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

Morbidity and mortality of suppurative bacterial meningitis show a very constant behavior over many decades. The introduction of antibiotics certainly lowered the lethality considerably, but since then it has remained fairly unchanged at about 15-20%. However, in the principal groups of pathogens--meningococci, pneumococci, Haemophilus influenzae--antibiotic resistence plays no special role. The significance of disorders of defense against infections for the course of the disease has not yet been investigated. Of 92 children examined with purulent meningitis, 49 showed a selective antibody deficiency syndrome against bacterial antigens, 38 of 48 children investigated showed further disorders of bactericidal activity. The proportion of these disorders is particularly high in children with defective healing of a meningitis.
MMW Munch Med Wochenschr 1976 Dec 03
PMID:[The importance of immune deficiency for the prognosis of purulent meningitis (author's transl)]. 82 6

Lymphocyte transformation responses in vitro were studied in eight patients with acute bacterial meningitis (in five due to Neisseria meningitidis). Sequential studies were done from 24--48 hr after the first symptoms of infection to complete recovery. In all cases lymphocyte transformation was depressed during the acute phases of illness. The responses to microbial antigens were more affected than the responses to mitogens. The course of the lymphocyte responses to the causative micro-organism showed no difference from the responses to other microbial species. A moderate shift towards increased sensitivity of the lymphocytes to lower doses of the causative micro-organism was observed during the course of illness in three cases. In N. meningitidis infection, a rapid rise was seen in the serum titres of complement-fixing antibodies and in the number of precipitating antibodies, whereas the rise in immunoglobulin concentrations was more prolonged. Characteristic patterns of elevation and return towards normal were found in the serum concentrations of the acute-phase reactants alpha1-antitrypsin, haptoglobin, and orosomucoid. It is concluded that the lymphocyte transformation responses in vitro during severe bacterial infection are largely governed by non-specific factors, and that studies of lymphocyte responses to micro-organisms should always include other microbial species as controls.
Clin Exp Immunol 1976 Dec
PMID:Sequential studies of lymphocyte responsiveness and antibody formation in acute bacterial meningitis. 82 3

Because cerebrospinal fluid (CSF) antibiotic levels fail to predict either clinical success or relapse in the treatment of bacterial meningitis, we examined simultaneous antibiotic concentrations in the blood, brain, and CSF of control rabbits and of animals with experimental pneumococcal meningitis. Cefamandole pharmacokinetics were analyzed in detail and compared with those of cephalothin, ampicillin, penicillin G, and tobramycin. After 4 h of continuous intravenous infusion, cefamandole reached concentrations in both brain and CSF in excess of the minimal bactericidal concentration for the test organism and compared favorably with ampicillin and penicillin in achieving bacteriological cure. Cephalothin levels in the central nervous system remained undetectable in both control and infected animals during this time. Tobramycin concentrations were measurable in the CSF, but not in brain tissue in association with an inflammatory stimulus.
Antimicrob Agents Chemother 1977 Dec
PMID:Blood, brain, and cerebrospinal fluid concentrations of several antibiotics in rabbits with intact and inflamed meninges. 93 69

The case-fatality rate for acute bacterial meningitis in childhood is still disappointingly high. A review of 687 cases of acute bacterial meningitis including 72 deaths, identified in a defined population of children under ten years of age, was done to determine where patients were treated and where they died. Ten per cent of all hospital admissions were to infectious-disease hospitals, 16 per cent to teaching hospitals, and 74 per cent to general, non-teaching ("regional-board") hospitals. The case-fatality rates associated with these hospitals were three per cent, three per cent and 11 per cent respectively. The difference between regional-board and other hospitals was smaller, although still present, when children who died within a few hours of hospital admission were excluded from the analysis. Twenty-two per cent of all deaths (10 children who died outside hospital and six who were certified dead on admission) occurred before specialist care was reached. It may be possible to reduce the mortality from this disease by improving facilities for treatment in some hospitals. There is, however, an important residue of deaths--those which occur before hospital care is reached and, no doubt, some of those which occur soon after hospital admission--which would be unaffected by such improvements.
Int J Epidemiol 1976 Dec
PMID:Acute bacterial meningitis: where do children die? 101 Jun 62

Gamma hemolytic streptococcal meningitis in a 17-year-old boy resulted in a severe purulent reaction and death. Review of the literature shows only one other case of a gamma hemolytic streptococcus as the cause of bacterial meningitis in the absence of endocarditis.
Neurology 1976 Dec
PMID:Acute bacterial meningitis secondary to gamma hemolytic streptococcus. Case report and review of the literature. 103 88

Albumin, IgG, IgA, IgM, transferrin, and alpha 1-antitrypsin were determined quantitatively in the cerebrospinal fluid (CSF) of 44 healthy children and 37 pediatric patients with central nervous system diseases. Neither IgA nor IgM were found in the CSF of normal children, but they were present in cases of purulent and non-bacterial meningitis. In cases of encephalitis all proteins studied were increased except IgA and IgM, which could not be demonstrated. On the basis of the results it may be concluded that the increase of IgG in the CSF in bacterial and a bacterial meningitis is due to an increased permeability of the blood-CSF barrier. Except in cases with ependymitis, IgG is produced only in small amounts in or near the CSF spaces even in the presence of inflammation of the meninges. The quantitative determination of IgG, IgA, and IgM in case of increased CSF protein content may facilitate the differential diagnosis between purulent and acute viral meningitis and encephalitis.
Eur J Pediatr 1975 Dec 09
PMID:[The quantitative determination of the individual CSF proteins in the diagnosis of inflammatory diseases of the CNS in children (author's transl)]. 108 15

All cases of unusual types of gram-negative bacillary meningitis in a university hospital over a five year period were retrospectively analyzed. These patients comprised 4.2 per cent of cases of bacterial meningitis among all patients, 69 per cent of neurosurgical cases and 42 per cent of neonatal cases. The over-all mortality was 40.3 per cent. The two most common bacterial isolates were Escherichia coli in patients younger than one year and Klebsiella species in patients above that age. Infection may be acquired at birth or at the time of surgery, or may be secondary to spread of infection from other body sites. Gram-negative bacillary meningitis is a nosocomial infection and this diagnosis should be suspected in patients in whom central nervous system infection develops in the hospital.
Am J Med 1975 Dec
PMID:Gram-negative bacillary meningitis. 110 20

In an attempt to understand the role of TNF in the central nervous system (CNS) pathophysiologic events associated with bacterial meningitis, we examined the effect of intravenous vs. intracisternal administration of TNF alpha on penetration of circulating 125I-labeled albumin into cerebrospinal fluid (CSF) and CSF white blood cell (WBC) counts in rats. Intracisternal administration of tumor necrosis factor alpha (TNF-alpha) resulted in dose- and time-dependent alterations of the CSF penetration and CSF WBCs, while intravenous administration of TNF-alpha did not induce any changes. These changes by intracisternal TNF were abolished by heat treatment of TNF or coadministration of MAb to TNF-alpha. Mab to TNF-alpha also significantly reduced the CSF penetration of circulating albumin in experimental hematogenous Haemophilus influenzae type b meningitis in infant rats but this salutary effect required both intravenous and intracisternal administration. However, MAb to TNF-alpha failed to affect CSF pleocytosis in experimental hematogenous meningitis. These findings suggest that some of CNS pathophysiologic changes in bacterial meningitis may be a result of the local production of TNF but other host inflammatory responses may also participate in CNS inflammation in hematogenous bacterial meningitis.
Lymphokine Cytokine Res 1992 Dec
PMID:Modulation of blood-brain barrier permeability by tumor necrosis factor and antibody to tumor necrosis factor in the rat. 147 82

Antiinflammatory therapy has been shown to reduce the adverse pathophysiological consequences that occur in bacterial meningitis and to improve outcome from disease. In the present study, modulation of two principal steps of the meningeal inflammatory cascade was accomplished by concomitant administration of dexamethasone to diminish overproduction of cytokines in response to a bacterial stimulus and of a monoclonal antibody directed against adhesion-promoting receptors on leukocytes to inhibit recruitment of white blood cells into the subarachnoid space. Dexamethasone and antibody therapy produced a marked attenuation of all indices of meningeal inflammation and reduction of brain water accumulation after H. influenzae-induced meningitis in rabbits compared with results of each agent given alone and of untreated animals. In addition, the enhanced host's meningeal inflammatory reaction that follows antibiotic-induced bacterial lysis was profoundly ameliorated when dual therapy was administered without affecting clearance rates of bacteria from cerebrospinal fluid and vascular compartments. The combination of both therapeutic approaches may offer a promising mode of treatment to improve further the outcome from bacterial meningitis.
J Clin Invest 1991 Dec
PMID:Enhanced attenuation of meningeal inflammation and brain edema by concomitant administration of anti-CD18 monoclonal antibodies and dexamethasone in experimental Haemophilus meningitis. 168 64

A case is described of fulminant meningococcal meningitis occurring 1 day after serious head and facial trauma. Although meningococcus is one of the most common causes of bacterial meningitis in general, it is distinctly rare as a cause of posttraumatic meningitis. A review of the literature is included.
J Trauma 1991 Dec
PMID:Posttraumatic meningococcal meningitis: case report. 174 45


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