Aseptic meningitis and high school football players. 1978 and 1980

During 1978 and 1980, epidemiologists at the Centers for Disease Control investigated seven outbreaks of aseptic meningitis-like illness (AMLI) occurring in high school football players in four different states. One or more enterovirus types were isolated from affected students at all seven schools. Attack rates were highest among the varsity football teams (range, 21% to 68%), although junior varsity teams were also affected at most schools (range, 5% to 63%). Non-football athletes were relatively spared. The illness was also reported by nonathletes at all three schools where more extensive investigations were undertaken. At one school, the AMLI attack rate was higher among students who were close friends of football players than among students who were not close friends; at the other two schools, these rates were similar. Hospitalization was more likely for football players with AMLI than for affected nonfootball players. Transmission of enteroviruses among football players was probably from person to person, although there was additional evidence to implicate common vehicle transmission at two schools. We conclude that football players may or may not have been more likely to be exposed to the enteroviruses circulating in their communities, but once introduction of a virus into a team occurred, transmission potential may have been enhanced, resulting in a large number of AMLI cases in players.     

Aseptic meningitis, Montreal, 1969: A Clinical and Laboratory Study

During the summer and fall of 1969 an outbreak of aseptic meningitis occurred in Montreal and its environs. Forty-four patients were admitted to the infectious disease ward of The Montreal Children's Hospital in August, September and October. Half of the patients were in the age group 6 to 10 years. The ratio of males to females was two to one. Patients showed the typical signs and symptoms of aseptic meningitis, namely fever, vomiting, headache, neck stiffness and pleocytosis of the cerebrospinal fluid.

Viruses were recovered from 19 (43%) of the 44 cases. The predominant virus in the outbreak was a non-hemagglutinating strain of echovirus 6. Other virus types isolated in the outbreak were echovirus 7, coxsackievirus A9 and coxsackievirus B4. Serological investigations confirmed the validity of the echovirus isolations and identified additional cases.

     

Aseptic meningitis: a 2-year review of diagnoses reached in a tertiary neurological and infectious disease centre

Background  Aseptic meningitis is a frequent diagnostic problem, with little data available regarding its prevalence and the commonly identified causes. Aims  To identify the common diagnostic tests requested, and their subsequent yields in obtaining a diagnosis in adult cases of aseptic meningitis in a tertiary neurological and infectious disease centre. Methods  Cases of aseptic meningitis were retrospectively reviewed for a 2-year period. Results  Of the 43 cases reviewed, a diagnosis based on subsequent microbiological, histological and immunological testing was obtained in 17 (40%). Altered levels of consciousness, and higher CSF protein levels were significantly more common in those patients attaining a definite diagnosis. Conclusion  The median duration of admission to hospital in the undiagnosed group was 12 days, which may be improved with increased accuracy and availability of diagnostic techniques such as polymerase chain reaction.     

复发性无菌性脑膜炎

1 基本概念复发性无菌性脑膜炎是指有两次或两次以上的脑膜炎发病,发病间期患者无临床症状而且脑脊液检查正常。依照病因学不同,每次发作持续时间(从数天到数周)、发病间期长短(数天到数年)和发作次数均有很大变化。区分复发性脑膜炎和慢性脑膜炎很重要。某些慢性脑膜炎患者的体征和症状可能时好时坏,貌似复发性脑膜炎,但脑脊液检查却持续异常。     

股骨头无菌性坏死

儿童股骨头无菌性坏死,应称为Legg-Cavé-Perthes病,简称为Legg-Perthes病或Perthes病。儿童股骨头缺血性坏死、儿童股骨头无菌性坏死仅是人们在临床上的俗称。1病因与发病机制近一个世纪以来,人们对该病的发病原因、病理机制做了大量探讨,但真正原因至今尚未完全明了。本病可能与种族有关,如日本人多见,而印第安人、黑人少见。髋关节反复、轻微的外伤也可能是致病因素。股骨头血运障碍导致头坏死是多年来很多学者关注的重点。C蛋白或S蛋白缺乏或抑制C蛋白活性可诱发血栓形成,导致小动脉栓塞和骨坏死。还有学者认为髋关节暂时性滑膜炎是…     

颅脑开颅术后无菌性脑膜炎的预后

目的探讨开颅手术术后无菌性脑膜炎(AM)的预后.方法 回顾性分析48例开颅手术术后AM患者的临床资料.按照处理因素不同分为无处理组(A组)、再次使用或升级抗生素组(B组)、单纯腰大池置管持续引流组(C组),比较3组间治愈率和治愈时间的差异.结果 3组治愈率无统计学差异(P＞0.05),但C组治愈时间明显短于A组和B组(均P＜ 0.05),A组与B组治愈时间无统计学差异(P＞0.05).结论 开颅手术术后AM具有自愈性,虽然抗生素和腰大池引流治疗不能提高术后AM的治愈率,而且抗生素也不能缩短术后AM的治愈时间,但是腰大池引流可以明显缩短术后AM的治愈时间.     

外科学无菌技术教学的改革体会

目的加强学生无菌观念培养。方法通过建立模拟手术室、动物实验、实验室开放、技能竞赛等反复强化无菌术的学习,对比改革前后考核成绩。结果改革后的无菌技术教学效果明显提高。结论医学生在校期间只有通过模拟手术室、动物实验、实验室开放、实习前强化训练、技能竞赛等环节反复强化才能很好地培养和掌握外科无菌技术。