جستجوی مقالات مرتبط با کلیدواژه « Meningitis » در نشریات گروه « پزشکی »

 Cryptococcal infection is a significant pathogen causing meningitis, often manifesting early with psychiatric abnormalities. Due to the lack of other specific symptoms, these behavioral changes are frequently misattributed to other mental disorders or overlooked, leading to delays in diagnosis. This article reports on the diagnosis and treatment process of a patient with cryptococcal meningitis and summarizes the abnormal behavior in terms of mental and behavioral aspects of cryptococcal meningitis patients, providing a reference for the diagnosis and treatment of cryptococcal meningitis.

 We present a case of cryptococcal meningitis where the initial abnormal behaviors were attributed to stress, resulting in a lack of emphasis on cryptococcal treatment and subsequent failure of standard anti-infective therapy. Ultimately, we discovered abnormalities through cerebrospinal fluid examination and conducted targeted tests for Cryptococcus, resulting in a clear diagnosis and timely adoption of appropriate treatment measures. The patient's condition improved, and they were discharged.

 It is crucial for clinicians to deepen their understanding of cryptococcal meningitis. When encountering patients with unexplained fever accompanied by psychiatric and behavioral changes, a high suspicion for cryptococcal infection should be maintained.

 Pneumococcus causes various infections, some of which are life-threatening, including pneumonia, meningitis, otitis media, bacteremia, and sinusitis. Currently, more than 95 serotypes have been identified.

 The purpose of this study was to isolate and determine Streptococcus pneumoniae serotypes from the cerebrospinal fluid (CSF) of children with suspected meningitis using the multiplex polymerase chain reaction (PCR) method.

 A total of 864 CSF samples were taken from children with suspected meningitis who were admitted to Imam Ali Hospital of Karaj for one year (January 2019 to January 2020). To collect positive S. pneumonia samples, the lytA gene was traced using specific primers and PCR techniques.

 The results of this study indicated that only 16 patients have a pneumococcal infection (1.85%), of whom 50% have encapsulated pneumococci. Furthermore, serotypes 38 (12.5%), 7F (12.5%), 23F (25%), and 6A/B (50%) were the most common serotypes causing invasive pneumococcal infections in the included samples.

 Among the techniques for serotyping S. pneumoniae, the multiplex PCR technique is known as a fast, easy, and low-cost method that can serotype a large number of samples. The results also showed that the 13-valent pneumococcal conjugate vaccine can cover at least 50% of the strains that cause invasive pneumococcal diseases (IPDs), which are life-threatening, especially in children. Therefore, it is suggested that the healthcare administrators of Iran design and implement a public vaccination program.

Brucellosis is a common zoonotic infection caused by the bacterial genus Brucella. It is one of the infectious diseases transmissible between humans and animals, and its clinical manifestations are very diverse and misleading. One of these manifestations is central nervous system involvement, which occurs in various forms. Better and more accurate identification of these diverse clinical manifestations can help physicians in the timely diagnosis and treatment of the disease.

In this study, we introduce a sixteen-year-old patient who complained of fever, low back pain, dizziness, and headache for two months. A detailed history of our patient revealed previous contact with sheep and consumption of unpasteurized milk. Further clinical tests confirmed the diagnosis of Brucella meningitis in this patient.

Patients with brucellosis can show a wide variety of clinical symptoms, and knowing these different clinical forms can help physicians in the early diagnosis of the disease. In a country like Iran, where brucellosis is endemic, any patient who presents with complex and unexplained neurological complaints, especially those with a history of brucellosis, should be considered for neurobrucellosis.

Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse myelitis, cerebellitis, Guillain-Barre syndrome, and cranial or peripheral neuritis most commonly in immunocompromised patients. These clinical manifestations may occur alone or accompanied by infectious mononucleosis. Usually, EBV encephalitis occurs infrequently and with non-specific symptoms. Herein, we report two patients: a 24-year-old female with generalized tonic-clonic fever and seizures for ten days. The other was a 28-year-old male with repeated fever, headache, 4-day amnesia, and symptoms of meningeal irritation. Since the physical examination results were not very helpful, the definite diagnosis was achieved by sampling, analysis, and polymerase chain reaction for the cerebrospinal fluid. Our patients had a direct EBV invasion of the CNS and were affected by Epstein-Barr virus encephalitis, confirmed by their clinical test results as a positive polymerase chain reaction of cerebrospinal fluid. The PCR results were negative for a panel of microorganisms that cause bacterial meningitis in the CSF, but positive for EBV. Image findings also did not show any significant results. Patients treated with acyclovir and precision control at the relative center with favorable outcomes. Acyclovir possibly will lessen viral replication. Finally, despite obtaining negative test results of EBV infection, every therapeutic effort should be undertaken and maintained continuous attention.

Children's meningitis is associated with many complications and deaths. Therefore, it is critical to develop reliable and available methods to predict these complications, diagnose them in a timely manner, and prevent the progression of complications. This study aimed to investigate the findings of computed tomography (CT) scan in patients with meningitis and evaluate its association with prognosis.

In this cross-sectional analytical study, we investigated the clinical files of 100 patients with meningitis (preferably bacterial meningitis) in Tabriz Children's Hospital, Iran between 2013-2017. The results of CT scan and disease complications were recorded and analyzed by statistical software.

Common symptoms identified in the patients included fever (88%), nausea and vomiting (36%), headache (27%), and convulsions (25%). Also, the results of CT scan included cerebral effusion (16%), hydrocephalus (7%), diffuse cerebral edema (7%), and cerebral atrophy (4%). Statistical analysis indicated a statistically significant association between the complications of meningitis (learning disorder, epilepsy, and hearing disorder) and the results of CT scan (cerebral effusion, diffuse cerebral edema, and hydrocephalus).

CT scan can be used as an early diagnostic and prognostic method in children with meningitis.

Meningitis is associated with many complications and deaths, and the lack of diagnostic methods and accurate prognosis is one of the important challenges in this field. Therefore, identifying and introducing accurate and cheap methods for predicting these complications and taking early measures to prevent the development of complications and treatment can be beneficial. The results of the present study showed that CT scan can be used as an early diagnostic and prognostic method in children with meningitis.

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).

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.

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).

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.

More than 20 years after the introduction of the mumps vaccine in the Iranian national vaccination program, there are concerns about meningitis induced by the Measles, Mumps, and Rubella (MMR) vaccine. The aim of this study is to virologically determine the incidence of MMR-induced meningitis in Mashhad, Iran.

This is an observational prospective study during which all children who were admitted (in all hospitals of Mashhad) under the clinical suspicion of meningitis and had a history of MMR vaccination during the past 45 days were included. A polymerase chain reaction (PCR) test for mumps virus and enterovirus (EV) was done on cerebrospinal fluid (CSF) samples with pleocytosis.

During 13 months of study, 55 children were hospitalized for suspicion of meningitis and had a history of recent MMR shots (94% presented with a febrile seizure). Meningitis was confirmed by CSF pleocytosis in 23 (2 bacterial and 21 aseptic) cases (44.2%). All incidents of meningitis had occurred after the first MMR. The incidence of any kind of aseptic meningitis, EV meningitis, and mumps meningitis during 45 days after the first MMR was, respectively, 19.9, 5.71, and 1.9 per 100,000 cases. The number of meningitis cases during the first 3 months after MMR was, respectively, 4.5 and 2 times more than the cases that occurred during the 3 months before and 3-6 months after MMR.

Around 40% of all cases of meningitis (between 4 and 43 months of age) occur during the first 3 months after the first MMR vaccination (12-15 months). The disproportionate increase of aseptic meningitis after the first MMR is strong epidemiologic evidence in favor of mumps vaccine induced meningitis.

Meningitis can quickly become a life-threatening sickness and therefore is considered a medical emergency. Viruses, after bacteria, are known as main pathogens involved in meningitis; therefore, we investigated the prevalence of viral meningitis worldwide and evaluated the clinical and preclinical features for rapid detection of viral meningitis. The results showed that the most prevalent viruses in viral meningitis are Enterovirus, Coxaci, Tick-borne encephalitis virus, Herpesviridae family; and the most prevalent viruses in aseptic meningitis are Echovirus, Enterovirus, Coxaci and HSV. The findings revealed differences in the prevalence of various viruses in these two types of meningitis, even though there was no significant difference in clinical manifestations between viral and bacterial meningitis. This indicates the importance of laboratory diagnostic methods for discriminating between these two types of meningitis.

Central nervous system involvement by SARS-CoV-19 appears to be very rare in neonates. We report a case of viral meningitis in a neonate admitted to Kerman Afzalipour Hospital in Southeastern Iran.

The patient was a 15-day-old neonate who presented with lethargy, fever, and poor feeding the day before admission. After the initial evaluation and experimental treatment, viral meningitis was diagnosed with SARS- CoV-19 by polymerase chain reaction (PCR) analysis of cerebrospinal fluid. Empirical treatment was done with antibiotics and supportive care. After viral meningitis was confirmed, the antibiotics were discontinued. In a follow-up two weeks later, the neonate had a good condition with no particular problem.

This report is a case of SARS-CoV-2 meningitis in a neonate. Therefore, if there is epidemiological evidence, the central nervous system involvement due to this virus should also be considered in neonates.

Identifying meningitis-causing bacteria play an important role in selecting the appropriate antibiotic vaccine and reducing the complications of meningitis. The present study aimed to identify the most common bacteria causing meningitis in patients referred to Afzalipour Hospital in Kerman.

In this cross-sectional study, 60 patients have participated. A 3-5 ml of cerebrospinal fluid specimens were obtained from each patient. Traditional and molecular methods identified bacterial agents.

Twenty-eight females and thirty-two males participated in the study. Bacterial agents were recovered from 33.3% of the samples. Streptococcus pneumonia (65%), Staphylococcus epidermidis (10%), Klebsiella (10%), Enterococcus (5%), Escherichia coli (5%) and cocci gram-positive (5%) were the microbial agents identified in this study. In the present study, the detection rate of bacteria was low. Streptococcus pneumonia, especially the 18CFBA serotype, was the most common bacteria.

 Hospitals niche as a source and repository for microbial infections are playing a significant role in the health of hospitalized patients. Bacteria are playing an essential role in human and animal blood infections and meningitis. The prevalence of bacterial agents and their susceptibility patterns are fundamental goals of current research.

 Sampling was carried out in two main educational hospitals, Sari City, Iran, from April 2016 to March 2017. After traditional biochemical tests, susceptibility testing of isolates was performed taking advantage of Kerby-Bauer. Subsequently, the frequency of related bacterial agents to meningitis and bacteremia and their susceptibility patterns were analyzed.

 Frequencies of bacterial isolates in Bouali and Imam Hospitals for meningitis (1.9%, 3.5%), bacteremia (31.9%, 26.3%), and urinary tract infection (UTI) were screened (66.2%, 70.1%). Staphylococcus aureus (41.7%) and Streptococcus pneumoniae (45%) were the highest isolates of meningitis in the mentioned hospital. These values to bacteremia were as follows: Gram-negative Staphylococci (30.7%), Escherichia coli (30%). Coagulase- negative Staphylococci isolates recovered from meningitis were completely sensitive to ciprofloxacin and Gentamycin. In addition, P. aeruginosa, Klebsiella and Acinetobacter spp showed higher than 90% resistance against ampicillin. E. coli, Klebsiella spp and S. aureus showed 100% resistance to amoxiclav; while Klebsiella spp were completely sensitive to amoxiclav.

 Given the bacterial isolates detected from hospital wards and following the findings prompt diagnosis method is essential to control infections and the proper use of effective antibiotics.

The novel corona virus infection involve both Central & Peripheral Nervous System. Some of the presentations include: acute cerebrovascular disease, impaired consciousness, transverse myelitis, encephalopathy, encephalitis and epilepsy. Our patient was 78 year –old man with dementia and diabetic nephropathy which was admitted two times for possibly COVID-19 infection. At the first hospitalization, the patient is treated with hydroxychloroquine and kaletra based on clinical symptoms and initial laboratory findings due to suspicion of COVID-19. After the negative RT-PCR test of nasopharyngeal sample for COVID-19 and evidence of aspiration pneumonia in CT scan, the patient was discharged with oral antibiotics. Five weeks later, he was rehospitalized with loss of consciousness, fever and hypoxemia in physical exam he had neck stiffness in all directions, So the central nervous system (CNS) infection was suspected, the cerebrospinal fluid (CSF) sample was in favor of aseptic meningitis and second RT-PCR test of nasopharyngeal sample for COVID-19 was positive but Brain MRI just showed small vessel disease without evidence of encephalitis. In the second hospitalization, he had acute renal failure, which was treated with supportive care, and also suffered from pulmonary embolism with cavitary lesions in his lungs. Meningitis with pulmonary embolism and acute renal failure have not yet reported. Our patient is the first one, so we decided to share it. This case showed different presentation of COVID-19 without typical lung involvement. So we must pay attention to any sign & symptoms in a patient suspected of having a COVID-19.

The major concerns related to the Endoscopic Endonasal Transsphenoidal (EET) surgery for sellar and suprasellar tumors include the risks of post-operative Cerebrospinal Fluid (CSF) leak, leading to morbidity and at times mortality, due to severe meningitis. Time is required to develop possible preventive measures that can reduce the risk of post-operative CSF rhinorrhea. The present study aimed to evaluate the effects of pre-operative CSF diversion by lumbar drainage in EET tumor surgeries on preventing post-operative CSF leak and its effect on the length of hospital stay.

 We conducted a prospective study on 20 patients with a pituitary tumor that underwent EET surgery between October 2018 and December 2019. Preoperative Lumbar Drain (LD) was inserted after induction in all explored patients. The tumor was excised with continuous intraoperative CSF drainage. Post-operatively, the LD was kept for 3 days and clamped for the next 24 hours. If no evidence of CSF rhinorrhea was present, it was removed. Complications related to CSF drainage, CSF leak, and hospital stays were evaluated.

Our study population consisted of 13(65%) men and 7(35%) women, with Mean±SD age of 39.8±10.71 years. The most commonly presented complaint was visual disturbance (60%) and the least common symptom was urinary disturbance (5%). The intra-operative leak was detected in 9(45%) patients, while the post-operative leak was present in only 1(5%) patient. LD blockage significantly contributed to post-operative CSF leak (P=0.001). The Mean±SD hospital stay in the post-operative period was 8.85±3.22 days with 65% of patients having a hospital stay of <7 days. Other post-operative complications (e.g. diabetes insipidus, electrolyte imbalance, and hormonal disturbances) were mainly responsible for prolonged post-operative hospital stay (P=0.001).

Pre-operative LD, apart from helping to reduce the incidence of post-operative CSF leak, is not associated with an overall increased post-operative hospital stay.

Meningitis is classified as a medical emergency where the identification and early treatment of bacterial meningitis can eliminate serious consequences, such as hearing loss, memory problems, learning disabilities, brain damage, seizures, and death. The purpose of this study was to investigate the incidence and geographical distribution of meningitis using Geographic Information system (GIS) and to predict its incidence in Iran in 2021.

This was a descriptive analytical study. Information on pertussis was obtained from the Center for Communicable Diseases Control during 2010-2015. In the next step, ArcGIS 9.3 was used to prepare geographic maps of the disease incidence and frequency. Then, the disease prediction map was drawn using the Raster Calculator tool.

The results showed that the highest incidence of meningitis during 2010-2015 was in Qazvin, Qom, and Kurdistan provinces. The incidence of meningitis in Iran increased from 9.77 in 2010 to 10.33 in 2015. Based on the modeling results for Iran, Qom, Qazvin, Kurdistan, Hamadan, and Mazandaran provinces with 78.89%, 74.68%, 70.07%, 43.97%, and 22.93% of their areas (Km2) are at high risk for meningitis in the coming years, respectively.

According to the results of this study, it can be concluded that Qom, Qazvin, Kurdistan, Hamedan, and Mazandaran provinces are at risk of the disease. Monitoring vaccination in high-risk groups can partially prevent the incidence of the disease in these areas.

Cryptococcal infection is a chronic opportunistic infection in patients with the Human Immunodeficiency Virus (HIV). A rare case of cryptococcal lymphadenitis is presented here in a 27-year-old woman with an enlarged cervical lymph node. Fine needle aspiration from the involved lymph nodes showed variable-sized, rounded yeast cells surrounded by halos with a prominent capsule. Early diagnosis by fine-needle aspiration is essential and reduces morbidity and mortality.