Meningoencephalitis

Meningoencephalitis
Meninges
Specialty Neurology Edit this on Wikidata

Meningoencephalitis (/mɪˌnɪŋɡoʊɛnˌsɛfəˈlaɪtɪs, -ˌnɪndʒoʊ-, -ən-, -ˌkɛ-/;[1][2] from Greek μῆνιγξ meninx, "membrane", ἐγκέφαλος, enképhalos "brain", and the medical suffix -itis, "inflammation") is a medical condition that simultaneously resembles both meningitis, which is an infection or inflammation of the meninges, and encephalitis, which is an infection or inflammation of the brain.

Causes

Causative organisms include protozoans, viral and bacterial pathogens.

Specific types include:

Bacterial

Viral

Other/multiple

Protozoal

Amoebic pathogens exist as free-living protozoans. Nevertheless, these pathogens cause rare and uncommon CNS infections. N. fowleri produces primary amoebic meningoencephalitis (PAM). The symptoms of PAM are indistinguishable from acute bacterial meningitis. Other amoebae cause granulomatous amoebic encephalitis (GAE), which is a more subacute and can even a non-symptomatic chronic infection. Amoebic meningoencephalitis can mimic a brain abscess, aseptic or chronic meningitis, or CNS malignancy.[7]

Animal

Animal pathogens exist as facultative parasites. They are an exceptionally rare cause of meningoencephalitis.[8]

Diagnosis

Clinical diagnosis includes evaluation for the presence of recurrent or recent herpes infection, fever, headache, altered mental status, convulsions, disturbance of consciousness, and focal signs.

CSF, EEG, CT, MRI are responsive to specific antivirus agent.

Definite diagnosis – besides the above, the following are needed: CSF: HSV－antigen,HSV－Antibody, brain biopsy or pathology: Cowdry in intranuclear

CSF: the DNA of the HSV(PCR)

cerebral tissue or specimen of the CSF:HSV

except other viral encephalitis

Treatment

Antiviral therapy: as early as possible

Acyclovir intravenously at a dosage of 10~15mg/kg every 8 hours for 14~21d

Ganciclovir intravenously at a dosage of 5~10mg/kg every 12hours for 14~21d immune therapy: interferon symptomatic therapy

High fever: physical regulation of body temperature Seizure: antiepileptic drugs high intracranial pressure-20%mannitol

Infections: antibiotic drugs

Prognosis

The disease is associated with high rates of mortality and severe morbidity.

Notable cases

It was cause of death of the popular British TV presenter Christopher Price.[9]

It was also the cause of death of Oscar Wilde.

In May, 2009 former Premier of New South Wales (Australia) Morris Iemma was admitted to hospital with meningoencephalitis.[10]

Recent medical research indicates that it was the cause of Mary Ingalls' (older sister of Laura Ingalls) blindness (not scarlet fever as the book indicates).[11][12][13][14]

In the 2011 film Contagion, the pandemic disease kills when it causes meningoencephalitis in patients. The film's virus is named Meningoencephalitis Virus One (MEV-1).

In the 'House' episode Euphoria (Part 2), primary amoebic meningoencephalitis was the cause of Foreman's symptoms.

See also

References

  1. ↑ "Meningoencephalitis". Oxford Dictionaries. Oxford University Press. Retrieved 2016-01-21.
  2. ↑ "Meningoencephalitis". Merriam-Webster Dictionary. Retrieved 2016-01-21.
  3. ↑ Bruyn HB, Sexton HM, Brainerd HD (March 1957). "Mumps meningoencephalitis; a clinical review of 119 cases with one death". Calif Med. 86 (3): 153–60. PMC 1512024. PMID 13404512.
  4. ↑ Newton, PJ; Newsholme, W; Brink, NS; Manji, H; Williams, IG; Miller, RF (2002). "Acute meningoencephalitis and meningitis due to primary HIV infection". BMJ (Clinical research ed.). 325 (7374): 1225–7. doi:10.1136/bmj.325.7374.1225. PMC 1124692. PMID 12446542.
  5. ↑ Del Saz, SV; Sued, O; Falcó, V; Agüero, F; Crespo, M; Pumarola, T; Curran, A; Gatell, JM; et al. (2008). "Acute meningoencephalitis due to human immunodeficiency virus type 1 infection in 13 patients: clinical description and follow-up". Journal of NeuroVirology. 14 (6): 474–9. doi:10.1080/13550280802195367. PMID 19037815.
  6. ↑ Orgogozo JM, Gilman S, Dartigues JF, et al. (2003-07-08). "Subacute meningoencephalitis in a subset of patients with AD after Aß42 immunization". Neurology. 61 (1): 46–54. doi:10.1212/01.WNL.0000073623.84147.A8. PMID 12847155.
  7. ↑ Amebic Meningoencephalitis at eMedicine
  8. ↑ "Rare parasitic worm kills two kidney donor patients, inquest hears". The Guardian. 2014-11-18. Retrieved 2014-11-24.
  9. ↑ "Presenter Killed by Rare Infection". BBC News. 2002-06-19. Retrieved 2008-05-01.
  10. ↑ Silmalis, Linda (2009-06-28). "Paralysed Iemma fights to walk again". The Sunday Telegraph. Retrieved 2009-06-28.
  11. ↑ Allexan SS, Byington CL, Finkelstein JI, Tarini BA (2013). "Blindness in Walnut Grove: how did Mary Ingalls lose her sight?". Pediatrics. 131 (3): 404–6. doi:10.1542/peds.2012-1438. PMC 4074664. PMID 23382439.
  12. ↑ Dell'Antonia, KJ (2013-02-04). "Scarlet Fever Probably Didn't Blind Mary Ingalls". New York Times. Retrieved 2013-02-04.
  13. ↑ Serena, Gordon (2013-02-04). "Mistaken Infection 'On The Prairie'?". U.S. News and World Report. Retrieved 2013-02-04.
  14. ↑ "What really made Mary Ingalls go blind?". NBC News. 2013-02-04.
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