Methylprednisolone pulse therapy as an adjuvant treatment of Streptococcus pneumoniae meningitis complicated by cerebral infarction-a case report and review of the literature

Delayed cerebral vasculopathy following pneumococcal meningitis: a case report

Acute bacterial meningitis (ABM) remains a common disease, especially in developing countries. Although morbidity and mortality have improved with advances in medicine, significant neurologic complications of meningitis still occur. Delayed cerebral vasculopathy (DCV) is a unique complication following ABM leading to ischemic strokes and poor functional outcomes. We describe a case of a 66-year-old man with repeated acute infarcts from DCV due to ABM, notably in the absence of empiric dexamethasone treatment, which was not administered as meningitis was diagnosed post-antibiotic initiation. New areas of acute ischemia were noted on repeat imaging on days 6, 24, and 30 of admission. Vascular imaging revealed multifocal vascular stenosis, consistent with vasospasm that was successfully treated with Milrinone.

Acute multiple brain infarctions associated with Streptococcus suis infection: a case report

Streptococcus suis is one of the most common zoonotic pathogens, in humans and can cause meningitis, endocarditis, arthritis and sepsis. Human cases of Streptococcus suis infection have been reported worldwide, and most of those cases occurred in Asia. Hearing loss is the most common sequela of Streptococcus suis meningitis. Streptococcus suis infection complicated with acute cerebral infarction has rarely been reported. Therefore, to provide a reference for this disease, we reported a case of acute multiple brain infarctions associated with Streptococcus suis infection. In our report, a 69yearold male patient had Streptococcus suis meningitis and sepsis, which were associated with multiple acute cerebral infarctions in the pons and bilateral frontotemporal parietal occipital lobes. After treatment, the patient exhibited cognitive impairment, dyspraxia and irritability. There are limited case reports of cerebral infarction associated with Streptococcus suis infection, and further research is needed to determine the best treatment method.

Effect of New Nursing on Patients with Acute Cerebral Infarction

Objective. To explore the effect of the comfortable intervention-based nursing mode under the quality nursing intervention combined with Internet mobile health on the quality of life (QOL) and psychological status of patients with acute cerebral infarction (ACI). Methods. 90 ACI patients treated in our hospital (June 2019-June 2020) were chosen and equally split into the experimental group (EG) and control group (CG) according to the order of admission. CG received routine nursing, while EG received the comfortable intervention-based nursing mode under the quality nursing intervention combined with Internet mobile health to compare the clinical indexes between the two groups. Results. Compared with CG, EG after intervention achieved obviously higher SS-QOL, ESCA, and GCQ scores ( $P<0.001$ ), and lower MSSNS and NIHSS scores ( $P<0.001$ ). Conclusion. The application of the comfortable intervention-based nursing mode under the quality nursing intervention combined with Internet mobile health effectively improves QOL and alleviates the negative emotions of patients. Compared with routine nursing, this model has higher application value, and further research of the joint intervention will help build better a solution for patients.

Outbreak of COVID-19: An emerging global pandemic threat

Since the first outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Wuhan, Hubei, China in December 2019, it is now recognized as a pandemic by the World Health Organization (WHO) as more than 200 countries and territories worldwide are affected with an increasing incidence. The SARS-CoV-2 infection results in a spectrum of non-specific signs and symptoms, ranging from asymptomatic infection, to flu-like illness such as fever, cough, dry cough and fatigue, to pneumonia, acute respiratory distress syndrome, and even multi-organ failures with high morbidity and mortality. SARS-CoV-2 is mainly transmitted through respiratory droplets that infected people exhale during incubation and onset period. By 12 June 2020, over 7.5 million confirmed cases of Coronavirus disease 2019 (COVID-19) with more than 421,000 deaths in the world have been reported to the WHO. No specific medication is approved to treat COVID-19, raising the urgent need for antiviral drug development. By 12 June 2020, there are over 1000 clinical trials registered in clinicaltrials.gov for treatment of COVID-19. This review summarizes the epidemiology, virology, clinical presentation, pathophysiology, diagnosis, and particularly the antiviral drugs currently under clinical trials for treatment of SARS-CoV-2 infection, together with the challenges and perspectives of this disease are also discussed.