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

We evaluated the diffusion of cefpirome into the cerebrospinal fluid (CSF) of 25 patients with bacterial meningitis or ventriculitis who were receiving conventional antibiotic treatment. A single cefpirome dose of 2 g was infused at day 2-3 after the onset of therapy. Concentrations of cefpirome in serum and CSF obtained at 2, 4, 8 or 12 h after the infusion were determined by high-performance liquid chromatography. The mean (+/- S.E.M.) concentrations of cefpirome in CSF ranged from 2.26 +/- 1.16 to 4.17 +/- 0.83 mg/L. These concentrations were higher than the MBCs for the pathogens usually responsible for bacterial meningitis.
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PMID:Diffusion of cefpirome into the cerebrospinal fluid of patients with purulent meningitis. 160 58

Thrombosis of cortical veins has been postulated as an important cause of seizures and focal neurologic deficits in patients with bacterial meningitis. Diagnoses from autopsies, angiograms, and medical records at Massachusetts General Hospital, 1960-1984, were reviewed to identify patients with septic cortical thrombophlebitis. Only 10 confirmed cases of septic cortical vein thrombosis without sagittal sinus thrombosis were found. Meningitis was present in nine patients; Streptococcus pneumoniae was isolated from the blood or cerebrospinal fluid of five patients. Common clinical manifestations included fever, seizures, and focal neurologic signs. Half the patients survived, but three had persistent disabilities. Cortical vein thrombosis could be documented in only approximately 1% of 790 cases of bacterial meningitis. In 97 patients with meningitis who died and had autopsies, cortical thrombophlebitis was identified in 5%. In autopsied patients, other pathologic processes including arteritis, ventriculitis, cavernous sinus thrombosis, and cerebral infarctions were usually more prominent than venous thrombosis. Cortical thrombophlebitis does not appear to be the major cause of seizures or focal neurologic signs during bacterial meningitis.
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PMID:Septic cortical thrombophlebitis. 218 5

Gd-DTPA-enhanced MR images of experimental bacterial meningitis were obtained after Staphylococcus aureus was inoculated directly into the cisterna magna of four dogs. Each animal was studied with both unenhanced and enhanced MR and CT with Gd-DTPA and meglumine iothalamate, respectively. The enhancement patterns resulting from these techniques were compared and images were correlated with histopathology. All animals demonstrated abnormal leptomeningeal enhancement on MR with Gd-DTPA, but only one of four dogs exhibited abnormal contrast enhancement on CT. In these animals Gd-DTPA-enhanced MR also identified complications of meningitis, such as ventriculitis and cerebritis, more effectively than CT did. Unenhanced MR was not helpful in identifying meningitis. Histologic evaluation demonstrated that the abnormal areas of contrast enhancement on MR and CT correlated with inflammatory cell infiltration. However, some regions of mild leptomeningitis, ependymitis, and cerebritis identified histologically did not demonstrate abnormal enhancement. Since the animal model used was clinically and pathologically similar to human meningitis, we propose that Gd-DTPA-enhanced MR will subsequently be found more effective than unenhanced MR and IV contrast-enhanced CT for demonstrating meningitis and its complications in humans.
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PMID:Dyke award. Gd-DTPA-enhanced MR imaging of experimental bacterial meningitis: evaluation and comparison with CT. 278 67

Despite significant improvement in mortality rate, survivors of neonatal bacterial meningitis experience a significant incidence of neurodevelopmental sequelae. Neuropathologic studies have demonstrated vasculitis, arachnoiditis, and ventriculitis with secondary edema and encephalomalacia. Areas of cerebral infarction, most commonly thought to be venous in origin, have been reported as well. We performed cranial computed tomographic scans on all eight neonates with bacterial meningitis admitted to our Newborn Special Care Unit within the past 36 months and demonstrated abnormalities in seven. Six of these infants were found to have large areas of infarction related primarily to major arterial vascular distributions. We suggest computed tomographic studies for all neonates with bacterial meningitis and subsequent scans at 4-6 months of age in those with abnormal neonatal scans in order to plan better for early intervention services.
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PMID:Bacterial meningitis as an etiology of perinatal cerebral infarction. 350

Serial cranial ultrasound examinations were performed through the anterior fontanel to detect and follow the complications of bacterial meningitis in 16 neonates. The final results included normal findings in 9 patients, and abnormal in the other 7 cases. Among the latter, 5 patients with hydrocephalus were sequentially found after the second week of the disease and the earlier the onset, the larger the ventricular dilation. One ventriculitis showed polycystic loculi with abnormal septa in the advanced stage. Cystic low attenuation lesion with mass effect at a later stage of meningitis specified one patient with brain abscess. Progressive dilatation of ventricular systems without associated growth of head girth disclosed a process of brain atrophy. They had neither obvious neurological signs nor specific CSF findings clinically, but their sonograms showed the abnormal changes which were finally proved by CT scans. The potential value of cranial ultrasound in the detection of post-meningitic complication besides CT scan is stressed.
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PMID:Cranial ultrasound in the detection of postmeningitic complications in the neonates. 351 20

We evaluated the diffusion of ciprofloxacin into the cerebrospinal fluid (CSF) in 23 patients with bacterial meningitis or ventriculitis undergoing treatment with other antibiotics. Three successive ciprofloxacin doses of 200 mg were administered intravenously at 12-h intervals, first between days 2 and 4 and again between days 10 and 20 after the admission. Concentrations of ciprofloxacin in plasma and CSF obtained at 60, 120, 240, and 480 min after the third infusion were determined by high-performance liquid chromatography. In addition, serial samples were obtained from ventricular fluid in four patients. The concentrations of ciprofloxacin in CSF ranged from 0.35 to 0.56 micrograms/ml. These concentrations were equal to or higher than the MICs for most of the enterobacteria.
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PMID:Penetration of ciprofloxacin into cerebrospinal fluid of patients with bacterial meningitis. 361 22

A retrospective study was performed on 78 patients (newborn to 2 years old) with clinically proved bacterial meningitis. Sonograms were obtained during the acute illness and medical records were reviewed. The spectrum of sonographic features of meningitis included normal scans (30 patients), ventriculomegaly (11 patients), echogenic sulci (31 patients), extra-axial fluid collections (26 patients), abnormal parenchymal echogenicity (9 patients), evidence of ventriculitis (5 patients), and brain abscess (1 patient). In 46 patients, correlation between the sonographic findings and neurologic outcome on clinical follow-up (6 months to 4 years) was made. Findings of abnormal parenchymal echogenicity and/or moderate-to-marked ventriculomegaly were associated with significant neurologic sequelae; however, echogenic sulci and small extra-axial fluid collections did not appear to have any prognostic significance. Twenty-nine of the 78 patients had sonography without clinical indication of complications of meningitis, and in no patient was a significant abnormality found. Our study suggests that sonography is indicated only when there is clinical suspicion of complications.
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PMID:Bacterial meningitis in infants: sonographic findings. 388 91

In three groups of patients levels of cefotaxime in serumand cerebrospinal fluid were determined. Therapeutic value and efficacy are discussed in meningitis patients. Nine concentrations of cefotaxime in lumbar and ventricular CSF out of 19 in a group of seven neurosurgical patients with mild to moderate impairment of the blood-CSF-barrier were higher than 0.5 micrograms/ml. In seven determinations in a second group of six patients with no or very little dysfunction of the blood-cerebrospinal-fluid barrier only twice cefotaxime was not detectable in lumbar CSF. Concentrations of cefotaxime in 25 determinations of lumbar or ventricular CSF in six patients with bacterial meningitis ranged from 1.1 micrograms/ml to 19.2 micrograms/ml. Treatment with cefotaxime alone was successful in a patient with E. coli meningitis and ventriculitis after infection of a ventriculo-atrial shunt and in another patient with pneumococcal meningitis and penicillin allergy. The other four patients with bacterial meningitis were treated successfully by antibiotics including cefotaxime.
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PMID:Cefotaxime in treatment of meningitis and ventriculitis? Evaluation of drug concentrations in human cerebrospinal fluid. 627 58

Pharmacokinetic variables were studied in children with central nervous system infections who received a single dose of ceftriaxone sodium. After initial lumbar puncture of children with documented or suspected bacterial meningitis, ventriculitis, or both, therapy was initiated with i.v. ampicillin and chloramphenicol. Children were randomly selected to receive a single i.v. dose of ceftriaxone. Concentrations of ceftriaxone were measured in plasma at intervals from 0 to 720 minutes after the beginning of the infusion and in cerebrospinal fluid (CSF) at one to five hours after the dose. Blood samples were obtained immediately after the second lumbar puncture for assessment of drug penetration into CSF. Elimination rate constant, elimination half-life, apparent volume of distribution, and plasma clearance were determined from samples obtained 30-720 minutes after the start of the infusion. In two children with ventriculoperitoneal shunts, serial determinations of ceftriaxone in CSF were obtained. All eight children who received 75 mg/kg and five of eight who received 50 mg/kg had positive CSF cultures. Volume of distribution was less after the 50 mg/kg dose than after the 75 mg/kg dose. In the children with shunts, adequate CSF drug concentrations were maintained throughout 12 hours of testing. These data support a 12-hour dosage interval, but clinical studies are needed to evaluate efficacy of the drug at both 12-hour and 24-hour dosage regimens.
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PMID:Single-dose plasma and cerebrospinal fluid pharmacokinetics of ceftriaxone in infants and children. 631 77

We evaluated the diffusion of pefloxacin into the cerebrospinal fluid (CSF) in 15 patients with bacterial meningitis or ventriculitis, 14 of whom were treated with other antibiotics. Three doses of pefloxacin were administered at 12-h intervals to 11 patients intravenously and to 4 patients orally. Individual doses were 7.5 mg/kg in seven patients and 15 mg/kg in eight patients. Plasma and CSF levels were determined by a high-performance liquid chromatographic assay. The concentrations of pefloxacin in CSF were measured 2 h after the third intravenous dose and 4 h after the third oral dose. In patients receiving 7.5 mg/kg, peak levels in plasma ranged from 6.8 to 16 micrograms/ml, and trough levels were from 2 to 7.5 micrograms/ml. Concentrations in CSF ranged from 2.4 to 9 micrograms/ml. In patients receiving 15 mg/kg, peak levels in plasma ranged from 14 to 18.6 micrograms/ml, and trough levels were from 4 to 13.2 micrograms/ml. Concentrations in CSF ranged from 6.5 to 13 micrograms/ml. These preliminary data indicate that pefloxacin diffuses well into the CSF of patients with inflamed meninges.
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PMID:Penetration of pefloxacin into cerebrospinal fluid of patients with meningitis. 659 70


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