scholarly journals Features of diagnosis of inflammatory lesions of central nervous system in HIV-infected patients at terminal stage of disease: clinical case

2021 ◽  
Vol 38 (4) ◽  
pp. 159-166
Author(s):  
Yu. V. Karakulova ◽  
N. E. Seksyaev ◽  
D. Yu. Sosnin

The authors of the article describe a case of the damage to the central nervous system by fungi of the genus Cryptococcus in a HIV-infected patient. The features of clinical manifestations and laboratory diagnostics are characterized. Special attention is paid to the discrepancy between the sharply changed appearance of the cerebrospinal fluid obtained during lumbar puncture and the clinical picture of the disease as well as the data of laboratory analysis of cerebrospinal fluid.

2019 ◽  
Vol 11 (1) ◽  
pp. 41-45
Author(s):  
L. V. Pypa ◽  
R. V. Svistilnik ◽  
Yu. N. Lysytsia ◽  
K. Yu. Romanchuk ◽  
I. V. Odarchuk

Aim of work – to analyze the etiological structure, epidemiological structure, social-demographic features and the nature of the development of complications of the central nervous system in aseptic meningitis in children in Khmelnitskyi region for the period 2004-2017.Materials and methods. It was conducted a prospective analysis of 208 cases of aseptic meningitis in children of whom 138 people were boys and 70 people were girls. The etiology of the disease was determined by studying cerebrospinal fluid using PCR method. Complications of the central nervous system were diagnosed on the basis of the clinical picture and CT or MRI scans. The analytical method was used to conduct the analysis of the received data.Results. The highest seasonal increase of the incidence was from August to October and it was 65.6% with its peak in September (24.0%). The clinical picture was characterized by a moderate trend in 71.2% of cases and in 28.8% by a severe course. In 100% of cases the disease began with a fever, headache (83.6%), vomiting (76.9%), abdominal pain with diarrhea (6.2%), epileptic seizures (0.9%). The average level of cytosis was 269.4±196.7 cells/mm3with a predominance of lymphocytes and the average protein level in cerebrospinal fluid was 73 ± 36 mg/dl. The etiological factor was established in 18 (8.6%) patients.Conclusions. Enterovirus remains to be the main pathogen which was determined in 72.2% of cases. The second place was taken by herpes viruses (22.2% of cases), the third place was given to the mumps virus (5.6% of cases) (in etiologically verified cases). In most cases the disease ended in complete recovery but in 47 (22.6%) patients the complications were observed. The prevalence of aseptic meningitis among children in Khmelnitskyi region was 6.2 per 100,000 children, and males outnumbered females by a 2:1 ratio.


Author(s):  
John J. Halperin

Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is involved. Several week courses of widely available oral or parenteral antimicrobials are curative in most patients.


2021 ◽  
Vol 9 (4) ◽  
pp. 39-42
Author(s):  
L.P. Shostakovych-Koretskaya ◽  
I.V. Budayeva ◽  
M.A. Nikolaichuk

Listeriosis is an infectious disease caused by Listeria monocytogenes microorganisms. A human can catch an infection through fecal-oral, aerogenous, or transplacental route. The listeriosis incidence in Ukraine is sporadic, single cases are not related to each other. Listeriosis is characterized by a high rate of mortality and polymorphism of clinical manifestations. The symptoms of the disease are multiple-organ: damage to the central nervous system, septic symptoms, aborts, mastitis; listeriosis can also be subclinical. The disorders of the central nervous system are associated with meningitis, meningoencephalitis, or brain abscess. The importance of the problem of diagnosis and treatment of listeriosis derived from the disease sporadicity, polymorphism of its manifestations, difficulties in etiological verification of the diagnosis. The case described is specific due to the diagnostic mistake: a child was not diagnosed with sepsis. Listeriosis in this child had a progressive course with sepsis development. Listeriosis is a rare infection, therefore it was difficult to suggest this particular infection intra vitam.


2014 ◽  
Vol 5 (2) ◽  
pp. 65-68 ◽  
Author(s):  
Tamara Vladimirovna Melashenko ◽  
Irina Romanovna Milyavskaya ◽  
Igor Aleksandrovich Gorlanov ◽  
Larisa Mikhaylovna Leina

Early congenital syphilis, in 60 % of cases, accompanied by a specific lesion of the central nervous system. Clinical manifestations of neurosyphilis in newborns are usually absent. Diagnosis is based on serological examination of cerebrospinal fluid and MRI. The paper presents two cases of early syphilis with central nervous system.


2016 ◽  
Vol 94 (5) ◽  
pp. 391-394
Author(s):  
A. V. Budnevskiy ◽  
V. A. Kutashov ◽  
Andrey Ya. Kravchenko

Antiphospholipid syndrome (APS) is one of the important but poorly known conditions. Its symptoms are ofparticular interest for neurologists since thrombi are most often localized in the cerebral blood vessels which leads to ischemic cerebrovascular accidents (AICS). APS can also manifest itself in the following symptoms: epileptic attacks, dementia, headache, chorea, peripheral neuropathy, myelo- and encephalopathy phenomenologically similar to multiple sclerosis. This article presents a clinical case of secondary APS with the neurological manifestations in a 25-year-old female patient.


2013 ◽  
Vol 71 (9B) ◽  
pp. 685-688 ◽  
Author(s):  
Sandro Luiz de Andrade Matas ◽  
Felipe von Glehn ◽  
Gustavo Bruniera Peres Fernandes ◽  
Carlos Augusto Senne Soares

The central nervous system demyelinating diseases are a group of disorders with different etiologies, characterized by inflammatory lesions that are associated with loss of myelin and eventually axonal damage. In this group the most studied ones are multiple sclerosis (MS), neuromyelitis optic (NMO) and acute disseminated encephalomyelitis (ADEM). The cerebrospinal fluid is essential to differentiate between these different syndromes and to define multiple sclerosis, helping to assess the probability of Clinical Isolated Syndrome turn into multiple sclerosis.


Author(s):  
V. Kysil’ ◽  
M. Nechkaluk ◽  
L. Drigant ◽  
V. Sereda

Neurosyphilis -  chronic, progressive infection of the central nervous system of humans. The development of the pathology caused by penetration of the body causative agent of syphilis - Treponema pale. Syphilis affects all parts of the central and peripheral nervous system, and the clinical picture of the disease is manifested by a number of neurological symptoms. Today syphilis treated well, but if we are dealing with advanced forms and the possible consequences. Particularly relevant for neurosyphilis high mortality. The problem of syphilis has not lost its relevance now. This is facilitated by low social and economic development, military events. Besides increasing the number of cases with atypical course. The article described the case of clinical practice - diagnosis and treatment tactics of patients diagnosed with neurosyphilis.


Tick-borne encephalitis (TBE) is a viral infectious disease of the central nervous system caused by the tick-borne encephalitis virus (TBEV). TBE is usually a biphasic disease and in humans the virus can only be detected during the first (unspecific) phase of the disease. Pathogenesis of TBE is not well understood, but both direct viral effects and immune-mediated tissue damage of the central nervous system may contribute to the natural course of TBE. The effect of TBEV on the innate immune system has mainly been studied in vitro and in mouse models. Characterization of human immune responses to TBEV is primarily conducted in peripheral blood and cerebrospinal fluid, due to the inaccessibility of brain tissue for sample collection. Natural killer (NK) cells and T cells are activated during the second (meningo-encephalitic) phase of TBE. The potential involvement of other cell types has not been examined to date. Immune cells from peripheral blood, in particular neutrophils, T cells, B cells and NK cells, infiltrate into the cerebrospinal fluid of TBE patients.


Life ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 300
Author(s):  
Petr Kelbich ◽  
Aleš Hejčl ◽  
Jan Krejsek ◽  
Tomáš Radovnický ◽  
Inka Matuchová ◽  
...  

Extravasation of blood in the central nervous system (CNS) represents a very strong damaged associated molecular patterns (DAMP) which is followed by rapid inflammation and can participate in worse outcome of patients. We analyzed cerebrospinal fluid (CSF) from 139 patients after the CNS hemorrhage. We compared 109 survivors (Glasgow Outcome Score (GOS) 5-3) and 30 patients with poor outcomes (GOS 2-1). Statistical evaluations were performed using the Wilcoxon signed-rank test and the Mann–Whitney U test. Almost the same numbers of erythrocytes in both subgroups appeared in days 0–3 (p = 0.927) and a significant increase in patients with GOS 2-1 in days 7–10 after the hemorrhage (p = 0.004) revealed persistence of extravascular blood in the CNS as an adverse factor. We assess 43.3% of patients with GOS 2-1 and only 27.5% of patients with GOS 5-3 with low values of the coefficient of energy balance (KEB < 15.0) in days 0–3 after the hemorrhage as a trend to immediate intensive inflammation in the CNS of patients with poor outcomes. We consider significantly higher concentration of total protein of patients with GOS 2-1 in days 0–3 after hemorrhage (p = 0.008) as the evidence of immediate simultaneously manifested intensive inflammation, swelling of the brain and elevation of intracranial pressure.


2021 ◽  
pp. 106689692199356
Author(s):  
Fleur Cordier ◽  
Lars Velthof ◽  
David Creytens ◽  
Jo Van Dorpe

Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory and demyelinating disorder of the central nervous system. Its characteristic perivenular demyelination and inflammation aid in the differential diagnosis with other inflammatory demyelinating diseases. Here, we present a clinical case of ADEM, summarize its histological hallmarks, and discuss pitfalls concerning the most important neuropathological differential diagnoses.


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