OBJECTIVE: To create a prediction rule to enable clinicians to differentiate patients with tuberculous meningitis (TBM) from those with viral meningitis.
DESIGN: We retrospectively analysed patients admitted to a tertiary
care facility between 2001 and 2011 with viral meningitis and TBM. Patients were defined as having TBM according to a recently published consensus definition, and as viral meningitis if a viral aetiology was confirmed, or after ruling out bacterial, fungal and noninfectious causes of meningitis.
RESULTS: We identified 433 patients with viral meningitis and 101 TBM patients and compared their clinical and laboratory features. check details Multivariable analysis showed SUMMARY a ATM/ATR tumor statistically significant association between TBM and the following variables: duration of symptoms before admission of >= 5 days, presence of neurological impairment (altered consciousness, seizures, mild focal signs, multiple cranial nerve palsies, dense hemiplegia or paraparesis),
cerebrospinal fluid/blood glucose ratio <0.5 and cerebrospinal fluid protein level >100 mg/dl. We propose a diagnostic score based on the coefficients derived from the logistic regression model with a sensitivity and specificity for TBM of respectively 92% and 94%.
CONCLUSIONS: Our study suggests that easily available clinical and laboratory data arc very useful for differentiating TBM from other causes of meningitis.”
“BackgroundSeveral studies have suggested an association between post-transplant immunoglobulin (Ig) levels and the development of infection in solid organ transplantation. VDA inhibitor We therefore conducted exploratory analyses of potential factors associated with bacterial infection/sepsis
after living-donor liver transplantation (LDLT).
MethodsBlood samples from 177 recipients who received primary LDLT between September 1999 and November 2011 were available for study. Hypogammaglobulinemia was defined as having at least 1 IgG level <650mg/dL within 7days after LDLT. Risk factors for developing post-transplant bacterial infection and sepsis within 3months after LDLT were analyzed.
ResultsFifty (28.2%) recipients experienced bacterial infection within 3months of LDLT. Eighty-four (47.5%) recipients had hypogammaglobulinemia, although no recipients had hypogammaglobulinemia before LDLT. Hypogammaglobulinemia, undergoing hepaticojejunostomy, and portal pressure at closure >15mmHg were independent risk factors for developing bacterial infection within 3months of LDLT (P < 0.0001 P=0.0008, and P=0.011, respectively). The odds ratio (OR) and confidence interval (CI) for hypogammaglobulinemia were 4.79 and 2.27-10.7, respectively. Twenty-four (13.6%) recipients developed bacterial sepsis within 3months.