• Title/Summary/Keyword: Acute bacterial meningitis

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Magnetic Resonance Imaging Feature of Bacterial Meningitis in a Neonate Hanwoo Calf (한우 송아지에서 세균성 뇌막염의 자기공명영상)

  • Cho, Young-Kwon;Kim, Jin-Won;Kim, Jae-Hoon;Kim, Jae-Hoon;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.650-654
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    • 2009
  • A 1-week-old, male Korean native calf with acute clinical signs of depression, mild diarrhea, ataxia, recumbency and tremor was referred to Chonbuk Veterinary Medical Center of Chonbuk National University. Vision loss and cornea edema were also observed on physical examination. The patient had been deteriorated with nystagumus, strabisumus and opisthtonus. Blood cell count test and blood biochemistry test revealed remarkable leukocytosis, and hypoalbuminemia and increased blood urea nitrogen. No remarkable findings were observed on radiography. On magnetic resonance imaging study, there were enlarge lateral, third, and forth ventricles. The cortical grey and subcortical white matter of left temporal lobe showed hypointense on T1-weighted images and hyperintense on T2-weighted images, and slightly enhanced on contrast-enhanced T1-weighted images. Escherichia coli strain was identified from cerebrospinal fluid sample. Palliative treatment was attempted but the neonatal calve was expired three days after admission. Severe multifocal fibrino-suppurative meningitis with Escherichia coli infection was confirmed histopathologically.

Diagnostic Value of Serum Procalcitonin in Febrile Infants Under 6 Months of Age for the Detection of Bacterial Infections (발열이 있는 6개월 미만의 영아에서 세균성 감염에 대한 procalcitonin의 진단적 가치)

  • Kim, Nam Hyo;Kim, Ji Hee;Lee, Taek Jin
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.142-149
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    • 2009
  • Purpose : The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants<6 months of age. Methods : A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/${\mu}L$) and an increased CRP level (>1.06mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis. Conclusion : Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source.

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Investigation on the Bacterial Diseases of Pig Occurred in Korea (한국에서 발생한 돼지의 세균성 질병 조사)

  • Yeh Jae-gil
    • Journal of Veterinary Clinics
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    • v.11 no.2
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    • pp.507-516
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    • 1994
  • The purposes of this investigations were survey of the occurred bacterial diseases, development of new animal health drug, guidance to formers on the treatment and control methods of diseases. Some series of investigations have been carried out by microbiological, pathological and serological examinations. The results could be summarized as follows. 1. A total of 953 cases of outbreaked swine diseases have been diagnosed in Clinical pathology laboratories, Bayer Vet Res Institute during 8 years (from 1986 to 1993). The high incidence diseases were colibacillosis, pleuropneumonia, streptococcal infection and pasteurellosis in decreasing order. 2. Pleuropneumonia caused by Actinobacillus pleuropneumoniae was the most important respiratory diseases and pasteurellosis by Pasteurella multocide could be confirmed in several cases. 3. Actinobacillus pleuropneumoniae 50 strains were isolated and identified by biochemical and serological tests. In serotyping test, 22 isolated strains were serotype 5, 21 strains as serotype 2, each 2 strains as serotype 3 and 7 by the coagglutination test. 4. Colibacillosis and edema discase caused by Escherichia coli has been the most predominant outbreaked disease in this investigations. The 100 isolates of E coli strains were sensitive to amikacin, colistin, enrofloxacin, gentamycin and trimethoprim -sulfamethoxazole. 5. Swine erysipelas caused by Erysipelothrix rhusiopathiae was confirmed 25 cases as acute septicemic forms. Isolates of E rhusiopathiae were highly sensitive to ampicillin, cephalothin, enrofloxcin, penicillin and tetracycline. 6. The 49 cases of hemorrhagic and necrotic enteritis in piglets were observed and 13 strains of Clostridium perfringens could be isolated and confirmed by biological and serological test. Isolates of Clostridium perfringens type C were highly sensitive to ampicillin, cephalothin, enrofloxacin, penicillin and trimethoprim- sulfamethoxazole. 7. The 14 strains of Streptococcus suis type II could be isolated from meningitis of piplets. 8. Polyserositis caused by Haemophilus parasuis and salmonellosis were observed and confirmed. Also Corynebacterial infections and several parasitosis have been also observed in this investigations.

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Two cases of Listeria monocytogenes isolation from celebrospinal fluid (뇌척수액에서의 Listeria monocytogenes 분리 2예 보고)

  • Chong, Yun-Sop;Kim, Yoon-Chung;Kim, Byung-Soo;Yi, Kui-Nyung;Lee, Sam-Uel Y.
    • The Journal of the Korean Society for Microbiology
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    • v.13 no.1
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    • pp.1-5
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    • 1978
  • Listeria monocytogenes infection was considered a rather rare disease and occurs mostly either in newborn babies or in young children. However, there has been increasing reports of this infection in elderly person with various underlying disease. Recently we have experienced two cases of Listeria meningitis; one in a 4-year-old male with an acute lymphoblastic leukemia, and the other in a 43-year-old female with a breast cancer. Both were on various chemotherapeutic agents for their primary diseases when the organism, L. monocytogenes was found in their celebospinal fluid(CSF). The degree of CSF pleocytosis were quite different by cases. The former case showed a marked increase, $3,350/mm^3$, and the latter slight, $410/mm^3$, Both showed a slight decrease of CSF glucose ranging 39 to 43mg/100ml. It seems that a routine CSF analysis bears a limitted value in the diagnosis or Listeria meningitis. A direct smear of CSF with Gram's stain revealed gram-positive bacilli in one case, but none in the other. Bacterial culture of CSF yielded plenty colonies in one case, but a few in the other. It seems that isolation of L. monocytogenes must not be considered very easy, and a negative direct smear does not necessarily mean a negative culture. The two isolates we obtained showed the typical cultural and biochemical characteristics of L. monocytogenes and were found to belong to serotypes 1b and 4b. It was our experience that the identification of this organism was not very much matter because of its distinct characteristics, but the most important matter was how to think of the possibility of this organism at the begining. The two isolates were both susceptible to cephalothin, chloramphenicol, erythromycin, tetracycline and gentamicin; intermediate to ampicillin, penicillin and kanamycin; and resistant to cloxacillin.

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A Korean familial case of hereditary complement 7 deficiency (선천성 보체 7번 결핍을 가진 한국인 한 가족)

  • Kim, Moon Kyu;Lee, Kyung Yul;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.721-724
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    • 2009
  • Meningococcal infections can be associated with abnormalities of the complement system, which contains 5 terminal complement proteins. Furthermore, deficiencies in 1 of these 5, complement component 7 (C7), leads to the loss of complement lytic function, and affected patients show increased susceptibility to recurrent meningococcal meningitis and systemic Neisseria gonorrhoeae infection. In September 2003, an 11-year-old female patient presented at our outpatient department with high fever, lower leg pain, headache, and petechiaes. She rapidly progressed to coma but later achieved full recovery due to prompt treatment. Her final diagnosis was meningococcal sepsis and arthritis. Her elder brother also had a similar bacterial meningoencephalitis history, which encouraged us to perform analyses for complement component and gene mutations. Resultantly, both the brother and sister were found to have the same mutation in the C7 gene. Subsequently, vaccinations of the meningococcal vaccine meningococcal vaccine ($Menomune^{(R)}$) were administered. However, in September 2006, the brother expired due to acute micrococcus meningoencephalitis. At present, the 16-year-old female patient is healthy. Here, we report a Korean family with a hereditary C7 deficiency with susceptibility to meningococcal infections due to C7 gene mutation.

Clinical Characteristics of Pneumococcal Bacteremia in Adults : The Effect of Penicillin Resistance on the Mortality of Patients with Pneumococcal Bacteremia (폐렴구균 균혈증에서 폐렴구균의 페니실린 내성 여부가 사망률에 미치는 영향)

  • HwangBo, Bin;Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;Park, Gye-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Min, Kyung-Up;Kim, You-Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.184-194
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    • 1999
  • Backgrounds : The advent of penicillin has led to the marked reduction in the mortality from pneumococcal bacteremia, however, the mortality is still relatively high in this post-antibiotic era. Actually the prevalence of infection due to penicillin-resistant penumococci is increasing worldwide, and it is especially high in Korea due to irrelevant use of antibiotics. So, the high mortality of pneumococcal sepsis might be related to the emergence of penicillin-resistant strains, however, many other antibiotics, which eradicate pneumococci effectively, are available in these days. This has led us to suspect the role of penicillin-resistance in the high mortality rate. In this study, we evaluated the effect of penicillin resistance on the mortality of patients with penumococcal bacte remia. Methods: The study population consisted of 50 adult patients with penumococcal bacteremia who were admitted between Jan, 1990 and July, 1997. Medical records were analyzed retrospectively. Results: Most of the patients (96%) had underlying diseases. The most common local disease associated with pneumococcal bacteremia was pneumonia (42%), which was followed by spontaneous bacterial peritonitis (14%), cholangitis (10%), meningitis (8%), liver abscess (4%), pharyngotonsillitis (4%), sinusitis (2%) and cellulitis (2%). While the overall case-fatality rate in this study was 24%, it was higher when peumococcal bacteremia was associated with pneumonia (42%) or meningitis (50%). The rate of penicillin resistance was 40%, which was increased rapidly from 1991. The rate of penicillin resistance was significantly higher in patients with the history of recent antibiotics use and hospitalization within 3 months respectively. The clinical manifestations, that is, age, severity of underlying diseases, nosocomial infection, associated local diseases, and the presence of shock or acute renal failure were not statistically different between the patients with penicillin-resistant and -sensitive pneumococcal bacteremia. The mortality of patients infected with penicillin-resistant pneumococci was not statistically different from those with penicillin-sensitive pneumococcal bacteremia. Conclusion: Penicillin resistance is not associated with high mortality in adult patients with pneumococcal bacteremia. As the overall mortality is high, active penumococcal vaccination is recommended in patients with high risk of infection.

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