Meningitis evaluation

Leist, T. P, Frei, K., Kam Hansen, S., Zinkemagel, R. M., and Fontana, A. Tumor necrosis factor alpha in cerebrospinal fluid during bacterial, but not viral, meningitis. Evaluation in murine model infections and in patients. J. Exp. Med. 167, 1743-1748 (1988). 

Evaluation Physical examination, complete blood count (CBC) with reticulocyte, urinalysis, chest x-ray, and cultures (blood, urine, and throat) lumbar puncture if toxic-looking or presenting with signs of meningitis needle aspirate in patients with findings suggestive of osteomyelitis... 

Tuberculous meningitis CSF culture, PCR evaluation (preferred), and acid-fast stain... 

Tipranavir, a VIH-PR inhibitor, was launched for AIDS therapy (Figure 8.12). Pleconaril inhibits adhesion by binding the viral capsid. It is currently being evaluated for viral infections of the respiratory tract, in particular, for picornavims (meningitis) and rhinovirus (colds) (Figure 8.12). 

Once the essential initial ABCD interventions have been instituted, one can begin a more detailed evaluation to make a specific diagnosis. This includes gathering any available history and performing a toxicologically oriented physical examination. Other causes of coma or seizures such as head trauma, meningitis, or metabolic abnormalities should be looked for and treated. Some common intoxications are described under Common Toxic Syndromes. 

In the evaluation of papilledema, magnetic resonance imaging (MRI) or CT is an invaluable and necessary adjunct to determine whether there is a mass in the head or signs of meningeal involvement, which can occur with infection, tumor, or infiltration. MRI is especially sensitive in imaging the enlargement of the subarachnoid space... 

The efficacy and safety of amphotericin in Intralipid 20% or 5 % glucose has been evaluated in a retrospective case analysis in 30 patients with AIDS and cryptococcal meningitis who received either formulation 1 mg/kg/day for 20 days with or without flucytosine (n = 20) or fluconazole (n = 4), followed by maintenance therapy with fluconazole 400 mg/day (45). Twenty patients received amphotericin deoxycholate in 500 ml 5% glucose over 5 hours, and 10 received amphotericin deoxycholate in 100 ml of 20% Intralipid given over 2 hours. Complete clinical resolution was obtained in 55 and 60% of the patients respectively. There were no differences regard-... 

Data on adverse events reported to a passive provincial surveillance system have been evaluated after the mass immunization with a polysaccharide meningococcal vaccine of 1 198 751 people aged 6 months to 20 years in Quebec. A total of 118 reports of severe adverse events were selected. The most frequent were allergic reactions (9.2 per 100 000 doses), followed by few neurological reactions (0.5 per 100 000 doses) and very few anaphylactic reactions (0.1 per 100 000 doses). There were no reports of long-lasting sequelae or of encephalopathy, encephalitis, or meningitis (15). 

A child is born with spina bifida, a defect in the lower spinal cord and meninges that may cause bladder and lower limb dysfunction. The family history reveals that the father had a small spina bifida that was repaired by surgery. The most critical aspect of the medical evaluation as it pertains to genetic counseling is... 

Lumbar puncture (LP) is used to obtain cerebrospinal fluid (CSF). It is used most often as an evaluation of CNS infections such as meningitis and encephalitis, but it is also useful in subarachnoid hemorrhage, multiple sclerosis, and dementia. Opening pressure, cell count and differential, glucose concentration, total protein... 

A recent case report exhibited favorable effects of high-dose intravenous ciprofloxacin (400 mg every 8 hours) plus intravenous ceftazidime for pseudomonal meningitis. However, this information must be evaluated in a controlled chnical trial before high-dose ciprofloxacin can be recommended for use. 

Clinical evaluation began in 1944 and streptomycin quickly attained the status of a miracle drug. Whereas patients with tubercular meningitis had previously had a zero chance of survival, as many as three-quarters of the patients could now be saved, and demand for the drug soon outstripped the rate of supply. By 1953, the rate of production in the USA had risen to 20,000 kg each month and there were eight companies in the USA producing the drug, with a further three in France, two in the UK, four in Japan and two in Italy. 

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