Central Nervous System Infections

2017 ◽  
Author(s):  
Anna Finley Caulfield ◽  
Brian G. Blackburn
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Diagnostic Testing ◽  
Developed Countries ◽  
Morbidity And Mortality ◽  
Molecular Diagnostic ◽  
High Morbidity ◽  
Vaccination Programs ◽  
Cns Infections ◽  
Acute Meningitis

Central nervous system (CNS) infections are associated with a high morbidity and mortality. Fortunately, the incidence of acute community-acquired bacterial meningitis has declined with the advancement and implementation of vaccination programs over the past 30 years. Treatment with corticosteroids, along with initial antimicrobial therapy, has also decreased the morbidity and mortality of patients with acute Streptococcus pneumoniae meningitis in developed countries. Molecular diagnostic testing may become a helpful tool to identify bacterial pathogens for targeted treatments. This review covers common CNS infections with a focus on the diagnosis and initial management of the adult patient suspected of having acute meningitis and encephalitis.  Key words: acute meningitis, brain abscess, chronic meningitis, encephalitis, ventriculitis 

scholarly journals Gnathostomiasis: Report of a Case and Brief Review

1994 ◽  
Vol 5 (3) ◽  
pp. 125-129 ◽  
Author(s):  
Stan Houston
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Involvement ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Eastern Asia ◽  
System Involvement

Nematodes of the genusGnathostomacan cause a spectrum of disease in humans. This includes a distinctive syndrome of intermittent migratory subcutaneous swellings, central nervous system involvement with high morbidity and mortality and occasionally, involvement of other organs. Gnathostomiasis is endemic in southern and eastern Asia, particularly Thailand, but has recently been reported from Ecuador and Mexico. Diagnosis is usually based on clinical, epidemiological and serological findings. A recent study suggests that treatment with albendazole is effective. This report describes a patient diagnosed in Canada in whom evidence of pericarditis was associated with gnathostomiasis and in whom treatment with albendazole appears to have been effective.

scholarly journals Gene Expression of Diverse Cryptococcus Isolates during Infection of the Human Central Nervous System

mBio ◽  
2021 ◽  
Author(s):  
Chen-Hsin Yu ◽  
Poppy Sephton-Clark ◽  
Jennifer L. Tenor ◽  
Dena L. Toffaletti ◽  
Charles Giamberardino ◽  
...  
Keyword(s):  
Gene Expression ◽  
Central Nervous System ◽  
Nervous System ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Human Central Nervous System ◽  
Content Type ◽  
The Central Nervous System

Cryptococcus is the most common fungus causing high-morbidity and -mortality human meningitis. This encapsulated yeast has a unique propensity to travel to the central nervous system to produce disease.

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 Metagenomic Next-Generation Sequencing for Pathogen Detection and Transcriptomic Analysis in Pediatric Central Nervous System Infections

2021 ◽  
Author(s):  
Nanda Ramchandar ◽  
Nicole G Coufal ◽  
Anna S Warden ◽  
Benjamin Briggs ◽  
Toni Schwarz ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Next Generation Sequencing ◽  
Usual Care ◽  
Transcriptomic Analysis ◽  
Cns Infection ◽  
Metagenomic Sequencing ◽  
Next Generation ◽  
Cns Infections ◽  
Generation Sequencing

Abstract Background Pediatric central nervous system (CNS) infections are potentially life-threatening and may incur significant morbidity. Identifying a pathogen is important, both in terms of guiding therapeutic management, but also in characterizing prognosis. Usual care testing by culture and PCR is often unable to identify a pathogen. We examined the systematic application of metagenomic next-generation sequencing (mNGS) for detecting organisms and transcriptomic analysis of cerebrospinal fluid (CSF) in children with CNS infections. Methods We conducted a prospective multi-site study that aimed to enroll all children with a CSF pleocytosis and suspected CNS infection admitted to one of three tertiary pediatric hospitals during the study timeframe. After usual care testing had been performed, the remaining CSF was sent for mNGS and transcriptomic analysis. Results We screened 221 and enrolled 70 subjects over a 12-month recruitment period. A putative organism was isolated from CSF in 25 (35.7%) subjects by any diagnostic modality. mNGS of the CSF samples identified a pathogen in 20 (28.6%) subjects, which were also all identified by usual care testing. The median time to result was 38 hours. Conclusion Metagenomic sequencing of CSF has the potential to rapidly identify pathogens in children with CNS infections.

Anemia and Blood Transfusion

2019 ◽  
pp. 319-324
Author(s):  
Joy D. Hughes ◽  
Mariela Rivera ◽  
Myung S. Park
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Blood Transfusion ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Signs ◽  
Mortality Rates ◽  
Hemoglobin Level ◽  
High Morbidity ◽  
Active Hemorrhage

Critically ill patients commonly present with anemia, defined as a hemoglobin level less than 13.0 g/dL in men and less than 11.6 g/dL in women or as clinical signs of bleeding, including tachycardia and low urine output with active hemorrhage. Anemia is common, occurring in up to a third of critically ill patients, and is associated with high morbidity and mortality rates, particularly in patients with central nervous system injuries and disease. The causes of anemia can vary from chronic conditions such as kidney disease or malnutrition to acute conditions such as bleeding or consumptive coagulopathy.

scholarly journals Epidemiology, Outcomes and Prognosis of Central Nervous System Infections in Singapore. Preliminary results from The Singapore Neurologic Infections Programme (SNIP)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S303-S304
Author(s):  
Fu Zi Yvonne Chan ◽  
Limin Wijaya ◽  
Kevin Tan ◽  
Monica Chan ◽  
Derek Soon ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Demographic Data ◽  
Altered Mental Status ◽  
Diagnostic Tools ◽  
Inclusion Criteria ◽  
Cns Infections ◽  
Tertiary Hospitals ◽  
Simplex Virus ◽  
A Prospective Study

Abstract Background Central Nervous System (CNS) infections frequently result in devastating consequences although the aetiology is seldom definitively identified. To address this knowledge gap, we conducted a prospective study to describe the epidemiology of CNS infections in Singapore. Methods Patient enrollment was conducted in 5 adult tertiary hospitals in Singapore, between August 2013 and December 2016. Patients aged ≥16 years who met the inclusion criteria were enrolled. Demographic data, neuroimaging, neurophysiology and biochemical results were collected. Cases were classified as “Confirmed” or “Probable” depending on whether the aetiological agent was detected by either culture or molecular methods in the CSF. The modified Rankin Scale (mRS) was recorded at enrollment, 2 weeks and 6 months, with scores of 0–2 classified as good and 3–6 as poor outcome. Results A total of 2061 patients were screened, of whom 199 met the inclusion criteria. A total of 106 (53.2%), 65 (32.7%) and 28 (14%) cases of meningitis, meningoencephalitis and encephalitis were diagnosed, respectively. An aetiologic agent was identified in 119 (60%) of cases. Mycobacterium tuberculosis (MTb) was the most common cause of meningitis and meningoencephalitis with 23 (13.5%) cases. Herpes simplex virus was the most common aetiology for encephalitis with 3 (10.7%) cases. Immune-mediated aetiologies accounted for 8 (4%) of the total cases. Fatal outcomes were observed in 7 (3.5%) patients. The absence of focal weakness (aOR 0.024 95% CI 0.001–0.535 P = 0.018) and absence of altered mental status (aOR 0.03; 95% CI 0.002–0.43; P = 0.009) at admission predicted good outcomes at 6 months. Vomiting was associated with poor prognosis (aOR 17.91; 95% CI 1.12–286.04; P = 0.041). Conclusion It is surprising that MTb was the most common aetiologic agent although none were fatal. Our study identified aetiologic diagnoses, clinical and biochemical results that correlated with outcome of CNS infections although it also underscores the need for better diagnostic tools for aetiologic confirmation. Disclosures All authors: No reported disclosures.

scholarly journals Beyond IDH-Mutation: Emerging Molecular Diagnostic and Prognostic Features in Adult Diffuse Gliomas

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1817 ◽  
Author(s):  
Kanish Mirchia ◽  
Timothy E. Richardson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Prognostic Factors ◽  
The United States ◽  
Molecular Diagnostic ◽  
Grading System ◽  
Diffuse Glioma ◽  
Prognostic Features ◽  
Molecular Features ◽  
Diffuse Gliomas

Diffuse gliomas are among the most common adult central nervous system tumors with an annual incidence of more than 16,000 cases in the United States. Until very recently, the diagnosis of these tumors was based solely on morphologic features, however, with the publication of the WHO Classification of Tumours of the Central Nervous System, revised 4th edition in 2016, certain molecular features are now included in the official diagnostic and grading system. One of the most significant of these changes has been the division of adult astrocytomas into IDH-wildtype and IDH-mutant categories in addition to histologic grade as part of the main-line diagnosis, although a great deal of heterogeneity in the clinical outcome still remains to be explained within these categories. Since then, numerous groups have been working to identify additional biomarkers and prognostic factors in diffuse gliomas to help further stratify these tumors in hopes of producing a more complete grading system, as well as understanding the underlying biology that results in differing outcomes. The field of neuro-oncology is currently in the midst of a “molecular revolution” in which increasing emphasis is being placed on genetic and epigenetic features driving current diagnostic, prognostic, and predictive considerations. In this review, we focus on recent advances in adult diffuse glioma biomarkers and prognostic factors and summarize the state of the field.

scholarly journals Histopathological analysis of central nervous system tumor; an observational study

2018 ◽  
Vol 8 (2) ◽  
pp. 1393-1398
Author(s):  
Trishna Kakshapati ◽  
Ranga Bahadur Basnet ◽  
Basant Pant ◽  
Deepti Gautam
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pituitary Adenoma ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Central Nervous System Tumor ◽  
Astrocytic Tumor ◽  
Who Grade ◽  
Cns Tumor ◽  
System Tumor

Background:  Though the central nervous system tumor comprises ~2% of all the tumors, an overall increase has been observed especially in less developed countries. This increase in the incidence may be due to exposure of population to various risk factors or improved diagnosis with advancement in the ancillary studies. This study aims to provide a single centre histopathological spectrum of this type of tumor.Materials and Methods: A retrospective cross sectional study on a series of cases was performed in the Department of Pathology, Annapurna Neurological Institute & Allied Science , Maitighar , Kathmandu, Nepal from April 2013 to Jan 2016. Data were analyzed using SPSS version 21.0.Results: A total of 221 brain and CNS tumors (125 females and 96 males) were studied. The mean age at diagnosis was 43.77 years. The most common tumor was meningioma(67 cases, 30.3%), followed by astrocytic tumor (57 cases, 25.7%) and pituitary adenoma(30 cases,13.6%). The frequency of WHO grade I, II,III and IV tumor were 94 cases (55%), 34 cases (19.9%),10 cases (5.8%), and 33 cases (19.3%) respectively. The astrocytic tumor was most frequent tumor in children (7/20 caes, 37 %).Conclusion: This study showed the most common CNS tumor to be meningioma followed by astrocytic tumors and pituitary adenoma. The spectrum of CNS tumor in children showed divergent histologic pattern according to the age. In age group 0-10 years embryonal tumors were common whereas ages group of 12-years showed propensity towards astrocytoma as in adults.  

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