-
Journal of Postgraduate Medicine 2009"Tripod Sign" or "Amoss's Sign" is a sign of meningeal irritation. Although useful in diagnosing meningitis, it is not pathognomic and may be seen in a variety of... (Review)
Review
"Tripod Sign" or "Amoss's Sign" is a sign of meningeal irritation. Although useful in diagnosing meningitis, it is not pathognomic and may be seen in a variety of clinical conditions. Infants < 1 year of age and immunocompromised individuals may not demonstrate signs of meningeal irritation. Since elicitation of the sign requires voluntary sitting up, it is of limited use in patients with marked altered sensorium and young infants.
Topics: Diagnosis, Differential; Diagnostic Techniques, Neurological; Humans; Meningism; Posture
PubMed: 19884752
DOI: 10.4103/0022-3859.57408 -
California Medicine Sep 1949Three hundred and forty-nine cases of disease affecting the meninges were observed at the San Bernardino County Charity Hospital in an eight year period.A total of 29...
Three hundred and forty-nine cases of disease affecting the meninges were observed at the San Bernardino County Charity Hospital in an eight year period.A total of 29 patients with meningococcal, H. influenzae and pneumococcal meningitis were treated. There were four deaths, of which three occurred during the first 24 hours in the hospital. Of 22 cases of unclassified meningitis, four probably were tuberculous, four probably were meningococcal and two probably were of virus origin. Under present treatment programs the differentiation between viral and bacterial meningitides is difficult and it is possible, therefore, that the reported incidence of the two groups may not represent the facts. Of 22 cases of unclassified meningitis, 12 had no specific characteristics which would permit a clinical diagnosis. One of the patients died. Of 70 cases of clinical meningitis, the infecting organism was identified in 69 per cent. Meningococcal meningitis made up only 17 per cent of 70 cases of purulent meningitis observed between July 1, 1945, and July 1, 1948.
Topics: Antigens, Bacterial; Cell Differentiation; Charities; Death; Haemophilus influenzae; Hospitals; Humans; Incidence; Meninges; Meningitis; Meningitis, Bacterial; Meningitis, Meningococcal; Meningitis, Pneumococcal; Meningococcal Vaccines; Risk Management
PubMed: 18137216
DOI: No ID Found -
The Medical Journal of Malaysia Mar 2006Tuberculous meningitis leads to a high mortality rate. However, it responds well to chemotherapy if the treatment is started early. Neuroimaging is one of the most...
Tuberculous meningitis leads to a high mortality rate. However, it responds well to chemotherapy if the treatment is started early. Neuroimaging is one of the most important initial investigations. There were 42 patients diagnosed with tuberculous meningitis in Kuala Lumpur Hospital based on clinical criteria, cerebrospinal fluid analysis and response to anti-tuberculous treatment over a 7 year period. Relevant information was obtained from patients' medical case notes and neuroimaging findings were evaluated. Male to female ratio was 3:1. The three major ethnics and the immigrant groups in Malaysia were represented in this study. The majority of the cases involved the Malays followed by immigrants, Chinese and Indians. The patients' age ranged from 18 to 62 years old with the mean age of 34.4 years. There were 95.2% (n = 40) of patients who presented with various neuroimaging abnormalities and only 2 (4.8%) patients had normal neuroimaging findings. Hydrocephalus and meningeal enhancement were the two commonest neuroimaging features. Other features include infarction, enhancing lesion, tuberculoma, abcess, oedema and calcification. Contrasted CT scan is an adequate neuroimaging tool to unmask abnormal findings in tuberculous meningitis.
Topics: Adolescent; Adult; Female; Humans; Hydrocephalus; Magnetic Resonance Imaging; Male; Meninges; Middle Aged; Tomography, Emission-Computed; Tuberculosis, Meningeal
PubMed: 16708732
DOI: No ID Found -
BMC Infectious Diseases Feb 2011Tuberculous meningitis is the most severe manifestation of extrapulmonary tuberculosis with a high mortality rate and a high rate of sequelae among survivors. The aim of...
BACKGROUND
Tuberculous meningitis is the most severe manifestation of extrapulmonary tuberculosis with a high mortality rate and a high rate of sequelae among survivors. The aim of this study is to assess the current epidemiology, clinical features, diagnostic procedures, treatment and outcome in patients with tuberculous meningitis in Denmark, a country with a low tuberculosis incidence.
METHODS
A nationwide retrospective study was conducted, comprising all patients notified with tuberculous meningitis (TBM) in Denmark from 2000-2008. Medical records were reviewed using a standardised protocol.
RESULTS
Fifty patients, including 12 paediatric patients, were identified. 78% of the patients were immigrants from countries of high tuberculosis endemicity. 64% of all patients had a pre-existing immunosuppressive condition; 10% were HIV positive, 48% were HIV seronegative and 42% had an unknown HIV status. Median symptom duration before admission was 14 days in the Danish patient population and 20 days in the immigrant group. Biochemical analysis of cerebrospinal fluid (CSF) samples revealed pleocytosis in 90% with lymphocyte predominance in 66%. Protein levels were elevated in 86%. The most common findings on neuro-radiological imaging were basal meningeal enhancement, tuberculomas and hydrocephalus. Lumbar puncture was performed on 42 patients; 31 of these specimens (74%) had a positive CSF culture for mycobacteria and 9.5% were smear positive for acid-fast bacilli. The overall mortality rate was 19% and 48% of the remaining patients had neurological sequelae of varying degree.
CONCLUSION
TBM is a rare but severe manifestation of extrapulmonary TB in Denmark. The clinician must be prepared to treat empirically if the suspicion of TBM has arisen to improve treatment outcome.
Topics: Adolescent; Adult; Aged; Cerebrospinal Fluid; Child; Child, Preschool; Denmark; Female; Humans; Infant; Male; Meninges; Middle Aged; Mycobacterium tuberculosis; Radiography; Retrospective Studies; Tuberculosis, Meningeal; Young Adult
PubMed: 21342524
DOI: 10.1186/1471-2334-11-47 -
Annals of Internal Medicine Apr 1965
Topics: Adrenal Cortex Hormones; Diagnosis; Drug Therapy; Estrogens; Familial Mediterranean Fever; Headache; Humans; Meningism; Meningitis; Seasons
PubMed: 14274843
DOI: 10.7326/0003-4819-62-4-778 -
British Medical Journal Jan 1950
Topics: Meninges; Streptomycin; Tuberculosis; Tuberculosis, Meningeal
PubMed: 15404999
DOI: 10.1136/bmj.1.4647.248-a -
British Medical Journal Jan 1948
Topics: Meninges; Streptomycin; Tuberculosis; Tuberculosis, Meningeal
PubMed: 18917862
DOI: 10.1136/bmj.1.4540.74 -
Journal of the American Medical... Sep 1947
Topics: Meninges; Streptomycin; Tuberculosis; Tuberculosis, Meningeal
PubMed: 20259768
DOI: 10.1001/jama.1947.62890030003007a -
Veterinary Pathology Nov 1991Granulomatous meningitis was present in 6/33 bovine fetuses from which Brucella abortus (B. abortus) had been isolated. Meningitis was severe in three fetuses, moderate...
Granulomatous meningitis was present in 6/33 bovine fetuses from which Brucella abortus (B. abortus) had been isolated. Meningitis was severe in three fetuses, moderate in one fetus, and mild in the remaining two fetuses. The meningitis was characterized by the infiltration of a mixed population of lymphocytes, plasma cells, and macrophages in the leptomeninges. Vasculitis characterized by the infiltration of lymphocytes and plasma cells in the vascular wall was observed in the vessels of the cerebral cortices of 4/6 fetuses. Gram negative coccobacilli were present in the cytoplasm of the leptomeningeal macrophages and extracellularly. Brucellar antigens labeled by the avidin-biotin-peroxidase complex method were present in massive amounts in leptomeningeal macrophages and in small foci of stained cells in the choroid plexus and ependyma. The findings indicate that B. abortus is one of pathogens capable of inducing meningitis in bovine fetuses.
Topics: Abortion, Veterinary; Animals; Bacteria; Brucella abortus; Brucellosis, Bovine; Cattle; Cattle Diseases; Cerebral Cortex; Cerebral Ventricles; Female; Fetal Diseases; Granuloma; Meninges; Meningitis; Pregnancy; Vasculitis
PubMed: 1771739
DOI: 10.1177/030098589102800605 -
La Semana Medica Jan 1949
Topics: Meninges; Tuberculosis; Tuberculosis, Meningeal
PubMed: 18109844
DOI: No ID Found