Salmonella encephalopathy successfully treated with high-dose methylpredonisolone therapy

Ichikawa, Kazushi; Kajitani, A; Tsutsumi, Akiko; Takeshita, Saoko

doi:10.1016/j.braindev.2008.12.019

Cited by 13 publications

(12 citation statements)

References 9 publications

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“…Previous studies have reported various features from MRI investigation, ranging from normal appearance, demyelinating changes, symmetrical diffuse abnormal signal with central area of restricted diffusion to diffuse cerebral oedema (10)(11)(12)(13). The literature on imaging findings of Parkinsonism is lacking.…”

Section: Discussionmentioning

confidence: 99%

Parkinsonism and Brain Mri Findings in a Relapsed Culture-Proven Salmonella Typhi Infection: A Case Report in Malaysia

Ym¹,

Jt²

2016

JUMMEC

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Typhoid fever is a systemic infection caused by Salmonella typhi, which may be associated with extra-intestinal complications. Neurological manifestations, particularly Parkinsonism, are rarely reported. We report a 17-year-old patient with relapsed culture-proven Salmonella typhi infection who developed septic shock and subsequently Parkinsonism. Lumbar puncture revealed acellular cerebrospinal fluid with raised protein level. Magnetic resonance imaging revealed cerebral petechial haemorrhages resulted from small vessels vasculitis. His symptoms resolved spontaneously after 3 months.

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Section: Discussionmentioning

confidence: 99%

Parkinsonism and Brain Mri Findings in a Relapsed Culture-Proven Salmonella Typhi Infection: A Case Report in Malaysia

Ym¹,

Jt²

2016

JUMMEC

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“…Also disturbances detected by EEG correlate with the severity of SEA [2,7]. Generally, the electroencephalogram findings of the patient with SEA demonstrate diffuse cerebral dysfunction [7][8][9]. Hosokawa et al reported that the incidence of EEG abnormalities during sepsis ranged from 12% to 100% for background abnormality and 6% to 12% for presence of triphasic waves.…”

Section: Discussionmentioning

confidence: 99%

Sepsis-Associated Encephalopathy in a Child with the Torsion of Meckel’s Diverticulum

2016

Ann Clin Anal Med

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ÖzetSepsis-ilişkili ensefalopati enfeksiyona sistemik yanıta ikincil gelişen yaygın bir beyin fonksiyon bozukluğudur ve yüksek mortalite oranı ile ilişkilidir. Biz 4 yaşın-daki sepsis-ilişkili ensefalopati görülen bir erkek hastayı sunduk. Hasta karın ağ-rısı ve kusma ile başvurdu. Yatışının ikinci gününde, dikkat bozukluğu, konfüzyon ve deliryumun eşlik ettiği bilinç bozukluğu geliştirdi. Rutin laboratuar testleri, beyin manyetik rezonans görüntüleme ve beyin omurilik sıvısı incelemesi normaldi. Elektroensefalografide sağ hemisferde epileptiform deşarjların eşlik ettiği yük-sek voltajlı yavaş dalga aktivitesi izlendi. Hasta acilen ameliyata alındı ve tortiöz, gangrenöz Meckel divertikülü ve komşuluğundaki ince bağırsağa uzanan iskemi alanı görüldü ve bu alanlar çıkarıldı. Hastanın üçüncü gün bilinci normale döndü ve izlemde sekelsiz olarak taburcu edildi. Sepsis-ilişkili ensefalopati hastalarında kötü prognozun üstesinden gelmek için, belirtilerinin erken tanınması ve altta yatan nedenin uygun tedavisi çok önemlidir. Anahtar KelimelerSepsis İlişkili Ensefalopati; Meckel Divertikülü; Çocuk Abstract Sepsis-associated encephalopathy (SEA) is a diffuse brain dysfunction secondary to the systemic response to infection and is associated with high mortality rate. We report a 4-year-old boy with SEA. He presented with abdominal pain and vomiting. On the second day of admission, he developed consciousness disturbance with impaired attention, confusion and delirium. Routine laboratory tests, brain magnetic resonance imaging and cerebrospinal fluid examination were normal. Electroencephalography (EEG) showed high-voltage slow wave activity on the right hemisphere with epileptiform discharge. He immediately underwent surgery and a torsed, gangrenous Meckel's diverticulum with extension of ischemia to adjacent small bowel was seen and resected. His consciousness had become normal by the third day and he was discharged without any sequela. To overcome a poor prognosis in patients with SEA, the early recognition of the symptoms of SEA and also appropriate treatment of the underlying cause are essential.

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“…11 Unfortunately, there has been a lack of studies to confirm this suspicion. Small studies of encephalopathy associated with non-typhoidal Salmonella infection have shown that proinflammatory cytokines are elevated in both cerebrospinal fluid (CSF) and serum, [29][30][31] and cytokine-induced neurotoxicity has been suggested as the cause. No studies to date have measured CSF cytokines in Salmonella Typhi infection.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Encephalopathy in Patients with Salmonella enterica Serotype Typhi Bacteremia Presenting to a Diarrheal Hospital in Dhaka, Bangladesh

Leung

Bogetz

Itoh

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. To characterize clinical correlates of typhoid fever-associated encephalopathy, we performed a retrospective chart review of patients with Salmonella enterica serotype Typhi bacteremia who were hospitalized at the International Centre for Diarrhoeal Disease Research, Bangladesh, from February of 2009 to June of 2011. Of 207 patients bacteremic with Salmonella Typhi who were 5 years of age, we identified 43 (21%) patients with encephalopathy. Univariate analysis revealed that patients with encephalopathy more often presented at ages of 10-24 years and had severe dehydration, low oxygen saturation, high respiratory rate, low leukocyte count, low platelet count, and Widal flagellar H agglutinin (TH) titer 1:640 compared with typhoid patients without encephalopathy. Multivariate analysis using logistic regression showed that age, dehydration, leukocyte count, and Widal TH titer were independently associated with encephalopathy. Our findings suggest that age, severity of disease, and immune responses are associated with encephalopathy during Salmonella Typhi bacteremia, perhaps reflecting the impact of prominent inflammatory responses.

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Salmonella encephalopathy successfully treated with high-dose methylpredonisolone therapy

Cited by 13 publications

References 9 publications

Parkinsonism and Brain Mri Findings in a Relapsed Culture-Proven Salmonella Typhi Infection: A Case Report in Malaysia

Parkinsonism and Brain Mri Findings in a Relapsed Culture-Proven Salmonella Typhi Infection: A Case Report in Malaysia

Sepsis-Associated Encephalopathy in a Child with the Torsion of Meckel’s Diverticulum

Factors Associated with Encephalopathy in Patients with Salmonella enterica Serotype Typhi Bacteremia Presenting to a Diarrheal Hospital in Dhaka, Bangladesh

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