• Neonatal Medicine
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• 제24권1호
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• pp.26-31
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• 2017

Purpose: To identify the factors associated with differential diagnosis of neonatal bacterial meningitis at the earliest opportunities possible and to evaluate the value of the bacterial meningitis score especially in neonates. Methods: We conducted a single-center, retrospective study of neonates diagnosed meningitis at our hospital between January 2000 and March 2014. We compared the general characteristics, clinical manifestations, laboratory findings, bacterial meningitis scores between the bacterial group and the aseptic group. Results: Bacterial meningitis differs significantly from aseptic meningitis in platelet count, the cerebrospinal fluid polymorphonuclear leukocyte count, and the serum protein including also the albumin (P<0.05). Except two infants, the bacterial meningitis score over 2 accurately predict bacterial meningitis in the other 11 infants. Conclusion: The bacterial meningitis score appears highly useful to identify neonatal infants with bacterial meningitis. However, its diagnostic and prognostic value is just 'adjunctive', because low score cannot rule out bacterial meningitis.

• Parasites, Hosts and Diseases
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• 제59권3호
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• pp.227-233
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• 2021

Eosinophilic meningitis is defined as the presence of more than 10 eosinophils per µl in the cerebrospinal fluid (CSF), or eosinophils accounting for more than 10% of CSF leukocytes in patients with acute meningitis. Parasites are the most common cause of eosinophilic meningitis worldwide, but there is limited research on patients in Korea. Patients diagnosed with eosinophilic meningitis between January 2004 and June 2018 at a tertiary hospital in Seoul, Korea were retrospectively reviewed. The etiology and clinical characteristics of each patient were identified. Of the 22 patients included in the study, 11 (50%) had parasitic causes, of whom 8 (36%) were diagnosed as neurocysticercosis and 3 (14%) as Toxocara meningitis. Four (18%) patients were diagnosed with fungal meningitis, and underlying immunodeficiency was found in 2 of these patients. The etiology of another 4 (18%) patients was suspected to be tuberculosis, which is endemic in Korea. Viral and bacterial meningitis were relatively rare causes of eosinophilic meningitis, accounting for 2 (9%) and 1 (5%) patients, respectively. One patient with neurocysticercosis and 1 patient with fungal meningitis died, and 5 (23%) had neurologic sequelae. Parasite infections, especially neurocysticercosis and toxocariasis, were the most common cause of eosinophilic meningitis in Korean patients. Fungal meningitis, while relatively rare, is often aggressive and must be considered when searching for the cause of eosinophilic meningitis.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.446-450
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• 2015

Purpose: Meningitis is among the most common infections affecting the central nervous system. It can be difficult to determine the exact pathogen responsible for the infection and patients are often treated with empiric antibiotics. This study was conducted to identify the most common clinical characteristics of enteroviral meningitis in children and evaluate the diagnostic efficacy of reverse transcriptase-polymerase chain reaction (RT-PCR) for early detection of an enterovirus. Methods: We analyzed the medical records of children admitted to Korea University Medical Center and diagnosed with meningitis on the basis of cerebrospinal fluid (CSF) analysis and RT-PCR from CSF and other samples from January 2010 to August 2013. Results: A total of 333 patients were enrolled and classified into four groups based on diagnosis: enteroviral meningitis (n=110), bacterial meningitis (n=23), other viral meningitis (n=36), and unknown etiology (n=164). Patients with bacterial meningitis were younger than those in the other groups (P<0.001). Pleocytosis in CSF was similar across all groups. Of patients in the enteroviral meningitis group, 92.7% were diagnosed based on RT-PCR findings. Mean length of hospital stay for patients with enteroviral meningitis was 6.08 days, which was significantly shorter than that for patients with meningitis of bacterial etiology (19.73 days, P<0.001). Conclusion: Diagnosis of enteroviral meningitis before viral culture results are available is possible using RT-PCR. Accurate diagnosis reduces the length of hospital stay and helps to avoid unnecessary empiric antibiotic treatment.

• Pediatric Infection and Vaccine
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• 제7권1호
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• pp.159-164
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• 2000

저자들은 14세 남아에서 4년간 3차례 발병한 Mollaret meningitis 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 아울러 정확한 진단과 감별을 위해 뇌척수액의 세포학적 검사, herpes virus 동정, 뇌자기공명촬영 추적 검사 등이 필요할 것으로 사료된다.

• Annals of Clinical Neurophysiology
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• 제16권2호
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• pp.77-80
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• 2014

Herpes simplex virus type 2 (HSV2) meningitis primarily develops during or following a primary genital HSV2 infection that was acquired from sexual contact or through the birth canal during delivery from mother. We describe a 15 year old virgin without history of previous herpes simplex infection who developed 2 episodes of HSV2 meningitis. Although recurrent meningitis due to HSV is primarily seen in young or sexually active adults. HSV2 meningitis should be in the differential diagnosis of recurrent meningitis in adolescent patients.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.67-71
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• 2022

This report describes a case of coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in a 66-year-old immunocompetent female patient. The patient had undergone traditional procedures, including acupuncture, which possibly caused the coinfection. During treatment with susceptible antibiotics for bacterial meningitis, she developed hydrocephalus on the third day. Consequently, the patient recovered with a mild neurological deficit of grade 4 motor assessment in both upper and lower extremities at discharge. S. paucimobilis and L. monocytogenes are rare pathogens in developed countries, occurring only during environmental outbreaks. S. paucimobilis meningitis is rarely reported. Hence, the various presentations of S. paucimobilis meningitis and the antibiotic regimen for its treatment are hereby reported, in addition to a review of other similar reported cases. This case is a possible traditional procedure-related infection. Appropriate oversight and training should be emphasized regarding preventive measures of this kind of infection. A team approach with neurologists and neurosurgeons is imperative in treating patients with hydrocephalus-complicated meningitis.

• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.175-177
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• 2011

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should be borne in mind in patient with pyogenic meningitis who exhibit neurological deterioration.

• Pediatric Infection and Vaccine
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• 제13권2호
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• pp.124-129
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• 2006

목 적 : 1996년부터 2005년까지 단일기관에서 발생한 세균성 수막염의 주요 원인균의 연령별 분포를 조사하였다. 방 법 : 1996년 1월부터 2005년 12월까지 세브란스병원 소아과에 입원하여 세균성 수막염이나 신생아 수막염으로 진단받은 환아들 중 뇌척수액 배양검사 및 라텍스응집반응검사에서 원인균이 확인된 증례들의 의무기록을 후향적으로 조사하였다. 결 과 : 원인균이 확인된 46례 중 신생아 수막염은 미숙아 4례를 포함하여 27례였고 신생아기 이후의 세균성 수막염은 19례였다. 신생아 수막염 환아 중 원인균이 혈액배양검사에서도 동정된 경우는 모두 15례(55.6%)였다. 신생아 수막염의 가장 흔한 원인균은 B군 연쇄상 구균이었다(44.4%). 또한 B군 연쇄상 구균에 의한 수막염의 75.0%가 지발형 감염이었다. 신생아기 이후의 세균성 수막염 환아들의 84.2%가 5세 미만에서 발생하여, 이들의 연령 중앙값은 23개월이었다. 신생아기 이후의 세균성 수막염의 원인균으로는 폐구균 8례(42.1%), 인플루엔자균 8례, 수막구균 3례 등이 있었으며, 이 중 인플루엔자균는 2001년 이후 최근 5년간 검출되지 않았다. 결 론 : 신생아 수막염의 가장 흔한 원인균은 B군 연쇄상 구균이고 신생아기 이후에는 폐구균과 인플루엔자균이 세균성 수막염의 가장 흔한 원인균이었다. 이 중 단백결합 백신의 도입으로 인플루엔자균에 의한 세균성 수막염은 감소되는 경향을 보였다.

• Journal of Korean Neurosurgical Society
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• 제53권4호
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• pp.249-251
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• 2013

Pneumocephalus is a condition characterized by the presence of air in the cranium, and it is mainly caused by trauma or a neurosurgical procedure. In the absence of head trauma or a neurosurgical procedure, meningitis is an extremely rare cause of pneumocephalus. Here, the authors present a rare case of spontaneous pneumocephalus caused by pneumococcal meningitis, in which simple lateral radiography and computed tomography (CT) findings of the skull suggested the diagnosis. Cerebrospinal fluid analysis showed bacterial meningitis which later revealed streptococcus pneumonia. The patient was treated with antibiotics and responded remarkably well. Repeat CT performed after 2 weeks of treatment showed complete resolution of the intracranial gas. Here, the authors report an unusual case of a pneumocephalus caused by meningitis in the absence of head trauma or a neurosurgical procedure.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.380-382
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• 2012

Bacterial meningitis is rarely complicated by an intradural spinal abscess, and recurrent meningitis is an uncommon presentation of a spinal intramedullary abscess. Here, we report a 63-year-old patient with recurrent meningitis as the first manifestation of an underlying spinal intramedullary abscess. To the best of our knowledge, no previous report has been issued on recurrent meningitis accompanied by a spinal intramedullary abscess in an adult. In this article, the pathophysiological mechanism of this uncommon entity is discussed and the relevant literature reviewed.