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1

Chang, Mary P. Bacterial Meningitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0005.

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Bacterial meningitis is a bacterial infection causing inflammation of the meninges, the lining around the brain and spinal cord. It is important for emergency physicians to recognize potential bacterial meningitis early. They are usually the providers that the patient will present to first. If the patient is critically ill and suspicion for meningitis is high, immediately give steroids followed by antibiotics and then pursue diagnostic workup. Lumbar puncture will aid in definitive diagnosis. If this procedure will be delayed and suspicion for bacterial meningitis is high, give dexamethasone f
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2

Meningitis: Causes, diagnosis, and treatment. Nova Science Publishers, 2011.

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3

Koch, Christel. Die Eitrige Meningitis im Säuglings- und Kindesalter: Diagnostik, Therapie, Verlauf, Prognose. 1987.

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4

Havens, Nicholas S., and William E. Roland. Ehrlichiosis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0158.

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Human infections with Ehrlichia species have been found worldwide. It appears that at least six different species infect humans, and clinical and epidemiological data are highly suggestive of sole transmission by ticks. The clinical illness is a nonspecific febrile syndrome, often accompanied by cytopenias, abnormal liver enzymes, and “aseptic” meningitis. When diagnosis is delayed, it is occasionally fatal. Currently, the polymerase chain reaction (PCR) technique is the most rapid technique to confirm the clinical diagnosis. The infection is responsive to tetracyclines and chloramphenicol. In
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5

Differential Diagnosis in Neuroimaging: Brain and Meninges. Thieme Medical Publishers, Incorporated, 2016.

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6

Cruz, Andrea T., and Jeffrey R. Starke. Central Nervous System Tuberculosis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0154.

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Mycobacterium tuberculosis is a common cause of bacterial meningitis in areas with high HIV prevalence and its diagnosis often is delayed in industrialized nations. Children (particularly infants) and immunocompromised persons are at higher risk of developing TB meningitis. Lymphocytic meningitis, high CSF protein, and (in children) frequently an abnormal chest radiograph should raise clinician index of suspicion for TB meningitis. Neuroimaging may show hydrocephalus, basilar leptomeningeal enhancement, ischemia, and/or tuberculomas. Prompt recognition and initiation of antituberculous antibio
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7

Greenlee, John E. Cerebrospinal Fluid. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0145.

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Evaluation of cerebrospinal fluid is of essential importance in the diagnosis of central nervous system infections, with a major role in the diagnosis of meningitis and encephalitis. In bacterial and viral meningitis, CSF evaluation is usually straightforward, and well-defined serological and molecular techniques are available for CSF examination in many of the more common viral encephalitides. This is in contrast to CSF evaluation in cases of tuberculous and chronic meningitis, in which organisms may be difficult to detect by culture or polymerase chain methods or antigen detection. This chap
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8

Nadel, Simon, and Johnny Canlas. Epidemiology, diagnosis, and assessment of meningitis and encephalitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0240.

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Despite advances in antimicrobial therapy, central nervous system infections have a high morbidity and mortality. Most pathogens reach the brain by haematogenous spread following invasion through the mucosal surface of the nasopharynx. The cerebrospinal fluid inflammatory response is responsible for most of the deleterious effects of the infection. Understanding this response has allowed a more rational approach to therapy. Patients may present with non-specific features, especially neonates, infants, post-neurosurgical patients, and the elderly. This chapter will review the epidemiology, path
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9

Orenstein, Robert. Clinical Syndromes in Infectious Diseases. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0411.

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This chapter approaches the field of infectious diseases from 3 perspectives. This second part covers clinical syndromes associated with various infections, such as infective endocarditis, meningitis, sexually transmitted infections, urinary tract infections, gastrointestinal infections, and soft-tissue infections. Symptoms, diagnosis, and treatment of these conditions are reviewed.
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10

Frenck, Robert, and Paula K. Braverman, eds. AM:STARs: Infectious Diseases and Immunizations, Vol. 21, No. 2. American Academy of Pediatrics, 2005. http://dx.doi.org/10.1542/9781581105636.

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Published by the American Academy of Pediatrics, Adolescent Medicine: State of the Art Reviews helps you stay up-to-date in key areas of current clinical practice of adolescent medicine. This widely respected resource continues to deliver high-quality, evidence-based information needed for day-to-day diagnostic and management problem-solving. Topics in Infectious Diseases and Immunizations in Adolescents include: Immunization Update, Sinusitis and Complications, Pneumonia, Pertussis, Influenza, Infectious Mononucleosis & CMV, Viral Hepatitis, Meningitis/Encephalitis, HIV, HPV
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11

Bicanic, Tihana, and Thomas S. Harrison. Fungal central nervous system infections. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0022.

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Infections of the central nervous system (CNS) are amongst the most severe of all fungal infections. Cryptococcus neoformans is the commonest cause of adult meningitis in many countries with high HIV prevalence. C gattii is usually seen in the tropics in apparently immunocompetent patients. Meningitis is also caused by Candida in premature babies, and by the dimorphic fungi in endemic areas. CNS infections with Aspergillus, the mucormycetes, and less common moulds usually present as intracranial mass lesions in immunocompromised hosts. Early suspicion, prompt imaging, and appropriate samples f
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12

Wilson, John W., and Lynn L. Estes. Central Nervous System Infections. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199797783.003.0089.

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•Clinical: The diagnosis of meningitis is suggested by the constellation of headache, fever, and neck stiffness. Some patients may also experience changes in mental status.•Radiology: Computed tomograms or magnetic resonance imaging of the brain may be indicated for immunocompromised patients and patients with papilledema or focal neurologic deficits. However, neuroimaging should not delay initiation of antimicrobial therapy....
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13

Moen, Vibeke. Neurological complications of neuraxial blockade. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0028.

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Neuraxial techniques for obstetric analgesia and anaesthesia are widespread, and serious complications are extremely rare. The most common of all complications following neuraxial blockade is postdural puncture headache, but headache may also be present in pathological conditions such as pre-eclampsia and sinus vein thrombosis. Headache may also be a symptom of cranial subdural haematoma, meningitis, and epidural abscess, all rare complications of central blockade, thus introducing a potential confounder in the newly delivered woman complaining of headache. Vertebral spinal haematomas are extr
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14

Halperin, John J. Nervous System Lyme Disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0159.

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Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is
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15

Viscardi, Rose M., and Ken B. Waites. Ureaplasma urealyticum and Ureaplasma parvum. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190604813.003.0022.

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The Mycoplasma species Ureaplasma parvum and Ureaplasma urealyticum colonize the human adult urogenital tract and are not typically associated with disease. Perinatal transmission, however, has been implicated in the pathogenesis of preterm birth, chorioamnionitis, and other complications of extreme prematurity, including neonatal pneumonitis, bronchopulmonary dysplasia (BPD), meningitis, and necrotizing enterocolitis (NEC). This chapter reviews the biology of these organisms. Epidemiologic and experimental evidence supporting a role for ureaplasmas in the pathogenesis of neonatal disease, cli
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16

Singhi, Pratibha, Karthi Nallasamy, and Sunit Singhi. Fungal Infections of the Central Nervous System. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0162.

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Fungal infections of the central nervous system are important because of their increasing incidence and the growing population of at-risk individuals. CNS spread is usually hematogenous but rarely can be due to direct invasion from adjacent structures. Morphology of the infecting fungus may predict the regions affected and the lesion phenotype. Meningitis and mass lesions are the most frequent. This chapter reviews the current understanding of the neuropathogenesis of fungal infections with mention of histopathological and imaging correlations. Important aspects of management are also discusse
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17

Sahota, Pradeep, and Niranjan N. Singh. Sleep in other neurological disorders—headache. Edited by Sudhansu Chokroverty, Luigi Ferini-Strambi, and Christopher Kennard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682003.003.0031.

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Headache and sleep disorder are among the most commonly reported problems in clinical practice and often coexist in the same patient. The two are related in several ways, though the relationship is very complex and is still not very well understood. The brainstem and hypothalamic nuclei are hypothesized to regulate both sleep and headache. Differential diagnosis of headache during sleep includes cluster headache, hypnic headache, migraine, sleep apnea headache, exploding head syndrome, tension-type headache, and paroxysmal hemicrania. Management of these headaches depends upon the diagnosis as
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18

Davies, Paul. Headache. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0048.

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Headache is a pain in the head, with the pain being above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. It may be secondary to numerous disorders such as meningitis (secondary headaches) or be a disorder in and of itself, such as migraine and cluster headache (primary headaches). Primary headaches are benign, diagnosed entirely on the history, and form the major morbidity in the problem of headache. They often exist in episodic and chronic forms. Secondary headaches may be acute or chronic, and benign or serious. Only some require investigation for their
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19

Messacar, Kevin, and Mark J. Abzug. Enterovirus and Parechovirus. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190604813.003.0003.

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Enteroviruses (EVs) comprise a genus in the Picornaviridae family. They are single-stranded RNA viruses and are common causes of human infection. Polioviruses, the prototypic EVs, were historically responsible for widespread outbreaks of paralytic poliomyelitis; now they are on the verge of global elimination through vaccination. More than 100 serotypes of nonpoliovirus EVs are described and are associated with a wide variety of diseases, ranging from respiratory infections, nonspecific febrile illnesses, herpangina, and hand-foot-and-mouth disease to meningitis, encephalitis, paralytic diseas
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20

Paech, Michael J., and Patchareya Nivatpumin. Postdural puncture headache. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0027.

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Postdural puncture headache (PDPH) may follow either deliberate or unintentional (accidental) penetration of the interdigitating meninges, the dura and arachnoid mater. It is one of the most common and clinically important complications of regional anaesthesia and analgesia in the obstetric population. The headache develops as a consequence of cerebrospinal fluid loss, low intracranial pressure and cerebrovascular changes in the upright position and can prove debilitating. The diagnosis is clinical, making thorough assessment and regular review all the more important, to revise treatment plans
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21

Debaveye, Yves, and Greet Van den Berghe. Pathophysiology and management of pituitary disorders in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0262.

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The pituitary gland plays a predominant role in the endocrine system. Consequently, patients with pituitary diseases or after pituitary surgery present unique challenges to the intensivist. Failure of the anterior pituitary gland to secrete one or more pituitary hormones results in a clinical syndrome known as hypopituitarism. While hypopituitarism is mostly encountered in patients in whom the diagnosis has already been made, acute exacerbation of an undiagnosed insufficiency may occasionally occur. Acute decompensated patients with suspected hypopituitarism should be admitted to an intensive
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