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

Although anaerobic bacterial meningitis is uncommon, patients subjected to resection of head and neck malignancy appear at special risk. In this article, the authors report on a 72-year-old man in whom meningitis developed after extensive resection of the right sinuses for squamous cell carcinoma; initial treatment consisted of intravenous vancomycin and ceftazidime. Intravenous penicillin G was added after the fortuitous early finding of intracellular cocci in Wright-Giemsa stained cerebral spinal fluid submitted for cell count. Cerebral spinal fluid cultures then grew out a pure culture of Peptostreptococcus magnus. The patient had a complete recovery, without neurologic sequelae, recurrence of malignancy, or evidence of infection. Appropriate handling of cerebral spinal fluid specimens is crucial to ensure the correct diagnosis when anaerobic organisms are suspected.
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PMID:Case report: anaerobic meningitis caused by Peptostreptococcus magnus after head and neck surgery. 807 38

The diagnosis of bacterial meningitis rests on examination of the CSF. The gross appearance of the fluid may be cloudy or turbid if the white cell count is elevated. Gram's staining should always be used in examining CSF, as it permits rapid and accurate identification of the etiologic agent in approximately 60 to 90 percent of cases of bacterial meningitis. The CSF culture is positive in approximately 70 to 85 percent of patients with bacterial meningitis. Many other rapid diagnostic tests have been developed to aid in the diagnosis of bacterial meningitis when Gram's staining gives negative results. Nevertheless, newer techniques are more rapid and sensitive, postgraduate training in laboratory medicine should include basic clinical skills (Communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain, etc.) and 24 hours on-call service system by laboratory physicians. It must not be focused solely on the sophistication of laboratory methods. We must notice that an increasing gap between the clinic and the laboratory. Current needs require us to make a major attempt to bridge this gap. We, laboratory physicians must modify our behavior effectively and accept the value and limitations of laboratory automation and information technology. We must work more closely with physicians and other health care professionals to establish a good collaborative partnership with them.
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PMID:[Laboratory logistics for infectious diseases--from clinical laboratory physicians]. 1218 1

We report a rare case of urinary retention secondary to meningitis. A 15-year-old previously healthy male patient admitted to our clinic with complaint of fever, inability to urinate and vomiting, with a two-day history of clavulanate amoxicillin usage. Lumbar puncture was performed, demonstrating a cloudy cerebrospinal fluid (CSF), with protein concentration of 86 mg/dl and glucose concentration of 72 mg/dl, and simultaneous blood glucose of 137 mg/dl. Cell count was 170/microL (neutrophil 154, lymphocyte 11), latex agglutination was negative and no microorganism was detected with Gram stain; there were few polymorphonuclear leukocytes with Wright stain. Cranial tomography was normal and CSF culture and blood culture did not yield any microorganisms. He was treated with ceftriaxone as empirical therapy for bacterial meningitis. In just six days after admission, voiding inability had recovered completely. Although acute urinary retention in patients with meningitis may be self-limited and there is no evidence that any treatment affects its clinical course, physicians should be aware of acute urinary retention as a rare but critical manifestation of meningitis.
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PMID:Unusual sign of meningitis: acute globe vesicalis. 2056 Feb 61