Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting
Abstract Background Meningitis is inflammation of the meninges, the layers that protect the brain and spinal cord. Acute meningitis is an emergent disease that develops over the course of hours to several days. Delay in treatment can lead to serious outcomes. Inflammation of the meninges is assessed by analysing cerebrospinal fluid. Identifying the pathogen in […]
Interventions for ulceration and other skin changes caused by nerve damage in leprosy
Abstract Background At the end of 2016, 145 countries reported to the World Health Organization (WHO) over 173,000 new cases of leprosy worldwide. In the past 20 years, over 16 million people have been treated for leprosy globally. The condition’s main complications are injuries and ulceration caused by sensory loss from nerve damage. In this […]
Antibiotic therapy for adults with neurosyphilis
Abstract Background Neurosyphilis is an infection of the central nervous system, caused by Treponema pallidum, a spirochete capable of infecting almost any organ or tissue in the body causing neurological complications due to the infection. This disease is a tertiary manifestation of syphilis. The first‐line treatment for neurosyphilis is aqueous crystalline penicillin. However, in cases such […]
Osmotic therapies added to antibiotics for acute bacterial meningitis
Abstract Background Every day children and adults die from acute community-acquired bacterial meningitis, particularly in low-income countries, and survivors risk deafness, epilepsy and neurological disabilities. Osmotic therapies may attract extra-vascular fluid and reduce cerebral oedema, and thus reduce death and improve neurological outcomes. This is an update of a Cochrane Review first published in 2013. […]
Intravenous immunoglobulin for the treatment of childhood encephalitis
Abstract Background Encephalitis is a syndrome of neurological dysfunction due to inflammation of the brain parenchyma, caused by an infection or an exaggerated host immune response, or both. Attenuation of brain inflammation through modulation of the immune response could improve patient outcomes. Biological agents such as immunoglobulin that have both anti-inflammatory and immunomodulatory properties may […]
Pre-admission antibiotics for suspected cases of meningococcal disease
Abstract Background Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. Objectives To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different […]
Antibiotics for the neurological complications of Lyme disease
Abstract Background Various central nervous system-penetrant antibiotics are bactericidal in vitro and in vivo against the causative agent of Lyme neuroborreliosis (LNB), Borrelia burgdorferi. These antibiotics are routinely used clinically to treat LNB, but their relative efficacy is not clear. Objectives To assess the effects of antibiotics for the treatment of LNB. Search methods On […]
Valacyclovir versus acyclovir for the treatment of herpes zoster ophthalmicus in immunocompetent patients
Abstract Background Herpes zoster ophthalmicus affects the eye and vision, and is caused by the reactivation of the varicella zoster virus in the distribution of the first division of the trigeminal nerve. An aggressive management of acute herpes zoster ophthalmicus with systemic antiviral medication is generally recommended as the standard first-line treatment for herpes zoster […]
Fluid therapy for acute bacterial meningitis
Abstract Background Acute bacterial meningitis remains a disease with high mortality and morbidity rates. However, with prompt and adequate antimicrobial and supportive treatment, the chances for survival have improved, especially among infants and children. Careful management of fluid and electrolyte balance is an important supportive therapy. Both over- and under-hydration are associated with adverse outcomes. […]
Six months therapy for tuberculous meningitis
Abstract Background Tuberculous meningitis (TBM) is the main form of tuberculosis that affects the central nervous system and is associated with high rates of death and disability. Most international guidelines recommend longer antituberculous treatment (ATT) regimens for TBM than for pulmonary tuberculosis disease to prevent relapse. However, longer regimens are associated with poor adherence, which […]