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

Among various genera of free-living amoebae prevalent in nature, some members are identified as causative agents of human encephalitis, in which Naegleria fowleri followed by Acanthamoeba spp. and Balamuthia mandrillaris have been successively discovered. As the three dominant genera responsible for infections, Acanthamoeba and Balamuthia work as opportunistic pathogens of granulomatous amoebic encephalitis in immunocompetent and immunocompromised individuals, whereas Naegleria induces primary amoebic meningoencephalitis mostly in healthy children and young adults as a more violent and deadly disease. Due to the lack of typical symptoms and laboratory findings, all these amoebic encephalitic diseases are difficult to diagnose. Considering that subsequent therapies are also affected, all these brain infections cause significant mortality worldwide, with more than 90% of the cases being fatal. Along with global warming and population explosion, expanding areas of human and amoebae activity in some regions lead to increased contact, resulting in more serious infections and drawing increased public attention. In this review, we summarize the present information of these pathogenic free-living amoebae, including their phylogeny, classification, biology, and ecology. The mechanisms of pathogenesis, immunology, pathophysiology, clinical manifestations, epidemiology, diagnosis, and therapies are also discussed.
Amebiasis/epidemiology* ; Balamuthia mandrillaris ; Brain ; Central Nervous System Protozoal Infections/epidemiology* ; Child ; Humans ; Naegleria fowleri

Primary amebic encephalitis (PAM) is a devastating central nervous system infection caused by Naegleria fowleri, a free-living amoeba, which can survive in soil and warm fresh water. Here, a 43-year-old healthy male was exposed to warm freshwater 5 days before the symptom onset. He rapidly developed severe cerebral edema before the diagnosis of PAM and was treated with intravenous conventional amphotericin B while died of terminal cerebral hernia finally. Comparing the patients with PAM who has similar clinical symptoms to those with other common types of meningoencephalitis, this infection is probably curable if treated early and aggressively. PAM should be considered in the differential diagnosis of purulent meningoencephalitis, especially in patients with recent freshwater-related activities during the hot season.
Adult ; Amoeba ; Amphotericin B ; Brain Edema ; Central Nervous System Infections ; Central Nervous System Protozoal Infections ; Diagnosis ; Diagnosis, Differential ; Encephalitis ; Encephalocele ; Fresh Water ; Humans ; Male ; Meningoencephalitis ; Naegleria fowleri ; Seasons ; Soil

After bathing at a hot spring resort, a 75-year-old man presented to the emergency department because of seizure-like attack with loss of conscious. This is the first case of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri in Taiwan. PAM was diagnosed based on detection of actively motile trophozoites in cerebrospinal fluid using a wet-mount smear and the Liu's stain. The amoebae were further confirmed by PCR and gene sequencing. In spite of administering amphotericin B treatment, the patient died 25 days later.
Aged ; Amebiasis/*diagnosis/parasitology/*pathology ; Central Nervous System Protozoal Infections/*diagnosis/parasitology/*pathology ; Cerebrospinal Fluid/parasitology ; DNA, Protozoan/chemistry/genetics ; Fatal Outcome ; Humans ; Male ; Microscopy ; Naegleria fowleri/classification/genetics/*isolation & purification ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Taiwan

Mixed falciparum-vivax infection accounts for 5% of all malaria cases seen in endemic region. However, a larger proportion of mixed malaria cases develop cerebral complication. We report one case of mixed infection resulted in cerebral malaria.
Coinfection ; Malaria* ; Malaria, Cerebral

No abstract available.
Malaria, Cerebral* ; Plasmodium falciparum*

Celebral malaria is the most common complications of plasmodium falciparum with a mortality of 20-50%. Apart from special chemotherapy, some additional therapies were applied. Fever relief: in addition of physical method of hypothermy, ventilation, freezing compress, ... paracetamol is recommended. Antiseizure: intravenous diazepam can be infected slowly with 10mg in adults and 0,15mg/kg in children. Blood replaced perfusion is rather an increase of parasite count than a simple special medication, safely regulating severe anemia in patient with circulation overload is recommended only for very severe subjects, with very high level of parasity in blood
Malaria ; drug therapy ; disease ; Therapeutics ; Malaria, Cerebral

Cerebral malaria is a severe neurological complication of Plasmodium falciparum infection. Cerebral malaria can lead to cerebral infarction by several mechanisms including systemic inflammatory response. The systemic inflammatory response is known to rarely occur in Plasmodium vivax infection. We report a patient who developed multiple cerebral infarctions following Plasmodium vivax infection.
Cerebral Infarction ; Humans ; Malaria, Cerebral ; Plasmodium ; Plasmodium falciparum ; Plasmodium vivax

Malaria is one of the most important parasitic infection in the world. Four species of the genus Plasmodium cause nearly all malarial infections in humans, but the clinical features vary according to the causative species. Among them, Plasmodium falcifarum malaria is associated with numerous complications such as renal failure, cerebral malaria, and DIC, but Plasmodium vivax malaria usually has benign course. The proposed mechanism is blockage of microcirculation to vital organ by sequestration of parasitized erythrocytes. In Korea, for recent 20 years, there have been increasing numbers of malaria infection especially at North area of Geonggi-do. But serious complications in association with Plasmodium vivax malaria are rarely reported. Recently we experienced a case of Plasmodium vivax infection complicated by acute renal failure and report it with literature review.
Acute Kidney Injury ; Dacarbazine ; Humans ; Korea ; Malaria ; Malaria, Cerebral ; Malaria, Vivax ; Microcirculation ; Plasmodium ; Plasmodium vivax ; Renal Insufficiency

Vivax malaria reemerged in the Republic of Korea in 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there is only a small number of case reports on severe complications in vivax malaria. We report a unique case of P. vivax infection complicated by seizure and shock. A 58 year-old male showed generalized tonic-clonic seizure and shock after P. vivax infection. The species of malarial parasite was identified using peripheral blood film examination and polymerase chain reaction (PCR). He successfully recovered after treatment with hydroxychloroquine.
Humans ; Hydroxychloroquine ; Malaria ; Malaria, Cerebral ; Malaria, Vivax* ; Male ; Middle Aged ; Parasites ; Plasmodium vivax ; Polymerase Chain Reaction ; Republic of Korea ; Seizures* ; Shock*