1/18. streptococcus pyogenes meningitis: report of a case and review of the literature.streptococcus pyogenes is a very uncommon cause of bacterial meningitis beyond the neonatal period. A case report and a review of the recent literature is presented. We report on a previously healthy 7-year-old boy who developed S. pyogenes meningitis following a 2-day history of otitis media. A CT scan revealed right-sided mastoiditis as a possible focus of infection. The patient was treated with penicillin g for 14 days. The clinical course was uneventful, and the recovered without sequelae. By means of the polymerase chain reaction, the presence of streptococcal pyrogenic exotoxin (SPE) B and SPE C, but not SPE A genes was discovered from the bacterial dna. CONCLUSION: streptococcus pyogenes is a rare cause of bacterial meningitis but has to be considered as the causative pathogen beyond the neonatal period.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
2/18. meningitis in a girl with recurrent otitis media caused by streptococcus pyogenes--otitis media has to be treated appropriately.streptococcus pyogenes rarely causes meningitis. A recent increase in the incidence and severity of diseases due to S. pyogenes has been observed worldwide, without an apparent increase in the incidence of S. pyogenes meningitis. However, more recently severe and fulminant cases of S. pyogenes meningitis have been reported in the literature. This case report emphasizes the fact that S. pyogenes can cause meningitis with severe clinical sequelae such as hygromas and right-sided third cranial nerve palsy. Most importantly, it is concluded that recurrent otitis media has to be treated carefully following appropriate identification of the causing organism in order to prevent severe clinical courses of streptococcal infections.- - - - - - - - - - ranking = 9keywords = otitis (Clic here for more details about this article) |
3/18. One case each of recurrent meningitis and hemoperitoneum infection with Ralstonia mannitolilytica.Two clinical cases of infection with Ralstonia mannitolilytica are described: a recurrent meningitis on an implanted intraventricular catheter and an infected hemoperitoneum as a complication of a cholangiocarcinoma. The strains were first misidentified as pseudomonas fluorescens and burkholderia cepacia. Further testing lead to the identification as ralstonia pickettii biovar 3/"thomasii," which was recently shown to represent a separate species, R. mannitolilytica (List editor N. Weiss, Int. J. Syst. Evol. Microbiol. 51:795-796, 2001), originally described as R. mannitolytica (De Baere et al., Int. J. Syst. Evol. Microbiol. 51:547-558, 2001). R. mannitolilytica can be distinguished from all described Ralstonia species by its acidification of D-arabitol and mannitol and by its lack of nitrate reduction and of alkalinization of tartrate. In order to determine the true prevalence of infections with this species, colistin-resistant "P. fluorescens" strains and strains growing on B. cepacia selective medium deserve further attention.- - - - - - - - - - ranking = 0.080196093115799keywords = medium (Clic here for more details about this article) |
4/18. pasteurella multocida meningitis: case report and review of the last 11 y.pasteurella multocida meningitis is a rare clinical occurrence. We report a new case and review the 28 other cases described in the English literature. A history of recent animal contact remains strongly associated with P. multocida meningitis (noted in 89% of all cases), with licking of mucus surfaces or injured skin being most common. bacteremia was present in 63% of all patients. Spread from an adjacent site of infection continues to be an important factor, with otitis media being documented or strongly suspected in 24% of all cases. The presenting signs and symptoms were characteristic of bacterial meningitis, with fever, headache, nucal rigidity and an altered level of consciousness being present in most patients. cerebrospinal fluid analysis was typical for bacterial meningitis. penicillin g or ampicillin was the most common definitive treatment; however, third-generation cephalosporins have been successful. The mean duration of treatment was 14 d. Neurologic complications were present in 17% of patients overall and mortality remains substantial at 25%. Although not statistically significant, there is a trend toward decreased neurologic complications and mortality during the last 11 y.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
5/18. Group-A streptococcal meningitis in an adult, secondary to purulent otitis media.Group A streptococcal meningitis is rarely encountered today, although group A streptococcal severe infections are on the increase. We present here a case of an adult male with bacterial meningitis as a complication of otitis media induced by Group A Streptococcus. The approach to diagnosis and treatment considerations are discussed.- - - - - - - - - - ranking = 5keywords = otitis (Clic here for more details about this article) |
6/18. Venous sinus thrombosis after proteus vulgaris meningitis and concomitant clostridium abscess formation.A 19-y-old woman presented with proteus vulgaris meningitis as a complication of chronic otitis media. Despite treatment with ceftazidime and amikacin no clinical improvement was observed. Cranial MRI revealed right-sided mastoiditis/otitis media and venous sinus thrombosis. After mastoidectomy, repeat cranial MRI demonstrated abscess formation in the venous sinuses. The abscess was drained. clostridium spp. was isolated from the abscess culture.- - - - - - - - - - ranking = 2keywords = otitis (Clic here for more details about this article) |
7/18. Complement component deficiencies and infection: C5, C8 and C3 deficiencies in three families.Three families are described with complement component deficiencies. In one family, five children had C5 deficiency; in a second family, two children had C8 deficiency and one child in a third family had C3 deficiency. The index cases were identified during screening of patients with recurrent pyogenic infections, recurrent meningitis and meningococcaemia. Two of the five C5 deficient patients had recurrent meningitis and meningococcaemia, two had recurrent respiratory tract infections and otitis and one was healthy. One of the C8 deficient patients had meningitis, meningococcaemia and pneumonia, whereas his sibling with the same deficiency was healthy. The patient with C3 deficiency had four episodes of meningitis and recurrent otitis.- - - - - - - - - - ranking = 2keywords = otitis (Clic here for more details about this article) |
8/18. A case of pneumocephalus and meningitis as a complication of silent otitis media.Silent otitis media is a progressive otogenic disease. Intracranial manifestations of this complication are limited; the most common is meningitis. We report a case of meningitis and pneumocephalus as a complication of silent otitis media. To the best of our knowledge, this is the first reported case of pneumocephalus as a complication of silent otitis media.- - - - - - - - - - ranking = 7keywords = otitis (Clic here for more details about this article) |
9/18. meningitis due to fusobacterium necrophorum in an adult.BACKGROUND: fusobacterium necrophorum may cause a number of clinical syndromes, collectively known as necrobacillosis. meningitis is a significant cause of mortality, rarely reported in the adult population. CASE PRESENTATION: We report a fatal case of meningitis, caused by fusobacterium necrophorum, secondary to otitis media in an alcoholic male. diagnosis was delayed due to the typical slow growth of the organism. The clinical course was complicated by encephalitis and by hydrocephalus. The patient failed to respond to metronidazole and penicillin. The patient died on day 12 from increased intracranial pressure and brain stem infarction. CONCLUSIONS: This case emphasizes the need for a high index of clinical suspicion to make the diagnosis of fusobacterium necrophorum meningitis. We recommend the use of appropriate anaerobic culture techniques and antimicrobial coverage for anaerobic organisms when the gram stain shows gram negative bacilli.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
10/18. Group A streptococcal meningitis.meningitis due to group A streptococci occurs uncommonly. We report two cases, one in a patient with otitis media and the other in a patient with bullous pemphigoid. Nineteen cases in the English-language literature from the past decade plus our two cases are reviewed. In 17 patients, an associated illness was present, most often otitis media or pharyngitis. When performed, gram staining of the cerebrospinal fluid and cultures of blood usually yielded organisms. cerebrospinal fluid was acellular in two patients. Of 21 patients, 20 survived. Antibiotic therapy, which consisted of penicillin for most patients, was effective. ceftriaxone may be an alternative agent. Neurologic sequelae occurred more often in children than in adults.- - - - - - - - - - ranking = 2keywords = otitis (Clic here for more details about this article) |
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