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)

Ventriculolumbar perfusion chemotherapy with methotrexate (MTX) and cytosine arabinoside (Ara-C) was performed in six patients with meningeal dissemination of malignant disease. Ten mg of MTX and 40 mg of Ara-C were injected via Ommaya reservoir every 12 hours for 3 days. During perfusion, we observed nausea and vomiting, low grade fever, confusion, nystagmus, paresthesia or numbness of the lower extremities, and multicranial nerve impairment, which disappeared soon after perfusion chemotherapy. After treatment, one patient developed bacterial meningitis, and two developed MTX-induced interstitial pneumonitis, which was cured by steroid therapy. Signs and symptoms due to involvement of the cerebrum, cranial nerves and spinal cord or spinal roots, improved more than by standard intrathecal chemotherapy. Laboratory cerebrospinal fluid (CSF) findings, i.e., cell count and cytological appearance, also improved more than by standard intrathecal chemotherapy. EEG, CT scan and MRI data revealed a worsening of EEG findings in one patient, and a small lesion on MRI, which was not seen by CT scan, disappeared after treatment in two patients.
 ...
PMID:[Ventriculo-lumbar perfusion chemotherapy with methotrexate and cytosine arabinoside for meningeal dissemination of malignant disease]. 205 75

A 45-year-old woman had pyrexia, headaches, collapse and hyponatraemia. Intracerebral abscess, bacterial meningitis and subarachnoid haemorrhage were excluded. She was given intravenous antibiotics and gradually recovered. One month later she was readmitted with diplopia, headache and vomiting. Serum sodium was low (107 mmol/l) and a diagnosis of inappropriate ADH secretion was made. MRI scan showed a suprasellar tumour arising from the posterior pituitary gland. A skin rash gradually faded. Serum cortisol, prolactin, gonadotrophins and thyroid hormone levels were low. A pituitary tumour was removed trans-sphenoidally, she had external pituitary radiotherapy, and replacement hydrocortisone and thyroxine. She was well for 12 months when she developed progressive weakness and numbness of both legs. Examination suggested spinal cord compression at the level of T2 where MRI scanning showed an intradural enhancing mass. This spinal tumour was removed and her neurological symptoms disappeared. Nine months after this she developed facial pain and nasal obstruction. CT scan showed tumour growth into the sphenoid sinus and nasal cavities. A right Cauldwell-Luc operation was done and residual tumour in the nasal passages was treated by fractionated external radiotherapy and Prednisolone. Histological examination of the specimens from pituitary, spinal mass, and nasal sinuses showed Rosai-Dorfman disease, a rare entity characterized by histiocytic proliferation, emperipolesis (lymphophagocytosis) and lymphadenopathy. Aged 48 she developed cranial diabetes insipidus. Although Rosai-Dorfman syndrome is rare, it is being reported with increasing frequency, and should be borne in mind as a possible cause of a pituitary tumour.
 ...
PMID:Rosai-Dorfman disease presenting as a pituitary tumour. 1034 67

Atrioesophageal fistula is a rare, devastating complication of atrial fibrillation ablation, reportedly occurring in 0.015-0.04% of catheter ablations. A 66-year-old African American male with a past medical history of chronic atrial fibrillation status post recent radiofrequency ablation and on chronic anticoagulation with rivaroxaban presented with left upper extremity numbness, tingling, and transient weakness. He was admitted for a cerebrovascular accident workup; a 12-lead electrocardiogram revealed atrial fibrillation and magnetic resonance imaging of the brain was consistent with multifocal embolic infarcts. Hospital course was further complicated by persistent high-grade fevers, gram-positive bacteremia, and worsening mental status requiring mechanical ventilation. Lumbar puncture was consistent with bacterial meningitis. Transthoracic echocardiogram was negative for vegetations. Computed tomography angiography of the chest with intravenous contrast revealed an outpouching off the posterior wall of the left atrium at the level of the inferior pulmonary vein, consistent with an atrioesophageal fistula. We present this case to highlight the clinical features of a rare but potentially fatal complication from a commonly performed procedure requiring prompt recognition and life-saving intervention.
 ...
PMID:Atrioesophageal fistula with meningitis: A rare complication of atrial fibrillation ablation, case report and literature review. 3272 37