Meningococcal disease and meningitis

Branco, Ricardo Garcia; Amoretti, C; Tasker, Robert C.

doi:10.2223/jped.1612

Cited by 16 publications

(16 citation statements)

References 38 publications

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“…Rapid diagnosis is important for the administration of appropriate treatment. Meningococcal infection is usually suspected on clinical grounds and confirmed by conventional laboratory tests: particularly samples of CSF (direct examination and culture), blood (blood cultures), and less commonly by pharyngeal samples (pharyngeal exudates) (13,14). However, the clinical diagnosis of meningococcal infection can be difficult due to the variability of symptoms.…”

Section: Discussionmentioning

confidence: 99%

The efficiency of sodC gene / N. meningitidis detection in comparison with the classical methods for the diagnosis of meningococcal infection / Evaluarea eficienţei Real Time PCR TaqMan utilizând gena sodC / N. meningitidis în comparaţie cu metodele clasice utilizate în diagnosticul infecţiei meningococice

Nemescu¹,

Ursu²,

Dorobăț³

et al. 2015

Romanian Review of Laboratory Medicine

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Meningococcal infection requires a fast and accurate diagnostic method in order to correctly initiate the antibiotic therapy. The aim of our study was to assess the efficiency of Real Time PCR -Taq Man using sod C gene / N. meningitidis in comparison with the classical methods for the diagnosis of meningococcal infection - direct microscopy, cultivation, latex agglutination and blood culture. We have detected 24/44 (54.54%) patients with meningococcal infection. In both cases of patients with / without previous antibiotic therapy before admission, the AUC (area under curve) had the highest values for RT PCR in CSF and blood analysis. This sod C RT-PCR assay is a highly sensitive and specific method for detection of Neisseria meningitis and it would be useful to include this method like a multiplex in routine testing of patients with clinical meningococcal infection for other etiological agents also.

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Section: Discussionmentioning

confidence: 99%

The efficiency of sodC gene / N. meningitidis detection in comparison with the classical methods for the diagnosis of meningococcal infection / Evaluarea eficienţei Real Time PCR TaqMan utilizând gena sodC / N. meningitidis în comparaţie cu metodele clasice utilizate în diagnosticul infecţiei meningococice

Nemescu¹,

Ursu²,

Dorobăț³

et al. 2015

Romanian Review of Laboratory Medicine

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“…This presentation is frequent in children and requires early recognition because persistent shock has a time-dependent adverse impact on survival: each hour of delay in treating shock is associated with at least a twofold increase in mortality. & Fluid resuscitation should be started with the first signs of shock, aiming to re-establish normal physiology for the patient's age (ie, heart rate, capillary refill time, urine output, blood pressure) [7,13,20], Class II]. In adults, targets are a central venous pressure from 8 mm to 12 mm Hg, mean arterial pressure higher than 65 mm Hg, urine output greater than 0.5 mL/kg per hour, and a central venous (or mixed venous) oxygen saturation of at least 65%.…”

Section: Treatment Of Shockmentioning

confidence: 99%

“…The use of colloids and steroid supplementation may be beneficial; other new therapies such as insulin and activated protein C need further study. Rescue therapy with extracorporeal membrane oxygenation seems to have good results when it is used for severe acute respiratory distress syndrome but not for refractory shock [7,20]. & In patients with MM without shock, raised ICP can induce vasoconstriction that increases capillary refill time.…”

Section: Treatment Of Shockmentioning

confidence: 99%

“…However, these patients are at risk of developing critical illness-related corticosteroid insufficiency, so low-dose ("stress dose") corticosteroids may be beneficial. In children, little is known about critical illness-related corticosteroid insufficiency, but low-dose corticosteroids are considered a useful approach [20]. The hemodynamic effect of low-dose hydrocortisone in children with shock is being evaluated in a placebo-controlled study.…”

Section: Corticosteroids In Meningococcal Diseasementioning

confidence: 99%

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Meningococcal Meningitis

Branco

Tasker

2010

Curr Treat Options Neurol

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Meningococcal meningitis (MM) is the most common presentation of meningococcal disease and an important cause of morbidity and mortality worldwide. When MM is associated with shock, early recognition and treatment of shock is essential. No investigation should delay starting antibiotics once the diagnosis is suspected. Corticosteroids can be started at the same time as the antibiotics or just before, but this is not a specific recommendation for MM. Low-dose steroids should be used in meningococcal disease with refractory shock. Altered blood flow, cerebral edema, and raised intracranial pressure are problems that should be considered in all patients with MM and decreased consciousness level. When mechanical ventilation is required, the target carbon dioxide level is 4.0 to 4.5 kPa, with avoidance of hypocapnia. Seizures, although not frequent, can occur in MM and require prompt treatment. Other treatments, such as mannitol and activated protein C, should be avoided. Potential new treatments requiring further investigation include neuroprotection with hypothermia or glycerol.

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“…Por ejemplo, las convulsiones tienden a presentarse con mayor frecuencia en neonatos con un peso igual o mayor a 2500 g o con una edad gestacional mayor, lo cual podría deberse a una mayor madurez relativa en el sistema nervioso central de estos últimos en comparación con aquellos de mas bajo peso al nacer; mientras que los recién nacidos con peso <1500 g presentan una mayor frecuencia de hemorragias intracraneales y secuelas neurológicas severas, incluyendo un coeficiente intelectual residual menor. Por último, la ventriculitis se reporta hasta en un 40 a 90% de los pacientes cuyos estudios revelan la persistencia de bacterias en el LCR (12,13).…”

Section: Descripción Clínicaunclassified

Actualización en el tratamiento de la meningitis neonatal bacteriana y reporte de un caso

2010

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100 rev. fac. med Actualización en el tratamiento de la meningitis neonatal bacteriana y reporte de un caso ResumenLa meningitis neonatal bacteriana es una de las enfermedades infecciosas que más se asocia a altas tasas de morbi-mortalidad en los individuos afectados. Aunque esta entidad se presenta a nivel mundial, su incidencia y prevalencia son más altas en los países en vía de desarrollo, debido a la falta de un adecuado control prenatal, que es uno de los factores asociados. En los últimos diez años se ha contado con la disponibilidad de agentes antibacterianos efectivos, que han permitido notables avances en su tratamiento ayudando a minimizar la severidad del cuadro clínico y/o secuelas y por lo consiguiente, a un mejor pronóstico y a la disminución de la mortalidad asociada; sin embargo, esta enfermedad sigue siendo frecuente, lo que hace pensar que la clave de un buen pronóstico radica tanto en su prevención, que se basa en la detección, y tratamiento precoz antes de la colonización del agente infeccioso en los gestantes, como en un buen diagnóstico clínico y la confirmación por estudios paraclínicos, que permitirán seleccionar el tratamiento adecuado. Los principales agentes causales siguen siendo el Streptococcus agalactiae (Grupo B), bacilos gram negativos, Listeria monocytogenes y Streptococcus pneumoniae. Los factores de riesgo son el parto pretérmino (menor a 37 semanas), la ruptura prematura de membranas mayor a 18 horas, o una temperatura materna mayor o igual a 38°C en el momento del parto. Aunque el manejo final deberá basarse en el resultado del antibiograma de las muestras de los hemocultivos, el tratamiento empírico iniciado con penicilinas más una cefalosporina de tercera generación y/o un aminoglucósido tipo gentamicina preferencialmente, después de haberse tomado las muestras, es el que ha mostrado la mejor de las respuestas clínicas. El tratamiento endovenoso deberá continuarse con el antibiótico apropiado para el germen aislado, hasta dos semanas después de la negativización del hemocultivo. Desafortunadamente, las secuelas severas a largo plazo son frecuentes (12% a 29% de los afectados), especialmente en las infecciones asociadas a Streptococcus del grupo B y a bacilos gram negativos, aún en los casos en los que el tratamiento ha sido oportuno y adecuado. Palabras clave: meningitis, neonato, Streptococcus agalactiae, Listeria monocytogenes , Streptococcus pneumoniae NEONATAL BACTERIAL MENINGITIS TREATMENT UPDATE AND REPORT OF A CASE AbstractNeonatal bacterial meningitis is one of the infectious diseases most commonly associated with high rates of morbidity and mortality in affected individuals. Although this entity is present worldwide, its incidence and prevalence are much higher in developing countries due to the lack of adequate prenatal care, which constitutes one of the associated factors. During the last decade more effective antibacterial

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Meningococcal disease and meningitis

Cited by 16 publications

References 38 publications

Meningococcal Meningitis

Actualización en el tratamiento de la meningitis neonatal bacteriana y reporte de un caso

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