Laryngeal tuberculosis.
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Antitubercular Agents↗
Biomedical subjects
M M Paris
Publications and source records attributed to M M Paris.
The limited role of pneumolysin in the pathogenesis of pneumococcal meningitis.
The aim of this study was to determine the role of pneumolysin, an intracellular toxin of Streptococcus pneumoniae, in the pathogenesis of pneumococcal meningitis. Recombinant pneumolysin (1 microgram), when injected intracisternally into rabbits, resulted in a brisk inflammatory response. However, a pneumolysin-deficient strain of S. pneumoniae caused meningeal inflammation in rabbits indistinguishable from that induced by the parent pneumolysin-producing strain. Furthermore, similar enhancement of meningeal inflammation occurred after ampicillin therapy in animals infected with either the parent strain or the pneumolysin-deficient mutant. These results suggest that although pneumolysin can stimulate the inflammatory cascade in the central nervous system, it is not necessary for the pathogenesis of meningeal inflammation nor does it play a role in postantibiotic enhancement of meningeal inflammation.
Ampicillin↗
Modulation of expression of genes involved in the inflammatory response by lipopolysaccharide and temperature in cultured human astroglial cells.
In bacterial sepsis and meningitis, large concentrations of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) correlate directly with morbidity and mortality. This laboratory has reported previously that elevated temperature in the physiologic range is associated with down regulation of IL-1 beta and TNF alpha expression in cultured astroglia after lipopolysaccharide (LPS) stimulation. To further investigate the role of elevated temperature in the CNS inflammatory response, the effects of LPS and elevated temperature on the expression of genes that participate in the inflammatory response were determined in cultured transformed human fetal astrocytes and in an astrocytoma cell line. The effect of physiologic temperature elevation on cytokine concentrations in cerebrospinal fluid (CSF) was also investigated in a rabbit meningitis model. The findings indicate that astrocytes express a wide variety of cytokines, growth factors, growth factor receptors, and other genes that could play important roles in CNS inflammation. Furthermore, temperature elevation in the febrile range can lead to alterations in the patterns of expression of many genes involved in the inflammatory response of these cells.
Animals↗
Cranial computed tomographic scans have little impact on management of bacterial meningitis.
OBJECTIVE: To assess which clinical features predict an increased likelihood of an abnormal computed tomographic (CT) scan and how frequently CT influences management of bacterial meningitis. DESIGN: Retrospective patient series. SETTING: University-affiliated hospitals in Dallas, Tex. PATIENTS: Three hundred thirty-seven children with bacterial meningitis, of whom 107 (32%) had undergone CT scans. RESULTS: One or more abnormalities were found in 52% of the initial scans. The most frequent indication for CT at our institution was persistent or secondary fever, and in 56% of these children, subdural effusion or empyema was noted. However, findings on CT rarely predicted a need for intervention. In contrast, children with focal seizures or focal neurologic signs were more likely to have brain parenchymal changes. Scans in 19 patients (12%) prompted surgical intervention, most commonly drainage of a subdural collection. The conditions of only nine children (8.4% of those who had undergone CT scans) improved following intervention that was initiated because of findings on CT. CONCLUSIONS: Although CT scans are frequently abnormal in children with meningitis, CT seldom reveals findings that require specific intervention.
Drainage↗