A case of Staphylococcus aureus meningitis associated with cryoglobulin-related renal failure and clinically mild encephalitis/encephalopathy with a reversible splenial lesion.
Identifieur interne : 001131 ( PubMed/Corpus ); précédent : 001130; suivant : 001132A case of Staphylococcus aureus meningitis associated with cryoglobulin-related renal failure and clinically mild encephalitis/encephalopathy with a reversible splenial lesion.
Auteurs : Koji Shimozono ; Hideki Korenaga ; Reiko Mawatari ; Naoki TsukishimaSource :
- Rinsho shinkeigaku = Clinical neurology [ 1882-0654 ] ; 2016.
English descriptors
- KwdEn :
- Anti-Bacterial Agents (administration & dosage), Cryoglobulinemia (etiology), Cryoglobulins, Encephalitis (diagnosis), Encephalitis (etiology), Encephalitis (therapy), Humans, Magnetic Resonance Imaging, Male, Meningitis, Bacterial (complications), Meningitis, Bacterial (diagnosis), Meningitis, Bacterial (microbiology), Meningitis, Bacterial (therapy), Methylprednisolone (administration & dosage), Middle Aged, Pulse Therapy, Drug, Renal Dialysis, Renal Insufficiency (diagnosis), Renal Insufficiency (etiology), Renal Insufficiency (therapy), Spondylitis (complications), Spondylitis (diagnosis), Spondylitis (microbiology), Spondylitis (therapy), Staphylococcal Infections, Staphylococcus aureus, Treatment Outcome.
- MESH :
- chemical , administration & dosage : Anti-Bacterial Agents, Methylprednisolone.
- complications : Meningitis, Bacterial, Spondylitis.
- diagnosis : Encephalitis, Meningitis, Bacterial, Renal Insufficiency, Spondylitis.
- etiology : Cryoglobulinemia, Encephalitis, Renal Insufficiency.
- microbiology : Meningitis, Bacterial, Spondylitis.
- therapy : Encephalitis, Meningitis, Bacterial, Renal Insufficiency, Spondylitis.
- chemical : Cryoglobulins, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pulse Therapy, Drug, Renal Dialysis, Staphylococcal Infections, Staphylococcus aureus, Treatment Outcome.
Abstract
A 59-years old man, having untreated hypertension and diabetes, was admitted to our hospital because of lumbago and fever. A T2-weighted image of spine showed increased signal intensity of vertebra at L3 and L4. Methicillin-susceptible staphylococcus aureus (MSSA) infection was confirmed by blood culturing. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Diagsosis of pyogenic spondylitis with bacterial meningitis was made. Diffusion-weighted magnetic imaging of the brain disclosed a focal hyperintense lesion in the corpus callosum which showed a low coefficient in the apparent diffusion coefficient mapping. This finding suggests a clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). His symptoms temporarily ameliorated by antibiotic therapy. Two weeks later, however, his conscious level rapidly worsened to comatose state. Concomitantly he developed acute renal failure with severe proteinuria. Serum serology showed a positive cryoglobulin test. Mechanical ventilation, hemodialysis and steroid pulse therapy improved his consciousness with a resultant complete recovery of all symptoms. We emphasize the possible complications in some cases of MERS.
DOI: 10.5692/clinicalneurol.cn-000824
PubMed: 27151224
Links to Exploration step
pubmed:27151224Le document en format XML
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<author><name sortKey="Korenaga, Hideki" sort="Korenaga, Hideki" uniqKey="Korenaga H" first="Hideki" last="Korenaga">Hideki Korenaga</name>
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<author><name sortKey="Mawatari, Reiko" sort="Mawatari, Reiko" uniqKey="Mawatari R" first="Reiko" last="Mawatari">Reiko Mawatari</name>
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<author><name sortKey="Tsukishima, Naoki" sort="Tsukishima, Naoki" uniqKey="Tsukishima N" first="Naoki" last="Tsukishima">Naoki Tsukishima</name>
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<term>Cryoglobulins</term>
<term>Encephalitis (diagnosis)</term>
<term>Encephalitis (etiology)</term>
<term>Encephalitis (therapy)</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
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<term>Meningitis, Bacterial (complications)</term>
<term>Meningitis, Bacterial (diagnosis)</term>
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<term>Methylprednisolone (administration & dosage)</term>
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<term>Renal Dialysis</term>
<term>Renal Insufficiency (diagnosis)</term>
<term>Renal Insufficiency (etiology)</term>
<term>Renal Insufficiency (therapy)</term>
<term>Spondylitis (complications)</term>
<term>Spondylitis (diagnosis)</term>
<term>Spondylitis (microbiology)</term>
<term>Spondylitis (therapy)</term>
<term>Staphylococcal Infections</term>
<term>Staphylococcus aureus</term>
<term>Treatment Outcome</term>
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<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-Bacterial Agents</term>
<term>Methylprednisolone</term>
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<term>Spondylitis</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Encephalitis</term>
<term>Meningitis, Bacterial</term>
<term>Renal Insufficiency</term>
<term>Spondylitis</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cryoglobulinemia</term>
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<term>Renal Insufficiency</term>
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<keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Meningitis, Bacterial</term>
<term>Spondylitis</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Encephalitis</term>
<term>Meningitis, Bacterial</term>
<term>Renal Insufficiency</term>
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<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pulse Therapy, Drug</term>
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<front><div type="abstract" xml:lang="en">A 59-years old man, having untreated hypertension and diabetes, was admitted to our hospital because of lumbago and fever. A T2-weighted image of spine showed increased signal intensity of vertebra at L3 and L4. Methicillin-susceptible staphylococcus aureus (MSSA) infection was confirmed by blood culturing. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Diagsosis of pyogenic spondylitis with bacterial meningitis was made. Diffusion-weighted magnetic imaging of the brain disclosed a focal hyperintense lesion in the corpus callosum which showed a low coefficient in the apparent diffusion coefficient mapping. This finding suggests a clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). His symptoms temporarily ameliorated by antibiotic therapy. Two weeks later, however, his conscious level rapidly worsened to comatose state. Concomitantly he developed acute renal failure with severe proteinuria. Serum serology showed a positive cryoglobulin test. Mechanical ventilation, hemodialysis and steroid pulse therapy improved his consciousness with a resultant complete recovery of all symptoms. We emphasize the possible complications in some cases of MERS.</div>
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<Abstract><AbstractText>A 59-years old man, having untreated hypertension and diabetes, was admitted to our hospital because of lumbago and fever. A T2-weighted image of spine showed increased signal intensity of vertebra at L3 and L4. Methicillin-susceptible staphylococcus aureus (MSSA) infection was confirmed by blood culturing. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Diagsosis of pyogenic spondylitis with bacterial meningitis was made. Diffusion-weighted magnetic imaging of the brain disclosed a focal hyperintense lesion in the corpus callosum which showed a low coefficient in the apparent diffusion coefficient mapping. This finding suggests a clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). His symptoms temporarily ameliorated by antibiotic therapy. Two weeks later, however, his conscious level rapidly worsened to comatose state. Concomitantly he developed acute renal failure with severe proteinuria. Serum serology showed a positive cryoglobulin test. Mechanical ventilation, hemodialysis and steroid pulse therapy improved his consciousness with a resultant complete recovery of all symptoms. We emphasize the possible complications in some cases of MERS.</AbstractText>
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