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

The authors report a case and treatment of multiple brain abscesses located in the cerebrum and cerebellum combined with subdural empyema. In conjunction with the case report, the authors review the literature on the pathogenesis of brain abscesses and discuss therapeutic strategies concerning the topic. In the case presented, the primary infection persisted in the lung causing subclinical bronchitis. The hemoculture showed evidence of Streptococcus mitis infection. Although the etiological role of this bacterium in meningitis is known, it rarely causes bacterial meningitis without underlying predisposing factors. In their case, the patient was free of the most common predisposing factors such as congenital heart disease or immunodeficiency. Following the 2 month period of latency, a rapid onset of the symptoms of intracranial inflammation could be observed: fever, headache, meningeal symptoms, focal neurological symptoms and coma. They were not able to identify any bacteria in the cerebrospinal fluid; the Streptocossus mitis could be cultivated only from the haemoculture. The cytological analysis of the cerebrospinal fluid showed typical signs of bacterial infection and the cranial Computed Tomography revealed multiple cerebral abscesses. Neurosurgical intervention was not recommended because of the number, localization and size of the focal lesions. The therapy consisted of intravenous administration of 24 x 10(6) IU/die Penicillin and 4 g/die ceftriaxon. For supportive therapy, Mannitol B, 3 mg/die clonazepam and 300 mg/die phenytoin were administered. Corticosteroids were not used during the course of therapy. Two years later the 55 year old female is symptom free and doing well.
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PMID:[Non-invasive management of multiple brain abscesses. Case report and review of the literature]. 1053 93

Bacterial meningitis remains a major cause of morbidity and mortality worldwide, especially in children. In this paper, we present the results of the first two years (1997-98) of activity of the National Reference Centre for Bacterial Meningitis (NRCBM) on the etiologic agents of bacterial meningitis in Poland. Of the 220 isolates sent to the NRCBM, the most frequently identified was Neisseria meningitidis (n = 90, 40.9%), followed by Haemophilus influenzae (n = 58, 26.4%), and Streptoccus pneumoniae (n = 46, 20.9%). Of the meningococcal isolates, 88.9% belonged to serogroup B and 10.0% to serogroup C, and the most prevalent serotype was 22 (43.3%). Most meningococci were highly sensitive to penicillin; however, 10% of them had decreased susceptibility to penicillin. More than 90% of H. influenzae belonged to serotype b, and all were susceptible to third generation cephalosporins and chloramphenicol. A broad distribution of serotypes was found among pneumococcal isolates, of which the most common were serotypes 3 and 8. Penicillin nonsusceptible isolates constituted 13% of all pneumococcal isolates. Three of the resistant pnemococci belonged to serotype 23F. Data presented in this paper demonstrate the current epidemiological situation of bacterial meningitis in Poland.
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PMID:Characteristics of the major etiologic agents of bacterial meningitis isolated in Poland in 1997-1998. 1099 Feb 70

Pasteurella multocida meningitis is a rare clinical occurrence. We report a new case and review the 28 other cases described in the English literature. A history of recent animal contact remains strongly associated with P. multocida meningitis (noted in 89% of all cases), with licking of mucus surfaces or injured skin being most common. Bacteremia was present in 63% of all patients. Spread from an adjacent site of infection continues to be an important factor, with otitis media being documented or strongly suspected in 24% of all cases. The presenting signs and symptoms were characteristic of bacterial meningitis, with fever, headache, nucal rigidity and an altered level of consciousness being present in most patients. Cerebrospinal fluid analysis was typical for bacterial meningitis. Penicillin G or ampicillin was the most common definitive treatment; however, third-generation cephalosporins have been successful. The mean duration of treatment was 14 d. Neurologic complications were present in 17% of patients overall and mortality remains substantial at 25%. Although not statistically significant, there is a trend toward decreased neurologic complications and mortality during the last 11 y.
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PMID:Pasteurella multocida meningitis: case report and review of the last 11 y. 1203 Apr

Penicillin-nonsusceptible Streptococcus pneumoniae isolates have become increasingly prevalent worldwide. They are well-known agents of community-acquired infections such as otitis media, pneumonia and bacterial meningitis. Therapy of pneumococcal infections is made difficult by the emergence and spread of bacterial resistance to penicillin and other beta-lactams, as well as other antimicrobials such as macrolides. This article reviews current concepts of epidemiology and the implications of penicillin-nonsusceptible pneumococci for management of community-acquired pneumonia and meningitis.
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PMID:Penicillin-resistant pneumococci-implications for management of community-acquired pneumonia and meningitis. 1204 85

Streptococcus pneumoniae is the third most frequent etiologic agent of bacterial meningitis in Poland. Therefore, the objective of this study was to characterize S. pneumoniae isolates responsible for meningitis in Poland from 1997 to 2001 by determining their serotypes, antimicrobial susceptibility, and genetic relatedness. Among 36 serotypes and rough isolates, the most common were serotypes 3, 8, 19F, 6B, 4, and 23F, altogether accounting for 45.3% of cases. Penicillin-nonsusceptible pneumococci constituted 14.8% of all isolates. A high heterogeneity of pneumococcal isolates concerning serological features as well as genetic relatedness based on pulsed-field gel electrophoresis analysis was observed. With the exception of some serotypes (e.g., 3, 7F, 19F), isolates of the same serotype do not appear to be more closely related to each other than to isolates of different serotypes.
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PMID:Genetic relatedness, antibiotic susceptibility, and serotype distribution of Streptococcus pneumoniae responsible for meningitis in Poland, 1997-2001. 1282 Aug 3

We report a patient of bacterial meningitis caused by penicillin-resistant streptococcus pneumoniae (PRSP). A 50-year-old Japanese man was admitted after developing a fever and quickly falling into unconsciousness. Neurological examination showed slightly consciousness disturbance and meningeal irritation. A lumbar puncture yielded turbid spinal fluid, with increased cell count (411/mm3), protein (685 mg/dl) and IgG (60.3 mg/dl) but decreased glucose (1 mg/dl). Bacterial meningitis was diagnosed and aminobenzylpenicillin (ABPC) and cefotaxime (CTX) were administered immediately, but they were ineffective. Penicillin-resistant streptcoccus pneumoniae (PRSP) was detected in the blood and spinal fluid, so antibiotics were changed to panipenem/betamipron (PAPM/BP) and vancomycin (VCM) with marked efficacy. With the increase in PRSP patients and documented failure in treatment of pneumococcal meningitis with ABPC and CTX, the need for alternative antibiotic therapy is critical. We emphasize the importance of initial therapy with PAPM/BP and VCM in patients with bacterial meningitis from streptcoccus pneumoniae.
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PMID:[An adult case of bacterial meningitis caused by penicillin-resistant streptococcus pneumoniae]. 1523 66

Community-acquired bacterial meningitis are due, in most of the cases, to S. pneumoniae and N. meningitidis. These two pathogenes are concerned by antibiotic resistance phenomenons. S. pneumoniae is developing resistance in some countries, including France. The recommended empirical treatment is nowadays a third-generation cephalosporin, combined with vancomycin if there is a risk of Penicillin resistant pneumococcus. Non-antibiotic drugs are now validated and very useful adjunctive treatment.
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PMID:[Antibiotic treatment of bacterial meningitis]. 1529 73

Acute bacterial meningitis and sepsis are the most severe among invasive diseases due to Streptococcus pneumoniae, particularly in pediatric age, and present a high risk of mortality and neurologic sequelae. S. pneumoniae is a major worldwide pathogen in children. The widespread emergence of penicillin-resistant pneumococci, a new pneumococcal conjugate vaccine, and the epidemiological prevalence of some serotypes, have recently focused attention on S. pneumoniae disease. We reviewed the data on incidence, epidemiology, diagnosis, therapy in children hospitalized with acute bacterial meningitis in the Division of Infectious Diseases of the Bambino Gesu Children's Hospital, Rome, between 1985- 2003. S. pneumoniae was isolated in 16.3% of the children, progressively emerging as the prevalent pathogen. The highest incidence was found in children younger than 2 yrs. The disease still presents a high rate of long-term sequelae, especially hearing loss and neurological handicap. Penicillin and ampicillin resistant isolates were found in 2.3% of positive cultures; no strain was resistant to cephalosporins and vancomycin. Our data support the recommendations to consider administration of the 7-valent pneumococcal conjugate vaccine for children older than 2 months of age, with special consideration for selected groups. We recommend monitoring all invasive pneumococcal infections in children, the emergence of antibiotic-resistance and changes in prevalence of pathogen serotypes.
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PMID:[Streptococcus pneumoniae meningitis in children. Case records 1985 - 2003]. 1572 15

Acute bacterial meningitis is more common in resource-poor than resource-rich settings. Survival is dependent on rapid diagnosis and early treatment, both of which are difficult to achieve when laboratory support and antibiotics are scarce. Diagnostic algorithms that use basic clinic and laboratory features to distinguish bacterial meningitis from other diseases can be useful. Analysis of the CSF is essential, and simple techniques can enhance the yield of diagnostic microbiology. Penicillin-resistant and chloramphenicol-resistant bacteria are a considerable threat in resource-poor settings that go undetected if CSF and blood can not be cultured. Generic formulations of ceftriaxone are becoming more affordable and available, and are effective against meningitis caused by penicillin-resistant or chloramphenicol-resistant bacteria. However, infection with Streptococcus pneumoniae with reduced susceptibility to ceftriaxone is reported increasingly, and alternatives are either too expensive (eg, vancomycin) or can not be widely recommended (eg, rifampicin, which is the key drug to treat tuberculosis) in resource-poor settings. Additionally, improved access to affordable antibiotics will not overcome the problems of poor access to hospitals and the fatal consequences of delayed treatment. The future rests with the provision of effective conjugate vaccines against S pneumoniae, Haemophilus influenzae, and Neisseria meningitides to children in the poorest regions of the world.
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PMID:The diagnosis and management of acute bacterial meningitis in resource-poor settings. 1856 45

The prevalence of penicillin-resistant Streptococcus pneumoniae (PRSP) meningitis has increased worldwide, particularly in East Asia and the United States. We recently experienced a case of PRSP meningitis that developed during frontofacial distraction. The patient was a 7-year-old girl with Crouzon disease who was treated by frontofacial monobloc/Le Fort IV minus glabellar osteotomy with quadruple internal distraction devices. Penicillin-resistant Streptococcus pneumoniae meningitis was diagnosed after surgery and treated successfully with meropenem (a carbapenem) at 120 mg kg d every 8 hours, ceftriaxone (a third-generation cephalosporin) at 100 mg kg d every 12 hours, and vancomycin (a glycopeptide) at 45 mg kg d every 6 hours. This case indicates that severe and fatal bacterial meningitis may occur as a postoperative complication due to multidrug-resistant bacteria indigenous to the nasal cavity after simultaneous osteotomy of the cranium and facial bone in intracraniofacial surgery, such as that for syndromic craniosynostosis and hypertelorbitism. In such cases, preventive strategies should include preoperative administration of pneumococcal vaccine, preoperative screening of nasal bacterial flora by nasal culture test, and prior administration of a carbapenem with good cerebrospinal fluid transfer or a third- or fourth-generation cephem covering PRSP. Postoperatively, suspected meningitis may be treated with a combination of the 3 drugs used in our case, in parallel with emergency cephalic contrast computed tomography and culture tests of blood and cerebrospinal fluid. Our experience suggests that these measures will facilitate a successful outcome in frontofacial distraction osteogenesis.
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PMID:Prevention and treatment of penicillin-resistant Streptococcus pneumoniae meningitis after intracraniofacial surgery with distraction osteogenesis. 1909 47


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