Community-acquired bacterial meningitis in adults

Schut, Ewout S.; Gans, Jan de; Beek, Diederik van de

doi:10.1136/jnnp.2007.139725

Cited by 64 publications

(39 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Computed tomography (CT) of the brain is indicated to detect brain shift either due to focal space-occuping lesion or severe diffuse brain swelling. The incidence of brain herniation after lumbar puncture in patients with acute bacterial meningitis is less than 1 % 25 . Clinical features can be used to predict patients where an abnormal CT scan is likely.…”

Section: Laboratorial Diagnosismentioning

confidence: 99%

“…Other contraindications for immediate lumbar puncture are septic shock, severe coagulopathy, skin infection at lumbar puncture site, and spinal cord compression 27 . Classic cerebrospinal fluid features to any acute bacterial meningitis are present in most cases of meningococcal meningitis: pleocytosis (usually >1000 cells/mL and >80% of polymorphonuclear, but about 20 % can present less of these values), reduction of glucose levels (lower than 40% of a simultaneously measured serum glucose), and raised protein levels (above 50 mg/dL) 8,25 . A culture showing growth of N. meningitidis is still the gold standard method for the diagnosis of meningococcal meningitis and other acute bacterial meningitis 2,8 .…”

Section: Laboratorial Diagnosismentioning

confidence: 99%

“…Clinical features can be used to predict patients where an abnormal CT scan is likely. The recommended criteria for adult patients with suspected bacterial meningitis who undergo CT of the brain prior to lumbar puncture include: severe immunocompromised state, new-onset seizure, papilledema, abnormal level of consciousness (Glasgow Coma Scale <10), and focal neurological deficit, not including cranial nerve palsies 25,26 . Other contraindications for immediate lumbar puncture are septic shock, severe coagulopathy, skin infection at lumbar puncture site, and spinal cord compression 27 .…”

Section: Laboratorial Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Invasive meningococcal disease

Strelow

Vidal

2013

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Invasive meningococcal disease (IMD) is a major public health issue due to its global distribution, potential of epidemic spread, predominant disease burden in children and adolescents, high case-fatality rates and substantial morbidity [1][2][3] . This disease presents a broad spectrum of manifestations and it is a neurological and clinical emergency that requires prompt recognition and initiation of therapy. In this article, we present a review on the epidemiology, pathophysiology, diagnosis, treatment and prevention of IMD, with focus on its neurological issues. MicrobiologyNeisseria meningitidis (N. meningitidis) is an exclusively human gram-negative diplococcus that has a great genetic variety 1 . Its genetic plasticity and phenotypic diversity are hallmarks of the meningococcus evolution, as this bacteria acquired various genes from other species of Neisseria and also from other bacterias, like Haemophilus spp. The microorganism is a frequent colonizer of the human nasopharynx and oropharynx, but can also be found in other places, like the oral mucosa, the rectum and the urogenital tract . Meningococcal virulence is related to the major outer membrane components: capsular polysaccharide, outer membrane proteins (pili, porins, Opa, Opc, meningococcal iron-acquiring proteins), and lipo-oligosaccharide (endotoxin) [4][5][6] . There are 13 serogroups of N. meningitidis based on different capsular polysaccharide structures, but only six serogroups (A, B, C, W-135, Y and more recently X) cause most life-threatening disease 2,6,7 .Instituto de Infectologia Emílio Ribas, São Paulo SP, Brazil.Correpondence: José Eduardo Vidal; Rua Capote Valente 688 / apto. 78; 05409-002 São Paulo SP, Brasil; E-mail: josevibe@gmail.com ABStrACt Invasive meningococcal disease (IMD) is a major public health and continues to cause substantial mortality and morbidity. Serotype C is the most frequent in Brazil. The clinical spectrum of IMD is broad (meningitis, meningococcemia or both) and the clinical evolution may be unpredictable. Main features associated with mortality are: age higher than 50 years old, seizures, shock, and meningococcemia without meningitis. Blood cultures should be obtained immediately. Lumbar puncture can be performed without previous computed tomography scan (CT) in most cases. Clinical features can be useful to predic patients where an abnormal CT scan is likely. Cerebrospinal fluid (CSF) culture and Gram stain should always be required. Latex agglutination sensitivity is highly variable. Polymerase chain reaction is specially useful when other methods are negative or delayed. Usually ceftriaxone should not be delayed while awaiting CSF study or CT. Dexamethasone can be used in meningococcal meningitis. Early suspicion of IMD and antibiotic in primary care before hospitalization, rapid transportation to a hospital, and stabilization in an intensive-care unit has substantially reduced the case-fatality rate. Vaccines against serotypes A, C, W-135, and Y are available while vaccines against serotype B are expecte...

show abstract

Section: Laboratorial Diagnosismentioning

confidence: 99%

Section: Laboratorial Diagnosismentioning

confidence: 99%

Section: Laboratorial Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Invasive meningococcal disease

Strelow

Vidal

2013

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…However, in some cases, blood glucose is not available at the time that CSF is obtained. CSF glucose is correlated with blood glucose concentrations (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Almeida

Faria

Fontes

et al. 2009

Clinical Chemistry and Laboratory Medicine

View full text Add to dashboard Cite

Background: The differential diagnosis between bacterial and viral meningitis is not easy in some cases. Cerebrospinal fluid (CSF) analysis is essential for establishing this diagnosis. The objectives were to quantitate lactic acid (LA) concentrations in bacterial and viral meningitis, and other central nervous system (CNS) diseases in order to evaluate the diagnostic utility of CSF LA for discriminating bacterial from viral meningitis. Methods: CSF LA was measured in 139 CSF samples from seven groups: viral meningitis with classic CSF; suspicion of viral meningitis with neutrophils in CSF; bacterial meningitis; non-infectious neurological diseases; chronic meningitis; traumatic lumbar puncture (LP) and normal CSF. Results: CSF LA was higher in bacterial meningitis 8.7q5.4 mmol/L compared with viral meningitis (1.9q0.6) and the other groups (p-0.0001). CSF LA in the groups with viral meningitis was not different compared to groups with non-infectious CNS diseases and chronic meningitis. The ability of CSF LA to discriminate bacterial from viral meningitis showed a sensitivity of 80% and specificity of 97%, positive predictive value (PPV) of 94%, and negative predictive value (NPV) of 89%. Conclusions: CSF LA is a powerful test to discriminate bacterial from viral meningitis with high sensitivity,

show abstract

“…10,11 Bakteriyel menenjitlerin gelişmiş ülkelerde görülme sıklığı 100.000'de 5 vaka, gelişmekte olan ülkelerde ise bundan 10 kat fazladır. 12 Çeşitli bakteriler menenjite neden olabilir ancak yeni doğan dönemi hariç menenjit vakalarının %80'den fazlasına Streptococcus pneumoniae, Haemophilus influenzae tip b ve Neisseria meningitidis tarafından oluşturulmaktadır. 2,10,13 Gelişmiş ülkelerde S.pneumoniae, H.influenzae tip b'ye karşı spesifik aşıların rutin aşı programına girmesinden sonra bu mikroorganizmalardan kaynaklı menenjit vakalarında azalma görülmüştür.…”

Section: Discussionunclassified

A Three years retrospective analysis of agents isolated from cerebrospinal fluid in a University Hospital

Duman

Yakupoğulları²,

Tekerekoğlu³

et al. 2012

Dicle Med J

View full text Add to dashboard Cite

Objectives: In this study, we aimed to investigate the agents which were isolated from cerebrospinal fluid (CSF) samples in our hospital for three years, retrospectively. Materials and methods:The CSF samples, which were sent our laboratory, of the patients those had presumptive diagnosis of meningitis between September 2008 and September 2011 were included into the study. Isolated bacteria were identified with conventional methods, biochemical tests and/or Phonix (BD, US) kits. Antimicrobial susceptibility of the strains were investigated according to Clinical Laboratory Standards Institute (CLSI) recommendations.Results: 11 Streptococcus pneumoniae, 8 Klebsiella pneumoniae, 7 Pseudomonas aeruginosa, 7 Acinetobacter baumannii, 5 Escherichia coli, 4 Enterococcus spp., 2 Enterobacter spp., 25 Coagulase-negative staphylococcus, 1 Morganella morganii, 2 Neisseria meningitidis, 1 Brucella spp., and 1 Candida albicans were isolated (overall n:74; 5.2%) from total 1408 CSF samples. In susceptibility test, 2 S.pneumonia was found as penicillin-resistant, and one E.coli and two K.pneumoniae were found as extended spectrum of beta-lactamase producers. Additionally, carbapenem resistance was detected in three A.baumannii and one P.aeruginosa strains. Conclusion:Determination of agent profile and antimicrobial resistance pattern from different localizations and patients' groups will help to improve protective and therapeutic health policies.

show abstract

Community-acquired bacterial meningitis in adults

Cited by 64 publications

References 53 publications

Invasive meningococcal disease

Invasive meningococcal disease

Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

A Three years retrospective analysis of agents isolated from cerebrospinal fluid in a University Hospital

Contact Info

Product

Resources

About