[Combined Tb and Candida meningitis in an 8-year old boy (author's transl)].
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Biomedical subjects
Publications and source records attributed to W Kristoferitsch.
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The questions of a causal connection between Mycoplasma pneumoniae infection and neurological psychiatric diseases is discussed on the basis of the case reports of two patients and a review of the literature. Since a causal connection can be assumed in the reported cases it is suggested that infection by Mycoplasma pneumoniae infections should be included in the differential diagnosis of aetiologically unclarified meningoencephalitis, polyradiculitis, and organically-based psychoses.
A case of Sjögren's disease is described in which isolated cerebellar symptoms were prominent. Serological investigations gave no evidence of disseminated immune vasculitis, systemic lupus erythematosus or any other autoimmune disease. The cerebrospinal fluid protein changes, which were diagnostic of an autoimmune process in the CNS and suggestive of Sjögren's syndrome are discussed.
After the isolation of Borrelia burgdorferi, the previously unknown causative agent of Lyme disease, two neurological disorders, Bannwarth's syndrome and acrodermatitis chronica atrophicans-associated neuropathy, which have been known in Europe for decades, gained new interest. With the availability of serodiagnostic tests, a chronic debilitating disorder--progressive borrelia encephalomyelitis--was found to be caused by chronic infection with B. burgdorferi. Beside these typical manifestations, a growing number of publications about various neurological phenomena appeared, which were thought to be caused by B. burgdorferi. This assumption was based in many cases on the results of serodiagnostic tests only. Considerations for causal connections were frequently lacking. While prior to the availability of serodiagnostic tests neurological manifestations of Lyme borreliosis frequently remained undiagnosed, we now face a tendency for overdiagnosis. The great variety of neurological manifestations in Lyme borreliosis--most of them can also be attributed to other conditions--and the high rate of seropositivity for B. burgdorferi amongst the population living in endemic areas require strict criteria for the correct diagnosis of new and typical neurological manifestations.
Various studies in the United States and Europe have established human leucocyte antigens (HLA) Cw3, DR2 and DR4 as risk factors for manifest Borrelia burgdorferi infection or the development of chronic courses of Lyme disease. Other studies failed to confirm these findings. In the present study the frequencies of HLA A, B, Cw and DR were analysed in 283 persons from Austria and Germany with manifest B. burgdorferi infection. No statistically significant differences were found between patients and the control groups with regard to the frequencies of particular HLA antigens, nor were differences in antigen frequencies in the patients with manifestations of different stages of disease significant. Furthermore, a statistical re-evaluation of all the European studies failed to confirm particular HLA antigens as risk factors for B. burgdorferi infections to become manifest or chronic.
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