Differential diagnosis of acute meningitis: an analysis of the predictive value of initial observations

Article Abstract:

One diagnostic problem in cases of meningitis (inflammation of the membrane covering the brain and spinal cord) is distinguishing acute bacterial meningitis (ABM) from acute viral meningitis (AVM). Laboratory analysis of cerebrospinal fluid (CSF) shows that approximately 25 percent of ABM cases reveal no bacteria while bacteria may be found in cases of AVM. After analyzing data from the records of 422 meningitis patients, the authors devised an equation designed to predict the relative probability that an individual patient has ABM versus AVM. The factors included in the equation are: age of the patient, number of months from August lst (date of peak incidence of AVM) to onset of the illness, CSF-blood glucose ratio, and number of white blood cells in the CSF. For ease of calculation, the equation was reduced to a nomogram on which the physician can plot the factors of the equation graphically. The authors emphasize that this method should not be the only diagnostic tool used in cases of meningitis. Rather, the results obtained from the equation should be given the same weight in the total diagnostic process as the laboratory reports. However, if laboratory tests are inconclusive, the physician may determine treatment on the basis of the ABM/AVM probability indicated by the equation.

Methods, Diagnosis, Virus diseases, Meningitis, Bacterial infections, Diagnosis, Differential, Differential diagnosis

---

Prevention of infective endocarditis

Article Abstract:

Infective endocarditis is an infection of the lining of the heart caused by bacteria circulating in the blood, often affecting heart valves. Prevention of infective endocarditis using antibiotics is standard but is somewhat controversial as its effectiveness is unproven. Persons with preexisting heart disorders may take antibiotics before dental and surgical procedures because these procedures can cause bacteria to enter the blood. Only a small number of cases of endocarditis have been attributed to bacteria generated during such procedures, however. Antibiotics and antimicrobial drugs may be useful in preventing infective endocarditis in persons with riskier underlying heart conditions. The American Heart Association recommends preventive treatment for persons with certain heart disorders who are undergoing particular dental and surgical procedures. The most common antibiotic treatment is 3.0 grams of amoxicillin one hour before the procedure, and 1.5 grams six hours after.

Prevention, Physiological aspects, Bacterial endocarditis, Bacteremia

---

Evaluating and optimizing outcomes of surgery for endocarditis

Article Abstract:

Heart valve replacement may be better than antibiotics for treating people who have a bacterial infection in the heart called endocarditis, according to a study published in 2003. This is especially true for people who also have heart failure. This might help increase survival rates, which have not changed since the 1950s despite the use of antibiotics.

Care and treatment, Editorial, Evaluation, Heart valve replacement, Infective endocarditis

Similar abstracts:

• Abstracts: Effects of aging and gonadal failure on the hypothalamic-pituitary axis in women. The lack of influence of age on male fertility
• Abstracts: The clinical significance of blood transfusion at the time of radical hysterectomy. Incisional hernia of the vaginal apex following vaginal hysterectomy in a premenopausal, sexually inactive woman
• Abstracts: Antenatal diagnosis of sacral agenesis syndrome in a pregnancy complicated by diabetes mellitus. Gestational Diabetes Mellitus: Does it recur in subsequent pregnancy?
• Abstracts: Clinical evaluation of jaundice; a guideline of the Patient Care Committee of the American Gastroenterological Association
• Abstracts: Diagnosis and laparoscopic grading of acute salpingitis. Managing the sexually transmitted disease pandemic: A time for reevaluation

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.