterial meningitis. Of 901 tests ordered, costing $26,000 per year, 29 showed positive results--and only four of these affected patient care. By using cerebrospinal fluid bacterial antigen testing only when another test does not identify an organism, or in an attempt to determine central nervous system infection late in therapy for presumed sepsis, one can greatly reduce costs with no detrimental effect on patients.
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PMID:Clinical usefulness of cerebrospinal fluid bacterial antigen studies. 784 87

A retrospective analysis of all patients admitted with the diagnostic codes of aseptic or viral meningitis was performed at two institutions over 3 years. Forty-one patients with cerebrospinal fluid confirmation of aseptic meningitis (increased protein; increased white count; negative gram stain; and negative fungal, tuberculosis, and bacterial cultures) were analyzed. All the patients had headache, which was typically severe and bilateral in 39 of the 41 patients. The headache was of abrupt onset or the worst of the patient's life in 24 of the patients. The quality of the headache, when described, was usually throbbing (11 of 14). Nineteen patients had prodromal symptoms, including malaise, myalgia, gastrointestinal symptoms, and urinary tract infections. All had associated symptoms, including nausea (25), vomiting (23), photophobia (18), stiff neck (25), and back pain (11). Thirty patients were febrile. Lumbar puncture was performed for headache and fever unexplained by systemic illness in 30 patients, meningeal signs in 15, headache of abrupt onset or the worst headache ever in 24, neurologic signs or symptoms in 12, and for other reasons in 2. Computerized tomography, when performed, was negative in all cases. Focal neurologic findings were present in 5 patients, a decreased level of consciousness in 6, and papilledema in 1. A severe headache that worsens, is abrupt in onset, or is the worst of the patient's life could be due to aseptic meningitis, bacterial meningitis, or a subarachnoid hemorrhage. Although not universally present, meningeal signs, fever, and neurologic signs or symptoms should alert one to a possible central nervous system infection.
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PMID:Headache associated with aseptic meningitis. 853 Feb 75

CRP level was determined in the cerebrospinal fluid in 40 cases of bacterial meningitis. Similar determination in serum was done in 32 of these patients. Aetiological verification was possible in 90% of cases. Meningitis caused by Str. pneumonia and Neisseria meningitides prevailed (52.5% and 27.5% respectively). The control group comprised 20 subjects. For CRP demonstration immunochemical and turbidimetric methods were used. CRP in CSF was raised in 62.5% of the study cases while in the serum it was raised in all of them. CRP detection in serum in acute phase of central nervous system infection is diagnostically important since CRP increase suggests a purulent process.
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PMID:[C-reactive protein (CRP) and its significance in purulent meningitis]. 858 95


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