Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early clinical data must lead to suspect bacterial meningitis if fever, the most frequent sign, is present and if it is associated with more or less constant neurological and meningeal signs (consciousness impairment, headache, neck stiffness, focal neurological deficit, seizure, etc.). A skin rash is frequent in case of meningococcal meningitis whereas cranial nerve palsy is more in favor of tuberculous or Listeria meningitis. Presence of otitis, sinusitis, pneumonia, or a recent head trauma strongly suggests a pneumococcal involvement. Tuberculous meningitis is generally characterized by a slow evolution of meningeal signs together with aspecific signs. The main prognostic factors are consciousness impairment, circulatory instability, focal neurological signs, and advanced age. Morbidity and mortality are increased in case of pneumococcal compared to meningococcal meningitis. Cranial tomodensitometry gives further information about intracranial complications of meningitis. In some cases, particularly if focal neurological or intracranial hypertension signs are present, it must be performed before a lumbar puncture. The risk factors of meningitis must be investigated and treated if possible according to the bacterium. The management of patient after hospital discharge depends on evolution after treatment. The presence of neurological sequels imposes a specialized ambulatory follow-up. Neuropsychological sequels (cognitive dysfunction, memory impairment) can also persist for years even in absence of other neurological disorders.
 ...
PMID:[Managing adult patients with acute community-acquired meningitis presumed of bacterial origin]. 1947 96

Clinical diagnosis of acute bacterial meningitis may be delayed, either because off lack of sensitivity of clinical signs, or because of a poor vital prognosis; but over diagnosing is also frequent, leading to useless, expensive, and potentially dangerous hospitalizations. We conducted a comprehensive review of English and French literature from 1997 to 2007 by searching MEDLINE to review the accuracy of clinical examination for the diagnosis of meningitis. Additional references were identified by reviewing reference lists of articles back to 1993. We used the keywords "meningitis", "meningitis and clinical features", "cerebrospinal fluid (CSF) pleocytosis", "headache and fever", "Kernig sign", "Brudzinski sign", and "neck stiffness". We excluded nosocomial meningitis. Sensitivity for clinical signs such as headache, vomiting, or fever was low, generally less than 30%, neck stiffness could reach 45%, but the absence of two signs among fever, headache, neck stiffness, and altered mental status eliminated meningitis with a negative predictive value of 95%. Given the seriousness of bacterial meningitis, clinicians perform lumbar puncture (or brain imaging) too often, especially in high-risk patients. Further prospective clinical research is needed to improve the accuracy of bacterial meningitis clinical diagnosis.
 ...
PMID:[Sensitivity and specificity of clinical signs in adults]. 1963 74

We describe a case of bacterial meningitis in a 37 year old man resulting from the direct extension of an spontaneously occurring ischiorectal abscess into the intradural space. The patient presented with back pain and urinary retention and this was followed by the development of headache, photophobia and a left VIth nerve palsy. The patient was not diabetic or immunocompromised. He was treated with broad spectrum antibiotics and with drainage of the ischiorectal abscess; no organism was grown from blood, abscess contents or cerebrospinal fluid. He went on to make a full recovery.
 ...
PMID:Bacterial meningitis associated with a complex ischiorectal abscess. 1980 Feb 42

Bacterial meningitis in adults is fatal in 20% of patients and leads to sequels in 30%. The clinical presentation includes two of the following four symptoms and signs: fever, headache, stiff neck, altered mental status. The essential ancillary test is the analysis of the cerebrospinal fluid. Sometimes, the lumbar puncture is not feasible or deferred (brain computer tomography), requiring antibiotics and corticosteroids early. 80% of bacterial meningitis are secondary to pneumococcus or meningococcus. Empirical antibiotics must be given as soon as possible and provide coverage for these both bacteria. Corticosteroids are also recommended for some meningitis. A score can predict the evolution. Preventive measure must be taken for close contacts of a patient with a meningococcal meningitis.
 ...
PMID:[Acute community-acquired bacterial meningitis in adults]. 1990 35

To report a case of bilateral endophthalmitis as the initial presentation of bacterial meningitis in a young, immunocompetent Korean patient. A 35-year-old female with a one day history of bilateral swollen eyes, visual disturbance, headache, petechial skin rash, and nausea visited our clinic. She was diagnosed as having endogenous endophthalmitis associated with bacterial meningitis. Intravenous broad spectrum antibiotic therapy was initiated with cefotaxime 3 g and ubacillin 3 g, four times daily. Intravitreal antibiotic (vancomycin 1 mg/0.1 mL and ceftazidime 2 mg/0.1 mL) injections were performed in both eyes. Two weeks post presentation, the best corrected visual acuity in both eyes improved to 0.7, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, intravitreal and intravenous antibiotics should be promptly administered to preserve vision.
 ...
PMID:Bilateral endophthalmitis as the initial presentation of bacterial meningitis. 2004 99

Bacterial meningitis remains a dangerous disease with frequent complications despite specific antibiotic therapy and intensive medical supportive treatment. Principal symptoms are headaches, high fever, meningismus and confusion or drowsiness that usually develop within a few hours. The diagnosis is mainly based on the examination of the cerebrospinal fluid and detection of the pathogen in the liquor or blood. Implementation of an early, empirical antibiotic therapy is important for the prognosis; community-acquired meningitides in adults should be treated with ceftriaxone and ampicillin. For infections with meningococci, the public health authorities must be also informed and chemoprophylaxis with rifampicin, ciprofloxacin or ceftriaxone for close contacts should be carried out.
 ...
PMID:[Could it be bacterial meningitis?]. 2010 9

Bacterial meningitis is a neurological emergency. Empiric antimicrobial and adjunctive therapy should be initiated as soon as a single set of blood cultures has been obtained. Clinical signs suggestive of bacterial meningitis include fever, headache, meningismus, vomiting, photophobia, and an altered level of consciousness. The peripheral white blood cell count with a left shift, an elevated serum procalcitonin and C-reactive protein, and a cerebrospinal fluid pleocytosis with a predominance of polymorphonuclear leukocytes, and a decreased glucose concentration are predictive of bacterial meningitis. Patients with documented bacterial meningitis and those in whom the diagnosis is a strong possibility should be admitted to the intensive care unit. Timely recognition of bacterial meningitis and initiation of therapy are critical to outcome.
 ...
PMID:Bacterial meningitis. 2010 74

Multiple myeloma is a hematolymphoid malignancy, and patients with this disorder are frequently complicated by infection. An 80-year-old woman with multiple myeloma was complicated by bacterial meningitis, and was admitted to our hospital in August 2007. She initially received ceftriaxone, but culture of cerebrospinal fluid detected Listeria monocytogenes. Ampicillin was administered, but headache and pyrexia persisted for 2 weeks, and on cerebrospinal fluid examination, the proliferation of polymorphonuclear leukocytes had not resolved. After medication with meropenem was started, the clinical symptoms completely disappeared, and the abnormalities on cerebrospinal fluid examination resolved. The patient ultimately received meropenem for 27 days, resulting in a cure. In conclusion, meropenem is useful to treat bacterial meningitis caused by L. monocytogenes. This agent is indicated when ampicillin shows inadequate effect or if the patient has an allergy to ampicillin.
 ...
PMID:Antibiotic treatment for bacterial meningitis caused by Listeria monocytogenes in a patient with multiple myeloma. 2011 40

In the acute setting, the primary objective is to decide whether the headache is primary, secondary but benign (for example a headache associated with a cold), or secondary to a potentially life-threatening cause (subarachnoid hemorrhage (SAH), bacterial meningitis, intracranial hypertension). The cornerstone of headache diagnosis is the interview with the patient, followed by a thorough physical examination. These two first clinical steps determine the need for investigation, immediate with inpatient care or on an outpatient basis, and the treatment to recommend, acutely and for future attacks in the case of primary headache. The indication for referral to a neurologist for long-term follow-up is assessed. Headaches can be separated into four groups: (1) recent onset and thunderclap; (2) recent onset with progressive installation: (3) well known to the patient and episodic (attacks with headache-free periods, as in episodic migraine or cluster headache); and (4) chronic daily headaches (more than 3 months, more than 15 days of headache per month). Headaches with a recent onset and judged unusual or worrisome by the patient (even one with frequent headaches) must raise the suspicion of a secondary cause and need to be investigated. Headaches that continue for months or years are more often primary, but secondary causes need to be ruled out in certain cases.
 ...
PMID:Acute headache in the emergency department. 2081 19

Meningococcal infections may develop as episodic or endemic cases particularly among children attending day-care centers, boarding schools or among military personnel. Bivalent (A/C) meningococcal vaccine is applied to all new military stuff since 1993 in Turkey. In this report two cases of meningococcemia and meningitis, developed in two soldiers vaccinated with meningococcal vaccine, were presented. The first case was a 21 years old male patient who was admitted to the emergency service with the complaints of high fever, headache, fatigue and vomiting. He was conscious, cooperative and oriented with normal neurological findings. Maculopapular exanthems were detected at the lower extremities. The patient was hospitalized with the initial diagnosis of sepsis or meningococcemia and empirical treatment was initiated with ceftriaxone and dexamethasone. Cerebrospinal fluid (CSF) examination yielded 10 cells/mm3 (lymphocytes) with normal CSF biochemical parameters. A few hours later skin rashes spread over the body rapidly, the symptoms got worse, confusion, disorientation and disorientation developed, and the patient died due to cardiac and respiratory arrest at the seventh hour of his admission. The second case was also a 21 years old male patient who was admitted to the hospital with the complaints of fever, headache, painful urination, confusion and agitation. He was initially diagnosed as acute bacterial meningitis due to clinical (stiff neck, positive Kernig and Brudzinsky signs) and CSF (8000 cells/mm3; 80% polymorphonuclear leukocytes, increased protein and decreased glucose levels) findings. Empirical antibiotic therapy with ceftriaxone was initiated and continued for 14 days. The patient was discharged with complete cure and no complication was detected in his follow-up visit after two months. The first case had an history of vaccination with bivalent (A/C) meningococcal vaccine three months ago and the second case had been vaccinated one month ago. The bacteria isolated from the blood culture of the first case and the CFS culture of the second case, were identified as Neisseria meningitidis by conventional and API NH system (BioMerieux, France). The isolates were serogrouped as W135 by slide agglutination method (Difco, USA), and both were found to be susceptible to penicillin and ceftriaxone. As far as the last decade's literature and these two cases were considered, it might be concluded that N.meningitidis W135 strains which were not included in the current bivalent meningococcal vaccine, gained endemic potential in Turkey. Since N.meningitidis W135 strains may lead to serious diseases, vaccination of the risk population with the conjugate tetravalent meningococcal vaccine (A/C/Y/W135) should be taken into consideration in Turkey.
 ...
PMID:[Meningococcemia and meningitis due to Neisseria meningitidis W135 developed in two cases vaccinated with bivalent (A/C) meningococcal vaccine]. 2106 98


<< Previous 1 2 3 4 5 6 7 8 9 10