Diagnosis Of Purulent Meningitis Research Articles

Moxifloxacin treatment for Mycoplasma hominis meningitis in an extremely preterm infant

The patient, a male newborn, was admitted to the hospital 2 hours after birth due to prematurity (gestational age 27+5 weeks) and respiratory distress occurring 2 hours postnatally. After admission, the infant developed fever and elevated C-reactive protein levels. On the fourth day after birth, metagenomic next-generation sequencing of cerebrospinal fluid indicated a positive result for Mycoplasma hominis (9 898 reads). On the eighth day, a retest of cerebrospinal fluid metagenomics confirmed Mycoplasma hominis (56 806 reads). The diagnosis of purulent meningitis caused by Mycoplasma hominis was established, and the antibiotic treatment was switched to moxifloxacin [5 mg/(kg·day)] administered intravenously for a total of 4 weeks. After treatment, the patient's cerebrospinal fluid tests returned to normal, and he was discharged as cured on the 76th day after birth. This article focuses on the diagnosis and treatment of neonatal Mycoplasma hominis purulent meningitis, introducing the multidisciplinary diagnosis and treatment of the condition in extremely preterm infants.

Clinical and Diagnostic Study of Cerebrospinal Fluid Parameters in the Laboratory of the Regional Children’s Hospital

The aim of the work is to analyze the morbidity of children who underwent CSF research for the period 2019-2021, as well as to consider the dynamics of the development of the disease picture with purulent and serous meningitis (against the background of anti-intoxication and antibacterial therapy) and to assess the condition of a sick child. The contingent of subjects is an experimental group of children under 14 years old with a diagnosis of purulent and serous meningitis who were being treated at the Penza regional Hospital. The main results of the work showed that in three years the number of children in need of cerebrospinal fluid examination has decreased. However, the number of pathological studies in children with meningitis remained at a fairly high level. In children during the newborn period with a diagnosis of purulent meningitis, there is a positive dynamic of indicators against the background of anti-intoxication and antibacterial therapy. In children diagnosed with serous meningitis, there was a slight lymphocytic pleocytosis, in several cases of the disease there is an increase in neutrophils. This indicates the most severe course of the disease and has a less favorable prognosis.

Purulent Meningitis in Children: A Retrospective Study of 70 Cases in Senegal

Introduction: Despite much progress, purulent childhood meningitis (PCM) remains a public health problem. The objective of this work was to determine the epidemiological, clinical, therapeutic and evolutionary profile of purulent meningitis in children. Methods: Based on retrospective work carried out over a 4-year period (01 January 2014 to 31 December 2017), we studied the epidemiological, clinical, therapeutic and evolutionary aspects of cases of purulent meningitis hospitalized in the pediatric ward of the Children's Hospital of Diamniadio. Included were all children from 29 days to 15 years of age in whom the diagnosis of purulent meningitis was confirmed by the laboratory. Results: The hospital frequency was 1.9%. The mean age of the patients was 41.0 months. Among the affected children, 68.6% were fully vaccinated. The main germ was Neisseria meningitidis W135 (58.8%). Third generation cephalosporins were the antibiotics of choice (97.1%). No resistance was found to them. The cure rate with sequelae was 5.7%. Streptococcus pneumoniae was the germ responsible for 50% of the objective sequelae. The mortality rate was 7.1%. Conclusion: Neisseria meningitidis W135 is the main germ of purulent meningitis in our study. It is not included in the national routine immunization. It is imperative to adapt vaccination to the epidemiological fluctuation of pathogens in our regions.

Diagnostic value of isotropic three-dimensional fast spin echo-CUBE enhancement sequence in children with purulent meningitis

Objective To explore the clinical value of 3D fast spin echo with an extended echo train acquistion (CUBE) T1WI enhancement sequence for purulent meningitis by comparing to contrast-enhanced T2WI-FLAIR sequence in the detection of lesions. Methods From August 2016 to July 2017,children with clinically suspected purulent meningitis underwent cranial magnetic resonance examination in our hospital.There were 35 children,19 males and 16 females,aged 2 months to 3 years (median age 8 months) in total.A GE Discovery MR 750 3.0 T scanner was used to perform routine plain and enhanced scan in all children. After enhancement,the sequences of CUBE T1WI and FLAIR T2WI were applied randomly. Using the FLAIR T2WI enhancement sequence as the reference,we evaluated the detection rate of CUBE T1WI enhancement sequence for dura mater and leptomeningeal thickening. The number of enhanced lesions detected was tested by χ2 test. Results The enhanced FLAIR T2WI sequence showed 21 cases with dural enhancement,showing a rate of 60.0%. The enhanced CUBE T1WI sequence showed 31cases with dural enhancement,showing a rate of 88.6%. There were significant differences between the dural lesions detected (χ2=6.058,P 0.05). Conclusion Enhancement of the CUBE T1WI sequence enables better visualization of meningeal thickening than FLAIR T2WI.It has great clinical value in the diagnosis of purulent meningitis in children. Key words: Child; Meningitis; Magnetic resonance imaging

Changes of soluble triggering receptor expressed on myeloid cells-1 and lactate in children with purulent meningitis

Objective To discuss the diagnosis significance of soluble triggering receptor expressed on myeloid cells-1(STREM-1) and lactate in children with purulent meningitis, and to investigate the changes of STREM-1, lactate in cerebrospinal fluid(CSF) of purulent meningitis before and after treatment. Methods Dry chemical method and enzyme linked immunosorbent assay( ELISA)were used to measure STREM-1 and lactate levels in CSF of purulent meningitis group(24 cases), viral meningitis group(27 cases), CSF normal group(25 cases) and purulent meningitis after treatment group(22 cases). Results 1.STREM-1 and lactate levels in CSF were higher in patients with purulent meningitis than in those with viral meningitis and CSF normal group(all P<0.05).2.STREM-1 and lactate levels in CSF were higher in patients with purulent meningitis before treatment than those after treatment(all P<0.05).3.The area under the curve(AUC) of STREM-1 in CSF was 0.891, and at a cutoff level of 27.86 ng/L STREM-1 yielded a sensitivity of 80.8% and specificity of 75.0%; the AUC of CSF lactate was 0.940, and at a cutoff level of 1.75 mmol/L lactate yielded a sensitivity of 90.4% and specificity of 83.3%. Conclusions 1.STREM-1 and lactate were asso-ciated with bacterial infection, they have considerable diagnostic values in purulent meningitis.2.STREM-1 and lactate maybe worthless in differential diagnosis of purulent meningitis when treated by effective antibiotics.3.The decline of STREM-1 and lactate in CSF prompts the control of infection and good prognosis. Key words: Purulent Meningitis; Viral meningitis; Soluble triggering receptor expressed on myeloid cells-1; Lactate; Diagnose; Differential diagnosis

Strongyloides hyperinfection in two patients with lymphoma, purulent meningitis, and sepsis

Strongyloides stercoralis hyperinfection syndrome is a rare complication of strongyloidiasis that occurs in immunosuppressed patients. It is caused by increasing autoinfection of the host by the nematode, leading to serious superimposed enterobacterial sepsis. Once established, it has a high fatality rate. Two cases are reported of Strongyloides hyperinfection in patients with lymphoma who presented with purulent meningitis. Both were receiving combination chemotherapy that included high-dose corticosteroids, and neither was granulocytopenic at infectious onset. The patients had respiratory insufficiency that required mechanical ventilation and serious septic episodes. Both were treated with thiabendazole, and one survived with clearance of the larvae. These cases illustrate the possibility of strongyloidiasis hyperinfection as an underlying diagnosis of purulent meningitis and serious septic episodes in lymphomatous patients. It may occur even without granulocytopenia.

Children Admitted for Observation for Suspected Meningitis:Problems in Diagnosis in General Practice

Infectious diseases in children are common in general practice. It is crucial not to overlook a case of purulent meningitis, and the aim of the present study was to evaluate and suggest ways of improving the diagnostic ability of the general practitioners in this respect. During a seven-year period 157 children under the age of 16 years, out of a population of 10,500 children, were referred from general practice to a district hospital for observation with symptoms and signs that suggested a possible diagnosis of meningitis. Seventy-eight underwent lumbar puncture, but only 14 of them received a final diagnosis of purulent meningitis. During the same period three other children proved to be cases of purulent meningitis, though they had been referred with other diagnosis. Twenty children had aseptic meningitis or encephalitis. The clinical findings in the groups of children with and without purulent meningitis were very similar, but an impaired level of consciousness and presence of petechiae were commoner in the former. Children with purulent meningitis had a significantly shorter duration of symptoms than children without meningitis. The present study could not suggest any ways of improving the referral procedures.

Rapid diagnosis of purulent meningitis by latex agglutination and counterimmunoelectrophoresis

Rapid diagnosis of purulent meningitis by latex agglutination and counterimmunoelectrophoresis

Rapid diagnosis of purulent meningitis by latex agglutination and counterimmunoelectrophoresis

Rapid diagnosis of purulent meningitis by latex agglutination and counterimmunoelectrophoresis

Risikofaktoren bei eitriger Meningitis im Kindesalter

Retrospective studies of the case histories of 237 children suffering from bacterial meningitis at the department of pediatrics, university of Graz, show the significant difference between cured, deceased and children with permanent sequels. The risk factors for the fatal outcome of meningitis were: age (less than 1 year), bacteria (pneumococcus), concomitant disease (pneumonia), low initial white cell count in the blood (less than or equal to 5000/cmm) as well as in cerebrospinal fluid (less than or equal to 4000/cmm), high cerebrospinal fluid protein (greater than or equal to 336 mg%) and a high bacterial inoculum (greater than or equal to 10(7) CFU/cmm). With all these risk factors at the time of diagnosis of purulent meningitis the chance for recovery is poor.

Aneurisma micotico cerebral bilateral em criança: registro de um caso e revisão da literatura

Os autores relatam caso de paciente masculino, de 6 anos de idade, hospitalizado com diagnóstico de meningite purulenta. A pneumencefalografia mostrou processo expansivo fronto-temporal esquerdo. A arteriografia carotídea bilateral demonstrou presença de aneurisma da artéria frontal ascendente, com hematoma circundante, à esquerda e, aneurisma da artéria temporal posterior, à direita. Cirurgia para evacuação do hematoma e clipagem do aneurisma foi realizada. O paciente piorou no pós-operatório e faleceu. A autópsia demonstrou a presença de hemorragia subaracnóide, hematoma fronto-temporal esquerdo e para-capsular direito. No interior do hematoma, à direita, evidencia-se massa arredondada, cujo exame histopatológico demonstrou tratar-se de paredes arteriais dilatadas, com intenso processo inflamatório supurativo. Os autores tecem considerações a respeito da frequência de aneurismas micóticos na infância, a multiplicidade dos mesmos, a sua etiopatogenia, a localização dos mesmos na árvore arterial intracraniana, do valor diagnóstico da angiografia carotídea e da indicação cirúrgica.

Letters to the Editor

We appreciate Dr. Nogen's concern with the diagnosis of purulent meningitis in the face of a normal spinal fluid protein and glucose. A careful review of the records of the second patient indicates that the spinal fluid protein of 24.5 mg/100 cc and glucose of 79 mg/100 cc are indeed correct. Further, the child did not receive intravenous glucose prior to the lumbar puncture. Nevertheless, one can never completely rule out the possibility of human error in recording of laboratory data.

POSTGRADUATE COURSE

Discussion of clinical recognition and differential diagnosis of purulent meningitis in children, and especially infants, is followed by an outline of therapeutic regimens currently employed at the Hospital for Sick Children. The clinical features and use of steroids in measles encephalitis are outlined. The differential diagnosis between poliomyelitis and the Guillain-Barré syndrome is discussed, together with points regarding early management of respiratory complications.

CLINICAL APPLICATIONS OF CHICK EMBRYO CULTURES

I. PRIMARY DIAGNOSIS OF MENINGITIS AND STUDY OF SPINAL FLUID IN MENINGOCOCCEMIA WITHOUT MENINGITIS THE PRINCIPAL aim of clinical bacteriology is the rapid and accurate identification of pathogenic organisms so that the clinician may employ suitable specific therapeutic measures at the earliest moment. There have been innumerable attempts by bacteriologists to improve on basic culture mediums by devising modifications of the chemical composition and changes in the oxygen tension of the mediums in order to insure the most rapid and constant bacterial growth. The developing chick embryo as a culture according to the Goodpasture technic has been used by us as an aid in a variety of clinical problems, among them the etiologic diagnosis of purulent meningitis, the study of spinal fluid in early meningococcemia without meningitis and the serial study of empyema fluid.

PURULENT TYPHOID MENINGITIS

Meningitis due to theB.typhosusis a relatively rare disease. Cole collected the cases recorded up to 1904. We have been able to find twenty-three cases recorded in the literature since that time. In addition to reviewing the cases reported by Cole, we wish to report a case in which cholecystitis and otitis media were additional complications. We had the opportunity of doing a necropsy in this case, thus making an anatomic study of the complications possible. The findings of the meningeal complication and of a pure typhoid culture comply with all of Cole's requirements for the diagnosis of purulent meningitis. REPORT OF CASE Case 3494. —R. A., aged 6, admitted to the Halstead Hospital, Oct. 12, 1919, with complaint of headache, fever and abdominal pain. Family History. —Negative. One brother living and well. The brother later developed typhoid fever and was a patient in the hospital. Positive Widal;