scholarly journals Aseptic meningitis due to infection with ECHO virus (Type 9)

1957 ◽  
Vol 55 (4) ◽  
pp. 464-474 ◽  
Author(s):  
D. M. McLean ◽  
D. Cameron
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Technical Assistance ◽  
Total Population ◽  
Severe Headache ◽  
Monkey Kidney ◽  
Neck Stiffness ◽  
Human Amnion ◽  
Group Type ◽  
Echo Virus

Eleven cases of aseptic meningitis occurred in a Cambridgeshire village between 17 October and 11 November 1955. The syndrome consisted of severe headache, backache, vomiting, fever and neck stiffness together with lymphocytes and frequently some granulocytes in the cerebrospinal fluid. Principally, it affected persons aged between 10 and 30 years. Out of a total population twenty-three at risk, seventeen were infected and eight became ill. A further three contacts who were living in Cambridge became ill.Identical strains of virus were isolated from the faeces of two patients by inoculation of trypsin-dispersed human amnion cells and from the faeces of another two patients by inoculation of monkey kidney cultures. Bourn virus, which belonged to the ECHO group, Type 9, multiplied readily and produced cytopathogenic effects in human amnion and monkey kidney cultures, but it was not cytopathogenic in HeLa cell cultures. These investigations strongly suggest that Bourn virus caused the epidemic.We wish to thank Dr M. G. P. Stoker for his advice and criticism and Mrs B. M. Cook for technical assistance.We are indebted to Dr J. O'H. Tobin and Dr F. K. Sanders for advice on certain technical procedures.It is a pleasure to acknowledge the assistance given by many colleagues and friends, including Dr D. I. Annear, Miss D. K. Bell, Mrs D. Ditchburn, Dr R. M. Fry, Dr D. Gairdner, Dr J. E. Power, Dr D. Simpson, Dr P. Tyzer and Dr P. J. Wormald.

scholarly journals An outbreak of aseptic meningitis associated with a previously unrecognized virus

1961 ◽  
Vol 59 (2) ◽  
pp. 181-189 ◽  
Author(s):  
I. B. R. Duncan
Keyword(s):  
Aseptic Meningitis ◽  
Kidney Tissue ◽  
Monkey Kidney ◽  
Human Thyroid ◽  
Tissue Cultures ◽  
Human Amnion ◽  
Echo Virus

In 1959, 69 cases of aseptic meningitis were admitted to various hospitals in Scotland—all apparently due to a Hitherto unrecognized virus. This agent had the characteristics of an ECHO virus but differed from the 28 ECHO viruses at present recognized. Seventy-five strains of the virus were isolated, and human thyroid and human amnion tissue cultures proved much superior to monkey kidney tissue cultures for its isolation.

scholarly journals Aseptic meningitis caused by ECHO virus

1957 ◽  
Vol 55 (4) ◽  
pp. 475-484 ◽  
Author(s):  
O. Lahelle
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Virus Type ◽  
Technical Assistance ◽  
Significant Proportion ◽  
Serological Examination ◽  
Cell Tissue ◽  
Echo Virus ◽  
Amniotic Cell ◽  
Embryonic Skin

1. An investigation of ninety-eight cases of aseptic meningitis admitted to hospital resulted in the isolation of ECHO virus Type 6 from fifty-one patients.2. The viruses were cultivated in both human embryonic skin-muscle tissue and human amniotic cell tissue. The latter was found to be more satisfactory.3. Forty-eight strains were isolated from the stools of patients, six from the cerebrospinal fluid and four from throat-washings.4. Serological examination of patients from whom the virus was isolated showed that a significant proportion of patients exhibited a specific antibody response. This included three out of six patients with the virus in their cerebrospinal fluid.5. The clinical picture of aseptic meningitis from which cases ECHO virus was isolated cannot be distinguished from that caused by other known viruses.6. The evidence presented supports the claim that ECHO virus Type 6 is one of the causes of aseptic meningitis.Grateful appreciation is acknowledged to Prof. P. M. Holst (Oslo), Prof. Johs. Böe (Bergen), Dr B. Helland-Hanssen (Molde), Dr O. Römcke (Drammen), Dr R. Tingstad (Namsos), and Dr A. H. Brinchmann (Bærum), for providing specimens and case records. I am also grateful to Mrs B. Zapffe and Mrs L. Kohmann for expert technical assistance.

AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6

PEDIATRICS ◽  
1962 ◽  
Vol 29 (3) ◽  
pp. 418-431
Author(s):  
David T. Karzon ◽  
Norman S. Hayner ◽  
Warren Winkelstein ◽  
Almen L. Barron
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Virus Type ◽  
Alimentary Tract ◽  
Febrile Illness ◽  
Acute Onset ◽  
Etiologic Agent ◽  
Abdominal Muscles ◽  
Older Children ◽  
Echo Virus

The clinical features of 130 cases of aseptic meningitis syndrome associated with ECHO virus type 6 infection were studied. Characteristically, the onset was acute with the development of fever, headache, muscle pains, and vomiting. A biphasic course was present in 8% of the cases. The physical findings included mild to moderate stiffness or spasm of the neck, back, and posterior thigh muscles. Disturbance in sensorium, cranial nerve involvement, and bulbar signs were conspicuously absent. Absence of deep tendon and superficial reflexes occurred in 16% of the cases. Evidence of mild muscle weakness occurred in 39% of cases, more commonly in the axial rather than peripheral muscles. Most of these patients had bilateral weakness of the anterior neck muscles, but included in the group were five with bilateral weakness of the back or abdominal muscles and six with some involvement of the extremities. Neuromuscular changes were mild and frequently questionable. Where follow-up was available, the changes were usually found to be transient. The effect of age upon the clinical picture was analyzed. Only 3 of 130 patients were less than 4 years of age. Young children had a more acute onset and were admitted to the hospital more promptly than older children and adults. The incidence of pleurodynia was 38% in adults and only 5% in patients less than 20 years of age. The cerebrospinal fluid revealed pleocytosis, with lymphocyte counts ranging from a few cells to 930/mm3. The protein values exceeded 40 mg/100 ml in 48% of the cases, the highest value being 102 mg/100 ml. An undifferentiated febrile illness in household associates of patients with aseptic meningitis, characterized by headache, vomiting and muscle pain, was associated with a high recovery rate of ECHO 6 virus. This is presumably the forme fruste of the fully developed aseptic meningitis syndrome. ECHO 6 virus was recovered from four patients in whom there was evidence of neurologic involvement beyond that seen in the aseptic meningitis syndrome. ECHO 6 virus was the probable etiologic agent in two of these cases. A 15-year-old girl with mild encephalitis marked by disorientation, hallucinations, and weakness of the legs yielded ECHO 6 from her alimentary tract. ECHO 6 was recovered from the cerebrospinal fluid and alimentary tract of a 15-year-old boy with features of the Guillain-Barré syndrome.

Naegleria fowleri Hemorrhagic Meningoencephalitis: Report of Two Fatalities in Children

2004 ◽  
Vol 19 (3) ◽  
pp. 231-233 ◽  
Author(s):  
Darin T. Okuda ◽  
Hank J. Hanna ◽  
Stephen W. Coons ◽  
John B. Bodenstelner
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Stem ◽  
Mass Effect ◽  
Severe Headache ◽  
Neurologic Examination ◽  
Naegleria Fowleri ◽  
Neck Stiffness ◽  
Nuchal Rigidity ◽  
Nægleria Fowleri ◽  
The Brain

Two cases of hemorrhagic meningoencephalitis secondary to Naegleria fowleri infection confirmed by postmortem analysis are described. The first patient is a 5-year-old boy who presented with a severe headache, neck stiffness, and lethargy. His neurologic examination was significant for somnolence and nuchal rigidity. Cerebrospinal fluid studies and structural neuroimaging were consistent with hemorrhagic meningoencephalitis. Another 5-year-old boy presented to a different institution 2 miles away in the same week with similar complaints. Both patients declined rapidly and expired within 48 hours of admission secondary to transtentorial herniation caused by the mass effect of inflammation, edema, and hemorrhage with displacement of the brain stem. Histopathologic and immunochemistry analysis of brain tissue revealed the presence of Naegleria trophozoites in both cases.

scholarly journals Recurrent aseptic mollaret’s meningitis

2021 ◽  
Author(s):  
Débhora Geny de Sousa Costa ◽  
Tércio Luz Barbosa ◽  
Maria Arlete da Silva Rodrigues ◽  
Larissa Alves dos Santos Silva ◽  
Sharlla Layana Leite Mendes ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Cranial Nerves ◽  
Etiologic Agent ◽  
Social Impairment ◽  
Motor Deficits ◽  
Neck Stiffness ◽  
Stiff Neck ◽  
Neurological Sequelae ◽  
Mollaret's Meningitis

Context: Mollaret’s meningitis is a rare disease, where there are recurrent episodes of aseptic meningitis, characterized by fever, headache, meningitis, and cerebrospinal fluid pleocytosis with Mollaret cells, and without neurological sequelae. It is characterized by episodes of illness and episodes of remission, with no detectable etiologic agent. Case report: 38-year-old man, previously healthy, with repeated cases of severe holocranial headache, associated with nausea and vomiting, without fever and with neck pain and stiff neck. The condition was repeated 9 times during the period of 1 and a half years. In the neurological examination (during the symptoms), he presented normal fundus examination, neck stiffness present, without other meningeal signs and focal motor deficits or associated cranial nerves. Extensive serum investigation (including serology, autoimmune markers, and sputum BK test) was performed, all negative. Skull CT and MRI of the skull and cervical spine with contrast during events without abnormalities. Lumbar punctures performed during this period did not show an increase in intracranial pressure on spinal manometry; CSF analyzes showed a clear and colorless appearance, pleocytosis (higher cell count 255 cells), lymphomononuclear predominance, hyperproteinorrhachia(higher value of 100 mg/dl), with normal glucose and lactate. In the CSF samples, extensive etiological investigation (broad viral panel, general bacteria search, syphilis and Mycobacterium tuberculosis, fungi and neoplastic cells) was carried out, all negative. Cisternoscintigraphy performed excluding cerebrospinal fluid fistulas. The patient evolved without neurological sequelae. Conclusions: Mollaret’s recurrent aseptic meningitis is associated with social impairment and functional limitations. Thus, further discussions on conduct and prognosis are needed.

Evaluation of IL-8 level in cerebrospinal fluid in acute bacterial meningitis in adults

2021 ◽  
Vol 42 (6) ◽  
pp. 634-641
Author(s):  
Zhinous Bayat-Makoo ◽  
Puran Karimi ◽  
Negar Mohtadi
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Aseptic Meningitis ◽  
High Sensitivity ◽  
Interleukin 8 ◽  
Acute Bacterial Meningitis ◽  
Neck Stiffness ◽  
Significant Difference ◽  
Level Of Consciousness ◽  
Consciousness Disorder

Background: Interleukin 8 increases in various types of meningitis, specifically acute bacterial meningitis inflammation, and it is important in the distinction between types of meningitis. The present paper aims at evaluation of the level of interleukin 8 in cerebrospinal fluid in acute adult bacterial meningitis. Methods: All adult patients’ with diagnosis of suspected meningitis with symptoms of fever, headache, neck stiffness, and consciousness disorder. Lumbar puncture was taken in between the third and fourth vertebra by a specialist physician for all patients suspected with meningitis. To determine the level of consciousness, the GCS of the patients was determined and the cerebrospinal fluid was cultured and sent to the laboratory for the analyses of cell count, diffraction, CSF fluid glucose, CSF fluid protein, LDH, or lactate dehydrogenase, and the level of interleukin 8. Results: The mean of IL-8 protein was 296.17±48.57Pg/ml in patients with aseptic meningitis and 1088.96±526.55Pg/ml in the group of patients with septic meningitis. There was a significant difference between the two groups in terms of the amount of interleukin 8 (p = 0.009). Cutoff was 297.6 Pg/ml for the detection of positive bacterial meningitis with a sensitivity of 92% and the specificity of 83.1% was 297.6 pg/ml. Conclusion: Interleukin 8 has a high sensitivity and specificity in the diagnosis of bacterial meningitis from aseptic meningitis, and along with the measurement of cerebrospinal fluid protein, it can be a good criterion for differentiation of bacterial from aseptic meningitis.

scholarly journals Leptomeningeal Carcinomatosis in a Patient with Pancreatic Cancer Responding to Nab-Paclitaxel plus Gemcitabine

2020 ◽  
Vol 13 (1) ◽  
pp. 35-42
Author(s):  
Garry Ceccon ◽  
Michael Wollring ◽  
Anna Brunn ◽  
Martina Deckert ◽  
Dirk Waldschmidt ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cerebrospinal Fluid ◽  
Multimodal Treatment ◽  
Poor Prognosis ◽  
Systemic Chemotherapy ◽  
Rare Condition ◽  
Leptomeningeal Carcinomatosis ◽  
Severe Headache ◽  
Neck Stiffness ◽  
Spinal Mri

Leptomeningeal carcinomatosis is an extremely rare, but devastating complication in pancreatic cancer patients with a poor prognosis despite multimodal treatment. We present a 51-year-old male patient with the very rare condition of leptomeningeal carcinomatosis originating from pancreatic cancer. He presented to our hospital with severe headache and neck stiffness 30 months after systemic chemotherapy. Cerebral and spinal MRI as well as cerebrospinal fluid examination confirmed the diagnosis of leptomeningeal carcinomatosis. The patient responded to gemcitabine plus nab-paclitaxel in terms of elimination of tumor cells from the CSF and concurrent clinical improvement for 3 months. The observed findings suggest that the combination of gemcitabine plus nab-paclitaxel is potentially effective in affected cerebrospinal fluid of pancreatic carcinoma patients.

Is cerebrospinal fluid lactate useful in differentiating scrub typhus meningitis from aseptic, bacterial and tuberculous meningitis?

2020 ◽  
pp. 004947552097595
Author(s):  
Shalabh Arora ◽  
Kundavaram Paul Prabhakar Abhilash ◽  
Shubhanker Mitra ◽  
Darpanarayan Hazra ◽  
Karthik Gunasekharan ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Clinical Features ◽  
Aseptic Meningitis ◽  
Scrub Typhus ◽  
Indian Subcontinent ◽  
Cross Sectional Study ◽  
Neck Stiffness ◽  
Cross Sectional ◽  
Reported Data

Scrub typhus is one of the most common causes of meningo-encephalitis in endemic areas of the Indian subcontinent. Numerous studies have established the reliability of cerebrospinal fluid lactate for differentiation of bacterial meningitis from aseptic meningitis. However, there are no reported data on the predictive value of cerebrospinal fluid lactate in scrub typhus meningitis. We thus conducted a cross-sectional study to examine the diagnostic accuracy of cerebrospinal fluid lactate in the differentiation of different causes of acute meningitis. Over two years, we studied 119 patients, with almost equal gender distribution, whose mean age was 43.58 (±18) years and their overall mean duration of fever was 11.7 (±21.0) days. Commonest clinical features overall were neck stiffness; values of cerebrospinal fluid lactate were lowest in aseptic meningitis, followed by scrub typhus, TB and bacterial meningitis. We conclude that cerebrospinal fluid lactate levels may be a useful adjunct to clinical features and laboratory investigations to differentiate between bacterial, viral, tubercular and scrub meningitis.

scholarly journals Cerebrospinal fluid changes and clinical features of aseptic meningitis in patients with Kawasaki disease

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098021
Author(s):  
Fan Hu ◽  
Xiaoqing Shi ◽  
Yang Fan ◽  
Hanmin Liu ◽  
Kaiyu Zhou
Keyword(s):  
Cerebrospinal Fluid ◽  
Kawasaki Disease ◽  
Aseptic Meningitis ◽  
Enzyme Level ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
C Reactive Protein ◽  
Neck Stiffness ◽  
Laboratory Parameters ◽  
Reactive Protein

Objective To assess the distinguishing features of aseptic meningitis (AM) in patients with Kawasaki disease (KD) compared with bacterial meningitis (BM) patients. Methods Thirty-eight patients with KD and 126 patients with BM were retrospectively investigated. The following clinical manifestations and laboratory parameters were compared between the two groups: duration of fever before lumbar puncture, conjunctival injection, oral cavity changes, rash, cervical lymphadenopathy and extremity changes, vomiting, front fontanel bulging, neck stiffness, leukocyte number, hemoglobin level, platelet number, C-reactive protein level, cerebrospinal fluid (CSF) content, liver enzyme level, and urinalysis. Results Vomiting and neck stiffness were more prevalent in patients with BM. KD patients with AM showed elevated blood leukocyte numbers and C-reactive protein levels in the early febrile stage. CSF glucose was significantly lower in patients with BM compared with KD patients with AM. Receiver operating characteristic curve analysis showed that the optimal cutoff value of CSF glucose for discrimination of BM and AM/KD was 2.945 mmol/L, with a sensitivity of 84.2% and a specificity of 71.4%. Conclusions Detailed investigations of clinical manifestation and laboratory parameters are necessary to distinguish AM and BM in patients with KD. Decreased CSF glucose is a potential indicator of BM.

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