Meningitis and Encephalitis at the Abbassia Fever Hospital, Cairo, Egypt, from 1966 to 1989

Girgis, Nabil I.; Sippel, John E.; Kilpatrick, Michael E.; Sanborn, Warren R.; Mikhail, Isis A.; Cross, Ernest S.; Erian, M. W.; Sultan, Yehia; Farid, Z.

doi:10.4269/ajtmh.1993.48.97

Cited by 32 publications

(40 citation statements)

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“…Other studies have not reported this (4,8,9,24,(29)(30)(31). However, the Todd Herson score for bacterial meningitis uses a low WBC/cmm of CSF AUDIOLOGICAL MEDICINE 2004 (<1000/cmm) as one of its prognostic indices of a poor outcome (32).…”

Section: Discussionmentioning

confidence: 99%

Hearing loss in Malawian children after bacterial meningitis: incidence and risk factors

Forsyth¹,

Kalumbi

Mphaka

et al. 2004

Audiological Medicine

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We had an objective to describe the incidence and risk factors for hearing loss following acute bacterial meningitis in children admitted to the Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. A double-blind placebo-controlled trial was designed from July 1997-March 2001 to determine whether early steroid therapy would reduce overall mortality and morbidity in childhood bacterial meningitis. The QECH, Blantyre, Malawi is a teaching and referral public hospital that serves the Blantyre area and receives referrals from throughout southern Malawi. Participants were children aged 2 months to 13 years, admitted with a diagnosis of bacterial meningitis, and the main outcome measures were mortality and morbidity following bacterial meningitis. Three hundred and ninety-nine of 598 (66.7%) children survived; 33.6% were due to S. pneumoniae, 30% to Haemophilus influenzae type b, 15% to Neisseria meningitides, and 16% had no growth on CSF culture. Two hundred and sixty-eight (67%) survivors had reliable hearing tests of whom 38% had impaired hearing, 77% of which was bilateral. Independent risk factors for hearing loss were the causative agent, presentation with a low coma score (52% vs. 34%, p = 0.006), a first CSF sample with a positive Gram stain for bacteria (65% vs. 44.3%, p = 0.003), a WBC < 100/cmm (p = 0.01), or a high protein level (50% if > 2000 mg/dl vs. 11% if <100 mg/dl). Associated neurological sequelae were highly associated with hearing impairment (p = 0.000012). We conclude that bacterial meningitis is the cause of many children's hearing impairment. Immunization against S. pneumoniae and H. influenzae would prevent many cases. Better first line antibiotics may reduce audiological damage. Deaf children in poorer parts of the world need more and vocal advocacy.

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Section: Discussionmentioning

confidence: 99%

Hearing loss in Malawian children after bacterial meningitis: incidence and risk factors

Forsyth¹,

Kalumbi

Mphaka

et al. 2004

Audiological Medicine

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“…Meningitis is the most common form of CNS disease and is discussed in depth here. The typical presenting signs and symptoms include fever, headache, and altered mental status, ranging from lethargy to coma (136,188,281,298,393). Meningismus, seizures, and focal neurological signs, in particular cranial nerve palsies, are also common.…”

Section: Mycobacterium Tuberculosismentioning

confidence: 99%

Invasion of the Central Nervous System by Intracellular Bacteria

2004

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Infection of the central nervous system (CNS) is a severe and frequently fatal event during the course of many diseases caused by microbes with predominantly intracellular life cycles. Examples of these include the facultative intracellular bacteria Listeria monocytogenes, Mycobacterium tuberculosis, and Brucella and Salmonella spp. and obligate intracellular microbes of the Rickettsiaceae family and Tropheryma whipplei. Unfortunately, the mechanisms used by intracellular bacterial pathogens to enter the CNS are less well known than those used by bacterial pathogens with an extracellular life cycle. The goal of this review is to elaborate on the means by which intracellular bacterial pathogens establish infection within the CNS. This review encompasses the clinical and pathological findings that pertain to the CNS infection in humans and includes experimental data from animal models that illuminate how these microbes enter the CNS. Recent experimental data showing that L. monocytogenes can invade the CNS by more than one mechanism make it a useful model for discussing the various routes for neuroinvasion used by intracellular bacterial pathogens

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“…tuberculosis was identified as the etiologic organism in 19.7% of 7,809 patients with infectious neurologic disease at the Abbassia Fever Hospital in Cairo, Egypt, from 1966 to 1989. This prevalence was second only to that of meningococci, and TBM was the most frequent cause of death at this hospital (6). In a subsequent study of 1,430 patients with a presumptive diagnosis of TBM at the same hospital from 1976 to 1996, MTC organisms were cultured from CSF samples of 857 (59.9%) of the patients.…”

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confidence: 99%

Characterization of Mycobacterium tuberculosis Complex Isolates from the Cerebrospinal Fluid of Meningitis Patients at Six Fever Hospitals in Egypt

et al. 2002

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Mycobacterium tuberculosis complex isolates from cerebrospinal fluid of 67 meningitis patients were obtained from six fever hospitals in Egypt. One M. bovis and 66 M. tuberculosis isolates were identified by PCR-restriction fragment length polymorphism (RFLP) analysis of oxyR. Among the M. tuberculosis isolates, 53 unique strain types (with 3 to 16 copies of IS6110) were found by RFLP analyses. Nine clusters (eight with two isolates each and one with six isolates) were also found. Thirty-six spoligotypes, including at least 10 that have been previously reported from other countries, were also observed. Forty-one (62.1%) of the isolates were in spoligotype clusters, and 22 (33%) of the isolates were in RFLP clusters. Fifty-one of the isolates were susceptible in vitro to all of the antituberculosis drugs tested, 11 were monoresistant to capreomycin, rifampin, isoniazid (INH), pyrazinamide, or streptomycin (STR), 4 were resistant to STR and INH, and 1 was resistant to STR, INH, and ethambutol.

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Meningitis and Encephalitis at the Abbassia Fever Hospital, Cairo, Egypt, from 1966 to 1989

Cited by 32 publications

References 0 publications

Hearing loss in Malawian children after bacterial meningitis: incidence and risk factors

Hearing loss in Malawian children after bacterial meningitis: incidence and risk factors

Invasion of the Central Nervous System by Intracellular Bacteria

Characterization of Mycobacterium tuberculosis Complex Isolates from the Cerebrospinal Fluid of Meningitis Patients at Six Fever Hospitals in Egypt

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