Some Selected Abstracts:


Kumar R, Dwivedi A, Kumar P, Kohli N. Tuberculous meningitis in BCG vaccinated and unvaccinated children. J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1550-4.

Department of Pediatrics, King George Medical University, Lucknow, India 226003.

BACKGROUND: A modified clinical presentation of tuberculous meningitis (TBM) in children vaccinated with BCG has been described in the literature. However, most reports are old and not based on actual comparisons and tests of significance. Also, neuroimaging features were not compared. With large scale BCG coverage, it becomes pertinent to describe the "modified" presentation and identify any significant differences between vaccinated and unvaccinated children with TBM. METHODS: A total of 150 consecutive hospitalised children (96 unvaccinated, 54 vaccinated) were enrolled. They all satisfied predefined criteria for diagnosis of TBM. Clinical and radiological features of children with/without a BCG scar were compared. RESULTS: Univariate analysis revealed that the vaccinated children with TBM had significantly lower rates of altered sensorium (68.5% v 85.4% unvaccinated; OR 2.2 (1.1 to 6.2); p = 0.019) and focal neurological deficits (20.3% v 39.5% unvaccinated; OR 2.6 (1.1 to 6.0); p = 0.016), and higher mean (SD) Glasgow Coma Scale score (10.2 (3.4) v 8.76 (2.7) unvaccinated; p = 0.010) and cerebrospinal fluid cell count (210.9 v 140.9 unvaccinated; p = 0.019). No significant radiological differences were seen. Short term outcome was significantly better in the vaccinated group with 70% of the total severe sequelae and 75% of the total deaths occurring in the unvaccinated group (p = 0.018). CONCLUSION: Children with TBM who have been vaccinated with BCG appear to maintain better mentation and have a superior outcome. This may in part be explained by the better immune response to infection, as reflected in the higher CSF cell counts in this group in the present study.


Saito T, Iinuma Y, Takakura S, Fujihara N, Inoue J, Hamaguchi Y, Ichiyama S.  Feasibility of flow cytometry for the detection of bacteria from body fluid samples. J Infect Chemother. 2005 Oct;11(5):220-5.

Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Shogoin, Kyoto, Japan.

The detection of microorganisms in body fluids is indispensable for identifying the source of infection and is one of the important examinations that influence subsequent treatment. In order to quickly detect bacteria in body fluid samples, a flow cytometry-based experimental automated bacteria counter (BF-FCM), was tested to determine its clinical value. The results for detectability obtained with the BF-FCM were compared with those obtained by conventional culture and Gram-staining techniques. We evaluated a total of 318 body fluid samples, excluding bile samples from which fungus alone was isolated. The samples consisted of 176 bile, 64 ascites, 42 pleural fluid, and 36 cerebrospinal fluid samples. Among the 318 samples, 154 (48.4%) were culture-positive. Of these 154, the BF-FCM identified 130 as positive (sensitivity, 84.4%). Of the 164 samples that were culture-negative, 141 were negative by the BF-FCM (specificity, 86.0%). Based on the culture results, the BF-FCM detected bacteria with a positive predictive value of 85.0% (130 of 153 samples), a negative predictive value of 85.5% (141 of 165 samples), and percent agreement of 85.2%. Although there were 23/164 (14.0%) false-positive samples, we consider that the BF-FCM, in combination with Gram staining and conventional cultures, would be helpful in the diagnosis and management of patients with diseases such as bacterial meningitis that present emergently.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

13938.   Antinori S, Radice A, Galimberti L, Magni C, Fasan M, Parravicini C. The role of cryptococcal antigen assay in diagnosis and monitoring of cryptococcal meningitis. J Clin Microbiol. 2005 Nov;43(11):5828-9. 

13939.   Hara T, Fukuma T. Diagnosis of the primary amoebic meningoencephalitis due to Naegleria fowleri. Parasitol Int. 2005 Dec;54(4):219-21.

13940.   Helbok R, Pongpakdee S, Yenjun S, Dent W, Beer R, Lackner P, Bunyaratvej P, Prasert B, Vejjajiva A, Schmutzhard E. Chronic meningitis in Thailand. Clinical characteristics, laboratory data and outcome in patients with specific reference to tuberculosis and cryptococcosis. Neuroepidemiology. 2006;26(1):37-44. 

13941.   Lins H, Wallesch CW, Wunderlich MT. Sequential analyses of neurobiochemical markers of cerebral damage in cerebrospinal fluid and serum in CNS infections. Acta Neurol Scand. 2005 Nov;112(5):303-8.

13942.   Nair PK, Bobade O, Kappikar GV. Tuberculous meningitis. Indian Practitioner. 2005 Jun; 58(6): 379-381.

13943.   Nayak B S, Bhat R. Cerebrospinal fluid lactate dehydrogenase andglutamine in meningitis. Indian J Physiol Pharmac 2005; 49(1): 108-10.

13944.   Sugiura Y, Homma M, Yamamoto T. Difficulty in diagnosing chronic meningitis caused by capsule-deficient Cryptococcus neoformans. J Neurol Neurosurg Psychiatry. 2005 Oct;76(10):1460-1.

13945.  Zaia A, Griffith JM, Hogan TR, Tapsall JW, Bainbridge P, Neill R, Tribe D.  Molecular tests can allow confirmation of invasive meningococcal disease when isolates yield atypical maltose, glucose or gamma-glutamyl peptidase test results. Pathology. 2005 Oct;37(5):378-9.


13946.      Bonacorsi S, Bingen E. Molecular epidemiology of Escherichia coli causing neonatal meningitis. Int J Med Microbiol. 2005 Oct;295(6-7):373-81. Review.

13947.  Centers for Disease Control and Prevention (CDC). Mycobacterium tuberculosis transmission in a newborn nursery and maternity ward--New York City, 2003. MMWR Morb Mortal Wkly Rep. 2005 Dec 23;54(50):1280-3.

13948.  Chen TL, Thien PF, Liaw SC, Fung CP, Siu LK. First report of Salmonella enterica serotype panama meningitis associated with consumption of contaminated breast milk by a neonate. J Clin Microbiol. 2005 Oct;43(10):5400-2.

13949.   Nicol MP, Sola C, February B, Rastogi N, Steyn L, Wilkinson RJ. Distribution of strain families of Mycobacterium tuberculosis causing pulmonary and extrapulmonary disease in hospitalized children in Cape Town, South Africa. J Clin Microbiol. 2005 Nov;43(11):5779-81.

13950.  Nicolas P, Norheim G, Garnotel E, Djibo S, Caugant DA. Molecular epidemiology of neisseria meningitidis isolated in the African Meningitis Belt between 1988 and 2003 shows dominance of sequence type 5 (ST-5) and ST-11 complexes. J Clin Microbiol. 2005 Oct;43(10):5129-35.

13951.  Rock JD, Mahnane MR, Anjum MF, Shaw JG, Read RC, Moir JW. The pathogen Neisseria meningitidis requires oxygen, but supplements growth by denitrification. Nitrite, nitric oxide and oxygen control respiratory flux at genetic and metabolic levels. Mol Microbiol. 2005 Nov;58(3):800-9.

13952.  Wiendl H, Feger U, Mittelbronn M, Jack C, Schreiner B, Stadelmann C, Antel J, Brueck W, Meyermann R, Bar-Or A, Kieseier BC, Weller M. Expression of the immune-tolerogenic major histocompatibility molecule HLA-G in multiple sclerosis: implications for CNS immunity. Brain. 2005 Nov;128(Pt 11):2689-704. 


13953.   Huo Z, Sinha R, McNeela EA, Borrow R, Giemza R, Cosgrove C, Heath PT, Mills KH, Rappuoli R, Griffin GE, Lewis DJ. Induction of protective serum meningococcal bactericidal and diphtheria-neutralizing antibodies and mucosal immunoglobulin A in volunteers by nasal insufflations of the Neisseria meningitidis serogroup Cpolysaccharide-CRM197 conjugate vaccine mixed with chitosan. Infect Immun. 2005 Dec;73(12):8256-65.

13954.   Rajshekhar V. BCG vaccination and severity of childhood tuberculous meningitis. J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1470. 


13955.      Blaivas AJ, Lardizabal A, Macdonald R. Two unusual sequelae of tuberculous meningitis despite treatment. South Med J. 2005 Oct;98(10):1028-30.

13956.   Hanly JG, Harrison MJ. Management of neuropsychiatric lupus. Best Pract Res Clin Rheumatol. 2005 Oct;19(5):799-821. Review. 

13957.   Hoey J. Lymphocytic choriomeningitis virus. CMAJ. 2005 Oct 25;173(9):1033. 

13958.   Pitisuttithum P, Negroni R, Graybill JR, Bustamante B, Pappas P, Chapman  Hare RS, Hardalo CJ. Activity of posaconazole in the treatment of central nervous system fungal  infections. J Antimicrob Chemother. 2005 Oct;56(4):745-55. 

13959.   Zagvazdina Ia, Zagvazdin Y, Willis GE, Gonzalez JH, Lesser W, Dickinson GM.  Rare infections are just an airplane trip away: Salmonella typhi meningitis in a recent immigrant to the United States. Am J Med Sci. 2005 Oct;330(4):198-200.