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Meningitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Meningitis is an inflammation of the three membranes (meninges) that surround the brain and spinal cord. Bacterial or viral infections in the cerebrospinal fluid within the subarachnoid space typically cause the inflammation and swelling. The disorder is characterized by intense headache and fever, sensitivity to light, and muscular rigidity (stiff neck), leading in severe cases to convulsions, delirium, and death.
Management of the Sick Child
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Meningitis is an infection of tissues surrounding the brain and spinal cord. Acute bacterial meningitis is a common and serious condition that frequently presents with altered consciousness and fever. It has a high associated mortality of up to 25%, with 25–30% of survivors having long-term disability.12
Epidural and Intrathecal Analgesia
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
If neurological signs develop, they may be delayed until some days later, although this is not always the case. Patients with meningitis may present with typical symptoms such as fever, severe headache, photophobia, neck stiffness, and altered levels of consciousness, without motor or sensory loss.
Cost-effectiveness analysis of pediatric immunization program with 15-valent pneumococcal conjugate vaccine in Japan
Published in Journal of Medical Economics, 2023
Atsushi Tajima, Machiko Abe, Jessica Weaver, Min Huang
Pneumococcal disease (PD) is a major cause of morbidity and mortality globally, especially in young children and older adults.1 PD includes a group of diseases caused by Streptococcus pneumoniae (S. pneumoniae, pneumococcus).1–3 The most common types of PD are non-bacteremic pneumococcal pneumonia (NBPP), which can affect individuals of all ages, and pneumococcal acute otitis media (AOM), which primarily affects children.3,4 Invasive pneumococcal disease (IPD), including meningitis, bacteremia without focus, and bacteremic pneumonia, is a less common but more severe form of PD.2–4 Meningitis, in particular, has a high mortality rate and can lead to long-term disabling neurological sequelae, such as hearing loss, seizures, and cognitive impairment.5,6
Current perspectives on the diagnosis and management of acute transverse myelitis
Published in Expert Review of Neurotherapeutics, 2023
Nanthaya Tisavipat, Eoin P Flanagan
Eculizumab is a humanized complement inhibitor targeting C5. Inhibiting C5 cleavage into C5b theoretically prevents formation of membrane attack complex (MAC) which destroys astrocytes and bystanding neurons [188–190]. In the randomized, time-to-event PREVENT trial, only 3% of AQP4+NMOSD patients receiving eculizumab (900 mg infusion weekly for 4 weeks, followed by 1,200 mg every 2 weeks), with or without concomitant immunosuppressant, had relapses compared to 43% receiving placebo. All patients received meningococcal vaccine before treatment or placebo. Serious adverse events occurred in a quarter of patients, similarly between eculizumab and placebo groups, and were related to infection [191]. Meningitis from meningococcal infection is the most feared complication and vaccination for all available variants is mandatory prior to starting treatment and prophylactic antibiotics should be strongly considered, particularly in those transitioning from B-cell depleting treatments in whom response to vaccinations are attenuated.
Recurrent benign lymphocytic (Mollaret’s) meningitis due to herpes simplex virus type 2
Published in Baylor University Medical Center Proceedings, 2022
Michael Grinney, Michael M. Mohseni
Recurrent meningitis is a rare clinical entity that requires prompt investigation to determine the underlying etiology. In cases of recurrent bacterial meningitis, the outcomes can be life threatening,1,2 while in recurrent viral or aseptic meningitis the clinical course is generally self-limited.3 Recent retrospective reviews have implicated herpes simplex virus type 2 (HSV-2) and varicella-zoster virus as the predominant viral causes of meningitis in adults.4,5 HSV-1 and Epstein-Barr viruses have also been reported in a minority of cases.6 Recurrent benign lymphocytic meningitis (RBLM) is a rare form of recurrent aseptic meningitis typically associated with HSV-2; this entity was first described in the mid-20th century by Dr. Pierre Mollaret.7 At the time of its first description, RBLM patients were noted to have mononuclear cells in the cerebrospinal fluid (CSF) that were later termed “Mollaret cells.”8 “Mollaret’s meningitis” has been used interchangeably with RBLM but the relationship with HSV-2 was not effectively established until the 20th century with widespread use of polymerase chain reaction (PCR) to isolate the implicated DNA.6,9 RBLM is characterized by at least three but up to 10 episodes of recurrent meningitis lasting from 2 to 5 days and subsequently followed by rapid recovery.10 We present a case of HSV-2 meningitis in a young woman with seven similar prior episodes.