Laboratory diagnosis of bacterial meningitis.

Gray, L D; Fedorko, D P

doi:10.1128/cmr.5.2.130-145.1992

Cited by 48 publications

(73 citation statements)

References 54 publications

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“…Although such clinical signs (altered mentation, seizures, CN and CP deficits, and gait abnormalities associated with pyrexia and neck pain) can arouse suspicion of the presence of a CNS inflammatory disease, the crucial diagnostic confirmation test remains early CSF evaluation. 34 The presence of increased numbers of white blood cells, predominantly polymorphonuclear neutrophils, high protein concentrations, and phagocytosed organisms in the CSF are diagnostic for bacterial meningoencephalomyelitis 10,18,21,25,[35][36][37] ; however, the latter finding is uncommon in veterinary medicine. In fact, results of almost all of the CSF taps (92%) performed in this study were abnormal.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Meningoencephalomyelitis in Dogs: A Retrospective Study of 23 Cases (1990–1999)

Radaelli¹,

Platt

2002

J Vet Int Med

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The clinical records of 23 dogs (1990-1999) with histopathologically confirmed bacterial meningoencephalomyelitis were evaluated retrospectively. No breed, age, sex, or weight predisposition was found. All the dogs presented with clinical signs of a brain lesion, whereas 5 of 23 had neck pain. Pyrexia was detected in 11 of 23 dogs on admission. CBCs revealed neutrophilic leucocytosis in 7 of 21 dogs and thrombocytopenia in 3 of 21 dogs. The serum chemistry profiles were abnormal in 15 of 21 dogs. The results of cerebrospinal fluid (CSF) analysis were abnormal in 13 of 14 dogs and aerobic CSF culture was positive for bacteria in 1of 8 samples. At postmortem examination, the lesions were localized to the central nervous system. Escherichia coli, Streptococcus, and Klebsiella spp were the most frequently isolated bacteria from cultures collected at postmortem examination. Twelve papers reporting 51 total clinical cases of canine bacterial meningoencephalomyelitis were reviewed. The clinical signs and results of the CBC, serum chemistry, blood culture, and CSF analysis were collated and compared with those of this study. The results of the CSF analysis in this study were similar to those in the literature. CSF cultures documented in the literature were positive for Staphylococcus, Pasteurella. Actinomyces, Nocardia spp, and various anaerobic species including Peptostreptococcus, Eubacterium, and Bacteroides spp.

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Section: Discussionmentioning

confidence: 99%

Bacterial Meningoencephalomyelitis in Dogs: A Retrospective Study of 23 Cases (1990–1999)

Radaelli¹,

Platt

2002

J Vet Int Med

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“…13 A positive Gram stain is more likely in pneumococcal meningitis compared with meningococcal or Listeria meningitis and is less likely if antibiotics have been given prior to LP. 20…”

Section: Gram Stainmentioning

confidence: 99%

“…A leukocyte count of ≥1000 cells/μL with a neutrophilic predominance is highly suggestive of bacterial meningitis, 1 whereas <1000 cells/μL with a lymphocytic predominance is more consistent with viral meningitis, tuberculous meningitis (TBM) or cryptococcal meningitis. 20 Bacterial meningitis due to L. monocytogenes is an important exception, with approximately 60% of cases having a leukocyte count of <1000 cells/μL, which may be lymphocytic. 10 If a traumatic tap occurs, the leukocyte count should be corrected by deducting one leukocyte for every 500-1000 red cells in the CSF.…”

Section: Cell Counts and Chemistrymentioning

confidence: 99%

“…1 This elevation is typically greater in bacterial and TBM (≥1 g/L) than in viral meningitis (<1 g/L), with the exception of meningitis due to the herpes simplex virus (HSV) or varicella zoster virus (VZV), where protein may be ≥1 g/L. 20,26 As with the leukocyte count, CSF protein should be corrected for a traumatic tap by deducting 0.01 g/L for every 1000 red cells. 23 Hypoglycorrhachia (low CSF glucose) is another helpful pointer towards bacterial meningitis, although it is also seen in TBM and cryptococcal meningitis.…”

Section: Young and Thomasmentioning

confidence: 99%

“…28 A normal ratio is usually found in viral meningitis. 20 A ratio of ≤0.5 has 100% sensitivity for bacterial meningitis but specificity of only 57%. 22 When a ratio of ≤0.23 is used, specificity improves to 99% but at the cost of sensitivity.…”

Section: Young and Thomasmentioning

confidence: 99%

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Meningitis in adults: diagnosis and management

Young

Thomas

2018

Internal Medicine Journal

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Bacterial meningitis is a medical emergency. All clinicians who provide acute medical care require a sound understanding of the priorities of managing a patient with suspected meningitis during the first hour. These include obtaining blood cultures, performing lumbar puncture and initiating appropriate therapy, while avoiding harmful delays such as those that result from not administering treatment until neuroimaging has been performed. Despite the increasing availability of newer diagnostic techniques, the interpretation of cerebrospinal fluid parameters remains a vital skill for clinicians. International and local guidelines differ with regard to initial empirical therapy of bacterial meningitis in adults; the North American guideline recommends ceftriaxone and vancomycin for all patients, while the Australian, UK and European guidelines recommend that vancomycin only be added for patients who are more likely to have pneumococcal meningitis or who have a higher likelihood of being infected with a strain of Streptococcus pneumoniae with reduced susceptibility to ceftriaxone. Patients with risk factors for Listeria meningitis also require an anti‐Listeria agent, such as benzylpenicillin, to be added to this treatment regimen. Dexamethasone should be a routine component of empirical therapy due to its proven role in reducing morbidity and mortality from pneumococcal meningitis.

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Emerging Antimicrobial-Resistant Infections

Roos¹

2004

Arch Neurol

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Laboratory diagnosis of bacterial meningitis.

Cited by 48 publications

References 54 publications

Bacterial Meningoencephalomyelitis in Dogs: A Retrospective Study of 23 Cases (1990–1999)

Bacterial Meningoencephalomyelitis in Dogs: A Retrospective Study of 23 Cases (1990–1999)

Meningitis in adults: diagnosis and management

Emerging Antimicrobial-Resistant Infections

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