Clinical Picture Neisseria meningitidis subdural empyema causing acute cauda equina syndrome
A 22-year-old man presented to a hospital emergency department with symptoms of bacterial meningitis but without focal neurology. Blood and CSF cultures were positive for Neisseria meningitidis serogroup B. He received empirical bacterial meningitis therapy on presentation to the hospital as per local guidelines with 4 g ceftriaxone every 24 h, vancomycin titrated to>20 mg/L and 10 mg dexamethasone every 6 h, and 1 ·8 g benzylpenicillin every 4 h. On day 2 after admission, after bacterial identification of N meningitidis, treatment was simplified to the use of high dose ceftriaxone monotherapy.
Four-month-old Killy Schultz, from Chesterfield, Virginia, developed a rash and fever within 24 hours back in June. Doctors told his shocked parents he had contracted meningitis.
Condition: Meningitis, Meningococcal Interventions: Biological: MenABCWY vaccine; Biological: rMenB+OMV NZ (Bexsero) vaccine; Biological: MenACWY (Menveo) vaccine Sponsor: GlaxoSmithKline Not yet recruiting
Fadil A. Bidmos, Simon Nadel, Gavin R. Screaton, J. Simon Kroll, Paul R. Langford
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 010 Peer Reviewer: Dr Jennifer Ho, ID physician QLD, Australia You are an ED doc working in Perth over schoolies week. An 18 yo man comes into ED complaining of fever, rash a “cracking headache” and body aches. He has just hopped off the plane from Bali where he spent the last 2 weeks partying, boozing and running amok. He got bitten by “loads” of mosquitoes because he forgot to take insect repellent. On e...
Conclusion: The presence of headache, mood disorders, psychosis, depression, and other neuropsychological manifestations in a patient with JSLE should prompt investigations into diagnosis of the primary nervous system involvement in order to reduce mortality and morbidity. PMID: 30002929 [PubMed]
This article provides an overview of the different types of compounding restrictions, reviews the current federal and state regulations and/or guidelines, discusses how newly proposed policies may affect the practice of dermatology, and presents an algorithm on how the practicing dermatologist should approach compounding. J Drugs Dermatol. 2018;17(7 Suppl):s17-22. PMID: 30005109 [PubMed - in process]
Cryptococcal meningitis is an opportunistic fungal infection commonly seen in immunocompromised individuals. Information on cryptococcal meningitis is scarce in immunocompetent children. The authors report an 8-year-old immunocompetent boy with cryptococcal meningitis and bilateral vision loss. The role of repeated therapeutic lumbar puncture in the management of raised intracranial pressure in cryptococcal meningitis is discussed.
Conclusions: In the absence of changes to other aspects of TB control, a switch to selective vaccination will result in increased cases of childhood TB. Although not considered cost-effective, selective vaccination may be preferable to no vaccination until other changes to TB control may be implemented to reduce the risk of TB in children.
No abstract available
Conclusions: Delayed cerebral injury occurred in 4.1% of adults with bacterial meningitis, and it was associated with the use of adjunctive steroids. Future studies should explore the etiology and prevention of this devastating complication.