Background: tuberculosis meningoencephalitis (TBME) is an acute infectious disease of the central nervous system. The disease had a high mortality rate and severe sequelae if late diagnosis and not timely treatment. However, in recent years, the patients with TBME who was transferred to National Pediatric Hospital Hospital remained to be diagnosed not exactly, affect to treatment outcomes. Objectives: study on the difficulties in diagnosing TBME in children. Subjectives and Method: a descriptive study on 34 children aged 4-14 months diagnosed with TBME at Department of infectious, National Pediatric Hospital from January 2002 to September 2005. Results: 35.29% of the patients were under 1 year old. The suggestive signs and symptoms for diagnosis included BCG\ufffd?scar (50%), tuberculosis exposure (32.4%), weight loss (31.8), fever (100%), vomiting (70.6%), stiff-neck (94.1%), meningeal sign (70.6%), Kernig\u2019s sign (61.8%), positive Tuberculin tests (35.29%) and typical lesions on chest x-rays (11.8%). In cerebrospinal fluids (CSF), mean cell count was 274/mm3 and protein concentration was 1.51g/l. These were hindrances for diagnosing TBME in children. Disease distribution was in both the urban and the rural areas. Conclusions: Clinical manifestations and disease progress are not typical for TBME diagnosis. Therefore, it is important to think about TBME in cases with acute meaningitidis lasting for more than 14 days. PCR will be a very good marker for definite diagnosis.
Meningoencephalitis/ diagnosis ; Tuberculosis ; Meningeal/ diagnosis ; Child ;

More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this from of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary crytococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocmpetent patients.
Chest Pain ; Cough ; Cryptococcosis ; Diagnosis ; Fever ; Hemoptysis ; Humans ; Immunocompromised Host ; Meningoencephalitis ; Pneumonia*

Brucellar meningoencephalitis is a rare complication of zoonotic brucellosis. A stockman with a previous diagnosis of brucellar spondylitis presented with recurrent episodes of fever, confusion, and headache. He showed lymphocytic pleocytosis and positive agglutinin test for Brucella spp in the cerebrospinal fluid without lesion in brain MRI. Brucellar meningoencephalitis should be included in the differential diagnosis of meningitis in high-risk patients for brucellosis.
Brain ; Brucella ; Brucellosis ; Diagnosis, Differential ; Fever ; Headache ; Humans ; Leukocytosis ; Meningitis ; Meningoencephalitis ; Spondylitis

BACKGROUND: Ocular flutter is a rare horizontal eye movement disorder characterized by rapid saccadic oscillations. Excessive discharge of burst neurons, and/or loss of tonic excitation of pause cells cause ocular flutter in several neurologic diseases. Ocular flutter can be easily differentiated from other saccadic oscillations with the aid of electro-oculography (EOG) findings showing an absence of intersaccadic intervals. METHODS: We analyzed EOG findings of ocular flutter in four patients. RESULTS: Ocular flutter, which was shown as rapid, repetitive, horizontal, symmetrical, and sinusoidal movements without intersaccadic intervals on EOG, was confirmed in four patients. The etiology of each patient was olivopontocerebellar atrophy (1 case), meningoencephalitis (2 cases), and lithium intoxication (1 case). CONCLUSIONS: Ocular flutter can be present in numerous neurologic diseases. Characteristic EOG findings are useful in the diagnosis of ocular flutter.
Diagnosis ; Electrooculography ; Humans ; Lithium ; Meningoencephalitis ; Neurons ; Ocular Motility Disorders ; Olivopontocerebellar Atrophies ; Saccades

CNS infection due to Listeria monocytogenes is a rare condition that occurs primarily in immunocompromised patients. A predilection for the brainstem has been proposed but definite abscess formation is extremely rare. We report a case of necrotizing meningoencephalitis with diffuse extensive abscesses caused by Listeria monocytogenes in a chronic diabetic patient, whose diagnosis was based on blood culture and MRI findings.
Abscess ; Brain Abscess* ; Brain Stem ; Brain* ; Diagnosis ; Humans ; Immunocompromised Host ; Listeria monocytogenes* ; Listeria* ; Magnetic Resonance Imaging ; Meningoencephalitis

Cryptococcosis is an opportunistic infection that generally occurs in patients with cell-mediated immune dysfunction and involves the central nervous system. Infection is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients because of its innate immune dysfunction along with the administration of steroids and immunosuppressants. However, central nervous system cryptococcosis has rarely been reported in SLE patients. A timely diagnosis is critical because of its significant mortality and morbidity. Most cases of cryptococcal meningitis in SLE patients have been reported in those treated with steroids or immunosuppressants. We report on a SLE patient not on medication, who was diagnosed with cryptococcal meningoencephalitis.
Central Nervous System ; Cryptococcosis ; Diagnosis ; Humans ; Immunosuppressive Agents* ; Lupus Erythematosus, Systemic* ; Meningitis, Cryptococcal ; Meningoencephalitis* ; Mortality ; Opportunistic Infections ; Steroids

Relapsing polychondritis (RP) is an autoimmune disorder characterized by inflammation in cartilaginous structures including the ears, noses, peripheral joints, and tracheobronchial tree. It rarely involves the central nervous system (CNS) but diagnosis of CNS complication of RP is challenging because it can present with varying clinical features. Herein we report 3 cases of relapsing polychondritis involving CNS with distinct manifestations and clinical courses. The first patient presented with rhombencephalitis resulting in brain edema and death. The second patient had acute cognitive dysfunction due to limbic encephalitis. He was treated with steroid pulse therapy and recovered without sequelae. The third patient suffered aseptic meningitis that presented as dementia, which was refractory to steroid and immune suppressive agents. We also reviewed literature on CNS complications of RP.
Brain Edema ; Central Nervous System* ; Dementia ; Diagnosis ; Ear ; Humans ; Inflammation ; Joints ; Limbic Encephalitis ; Meningitis, Aseptic ; Meningoencephalitis ; Nose ; Polychondritis, Relapsing* ; Trees

Severe complications such as meningoencephalitis are quite rare in the setting of mumps infection. We report here on a 24-year-old soldier with a past history of MMR vaccination who was admitted because of aseptic meningitis. His mental status rapidly deteriorated and swelling of both parotid glands was observed. The MR findings revealed discrete lesions in the brainstem and thalamus. He barely recovered within 2 months. Among the adults with failure to acquire immunity despite MMR vaccination, institutional crowding can lead to cases of potentially fatal CNS complication such as mumps meningoencephalitis.
Vaccination ; Mumps/*complications ; Meningoencephalitis/diagnosis/*etiology ; Measles-Mumps-Rubella Vaccine/*immunology ; Male ; Magnetic Resonance Imaging ; Humans ; Adult

Petechial cortical hemorrhages are common in Herpes simplex virus (HSV) encephalitis, however, cerebral hematoma is extremely rare. We report a case of a 47-year-old immunocompetent woman diagnosed with herpes encephalitis but complicated by cerebral hematoma despite of early diagnosis and treatment.
Acyclovir ; Early Diagnosis ; Encephalitis ; Encephalitis, Herpes Simplex ; Female ; Hematoma ; Hemorrhage ; Humans ; Meningoencephalitis ; Methylmethacrylates ; Middle Aged ; Polystyrenes ; Simplexvirus

We report a 43-yr-old man manifesting bacterial meningoencephalitis and multiple abscesses by Streptococcus pneumoniae. Serial magnetic resonance (MR) imagings and MR spectroscopy showed the evolution of multiple brain abscesses over 4 weeks: the enhanced rings became thicker and the dimension of whole lesions larger despite shrinkage of the ring-enhanced regions. These findings may be evidence of active inflammation working to sequestrate the lesion and protect the surrounding normal brain parenchyma from additional damage, even in the final stage of the brain abscess.
Brain Abscess/*diagnosis ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Meningoencephalitis/*diagnosis ; Middle Aged ; Pneumococcal Infections/*diagnosis ; Tomography, X-Ray Computed