RESUMO
BACKGROUND: Streptococcus suis is an emerging zoonotic pathogen that mainly causes meningitis, sepsis, arthritis, endocarditis, and endophthalmitis in human. To the best of our knowledge, Spinal canal infection caused by Streptococcus suis has rarely been reported. CASE PRESENTATION: Here we report a case of spinal canal infection caused by Streptococcus suis in a 50-year-old male patient. The patient had a history of close contact with sick pigs days before disease onset. Initially he presented with headache and fever. After admission, the patient began to experience lower back pain, which led physicians to perform a lumber puncture. Meta-genomic next generation sequencing helped identify Streptococcus suis in the cerebrospinal fluid. MRI imaging indicated a spinal canal infection caused by Streptococcus suis. CONCLUSIONS: Spinal canal infection is an uncommon disease of Streptococcus suis infection. This case report indicates that people presented with fever, headache and lower back pain should also be suspected as Streptococcus suis infection, especially for those who have had a history of sick pig contact.
Assuntos
Dor Lombar , Meningites Bacterianas , Infecções Estreptocócicas , Streptococcus suis , Cefaleia , Humanos , Masculino , Meningites Bacterianas/diagnóstico , Canal Medular , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/diagnóstico , Streptococcus suis/genéticaRESUMO
During infection and inflammation, a reduced oxygen level clearly affects cellular functions. Oxygen levels during CNS infections are unknown. Here we established and evaluated an in vivo measurement system to characterize the oxygen level in parallel with bacterial numbers (CFU/mL), the cell number and pH level inside the CSF of healthy compared to Streptococcus suis-infected pigs. The animals were anesthetized over a seven-hour period with isoflurane in air/oxygen at physiologic arterial partial pressure of oxygen. Oxygen levels in CSF of anesthetized pigs were compared to euthanized pigs. The detected partial pressure of oxygen in the CSF remained constant in a range of 47-63 mmHg, independent of the infection status (bacterial or cell number). In contrast, the pH value showed a slight drop during infection, which correlated with cell and bacterial number in CSF. We present physiologic oxygen and pH values in CSF during the onset of bacterial meningitis.
Assuntos
Infecções Bacterianas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Bacterianas do Sistema Nervoso Central/fisiopatologia , Oxigênio/líquido cefalorraquidiano , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/fisiopatologia , Streptococcus suis/isolamento & purificação , Animais , Feminino , Masculino , SuínosRESUMO
Streptococcus agalactiae or group B streptococcus (GBS) is a pathogen that causes severe neonatal infections, resulting in sepsis, pneumonia, and meningitis. Neonatal GBS meningitis has a poor neurological prognosis and a high mortality rate. GBS disease is classified as early- and late-onset if the onset age is 0-6 and 7-89 days after birth, respectively. There is currently no effective preventive strategy against late-onset GBS (LOGBS) disease. Here, we report a case of female infant with LOGBS meningitis who recovered from the septic shock by two exchange transfusions (ExTs) but still experienced severe neurological sequela. She was born at a gestational age of 39 weeks via caesarian section due to oligohydramnios and had fever 11 days after birth. GBS was detected in her cerebrospinal fluid (CSF) and blood but not in the vaginal or breast-milk cultures of the mother. The patient was treated with intravenous antibiotic administration; however, she suddenly developed pulseless ventricular tachycardia and asystole the next day. Her heart rate was normalized via cardiopulmonary resuscitation. We also performed two ExTs, and she recovered from the septic shock. Cytokine-profile analysis revealed that the serum and CSF levels of various pro-inflammatory and anti-inflammatory cytokines were elevated before the ExTs, after which the serum levels of several of these cytokines decreased. Two ExTs were effective in saving the life of the patient but did not improve the neurological prognosis. Given that neonatal GBS meningitis has high fatality and sequela rates; thus, it is necessary to establish a preventive strategy.
Assuntos
Citocinas/sangue , Citocinas/líquido cefalorraquidiano , Transfusão Total , Meningites Bacterianas/sangue , Meningites Bacterianas/microbiologia , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/fisiologia , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Meningites Bacterianas/líquido cefalorraquidiano , Infecções Estreptocócicas/líquido cefalorraquidianoRESUMO
We report our experience caring for an infant with respiratory syncytial virus infection (RSV) and group B Streptococcus (GBS) bacteremia and meningitis. Concurrent GBS meningitis and RSV is rare but highlights the importance of correlating clinical symptoms with viral diagnostic testing during the evaluation of infants at risk for serious bacterial infection.
Assuntos
Meningites Bacterianas/diagnóstico , Infecções Estreptocócicas/diagnóstico , Coinfecção , Diagnóstico Tardio , Feminino , Humanos , Recém-Nascido , Meningites Bacterianas/etiologia , Meningites Bacterianas/microbiologia , Infecções por Vírus Respiratório Sincicial/complicações , Infecções por Vírus Respiratório Sincicial/diagnóstico , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/complicações , Streptococcus agalactiae/isolamento & purificaçãoRESUMO
BACKGROUND: Streptococcus suis meningoencephalitis is a zoonotic disease that mostly infects slaughterhouse workers. Rapid diagnosis of Streptococcus suis meningoencephalitis is critical for effective clinical management of this condition. However, the current diagnostic techniques are not effective for early diagnosis of this condition. To the best of our knowledge, the use of cerebrospinal fluid metagenomic next generation sequencing in the diagnosis of Streptococcus suis meningoencephalitis has been rarely reported. CASE PRESENTATION: Here, we report a case of Streptococcus suis meningoencephalitis in a 51-year-old female patient. The patient had a history of long-term contact with pork and had a three-centimeter-long wound on her left leg prior to disease onset. Conventional tests, including blood culture, gram staining and cerebrospinal fluid culture, did not reveal bacterial infection. However, Streptococcus suis was detected in cerebrospinal fluid using metagenomic next generation sequencing. CONCLUSIONS: Metagenomic next generation sequencing is a promising approach for early diagnosis of central nervous system infections. This case report indicates that cases of clinical meningeal encephalitis of unknown cause can be diagnosed through this method.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala/métodos , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/diagnóstico , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/diagnóstico , Streptococcus suis/genética , Zoonoses/líquido cefalorraquidiano , Zoonoses/diagnóstico , Animais , Antibacterianos/uso terapêutico , Ceftazidima/uso terapêutico , Diagnóstico Precoce , Encefalite , Feminino , Seguimentos , Humanos , Meningoencefalite/tratamento farmacológico , Meningoencefalite/microbiologia , Pessoa de Meia-Idade , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Resultado do Tratamento , Zoonoses/tratamento farmacológico , Zoonoses/microbiologiaRESUMO
BACKGROUND: Brain abscesses, a severe infectious disease of the CNS, are usually caused by a variety of different pathogens, which include Streptococcus intermedius (S. intermedius). Pulmonary arteriovenous fistulas (PAVFs), characterized by abnormal direct communication between pulmonary artery and vein, are a rare underlying cause of brain abscesses. CASE PRESENTATION: The patient was a previous healthy 55-year-old man who presented with 5 days of headache and fever. Cerebral magnetic resonance imaging (MRI) suggested a brain abscess. Thoracic CT scan and angiography demonstrated PAVFs. Aiding by metagenomic next-generation sequencing (mNGS) of the cerebrospinal fluid (CSF) sample which identified S. intermedius as the causative pathogen, the patient was switched to the single therapy of large dose of penicillin G and was cured precisely and economically. CONCLUSIONS: It is an alternative way to perform mNGS to identify causative pathogens in patients with brain abscesses especially when the results of traditional bacterial culture were negative. Further thoracic CT or pulmonary angiography should also be undertaken to rule out PAVFs as the potential cause of brain abscess if the patient without any known premorbid history.
Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/tratamento farmacológico , Penicilina G/uso terapêutico , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus intermedius/genética , Fístula Arteriovenosa/complicações , Abscesso Encefálico/líquido cefalorraquidiano , Abscesso Encefálico/microbiologia , Angiografia por Tomografia Computadorizada , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/microbiologia , Streptococcus intermedius/isolamento & purificação , Resultado do TratamentoAssuntos
Meningites Bacterianas/diagnóstico por imagem , Quadriplegia/diagnóstico por imagem , Medula Espinal/diagnóstico por imagem , Infecções Estreptocócicas/líquido cefalorraquidiano , Adulto , Antibacterianos/uso terapêutico , Feminino , Humanos , Imageamento por Ressonância Magnética , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Medula Espinal/patologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/patologia , Streptococcus constellatus/isolamento & purificaçãoRESUMO
Substantiation of the shunt failure diagnosis and subsequent consideration of indications for surgical elimination of the malfunction is a laborious and challenging process. Identification of a malfunction in doubtful cases requires, in addition to standard examinations, extra diagnostic procedures, which may delay making a decision for several weeks to several months. The article describes a case of mechanical CSF shunt malfunction (breakage and failure of a peritoneal catheter in a 7-year-old girl) with intracranial hypertension symptoms, but without typical enlargement of the brain ventricles. According to the medical history, congenital hydrocephalus in the child was accompanied by an inflammatory process of bacterial and viral etiology. The absence of brain ventricle enlargement was shown not to exclude a probability of shunt malfunction. In this case, a specific phenomenon, an intraparenchymatous cerebrospinal fluid "lake" surrounding a ventricular catheter, was observed. Shunting recovery did not lead to a significant reduction in the phenomenon size. Causes underlying this phenomenon require further investigation.
Assuntos
Ventrículos Cerebrais/cirurgia , Derivações do Líquido Cefalorraquidiano , Hidrocefalia/fisiopatologia , Hipertensão Intracraniana/cirurgia , Ventrículos Cerebrais/microbiologia , Ventrículos Cerebrais/fisiopatologia , Ventrículos Cerebrais/virologia , Derivações do Líquido Cefalorraquidiano/efeitos adversos , Criança , Citomegalovirus/isolamento & purificação , Citomegalovirus/patogenicidade , Infecções por Citomegalovirus/líquido cefalorraquidiano , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/microbiologia , Infecções por Citomegalovirus/virologia , Feminino , Humanos , Hidrocefalia/complicações , Hidrocefalia/microbiologia , Hidrocefalia/virologia , Hipertensão Intracraniana/fisiopatologia , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/virologia , Streptococcus pyogenes/isolamento & purificação , Streptococcus pyogenes/patogenicidadeRESUMO
Streptococcus gallolyticus subsp. pasteurianus, previously known as Streptococcus bovis biotype II.2, is an uncommon pathogen in neonates. Nevertheless, it can cause severe neonatal sepsis and meningitis often clinically indistinguishable from those caused by group B streptococci and has been associated with considerable morbidity. We report the first known cases of S. gallolyticus subsp. pasteurianus infection in twin infants.
Assuntos
Meningites Bacterianas/microbiologia , Sepse/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/classificação , Antibacterianos/uso terapêutico , Feminino , Humanos , Recém-Nascido , Masculino , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/patologia , Sepse/tratamento farmacológico , Sepse/patologia , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/patologia , Streptococcus/isolamento & purificação , GêmeosRESUMO
BACKGROUND & OBJECTIVES: Haemophilus influenzae type b (Hib) is one of the leading bacterial causes of invasive disease in populations without access to Hib conjugate vaccines (Hib-CV). India has recently decided to introduce Hib-CV into the routine immunization programme in selected States. Longitudinal data quantifying the burden of bacterial meningitis and the proportion of disease caused by various bacteria are needed to track the impact of Hib-CV once introduced. A hospital-based sentinel surveillance network was established at four places in the country and this study reports the results of this ongoing surveillance. METHODS: Children aged 1 to 23 months with suspected bacterial meningitis were enrolled in Chennai, Lucknow, New Delhi, and Vellore between July 2008 and June 2010. All cerebrospinal fluid (CSF) samples were tested using cytological, biochemical, and culture methods. Samples with abnormal CSF (≥10 WBC per µl) were tested by latex agglutination test for common paediatric bacterial meningitis pathogens. RESULTS: A total of 708 patients with abnormal CSF were identified, 89 of whom had a bacterial pathogen confirmed. Hib accounted for the majority of bacteriologically confirmed cases, 62 (70%), while Streptococcus pneumoniae and group B Streptococcus were identified in 12 (13%) and seven (8%) cases, respectively. The other eight cases were a mix of other bacteria. The proportion of abnormal CSF and probable bacterial meningitis that was caused by Hib was 74 and 58 per cent lower at Christian Medical College (CMC), Vellore, which had a 41 per cent coverage of Hib-CV among all suspected meningitis cases, compared to the combined average proportion at the other three centres where a coverage between 1 and 8 per cent was seen (P<0.001 and P= 0.05, respectively). INTERPRETATION & CONCLUSIONS: Hib was found to be the predominant cause of bacterial meningitis in young children in diverse geographic locations in India. Possible indications of herd immunity was seen at CMC compared to sites with low immunization coverage with Hib-CV. As Hib is the most common pathogen in bacterial meningitis, Hib-CV would have a large impact on bacterial meningitis in Indian children.
Assuntos
Cápsulas Bacterianas , Vacinas Anti-Haemophilus , Haemophilus influenzae tipo b/patogenicidade , Meningite por Haemophilus/líquido cefalorraquidiano , Meningite por Haemophilus/epidemiologia , Feminino , Haemophilus influenzae tipo b/isolamento & purificação , Humanos , Programas de Imunização , Índia , Lactente , Masculino , Meningite por Haemophilus/microbiologia , Estudos Prospectivos , Vigilância de Evento Sentinela , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Streptococcus agalactiae/patogenicidade , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pneumoniae/patogenicidadeRESUMO
Streptococcus agalactiae is a rare cause of acute bacterial meningitis. We report the case of a middle age non-pregnant female patient, with no comorbitidies, who was hospitalized with acute meningitis. The pathogen was identified both in blood and CSF. She recovered uneventfully with ceftriaxone and dexamethasone. A CSF leak was suspected by previous history of unilateral watery rhinorrhea, that was demonstrated with a high resolution paranasal sinus CT and beta-2 transferrin analysis of the nasal fluid. Vulvovaginitis was also diagnosed after admission, but no cultures were obtained. Streptococcus agalactiae is an infrequent cause of bacterial meningitis that should promote the search of anatomical abnormalities or comorbidities in non-pregnant adults and beyond newborn period.
Assuntos
Rinorreia de Líquido Cefalorraquidiano/complicações , Meningites Bacterianas/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Doença Aguda , Vazamento de Líquido Cefalorraquidiano , Feminino , Humanos , Hospedeiro Imunocomprometido , Meningites Bacterianas/líquido cefalorraquidiano , Pessoa de Meia-Idade , Infecções Estreptocócicas/líquido cefalorraquidiano , Tomografia Computadorizada por Raios XRESUMO
Streptococcus salivarius is a normal member of the human oral microbiome that is an uncommon cause of invasive infections. Meningitis is a rare but increasingly reported infection caused by S. salivarius. Despite the growing number of reported cases, a comprehensive review of the literature on S. salivarius meningitis is lacking. We sought to gain a better understanding of the clinical presentation, evaluation, management, and outcome of S. salivarius meningitis by analyzing previously reported cases. In addition to a single case reported here, 64 previously published cases of meningitis were identified for this review. The collected data confirm that most patients presented with classical signs and symptoms of bacterial meningitis with a predominance of neutrophils in the cerebrospinal fluid (CSF) and hypoglycorrhachia. The majority of cases followed iatrogenic or traumatic CSF contamination. Most cases were diagnosed by CSF culture within one day of symptom onset. There was no clear evidence of predisposing co-morbid conditions in patients with meningitis, although in most case reports, limited information was given on the medical history of each patient. Outcomes were generally favorable with antibiotic management. Clinicians should suspect S. salivarius meningitis in patients presenting acutely after medical or surgical procedures involving the meninges.
Assuntos
Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/microbiologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Streptococcus , Feminino , Humanos , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/patologia , Pessoa de Meia-Idade , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/patologiaRESUMO
Streptococcus suis (S. suis) is a zoonotic pathogen that primarily inhabits the upper respiratory tract of pigs. Therefore, pigs that carry these pathogens are the major source of infection. Most patients are infected through contact with live pigs or unprocessed pork products and eating uncooked pork. S. Suis mainly causes sepsis and meningitis. The disease has an insidious onset and rapid progress. The patient becomes critically ill and the mortality is high. In this case report, we described a rare case of S. suis isolated from a middle-aged woman in Jinhua City, Zhejiang Province, China, who did not have any contact with live pigs and had not eaten uncooked pork. S. Suis was isolated from both the patient's blood and cerebrospinal fluid samples.
Assuntos
Meningite , Sepse , Infecções Estreptocócicas , Animais , China , Humanos , Meningite/diagnóstico , Meningite/etiologia , Meningite/microbiologia , Pessoa de Meia-Idade , Carne de Porco , Sepse/diagnóstico , Sepse/etiologia , Sepse/microbiologia , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/transmissão , Streptococcus suis/genética , SuínosRESUMO
BACKGROUND: Streptococcus suis (Ss) is a Gram-positive and anaerobic zoonotic pathogen that is susceptible to all populations and can cause meningitis, septicemia, endocarditis and arthritis in humans. METHODS: In this study, patients with meningitis who were admitted to our hospital with negative blood and cerebrospinal fluid culture were divided into a next-generation sequencing group and a control group. In the next-generation sequencing group, we used the next-generation sequencing method to detect pathogenic bacteria in the patients' cerebrospinal fluid. In the control group, we used blood and cerebrospinal fluid bacterial culture method to detect pathogenic bacteria in the patients' cerebrospinal fluid. The detection rates of pathogenic bacteria in the cerebrospinal fluid of the two groups were compared and analyzed. RESULTS: A total of 18 patients were included in this study, including 8 patients in the next-generation sequencing group and 10 patients in the control group. The mean age (P = 0.613) and mean disease duration (P = 0.294) were similar in both groups. Patients in the next-generation sequencing group had a leukocyte count of 13.13 ± 4.79 × 109, a neutrophil percentage of 83.39 ± 10.36%, and a C-reactive protein level of 134.95 ± 107.69 mg/L. Patients in the control group had a temperature of 38.32 ± 1.07, a leukocyte count of 8.00 ± 2.99 × 109, and a neutrophil percentage of 74.61 ± 8.89%, and C-reactive protein level was 4.75 ± 6.8 mg/L. The statistical results showed that the leukocytes (P = 0.013) and C-reactive protein levels (P = 0.001) were significantly higher in the patients of the next-generation sequencing group than in the control group. No statistically significant differences were seen in body temperature and neutrophil percentage between the two groups (P > 0.05). The incidence of intracranial pressure and meningeal irritation signs were similar in the two groups (P > 0.05). The detection rate of Streptococcus suis in the cerebrospinal fluid of patients in the next-generation sequencing group was 100%, and the detection rate of Streptococcus suis in the cerebrospinal fluid of the control group was 0%. CONCLUSION: The detection rate of Streptococcus suis infection in cerebrospinal fluid by next-generation sequencing was significantly higher than that by blood and cerebrospinal fluid bacterial culture. Therefore, the diagnosis of porcine streptococcal meningitis by next-generation sequencing method is worthy of clinical promotion and application.
Assuntos
Sangue/microbiologia , Líquido Cefalorraquidiano/microbiologia , Técnicas de Cultura/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Meningites Bacterianas/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus suis/isolamento & purificação , Animais , Estudos de Casos e Controles , Líquido Cefalorraquidiano/metabolismo , Feminino , Seguimentos , Humanos , Masculino , Meningites Bacterianas/sangue , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/microbiologia , Pessoa de Meia-Idade , Prognóstico , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/microbiologia , Streptococcus suis/genética , SuínosRESUMO
INTRODUCTION: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) samples has greatly facilitated the diagnosis of central nervous system (CNS) infections. However, the clinical significance of Epstein-Barr virus (EBV) DNA in CSF of individuals with suspected CNS infection remains unclear. We wanted to gain a better understanding of EBV as an infectious agent in immunocompetent patients with CNS disorders. METHODS: We identified cases of EBV-associated CNS infections and reviewed their clinical and laboratory characteristics. The study population was drawn from patients with EBV PCR positivity in CSF who visited Pusan National University Hospital between 2010 and 2019. RESULTS: Of the 780 CSF samples examined during the 10-year study period, 42 (5.4 %) were positive for EBV DNA; 9 of the patients (21.4 %) were diagnosed with non-CNS infectious diseases, such as optic neuritis, Guillain-Barré syndrome, and idiopathic intracranial hypotension, and the other 33 cases were classified as CNS infections (22 as encephalitis and 11 as meningitis). Intensive care unit admission (13/33 patients, 39.3 %) and presence of severe neurological sequelae at discharge (8/33 patients, 24.2 %) were relatively frequent. In 10 patients (30.3 %), the following pathogens were detected in CSF in addition to EBV: varicella-zoster virus (n = 3), cytomegalovirus (n = 2), herpes simplex virus 1 (n = 1), herpes simplex virus 2 (n = 1), Streptococcus pneumomiae (n = 2), and Enterococcus faecalis (n = 1). The EBV-only group (n = 23) and the co-infection group (n = 10) did not differ in age, gender, laboratory data, results of brain imaging studies, clinical manifestations, or prognosis; however, the co-infected patients had higher CSF protein levels. CONCLUSION: EBV DNA in CSF is occasionally found in the immunocompetent population; the virus was commonly associated with encephalitis and poor prognosis, and frequently found together with other microbes in CSF.
Assuntos
DNA Viral/líquido cefalorraquidiano , Infecções por Vírus Epstein-Barr/fisiopatologia , Herpesvirus Humano 4/genética , Imunocompetência , Encefalite Infecciosa/fisiopatologia , Meningite/fisiopatologia , Adulto , Idoso , Coinfecção , Infecções por Citomegalovirus/líquido cefalorraquidiano , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/fisiopatologia , Encefalite por Herpes Simples/líquido cefalorraquidiano , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/fisiopatologia , Encefalite Viral/líquido cefalorraquidiano , Encefalite Viral/complicações , Encefalite Viral/fisiopatologia , Enterococcus faecalis , Infecções por Vírus Epstein-Barr/líquido cefalorraquidiano , Infecções por Vírus Epstein-Barr/complicações , Feminino , Infecções por Bactérias Gram-Positivas/líquido cefalorraquidiano , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/fisiopatologia , Síndrome de Guillain-Barré/líquido cefalorraquidiano , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/fisiopatologia , Humanos , Encefalite Infecciosa/líquido cefalorraquidiano , Encefalite Infecciosa/complicações , Encefalite Infecciosa/microbiologia , Unidades de Terapia Intensiva , Hipotensão Intracraniana/líquido cefalorraquidiano , Hipotensão Intracraniana/complicações , Hipotensão Intracraniana/fisiopatologia , Masculino , Meningite/líquido cefalorraquidiano , Meningite/complicações , Meningite/microbiologia , Meningite Pneumocócica/líquido cefalorraquidiano , Meningite Pneumocócica/complicações , Meningite Pneumocócica/fisiopatologia , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/complicações , Meningite Viral/fisiopatologia , Pessoa de Meia-Idade , Neurite Óptica/líquido cefalorraquidiano , Neurite Óptica/complicações , Neurite Óptica/fisiopatologia , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/fisiopatologia , Streptococcus pneumoniae , Infecção pelo Vírus da Varicela-Zoster/líquido cefalorraquidiano , Infecção pelo Vírus da Varicela-Zoster/complicaçõesRESUMO
INTRODUCTION: Streptococcus suis serotype 2 (SS2) is an important zoonotic pathogen that causes meningitis in China. This study's aim was comparative analysis of serum proteomics from meningitis and non-meningitis piglets. METHODOLOGY: SS2 meningitis and non-meningitis piglet models were established. The serum samples were collected and analyzed by label-free LC-MS/MS proteomics technology. Differentially expressed proteins (DEPs) from serum were screened out by comparing the meningitis group and non-meningitis group to the healthy group (M/C; N/C), respectively. And then, globally and comparative analysis of DEPs in "M/C" and "N/C" in serum were performed using bioinformatics method. Finally, we comparatively analyzed the serum and cerebrospinal fluid proteomics in piglets that lived with meningitis. RESULTS: We obtained 316 and 191 DEPs from "M/C" and "N/C" which classification visualizations were established. 157 DEPs were common in both groups and 159 DEPs were unique to the "M/C". These DEPs and the signaling pathways which they participated in were visualized. Moreover, some DEPs which participated in multiple pathways were discovered and the interaction between 159 DEPs was also mapped. 39 common DEPs were also screened out in serum and cerebrospinal fluid during meningitis, and signaling pathways associated with these DEPs were further visualized. CONCLUSIONS: DEPs in "M/C" and "N/C" were comparatively analyzed and the similarities and differences of these DEPS which were involved in signal pathways were summarized. Moreover, several important molecules were screened out.
Assuntos
Meningites Bacterianas/sangue , Meningites Bacterianas/veterinária , Proteômica , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/veterinária , Fatores Etários , Animais , China , Biologia Computacional , Meningites Bacterianas/líquido cefalorraquidiano , Sorogrupo , Infecções Estreptocócicas/líquido cefalorraquidiano , Streptococcus suis/classificação , SuínosRESUMO
Meningitis is one of the top ten causes of death among Ethiopian infants. Group B streptococcus (GBS) has emerged as a leading cause of meningitis in neonates and young infants, resulting in high mortality. Despite this, there is no report on GBS associated meningitis in Ethiopia where infant meningitis is common. Hence, the aim of this study was to determine the proportion of GBS associated meningitis among Ethiopian infants. PCR was prospectively used to detect GBS in culture-negative cerebrospinal fluid (CSF) samples, which were collected from infants suspected for meningitis, at Tikur Anbessa specialized hospital, Ethiopia, over a one-year period. GBS was detected by PCR in 63.9% of culture-negative CSF samples. Out of the 46 GBS positive infants, 10.9% (n = 5) of them died. The late onset of GBS (LOGBS) disease was noted to have a poor outcome with 3 LOGBS out of 5 GBS positive samples collected from patients with the final outcome of death. PCR was advantageous in the identification of GBS in culture-negative CSF samples. GBS was detected in 64% of the CSF samples from infants with meningitis compared with zero-detection rate by culture.
Assuntos
Meningites Bacterianas , Reação em Cadeia da Polimerase , Infecções Estreptocócicas , Streptococcus agalactiae/genética , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/epidemiologia , Meningites Bacterianas/genética , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/genéticaRESUMO
OBJECTIVES: Streptococcus agalactiae (group B streptococcus, GBS) is an uncommon cause of bacterial meningitis in adults. We describe clinical characteristics, serotype distribution and outcome of adult GBS meningitis. PATIENTS AND METHODS: Patients aged 16 years or older with GBS cultured in cerebrospinal fluid included in two prospective nationwide cohort studies performed in the Netherlands between 1998-2002 and 2006-2017 were evaluated. RESULTS: We identified 33 patients with GBS meningitis with a median age of 58 years of whom 22 were male (67%). The mean annual incidence was .16 per 1.000.000 adults. Ten patients (30%) had an immunocompromised state, which was due to alcoholism in 6 (18%) and diabetes mellitus in 4 (12%). Eleven patients (33%) had a distant focus of infection of whom 4 had endocarditis (13%). Seven patients (21%) died and 6 (18%) survivors had sequelae causing disability, including reduced vision and blindness due to endophthalmitis (nâ¯=â¯2). Twenty patients (61%) made a full recovery. Most common bacterial serotypes were serotype III (41%) and Ia (25%). Serotype V was associated with increased mortality (3 of 4 [75%] serotype V died vs. 4 of 28 [14%] other serotypes, Pâ¯=â¯.025). CONCLUSION: GBS is a rare cause of meningitis in adults that more frequently occurs in patients with underlying comorbidities. Patients should be carefully evaluated for distant foci of infection. GBS serotype V is associated with poor outcome.
Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Meningites Bacterianas/etiologia , Infecções Estreptocócicas/etiologia , Idoso , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Estudos Prospectivos , Sorogrupo , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/imunologiaRESUMO
Streptococcus intermedius is considered as a commensal of the oropharynx, but can be a source of serious infections. We report a case of cerebral abscess in a young man of 18 years, who was admitted to the emergency room for consciousness disorder, and whose cerebral CT showed a frontal mass evoking the diagnosis of abscess. Diagnosis was confirmed by bacteriological examination of puncture fluid which was in favor of Streptococcus intermedius abscess.
Assuntos
Abscesso Encefálico/diagnóstico , Infecções Bacterianas do Sistema Nervoso Central/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus intermedius/isolamento & purificação , Adolescente , Antibacterianos/uso terapêutico , Abscesso Encefálico/líquido cefalorraquidiano , Abscesso Encefálico/microbiologia , Abscesso Encefálico/terapia , Infecções Bacterianas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Infecções Bacterianas do Sistema Nervoso Central/terapia , Craniectomia Descompressiva , Drenagem , Humanos , Masculino , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/terapia , Streptococcus intermedius/patogenicidade , Tomografia Computadorizada por Raios XRESUMO
Bacterial meningitis is a public health crisis in the northern part of Ghana, where it contributes to very high mortality and morbidity rates. Early detection of the causative organism will lead to better management and effective treatment. Our aim was to evaluate the diagnostic accuracy of Pastorex and Wellcogen latex agglutination tests for the detection of bacterial meningitis in a resource-limited setting. CSF samples from 330 suspected meningitis patients within the northern zone of Ghana were analysed for bacterial agents at the zonal Public Health Reference Laboratory in Tamale using polymerase chain reaction (PCR) and two latex agglutination test kits; Pastorex and Wellcogen. The overall positivity rate of samples tested for bacterial meningitis was 46.4%. Streptococcus pneumoniae was the most common cause of bacterial meningitis within the sub-region, with positivity rate of 25.2%, 28.2% and 28.8% when diagnosed using Wellcogen, Pastorex and PCR respectively. The Pastorex method was 97.4% sensitive while the Wellcogen technique was 87.6% sensitive. Both techniques however produced the same specificity of 99.4%. Our study revealed that the Pastorex method has a better diagnostic value for bacterial meningitis than the Wellcogen method and should be the method of choice in the absence of PCR.