scholarly journals Introduction of a Patient with Neurobrucellosis with Clinical Manifestations of Vertigo and Nausea-Vomiting

2021 ◽  
Author(s):  
Maryam Dehghan ◽  
Zohre Akhondimeibody
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Mental Disorders ◽  
Clinical Response ◽  
Brain Abscess ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Routine Treatment ◽  
History Of

Introduction: Brucellosis is a common zoonotic disease. The clinical manifestations of this infection are different due to the involvement of different body systems. These include central nervous system (neurobrucellosis), which presents as meningitis, meningoencephalitis, cognitive-mental disorders and brain abscess. Our patient was a 59-year-old woman who presented with fever, nausea, vomiting, and dizziness 2 weeks prior to admission. A cerebrospinal fluid that was positive for brucellosis was diagnosed.The patient was treated with drugs effective in neuroblastosis and had an appropriate clinical response to treatment. Consider neurobrucellosis in endemic areas such as Iran in the patients with clinical manifestations of fever and vertigo who do not respond to routine treatment and other investigations, especially in a person with a history of exposure to brucellosis

Brain and Spinal Abscesses

2017 ◽  
Author(s):  
Allan R Tunkel ◽  
W Michael Scheld
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Epidural Abscess ◽  
Clinical Manifestations ◽  
Spinal Epidural Abscess ◽  
Diffusion Weighted Images ◽  
Optimal Approach ◽  
Spinal Cord Dysfunction

Brain and spinal abscesses are focal infections of the central nervous system that are often associated with significant morbidity and mortality if not recognized early and managed in a timely manner. In patients with brain abscess, the clinical manifestations run the gamut from indolent to fulminant; most are related to the size and location of the space-occupying lesion within the brain and the virulence of the infecting organism. Untreated spinal epidural abscess usually progresses through four stages: backache and focal vertebral pain, nerve root pain, spinal cord dysfunction, and complete paralysis. Magnetic resonance imaging is the diagnostic neuroimaging procedure of choice in patients with brain and spinal abscesses; on diffusion-weighted images, restricted diffusion may be seen and may help distinguish abscesses from necrotic neoplasms. Aspiration of the abscess is important to facilitate microbiologic diagnosis; after aspiration and submission of specimens for special stains, histopathologic examination, and culture, empirical antimicrobial therapy should be initiated based on stains of the aspirated specimen and the probable pathogenesis of infection. Once the infecting pathogen is isolated, antimicrobial therapy can be modified for optimal treatment. Surgical therapy is often required for the optimal approach to patients with brain and spinal abscesses. This review contains 6 figures, 5 tables, and 72 references. Key words: antimicrobial therapy for central nervous system infections, brain abscess, epidural abscess, focal intracranial infections, head trauma, infections in immunocompromised hosts, spine infections, subdural empyema, toxoplasmosis 

scholarly journals Coinfection withCryptococcus GattiiandMycobacterium Tuberculosisin an Otherwise Healthy 18-Year-Old Woman

2011 ◽  
Vol 18 (4) ◽  
pp. e62-e63 ◽  
Author(s):  
Lindsay Van Tongeren ◽  
Tawimas Shaipanich ◽  
John A Fleetham
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Mycobacterium Tuberculosis ◽  
Immune System ◽  
Medical History ◽  
Healthy Individual ◽  
Host Immune System ◽  
Healthy Young Woman ◽  
History Of

A case ofCryptococcus gattii(pulmonary and central nervous system) andMycobacterium tuberculosis(pulmonary) coinfection in an otherwise healthy young woman is reported. The patient presented with a two-month history of dry cough. She had an unremarkable medical history. Both tuberculosis and cryptococcosis were diagnosed following bronchoscopy, and a subsequent lumbar puncture revealedC gattiiin the cerebrospinal fluid. There is evidence that bothM tuberculosisandC gattiimay have suppressive effects on the host immune system. This suggests a mechanism by which an otherwise healthy individual developed these two infections.

scholarly journals Brain Abscess Due to Nocardia in a Patient With Systemic Lupus Erythematosus

2021 ◽  
pp. jrheum.210971
Author(s):  
Zhuoxuan Li ◽  
Dongling Li ◽  
Pan Lv ◽  
Jianping Liu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Brain Abscess ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Central Nervous System Infections ◽  
Systemic Lupus ◽  
Brain Abscesses

Nocardia brain abscesses mainly occur in immunosuppressive hosts1 and comprise only 2% of all intracranial abscesses. It is difficult to identify central nervous system infections in patients with systemic lupus erythematosus because of the silent clinical manifestations and their simulation of lupus encephalopathy.2

Nervous System Lyme Disease

2017 ◽  
Author(s):  
John J. Halperin
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Clinical Manifestations ◽  
Cerebrospinal Fluid Examination ◽  
The Central Nervous System ◽  
Cranial Neuropathies ◽  
Lymphocytic Meningitis

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.

scholarly journals Towards Central Nervous System Involvement in Adults with Hereditary Myopathies

2020 ◽  
Vol 7 (4) ◽  
pp. 367-393
Author(s):  
Jens Reimann ◽  
Cornelia Kornblum
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neuromuscular Disorders ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Central Nervous System Involvement ◽  
Epileptic Seizures ◽  
System Involvement ◽  
History Of ◽  
Neuroimaging Techniques

There is increasing evidence of central nervous system involvement in numerous neuromuscular disorders primarily considered diseases of skeletal muscle. Our knowledge on cerebral affection in myopathies is expanding continuously due to a better understanding of the genetic background and underlying pathophysiological mechanisms. Intriguingly, there is a remarkable overlap of brain pathology in muscular diseases with pathomechanisms involved in neurodegenerative or neurodevelopmental disorders. A rapid progress in advanced neuroimaging techniques results in further detailed insight into structural and functional cerebral abnormalities. The spectrum of clinical manifestations is broad and includes movement disorders, neurovascular complications, paroxysmal neurological symptoms like migraine and epileptic seizures, but also behavioural abnormalities and cognitive dysfunction. Cerebral involvement implies a high socio-economic and personal burden in adult patients sometimes exceeding the everyday challenges associated with muscle weakness. It is especially important to clarify the nature and natural history of brain affection against the background of upcoming specific treatment regimen in hereditary myopathies that should address the brain as a secondary target. This review aims to highlight the character and extent of central nervous system involvement in patients with hereditary myopathies manifesting in adulthood, however also includes some childhood-onset diseases with brain abnormalities that transfer into adult neurological care.

Brain and Spinal Abscesses

2017 ◽  
Author(s):  
Allan R Tunkel ◽  
W Michael Scheld
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Epidural Abscess ◽  
Clinical Manifestations ◽  
Spinal Epidural Abscess ◽  
Diffusion Weighted Images ◽  
Optimal Approach ◽  
Spinal Cord Dysfunction

Brain and spinal abscesses are focal infections of the central nervous system that are often associated with significant morbidity and mortality if not recognized early and managed in a timely manner. In patients with brain abscess, the clinical manifestations run the gamut from indolent to fulminant; most are related to the size and location of the space-occupying lesion within the brain and the virulence of the infecting organism. Untreated spinal epidural abscess usually progresses through four stages: backache and focal vertebral pain, nerve root pain, spinal cord dysfunction, and complete paralysis. Magnetic resonance imaging is the diagnostic neuroimaging procedure of choice in patients with brain and spinal abscesses; on diffusion-weighted images, restricted diffusion may be seen and may help distinguish abscesses from necrotic neoplasms. Aspiration of the abscess is important to facilitate microbiologic diagnosis; after aspiration and submission of specimens for special stains, histopathologic examination, and culture, empirical antimicrobial therapy should be initiated based on stains of the aspirated specimen and the probable pathogenesis of infection. Once the infecting pathogen is isolated, antimicrobial therapy can be modified for optimal treatment. Surgical therapy is often required for the optimal approach to patients with brain and spinal abscesses. This review contains 6 figures, 5 tables, and 72 references. Key words: antimicrobial therapy for central nervous system infections, brain abscess, epidural abscess, focal intracranial infections, head trauma, infections in immunocompromised hosts, spine infections, subdural empyema, toxoplasmosis 

scholarly journals Suppurative intracranial processes in 15 domestic ruminants

2014 ◽  
Vol 34 (5) ◽  
pp. 421-426 ◽  
Author(s):  
Antônio Carlos Lopes Câmara ◽  
André Menezes do Vale ◽  
Jael Soares Batista ◽  
Francisco Marlon C. Feijó ◽  
Benito Soto-Blanco
Keyword(s):  
Escherichia Coli ◽  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Brain Abscess ◽  
Preventive Measures ◽  
Light Yellow ◽  
Domestic Ruminants ◽  
Yellow Coloration ◽  
Arcanobacterium Pyogenes

In addition to listeriosis which is relatively common in ruminants, there are three other uncommon suppurative intracranial processes (SIP) identifiable in adult ungulates as brain abscess, basilar empyema and suppurative meningitis. The present paper reports the epidemiological, clinical, laboratorial, pathological and microbiological findings of 15 domestic ruminants with SIP. A total of 15 animals were selected (eight sheep, four cattle and three goats); with the definitive diagnoses of basilar empyema (n=3), brain abscess (n=1), listeriosis (n=5) and suppurative meningitis (n=6). Hematology revealed leukocytosis with inversion of the lymphocyte/ neutrophil ratio in 4 cases. In the majority of animals, cerebrospinal fluid (CSF) presented light yellow coloration and cloudy aspect due to neutrophilic pleocytosis (15 - 997 leukocytes/µL). Microbiological culture of CSF or central nervous system (CNS) fragments resulted on isolation of Trueperella (Arcanobacterium) pyogenes,Listeria monocytogenes,Escherichia coli and Stenotrophomonas sp. In a goat with thalamic abscess, microbiological assay was not performed, but Gram positive bacilli type bacteria were observed in histology. The diagnosis of these outbreaks was based on the association of epidemiological, clinical, pathological and bacteriological findings; reiterating that the infectious component remains an important cause of CNS disease in domestic ruminants and also shows the need for dissemination of information about the most effective preventive measures for the ranchers.

Central Nervous System Infections

2016 ◽  
Author(s):  
Nicholas J. Johnson ◽  
David F. Gaieski
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Bacterial Meningitis ◽  
Lumbar Puncture ◽  
Clinical Manifestations ◽  
Empirical Therapy ◽  
Cns Infection ◽  
Cns Infections ◽  
Associated Conditions

Infections of the central nervous system (CNS) are among the most devastating diseases that present to the emergency department (ED). Because of the great potential for morbidity, as well as the importance of prompt treatment, emergency physicians must remain vigilant of these diseases, which are also fraught with diagnostic challenges. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of CNS infections. Figures show causes of viral meningitis, an algorithm for the initial evaluation and management of patients with a suspected CNS infection, clinical manifestations of community-acquired meningitis in patients 16 years of age and older, assessment of nuchal rigidity, Kernig sign, and Brudzinski sign for meningeal irritation, proper positioning of the patient for lumbar puncture, and a sagittal view of the lumbar puncture needle as it is advanced into the subarachnoid space. Tables list CNS pathogens based on predisposing and associated conditions, cerebrospinal fluid diagnostic studies for meningitis, adult patients who should receive computed tomography prior to lumbar puncture, classic cerebrospinal fluid characteristics in meningitis, empirical therapy for bacterial meningitis based on predisposing and associated conditions, recommended doses for antibiotics commonly used in the treatment of bacterial meningitis, and antimicrobial therapy for selected CNS infections.   This review contains 8 highly rendered figures, 7 tables, and 94 references

scholarly journals Diagnosis of Central Nervous System Tuberculosis by T-Cell-Based Assays on Peripheral Blood and Cerebrospinal Fluid Mononuclear Cells

2008 ◽  
Vol 15 (9) ◽  
pp. 1356-1362 ◽  
Author(s):  
Sung-Han Kim ◽  
Kon Chu ◽  
Su-Jin Choi ◽  
Kyoung-Ho Song ◽  
Hong-Bin Kim ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Sensitivity And Specificity ◽  
Mononuclear Cell ◽  
Peripheral Blood ◽  
Elispot Assay ◽  
Mononuclear Cells ◽  
Clinical Manifestations ◽  
Peripheral Blood Mononuclear

ABSTRACT In active tuberculosis (TB), Mycobacterium tuberculosis-specific T cells are compartmentalized more to the site of infection than to the circulating blood. Therefore, an M. tuberculosis-specific enzyme-linked immunospot (ELISPOT) assay with samples from the site of infection may permit a more sensitive or specific diagnosis of active central nervous system (CNS) TB than that achieved by the assay with blood alone. Therefore, we prospectively evaluated the usefulness of circulating and compartmentalized mononuclear cell (MC; i.e., peripheral blood mononuclear cell [PBMC] and cerebrospinal fluid [CSF] MC)-based ELISPOT assays (i.e., the T-SPOT.TB test) for the diagnosis of active TB in patients with suspected CNS TB. The clinical categories of CNS TB were classified as described previously (G. E. Thwaites, T. T. Chau, K. Stepniewska, N. H. Phu, L. V. Chuong, D. X. Sinh, N. J. White, C. M. Parry, and J. J. Farrar, Lancet 360:1287-1292, 2002). Thirty-seven patients with suspected CNS TB were enrolled over a 12-month period. Of these, 31 (84%) showed clinical manifestations of suspected TB meningitis and 6 (16%) gave indications of intracranial tuberculoma with disseminated TB. The final clinical categories of the 37 patients with suspected CNS TB were as follows: 12 (32%) were classified as having CNS TB (7 with confirmed TB, 3 with probable TB, and 2 with possible TB) and 25 (68%) were classified as not having active TB. The sensitivity and specificity of the PBMC ELISPOT assay were 91% (95% confidence interval [CI], 59% to 100%) and 63% (95% CI, 41% to 81%), respectively. By comparison, the sensitivity and specificity of the CSF MC ELISPOT assay were 75% (95% CI, 19% to 99%) and 75% (95% CI, 43% to 95%), respectively. When the ratio of the CSF MC ELISPOT assay results to the PBMC ELISPOT results was 2 or more, the sensitivity and specificity were 50% (95% CI, 7% to 93%) and 100% (95% CI, 74% to 100%), respectively. The ELISPOT assay with PBMCs and CSF MCs is a useful adjunct to the current tests for the diagnosis of CNS TB.

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