No abstract available.
Central Nervous System Infections* ; Central Nervous System*

No abstract available.
Central Nervous System Infections ; Central Nervous System ; Eye Movements ; Humans

The CNS Infection Censuses for 2011 and 2012 from 9 neurology training programs in 7 institutions in the Philippines were collated to determine the types of CNS infections seen in the country and their relative frequencies. A comparison with a similar survey done in 1999 was made. A total of 1629 cases of CNS infections were recorded. There were 23 categories. Bacterial meningitis (34.3%) and TB meningitis (30.7%) were the top two infections, constituting more than half of all CNS infections seen. When the adult and pediatric census were separated, TB meningitis came up to be the most common infection in adults (43%) with bacterial meningitis a poor second at 19.4%. The reverse is seen in the pediatric population – bacterial meningitis (41.7%) vs. TB meningitis (24.6%). Cryptococcal meningitis was more frequent in the adult census (8.1%) compared with the pediatric census (0.1%). These patterns were seen in a similar census done in 1999. A significant increase in relative frequency in cryptococcal cases was seen in the later census (2.8% vs. 2.0%), the increase being due to the marked increase in the adult group (8.1% vs. 4.3%), probably due to the upward trend in the incidence of HIV cases in the country. No increase in this category was seen in the pediatric population. The benefits of collaboration among institutions in coming up with a large number of cases of CNS infections and a greater variety to study was highlighted. The study was conducted by the CNS Infection Council of the Philippine Neurological Association.
Central Nervous System Protozoal Infections ; Censuses ; Philippines

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

Central nervous system (CNS) fungal infections are challenging and difficult to diagnose and treat. This article introduces the high risk factors, pathogen spectrum and laboratory indicators that cause CNS fungal infection. As patients with CNS fungal infections are often accompanied by immunodeficiency, it is especially necessary for clinical early detection, early prevention, and early diagnosis, and timely and effective implementation of optimized diagnosis and treatment programs to prevent further deterioration of the disease.
Central Nervous System ; Central Nervous System Fungal Infections/microbiology* ; Central Nervous System Infections ; Fungi ; Humans ; Risk Factors

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

Infections of the central nervous system (CNS) can be rapidly progressive, RESULTing in death or permanent neurological damage in a short period of time, because of focal immunocompromised milieu with few complements and immunoglobulins in the cerebrospinal fluid. In order to provide effective antimicrobial therapy in a timely manner, all clinicians need to have a basic understanding of the antimicrobial agents and epidemiological data of the disease. It takes time to reveal the causative organisms of the infection. One should start antimicrobial treatment empirically as soon as possible after collecting the specimens from the patient. Many factors influence the choice of antimicrobial agents in the treatment of the infection which include microorganisms, environmental factors, and host factors such as age, sex, site of infection, and the underlying disease of the patient. Especially, in CNS infections, the efficacy of an antimicrobial agent depends upon its ability to penetrate the blood-brain barrier. The antimicrobial agent should also be active in purulent cerebrospinal fluid and demonstrate rapid bactericidal activity against the offending pathogen. The recent emergence of resistant pathogens, (also seen in Korea), has posed a challenge to the antimicrobial therapy. Therefore, the guidelines of antimicrobial therapy should be suitable for these considerations. This article reviews the basic therapeutic principles for the treatment of infections of the CNS and gives recommendations for the treatment of specific infections.
Anti-Infective Agents* ; Blood-Brain Barrier ; Central Nervous System Infections* ; Central Nervous System* ; Cerebrospinal Fluid ; Complement System Proteins ; Humans ; Immunoglobulins

Central Nervous System Infections/drug therapy* ; Child ; Humans ; Nervous System Malformations

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

Cryptococcal meningitis is a relatively common central nervous system infection by Cryptococcus neoformans. Before the introduction of amphotericin B in 1956, cryptococcal infection of the central nervous system had been almost uniformly fatal. Although amphotericin B(alone or in combination with flucytosine) has been the standard therapeutic regimen, problems such as modest efficacy, nephrotoxcity, other clinically significant toxicities, and the inconvinience of intravenous dosing have led to search for a new antimycotic agents. Fluconazole is a new therapeutic agent which is effective as amphoterin B. Accumulating evidence suggests that the antifungal triazole fluconazole represent an advance in the treatment of cryptococcal meningitis, particulary in acquired immunodeficiency syndrom patients. Thus we report clinical experiences of fluconazole therapy for 5 cases of cryptococcal meningitis. Four of 5 patients are improved clinically and microbiologically, 1 of 5 patients is expired due to concomittent tuberculous infection.
Amphotericin B ; Central Nervous System ; Central Nervous System Infections ; Cryptococcus neoformans ; Fluconazole* ; HMGB1 Protein ; Humans ; Meningitis, Cryptococcal*