Gender Differences in Community-acquired Meningitis in Adults: Clinical Presentations and Prognostic Factors

Community-acquired meningitis is a serious disease that is associated with high morbidity and mortality. The purpose of this study was to investigate the gender differences involved with the clinical presentations of and prognostic factors for this disease. 

We conducted a retrospective study of 619 adults diagnosed with community acquired meningitis in Houston, Texas, who were hospitalized between 2005 and 2010. Patients were categorized as male or female. Those who were evaluated to have a Glasgow Outcome Scale score of four or less were classified to have an adverse clinical outcome. Males consisted of 47.2% (292/619) of the total cohort, and more often presented with coexisting medical conditions, fever, abnormal microbiology results, and abnormalities on head computed tomography. Females more often presented with nuchal rigidity. Read more>>>>>>>>>>>

Candida Albicans Ventriculitis Post Trans-Sphenoidal Surgery

Candida infection of the central nervous system (CNS) is relatively unusual in children. It is commonly reported among premature neonates and immunocompromised or post-surgical patients. Patients undergone neurosurgical procedure are at particular risk as the use of CSF shunt devices is a common practice in neurosurgery and infection of the shunt is the most frequently reported complication. Herein, we report an unusual presentation of Candida albicans meningitis and ventriculitis in a young child who underwent transsphenoidal surgery.

Case report:

A four and half-year-old female child was admitted to the pediatric ward of our hospital with fever and excessive sleep since one week. Two weeks before admission she underwent trans-sphenoidal removal of suprasellar pilocytic astrocytoma complicated by ventricular dilatation. Read more>>>>>>>>>>>>>>>

Gender Differences in Community-acquired Meningitis in Adults: Clinical Presentations and Prognostic Factors

Community-acquired meningitis can be caused by several treatable and untreatable infectious etiologies (e.g., bacterial, viral, and fungal infections), but most commonly the etiology is unknown. Studies show that risk factors for bacterial meningitis include age, immunosuppression, genetic susceptibility, and anatomical defects. Mortality and morbidity for bacterial meningitis is high, with risk factors for a poor outcome including systemic compromise and a low level of consciousness . Outcome largely depends on rapid initiation of an effective empiric treatment, adjusting for age, systemic symptoms, and antimicrobial resistance.

While there is some understanding of the effect of age and other risk factors on susceptibility to community-acquired meningitis, there are no studies exploring gender differences in community-acquired meningitis. The purpose of this study is to investigate gender differences in clinical presentation, laboratory and imaging results, etiologies and prognostic factors in male and female patients with community-acquired meningitis. Read more...................

A First Clinical Case Report of West-Nile Viral Meningoencephalitis Complicated with Acute Pancreatitis in North America

WNV is a mosquito-borne virus of the flaviviridae family. It is indigenous to Africa, Asia, Europe and Australia, and has been associated with several outbreaks in Israe. WNV was virtually unknown to North America until 1999, when it made a first appearance during an epidemic of meningo-encephalitis in Queens, New York, NY . From the period between 1999 and 2004, there have then been over 7,000 reportedcases of neuro-invasive WNV induced encephalitis in the United States . The neurological manifestations of WNV infection can range from meningitis, encephalitis and cranial nerve dysfunction to acute flaccid paralysis and motor neuron disease . 

Most cases of WNV infections are asymptomatic. The incubation period is typically 2 to 14 days. There are no specific symptoms that typify WNV infections. Clinically, they may present with symptoms similar to aseptic viral meningitis, usually with fever, headache, and other non-specific symptoms. These typically carry a low associated mortality. Some patients may present with a more abrupt onset of encephalitis with altered mental status, vomiting, severe headaches, accompanied by a high grade fever. In about 15% of cases, cerebral dysfunction may progress to coma, with accompanying abnormalities such as diffuse muscle weakness, flaccid paralysis, and respiratory failure. Read more...........

Gender Differences in Community-acquired Meningitis in Adults: Clinical Presentations and Prognostic Factors

Community-acquired meningitis can be caused by several treatable and untreatable infectious etiologies (e.g., bacterial, viral, and fungal infections), but most commonly the etiology is unknown. Studies show that risk factors for bacterialmeningitis include age, immunosuppression, genetic susceptibility, andanatomical defects. Mortality and morbidity for bacterial meningitis is high, with risk factors for a poor outcome including systemic compromise and a low level of consciousness. Outcome largely depends on rapid initiation of an effective empiric treatment, adjusting for age, systemic symptoms, and antimicrobial resistance .While there is some understanding of the effect of age and other risk factors on susceptibility to community-acquired meningitis, there are no studies exploring gender differences in community-acquired meningitis. The purpose of this study is to investigate gender differences in clinical presentation, laboratory and imaging results, etiologies and prognostic factors in male and female patients with community-acquired meningitis.

Case definition:This is a sub-study of another community-acquired meningitis study. Each adult patient (older than 17 years) enrolled in the study had community-acquired symptoms of meningitis (such as headache, stiff neck, fever, focal neurological deficits, or altered mental status) and a cerebrospinal fluid (CSF) white cell count of greater than 5 cells/mm3. These patients presented to an emergency department at a Houston-area hospital between 2005 and 2010. The University of Texas Health Science Center in Houston Committee for the Protection of Human Subjects and the Memorial Hermann Hospital Research Review Committee approved this study. For more.....