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)

We identified all diagnosed cases of infections of the central nervous system (CNS), excluding poliomyelitis, in the population of Olmsted County, Minnesota, from 1950 to 1981 and described incidence, time trends, etiologic agents, and mortality for these infections. The adjusted incidence rate for bacterial meningitis was 8.6/100,000 person-years (with a case fatality ratio of 10%) and was highest in children less than five years of age; in this age-group, rates more than doubled from 1950 to 1981. The adjusted incidence rate of brain abscess was 1.1, with a case fatality ratio of 37%. The adjusted incidence rate of aseptic meningitis was 10.9/100,000 person-years. Age-specific rates were highest in children less than one year of age and in men, and increased during the study period. The adjusted incidence rate of viral encephalitis was 7.4, with a case fatality ratio of 3.8%. Rates were highest in children less than 10 years of age and in men. By 10 years of age, 0.9% of the men and 0.7% of the women were affected by a CNS infection. Cumulative incidence (risk) through age 80 was 2.3% for men and 1.5% for women.
J Infect Dis 1986 Sep
PMID:Epidemiology of central nervous system infections in Olmsted County, Minnesota, 1950-1981. 373 90

We examined the diagnostic value of C-reactive protein (CRP) in cerebrospinal fluid (CSF) on initial lumbar puncture in a prospective study including 126 patients (30 neonates, 96 infants and children) suspected of having meningitis. Twenty patients were considered to have bacterial and 25 were considered to have viral meningitis. In infants and children, a retrospectively chosen cut-off CRP titre of 4 (i.e. approximately equal to 0.4 mg/l CRP) had a sensitivity of 100% and a specificity of 94% for differentiating bacterial meningitis from both viral meningitis and normal. It was a more sensitive and selective test for differentiating bacterial from viral meningitis on initial CSF examination than was the CSF leucocyte count, glucose concentration or protein concentration. In neonates, no such cut-off CRP titre could be found, presumably due to the immaturity of the blood-CSF-barrier (B1-CSF-B) during the first weeks of life. In a parallel study including a non-selected group of 13 infants and children (4 without, 9 with bacterial meningitis), the serum/CSF CRP concentration ratios were determined and inserted in the individual B1-CSF-B diagrams according to Felgenhauer. The results were fully consistent with the hypothesis that the CRP concentration in CSF reflects the normal permeability characteristics of the B1-CSF-B, or the degree of its impairment. Based on our results, we recommend the CSF CRP estimation in the routine evaluation of infants and children suspected of having meningitis.
Eur J Pediatr 1986 Sep
PMID:Cerebrospinal fluid C-reactive protein in meningitis: diagnostic value and pathophysiology. 376 91

A single intravenous dose of 2.0 g of amoxicillin and 0.2 g of potassium clavulanate was given to patients with bacterial meningitis, and the pharmacokinetics of both drugs in the cerebrospinal fluid (CSF) and plasma were evaluated. Twenty-one patients aged 14 to 76 years were studied. Both amoxicillin and potassium clavulanate were detectable in the CSF as early as 1 h and reached peak concentrations by approximately 2 h. The highest mean CSF concentrations were 2.25 micrograms/ml for amoxicillin and 0.25 micrograms/ml for potassium clavulanate and were found in patients with moderately or severely inflamed meninges. The CSF penetration relative to plasma for amoxicillin and potassium clavulanate was 5.8 and 8.4%, respectively. These levels suggest that the amoxicillin-potassium clavulanate combination may be effective for the treatment of bacterial meningitis caused by beta-lactamase-producing pathogens.
Antimicrob Agents Chemother 1986 Sep
PMID:Penetration of amoxicillin and potassium clavulanate into the cerebrospinal fluid of patients with inflamed meninges. 377 11

This report analyses the locomotory capacity of polymorphonuclear leucocytes (PMNL) isolated from 7 patients with bacterial meningitis. 7 healthy control subjects were also investigated in parallel. It was found that PMNL from the patients suffering from meningitis, isolated both from peripheral blood and from the cerebrospinal fluid, had lost their ability to respond chemotactically to activated serum but not to the chemotactic peptide f-Met-Leu-Phe. The normal chemotactic responsiveness of blood PMNL was restored once the patients recovered from infection.
Scand J Haematol 1986 Sep
PMID:Factor-specific deactivation of leucocyte chemotaxis in vivo. 378 76

Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age less than 1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear greater than or equal to 10,000/mm3 and band count greater than or equal to 500/mm3) were correlated with bacterial infection by step-wise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.
Pediatr Emerg Care 1985 Sep
PMID:Fever in infants less than two months of age: spectrum of disease and predictors of outcome. 384 82

We report the case of a 3-month-old boy suffering from an acute bacterial meningitis due to a multi-resistant strain of Haemophilus influenzae type b. Also presented is our current strategy of treatment and chemoprophylaxis of Haemophilus influenzae meningitis in children.
Eur J Pediatr 1985 Sep
PMID:Fatal meningitis due to multi-resistant Haemophilus influenzae type b. 387 37

A 17-year-old male with Hemophilus influenzae type f meningitis is reported. Recent studies which suggest that the incidence of H. influenzae meningitis in older individuals is increasing are reviewed. Therefore, we recommend that antimicrobial therapy directed against H. influenzae be included in the initial management of older children, adolescents, and adults with acute bacterial meningitis.
Pediatr Emerg Care 1985 Sep
PMID:Hemophilus influenzae type f meningitis in an adolescent. 387 85

This study compared the sensitivity and specificity of four test systems in detecting Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, and gram-negative organisms in cerebrospinal fluid (CSF), versus culture. The tests used on CSF from 155 patients with meningitis were the Phadebact coagglutination (CoA) test, the Directigen latex agglutination (LA) test, counterimmunoelectrophoresis (CIE), and the Limulus amebocyte lysate (LAL) test. The sensitivity for patients with bacterial meningitis was 78% (18/23) for LA, 78% (25/32) for CoA, and 67% (18/27) for CIE for detection of H. influenzae type b; 71% (10/14) for CoA, 100% (6/6) for LA, and 50% (6/13) for CIE in detecting S. pneumoniae; and 33% (1/3) for LA and 50% (2/4) for CIE in detecting N. meningitidis. LAL had a sensitivity of 77% (37/48) in detecting CSF gram-negative endotoxin. The specificities of those with bacterial meningitis for H. influenzae, S. pneumoniae, and N. meningitidis tested by LA were, respectively, 100% (35/35), 96% (50/52), and 100% (54/54); for H. influenzae and S. pneumoniae using CoA 97% (62/64) and 96% (80/83); for H. influenzae, S. pneumoniae, and N. meningitidis using CIE 67% (18/27), 50% (6/12), and 50% (2/4). The specificity of LAL was 86% (38/44). The detection of bacterial antigen from CSF in patients with meningitis by commercial agglutination tests is more sensitive than CIE and is highly specific.
Diagn Microbiol Infect Dis 1985 Sep
PMID:Bacterial antigen detection in cerebrospinal fluid of patients with meningitis. 392 37

Ceftriaxone, a new third-generation cephalosporin, appears to be promising for the therapy of acute bacterial meningitis. The 90% MBCs of ceftriaxone against 54 recent cerebrospinal fluid isolates of Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae were less than or equal to 0.06 to 0.25 micrograms/ml. We examined the efficacy and safety of ceftriaxone therapy of meningitis in Bahia, Brazil. The study was conducted in two phases; in phase A, ceftriaxone was coadministered with ampicillin. The mean cerebrospinal fluid concentrations of ceftriaxone 24 h after an intravenous dose of 80 mg/kg were 4.2 and 2.3 micrograms/ml on days 4 to 6 and 10 to 12 of therapy, respectively. These concentrations were 8- to more than 100-fold greater than the 90% MBCs against the relevant pathogens. In phase B, ceftriaxone (administered once daily at a dose of 80 mg/kg after an initial dose of 100 mg/kg) was compared with conventional dosages of ampicillin and chloramphenicol in a prospective randomized trial of 36 children and adults with meningitis. The groups were comparable based on clinical, laboratory, and etiological parameters. Ceftriaxone given once daily produced results equivalent to those obtained with ampicillin plus chloramphenicol, as judged by cure rate, case fatality ratio, resolution with sequelae, type and severity of sequelae, time to sterility of cerebrospinal fluid, and potentially drug-related adverse effects. The cerebrospinal fluid bactericidal titers obtained 16 to 24 h after ceftriaxone dosing were usually 1:512 to greater than 1:2,048 even late in the treatment course, compared with values of 1:8 to 1:32 in patients receiving ampicillin plus chloramphenicol. Ceftriaxone clearly deserves further evaluation for the therapy of meningitis; the optimal dose, dosing frequency (every 12 h or every 24 h), and duration of therapy remain to be determined.
Antimicrob Agents Chemother 1985 Sep
PMID:Comparison of ceftriaxone and ampicillin plus chloramphenicol for the therapy of acute bacterial meningitis. 407 58

The pharmacokinetics of ceftriaxone was studied in the plasma, urine, and cerebrospinal fluid of seven neonates and seven infants with meningitis. In addition, plasma and urine data were obtained in five neonates and one infant receiving ceftriaxone for other serious infections. All neonates younger than 14 days received daily doses of 50 mg/kg ceftriaxone; all other patients but two received 100 mg/kg. The average weight-corrected values for total body clearance (ClT), volume of distribution (Vdss), and biologic half-life (t 1/2) were 0.37 ml/min/kg, 0.45 L/kg, and 16.2 hours in neonates younger than 1 week; 0.77 ml/min/kg, 0.48 L/kg, and 9.2 hours in neonates older than 1 week; and 1.03 ml/min/kg, 0.39 L/kg, and 7.1 hours in older infants, respectively. There was a significant difference in ClT and t 1/2 between the neonates younger and both neonates older than 1 week, and infants. The Vdss was not significantly different among the three age groups. The average renal clearance in neonates younger than 1 week (0.28 ml/min/kg was 70%, in neonates older than 1 week (0.54 ml/min/kg) was 77%, and in older infants (0.49 ml/min/kg) was 47% of ClT, indicating that nonrenal elimination was less developed in neonates. The quantitation of CSF diffusion of ceftriaxone was assessed by comparison of the areas under the CSF and plasma concentration-time curve. The mean ceftriaxone penetration into the CSF in neonates and infants with bacterial meningitis was 17%. On the other hand, penetration in patients with aseptic meningitis amounted to only 4%. Mean ceftriaxone concentrations in the CSF in patients with bacterial meningitis were 2.8 mg/L after 24 hours, exceeding by many times the minimum inhibitory concentration of the common meningitis pathogens at this time.
J Pediatr 1984 Sep
PMID:Pharmacokinetics of ceftriaxone in neonates and infants with meningitis. 608 47


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