Relapsing polychondritis with encephalitis: a case report and literature review.

We herein report the case of a 39-year-old man who developed bilateral auricular chondritis, conjunctivitis, and central neurological symptoms. He was diagnosed with encephalitis associated with relapsing polychondritis (RP) based on the findings of an ear cartilage biopsy, cerebrospinal fluid examination and magnetic resonance imaging. Although oral prednisolone (60 mg/day) was administered, the initial steroid therapy did not improve his symptoms. In contrast, methylprednisolone (mPSL) pulse therapy followed by prednisolone gradually ameliorated his condition. There were no episodes of recurrence during the two-year follow-up period. A review of the literature revealed that meningoencephalitis and encephalitis are rare, but important, complications of RP responsive to mPSL pulse therapy.

Vitamin D deficiency decreases survival of bacterial meningoencephalitis in mice.

BACKGROUND: Meningoencephalitis caused by Escherichia coli is associated with high rates of mortality and risk of neurological sequelae in newborns and infants and in older or immunocompromised adults. A high prevalence of neurological disorders has been observed in geriatric populations at risk of hypovitaminosis D. METHODS: In vivo, we studied the effects of vitamin D3 on survival and the host's immune response in experimental bacterial meningoencephalitis in mice after intracerebral E. coli infection. To produce different systemic vitamin D3 concentrations, mice received a low, standard, or high dietary vitamin D3 supplementation. Bacterial titers in blood, spleen, and brain homogenates were determined. Leukocyte infiltration was assessed by histological scores, and tissue cytokine or chemokine concentrations were measured. RESULTS: Mice fed a diet with low vitamin D3 concentration died earlier than control animals after intracerebral infection. Vitamin D deficiency did not inhibit leukocyte recruitment into the subarachnoid space and did not lead to an increased density of bacteria in blood, spleen, or brain homogenates. The release of proinflammatory interleukin (IL)-6 was decreased and the release of anti-inflammatory IL-10 was increased in mice fed a diet with high vitamin D3 supplementation. CONCLUSION: Our observations suggest a detrimental role of vitamin D deficiency in bacterial central nervous system infections. Vitamin D may exert immune regulatory functions.

[FEATURES OF OTOGENIC INTRACRANIAL COMPLICATIONS AT THE PRESENT STAGE].

A retrospective analysis of treatment was made in 127 adult patients with acute and chronic otitis media complicated by suppurative-inflammatory pathology of the brain. Purulent meningitis was revealed in 52 (40.9%) of hospitalized patients. Meningoencephalitis was often diagnosed in the cases of acute otitis media (15.4%) and in cases of chronic otitis (22.7%). The otogenic brain abscess was detected in 13.5% of otitis media cases and it was noted to be twice frequent (33.3%) in cases of purulent otitis media. The patients 124 (97.6%) have been operated. An extended mastoidotomy and antromastoidotomy were performed in the acute purulent otitis media. An extended radical operation on the ear was applied in case of chronic otitis media. Performance of craniotomy and complete removal of the abscess using modern systems of neuronavigation showed a higher clinical efficacy as compared with transtemporal approach during sanitizing intervention on the ear including the opening and abscess drainage in surgery of otogenic abscesses of the brain.

Características clínicas de la meningoencefalitis tuberculosa en los pacientes del Hospital Arzobispo Loayza durante el periodo 2008-2012 / Characteristics clinical of tuberculous meningoencephalitis in patients of the Hospital Arzobispo Loayza during the period 2008-2012

Se realizó un estudio retrospectivo para conocer las características clínicas de la meningoencefalitis tuberculosa en el adulto. De 162 historias clínicas con ese diagnostico en el Hospital Arzobispo Loayza entre 2008-2012, 132 cumplieron los criterios de inclusión. Se hallo que la población más afectada fueron mujeres (56.92 por ciento) de mediana edad (41.59 años) amas de casa (41.54 por ciento). El tiempo de enfermedad promedio de los pacientes fue de 15.86 días. El 10 por ciento de los pacientes tuvo historia de contacto TBC y antecedente de VIH. La forma de presentación clínica más frecuente fue cefalea (85.38 por ciento), vómitos (57.69 por ciento), fiebre (56.15 por ciento), rigidez de nuca (34.62 por ciento), estadio 2 (59.23 por ciento), hipoglucorraquia (30.06 mg/dl), hiperproteinorraquia (178.05 mg/dl), pleocitosis (81.61 por ciento), ADA (14.18). Se concluye que lo inespecífico del cuadro clínico retarda el diagnóstico específico y tratamiento oportuno.

We made a retrospective study in order to determine clinical features of TBC meningoencephalitis in adults patients. From 162 clinical records with this diagnosis at the Hospital Arzobispo Loayza of Lima, between 2008-2012, 130 records fulfilled the inclusion criteria. Most of the affected were women (56.92 per cent), of age 41.59 years, housewife (41.54 per cent). The mean time of disease of the 15.86 days. The TBC contact was 10 per cent. The most usual clinical presentation was headache (85.38 per cent), vomiting (57.69 per cent), fever (56.15 per cent), rigidity of neck (34.62 per cent), stage II (59.23 per cent), low CSF glucose (30.06 mg/dl), high CSF protein (178.05 mg/dl), CSF pleocytosis (81.61 per cent), ADA (14.18). The conclusion that the inspecify of clinic delays the specify diagnostic and opportune treatment.

Refining an Alzheimer's vaccine to avoid an inflammatory response.

The utility of vaccine strategies to treat neurodegenerative diseases such as Alzheimer's disease may still hold promise. Phase IIa clinical trials were halted due to a small but significant occurrence of meningoencephalitis. Knowledge gained from studies on amyloid-beta peptide (Abeta) immunotherapy will allow optimisation of new-generation vaccines, targeting highly specific epitopes while reducing undesired side effects. In harnessing and steering the immune system, an effective response can be generated against Abeta, one that might have attenuated immune responses with robust disease-altering activity.

Eficacia de ampicilina en infecciones por Streptococcus pneumonia en un hospital pediátrico / Efficacy of ampicilin in Streptococcus pneumoniae infections in a Pediatrics Hospital

Se realizó un estudio prospectivo para conocer la prevalencia de las cepas de S. pneumoniae resistentes a la penicilina y ampicilina entre los pacientes del Hospital para el Niño DIF en Toluca, Estado de Médico. Se lograron aislar 86 cepas de S. pneumoniae de otros tantos procesos infecciosos. Las infecciones más comunes fueron meningoencefalitis, neumonía y otitis. Todas las cepas aisladas fueron susceptibles a penicilina y ampicilina. Concluimos que la penicilina y la ampicilina siguen siendo el tratamiento de elección para las infecciones por S. pneumoniae en México

[The intra-aortic antibacterial therapy of wounded patients with gunshot meningoencephalitis]. / Vnutriaortal'naia antibakterial'naia terapiia ranenykh s ognestrel'nym meningoéntsefalitom.

The original decision of permanent introduction of antibacterial means to tissues of brain at gunshot meningoencephalitis is offered. For antibacterial therapy the intra-aortal catheter with diameter of 2,5 mm (through a.femoralis) was introduced. After washing the catheter by solution of crystalloid with heparin the various combinations of preparations in 5% solution of glucose were introduced: cephalosporin--8 g/day; hentamicin and brumacilin--240 mg/day accordingly, amicacin--1500 mg/day. Speed of introduction--20-50 mg/h, total volume--500 ml. The catheter was in aorta not more than 10 days, maximum--14 days. A described technique was applied in Burdenko Main Military Clinical Hospital on 34 wounded in head. At computer tomography of brain of all wounded intracranially the splinters and bullets were revealed, clinically--meningoencephalitis. Foreign bodies have been extracted after cupping of clinical and laboratory signs of meningoencephalitis. The authors consider, that the technique is effective not only at wounds of brain, but also at suppurative meningoencephalitis of other etiology.

[The etiology of purulent meningoencephalitis in pediatrics. The therapeutic implications]. / Etiología de la meningoencefalitis purulenta en pediatría. Implicaciones terapéuticas.

In order to know the etiology of purulent meningitis in infant and children, a retrospective study was done; 709 cases of a pediatric infectious disease service were analyzed. Diagnosis was established either by antigen detection (coagglutination) or bacterial culture. In 334/709 (48%) the bacterial agent was identifies. Haemophilus influenzae type b (70%), Streptococcus pneumoniae (14%), Enterobacteriaceae (8%) and Streptococcus sp (6.5%) were the most frequent. According to our results the epidemiologic pattern of purulent meningitis has not changed. A therapeutic approach is suggested.

[Development and practical use of new experimental models of the various forms of herpetic infection]. / Razrabotka i prakticheskoe ispol'zovanie novykh éksperimental'nykh modelei raznykh form gerpeticheskoi infektsii.

New experimental models of neurological herpes in cotton rats and genital herpes in male guinea pigs have been developed which are more adequate to the corresponding human diseases, and models of ophthalmic herpes in rabbits and guinea pigs have been improved. These models may be used for screening and evaluation of the effectiveness of drugs for herpes. A high activity against herpes of bromovinyldeoxyuridine and acyclovir has been verified, a marked therapeutic effect of Soviet monophosphates ara-A, ara-C, and original silur preparation in some forms of herpes infection has been demonstrated.