Chronic meningitis caused by Erysipelothrix rhusiopathiae

A 47-year-old man presented with headache, nausea, vomiting and fever. Laboratory findings including analysis of cerebrospinal fluid suggested bacterial meningitis. Erysipelothrix rhusiopathiae was identified in cultures of cerebrospinal fluid. The patient recovered without any neurological sequelae after antimicrobial treatment. It is interesting that intracranial infection by E. rhusiopathiae reappeared after scores of years and that it presented with absence of an underlying cause or bacteraemia.

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Diagnostic Value of Clinical and Laboratory Findings in Childhood Meningitis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0039-3400960 ◽

2019 ◽

Vol 15 (02) ◽

pp. 079-085

Author(s):

Melike Emiroglu ◽

Recep Kesli ◽

Murat Kilicaslan

Keyword(s):

Cerebrospinal Fluid ◽

Statistical Analysis ◽

Bacterial Meningitis ◽

Diagnostic Value ◽

Human Enterovirus ◽

Study Patient ◽

Laboratory Findings ◽

Cell Counts ◽

Acute Meningitis ◽

Meningitis In Children

Abstract Objective Acute meningitis in childhood is a serious infectious disease that requires immediate medical assessment to ensure appropriate treatment and healthy outcomes. The aim of this retrospective study was to evaluate clinical and laboratory findings in the diagnosis of acute meningitis in children. Materials and Methods Between February 2011 and March 2013, 258 children aged between 1 month and 18 years who were admitted to Konya Training and Research Hospital, Turkey, with clinically suspected meningitis and undergoing lumbar puncture were enrolled in the study. Patient charts were reviewed using a standardized data collection tool. Fifty-nine patients were excluded because of incomplete data or because they did not meet the enrollment criteria. Further statistical analysis was conducted on the remaining 199 patients. The diagnostic values of clinical and laboratory findings for acute meningitis were investigated. IBM SPSS 21.0 for Windows was used for the statistical analysis. Results Of the 199 patients (61.3% male; median age: 24 months), 101 (50.8%) were diagnosed with meningitis. A definitive diagnosis of bacterial meningitis was made in 16 patients, while 5 patients had probable bacterial meningitis. In addition, 80 patients diagnosed as aseptic meningitis and 47 of these patients had human enterovirus meningitis. Headache was more common in patients with meningitis. In patients without meningitis, the most common complaints were seizures or seizures accompanied by fever. Erythrocyte sedimentation rates (ESR), levels of cerebrospinal fluid protein, and cell counts in cerebrospinal fluid examinations were higher in the meningitis group. C-reactive protein, ESR, and procalcitonin higher than 22.55 mg/L, 36.5 mm/hour, and 6.795 mg/mL, respectively, indicated bacterial meningitis. Conclusion Our results showed that a combination of clinical and laboratory markers could facilitate recognition of bacterial meningitis in children.

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A Diagnostic Scoring System for Distinguishing between Tuberculous and Bacterial Meningitis Based on Clinical and Laboratory Findings

BioMed Research International ◽

10.1155/2021/1220650 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Yongyan He ◽

Yueli Zou ◽

Junying He ◽

Hui Bu ◽

Yaling Liu

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Cell Count ◽

Tuberculous Meningitis ◽

Scoring System ◽

White Cell Count ◽

Characteristic Curve ◽

Chinese Patients ◽

Laboratory Findings ◽

Microbial Resources

It is very difficult to diagnose and distinguish tuberculous meningitis, and the current laboratory methods are unsubstantial in developing countries. The study is aimed at creating a scoring system on the basis of basic laboratory and clinical achievements that could be used as diagnostic aid for tuberculous meningitis for Chinese patients. A retrospective study of cases was conducted for comparison between clinical characteristics and laboratory features of 241 patients on admission who conformed to inclusion criteria of tuberculous meningitis ( n = 141 ) or bacterial meningitis ( n = 100 ). Logistic regression was employed to establish a diagnostic formula to distinguish between tuberculous meningitis and bacterial meningitis. The receiver operating characteristic curve analysis was applied to determine the best diagnostic critical point of the diagnostic formula. It was found that five variables (disease course, white blood cell count, serum sodium, total white cell count of cerebrospinal fluid, and neutrophil proportion in cerebrospinal fluid) were independently associated with tuberculous meningitis. The 87% sensitivity and 94% specificity were included in the diagnostic scoring system derived from these variables. Especially in the case of limited microbial resources, doctors can use this diagnostic scoring system to distinguish tuberculous meningitis from bacterial meningitis.

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Matrix Metalloproteinase (MMP)-8 and MMP-9 in Cerebrospinal Fluid during Bacterial Meningitis: Association with Blood-Brain Barrier Damage and Neurological Sequelae

Clinical Infectious Diseases ◽

10.1086/313922 ◽

2000 ◽

Vol 31 (1) ◽

pp. 80-84 ◽

Cited By ~ 173

Author(s):

D. Leppert ◽

S. L. Leib ◽

C. Grygar ◽

K. M. Miller ◽

U. B. Schaad ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Matrix Metalloproteinase ◽

Blood Brain Barrier ◽

Brain Barrier ◽

Neurological Sequelae ◽

Blood Brain ◽

Blood Brain Barrier Damage

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Swiftly Decreasing Cerebrospinal Fluid Cathelicidin Concentration Predicts Improved Outcome in Childhood Bacterial Meningitis: TABLE 1

Journal of Clinical Microbiology ◽

10.1128/jcm.00420-16 ◽

2016 ◽

Vol 54 (6) ◽

pp. 1648-1649 ◽

Cited By ~ 2

Author(s):

Okko Savonius ◽

Otto Helve ◽

Irmeli Roine ◽

Sture Andersson ◽

Josefina Fernández ◽

...

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Disease Process ◽

Antimicrobial Treatment ◽

Response To Treatment ◽

Cns Inflammation ◽

Protein Levels ◽

Cell Counts ◽

Improved Outcome

We investigated cerebrospinal fluid (CSF) cathelicidin concentrations in childhood bacterial meningitis on admission and during antimicrobial treatment. CSF cathelicidin concentrations on admission correlated with CSF white cell counts and protein levels but not with bacterial etiology. A greater decrease in the concentration in response to treatment was associated with a better outcome. Since the CSF cathelicidin concentration reflects the degree of central nervous system (CNS) inflammation, it may be used as a novel biomarker in childhood bacterial meningitis. An early decrease during treatment likely signals more rapid mitigation of the disease process and thus a better outcome.

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Culture NegativeListeria monocytogenesMeningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy

Case Reports in Neurological Medicine ◽

10.1155/2015/248302 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Shahin Gaini ◽

Gunn Hege Karlsen ◽

Anirban Nandy ◽

Heidi Madsen ◽

Debes Hammershaimb Christiansen ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Cerebrospinal Fluid ◽

Listeria Monocytogenes ◽

Bacterial Meningitis ◽

Penicillin Allergy ◽

Ventricular Catheter ◽

Chain Reaction ◽

Neck Stiffness ◽

Neurological Sequelae ◽

Polymerase Chain

A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy for bacteria, no bacterial growth, and negative polymerase chain reaction for bacterial DNA. The patient developed hydrocephalus on a second CT scan of the brain on the 5th day of admission. An external ventricular catheter was inserted andListeria monocytogenesgrew in the cerebrospinal fluid from the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically forListeria monocytogenesin all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection and inflammation even with negative microscopy, negative cultures, and negative broad range polymerase chain reaction in cases ofListeriameningitis. Follow-up spinal taps can be necessary to detect the presence ofListeria monocytogenes.

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Drug-Induced Aseptic Meningitis Following Spinal Anesthesia

European Journal of Case Reports in Internal Medicine ◽

10.12890/2019_001334 ◽

2019 ◽

Author(s):

Ricardo Paquete Oliveira ◽

Mafalda Teixeira ◽

Sofia Cochito ◽

Ana Furtado ◽

Bruno Grima ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Spinal Anesthesia ◽

Aseptic Meningitis ◽

Cerebrospinal Fluid Analysis ◽

Drug Induced ◽

Neurological Sequelae ◽

Fluid Analysis ◽

Empirical Antibiotics ◽

Uncommon Complication

Meningitis is a very uncommon complication of spinal anesthesia, and drug-induced aseptic meningitis (DIAM) is even rarer. We present two cases of DIAM following spinal anesthesia with bupivacaine and ropivacaine, respectively. The patients presented shortly after the procedure with typical meningitis symptoms. Since CSF (cerebrospinal fluid) analysis could not initially exclude bacterial meningitis, they were started on empirical antibiotics. CSF was subsequently found to be negative for viruses and bacteria in both cases, and antibiotics were promptly stopped. Both patients improved rapidly and without neurological sequelae. While it remains a diagnosis of exclusion, it is important to be aware of DIAM as recognition of the condition can lead to shorter admission times and avoid unnecessary use of antibiotics.

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Clinical profile and outcome of children with acute bacterial meningitis in a tertiary care centre in eastern Nepal

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v10i2.40016 ◽

2021 ◽

Vol 10 (2) ◽

pp. 64-73

Author(s):

Mukesh Bhatta ◽

Shyam Prasad Kafle ◽

Basant Rai ◽

Rejeena Subedi

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Tertiary Care ◽

Clinical Profile ◽

Response To Treatment ◽

Acute Bacterial Meningitis ◽

Tertiary Care Centre ◽

Laboratory Findings ◽

Female Ratio ◽

Mortality And Morbidity

Background: Bacterial meningitis is a severe infection of the central nervous system with varied clinical presentations. It is associated with substantial mortality and morbidity. Objectives: The objective of this study was to assess the clinical profile, including the clinical features, laboratory and radiological parameters, clinical course, treatment, response to treatment, complications, and outcome of children at discharge. Methods: A prospective observational study was conducted among 52 inpatient children of acute bacterial meningitis aged one month to 14 years over a period of six months. The patients were enrolled during admission and followed up daily till discharge. Socio-demographic, clinical, and diagnostic details and outcomes were recorded and analysed using statistical package for social sciences version 20. Results: The median age of the patients was two years with male to female ratio of 2:1. Fever (45, 87%), vomiting (37, 71%), seizure (33, 64%) and headache (22, 46%) were the most common symptoms. The cerebrospinal fluid culture was positive in three (6%) cases. Complications were seen in 20 (39%) patients including four (7.7%) deaths. Patients with prolonged fever, malnutrition, loss of consciousness, ear discharge, presence of meningeal signs, abnormal pupil, high cerebrospinal fluid protein, positive cerebrospinal fluid, and blood culture, low blood pH, and hyperlactataemia were significantly associated with complications (p <0.05). Conclusion: Factors like malnutrition, longer duration of fever, and abnormal neurological and laboratory findings were associated with higher rates of complications.

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Extremely Elevated Cerebrospinal Fluid Protein and Glucose Level in a Neonate with Hypernatremic Dehydration

Journal of Pediatric Neurology ◽

10.1055/s-0040-1708496 ◽

2020 ◽

Author(s):

Arti Maria ◽

Tapas Bandyopadhyay

Keyword(s):

Cerebrospinal Fluid ◽

Neurodevelopmental Outcome ◽

Neurological Sequelae ◽

Glucose Levels ◽

Csf Analysis ◽

First Case ◽

Time Of Admission ◽

Cerebrospinal Fluid Protein ◽

Hypernatremic Dehydration

AbstractWe describe the case of a term newborn who presented with hypernatremic dehydration on day 19 of life. The baby was otherwise hemodynamically stable with no evidence of focal or asymmetric neurological signs. The laboratory tests at the time of admission were negative except for hypernatremia and the extremely elevated levels of cerebrospinal fluid (CSF) protein (717 mg/dL) and glucose levels (97 mg/dL). The hypernatremic dehydration was corrected as per the unit protocol over 48 hours. Repeat CSF analysis done after 5 days showed normalization of the protein and glucose levels. Serial follow-up and neuroimaging showed no evidence of neurological sequelae. Unique feature of our case is this is the first case reporting such an extreme elevation of CSF protein and glucose levels that have had no bearing on neurodevelopmental outcome at 1 month and 3 months of follow-up.

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