Showing 5 results for Meningitis
Seyed Mohammad Alavi , Shahram Shokri ,
Volume 3, Issue 1 (1-2012)
Abstract
Background: Previous studies have demonstrated the value of serum procalcitonin (PCT) as a marker of bacterial infection, as well as the rapid decrease in its concentration with appropriate antibiotic treatment. The aim of this study was to determine the variation in serum PCT levels over time during the treatment of acute bacterial meningitis (ABM) in adults.
Methods: In this prospective analytical study, 36 acute meningitis patients (26 males and 10 females) with mean age of 38.4±20.1 years were studied. Among them, 17 patients with fever and neck stiffness and CSF profiles consistence, ABM was treated by appropriate antibiotic regimen. We measured PCT serum levels before and after 24 and 72 hours after initiation of treatment. Decrease in the body temperature and feeling of well being were the clinical criteria for treatment response. The data were collected and analyzed.
Results: Serum level of PCT in the beginning of treatment, 24 and 72 hours after initiation of treatment was 2.58±4.62, 2.50±4.6 and 1.52±3.03 ng/ml, respectively. Difference in PCT initially and 24 h later was 0.044±0.08 (p=0.025) and after 72 h was 1.74±2.92 (p=0.013). The mean of PCT level was greater in patients not improving (5.34±4.42 vs. 2.08±3.46).
Conclusion: Although decreasing PCT was low in 24 h after treatment, this decrement is more significant after 72 h. PCT serum level may be used as a follow up of treatment response in ABM.
Davood Yadegarynia, Latif Gachkar, Alireza Fatemi, Alireza Zali, Niloufar Nobari, Mitra Asoodeh, Zahra Parsaieyan,
Volume 5, Issue 3 (5-2014)
Abstract
Background: The rates of postneurosurgical infections, particularly meningitis and the most common pathogens have been reported variable during the recent years. The aim of this research was to determine the prevalence of postneurosurgical meningitis and its current spectrum of infectious agent.
Methods: In a descriptive study, the postneurosurgical patients’ cerebrospinal fluid was cultured on blood and MacConkey agar plates and evaluated at Microbiology Laboratory. 55 significant isolates as species level were recognized by bacteriological techniques.
Results: Acinetobacter baumannii (A. baumannii) was the most common organism [29(52.7%)], followed by Klebsiella pneumoniae [8(14.5%)], Methicillin-resistant Staphylococcus aureus [6(10.9%)], Staphylococcus saprophyticus [5(9.1%)], Pseudomonas aeruginosa [3(5.5%)], Methicillin-sensitive Staphylococcus aureus [3(5.5%)], and Enterococcus faecalis [1(1.8%)]. The majority of carbapenem-resistant isolates were A. baumannii isolates.
Conclusion: Our research revealed that the rate of postneurosurgical meningitis due to carbapenem-resistant A. baumannii had increased. This finding emphasized the importance of preventive strategies against A. baumannii. The changing pattern of infectious agents in postneurosurgical meningitis over time suggests the necessity of other studies.
Timothy Cochrane, Gurpreet Singh Ranger,
Volume 8, Issue 2 (2-2017)
Abstract
Background: Occult dural injuries are rare and can occur as a result of major or minor head injury. These injuries usually manifest with cerebrospinal fluid rhinorrhea alone, or with meningitis and cerebral abscess, sometimes many years after the original injury.
Case presentation: We present a case of occult dural injury with endocranial complications which occurred in a 34 year old man, with a history of head injury forty-three years ago. The patient presented with a triad of findings; meningitis, CSF rhinorrhoea and pneumocephalus. He was managed conservatively with intravenous antibiotics and observation and made a full recovery. The presence of acute endocranial symptoms and particularly these three findings in a patient with a previous history of head injury, no matter how long it had been should raise suspicion of the presence of an occult dural injury.
Conclusion: It need to retain a high index of suspicion for occult dural injury in patients who present with endocranial symptoms of unknown origin, especially if there is a previous history of head injury.
Farzin Sadeghi, Masoumeh Talebi-Nesami, Rahim Barari-Savadkouhi, Ali Bijani, Elahe Ferdosi-Shahandashti, Yousef Yahyapour,
Volume 8, Issue 2 (2-2017)
Abstract
Background: Enterovirus (EV) infections are one of the most common causes of aseptic meningitis in pediatrics. To diagnose EV meningitis, virus isolation in cell cultures is often time consuming and lacks sensitivity to be of clinical relevance. This makes the virus culture results difficult to interpret. The rapid detection of EVs in cerebrospinal fluid (CSF) by molecular diagnostic techniques may improve the management of patients with aseptic meningitis. The purpose of the present study was to develop a more convenient and sensitive alternative technique to viral culture. The current investigation aimed to explore the prevalence of EVs in CSF of children with suspected aseptic meningitis in northern Iran, between June 2014 and March 2015 via the one-step real-time RT-PCR technique.
Methods: A single center cross-sectional study was carried out on 50 children suspected with aseptic meningitis, aged 6 months to 13 years. The presence of EV RNA in CSF samples was screened by the use of qualitative one-step real-time RT-PCR.
Results: Enteroviral RNA was detected in 9 (18%) subjects using the one-step real-time RT-PCR assay. There was significant difference between EV positive and negative subjects regarding mean age (P=0.023), mean lymphocyte percentage (P=0.001) and mean glucose levels in CSF (P=0.037). The disease onset data indicate that the majority of EV meningitis occurred in the summer.
Conclusion: This study provides the first data on the prevalence and epidemiology of EV infections in children with suspected aseptic meningitis in northern Iran.
Mehdi Zeinalizadeh, Roya Yazdani, Mohammad Mehdi Feizabadi, Maryam Shadkam, Arash Seifi, Seyed Ali Dehghan Manshadi, Alireza Abdollahi, Mohammadreza Salehi,
Volume 13, Issue 3 (6-2022)
Abstract
Background: Post-neurosurgical meningitis is a significant cause of mortality and morbidity. In this study we aimed to compare the differences of clinical, laboratory features and outcomes between the post-neurosurgical meningitis caused by gram-negative bacilli (GNB) and gram-positive cocci (GPC).
Methods: Cases of post-neurosurgical meningitis (with positive CSF culture) were included. After classifying patients as GNB and GPC groups, clinical and paraclinical data were compared.
Results: Out of 2667 neurosurgical patients, CSF culture was positive in 45 patients. 25 (54.3%) were GNB, 19 (41.3%) GPC. The most common microorganisms were Klebsiella pneumoniae (n=14, 31.1%), Coagulase negative staphylococcus (n=8, 17.8%), Staphylococcus aureus (n=6, 13.3%), Acinetobacter baumannii (n=4, 8.9%), Pseudomonas aeruginosa (n=2, 4.4%), and Escherichia coli (n=2, 4.4%). There were no correlation between CSF Leakage, Surgical site appearance, presence of drain, Age and GCS between two groups (P=0.11, P=0.28, P=0.06, P=0.86, P=0.11 respectively). The only different laboratory indexes were ESR (86.8 mm/h vs. 59.5 mm/h, P=0.01) and PCT (13.1 ng/ml vs. 0.8 ng/ml, P=0.02) which were higher in GNB cases. 20% (n=5) of patients with GNB meningitis received preoperative corticosteroid, while none of GPC cases received (P=0.03). The median length of hospitalization for GNB and GPC cases was 56 and 44.4 days respectively (P=0.3).
Conclusion: The GNB antibiotic coverage should be designed more carefully in post-neurosurgical meningitis especially in patients with recent corticosteroid therapy and elevated ESR and procalcitonin.
