-
The Lancet. Infectious Diseases Sep 2021Cryptococcal meningoencephalitis was first described over a century ago. This fungal infection is preventable and treatable yet continues to be associated with excessive... (Review)
Review
Cryptococcal meningoencephalitis was first described over a century ago. This fungal infection is preventable and treatable yet continues to be associated with excessive morbidity and mortality. The largest burden of disease resides in people living with HIV in low-income and middle-income countries. In this group, mortality with the best antifungal induction regimen (7 days of amphotericin B deoxycholate [1·0 mg/kg per day] and flucytosine [100·0 mg/kg per day]) in a clinical trial setting was 24% at 10 weeks. The world is now at an inflection point in terms of recognition, research, and action to address the burden of morbidity and mortality from cryptococcal meningoencephalitis. However, the scope of interventional programmes needs to increase, with particular attention to implementation science that is specific to individual countries. This Review summarises causes of excessive mortality, interventions with proven survival benefit, and gaps in knowledge and practice that contribute to the ongoing high death toll from cryptococcal meningoencephalitis. TRANSLATIONS: For the Vietnamese and Chichewa translations of the abstract see Supplementary Materials section.
Topics: Amphotericin B; Antifungal Agents; Cryptococcosis; Databases, Factual; Deoxycholic Acid; Drug Combinations; Drug Therapy, Combination; Fluconazole; Flucytosine; Humans; Meningoencephalitis
PubMed: 33872594
DOI: 10.1016/S1473-3099(20)30771-4 -
The Laryngoscope Mar 1978As a serendipitous by-product of polio virus research, a highly fatal amoebic meningoencephalitis was recognized in animals. The causative microorganisms, contaminants... (Review)
Review
As a serendipitous by-product of polio virus research, a highly fatal amoebic meningoencephalitis was recognized in animals. The causative microorganisms, contaminants of the viral cultures, were identified as small soil amoebae. These organisms, previously considered non-pathogenic, are prevalent throughout the world. Based on animal studies, the original investigators suggested the possibility of a similar disease in humans. Seven years later, human cases of amoebic meningoencephalitis were reported from widely separated areas of the world. Since 1965, a total of 79 cases have been reported. The literature of primary amoebic meningoencephalitis is presented. The history of the discovery and elucidation of this disease is reviewed. The 79 cases reported in the world literature are divided into two groups, those diagnosed retrospectively after reviewing previous deaths from meningoencephalitis, and those diagnosed at the time of the illness. The classification, morphology, pathogenicity, virulence and distribution of pathogenic soil amoebae are reviewed. The presenting clinical findings, diagnostic procedures, pathology, and management of this recently recognized, highly fatal, human disease is presented along with a report of a new case. Otolaryngologists should become familiar with this serious disorder with a transnasal portal of entry.
Topics: Amebiasis; Amoeba; Animals; Brain; Child; Hartmannella; Humans; Male; Meningoencephalitis; Soil Microbiology; Virulence; Water Microbiology
PubMed: 342849
DOI: 10.1288/00005537-197803000-00012 -
Clinical Microbiology and Infection :... Apr 2019Encephalitis and meningoencephalitis are severe, sometime life-threatening infections of the central nervous system. Travellers may be exposed to a variety of... (Review)
Review
BACKGROUND
Encephalitis and meningoencephalitis are severe, sometime life-threatening infections of the central nervous system. Travellers may be exposed to a variety of neurotropic pathogens.
AIMS
We propose to review known infectious causes of encephalitis in adults acquired outside Europe, and how to identify them.
SOURCES
We used Pubmed and Embase, to search the most relevant publications over the last years.
CONTENT
Microbiologic tests and radiological tools to best identify the causative pathogen in travellers presenting with encephalitis and ME are presented in this narrative review, as well as a diagnostic approach tailored to the visited area and types of exposures.
IMPLICATIONS
This review highlights the diagnostic difficulties inherent to exotic causes of central nervous system infections, and attempts to guide clinicians with respect to which microbiological tests to consider, in addition to brain MRI, when approaching a returning traveller presenting with encephalitis.
Topics: Adult; Animals; Bacteria; Brain; Europe; Fungi; Humans; Magnetic Resonance Imaging; Meningoencephalitis; Parasites; Parenchymal Tissue; Travel; Travel-Related Illness; Viruses
PubMed: 30708123
DOI: 10.1016/j.cmi.2019.01.008 -
Przeglad Epidemiologiczny 1980
Topics: Adolescent; Adult; Child; Child, Preschool; Humans; Infant; Meningoencephalitis; Middle Aged; Poland
PubMed: 7367670
DOI: No ID Found -
Pediatric Clinics of North America Aug 1985Primary amebic meningoencephalitis is a disease caused by the free-living amebae of the genera Naegleria or Acanthamoeba. The clinical course may result in death a few... (Review)
Review
Primary amebic meningoencephalitis is a disease caused by the free-living amebae of the genera Naegleria or Acanthamoeba. The clinical course may result in death a few days after presentation or it may be insidious, with progressive neurologic deterioration and death after a chronic course. This article describes the organisms involved, the clinical course, pathology, diagnosis, and treatment of the disease.
Topics: Adolescent; Adrenal Cortex Hormones; Amebiasis; Amoeba; Amphotericin B; Blood; Cerebrospinal Fluid; Child; Female; Humans; Meningoencephalitis; Swimming Pools; Water Microbiology
PubMed: 3895137
DOI: 10.1016/s0031-3955(16)34860-x -
Journal of Veterinary Diagnostic... Sep 2021A 3-y-old, female Quarter Horse with a history of acute neurologic signs was found dead and was submitted for postmortem examination. Areas of petechial and ecchymotic...
A 3-y-old, female Quarter Horse with a history of acute neurologic signs was found dead and was submitted for postmortem examination. Areas of petechial and ecchymotic hemorrhage were present on cross-sections of the cerebrum, cerebellum, and brainstem. Histologic examination of the brain revealed severe, purulent meningoencephalitis and vasculitis with a myriad of intralesional gram-positive cocci. was identified from formalin-fixed, paraffin-embedded tissue obtained from sites with active lesions by PCR and nucleotide sequencing of bacterial 16S ribosomal RNA. should be considered as a cause of meningoencephalitis in a horse.
Topics: Animals; Brain; Female; Horse Diseases; Horses; Meningoencephalitis; RNA, Ribosomal, 16S; Streptococcus
PubMed: 34109867
DOI: 10.1177/10406387211023465 -
British Medical Journal Jul 1975A patient was admitted to hospital with an apparent psychiatric disturbance. When she became stuporous the cerebrospinal fluid was cultured but proved sterile. The latex...
A patient was admitted to hospital with an apparent psychiatric disturbance. When she became stuporous the cerebrospinal fluid was cultured but proved sterile. The latex test showed that serum was positive for cryptococcal antigens, and cryptococcal meningoencephalitis was diagnosed. Amphotericin B was given but when she developed a toxic reaction it was replaced by flucytosine. She responded well to flucytosine alone and no side effects appeared on continued treatment. Cryptococcal meningitis may present as a psychiatric disturbance, and serological tests are invaluable aids to diagnosis.
Topics: Adult; Cerebrospinal Fluid; Cryptococcosis; Cryptococcus neoformans; Female; Flucytosine; Humans; Latex Fixation Tests; Meningoencephalitis; Mental Disorders
PubMed: 1095135
DOI: 10.1136/bmj.3.5975.75 -
The Lancet. Infectious Diseases Mar 2015Cryptococcosis is a fungal disease caused by Cryptococcus neoformans and Cryptococcus gattii. By inhalation and subsequent pulmonary infection, it may disseminate to the... (Review)
Review
Cryptococcosis is a fungal disease caused by Cryptococcus neoformans and Cryptococcus gattii. By inhalation and subsequent pulmonary infection, it may disseminate to the CNS and cause meningitis or meningoencephalitis. Most cases occur in immunosuppressed hosts, including patients with HIV/AIDS, patients receiving immunosuppressing drugs, and solid organ transplant recipients. However, cryptococcosis also occurs in individuals with apparently healthy immune systems. A growing number of cases are caused by C gattii, with infections occurring in both immunosuppressed and immunocompetent individuals. In the majority of documented cases, treatment of C gattii infection of the CNS requires aggressive management of raised intracranial pressure along with standard antifungal therapy. Early cerebrospinal fluid evacuation is often needed through placement of a percutaneous lumbar drain or ventriculostomy. Furthermore, pharmacological immunosuppression with a high dose of dexamethasone is sometimes needed to ameliorate a persistently increased inflammatory response and to reduce intracranial pressure. In this Grand Round, we present the case of an otherwise healthy adolescent female patient, who, despite aggressive management, succumbed to C gattii meningoencephalitis. We also present a review of the existing literature and discuss optimum clinical management of meningoencephalitis caused by C gattii.
Topics: Adolescent; Anti-Inflammatory Agents; Antifungal Agents; Brain; Cryptococcosis; Cryptococcus gattii; Female; Humans; Intracranial Hypertension; Magnetic Resonance Imaging; Meningoencephalitis; Microbiological Techniques; Microscopy; Radiography
PubMed: 25467646
DOI: 10.1016/S1473-3099(14)70945-4 -
Medecine Et Maladies Infectieuses Oct 2017
Topics: Aged; Female; Humans; Influenza B virus; Influenza, Human; Male; Meningoencephalitis; Middle Aged
PubMed: 28690035
DOI: 10.1016/j.medmal.2017.06.001 -
Neurology May 2013Skin rash and depigmentation are common in patients with meningitis and meningoencephalitis. Skin changes must always be evaluated in conjunction with the clinical... (Review)
Review
Skin rash and depigmentation are common in patients with meningitis and meningoencephalitis. Skin changes must always be evaluated in conjunction with the clinical symptoms, signs, brain imaging, and laboratory abnormalities, particularly the features of the CSF pleocytosis. The purpose of this montage is to help the clinician identify a specific etiologic agent as early as possible.
Topics: Exanthema; Humans; Meningitis; Meningoencephalitis
PubMed: 23650233
DOI: 10.1212/WNL.0b013e3182918cda