The fitting patient
Andrew Stewart, Rory Mackinnon in Pocket On Call, 2015
Patients can fit for a wide variety of reasons. Common causes to consider are: Epilepsy/seizure disorder.Alcohol withdrawal.Hypoglycaemia. (Always measure blood glucose as a priority in any fitting patient.)Intracranial haemorrhage.Hypoxia.Head injury.Overdose.Fever.Central nervous system (CNS) infection.
Microbiological Diagnosis of Bacterial Diseases
Nancy Khardori in Bench to Bedside, 2018
Infection of central nervous system is a life-threatening condition and needs urgent evaluation and treatment. Microbiology laboratory plays an important role not only in establishing the etiological agent but also in helping start appropriate antibiotic treatment. Most common infections are meningitis, encephalitis, meningoencephalitis, myelitis and brain abscess. Cerebrospinal fluid (CSF) specimen is the most reliable specimen for laboratory investigation of CNS infection. The etiological agents are different for different age groups of patients and also depend on a number of host factors. Both the clinician and microbiologist should be aware of these factors so that appropriate processing is done in the microbiology laboratory. The association of etiological agents in different groups of patients is given in Table 6.
Disseminated Histoplasmosis, Coccidioidomycosis, And Cryptococcosis
Lourdes R. Laraya-Cuasay, Walter T. Hughes in Interstitial Lung Diseases in Children, 2019
Pulmonary cryptococcosis may be expressed over a wide range of disease patterns, from a subclinical asymptomatic infection to bilateral diffuse pneumonitis. The diffuse, peribronchial, and miliary pneumonic lesions tend to occur in patients with underlying diseases such as malignancy or immunodeficiency disorders. Also, patients who are immunocompromised are likely to have disseminated, extrapulmonary cryptococcosis. In a study of 36 patients with fatal pulmonary cryptococcosis at The Johns Hopkins Hospital, all but 3 had underlying debilitating disease.7 Twenty-four (67%) of the patients had disseminated infection and one half of the patients had central nervous system involvement. The most common histologic pulmonary pattern, seen in 19 of the cases, was that of proliferating organisms within adjacent alveolar spaces and larger airways with a granulomatous inflammatory response. However, in seven patients organisms were present within the alveolar capillaries; in some cases the interstitial tissue was also involved (Figure 3).
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
Mass spectrometry based metabolomics for small molecule metabolites mining and confirmation as potential biomarkers for schistosomiasis – case of the Okavango Delta communities in Botswana
Published in Expert Review of Proteomics, 2022
Sedireng M. Ndolo, Matshediso Zachariah, Lebotse Molefi, Nthabiseng Phaladze, Kwenga F. Sichilongo
The acute stage is commonly a manifestation of schistosomiasis eggs deposited in host tissues. Hematuria is a common symptom of S. haematobium in the acute stage of infection, and is usually a result of granulomatous inflammation caused by the deposition of eggs into the host tissues. At the acute stage, S. mansoni deposits eggs into the gut wall, inducing inflammation, ulceration, and polyposis. Symptoms usually include blood in the feces or diarrhea, and colicky, hypogastric pain in children [15]. Colonic polyposis and an inflammatory mass in the colon are associated with protein leaching [15,16]. When eggs are voided to the outside of the host in urine or feces, they need fresh water to hatch and continue the life cycle [8,14]. Eggs not voided are swept into the blood circulation, and the periportal tract of the liver filters them. Some eggs are trapped in the spinal cord, brain, cerebellum, leptomeninges, and choroid plexus [8,14,17]. These manifest in central nervous system (CNS) infections and cause symptoms such as dizziness, vomiting, headache, and even paralysis [18,19]. Schistosomiasis disrupts the host’s metabolic regulation host, such as the tricarboxylic acid (TCA) cycle and glycolysis, as the schistosomula consumes glucose [20,21]. Although there is limited information on the disruption of energy production systems in humans as a result of parasitic infection, there is evidence that schistosomiasis in birds interferes with the molecular pathways critical for protein production and lipid biogenesis in tissues that are along the schistosomiasis migration pathway [22].
Cochlear implantation in neurobrucellosis: Two case reports
Published in Acta Oto-Laryngologica Case Reports, 2022
Afrah Alshalan, Medhat Yousef, Abdulrahman Alsanosi
Brucellosis is one of the most frequent zoonotic diseases worldwide. While Brucella melitensis is the most commonly reported subtype, other main subtypes include Brucella suis and Brucella abortus. The primary host is animals such as goats, sheep, cattle, and pigs while humans are the secondary host [1]. Infection is usually transmitted through undercooked meat and unpasteurized dairy products including milk and fresh cheese. The most common presenting clinical features are arthralgia and fever. Although brucellosis is highly contagious, the mortality rate is not high and antibiotics such as tetracyclines, rifampicin, and streptomycin are effective therapeutic choices [1]. Nonetheless, brucellosis is a systemic infectious condition with a wide spectrum of serious events. For instance, central nervous system (CNS) complications occur among approximately 5% of patients; however, the diagnosis could be challenging with lack of characteristic signs and the presence of several other infectious diseases considered in the differential diagnosis [2]. Involvement of CNS comes acutely; patients may have meningitis, encephalitis, epilepsy, ataxia, brain hemorrhage, depression, and even coma. The affection of cranial nerves by neurobrucellosis is not rare; the vestibulocochlear nerve is considered the commonest affected nerve based on data from previous studies [3,4]. Herein, we present a report of two female patients who underwent cochlear implant because of sensorineural hearing loss (SNHL) induced by neurobrucellosis.
Related Knowledge Centers
- Cerebrospinal Fluid
- Extracellular Fluid
- Meninges
- Nervous System
- Nervous Tissue
- Neurotoxin
- Spinal Cord
- Brain
- Blood–Brain Barrier
- Dorsal Body Cavity