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.
Viruses are the most commonly identified causes of meningitis and encephalitis, but in as many as half of patients, particularly those with encephalitis, the cause is not identified. Hasbun and colleagues1 examined the epidemiology of meningitis and encephalitis in 26 429 adults in the USA between 2011 and 2014. The most common causes were enterovirus (52%), unknown causes (21%), bacterial meningitis (14%), herpes viruses (8%), non-infectious causes (4%), fungi (3%), arboviruses (1%), and other viruses (1%).
We present a case of 13 year old male, presented with hypoactivity and inability to bare his own weight, developed septic shock due to pneumococcus with Acute Respiratory Distress Syndrome, and was found to have neurological findings of Guillain-Barre Syndrome. A new association in pediatric age group, never been reported before.
CONCLUSIONS: Complete resection of intra-extracranial growing tumors in various skull base regions can be achieved via the pure ETA in one stage in selected cases. Surgical procedure for radical removal of tumors is feasible and safe. PMID: 29237926 [PubMed - in process]
CONCLUSION: Our study characterizes the largest longitudinal cohort of fungal meningitis in the United States. Importantly, the health economic impact and long-term morbidity from these infections are quantified and reviewed. The healthcare resource utilization of fungal meningitis patients in the United States is substantial. PMID: 29244019 [PubMed - as supplied by publisher]
• Burkina Faso introduced 13-valent pneumococcal conjugate vaccine (PCV13) in 2013.• By 2015, incidence of PCV13 pneumococcal meningitis decreased by 32%.• Large decreases occurred among children aged
Abstract On February 16, 2017, the Ministry of Health in Zamfara State, in northwestern Nigeria, notified the Nigeria Centre for Disease Control (NCDC) of an increased number of suspected cerebrospinal meningitis (meningitis) cases reported from four local government areas (LGAs). Meningitis cases were subsequently also reported from Katsina, Kebbi, Niger, and Sokoto states, all of which share borders with Zamfara State, and from Yobe State in northeastern Nigeria. On April 3, 2017, NCDC activated an Emergency Operations Center (EOC) to coordinate rapid development and implementation of a national meningitis emerg...
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Tuberculous meningitis (TBM) is an endemic infectious disease in developing countries, and it can become a serious illness in children. TBM treatment is more difficult and prone to failure than lung TB. TBM causes hydrocephalus, cerebral edema, increased intracranial pressure, global ischemia and neurological deficits, which disturb cellular metabolism and increase lactate levels. Therefore, a reliable and widely available clinical indicator of TBM severity is needed. Successful treatment of TBM is assessed using the Glasgow outcome scale (GOS).
Conclusions: In our retrospective single-center series of CRGNB nonbacteremic infections, CCCT was not superior to CMT. Multicenter large observational studies or prospective randomized clinical trials are the need of the hour.