Evaluation Of Meningitis Research Articles

Epidemiological evaluation of meningitis in hospitalized patients in shahid Madani Hospital in Khorramabad

Background: Bacterial meningitis is an acute infection of the meninges requiring immediate diagnosis and treatment. Clinical, laboratory, and epidemiological findings of meningitis are of utmost importance for rapid diagnosis and treatment. The present study aimed to evaluate patients with meningitis based on their epidemiological, clinical, and laboratory findings and compare these variables between patients with septic and aseptic meningitis. Materials and Methods: In this retrospective cross-sectional descriptive study, all children with suspected meningitis in Shahid Madani Hospital in Khorramabad in 2014-2015 were examined for spinal fluid culture, age, gender, seasonal distribution, and antibiogram results. Results: Among 63 patients with meningitis, 30 (47.6%) cases had septic meningitis, and 33 (52.4%) subjects had aseptic meningitis. Out of 30 patients with septic meningitis, 4 (13.3%) patients had positive microbial culture. Among patients with septic meningitis, only four bacterial isolates were isolated by the microbial culture method, out of which Streptococcus pneumoniae was the most common bacterium and the prevalence was higher in autumn and winter. The most effective antibiotics were cotrimoxazole and vancomycin with a sensitivity of 100%; nonetheless, there was relatively high resistance to cloxacillin, erythromycin, and clindamycin. The number of white blood cells (WBCs), sugar, and protein in cerebrospinal fluid (CSF) in septic meningitis were compared with aseptic meningitis, and a significant difference was observed between the two groups. There was also a significant difference between gender and septic meningitis, and male patients were more likely to suffer from septic meningitis. Conclusion: The prevalence of aseptic meningitis was higher than that of septic meningitis. Microbial tests are very effective in the correct diagnosis and treatment; however, the level of WBC, glucose, and protein in CSF can also be of great help in diagnosing different types of meningitis, especially septic meningitis.

Cranial Ultrasonography in Evaluation of Meningitis in Neonates and Infants

Cranial Ultrasonography in Evaluation of Meningitis in Neonates and Infants

Salmonella meningitis in children at Texas Children's Hospital

Salmonella spp., a common cause of gastroenteritis, can result in invasive infections in children. While reported in developing countries, Salmonella meningitis has rarely been described in the United States. To evaluate the incidence and clinical characteristics of Salmonella meningitis at Texas Children's Hospital, we conducted a retrospective chart review to identify children up to 18 years of age with positive cerebrospinal fluid cultures for Salmonella from 2000 to 2010. Salmonella meningitis occurred in 7 of 112 (6.5%) cases of invasive Salmonella infection in children at our institution. Non-typhi Salmo- nella species were isolated in all cerebrospinal fluid samples, but only one had bacteremia. Patients were otherwise healthy infants under 4 months of age with no travel history. The most frequent symptoms at presentation included irritability, fever and diarrhea. Management and treatment regimens were varied. All infants survived and recovered without sequelae. Patients who received longer duration of intravenous antibiotics had a longer hospital stay, required central venous access, and developed side effects from medications. Non-typhi Salmonella meningitis was exclusively diagnosed in healthy infants younger than 4 months of age, and was not associated with high morbidity or mortality. Evaluation for meningitis is warranted in infants with gastro- enteritis and systemic symptoms such as fever and irritability. The management of non-typhi Salmonella meningitis in children is not standardized and deserves further evaluation.

Meningitis in Children: Diagnosis and Treatment for the Emergency Clinician

This article provides a review of the evaluation and management of meningitis in young children. It highlights the most common causes of meningitis and the most current treatment recommendations. Since the development of the hemophilus and pneumococcal conjugate vaccines, pediatric bacterial meningitis has been diagnosed less frequently. Viral meningitis is far more common and tends to be a less severe disease. It is very important to maintain a high index of suspicion and a low threshold for evaluation of meningitis in febrile young infants younger than 3 months.

Levels of antimicrobial molecules defensin and lactoferrin are elevated in the cerebrospinal fluid of children with meningitis.

To measure levels of defensins and lactoferrin in the cerebrospinal fluid (CSF) of children with meningitis. STUDY DESIGN. Prospective descriptive study involving children undergoing lumbar puncture during evaluation for meningitis. CSF concentrations of defensins and lactoferrin were determined using enzyme-linked immunosorbent assays on 19 children with bacterial meningitis, 31 children with aseptic meningitis, and 32 control children found to have normal CSF during evaluation for meningitis. Pertinent clinical and laboratory data were gathered on all children. CSF concentrations of both defensins and lactoferrin were elevated markedly in children with bacterial and aseptic meningitis, compared with control children. No control subject had detectable levels of defensins in the CSF. Lactoferrin was undetectable in the CSF of 31 of 32 control subjects. Defensin and lactoferrin levels were significantly higher in the CSF of children with bacterial meningitis than in those with aseptic meningitis. Defensin levels in the CSF of children with bacterial meningitis ranged from 128 ng/mL to 99 430 ng/mL with a mean of 30 311 ng/mL (SD +/- 28 865) and a median of 23 042 ng/mL. Defensin levels in the CSF of children with aseptic meningitis ranged from 0 ng/mL to 1675 ng/mL with a mean of 227 ng/mL (SD +/- 433) and a median of 23 ng/mL. A significant correlation was found between defensin levels in the CSF and the total leukocyte count and the absolute neutrophil count in the CSF of children with bacterial meningitis. Lactoferrin levels in the CSF of children with bacterial meningitis ranged from 184 ng/mL to 31 412 ng/mL with a mean of 13 209 ng/mL (SD +/- 9644) and a median of 10 382 ng/mL. Lactoferrin levels in the CSF of children with aseptic meningitis ranged from 0 ng/mL to 2715 ng/mL with a mean of 1042 ng/mL (SD +/- 878) and a median of 852 ng/mL. No correlation was found between lactoferrin level in the CSF and the total leukocyte count or the absolute neutrophil count in the CSF of children with bacterial meningitis. In our study population, the sum total of CSF defensins and lactoferrin was found to be highly sensitive and specific in delineating bacterial from aseptic meningitis when compared with standard CSF studies. Significant elevations of defensins and lactoferrin, indicative of endogenous local antimicrobial peptide and polypeptide release, are found in the CSF of children with meningitis. We speculate that elevations in these antimicrobial molecules may reflect the intensity of the host response. Defensins seem to parallel neutrophil activation more closely than lactoferrin. Cumulative levels of CSF defensins and lactoferrin clearly distinguished bacterial meningitis from aseptic meningitis and control patients. Further investigation is warranted to determine the usefulness of measuring defensins and lactoferrin as a diagnostic tool and therapeutic monitor in the evaluation of children with meningitis.

Sensorineural Hearing Loss Caused by NSAID-Induced Aseptic Meningitis

Aseptic meningitis is a rare complication of nonsteroidal anti-inflammatory drug (NSAID) use. Otologic symptoms may include sensorineural hearing loss and tinnitus. A 66-year-old woman sought the care of an otologist for sudden bilateral sensorineural hearing loss and a substantial increase in baseline tinnitus. The patient had previously undergone a left tympanoplasty secondary to cholesteatoma and had been treated for atypical face pain with ibuprofen taken every six hours for three months. Magnetic resonance imaging (MRI) with gadolinium demonstrated abnormal enhancement of the dura mater and the surrounding basal cisterns, with extension of enhancing dura mater into the internal auditory canals. Cerebrospinal fluid examination revealed evidence of aseptic meningitis. An audiogram confirmed new bilateral sensorineural hearing loss. Hearing loss and tinnitus resolved and no abnormalities were observed with MRI when nonsteroidal anti-inflammatory medication was discontinued. Otolaryngologists are well aware of the otologic sequelae in patients with meningitis. However, NSAIDs need to be considered as possible causal agents in the evaluation of meningitis with otologic symptoms.