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Journal of Neurology, Neurosurgery, and... Apr 2006Many bacterial meningitis patients experience neurological or neuropsychological sequelae, predominantly deficits in short-term memory, learning, and attention....
BACKGROUND
Many bacterial meningitis patients experience neurological or neuropsychological sequelae, predominantly deficits in short-term memory, learning, and attention. Neuropsychological symptoms after viral meningitis are observed less frequently. Sleep disturbance has been reported after both viral and bacterial meningitis.
OBJECTIVES
To examine systematically the frequency and extent of sleep disturbance in meningitis patients.
METHODS
Eighty six viral or bacterial meningitis (onset of acute disease at least 1 year previously) patients were examined using two standardised questionnaires (Schlaffragebogen B and the Pittsburgh Sleep Quality Index, PSQI) in conjunction with a standardised neurological examination, and compared to a control group of 42 healthy age-matched volunteers.
RESULTS
Patients after both viral and bacterial meningitis described their sleep as reduced in quality and less restful than that of healthy control subjects; both patient groups had a pathological mean PSQI total score. Impaired sleep scores after meningitis were not correlated to either the Glasgow Coma Scale or the Glasgow Outcome Scale. Moreover, no relationship between residual neurological dysfunction or depressivity and sleep quality was observed.
CONCLUSIONS
Impaired sleep is a long-term consequence of meningitis. Additional, so far undetermined, factors other than the severity of concomitant neurological deficits are responsible for the development of this sequela.
Topics: Acute Disease; Adult; Female; Glasgow Coma Scale; Humans; Male; Meningitis, Bacterial; Meningitis, Viral; Severity of Illness Index; Sleep Wake Disorders; Surveys and Questionnaires; Time
PubMed: 16543543
DOI: 10.1136/jnnp.2005.071142 -
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 -
Developmental Medicine and Child... May 1991
Review
Topics: Child; Chronic Disease; Diagnosis, Differential; Humans; Meningitis, Aseptic; Meningitis, Viral
PubMed: 2065831
DOI: 10.1111/j.1469-8749.1991.tb14905.x -
Public Health Reports (Washington, D.C.... 1999A report of five cases of viral meningitis among adults with children enrolled in a child care center prompted an investigation of risk factors for viral transmission...
OBJECTIVE
A report of five cases of viral meningitis among adults with children enrolled in a child care center prompted an investigation of risk factors for viral transmission from children to adult household members.
METHODS
To determine recent echovirus 30 (E30) infections, the authors conducted a serologic survey. To determine risk factors for infection among adult household members, they conducted a retrospective cohort study using written questionnaires.
RESULTS
Recent E30 infections were found in 84% of children tested, 57% of adult household members tested, and 47% of staff members tested. Infected adults were more likely than infected children to have clinical meningitis. Among adult household members, changing diapers was a risk factor for recent infection. Women who changed > or = 90 diapers per month had a higher infection rate than women who changed fewer diapers; in contrast, men who changed > or = 90 diapers per month had a lower infection rate than men who changed fewer diapers. Handwashing was protective: there was a negative correlation between handwashing after diaper changes and E30 infection among adults with infected children in diapers.
CONCLUSIONS
Because child care centers can be a source of enteroviral infections among adult household members, adults with viral meningitis should be questioned about their children's day care or preschool attendance. The importance of handwashing should be stressed to adults with children in day care.
Topics: Adult; Antibodies, Viral; California; Child; Child Day Care Centers; Child, Preschool; Cohort Studies; Disease Outbreaks; Echovirus Infections; Enterovirus B, Human; Female; Hand Disinfection; Humans; Infant; Infant Care; Male; Meningitis, Viral; Retrospective Studies; Risk Factors; Seroepidemiologic Studies; Severity of Illness Index
PubMed: 10476994
DOI: 10.1093/phr/114.3.249 -
BMJ Case Reports Jul 2014An 18-year-old woman presented with a progressively worsening headache, photophobia feverishness and vomiting. Three weeks previously she had returned to the UK from a...
An 18-year-old woman presented with a progressively worsening headache, photophobia feverishness and vomiting. Three weeks previously she had returned to the UK from a trip to Peru. At presentation, she had clinical signs of meningism. On admission, blood tests showed a mild lymphopenia, with a normal C reactive protein and white cell count. Chest X-ray and CT of the head were normal. Cerebrospinal fluid (CSF) microscopy was normal. CSF protein and glucose were in the normal range. MRI of the head and cerebral angiography were also normal. Subsequent molecular testing of CSF detected enterovirus RNA by reverse transcriptase PCR. The patient's clinical syndrome correlated with her virological diagnosis and no other cause of her symptoms was found. Her symptoms were self-limiting and improved with supportive management. This case illustrates an important example of viral central nervous system infection presenting clinically as meningitis but with normal CSF microscopy.
Topics: Adolescent; Analgesia; Antiemetics; Enterovirus Infections; Female; Fluid Therapy; Headache; Humans; Magnetic Resonance Imaging; Meningitis, Viral; Travel; Treatment Outcome; Vomiting
PubMed: 25035443
DOI: 10.1136/bcr-2014-203733 -
Japanese Journal of Infectious Diseases Jan 2008The purpose of the present study was to compare the incidence of childhood meningitis in regions with fewer than 2,000 inhabitants (rural regions) and regions with more...
The purpose of the present study was to compare the incidence of childhood meningitis in regions with fewer than 2,000 inhabitants (rural regions) and regions with more than 2,000 inhabitants (urban regions) in the prefecture of Achaia in Western Greece during 1991-2005. Included were all 555 children hospitalized for meningitis. The criteria for bacterial meningitis were (i) positive blood/cerebralspinal fluid (CSF) culture, Gram stain, or latex agglutination and/or (ii) increased beta-glucuronidase in CSF. In case of suspected bacterial meningitis, the following findings were considered: compatible clinical and laboratory findings, and whether or not a cure was achieved with antibiotic treatment and finally resulted in negative cultures. In cases of suspected viral meningitis, compatible clinical and laboratory findings were considered, together with observation of a cure without antibiotic treatment. Only 28 of 555 meningitis patients were from rural regions. The incidence per 10,000 children in rural and urban regions, respectively, was as follows: meningitis, 1.13 and 8.99; bacterial meningitis, 0.16 and 2.40; suspected bacterial meningitis, 0.52 and 3.00; and viral meningitis, 0.44 and 3.58. The incidence ratio for bacterial, suspected bacterial, and viral meningitis in urban versus rural regions was 14.85, 5.72, and 8.10, respectively. Only 2 of the 79 cases with a confirmed causative pathogen came from rural regions. In conclusion, compared to those living in urban regions, children living in rural regions are relatively spared from bacterial and viral meningitis.
Topics: Adolescent; Bacteria; Child; Child, Preschool; Glucuronidase; Greece; Humans; Incidence; Infant; Meningitis, Bacterial; Meningitis, Viral; Rural Health; Urban Health
PubMed: 18219135
DOI: No ID Found -
Archives of Disease in Childhood Mar 2015Bacterial conjugate vaccines have dramatically changed the epidemiology of childhood meningitis; viral causes are increasingly predominant, but the current UK...
Bacterial conjugate vaccines have dramatically changed the epidemiology of childhood meningitis; viral causes are increasingly predominant, but the current UK epidemiology is unknown. This prospective study recruited children under 16 years of age admitted to 3 UK hospitals with suspected meningitis. 70/388 children had meningitis-13 bacterial, 26 viral and 29 with no pathogen identified. Group B Streptococcus was the most common bacterial pathogen. Infants under 3 months of age with bacterial meningitis were more likely to have a reduced Glasgow Coma Score and respiratory distress than those with viral meningitis or other infections. There were no discriminatory clinical features in older children. Cerebrospinal fluid (CSF) white blood cell count and plasma C-reactive protein at all ages, and CSF protein in infants <3 months of age, distinguished between bacterial meningitis and viral meningitis or other infections. Improved diagnosis of non-bacterial meningitis is urgently needed to reduce antibiotic use and hospital stay.
Topics: Child; Child, Preschool; Cohort Studies; Female; Humans; Infant; Male; Meningitis, Bacterial; Meningitis, Viral; Prospective Studies; United Kingdom; Vaccines, Conjugate
PubMed: 25256088
DOI: 10.1136/archdischild-2014-306813 -
Neurologia (Barcelona, Spain) Oct 2011our study aims to identify the clinical and epidemiological characteristics of viral meningitis in our environment and observe the differences with age.
INTRODUCTION AND OBJECTIVES
our study aims to identify the clinical and epidemiological characteristics of viral meningitis in our environment and observe the differences with age.
MATERIAL AND METHODS
retrospective study of viral meningitis that required admission to our hospital between 2000 and 2008. We compare characteristics between groups of children (under 15 years) and adults (15 years or older). Results. The viral meningitis prevalent in males, is higher during the summer months and the agent most involved is enterovirus. Children are seen in the hospital with shorter time of onset and their average stay is less. In children, the analytical data show greater systemic disorder, whilst in adults the in the cerebrospinal fluid anomalies are more important.
CONCLUSIONS
the viral meningitis in our environment is more common in males and in summer months. The clinical presentation and prodrome is similar in children and adults, although the average hospital stay is less in children of this age probably because the clinical outcome is shorter. The analytical data show that children have a higher systemic inflammation but lower CSF level, probably because lumbar puncture is performed earlier than in adults. Enteroviruses are common pathogens in both children and adults.
Topics: Adolescent; Adult; Age Factors; Child; Enterovirus; Enterovirus Infections; Female; Hospitals, General; Humans; Male; Meningitis, Viral; Retrospective Studies; Seasons; Sex Factors; Young Adult
PubMed: 21349608
DOI: 10.1016/j.nrl.2010.12.010 -
The Journal of the Louisiana State... 2003The purpose of this paper is to present three case reports of patients who presented to a local hospital in Northern Louisiana with symptoms of viral meningitis and...
The purpose of this paper is to present three case reports of patients who presented to a local hospital in Northern Louisiana with symptoms of viral meningitis and encephalitis. It also updates physicians on the signs and symptoms of persons infected with West Nile virus (WNV), a new and emerging infection in the Western Hemisphere. Beginning in June 2002, persons in Louisiana, particularly the southern part of the state, started presenting to health facilities with symptoms of infection with the WNV. By August 2002, persons in the northern part of the state were also experiencing symptoms that include neurologic presentations of the disease. After completing recommended diagnostic measures for possible infection with flaviviruses, the three cases presented here were positive for viral meningitis/encephalitis. Beginning in June 2002, the state experienced an outbreak of WNV of epidemic proportions. Consequently, clinicians need to be mindful of the symptoms, diagnostic measures, treatment, prevention, and reporting of meningitis/encephalitis.
Topics: Adult; Diagnosis, Differential; Female; Hospitalization; Humans; Louisiana; Male; Meningitis, Viral; Middle Aged; West Nile Fever
PubMed: 12873102
DOI: No ID Found -
Journal of Neurology May 2002To evaluate cognitive outcome in unselected patients with previously diagnosed viral meningitis. (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate cognitive outcome in unselected patients with previously diagnosed viral meningitis.
METHODS
Twenty-one unselected patients were examined neurologically, psychiatrically, and psychometrically 25+/-12 months after the acute stage of viral meningitis. The results were compared with the results of twenty-one healthy controls.
RESULTS
Despite of a very good clinical outcome in the post-meningitis group patients performed significantly worse on tasks concerning non-verbal memory functions (BVRT), attention and speed of cognitive performance (WMS-3) even when there was no sign of parenchymal involvement. Forty percent of the patients were categorised as suffering from mild to moderate cognitive impairment.
CONCLUSIONS
Viral meningitis in adults results in mild cognitive impairment in a significant proportion of patients that is not identified by clinical examination or cognitive screening tests. Nevertheless, even mild deficits in non-verbal learning and cognitive speed might lead to overstrain and handicap in complex situations of daily living and working. We therefore recommend that the neuropsychiatric evaluation of all patients with intracranial infections include neuropsychological testing.
Topics: Adult; Attention; Brain; Cognition Disorders; Female; Follow-Up Studies; Humans; Intelligence; Magnetic Resonance Imaging; Male; Memory Disorders; Meningitis, Viral; Middle Aged; Neuropsychological Tests; Pattern Recognition, Visual; Psychomotor Disorders; Tomography, X-Ray Computed
PubMed: 12021945
DOI: 10.1007/s004150200064