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

A retrospective review of charts for 650 children who had lumbar puncture for suspected meningitis was undertaken to determine the characteristics of patients with and without meningitis, identify other conditions suggesting meningitis, and evaluate the predictive value of signs and symptoms of meningitis. The incidence of positive lumbar punctures increased with patient age. Younger infants did not present with classical features of meningitis. Bulging fontanel, lethargy, and irritability were nonspecific symptoms. Vomiting and headache, although not specific, proved to be more sensitive indicators of meningeal infection. Most patients with meningitis (75%) had at least one sign of meningeal irritation, but so did 25% of patients without meningitis. Brudzinski's sign was not specific. In contrast, nuchal rigidity and Kernig's sign had high predictive value. Up to age five, the diseases most often suggesting meningitis were right-sided pneumonia, gastroenteritis, otitis, tonsillitis, exanthema subitum, and urinary tract infections. Of 171 patients with febrile convulsion, one (0.5%) had bacterial meningitis and four had aseptic meningitis.
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PMID:Diseases that mimic meningitis. Analysis of 650 lumbar punctures. 220 11

A clinical diagnosis of meningitis in neonates is difficult because of paucity of physical findings. In older infants and children, nuchal rigidity, Kernig's or Brudzinski's sign, or bulging fontanelles are sought. A review of 1,064 cases of bacterial meningitis beyond the neonatal period revealed that 16 (1.5%) patients had none of those meningeal signs during the entire hospitalization, despite CSF pleocytosis. Eight patients (50%) were 2 years old or older. Lumbar punctures were done because of unexplained fever, changes in behavior or mental status,, seizures, or occurrence of skin petechiae in febrile patients. These patients frequently had moderate pleocytosis and all survived. The meningitis was caused by Neisseria meningitidis in seven patients, Haemophilus influenzae in six, Streptococcus pneumoniae in two, and Salmonella enteritidis in one patient. CSF should be examined in a patient of any age whenever meningitis is a consideration, even if patients lack meningeal signs.
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PMID:Bacterial meningitis without clinical signs of meningeal irritation. 707 40

The purpose of this report is to describe the bacteriological features, clinical signs and therapeutic outcome of 148 cases of W135 meningococcus meningitis observed during meningitis outbreaks in Burkina Faso in 2002 and 2003. Diagnosis was based on microbiological study of cerebrospinal fluid. Cases of meningococcus meningitis were recorded throughout the study period with the peak number of cases occurring around the 14th week. There was a slight male predominance (56.1%) and young patients between one and 15 years accounted for 81.7% of cases. The mean interval between onset of symptoms and hospitalization was 2.6 days and the mean duration of hospitalization was 5.5 days. The most common clinical signs were fever (98.6%), stiff neck (90.5%),Brudzinski's sign (85.1%),Kernig's sign (66.2%), altered consciousness (41.9%), vomiting (36.5%) and headaches (34.5%). In most cases treatment with a singie dose of chiorazuphenicol in oil was curative. Overall mortality was 15.5% idth no correlation with sex or age. Seventeen of the 23 deaths occurred within 24 hours after their admission to the hospital. The other six deaths occurred on the second day after admission inS cases and fifth day in one case. Convulsions, shock and altered consciousness were consistent poor prognostic signs. A correlation was found between mortality and interval for hospitalization with better survival in patients receiving prompt treatment. Study of the susceptibility of 102 samples showed that W135 meningococcus was sensitive to penicillin G, ampicillin,ceftriaxone and chloramphenicol but resistant to sulfamides (cotrimoxazole). Bacterial meningitis is an Important factor of morbidity and mortality worldwide. Our findings indicate that the bacteriological, clinical and epidemiological characteristics of W135 meningococcus is do not differ greatly from those of meningococcus A. Since W135 meningitis is susceptible to antibiotics used to cure meningitis, campaigns to promote early detection and treatment must be continued.
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PMID:[W135 meningococcus meningitis: study of 148 cases observed in 2002 and 2003 at the National Teaching Hospital of Ouagadougou, Burkina Faso]. 1677 36

To prospectively determine the diagnostic accuracy of nuchal rigidity, Kernig's sign, and Brudzinski's sign in children with suspected bacterial meningitis. Children 3 months to 17 years old diagnosed with bacterial meningitis and matched controls without bacterial meningitis were enrolled. The diagnostic accuracy was calculated independently for each test and for a combinations of tests. Of 86 children, 40 (46.5%) had bacterial meningitis. The sensitivity, specificity, LR+, and LR- were 64.5%, 53.5%, 1.4, and 0.7 for nuchal rigidity, 52.6%, 77.5%, 2.3, and 0.6 for Brudzinski's sign, and 51.4%, 95.0%, 10.3, and 0.5 for Kernig's sign. The three tests did not yield any better results in the subsets of children with moderate or severe meningeal inflammation, nor in relation to any of the causative pathogens. In children with suspected meningitis, the three classic signs did not have a high diagnostic value and better bedside diagnostic signs are required.
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PMID:The diagnostic accuracy of the 'classic meningeal signs' in children with suspected bacterial meningitis. 2291 16

Invasive Haemophilus influenzae type b (Hib) disease decreased dramatically after the introduction of conjugate vaccine in routine immunization schedules. We report a case of a fifteen-months-old girl, previously healthy and vaccinated, admitted in the emergency room with fever and vomiting. She was irritable and the Brudzinski's sign was positive. The cerebrospinal fluid (CSF) analysis showed pleocytosis and high protein level. Empiric intravenous antibiotics (ceftriaxone and vancomycin) were administered for suspected bacterial meningitis during 10 days. Serotyping of the Haemophilus influenzae strain found in CSF revealed a serotype b. After one year of follow-up no Hib meningitis sequelae were noted. Despite vaccination compliance and absence of risk factors, invasive Hib disease can occur due to vaccine failure. Efforts to keep the low incidence of invasive Hib disease should be directed to the maintenance of high vaccination coverage rates, combined with the notification and surveillance strategies already implemented in each country.
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PMID:Haemophilus influenzae type b meningitis in a vaccinated and immunocompetent child. 2875 97