Acute meningitis can be the first manifestation of an underlying systemic inflammatory disorder (SID). In the current study, we aimed to identify clinical indicators for SIDs in patients admitted for acute aseptic meningitis. All patients hospitalised for acute aseptic meningitis over a 4-year period in a department of internal medicine were included retrospectively. Patients with neoplastic meningitis were excluded. Extraneurological signs were recorded using a systematic panel. Systemic inflammatory disorder diagnosis was made according to current international criteria. Forty-three (average age 46 years [range 19-82 years], 60% females) consecutive patients were analysed retrospectively. Of these, 23 patients had an SID (mostly sarcoidosis and Behçet's disease). -Multiple logistic regression analysis showed that the probability of an SID was 93.7% in patients with both neurological and extraneurological signs, but 14.9% in patients with neither neurological nor extraneurological signs. In conclusion, clinical sorting according to both neurological and extraneurological signs could help to identify patients with acute aseptic meningitis caused by an SID.
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http://dx.doi.org/10.7861/clinmedicine.18-2-132 | DOI Listing |
BMC Infect Dis
January 2025
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
Background: Bacterial meningitis (BM) is a life-threatening central nervous system infection with potential for severe neurological sequelae. High mobility group box 1 (HMGB1) is known as a late inflammatory mediator associated with lethal pathology. This study aims to investigate the serial cerebrospinal fluid (CSF) concentrations of HMGB1 in children with BM and its relationship to neurological prognosis.
View Article and Find Full Text PDFJ Community Hosp Intern Med Perspect
November 2024
MedStar Health Internal Medicine Residency Program, USA.
Herpes simplex virus (HSV) is well known to cause Central Nervous System (CNS) infections, ranging from more common HSV-2 viral meningitis to the more rare and severe HSV-1 encephalitis. Here we present an atypical case of aseptic meningitis due to HSV-1. Intriguingly, despite the potential severity of HSV-1 infections, the patient had an uncomplicated course with only mild symptoms that resolved with conservative management alone.
View Article and Find Full Text PDFJ Child Neurol
January 2025
Department of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Turkey.
Autoimmune diseases are a heterogeneous group resulting from dysregulation or dysfunction of the immune system due to genetic predisposition and environmental triggers. It is common for these diseases to coexist. However, except for a single case secondary to varicella zoster virus infection, the association between juvenile idiopathic arthritis and acute cerebellitis has not been reported in the literature.
View Article and Find Full Text PDFJ Child Neurol
January 2025
Department of pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
This review evaluated the correlation between inflammatory response and clinical outcomes in pediatric patients with meningitis. PubMed, Scopus, and Web of Science were searched for relevant studies published until March 2024. A total of 139 articles were identified; 7 studies were eligible, and 3 provided data for the meta-analysis.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Graduate Medical Education, University of Miami Miller School of Medicine, Fort lauderdale, Florida, USA.
Sexually transmitted proctitis, a prevalent concern among men who have sex with men (MSM) is frequently caused by a range of pathogens, including herpes simplex virus (HSV), and While HSV-associated proctitis typically presents with visible lesions, cases without external manifestations remain evasive. We report the case of an MSM in his early 30s presenting with dyschezia and perineal discomfort after unprotected anoreceptive intercourse. Despite initial inconspicuous findings, rectal swabs revealed HSV-2 infection.
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