1/42. Long-term remission of malignant brain tumors after intracranial infection: a report of four cases.OBJECTIVE: This report describes four patients with malignant brain tumors in whom regression or cure seems to be related to infection with bacteria. methods: An analysis of the four clinical cases reported and a review of the literature produced a comprehensive body of both experimental and clinical data concerning the antineoplastic properties of bacteria. RESULTS: Although direct oncolytic effects from bacteria have been suggested, immune adjuvant responses to tumor suppression are emphasized. In one of our patients, infiltration of numerous granulocytes and lymphocytes into the tumor at the time of initial surgery was observed, suggesting that a spontaneous immune reaction had begun. Also, in two other patients, tumor aggression occurred in association with a bacterial process that was not in direct contact with the tumor. In three of the cases described, enterobacter aerogenes was recovered from the microbial cultures. Whether the presence of this organism was coincidental or whether this organism plays an important role in tumor defense is not known; however, a specific cross-reactive immunological attack to the tumor is suggested. CONCLUSION: The case histories presented in conjunction with the relevant literature reviewed support the concept that microbial infections may influence immune responses in brain tumor defense.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/42. trimethoprim-sulfamethoxazole-induced tremor in an immunocompetent patients.trimethoprim-sulfamethoxazole (TMP-SMX) is a widely administered antibiotic that is well tolerated by most patients. hypersensitivity reactions and gastrointestinal intolerance are the most common adverse events associated with it. Central nervous system adverse effects such as tremors are less common and occur primarily in patients with acquired immune deficiency syndrome. A 29-year-old immunocompetent man developed a tremor while taking TMP-SMX. The tremor resolved within 2 days after the drug was discontinued.- - - - - - - - - - ranking = 0.084414209133328keywords = nervous system (Clic here for more details about this article) |
3/42. Enterobacter sakazakii brain abscess in the neonate: the importance of neuroradiologic imaging.BACKGROUND: Enterobacter sakazakii is a rare but important cause of life-threatening neonatal sepsis and meningitis complicated by the development of brain abscess. OBJECTIVE: Given the neurotropic qualities of this organism, early diagnosis and treatment are crucial as a poor prognosis follows brain abscess formation. MATERIALS AND methods: Cross-sectional imaging (CT and MRI) play an important role in the diagnostic work-up. CONCLUSION: A biopsy-proven case of E. sakazakii brain abscess, which was diagnosed on MR images, is presented, and the importance of prompt radiologic imaging of the central nervous system in the work-up of patients with this life-threatening disease is discussed.- - - - - - - - - - ranking = 1.5321451410529keywords = central nervous system, brain, nervous system (Clic here for more details about this article) |
4/42. 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 = 0.084414209133328keywords = nervous system (Clic here for more details about this article) |
5/42. CSF interleukin-6 in neonatal Citrobacter ventriculitis after meningitis.An infant with neonatal severe citrobacter koseri (formerly Citrobacter diversus) meningoencephalitis developed necrosis with multicystic regression of both hemispheres. The ventriculitis persisted over months in spite of antibiotic therapy.The treatment succeeded with cefotaxime in a high dose (300 mg/kg/day) without surgical intervention.The infant had been previously treated with cefotaxime (200 mg/kg/day) over 5 weeks. High levels of CSF interleukin-6 (IL-6) permitted to attribute persisting CSF pleocytosis in spite of sterile CSF cultures to chronic infection and not to reminiscence of brain necrosis. This report reveals two main points. On the one hand, the importance of therapy monitoring with IL-6 in CSF for the consequent treatment of Citrobacter meningitis and on the other hand, high-dose cefotaxime (300 mg/kg/day) treatment of Citrobacter ventriculitis, which succeeded without surgical intervention.- - - - - - - - - - ranking = 0.16666666666667keywords = brain (Clic here for more details about this article) |
6/42. brain abscess by citrobacter diversus in infancy: case report.Citrobacter diversus is closely related to brain abscess in newborn infants. We describe a case of brain abscess by this bacteria in a newborn infant and his clinical and cranial computed tomographic evaluation until the fourth month of life and discuss therapeutic management of this patient.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
7/42. Enterobacter sakazakii infections among neonates, infants, children, and adults. case reports and a review of the literature.Enterobacter sakazakii can cause serious infections especially among the very young and the elderly. It continues to be more common among neonates and infants than adults. Its tropism for the central nervous system in neonates and infants remains a mystery. Among neonates and infants, E. sakazakii has a propensity to cause meningitis resulting in ventriculitis, brain abscess or cyst formation, and development of hydrocephalus requiring ventricular-peritoneal shunt. Computed tomography of the head is therefore useful in following patients with E. sakazakii meningitis. mortality and morbidity of E. sakazakii meningitis is high, and virtually all patients recovering from the central nervous system infection suffered mental and physical developmental delays. The case-fatality rate decreased among patients with meningitis treated with the third-generation cephalosporins. Most adults with E. sakazakii infection had serious underlying diseases and 50% of the adults with the infection had malignancies. However there has never been a known case of meningitis. Increasing antibiotic resistance among Enterobacter species should lead one to consider using the carbapenems or the newer cephalosporins in combination with a second agent such as an aminoglycoside. Limited data suggest that trimethoprim-sulfamethoxazole may be a useful agent in the treatment of infections caused by the Enterobacter species, especially in view of the production of extended-spectrum beta-lactamases capable of inactivating the cephalosporins and extended-spectrum penicillin.- - - - - - - - - - ranking = 0.89762361543904keywords = central nervous system, brain, nervous system (Clic here for more details about this article) |
8/42. Long-Term outcome of neonatal citrobacter koseri (diversus) meningitis treated with imipenem/meropenem and surgical drainage.Neonatal citrobacter koseri (diversus) meningitis is often complicated by the formation of brain abscesses and has a poor neurological outcome with seizures, mental retardation and paresis as sequelae in 50% of the cases. As there is emerging resistance to ampicillin, gentamicin and third-generation cephalosporins, we attempted to treat this infection with carbapenems. carbapenems in combination with cefotaxime and surgical drainage may play an important role in treating C. koseri meningitis.- - - - - - - - - - ranking = 0.16666666666667keywords = brain (Clic here for more details about this article) |
9/42. Neonatal brain abscess--potential pitfalls of CT scanning.CASE REPORT. A 6-day-old preterm infant collapsed on the neonatal unit and was found to have enterobacter meningitis. Cranial ultrasounds had been normal in the first few days of life, but an ultrasound on day 9 of life showed a well-defined lesion, which was thought to be an abscess in view of his underlying illness. This finding could not be confirmed on CT scanning, which showed oedematous frontal lobes with a lack of grey-white differentiation. OUTCOME. The correct diagnosis and treatment were delayed until a follow-up CT scan showed more typical features of an abscess 4 days later.- - - - - - - - - - ranking = 0.66666666666667keywords = brain (Clic here for more details about this article) |
10/42. enterobacter cloacae ventriculitis successfully treated with cefepime and gentamicin: case report and review of the literature.A 55-year-old woman was found unresponsive and subsequently was diagnosed with a subarachnoid hemorrhage secondary to a right posterior communicating artery aneurysm. The development of hydrocephalus and decreased mental status necessitated placement of an intraventricular catheter; 18 days later she was diagnosed with enterobacter cloacae ventriculitis. After treatment was begun with intravenous cefepime 2 g every 8 hours and intraventricular gentamicin 5 mg every 24 hours, the catheter was replaced. cerebrospinal fluid (CSF) and plasma cefepime concentrations and a CSF trough gentamicin concentration were obtained. Intraventricular gentamicin was administered for 6 days and cefepime for 21 days; both clinical and microbiologic resolution of the ventriculitis occurred. The literature reports limited clinical experience with cefepime for the treatment of central nervous system infections in humans. This case report provides clinical evidence to support administration of intravenous cefepime in critically ill adult patients with Enterobacter ventriculitis. Because CSF is easily obtained from patients with intraventricular catheters, strong consideration should be given to monitoring CSF cefepime concentrations in concert with the minimum inhibitory concentration of the offending pathogen to help assure the efficacy of this approach to therapy.- - - - - - - - - - ranking = 0.36547847438619keywords = central nervous system, nervous system (Clic here for more details about this article) |
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