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

Acquired central auditory disorders not due to a tumour are unusual. The well-known conditions such as hypoxic encephalopathy, erythroblastosis, bacterial meningitis and trauma are reviewed. Recent experimental and clinical studies contribute to progress in the understanding of the pathogenesis and etiology of these conditions. The pattern of presbyacusis and cortical deafness is discussed also. AIDS must be considered as a new cause of acquired central auditory dysfunction.
HNO 1991 Sep
PMID:[Non-neoplastic central hearing loss--a review]. 174 76

Adenosine deaminase activity was measured in cerebrospinal fluid of patients with confirmed tuberculous and bacterial meningitis. The values were compared with those of control subjects without meningitis. A statistically significant increase in the level of this enzyme was noted in the two types of meningitis, but no definite demarcation in the levels was observed between the two types. Therefore increases in adenosine deaminase activity may not be of such diagnostic significance as reported elsewhere.
Tubercle 1991 Sep
PMID:Adenosine deaminase levels in cerebrospinal fluid in tuberculosis and bacterial meningitis. 757 24

Injury to the blood brain barrier (BBB) is a fundamental sequela of bacterial meningitis, yet the precise mechanism facilitating exudation of albumin across the endothelium of the cerebral microvasculature remains conjectural. After intracisternal inoculation of Escherichia coli (0111:B4) lipopolysaccharide in rats to elicit a reversible meningitis and BBB injury, we utilized in situ tracer perfusion and immunolabeling procedures to identify by transmission electron microscopy the precise topography and microvascular exit pathway(s) of bovine serum albumin (BSA). Results revealed that during meningitis there was: (a) an inducible increase in immunodetectable monomeric BSA binding to the luminal membrane of all microvascular segments in the pia-arachnoid and superficial brain cortex; (b) similar uptake of both colloidal Au-BSA (as well as monomeric BSA) by plasmalemmal vesicles but no detectable transcytosis to the abluminal side; and (c) predominant exit of both perfused Au-BSA and immunodetectable monomeric BSA through open intercellular junctions of venules in the pia-arachnoid. This was corroborated in separate experiments documenting focal pial venular leaks of in situ perfused 0.01% colloidal carbon black during experimental meningitis. These results provide precise localization of BBB injury in meningitis to meningeal venules, confirm a paracellular exit pathway of albumin via open intercellular junctions, and suggest an injury mechanism amenable to specific therapeutic intervention.
J Exp Med 1991 Sep 01
PMID:Ultrastructural localization of albumin transport across the cerebral microvasculature during experimental meningitis in the rat. 187 66

We measured urine vasopressin (VP) once daily on days 1 through 3 in 18 patients hospitalized with meningitis. Urine VP values were 215 +/- 100, 116 +/- 44, and 69 +/- 23 pg/mL on days 1 through 3, respectively, for children with bacterial meningitis and 34 +/- 14, 20 +/- 4, and 15 +/- 4 pg/mL for those with aseptic meningitis. Urinary VP levels of infants with bacterial meningitis were significantly greater than those of healthy ambulatory subjects (n = 18) on all three study days; VP values of infants with bacterial meningitis were also greater than those of infants with aseptic meningitis on study days 2 and 3. The VP levels for the subjects with aseptic meningitis were significantly greater than those of the controls on day 1 only. None of the infants exhibited the clinical syndrome of inappropriate antidiuretic hormone secretion.
Am J Dis Child 1991 Sep
PMID:Vasopressin levels in infants during the course of aseptic and bacterial meningitis. 162 52

This study tests the hypothesis that if cerebrospinal fluid (CSF) has a nucleated blood cell count (NucBC) of less than 6/mm3, CSF tests other than bacterial culture need not be performed to exclude the diagnosis of bacterial meningitis in patients not receiving antimicrobial agents. The results of tests performed on the first specimen of CSF obtained for a given hospital visit from children younger than 3 years of age, exclusive of newborn infants admitted to the hospital on their date of birth, were analyzed. Of 3356 CSF specimens evaluated, 122 were from patients with bacterial meningitis; 460 specimens were analyzed separately because the erythrocyte count was greater than 1000/mm3. A negative CSF screening test result was defined as a CSF NucBC less than 6/mm3. In facilitating the diagnosis of bacterial meningitis, this screening test had a sensitivity of 98.4%, a specificity of 75.2%, and a negative predictive value of 99.9%. The other CSF tests varied widely in screening effectiveness: a Gram-stained smear had a sensitivity of 53% and a specificity of 97%. Receiver operating characteristic curve analysis was used to assess the screening relevance of CSF tests. The CSF NucBC and CSF segmented NucBC performed indistinguishably and superiorly compared with the CSF protein or glucose concentration and the ratio of CSF glucose to serum glucose concentration. Logistic regression analysis showed that the NucBC alone is superior to any combination of the other CSF tests. In a prospective study of 215 children younger than 3 years of age undergoing a lumbar puncture in our emergency department, 85% had empiric criteria identifying them as appropriate for an abbreviated CSF evaluation. The CSF NucBC was less than 6/mm3 in 70% of the 181 patients who would have been eligible for an abbreviated CSF evaluation. These data suggest that a strategy for the sequential testing of CSF could be adopted that would exclude unnecessary determinations and thereby save time, effort, and health care dollars.
J Pediatr 1991 Sep
PMID:Relevance of common tests of cerebrospinal fluid in screening for bacterial meningitis. 188 Jun 47

In many pediatric infectious disease programs, ceftriaxone or cefotaxime is now the preferred drug for bacterial meningitis caused by H. influenzae, meningococci, and pneumococci. Ceftriaxone reaches a high bactericidal titer in the cerebrospinal fluid and persists at the site of infection longer than any other beta-lactam antibiotic. Short-course, once-daily therapy with ceftriaxone requires more study; currently, many pediatricians administer the agent twice daily for suspected or proven meningitis. Given the association of sequelae with prolongation of positive CSF cultures, ceftriaxone's rapid bactericidal activity is an advantage, which may require an adjunctive agent to block the inflammatory response due to antibiotic-induced release of endotoxin and other cell wall components. As empiric therapy, ceftriaxone is effective in infants and children three months to 18 years old. It is not yet recommended in neonates, because of concerns about bilirubin displacement. Thus, infants up to three months of age should receive ampicillin plus cefotaxime. In adults, ceftriaxone is effective therapy for presumed bacterial meningitis but must be combined with ampicillin initially, since L. monocytogenes meningitis cannot be excluded in most cases until CSF culture results are available.
Hosp Pract (Off Ed) 1991 Sep
PMID:Ceftriaxone in treatment of serious infections. Meningitis. 191 17

Fibronectin concentrations in the cerebrospinal fluid were assessed in 20 patients with acute meningitis using a turbidimetric immunoassay. A significant increase in fibronectin concentrations was observed in patients with bacterial meningitis; decreased concentrations were observed in patients with viral meningitis. The determination of fibronectin concentration in patients with bacterial meningitis may represent a useful marker in differentiating bacterial from viral meningitis.
J Clin Pathol 1991 Sep
PMID:Cerebrospinal fluid concentration of fibronectin in meningitis. 162 13

The principles for the management of bacterial meningitis in the State University Hospital are presented. The combination of ceftriaxone and ampicillin was chosen for initial, empirical therapy.
Ugeskr Laeger 1991 Sep 23
PMID:[Treatment of purulent meningitis]. 194 82

Bacterial meningitis is a common cause of profound deafness and, hence, a common cause of deafness in published series of patients treated with a cochlear prosthesis. Labyrinthitis ossificans is a common finding in meningogenic labyrinthitis and has been considered a relative contraindication to cochlear implantation. In the present study, the numbers of remaining spiral ganglion cells in cases of meningogenic labyrinthitis were correlated with the severity of new bone formation within the inner ear. Six temporal bones in which profound sensorineural hearing loss occurred in life secondary to meningogenic labyrinthitis were studied by serial section light microscopy. Some degree of labyrinthitis ossificans was found in four of six. There was a moderately strong negative correlation between the number of years of total deafness and the percentage of normal of the remaining spiral ganglion cell count. There was a strong negative correlation between the degree of bony occlusion by labyrinthitis ossificans and the normality of the spiral ganglion cell count. The percentage of bony occlusion of the membranous labyrinth increased with the years of total deafness. The significance of these findings for cochlear implantation of individuals with meningogenic labyrinthitis is discussed.
Ann Otol Rhinol Laryngol 1991 Sep
PMID:Histopathologic correlation of spiral ganglion cell count and new bone formation in the cochlea following meningogenic labyrinthitis and deafness. 195 61

In the pathogenesis of acute bacterial meningitis (ABM), the direct entry of the responsible microorganism at the level of the upper respiratory tract is considered as one of the most important etiopathogenic mechanisms, occasionally presenting catarrhal symptoms in the initial stages of the disease. It appears that upper respiratory tract infections favor the penetrability of certain bacteria, such as N. meningitidis and S. pneumoniae, which constitute the most frequent causes of ABM in our medium. The rhinopharynx is the most usual entry point. The present study was designed to ascertain the frequency of these prodromic signs and symptoms in ABM. The presence of this catarrhal semiology in the days prior to hospital admission was analyzed, in addition to the existence of pharyngotonsillar hyperemia (FTH) at the moment of admission of 250 cases of community-acquired ABM. We believe that these data are of clinical interest, and were not found in the reviewed series.
Aten Primaria 1990 Sep
PMID:[Catarrhal prodromes and pharyngotonsillar hyperemia in acute bacterial meningitis]. 210 51


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