-
Pediatric Emergency Care Jun 2001Although signs of meningeal irritation are highly indicative of meningitis, they are not pathognomonic. In this study, we described the final diagnoses in children with...
OBJECTIVE
Although signs of meningeal irritation are highly indicative of meningitis, they are not pathognomonic. In this study, we described the final diagnoses in children with signs of meningeal irritation, and we assessed the frequency of bacterial meningitis related to specific signs of meningeal irritation.
METHODS
Information was collected from records of 326 patients (aged 1 month to 15 years) who visited the emergency department of the Sophia Children's Hospital between 1988 and 1998 with signs of meningeal irritation, assessed by either the general practitioner or the pediatrician.
RESULTS
Bacterial meningitis was diagnosed in 99 patients (30%), viral or aseptic meningitis in 43 (13%). Other diagnoses were pneumonia (8%), other serious bacterial infections (2%), and upper respiratory tract infections or other self-limiting diseases (46 %). Presence of one of the signs of meningeal irritation assessed by the pediatrician was related to bacterial meningitis in 39%. Specific tests eliciting meningeal irritation, such as Brudzinski's and Kernig's signs, were not related to a higher frequency of bacterial meningitis than neck stiffness and the tripod phenomenon. In children < or =1 year, bacterial meningitis is more frequently related to presence of irritability and a bulging fontanel.
CONCLUSION
Bacterial meningitis is present in 30% of children with signs of meningeal irritation. Presence of meningeal irritation as assessed by the pediatrician is related to bacterial meningitis in 39%. A better prediction of bacterial meningitis was not achieved by using more specific tests for signs of meningeal irritation.
Topics: Adolescent; Child; Child, Preschool; Emergency Service, Hospital; Female; Hospitals, Pediatric; Humans; Infant; Male; Meningism; Meningitis, Aseptic; Meningitis, Bacterial; Meningitis, Viral; Netherlands; Respiratory Tract Infections
PubMed: 11437138
DOI: 10.1097/00006565-200106000-00003 -
Revista Medico-chirurgicala a... 2012To analyze the clinical features and course of and to define the risk factors for bacterial meningitis in children.
AIM
To analyze the clinical features and course of and to define the risk factors for bacterial meningitis in children.
MATERIAL AND METHODS
Retrospective study of 100 cases of bacterial meningitis in patients aged 0-18 years admitted to the Iasi Infectious Diseases Hospital between 2005 and 2010.
RESULTS
We found a clear prevalence in male children (58%) from rural area (67%), with the highest incidence in the age group 2-5 years. A significant percentage of patients (43%) had previous hospitalization, condition which is known as predisposing factor for bacterial meningitis, the most common being ear infections (20%) and height and weight deficit (9%). 71% of patients were admitted within the first 48 h. The most common onset clinical manifestations were fever (84%), vomiting (70%), signs of meningeal irritation (59%), somnolence (23%), loss of appetite (19%), and coma in 5% of patients. In 36% of cases CSF was opalescent with moderate pleocytosis (35%); in 29% of patients CSF albumin level ranged between 0.7-1.0 g, the majority presenting normal glycorahia (71%). In only 21% of cases the microbial agent was identified (pneumococcal and meningococcal etiology, 8% and 6%, respectively). The course was generally favorable, and mortality rate was low (5%). Complications occurred in 3% of patients consisting in hydrocephalus and brain abscess.
CONCLUSIONS
Bacterial meningitis remains a disease with potentially severe course. Clinical onset, most commonly atypical in children, requires differential diagnosis at the time of admission in order to initiate the most appropriate antibiotic therapy.
Topics: Adolescent; Age Distribution; Anorexia; Child; Child, Preschool; Coma; Ear Diseases; Female; Fever; Hospitalization; Hospitals, University; Humans; Infant; Infant, Newborn; Male; Malnutrition; Meningism; Meningitis, Bacterial; Poverty; Prevalence; Retrospective Studies; Risk Factors; Romania; Sex Distribution; Survival Rate; Vomiting
PubMed: 23272517
DOI: No ID Found -
The Indian Journal of Medical Research May 1971
Topics: Animals; Candidiasis; Injections, Spinal; Meninges; Meningitis; Mice
PubMed: 5109983
DOI: No ID Found -
Neurology India 2020
Expert Commentary on "The Brain and Meninges in Tuberculosis Meningitis - Gross Pathology in 100 Cases and Pathogenesis" by Darab K Dastur, VS Lalitha, PM Udani, and Usha Parekh.
Topics: Brain; Humans; Meninges; Meningitis; Tuberculosis, Meningeal
PubMed: 33342853
DOI: 10.4103/0028-3886.304083 -
Journal of Clinical Neuroscience :... Jan 2010Rheumatoid meningitis (RM) is one of the most severe complications of rheumatoid arthritis. The mortality rate of RM is relatively high and diagnosis can be difficult....
Rheumatoid meningitis (RM) is one of the most severe complications of rheumatoid arthritis. The mortality rate of RM is relatively high and diagnosis can be difficult. We present an 80-year-old woman who was diagnosed with microscopic findings of RM after analysis of biopsy specimens taken from a brain lesion. MRI scanning revealed meningeal enhancement in the brain, and the pathological findings were those of meningeal lymphocytic infiltration, vasculitis and rheumatoid nodules. RM is a treatable disease and in this patient RM was diagnosed on the basis of biopsy findings.
Topics: Aged, 80 and over; Arachnoid; Arthritis, Rheumatoid; Biopsy; Brain; Diagnosis, Differential; Dura Mater; Female; Humans; Lymphocyte Activation; Magnetic Resonance Imaging; Meninges; Meningitis, Aseptic; Rheumatoid Nodule; Steroids; Treatment Outcome; Vasculitis
PubMed: 19864143
DOI: 10.1016/j.jocn.2009.01.033 -
Internal Medicine (Tokyo, Japan) 2006Although meningism manifesting acute headache has been observed to be associated with common viral and bacterial infections, its definition and pathogenesis have not... (Comparative Study)
Comparative Study
OBJECTIVE
Although meningism manifesting acute headache has been observed to be associated with common viral and bacterial infections, its definition and pathogenesis have not been clarified. Clinical findings and cerebrospinal fluid (CSF) cytokines in adult patients with meningism were investigated and compared with those in viral meningitis.
PATIENTS AND METHODS
Among the adult inpatients in our hospital from 1997 to 2004, 5 with meningism and 17 with viral meningitis were identified according to the criteria described in this study, and their clinical data were analyzed. In the CSF samples of the 5 patients with meningism and the 17 with viral meningitis, the concentrations of interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2), IL-4, IL-6, and IL-10 were determined using a cytometric bead array.
RESULTS
The five patients with meningism all showed fever and meningeal signs such as severe headache and nuchal stiffness without CSF pleocytosis (<5 cells/mm3). Four patients were associated with herpetic Kaposi's eczema, herpes simplex, or herpes zoster, and all five patients had favorable outcomes. The levels of all CSF cytokines in patients with meningism were below normal values, whereas IFN-gamma and IL-6 in patients with viral meningitis were moderately elevated.
CONCLUSION
The normal cytokine levels in meningism may possibly reflect the lack of direct viral infection and may be helpful in differentiating both meningism and viral meningitis at an early stage.
Topics: Adult; Aged; Cytokines; Female; Hospitalization; Humans; Male; Meningism; Meningitis, Viral; Middle Aged
PubMed: 17139119
DOI: 10.2169/internalmedicine.45.1769 -
Australian and New Zealand Journal of... Dec 1995The cause is not found in one third of patients presenting with chronic meningitis. Biopsy of the leptomeninges and brain is often recommended in these patients, but the...
BACKGROUND
The cause is not found in one third of patients presenting with chronic meningitis. Biopsy of the leptomeninges and brain is often recommended in these patients, but the value of a biopsy is uncertain.
AIMS
To review the results of leptomeningeal and brain biopsies and their effect on diagnosis and management in patients with chronic meningitis, if the diagnosis was uncertain after clinical assessment, lumbar puncture and radiological investigations.
METHODS
The clinical features, investigations and the results of leptomeningeal and brain biopsies were reviewed retrospectively in 25 patients presenting with chronic meningitis between 1967 and 1990.
RESULTS
The biopsy identified the cause of the chronic meningitis in five patients (neoplastic meningitis in three, tuberculous meningitis in one, granulomatous angiitis in one). In 17 patients the biopsy was abnormal but it did not identify the cause (non-granulomatous lymphocytic meningitis in eight, granulomatous meningitis in two, non-specific abnormalities in seven). In two patients the biopsy was normal and in one patient the tissue was used only for culture. The results of the biopsy led to a beneficial change in treatment in two patients but did not influence management in the other patients.
CONCLUSIONS
A leptomeningeal and brain biopsy was of limited practical value in diagnosis and management in most patients with chronic meningitis.
Topics: Adolescent; Adult; Aged; Biopsy; Brain; Child; Child, Preschool; Chronic Disease; Diagnosis, Differential; Female; Humans; Male; Meninges; Meningitis; Middle Aged; Tuberculosis, Meningeal
PubMed: 8770335
DOI: 10.1111/j.1445-5994.1995.tb02857.x -
The Yale Journal of Biology and Medicine Jan 1946
Topics: Meninges; Streptomycin; Tuberculosis; Tuberculosis, Meningeal
PubMed: 21012190
DOI: No ID Found -
The Medical Clinics of North America Mar 1946
Topics: Adult; Humans; Meninges; Tuberculosis; Tuberculosis, Meningeal
PubMed: 21019263
DOI: 10.1016/s0025-7125(16)35963-6 -
Journal of the American Medical... Sep 1947
Topics: Heart Arrest; Meninges; Streptomycin; Tuberculosis; Tuberculosis, Meningeal; Tuberculosis, Miliary
PubMed: 20259767
DOI: 10.1001/jama.1947.62890030001007