ALTERATIONS IN THE GLUCOSE TRANSPORT MECHANISM IN PATIENTS WITH COMPLICATIONS OF BACTERIAL MENINGITIS

Glucose diffusion tests were made on 8 children with bacterial meningitis, in 7 [SEE TABLE IV AND FIG 8. IN SOURCE PDF] of whom the organism had been identified. The results of the tests were correlated with the outcome of the illness. Of 3 patients who recovered without sequelae the glucose diffusion patterns were normal in 2 cases, while the third case had somewhat low curves. In 4 cases of proven bacterial meningitis with complication all the tests were abnormal. Three of these were cases of proven hydrocephalus and there was a reversal of the normal pattern of diffusion for the entry of glucose into the cisternal and lumbar regions. An actual lowering of the cisternal glucose following the intravenous injection of glucose was observed in two cases with initial very low spinal fluid sugars. The hypothesis is proposed that alterations in the blood cerebrospinal fluid barrier perhaps due to increased metabolism of arachnoid lining cells or edema in [SEE FIG 9 IN SOURCE PDF] addition to the action of bacteria and leukocytes contribute to the persistent hypoglycorrhachia seen in complicated cases of bacterial meningitis.

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Listeria monocytogenes meningitis in an immunocompetent 18-year old patient as a possible diagnostic and therapeutical problem

Vojnosanitetski pregled ◽

10.2298/vsp1310976v ◽

2013 ◽

Vol 70 (10) ◽

pp. 976-978

Author(s):

Miodrag Vrbic ◽

Marina Dinic ◽

Maja Jovanovic ◽

Aleksandar Rankovic ◽

Lidija Popovic-Dragonjic ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Listeria Monocytogenes ◽

Bacterial Meningitis ◽

Initial Treatment ◽

Clinical Effect ◽

Complete Recovery ◽

Cell Mediated Immunity ◽

The Third ◽

Appropriate Treatment

Introduction. Listeria monocytogenes is the third most frequent cause of bacterial meningitis in adults. It commonly affects persons with defective cell-mediated immunity or advanced age, and only a few patients with no underlying predisposition have been reported. Case report. We presented an previously healthy, 18-year-old man with typical clinical features of meningitis. On the account of earlier treatment with ceftriaxone and cerebrospinal fluid finding, an assumption of partially treated bacterial meningitis was made. The initial treatment with vancomycin and ceftriaxone, substituted on day 4 with meropenem, did not produce any clinical effect. On day 6 Listeria monocytogenes was isolated and, even as late as that, the administration of ampicillin was followed by complete recovery of the patient. Conclusion. In younger, immunocompetent individuals, in spite of the existent diagnostic and therapeutic problems, the subacute course of Listeria monocytogenes meningitis provides enough time for appropriate treatment and favorable disease outcome.

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Low Spinal Fluid Sugar in Meningitis

PEDIATRICS ◽

10.1542/peds.45.4.717a ◽

1970 ◽

Vol 45 (4) ◽

pp. 717-718

Author(s):

Manfred Weichsel

Keyword(s):

Bacterial Meningitis ◽

Glucose Transport ◽

Tuberculous Meningitis ◽

Spinal Fluid ◽

The Brain

Dr. John H. Menkes's review of the factors responsible for the lowering of the spinal fluid sugar in bacterial and tuberculous meningitis1 presents evidence that the primary factors for the low spinal fluid sugar in bacterial meningitis may be a combination of increased utilization of glucose by the brain, combined with a defective glucose transport. We2 presented evidence over 30 years ago that the lowering of the spinal fluid sugar in tuberculous meningitis was not due predominantly to utilization of the glucose by either bacteria or leukocytes:

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A STUDY OF THE CEREBROSPINAL FLUID IN ACUTE POLIOMYELITIS

Journal of Experimental Medicine ◽

10.1084/jem.18.3.242 ◽

1913 ◽

Vol 18 (3) ◽

pp. 242-251 ◽

Cited By ~ 9

Author(s):

Francis R. Fraser

Keyword(s):

Cerebrospinal Fluid ◽

Mononuclear Cells ◽

Great Increase ◽

Spinal Fluid ◽

The Third ◽

Early Stages ◽

Acute Poliomyelitis ◽

Number Of Cells

The spinal fluid in the cases of acute epidemic poliomyelitis examined was usually clear, colorless, and did not appear to be under any great increase of pressure. It showed changes in the number of cells present, or in the globulin content, or in both, in the majority of cases examined on the first few days after onset of symptoms. The number of cells was usually highest during the first week, and in one case reached the figure of 1,221 per cubic millimeter. The globulin reaction was usually most marked during the third week. The number of cells diminished rapidly and was above normal in only 32 per cent. of the cases in the third week. The increase in the globulin reaction persisted to the fourth week and might be present for a considerably longer period. The cell increase was due almost invariably to mononuclear cells of various types. The lymphocytic type of cell was the most common. A high polymorphonuclear count was noted in the very early stages. All the fluids reduced Fehling's solution. The examination of the spinal fluid may be of value in diagnosis in the preparalytic stages and in abortive cases. It is not of value in prognosis as to life or ultimate recovery.

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STUDIES ON ABSORPTION AND DISTRIBUTION OF TERRAMYCIN IN CHILDREN

PEDIATRICS ◽

10.1542/peds.9.5.607 ◽

1952 ◽

Vol 9 (5) ◽

pp. 607-616

Author(s):

ANDREW D. HUNT ◽

RICHARD S. KELLEY ◽

LEWIS L. CORIELL ◽

M. LOIS MURPHY ◽

SYLVIA G. TASHMAN ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Body Weight ◽

Serum Levels ◽

High Serum ◽

Spinal Fluid ◽

Peak Serum ◽

The Third ◽

The Mean ◽

Fluid Levels ◽

Oral Doses

The absorption of terramycin from the gastrointestinal tract is rather similar to that of aureomycin. Peak levels are low, tend to be achieved in 2 to 6 hours after ingestion, and are prolonged for several hours. Single oral doses of 11 mg/kg. body weight give peak serum levels ranging from 0.20 to 1.95 µg./cc., with a mean of 1.0 µg./cc. Doubling or tripling this single dose did not produce marked increases in serum levels. Dosage of 11 mg./kg. orally every six hours (44 mg./kg./24 hours) resulted in peak serum levels on the third day which were essentially identical with those after the initial dose. However, when a dosage of 33 mg./kg. was given orally every six hours (132 mg./kg./24 hours), marked cumulation in the serum was noted. The mean serum level on the first day on this schedule was 2.7 µg./cc., and on the third day, 8.0 µg./cc. Diffusion into the cerebrospinal fluid in three cases was poor. With spinal fluid and serum levels simultaneously obtained, the spinal fluid levels were ¼, ⅙ and ⅛, respectively of the serum levels. Intravenously administered terramycin in dosage of 6.6 mg./kg. gave peak serum levels at one-half hour, ranging from 10.0 to 12.8 µg./cc. Six hours after injection, serum levels ranged from 1.8 to 4.4 µg./cc., and at 12 hours, from 0.78 to 2.6 µg./cc. Terramycin given rectally in perforated capsules was well tolerated. However, in four patients given 66 mg./kg. by this route, peak serum levels ranged from 0 to 1.0 µg./cc. Recommended terramycin dosage: (a) Oral: 11 mg./kg./dose every six hours (44 mg./kg./24 hours). Adequate antibacterial serum levels for most susceptible organisms are produced with this dosage. Increasing the dosage to 33 mg./kg./dose every six hours (132 mg./kg./24 hours) may be done in cases when high serum levels seem indicated. (b) Intravenous: 6.6 to 11 mg./kg./dose every 6 to 8 hours.

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THE CAUSES FOR LOW SPINAL FLUID SUGAR IN BACTERIAL MENINGITIS: ANOTHER LOOK

PEDIATRICS ◽

10.1542/peds.44.1.1 ◽

1969 ◽

Vol 44 (1) ◽

pp. 1-3

Author(s):

John H. Menkes

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Experimental Evidence ◽

Tuberculous Meningitis ◽

Spinal Fluid ◽

Glucose Content ◽

The Face

One of the most characteristic abnormalities of cerebrospinal fluid (CSF) in patients with bacterial and tuberculous meningitis is a decrease in its glucose content. This finding, first observed by Lichtheim, was initially attributed to utilization of glucose by the bacteria growing in the fluid This explanation, as many subsequent ones, has been abandoned in the light of conflicting experimental evidence, and at present the mechanisms inducing a low CSF sugar are enigmatic. Recent publications bearing on this problem prompt a review of the factors involved in lowering cerebrospinal fluid sugar. Goldring and Harford found that the utilization of glucose by concentrations of pneumococci equal to or higher than those usually seen in meningitis was too small to be measured and could, therefore, not affect the spinal fluid sugar in the face of a normal mechanism for its replenishment.

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Primary intranasal encephalocele

Journal of Neurosurgery ◽

10.3171/jns.1982.57.4.0552 ◽

1982 ◽

Vol 57 (4) ◽

pp. 552-555 ◽

Cited By ~ 24

Author(s):

A. Rashid Choudhury ◽

Julien C. Taylor

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Nasal Polyp ◽

Nasal Polyps ◽

Csf Rhinorrhea ◽

Content Type ◽

Cranial Trauma ◽

The Third ◽

Fine Print ◽

Anatomical Defects

✓ Four cases of primary intranasal encephalocele are presented. Three of the patients had been treated for nasal polyps. One of these three patients presented with persistent cerebrospinal fluid (CSF) rhinorrhea after a fourth polypectomy, another with recurrent CSF rhinorrhea and bacterial meningitis following a second polypectomy, and the third case with recurrence of meningitis, also following polypectomy. Recurrent bacterial meningitis was the mode of presentation in the fourth case. Encephalocele was the isolated abnormality in three, but the fourth had a degree of associated hypertelorism. The diagnosis of encephalocele should be considered in any patient with a nasal polyp, especially in children and in patients with recurrent bacterial meningitis, with or without rhinorrhea, in the absence of cranial trauma or surgery, or in the absence of external craniospinal anatomical defects.

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Human liver‐expressed antimicrobial peptide 2 elevation in the cerebrospinal fluid in bacterial meningitis

Brain and Behavior ◽

10.1002/brb3.2111 ◽

2021 ◽

Author(s):

Katsuya Sakai ◽

Kazutaka Shiomi ◽

Hitoshi Mochizuki ◽

Md Nurul Islam ◽

Hiroki Nabekura ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Antimicrobial Peptide ◽

Human Liver

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Creatine kinase isoenzymes in cerebrospinal fluid in a case of brain damage.

Clinical Chemistry ◽

10.1093/clinchem/22.8.1405 ◽

1976 ◽

Vol 22 (8) ◽

pp. 1405-1407 ◽

Cited By ~ 15

Author(s):

P M Bayer ◽

F Gabl ◽

G Granditsch ◽

K Widhalm ◽

H Zyman ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Creatine Kinase ◽

High Activity ◽

Brain Damage ◽

Acute Phase ◽

Clinical Importance ◽

Total Activity ◽

Spinal Fluid ◽

Consumption Coagulopathy ◽

Creatine Kinase Isoenzymes

Abstract We present a case of a 11/2-year-old boy with toxic enteritis, consecutive consumption coagulopathy, and sever brain damage. During the acute phase we found high activity of the BB isoenzyme of creatine kinase in cerebrospinal fluid, but not in the serum. Isoenzyme MM could also be found in the spinal fluid (37.9% of the total activity). We conclude that analysis for creatine kinase isoenzymes in spinal fluid is of clinical importance.

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