The effect of antibiotic therapy before admission to hospital on recognition of the causative organism in acute bacterial meningitis

1987 ◽  
Vol 6 (9) ◽  
pp. 72
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Acute Bacterial Meningitis ◽  
Causative Organism

scholarly journals Effect of Antibiotic Pretreatment on Cerebrospinal Fluid Profiles of Children with Acute Bacterial Meningitis

2013 ◽  
Vol 2 (2) ◽  
pp. 135-139 ◽  
Author(s):  
S Adhikari ◽  
E Gauchan ◽  
G BK ◽  
KS Rao
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Lumbar Puncture ◽  
Laboratory Finding ◽  
Clinical Findings ◽  
Acute Bacterial Meningitis ◽  
Antibiotic Administration ◽  
Intravenous Antibiotic ◽  
Considerable Difficulty

Background: Analysis of cerebrospinal fluid is gold standard for diagnosis of meningitis. There is considerable difficulty in interpreting laboratory finding after prior antibiotic therapy. This study was conducted to evaluate the effect of intravenous antibiotic administration before lumbar puncture on cerebrospinal fluid profiles in children with bacterial meningitis. Methods: A hospital based retrospective study carried out using the data retrieved from the medical record department of Manipal Teaching Hospital Pokhara, Nepal; from 1st July 2006 to 31st July 2011. Clinical findings and relevant investigations were entered in a predesigned proforma. Patients were divided in two different groups as bacterial meningitis with and without prior intravenous antibiotic therapy. Various laboratory parameters including CSF were compared between these two groups using the statistical software, SPSS version 18.0. Results: A total of 114 children were included in this study among which 49(43%) children had received intravenous antibiotics before lumbar puncture. Mean CSF WBC count was(267.6± 211 vs. 208.1±125.3.3) and protein level (114.1±65.9 vs. 98.3±37.7mg/dl) in untreated vs. pretreated groups respectively. Neutrophil percentage was decreased (57.1±28.1vs.72.9±18.9) with higher CSF sugar level (43.3±11.8 vs. 51.2±13.2) after prior antibiotics therapy (p<0.001). Conclusion: Antibiotic pretreatment was associated with higher cerebrospinal fluid glucose levels with decreased neutrophils and increased lymphocytes. Pretreatment did not modify total cerebrospinal fluid white blood cell count and cerebrospinal fluid protein levels. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 135-139 DOI: http://dx.doi.org/10.3126/njms.v2i2.8963

Acute Bacterial Meningitis

2017 ◽  
Author(s):  
Pratibha Singhi ◽  
Naveen Sankhyan ◽  
Sunit Singhi
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Supportive Care ◽  
Pathogenic Bacteria ◽  
Neuronal Damage ◽  
Current Understanding ◽  
Acute Bacterial Meningitis ◽  
Clinical Aspects ◽  
Inflammatory Cascade ◽  
Cytokines And Chemokines

Bacterial meningitis is one of the severest infections in childhood. Neuronal damage in meningitis is largely due to the extensive inflammatory cascade induced by pathogenic bacteria. This chapter discusses the current understanding of the interaction of multitude of factors in the pathogenesis of bacterial meningitis. This includes the mechanisms involved in transcellular traversal of the bacteria, and induction and release of several inflammatory cytokines and chemokines. The management of a child with bacterial meningitis requires meticulous supportive care and timely, appropriate, and adequate antibiotic therapy. The chapter also reviews the current understanding of some important clinical aspects of care of a child with bacterial meningitis.

scholarly journals Latex Agglutination Test for Early Detection of Causative Organism in Acute Bacterial Meningitis

2013 ◽  
Vol 33 (1) ◽  
pp. 34-38
Author(s):  
B Mishra ◽  
C Mahaseth ◽  
A Rayamajhi
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Group B Streptococcus ◽  
Latex Agglutination ◽  
Agglutination Test ◽  
Latex Agglutination Test ◽  
Acute Bacterial Meningitis ◽  
Causative Organism ◽  
Hemophilus Influenzae Type B ◽  
Group B

Introduction: Acute bacterial meningitis is one of the leading causes of mortality and morbidity in children. Identification of the causative organism is crucial to its management and outcome. The objective of this study was to see the usefulness of latex agglutination test in the early diagnosis of acute bacterial meningitis. Materials and Methods: A hospital based prospective cross-sectional study was conducted at Kanti Children’s Hospital during December 2004 to August 2005. Cerebrospinal fluid from 150 consecutive clinically suspected cases of acute bacterial meningitis between the age group of 2 months to 14 years were analyzed. Bacterial culture and latex agglutination test was done on cerebrospinal fluid obtained from all 150 suspected cases of acute bacterial meningitis. Latex agglutination test was done using the BD DirectigenTM Meningitis Combo test kit (Becton, Dickinson and company, USA) for Streptococcus pneumoniae, group B Streptococcus, Escherichia coli, Neisseria meningitidis group A,C and Y/ W135, and Hemophilus influenzae type b. Data was analysed by using SPSS Version 11.5. Results: Of the 150 Cerebrospinal fluid samples analysed bacterial culture identified only 4 meningitis cases giving an isolation rate of 1.3% whereas latex agglutination test identified 29 cases giving an isolation rate of 19.3% from 150 samples. Streptococcus pneumoniae, Hemophilus influenzae type b and Group B Streptococcus were the most common causative organism. Conclusion: Latex agglutination test has a better yield, higher sensitivity, provides microbiological diagnosis earlier than the traditional cerebrospinal fluid culture and is easy to perform. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7047 J Nepal Paediatr Soc. 2013;33(1):34-38

Promptness of antibiotic therapy in acute bacterial meningitis

1986 ◽  
Vol 15 (5) ◽  
pp. 544-547 ◽  
Author(s):  
Charles S Bryan ◽  
Kenneth L Reynolds ◽  
Linda Crout
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Acute Bacterial Meningitis

scholarly journals Bacterial meningitis – ten years experience

1982 ◽  
Vol 88 (3) ◽  
pp. 383-401 ◽  
Author(s):  
P. G. Davey ◽  
J. K. Cruikshank ◽  
I. C. McManus ◽  
B. Mahood ◽  
M. H. Snow ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Pneumococcal Meningitis ◽  
Age Groups ◽  
Acute Bacterial Meningitis ◽  
Causative Organism ◽  
Antibiotic Administration ◽  
Treatment Regimes ◽  
Children And Young Adults ◽  
Laboratory Investigations ◽  
Area Health

SummaryBetween January 1968 and December 1977, 635 cases of acute bacterial meningitis were admitted to hospitals in the Birmingham Area Health Authority. The epidemiology of these cases was analysed and compared with the 270 cases which were admitted to the regional infectious diseases unit at East Birmingham Hospital (E.B.H.). In children and young adults the meningococcus was the commonest causative organism while over the age of 25 pneumococcal meningitis predominated. AlthoughHaemophilus influenzaewas the second commonest infecting organism it was a rare cause of meningitis in school children and adults, only four cases presenting in these age groups in the Birmingham Area.A detailed analysis was made of the symptoms, signs, laboratory investigations and clinical course of the 270 cases treated at E.B.H.The mortality in the patients with pneumococcal meningitis was 30%. In the meningococcal group it was 3·5% and in the haemophilus groups 7·7%.An analysis of the various treatment regimes employed in the 270 E.B.H. patients supports the view that a single antibiotic is sufficient for the therapy of most forms of bacterial meningitis. Intrathecal antibiotic administration is unnecessary in pyogenic meningitis caused by meningococci, pneumococci orH. influenzae.

scholarly journals Intramedullary abscess associated with acute bacterial meningitis: a case report and review of the literature

2020 ◽  
Vol 10 (3) ◽  
pp. 120-123
Author(s):  
Marouane Hammoud ◽  
Fayçal Lakhdar ◽  
Mohammed Benzagmout ◽  
Khalid Chakour, ◽  
Mohammed El Faiz Chaou
Keyword(s):  
Spinal Cord ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Contralateral Side ◽  
Acute Bacterial Meningitis ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Abscess ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Central Nervous System

Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system. Untreated, it may result in significant morbidity and mortality. We describe the case of a 34-year-old man, who initially was admitted for bacterial meningitis. 3 days after initiation of antibiotic therapy, a gradually and progressive weakness appeared on the left side of his body with numbness on the contralateral side. MRI of the spine demonstrated an ISCA at level of C4. A myelotomy and surgical drainage was performed. Postoperatively, the patient had improved significantly his neurological deficit. ISCA is still a life-threatening condition, we point out that the diagnosis should be highly suspected, if a cystic spinal cord lesion is surrounded by significant medullar edema associated with fast onset of symptoms, especially in a context of sepsis or acuate meningitis. Prompt surgical evacuation followed by adequate antibiotic therapy, are the mainstays of treatment.

scholarly journals The use of magnetic resonance and MR angiography in the detection of cerebral infarction: A complication of pediatric bacterial meningitis

2005 ◽  
Vol 62 (9) ◽  
pp. 645-648
Author(s):  
Tatjana Stosic-Opincal ◽  
Katarina Kacar ◽  
Srboljub Stosic ◽  
Slobodan Lavrnic ◽  
Vesna Peric ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Bacterial Meningitis ◽  
Cerebral Infarction ◽  
Antibiotic Therapy ◽  
Mr Angiography ◽  
Time Course ◽  
Acute Bacterial Meningitis ◽  
Vascular Involvement ◽  
Invasive Technique ◽  
Meningitis In Children

Bacground. Association of both cerebral infarction and acute bacterial meningitis is more common in younger patients than in the elderly. The rate of mortality and the frequency of sequel are very high inspite of the use of modern antibiotic therapy. In more than 30% of the cases of childhood bacterial meningitis, both arterial and venous infarctions can occur. The aim of this study was to present the role of the use of magnetic resonance (MRI), and MR angiography (MRA) in the detection of bacterial meningitis in children complicated with cerebral infarctions. Method. In the Centre for MR, the Clinical Centre of Serbia, 25 patients with the diagnosis of bacterial meningitis, of which 9 children with cerebral infarction whose clinical conditon deteriorated acutely, despite the antibiotic therapy, underwent MRI and MR angiography examination on a 1T scanner. Examination included the conventional spin-echo techniques with T1-weighted saggital and coronal, and T2- weighted axial and coronal images. Coronal fluid attenuated inversion recovery (FLAIR) and the postcontrast T1-weighted images in three orthogonal planes were also used. The use MR angiography was accomplished by the three-dimensional time-of-flight (3D TOF) technique. Results. The findings included: multiple hemorrhagic infarction in 4 patients, multiple infarctions in 3 patients, focal infarction in 1 patient and diffuse infarction (1 patient). Common sites of involvement were: the frontal lobes, temporal lobes and basal ganglia. The majority of infarctions were bilateral. In 3 of the patients empyema was found, and in 1 patient bitemporal abscess was detected. In 8 of the patients MR angiography confirmed inflammatory vasculitis. Conclusion. Infarction is the most common sequel of severe meningitis in children. Since the complication of cerebral infarction influences the prognosis of meningitis, repetitive MRI examinations are very significant for the evaluation of the time course of vascular involvement. The use of MRI, especially FLAIR imaging, confirmed its value in the detection and determination of the site and the extent of cerebral infarction. Non-invasive technique of examination, 3D TOF MR angiography clearly should show the presence of inflammatory vasculitis.

scholarly journals Rapid diagnosis of gram-negative bacterial meningitis by the Limulus endotoxin assay

1978 ◽  
Vol 7 (1) ◽  
pp. 12-17 ◽  
Author(s):  
J H Jorgensen ◽  
J C Lee
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Pneumococcal Meningitis ◽  
Rapid Diagnosis ◽  
Acute Bacterial Meningitis ◽  
Gram Negative ◽  
Bacterial Cultures ◽  
Limulus Amoebocyte Lysate ◽  
Gram Negative Organisms

The Limulus amoebocyte lysate endotoxin assay was evaluated as a method for rapid diagnosis of acute bacterial meningitis in a series of 305 patients. The results of Limulus assays on cerebrospinal fluid (CSF) samples from these patients were compared with the results for each patient of routine bacterial cultures and Gram stains. Positive Limulus tests were obtained on initial CSF specimens from 84% of patients with culture-proven bacterial meningitis, including all patients with meningitis due to gram-negative organisms. Initial Gram-stained smears revealed the presence of organisms in 68% of the patients. One patient with pneumococcal meningitis had a weakly positive Limulus assay, whereas patients with meningitis due to other gram-positive organisms, those with aseptic meningitis, or patients without meningitis had negative CSF Limulus tests. The Limulus assay also demonstrated the persistence of endotoxin in the CSF of certain patients during antibiotic therapy, especially patients with Haemophilus influenzae meningitis. The Limulus test proved to be a rapid, reliable indicator of the presence of gram-negative organisms in the CSF of patients suspected of acute bacterial meningitis.

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