Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective, controlled, randomized single-blind clinical trial, treatment with cefotaxime (CTX) was compared with that with standard therapy (ST), which consisted of a penicillin-chloramphenicol combination with or without sulphadiazine, in 31 patients (excluding neonates) with proven bacterial meningitis. The two groups of patients were comparable in age, sex, clinical presentation and causative pathogens. The case fatality rate was 12.5% for the CTX group and 20% for the ST group, but this difference was not significant. The times taken for the cerebrospinal fluid (CSF) to become sterile and the temperature to normalize, the mean duration of treatment, complications and adverse effects were similar for the two regimens. Neurological or developmental abnormalities on follow-up were not significantly different for the two groups. It is concluded that CTX is a suitable alternative for treatment of bacterial meningitis in infants and children.
Ann Trop Paediatr 1988 Dec
PMID:Cefotaxime versus penicillin-chloramphenicol in purulent meningitis: a controlled single-blind clinical trial. 246 8

We have studied prospectively the C-reactive protein values in the cerebrospinal fluid of 54 patients with bacterial meningitis, tuberculous meningitis, and severe malarial infection and convulsions without infections of the central nervous system. CSF CRP above 1 mg/l was observed in 23 out of 28 patients with bacterial meningitis (sensitivity of 82%). The specificity was 73% at the 1 mg/l level. Five out of 19 patients with severe malarial infection had CSF CRP levels above 1 mg/l. Two patients with TB meningitis were also studied. Both of them had CSF CRP above 1 mg/l. Five patients with febrile convulsions or sepsis without meningitis had CSF CRP below 1 mg/l. It is concluded that CSF CRP would not be used as a useful discriminatory test in areas where malaria and TB meningitis are common.
Ann Trop Paediatr 1988 Dec
PMID:C-reactive protein and bacterial meningitis. 246 9

All cases of bacterial meningitis in the neonatal unit at King Edward VIII Hospital, Durban for the period 1 January 1981 to 31 December 1987 were reviewed. In particular, we looked at the impact of cefotaxime on mortality rates and amikacin on the incidence of hospital-acquired Gram-negative bacillary (GNB) meningitis. Klebsiella was found to be the commonest cause of neonatal meningitis, followed by Escherichia coli and Streptococcus agalactiae. Eighty-four per cent of all cases of GNB meningitis presented more than 3 days after birth, with the vast majority being caused by gentamicin-resistant Klebsiella. A decline in the incidence of meningitis from 1.27/1000 live births in 1981 and 0.95/1000 for the period 1981-1986 to 0.22/1000 live births in 1987, with no cases of Klebsiella meningitis being seen in that year, coincided with the exclusive use of amikacin as the parenteral aminoglycoside in place of gentamicin in the unit after August 1986. The initial decline in the incidence of meningitis from 0.93/1000 in 1985 to 0.46/1000 in 1986 was attributed to the introduction in 1985 of strict hand disinfection measures to prevent cross-infection in the unit. The case mortality rate (CMR) fell from 0.65 for the period 1981-1984 to 0.42 for the period 1985-1987, and we believe this was largely a result of the introduction of cefotaxime in 1984 as first-line therapy for GNB meningitis, together with better patient care facilities.(ABSTRACT TRUNCATED AT 250 WORDS)
Ann Trop Paediatr 1989 Dec
PMID:Hospital-acquired neonatal bacterial meningitis: the impacts of cefotaxime usage on mortality and of amikacin usage on incidence. 248 5

Between September 1981 and March 1987, 92 episodes of bacterial meningitis in 90 children were treated in three major hospitals in Kuwait. The diagnosis was bacteriologically confirmed in 80 (87%). Haemophilus influenzae was the most common aetiological organism and accounted for 42 episodes (45.6%) followed by Streptococcus pneumoniae in 21 (22.8%) and Neisseria meningitidis in only three (3.3%). Bacterial meningitis occurred in 53 children (57.6%) below the age of 1 year and in 81 (88%) below 5 years. The overall case fatality rate was 5.4% and ten children (9%) had severe neurological sequelae of their disease. Sequelae were more common following pneumococcal meningitis (28%) than after Haemophilus (7%). All 12 children with unknown pathogen recovered completely.
J Trop Med Hyg 1989 Dec
PMID:Morbidity and mortality of bacterial meningitis in Arab children. 260 74

Twenty-three newborn and young infants, including 13 low-birth-weight infants, were treated with cefmenoxime (CMX) and the clinical efficacy and side effects were evaluated. The ages of the patients ranged from 1 to 102 days, and their weights ranged from 0.83 to 4.19 kg. Doses given were 18-42 mg/kg every 6 to 12 hours for 2 to 16 days. Among 12 infants with bacterial meningitis and sepsis, the results were excellent in 2, good in 7 and fair in 3 patients. The drug was well tolerated and no adverse effects were observed in the 23 patients. Pharmacokinetic studies of CMX were done in 5 infants whose mean body weight was 3.03 kg (range 2.4 to 4.2 kg). Serum concentrations at 15 minutes after 10 mg/kg intravenous bolus injections were 35.6 and 55.7 micrograms/ml in two 12- and 18-day-old patients. In 3 patients with ages of 7, 7 and 24 days, serum concentrations were 54.6, 102 and 100 micrograms/ml, respectively, at 15 minutes after 20 mg/kg doses. Elimination half-lives of the drug were 1.3 to 1.5 (mean 1.4) hours in these patients. Excretion rates into urine in the first 8 hours were 30.3, 74.2, 77.6 and 85.6% in four patients given 10 or 20 mg/kg doses. The cerebrospinal fluid level at 3 hours after the dose was 0.4 micrograms/ml on 15th day of treatment in 1 patient with bacterial meningitis given 20 mg/kg every 6 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
Jpn J Antibiot 1989 Dec
PMID:[Clinical and pharmacokinetic evaluation of cefmenoxime in neonates and young infants]. 261 14

Four hundred twenty-nine patients with bacterial meningitis were assigned on a nonselective alternating basis into one of two therapeutic regimens. Patients in Group I received dexamethasone in addition to standard antibacterial chemotherapy of ampicillin and chloramphenicol whereas those in Group II received antibacterial chemotherapy alone. Dexamethasone was given intramuscularly (8 mg to children younger than 12 years and 12 mg to adults every 12 hours for 3 days). Both treatment groups were comparable with regard to age, sex, duration of symptoms and state of consciousness at the time of hospitalization. A significant reduction in the case fatality rate (P less than 0.01) was observed in patients with pneumococcal meningitis receiving dexamethasone; only 7 of 52 patients died compared with 22 of 54 patients not receiving dexamethasone. A reduction in the overall neurologic sequelae (hearing impairment and paresis) was observed in patients receiving dexamethasone. This reduction was significant only in patients with Streptococcus pneumoniae meningitis; none of the 45 surviving patients receiving steroids had hearing loss whereas 4 of 32 patients not receiving dexamethasone had severe hearing loss (P less than 0.05). No significant difference was observed between the two groups with regard to time for patients to become afebrile or to regain consciousness or in the mean admission and 24- to 36-hour cerebrospinal fluid leukocyte count, glucose or protein content.
Pediatr Infect Dis J 1989 Dec
PMID:Dexamethasone treatment for bacterial meningitis in children and adults. 262 85

The authors report a case of Pasteurella multocida meningoencephalitis in a 5 week-old female infant, with special attention to clinical, laboratory and evolutive features. A moderate neurological sequel was observed at follow-up examinations. A brief review of the importance of P. multocida in human pathology is presented on the basis of the international literature, since the authors did not find any Brazilian reports. The most important feature on P. multocida is the prevalence of bacterial meningitis at the extremes of age. Otherwise, significant mistaken was found between Gram stained smears of body fluids for P. multocida and Haemophilus influenzae or Neisseria meningitidis. Because its role in infections following animal bite or scratch and its opportunistic feature, P. multocida must be included among the possible etiologic agent of bacteremia or sepsis in patients with liver cirrhosis or immunosuppression.
Arq Neuropsiquiatr 1989 Dec
PMID:[Meningoencephalitis due to Pasteurella multocida: clinico-laboratory study of a case in an infant]. 263 88

Beta-2-microglobulin was determined in 147 patients admitted to hospital because of suspicion of CNS disease. Patients with meningism were chosen as control group. The concentration of beta-2-microglobulin in the spinal fluid of control patients was correlated with age. Reference values for 0-40 years were 0.34-1.58 mg/l. Above 40 years of age the values were 0.46-3.14 mg/l. CSF beta-2-microglobulin levels of patients with meningism, aseptic and bacterial meningitis overlap too much to be relevant in distinguishing between these entities. Five patients with herpes simplex encephalitis had markedly elevated levels ranging from 4.4 to 9.0 mg/l. Ten patients with herpes zoster-associated encephalitis had values from 1.1 to 6.1 mg/l. In the patient groups with CNS infections, the ratio of serum to spinal fluid beta-2-microglobulin was significantly more frequently less than 1 as compared with the meningism group, indicating intrathecal production of the protein. Further studies on the clinical relevance of CSF beta-2-microglobulin in the diagnosis of encephalitis seem warranted.
Acta Neurol Scand 1989 Dec
PMID:Beta-2-microglobulin in the cerebrospinal fluid of patients with infections of the central nervous system. 269 28

The hospital records of 85 children with bacterial meningitis were reviewed and a subset of 25 children who underwent computed tomography of the head were identified. The major stated indications for computed tomography were fever (8 patients), seizures (4 patients), signs of increased intracranial pressure (4 patients), focal neurologic dysfunction (3 patients) and recurrent meningitis (2 patients). Abnormal findings were demonstrated by computed tomography in 20 of 25 patients but in 8 patients consisted solely of nonspecific dilatation of spaces containing cerebrospinal fluid or of basilar enhancement. The yield of information that was useful either diagnostically or therapeutically was low; positive findings of obvious clinical relevance were present in only 2 cases. Computed tomography provides an accurate means of diagnosing intracranial complications of bacterial meningitis. It must be used conservatively, however, to limit expense and radiation exposure and enhance the yield of potentially relevant information. Computed tomography is indicated for children with persistent neurologic dysfunction, persistently positive cerebrospinal fluid cultures or recurrent meningitis, whereas it is of little value for children with prolonged fever alone.
Pediatr Infect Dis J 1988 Dec
PMID:Computed tomography in bacterial meningitis of childhood. 306 62

The study is based on 333 cerebrospinal fluid (CSF) samples from patients with clinical diagnosis of acute bacterial meningites. The aim of the study is a critical evaluation on latex agglutination tests in CSF for H. influenzae type b, N. meningitidis A and C, and S. pneumoniae. These tests are compared with direct examination (Gram method), and culture results. It was shown that results of the latex test in the CSF are basic for rapid diagnosis of etiological agent in a bacterial meningitis. Data on 106 CSF samples confirmed the etiology through latex tests in 98.2% for H. influenzae type b, in 15.8% for N. meningitidis A or C, in 96.8% for S. pneumoniae. Emphasis is given for evidence of antibiotic therapy previous to CSF collection, which may be responsible for the great number of negative results registered in the present series.
Arq Neuropsiquiatr 1988 Dec
PMID:[Latex agglutination tests of the cerebrospinal fluid in bacterial meningitis: an analysis of 333 cases]. 314 88


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