1/63. headache and bilateral visual loss in a young hypothyroid Indian man.We describe the exceptional association of Vogt-Koyanagi-Harada syndrome (VKHS) and hypothyroidism in a 29-year-old man of Indian heritage. VKHS is a rare uveomeningoencephalitic syndrome with probably autoimmune pathogenesis. Nontraumatic uveitis, aseptic meningoencephalitis, vitiligo, alopecia and poliosis are the leading clinical features of VKHS. The reported patient presented with bilateral visual loss and progressive frontal headache. VKHS was diagnosed due to characteristic ophthalmological findings and the diagnosis of aseptic meningitis. Due to the autoimmune pathogenesis, VKHS may be rarely associated with other autoimmune disorders. association of VKHS with autoimmune thyroid disease has been described in the literature in three patients. In the reported case hypothyroidism due to chronic autommune thyroiditis was diagnosed in association with VKHS. Routinely determination of thyroid function in patients with VKHS is recommended.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/63. histiocytic necrotizing lymphadenitis (Kikuchi's disease) with aseptic meningitis.histiocytic necrotizing lymphadenitis, or Kikuchi's disease (KD), is a self-limited clinicopathologic entity recognized increasingly worldwide. A 27-year-old man with cervical lymphadenopathy and fever who was diagnosed with KD developed mild headache with no nuchal rigidity. The cerebrospinal fluid (CSF) was sterile and contained 78 white blood cells/mm3 with lymphocytes predominating, accompanied by smaller numbers of monocytes and granulocytes. This abnormality normalized spontaneously over 5 weeks. Eleven similar cases have been reported, all but one from japan. The development of meningitis in KD was observed in four (9.8%) of 41 KD patients we have treated, suggesting that the meningitis was related to KD and not merely coincidental.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
3/63. Eosinophilic meningitis. An unusual cause of headache.Human parasitic infections are uncommon outside the tropical north but common in animals throughout australia. The rat lung worm, angiostrongylus cantonensis, can invade the human brain to cause a chronic meningitis with prolonged headache. This condition can be diagnosed by finding a high eosinophil count in cerebrospinal fluid (CFS), the lumbar puncture also provides symptomatic relief. The outcome is usually benign but death has been reported.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
4/63. Palmoplantar pustulosis with pustulotic arthroosteitis involving temporal osteomyelitis and meningitis.A 46-year-old man who had been suffering from palmoplantar pustulosis (PPP) for 3 years had anterior chest pain and left temporal pain from six months after the onset of his disease. A bone scan revealed abnormal uptake at the sternoclavicular joint and left temporal region. The head CT and MRI gave the diagnosis of temporal osteomyelitis with meningitis and myositis. His headache continued even after tonsillectomy and was effectively treated with cyclosporine A (3 mg/kg/day). Oral cyclosporine A was beneficial for the osteomyelitis and skin lesions. Sterile lytic bone lesions occurring most often at the sternocostoclavicular joint have been associated with PPP. However, there have been no reports of a PPP patient with temporal osteomyelytic involvement.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
5/63. mortality from peripartum meningitis.A young primigravid parturient had an uneventful labour under epidural analgesia and delivered a healthy male infant. She returned 48 hours later with fever, vomiting and severe headache, but was misdiagnosed as having endometritis. Further signs of meningitis appeared six hours later, however she succumbed to the infection and died four weeks later despite intensive care and high-dose antibiotic management. Causes of meningitis in the peripartum period are discussed. The possibility of a causal association between the patient's epidural analgesia and her infection are considered and preventive measures discussed.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
6/63. recurrence of ibuprofen-induced aseptic meningitis in an otherwise healthy patient.We report the case of a 74-year-old woman who had three episodes of aseptic meningitis in a period of 20 years. These episodes always occurred a few hours after the assumption of a non-steroidal anti-inflammatory drug (NSAID) per os. Nevertheless, the pharmacological anamnesis did not receive proper attention, neither the first nor the second time, and the meningeal syndrome with aseptic liquor was attributed to a viral aggression. However, when the third episode occurred, due to the strict time correlation between the assumption of the drug and the occurrence of symptoms, both the results of the liquoral analysis and the anamnestic records allowed recognition of ibuprofen as the cause of acute meningitis.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
7/63. Pachymeningitis with pseudo-Foster Kennedy syndrome.PURPOSE: To report a case of pachymeningitis with pseudo-Foster Kennedy syndrome in a patient who was positive for perinuclear antineutrophil cytoplasmic antibody. methods: Case report. A 44-year-old man was examined for headache and diplopia. RESULTS: Left eye showed limitation of abduction. Ocular fundus, computed tomography (CT), and magnetic resonance imaging (MRI) of the head and orbits were normal. The diplopia subsided spontaneously. Six months later, he noticed sudden visual loss in the left eye. The left eye showed optic disk atrophy and episcleritis, and the right eye showed papilloedema. Computed tomography and MRI exhibited thickened dura mater. serum perinuclear antineutrophil cytoplasmic antibody level was highly increased. CONCLUSION: Pachymeningitis with ocular involvement sometimes requires repeated CT or MRI for diagnosis. This disorder may be caused by microvasculitis.- - - - - - - - - - ranking = 23.849347746402keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
8/63. Multifocal fibrosclerosis as a possible cause of panhypopituitarism with central diabetes insipidus.Multifocal fibrosclerosis denotes a combination of similar fibrous disorders occurring at different anatomical sites. We encountered a 53-year-old male patient with orbital pseudotumor, chronic paranasal sinusitis, fibrous nodules of the lungs, intracranial pachymeningitis, and panhypopituitarism with central diabetes insipidus (DI) as a possible manifestation of multifocal fibrosclerosis. It has been reported that intracranial pachymeningitis or orbital pseudotumor associated with multifocal fibrosclerosis could invade the sella turcica causing a variety of anterior and/or posterior pituitary dysfunctions. In our case, intracranial pachymeningitis apparently involved the pituitary stalk and gland. Isolated gonadotropin deficiency, in addition to central DI, preceded panhypopituitarism. Although panhypopituitarism with central DI due to multifocal fibrosclerosis is quite rare and only one case has ever been reported, this systemic fibrotic disorder can be a possible cause of panhypopituitarism with central DI.- - - - - - - - - - ranking = 56.548043239205keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
9/63. optic nerve involvement in neuro-Behcet's disease.BACKGROUND: To report the ocular manifestations of neuro-Behcet's disease. CASES: A 34-year-old woman had recurrent meningitis. She developed diplopia, headache, and ataxia, and was diagnosed as having neuro-Behcet's disease. OBSERVATIONS: Imaging revealed two infarct foci in the transitional midbrain and pons. After treatment with prednisolone and colchicine, the diplopia resolved. Two years later, a scotoma developed in the right eye, in which the best-corrected visual acuity was 4/200. Papillitis and a prepapillary vitreous opacity were seen in the right fundus. These findings disappeared 11 days after subconjunctival steroid injections and increased colchicine. Her vision gradually improved to 20/20 two months later. CONCLUSION: Neuro-Behcet's disease may manifest with transient optic neuritis and prepapillary vitreous opacity.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
10/63. Acute urinary retention as an unusual manifestation of aseptic meningitis.A formerly healthy 32-year-old woman was hospitalized for a closer examination of undiagnosed fever with mild headache. Despite lack of distinct findings on physical and laboratory examinations at admission, she suddenly developed anuresis due to acontractile neurogenic bladder. On the basis of her symptoms and the faint nuchal rigidity revealed later, as well as the results of cerebrospinal fluid analyses, a diagnosis of aseptic meningitis was eventually reached. While aseptic meningitis subsided within 3 weeks, about 10 weeks, including a 26-day period of anuria, was necessary for complete restoration of normal voiding function, necessitating intermittent self-catheterization. Acute urinary retention should be considered an uncommon but critical manifestation of aseptic meningitis.- - - - - - - - - - ranking = 7keywords = meningitis (Clic here for more details about this article) |
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