MICROBIAL STUDY ON MENINGITIS AND ENCEPHALITIS CASES IN EL-BEHERA, KAFR EL-SHEIKH, AND ALEXANDRIA GOVERNORATES
Magda Fawzy Baskharoun;
Abstract
Infection of the central nervous system manifested as meningitis and/or encephalitis can pose a serious public health problem especially during outbreaks. These infections are associated with significant morbidity and mortality despite advances in antimicrobial therapy. A rapid and accurate diagnosis is important for effective earlier treatment of serious infections.
Direct microscopic examination and culture of CSF are the basis for routine etiological examination, microscopy, requires a high concentration of bacteria in CSF (10 5/ml) and culture is time consuming, and prior antibiotics treatment gives false negative results. Rapid methods such as latex agglutination test, PCR and IgM capture ELISA have been developed. PCR is the technique with the highest degree of sensitivity and specificity, available for carrying out rapid diagnosis for viral, bacterial and fungal infections.
The present work aimed to:
1- Identification of the possible bacterial, viral, and fungal causes of meningitis and encephalitis.
2- Detection of the role ofRVF virus as a causative agent in meningo-encephalitis.
3- Calculation of the attack rate of meningitis and/or encephalitis by the causative agents.
This study was carried out on 322 cases with acute febrile illness, and neurological signs suggesting meningitis and/or encephalitis admitted to Damanhour, Alexandria and
l/ Kafr El-Sheikh fever hospitals during the period from April 2004 to September 2005. Their
l ages ranged from 2 months to 75 years old. A questionnaire sheet was completed for each
patient including personal data and medical history, also consent was taken from each patient. CSF and blood samples were collected from all patients. Samples were collected randomly by fully trained persons during routine hospital work from the three mentioned hospitals, and were subjected for:
A- CSF examination
CSF samples were divided into 4 portions:- the first CSF portion was examined for macroscopic appearance to detect any physical abnormalities, cytological count of WBCs and chemical examination for sugar and protein. After centrifugation of the second CSF sample the supernatant was decanted and about 0.5 ml was left behind to suspend the sediment for direct microscopic examination (by Gram stain, methylene blue, Zeihl Neelsen, and India ink stains), and bacterial culture on:
1- Blood agar and chocolate agar plates incubated at 37°C for 72 hours in 5-10% C02•
2- Mac Conkey agar, incubated at 37°C for 72 hours.
3- Three slopes of Lowenstein Jensen medium two at 37°C and one at 25°C for 8 weeks, and checked weekly for evidence of growth.
4- Sabouraud's dextrose agar and brain heart infusion media for fungal detection
incubated at 37°C and 28°C.
Direct microscopic examination and culture of CSF are the basis for routine etiological examination, microscopy, requires a high concentration of bacteria in CSF (10 5/ml) and culture is time consuming, and prior antibiotics treatment gives false negative results. Rapid methods such as latex agglutination test, PCR and IgM capture ELISA have been developed. PCR is the technique with the highest degree of sensitivity and specificity, available for carrying out rapid diagnosis for viral, bacterial and fungal infections.
The present work aimed to:
1- Identification of the possible bacterial, viral, and fungal causes of meningitis and encephalitis.
2- Detection of the role ofRVF virus as a causative agent in meningo-encephalitis.
3- Calculation of the attack rate of meningitis and/or encephalitis by the causative agents.
This study was carried out on 322 cases with acute febrile illness, and neurological signs suggesting meningitis and/or encephalitis admitted to Damanhour, Alexandria and
l/ Kafr El-Sheikh fever hospitals during the period from April 2004 to September 2005. Their
l ages ranged from 2 months to 75 years old. A questionnaire sheet was completed for each
patient including personal data and medical history, also consent was taken from each patient. CSF and blood samples were collected from all patients. Samples were collected randomly by fully trained persons during routine hospital work from the three mentioned hospitals, and were subjected for:
A- CSF examination
CSF samples were divided into 4 portions:- the first CSF portion was examined for macroscopic appearance to detect any physical abnormalities, cytological count of WBCs and chemical examination for sugar and protein. After centrifugation of the second CSF sample the supernatant was decanted and about 0.5 ml was left behind to suspend the sediment for direct microscopic examination (by Gram stain, methylene blue, Zeihl Neelsen, and India ink stains), and bacterial culture on:
1- Blood agar and chocolate agar plates incubated at 37°C for 72 hours in 5-10% C02•
2- Mac Conkey agar, incubated at 37°C for 72 hours.
3- Three slopes of Lowenstein Jensen medium two at 37°C and one at 25°C for 8 weeks, and checked weekly for evidence of growth.
4- Sabouraud's dextrose agar and brain heart infusion media for fungal detection
incubated at 37°C and 28°C.
Other data
| Title | MICROBIAL STUDY ON MENINGITIS AND ENCEPHALITIS CASES IN EL-BEHERA, KAFR EL-SHEIKH, AND ALEXANDRIA GOVERNORATES | Other Titles | دراسة ميكروبية لحالات الالتهاب السحائى والالتهاب المخى فى محافظات البحيرة وكفر الشيخ والإسكندرية | Authors | Magda Fawzy Baskharoun | Issue Date | 2007 |
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