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Query: UMLS:C0085437 (
bacterial meningitis
)
4,038
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The effects of full short-term antibiotic treatment on cerebrospinal fluid (CSF) findings were studied retrospectively in 68 children with acute
bacterial meningitis
. The features of CSF at admission were compared with those of the CSF obtained after 44-68 hours of therapy. Except in one case with H. influenzae and one case with pneumococcal meningitis, all CSF cultures were negative in the repeat specimen. In three of 16 children with meningococcal meningitis, the CSF glucose levels became normal in the second specimen. In all remaining 65 children, however, full intravenous antibiotic treatment for 44-68 hours did not alter the biochemistry and cytology of the CSF, which retained its "bacterial" character. From these findings it may be discerned that partial antibiotic treatment is even less likely to distort a 'bacterial' CSF.
Am J Clin Pathol 1983
Sep
PMID:Bacterial meningitis. Effect of antibiotic treatment on cerebrospinal fluid. 688 Nov 4
The aetiology of acute
bacterial meningitis
in adults was investigated in Papua New Guinea. During a five-year period, a total of 228 Melanesian adults with acute purulent meningitis were admitted to three major hospitals representing mainland coasts, highlands and islands of the country. Two-thirds of these patients had negative cerebrospinal fluid (CSF) cultures, presumably because they had received antibiotics prior to hospitalisation. Eighty of 84 bacterillogically confirmed cases were caused by either pneumococci or meningococci (95%). Pneumococcus was the most common organism encountered (59%). Three patients in the highland area and none in other areas had Heamophilus influenzae meningitis. These data provide the basis for formulating guidelines for the use of antibiotics in the treatment of acute
bacterial meningitis
in areas of Papua New Guinea where there are no facilities to examine or culture the CSF and in hospitals before the CSF culture result is known.
P N G Med J 1980
Sep
PMID:Aetiology of acute bacterial meningitis in the highlands & islands of Papua New Guinea. 693 17
Two cases of acute
bacterial meningitis
occurred with an absent CSF WBC response. To determine the incidence and clinical characteristics of such patients, 50 consecutive cases of meningitis were reviewed retrospectively. In addition to the two initially noted cases, five additional cases were found. In the seven cases, there were six or fewer cells, but bacteria were detected in the CSF. A distinctive clinical and laboratory syndrome emerged. All seven patients were either old or had Hodgkin's disease or severe alcoholism. All patients had evidence of an overwhelming infection with confusion or nuchal rigidity. As compared with the remaining 45 patients with meningitis and CSF pleocytosis, no fever (less than 38 degrees C), a lower peripheral WBC count, and near-normal CSF glucose and protein concentrations were common. Organisms involved were EScherichia coli in three patients, Pneumococcus in three patients, and mixed anaerobes in patient. A fatal outcome ensued in six of seven patients. Despite the correct choice of an antibacterial agent, doses were late and suboptimal for meningitis. This syndrome is surprisingly common in host-defective cases, has an ominous prognosis, and must be treated expectantly with antimicrobial agents that enter the CSF.
Arch Intern Med 1981
Sep
PMID:Bacterial meningitis in the absence of CSF pleocytosis. 702 10
The increasing prevalence of ampicillin-resistant Haemophilus influenzae type b has led to the recommendation that ampicillin and chloramphenicol be given as the initial therapy for suspected
bacterial meningitis
in infants and children. However, during the first 2 months of life, H. influenzae type b is a rare cause of meningitis, whereas group B streptococcus is the most frequently isolated agent. Since ampicillin and chloramphenicol have been shown to be antagonistic for other streptococci, an in vitro study of their effect on group B streptococci was performed. The effect of ampicillin and chloramphenicol, alone and in combination, on 18 meningeal isolates was determined for 2 different inocula of group B streptococci, using microtiter broth dilution and growth kinetic assays. Isoboles, fractional lethal concentration indices, or both indicated antagonism for all strains. Growth kinetic assays for two representative strains demonstrated inhibition of the early bactericidal activity of ampicillin by chloramphenicol. These findings of in vitro antagonism suggest that this combination may be contraindicated for the treatment of infants with group B streptococcal meningitis.
Antimicrob Agents Chemother 1981
Sep
PMID:Antagonism of ampicillin and chloramphenicol for meningeal isolates of group B streptococci. 703 Jan 97
Unrecognized spontaneous cerebrospinal fluid (CSF) otorrhea led to recurrent
bacterial meningitis
in three children. The underlying cause of the spontaneous CSF otorrhea was proved to be a congenital cystic dilatation of the cochlear aqueduct and Mondini dysplasia of the temporal bone. The CSF leak recurred in all patients after an initial surgical attempts to close the defects through a tympanotomy. A suboccipital approach was used successfully to obliterate the CSF fistulas in two children; a translabyrinthine approach was used in the other. A search of the literature revealed that Mondini dysplasia is a congenital anomaly that can commonly cause spontaneous CSF otorrhea in children. The authors discuss the management of this uncommon entity on the basis of a literature review and their own experience.
Neurosurgery 1982
Sep
PMID:Spontaneous cerebrospinal fluid otorrhea in association with a congenital defect of the cochlear aqueduct and Mondini dysplasia. 713 52
We have evaluated a commercially available latex agglutination system for the detection of C-reactive protein in CSF by a prospective study of 56 patients with CSF pleocytosis. On initial lumbar puncture, C-RP was detected in 100% (24/24) of patients with culture-proven
bacterial meningitis
, compared to 6% (2/32) of patients in the nonbacterial group (chi 2 c = 44.8, P less than 0.0001). C-RP in CSF had a sensitivity of 1.0 and a specificity of 0.94 for detecting culture-positive,
bacterial meningitis
. It was a more sensitive test for differentiating bacterial from nonbacterial meningitis on initial CSF examination than was the number of CSF leukocytes, the absolute number of CSF polymorphonuclear leukocytes, CSF glucose concentration, CSF protein concentration, or Gram staining of CSF. Detection of C-RP by latex agglutination may prove to be a practical and reliable method for differentiating bacterial from nonbacterial meningitis.
J Pediatr 1981
Sep
PMID:C-reactive protein in spinal fluid of children with meningitis. 726 88
A rapid, microenzymatic method was used to measure cerebrospinal fluid lactate levels in 205 children with suspected
bacterial meningitis
. Fifty children with normal CSF containing fewer than 0.005 X 10(9)/l WBC, no segmented neutrophils, glucose 3.4 +/- 0.8 mmol/l (61.2 +/- 14.4 mg/100 ml), and a protein of less than 0.30 g/l had CSF lactate levels below 2.0 mmol/l (18 mg/100 ml) (mean and standard deviation 1.3 +/- 0.3 mmol/l (11.8 +/- 2.7 mg/100 ml)). In 31 cases of proved viral meningitis as with 58 cases of clinically diagnosed viral meningitis, levels were below 3.8 mmol/l (34.5 mg/100 ml), being 2.3 +/- 0.6 mmol/l (20.9 +/- 5.4 mg/100 ml), and 2.1 +/- 0.7 mmol/l (19.1 +/- 6.4 mg/100 ml) respectively. Sixty-six cases of
bacterial meningitis
had CSF lactate levels ranging from 3.9 mmol/l (35.4 mg/100 ml) to greater than 10.0 mmol/l (90.0 mg/100 ml). Longitudinal studies in 7 children with
bacterial meningitis
showed that cerebrospinal fluid lactate levels differentiated bacterial from viral meningitis up to 4 days after starting treatment with antibiotics. Use of CSF lactate measurement for monitoring the efficacy of treatment is illustrated in a case of
bacterial meningitis
due to Pseudomonas aeruginosa. The origin of the cerebrospinal fluid lactate acidosis and the role of lactate in the pathophysiological cycle leading to intensification of brain tissue hypoxia and cellular damage is discussed with respect to the short-term prognosis and the long-term neurological sequelae.
Arch Dis Child 1981
Sep
PMID:Cerebrospinal fluid lactic acidosis in bacterial meningitis. 729 72
A new technique for intraventricular application of antibiotics by means of an indwelling catheter is described for the treatment of
bacterial meningitis
in the newborn. In cases of neonatal gram-negative meningitis with proven ventriculitis resistant to systemic therapy alone, a ventricular tap is performed. Through the needle an indwelling catheter is inserted into the right lateral ventricle. After removal of the needle the remaining catheter is used for obtaining ventricular fluid for diagnostic purposes as well as for direct intraventricular injection of antibiotics. This catheter can easily be inserted while the child is in the incubator in a neonatal intensive care unit, avoiding neurosurgery. Our present treatment procedure for neonatal meningitis is described.
Monatsschr Kinderheilkd 1981
Sep
PMID:[Technique for intraventricular application of antibiotics in bacterial meningitis of the newborn (author's transl)]. 734 30
The objectives of the present investigation are as follows: to prospectively assess the incidence of sensorineural hearing loss (SHL) associated with
bacterial meningitis
; to evaluate the onset and degree of SHL; and to describe the audiometric pattern. Forty-seven patients were studied otologically and audiologically. The incidence of SHL was 11%. Late onset of SHL was not observed, however, one patient demonstrated a probable progressive hearing loss. Both bilateral and unilateral hearing loss were noted. The degree of hearing loss varied from mild to profound, with no consistent audiometric pattern. Intensive follow-up on one hearing-impaired patient included temporal bone polytomograms. Obliterative labyrinthitis is detailed. Antibiotic treatment and laboratory data are evaluated. Suggestions are provided for the post-meningitic course.
Laryngoscope 1980
Sep
PMID:Bacterial meningitis and sensorineural hearing loss: a prospective investigation. 740 46
Bacterial meningitis
after pelvic trauma has never been described. We recently treated a patient who developed, during the course of his hospitalization, multiresistant enterococcal meningitis after severe pelvic injury, including a comminutive sacral fracture. Dural tear may have been the main factor leading to secondary infection of the cerebrospinal fluid. Treatment with intravenous continuous infusion of vancomycin plus rifampin, associated with closed subarachnoid drainage, resulted in a complete cure. Therapeutic cerebrospinal fluid levels of vancomycin were obtained only during the first 8 days of treatment. Use of glycopeptides in meningitis and the role of cerebrospinal fluid drainage are discussed. Physicians should be aware of the diagnosis and therapeutic features of this life-threatening complication.
J Trauma 1995
Sep
PMID:Nosocomial meningitis caused by multiresistant enterococcus as a life-threatening complication of pelvic injury: case report. 747 36
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