scholarly journals Meningitis

2022 ◽  
pp. 33-47
Author(s):  
Rupsi . ◽  
Rakesh Kumar
Keyword(s):  
Aseptic Meningitis ◽  
Clinical Manifestations ◽  
Accurate Method ◽  
Neurological Deficits ◽  
Polymerase Chain ◽  
Diagnostic Work ◽  
Microbial Dna ◽  
Work Up ◽  
The Brain ◽  
Csf Examination

The term aseptic meningitis encompasses all types of inflammations of the brain meninges other than that caused by pus producing organisms. It is usually a mild illness. Etiology of aseptic meningitis is very wide and includes many infections - both viral and non viral, drugs, malignancy and systemic illness. The most common cause is viral infection and enteroviruses - Coxsackie and ECHO viruses account for more than half of all cases. Clinical manifestations include headache, fever, malaise, photophobia and meningeal signs. Convulsions, neurological deficits and severe obtundation are rare except with certain non viral infectious meningitis. Diagnostic work up includes blood and cerebrospinal fluid (CSF) examination and serology for infectious meningitis. The polymerase chain reaction is a rapid and accurate method for detection of microbial DNA in CSF. Treatment is mainly supportive, except for the nonviral infectious etiology.

scholarly journals Suspected phenobarbital-induced fever in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691983021
Author(s):  
Dylan M Djani ◽  
William E Draper
Keyword(s):  
Fever Of Unknown Origin ◽  
Clinical Signs ◽  
Unknown Origin ◽  
Drug Induced ◽  
Fluid Analysis ◽  
Diagnostic Work ◽  
Phenobarbital Administration ◽  
Work Up ◽  
The Brain ◽  
Diagnostic Work Up

Case summary A 3-year-old spayed female domestic shorthair cat developed a fever 1 week after starting the anticonvulsant phenobarbital. A diagnostic work-up for seizures and subsequent onset of fever of unknown origin, consisting of MRI of the brain, cerebrospinal fluid analysis and infectious disease testing, was unremarkable. The cat was switched from phenobarbital onto pregabalin with complete resolution of the fever within 24 h, consistent with a drug-induced fever following phenobarbital administration. Relevance and novel information While anticonvulsant hypersensitivities have been reported and studied in veterinary medicine, phenobarbital-induced fever outside of the context of systemic clinical signs has not been documented in the veterinary scientific literature. Drug-induced fever secondary to anticonvulsants should be considered in patients that develop a fever after starting anticonvulsant therapy with an unrewarding diagnostic work-up for fever of unknown origin.

scholarly journals Cerebrospinal fluid p-tau217 performs better than p-tau181 as a biomarker of Alzheimer’s disease

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Shorena Janelidze ◽  
Erik Stomrud ◽  
Ruben Smith ◽  
Sebastian Palmqvist ◽  
Niklas Mattsson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Amyloid Β ◽  
Pet Tracer ◽  
Positron Emission ◽  
Diagnostic Work ◽  
Work Up ◽  
The Brain ◽  
Better Than

AbstractCerebrospinal fluid (CSF) p-tau181 (tau phosphorylated at threonine 181) is an established biomarker of Alzheimer’s disease (AD), reflecting abnormal tau metabolism in the brain. Here we investigate the performance of CSF p-tau217 as a biomarker of AD in comparison to p-tau181. In the Swedish BioFINDER cohort (n = 194), p-tau217 shows stronger correlations with the tau positron emission tomography (PET) tracer [18F]flortaucipir, and more accurately identifies individuals with abnormally increased [18F]flortaucipir retention. Furthermore, longitudinal increases in p-tau217 are higher compared to p-tau181 and better correlate with [18F]flortaucipir uptake. P-tau217 correlates better than p-tau181 with CSF and PET measures of neocortical amyloid-β burden and more accurately distinguishes AD dementia from non-AD neurodegenerative disorders. Higher correlations between p-tau217 and [18F]flortaucipir are corroborated in an independent EXPEDITION3 trial cohort (n = 32). The main results are validated using a different p-tau217 immunoassay. These findings suggest that p-tau217 might be more useful than p-tau181 in the diagnostic work up of AD.

Stroke as Presenting Feature of COVID-19 in a Pediatric Patient

2021 ◽  
Author(s):  
Shanna Swartwood ◽  
Gary R. Nelson ◽  
Audie C. Espinoza
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Adult Population ◽  
Acute Onset ◽  
Cerebrovascular Complications ◽  
Novel Virus ◽  
Polymerase Chain ◽  
Diagnostic Work ◽  
Novel Coronavirus ◽  
Work Up

AbstractNeurologic manifestations of severe acute respiratory syndrome coronavirus 2, the virus responsible for novel coronavirus 2019 (COVID-19) infection, have been frequently reported in the adult population but remain relatively rare in pediatric patients, specifically in regard to cerebrovascular accidents (CVAs). We present the case of a previously healthy 16-year-old adolescent boy with no preceding infectious symptoms who developed acute onset of left-sided weakness and slurred speech subsequently diagnosed with acute ischemic stroke (AIS). After performing a thorough diagnostic work-up, no clear etiology for AIS was identified. He was found to be COVID-19 positive by reverse transcription polymerase chain reaction upon admission. Accumulating evidence supports a link between COVID-19 and a systemic prothrombotic state suggesting pediatric patients who present with AIS and no other risk factors should be screened for this novel virus and potentially for extracranial sources of thrombi. As the rates of positive COVID-19 infection increase in the pediatric population, pediatricians and other pediatric subspecialists should be aware of the potential neurological and cerebrovascular complications of this novel virus to avoid delays in evaluation and intervention.

Hereditary neurocutaneous angiomatosis

1996 ◽  
Vol 85 (6) ◽  
pp. 1135-1142 ◽  
Author(s):  
Richard Leblanc ◽  
Denis Melanson ◽  
Ralph D. Wilkinson
Keyword(s):  
Cerebral Hemorrhage ◽  
Venous Malformation ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Neurological Deficits ◽  
Content Type ◽  
Male Patients ◽  
The Brain ◽  
Fine Print ◽  
Variable Penetrance

✓ The authors report the coexistence of vascular nevi (hemangiomas and arteriovenous malformations (AVMs) of the skin) with AVMs and venous malformations of the brain in male siblings from two related but nonconsanguineous families of three generations. The proband, his siblings, parents, aunts, uncles, and cousins were examined, underwent magnetic resonance (MR) imaging and MR angiography, and when appropriate, cerebral angiography. A father had vascular nevi and a mother, his sister, had an azygos anterior cerebral artery. No other cutaneous or cerebrovascular malformations were present in the parents. Each of the two families had two boys and one girl, 9 to 18 years of age. All the children had vascular nevi and all of the boys had coexisting cerebrovascular malformations: AVMs in three, and a venous malformation in another. One boy had three cerebral AVMs. Two boys had a cerebral hemorrhage, and one also had focal motor seizures. The skin lesions were not those of the Sturge-Weber-Dimitri, Rendu-Osler-Weber, or Wyburn—Mason syndromes. The association of cutaneous and cerebrovascular malformations was seen only in males in these families, but females have also been reported in the literature. The results obtained in these families and three other families reported from Western and Central Europe indicate that the association of cerebral and cutaneous vascular hamartomas constitutes a distinct, hereditary clinicopathological entity with autosomal dominant inheritance and variable penetrance. The clinical manifestations of this syndrome are visible, painful vascular nevi, epilepsy, cerebral hemorrhage, and focal neurological deficits. The preponderance of male patients with the full expression of the syndrome suggests a possible hormonal influence on the expression of the gene.

scholarly journals DIAGNOSTIC UTILITY OF FLOW CYTOMETRY IN MYELODYSPLASTIC SYNDROMES.

2017 ◽  
Vol 9 (1) ◽  
pp. e2017017 ◽  
Author(s):  
Matteo Della Porta ◽  
Cristina Picone
Keyword(s):  
Flow Cytometry ◽  
Myelodysplastic Syndromes ◽  
Qualitative Evaluation ◽  
Normal Karyotype ◽  
Accurate Method ◽  
Specificity And Sensitivity ◽  
Sensitivity Data ◽  
Fcm Analysis ◽  
Diagnostic Work ◽  
Work Up

The pathological hallmark of myelodysplastic syndromes (MDS) is marrow dysplasia, which representsthe basis of the WHO classification of these disorders. This classification provides clinicians with a useful tool for defining the different subtypes of MDS and individual prognosis. The WHO proposal has raised some concern regarding minimal diagnostic criteria particularly in patients with normal karyotype without robust morphological markers of dysplasia (such as ring sideroblasts or excess of blasts). Therefore, there is clearly a need to refine the accuracy to detect marrow dysplasia. Flow cytometry (FCM) immunophenotyping has been proposed as a tool to improve the evaluation of marrow dysplasia. Rationale for the application of FCM in the diagnostic work up of MDS is that immunophenotyping is an accurate method for quantitative and qualitative evaluation of hematopoietic cells and that MDS have been found to have abnormal expression of several cellular antigens. To become clinically applicable, FCM analysis should be based on parameters with sufficient specificity and sensitivity, data should be reproducible between different operators and the results should be easily understood by clinicians. In this review, we discuss the most relevant progresses in detection of marrow dysplasia by FCM in MDS

scholarly journals Congenital Cytomegalovirus Infection - Lessons from a Clinical Case

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 403-407
Author(s):  
Zhivka Stoykova ◽  
Liliya Ivanova ◽  
Snejinka Cvetkova ◽  
Diana Yordanova
Keyword(s):  
Latent Infection ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Congenital Infection ◽  
Rt Pcr ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Polymerase Chain ◽  
The Brain

Background: Cytomegalovirus (CMV) is a worldwide spread herpes virus that establishes a latent infection after the primary infection. It becomes a major problem in immunocompromised patients and in cases of primary or reactivated infection during pregnancy. CMV is the most common congenital infection and is the leading infectious cause of sensoneural deafness and cerebral mental retardation. Aim: Тo raise the attention to the discordance in our knowledge of cCMV infection and the implementation of the knowledge in prac­tice. Materials and methods: CMV-DNA was extracted from saliva and plasma samples according to the protocol of DNA-Sorb-A, Sacace, Biotechnologies, Italy. Polymerase chain reaction (PCR) was performed using a commercial kit based on the Taq-man principle: Quantitative RT-PCR for CMV-DNA detection (Sacace, Biotechnologies, Italy). The linear range of the CMV Real-TM Quant PCR test is 500-10000000 copies/ml, and the reported sensitivity is 400 copies/ml. Results: The infant was born with clinical manifestations involving development of hepatosplenomegaly, chorioretinitis, anemia, mi­crocephaly and simultaneous dilatation of the brain ventricles. CMV infection was confirmed using modern PCR studies. Conclusions: This case highlights the need for specific virological/PCR tests to be performed for all children with the least suspected congenital infection, especially when there is an option of a specific treatment.

scholarly journals Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine

2020 ◽  
Vol 9 (3) ◽  
pp. 864
Author(s):  
Louis Kreitmann ◽  
David Montaigne ◽  
David Launay ◽  
Sandrine Morell-Dubois ◽  
Hélène Maillard ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Infective Endocarditis ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
High Sensitivity ◽  
University Hospital ◽  
Delay In Diagnosis ◽  
Duke Classification ◽  
Diagnostic Work ◽  
Work Up

Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved adult patients admitted to the department of internal medicine at Lille University Hospital between 2004 and 2015 who fulfilled Duke Classification criteria for definite IE. Thirty-five patients were included. The most frequently involved bacteria were non-hemolytic streptococci. Most patients presented with various systemic, cardiac, embolic, rheumatic, and immunological findings, with no sign or symptom displaying high sensitivity. The first transthoracic echocardiogram was negative in 42% of patients. Furthermore, definite diagnosis required performing at least 2 transesophageal examinations in 24% of patients. We observed a trend towards decreased survival in the subgroup of patients in whom the delay between onset of symptoms and diagnosis was >30 days. In conclusion, patients who are initially referred to internal medicine for a diagnosis work-up and who are ultimately diagnosed with IE have non-specific symptoms and a high percentage of initial normal echocardiography. Those patients require prolonged echocardiographic monitoring as a prolonged delay in diagnosis is associated with poorer outcomes such as death.

scholarly journals Airway Malacia: Clinical Features and Surgical Related Issues, a Ten-Year Experience from a Tertiary Pediatric Hospital

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 613
Author(s):  
Michele Ghezzi ◽  
Enza D’Auria ◽  
Andrea Farolfi ◽  
Valeria Calcaterra ◽  
Alessandra Zenga ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Surgical Treatment ◽  
Acute Respiratory Failure ◽  
Chronic Cough ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Diagnostic Work ◽  
Work Up ◽  
Cardiovascular Anomalies

Background: Few studies have been carried out with the aim of describing the clinical course and follow-up of patients with tracheomalacia. We aim to describe the symptoms at diagnosis and the post-treatment clinical course of patients affected by airway malacia. Methods: We retrospectively analyzed characteristics of pediatric patients with a diagnosis of airway malacia. Patients were classified into three groups: bronchomalacia (BM), tracheomalacia (TM) and tracheo-bronchomalacia (TBM). Demographic and clinical data, diagnostic work-up and surgical treatment were recorded. Results: 13/42 patients were affected by congenital syndromes (30.9%). Esophageal atresia with or without tracheal-esophageal fistula (EA/TEF) was detected in 7/42 patients (16.7%). Cardiovascular anomalies were found in 9/42 (21.4%) and idiopathic forms in 13/42 (30.9%). BM occurred in 7/42 (16.6%), TM in 23/42 (54.7%) and TBM in 12/42 (28.6%). At the diagnosis stage, a chronic cough was reported in 50% of cases with a higher prevalence in EA/TEF (p = 0.005). Surgery was performed in 16/42 (40%) of children. A chronic cough and acute respiratory failure were correlated to the need for surgery. During follow-up, there was no difference in persistence of symptoms between conservative vs surgical treatment (p = 0.47). Conclusion: the management of tracheomalacia remains a challenge for pediatricians. Clinical manifestations, such as a barking cough and acute respiratory failure may suggest the need for surgery. Follow-up is crucial, especially in those patients affected by comorbidities, so as to be able to manage effectively the possible persistence of symptoms, including those that may continue after surgical treatment.

scholarly journals Rare acute idiopathic subdural hematoma: A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 9
Author(s):  
Adilson de Oliveira ◽  
Wellingson da Silva Paiva ◽  
Manoel Jacobsen Teixeira
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Subdural Hematoma ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Deficits ◽  
Acute Subdural Hematoma ◽  
Acute Epidural Hematoma ◽  
Work Up ◽  
The Brain

Background: Acute spontaneous subdural hematoma is rare. For patients under 40 years of age, we found only five previous reports. Here, we have presented a sixth case study. Case Description: A 27-year-old male initially presented with a high-intensity headache without any neurological deficits. The brain computed tomography revealed a left frontoparietal lesion, consistent with an acute epidural hematoma. However, the bone window examination showed no fracture, and at surgery, this lesion proved to be an acute subdural hematoma. Additional studies, including cerebral angiography, brain magnetic resonance imaging, and a complete coagulation work-up, were all negative. Conclusion: This case report and literature review focused on the rarity of acute idiopathic/spontaneous subdural hematomas.

scholarly journals A case report on Sarcoidosis

2015 ◽  
Vol 22 (2) ◽  
pp. 225-228
Author(s):  
Sudip Ranjan Deb ◽  
Ratul Sarkar ◽  
Pratyay Hasan ◽  
Shegufta Mishket Mukerrama ◽  
Prianka Baral ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Organ System ◽  
Mediastinal Lymphadenopathy ◽  
Unknown Aetiology ◽  
Multisystem Disease ◽  
Medical College ◽  
Subcutaneous Nodules ◽  
The World ◽  
Diagnostic Work ◽  
Work Up

Sarcoidosis is a multisystem disease that may involve almost any organ system. Infiltration with non-caseating granulomas is the hallmark of the disease, and it may result in various clinical manifestations. Since the first description of the disease by British dermatologist Jonathan Hutchison in 1869, sarcoidosis has been seen in almost every part of the world and continues to engender considerable interest among clinicians because of its unknown aetiology, protean manifestations, and variable course and prognosis. Here we report a 65-year old woman who presented to us with a rather atypical presentation of sarcoidosis- subcutaneous nodules. Later, on subsequent diagnostic work-up, she was found to have bilateral hilar and mediastinal lymphadenopathy and pulmonary reticular lesions. It is a bit unusual to have only subcutaneous nodules as the presenting complaint of sarcoidosis without any prominent systemic and respiratory symptoms, which is what prompted this report. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21549 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 225-228

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