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Cronobacter: An Opportunistic Pathogen
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
NEC in newborns is diagnosed by palpating the baby's abdomen for swelling, pain, and tenderness followed by x-ray analysis of the abdomen (55). Signs of inflammation and intestinal damage in x-ray will give the physician an idea about NEC. However, there is no clear diagnostic parameter to determine if that NEC is due to Cronobacter spp. Similarly, central nervous system infections by Cronobacter spp. are unknown to pediatricians and neurologists. C. sakazakii–induced meningitis exhibits a greater propensity to cause brain abscess with associated poor prognosis. A case report showed that a female infant admitted to the hospital showed positive cerebrospinal culture for C. sakazakii (then E. sakazakii). The patient had a seizure 5 days after admission and had a head computed tomography scan that showed a large region of decreased attenuation in the left frontal lobe with associated mass effect and partial gyriform enhancement, findings most consistent with cerebritis. Magnetic resonance images (Figure 29.2) taken the following day revealed a 4 cm ring-enhancing fluid-containing lesion in the left frontal lobe, in keeping with an intraparenchymal abscess (56). Thus, neuroimaging has been proposed to diagnose for brain abscess formation if the culture is positive for C. sakazakii.
Case 37: Collapsed in the Corridor
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
The ward team noticed that the patient seemed confused at times, with episodes of both anxiety and depressed affect. On the fifth day of his admission, he tried to smash a window and was transiently unaware of his surroundings. A CT scan of the brain was performed – this was unremarkable. A lumbar puncture was carried out to investigate for possible central nervous system infections, including viral encephalitis, but identified no abnormalities. Autoimmune encephalitis was also considered as a possible diagnosis.
Psychiatric Emergencies in the Elderly
Published in R. Thara, Lakshmi Vijayakumar, Emergencies in Psychiatry in Low- and Middle-Income Countries, 2017
Infections – Pneumonia– Urinary tract infections– Central nervous system infections
Actinomyces odontolyticus causing meningitis and cervical abscess
Published in Baylor University Medical Center Proceedings, 2021
Hanish Jain, Garima Singh, Ambika Eranki
Actinomycosis is a chronic suppurative infection characterized by abscess formation caused by Actinomyces spp. It typically resides in mucosal areas mainly in the oral cavity, alimentary tract, and genital tracts. It can rarely cause central nervous system infections, mainly through translocation of the bacteria from adjacent sites such as paranasal areas or through hematogenous seeding from a dental abscess, lungs, and cervicofacial areas. Central nervous system involvement mainly consists of spinal and epidural abscess, brain abscess, and meningitis. In one study of 70 cases, central nervous system infection presented as brain abscess in 67% of the patients, meningitis or meningoencephalitis in 13%, actinomycosis in 7%, subdural empyema in 6%, and epidural abscess in 6%.9A. israelii comprises almost 70% of the orocervicofacial infections.10 Less common species include A. naeslundii, A. odontolyticus, A. viscosus, A. meyeri, A. turicensis, and A. radingae.1,11 Twenty-five cases of A. odontolyticus bacteremia have been reported, according to one literature review, of which only one was a brain abscess.12
Key considerations in the pharmacotherapy of tuberculous meningitis
Published in Expert Opinion on Pharmacotherapy, 2019
Sean Wasserman, Angharad Davis, Robert J. Wilkinson, Graeme Meintjes
Linezolid is well established in the treatment of drug-resistant pulmonary TB, with two RCTs and multiple observational studies demonstrating improved outcomes when added to treatment. In vitro models have demonstrated potent activity against a non-replicative persister M. tuberculosis phenotype, as well as additive activity when administered with rifampicin, particularly at higher doses, spurring interest in its use as a treatment-shortening agent in drug-sensitive pulmonary TB [13,14]. Linezolid is attractive for TBM therapy due to moderate EBA and sterilizing ability against M. tuberculosis as well as favorable PK characteristics: linezolid has almost complete oral bioavailability with extensive tissue distribution, including in CSF. This feature has led to successful use in severe central nervous system infections caused by Gram-positive bacteria. Retrospective studies have demonstrated favorable clinical outcomes in children [15] and adults [16] with drug-sensitive TBM and provide further rationale for its inclusion in experimental regimens in upcoming clinical trials.
Closure of a large myelomeningocele defect using the V–Y rotation advancement flap (butterfly flap): a case report and literature review
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Hatan Mortada, Tareg Alhablany, Tanveer A. Bhat, Abdulla Al Tamimi
MMC is a congenital disorder of idiopathic cause due to closure failure of the posterior portion of the neural tube. The unusual growth of the vertebrae at the lamina and spinal apophysis level may involve one or more arcs, causing hernias that contain CSF and spinal cord meninges with a potential adhesion in the spinal cord or nerve roots. Multiple complications may occur in individuals with this defect. Therefore, early surgical intervention decreases the increasing number of the central nervous system infections and prevents the progression of neurological function deficit by protecting the neural tissue [7].