Objective: Bacterial meningitis is associated with significant morbidity and mortality if not diagnosed and treated early. Isolation of the causative agent from cerebrospinal fluid culture is the gold standard for the diagnosis of this condition; however, it takes several days for results to be available. The FilmArray™ Meningitis/Encephalitis (ME) panel is a nucleic acid-based test that allows simultaneous detection of 14 bacterial, viral, and fungal pathogens in the cerebrospinal fluid with a rapid turnaround time. Our aim was to evaluate the diagnostic performance of the ME panel in detecting bacterial pathogens in the cerebrospinal fluid of adult patients with suspected bacterial meningitis in a tertiary hospital in the Philippines. Methods: We performed a retrospective review of hospital records of adult patients with suspected bacterial meningitis who were admitted at our institution and underwent diagnostic testing with the FilmArray™ ME panel from January 1, 2018 to July 31, 2019. Overall percent agreement, sensitivity, and specificity for individual bacterial pathogens included in the panel were determined. Results: A total of 88 cerebrospinal fluid samples were included in the analysis of diagnostic accuracy. The ME panel demonstrated 93.2% overall agreement, 50% sensitivity for E. coli, and 99–100% specificity in comparison with CSF culture in detecting bacterial pathogens that are included in the ME panel. Conclusion The results show that the FilmArray™ ME panel has high diagnostic accuracy and can be utilized in the rapid diagnosis and targeted treatment of patients with suspected bacterial meningitis.
Meningitis, Bacterial ; Central Nervous System Infections

A retrospective study involved 110 patients (72 males, 38 females, aged from 1 - 76 years) who underwent surgery for brain abscesses at ViÖt -§øc Hospital from January 1990 to December 1993. 79 patients with brain abscesses were found bacteria in culture. The bacteria were not identified in 31 patients. Results: Rate of bacterial isolation in brain abscesses is quite high. Among these, streptococci make up 37.7%, staphylococci 23.8%, and anaerobic bacteria 17.5%. Streptococci and staphylococci are cause of more than 90% of secondary brain abscesses due to localized infection. Postoperative antibiotics reduced significantly the bacterial isolation rate, comparison with that rate of 87.5% on patients who have not used antibiotics before operation. Rate of recurrence is 7.6% in the patients who were isolated bacteria and 25.8% in the patients who were not identified bacteria.
Brain Abscess ; Central Nervous System Bacterial Infections ; Bacterial Infections

Authors report on the general features of postoperative central nervous system infection in patients undergoing neurosurgical procedures. The postoperative central nervous system infection was defined was defined as 1) emergence of purulent material from any site that had been exposed to surgical field, and/or 2) development of meningitis during postoperative recovery period. The materials were obtained from 50 cases of postoperative central nervous system infection out of 1,232 cases of operations that had been performed in neurosurgical department of Seoul National University Hospital during the last three years. Various predisposing factors, associated problems, and therapeutic aspects are discussed. General features of hospital infection are also considered.
Anti-Bacterial Agents ; Causality ; Central Nervous System Infections* ; Central Nervous System* ; Cross Infection ; Humans ; Meningitis ; Neurosurgical Procedures ; Seoul ; Wound Infection

Advances in the antimicrobials lower the mortality rate in most infectious diseases. But bacterial infections of the CNS is still one of the life-threatening infections. Untreated acute bacterial meningitis is fatal in 70% to 100% of patients. With appropriate antibacterial therapy, the case-fatality rate had been greatly reduced with death occurring principally in the very young the very old, or those with potentially lethal underlying diseases. Early recognition and antimicrobial therapy is mostly desirable. The causes of acute bacterial meningitis vary with age and the clinical setting under which the infection occurs. Empirical antibiotic treatment was started immediately on suspicion of the bacterial meningitis prior to etiologic diagnosis. The most effective and least toxic bactericidal drugs should be selected on the basis of known or predicted susceptibility of the bacterial cause of the disease. After the identification of the specific organism and determination of susceptibilities, effective antimicrobial was administered parenterally at maximum dose. The third-generation cephalosporins(cefotaxime, ceftriaxone, and ceftzidime) offer new advantages in the treatment of meningitis because they are active at the CSF concentraions obtainable. Newer antimicrobials(monobactam and newer quinolones) with improved access and an appropriately focused spectrum for CNS infections will become available.
Bacterial Infections* ; Ceftriaxone ; Central Nervous System* ; Communicable Diseases ; Diagnosis ; Humans ; Meningitis ; Meningitis, Bacterial ; Mortality

Brain abscess is a common bacterial infection of the central nervous system. Previously, the most common source of brain abscess is from the otorrhinologic infection, the hematogenous spread of infection from a distant site to the central ner vous system is increased(Alvord & Shaw, 1977; Zimmerman & Weingerten, 1991). Since intact brain parenchyma is usually resistant to inecton, focal areas of ischemia or necrosis are a prequisite to invasion by pathogenic microorganisms(Patric & Kaplan, 1988). There have been a few reports about the stroke lesions changed into brain abscess(Chen et al, 1995; Scully et al. 1991). We report serial brain images with the clinical observations in a patient with a transformation of spontaneous intracerebral hemorrhage into brain abscess.
Bacterial Infections ; Brain Abscess* ; Brain* ; Central Nervous System ; Cerebral Hemorrhage* ; Humans ; Ischemia ; Necrosis ; Stroke

PURPOSE: To compare the effect of different etiologies in children with central nervous system (CNS) infections on the incidence of initial and hospital-acquired hyponatremia (IH and HAH) (plasma sodium concentration, PNa <135 mEq/L). METHODS: Children with CNS infections during the period between 2011 and 2012 were evaluated retrospectively. Patients were classified into 4 groups: group A, aseptic meningitis; group B, viral meningoencephalitis; group C, bacterial meningitis; group D, tuberculous meningitis. All patients had measured the initial PNa and were retested serially. By the sodium concentration of IV fluid, children were divided into 2 groups: group-I of <0.45% saline in dextrose, and group-II of > or =0.45% saline in dextrose. RESULTS: Of 244 children with CNS infections (group A: 185, group B: 33, group C: 23, and group D: 3), 55 patients (22.5%) revealed IH- or HAH-hyponatremia. IH and HAH was found in 13.1% (32/244) and 9.4% (23/244), respectively. The incidence of IH was significantly higher in group-C (30.4%, P=0.010) than in group-A (9.2%) or group-B (21.2%). HAH was more frequent in group-B (27.3%, P<0.001) and in group-D (66.7%, P=0.001) than in group-A (4.9%) or in group-C (13.0%). Of the patients in group-I, 28.6% (8/28) developed more common HAH compared with 6.9% (15/216) of children in group-II (P<0.001). CONCLUSION: IH and HAH were relatively common in children with CNS infections and their incidences were distinctly different among patients from different etiologies. It seems that the administration of hypertonic saline can help to reduce the incidence of HAH among children with CNS infections. election.
Central Nervous System Infections* ; Central Nervous System* ; Child* ; Glucose ; Humans ; Hyponatremia* ; Incidence ; Meningitis ; Meningitis, Aseptic ; Meningitis, Bacterial ; Meningoencephalitis ; Retrospective Studies ; Sodium ; Tuberculosis, Meningeal

Infectious diseases of the central nervous system (CNS) cause inflammatory processes within the brain and spinal cord that can lead to morbidity and mortality in a high proportion of patients. Pharmacological strategies to dampen inflammation have been investigated, and steroids are one of the adjunctive treatments for bacterial meningitis, tuberculous meningitis, and herpes simplex virus encephalitis. In this paper, we review the recent literature that provides guidelines for the use of steroids in combination with appropriate antimicrobial therapy, and we discuss how systemic steroid treatment is an important aspect of treatment regimens for CNS infectious diseases.
Brain ; Central Nervous System Infections ; Central Nervous System ; Communicable Diseases ; Encephalitis ; Humans ; Inflammation ; Meningitis, Bacterial ; Mortality ; Simplexvirus ; Spinal Cord ; Steroids ; Tuberculosis ; Tuberculosis, Meningeal

The author have had experience with seven cases of acute pulmonary edema. There are many predisposing factors for acute pulmonary edema, namely, left ventricular failure due to cardiac disease or overloading, hypoalbuminemia, pulmonary capillary endothelial damage from bacterial infections, toxins or irritant gases, rarely central nervous system injuries and pulmonary hypersensitivity reactions. For these presented cases, we believe that overloading, hypoalbuminemia, bile pneumonitis were the causative factors. There are many preventive measures and treatment for acute pulmonary edema. We conclude that prompt recognition and attention by the anesthesiologist are the most important preventive measures.
Anesthesia, General* ; Bacterial Infections ; Bile ; Capillaries ; Causality ; Central Nervous System ; Gases ; Heart Diseases ; Hypersensitivity ; Hypoalbuminemia ; Pneumonia ; Pulmonary Edema

PURPOSE: Streptococcus pyogenes is an important cause of invasive diseases in children. We aimed to describe the clinical characteristics of invasive infections due to S. pyogenes in children in Korea. METHODS: A retrospective study of children under 18 years of age with invasive infections due to S. pyogenes at Seoul National University Children's Hospital between March 1992 and December 2012, and Seoul National University Bundang Hospital between March 2003 and December 2012 was conducted. Demographic factors, clinical characteristics, laboratory findings, treatment, mortality and morbidity of all patients were reviewed. RESULTS: A total of 30 among 36 cases identified as invasive disease due to S. pyogenes were available for review. There was a predominance for male subjects (male:female=2.75:1). The median age was 50 months (range 12 days to 15 years) and 53.3% were under 5 years of age. Skin and soft tissue infections (9/30, 30.0%), bacteremia without identified focus (4/30, 13.3%) and bone and joint infections (6/30, 20.0%) were the most frequent clinical presentations. Streptococcal toxic shock syndrome (3/30, 10.0%) pulmonary, abdomen and central nervous system infections (2/30, 6.7%) were also seen. There was a peak in number of patients in year 2012 (9/30, 30.0%). There were no cases of mortality. Erythromycin and clindamycin resistance rates were low by 3.8% and 7.5%, respectively. CONCLUSION: We studied the clinical presentations of invasive infections due to S. pyogenes during the past 20 years in Korean children. The findings of this study help us understand the characteristics of the disease, enhancing early recognition and prompting adequate antibiotic therapy which is important in reducing morbidity and mortality.
Abdomen ; Bacteremia ; Bacterial Infections ; Central Nervous System Infections ; Child* ; Clindamycin ; Demography ; Erythromycin ; Humans ; Joints ; Korea ; Male ; Mortality ; Retrospective Studies ; Seoul ; Shock, Septic ; Skin ; Soft Tissue Infections ; Streptococcus pyogenes*

Adult ; Anti-Bacterial Agents ; therapeutic use ; Brucellosis ; diagnosis ; drug therapy ; pathology ; Central Nervous System Bacterial Infections ; diagnosis ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies