1/82. The successful containment of coxsackie B4 infection in a neonatal unit.This report describes the containment of a potential enterovirus epidemic in a neonatal intensive care unit. A case of neonatal enterovirus meningitis and myocarditis was identified. polymerase chain reaction (PCR) was used to assist in appropriate cohorting of contacts. One further infant became cross-infected with Coxsackie B4. serum PCR was accurate in detecting the infection in the early stages in this asymptomatic neonate. Neonatal enterovirus infection is relatively rare but has the potential to cause outbreaks in neonatal wards. PCR can be used to diagnose and monitor for cross infection.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/82. Delayed intracranial abscess after acoustic neuroma surgery: a report of two cases.OBJECTIVE: The use of antibiotics before and after surgery has made infectious complications of neurotologic surgery rare. The neurosurgical literature cites a rate of postoperative meningitis between 1% and 2% for "clean" cases and 1.5% to 2.5% for "clean contaminated" cases, such as cerebrospinal fluid contact with the middle ear or mastoid. Reports of infections after neurotologic procedures are rare in the otologic literature. In this report, two patients with brain abscess occurring in a delayed fashion after surgery are described. STUDY DESIGN: The study design was a retrospective chart review and case report. SETTING: The study was conducted at a tertiary referral center. RESULTS: Patient 1 underwent a suboccipital craniotomy for removal of an acoustic neuroma and had an uneventful postoperative recovery. Three months after surgery, he reported mild unsteadiness. Examination revealed mild ataxia, which led to repeat magnetic resonance imaging (MRI) and a diagnosis of cerebellar abscess. Patient 2 underwent translabyrinthine removal of an acoustic neuroma complicated by postoperative pseudomonas aeruginosa meningitis, which responded promptly to intravenous antibiotics. Fifteen months after surgery, he visited a neurologist after having a seizure and was treated with anticonvulsants. After a second episode of seizure, imaging studies showed a temporal lobe abscess. CONCLUSIONS: The signs of intracranial abscess may be subtle and can occur weeks or months after surgery, requiring vigilance and a high index of suspicion for diagnosis. A change in postoperative symptoms after acoustic neuroma surgery should signal further investigation using MRI with gadolinium.- - - - - - - - - - ranking = 2keywords = meningitis (Clic here for more details about this article) |
3/82. Aseptic herpetic meningitis: an uncommon genital herpes sequelae.Aseptic herpetic meningitis is a clinical syndrome characterized by fever, headaches, confusion, and a combination of meningeal signs. The spinal fluid findings consist of an increase in mononuclear cells (mononuclear pleocytosis), increased protein concentration, and normal glucose concentrations. Aseptic herpetic meningitis is thought to be caused by a viral infection, although the specific virus is usually not demonstrated. The condition is self-limited and requires no treatment.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
4/82. The west nile virus outbreak of 1999 in New York: the flushing Hospital experience.west nile virus (WNV) is a mosquito-borne flavivirus, which has been known to cause human infection in africa, the middle east, and southwestern asia. It has also been isolated in australia and sporadically in europe but never in the americas. Clinical features include acute fever, severe myalgias, headache, conjunctivitis, lymphadenopathy, and a roseolar rash. Rarely is encephalitis or meningitis seen. During the month of August 1999, a cluster of 5 patients with fever, confusion, and weakness were admitted to the intensive care unit of the same hospital in new york city. Ultimately 4 of the 5 developed flaccid paralysis and required ventilatory support. Three patients with less-severe cases presented shortly thereafter. With the assistance of the new york city and New York State health departments and the Centers for disease Control and Prevention, these were documented as the first cases of WNV infection on this continent.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
5/82. 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) |
6/82. Varicella zoster meningitis preceeded by thrombophlebitis in a patient with Hodgkin's disease.Varicella zoster (V-Z) infections are common among patients with hematological malignancies, particularly Hodgkin's disease (HD). The common denominator in both HD and V-Z infections is immunosuppression. Most of V-Z infections occur in patients with HD during the remission period, who have mixed cellularity sub-type, with stage III disease and who have received combined chemo-radiation therapy. Involvement of the central nervous system usually manifests as post-herpetic neuralgia or encephalitis. Angiitis has also been found in association with V-Z infections. The authors describe a case of HD who developed V-Z meningitis preceeded by superficial thrombophlebitis of upper extremities during the period of active chemotherapy.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
7/82. Findings in a patient with herpes simplex viral meningitis associated with acute retinal necrosis syndrome.We report the case of a 41-year-old man with clinical findings of viral meningitis associated with acute retinal necrosis syndrome in his right eye. MR images showed right optic nerve enlargement and high-intensity signal abnormalities in the region of the left lateral geniculate body and the left occipital lobe.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
8/82. Recurrent stroke as a manifestation of primary angiitis of the central nervous system in a patient infected with human immunodeficiency virus.CONTEXT: Cerebral vasculitis in patients infected with human immunodeficiency virus (hiv) is usually related to additional or secondary infectious agents other than neoplastic diseases or hiv itself. OBJECTIVE: To describe a 31-year-old patient infected with hiv who presented with 2 recurrent, acute episodes of neurologic impairment in a 5-month period. DESIGN: Comparison of clinical and histologic data between the present case and previously published cases. SETTING: Community hospital. PATIENT: A 31-year-old, hiv-infected patient with recurrent strokes and chronic lymphocytic meningitis. INTERVENTION: After ruling out cardiac embolisms and coagulation disorders, the presence of central nervous system vasculitis, probably secondary to an infectious process, was suspected based on the clinical examination and cerebrospinal fluid abnormalities. RESULTS: Necropsy findings suggest the diagnosis of primary angiitis of the central nervous system, and the only infectious agent that could be found was hiv. CONCLUSIONS: Histologic studies were compatible with a diagnosis of primary angiitis of the central nervous system, but the pathogenic role of hiv in the genesis of the vasculitic process cannot be elucidated.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
9/82. Recurrent herpes simplex virus type 2 meningitis: a case report of Mollaret's meningitis.It is well known that herpes simplex virus (HSV) type 2 produces acute meningitis, while HSV type 2 rarely causes recurrent meningitis (Mollaret's meningitis). We report the history of a 40-year-old patient with recurrent HSV type 2 meningitis (Mollaret's meningitis). The patient had seven episodes of meningeal symptoms within a 7-year period. In the seventh episode, HSV type 2 dna was confirmed by nested polymerase chain reaction (PCR) with the cerebrospinal fluid (CSF). A real-time quantitative PCR study of the first CSF sample detected 2,000 copies of the HSV genome, which rapidly disappeared following treatment with acyclovir. The present case may be the first case of HSV type 2 Mollaret's meningitis to be documented in japan. In our case, HSV serum antibody titers were at low levels during the whole course of the disease. The possible pathophysiology of this case is discussed.- - - - - - - - - - ranking = 14keywords = meningitis (Clic here for more details about this article) |
10/82. Non-01 vibrio cholerae septicemia and meningitis in a neonate.Non-O1 vibrio cholerae is known to cause diarrhoea as well as extra-intestinal infections in adults and children. However meningitis in children is a rare occurrence. We report a neonate who developed septicemia and meningitis due to Non-O1 vibrio cholerae.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
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