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

Labyrinthine ossification can be found in a high percentage of patients with profound deafness resulting from bacterial meningitis. Radiographic evidence of ossification can be found as early as 2 months after the acute infection, indicating that the intracochlear process probably begins much earlier. If long, intracochlear cochlear implants are to be most successfully used in these patients, an aggressive approach to clinical management following the meningitis should be taken. Illustrative case reports and suggested guidelines for evaluation and treatment are given.
Otolaryngol Head Neck Surg 1990 Sep
PMID:Labyrinthine ossification after meningitis: its implications for cochlear implantation. 212 62

A case of Haemophilus influenzae type b (Hib) meningitis in which the diagnosis and treatment were delayed because of normal cerebrospinal fluid analysis is presented. A retrospective review was conducted at two children's hospitals to determine the frequency and clinical characteristics of patients with Hib meningitis whose spinal fluid had a normal total white blood cell count, normal chemistries, and negative Gram stain, but subsequent growth of Hib in culture. Of 379 cases of Hib meningitis, two had completely normal CSF, and two had CSF containing small numbers of polymorphonuclear cells as the sole abnormality. In three of the four cases, the duration of symptoms was less than 24 hours, and appropriate therapy was significantly delayed because of benign-appearing CSF. Normal CSF cell counts, chemistries, and Gram stain do not exclude the possibility of bacterial meningitis, and one should remain suspicious when a child has clinical findings suggesting meningitis.
Pediatr Emerg Care 1990 Sep
PMID:Absent or minimal cerebrospinal fluid abnormalities in Haemophilus influenzae meningitis. 221 23

A 30-year-old Vietnamese patient is reported who was admitted with a resistant acute otitis externa, and who complained also of headache and fever. The symptoms were found to be caused by the intracranial complications (epidural abscess and bacterial meningitis) of an aural cholesteatoma. A secondary occlusive hydrocephalus developed in spite of successful otological surgery that preserved hearing and vestibular function.
HNO 1990 Sep
PMID:[Internal occlusive hydrocephalus following cholesteatoma]. 226 54

Splenic function in sickle hemoglobinopathy syndromes was assessed to determine the developmental pattern of splenic dysfunction. Nonvisualization of the spleen using technetium-99 metastable (99mTc) spleen scans correlated strongly with pocked (vesiculated) RBCs greater than or equal to 3.5%. Cross-sectional analysis of pocked RBC data from 2,086 patients showed differences in the developmental pattern of splenic dysfunction between several disorders. In hemoglobin SS disease (sickle cell anemia) and hemoglobin S beta(0) thalassemia, splenic dysfunction (greater than or equal to 3.5% pocked RBCs) often occurred in the first 6 to 12 months of life. In hemoglobin S beta(+) thalassemia, splenic dysfunction occurred less frequently and later. Splenic dysfunction in hemoglobin SC disease (sickle cell-hemoglobin C) was intermediate. The level of pocked RBCs was inversely associated with fetal hemoglobin (P less than .007) and directly associated with age (P less than or equal to .001). These patterns of splenic dysfunction reflect the known severity of hemolysis and intravascular sickling and are consistent with the epidemiology of severe bacterial meningitis and sepsis in these diseases. Serial measurement of pocked RBCs permits determination of the onset of splenic dysfunction and the time of increased susceptibility to severe bacterial infections.
Pediatrics 1985 Sep
PMID:Developmental pattern of splenic dysfunction in sickle cell disorders. 241

A review of consecutive previously healthy children with fever and newly discovered neutropenia without underlying malignancy, evaluated during a three-year period, was performed. A total of 68 episodes occurred in 68 patients; blood culture was performed on each. Of 17 patients who appeared compromised (ill, irritable, toxic) on presentation, five (30%) had either bacteremia or bacterial meningitis. All five patients had clinical evidence of a fulminant disease process on examination. By contrast, all 51 patients who appeared to be well on presentation were culture-negative. Fever and new-onset neutropenia in children is a heterogeneous disorder with several outcomes. Any child with fever and newly discovered neutropenia who appears ill should be presumed to be at high risk for systemic bacterial infection and receive hospitalization for parenteral antibiotic therapy. By contrast, the previously healthy child older than two months of age with fever and new-onset neutropenia who appears to be well, and whose clinical evaluation does not indicate a serious underlying disease process, is at low risk for accompanying systemic bacterial infection; hospitalization with empiric antibiotic therapy pending culture results is not warranted for the majority of such children. Close outpatient monitoring with serial evaluation of the peripheral blood absolute neutrophil count to document bone marrow recovery is recommended for such cases.
Pediatr Emerg Care 1989 Sep
PMID:Clinical characteristics of children with fever and transient neutropenia who experience serious bacterial infections. 260 44

The movement of drugs from the systemic circulation into the central nervous system is restricted by several factors, including the blood-brain and blood-CSF barriers, an active transport system that affects primarily the beta-lactam antibiotics, and the high degree of serum protein binding of certain agents. The functions of the blood-brain and blood-CSF barriers and of the active transport system are reduced but not abolished by inflammation. For most antimicrobial agents, the major determinant of passage aside from serum protein binding is the degree of lipid-solubility of the drug. The beta-lactam and aminoglycoside antibiotics and vancomycin penetrate the central nervous system relatively poorly, whereas chloramphenicol, metronidazole, the fluoroquinolones and trimethoprim-sulfamethoxazole fare better. Knowledge of the relative capacity of various drugs to penetrate the central nervous system after systemic administration may help the physician to choose an optimum regimen for the treatment of bacterial meningitis and brain abscess.
Infect Dis Clin North Am 1989 Sep
PMID:Use of antibacterial agents in infections of the central nervous system. 267 Nov 39

A 40-day-old girl with B-group streptococcal meningitis was examined with ultrasonography (US) and transcranial Doppler flowmeter. Transfontanelle US with a 7.5 MHz probe showed a dilatation of the extracerebral space (ECS). The flow velocity in the middle cerebral artery increased remarkably in the acute phase, and thereafter returned to normal. The superficial arterial velocity on the left side could not be recorded in the period of fluid collection in the left ECS. These two methods are useful procedures in the evaluation of infantile bacterial meningitis and its complications.
No To Hattatsu 1989 Sep
PMID:[Usefulness of ultrasonography and transcranial Doppler flowmetry in evaluation of infantile bacterial meningitis]. 267 17

Acute bacterial meningitis following epidural anesthesia is a rare event. We describe a case in which a young woman received epidural anesthesia for vaginal delivery. The initial attempt at placement of the epidural resulted in entry into the subarachnoid space. The patient's postpartum course was complicated by persistent headache. She received epidural blood patch on two occasions, but her headache continued and she developed persistent fever. The diagnosis of acute bacterial meningitis was made on postpartum day 3. Contamination of the subarachnoid space may have occurred at the time of the inadvertent spinal tap or via the epidural blood patch. Alternatively, this contamination may have occurred during a spontaneous bacteremic episode, as Streptococcus sanguis is a mouth organism commonly involved in dental caries.
Obstet Gynecol 1989 Sep
PMID:Bacterial meningitis following epidural anesthesia for vaginal delivery: a case report. 276 26

We evaluated the records of 428 patients with bacterial meningitis to document initial cerebrospinal fluid (CSF) findings and detail their changes during therapy. Compared to patients with an initial polymorphonuclear cell predominance in the CSF, patients with initial CSF lymphocytosis had lower CSF leukocyte counts, milder CSF chemical abnormalities, and a lower frequency of positive CSF Gram stains and cultures. These findings suggest that CSF lymphocytosis may represent an early phase of infection. A low CSF leukocyte count was associated with a poor outcome, presumably reflecting an inadequate host response to infection. The CSF white cell count increased during the first 24 hours of therapy in 45% of cases. Morbidity and case fatality rates were not significantly increased in this group, suggesting that an initial rise in the CSF leukocyte count does not reflect a poor response to therapy.
South Med J 1989 Sep
PMID:Cerebrospinal fluid cell counts and chemistries in bacterial meningitis. 277 83

The latex agglutination test (Wellcogen) was evaluated specifically in cases of 'septic unknown' meningitis, with CSF findings characteristic of bacterial meningitis but with no bacterial organisms grown on CSF culture or seen on microscopy after Gram staining. In only 4 (12%) of 33 cases of 'septic unknown' meningitis were antigens identified in the CSF. This kit contains for the first time reagents for the detection of serogroup B Neisseria meningitidis antigens and was also evaluated for this bacteria. Only 6 (27%) of 22 serogroup B N. meningitidis cases were identified.
S Afr Med J 1989 Sep 02
PMID:Detection of bacterial antigens in cerebrospinal fluid by a latex agglutination test in 'septic unknown' meningitis and serogroup B meningococcal meningitis. 277 70


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