[show abstract][hide abstract] ABSTRACT: An immunocompetent 8-year-old boy with cytomegalovirus (CMV)-associated transient protein-losing enteropathy (PLE) is described. Colonoscopic examination revealed lymphoid hyperplasia of the terminal ileum. Histological examination of the biopsied specimens showed marked dilation of the lymphatic vessels. Primary CMV infection was demonstrated by serological test and polymerase chain reaction. The child had complete resolution of the disease without antiviral treatment. The present case suggests the etiologic role of CMV infection in PLE resulting from intestinal lymphangiectasia in childhood.
Japanese journal of infectious diseases 06/2009; 62(3):236-8. · 1.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: We report the case of a 1-year-old boy with an infected subdural hematoma due to Streptococcus pneumoniae identified by latex agglutination test and polymerase chain reaction amplification of a bacteria-specific gene. The present case demonstrated the need to include infected subdural hematoma in the differential diagnosis of suspected subdural empyema, and suggested the usefulness of combining these methods to identify a causative organism.
Japanese journal of infectious diseases 10/2008; 61(5):412-4. · 1.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: The neurotrophin-4 and glial cell line-derived neurotrophic factor levels were measured in cerebrospinal fluid from 61 patients with bacterial meningitis, viral meningitis, or encephalitis, and other diseases by means of two-site enzyme-linked immunoassay. Elevated cerebrospinal fluid levels of neurotrophin-4 were demonstrated in four of the 11 patients with bacterial meningitis, and seven of the 23 patients with viral meningitis or encephalitis. None of the other patients demonstrated elevation of the neurotrophin-4 level in cerebrospinal fluid. The neurotrophin-4 levels in cerebrospinal fluid were correlated with the numbers of total and mononuclear cells in patients with viral meningitis/encephalitis. In patients with bacterial meningitis, three of the four patients with elevated neurotrophin-4 levels exhibited persistent abnormalities on computed tomography, and one revealed transient subdural effusion. On the other hand, none of the seven patients without neurotrophin-4 elevation had persistent computed tomography abnormalities, and five patients demonstrated transient computed tomography abnormalities. The glial cell line-derived neurotrophic factor levels were below the detection limit, or only slightly higher than the detection limit, in the patients with or without central nervous system infections. Although the precise roles of neurotrophin-4 and glial cell line-derived neurotrophic factor in central nervous system infections remain to be determined, neurotrophin-4 might play a neuroprotective or immunomodulatory role in central nervous system infections.
[show abstract][hide abstract] ABSTRACT: Objectives: cerebrospinal fluid (CSF) levels of interleukin (IL)-1 β and tumor necrosis factor (TNF) a were measured to assess the effect and application of dexamethasone (Dex) therapy for bacterial meningitis.Methods: associations between clinical findings and CSF parameters were first investigated, and prognosis was compared between 25 patients with Dex and 12 without Dex therapy.Results: patients with the presence of disturbed consciousness showed higher CSF levels of TNF α (mean: 3015 pg/ml) or protein (mean: 215 mg/dl) than those without it (both, P<0,05). Simultaneous increase of TNF α (>1000 pg/ml) and protein (>100 mg/dl) was observed in 80% of patients with profoundly disturbed consciousness. Patients with Dex therapy presented higher TNF α protein levels at diagnosis than those without Dex therapy (P<0,05). Despite worse conditions at diagnosis, only one of 14 Dex-treated patients whose initial CSF TNF α levels exceeded 1000 pg/ml developed deafness. On the other hand, two of four patients without Dex therapy who had the same TNF α level suffered from psychomotor retardation. The differences in the frequency of sequelae between those with and without Dex therapy were significant in patients showing high TNF α level (P<0.05), but not in those showing high CSF levels of IL-1 β or protein. The logistic regression analysis indicated that high CSF protein level (P<0.0001), or no Dex therapy (P=0.0001) was the independent risk factor for sequelae.Conclusions: although the study number was small, our observations suggested that CSF TNF α/protein levels reflected the neurologic severity, and implied that early Dex therapy might be beneficial for patients with prominently high TNF α levels.
Journal of Infection 07/1999; · 4.07 Impact Factor