Community-acquired acute meningitis and encephalitis: a narrative review.

Community-acquired acute meningitis and encephalitis: a narrative review. Med J Aust. 2018 Oct 15; Authors: Beaman MH Abstract Meningitis and encephalitis are medical emergencies. Patients need prompt evaluation and immediate empiric therapy to reduce the likelihood of fatal outcomes and chronic neurological sequelae. Conjugate bacterial vaccines have significantly reduced the incidence of bacterial meningitis, especially in children. As the results of changes in patterns of bacterial drug sensitivity, ceftriaxone is now part of the recommended empiric treatment for bacterial meningitis and should be administered as early as possible. Neuroimaging delays the treatment of meningitis and is not needed in most cases. Adjunctive corticosteroid therapy is of benefit for many patients with meningitis and should be initiated in most adults before antibiotic therapy. Molecular testing can assist the specific diagnosis of encephalitis and should be based on the exposure history and geographic risk factors relevant to the patient, but non-infectious causes of encephalitis are also common. Empiric therapy for encephalitis should be directed at the most frequently identified infectious pathogen, herpes simplex virus type 1 (ie, intravenous aciclovir). Vaccines can protect against the major pathogens of childhood infections (measles, mumps, rubella, polio, varicella viruses), influenza viruses, and exotic pathogens that cause meningitis and encephalitis (rabies, Japan...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research

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Publication date: January 2020Source: Epilepsy &Behavior, Volume 102Author(s): Niels Hansen, Kerstin Schwing, Demet Önder, Guido Widman, Pitshaporn Leelaarporn, Indra Prusseit, Rainer Surges, Nico Melzer, Catharina Gross, Albert J. Becker, Juri-Alexander Witt, Christian E. Elger, Christoph HelmstaedterAbstractPurposeInvestigating immune cells in autoimmune limbic encephalitis (LE) will contribute to our understanding of its pathophysiology and may help to develop appropriate therapies. The aim of the present study was to analyze immune cells to reveal underlying immune signatures in patients with temporal lobe epi...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Publication date: January 2020Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 129, Issue 1Author(s): Kevin MaObjectivesSjögren syndrome (SS) is an autoimmune disease with oral manifestations. SS may result in hormonal imbalance and immune dysfunction, and its occurrence could be related to comorbidities, including endometriosis. The prevalence rate of endometriosis in women with chronic pelvic pain is greater than 33%, and in SS patients, the prevalence rate is 6.3%. Given the limited number of available studies, we sought to determine whether patients with endometriosis have a higher ri...
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
ConclusionsAdjunctive procedures that can facilitate a decrease in the cumulative dosages of corticosteroids and immunosuppressants have great value in the management of PV. CO2 laser vaporization is a safe procedure with minimal morbidity and no long-term side effects and should be considered as an adjunctive treatment option for management of recalcitrant lesions in patients with oral PV.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
Publication date: January 2020Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 129, Issue 1Author(s): MARINA LINS MAYMONE DE MELO, THYAGO MORAIS VICENTE DA SILVA, THAYANARA SILVA MELO, IGOR HENRIQUE SILVA, ALESSANDRA TAVARES CARVALHO, JAIR CARNEIRO LEÃO, LUIZ ALCINO MONTEIRO GUEIROSIntroductionDelayed bone repair postdental extraction in patients who underwent head and neck radiation is a clinical challenge, and an adequate management is necessary to prevent osteoradionecrosis.ObjectiveTo evaluate the effect of photobiomodulation (PBM) in the alveolar mucosal healing of patients submitt...
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
ConclusionsThis study reports the first DENV detection in saliva of BALB/c immunocompetent mice experimentally infected with nonneuroadapted DENV-4.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
Plasma cell cheilitis (PCC) is an unusual benign plasma cell proliferative disease of an unknown etiology that clinically presents as erythematous-violaceous plaques, ulcerations, or eruptions often affecting the lower lip. PCC is known to respond poorly to corticosteroid treatment. A 43-year-old male presented with multiple painful hemorrhagic crusts on the lower lip that had developed over 1 month. An incisional biopsy was performed and microscopy showed a bandlike inflammatory cell infiltration composed mainly of plasma cells in the connective tissue.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
A 32-year-old white woman was referred for evaluation of palate lesion with 3 months ’ duration. Medical history included recent investigation for tuberculosis due to the presence of nodules detected on chest radiograph and previous treatment for syphilis. The patient exam revealed nasal obstruction, cough, secretion drainage, and weight loss. Extraoral examination showed erythema and edema in the face. Moreover, erosive lesions, crusts and purulent drainage were observed in the nasal area. Intraorally, an extensive necrotic lesion with bone destruction and exposure, midline palatal perforation was detected.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
A white 47-year-old woman complained about a lesion in gingiva present for 2 months. Her medical history included systemic erythematosus lupus with previous use of corticosteroids. The intraoral examination revealed an irregularly shaped gingival ulcer in the upper posterior region. Radiographic examination showed no significant abnormalities. According to clinical and radiographic features, malignant or infectious lesions were hypothesized. After an incisional biopsy, microscopic evaluation revealed an intense mixed inflammatory infiltrate with the presence of Reed-Sternberg –like cells of Hodgkin lymphoma.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
The therapeutic use of liquid nitrogen has been used since the 20th century for the treatment of various dermatologic, urologic, gynecologic, and oncologic diseases among others. However, this modality is not widespread in the stomatology specialty. It will be presented with a brief introduction of mechanism of action, equipment, technique, and results obtained in the following oral lesions: salivary gland (mucocele and ranula), reactive lesion (pyogenic granuloma), vascular lesions (varicosities and hemangioma), and viral infection (herpes simplex).
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
Vascular injuries in the oral cavity cause anesthetic and functional problems, and a high risk of severe hemorrhages in simple surgical treatments; therapy with copper wires and corticosteroids generates local coagulation and fibrosis and are effective for an uncomplicated resection. Through a series of cases, clinical and anatomopathologic characteristics of the combined sclerotherapy effects are described, as an alternative for the treatment of vascular malformations performed on 7 patients, using intralesional corticoid (0.2 mL/cm2) for 2 or 3 weeks, followed by a cerclage with copper wires, for 1 week, until color chan...
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
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