RESUMEN
We present the case of a patient with clinical signs of meningococcemia and negative bacterial culture. Microbiological diagnosis was possible only by testing with real time PCR technique the cerebrospinal fluid and blood samples. Both pathologic samples were positive for Neisseria meningitidis by this rapid and sensitive diagnostic method.
Asunto(s)
Infecciones Meningocócicas/diagnóstico , Neisseria meningitidis/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , ADN Bacteriano/aislamiento & purificación , Diagnóstico Diferencial , Exantema/microbiología , Humanos , Lactante , Masculino , Meningismo/microbiología , Infecciones Meningocócicas/sangre , Infecciones Meningocócicas/líquido cefalorraquídeo , Infecciones Meningocócicas/tratamiento farmacológico , Neisseria meningitidis/genética , Valor Predictivo de las Pruebas , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Sensibilidad y Especificidad , Resultado del TratamientoRESUMEN
AIM: To analyze the clinical features and course of and to define the risk factors for bacterial meningitis in children. MATERIAL AND METHODS: Retrospective study of 100 cases of bacterial meningitis in patients aged 0-18 years admitted to the Iasi Infectious Diseases Hospital between 2005 and 2010. RESULTS: We found a clear prevalence in male children (58%) from rural area (67%), with the highest incidence in the age group 2-5 years. A significant percentage of patients (43%) had previous hospitalization, condition which is known as predisposing factor for bacterial meningitis, the most common being ear infections (20%) and height and weight deficit (9%). 71% of patients were admitted within the first 48 h. The most common onset clinical manifestations were fever (84%), vomiting (70%), signs of meningeal irritation (59%), somnolence (23%), loss of appetite (19%), and coma in 5% of patients. In 36% of cases CSF was opalescent with moderate pleocytosis (35%); in 29% of patients CSF albumin level ranged between 0.7-1.0 g, the majority presenting normal glycorahia (71%). In only 21% of cases the microbial agent was identified (pneumococcal and meningococcal etiology, 8% and 6%, respectively). The course was generally favorable, and mortality rate was low (5%). Complications occurred in 3% of patients consisting in hydrocephalus and brain abscess. CONCLUSIONS: Bacterial meningitis remains a disease with potentially severe course. Clinical onset, most commonly atypical in children, requires differential diagnosis at the time of admission in order to initiate the most appropriate antibiotic therapy.
Asunto(s)
Meningitis Bacterianas/diagnóstico , Meningitis Bacterianas/epidemiología , Pobreza , Adolescente , Distribución por Edad , Anorexia/microbiología , Niño , Preescolar , Coma/microbiología , Enfermedades del Oído/epidemiología , Femenino , Fiebre/microbiología , Hospitalización/estadística & datos numéricos , Hospitales Universitarios , Humanos , Lactante , Recién Nacido , Masculino , Desnutrición/epidemiología , Meningismo/microbiología , Meningitis Bacterianas/complicaciones , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/mortalidad , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Rumanía/epidemiología , Distribución por Sexo , Tasa de Supervivencia , Vómitos/microbiologíaRESUMEN
UNLABELLED: Leptospirosis is a zooantroponosis manifested as an infection with a severe evolution, with liver and renal failure and haemoragic manifestation. The aim of the study was to present the epidemiologic, clinic and therapeutical aspects of 100 cases of leptospirosis admitted in the clinic of Infectious Diseases of Iasi, during 5 years (2002-2006). MATERIAL AND METHOD: The diagnostic was based on the clinical-biologic study and risk factors with febrile syndrome, mialgic syndrome, headache, meningial, liver and renal failure and hematological syndromes, with the serologic evidence of serotypes of leptospirosis. RESULTS: All the patients were serologic confirmed with leptospirosis. Leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with lever and renal failure.
Asunto(s)
Hospitales de Aislamiento/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Leptospira , Leptospirosis/diagnóstico , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Fiebre/microbiología , Cefalea/microbiología , Hemorragia/microbiología , Hospitales Universitarios , Humanos , Leptospira/aislamiento & purificación , Leptospirosis/sangre , Leptospirosis/epidemiología , Leptospirosis/microbiología , Fallo Hepático/microbiología , Masculino , Meningismo/microbiología , Persona de Mediana Edad , Enfermedades Musculares/microbiología , Prevalencia , Insuficiencia Renal/microbiología , Factores de Riesgo , Rumanía/epidemiología , Pruebas SerológicasRESUMEN
The spread of adenovirus type 7 in England and Wales between 1971 and 1974 and the clinical features of infections with this virus were investigated in a retrospective study of virological reports and patients' clinical records. An epidemic in 1972-74 apparently stared in the North-East and spread to the South-West. Between March 1973 and the end of October 1974 the virus was recovered in 59 of 74 specimens from 42 patients. The mean age of the patients was 9 years, which suggests that a large pool of young susceptibles was important in the dissemination of the epidemic. Sore throats, cervical lymphadenopathy, conjunctivitis, and abdominal pain were common symptoms. Meningism was present in 12 patients; 2 cases had apparent neuropsychiatric sequelae.