Displaying publications 21 - 40 of 114 in total

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  1. Halder D, Zainal N, Wah CM, Haq JA
    Ann Trop Paediatr, 1998 Jun;18(2):161-4.
    PMID: 9924578
    We report a case of meningitis and one of fatal septicaemia in neonates due to Burkholderia pseudomallei and review the literature on neonatal melioidosis. Pneumonia was the primary presentation and was complicated by shock in the latter case. The epidemiological findings suggest that the cases reported from Malaysia were community-acquired in contrast with those from the USA and Thailand.
    Matched MeSH terms: Meningitis, Bacterial/microbiology*
  2. Pit S, Jamal F, Isahak I, Minhaj AA
    Med J Malaysia, 1987 Dec;42(4):302-5.
    PMID: 3454403
    Lactic acid concentration was determined in 37 specimens of cerebrospinal fluid by gas liquid chromatography. It was found to be raised (30 mg/dl) in 15 specimens from culture positive cases of bacterial meningitis and one of fungal meningitis. It was < 30 mg/dl in cerebrospinal fluid from four cases of viral meningoencephalitis and 10 contaminated specimens. It was also raised in two specimens from culture negative cases. Determination of cerebrospinal fluid lactic acid concentration by gas liquid chromatography provides a useful, additional test in the diagnosis of bacterial meningitis
    Matched MeSH terms: Meningitis/cerebrospinal fluid*
  3. Watts MB
    Med J Malaya, 1969 Dec;24(2):89-93.
    PMID: 4244149
    Matched MeSH terms: Meningitis/drug therapy*
  4. Hussain IH, Sofiah A, Ong LC, Choo KE, Musa MN, Teh KH, et al.
    Pediatr Infect Dis J, 1998 Sep;17(9 Suppl):S189-90.
    PMID: 9781759
    To determine the pattern of postneonatal childhood meningitis in Malaysia.
    Matched MeSH terms: Meningitis, Haemophilus/epidemiology*
  5. Sundaramurthy SSR, Allen KE, Fletcher MA, Liew KF, Borhanuddin B, Ali M, et al.
    BMC Infect Dis, 2024 Jan 12;24(1):79.
    PMID: 38216882 DOI: 10.1186/s12879-023-08611-3
    BACKGROUND: Pneumococcal disease caused by Streptococcus pneumoniae is an important cause of morbidity and mortality across all ages, particularly in younger children and older adults. Here, we describe pneumococcal disease hospitalizations at Ministry of Health (MoH) facilities in Malaysia between 2013 and 2015.

    METHODS: This was a retrospective databases analysis. Tabular data from the Malaysian Health Data Warehouse (MyHDW) were used to identify microbiologically confirmed, pneumococcal disease hospitalizations and deaths during hospitalization, using hospital-assigned ICD-10 codes (i.e., classified as meningitis, pneumonia, or non-meningitis non-pneumonia). Case counts, mortality counts, and case fatality rates were reported by patient age group and by Malaysian geographic region.

    RESULTS: A total of 683 pneumococcal disease hospitalizations were identified from the analysis: 53 pneumococcal meningitis hospitalizations (5 deaths and 48 discharges), 413 pneumococcal pneumonia hospitalizations (24 deaths and 389 discharges), and 205 non-meningitis non-pneumonia pneumococcal disease hospitalizations (58 deaths and 147 discharges). Most hospitalizations occurred in children aged 

    Matched MeSH terms: Meningitis, Pneumococcal*
  6. Dugdale AE
    Med J Aust, 1970 Dec 5;2(23):1087-91.
    PMID: 5491085
    Matched MeSH terms: Meningitis/therapy
  7. Mohd Nor F, Tan LH, Na SL, Ng KP
    Mycopathologia, 2015 Aug;180(1-2):95-8.
    PMID: 25739670 DOI: 10.1007/s11046-015-9879-0
    Rhodotorula species are increasingly being identified as a cause of fungal infection in the central nervous system, especially in patients with compromised immunity. The diagnosis could easily be missed due to low index of suspicion, as cryptococcus meningitis and cerebral toxoplasmosis are more common amongst immunocompromised hosts. To date, there are six cases of Rhodotorula-related meningitis reported, and three are associated with human immunodeficiency virus infection. In this report, a case of a Malaysian male with underlying human immunodeficiency virus infection who developed Rhodotorula mucilaginosa meningitis is presented. High-grade fever and severe headaches were the complaints presented in three previous case reports. India ink and nigrosin stainings were performed in the two previous reports and both revealed positive results. R. mucilaginosa were isolated from the culture of the patient's cerebrospinal fluid in all three previous reports. Predominant lymphocyte infiltration in the cerebrospinal fluid examination was documented in two reports. CD4 counts were above 100/µl in two previously published reports, while another report documented CD4 count as 56/µl. Amphotericin B and itraconazole are identified to be the first line of antifungal used and as the maintenance therapy, respectively. The possibility of relapse cannot be excluded as it was reported in the first report. It was also revealed that the current case has almost similar clinical presentation and therapeutic outcome as compared to the published reports, but some differences in diagnostic details were to be highlighted.
    Matched MeSH terms: Meningitis, Fungal/diagnosis*; Meningitis, Fungal/microbiology*; Meningitis, Fungal/pathology
  8. Othman N, Abdullah NA, Wahab ZA
    PMID: 15916093
    An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.
    Matched MeSH terms: Meningitis, Cryptococcal/diagnosis; Meningitis, Cryptococcal/drug therapy; Meningitis, Cryptococcal/physiopathology*
  9. McNeil HC, Jefferies JM, Clarke SC
    Expert Rev Anti Infect Ther, 2015 06;13(6):705-14.
    PMID: 25962101 DOI: 10.1586/14787210.2015.1033401
    Worldwide bacterial meningitis accounts for more than one million cases and 135,000 deaths annually. Profound, lasting neurological complications occur in 9-25% of cases. This review confirms the greatest risk from bacterial meningitis is in early life in Malaysia. Much of the disease burden can be avoided by immunization, particularly against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae. Despite inclusion of the Hib vaccine in the National Immunisation Programme and the licensure of pneumococcal vaccines, these two species are the main contributors to bacterial meningitis in Malaysia, with Neisseria meningitidis and Mycobacterium tuberculosis, causing a smaller proportion of disease. The high Hib prevalence may partly be due to dated, small-scale studies limiting the understanding of the current epidemiological situation. This highlights the need for larger, better quality surveillance from Malaysia to evaluate the success of Hib immunization and to help guide immunization policy for vaccines against S. pneumoniae and N. meningitidis.
    Matched MeSH terms: Meningitis, Bacterial/classification; Meningitis, Bacterial/mortality; Meningitis, Bacterial/prevention & control*
  10. Wong CM, Lim KH, Liam CK
    Postgrad Med J, 1999 May;75(883):297-8.
    PMID: 10533638
    Cryptococcal infection uncommonly presents with pulmonary manifestations and even more rarely so as massive bilateral effusions. Pleural involvement is usually associated with underlying pulmonary parenchymal lesions and is unusual while on antifungal therapy. We report a patient with cryptococcal meningitis who, while on intravenous 5-flucytosine and amphotericin B, developed life-threatening bilateral massive pleural effusions with evidence of spontaneous resolution, consistent with prior hypothesis of antigenic stimulation as the cause of pleural involvement.
    Matched MeSH terms: Meningitis, Cryptococcal/complications*; Meningitis, Cryptococcal/drug therapy
  11. Cheong YM, Jegathesan M, Lo SB
    Med J Malaysia, 1984 Mar;39(1):38-41.
    PMID: 6513838
    The usefulness of counterimmunoelectrophoresis (CIEP) and coagglutination (COAG) methods in the diagnosis of bacterial meningitis was evaluated. Out of the 31 cerebrospinal fluid (CSF) specimens which had a cell count of >5 x10^6 wbc/l and were negative on gram stain and culture, pneumococcal antigens were detected in four specimens and Haemophilus influenzae type b antigen was detected in one specimen by both the methods. No false positives were detected in 10 specimens obtained from cases of febrile fits whose CSF showed no evidence of meningitis. One CSF sample, from which Klebsiella spp. was isolated, cross reacted with the meningococcal polyvalent group A-D antiserum in the CIEP test. From this study we found that these methods are rapid, simple and useful adjunctive tests In the diagnosis of bacterial meningitis, especially in the partially treated cases.
    Matched MeSH terms: Meningitis/diagnosis*; Meningitis/immunology
  12. Lim VKE, Talib S
    Med J Malaysia, 1982 Mar;37(1):11-3.
    PMID: 6981750
    A case of neonatal meningitis caused by an unusual organism, Acinetobacter calcoaceticus var anitratus is reported. The source of the meningitis is probably a scalp abscess caused by the same organism. This patient was successfully treated with cotrimoxazole. Infections caused by Acinetobacter are rare and are briefly reviewed in this article
    Matched MeSH terms: Meningitis/diagnosis*; Meningitis/etiology
  13. Kong NC, Shaariah W, Morad Z, Suleiman AB, Wong YH
    Aust N Z J Med, 1990 Oct;20(5):645-9.
    PMID: 2285381
    Cryptococcosis is a known opportunistic infection in immunosuppressed hosts. We report our experience of all cases presenting to our Department between December 1975 and September 1988. Eight post-renal transplant patients and three systemic lupus erythematosus (SLE) patients were affected. All were receiving treatment with steroids, in association with either azathioprine or cyclosporin. The diagnosis of cryptococcal meningitis was initially based on a positive cerebrospinal fluid (CSF) cryptococcal antigen, by latex agglutination test, and subsequently confirmed by cultures. Common clinical presentations, in descending order of frequency, included headaches, fever, mental confusion, epilepsy and papilloedema. Meningism was not a prominent feature. CT brain scans were obtained in eight patients and one showed a focal lesion and one showed cerebral atrophy. Four patients also had an abnormal chest X-ray (CXR) and one had disseminated cryptococcosis. Amphotericin and 5-fluorocytosine were the mainstay of therapy, although ketoconazole alone was subsequently used in three selected patients with cure. Four early deaths occurred in patients with delayed diagnosis and treatment, usually in association with other severe concurrent infections. We conclude that awareness of cryptococcosis is essential in immunocompromised hosts presenting with headache with, or without, mental confusion or fever.
    Matched MeSH terms: Meningitis/diagnosis*; Meningitis/drug therapy
  14. Thiruchelvan N, Wuu KY, Arseculeratne SN, Ashraful-Haq J
    J Clin Pathol, 1998 Mar;51(3):246-8.
    PMID: 9659271
    Wet India ink mounts of cerebrospinal fluid (CSF) are useful in the laboratory diagnosis of cryptococcal meningitis. Pseudo-cryptococcal artefacts in such mounts have been attributed to leucocytes in CSF but their mode of formation has not been explained. This report describes the reproduction of such an artefact in cryptococcus free CSF-leucocyte mixtures that had been subjected to high speed centrifugation. The viscosity of DNA that could provide a morphological pseudo-capsule, and the yellow-green fluorescence of the pseudo-capsular material on staining with acridine-orange, suggest that lymphocytic nuclear DNA, which possibly leaked out after damage to the lymphocyte membrane by centrifugation, was responsible for this artefact.
    Matched MeSH terms: Meningitis, Cryptococcal/cerebrospinal fluid; Meningitis, Cryptococcal/pathology*
  15. Carol L, Tai MS, Yusoff SM, Rose N, Rafia MH, Viswanathan S
    Neurol India, 2018 7 25;66(4):1181-1183.
    PMID: 30038119 DOI: 10.4103/0028-3886.237012
    Matched MeSH terms: Meningitis, Cryptococcal/etiology*; Meningitis, Cryptococcal/mortality
  16. Tan HJ, Raymond AA, Phadke PP, Rozman Z
    Singapore Med J, 2004 Jul;45(7):337-9.
    PMID: 15221051
    Symptomatic rheumatoid pachymeningitis is a rare extra-articular manifestation of rheumatoid arthritis. Clinical symptoms are non-specific and diagnosis is frequently made by exclusion. We present a 61-year-old woman with a 9-year history of rheumatoid arthritis presenting with deafness and progressive disability over a two month duration. She was diagnosed as having rheumatoid pachymeningitis based on the cerebral magnetic resonance imaging findings.
    Matched MeSH terms: Meningitis/diagnosis*; Meningitis/etiology*
  17. Lee WS, Puthucheary SD, Omar A
    J Paediatr Child Health, 1999 Aug;35(4):379-82.
    PMID: 10457297
    OBJECTIVE: To review the presenting features, complications and outcome of infants with Salmonella meningitis.

    METHODOLOGY: Retrospective review of all cultures of cerebrospinal fluid positive for bacteria in children below 12 years of age, processed at the Department of Medical Microbiology, University of Malaya Medical Centre, Kuala Lumpur from 1973 to 1997. Records of all cases positive for Salmonella species were retrieved and studied.

    RESULTS: Thirteen infants aged 3 days to 9 months with Salmonella meningitis were included. The median age of onset of symptoms was 4 months. The clinical and laboratory features were similar to other causes of bacterial meningitis. Salmonella enteritidis was the commonest serotype isolated. Nine infants developed fits, six of which were difficult to control. Other complications noted were hydrocephalus (five), subdural effusions (four), empyema (three), ventriculitis (two), intracranial haemorrhage and cerebral abscess (one each). The use of ampicillin and/or chloramphenicol and inadequate duration of therapy resulted in recrudescence or relapse in five infants. The overall mortality was 18%. The presence of empyema, intracerebral abscess, ventriculitis, hydrocephalus, and intracranial haemorrhage were associated with adverse neurodevelopmental sequelae or death. More than half of those who survived had normal long-term outcome.

    CONCLUSION: Infants who developed neurological complications as a result of Salmonella meningitis had significant mortality and adverse long-term neurodevelopment outcome.

    Matched MeSH terms: Meningitis, Bacterial/complications*; Meningitis, Bacterial/drug therapy; Meningitis, Bacterial/microbiology; Meningitis, Bacterial/mortality
  18. Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA
    J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.
    PMID: 17441895
    We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.
    Matched MeSH terms: Meningitis, Bacterial/complications; Meningitis, Bacterial/epidemiology*
  19. Shekhar K, Lye MS, Norlijah O, Ong F, Looi LM, Khuzaiah R, et al.
    Med J Malaysia, 2005 Aug;60(3):297-304.
    PMID: 16379183
    From July through December 1997, 11 previously healthy children in Peninsular Malaysia succumbed to an illness clinically characterised by an acute severe refractory left-ventricular failure, following a brief prodromal illness, in the midst of an outbreak of hand, foot and mouth disease (HFMD), similar to the reported experience in Sarawak and Taiwan. Retrospective reviews of the clinical features and results of laboratory, pathological and virological investigations of cases were conducted. The median age of the 11 case-patients was 31 months (range, 13 to 49 months); 6 were males. A brief prodromal illness of 3 days (range, 2 to 5 days) was characterised by fever (axillary temperature > 38 degrees C) (100%), oral ulcers (72%), extremity rashes (45%) and significant vomiting (55%). Upon hospitalisation, 7 of 11 case-patients had features suggestive of cardiogenic shock, while 4 of 11 case-patients developed shock during hospitalisation as evidenced by marked sustained tachycardia (heart rate > or = 180 beats per minute), poor peripheral pulses and peripheral perfusion, mottled extremities, pulmonary oedema (haemorrhagic pulmonary secretions in 8 of 11 cases during tracheal intubation, often precipitated by conservative crystalloid boluses, and radiographic evidence of acute pulmonary oedema in 5 of 7 cases) and markedly impaired left ventricular function on echocardiographic examination (7 of 7 cases). Three of 4 case-patients had aseptic meningitis while one case-patient also had an acute flaccid paraparesis. Despite supportive therapy, death occurred within a median of 13.4 hours following hospitalization. Post-mortem findings (all 8 specimens examined) consistently demonstrated brain-stem encephalitis with foci of neuronal necrosis and micro-abscesses. None of the 11 specimens examined revealed histological evidence of myocarditis. Enterovirus 71 (EV71) was detected in 10 of 11 case-patients, many (7) from various sterile tissue sites (5 from central nervous tissues). No other viruses were isolated or identified. Clinical features and pathological studies closely paralleled the reported experience in Sarawak and Taiwan. The uniform necropsy findings of necrotizing brain-stem encephalitis coupled with essentially normal myocardial histology, in concert with the concurrent and consistent detection of EV71 points to a primary EV71 encephalitis; as yet unclear neurogenic mechanisms may account for the cardiovascular manifestations.
    Matched MeSH terms: Meningitis, Aseptic/mortality; Meningitis, Aseptic/pathology
  20. Lim CT, Parasakthi N, Puthucheary SD
    Singapore Med J, 1994 Feb;35(1):104-5.
    PMID: 8009266
    A set of twins born to a 24-year-old primigravida had evidence of sepsis 24 to 60 hours after birth and were treated empirically with penicillin and gentamicin. A non-encapsulated H. influenzae biotype IV strain was isolated from the blood cultures of both and from the CSF of twin II. The isolates were beta-lactamase positive and hence showed resistance to ampicillin and therapy was changed to chloramphenicol only. Twin II recovered but Twin I developed a brain abscess in the left occipital region which resolved with extended antibiotic treatment. Although ampicillin-resistant H. influenzae have been reported in Malaysia, invasive disease by such strains are rare.
    Matched MeSH terms: Meningitis, Haemophilus/diagnosis*; Meningitis, Haemophilus/drug therapy
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