rifampin and Meningitis--Viral

Topics: Animals; Anti-Bacterial Agents; Chick Embryo; Chlamydiaceae; Conjunctivitis, Inclusion; DNA Viruses; Fluorescent Antibody Technique; Hepatitis A; Hepatitis B Antigens; Humans; Immunologic Techniques; Keratitis, Dendritic; Meningitis, Viral; Methods; Microscopy, Electron; Rabbits; Recurrence; Rickettsia Infections; Rifampin; RNA Viruses; Sulfonamides; Trachoma; Virus Diseases

Tuberculomas optoquiasmaticos como reaccion paradojica al tratamiento de tuberculosis meningea.

Topics: Adult; Antitubercular Agents; Brain Infarction; Diagnostic Errors; Disease Progression; Drug Resistance, Microbial; Drug Substitution; Ethambutol; Female; Host-Pathogen Interactions; Humans; Isoniazid; Magnetic Resonance Imaging; Meningitis, Viral; Moxifloxacin; Mycobacterium tuberculosis; Neuroimaging; Optic Chiasm; Paresis; Prednisone; Pyrazinamide; Rifampin; Thalamus; Tuberculoma; Tuberculosis, Meningeal; Vision Disorders

This statement provides guidelines for therapy of children with serious infections possibly caused by Streptococcus pneumoniae. Resistance of invasive pneumococcal strains to penicillin, cefotaxime, and ceftriaxone has increased over the past few years. Reports of failures of cefotaxime or ceftriaxone in the treatment of children with meningitis caused by resistant S pneumoniae necessitates a revision of Academy recommendations. For nonmeningeal infections, modifications of the initial therapy need to be considered only for patients who are critically ill and those who have a severe underlying or potentially immunocompromising condition or patients from whom a highly resistant strain is isolated. Because vancomycin is the only antibiotic to which all S pneumoniae strains are susceptible, its use should be restricted to minimize the emergence of vancomycin-resistant organisms. Patients with probable aseptic (viral) meningitis should not be treated with vancomycin. These recommendations are subject to change as new information becomes available.

Topics: Anti-Bacterial Agents; Child; Diagnosis, Differential; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Meningitis, Bacterial; Meningitis, Viral; Microbial Sensitivity Tests; Pneumococcal Infections; Rifampin; Vancomycin

Important aspects of the management of meningitis in children include notification to local officers for control of communicable diseases; chemoprophylaxis for index cases and close contacts in cases of meningococcal or Haemophilus influenzae meningitis; and a formal hearing assessment for all survivors. A retrospective audit of these aspects of management was carried out for children admitted with meningitis in 12 months from 1 September 1990 to 31 August 1991 at the Royal Belfast Hospital for Sick Children. Only 20 of 36(56%) cases were notified by medical staff. Chemoprophylaxis was arranged for all close family contacts but to only five of the 23(22%) index cases for whom it was indicated. Appointments for audiological testing were arranged for only 19 of the 32(59%) survivors. Subsequently all doctors, including each intake of junior doctors, were given written information on the importance of notification and locally agreed guidelines for chemoprophylaxis and hearing assessments for survivors before discharge. Guidelines were also displayed prominently in each ward. A repeat audit from January 1992 to December 1992 showed significant improvement in these aspects of care. Twenty eight of 32 cases (88%) were notified, chemoprophylaxis was given to 20 of 22(91%) index cases for whom it was indicated, and 25 of 29(86%) survivors had hearing assessments arranged before discharge. Correct management of some aspects of care cannot be assumed, even if statutory (notification), nationally agreed (chemoprophylaxis), or generally agreed good practice (hearing assessments). These aspects of care improved after the first audit but the authors conclude that the notification rate remains below 100% and a repeat audit is necessary.

Topics: Adolescent; Child; Child, Preschool; Disease Notification; Hearing Loss, Sensorineural; Hearing Tests; Humans; Infant; Medical Audit; Meningitis, Bacterial; Meningitis, Viral; Northern Ireland; Practice Guidelines as Topic; Retrospective Studies; Rifampin

Topics: Chronic Disease; Coma; Dactinomycin; Daunorubicin; Dexamethasone; Encephalomyelitis; Fever; Headache; Humans; Idoxuridine; Leukopenia; Meningitis, Viral; Mental Disorders; Pain; Paralysis; Respiratory Insufficiency; Rifampin; Vomiting