1/55. Anterior sacral meningocele associated with a rectal fistula. Case report and review of the literature.The authors report a case of anterior sacral meningocele associated with a rectal fistula in a patient who had presented 20 years earlier with bacterial meningitis. To their knowledge, this is the first case in which a rectal fistula developed due to an anterior sacral meningocele. The clinical presentation, diagnosis, and treatment of this uncommon lesion is discussed.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/55. Transient diabetes insipidus following Escherichia coli meningitis complicated by ventriculoperitoneal shunt.Although disorders of ADH secretion associated with meningitis are usually consistent with the syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH), central diabetes insipidus (DI) is an exceptional complication of meningitis. Transient DI as a complication of Escherichia coli (E. coli) meningitis due to ventriculoperitoneal shunt in an 18-month-old boy is presented. blood and spinal fluid cultures yielded E. coli, sensitive to cefotaxime. The DI arose on the day 3 after admission and continued to the day 20. Treatment comprised cefotaxime, dexamethasone, fluid adjustment and vasopressin. The course of our case supports that in cases of bacterial meningitis, initial fluid restriction may occasionally result in dangerous conditions. Therefore, all children with bacterial meningitis should be followed closely not only in terms of SIADH but also DI. To our knowledge this is the first transient DI associated with E. coli-caused meningitis case reported.- - - - - - - - - - ranking = 10keywords = meningitis (Clic here for more details about this article) |
3/55. Spontaneous Escherichia coli meningitis in an adult.Spontaneous meningitis due to gram-negative bacilli (excluding Hemophilus influenzae) is an infrequent infection in adult patients. It usually occurs in patients with underlying immunosuppressive conditions. Most of the cases are due to Escherichia coli and represent a complication of bacteraemia. The infection has a high mortality rate which may be as high as 90%, especially if associated with septicaemia. We report the case of a 53-y-old man with spontaneous, community-acquired Escherichia coli meningitis who was admitted with an unusual presentation. blood and urine cultures were negative.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
4/55. Behcet's disease complicated by pylephlebitis and hepatic abscesses.A 22 year old man presented with fever, abdominal pain, weight loss and diarrhea. Past medical history revealed recurrent aseptic meningitis, uveitis, and erythema nodosum. Further inquiry unveiled a prominent history of oral aphthous ulcers; all features of Behcet's disease. Imaging revealed mesenteric arteritis and pylephlebitis, septic thrombophlebitis of the portal vein, a previously unrecognized complication of Behcet's disease, with multiple intrahepatic abscesses. Portal venography demonstrated an extensively diseased, expanded, and obstructed portal venous system. blood cultures and portal vein aspirate yielded polymicrobial flora. Percutaneous intraportal thrombolytic therapy and mechanical thrombectomy were attempted to restore flow to the portal venous system. This distinctly rare manifestation of Behcet's disease, pylephlebitis, may result from ischemic injury and structural compromise of the bowel mucosa, resulting from underlying vasculitis.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
5/55. uropathogenic escherichia coli as agents of diverse non-urinary tract extraintestinal infections.Escherichia coli isolates from 3 consecutively encountered patients with serious, invasive, non-urinary tract extraintestinal infections (pneumonia, deep surgical wound infection, and vertebral osteomyelitis with associated epidural/psoas/iliacus abscesses) were characterized, using molecular methods, as to extended virulence genotype and phylogenetic background. All 3 isolates exhibited virulence genotypes and genomic profiles characteristic of specific familiar virulent clones of extraintestinal pathogenic E. coli (ExPEC), which traditionally have been regarded primarily as uropathogenic or as associated with meningitis. These included E. coli O1/O2:K1:H7, E. coli O18:K1:H7, and a recently described E. coli O11/O17/O77:K52:H18 clonal group (clonal group A). These findings demonstrate the extraintestinal pathogenic versatility of ExPEC clones, which supports the use of an inclusive designation for such strains and suggests the possibility of cross-syndrome protective interventions. They also provide novel evidence that multidrug-resistant epidemic clonal group A can cause extraintestinal infections other than uncomplicated urinary tract infections and can cause them in hosts other than young women.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
6/55. Infected cephalohematoma complicated with meningitis: report of one case.Infected cephalohematoma associated with meningitis is rarely reported. We report the case of 19-day-old female newborn with a cephalohematoma infected by Escherichia coli, and whose cerebrospinal fluid showed pleocytosis. Antibiotics alone could not eradicate the infection of the cephalohematoma, and surgical incision and drainage resulted in obvious clinical improvement. Three weeks of antibiotic usage completed the course of treatment.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
7/55. Extraintestinal pathogenic Escherichia coli as a cause of invasive nonurinary infections.Multiple Escherichia coli isolates from four adults with extraintestinal infections underwent molecular phylotyping and virulence profiling. A patient with secondary peritonitis had two low-virulence E. coli strains from phylogenetic groups A and D. In contrast, three patients with invasive extraurinary infections (septic arthritis/pyomyositis, nontraumatic meningitis/hematogenous osteomyelitis, and pneumonia) each had a single high-virulence phylogenetic group B2 strain resembling typical isolates causing urinary infection and/or sepsis, i.e., extraintestinal pathogenic E. coli.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
8/55. Acute spinal epidural abscess and spinal leptomeningitis: report of 2 cases with comparative neuroradiological and autopsy study.A 21-year-old male developed back pain, fever, and rapidly progressive quadriparesis. Lumbar tap yielded frank pus which was confirmed on magnetic resonance imaging (MRI) to be located mainly in the cervical epidural space. Conservative antibiotic remedy was partially effective for restoration of the neurological deficits. A 82-year-old female noticed low-back pain which was rapidly accompanied with clouding of consciousness, paraplegia, and sphincter disturbances. Lumbar puncture revealed thick pus which was best depicted on MRI in the thoracolumbar subarachnoid space. At autopsy, spinal subarachnoid abscess or leptomeningitis was confirmed, and a spinal infarction previously unrecognized on MRI was found. Usefulness and shortcomings of MRI in the diagnosis of paraspinal infections are discussed.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
9/55. meningitis in a newborn infant with urosepsis, negative blood cultures and initially normal cerebrospinal fluid findings.This case presentation supports the observation that initial cerebrospinal fluid findings can be normal in newborn infants with sepsis syndrome who then develop evidence for meningeal involvement. Therefore, if initial lumbar puncture results are negative, a repeat lumbar puncture is recommended to look for meningitis in newborns that are critically ill with sepsis syndrome.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
10/55. The probable role of hydrocephalus in the development of intraventricular septa. An observation of one case.Multiloculated cerebral ventricles are a well-known complication of neonatal meningitis secondary to gram-negative bacteria. Their presence often hampers the proper functioning of the multiple shunts required for draining the ventricles. To determine whether the associated hydrocephalus may contribute to the development of the ventricular septa, we analyzed the histological structure of the ventricular wall and of the ventricular septa of a child who died as a consequence of Escherichia coli meningitis and unilateral hydrocephalus. Our results show that the ventricular septa are formed by glial protrusion into the ventricles. The ependymal wall of the grossly dilated ventricle was disrupted, but not that of the contralateral ventricle. We hypothesize that the presence of an insufficiently controlled hydrocephalus may have been one of the factors that induced the formation of the septa. It is suggested that an external ventricular derivation should be used during the active phase of the infection.- - - - - - - - - - ranking = 2keywords = meningitis (Clic here for more details about this article) |
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