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PubMed1984

Meningoencephalitis due to serratia marcescens infection in neonates.

Six autopsy cases of Serratia meningoencephalitis were reported. The symptoms of this infection become apparent at an early stage in neonates; the meningoencephalitis in these six cases was severe, with or without inflammatory lesions in other organs. Serratia marcescens was originally described as a nonpathogenic organism; however, it is believed that after entering the blood stream of neonates, it becomes pathogenic, especially to the central nervous system. Meningoencephalitis due to Serratia marcescens is very severe and takes a rapid and progressive course against which no antibiotics have been found effective. Prevention of this infection is therefore considered of crucial importance.

Cerebrospinal Fluid↗

PubMed2001

Association of human parvovirus B19 infection with acute meningoencephalitis.

To find out the incidence and clinical presentation of parvovirus B19 meningoencephalitis, we tested samples of cerebrospinal fluid from 162 patients (one from each patient) with undiagnosed meningoencephalitis, who presented between March, 1997, and March, 1998 (an outbreak period) using nested PCR for B19 genes. Seven patients were positive; an incidence of 4.3%. Five additional cases of meningoencephalitis were detected from other years. Three patients with underlying disorders (haemophagocytic lymphohistiocytosis, Cockayne's syndrome, and Turner's syndrome) died. Neurological sequelae were observed in three surviving patients, all of whom had had striking abnormalities detected on brain scans done during the acute phase.

Adolescent↗

PubMed1996

Primary amoebic meningoencephalitis with Naegleria fowleri: clinical review.

Two children with primary amoebic meningoencephalitis secondary to Naegleria fowleri are reported. Both children died, and the causative agent was identified at autopsy. Presentation and outcome conformed to the usual course of primary amoebic meningoencephalitis and reaffirm the gravity and rapid progression of this infection. The epidemiology, microbiology, diagnostic considerations, and treatment are discussed. Primary amoebic meningoencephalitis should be considered in the differential diagnosis of children with meningitis or encephalitis.

Amebiasis↗

PubMed1998

Acanthamoeba meningoencephalitis following autologous peripheral stem cell transplantation.

Amoebic meningoencephalitis is an unusual complication of bone marrow transplantation. We report a case of Acanthamoeba meningoencephalitis in a patient with non-Hodgkin's lymphoma after autologous stem cell transplantation. Leg weakness, fever and urinary retention developed 69 days following transplantation. The patient then developed fever, generalized tonic clonic seizure, rapid deterioration of mental functions and hypercapneic respiratory failure. Magnetic resonance imaging demonstrated a ring enhancing lesion at the level of the thoracic spines 11 and 12. Examination of the cerebrospinal fluid revealed pleocytosis. Despite empiric therapy with broad-spectrum antimicrobial agents, the patient's condition worsened and she died 11 days following admission. Autopsy findings revealed a subacute meningoencephalitis secondary to Acanthamoeba culbertsoni.

Acanthamoeba↗

PubMed1999

Primary amebic meningoencephalitis due to Naegleria fowleri: an autopsy case in Japan.

Free-living amebas represented by Naegleria fowleri, Acanthamoeba and Balamutia have been known to cause fatal meningoencephalitis since Fowler and Carter (1965) reported the first four human cases. An autopsy case of a 25-year-old female with primary amebic meningoencephalitis (PAM) due to Naegleria fowleri is described. Headache, lethargy and coma developed in this patient, and her condition progressed to death 8 days after the onset of clinical symptoms. Cerebral spinal fluid examination confirmed clusters of amebas, which were grown in culture and identified as Naegleria fowleri. At autopsy, lesions were seen in the central nervous system (CNS) and the ethmoid sinus. The CNS had severe, suppurative meningoencephalitis with amebic trophozoites mingled with macrophages. This case is the first report of PAM due to Naegleria fowleri in Japan.

Adult↗

PubMed2003

West Nile virus-associated meningoencephalitis in two chronically immunosuppressed renal transplant recipients.

West Nile virus is a mosquito-borne, single-stranded RNA virus of the Flaviviridae family. Approximately 1 in 150 patients who have serologic evidence of West Nile virus infection develop encephalitis or meningitis. We report two chronically immunosuppressed renal transplant recipients with confirmed West Nile virus meningoencephalitis acquired through community exposure. Both patients presented with fever and neurological changes in the autumn of 2002. Flavivirus-specific immunoglobulin M in antibodies in the cerebral spinal fluid and serum were detected by antibody-capture enzyme immunoassay, and antibodies for West Nile virus were confirmed by the plaque neutralization reduction assay. Reduction in immunosuppression and supportive care were successful in treating both patients. West Nile meningoencephalitis should be considered in transplant recipients that present with signs and symptoms of meningoencephalitis.

Adult↗

PubMed2003

Electroencephalography findings in adult patients with West Nile virus-associated meningitis and meningoencephalitis.

Eighteen adult patients with serologically confirmed West Nile virus (WNV)-associated meningitis or meningoencephalitis were admitted to our hospital during the 2000 West Nile fever outbreak in Israel. Thirteen of the patients had a more severe and prolonged clinical course, and an electroencephalogram (EEG) was, therefore, requested. A specific EEG pattern was seen in 8 patients, consisting of generalized slowing, which was more prominent over the anterior regions. Generalized slowing that was prominent over the temporal area was seen in 2 patients, and intermittent slowing over the temporal region was seen in 1 patient. Two patients had normal EEG findings. We suggest that WNV meningoencephalitis should be considered in the differential diagnosis of meningitis or meningoencephalitis with a prolonged clinical course and anteriorly predominant slowing on an EEG.

Adult↗

PubMed1975

A case of hartmannellid amebic meningoencephalitis in Zambia.

A case of amebic meningoencephalitis recognized in an adult Zambian is described. This is the first authenticated case from Africa. The morphologic features of the organism, its ability to form cysts in tissue, and the granulomatous tissue response denote that the ameba is an hartmannellid rather than a Naegleria. Free-living amebas of the family Hartmannellidae have not been incriminated before as a cause of primary amebic meningoencephalitis in man. To our knowledge this is the only case where such an ameba was responsible for fulminating meningoencephalitis. The presence of the amebas in a cellulocutaneous abdominal lesion suggests hematogenous dissemination.

Amebiasis↗

PubMed1992

Culture isolation of Acanthamoeba species and leptomyxid amebas from patients with amebic meningoencephalitis, including two patients with AIDS.

Acanthamoeba species and leptomyxid organisms are free-living amebas that cause meningoencephalitis, primarily in immunocompromised patients. We report the isolation and culture of Acanthamoeba species and leptomyxid amebas from four patients with fatal amebic meningoencephalitis. Acanthamoeba species were cultured from brain abscess specimens from three immunocompromised patients (including two patients with AIDS). In the case of the fourth patient, who had no identifiable immunodeficiency, leptomyxid amebas were cultured from a specimen from a subcutaneous nodule and were identified in amebic granulomas in brain tissue by the indirect immunofluorescence test. Persons with advanced infection due to the human immunodeficiency virus may be at increased risk for amebic meningoencephalitis, but the diagnosis should be considered in the differential diagnosis of any immunocompromised patient with cerebral abscesses.

AIDS-Related Opportunistic Infections↗

PubMed1978

Viral meningoencephalitis and head injury.

Among 162 children referred with head injury (in a 3-year period) a viral meningoencephalitis was proven to be present in seven cases. Only one patient showed symptoms of infection before the accident. On admission classical signs of viral meningoencephalitis were absent or mixed with the complications of head injury. A diagnosis of viral meningitis/meningoencephalitis was documented by immunofluorescent demonstration of viral antigens in CSF cells and/or pattern of CSF cytology and/or conventional serological methods. Whether the trauma and the infection are coincidental or causally related can not be decided definitively. A hypothesis is presented suggesting diminished alertness in subclinical viral meningoencephalitis, leading to accident proneness.

Antigens, Viral↗

PubMed2006

Meningoencephalitis associated with Staphylococcus warneri in a dog.

A case of meningoencephalitis in a dog caused by Staphylococcus warneri is reported here. The history and clinical signs were suggestive of possible central nervous system infection. Analysis of cerebrospinal fluid documented a neutrophilic pleocytosis (890 cells/mul) and the presence of occasional intracellular cocci. Staphylococcus warneri was isolated from the microbiological culture of the cerebrospinal fluid. Treatment consisted of intravenous antibiotics, supportive care and anticonvulsants for the generalised seizures that developed after admission. Histological assessment confirmed the location and extension of bacterial meningoencephalitis. Thrombotic meningoencephalitis associated with Staphylococcus warneri infection has not, to the authors' knowledge, been previously reported in dogs.

Animals↗

PubMed1991

Meningoencephalitis and other conditions associated with Histophilus ovis infection in sheep.

Histophilus ovis was isolated from 29 sheep in 20 flocks and 2 artificial insemination (AI) centres in southern New South Wales from 1984 to 1990. The clinical and pathological findings were consistent with previous reports and included polyarthritis (7 flocks), epididymo-orchitis (5), meningoencephalitis (3), pneumonia (3), septicaemia (2), mastitis (1) and metritis (1). Six sheep had meningoencephalitis, a syndrome not previously associated with H ovis infection in sheep, which was similar pathologically to thromboembolic meningoencephalitis in cattle, caused by the related organism, Haemophilus somnus. H ovis was isolated from the semen of 12-month-old rams in a flock that had polyarthritis due to H ovis, in 4-month-old ram lambs and from the uterus of a ewe in a flock that had sporadic cases of H ovis septicaemia.

Animals↗

PubMed1997

Amoebic meningoencephalitis caused by Balamuthia mandrillaris in an orang utan.

OBJECTIVE: To describe a case of meningoencephalitis caused by Balamuthia mandrillaris in an orang utan. DESIGN: A pathological case report. ANIMAL: A 20 years old male orang utan (Pongo pygmaeus). PROCEDURE: The disease process was investigated by clinical pathology, necropsy, histopathology and immunofluorescence labelling. RESULTS: The orang utan developed sudden onset of depression, lethargy, inappetence and apparent head pain. The condition was considered to be related to a 2 year history of upper and lower respiratory disease, and the animal was placed on antibiotics after extensive testing. By the seventh day the animal had become ataxic and disoriented and a brain abscess was suspected. He died on the ninth day of illness. At necropsy, and subsequent sectioning, the brain showed multiple circular, soft, white to grey brown areas of varying size, the largest being in the left temporal (3.5 cm diameter) and right occipital (2.5 cm diameter) regions of the cerebrum. Histological examination of these regions revealed many amoebic trophozoites and occasional cysts associated with areas of haemorrhage and inflammatory necrosis. The trophozoites were packed in perivascular spaces and their nuclei often contained two or more prominent nucleoli. Immunofluorescent labelling of histological sections suggested that the agent was B mandrillaris. CLINICAL IMPLICATIONS: This report provides further evidence that B mandrillaris, a free living amoeba, can act as a pathogen in animals as well as people, and cause fatal meningoencephalitis. Along with Naegleria and Acanthamoeba spp, B mandrillaris should be considered amongst the causes of acute onset meningoencephalitis in animals.

Amebiasis↗

PubMed2001

Nitric oxide is protective in listeric meningoencephalitis of rats.

The bacterium Listeria monocytogenes causes meningoencephalitis in humans. In rodents, listeriosis is associated with granulomatous lesions in the liver and the spleen, but not with meningoencephalitis. Here, infant rats were infected intracisternally to generate experimental listeric meningoencephalitis. Dose-dependent effects of intracisternal inoculation with L. monocytogenes on survival and activity were noted; 10(4) L. monocytogenes organisms induced a self-limiting brain infection. Bacteria invaded the basal meninges, chorioid plexus and ependyme, spread to subependymal tissue and hippocampus, and disappeared by day 7. This was paralleled by recruitment and subsequent disappearance of macrophages expressing inducible nitric oxide synthase (iNOS) and nitrotyrosine accumulation, an indication of nitric oxide (NO.) production. Treatment with the spin-trapping agent alpha-phenyl-tert-butyl nitrone (PBN) dramatically increased mortality and led to bacterial numbers in the brain 2 orders of magnitude higher than in control animals. Treatment with the selective iNOS inhibitor L-N(6)-(1-iminoethyl)-lysine (L-NIL) increased mortality to a similar extent and led to 1 order of magnitude higher bacterial counts in the brain, compared with controls. The numbers of bacteria that spread to the spleen and liver did not significantly differ among L-NIL-treated, PBN-treated, and control animals. Thus, the infant rat brain is able to mobilize powerful antilisterial mechanisms, and both reactive oxygen and NO. contribute to Listeria growth control.

Animals↗

PubMed1990

Leptomyxid ameba, a new agent of amebic meningoencephalitis in humans and animals.

Amebae belonging to the order Leptomyxida are regarded as innocuous soil organisms incapable of infecting mammals. We report here the isolation of a leptomyxid ameba from the brain of a pregnant baboon (Papio sphinx) that died of meningoencephalitis at the San Diego Zoo Wild Animal Park. By using rabbit anti-leptomyxid serum in the immunofluorescence assay, we have identified the leptomyxid ameba in the brain sections of a number of human encephalitic cases from around the world as well as a few cases of meningoencephalitis in animals in the United States, which suggests that the leptomyxid amebae are potential etiologic agents of fatal meningoencephalitis in humans and animals.

Amebiasis↗

PubMed1990

Passive immunity to fatal reovirus serotype 3-induced meningoencephalitis mediated by both secretory and transplacental factors in neonatal mice.

The role of passively acquired immunity to reovirus-induced meningoencephalitis in neonatal mice was examined. It was determined that female mice were capable of conferring protection against viral infection and meningoencephalitis in neonates depending on the route by which the dams were immunized and the serotype of the immunizing virus. Female mice immunized with homotypic virus via the oral route developed the most potent response. Infected neonates born and nursed by these females developed no signs of disease, and no virus was recoverable from their small intestines, livers, or brains following infection. Neonates born to females immunized with homotypic virus by the subcutaneous route manifested no evidence of meningoencephalitis or virus dissemination, yet virus was recovered from neonatal intestines. Mice immunized with heterotypic virus by either the subcutaneous or the oral route also conferred protection against disease; however, virus was recovered in small intestines and livers of infected neonates. Based on results from foster-nursing experiments, it appears that factors obtained both during suckling and by transplacental transfer contribute to protection. Passive transfer of reovirus-immune mouse serum also protected neonates from disease. These results demonstrate that passive immune mechanisms can mediate the protection of neonates against reovirus infection and provide further evidence of the importance of the mucosal immune response in protection against pathogens that invade the host via mucosal tissues.

Animals↗

PubMed1969

Primary amoebic meningoencephalitis in Britain.

Primary amoebic meningoencephalitis is caused by amoebae of the genera Naegleria and Hartmannella (Acanthamoeba), which ordinarily are free-living saprophytes. The infection may be acquired from fresh water-for example, while bathing-the amoebae invading the nasal mucosa and reaching the meninges and brain along the olfactory nerve filaments. The disease is designated "primary" to distinguish it from meningocerebral infection caused by the parasitic amoebae, particularly Entamoeba histolytica, which invade the central nervous system only as a result of dissemination in the blood stream from lesions in other parts of the body.During histological reappraisal of old specimens in a medical museum in London an instance of amoebic meningoencephalitis histologically indistinguishable from the published cases has been found. The specimen dates from 1909. The patient was said to be from Essex. What may have been another case, seen in Northern Ireland in 1937, is also described briefly. These observations may indicate that this disease occurs in the British Isles.Primary amoebic meningoencephalitis should be considered in the differential diagnosis of every case of acute meningitis.

Adolescent↗

PubMed1993

A field study of meningoencephalitis in calves with particular reference to analysis of cerebrospinal fluid.

Meningoencephalitis was recorded in 10 two- to 14-day-old calves during a two-year field study. Analysis of lumbosacral cerebrospinal fluid revealed a marked increase in protein concentration with a pronounced neutrophilic pleocytosis. Three calves with positive bacteriological cultures which were treated with chloramphenicol survived whereas six calves treated with penicillin G had to be destroyed on humane grounds after their condition deteriorated. Only two of the 10 calves had concurrent lesions of omphalophlebitis which may indicate that this is not the major route of bacterial invasion in neonatal meningoencephalitis. None of the constituents of cerebrospinal fluid proved to be a reliable prognostic indicator of meningoencephalitis. It is concluded that the analysis of cerebrospinal fluid is a useful ancillary aid in the investigation of abnormal mental states in neonatal calves and a sensitive test for the presence of an inflammatory lesion involving the leptomeninges.

Animals↗