1/184. cauda equina syndrome complicating pneumococcal meningitis.A 14-month-old female with pneumococcal meningitis presented with flaccid paraplegia, saddle anesthesia, and bladder and bowel dysfunction. magnetic resonance imaging of the spine demonstrated intense gadolinium enhancement of the cauda equina, whereas the conus medullaris appeared normal. This finding indicated that lumbosacral polyradiculopathy caused her symptoms.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/184. purpura fulminans associated with streptococcus pneumoniae infection in a child.BACKGROUND: neisseria meningitidis is the most frequent isolate associated with purpura fulminans in children. Although streptococcus pneumoniae infection has been associated with purpura fulminans, with the exception of one adult, it has only been reported in immunocompromised hosts. PURPOSE: We report an apparently previously healthy child who presented with purpura fulminans associated with pneumococcal meningitis. methods: Case report and review of the medical literature from September 1966 to June 1997, using a medline search. CONCLUSION: While systemic pneumococcal infection is common in childhood, progression to purpura fulminans does not typically occur in overtly healthy children. Our patient illustrates that invasive pneumococcal infection should be considered and empirically treated in a child who presents with purpura fulminans, even in the absence of preexisting functional or anatomic asplenia.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
3/184. meningitis following stapedectomy: its occurrence in the immediate postoperative period.meningitis following stapedectomy occurring in the immediate postoperative period has not been previously described. This case report documents a case of diplococcus pneumoniae meningitis occurring within 36 hours following surgery with survival of the patient.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
4/184. Isolation and characterization of vancomycin-tolerant streptococcus pneumoniae from the cerebrospinal fluid of a patient who developed recrudescent meningitis.The emergence of tolerance to vancomycin has recently been reported in streptococcus pneumoniae, the most common cause of bacterial meningitis. A vancomycin- and cephalosporin-tolerant strain of S. pneumoniae, the Tupelo strain, was isolated from the cerebrospinal fluid of a patient who then developed recrudescence of meningitis despite treatment with vancomycin and a third-generation cephalosporin. The Tupelo strain evidenced no lysis in the exponential or stationary phase of growth when exposed to vancomycin and only minimal loss of viability. Further characterization revealed normal autolysin expression, localization, and triggering by detergents, indicating that the defect leading to tolerance in the Tupelo strain is in the control pathway for triggering of autolysis. Because tolerance is a precursor phenotype to resistance and may lead to clinical failure of antibiotic therapy, these observations may have important implications for vancomycin use in infections caused by S. pneumoniae.- - - - - - - - - - ranking = 1.2keywords = meningitis (Clic here for more details about this article) |
5/184. Decreased susceptibility to extended-spectrum cephalosporins of a penicillin-susceptible streptococcus pneumoniae in meningitis.A 69-year-old woman was admitted to the hospital with meningitis due to streptococcus pneumoniae. The strain was susceptible to penicillin but intermediate to cefotaxime. In europe the decrease of susceptibility generally pertains more to penicillin than to cefotaxime. Such a strain is perhaps a forewarning of the existence of high-level cephalosporin-resistant strains. Despite the possible detection of the resistance by oxacillin disk, it underlines the need to determine the MICs of different beta-lactams without delay and to choose the most efficient treatment.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
6/184. Cerebellar involvement as a rare complication of pneumococcal meningitis.A 4-year old girl with meningitis, caused by streptococcus pneumoniae, developed a subcoma with respiratory insufficiency, followed by a severe cerebellar syndrome. Cerebellar involvement after regaining consciousness consisted of a symmetrical ataxia and mutism. This mutism changed into dysarthria and finally into normal speech. magnetic resonance imaging revealed lesions in both cerebellar hemispheres, suggesting cerebellitis. She recovered with prompt antibiotic treatment.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
7/184. Flaccid quadriplegia from tonsillar herniation in pneumococcal meningitis.A young woman with fulminant pyogenic meningitis became quadriplegic, areflexic and flaccid due to herniation of the cerebellar tonsils and compression of the upper cervical cord. This state of spinal shock was associated with absent F-waves. intracranial pressure was greatly elevated and there was an uncertain relationship of tonsillar descent to a preceding lumbar puncture. Partial recovery occurred over 2 years. Tonsillar herniation can cause flaccid quadriplegia that may be mistaken for critical illness polyneuropathy. This case demonstrates cervicomedullary infarction from compression, a mechanism that is more likely than the sometimes proposed infectious vasculitis of the upper cord.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
8/184. A case of streptococcus pneumoniae meningitis showing a marked contrast enhancement effect of whole arachnoid membrane on MRI.We have experienced the adult case of meningitis caused by the streptococcus pneumoniae, which showed the most aggressive clinical course. The peculiar and unique magnetic resonance images are reported. The whole arachnoid membrane was prominently enhanced following the contrast material injection, however, no contrast enhancement was observed in subarachnoid space, ependyma, intraventricular cerebrospinal fluid, and dura mater. This implies the superacute phase of the bacterial meningitis, in which inflammation is localized in the whole arachnoid membrane. The contrast enhancement effect in the meningitis may vary depending on the phase and severity, because it is a time-progressive disease.- - - - - - - - - - ranking = 1.4keywords = meningitis (Clic here for more details about this article) |
9/184. meningitis following stapedotomy: a rare and early complication.Controversy exists concerning stapedotomy for patients with small unilateral air-bone gaps. Surgical treatment of otosclerosis involves an opening to the labyrinth and accordingly, a risk of complications, usually vertigo and sensorineural hearing loss and infrequently anacusis. In this paper we present a 33-year-old woman with a small unilateral air-bone gap, who developed bacterial labyrinthitis with meningitis and anacusis three days after stapes surgery. The patient had a stapedotomy with the small fenestra piston prosthesis technique. Due to the potential for serious complications, patients with unilateral otosclerosis and mild hearing loss should be given the possibility to choose between a hearing aid and surgery. Although stapedotomy in the vast majority of interventions is a highly successful procedure and the best method of treatment for otosclerosis if successful, there is a high price to pay in the event of failure.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
10/184. Juxtapositioning of the temporalis muscle for intractable subdural empyema in infants.We present a case of refractory infantile subdural empyema secondary to pneumococcal meningitis. Initial treatment was with antibiotics and multiple burr hole drainage of the subdural space. As there was no significant improvement with this standard procedure, craniectomy, and juxtapositioning of the temporalis muscle was conducted and the patient recovered promptly.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
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