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Infectious Disease Clinics of North... Mar 2018Encephalitis is an uncommon but severe disease characterized by neurologic dysfunction with central nervous system inflammation. Children with encephalitis should... (Review)
Review
Encephalitis is an uncommon but severe disease characterized by neurologic dysfunction with central nervous system inflammation. Children with encephalitis should receive supportive care and empiric therapies for common and treatable causes while prioritizing diagnostic evaluation for common, treatable, and high-risk conditions. Even with an extensive diagnostic workup, an infectious cause is identified in less than half of cases, suggesting a role for postinfectious or noninfectious processes.
Topics: Arboviruses; Brain; Child; Diagnosis, Differential; Encephalitis; Enterovirus; Female; Herpes Simplex; Humans; Male; Meningoencephalitis; Myelitis; United States
PubMed: 29224854
DOI: 10.1016/j.idc.2017.10.007 -
Clinical Microbiology and Infection :... Apr 2019
Topics: Autoimmune Diseases of the Nervous System; Central Nervous System; Clinical Laboratory Techniques; Diagnosis, Differential; Encephalitis; Humans; Meningoencephalitis
PubMed: 30703529
DOI: 10.1016/j.cmi.2019.01.013 -
Veterinary Journal (London, England :... Feb 2019Meningoencephalomyelitis of unknown origin (MUO) encompasses a group of idiopathic, most likely immune mediated, inflammatory central nervous system diseases that cause... (Review)
Review
Meningoencephalomyelitis of unknown origin (MUO) encompasses a group of idiopathic, most likely immune mediated, inflammatory central nervous system diseases that cause clinical, diagnostic and treatment challenges to veterinary neurologists. Clinical criteria for obtaining this presumptive diagnosis are currently available, and multiple treatment protocols have previously been investigated in small (prospective or retrospective) case series. As this group of diseases is considered fatal if left untreated, the identification of clinically usable prognostic indices could be of great value. This review provides an overview of recent developments in the clinical presentation, diagnostic findings, possible prognostic factors, treatment and outcome in dogs diagnosed with MUO.
Topics: Animals; Cyclosporine; Cytarabine; Dog Diseases; Dogs; Immunosuppressive Agents; Magnetic Resonance Imaging; Meningoencephalitis; Prednisolone; Prognosis; Treatment Outcome
PubMed: 30825893
DOI: 10.1016/j.tvjl.2018.12.007 -
The New England Journal of Medicine Jun 2014A 14-year-old boy with severe combined immunodeficiency presented three times to a medical facility over a period of 4 months with fever and headache that progressed to...
A 14-year-old boy with severe combined immunodeficiency presented three times to a medical facility over a period of 4 months with fever and headache that progressed to hydrocephalus and status epilepticus necessitating a medically induced coma. Diagnostic workup including brain biopsy was unrevealing. Unbiased next-generation sequencing of the cerebrospinal fluid identified 475 of 3,063,784 sequence reads (0.016%) corresponding to leptospira infection. Clinical assays for leptospirosis were negative. Targeted antimicrobial agents were administered, and the patient was discharged home 32 days later with a status close to his premorbid condition. Polymerase-chain-reaction (PCR) and serologic testing at the Centers for Disease Control and Prevention (CDC) subsequently confirmed evidence of Leptospira santarosai infection.
Topics: Adenosine Deaminase; Adolescent; Agammaglobulinemia; Biopsy; Brain; Cerebrospinal Fluid; DNA, Bacterial; Fever; Headache; Humans; Leptospira; Leptospirosis; Male; Meningoencephalitis; Sequence Analysis, DNA; Severe Combined Immunodeficiency
PubMed: 24896819
DOI: 10.1056/NEJMoa1401268 -
Clinical Infectious Diseases : An... Oct 2022The neurological sequelae of Bacillus anthracis infection include a rapidly progressive fulminant meningoencephalitis frequently associated with intracranial hemorrhage,... (Review)
Review
The neurological sequelae of Bacillus anthracis infection include a rapidly progressive fulminant meningoencephalitis frequently associated with intracranial hemorrhage, including subarachnoid and intracerebral hemorrhage. Higher mortality than other forms of bacterial meningitis suggests that antimicrobials and cardiopulmonary support alone may be insufficient and that strategies targeting the hemorrhage might improve outcomes. In this review, we describe the toxic role of intracranial hemorrhage in anthrax meningoencephalitis. We first examine the high incidence of intracranial hemorrhage in patients with anthrax meningoencephalitis. We then review common diseases that present with intracranial hemorrhage, including aneurysmal subarachnoid hemorrhage and spontaneous intracerebral hemorrhage, postulating applicability of established and potential neurointensive treatments to the multimodal management of hemorrhagic anthrax meningoencephalitis. Finally, we examine the therapeutic potential of minocycline, an antimicrobial that is effective against B. anthracis and that has been shown in preclinical studies to have neuroprotective properties, which thus might be repurposed for this historically fatal disease.
Topics: Anthrax; Bacillus anthracis; Cerebral Hemorrhage; Humans; Meningoencephalitis; Minocycline
PubMed: 36251558
DOI: 10.1093/cid/ciac521 -
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 -
Neurologia Jun 2020
Topics: Female; Humans; Meningoencephalitis; Postpartum Period; Tuberculosis, Meningeal; Tuberculosis, Spinal
PubMed: 29102528
DOI: 10.1016/j.nrl.2017.08.007 -
Revista Da Sociedade Brasileira de... 2022Neurobrucellosis is caused by bacteria of the genus Brucella and is responsible for several clinical manifestations, making diagnosis challenging. The most common route...
Neurobrucellosis is caused by bacteria of the genus Brucella and is responsible for several clinical manifestations, making diagnosis challenging. The most common route of infection is through the consumption of unpasteurized or raw dairy products such as fresh milk, butter, and cheese. As neurological complications can develop chronically, they are frequently misdiagnosed as other infections, such as tuberculosis. This report reviews the clinical manifestations, diagnostic approach, treatment, and prognosis of neurobrucellosis, illustrating a case of chronic intracranial hypertension and meningoencephalitis secondary to brucellosis. The clinical presentation of brucellosis can mimic several systemic diseases, resulting in diagnostic delays and clinical complications. A high degree of suspicion is required, and neurobrucellosis should always be considered in the differential diagnosis of chronic meningitis.
Topics: Brucella; Brucellosis; Diagnosis, Differential; Humans; Meningoencephalitis; Nervous System Diseases
PubMed: 35416876
DOI: 10.1590/0037-8682-0567-2021 -
Clinical Microbiology Reviews Oct 2005The raccoon roundworm, Baylisascaris procyonis, is the most common and widespread cause of clinical larva migrans in animals. In addition, it is increasingly recognized... (Review)
Review
The raccoon roundworm, Baylisascaris procyonis, is the most common and widespread cause of clinical larva migrans in animals. In addition, it is increasingly recognized as a cause of devastating or fatal neural larva migrans in infants and young children and ocular larva migrans in adults. Humans become infected by accidentally ingesting infective B. procyonis eggs from raccoon latrines or articles contaminated with their feces. Two features distinguish B. procyonis from other helminthes that cause larva migrans: (i) its aggressive somatic migration and invasion of the central nervous system and (ii) the continued growth of larvae to a large size within the central nervous system. Typically, B. procyonis neural larva migrans presents as acute fulminant eosinophilic meningoencephalitis. Once invasion of the central nervous system has occurred, the prognosis is grave with or without treatment. To date, despite anthelmintic treatment of cases of B. procyonis neural larva migrans, there are no documented neurologically intact survivors. Epidemiologic study of human cases of neural larva migrans demonstrate that contact with raccoon feces or an environment contaminated by infective eggs and geophagia or pica are the most important risk factors for infection. In many regions of the United States, increasingly large populations of raccoons, with high rates of B. procyonis infection, live in close proximity to humans. Although documented cases of human baylisascariasis remain relatively uncommon, widespread contamination of the domestic environment by infected raccoons suggests that the risk of exposure and human infection is probably substantial. In the absence of early diagnosis or effective treatment, prevention of infection is the most important public health measure.
Topics: Animals; Ascaridida Infections; Ascaridoidea; Eye Diseases; Humans; Larva Migrans; Meningoencephalitis; Raccoons
PubMed: 16223954
DOI: 10.1128/CMR.18.4.703-718.2005 -
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