1/162. Spinal anaesthesia and meningitis in former preterm infants: cause-effect?meningitis associated with spinal anaesthesia is a rare but well-known complication. We report on a case of fatal bacterial meningitis following spinal anaesthesia in a former preterm infant. The aetiology of this meningitis could not be established. Former preterm infants represent a high-risk population because of their susceptibility to group B streptococcal meningitis at this age as documented in a second case. Therefore we discuss whether meningitis was consequential or coincidental with spinal anaesthesia and could have been prevented by more comprehensive preoperative laboratory screening or prophylactic antibiotics.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/162. Congenital malformation of the inner ear associated with recurrent meningitis.Congenital deformities of the labyrinth of the inner ear can be associated with meningitis and varying degrees of hearing loss or deafness. A recurrence of meningitis is due to the development of a fistulous communication between the subarachnoid space and the middle ear cavity, and can prove lethal. An illustrative case of a 4-year-old Japanese girl with bilateral severe hearing loss, recurrent meningitis and malformations of the inner ear and stapes footplate is presented. Removal of the stapes during tympanotomy provoked a gush of cerebrospinal fluid. The defect was repaired successfully, and there has been no further episodes of meningitis to date.- - - - - - - - - - ranking = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
3/162. cholesteatoma extending into the internal auditory meatus.We report our experiences in managing a patient with cholesteatoma complicated by meningitis, labyrinthitis and facial nerve palsy. The antero-inferior half of the tympanum was aerated but the postero-superior portion of the tympanic membrane was tightly adherent to the promontry mucosa. An attic perforation was present at the back of the malleolar head. High-resolution computed tomography also uncovered a fistula in the lateral semicircular canal. Surgical exploration of the middle ear cavity demonstrated that both the vestibule and cochlea were filled with cholesteatoma, and the cholesteatoma extended into the internal auditory meatus through the lateral semi-circular canal fistula. The cholesteatoma was removed by opening the vestibule and cochlea with a preservation of the facial nerve. Post-operatively, an incomplete facial palsy remained, but has improved slowly. There is no sign of recurrence to date after a 3-year period of observation.- - - - - - - - - - ranking = 0.021165048132583keywords = canal (Clic here for more details about this article) |
4/162. nocardia asteroides pneumonia, subcutaneous abscess and meningitis in a patient with advanced malignant lymphoma: successful treatment based on in vitro antimicrobial susceptibility.nocardia asteroides pneumonia, subcutaneous abscess and meningitis without brain abscesses developed in a patient with advanced non-Hodgkin's lymphoma, who had received corticosteroid therapy and cancer chemotherapy for a long time. At the time of nocardial pneumonia, profound lymphocytopenia and hypogammaglobulinemia was seen. The severely immunosuppressed condition most likely accounted for the uncommon infection, nocardiosis. The organism isolated from the sputum, subcutaneous abscess and cerebrospinal fluid was strongly resistant to cotrimoxazole, which is the recommended standard treatment, but it was susceptible to imipenem (IPM) and erythromycin (EM) in an in vitro antimicrobial susceptibility study. The patient's nocardiosis responded well to chemotherapy including IPM and EM.- - - - - - - - - - ranking = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
5/162. Infectious meningitis mimicking recurrent medulloblastoma on magnetic resonance imaging. Case report.This report and the accompanying review of the literature address the challenges, when using surveillance magnetic resonance (MR) imaging, of establishing the origin of newly detected central nervous system lesions. Routine surveillance MR imaging in a 16-year-old boy, whose medulloblastoma had been successfully treated, demonstrated asymptomatic nodular leptomeningeal enhancement of the brain and spinal cord, which was consistent with recurrent disease. Examination of the cerebrospinal fluid, however, led to the diagnosis of bacterial meningitis. Two weeks after completion of antibiotic therapy, the original MR imaging findings were seen to have resolved. This case illustrates the importance of considering clinical and laboratory data, including results from a complete examination of the cerebrospinal fluid, when interpreting the origin of new lesions revealed by MR imaging.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
6/162. streptococcus suis meningitis: report of a case.A 50-year-old policeman who presented with subacute meningitis, bilateral rectus muscle palsies, dizziness and early bilateral deafness was reported. cerebrospinal fluid (CSF) revealed polymorphonuclear pleocytosis with gram-positive cocci. blood and CSF cultures grew Streptococcus viridans which subsequently identified to be streptococcus suis. The patient improved after treatment but deafness persisted.- - - - - - - - - - ranking = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
7/162. 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 = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
8/162. Successful treatment of late-onset infection due to resistant klebsiella pneumoniae in an extremely low birth weight infant using ciprofloxacin.OBJECTIVE: This paper presents a case in which an extremely low birth weight infant with multidrug-resistant klebsiella pneumoniae infection was successfully treated with ciprofloxacin and gentamicin. STUDY DESIGN: A clinical case report of a neonate who received broad spectrum antibiotics for possible infection despite negative cultures. The infant developed sepsis and meningitis resulting from multidrug-resistant K. pneumoniae, which was treated with ciprofloxacin and gentamicin. The literature for the use of ciprofloxacin in pediatric patients was reviewed. RESULTS: The infant responded to the antibiotic regimen with sterilization of blood and cerebrospinal fluid; no adverse effects were attributable to the ciprofloxacin. Although ciprofloxacin has been found to cause irreversible injury to cartilage in juvenile laboratory animals, a review of the literature found that this complication occurs rarely if at all in pediatric patients. ciprofloxacin has been found to be effective in the treatment of multidrug-resistant Gram-negative infections in pediatric patients, including premature infants. CONCLUSION: ciprofloxacin should be considered in the treatment of neonatal infection caused by multidrug-resistant Gram-negative organisms. Although the published experience with this drug suggests that it is effective and that significant toxicity is not common, its use should be restricted to the treatment of serious infections for which an alternative antibiotics is not available.- - - - - - - - - - ranking = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
9/162. adult citrobacter freundii meningitis: case report.Citrobacter is a distinct group of Gram-negative bacilli belonging to the enterobacteriaceae family. central nervous system (CNS) infections due to Citrobacter are uncommon, though they occur more frequently in neonates and young children. In adults, Citrobacter meningitis is extremely unusual with only 6 cases reported in the literature before 1998. This rare CNS infection has been seen in patients with head trauma, following neurosurgical procedures, and in those who are immunocompromised. Of the patients in the 6 reported cases, only one developed multi-antibiotic resistant Citrobacter CNS infection. Adding to this small number of reported cases, we report an adult case of post-neurosurgical meningitis and subdural empyema caused by multi-antibiotic resistant citrobacter freundii and also review the literature related to this infection. Antimicrobial therapy with imipenem and third-generation cephalosporins failed to result in cerebrospinal fluid sterilization in our patient. Because of the use of broad-spectrum antibiotics, multi-antibiotic resistant Citrobacter species have developed in this nosocomial CNS infection and now present a therapeutic challenge. Therefore, further clinical studies are needed to determine updated therapeutic modalities for treating this life-threatening infection.- - - - - - - - - - ranking = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
10/162. Molecular identification and epidemiological tracing of pasteurella multocida meningitis in a baby.We report a case of pasteurella multocida meningitis in a 1-month-old baby exposed to close contact with two dogs and a cat but without any known history of injury by these animals. 16S rRNA gene sequencing of the isolate from the baby allowed identification at the subspecies level and pointed to the cat as a possible source of infection. molecular typing of Pasteurella isolates from the animals, from the baby, and from unrelated animals clearly confirmed that the cat harbored the same P. multocida subsp. septica strain on its tonsils as the one isolated from the cerebrospinal fluid of the baby. This case stresses the necessity of informing susceptible hosts at risk of contracting zoonotic agents about some basic hygiene rules when keeping pets. In addition, this study illustrates the usefulness of molecular methods for identification and epidemiological tracing of Pasteurella isolates.- - - - - - - - - - ranking = 0.33333333333333keywords = spinal (Clic here for more details about this article) |
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