scholarly journals Ureaplasma parvum meningitis following atypical choroid plexus papilloma resection in an adult patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Xing ◽  
Zhenxiang Zhao ◽  
Qingjing Li ◽  
Yalan Dong ◽  
Jianfeng Li ◽  
...  
Keyword(s):  
Adult Patient ◽  
Choroid Plexus Papilloma ◽  
Simultaneous Detection ◽  
Perinatal Complications ◽  
Ureaplasma Parvum ◽  
Protein Levels ◽  
Csf Analysis ◽  
Invasive Infections ◽  
Empirical Antibiotics ◽  
Atypical Presentations

Abstract Background While Ureaplasma parvum has previously been linked to the incidence of chorioamnionitis, abortion, premature birth, and perinatal complications, there have only been rare reports of invasive infections of the central nervous system (CNS) in adults. Owing to its atypical presentation and the fact that it will yield sterile cultures using conventional techniques, diagnosing U. parvum meningitis can be challenging. Case presentation We describe a case of U. parvum meningitis detected in an adult patient following surgical brain tumor ablation. After operation, the patient experienced epilepsy, meningeal irritation, and fever with unconsciousness. Cerebrospinal fluid (CSF) analysis showed leukocytosis (484 * 106 /L), elevated protein levels (1.92 g/L), and decreased glucose concentrations (0.02 mmol/L). Evidence suggested that the patient was suffering from bacterial meningitis. However, no bacterial pathogens in either CSF or blood were detected by routine culture or serology. The symptoms did not improve with empirical antibiotics. Therefore, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the meningitis. Ureaplasma parvum was detected by mNGS in CSF samples. To the best of our knowledge, this case is the first reported instance of U. parvum meningitis in an adult patient in Asian. After diagnosis, the patient underwent successful moxifloxacin treatment and recovered without complications. Conclusions As mNGS strategies can enable the simultaneous detection of a diverse array of microbes in a single analysis, they may represent a valuable means of diagnosing the pathogens responsible for CNS infections and other clinical conditions with atypical presentations.

scholarly journals Neonatal Ureaplasma parvum meningitis complicated with subdural hematoma: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Canyang Zhan ◽  
Lihua Chen ◽  
Lingling Hu
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Subdural Hematoma ◽  
Central Nervous System Infection ◽  
Neonatal Meningitis ◽  
High Morbidity ◽  
Ureaplasma Parvum ◽  
Protein Levels ◽  
Csf Analysis ◽  
Empirical Antibiotics

Abstract Background Neonatal meningitis is a severe infectious disease of the central nervous system with high morbidity and mortality. Ureaplasma parvum is extremely rare in neonatal central nervous system infection. Case presentation We herein report a case of U. parvum meningitis in a full-term neonate who presented with fever and seizure complicated with subdural hematoma. After hematoma evacuation, the seizure disappeared, though the fever remained. Cerebrospinal fluid (CSF) analysis showed inflammation with CSF pleocytosis (1135–1319 leukocytes/μl, mainly lymphocytes), elevated CSF protein levels (1.36–2.259 g/l) and decreased CSF glucose (0.45–1.21 mmol/l). However, no bacterial or viral pathogens in either CSF or blood were detected by routine culture or serology. Additionally, PCR for enteroviruses and herpes simplex virus was negative. Furthermore, the CSF findings did not improve with empirical antibiotics, and the baby experienced repeated fever. Thus, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the infection. U. parvum was identified by mNGS in CSF samples and confirmed by culture incubation on mycoplasma identification medium. The patient’s condition improved after treatment with erythromycin for approximately 5 weeks. Conclusions Considering the difficulty of etiological diagnosis in neonatal U. parvum meningitis, mNGS might offer a new strategy for diagnosing neurological infections.

scholarly journals Cerebrospinal fluid examination may be useful in diagnosing neurosyphilis in asymptomatic HIV+ patients with syphilis

2016 ◽  
Vol 74 (2) ◽  
pp. 128-132 ◽  
Author(s):  
Ronald Salamano ◽  
Raquel Ballesté ◽  
Abayubá Perna ◽  
Natalia Rodriguez ◽  
Diego Lombardo ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Hiv Patients ◽  
Hemagglutination Assay ◽  
Protein Levels ◽  
Disease Research ◽  
Csf Analysis ◽  
High Degree ◽  
Asymptomatic Hiv

ABSTRACT Lumbar puncture in neurologically asymptomatic HIV+ patients is still under debate. There are different criteria for detecting neurosyphilis through cerebrospinal fluid (CSF), especially in cases that are negative through the Venereal Disease Research Laboratory (VDRL), regarding cellularity and protein content. However, a diagnosis of neurosyphilis can still exist despite negative VDRL. Treponema pallidum hemagglutination assay (TPHA) titers and application of the TPHA index in albumin and IgG improve the sensitivity, with a high degree of specificity. Thirty-two patients were selected for this study. VDRL was positive in five of them. The number of diagnoses reached 14 when the other techniques were added. It was not determined whether cellularity and increased protein levels were auxiliary tools in the diagnosis. According to our investigation, CSF analysis using the abovementioned techniques may be useful in diagnosing neurosyphilis in these patients.

scholarly journals Primary Diffuse Leptomeningeal Gliomatosis: Radiological/Pathological Features

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Ehtasham Ahmad ◽  
Mohamed Mohamed ◽  
Apostolos Vrettos
Keyword(s):  
Visual Impairment ◽  
Pathological Features ◽  
Imaging Studies ◽  
Primary Diffuse Leptomeningeal Gliomatosis ◽  
Leptomeningeal Gliomatosis ◽  
Protein Levels ◽  
Csf Analysis ◽  
Diagnostic Biopsy

We present the case of a 43-year-old lady who presented with headaches, visual impairment, and seizures, progressing rapidly over the course of a few weeks. Extensive workup excluded an inflammatory or infectious cause. Imaging studies revealed diffuse thickening of the leptomeninges and serial CSF analysis showed raised opening pressures and increased protein levels. A diagnostic biopsy of the lower thoracic dura confirmed the diagnosis of primary diffuse leptomeningeal gliomatosis (PDGL). She was managed supportively for her symptoms and unfortunately she passed away a few weeks later.

Plantar Molluscum Contagiosum in an Adult Patient

2016 ◽  
Vol 106 (3) ◽  
pp. 235-236 ◽  
Author(s):  
Anıl Gülsel Bahalı ◽  
Ozlem Su ◽  
Dilek Bıyık Ozkaya ◽  
Kadriye Sallahoglu ◽  
Pelin Yıldız ◽  
...  
Keyword(s):  
Viral Infection ◽  
Adult Patient ◽  
Skin Surface ◽  
Molluscum Contagiosum ◽  
Unusual Presentation ◽  
Genital Region ◽  
The Face ◽  
Atypical Presentations ◽  
Plantar Area ◽  
Immunocompetent Patients

Molluscum contagiosum is a viral infection of the skin. It may occur anywhere on the skin surface but is most common in skinfolds, on the face, and in the genital region. Atypical presentations are usually seen in conditions with altered immunity, but they may occur in immunocompetent patients as well. We present a case of an unusual presentation of molluscum contagiosum lesions (multiple normal and one giant) on the plantar area of the foot in an adult.

scholarly journals Utility of Urine Reagent Strips in CSF Analysis as An Aid to Rapid Diagnosis of Meningitis

2020 ◽  
Vol 7 (6) ◽  
pp. A306-310
Author(s):  
Abhirami Ganesh R ◽  
Prabhu M H
Keyword(s):  
Rural Areas ◽  
High Specificity ◽  
Turnaround Time ◽  
Rapid Diagnosis ◽  
Medical Emergency ◽  
Index Test ◽  
Protein Levels ◽  
Csf Analysis ◽  
Cell Counts ◽  
Strip Test

Background: Bacterial Meningitis is a medical emergency and timely intervention has an implication on the prognosis and outcome. Examination of the CSF for leucocytes, glucose and proteins are the cornerstones in the diagnosis of meningitis in general and to arrive at the cause. Hence, this study is done to evaluate the usefulness of urinary reagent strip for rapid diagnosis of meningitis.   Methods: This is a prospective single blinded study on 100 CSF samples subjected to index test (Urine reagent strip test-Dirui H10) and definitive test comprised of CSF microscopy and biochemical analysis for proteins and sugar. The diagnostic accuracy of each index test at different cut off levels tabulated in the form of sensitivity, specificity, PPV and NPV.   Result: The sensitivity and specificity for leukocytes by the strip method for ≥15 cells/cumm were 92% and 98.66%, and for protein levels >30 mg/dl were 84.33% and 94.11% respectively. The test showed high specificity (100%) but less sensitivity for glucose <50mg/dl. It was observed that the accuracy of the tests increased with increase in the values of cell counts and proteins and decrease in sugar reaching 100% accuracy for higher cut-offs.   Conclusion: Urine reagent strip can be utilized for the rapid analysis of CSF in both rural areas as well as in centres where the facility is available as it reduces turnaround time.

scholarly journals A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19

2020 ◽  
Author(s):  
Medha Tandon ◽  
Tejas R Mehta ◽  
Maha Daimee ◽  
Viral Patel ◽  
Apoorv Prasad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurological Complications ◽  
Common Finding ◽  
Pathophysiological Mechanism ◽  
Neurological Manifestations ◽  
Protein Levels ◽  
Csf Analysis ◽  
Cell Counts ◽  
Neurological Illness ◽  
Elevated Protein

Abstract Background: Here we performed a systematic review of literature of CSF findings associated with neurological complications in coronavirus disease-2019 (COVID-19) to establish a pattern and understand the significance of CSF analysis which can possibly be useful in deciding prognosis and exploring therapeutic options in the future. Methods: We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords “SARS-CoV-2 in cerebrospinal fluid”, “SARS-CoV-2 and CNS Complication”.Results: We performed CSF analysis results in total of 113 patients from 67 papers. There were 7 patients out of 113 patients (6.2 %) were fatal and 35 patients (31 %) were considered severe and rest non-severe. Elevated cell counts (>5 cells/µL) were found in 43% (3/7) of the fatal cases, 25.7% (9/35) of the severe cases and 29.4% (15/51) of non-severe cases. The average CSF protein of 110.0 mg/dl found in fatal, and in 85.4mg/dl in non-fatal cases. Whereas, average CSF protein levels were 78 mg/dl in severe and 103 mg/dl in non-severe cases. In addition, 76.5% (13/17) of the patients with CNS complications and 74.1% (40/54) of the patients with a PNS manifestation showed elevated protein levels.Conclusion: The most common finding of CSF analysis in the setting of neurological manifestations in Covid-19 is noted to be elevated CSF protein with occasionally elevated, predominantly lymphocytic cell count. Interestingly, CSF protein is noted to be majorly elevated in all spectrums of severity of neurological illness including CNS and PNS complications. This may be indicative of only one common pathophysiological mechanism of neurological illness. In future, A combination of SARS-CoV-2 CSF RT-PCR, CSF IgM testing, and CNS targeting antibodies should be further studied to understand pathophysiology of neurological complications in Covid-19.

scholarly journals Melanomatous Leptomeningeal Carcinomatosis masquerading as Guillain-Barré Syndrome

2010 ◽  
Vol 9 (1) ◽  
pp. 20-23
Author(s):  
James R Noake ◽  
◽  
Andrew Shepherd ◽  
William R Smith ◽  
◽  
...  
Keyword(s):  
Intravenous Immunoglobulins ◽  
Rapid Onset ◽  
Leptomeningeal Carcinomatosis ◽  
Guillain Barre Syndrome ◽  
High Dose ◽  
Limb Weakness ◽  
Protein Levels ◽  
Csf Analysis ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

A 49 year old man presented with rapid onset paraparesis, evidence of lower motor neurone features and sensory impairment following a respiratory tract infection. Initially he was treated with intravenous immunoglobulins for suspected Guillain-Barré syndrome (GBS). Subsequent cerebrospinal fluid (CSF) analysis identified unexpectedly high protein levels (attributable to Froin’s syndrome1) and magnetic resonance imaging (MRI) was highly suggestive of leptomeningeal carcinomatosis and cerebral metastases secondary to disseminated malignant melanoma. The disease progressed with rapid deterioration despite high dose corticosteroids and the patient died 12 days after admission. This case brings several key points to the attention of the acute physician, in particular the need to give serious consideration to the differential diagnosis of cancer in a patient presenting with lower limb weakness.

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