No abstract available.
Diagnosis* ; Meningitis, Cryptococcal*

The authors reviewed 68 medical records of children between the ages of 6-15 during 12/1998-12/1999. The tests for identification of microbial by culture of cerebro spinal fluid have shown that the frequent pathogens were H. influenzae (50%), S.peumoniae (22/6%), Neiseria meningitidis (11,7%), and streptococus. The common clinical symptoms in newborn and infant were anorexia, moan, fontanelle inflation. The common clinical symptoms in older children were high fever and headache. The purulent meningitis due to Neiseria meningitis had a high rate of septic shock and necrosis hemorrhage. The purulent meningitis frequently occurs in winter-spring season and in men than women. There was difference of biochemical and cellular indicators between age groups and pathogen
Meningitis ; Child ; diagnosis

To evaluate the diagnosis value of Lactate dehydrogenase (LDH) in meningitis, LDH activity was determined in cerebrospinal fluid (CSF) and in sera of 125 children suffering from meningitis (51 bacterial meningitis, 38 viral meningitis, and 36 tuberculosis meningitis) and 33 normal children. In blood, LDH activity elevated significantly in bacterial meningitis and viral meningitis in comparison with control group (p<0.05), but slightly in tuberculosis meningitis. However, no statistical difference between 3 groups has been found. So, LDH in blood might be not helpful in the practical diagnosis. In the CSF, LDH activity in meningitis elevated significantly in comparison with control group (p<0.001). There is highly statistically difference of activities between 3 groups. LDH activity in CSF is useful in the differential diagnosis of meningitis
Meningitis ; L-Lactate Dehydrogenase ; diagnosis

Bilateral sensorineural hearing loss (SNHL) is a relatively well-recognized complication of bacterial meningitis, but is a rare initial manifestation in acute cryptococcal meningitis. We report a case of cryptococcal meningitis initially presenting with bilateral SNHL. Cryptococcal meningitis should be included in the differential diagnosis of abrupt-onset bilateral SNHL.
Diagnosis, Differential ; Hearing Loss, Sensorineural* ; Meningitis, Bacterial ; Meningitis, Cryptococcal*

We report herein a case of meningitis due to Streptococcus viridans that occurred after epidural nerve block. The low virulence of S. viridans resulted in milder clinical symptoms and signs than are usually observed for bacterial meningitis, thus mimicking viral meningitis. The infection may have originated from the oral cavity of the medical personnel, and so S. viridans infection should be included in the differential diagnosis of meningitis subsequent to spinal manipulation.
Diagnosis, Differential ; Manipulation, Spinal ; Meningitis ; Meningitis, Bacterial ; Meningitis, Viral ; Mouth ; Nerve Block ; Streptococcus ; Viridans Streptococci

Female ; Humans ; Infant ; Meningitis, Meningococcal ; diagnosis

Some techniques of detection of Hib were compared, including classic techniques such as bacterial culture and modern techniques such as PCR method. The results were as follows: 21% (+) culture with Hib compared to the total of clinically diagnosed cases, Hib-latex agglutination with 95% sensitivity and 99.6% specificity, counter immunophoresis assay to detect Hib by 97% sensitivity and 100% specificity. PCR increased the number of positive cases of Hib meningitis by 42.8% compared to culture alone. Blood culture gave a highly significant value to diagnose (51% Hib-possitive culture)
Haemophilus influenza type b ; Meningitis ; methods ; diagnosis

BACKGROUND: The enteroviruses are the most common etiologic agent of aseptic meningitis in adults and children. The incidence of enteroviral meningitis in childhood meningitis is up to 80%, but in adults is not known, worldwidely. In Korea, where tuberculosis is endemic, the rapid and accurate diagnostic method for enteroviral meningitis is required especially because early differential diagnosis of viral meningitis from tuberculous meningitis is very important. The aims of this study were the demonstration of enteroviruses from cerebrospinal fluid (CSF) of adult patients with aseptic meningitis by PCR/Southern hybridization and the verification of the usefulness of PCR/southern hybridization as a rapid diagnostic tool. METHODS: From July 1992 to June 1995, total 34 CSF samples (10 from children, 24 from adults) of patients with aseptic meningitis were studied. As a control group, 15 patients with tuberculous meningitis and 15 patients with bacterial meningitis were studied. Viral RNA was extracted from CSF, reverse transcriptied into cDNA and amplified. The PCR products were Southern hybridizied with enteroviruses-specific digoxigenin-labelled probe. RESULTS: 16/24(66.7%) samples of adult patients with aseptic meningitis were positive for enteroviruses, while in child patients with aseptic meningitis, 9/10(90%) samples were positive. And in one patient, PCR was positive from asymptomatic, onset-7th day CSF sample. CONCLUSION: Enteroviruses were the most common causative organisms of adult aseptic meningitis in Korea. And, this study showed the usefulness of PCR/Southern hybridization of enteroviruses from CSF for etiologic diagnosis of adult aseptic meningitis in subclinical, asymptomatic period.
Adult* ; Cerebrospinal Fluid* ; Child ; Diagnosis ; Diagnosis, Differential ; DNA, Complementary ; Enterovirus* ; Humans ; Incidence ; Korea ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Meningitis, Viral ; Polymerase Chain Reaction ; RNA, Viral ; Tuberculosis ; Tuberculosis, Meningeal

PURPOSE: To identify the factors associated with differential diagnosis of neonatal bacterial meningitis at the earliest opportunities possible and to evaluate the value of the bacterial meningitis score especially in neonates. METHODS: We conducted a single-center, retrospective study of neonates diagnosed meningitis at our hospital between January 2000 and March 2014. We compared the general characteristics, clinical manifestations, laboratory findings, bacterial meningitis scores between the bacterial group and the aseptic group. RESULTS: Bacterial meningitis differs significantly from aseptic meningitis in platelet count, the cerebrospinal fluid polymorphonuclear leukocyte count, and the serum protein including also the albumin (P<0.05). Except two infants, the bacterial meningitis score over 2 accurately predict bacterial meningitis in the other 11 infants. CONCLUSION: The bacterial meningitis score appears highly useful to identify neonatal infants with bacterial meningitis. However, its diagnostic and prognostic value is just ‘adjunctive’, because low score cannot rule out bacterial meningitis.
Cerebrospinal Fluid ; Diagnosis, Differential ; Humans ; Infant ; Infant, Newborn* ; Meningitis* ; Meningitis, Aseptic ; Meningitis, Bacterial* ; Neutrophils ; Platelet Count ; Retrospective Studies

BACKGROUND: Postoperative bacterial meningitis (PBM) is a serious potential complication after neurosurgery. Early diagnosis and introduction of antimicrobial therapy are necessary to reduce the rate of fatal outcomes from PBM. However, PBM is not easily differentiated from postoperative aseptic meningitis (PAM), which usually has favorable clinical outcomes. Serum procalcitonin (S-PCT) has been found to be a useful marker for distinguishing community-acquired bacterial from viral meningitis. We investigated the predictive performance of S-PCT for PBM in patients who underwent neurosurgery. MATERIALS AND METHODS: Between September 2009 and August 2010, we prospectively collected data from patients who underwent neurosurgery and had cerebrospinal fluid (CSF) pleocytosis within 14 days of surgery. Based on the CSF culture results, patients were categorized as either PBM or PAM cases. We compared the laboratory test results including S-PCT levels between PBM and PAM cases, and investigated the predictive performance of S-PCT for PBM. RESULTS: During the study period, PBM and PAM occurred in 14 and 64 patients, respectively. There was no significant difference in CSF profiles between PBM and PAM cases. S-PCT level > or = 0.15 ng/mL (50.0% vs. 20.0%, P = 0.07) and C-reactive protein (CRP) level > or = 2.5 mg/dL (75.0% vs. 46.5%, P = 0.16) tended to be more frequent in PBM than in PAM cases. A blood white blood cell (B-WBC) count > or = 9,500/mm3 was more frequently found in PBM cases (85.7% vs. 50.8%, P = 0.02) than in PAM cases. For the diagnosis of PBM, an S-PCT level > or = 0.15 ng/mL had a specificity of 80.0%. The combined criteria of a CRP level > or = 2.5 mg/dL, B-WBC count > or = 9,500/mm3, and an S-PCT level > or = 0.15 ng/mL had the highest specificity (92.6%) of all the criteria. An S-PCT level > or =0.15 ng/mL had low sensitivity (50.0%), and the combined criteria of CRP level > or = 2.5 mg/dL, B-WBC count > or = 9,500/mm3, and S-PCT level > or = 0.15 ng/mL had an improved sensitivity of 85.7%. However, the sensitivity did not significantly differ from that of a B-WBC count > or = 9,500/mm3 (85.7%). CONCLUSIONS: S-PCT showed limited performance for the diagnosis of postoperative meningitis. However, it could be a useful adjunct for the improvement of diagnostic sensitivity when used in combination with other inflammatory markers.
Adenosine Deaminase ; C-Reactive Protein ; Early Diagnosis ; Fatal Outcome ; Humans ; Leukocytes ; Leukocytosis ; Meningitis ; Meningitis, Aseptic ; Meningitis, Bacterial ; Meningitis, Viral ; Neurosurgery ; Prospective Studies ; Sensitivity and Specificity