ABSTRACT
JUSTIFICATIVA E OBJETIVOS: As meningites assépticas (MA) representam a grande maioria das meningites presentes em nosso meio. Os principais causadores dessa doença são os enterovírus. O quadro clínico caracteriza-se por cefaleia, fotofobia, sinais de irritação meníngea, náuseas, vômitos e febre. A grande dificuldade diagnóstica é que estes mesmos sintomas são encontrados nos quadros de meningites bacterianas, mais graves, demandando condutas mais agressivas. O objetivo deste estudo foi rever o assunto, destacando o manuseio dos casos suspeitos bem como suas etiologias e fisiopatologias. CONTEÚDO: Conceitos de MA, suas etiologias virais e não virais, incluindo àquelas causadas pela utilização de medicamentos. CONCLUSÃO: Devido às sobreposições sintomatológicas, introduziu-se empiricamente a antibioticoterapia intra-hospitalar no momento da suspeita de infecção meníngea, observando a evolução clínico-laboratorial do paciente.
BACKGROUND AND OBJECTIVES: The aseptic meningitis (AM) representing the vast majority of meningitis in our society. The main cause of this disease is the enteroviruses. The clinical picture is characterized by headache, photophobia, and signs of meningeal irritation, nausea, vomiting and fever. The diagnostic difficulty is that these same symptoms are found in the tables of bacterial meningitis, the most serious, demanding more aggressive treatment. This article aims to review the issue, emphasizing the management of suspected cases as well as its etiology and pathophysiology. CONTENTS: Address the concept of AM, its viral and nonviral etiologies, including those caused by medication use. CONCLUSION: Due to the overlap of the symptoms, we introduced an empirical intrahospital antibiotic treatment at the moment we suspect meningeal infection, observing the evolution of clinical and laboratory signs.
Subject(s)
Humans , Cerebrospinal Fluid , Meningism/diagnosis , Meningism/physiopathology , Meningitis, Aseptic/diagnosis , Meningitis, Aseptic/physiopathologyABSTRACT
manifestations may be neurological with variable expression, encephalitis being the most frequent. Meningitis, myelitis or polyradiculoneuritis are also reported. The pathophysiology of neurological manifestations remains poorly understood. Although not isolated from cerebral tissue, MP was reportedly detected in cerebro-spintal fluid [CSF] on several occasions. We report the case of a five-year old girl who presented with fever, then pneumonia, and later developed spastic quadriparesis. MP was identified as the causative agent, evidenced by the presence of specific antibodies in both serum and CSF. The identification of a central nervous syndrome associated with confirmed MP infection extends the list of similar cases documented in individuals younger than 17 years of age
Subject(s)
Humans , Female , Mycoplasma pneumoniae , Meningism/diagnosis , Quadriplegia/diagnosis , Nervous System/physiopathologyABSTRACT
Se estudiaron retrospectivamente las características clínicas de mayor frecuencia en un grupo de 67 pacientes adulto con meningitis bacteriana a su ingreso, con el objeto de conocer los signos y síntomas claves que permitan realizar un diagnóstico más rápido y preciso que garantice un mejor pronóstico. Se encontró que los signos y síntomas más frecuentes fueron: Cefalea, fiebre, rigidez de nuca, náuseas y vómitos, alteración del estado de conciencia, signos de Kernig y Brudzinski y cambios de conducta. Igualmente se procedió a determinar la sensibilidad (SE) y especificidad (ES) de los signos de irritación meníngea. Rigidez de nuca (SE= 60,74 por ciento/Es= 55,73 por ciento), signo de Kernig (SE= 34,21 por ciento/ES= 91,80 por ciento) y signo de Brudzinski (SE= 38,16/ES= 91,80 por ciento) para conocer objetivamente su verdadera utilidad clínica en el diagnóstico de meningitis bacteriana