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A. Chandramuki , Premlatha Shankar , Anjali Chattopadhyay

Abstract

Haemophilus aphrophilus was responsible for seventeen cases of Central Nervous System (CNS) infections at the National Institute of Mental Health&Neuro Sciences, Bangalore in the past three years. The clinical spectra of the infections included Brain abscess (14), Meningitis (1), Ventriculitis (1) and Osteomyelitis of parietal bone (1). In 11 of these cases, H. aphrophilus was isolated as the only infective entity whereas in six of the cases the organism was isolated in association with other microbes. This report attempts to highlight the significant pathogenic role of this unusual bacterium in CNS settings.

Keywords

Brain Abscess, Meningitis, Ventriculitis

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B. N. Gokul , A. Chandramuki , R. Ravikumar , Neelam Khanna

Abstract

Over a period of 8 years from 1979 to 1987, 27 cases of central nervous system Salmonella infection were encountered. These included 10 cases of community acquired pyogenic meningitis, 10 cases of post operative meningitis, 5 cases of brain abscesses and 2 cases of post traumatic meningitis. S. typhimurium was the most frequently isolated serotype accounting for 77.8% of cases. S. typhi was isolated from 18.5% of cases. The only other serotype found in this study was S. enteritidis isolated from a case of pyogenic meningitis. S. typhimurium was most frequently isolated from post operative cases. There was a preponderance of these salmonella infections in males of younger age group. Antibiogram showed the majority of S. typhimurium isolated were multidrug resistant. The other serotypes showed a variable sensitivity pattern. The 3 isolates of S. typhi from brain abscess cases were resistant to chloramphenicol.

Keywords

Meningitis, Salmonella Brain Abscess, CNS Salmonella Infections, Nosocomial Infections

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B. N. Gokul , A. Chandramuki , Neelam Khanna , R. Ravi Kumar

Abstract

A total of 454 pus samples from various intracranial abscess cases were analysed microbiologically for aerobic and anaerobic organisms over a period of ten years. More than 85% of these were culture positive. 22.33% of culture positive cases were due to only anaerobes, 33.67% showed both aerobes and anaerobes and 44.04% yielded only aerobes. Thus the total incidence of anaerobes in brain abscess cases was over 56%, signifying their importance in these infections. Bacteroides spp. was the most commonly isolated anaerobe. Clostridia were isolated from cases secondary to trauma. Proteus mirabilis was the most frequently isolated aerobe followed by non-haemolytic Streptococci and Staphylococcus aureus. Characterisation of the metabolites of a few anaerobic isolates was made by Gas Chromatography, for speciation of the organisms. Rare etiological agents like Mycobacterium tuberculosis and the fungus Cladosporium bantianum were isolated from four and two cases of brain abscess respectively. The microbial spectra as etiological agents in intracranial abscess cases and their predisposing factors are discussed.

Keywords

Brain Abscess, Intracranial Abscess, Microbiology of Intracranial Abscess, CNS Infections, Anaerobes

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Muralidhar K. Katti , B. N. Gokul , A. Chandramuki

Abstract

A simple and sensitive method has been described for the demonstration of class specific antibody to Cysticerous cellulosae by passive haemagglutination (PHA) reaction through intact cells of Staphylococcus aureus Protein - A (SAPA). SAPA binds rapidly to Fc portion of IgG with high affinity without affecting the immunological reactivity of bond immunoglobulin. Double aldehyde stabilized (DAS) sheep red blood cells sensitized with soluble antigens from porcine cyst sonicate were used in the test. This study was conducted on 142 cerebrospinal fluid (CSF) specimens. Of these, 5 cases were confirmed neurocysticercosis, 66 were clinically suspected and 71 controls. For comparative evaluation, all CSF specimens were examined by enzyme linked immunosorbent assay (ELISA). The results indicate that PHA and SAPA-AMHA tests are sensitive methods in demonstration and quantitation of anticysticercal antibodies. The results also suggest that reaction was mediated predominantly by IgG and in some cases by both IgG and IgM which finally has importance in the diagnosis of the disease.

Keywords

Neurocysticercosis, Staphylococcus Aureus, Haemagglutination Assay, Cerebrospinal Fluid, ELISA

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H. Sathyanarayana Swamy , S. K. Shankar , A. Chandramuki , R. Ravikumar , Atul Prasad , V. Anisya

Abstract

Fifty-five patients with neurological complications due to Salmonella typhi (S. typhi) infection were studied. Seven (12.7%) of them presented with pyogenic meningitis, 2(3.6%) with cerebral abscess and 46(83.6%) had neurological deficits without pyogenic meningitis. The mean age was 19.24 ± 12 years. The mean duration of illness at the time of admission was 16.4 ± 13 days. Fever was the initial and most prominent symptom in 46(83.6%) and most of them had headache, vomiting, myalgia and/or loose motions. Hepatomegaly and/or splenomegaly was present in 27(49%). The mean interval between the onset of fever and the development of neurological deficits was 9.5 ± 9 days. The neurological deficits included those of pyramidal, extrapyramidal, cerebellar, brain stem, spinal cord and/or peripheral nerves. One had polymyositis. Blood Widal was done in 45 cases and was positive in 43 (95%) of them. The S. typhi was isolated from blood in 21, CSF in 3, cerebral abscess pus in 2, and from other sources in 4. The phage and biotype of isolates was done in 17 patients. The antibiotic sensitivity studied in 25 cases revealed resistance to ampicillin in 5 and to chloramphenicol in 10, while all were sensitive to co-trimoxazole and gentamycin. The lumbar CSF analysis done in 47 patients, was abnormal in 14 (29.7%). The EEG done in 29, was abnormal in 19 (66%) and the abnormalities were subclinical in 1. The ENMG done in 7 patients, was abnormal in 4. The mean duration of hospital stay of 54 patients was 14.8 ± 14 days. At the end of hospital stay 46 of them (83.6%) recovered (completely or partially) and 9 of them (16.4%) died. Seven of them were autopsied. At autopsy, brains showed features of pyogenic meningitis in 3 cases, while the other four had degenerative changes involving the dentato-olivary pathway.

Keywords

Typhoid, Salmonella Typhi, Pyogenic Meningitis, Cerebral Abscess, Bacterial Encephalomyeloradiculopathy

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A. Chandramuki , Pratima Nayak , S. K. Shankar , T. Vasudev Rao , S. Chatterjee , S. Jain , R. Srinivasa Murthy

Abstract

no abstract

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Shripad A. Patil , Arun B. Taly , P. Sowbhagya , Ashok Menon , A. Chandramuki

Abstract

Guillain - Barre syndrome (GBS) is an immune mediated acute polyradiculopathy of undetermined etiology. A range of probable etiological agents such as viruses, bacteria, malignancy, surgery etc. have been suspected for the condition. In view with the endemicity of mycobacterial infections an attempt has been made to look for antimycobacterial immune response in the serum of patients with GBS. Anti-Mycobacterial antibodies of both IgG and IgM type are significantly high in serum of GBS than in controls (p<0.05). Immune complexes which generally reveal the acute phase of infection were absent both in GBS and controls. The study indicates the probability of chronic association of mycobacterial infection in GBS cases.

Keywords

Guillain Barre' Syndrome, Mycobacteria, Antibodies, Immune Complexes

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