Journal articles: 'Pneumonia; Meningitis'

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Dondo, Vongai, Hilda Mujuru, Kusum Nathoo, Vengai Jacha, Ottias Tapfumanei, Priscilla Chirisa, Portia Manangazira, et al. "Pneumococcal Conjugate Vaccine Impact on Meningitis and Pneumonia Among Children Aged <5 Years—Zimbabwe, 2010–2016." Clinical Infectious Diseases 69, Supplement_2 (September 5, 2019): S72—S80. http://dx.doi.org/10.1093/cid/ciz462.

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Abstract Background Streptococcus pneumoniae is a leading cause of pneumonia and meningitis in children aged <5 years. Zimbabwe introduced 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose infant schedule with no booster dose or catch-up campaign. We evaluated the impact of PCV13 on pediatric pneumonia and meningitis. Methods We examined annual changes in the proportion of hospitalizations due to pneumonia and meningitis among children aged <5 years at Harare Central Hospital (HCH) pre-PCV13 (January 2010–June 2012) and post-PCV13 (July 2013–December 2016) using a negative binomial regression model, adjusting for seasonality. We also evaluated post-PCV13 changes in serotype distribution among children with confirmed pneumococcal meningitis at HCH and acute respiratory infection (ARI) trends using Ministry of Health outpatient data. Results Pneumonia hospitalizations among children aged <5 years steadily declined pre-PCV13; no significant change in annual decline was observed post-PCV13. Post-PCV13 introduction, meningitis hospitalization decreased 30% annually (95% confidence interval [CI], –42, –14) among children aged 12–59 months, and no change was observed among children aged 0–11 months. Pneumococcal meningitis caused by PCV13 serotypes decreased from 100% in 2011 to 50% in 2016. Annual severe and moderate outpatient ARI decreased by 30% (95% CI, –33, –26) and 7% (95% CI, –11, –2), respectively, post-PCV13 introduction. Conclusions We observed declines in pediatric meningitis hospitalizations, PCV13-type pneumococcal meningitis, and severe and moderate ARI outpatient visits post-PCV13 introduction. Low specificity of discharge codes, changes in referral patterns, and improvements in human immunodeficiency virus care may have contributed to the lack of additional declines in pneumonia hospitalizations post-PCV13 introduction.

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Andriatahirintsoa, Emilson Jean P. R., Julia Liliane Raboba, Vonintsoa Lalaina Rahajamanana, Ando Lalaina Rakotozanany, Mengouom M. Nimpa, Yolande Vuo Masembe, Goitom Weldegebriel, Linda De Gouveia, Jason M. Mwenda, and Annick Lalaina Robinson. "Impact of 10-Valent Pneumococcal Conjugate Vaccine on Bacterial Meningitis in Madagascar." Clinical Infectious Diseases 69, Supplement_2 (September 5, 2019): S121—S125. http://dx.doi.org/10.1093/cid/ciz504.

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Abstract Background The 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in Madagascar in 2012. The objective of this study was to determine the impact of PCV10 on bacterial meningitis in hospitalized children <5 years of age. Methods During 2010–2017, data from the hospital admission logbook were recorded for bacterial meningitis and pneumonia hospitalizations in children <5 years of age. Between April 2011 and December 2017, 3312 cerebrospinal fluid (CSF) samples collected from children who fulfilled the World Health Organization case definition of suspected bacterial meningitis were analyzed at the sentinel site laboratory (SSL) by microscopy, culture, and antigen detection tests. A total of 2065 CSF samples were referred to the regional reference laboratory for real-time polymerase chain reaction (RT-PCR) analysis. 2010–2011 was defined as the prevaccine period, 2012 as vaccine introduction year, and 2013–2017 the postvaccine period. The number of cases, causative agent, and pneumonia hospitalizations were compared before and after PCV10 introduction. Results In the prevaccine period, bacterial meningitis and pneumonia hospitalizations accounted for 4.5% and 24.5% of all hospitalizations while there were 2.6% and 19%, respectively, in the postvaccine period (P < .001). In samples tested at the SSL, 154 were positive with 80% Streptococcus pneumoniae and 20% other bacteria. Pneumococcal meningitis diagnosed by RT-PCR declined from 14% in 2012 to 3% in 2017. Also, 14% of children with pneumococcal meningitis died. Conclusions Following PCV10 introduction, pneumococcal meningitis, bacterial meningitis, and pneumonia hospitalizations declined. Surveillance should continue to monitor the impact of PCV10.

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Amin, Muhammad, Asim Khurshid, Mukhtar Ahmad, and Zunaira Javed. "Etiology and outcome of culture proven bacterial meningitis in children 6 to 24 months of age." Professional Medical Journal 26, no. 09 (September 10, 2019): 1451–56. http://dx.doi.org/10.29309/tpmj/2019.26.09.2562.

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Introduction: Pediatric bacterial meningitis is a life-threatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. More than 2/3 cases of meningitis occur in the 1st 2 years of life, owing to decreased immunity and high vascularity of the brain.This study was conducted to determine the frequency of hemophilus influenzae type b, streptococcus pneumonia and neisseria meningitidis and outcome in culture proven meningitis in children 6 months to 24 months. Study Design: Case series. Setting: Paeds Unit 1, Bahawal Victoria Hospital, Bahawalpur and Paeds Unit of District Headquarter (DHQ) Teaching Hospital, Dera Ghazi Khan. Period: 1st April 2017 to 30th September 2018. Material and Methods: A total of 220 children (110 from each center) of either sex with culture proven meningitis, aged 6 months to 24 months, were included in the study. Demographics, duration of fever, history of seizures, weight of child, vaccination status and bacteria isolated from CSF and outcome were analyzed. The outcome in the form of mortality was noted during the first 10 days of hospital stay. Results: Amongst a total of 220 children, 123 (55.9%) were male. There were 130 (59.1%) children who were less than or equal to 1 year of age. There were 154 (70.0%) children who were having a weight of 7 to 10 kg. Vaccination status was, 111 (50.5%) were fully vaccinated, 59 (26.8%) partially vaccinated and 50 (22.7%) not vaccinated. Duration of fever was, 141 (64.1%) had fever for more than 5 days. There were 139 (63.2%) children who had a history of seizures. Streptococcus pneumonia was the commonest bacteria found in 110 (50%) children followed by neisseria meningitides 53 (24.1%), H. Influenza 37 (16.8%). Overall mortality was noted in 34 (15.5%) children. Conclusion: In children with bacterial meningitis, mortality was high and most common bacteria were found to be s.pneumoniae followed by neisseria meningitidis and h.influenzae. Awareness about the empiric and directed antimicrobial therapy will help to lower the burden of morbidity and mortality related to bacterial meningitis.

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Idris, Mohamad Imran, Sharon Mei Ling Tai, Chong Tin Tan, and Kay Sin Tan. "Streptococcus pneumoniae Meningitis and Intracranial Vasculopathy: Clinical Correlation with Improving Transcranial Doppler Hemodynamics." Case Reports in Neurology 12, Suppl. 1 (December 14, 2020): 106–9. http://dx.doi.org/10.1159/000500950.

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<i>Streptococcus pneumoniae</i> are Gram-positive bacteria that are responsible for many types of illnesses including pneumonia, sinus infections, and community-acquired meningitis. One important complication of bacterial meningitis is intracranial vasculopathy. Possible etiologies include vasculitis, vasospasm, endocarditis, or intra-arterial thrombosis. We present a case report of <i>S. pneumoniae</i> meningitis treated with antibiotics in which clinical improvement correlated with serial transcranial Doppler ultrasonography (TCD) improvement, suggesting vasospasm or vasculitis as a possible mechanism for intracranial vasculopathy.

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Shann, Frank. "CHLORAMPHENICOL FOR MENINGITIS AND PNEUMONIA." Lancet 327, no. 8479 (March 1986): 507. http://dx.doi.org/10.1016/s0140-6736(86)92971-5.

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Soltani, Peter, Terence McGarry, and Parth Rali. "Primary Meningococcal Pneumonia Without Meningitis." Chest 142, no. 4 (October 2012): 243A. http://dx.doi.org/10.1378/chest.1373686.

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Bhatta, Sabita, Raina Chaudhary, and Dhirendra Ayer. "Klebsiella pneumoniae associated nosocomial meningitis in a patient after resection of meningioma." Medical Journal of Shree Birendra Hospital 13, no. 1 (July 19, 2015): 46–48. http://dx.doi.org/10.3126/mjsbh.v13i1.13004.

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Klebsiella pneumoniae is a primary pathogen capable of causing urinary tract infection (UTIs), liver abscess and pneumonia in otherwise healthy individuals. However, most infections caused by K. pneumoniae are acquired in the hospitals and/or occur in those who are debilitated by various under lying conditions. Nosocomial infections caused by K. pneumoniae includes wound infections, infections of intravascular and other invasive devices, biliary tract infections, peritonitis and meningitis. We report a case of a 29 year old male who developed meningitis after excision of meningioma.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.13004

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Cadwgan, A. M., A. R. MacKenzie, and R. B. S. Laing. "Neisseria Meningitidis W135 Pneumonia with Sepicaemia in a Nonogenarian." Scottish Medical Journal 43, no. 5 (October 1998): 148. http://dx.doi.org/10.1177/003693309804300508.

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Neisseria meningitidis infection is generally considered a disease of children or young adults, classically presenting as meningitis or sepicaemia. This infection is rare but recognised in the elderly. Wepresent the case of a nonogenarian with meningococcal pneumonia and sinusitis with bacteraemia caused by N.meningitidis W135 a rare serogroup. We therefore thought this unusual situation of interest and worthwhile reporting.

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Tilahun, Getachew Teshome. "Optimal Control Analysis of Pneumonia and Meningitis Coinfection." Computational and Mathematical Methods in Medicine 2019 (September 22, 2019): 1–15. http://dx.doi.org/10.1155/2019/2658971.

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In this paper, we proposed a deterministic model of pneumonia-meningitis coinfection. We used a system of seven ordinary differential equations. Firstly, the qualitative behaviours of the model such as positivity of the solution, existence of the solution, the equilibrium points, basic reproduction number, analysis of equilibrium points, and sensitivity analysis are studied. The disease-free equilibrium is locally asymptotically stable if the basic reproduction number is kept less than unity, and conditions for global stability are established. Then, the basic model is extended to optimal control by incorporating four control interventions, such as prevention of pneumonia as well as meningitis and also treatment of pneumonia and meningitis diseases. The optimality system is obtained by using Pontryagin’s maximum principle. For simulation of the optimality system, we proposed five strategies to check the effect of the controls. First, we consider prevention only for both diseases, and the result shows that applying prevention control has a great impact in bringing down the expansion of pneumonia, meningitis, and their coinfection in the specified period of time. The other strategies are prevention effort for pneumonia and treatment effort for meningitis, prevention effort for meningitis and treatment effort for pneumonia, treatment effort for both diseases, and using all interventions. We obtained that each of the listed strategies is effective in minimizing the expansion of pneumonia-only, meningitis-only, and coinfectious population in the specified period of time.

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Mahmoud, Fatma Mohamed, and Thana Harhara. "Neisseria meningitidis pneumonia with bacteremia without meningitis: An atypical presentation." IDCases 21 (2020): e00897. http://dx.doi.org/10.1016/j.idcr.2020.e00897.

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Ceyhan, Mehmet, Yasemin Ozsurekci, Cihangül Bayhan, Nezahat Gurler, Enes Sali, Melike Keser Emiroglu, Fatma Nur Öz, et al. "682. The Changing Epidemiology of Bacterial Meningitis During 2015–2017 in Turkey: A Hospital-Based Prospective Surveillance Study." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S246. http://dx.doi.org/10.1093/ofid/ofy210.689.

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Abstract Background The etiology of bacterial meningitis in Turkey has been changed after the implementation of conjugated vaccines against Streptococcus pneumonia and Haemophilus influenzae type b (Hib) in Turkish national immunization schedule. Methods. This prospective study was conducted in 25 hospitals located seven regions of Turkey (representing 30% of Turkey population) and children aged between 1 month and 18 years with suspected meningitis and hospitalized were included. Cerebrospinal fluid samples were collected and bacterial identification was made according to the multiplex PCR assay results. Results. During the study period, 927 children were hospitalized for suspected meningitis and Hib (n:1), S. pneumonia (n:17) and Neisseria meningitidis (n:59) were detected in 77 samples (Figure 1, Table 1). During 2015–2016, N. meningitidis serogroup W, B, A, Y, X frequencies were as 5 (13.9%), 16 (44.4%), 1 (2.8%), 1 (2.8%), 1 (2.8%), respectively. There were 12 nongroupable N. meningitidis samples and serogroup C was not detected. In 2017, of meningococcal meningitis serogroup B, W, A, Y and X were identified in two (8.7%), 15 (65.2%), two (8.7%), 1 (4.3%) and 1 (4.3%) cases, respectively (Figure 2). There were four deaths in this study period, all of them were caused by N. meningitidis serogroup B and three of them were under 1 year old. Conclusion. The epidemiology of meningococcal diseases has been varied in time with or without any apparent reasons. Hajj is a well-known cause for serogroup W epidemics and serogorup W was the most common cause of meningitis in Turkey during 2009–2014 as in other Middle East countries. After the impact of serogroup W epidemics related to Hajj seen in 2010’s was diminished, serogroup B has been leading cause of childhood meningitis since 2015. In countries affected from Hajj like Turkey, vaccination of children with serogroup B meningococcal vaccine as well as quadrivalentconjugated vaccine seems to be very important. It should be kept in mind that meningococcal epidemiology is dynamic and needed to be closely monitored to detect changes in years Disclosures All authors: No reported disclosures.

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Koehler, Peter J. "The Origin of the Idea That Herpes Labialis Is of Prognostic Importance in Bacterial Meningitis." European Neurology 83, no. 1 (2020): 105–10. http://dx.doi.org/10.1159/000506681.

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Objective:The aim of the work was to study the origin of the idea that herpes labialis (HL) in patients with pneumonia and meningitis was believed to be of prognostic importance. Background:HL is caused by a primary infection or reactivation of herpes simplex type I. In the past, it has been related to pneumonia and meningitis; moreover, HL was believed to be of prognostic importance. Methods:A selection of 19th- and 20th-century textbooks and referred articles was consulted. The relation between meningitis and herpes, type of meningitis, and attributed diagnostic and prognostic importance were studied. In addition, the HL-pneumonia association was studied. Results:The Strasbourg physician Charles-Polydore Forget was the first to describe the HL-meningitis association in 1843. Tourdes (1843), Drasche (1859), and Salomon (1864) attributed a favorable prognostic importance to the HL-meningitis relation. In a comprehensive monograph (1866), August Hirsch, although confirming the association, denied the prognostic importance through critical analysis of the data. Few authors attributed a diagnostic importance to the occurrence of HL, suggesting meningococcal meningitis. Conclusions:The HL-meningitis relation, but not the prognostic importance, has been mentioned in most neurological textbooks since then. In contrast to meningitis, in which a prognostic attribution of HL was only a short-lived 19th-century idea, the favorable prognostic importance of HL in pneumonia continued to be described until the 1950s. A possible protective effect of herpesviruses has been found in recent years. One could speculate that the disappearance of the prognostic HL-pneumonia relation could be related to the introduction of antibiotics in the late 1940s.

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Mpabalwani, Evans M., Chileshe Lukwesa-Musyani, Akakambama Imamba, Ruth Nakazwe, Belem Matapo, Chilweza M. Muzongwe, Trust Mufune, et al. "Declines in Pneumonia and Meningitis Hospitalizations in Children Under 5 Years of Age After Introduction of 10-Valent Pneumococcal Conjugate Vaccine in Zambia, 2010–2016." Clinical Infectious Diseases 69, Supplement_2 (September 5, 2019): S58—S65. http://dx.doi.org/10.1093/cid/ciz456.

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Abstract Background Pneumococcus is a leading cause of pneumonia and meningitis. Zambia introduced a 10-valent pneumococcal conjugate vaccine (PCV10) in July 2013 using a 3-dose primary series at ages 6, 10, and 14 weeks with no booster. We evaluated the impact of PCV10 on meningitis and pneumonia hospitalizations. Methods Using hospitalization data from first-level care hospitals, available at the Ministry of Health, and from the largest pediatric referral hospital in Lusaka, we identified children aged <5 years who were hospitalized with pneumonia or meningitis from January 2010–December 2016. We used time-series analyses to measure the effect of PCV10 on monthly case counts by outcome and age group (<1 year, 1–4 years), accounting for seasonality. We defined the pre- and post-PCV10 periods as January 2010–June 2013 and July 2014–December 2016, respectively. Results At first-level care hospitals, pneumonia and meningitis hospitalizations among children aged <5 years accounted for 108 884 and 1742 admissions in the 42 months pre-PCV10, respectively, and 44 715 and 646 admissions in the 30 months post-PCV10, respectively. Pneumonia hospitalizations declined by 37.8% (95% confidence interval [CI] 21.4–50.3%) and 28.8% (95% CI 17.7–38.7%) among children aged <1 year and 1–4 years, respectively, while meningitis hospitalizations declined by 72.1% (95% CI 63.2–79.0%) and 61.6% (95% CI 50.4–70.8%), respectively, in these age groups. In contrast, at the referral hospital, pneumonia hospitalizations remained stable and a smaller but significant decline in meningitis was observed among children aged 1–4 years (39.3%, 95% CI 16.2–57.5%). Conclusions PCV10 introduction was associated with declines in meningitis and pneumonia hospitalizations in Zambia, especially in first-level care hospitals.

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Domo, Nuoh R., Culbert Nuolabong, Kofi M. Nyarko, Ernest Kenu, Phoebe Balagumyetime, Godfrey Konnyebal, Charles L. Noora, Kofi D. Ameme, Fred Wurapa, and Edwin Afari. "Uncommon mixed outbreak of pneumococcal and meningococcal meningitis in Jirapa District, Upper West Region, Ghana, 2016." Ghana Medical Journal 51, no. 4 (February 7, 2018): 149–55. http://dx.doi.org/10.4314/gmj.v51i4.2.

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Objective: The Jirapa District in Ghana falls within the African meningitis belt where over 500 million people are at risk of epidemic meningitis. The district suffered an outbreak of Neisseria meningitides, W (NMW) in 2012 and a mixed outbreak of Streptococcus pneumonia and NMW in early 2016. We investigated the outbreak to identify the source, causative agents, and magnitude and assess health facility preparedness and propose control measures.Design and Setting: We conducted a descriptive study in all sub-districts of Jirapa, between 28th February to10th April 2016. We reviewed records at health facilities, assessed health facility preparedness, searched for cases, traced contacts of case to administer chemoprophylaxis and collect CSF for laboratory analysis. Data were entered in Microsoft excel cleaned, and exported to stata-13 for analysis by person place and time.Results: A total 233 meningitis cases were reported with mean age of 22.4years and standard deviation 21.6. Males were (57%), females (43%) and 60.8% were less than 19 years. Attack rate of meningitis was 214/100,000 with case fatality rate (CFR) of 12.4% (29/233). Causative agents were NMW (69.5%) and streptococcus pneumonia (27.1%), mainly serotype STN1 and H. influenza (3.4%). The index case had travel history to dollar power, close to Tain District which is the epicentre for the 2016 meningitis outbreak in Ghana.Conclusion: The Jirapa district experienced a mixed outbreak of streptococcal and meningococcal meningitis in early 2016, facilitated by migration. Active surveillance and mass vaccination with multivalent vaccines is required to protect the population.Funding: Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)Keywords: Meningitis, outbreak, surveillance, Jirapa, CSF

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Noble, Robert C. "Delayed Treatment of Pneumonia and Meningitis." Annals of Internal Medicine 114, no. 9 (May 1, 1991): 809. http://dx.doi.org/10.7326/0003-4819-114-9-809_2.

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Ludwig, Endre, Lindsay Jorgensen, Sharon Gray, Samantha Munson, Kathy Chou, and Elane M. Gutterman. "Clinical burden of multi-cause and pneumococcal pneumonia, meningitis, and septicemia in Hungary. Results of a retrospective study (2006–2011)." Orvosi Hetilap 155, no. 36 (September 2014): 1426–36. http://dx.doi.org/10.1556/oh.2014.29990.

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Introduction: Assessment of the impact of pneumococcal conjugate vaccines on the burden of pneumonia, meningitis, and septicemia in Hungary is limited. Aim: The aim of this retrospective study was to quantify rates of hospitalized multi-cause and pneumococcal pneumonia, meningitis, and septicemia in all age groups in Hungary between 2006 and 2011. Method: Aggregate data were obtained from the Hungarian National Healthcare Fund using pre-specified ICD-10 codes. Comparisons included average rates pre-vaccine (2006–2007) versus post-vaccine (2010–2011) using a χ2test. Results: Hospitalization rates among children aged 0–4 years significantly declined for multi-cause pneumonia and meningitis, but increased for septicemia. There were significant increases in multi-cause pneumonia and septicemia in other age groups. In-hospital mortality rates increased with age. Limited use of pneumococcal-specific codes led to inconclusive findings for pneumococcal diseases. Conclusions: Declines in multi-cause pneumonia and meningitis in children aged 0–4 years suggest direct effects of pneumococcal conjugate vaccination on hospitalization rates. Orv. Hetil., 2014, 155(36), 1426–1436.

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Zaripova, A. Z., Yu A. Tyurin, L. T. Bayazitova, O. F. Tyupkina, and G. Sh Isaeva. "IgA-protease activity coupled to cellular enzymes of different Streptococcus pneumonia serotypes isolated in pediatric bacteria carriers." Russian Journal of Infection and Immunity 9, no. 5-6 (February 1, 2020): 680–86. http://dx.doi.org/10.15789/2220-7619-2019-5-6-680-686.

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Streptococcus pneumoniae are significant causative agents of severe and life-threatening acute pneumonia, meningitis, as well as otitis and sinusitis both in children and elderly. As many as 1.2 million pediatric lethal outcomes due to pneumonia and infections of the central nervous system (meningitis) caused by S. pneumoniae, are recorded worldwide annually, a large proportion of which occur in developing countries. Metal-dependent IgA1 proteases derived from pathogenic bacteria comprise an important group of bacterial enzymes cleaving human immunoglobulin A1 (IgA1) at the hinge region, thereby interfering with fully-executed host antibacterial immunity.Objective. To study activity of IgA1proteinases and their class profile (Na2-EDTA and PMSF-inhibited) in various pneumococcal serotypes isolated from nasopharyngeal carrier children.Materials and methods. There were examined 585 children attending preschool facilities residing in Kazan (n = 331) and rural areas (n = 254). Microbiological, molecular genetics and immunochemical methods were used to identify, serotyping composition and protease activity of Streptococcus pneumoniae isolates. Data statistical processing was carried out by using software Graph Pad Prism version 5.0.Results. Prevalence of S. pneumonie in pediatric carriers aged 1.5–3 years was 35.1%, 3–5 years — 23.4%, 5–7 years — 19.6%, and over 7 years — 21.9%. Vaccine serotypes 14, 19F, 23F as a part of current pneumococcal vaccines (Prevenar, Pneumavax-23) comprised as high as 55.8%. However, in 19% of cases were positive for non-vaccine S. pneumoniae strains. Non-typeable strains were detected in 5.8% isolates. IgA-proteinase activity was detected in cell lysates of 45 (86.5%) S. pneumoniae strains isolated from pediatric carriers. Cell lysates of S. pneumoniae strains showing no proteolytic properties, were assigned to serotypes 12F, Sg18. Thus, studies on development of alternative vaccines containing immunogenic proteins, adhesins or other virulence factors common to capsulated and non-typeable (encapsulated) pneumococcal strains hold promise. All the aforementioned accounts for a need for microbiological monitoring of S. pneumoniae carriage and search for new diagnostic approaches for etiological interpretation of S. pneumoniae-associated diseases.

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Kurniawan, Arief, and Ardi Zulfariansyah. "Tatalaksana Pasien Post Ventriculo Peritoneal (VP) Shunt et causa Meningitis disertai Aspirasi Pneumonia dan Gagal Napas di Ruang Rawat Intensif." Jurnal Neuroanestesi Indonesia 9, no. 2 (June 18, 2020): 87–91. http://dx.doi.org/10.24244/jni.v9i2.245.

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Ventriculo Peritoneal (VP) Shunt adalah tindakan operasi pemasangan kateter yang menghubungkan ventrikel otak dan rongga peritoneum. Tindakan VP Shunt bertujuan menurunkan tekanan intrakranial yang tinggi pada hidrosefalus. Pasien hidrosefalus akibat meningitis sering mengalami gagal napas akibat gangguan otak atau aspirasi pneumonia. Terapi ventilasi mekanik diperlukan sebelum, selama dan setelah operasi VP Shunt. Laporan kasus laki-laki 21 tahun datang ke rumah sakit karena gangguan kesadaran dan didiagnosis dengan meningitis. Pasien mengalami gagal napas akibat aspirasi pneumonia dan mendapat terapi ventilasi mekanik, kemudian menjalani operasi VP Shunt atas indikasi hidrosefalus komunikan. Induksi anestesi menggunakan fentanil dan propofol, pemeliharaan anestesi menggunakan sevofluran dan analgesi pascabedah menggunakan fentanil kontinyu. Berdasarkan pemeriksaan cairan serebrospinal pasien didiagnosis meningitis serosa akibat Tuberkulosis. Pasien mendapat terapi antibiotik empirik untuk aspirasi pneumonia dan antituberkulosis. Setelah kesadaran membaik dan weaning ventilator pasien dipindahkan dari ruang perawatan intensif. Management Patient Post Ventriculo Peritoneal (VP) shunt et causa Meningitis with Pneumonia Aspiration and Respiratory Failure in ICUAbstractVentriculo Peritoneal (VP) Shunt is a surgery that connects the brain ventricles and the peritoneal cavity with a catheter. VP Shunt aims to reduce high intracranial pressure in hydrocephalus. Hydrocephalus patients due to meningitis often experience respiratory failure from brain disorder or pneumonia aspiration. Mechanical ventilation therapy is needed before, during and after VP Shunt surgery. Case report of 21-year-old came to the hospital with decreased of conciousness and diagnosed with meningitis. The patient experienced respiratory failure and received mechanical ventilation therapy in the intensive care unit. The patient underwent VP Shunt surgery for indications of communicant hydrocephalus. Induction of anesthesia used fentanyl and propofol, maintenance of anesthesia used sevoflurane and postoperative analgesia used continuous fentanyl. Based on the results of the examination of cerebrospinal fluid, the diagnosis leads to serous meningitis due to Tuberculosis bacteria. Empiric antibiotics therapy for aspiration pneumonia and antituberculosis were given even if no bacteria was found in the blood or cerebrospinal fluid. After improvement in clinical condition and weaning from mechanical ventilator, the patient discharge from the ICU and sent to the ward.

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Rossoni, Andrea Maciel de Oliveira, Libera Maria Dalla Costa, Denize Bonato Berto, Sônia Santos Farah, Marilene Gelain, Maria Cristina de Cunto Brandileone, Vitor Hugo Mariano Ramos, and Sergio Monteiro de Almeida. "Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes." Arquivos de Neuro-Psiquiatria 66, no. 3a (September 2008): 509–15. http://dx.doi.org/10.1590/s0004-282x2008000400014.

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The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from April 2001 to august 2002 have been evaluated. One hundred S. pneumoniae have been isolated, of which 15% were resistant to penicillin, 1% to cephalosporin and 0% to vancomycin. The serotypes most found were 14 (19%), 3 and 23F (10% each). When only the resistant serotypes were analyzed, the most prevalent was the 14 with 44%. The risk factors found in relation to the S. pneumoniae resistance were: age under one year old (p=0.01) and previous use of antibiotic (p=0.046). The resistance rates found, which were moderate to penicillin, low to cephalosporin and neutral to vancomycin, suggest the isolated use of a 3rd generation cephalosporin as an initial empirical therapy for the treatment of acute bacterial meningitis with a communitarian background.

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Shahrin, Lubaba, Mohammod Jobayer Chisti, Sayeeda Huq, Md Munirul Islam, Shafiqul Alam Sarker, Mahmuda Begum, Shukla Saha, and Tahmeed Ahmed. "Diarrhea-associated pneumococcal meningitis with complicating hydrocephalus in a child in a resource-limited setting." Journal of Infection in Developing Countries 10, no. 08 (August 31, 2016): 888–91. http://dx.doi.org/10.3855/jidc.7921.

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Introduction: Streptococcus pneumonia is the most common and intimidating cause of childhood meningitis. Its delayed diagnosis may be associated with hyponatremia and hypernatremia with fatal outcome. Case presentation: A previously healthy nine-month-old Bangladeshi female infant was diagnosed with diarrhea, pneumonia, and convulsion due to hypernatremia. Pneumonia was confirmed by respiratory distress and radiological findings. Routine cerebrospinal fluid study detected pneumococcal meningitis. Ampicillin, gentamicin, and dexamethasone were promptly started. On day three of hospitalization, convulsion re-appeared with worsening of consciousness level. Antibiotics were switched to ceftriaxone and vancomycin, although ultrasonography of the brain revealed no abnormality. Contrast-enhanced computed tomography scan of the head was performed and revealed dilated ventricles with diffused enhancement of meninges and basal cisterns, demonstrating meningitis with ventriculomegaly. Ceftriaxone was replaced by meropenem to control fever. Magnetic resonance imaging (MRI) of the brain confirmed the progression of hydrocephalus. An emergency ventriculo-peritoneal (VP) shunt operation was performed with continuation of antibiotics for 21 days. After three months, follow-up MRI showed reduction of ventricular size with functioning VP shunt in situ with no neurological deficits. Conclusions: Childhood pneumococcal meningitis may be associated with diarrhea, pneumonia, and other related complication. Appropriate antibiotic therapy alone may not be sufficient to avert complications. Communicating hydrocephalus is potentially an ominous ramification of meningitis even when the ultrasonography result is normal. Rapid diagnosis is imperative to attain good outcome. Evidence advocates further research into the risk factors of meningitis in diarrheal children that may help in early diagnosis and management to reduce meningitis-related fatal outcome.

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Muley, Vrishali Avinash, Dnyaneshwari Purushottam Ghadage, Gauri Eknath Yadav, and Arvind Vamanrao Bhore. "Study of Invasive Pneumococcal Infection in Adults with Reference to Penicillin Resistance." Journal of Laboratory Physicians 9, no. 01 (January 2017): 031–35. http://dx.doi.org/10.4103/0974-2727.187918.

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ABSTRACT Background: Invasive pneumococcal infections often prove rapidly fatal, even where good medical treatment is readily available. In developed countries, up to 20% of people who contract pneumococcal meningitis die; however, in developing world, mortality is closer to 50%, even among hospitalized patients. The World Health Organization estimated 600,000–800,000 adult deaths each year from pneumococcal pneumonia, meningitis, and sepsis. Aims: This study aims to estimate isolation rate of invasive pneumococcal infection in adults, to determine the antimicrobial susceptibility profile of Streptococcus pneumoniae. isolates and to study the associated risk factors. Materials and Methods: A total of 120 patients with suspected invasive infection such as meningitis, septicemia, and pleural effusion, were included in the study. Various clinical specimens such as pus, cerebrospinal fluid, and other sterile body fluids were processed for isolation and identification of S. pneumoniae. Kirby–Bauer disc diffusion method was performed to determine the antimicrobial susceptibility profile. Minimum inhibitory concentration test was performed to determine the penicillin resistance. Results: Of 120 patients, 40 (33.33%) cases were proven by culture to have an invasive pneumococcal infection. The most common clinical condition observed was meningitis followed by pneumonia with pleural effusion and sepsis. Pneumococcal isolates exhibited 40% resistance to cotrimoxazole and 12.73% to chloramphenicol. Two meningeal isolates exhibited penicillin resistance. Comorbidities observed in 21 (52.5%) cases were mainly Diabetes mellitus, smoking, and alcoholism. Conclusions: Invasive pneumococcal infection has poor prognosis and penicillin‑resistant strains have become increasingly common. This study emphasizes the importance of judicious use of antibiotics, especially to refrain their use in mild self-limiting upper respiratory infections.

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Faye, Papa M., Mouhamadou A. Sonko, Amadou Diop, Aliou Thiongane, Idrissa D. Ba, Michael Spiller, Ousmane Ndiaye, et al. "Impact of 13-Valent Pneumococcal Conjugate Vaccine on Meningitis and Pneumonia Hospitalizations in Children aged <5 Years in Senegal, 2010–2016." Clinical Infectious Diseases 69, Supplement_2 (September 5, 2019): S66—S71. http://dx.doi.org/10.1093/cid/ciz457.

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Abstract Background Senegal introduced a 13-valent pneumococcal conjugate vaccine (PCV13) in October 2013, given at 6, 10, and 14 weeks of age. We document trends of meningitis and pneumonia after the PCV13 introduction. Methods From October 2010–October 2016, hospitalization data for clinical meningitis and pneumonia in children aged <5 years were collected from logbooks at a large, tertiary, pediatric hospital in Dakar. We used a set of predetermined keywords to define hospitalizations for extraction from hospital registers. We conducted a time-series analysis and compared hospitalizations before and after the PCV13 introduction, accounting for seasonality. The initial PCV13 uptake period (October 2013–September 2014) was considered to be transitional and was excluded. Results Over the 7-year period, 1836 and 889 hospitalizations with a discharge diagnosis of pneumonia and meningitis, respectively, occurred in children aged <5 years. In children aged <12 months, a small, significant reduction in pneumonia was observed post-PCV13 (−3.8%, 95% confidence interval [CI] −1.5 to −5.9%). No decline was observed among children aged 12–59 months (−0.7%, 95% CI −0.8 to 2.2%). Meningitis hospitalizations remained stable for children aged <12 months (1.8%, 95% CI −0.9 to 4.4%) and 12–59 months (−0.5%, 95% CI −3.6 to 2.6%). Conclusions We used data from 1 hospital to detect a small, significant reduction in all-cause pneumonia hospitalizations 2 years post-PCV13 introduction in infants; the same trend was not measurable in children aged 12–59 months or in meningitis cases. There is a need for continued surveillance to assess the long-term impact of sustained PCV13 use and to monitor how pneumococcus is causing disease in the meningitis belt.

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Purniti, Putu Siadi, Ida Bagus Subanada, I. Komang Kari, BNP Arhana, Ida Sri Iswari, and Ni Made Adi Tarini. "Surveilan Pneumokokus dan Dampak Pneumonia pada Anak Balita." Sari Pediatri 12, no. 5 (November 18, 2016): 359. http://dx.doi.org/10.14238/sp12.5.2011.359-64.

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Latar belakang. Streptococcus pneumonia (SP) adalah penyebab utama meningitis, pneumonia, danbakteremia pada bayi dan anak. Mikroorganisme tersebut adalah penyebab utama kematian yang dapatdicegah dengan imunisasi pada anak usia di bawah lima tahun. Data tentang insiden invasive pneumococcaldisease (IPD) di Indonesia masih terbatas.Tujuan. Mengetahui dampak pneumonia dan IPD pada populasi target di Rumah Sakit Umum PusatSanglah Denpasar, Bali, Indonesia.Metode. Surveilan aktif berbasis rumah sakit, prospektif selama satu tahun pada anak usia 28 hari sampai 60bulan. Seluruh anak yang tinggal dalam area cakupan penelitian, usia 28 hari sampai 􀁤36 bulan mengalamidemam 􀁴39°C atau menderita pneumonia, menunjukkan gejala IPDHasil. Subjek 736 anak dengan median usia 10 bulan (79,2% usia 28 hari sampai <24 bulan). S. pneumoniatidak terdeteksi dari seluruh subjek. Biakan darah dilakukan pada 736 subjek, 125 di antaranya (17,19%)menunjukkan pertumbuhan bakteri. Bakteri yang diisolasi dari biakan darah antara lain Staphylococcus sp 58(46,4%), S. aureus 45 (36,0%), Pseudomonas sp 9 (7,2%), E. coli 3 (2,4%). Diagnosis awal terbanyak adalahpneumonia, 439 (59,7%). Insiden pneumonia 534,2/100000, usia 28 hari - <6 bulan 167,1/100000, danusia 28 hari - <24 bulan 839/100000. Angka insiden tertinggi pneumonia dengan foto dada usia 28 hari - <6bulan yaitu 10,9/100000, dan kelompok usia 28 hari - <24 bulan 19,4/100000. Angka insiden pneumoniadan foto dada dengan CRP 􀁴40 mg/L tertinggi pada kelompok usia 12 bulan - <24 bulan, 82,9/100000.Dilakukan pemeriksaan PCR S. pneumoniae terhadap 106 sampel, terdiri dari kasus meninggal, meningitis,sepsis dan pneumonia berat tidak terdeteksi S. pneumoniaeKesimpulan. Pneumonia mempunyai dampak yang cukup berarti bagi daerah cakupan RSUP Sanglah yangdisebabkan oleh pneumokokus, dan saat ini masih merupakan tantangan.

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Shann, F., and S. Germer. "Hyponatraemia associated with pneumonia or bacterial meningitis." Archives of Disease in Childhood 60, no. 10 (October 1, 1985): 963–66. http://dx.doi.org/10.1136/adc.60.10.963.

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Del Fava, Claudia, Flávia L. Levy, Eloisa M. Scannapieco, Maria do Carmo C. S. H. Lara, Eliana M. C. Villalobos, Alessandra F. C. Nassar, Mariana S. Cunha, and Elenice M. S. Cunha. "Cryptococcal Pneumonia and Meningitis in a Horse." Journal of Equine Veterinary Science 31, no. 12 (December 2011): 693–95. http://dx.doi.org/10.1016/j.jevs.2011.05.001.

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Bennaoui, F., N. El Idrissi Slitine, S. B. Cissé, N. Soraa, and F. M. R. Maoulainine. "Bacterial Meningitis Profile in Newborns: Is the Epidemiology Changing?" Open Infectious Diseases Journal 10, no. 1 (October 31, 2018): 160–65. http://dx.doi.org/10.2174/1874279301810010160.

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Objective: The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates. Materials and Methods: A retrospective study of all cases of meningitis, hospitalized in the neonatal intensive care unit, Mohamed VI University Hospital, from January 2016 to December 2016. Results: Twenty of 794 neonates admitted (2.5%) developed meningitis,with a male predominance (12 boys). The mean age of symptom presentation was 5 days. All patients were symptomatic. The most common clinical features were: fever, respiratory distress and seizure. Microbiological analysis of cerebrospinal fluid was positive in 14 cases and resulted in the isolation of several unusual species such as, Streptococcus pneumoniae (4 cases), Coagulase-negative Staphylococci (3 cases), Enterococci (2 cases), Acinetobacter baumannii (2 cases) and one case each of Escherichia coli , Neisseria meningitidis and Klebsiella pneumonia. Interestingly, the two A. baumannii cases were nosocomially-acquired, while the origins of the other infections were community-acquired. Gram-positive bacteria were more frequently responsible (9/14, 64%). All cases were treated with a combination of third-generation cephalosporins-aminoglycosides, 1 case as treated by by adding ciprofloxacin and 3 cases were treated by adding glycopeptide antibiotics to the clinical therapeutic regimes. We reported 3 cases complicated with hydrocephalus. The mortality rate was 25%. Conclusion: Bacterial meningitis is a medical emergency, and immediate diagnostic steps must be taken to establish the specific cause so that appropriate antimicrobial therapy can be initiated. Even with optimal therapy, morbidity and mortality may occur. Neurologic sequelae are common among survivors.

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Novaes, Hillegonda Maria Dutilh, Ana Marli Christovam Sartori, and Patricia Coelho de Soárez. "Hospitalization rates for pneumococcal disease in Brazil, 2004 - 2006." Revista de Saúde Pública 45, no. 3 (June 2011): 539–47. http://dx.doi.org/10.1590/s0034-89102011005000028.

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OBJECTIVE: To estimate hospitalization rates for pneumococcal disease based on the Brazilian Hospital Information System (SIH). METHODS: Descriptive study based on the Hospital Information System of Brazilian National Health System data from January 2004 to December 2006: number of hospitalizations and deaths for pneumococcal meningitis, pneumococcal sepsis, pneumococcal pneumonia and Streptococcus pneumoniae as the cause of diseases reported in Brazil. Data from the 2003 Brazilian National Household Survey were used to estimate events in the private sector. Pneumococcal meningitis cases and deaths reported to the Notifiable Diseases Information System during the study period were also analyzed. RESULTS: Pneumococcal disease accounted for 34,217 hospitalizations in the Brazilian National Health System (0.1% of all hospitalizations in the public sector). Pneumococcal pneumonia accounted for 64.8% of these hospitalizations. The age distribution of the estimated hospitalization rates for pneumococcal disease showed a "U"-shape curve with the highest rates seen in children under one (110 to 136.9 per 100,000 children annually). The highest hospital case-fatality rates were seen among the elderly, and for sepsis and meningitis. CONCLUSIONS: PD is a major public health problem in Brazil. The analysis based on the SIH can provide an important input to pneumococcal disease surveillance and the impact assessment of immunization programs.

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Pachón-Ibáñez, María E., Fernando Docobo-Pérez, Rafael López-Rojas, Juan Domínguez-Herrera, Manuel E. Jiménez-Mejias, Andrés García-Curiel, Cristina Pichardo, Luis Jiménez, and Jerónimo Pachón. "Efficacy of Rifampin and Its Combinations with Imipenem, Sulbactam, and Colistin in Experimental Models of Infection Caused by Imipenem-Resistant Acinetobacter baumannii." Antimicrobial Agents and Chemotherapy 54, no. 3 (January 4, 2010): 1165–72. http://dx.doi.org/10.1128/aac.00367-09.

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ABSTRACT There are currently no defined optimal therapies available for multidrug-resistant (MDR) Acinetobacter baumannii infections. We evaluated the efficacy of rifampin, imipenem, sulbactam, colistin, and their combinations against MDR A. baumannii in experimental pneumonia and meningitis models. The bactericidal in vitro activities of rifampin, imipenem, sulbactam, colistin, and their combinations were tested using time-kill curves. Murine pneumonia and rabbit meningitis models were evaluated using the A. baummnnii strain Ab1327 (with MICs for rifampin, imipenem, sulbactam, and colistin of 4, 32, 32, and 0.5 mg/liter, respectively). Mice were treated with the four antimicrobials and their combinations. For the meningitis model, the efficacies of colistin, rifampin and its combinations with imipenem, sulbactam, or colistin, and of imipenem plus sulbactam were assayed. In the pneumonia model, compared to the control group, (i) rifampin alone, (ii) rifampin along with imipenem, sulbactam, or colistin, (iii) colistin, or (iv) imipenem plus sulbactam significantly reduced lung bacterial concentrations (10.6 ± 0.27 [controls] versus 3.05 ± 1.91, 2.07 ± 1.82, 2.41 ± 1.37, 3.4 ± 3.07, 6.82 ± 3.4, and 4.22 ± 2.72 log10 CFU/g, respectively [means ± standard deviations]), increased sterile blood cultures (0% versus 78.6%, 100%, 93.3%, 93.8%, 73.3%, and 50%), and improved survival (0% versus 71.4%, 60%, 46.7%, 43.8%, 40%, and 85.7%). In the meningitis model rifampin alone or rifampin plus colistin reduced cerebrospinal fluid bacterial counts (−2.6 and −4.4 log10 CFU/ml). Rifampin in monotherapy or with imipenem, sulbactam, or colistin showed efficacy against MDR A. baumannii in experimental models of pneumonia and meningitis. Imipenem or sulbactam may be appropriate for combined treatment when using rifampin.

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Chiavolini, Damiana, Gianni Pozzi, and Susanna Ricci. "Animal Models of Streptococcus pneumoniae Disease." Clinical Microbiology Reviews 21, no. 4 (October 2008): 666–85. http://dx.doi.org/10.1128/cmr.00012-08.

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SUMMARY Streptococcus pneumoniae is a colonizer of human nasopharynx, but it is also an important pathogen responsible for high morbidity, high mortality, numerous disabilities, and high health costs throughout the world. Major diseases caused by S. pneumoniae are otitis media, pneumonia, sepsis, and meningitis. Despite the availability of antibiotics and vaccines, pneumococcal infections still have high mortality rates, especially in risk groups. For this reason, there is an exceptionally extensive research effort worldwide to better understand the diseases caused by the pneumococcus, with the aim of developing improved therapeutics and vaccines. Animal experimentation is an essential tool to study the pathogenesis of infectious diseases and test novel drugs and vaccines. This article reviews both historical and innovative laboratory pneumococcal animal models that have vastly added to knowledge of (i) mechanisms of infection, pathogenesis, and immunity; (ii) efficacies of antimicrobials; and (iii) screening of vaccine candidates. A comprehensive description of the techniques applied to induce disease is provided, the advantages and limitations of mouse, rat, and rabbit models used to mimic pneumonia, sepsis, and meningitis are discussed, and a section on otitis media models is also included. The choice of appropriate animal models for in vivo studies is a key element for improved understanding of pneumococcal disease.

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Grandgirard, Denis, Rahel Gäumann, Boubacar Coulibaly, Jean-Pierre Dangy, Ali Sie, Thomas Junghanss, Hans Schudel, Gerd Pluschke, and Stephen L. Leib. "The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis." Mediators of Inflammation 2013 (2013): 1–12. http://dx.doi.org/10.1155/2013/312476.

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Background. The brain’s inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activating resident immune cells and leading to the influx of blood derived leukocytes. To elucidate the pathomechanisms behind the observed difference in outcome between different pathogens, we compared the inflammatory profile in the CSF of patients with BM caused byStreptococcus pneumonia(n=14),Neisseria meningitidis(n=22), andHaemophilus influenza(n=9).Methods. CSF inflammatory parameters, including cytokines and chemokines, MMP-9, and nitric oxide synthase activity, were assessed in a cohort of patients with BM from Burkina Faso.Results. Pneumococcal meningitis was associated with significantly higher CSF concentrations of IFN-γ, MCP-1, and the matrix-metalloproteinase (MMP-) 9. In patients with a fatal outcome, levels of TNF-α, IL-1β, IL-1RA, IL-6, and TGF-αwere significantly higher.Conclusion. The signature of pro- and anti-inflammatory mediators and the intensity of inflammatory processes in CSF are determined by the bacterial pathogen causing bacterial meningitis with pneumococcal meningitis being associated with a higher case fatality rate than meningitis caused byN. meningitidisorH. influenzae.

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Baas Rubarth, Lori. "Sepsis, Pneumonia, and Meningitis: What Is the Difference?" Newborn and Infant Nursing Reviews 10, no. 4 (December 2010): 177–81. http://dx.doi.org/10.1053/j.nainr.2010.09.013.

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Aller, Steve C., and Michael J. Chusid. "Citrobacter koseri Pneumonia and Meningitis in an Infant." Journal of Infection 45, no. 1 (July 2002): 65–67. http://dx.doi.org/10.1053/jinf.2002.1018.

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Koshinski, Rita, John Hasyn, and Nick Burdash. "Listeria and Mycobacteria Meningitis following Haemophilus influenzae pneumonia." Clinical Microbiology Newsletter 10, no. 22 (November 1988): 174–75. http://dx.doi.org/10.1016/0196-4399(88)90086-4.

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Becker-Dreps, Sylvia, Bryan Blette, Rafaela Briceno, Jorge Aleman, Michael G. Hudgens, Gilberto Moreno, Ana Ordonez, Julio Rocha, David J. Weber, and Erick Amaya. "Changes in Pneumonia Incidence and Infant Mortality 5 Years Following Introduction of the 13-valent Pneumococcal Conjugate Vaccine in a “3+0” Schedule in Nicaragua." Open Forum Infectious Diseases 4, suppl_1 (2017): S67—S68. http://dx.doi.org/10.1093/ofid/ofx162.161.

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Abstract Background Streptococcus pneumoniae causes an estimated 826,000 deaths of children in the world each year and many health facility visits. To reduce the burden of pneumococcal disease, many nations have added pneumococcal conjugate vaccines to their national immunization schedules. Nicaragua was the first country eligible for funding from the GAVI Alliance to introduce the 13-valent pneumococcal conjugate vaccine (PCV13), provided to infants at 2, 4, and 6 months of age. The goal of this study was to evaluate the population impact of the first five years of the program. Methods Numbers of visits for pneumonia, pneumonia-related deaths, bacterial meningitis, and infant deaths between 2008 and 2015 were collected from all 107 public health facilities in León Department. Vital statistics data provided additional counts of pneumonia-related deaths that occurred outside health facilities. Adjusted incidence rates and incidence rate ratios (IRRa) in the vaccine (2011–2015) and pre-vaccine periods (2008–2010) were estimated using official population estimates as exposure time. Results The IRRa for pneumonia hospitalizations was 0.70 (95% confidence interval [CI]: 0.66, 0.75) for infants, and 0.92 (95% CI: 0.85, 0.99) for one year olds. The IRRa for post-neonatal infant mortality was 0.56 (95% CI: 0.41, 0.77). In the population as a whole, ambulatory visits and hospitalizations for pneumonia, as well as pneumonia-related mortality and rates of bacterial meningitis were lower in the vaccine period. Conclusion Five years following program introduction, reductions were observed in health facility visits for pneumonia in immunized age groups and infant mortality, which would be hard to achieve with any other single public health intervention. Future study is warranted to understand whether the lack of a booster dose (e.g.,, at 12 months) may be responsible for the small reductions in pneumonia hospitalizations observed in one year-olds as compared with infants. Disclosures S. Becker-Dreps, Pfizer: Consultant and Grant Investigator, Consulting fee and Research grant; D. J. Weber, Pfizer: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium

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Ji, Chenhui, Min Wang, and Xiaocheng Fan. "Water Extract of Gallnut Reduces the Injury of Alveolar Epithelial Cells Induced by Streptococcus pneumoniae by Up-Regulating miRNA-338-3p." Journal of Biomaterials and Tissue Engineering 11, no. 10 (October 1, 2021): 1969–76. http://dx.doi.org/10.1166/jbt.2021.2775.

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Streptococcus pneumoniae (S. pneumoniae) is the primary pathogen causing pneumonia, in addition to lobar pneumonia, meningitis, bronchitis, and other diseases. Inhibiting the apoptosis and inflammation of alveolar epithelial cells is essential for the treatment of pneumonia caused by S. pneumoniae. Traditional Chinese medicine has the characteristics of multiple components, multiple targets, and few adverse reactions. It is recognized by doctors and patients in the treatment of pneumonia and other diseases. We conducted this study to explore the effect of the water extract of gallnut on alveolar epithelial cells affected by S. pneumoniae. Studies have found that the water extract of gallnut can increase the optical density value, Bcl-2 protein expression, IL-10 content, and miRNA-338-3p levels of alveolar epithelial cells affected by S. pneumoniae. Additionally, it can reduce the rate of cell apoptosis, Bax protein expression, and IL-6 content. Further, its effect is dose-dependent: the higher the concentration of gallnut water extract, the more evident its effect on alveolar epithelial cells. Through nano PCR detection, it was found that overexpression of miRNA-338-3p can increase the activity of alveolar epithelial cells affected by S. pneumoniae and promote cell growth. Knockdown of miRNA-338-3p reduced the impact of the water extract of gallnut on the growth of alveolar epithelial cells and the expression of inflammatory factors affected by S. pneumoniae. Therefore, our findings suggest that the water extract of gallnut could inhibit the apoptosis of alveolar epithelial cells affected by S. pneumoniae by up-regulating the expression of miRNA-338-3p.

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Shrestha, Prakash, Sean E. O’Neil, Barbara S. Taylor, Olaoluwa Bode-Omoleye, and Gregory M. Anstead. "Hemoptysis in the Immunocompromised Patient: Do Not Forget Strongyloidiasis." Tropical Medicine and Infectious Disease 4, no. 1 (February 12, 2019): 35. http://dx.doi.org/10.3390/tropicalmed4010035.

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Strongyloidiasis, due to infection with the nematode Strongyloides stercoralis, affects millions of people in the tropics and subtropics. Strongyloides has a unique auto-infective lifecycle such that it can persist in the human host for decades. In immunosuppressed patients, especially those on corticosteroids, potentially fatal disseminated strongyloidiasis can occur, often with concurrent secondary infections. Herein, we present two immunocompromised patients with severe strongyloidiasis who presented with pneumonia, hemoptysis, and sepsis. Both patients were immigrants from developing countries and had received prolonged courses of corticosteroids prior to admission. Patient 1 also presented with a diffuse abdominal rash; a skin biopsy showed multiple intradermal Strongyloides larvae. Patient 1 had concurrent pneumonic nocardiosis and bacteremia with Klebsiella pneumoniae and Enterococcus faecalis. Patient 2 had concurrent Aspergillus and Candida pneumonia and developed an Aerococcus meningitis. Both patients had negative serologic tests for Strongyloides; patient 2 manifested intermittent eosinophilia. In both patients, the diagnosis was afforded by bronchoscopy with lavage. The patients were successfully treated with broad-spectrum antibiotics and ivermectin. Patient 1 also received albendazole. Strongyloidiasis should be considered in the differential diagnosis of hemoptysis in immunocompromised patients with possible prior exposure to S. stercoralis.

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Kumar, Shailesh, Sivaraman Umadevi, Joshy Maducolil Easow, Noyal Mariya Joseph, Sreenivasan Srirangaraj, Kandha Kumari, and Selvaraj Stephen. "Anterior abdominal wall abscess caused by Streptococcus pneumoniae in a patient with self-inflicted stab injury: An unusual presentation." Journal of Infection in Developing Countries 5, no. 04 (March 4, 2011): 307–9. http://dx.doi.org/10.3855/jidc.1384.

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Streptococcus pneumoniae is a major cause of community-acquired pneumonia, otitis media, paranasal sinusitis, bacteremia and meningitis, as well as osteomyelitis and occasionally peritonitis. We report the case of a 25-year-old female who had stabbed herself with a kitchen knife above the umbilicus 10 days prior to admission. Subsequently, she developed an anterior abdominal wall abscess caused by S. pneumoniae. This case is unusual as the focus was distant from the respiratory tract, the usual primary site of infection caused by this organism. Furthermore, the case assumes significance because it occurred in the absence of any typical risk factors for S. pneumoniae.

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Pinto, Elisabeth Ataíde E., and JoãO Guilherme Alves. "The causes of death of hospitalized children in Angola." Tropical Doctor 38, no. 1 (January 2008): 66–67. http://dx.doi.org/10.1258/td.2006.006352.

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Angola currently has the second mortality rate for children in the world. A cross-sectional study was performed containing 1322 random selected children of the 10288 hospitalized from December 2004 to May 2005 at the Hospital Pediátrico David Bernardino, the largest hospital in Angola and health reference centre located in the capital city of Luanda. Hospital mortality was 18% and the main causes of death were:malaria (22.4%), undernutrition (21.5%), pneumonia (11.8%), neonatal affections (9.3%) and meningitis (8.0%). Programmes must be rapidly implemented to eradicate undernutrition, improve perinatal care and control infections, especially malaria, pneumonia and meningitis.

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Ferreira, Muriel, Henrique Oliveira, Nuno Costa e. Silva, Luís Januário, and Fernanda Rodrigues. "Doença Invasiva Pneumocócica Pediátrica Antes da Vacinação Universal: 1995 - 2015." Acta Médica Portuguesa 30, no. 6 (June 30, 2017): 457. http://dx.doi.org/10.20344/amp.8493.

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Introduction: Pneumococcal conjugate vaccine was introduced in the private market in Portugal in 2001, reaching over the years a moderately high coverage. In July 2015, it was included in the National Immunisation Program. The aim of this study was to characterize invasive pneumococcal disease in a pediatric hospital before universal use of the vaccine.Material and Methods: Retrospective analysis of medical records of all children with Streptococcus pneumoniae identified by culture and/or molecular biology (available since 2008), in products obtained from sterile sites, from January 1995 to June 2015. We evaluated demographic, clinical and microbiological data. Serotype results are available since 2004.Results: Over those 20 years, 112 invasive pneumococcal disease cases were identified, with a median age of 15 months (1 month - 15 years). The median number of cases /year was 4, the highest between 2001 - 2002 (8/year) and 2007 - 2012 (7 - 11/year). The identification occurred mostly in blood culture (72), cerebrospinal fluid (24), pleural fluid (11) an others (5). The most frequent diagnoses were pneumonia (38%), occult bacteraemia (34%) and meningitis (21%). Over the period under review, there was an increase of pneumonia and slight increase of OB, with meningitis cases remaining relatively unchanged.Discussion: In the last two decades, there was no reduction in the number of cases of invasive pneumococcal disease. There was an increase in isolates from pneumonia and occult bacteraemia that might be due to the introduction of molecular biological methods for Streptococcus pneumoniae detection. Vaccine serotypes were predominant.Conclusion: This retrospective analysis before universal vaccination will contribute to evaluate the impact of vaccination in the Portuguese pediatric population.

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Chirteș, Ioana Raluca, Dragos Florea, Carmen Chiriac, Oana Maria Mărginean, Cristina Mănășturean, Alexander A. Vitin, and Anca Meda Georgescu. "Severe Austrian Syndrome in an Immunocompromised Adult Patient – A Case Report." Journal of Critical Care Medicine 4, no. 1 (January 1, 2018): 17–22. http://dx.doi.org/10.1515/jccm-2017-0025.

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AbstractBackground: Known also as Osler’s triad, Austrian syndrome is a complex pathology which consists of pneumonia, meningitis and endocarditis, all caused by the haematogenous dissemination of Streptococcus pneumoniae. The multivalvular lesions are responsible for a severe and potential lethal outcome.Case report: The case of a 51-year-old female patient, with a past medical history of splenectomy, is presented. She developed bronchopneumonia, acute meningitis and infective endocarditis as a result of Streptococcus pneumoniae infection and subsequently developed multiple organ dysfunction syndromes which led to a fatal outcome. Bacteriological tests did not reveal the etiological agent. The histopathological examination showed a severe multivalvular endocarditis, while a PCR based molecular analysis from formalin fixed valvular tissue identified Streptococcus pneumoniae as the etiologic agent.Conclusions: The presented case shows a rare syndrome with a high risk of morbidity and mortality. Following the broad-spectrum treatment and intensive therapeutic support, the patient made unfavourable progress which raised differential diagnosis problems. In this case, the post-mortem diagnosis demonstrated multiple valvular lesions occurred as a result of endocarditis.

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Leis, Paul, Saman Setareh-Shenas, Nina Kukar, and Robert Kornberg. "AUSTRIAN SYNDROME, THE UNLUCKY TRIAD: A CASE OF STREP PNEUMONIAE ENDOCARDITIS, MENINGITIS, AND PNEUMONIA." Journal of the American College of Cardiology 75, no. 11 (March 2020): 2956. http://dx.doi.org/10.1016/s0735-1097(20)33583-x.

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TRAM, TRAN TAN, LE QUOC THINH, TRAN TUYET NGA, NGUYEN NGOC TUONG VY, FREDDY KARUP PEDERSEN, and M. SCHLUMBERGER. "The etiology of bacterial pneumonia and meningitis in Vietnam." Pediatric Infectious Disease Journal 17, Supplement (September 1998): S192—S194. http://dx.doi.org/10.1097/00006454-199809001-00023.

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HIRST, R. A., A. KADIOGLU, C. O'CALLAGHAN, and P. W. ANDREW. "The role of pneumolysin in pneumococcal pneumonia and meningitis." Clinical and Experimental Immunology 138, no. 2 (November 2004): 195–201. http://dx.doi.org/10.1111/j.1365-2249.2004.02611.x.

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Klugman, K. P., H. J. Koornhof, V. Kuhnle, S. D. Miller, P. J. Ginsburg, and A. C. Mauff. "Meningitis and pneumonia due to novel multiply resistant pneumococci." BMJ 292, no. 6522 (March 15, 1986): 730. http://dx.doi.org/10.1136/bmj.292.6522.730.

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Ali, Shahnila, and Taarif Hussain. "Atypical presentation of streptococcus salivarius meningitis." International Journal of Research in Medical Sciences 5, no. 9 (August 26, 2017): 4164. http://dx.doi.org/10.18203/2320-6012.ijrms20173724.

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Abstract:

Patient with past medical history significant for multiple co morbidities including hypertension, diabetes mellitus, paroxysmal atrial fibrillation (on Coumadin but sub-therapeutic INR on presentation), chronic systolic congestive cardiac failure/cardiomyopathy, aortic valve stenosis, mitral valve regurgitation presented with slurred speech. Due to concern for stroke, patient received initial CT scan head which was negative and admitted for further work up including MRI. Patient was also observed to be having shortness of breath and mild hypoxia in ED. Patient also had leukocytosis on complete blood count. Initial arterial blood gases results were within normal limits. CXR showed right lower lobe infiltrates suggestive of pneumonia. Infectious work up including blood cultures were also ordered. On clinical examination, no neck rigidity or any focal weakness. No facial droop either. No neurological abnormality other than slurred speech. In addition, patient was initiated on empirical coverage for possible pneumonia with consideration of aspiration event considering a sequela of stroke. Next morning, patient was able to speak clearly and stated that he did have headache few days before presentation. LP was ordered and patient found to have meningitis. Blood cultures grew Streptococcus salivarius. Patient received ceftriaxone and discharged without any complications in stable condition.

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Shamina, Olga V., Ekaterina A. Samoylova, Irina E. Novikova, and Anna V. Lazareva. "Klebsiella pneumoniae: microbiological characterization, antimicrobial resistance, and virulence." Russian Pediatric Journal 23, no. 3 (July 3, 2020): 191–97. http://dx.doi.org/10.18821/1560-9561-2020-23-3-191-197.

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Klebsiella pneumoniae (KP) represents one of the main causative agents of opportunistic infections. KP associated infectious diseases can be local, for example, pneumonia, and generalized, including severe, often life-threatening conditions (meningitis, sepsis). Besides the chromosomal genome with a variety of different genetic loci, KP contains an additional plasmid genome which endues it with important biological properties. That’s why KP strains can be opportunistic, hypervirulent, and resistant to antimicrobials. In this literature review, literature data on the molecular resistant mechanisms, virulence factors and infectious diseases caused by KP is discussed.

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Jesus, Gustavo Nobre de, Tânia Carvalho, Alexandre Caldeira, and Susana M. Fernandes. "Austrian Syndrome: a report of an exceptionally rare and deadly syndrome." Medicina (Ribeirão Preto) 53, no. 4 (December 11, 2020): 468–71. http://dx.doi.org/10.11606/issn.2176-7262.v53i4p468-471.

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Austrian Syndrome is the rare combination of a triad of endocarditis, meningitis, and pneumonia in the context of pneumococcal infection. Due to the involvement of several anatomical sites, the Austrian syndrome has a high mortality. Importantly, endocarditis is usually not considered during pneumococcal infection. We present a case of Austrian syndrome in a previously healthy 67-year-old woman. She featured with mental state alteration, respiratory failure, and shock, and was diagnosed with ceftriaxone-sensitive pneumococcal bacteremia, meningitis, and pneumonia. A transesophageal echocardiogram revealed vegetation of the mitral valve. Despite an improvement in her medical condition, she remained in a coma and died due to neurological complications. Even though the major cause of mortality in Austrian syndrome is cardiac involvement, meningitis is also linked with high morbidity and eventually death. We emphasize the relevance of an early diagnosis of the triad in order to decrease the very high mortality associated with this syndrome.

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Savva, Athina, Matthijs C. Brouwer, Thierry Roger, Mercedes Valls Serón, Didier Le Roy, Bart Ferwerda, Arie van der Ende, Pierre-Yves Bochud, Diederik van de Beek, and Thierry Calandra. "Functional polymorphisms of macrophage migration inhibitory factor as predictors of morbidity and mortality of pneumococcal meningitis." Proceedings of the National Academy of Sciences 113, no. 13 (March 14, 2016): 3597–602. http://dx.doi.org/10.1073/pnas.1520727113.

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Pneumococcal meningitis is the most frequent and critical type of bacterial meningitis. Because cytokines play an important role in the pathogenesis of bacterial meningitis, we examined whether functional polymorphisms of the proinflammatory cytokine macrophage migration inhibitory factor (MIF) were associated with morbidity and mortality of pneumococcal meningitis. Two functional MIF promoter polymorphisms, a microsatellite (−794 CATT5–8; rs5844572) and a single-nucleotide polymorphism (−173 G/C; rs755622) were genotyped in a prospective, nationwide cohort of 405 patients with pneumococcal meningitis and in 329 controls matched for age, gender, and ethnicity. Carriages of the CATT7 and −173 C high-expression MIF alleles were associated with unfavorable outcome (P = 0.005 and 0.003) and death (P = 0.03 and 0.01). In a multivariate logistic regression model, shock [odds ratio (OR) 26.0, P = 0.02] and carriage of the CATT7 allele (OR 5.12, P = 0.04) were the main predictors of mortality. MIF levels in the cerebrospinal fluid were associated with systemic complications and death (P = 0.0002). Streptococcus pneumoniae strongly up-regulated MIF production in whole blood and transcription activity of high-expression MIF promoter Luciferase reporter constructs in THP-1 monocytes. Consistent with these findings, treatment with anti-MIF immunoglogulin G (IgG) antibodies reduced bacterial loads and improved survival in a mouse model of pneumococcal pneumonia and sepsis. The present study provides strong evidence that carriage of high-expression MIF alleles is a genetic marker of morbidity and mortality of pneumococcal meningitis and also suggests a potential role for MIF as a target of immune-modulating adjunctive therapy.

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Anzai, Takashi, Akira Baba, Shin Ito, Yo Suzuki, Shori Tajima, Satoshi Hara, Yusuke Takata, Fumihiko Matsumoto, and Katsuhisa Ikeda. "A Case of Aspiration Pneumonia Caused by Cerebrospinal Fluid Leaks Associated with Delayed Identification of Iatrogenic Skull Base Injury during Endoscopic Sinus Surgery." Case Reports in Otolaryngology 2021 (April 8, 2021): 1–4. http://dx.doi.org/10.1155/2021/5532194.

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Cerebrospinal fluid (CSF) leaks associated with endoscopic sinus surgery (ESS) are a rare complication affecting approximately 0.09% of patients. Although meningitis is a well-known complication of CSF leaks, the case we present is a rare and cautionary case of CSF leakage associated with ESS leading to aspiration pneumonia. A 43-year-old man with CSF leaks after ESS was referred to our hospital. After the operation, sometimes, he reported having a serous nasal discharge from the right side when he bent over, and he woke up choking on something every day. He also experienced headache, fever, fatigue, and cough. Interestingly, chest computed tomography (CT) showed a consolidation and ground-glass opacity in the posterior segments of the right upper lobes and superior segments of the bilateral lower lobes. These CT imaging findings were similar to those of aspiration pneumonia in bedridden patients who are always in a supine position. These findings suggest that CSF caused aspiration pneumonia. To the best of our knowledge, no case of aspiration pneumonia caused by CSF during endoscopic sinus surgery has been reported until now. If a patient with CSF leakage after ESS experiences fever, cough, or fatigue, physicians should consider aspiration pneumonia in addition to meningitis.

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Rashid, Muhammad, Iqbal Bano, and Asif Hanif. "Prevalence of Common Infectious Diseases in Paediatric Age Group Admitted in Children’s Hospital Lahore, Pakistan." International Journal of Frontier Sciences 1, no. 1 (January 1, 2017): 19–28. http://dx.doi.org/10.37978/tijfs.v1i1.12.

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Background: Infectious diseases are common causes of presenting in emergency having severe signs and symptoms. Having significant mortality and morbidity are on the rise in Pakistan. The objective of the study was to determine the prevalence of infectious diseases in paediatric population.Methodology: We studied 200 consecutive patients from 1 month to 12 years of age presenting with infectious diseases. Their detailed history was then taken including symptoms at presentation and the type of infection was assessed with the help of history and laboratory investigations. Following are the common infectious diseases including pneumonia, meningitis, enteric fever, malaria, measles, tuberculosis, acute watery diarrhoea.Results: Frequency wise infectious diseases are pneumonia (63.5%), meningitis (20%), acute watery diarrhoea (8.5%), enteric fever (4%), malaria (2%), tuberculosis (2%), and no measles case found. Infectious diseases are more common in rural areas than urban areas and success after treatment is more (49.5) than death (2%) but a bad impact is that (48.5%) patient went without treatment.Conclusion: This data is taken in winter season that is why Pneumonia is most common infectious disease, second most common infectious disease is meningitis, and others are acute watery diarrhoea, enteric fever, malaria and tuberculosis in our patients. The awareness of risk factors amongst the public is low. Thus, there is an urgent need to create more and more awareness about the preventive aspects and healthier life style behaviour in our community.

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Journal articles on the topic 'Pneumonia; Meningitis'

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