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Clinical Microbiology Reviews Apr 2009Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most... (Review)
Review
Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Worm parasites enter an organism through ingestion of contaminated water or an intermediate host and can eventually affect the central nervous system (CNS). These infections are potentially serious events leading to sequelae or death, and diagnosis depends on currently limited molecular methods. Identification of parasites in fluids and tissues is rarely possible, while images and clinical examinations do not lead to a definitive diagnosis. Treatment usually requires the concomitant administration of corticoids and anthelminthic drugs, yet new compounds and their extensive and detailed clinical evaluation are much needed. Eosinophilia in fluids may be detected in other infectious and noninfectious conditions, such as neoplastic disease, drug use, and prosthesis reactions. Thus, distinctive identification of eosinophils in fluids is a necessary component in the etiologic diagnosis of CNS infections.
Topics: Animals; Central Nervous System Parasitic Infections; Eosinophilia; Helminthiasis; Humans; Meningoencephalitis
PubMed: 19366917
DOI: 10.1128/CMR.00044-08 -
Neurology India 2023
Topics: Humans; Bacillus cereus; Meningoencephalitis
PubMed: 37635561
DOI: 10.4103/0028-3886.383861 -
Internal Medicine (Tokyo, Japan) Feb 2023We herein report a 49-year-old Japanese man with relapsing polychondritis (RP) and aseptic meningoencephalitis. Four years ago, the patient was diagnosed with RP....
We herein report a 49-year-old Japanese man with relapsing polychondritis (RP) and aseptic meningoencephalitis. Four years ago, the patient was diagnosed with RP. Prednisolone (PSL) was started at 30 mg/day, and the symptoms promptly disappeared. However, cognitive impairment gradually appeared from six months before hospitalization. Methylprednisolone pulse therapy was immediately initiated, followed by administration of PSL at 1 mg/kg/day. Intravenous cyclophosphamide was combined with PSL. After treatment, the patient's cognitive impairment clearly improved. In conclusion, RP rarely causes aseptic meningoencephalitis, highlighting the need for prompt and aggressive immunosuppressive therapy.
Topics: Male; Humans; Middle Aged; Polychondritis, Relapsing; Meningoencephalitis; Prednisolone; Cyclophosphamide; Immunosuppression Therapy
PubMed: 35831110
DOI: 10.2169/internalmedicine.9411-22 -
BMC Neurology Dec 2021Depending on geographic location, causes of encephalitis, meningoencephalitis and meningitis vary substantially. We aimed to identify the most frequent causes, clinical... (Observational Study)
Observational Study
BACKGROUND
Depending on geographic location, causes of encephalitis, meningoencephalitis and meningitis vary substantially. We aimed to identify the most frequent causes, clinical presentation and long-term outcome of encephalitis, meningoencephalitis and meningitis cases treated in the Inselspital University Hospital Bern, Switzerland.
METHODS
In this monocentric, observational study, we performed a retrospective review of clinical patient records for all patients treated within a 3-year period. Patients were contacted for a telephone follow-up interview and to fill out questionnaires, especially related to disturbances of sleep and wakefulness.
RESULTS
We included 258 patients with the following conditions: encephalitis (18%), nonbacterial meningoencephalitis (42%), nonbacterial meningitis (27%) and bacterial meningoencephalitis/meningitis (13%). Herpes simplex virus (HSV) was the most common cause of encephalitis (18%); tick-borne encephalitis virus (TBEV) was the most common cause of nonbacterial meningoencephalitis (46%), enterovirus was the most common cause of nonbacterial meningitis (21%) and Streptococcus pneumoniae was the most common cause of bacterial meningoencephalitis/meningitis (49%). Overall, 35% patients remained without a known cause. After a median time of 16 months, 162 patients participated in the follow-up interview; 56% reported suffering from neurological long-term sequelae such as fatigue and/or excessive daytime sleepiness (34%), cognitive impairment and memory deficits (22%), headache (14%) and epileptic seizures (11%).
CONCLUSIONS
In the Bern region, Switzerland, TBEV was the overall most frequently detected infectious cause, with a clinical manifestation of meningoencephalitis in the majority of cases. Long-term neurological sequelae, most importantly cognitive impairment, fatigue and headache, were frequently self-reported not only in encephalitis and meningoencephalitis survivors but also in viral meningitis survivors up to 40 months after acute infection.
Topics: Communicable Diseases; Encephalitis; Humans; Meningitis, Bacterial; Meningoencephalitis; Retrospective Studies
PubMed: 34872509
DOI: 10.1186/s12883-021-02502-3 -
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 -
The Israel Medical Association Journal... Aug 2016
Topics: Adenoviridae; Adenoviridae Infections; Antiviral Agents; Child; Child, Preschool; Humans; Male; Meningoencephalitis
PubMed: 28471592
DOI: No ID Found -
Revista de Neurologia Oct 2017
Topics: Adult; Arachnoid Cysts; Humans; Male; Meningoencephalitis; Syringomyelia; Tuberculoma, Intracranial; Tuberculosis, Central Nervous System
PubMed: 28990650
DOI: No ID Found -
Clinical Microbiology and Infection :... Apr 2019Encephalitis and meningoencephalitis imply inflammation of the brain parenchyma, and comprise many diagnostic entities, such as various infections and causes of... (Review)
Review
BACKGROUND
Encephalitis and meningoencephalitis imply inflammation of the brain parenchyma, and comprise many diagnostic entities, such as various infections and causes of dysimmunity. The cause remains unknown in around 50% of cases.
OBJECTIVES
To summarize the main infectious causes of encephalitis and meningoencephalitis acquired in Europe, and the diagnostic means to identify them.
SOURCES
PubMed, ECDC and WHO websites, personal experience.
CONTENT
The principal infectious causes of encephalitis and meningoencephalitis acquired in Europe in adults are discussed in this review, with special emphasis on the microbiological and imaging diagnostic approaches. The role of electroencephalography in diagnosing encephalitis is also mentioned. Among infections, viruses are more frequent than other pathogen types, and their epidemiology varies according to geographic area. A few bacteria, such as Listeria monocytogenes and Mycobacterium tuberculosis, are also to be considered. In contrast, parasites and fungi are rare encephalitis causes in Europe.
IMPLICATIONS
Identifying the causative pathogen of infectious encephalitis and meningoencephalitis is complex because of the variety of pathogens, the epidemiology of which is determined by geography and environmental factors. Furthermore, despite extensive microbiological testing, many cases of encephalitis remain of unknown origin. Brain magnetic resonance imaging and electroencephalography are useful complementary diagnostic tools, and newer unbiased sequencing technologies might help to fill in the diagnostic gap.
Topics: Adult; Bacteria; Brain; Electroencephalography; Europe; Humans; Magnetic Resonance Imaging; Meningoencephalitis; Parenchymal Tissue; Viruses
PubMed: 30654044
DOI: 10.1016/j.cmi.2018.12.035 -
Japanese Journal of Infectious Diseases Nov 2021The etiology of viral meningoencephalitis is frequently unidentified. Chikungunya virus (CHIKV) and Zika virus (ZIKV) are known to affect the central nervous system and...
The etiology of viral meningoencephalitis is frequently unidentified. Chikungunya virus (CHIKV) and Zika virus (ZIKV) are known to affect the central nervous system and should therefore be considered in the diagnosis of meningoencephalitis, as its outcome may be influenced by the etiologic agent, age, and immunological condition of the patient. In this study, we aimed to determine whether CHIKV and ZIKV were the etiological agents of viral encephalitis in patients with meningoencephalitis admitted to the main hospital of infectious diseases in the city of Salvador, Brazil. Of the 1,049 patients with neurological symptoms who were admitted to the hospital during the study period, 149 were enrolled and 20 (13.34%) tested positive for ZIKV (12%) or CHIKV (1.34%). No specific clinical manifestations were observed to be associated with ZIKV or CHIKV infections. Determination of the etiological agent of meningitis and encephalitis is important for patient management and appropriate treatment.
Topics: Brazil; Chikungunya Fever; Chikungunya virus; Dengue; Humans; Meningoencephalitis; Zika Virus; Zika Virus Infection
PubMed: 33952765
DOI: 10.7883/yoken.JJID.2020.1000 -
Journal of Veterinary Diagnostic... Nov 2021Neuroleptospirosis is a rare disease caused by pathogenic in humans; however, it has not been fully studied in animals. A young wild raccoon dog was found convulsing in...
Neuroleptospirosis is a rare disease caused by pathogenic in humans; however, it has not been fully studied in animals. A young wild raccoon dog was found convulsing in the recumbent position and died the next day. Histologic examination revealed nonsuppurative meningoencephalitis in the cerebrum, cerebellum, midbrain, and medulla oblongata. The lesions consisted of mixed infiltrates of Iba1-positive macrophages and CD3-positive T cells, with a small number of CD79α-positive B cells and myeloperoxidase-positive neutrophils. In the frontal cortex, perivascular cuffs and adjacent microglial nodules were distributed diffusely, especially in the molecular layer. Glial nodules were comprised of Iba1- and myeloperoxidase-positive activated microglia. Immunohistochemistry revealed leptospires in mononuclear cell perivascular cuffs, but not in glial nodules. Neuroleptospirosis was accompanied by -related nonsuppurative interstitial nephritis, pulmonary edema and hemorrhage, and coronary periarteritis, as well as in the small intestine and nonspecific foreign-body granulomas in the lungs and stomach.
Topics: Animals; Immunohistochemistry; Leptospira; Meningoencephalitis; Raccoon Dogs; Toxocara
PubMed: 34672844
DOI: 10.1177/10406387211033583