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Human infection with rat lungworm Angiostrongylus cantonensis (Chen, 1935) in West Malaysia

Bisseru B, Gill SS, Lucas JK

Med J Malaya, 1972 Mar;26(3):164-7.
PMID: 5064003
Matched MeSH terms: Meningoencephalitis/etiology*
Free-living ciliates in CSF of a patient with meningoencephalitis: a contaminant?

Isa NH, Sulaiman S, Shahid MS, Rose IM, Eugene CB

Southeast Asian J. Trop. Med. Public Health, 1994 Mar;25(1):212-4.
PMID: 7825018
Matched MeSH terms: Meningoencephalitis/cerebrospinal fluid*; Meningoencephalitis/parasitology*; Meningoencephalitis/therapy
Draft genome of neurotropic nematode parasite Angiostrongylus cantonensis, causative agent of human eosinophilic meningitis

Yong HS, Eamsobhana P, Lim PE, Razali R, Aziz FA, Rosli NS, et al.

Acta Trop, 2015 Aug;148:51-7.
PMID: 25910624 DOI: 10.1016/j.actatropica.2015.04.012

Angiostrongylus cantonensis is a bursate nematode parasite that causes eosinophilic meningitis (or meningoencephalitis) in humans in many parts of the world. The genomic data from A. cantonensis will form a useful resource for comparative genomic and chemogenomic studies to aid the development of diagnostics and therapeutics. We have sequenced, assembled and annotated the genome of A. cantonensis. The genome size is estimated to be ∼260 Mb, with 17,280 genomic scaffolds, 91X coverage, 81.45% for complete and 93.95% for partial score based on CEGMA analysis of genome completeness. The number of predicted genes of ≥300 bp was 17,482. A total of 7737 predicted protein-coding genes of ≥50 amino acids were identified in the assembled genome. Among the proteins of known function, kinases are the most abundant followed by transferases. The draft genome contains 34 excretory-secretory proteins (ES), a minimum of 44 Nematode Astacin (NAS) metalloproteases, 12 Homeobox (HOX) genes, and 30 neurotransmitters. The assembled genome size (260 Mb) is larger than those of Pristionchus pacificus, Caenorhabditis elegans, Necator americanus, Caenorhabditis briggsae, Trichinella spiralis, Brugia malayi and Loa loa, but smaller than Haemonchus contortus and Ascaris suum. The repeat content (25%) is similar to H. contortus. The GC content (41.17%) is lower compared to P. pacificus (42.7%) and H. contortus (43.1%) but higher compared to C. briggsae (37.69%), A. suum (37.9%) and N. americanus (40.2%) while the scaffold N50 is 42,191. This draft genome will facilitate the understanding of many unresolved issues on the parasite and the disorder it causes.

Matched MeSH terms: Meningoencephalitis/parasitology*
Eosinophilic meningoencephalitis caused by the rat lung worm, angiostrongylus cantonensis with special reference to A. malaysiensis in Malaysia

Lait LB

Med J Malaysia, 1976 Mar;30(3):207-11.
PMID: 822262
Matched MeSH terms: Meningoencephalitis/etiology*
Fulltext Triclosan Demonstrates Synergic Effect with Amphotericin B and Fluconazole and Induces Apoptosis-Like Cell Death in Cryptococcus neoformans

Movahed E, Tan GM, Munusamy K, Yeow TC, Tay ST, Wong WF, et al.

Front Microbiol, 2016;7:360.
PMID: 27047474 DOI: 10.3389/fmicb.2016.00360

Cryptococcus neoformans is an opportunistic fungus that causes fatal meningoencephalitis especially in AIDS patients. There is an increasing need for discovery of new anti-cryptococcal drugs due to emergence of resistance cases in recent years. In this study, we aim to elucidate the antifungal effect of triclosan against C. neoformans.

Matched MeSH terms: Meningoencephalitis
Fulltext Cerebral infarction and cerebral salt wasting syndrome in a patient with tuberculous meningoencephalitis

Loo KL, Ramachandran R, Abdullah BJ, Chow SK, Goh EM, Yeap SS

Southeast Asian J. Trop. Med. Public Health, 2003 Sep;34(3):636-40.
PMID: 15115143

A 38-year old female with underlying systemic lupus erythematosus was admitted with tuberculous meningoencephalitis. After an initial good response to anti-tuberculous treatment, she developed cerebral infarction and profound hyponatremia. This was due to cerebral salt wasting syndrome, which has only previously been described in 2 cases. The difficulties in diagnosis and management of this case are discussed.

Matched MeSH terms: Meningoencephalitis/complications*; Meningoencephalitis/diagnosis; Meningoencephalitis/microbiology
Malignant catatonia secondary to viral meningoencephalitis in a young man with bipolar disorder

Saini SM, Eu CL, Wan Yahya WN, Abdul Rahman AH

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:55-8.
PMID: 23857838 DOI: 10.1111/appy.12045
Matched MeSH terms: Meningoencephalitis/complications*; Meningoencephalitis/psychology
[Emergence of transmissible disorders, a continuous process--a new type of viral meningoencephalitis]

Ivan A, Indrei LL

Rev Med Chir Soc Med Nat Iasi, 2000 Apr-Jun;104(2):51-5.
PMID: 12089991

In the interval 1994-1999, in Australia, Malaysia and Singapore, epizootic and epidemiological episodes of meningoencephalitis and severe acute respiratory syndromes were reported. Highly lethal in horses, swine and humans, the episodes were proved to be caused by the "new" viruses Hendra (HeV) and Nipah (NiV). At the same time three "new" viral agents have been isolated: Lyssavirus, Menanglevirus and Tupaia paramyxovirus. The intense contemporary circulation of people, animals and food products together with changes in human ecosystem favor new relations between humans and the "natural reservoirs" of biologic agents with a pathogenic potential for domestic and peridomestic animals and humans.

Matched MeSH terms: Meningoencephalitis/epidemiology; Meningoencephalitis/veterinary; Meningoencephalitis/virology*
Angiostrongylus malaysiensis from Tuaran, Sabah, with reference to the distribution of the parasite in Malaysia

Liat LB, Wah LT, Cheah W, Cheah W, Fong YL, Fong YL

Southeast Asian J. Trop. Med. Public Health, 1976 Sep;7(3):384-9.
PMID: 1030843

A survey of Angiostrongylus malaysiensis among wild rodent and molluscan hosts was made in the Tuaran Central Agricultural Research Station and within the vicinity of Tuaran, Sabah. Three of 19 Rattus rattus diardii, one of 2 R. exulans and one R. argentiventer were found naturally infected with the parasite. In this survey 56 of 382 molluscs comprising of Pila scutata, Achatina fulica and two species of land slugs, Laevicaulis alte and Microparmarion malayanus, were found naturally infected with the parasite. Samples of larvae from each of these molluscs were experimentally transferred to laboratory albino rats and adult worms consistent with A. malaysiensis were recovered. Comparison of the rat hosts and the molluscan intermediate hosts of the parasite in Peninsular Malaysia, Sarawak and Sabah was made, and the finding of A. malaysiensis in Tuaran is the first report of the parasite from Sabah. The distribution of the parasite throughout Malaysia is discussed. Observation on the human consumption of the freshwater snail, P. scutata, was made. Although the infection rate of this snail is low compared with other molluscan hosts examined. The importance of this mollusc as a potential source of human infection should not be overlooked. Hospital records for 1974 and 1975 were examined and clinical human angiostrongyliasis was rarely recorded in Sabah.

Matched MeSH terms: Meningoencephalitis/epidemiology
Fulltext Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study

Lee HG, William T, Menon J, Ralph AP, Ooi EE, Hou Y, et al.

BMC Infect Dis, 2016 06 16;16:296.
PMID: 27306100 DOI: 10.1186/s12879-016-1640-x

BACKGROUND: Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there may be regional differences due to variation in the socio-economic levels, public health services and vaccination policies. Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections. A better understanding of these is essential for the development of local guidelines for diagnosis and management.
METHODS: We conducted a prospective observational cohort study in patients aged 12 years and older with suspected central nervous system infections at Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia between February 2012 and March 2013. Cerebrospinal fluid was sent for microscopy, biochemistry, bacterial and mycobacterial cultures, Mycobacterium tuberculosis polymerase chain reaction (PCR), and multiplex and MassCode PCR for various viral and bacterial pathogens.
RESULTS: A total of 84 patients with clinically suspected meningitis and encephalitis were enrolled. An aetiological agent was confirmed in 37/84 (44 %) of the patients. The most common diagnoses were tuberculous meningitis (TBM) (41/84, 48.8 %) and cryptococcal meningoencephalitis (14/84, 16.6 %). Mycobacterium tuberculosis was confirmed in 13/41 (31.7 %) clinically diagnosed TBM patients by cerebrospinal fluid PCR or culture. The acute case fatality rate during hospital admission was 16/84 (19 %) in all patients, 4/43 (9 %) in non-TBM, and 12/41 (29 %) in TBM patients respectively (p = 0.02).
CONCLUSION: TBM is the most common cause of CNS infection in patients aged 12 years or older in Kota Kinabalu, Sabah, Malaysia and is associated with high mortality and morbidity. Further studies are required to improve the management and outcome of TBM.

Matched MeSH terms: Meningoencephalitis/cerebrospinal fluid; Meningoencephalitis/microbiology; Meningoencephalitis/mortality; Meningoencephalitis/epidemiology*
Benign afebrile convulsion with gastroenteritis - A differential to consider for afebrile seizure in children

Ng RL

Med J Malaysia, 2018 10;73(5):328-329.
PMID: 30350815

A 5-year-old girl presented with three brief episodes of afebrile seizure within 24 hours. There was no significant past medical history but she had symptoms of acute gastroenteritis for the past 2 days. She was mildly dehydrated with no neurological signs. Serum electrolytes and blood sugar were normal and cerebrospinal fluid examination was negative for meningoencephalitis. Contrast-enhanced CT Brain showed no evidence of intracranial lesion, haemorrhage or meningeal enhancement. Only stool investigation was positive for Rotavirus. The conclusion of Benign Afebrile Convulsion with gastroenteritis (CwG) was established after excluding other serious causes of afebrile seizure in children.

Matched MeSH terms: Meningoencephalitis
Fulltext Acute Disseminated Encephalomyelitis (ADEM) Presenting with Bilateral Optic Neuritis

Sapuan S, Basri H

Malays J Med Sci, 2007 Jan;14(1):71-4.
PMID: 22593657 MyJurnal

A 43-year old lady presented with progressive loss of vision in both eyes followed by rapid deterioration of consciousness within the next few days. This was preceded by a viral infection one week before her presentation. At presentation she had evidence of meningism and signs of bilateral upper motor neuron lesions and was managed initially as acute meningoencephalitis with antibiotics. The brain CT was within normal limits but subsequent MRI of the brain revealed multiple foci of hyperintense lesions on T2-weighted and FLAIR images. The cerebrospinal fluid examination revealed lymphocytosis, and normal protein and glucose levels. Cultures of the CSF were negative. She was managed as acute disseminated encephalomyelitis (ADEM) with high-dose of intravenous methlyprednisolone one gram/day for three consecutive days followed by oral prednisolone 60 mg/day. Despite the management she lapsed into coma and succumbed to her illness nine days after admission.

Matched MeSH terms: Meningoencephalitis
Biofilm is associated with chronic streptococcal meningoencephalitis in fish

Isiaku AI, Sabri MY, Ina-Salwany MY, Hassan MD, Tanko PN, Bello MB

Microb Pathog, 2017 Jan;102:59-68.
PMID: 27890651 DOI: 10.1016/j.micpath.2016.10.029

Biofilms are aggregates of attached microbial organisms whose existence on tissues is often recognised as a mechanism for the establishment of most chronic diseases. Herein we investigated the ability of piscine Streptococcus agalactiae, an important aquatic pathogen, for adaptation to this sessile lifestyle in vitro and in the brain of a tilapia fish model. Piscine S. agalactiae exhibited a weak attachment to polystyrene plates and expressed a low biofilm phenotype under the study conditions. Furthermore, fluorescent in situ hybridization and confocal laser scanning microscopy revealed discrete aggregates of attached S. agalactiae within brain tissues and around meningeal surfaces. They were embedded in an exopolysaccharide containing matrix, intractable to inflammatory response and showed some level of resistance to penicillin despite proven susceptibility on sensitivity test. Intracellular bacterial aggregates were also observed, moreover, antibody mediated response was not demonstrated during infection. Nucleated erythrocytes appear to facilitate brain invasion possibly via the Trojan horse mechanism leading to a granulomatous inflammation. We have demonstrated that biofilm is associated with persistence of S. agalactiae and the development of chronic meningoencephalitis in fish.

Matched MeSH terms: Meningoencephalitis/veterinary*
Fulltext A multi-disciplinary team approach to klüver-bucy syndrome: a case report

Kanchan Thadani, Chee Kok Yoon, Hanis Aminah John Mohamad, Norzaini Rose Mohd Zain, Chan Pek Har, Noor Jannah Ariffin

Malaysian Journal of Psychiatry, 2018;27(2):0-0.
MyJurnal

Klüver-Bucy syndrome was first diagnosed in humans in 1955, after a group
of people who had experienced temporal lobectomy. It is a rare
neuropsychiatry disease and of which little is understood about its
pathophysiological processes. Here we present a 60-year-old man seen in the
outpatient psychiatric department in a tertiary hospital in Kuala Lumpur
who presented to us with hyper sexuality, impulsivity, docility, amnesia and
hyperphagia for the past 10 months. He was diagnosed with Herpes Simplex
Virus with encephalitis 18 months ago and was shown to have bilateral
meningoencephalitis of his temporal lobes. Thus, a diagnosis of Klüver-Bucy
was made. We have taken a multi-disciplinary team approach to treat his
illness and specific goals has been laid out in each discipline. A written
consent has been taken by the patient and his family for the publication of
this report.

Matched MeSH terms: Meningoencephalitis
Fulltext Lung-infiltrating T helper 17 cells as the major source of interleukin-17A production during pulmonary Cryptococcus neoformans infection

Movahed E, Cheok YY, Tan GMY, Lee CYQ, Cheong HC, Velayuthan RD, et al.

BMC Immunol, 2018 Nov 08;19(1):32.
PMID: 30409128 DOI: 10.1186/s12865-018-0269-5

BACKGROUND: IL-17A has emerged as a key player in the pathologies of inflammation, autoimmune disease, and immunity to microbes since its discovery two decades ago. In this study, we aim to elucidate the activity of IL-17A in the protection against Cryptococcus neoformans, an opportunistic fungus that causes fatal meningoencephalitis among AIDS patients. For this purpose, we examined if C. neoformans infection triggers IL-17A secretion in vivo using wildtype C57BL/6 mice. In addition, an enhanced green fluorescence protein (EGFP) reporter and a knockout (KO) mouse models were used to track the source of IL-17A secretion and explore the protective function of IL-17A, respectively.
RESULTS: Our findings showed that in vivo model of C. neoformans infection demonstrated induction of abundant IL-17A secretion. By examining the lung bronchoalveolar lavage fluid (BALF), mediastinal lymph node (mLN) and spleen of the IL-17A-EGFP reporter mice, we showed that intranasal inoculation with C. neoformans promoted leukocytes lung infiltration. A large proportion (~ 50%) of the infiltrated CD4+ helper T cell population secreted EGFP, indicating vigorous TH17 activity in the C. neoformans-infected lung. The infection study in IL-17A-KO mice, on the other hand, revealed that absence of IL-17A marginally boosted fungal burden in the lung and accelerated the mouse death.
CONCLUSION: Therefore, our data suggest that IL-17A is released predominantly from TH17 cells in vivo, which plays a supporting role in the protective immunity against C. neoformans infection.

Matched MeSH terms: Meningoencephalitis