1/199. A case of Austrian's syndrome with ocular involvement.A man with a history of alcohol abuse was admitted to hospital with pneumonia and meningitis due to streptococcus pneumoniae. Because of the worsening of respiratory function and the persistence of fever, an echocardiographic examination was made, which showed endocarditis with destruction of the aortic valve. The patient underwent surgical valve replacement. In addition, he showed a choroiditis in the left eye which improved after antibiotic therapy. The interest of this case lies in the rarity of the triad described as Austrian's syndrome and in the coexistent fourth septic localization, namely in the left eye.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/199. Fatal maternal beta-hemolytic group B streptococcal meningitis: a case report.meningitis secondary to beta-hemolytic group B streptococcus is rare and represents less than 1% of cases of adult meningitis. We report the first known case of maternal mortality attributed to beta-hemolytic group B streptococcal meningitis. A 23-year-old African-American woman with a benign prenatal course delivered a viable male infant at term. Labor was complicated by thick meconium for which a saline amnioinfusion was utilized. On postpartum Day 1, the patient complained of right hip pain and a headache. Within 12 hr the patient was comatose with fixed and dilated pupils. life support measures were discontinued secondary to absence of electrocortical activity. Postmortem examination revealed endomyometritis and fulminant meningitis with gram-positive cocci. Placental histologic sections demonstrated acute chorioamnionitis and bateriological cultures noted beta-hemolytic group B streptococcus. The virulence of beta-hemolytic group B streptococcus in the neonate is well recognized. This case demonstrates that beta-hemolytic group B streptococcus is also a potentially fatal maternal pathogen.- - - - - - - - - - ranking = 7keywords = meningitis (Clic here for more details about this article) |
3/199. Non-group D streptococcal meningitis misidentified as enterococcal meningitis. Diagnostic and therapeutic implications of misdiagnosis by screening microbiology.Two patients had nonhemolytic Gram-positive coccal meningitis. Both pathogens were initially misidentified as a group D enterococcus by growth in "selective" media, which led to the use of inappropriate and potentially toxic systemic and intrathecal aminoglycosides. Careful evaluation of the antibiotic sensitivity data and additional microbiological studies allowed correct identification of the organism. The important diagnostic and therapeutic considerations in differentiating true enterococcal infections, especially meningitis, from those caused by other alpha-hemolytic or nonhemolytic streptococci are emphasized. A simple laboratory schema for rapid recognition of such pathogens is reviewed.- - - - - - - - - - ranking = 10keywords = meningitis (Clic here for more details about this article) |
4/199. 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 = 8keywords = meningitis (Clic here for more details about this article) |
5/199. Acute bacterial meningitis secondary to gamma hemolytic streptococcus. Case report and review of the literature.Gamma hemolytic streptococcal meningitis in a 17-year-old boy resulted in a severe purulent reaction and death. review of the literature shows only one other case of a gamma hemolytic streptococcus as the cause of bacterial meningitis in the absence of endocarditis.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
6/199. Recurrent meningitis in the pediatric patient--the otolaryngologist's role.OBJECTIVE: To assess the etiology of recurrent meningitis in the pediatric patient. DESIGN: Retrospective case series and literature review. SETTING: Tertiary-care pediatric hospital. patients: Children (< 17-years-old) with recurrent meningitis, treated at texas Children's Hospital (TCH) between 1984 and 1995. RESULTS: A review of 463 cases of bacterial meningitis over an 11 year period revealed six children aged 3 months to 15 years with the diagnosis of recurrent meningitis. The patient's age, number of episodes of meningitis, diagnostic investigations performed and etiologies of recurrent meningitis were recorded. Fifteen episodes of meningitis were identified in these six patients; streptococcus pneumoniae represented the bacteriology in 73% of the cases. Two patients were diagnosed with temporal bone abnormalities, two children with immunological deficiencies and no underlying etiology for the recurrent meningitis was identified in the remaining two patients. In this series, one-third of patients had an otolaryngologic etiology for their recurrent meningitis. These six patients, along with a review of the recent literature, will highlight the need for otolaryngological assessment and the importance of considering immunological investigations when managing recurrent meningitis in the pediatric patient. CONCLUSION: We propose that children with recurrent meningitis of unknown etiology undergo: (1) an audiological evaluation; (2) a CT scan of the temporal bones, skull base and paranasal sinuses; and (3) an immunological evaluation.- - - - - - - - - - ranking = 15keywords = meningitis (Clic here for more details about this article) |
7/199. Bacterial complications of strongyloidiasis: streptococcus bovis meningitis.We report the case of a 64-year-old veteran who had streptococcus bovis meningitis as a result of a long latent strongyloides infection that became acute when he was treated with prednisone. We reviewed 38 reported cases of serious bacterial infections associated with strongyloidiasis. patients most frequently had nonspecific gastrointestinal symptoms. Of these 38 patients, 21 (55%) had meningitis, and 28 (73%) had bacteremia that was polymicrobial in 3 cases (8%). Other sites of infection included lung, bone marrow, ascites, mitral valve, and lymph node. Most infections were due to enteric gram-negative bacteria. There is one previously reported case of S bovis meningitis. Thirty-four of the patients (89%) were immunosuppressed; 21 of these (55%) were taking pharmacologic doses of adrenal corticosteroids. Thirty-three of the 38 (87%) patients died. patients with enteric bacterial infection without an obvious cause should be tested for the presence of strongyloidiasis.- - - - - - - - - - ranking = 7keywords = meningitis (Clic here for more details about this article) |
8/199. Group A streptococcal meningitis in the antibiotic era.A case of group A streptococcal meningitis is reported and the 51 cases reported in the literature since 1966 reviewed. A total of 24 men and 24 women were included in the study; the mean age ( /-SD) was 20.9 /-25.5 years. Fifty-eight percent of the patients had comorbid conditions, 80% had a distant focus of infection, and 65.8% had blood cultures positive for group A streptococci. Seventy-five per cent of the patients were treated with penicillin. The overall case-fatality rate was 12% (6 patients). Sequelae were more prevalent among children (44%) than among adults (7.7%) (OR=9.43; 95% CI, 1.02-438.95; P=0.03). Group A streptococcus is a rare cause of pyogenic meningitis, affecting mainly children or adults with comorbidity. Although the case-fatality rate is relatively low, neurological sequelae are frequent among survivors, especially children.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
9/199. 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 = 5keywords = meningitis (Clic here for more details about this article) |
10/199. streptococcus bovis meningitis in an infant.streptococcus bovis is a nonenterococcal, group D streptococcus which has been identified as a causative agent for serious human infections, including endocarditis, bacteremia, and septic arthritis. Several cases of adult S. bovis meningitis have been reported, usually in association with underlying disease. In the neonatal period, it is an uncommon agent of meningitis. We report, to our knowledge, the third documented case of neonatal S. bovis meningitis in the English language literature. As in the previous cases, this neonate showed no anatomical or congenital immunologic lesion which might be expected to predispose the patient to meningitis. Sequencing of the 16S ribosomal dna gene was performed and a new PCR test was used to secure a more reliable identification of the strain.- - - - - - - - - - ranking = 8keywords = meningitis (Clic here for more details about this article) |
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