1.Listeria monocytogenes meningitis in infants: report of two cases.
Qing-Hua KANG ; Yi GUO ; Si-Qi HONG ; Li JIANG
Chinese Journal of Contemporary Pediatrics 2013;15(12):1150-1152
Brain
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pathology
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Female
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Humans
;
Infant
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Magnetic Resonance Imaging
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Male
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Meningitis, Listeria
;
diagnosis
;
drug therapy
2.Clinical analysis of otogenic Mouret abscess: a case report.
Xin Ping HAO ; Biao CHEN ; Yong Xin LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2018;32(6):472-473
Mouret abscess is a rare extracranial complication of suppurative otitis media. It is generally believed to be a deep neck abscess caused by inflammation leading to the rupture of the bony tip of the mastoid tip. The location of Mouret abscess is deep. The symptoms are insidious at the onset, but may eventually spread to the surrounding tissue, and even lead to mediastinal abscess, cavernous sinus thrombosis, meningitis, dyspnea and other serious complications. At present, with the popularization of antibiotics, the occurrence rate of Mouret abscess is very low, and only sporadic cases have been reported.In this paper, a case of Mouret abscess caused by cholesteatoma was analyzed to explore Mouret abscess in terms of the route of infection, clinical manifestations, imaging features, diagnosis and treatment.
Abscess
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diagnosis
;
drug therapy
;
therapy
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Cholesteatoma
;
complications
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Humans
;
Mastoid
;
pathology
;
Meningitis
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Neck
;
pathology
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Otitis Media
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Otitis Media, Suppurative
;
complications
3.Idiopathic Hypertrophic Spinal Pachymeningitis: A Case Report.
Sung Hye PARK ; C Jin WHANG ; Moonjun SOHN ; Yeun Chul OH ; Chae Hyuk LEE ; Yoon Joon WHANG
Journal of Korean Medical Science 2001;16(5):683-688
Idiopathic hypertrophic pachymeningitis (IHP) is a rare, chronic nonspecific and granulomatous inflammatory disorder of the dura with unknown etiology. The diagnosis can be established by open biopsy and exclusion of all other specific granulomatous and infectious diseases. We report a typical case of spinal IHP occurring in a long segment of cervical and thoracic dura from C6 to T8. The patient was 56-yr-old female, who had been suffered from pain on her upper back and both arms for 3 months and recent onset motor weakness of both legs. During the 9 months of follow-up period, she experienced the improvement of her neurologic symptoms with combined therapy of partial excision and corticosteroid medication. Since early surgical intervention and subsequent pulse ste-roid therapy are mandatory for this disease to avoid irreversible damage of nervous system, the identification of this unique disease entity is essential on frozen diagnosis. A few cases have been reported in Korean literature.
Case Report
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Female
;
Follow-Up Studies
;
Human
;
Magnetic Resonance Imaging
;
Meningitis/diagnosis/*pathology/therapy
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Middle Age
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Spinal Diseases/diagnosis/*pathology/therapy
4.Clinical analysis and follow-up of neonatal purulent meningitis caused by group B streptococcus.
Minli ZHU ; Jianghu ZHU ; Haijing LI ; Peining LIU ; Zhenlang LIN
Chinese Journal of Pediatrics 2014;52(2):133-136
OBJECTIVETo study the clinical characteristics, antibiotics sensitivity and outcome of group B streptococcus (GBS) meningitis in neonates in order to provide the guide for early diagnosis and appropriate treatment.
METHODA retrospective review was performed and a total of 13 cases of neonatal purulent meningitis caused by GBS were identified in the Neonatal Intensive Care Unit of Yuying Children's Hospital of Wenzhou Medical University from January 1, 2005 to May 31, 2013. The clinical characteristics, antibiotics sensitivity test results and outcome were analyzed.
RESULTFever, poor feeding, seizure and lethargy were common clinical signs of neonatal purulent meningitis caused by GBS. Three cases of early onset GBS meningitis received prepartum antibiotics. All 13 cases had abnormal C-reactive protein (CRP) level, and 11 cases had increased CRP within hours after admission. Of the 13 patients, 7 were cured, 4 discharged with improvement, 2 patients died during hospitalization after being given up because of serious complication. The average length of stay for recovered patients was (47 ± 21)d. Acute complications mainly included hyponatremia (5 cases), intracranial hemorrhage (3 cases) , ventriculomegaly (3 cases) , subdural collection (2 cases) , hydrocephalus (2 cases), septic shock (2 cases), cerebral hernia (1 case), encephalomalacia (1 case). One preterm patient with early onset GBS meningitis died 1 month after hospital discharge. Among 7 survivors with 10-24 months follow-up, 3 were early onset GBS meningitis, 2 with normal results of neurologic examination, 1 with delayed motor development, 4 were late onset GBS meningitis, 1 with normal results of neurologic examination, 3 were neurologically impaired with manifestations including delayed motor development (2 cases) and seizures (1 case). All the GBS strains were sensitive to penicillin and linezolid (13/13, 10/10), the susceptibility to levofloxacin, ampicillin and vancomycin were 11/12, 9/10, 8/13 respectively.
CONCLUSIONThe clinical manifestations of neonatal purulent meningitis caused by GBS are usually non-specific. It is associated with long hospitalization, neurological impairments and sequelae. Monitoring of serum CRP level is valuable for early diagnosis. Antepartum prophylaxis, early diagnosis and therapy are vital. Large dose penicillin is the priority choice to treat the neonatal purulent meningitis caused by GBS, linezolid should be used in intractable cases.
Anti-Bacterial Agents ; therapeutic use ; C-Reactive Protein ; analysis ; Drug Resistance, Bacterial ; Female ; Fever ; diagnosis ; drug therapy ; pathology ; Follow-Up Studies ; Humans ; Hyponatremia ; etiology ; Infant, Newborn ; Leukocyte Count ; Male ; Meningitis, Bacterial ; diagnosis ; drug therapy ; pathology ; Microbial Sensitivity Tests ; Penicillins ; therapeutic use ; Pregnancy ; Pregnancy Complications, Infectious ; Retrospective Studies ; Streptococcal Infections ; diagnosis ; drug therapy ; pathology ; Streptococcus agalactiae
5.A Case of Steroid-induced Hyperinfective Strongyloidiasis with Bacterial Meningitis.
Joo Yun CHO ; Joong Goo KWON ; Kyung Ho HA ; Jae Young OH ; Myung In JIN ; Seong Wook HEO ; Geun Ho LEE ; Chang Ho CHO
The Korean Journal of Gastroenterology 2012;60(5):330-334
Strongyloides stercoralis is a soil transmitted intestinal nematode that is endemic in the tropical and subtropical regions. In most individuals who are infected, chronic, usually asymptomatic, gastrointestinal infection persists. But, in immunocompromized hosts or in patients receiving immunosuppressive therapy, autoinfection of S. stercoralis may result in the dissemination of larvae, leading to fatal hyperinfection and increased rate of complications. We report a case of hyperinfective strongyloidiasis with bacterial meningitis in a patient receiving steroid therapy. Strongyloidiasis was diagnosed by the presence of filariform larvae of S. stercoralis in the bronchoalveolar lavage cytology and upper gastrointestinal endoscopic biopsy specimen. Her clinical symptoms had progressively aggravated and developed bacterial meningitis during treatment. She died despite aggressive antibiotic and antihelminthic therapy.
Adrenal Insufficiency/drug therapy
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Aged
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Animals
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Bronchoalveolar Lavage Fluid/parasitology
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Endoscopy, Gastrointestinal
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Enterococcus faecium/isolation & purification
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Female
;
Humans
;
Immunocompromised Host
;
Intestinal Mucosa/pathology
;
Larva/physiology
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Magnetic Resonance Imaging
;
Meningitis, Bacterial/complications/*diagnosis/microbiology
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Steroids/adverse effects/therapeutic use
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Strongyloides stercoralis/growth & development/isolation & purification
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Strongyloidiasis/complications/*diagnosis/parasitology