Tropical and parasitic infections of the CNS

Related topics

• Eosinophilic meningitis
• Leprosy of the CNS
• Tropical and parasitic infections of the CNS
• Congenital infections of the CNS
• Retroviral infections and AIDS
• Bacterial meningitis

Main source

• Brett's Paediatric Neurology 3rd edition

Introduction

A large number of parasites may invade the brain and cause neurological dysfunction. Most parasitic infections are endemic to specific regions, and the possibility of infection with these organisms is usually indicated by a history of travel or residence in an endemic area. Specific questions to elucidate travel or exposure to tropical infections are essential in every child presenting with an unexplained illness.

Cerebral Malaria

Malaria remains one of the most important causes of childhood mortality and morbidity worldwide. The World Health Organization has estimated that at least one million children die of malaria annually in Africa alone (Zucker et al 1993[1]). The vast majority of deaths from malaria are due to cerebral malaria which is the most common, severe and potentially fatal complication of P.falciparumm infection.

In malarial endemic countries, cerebral malaria most commonly affects young children. However, in non-endemic areas, and in non-immune travellers who acquire malaria, cerebral malaria may occur at any age (Phillips et al 1990[2], Warrell 1989[3]). In the past it was assumed that most patients who recovered from acute cerebral malaria had no sequelae of the illness. However, there is increasing recognition that a significant proportion of the survivors are left with long-term neurological sequelae (Brewster et al 1990[4]). Cerebral malaria is therefore an important cause of long-term childhood neurological disability in many countries.

The clinical features of cerebral malaria are those of an acute febrile encephalopathic illness, and are overlapping with other infective and metabolic causes of childhood encephalopathy (Wright et al 1993[5], White et al 1992[6]). Cerebral malaria is diagnosed in patients with impaired consciousness who have malarial parasites detected in the peripheral blood. Convulsions alone are insufficient for the diagnosis of cerebral malaria, although they may herald the onset of cerebral malaria in a high proportion of cases (Phillips et al 1990[2], Molyneux 1989[7]).

In children with malaria who have suffered febrile convulsions, the possibility of cerebral malaria must always be considered if neurological abnormality persists or progresses 30 minutes after convulsions have stopped. The disease typically presents in children under 5 with fever, headache, malaise, anorexia and vomiting. Neurological signs are those of a diffuse encephalopathy with symmetrical upper motor neurone signs and brain stem disturbances, including dis-conjugate gaze, palsies, stertorous breathing, hypo or hypertonicity, upgoing extensor plantar responses and absent abdominal reflexes. Retinal haemorrhages may be preset, and decerebrate and decorticate posturing are seen in severe cases (Molyneux et al 1989[7], Lewallen et al 1993[8]). All of these features may be seen in bacterial and viral infections of the central nervous system or in metabolic disorders (Wright et al 1993[5], White et al 1983, 1992[6, 9]).

In malarial endemic areas there are two difficulties in the diagnosis of cerebral malaria. Firstly, malaria parasitaemia is common in otherwise healthy children, and the finding of peripheral blood parasitaemia in a child with neurological abnormalities does not exclude the possibility of other diagnoses such as bacterial meningitis. Conversely, occasional patients with cerebral malaria may not have detectable PP falciparum in the peripheral blood, due either to sequestration of the parasitized cells within the vas-culature, or due to previous antimalarial treatment. In such cases treatment for cerebral malaria must always be commenced without awaiting definite confirmation of the diagnosis (Wright et al 1993[5], White et al 1992[6]).

Lumbar puncture is generally required to exclude the possibility of bacterial meningitis but should not be performed if there are signs of raised intracranial pressure. The cerebrospinal fluid in cerebral malaria contains normal numbers of white cells, and normal or minimally elevated protein concentrations. CSF glucose may be depressed and CSF lactate increased (Molyneux et al 1989, White et al 1983[7, 9]). A number of clinical and laboratory features which are present on admission of children with cerebral malaria are predictive of severe disease and a poor outcome. Clinical signs associated with adverse outcome (death or sequelae) are profound coma, signs of decerebration, absence of corneal reflex, and convulsions at the time of admission. Laboratory findings predictive of a poor outcome are hypoglycaemia, leukocytosis, hyperparasitaemia, elevated plasma concentrations of alanine transferance, and elevated plasma or cerebrospinal fluid lactate (Molyneux et al 1989[7]).

Pathophysiology of cerebral malaria

A major impediment to the development of treatments to improve the prognosis of cerebral malaria, is our current inadequate understanding of the pathophysiology of the disorder. Early pathological studies suggested that cerebral malaria was associated with occlusion of cerebral capillaries by parasitized erythrocytes. These pathological findings led to the hypothesis that sequestration of parasitized cells in the cerebral capillary bed is a key initial step in the pathogenesis of cerebral malaria (MacPherson et al 1985[10], Aikawa et al 1990[11]). Although more recent pathological studies in fatal cases have confirmed that there are large numbers of parasitized red cells within cerebral capillaries, simple mechanical occlusion of the cerebral circulation by parasitized red cells is unlikely to explain the disorder (Phillips et al 1990, Aikawa et al 1990[11]). Adherence of parasitized red cells within the cerebral vasculature has also been observed in patients who have died without developing cerebral malaria; although there are greater numbers and increased density of parasitized red cells in the cerebral circulation of patients who have died of cerebral malaria than are found in those who die of other causes, a number of features argue against simple mechanical occlusion of the vasculature as the prime cause of the disorder. In contrast to the findings in thrombotic occlusion of the cerebral vasculature, diffuse encephalopathy rather than focal neurological abnormalities, are the usual manifestation of the disorder. Moreover, complete recovery of neurological function occurs in the majority of patients, including those who have been in deep coma, an outcome which would be unlikely if thrombotic occlusion of the vasculature had occurred. These observations have led to the suggestion that adherence of parasitized red cells to the cerebral vasculature is only one component of a more complex disorder leading to neurological dysfunction (Phillips et al 1990, Ho et al 1991[2, 12]).

Adherence of parasitized red cells to the endothelium has been shown to occur through specific knob-like projections from the surface of infected red cells (Nakamura et al 1992[13]). Binding of parasitized red cells can be inhibited by antibodies to the membrane surface molecules CD 36, and there is evidence that the intercellular adhesion molecule one (ICAM 1) is one of the receptors for parasitized cells on the endothelial surface (Nakamura et al 1992[13], Barnwell et al 1989[14], Ockenhouse et al 1992[15]).

Thrombospondin is an additional candidate receptor for parasitized cells (Ockenhouse et al 1989[16]). It has been suggested that cyto-kines such as tumour necrosis factor, released during malaria infection, may increase expression of ICAM 1, and facilitate increased adherence of parasitized cells within the cerebral circulation (Johnson et al 1993[17], Clark et al 1989[18]). The mechanisms by which parasitized red cells within the cerebral circulation alter brain function remain unclear. Release of parasite or host toxins is postulated to be responsible for altering the blood brain barrier, inducing cerebral oedema, and impairing cerebral metabolism. Candidate toxic mediators included malaria derived endotoxin-like factors, kinins, cytokines such as tumour necrosis factor, and nitric oxide (Clark et al 1989[19], 1992). Tumour necrosis factor (TNF) levels have been shown to be increased in children with a severe malaria and are higher on admission in those who died as compared with survivors (Kwiatkowski et al 1990[20]). Increased interleukin I levels also correlate positively with poor outcome (Kwiatkowski et al 1990[20], Grau et al 1989[21]). It is unclear whether TNF is simply a marker of severity of the inflammatory process leading to cerebral malaria or a specific mediator of that process.

Metabolic factors are increasingly implicated in the pathophysiology of cerebral malaria. Hypoglycaemia is found in almost a third of children with cerebral malaria and children who are hypoglycaemic on admission are at significantly greater risk of death from the development of neurological sequelae (Molyneux et al 1989[7], Arya et al 1989[22]). Hypoglycaemia has been associated with depth of coma, and elevated levels of lactate (Molyneux et al 1989[7]). Lactate concentrations in venous plasma and cerebrospinal fluid are significantly higher in patients with poorer outcome than in those making a full recovery. Plasma insulin concentrations are appropriately low suggesting that inhibition of gluconeogenesis is the most likely mechanism responsible (Molyneux et al 1989[7], Arya et al 1989[22], Kawo et al 1990[23]). Competition between parasites and host cells for essential nutrients may contribute to the metabolic derangement, but alternatively release of toxic metabolites which impair brain cell metabolism may also occur (Phillips et al 1990[2]).

Evidence for the presence of cerebral oedema and impaired blood-brain barrier function in children with cerebral malaria is conflicting. Studies in adult cerebral malaria in Thailand did not detect signs of cerebral oedema (Warrell 1989[3], Looareesuwan et al 1983[24]) and opening CSF pressures were usually normal. Isotope studies of the blood CSF barrier showed no evidence of increased permeability in Thai adults with cerebral malaria. In contrast, more recent studies on children in Africa have documented elevated CSF opening pressures during lumbar puncture, and clinical features suggestive of brain stem herniation in children with severe cerebral malaria (Newton et al 1991[25]). Further physiological studies are required to resolve the pathophysiology of the disorder.

Treatment of cerebral malaria

In childhood malaria death can occur within hours of the onset of illness. Antimalarial drugs are the only specific therapy known to arrest the infection, and children sus pected of having cerebral malaria must be given the best available antimalarials via the parenteral route as quickly as possible. Specific therapy should not be delayed if cerebral malaria is suspected but cannot be ruled out by appropriate investigations. Because of the worldwide spread of chlo-roquine resistant P fji in most countries parenteral quinine is recommended for patients with cerebral malaria (Hoffman 1986[26]). In countries with low levels of chlo-roquine resistance, chloroquine is often given to patients with uncomplicated malaria, with quinine being reserved for those with severe malaria. Even with parenteral administration, quinine may take up to 48 hours to achieve desirable plasma concentrations and a loading dose is frequently recommended (White et al 1983[9]).

Quinine dyhy-drochloride is given in a dose of 20 mg salt (16.7 mg base) per kg body weight by intravenous infusion over 4 hours as a loading dose, followed by 10 mg salt (8.3 mg base) per kg infused over 4 hours every 12 hours until the patient has regained consciousness. Quinidine gluconate is used as an alternative to quinine in some countries (Phillips et al 1985[27]). Quinine may be given by intramuscular route if intravenous access is difficult. Careful monitoring of blood glucose is required, although hyperinsulinaemia has rarely been documented during the treatment of children with cerebral malaria. Quinine does not result in rapid parasite clearance, and many regimes utilize additional antimalarial agent such as pyrimethamine sulfadoxine or mefloquine to ensure parasite killing once consciousness has been regained. A number of new antimalarial agents have been evaluated for use in cerebral malaria, particularly in regions where multidrug-resistant parasites are increasingly found. The artemethrin derivative artemether developed in China from the traditional remedy Quinghaosu is among the most promising new antimalarial drugs (Shwe et al 1989[28]). In studies in Malawai, artemether was found to clear para-sitaemia more rapidly than quinine and was associated with more rapid recovery from coma (Taylor et al 1993[29]). Further trials are required to establish whether this agent is associated with improved survival. In areas of the world with increasing resistance to quinine, such as the Thai-Burmese border, combination regimes of quinine with tetracycline or cotrimoxazole may be required.

As in any comatose patients, successful outcome of patients with cerebral malaria depends on control of convulsions, with particular attention to fluid and electrolyte balance, maintenance of the airway, and good nursing care. The vast majority of patients with cerebral malaria are treated in hospitals with minimal facilities for intensive medical support. Patients with cerebral malaria in more developed countries are treated with full intensive care support, with elective ventilation and optimization of cerebral perfusion to reduce raised intracranial pressure. A wide number of adjunctive agents have been suggested as being beneficial in the treatment of cerebral malaria, including corticosteroids, heparin, mannitol, low molecular weight dextran, prostacyclin, tumour necrosis factor antibodies, and desferrioxamine. Most of these agents have not been subjected to controlled clinical trials or clinical trials have shown no benefit. However, a recent randomized double blind placebo-controlled trial of iron chelation therapy with desferrioxamine documented more rapid resolution of coma, and increased parasite clearance in patients receiving desferrioxamine (Gordeuk et al 1992[30]). Further trials of this and other experimental agents such as antitumour necrosis factor antibodies are required before any specific recommendations can be made.

Prognosis

The mortality rates for patients admitted with cerebral malaria range from 6-30% in different series. Some of the variations in mortality may be explained by differences in the criteria for diagnosis (Molyneux et al 1989[7]). Although in the past survivors of cerebral malaria were thought to have an excellent prognosis for full neurological recovery, more recent studies from several countries have documented a significant rate of long-term neurological sequelae (Brewster et al 1990, Molyneux et al 1989[4, 7]). Approximately 10% of survivors may suffer neurological defects including hemiplegia, ataxia and generalized motor defects, with spasticity or hypotonia. There have been no detailed studies of long-term effects on intellect or later development and it is likely that an even greater proportion of the survivors may have suffered more subtle long-term consequences. Persistance of neurological abnormalities is associated with the same poor prognostic features which are predictive of increased mortality.

Hydatid disease

The larval stages of several species of Echinococcus may invade the tissues of man, and develop into cysts. Humans are infected by ingestion of food or drink contaminated by faeces of the definitive hosts, usually dogs. The eggs of the Echinococcus hatch in the lumen of the intestine, and the larvae burrow through the tissues and enter the portal circulation, from where they are disseminated to other organs, including the lungs and brain. The disease is prevalent in both tropical and temperate climates where dogs, sheep and man coexist; the highest morbidity from hydatid infection occurs in Kenya and Uganda, and sheep-rearing countries of South America (Turner 1987[31]).

CNS hydatid disease is more common in children than in adults. The cysts may be single or multiple, and cause symptoms by compression of surrounding structures. The symptoms and signs are those of raised intracranial pressure. The diagnosis of intracranial hydatid disease is usually made on CT scan. Calcification of the cyst wall is rarely seen in children as it takes more than two decades to develop (McIntyre 1971[32]). The appearance on CT scan of a hydatid cyst in a 4-year-old boy is shown in Figure 22.18

Fig 22.18

.

The diagnosis may be confirmed by the Casoni test, which elicits a delayed-type hypersensitivity reaction on injection of hydatid fluid into the dermis. The test has been largely replaced by serological tests to detect the presence of antibodies or antigens using complement fixation, indirect haemagglutination or immuno-electrophoresis. IgE levels are usually elevated and may be useful in monitoring the course of the disease. Treatment is usually surgical if the cyst is causing significantly raised intracranial pressure (Carrera et al 1975[33]). Chemotherapy with mebendazole has not been very effective, but albendazole may be more effective.

Cysticerosis

Cysticerosis is one of the commonest parasitic infection of the CNS, and is endemic in central and south America,south-east Asia, India and parts of Africa. The disease is caused by the encysted larval form of Taenia solium, the pork tapeworm. The pig is the intermediate host and harbours the larvae, and infection is acquired by ingestion of undercooked pork, containing the viable cysticerci. The embryos are liberated in the intestine, enter the bloodstream and are carried to the tissues, including the brain. Living cysticerci produce little inflammatory reaction, but when the parasite dies an immune response is elicited which causes marked inflammation and oedema. The dead organisms are absorbed, sometimes leaving a calcified granuloma (Dawood & Moosa 1984[34]).

The symptoms of neurocysticerosis include epilepsy, with or without focal neurological signs. Symptoms of raised intracranial pressure, meningoencephalitis or hydro-cephalus may also occur.

The diagnosis is usually made on the basis of the typical CT scan appearance. Enhancing ring lesions 5-20 mm in diameter are usually located in the cortex or at the grey-white junction. Surrounding oedema is commonly seen. Calcification occurs in resolving lesions, and inactive calcified lesions are also found. A punctuate high density due to the scolex is seen within the ring-enhancing area in about half of the patients. There is often a discrepancy between the severity of the CT scan appearances and the relatively healthy appearance of the child. The diagnosis may be confirmed serologically in most cases, using the newer enzyme-linked immunosorbent assays. Both serum and CSF should be tested, but false negatives do occur (Earnest et al 1987[35]).

There is considerable debate as to the role of antiparasitic treatment with praziquantel (Moodley & Moosa 1989[36]). Several reports suggest that the size of the cysts is decreased by treatment. However, treatment may result in severe inflammatory reactions around the dying cysts, necessitating steroid treatment to reduce cerebral oedema. Reports of spontaneous resolution of clinical signs and CT scan appearances have led some authorities to advocate treatment with anticonvulsants alone, as the disorder has a benign prognosis even without antiparasitic treatment (Mitchell & Crawford 1988[37]). Surgical intervention may occasionally be required to relieve hydrocephalus.

Other parasitic infections

The brain may also be invaded by nematodes, including Toxocara, Trichinella, Strongyloides and the rat lung worm Angiostronglus cantonensis. Toxocara may cause a syndrome of wheezing and eosinophilia, and occasionally infects the eye, leading to blindness. The infection is most common in toddlers, and occasionally may present as a meningoencephalitis (Huntley et al 1965, Glickman & Schantz 1981).

Trichinella spiralis, which is acquired by consumption of undercooked pork, usually causes disease of the skeletal muscles, but occasionally induces encephalitis or meningitis (Kramer & Aita 1972[38]). Strongyloides stercoralis causes a severe disseminated disease in immunocompromised hosts, but can also cause an allergic meningoencephalitis.

The trematode infections include schistosomiasis and Paragonimus westermani (lung fluke). Many millions of individuals in Africa, South America and Asia are affected by schistosomiasis. Invasion of the cerebral circulation with Schistosoma japonicum or S. mansoni may result in granu-lomatous inflammation of the white and grey matter (Marcial-Rojas & Fiol 1963[39], Lechtenberg & Vaida 1977[40]). The lung fluke Paragonimus westermani occurs primarily in the Orient, and may occasionally cause meningitis or space-occupying lesions in the CNS (Oh 1968). Most affected patients have abnormal chest X-rays and peripheral blood eosinophilia.

Trypanosomiasis

Both American and African trypanosomiasis cause neurological disease. In south America the acute forms of infection with Trypanosoma cruzi are more frequent in children, especially in the very young. The primary lesion of the skin (chagoma) is often present. There is fever with a generalized lymphadenopathy and local oedema, which can become generalized. Hepatosplenomegaly and myocarditis are other features which may develop. Rarely, meningoen-cephalitis can occur in the acute stage, and can be associated with focal or generalized seizures. The chronic form of Chagas' disease is usually seen in adults. Treatment in the acute stage with the nitrofuran compound nifurtiniox has been claimed to be effective. Congenital Chagas' disease may resemble the multisystem involvement which can occur in congenital Toxoplasma gondii, cytomegalovirus or neonatal herpes simplex infections (Bittencourt 1976[41]). Trypanosomes can be seen in the CSF in such infections. African trypanosomiasis, the result of infection with Trypanosoma rhodesiense or gambiense, does not behave differently in the child. The former is the more acute and may be a fulminating infection. Both can have a short incubation period of 1-2 weeks, but Tgambiense may be considerably longer. A nodule develops at the site of the infected bite and then a recurrent febrile illness occurs. In T gambiense infection, severe headaches can be followed by deterioration in the mental state. Tremors and fits are late manifestations, then coma ensues. If the course of the illness in T rhodesiense infection is rapid, as in epidemic disease, there may be little evidence of involvement of the nervous system, but mild pleocytosis and elevated protein are usually present in the CSF. Endemic disease is stated to be more prolonged and tremors of the limbs more common. Treatment early in these infections with metarsoprol and antyprol (suramin) is often curative but re-treatment may be required (Winner 1987[42]).

Amoebic meningoencephalitis

Infection with amoebae of the genus Naegleria is acquired from exposure to fresh waters contaminated with these free-living amoebae. The amoeba Naegleria fowleri grows rapidly as water temperature rises to 37-45°C, but the risk of infection from infected water is remote. Entry to the nervous system is thought to occur via the olfactory epithelium. The disease, which usually affects children and young adults, presents as an acute fulminating, meningoencephalitis which is usually fatal within 7 days. There is usually a history of swimming in fresh warm water 1-2 weeks previously. The CSF contains several hundred white cells which are mainly polymorphs; the protein is usually increased and the glucose decreased. Motile amoebae may be seen in cultured CSF and may be identified in brain tissue at post mortem by immunohistological techniques. Treatment has rarely been effective but success has been achieved using intravenous and intrathecal amphotericin B and miconazole, together with oral rifampicin. The infection is very rare in the UK (Cain et al 1981[43]) but should be suspected in children who are severely ill with 'pyogenic' meningitis, in whom no bacteria are visible on staining.

In immunosuppressed patients, a chronic form of amoebic meningitis is caused by the genus Acanthamoeba and is presumed to be caused by spread to the nervous system from another site in the body, rather than being acquired from an environmental source such as infected water.

Rarely, disseminated disease is caused by Entamoeba histolytica, with multiple abscesses of the liver and lung predominantly; cerebral abscesses and meningoencephalitis may complicate the infection in patients of this type.

The protozoon Toxoplasma gondii causes extensive disease of the nervous system when acquired prenatally as a primary infection during pregnancy. One of the hallmarks of infection is chorioretinitis. It is generally accepted that eye disease is always the result of prenatal infection even though it may make its appearance several years after birth. Postnatal infection very rarely causes disease of the nervous system, but takes the form of acute meningoencephalitis with some elevation of the protein and mild lymphocytic pleocytosis (Koeze & Klingon 1964[44]).

References

1. Zucker J R, Campbell C C 1993 Malaria: principles of prevention and treatment. Infectious Diseases Clinics of North America 7(3): 547-567
4. Brewster D R, Kwiatkowski, D, White N J 1990 Neurological sequelae of cerebral malaria in children. Lancet 336 (8722): 1039-1043

5. Wright P W, Avery W G, Ardill W D et al 1993 Initial clinical assessment of the comatose patient: cerebral malaria vs. meningitis. Pediatric Infectious Disease Journal 12(1): 37-41

6. White N J, Krishna S, Looareesuwan S 1992 Encephalitis, not cerebral malaria, is likely cause of coma with negative blood smears [letter]. Journal of Infectious Diseases 166(5): 1195-1196

7. Molyneux M E, Taylor T E, Wirima J J et al 1989 Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children [see comments]. Q Journal of Medcine 71 (265): 441-459

8. Lewallen S, Taylor T E, Molyneux M E et al 1993 Ocular fundus findings in Malawian children with cerebral malaria. Ophthalmology 100(6): 857-861

9. White N J, Looareesuwan S, Warrell D A et al 1983 Quinine loading dose in cerebral malaria. American Journal of Tropical Medicine and Hygiene 32(1): 1-5

9. White N J, Warrell D A, Chanthavanich P et al 1983 Severe hypoglycemia and hyperinsulinemia in falciparum malaria. New England Journal of Medicine 309(2): 61-66

11. Aikawa M, Iseki M, Barnwell J W et al 1990 The pathology of human cerebral malaria. American Journal of Tropical Medicine Hygiene

12. Ho M, Singh B, Looareesuwan S, Davis T M et al 1991 Clinical correlates of in vitro Plasmodium falciparum cytoadherence. Infectious Immunology 59(3): 873-878

13. Nakamura K, Hasler T, Morehead K et al 1992 Plasmodium falciparum- infected erythrocyte receptor(s) for CD36 and thrombospondin are restricted to knobs on the erythrocyte surface. Journal of Histochemistry and Cytochemistry 40(9): 1419-1422

14. Barnwell J W, Asch A S, Nachman R L et al 1989 A human 88-kD membrane glycoprotein (CD36) functions in vitro as a receptor for a cytoadherence ligand on Plasmodium falciparum-infected erythrocytes. Journal of Clinical Investigation 84(3): 765-772

15. Ockenhouse C F, Tegoshi T, Maeno Y et al 1992 Human vascular endothelial cell adhesion receptors for Plasmodium falciparum- infected erythrocytes: roles for endothelial leukocyte adhesion molecule 1 and vascular cell adhesion molecule 1. Journal of Experimental Medicine 176(4): 1183-1189

16. Ockenhouse C F, Tandon N N, Magowan C et al 1989 Identification of a platelet membrane glycoprotein as a falciparum malaria sequestration receptor [see comments]. Science 243(4897): 1469-1471

17. Johnson J K, Swerlick R A, Grady K K et al 1993 Cytoadherence of Plasmodium falciparum-infected erythrocytes to microvascular endothelium is regulatable by cytokines and phorbol ester. Journal of Infectious Diseases 167(3): 698-703

18. Clark I A, Chaudhri G, Cowden W B 1989 Roles of tumour necrosis factor in the illness and pathology of malaria. Transcriptions of Royal Society Tropical Medicine and Hygiene 83(4): 436-440

19. Clark I A, Rockett K A, Cowden W B 1992 Possible central role of nitric oxide in conditions clinically similar to cerebral malaria. Lancet 340(8824): 894-896

20. Kwiatkowski D, Hill A V, Sambou I et al 1990 TNF concentration in fatal cerebral, non-fatal cerebral, and uncomplicated Plasmodium falciparum malaria. Lancet 336(8725): 1201-1204

21. Grau G E, Taylor T E, Molyneux M E et al 1989 Tumor necrosis factor and disease severity in children with falciparum malaria. New England Journal of Medicine 320(24): 1586-1591

22. Arya T V, Prasad R N, Bhandari S et al 1989 Spontaneous and quinine induced hypoglycaemia in severe falciparum malaria. Tropical Geography and Medicine 41(1): 73-75

23. Kawo N G, Msengi A E, Swai A B et al 1990 Specificity of hypoglycaemia for cerebral malaria in children [see comments]. Lancet 336(8713): 454-457

25. Newton C R, Kirkham F J, Winstanley P A et al 1991 Intracranial pressure in African children with cerebral malaria [see comments]. Lancet 337(8741): 573-576

26. Hoffman S L 1986 Treatment of malaria. Clinics in Tropical Medicine and Communicable Diseases 1: 171-224

27. Phillips R E, Warrell D A, White N J et al 1985 Intravenous quinidine for the treatment of severe falciparum malaria. Clinical and pharmacokinetic studies. New England Journal of Medicine 312(20): 1273-1278

28. Shwe T, Myint P T, Myint W et al 1989 Clinical studies on treatment of cerebral malaria with artemether and mefloquine. Transcripitions of the Royal Society of Tropical Medicine and Hygiene 83(4)

29. Taylor T E, Wills B A, Kazembe P et al 1993 Rapid coma resolution with artemether in Malawian children with cerebral malaria. Lancet 341(8846):661-662

30. Gordeuk V, Thuma P, Brittenham G et al 1992 Effect of iron chelation therapy on recovery from deep coma in children with cerebral malaria [see comments] New England Journal of Medicine 327(21): 1473-1477

31. Turner J A 1987 Cestodes. In: Cherry J D, Feigin R J (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 2110-2124

32. McIntyre A 1971 Hydatid disease in children in South Australia. Medical Journal of Australia 1: 1064-1065

33. Carrera R, Dowling E, Guevara J 1975 Surgical treatment of hydatid cysts of the central nervous system in the pediatric age. Child's Brain 1: 4-21

34. Dawood A A, Moosa A 1984 Cerebral cysticercosis in children. Journal of Tropical Paediatrics 30: 136-139

35. Earnest M P, Barth Relier L, Filley C M et al 1987 Neurocysticercosis in the United States: 35 cases and a review. Reviews of Infectious Diseases 9: 9617-9619

36. Moodley M, Moosa A 1989 Treatment of neurocysticercosis: is praziquantel the new hope? Lancet: 262-263

37. Mitchell W G, Crawford T 0 1988 Intraparenchymal cerebral cysticercosis in children: diagnosis and treatment. Pediatrics 82: 76-82

38. Kramer M D, Aita J F 1972 Trichinosis with central nervous system involvement. Neurology 22: 485-491

40. Lechtenberg R, Vaida G A 1977 Schistosomiasis of the spinal cord. Neurology 27: 55-59

41. Bittencourt A L 1976 Congenital Chagas disease. American Journal of Diseases of Children 130: 97-103

42. Winner M 1987 Trypanosomiasis. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 2079-2087

43. Cain A R, Wiley P F, Brownell R et al 1981 Primary amoebic meningoencephalitis. Archives of Disease in Childhood 56: 140-143

44. Koeze T H, Klingon G H 1964 Acquired toxoplasmosis. Archives of Neurology 11: 191-197

45. Abbott J D, Jones D M, Painter M J et al 1985 The epidemiology of meningococcal infections in England and Wales 1912-1983. Journal of Infection 11: 241-257

46. Abramovitz P, Schuartzman P, Harel D et al 1987 Direct invasion of the central nervous system by Mycoplasma pneumoniae: a report of two cases. Journal of Infectious Diseases 155: 482-487

47. Adams J M, Kenny J D, Rudolph A J 1979 Modern management of tetanus neonatorum. Pediatrics 64: 472-477

48. Alford C A, Stagno S, Pass R 1980 Natural history of perinatal cytomegaloviral infection. In: Perinatal infections. Ciba Symposium 77: 125-147

49. Alkalay A L, Pomerance J J, Rimoin D C 1987 Fetal varicella syndrome. Journal of Pediatrics 11 1: 320-323

50. American Academy of Pediatrics 1991 Report of the Committee of Infectious Diseases, Elk Grove Village, Illinois. Leprosy 290-292

51. American Academy of Pediatrics 1994 Report of the Committee of Infectious Diseases, Elk Grove Village, Illinois, 23rd edn. Herpes simplex 242-252

52. American Academy of Pediatrics 1994 Report of the Committee on Infectious Diseases, Elk Grove Village Illinois, 23rd edn. Tuberculosis, 480-500

53. Ames M D, Plotkin S A, Winchester R A et al 1970 Central auditory imperception: a significant factor in congenital rubella deafness. Journal of the American Medical Association 1970: 419-421

54. Anders B J, Laurer B A, Foley L C 1980 Computerised tomography to define CNS involvement in congenital cytomegalovirus infection. American Journal of Diseases of Children 134: 795-797

55. Anderson J R 1988 Viral encephalitis and its pathology. Current Topics in Pathology 76: 23-60

56. Andiman W A 1986 Lyme disease: epidemiology, etiology, clinical spectrum, diagnosis and treatment. Advances in Pediatric Infectious Disease 1: 163-186

57. Anonymous Editorial 1992 Ocular complications in leprosy. Lancet 340:642-643

58. Arditi M, Manogue K R, Caplan M et al 1990 Cerebrospinal fluid cachectin/tumor necrosis factor-a and platelet activating factor concentrations and severity of bacterial meningitis in children. Journal of Infectious Diseases 162: 139-147

59. Arnon S S 1980 Infant botulism. Annual Reviews in Medicine 31:541-560

60. Aszkenazy 0 M, George R C, Begg N T 1995 Pneumococcal bacteraemia and meningitis in England and Wales 1982-1992. Communicable Disease Report 5: R45-50

61. Aurelius E, Johansson B, Skoldenberg B et al 1991 Rapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid. Lancet. 337: 189-192

62. Austrian R, Lukens J, Seeler R A 1972 Pneumococcal infections in sickle cell anemia. American Journal of Disease in Childhood 123: 614-615

63. Baker C J 1971 Primary spinal epidural abscess. American Journal of Diseases of Children 121: 337-339

64. Band J D, Clegg H W, Hayes P S 1981 Transmission of group B streptococci: traced by use of multiple epidemiologic markers. American Journal of Diseases in Children 135: 355-358

65. Bare D U, Wood R P, Stears et al 1985 Subarachnoid space: middle ear pathways and recurrent meningitis. American Journal of Otology 6:157-163

66. Bastian F 0, Rabson A S, Lee C Y et al 1972 Herpes virus hominis: isolation from human trigeminal ganglion. Science 178: 306-307

67. Bayston R 1989 Hydrocephalus shunt infections. Chapman & Hall, London

68. Bellman M H, Dick G 1980 Surveillance of subacute sclerosing panencephalitis. British Medical Journal 2: 393-394

69. Belman A L, Lantos G, Horoupian D et al 1986 AIDS: calcification of the basal ganglia in infants and children. Neurology 36: 1192-1199

70. Belman A L, Ultmann M H, Horoupian D et al 1985 Neurological complications in infants and children with acquired immune deficiency syndrome. Annals of Neurology 18: 560-566

71. Bergen D, Grossman H 1976 Infectious mononucleosis as a cause of acute cerebellar ataxia of childhood. Developmental Medicine and Child Neurology 18: 799-802

72. Berger J R, Kaszovitz B, Donovan-Post M J et al 1987 Progressive multifocal leukoencephalopathy associated with human immunodeficiency virus: a review of the literature with a report of sixteen cases. Annals of Internal Medicine 107: 78-87

73. Berkowitz F 1989 Bacterial exotoxins: how they work. Pediatric Infectious Disease Journal 8: 42-47

74. Bernstein L J, Krieger B Z, Novick B 1985 Bacterial infection in the acquired immunodeficiency syndrome of children. Pediatric Infectious Diseases 4: 472-475

75. Bhagavati S, Ehrlich G, Kula R W et al 1988 Detection of human T cell lymphoma/leukemia virus type I DNA and antigen in spinal fluid and blood of patients with chronic progressive myelopathy. New England Journal of Medicine 318: 1141-1147

76. Bhagwati S N, Parulekar G D 1986 Management of intracranial tuberculoma in children. Child's Nervous System 2: 32-34

77. Bierman F Z, Gersony W M 1987 Kawasaki disease, clinical perspective. Journal of Pediatrics II 1: 789-792

78. Blake K, Pillay D, Knowles W et al 1992 JC virus associated meningoencephalitis in an immunocompetent girl. Archives of Disease in Children 67: 956-957

79. Boom W H, Tuazon C U 1985 Successful treatment of multiple brain abscess with antibiotics alone. Reviews of Infectious Diseases 7: 189-199

80. Borchelt D R. Taraboulos A Prusiner S B 1992 Evidence for synthesis of scrapie prion proteins in the endocytic pathway. Journal of Biological Chemistry 267: 6188-6199

81. Bouma G J, Muizelaar J P 1990 Relationship between cardiac output and cerebral blood flow in patients with intact and impaired autoregulation. Journal Neurosurgery 73: 368-374

82. Brenneman D E, Westbrook G L, Fitzgerald S P et al 1988 Neuronal cell killing by the envelope protein of HIV and its prevention by vasoactive interstinal peptide. Nature 335: 639-642

83. Brew B J, Price R W 1988 Another retroviral disease of the nervous system: chronic progressive myelopathy due to HTLV-1. New England Journal of Medicine 318: 1195-1197

84. Brisson-Noel A, Aznar C, Chureau C et al 1991 Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation. Lancet 338:364-366

85. Britt R H, Enzmann D R 1983 Clinical stages of human brain abscesses on serial CT scans after contrast infusion: computerized tomographic, neuropathological and clinical correlations. Journal of Neurosurgery 59:972-989

86. Brody J A, Detels R 1970 Subacute sclerosing panencephalitis: a zoonosis following aberrant measles. Lancet 2: 500-501

87. Broome C V 1989 Epidemiology of toxic shock syndrome in the United States: overview. Reviews of Infectious Diseases 11 (suppl): 14-21

88. Broughton C R 1964 Morbilli in Sydney 11. Neurological sequelae of morbilli. Medical Journal of Australia 908-915

89. Brown R E 1967 Prevention of leprosy: new ideas out of Africa. Clinical Pediatrics (Phila) 6: 446-450

90. Browne S G 1965 Some less common neurological findings in leprosy. Journal of Neurological Science 2: 253-261

91. Brunell P A, Kotchmar G S 1981 Zoster in infancy: failure to maintain virus latency following intrauterine infection. Journal of Pediatrics 98:71-73

92. Buchanan C R, Preece M A, Milner R D G Mortality, neoplasia and Creutzfeldt-Jakob disease in patients treated with pituitary growth hormone in the United Kingdom. British Medical Journal 302:824-828

93. Bullock W E 1968 Studies of immune mechanisms in leprosy. Depression of delayed allergic responses to skin test antigens. New England Journal of Medicine 278: 298-301

94. Bullock W E 1990. Mycobacterium leprae In: Mandel C L (ed.) Principles and practice of infectious diseases. Douglas

95. Burgdorfer W,Barbour A G, Hayes S F et al 1982 Lyme disease: a tick borne spirochetosis. Science 216: 1317-1319

96. Burman L A, Norrby R, Trollfors B 1985 Invasive pneumococcal infections: incidence, predisposing factors and prognosis. Reviews of Infectious Dieases 7: 133-142

97. Burroughs M, Cabellos C, Prasad S et al 1992 Bacterial components and the pathophysiology of injury to the blood-brain barrier: does cell wall add to the effects of endotoxin in gram-negative meningitis? Journal of Infectious of Disease 165: S82-85

98. Burroughs M, Prasad S, Cabellos C et al 1993 The biologic activities of peptidoglycan in experimental Haemophilus influenzae meningitis. Journal of Infectious Disease 167: 464-468

99. Carter A 0, Frank J W 1986 Congenital toxoplasmosis: epidemiologic features and control. Canadian Medical Association journal 135:618-623

100. Celermajer J M, Brown J 1966 The neurological complications of pertussis. Medical Journal of Australia 1: 1066-1069

101. Chang K H, Han M H, Roh J K et al 1990 Gd-DTPA-enhanced MR imaging of the brain in patients with meningitis: comparison with CT American journal of Neurological Research 154: 69-76

102. Cherry J D 1987a Aseptic meningitis and viral meningitis. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 478-484

103. Cherry J D 1987b Enteroviruses: polioviruses (poliomyelitis, Coxsackieviruses, echoviruses and enteroviruses). In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 1729-1790

104. Cherry J D, Shields W D 1987 Encephalitis and meningoencephalitis. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 484-496

105. Chesebro B, Race R, Wehrly K et al 1985 Identifications of scrapie prion protein-specific mRNA in scrapie-infected and uninfected brain. Nature 315: 331-333

106. Chesney J C, Hodgson G E 1980 CSF eosinophilia during acute Coxsackie B4 viral meningitis. American Journal of Diseases in Children 134: 703

107. Chesney P J 1989 Clinical aspects and spectrum of illness of toxic shock syndrome: overview. Reviews of Infectious Disease II (suppl. 1): 1-7

108. Chesney P J, Chesney R W 1989 Hemorrhagic shock and encephalopathy: reflections about a new devastating disorder that affects normal children. Journal of Pediatrics 114: 254-256

109. Chesney P J, Ketcher M L, Nelson D B et al 1979 CSF eosinophilia in chronic lymphocytic choriomeningitis virus meningitis. Journal of Pediatrics 94: 750-752

110. Chess S 1971 Autism in children with congenital rubella. Journal of Autism and Childhood Schizophrenia 1: 33-47

111. Chin J 1990 Current and future dimensions of the HIV/AIDS pandemic in women and children. Lancet 336: 221-224

112. Clyde W A 1980 Neurological syndromes and mycoplasmal infections. Archives of Neurology 37: 65-66

113. Cobb W A, Morgan Hughes J A 1968 Non-fatal subacute sclerosing leucoencephalitis. Journal of Neurology, Neurosurgery and Psychiatry 31: 115-123

114. Cochi S L, Fleming D W, Hightower A W 1986 Primary invasive Haemophilus influenzae type B disease: a population-based assessment of risk factors. Journal of Pediatrics 108: 887-896

115. Communicable Diseases Report 1989 23:Communicable Diseases Surveillance Centre 1984 Virus meningitis and encephalitis 1978-1982.

116. Communicable Disease Report 39: 3-4 Communicable Diseases Report Weekly 1995 Notifications to OPCS of meningitis and meningococcal infections in England and Wales 5(52): 303

117. Congeni B L, Bradley J, Hammerschlag M R 1986 Safety and efficacy of once daily ceftriaxone for the treatment of bacterial meningitis. Pediatric Infectious Disease journal 5: 293-297

118. Connolly J H, Allen I V, Hurwitz L J et al 1967 Measles-virus antibody and antigen in subacute sclerosing panencephalitis. Lancet 1: 542-544

119. Cooper L Z 1985 The history and medical consequences of rubella. Reviews of Infectious Diseases 7 (suppl. 1): 52-510

120. Corey L, Whitley R J, Stone E F et al 1988 Difference between herpes simplex virus type 1 and type 2 neonatal encephalitis in neurological outcome. Lancet 1: 2-4

121. Costantino P, Viti S, Podda A et al 1992 Development and phase 1 clinical testing of a conjugate vaccine against meningococcus A and C. Vaccine 10: 691-698

122. Crawford C T 1968 Neurological lesions in leprosy. Leprosy Review 399: 9

123. Curless R G, Scott G B, Post M J et al 1987 Progressive cytomegalovirus encephalopathy following congenital infection in an infant with acquired immunodeficiency syndrome. Child's Nervous System 3: 255-257

124. Daffos F, Forestier F, Capella-Pavlovsky M, Thulliez P, Aufrant C, Valenti D, Cot W L 1988 Prenatal management of 746 pregnancies at risk for congenital toxoplasmosis. New England Journal of Medicine 318:271-275

125. Dalgleish A, Weiss R A 1987 Human retroviruses. In: Zuckerman A J, Banatvala J E, Pattison J R (eds) Principles and practice of clinical virology. Wiley, Chichester, pp 517-543

126. Damany B J 1982 Surgery in tuberculous meningitis. Progress in Pediatric Surgery 15: 181-185

127. Daniel T M 1988 Antibody and antigen for the immunodiagnosis of tuberculosis: Why not? What more is needed? Where do we stand? Journal of Infectious Diseases 158: 678-680

128. Daniel T M, Debanne S M 1987 The serodiagnosis of tuberculosis and other mycobacterial diseases by enzyme-linked immunosorbent assay. American Review of Respiratory Diseases 135: 1137-1151

129. Dash M S 1968 A study of the mechanisms of cutaneous sensory loss in leprosy. Brain 91: 379-392

130. Davis J M, David K R, Kleinman G M 1978 Computed tomography of herpes simplex encephalitis with clinicopathological correlation. Radiology 129: 409-417

131. Dawson J R 1934 Cellular inclusions in cerebral lesions of epidemic encephalitis. Archives of Neurology and Psychiatry 31: 685-700

132. De Louvois J, Gortvai P, Hurley R 1977 Bacteriology of abscesses of the central nervous system: a multicentre prospective study. British Medical journal 11: 981-984

133. De Nicola L K, Hanshaw J B 1979 Congenital and neonatal varicella. Journal of Pediatrics 94: 175-176

134. De Wals P, Hertoghe L, Borlee-Grimee I et al 1981 Meningococcal disease in Belgium. Secondary attack rate amongst household, day-care nursery and pre-elementary school contacts. Journal of Infection 3 (suppl. 1): S53-61

135. Dean j M, Rogers M C, Traystman R J 1992 Pathophysiology and clinical management of the intracranial vault. In: Rogers M C (ed.) Textbook of pediatric intensive care. Williams & Wilkins, Baltimore, pp 639-666

136. DeCarli C, Fugate K, Falloon J et al 1991 Brain growth and cognitive improvement in children with human immunodeficiency virus- induced encephalopathy after 6 months of continuous infusion zidovudine therapy. Journal of Acquired Immune Deficiency Syndrome 4: 585-592

137. Desmond M M, Fisher E S, Vordeman A L et al 1978 The longitudinal course of congenital rubella encephalitis in non-retarded children. Journal of Pediatrics 93: 584-591

138. Desmond M M, Wilson G S, Melnick J L et al 1976 Congenital rubella encephalitis. Journal of Pediatrics 71: 311-331

139. Desmonts G, Couvreur J 1975 Toxoplasmosis: epidemiologic and serologic aspects of perinatal infections. In: Krugman S, Gershon A A (eds) Infections of the fetus and the newborn infant. Liss, New York, vol 3, p 118

140. Deutman A F, Grizzard W S 1978 Rubella retinopathy and subretinal neovascularization. American Journal of Ophthalmology 85: 82-87

141. Dezateux C, Dinwiddie R J 1986 Dangers of lumbar puncture. British Medical journal I: 827-828

142. Dismukes W E 1988 Cryptococcal meningitis in patients with AIDS. Journal of Infectious Diseases 157: 624-628

143. Doane F W, Anderson N, Chatiyanonda K et al 1967 Rapid laboratory diagnosis of paramyxovirus infections by electron microscopy. Lancet 2: 751-753

144. Dodge P R, Swartz M N 1965 Bacterial meningitis: a review of selected aspects. 11: Special neurological problems, post-meningitic complications and clinicopathological correlations. New England Journal of Medicine 272: 1003-1010

145. Doern G V 1995 Resistance among respiratory pathogens in paediatrics. Paediatric Infectious Diseases journal. 14: 420-423

146. Dowell V R 1984 Botulism and tetanus: selected epidemiologic andmicrobiologic aspects. Reviews of Infectious Diseases 6 (suppl. 1): 5202-5207

147. Dudgeon J A 1967 Maternal rubella and its effect on the foetus. Archives of Disease in Childhood 42: 110-125

148. Dreyer E B, Kaiser P K, Offerman J T et al 1990 HIV -1 coat protein neurotoxicity prevented by calcium channel antagonists. Science 248:364-367

149. Duffy G P 1969 Lumbar puncture in the presence of increased intracranial pressure. British Medical Journal I: 407-409

150. Editorial 1985 Haemorrhagic shock and encephalopathy. Lancet 2:535-536 Editorial 1988 Penicillin resistant pneumococci. Lancet: 1142-1143

151. Ellard G A, Humphries M J, Allen B W. 1993 Cerebrospinal fluid concentrations and the treatment of tuberculous meningitis. Am Rev Respir Dis. 148: 650-655

152. Ellison R T, Kohler P F, Curd J G 1983 Prevalence of congenital or acquired complement deficiency in patients with sporadic meningococcal disease. New England Journal of Medicine 308:913-916

153. Enders G 1985 Serologic test combinations for safe detection of rubella infections. Reviews of Infectious Diseases 7 (suppl. 1): 5113-5122

154. Epstein L G, Sharer L R, Joshi V V et al 1985 Progressive encephalopathy in children with acquired immune deficiency syndrome. Annals of Neurology 17: 488-496

155. Epstein L G, Sharer L R, Oleske J M et al 1986b Neurologic manifestations of human immunodeficiency virus infection in children. Pediatrics 78: 678-687

156. Eraklis A J, Kevij S V, Diamond L K 1967 Hazard of overwhelming infection after splenectomy in childhood. New England Journal of Medicine 276: 1225-1229

157. Escobar J A, Belsey M A, Duenas A et al 1975 Mortality from tuberculous meningitis reduced by steroid therapy. Pediatrics 56: 1050-1055

158. Eskola J, Peltola H, Takala A K 1987 Efficacy of Haemophilus influenzae type B polysaccharide-diphtheria toxoid conjugate vaccine in infancy. New England Journal of Medicine 317: 717-722

159. European Collaborative Study 1992 Risk factors for mother-to-child transmission of HIV 1. Lancet 339: 1007-1012.

160. Fallon R J, Kennedy D H 1981 Treatment and prognosis in tuberculous meningitis. Journal of Infection 3 (suppl. 1): 39-44

161. Feigin R D 1987 Bacterial meningitis beyond the neonatal period. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 439-465

162. Feigin R D, Stechenberg B W 1987 Diphtheria. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 1134-1141

163. Feigin R D, McCracken G H Jr, Klein J 0 1992 Diagnosis and management of meningitis. Pediatric Infectious Diseases Journal 11:785-814

164. Feldstein T J, Uden D L, Larson T A 1987 Cefotaxime for treatment of Gram-negative bacterial meningitis in infants and children. Pediatric Infectious Disease Journal 6: 471-475

165. Figueroa J E, Densen P 1991 Infectious diseases associated with complementary deficiencies. Clinical Microbiology Reviews 4:359-395

166. Finegold S M, Arnon S S 1987 Clostridial intoxication and infection. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 1118-1125 fischer1981 #Fischer E G, McLennan J E, Suzuki Y 1981 Cerebral abscess in children. American journal of disease in Children 135: 746-749

167. Flaguel B, Walolach D, Vignon-Pennamer M 1989 Late onset reversal reaction in borderline leprosy. Journal of the American Academy of Advanced Dermatology 20: 857-860

168. Foreman S D, Smith E E, Ryan N J et al 1984 Neonatal citrobacter meningitis: pathogenesis of cerebral abscess formation. Annals of Neurology 16: 655-659

169. FradkinJ E, Schoenberger L B, Mills J L et al 1991 Creutzfeldt-Jakob disease in pituitary growth hormone recipients in the United States. Journal of the American Medical Association 265: 880-8 84

170. Fraser D W, Darby C P, Koehler R E 1973 Risk factors in bacterialmeningitis: Charleston County, South Carolina. Journal of Infectious Diseases 127: 271-277

171. Gajdusek D C 1977 Unconventional viruses and the origin and disappearance of Kuru. Science 197: 943-960

172. Gajdusek D C, Vigas V 1959 Clinical pathological and epidemiological study of an acute progressive degenerative disease of the central nervous system among natives of the Eastern Highlands of New Guinea. American Journal of Medicine 26: 442-469

173. Gallo R C 1984 Human T cell leukaemia-lymphoma virus and T cell malignancies in adults. Cancer Surveys 3: 113-159

174. Gallo R C 1987 The AIDS virus. Scientific American 256: 46-56

175. Gessain A, Barin F, Vernant J C 1985 Antibodies to human T lymphotropic virus type 1 in patients with tropical spastic paraparesis. Lancet 2: 407-410

176. Gibbs C J, Toy A, Heffner R et al 1985 Clinical and pathological features of laboratory confirmation of a Creutzfeldt-Jakob disease in a recipient of pituitary derived human growth hormone. New England Journal of Medicine 313: 734-738

177. Girgis N I, Farid Z, Mikhail I A et al 1989 Dexamethasone treatment for bacterial meningitis in children and adults. Pediatric Infectious Disease journal 8: 848-851

178. Glickman L T, Schantz P M 1981 Epidemiology and pathogenesis of zoonotic toxocariasis. Epidemiologic Reviews 3: 230-250

179. Granoff D M, Basden M 1980 Haemophilus influenzae infections in Fresno County. California: a prospective study of the effects of age, race, and contact with a case on incidence of disease. Journal of Infectious Diseases 141: 40-46

180. Granoff D M, Squires J E, Munson R S 1983 Siblings of patients with haemophilus meningitis have impaired anticapsular antibody responses to haemophilus vaccine. Journal of Pediatrics 103: 185-191

181. Green W R, Sweet L K, Pritchard R W 1974 Acute lymphocytic choriomeningitis. Journal of Pediatrics 35: 688-701

182. Greenberg M, Pellitteri 0, Eisenstein D T 1955 Measles encephalitis. 1. Prophylactic effect of gama globulin. Journal of Pediatrics 46:462-467

183. Greenfield S, Sheehe P R, Feldman H A 1971 Meningococcal carriage in a population of normal families. Journal of Infectious Diseases 123: 67-73

184. Greenwood B M 1984 Treatment and prevention of meningococcal disease. Tropical Doctor 14: 61-66

184. Greenwood B M, Bradley A K, Blakeborough I S et al 1984 Meningococcal disease and season in Sub-Saharan Africa. Lancet: 1339-1342

185. Greenwood B M 1987 The epidemiology of acute bacterial meningitis in tropical Africa. In: Williams J D, Burnie J (eds) Bacterial meningitis. Academic Press, London, pp 61-91

186. Grose C, Henle W, Henle G, Feorino P M 1975 Primary Epstein-Barr virus infections in acute neurological diseases. New England Journal of Medicine 292: 392-395

187. Haase J, Christensen P B, Kock K et al 1985 Cerebellar tuberculoma: a rare disease in an industrialized country. Child's Nervous System 1: 295-297

188. Hall W W, Choppin P W 1981 Measles-virus proteins in brain tissue of patients with subacute sclerosing panencephalitis. New England Journal of Medicine 304: 1152-1155

189. Hanshaw J B, Dudgeon J A, Marshall M D 1985b Viral diseases of the fetus and newborn. Saunders, London

190. Hanshaw J B, Dudgeon J A, Marshall W C 1985a Congenital cytomegalovirus. In: Viral diseases of the fetus and newborn, 2nd edn. Saunders, London, pp 92-131

191. Hanshaw J B, Scheiner A P, Moxley A W et al 1976 School failure and deafness after `silent' congenital cytomegalovirus infection. New England Journal of Medicine 295: 468-470

192. Havens P L, Garland J S, Brook M M et al 1989 Trends in mortality in children hospitalized with meningococcal infections 1957-1987. Pediatric Infectious Disease journal 8: 8-10

193. Heyderman R S, Robb S A, Kendall B et al 1992 Does computerized tomography have a role in the evaluation of complicated acute bacterial meningitis? Developments in Medicine and Childhood Neurology 34:870-875.

194. Hirsch M S, Moellering R C, Pope H G et al 1974 Lymphocytic- choreomeningitis-virus infection traced to a pet hamster. New England Journal of Medicine 291: 610-612

195. Hoke C H, Nisalak A, Sangawhipa N et al 1988 Protection against Japanese encephalitis by inactivated vaccines. New England Journal of Medicine 319: 608-613

196. Hollander H, Levy J A 1987 Neurological abnormalities and recovery of human immunodeficiency virus from the cerebrospinal fluid. Annals of Internal Medicine 106: 692-695

197. Holliman R E 1988 Toxoplasmosis and the acquired immune deficiency syndrome. Journal of Infection 16: 121-128

198. Hope-Simpson R E 1965 The nature of herpes zoster. A long-term study and a new hypothesis. Proceedings of the Royal Society of Medicine 58: 9-20

199. Houff S A, Major E 0, Katz D et al 1988 Involvement of JC virus- infected mononuclear cells from the bone marrow and spleen in the pathogenesis of progressive multifocal leukoencephalopathy. New England Journal of Medicine 318: 301-305

200. Humphries M 1992. The management of tuberculous meningitis. Thorax 47: 577-581

201. Huntley C C, Costas M C, Lyverly B S 1965 Visceral larva migrant syndrome: clinical characteristics and immunologic studies in 51 patients. Pediatrics 36: 523-563

202. Hutto C, Arvin A, Jacobs R et al 1987 Intrauterine herpes simplex virus infections. Journal of Pediatrics 110: 97-101

203. Idriss Z H, Sinno A, Kronfol N M 1976 Tuberculous meningitis in childhood: forty-three cases. American Journal of Diseases in Children 130:364-367

204. Irving W L, Chang J, Raymond D R et al 1990 Roseola infantum and other syndromes associated with acute HHV6 infection. Archives of Disease in Childhood 65: 1297-1300

205. Ishiguro N, Yamada S, Takahashi T 1990 Meningo-encephalitis associated with HHV 6 related exanthem subitum. Acta Paediatrica Scandinavica 79: 987-989

206. Istre C R, Compton R, Novotney T et al 1986 Infant botulism: three cases in a small town. American Journal of Diseases in Children 140:1013-1014

207. Istre C R, Connor J S, Broome C V 1985 Risk factors for primary invasive Haemophilus influenzae disease: increased risk from day care attendance and school aged household members. Journal of Pediatrics 105:190-195

208. Jacobs R F, Wells T G, Steele R W et al 1985 A prospective randomized comparison of cefotaxime versus ampicillin and chloramphenicol for bacterial meningitis in children. Journal of Pediatrics 107: 129-133

209. Jaffe I P 1982 Tuberculous meningitis in childhood. Lancet 1: 738-739

210. James I I E, Walsh J W, Wilson H D 1980 Prospective randomized study of therapy in cerebrospinal fluid shunt infections. Neurosurgery 7:459-463

211. Job C K et al 1969 Leprous myositis - a histopathological and electron microscopic study. Leprosy Review 40: 9

212. Job C K, Desikan K V 1968 Pathological changes and their distribution in peripheral nerves in lepromatous leprosy. International Journal of Leprosy 36: 257-270

213. Johnson R T 1987 The pathogenesis of acute viral encephalitis and postinfectious encephalomyelitis. Journal of Infectious Diseases 155:359-361

214. Johnston I D, Anderson H R, Lambert H P et al 1985 Reading attainment and physical development after whooping cough. Journal of 1Epidemiology and Community Health 39: 314-319

215. Jones D 1995 Epidemiology of meningococcal disease in Europe and theUSA. In: Cartwright K (ed.) Meningococcal disease Wiley, Chichester, ch 9

216. Jones D, Mallard R 1993 Age incidence of meningococcal infection in England and Wales. 1984-1991. Journal of Infection 27: 83-88

217. Kahlon J, Chatterjee S, Lakeman F et al 1987 Detection of antibodies to herpes simplex virus in the cerebrospinal fluid of patients with herpes simplex encephalitis. Journal of Infectious Diseases 155: 38

218. Kaneko K, Onodera 0, Miyatake T et al 1990 Rapid diagnosis of tuberculous meningitis by polymerase chain reaction. Neurology 40:1617-1618

219. Kaplan S L, Catlin F I, Weaver T 1984 Onset of hearing loss in children with bacterial meningitis. Pediatrics 73: 575-578

220. Kaplan S L, Feigin R D 1978 The syndrome of inappropriate secretion of antidiuretic hormone in children with bacterial meningitis. Journal of Pediatrics 92: 758-761

221. Kaplan S L, Fishman M A 1987 Supportive therapy for bacterial meningitis. Pediatric Infectious Diseases Journal 6: 670-677

222. Kaplan S L, Smith E 0 B, Wills C et al 1986 Association between preadmission oral antibiotic therapy and cerebrospinal fluid findings and sequelae caused by Haemophilus influenzae type B meningitis. Pediatric Infectious Disease Journal 5: 626-632

223. Katz B Z, Andiman W A, Eastman R et al 1986 Infection with two genotypes of Epstein Barr virus in an infant with AIDS and lymphoma of the central nervous system. Journal of Infectious Diseases 153:601-604

224. Kaufman H H, Catalano L W 1979 Diagnostic brain biopsy: a series of 50 cases and a review. Neurosurgery 4: 129-136

225. Kawasaki T 1967 Acute febrile mucotaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes. Japanese journal of Allergy 16: 178-222

226. Kennard C, Swash M 1981 Acute viral encephalitis: its diagnosis and outcome. Brain 104: 129-148

227. Kennedy C R, Duffy S W, Smith R et al 1987 Clinical prediction of outcome in encephalitis. Archives of Disease in Childhood 62:1156-1162

228. Kennedy C R, Robinson R 0, Valman H B et al 1986 A major role for viruses in acute childhood encephalopathy. Lancet: 989-991

229. Khang T Y, Frappell J M, Steel H M et al 1986 Perinatal listeriosis: a report of six cases. British Journal of Obstetrics and Gynaecology 93:1083-1087

230. Kimura H, Aso K, Kuzushima K et al 1992 Relapse of herpes simplex encephalitis in children. Pediatrics 89: 891-894

231. King S M, Gorensek M, Ford Jones E I et al 1986 Fatal varicella zoster infection in a newborn treated with varicella zoster immunoglobulin. Pediatric Infectious Disease journal 5: 588-589

232. Klein J 0, Feigin R D, McCracken G H 1986 Report of the task force on diagnosis and management of meningitis. Journal of Pediatrics 78(S): 959-982

233. Klein N J, Heyderman R S, Levin M 1992 Antibiotic choices for meningitis beyond the neonatal period. Archives of Disease in Childhood 67: 157-161

234. Koenig S, Gendelman, H E, Orsenstein J M et al 1986 Detection of AIDS virus in macrophages in brain tissue from AIDS patients with encephalopathy. Science, 223: 1089-1093

235. Kohl S 1988 Herpes simplex virus encephalitis in children. Pediatric Clinics of North America 35: 465-483

236. Kovanen J, Schauma N K, Valpas J 1986 Banwath's syndrome and Lyme disease in Finland. Scandinavian Journal of Infectious Disease 18:421-424

237. Krambovitis E, Mclllmarray M B, Lock P E et al 1984 Rapid diagnosis of tuberculous meningitis by latex particle agglutination. Lancet 2:1229-1231

238. Kranski K, Borkowskv W, Bonk S et al 1988 Bacterial infections in human immunodeficiency virus-infected children. Pediatric Infectious Disease journal 7: 323-328

239. Kresky B, Nauheim J S 1967 Rubella retinitis. American Journal of Diseases of Children 113: 305-310

240. Kreth H W, Ter Meulen V, Eckert G 1975 HL-A and subacute sclerosing panencephalitis. Lancet 2: 415-416

241. Kurent J E, Sever J L, Terasaki P 1 1975 HL-A W29 and subacute sclerosing panencephalitis. Lancet 2: 927

242. Kroll J S, Booy R 1996 Haemophilus influenzae: capsule vaccine and capsulation genetics. Molecular Medicine Today 2: 160-165

243. La Boccetta A C, Tornay A S 1964 Measles encephalitis: report of 61 cases. American Journal of Diseases in Childhood 107: 247--255

244. Lakeman F D, Koga J, Whitley R J 1987 Detection of antigen to herpes simplex in cerebrospinal fluid from patients with herpes simplex encephalitis. Journal of Infectious Diseases 155: 1172-1178

245. Lambert H P 1987 Problems of standard therapy and their possible solution. In Williams J D, Burnie J (eds) Bacterial meningitis. Academic Press, London, pp 203-209

246. Lauter C B 1980 Herpes simplex encephalitis: a great clinical challenge. Annals of Internal Medicine 93: 696-698

247. Label M H, Freij R J, Syrogiannopoulos G A et al 1988 Dexamethasone therapy for bacterial meningitis: results of two double-blind placebo- controlled trials. New England Journal of Medicine 319: 964-971

248. Lecour H, Seara A, Miranda A M et al 1984 Treatment of 160 cases of acute bacterial meningitis with cefotaxime. Journal of Antimicrobiology and Chemotherapy 14(S): 195-202

249. Legg N J 1967 Virus antibodies in subacute sclerosing panencephalitis: a study of 22 patients. British Medical Journal 3: 350-352

250. Lennon D, Voss L, Sinclair J et al 1989 An outbreak of meningococcal disease in Auckland, New Zealand Pediatric Infectious Diseases 8: 11-15

251. Lerer R J, Kalavsky S M 1973 Central nervous system disease associated with Mycoplasma pneumoniae infection: report of five cases and review of the literature. Pediatrics 52: 658-668

252. Levin M 1989 Treatment of meningitis. Current Medical Literature, Paediatrics 2: 3-8

253. Levin M, Eley B, Louis J et al 1995 Postinfectious purpura fulminans caused by an autoantibody directed against protein. S. Journal of Pediatrics 127: 355-363

254. Levin M, Heyderman R S. 1990 Bacterial meningitis. Advances in Paediatrics 9: 1-19

255. Levin M, Kay J D S, Gould J D et al 1983 Haemorrhagic shock and encephalopathy: a new syndrome with a high mortality in young children.Lancet 2: 64-67

256. Levin M, Pincott J R, Hjelm M et al 1989b Haemorrhagic shock and encephalopathy: clinical, pathologic, and biochemical features. Journal of Pediatrics 114: 194-203

257. Levin M, Walters M D S, Barratt T M 1989a Hemolytic uremic syndrome. Advances in Pediatric Infectious Diseases 4: 51-82

258. Levin D P, Lauter C B, Lerner A M 1978 Simultaneous serum and CSF antibodies in herpes simplex encephalitis. Journal of the American Medical Association 240: 356-360

259. Lipton S A 1992 Models of neuronal injury in AIDS: another role for the NMDA receptor? Trends in Neuroscience 15: 75-79

260. Lipton S A, Sucher N K, Kaiser P K et al 1991 Synergistic effects of the HIV coat protein and NMDA receptor-mediated neurotoxicity. Neurology 7: 111-118

261. Loft R J, Remington J S 1988 Toxoplasmic encephalitis. Journal of Infectious Diseases 157: 1-6

262. Looareesuwan S, Warrell D A, White N J et al 1983 Do patients with cerebral malaria have cerebral oedema? A computed tomography study. Lancet 1(8322): 434-437

263. MacPherson G, Warrell M J, White N J et al 1985 Human cerebral malaria: a quantitative ultrastructural analysis of parasitised erythrocyte sequestration. American Journal of Pathology 119:385-401

264. Manco Johnson M, Nuus R, Iley N, Moertel C, Jacobson L 1996 LupusAnticoagulant and protein S deficiency in children with post varicella purpura fulminans and thrombosis. Journal of Pediatrics 128:319-323

265. Marcial Rojas R A, Fiol R E 1963 Neurological complications of schistosomiasis: review of the literature and report of two cases of transverse myelitis. Annals of Internal Medicine 59: 215-230

266. Marks W A, Stutman H R, Marks M 1 1986 Cefuroxime versus ampicillin plus chloramphenicol in childhood bacterial meningitis: a multicenter randomized control trial. Journal of Pediatrics 109: 123-130

267. Marshall W C 1983 Infections of the nervous system. In: Brett E M (ed.) Pediatric neurology. Churchill Livingstone, Edinburgh

268. Mascola L, Pelosi R, Blount J H et al 1985 Congenital syphilis revisited. American Journal of Diseases in Children 139: 575-580

269. Masters C L, Richardson E P 1978 Subacute spongiform encephalopathy (Creutzfeldt-Jakob disease): the nature and progression of spongiform change. Brain 101: 333-344

270. McCabe R, Remington J C 1988 Toxoplasmosis, the time has come. New England Journal of Medicine 318: 313-315

271. McCarthy J I, Amer J 1978 Post varicella acute transverse myelitis: a case presentation and review of the literature. Pediatrics 62: 202-204

272. Mc Comb J A, Dwyer R C 1963 Passive-active immunization with tetanus immune globulin. New England Journal of Medicine 268: 857-862

273. McCracken G H, Freil B J 1987 Perinatal bacterial diseases. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 940-966

273. McCracken G H, Nelson J D, Kaplan S L et al 1987 Consensus report: antimicrobial therapy for bacterial meningitis in infants and children. Pediatric Infectious Diseases Journal 6: 501-505

274. McCracken G H, Kaplan J M 1974 Penicillin treatment for congenital syphilis. Journal of the American Medical Association 228: 855-858

275. McCracken G H, Mize S G 1976 A controlled study of intrathecal antibiotic therapy in Gram negative enteric meningitis of infancy. Journal of Pediatrics 89: 66-72

276. McCracken G H, Mize S G, Threlkeld N 1980 Intraventricular gentamicin therapy in gram-negative bacillary meningitis of infancy. Lancet: 787-791

277. McCracken G H, Threlkeld N, Mize S B et al 1984 Moxalactam therapy for neonatal meningitis due to gram negative enteric bacilli: a prospective controlled evaluation. Journal of the American Medical Association 252: 1427-1432

278. McDonald J C, Moore D L 1988 Mycoplasma hominis meningitis in a premature infant. Pediatric Infectious Disease journal 7: 795-798

279. McGee Z A, Kaiser A B, Rubens C et al 1977 Emergence of chloramphenicol resistance during chloramphenicol therapy of gram negative bacillary meningitis. In: Proceedings and abstracts of the 17th interscience conference on antimicrobial agents and chemotherapy. New York. American Society for Microbiology, Washington

280. McGrath E, Rosenbloom L 1980 Use of isoprinosine in subacute sclerosing panencephalitis. Archives of Disease in Childhood 55:829-830

281. McKendrick G D W 1979 Diagnosis of herpes simplex encephalitis. Lancet 2: 1181-1182

282. McLaurin R L, Frame P T 1987 Treatment of infections of cerbrospinal fluid shunts. Reviews of Infectious Diseases 9: 59 5-602

283. McLean D M, Larke R P B, Cobb C et al 1967 Mumps and enteroviral meningitis in Toronto 1966. Canadian Medical Association journal 96:1355-1361

284. Meirovitch J, Kitai-Cohen Y, Keren G et al 1987 Cerebrospinal fluid shunt infections in children. Pediatric Infectious Disease journal 6:921-924

285. Meissner H C, Gellis S E, Milliken J 1982 Lyme disease first observed to be aseptic meningitis. American Journal of Diseases in Children 136:465-467

286. Melgaard B, Mutie D M, Kimani G 1988 A cluster survey of mortality due to neonatal tetanus in Kenya. International Journal of Epidemiology 17: 174-177

287. Meningococcal Disease Surveillance Group 1976 Analysis of endemic meningococcal disease by serogroup and evaluation of chemoprophylaxis. Journal of Infectious Diseases 134: 201-204

288. Mertsola J, Kennedy W A, Wagner D C et al 1991 Endotoxin concentrations in cerebrospinal fluid correlated with clinical severityand neurological outcome of Haemophilus influenzae type b meningitis. American Journal of Diseases in Children 145: 1079-1103

289. Merz P A, Rohwer R G, Kascsak R 1984 Infection-specific particle from the unconventional slow virus diseases. Science 225: 437-440

290. Metz H, Gregoriou M, Sandifer P 1964 Subacute sclerosing panencephalitis. Archives of Disease in Childhood 39: 554-557

291. Meyer H M, Johnson R T, Crawford I P et al 1960 Central nervous system syndromes of viral etiology: a study of 713 cases. American Journal of Medicine 334-346

292. Meyer N, Rosenbaum V, Schmidt B et al 1991 Search for a putative scrapie genome in purified prion fractions reveals a paucity of nucleic acids. Journal of General Virology 72: 37-49

293. Meyers W M 1992 Leprosy. In: Feigin R D, Cherry J D (eds) Textbook of pediatric infectious diseases, 3rd edn. Saunders, Philadelphia, pp 1149-1166

294. Michaels J, Sharer L R, Epstein L G 1988 Human immunodeficiency virus type 1 (HIV 1) infection of the nervous system: A review. Immunodeficiency Review 1: 71-104

295. Miko T L, Maitre C L, Kinfu Y 1993 Damage and exaggeration of peripheral nerves in advanced treated leprosy. Lancet 342: 521-525

296. Miller D L, Alderslade R, Ross E M 1982 Whooping cough and whooping cough vaccine: the risks and benefit debate. Epidemiology Reviews 4: 1-24

297. Miller D L, Ross E M, Alderslade R et al 1981 Pertussis immunization and serious acute neurological illness in childhood. British Medical Journal 1: 1595-1599

298. Miller J D, Ross C A C 1968 Encephalitis: a four year survey. Lancet: 1121-1126

299. Mintz M, Epstein L G, Koeningsberger M R 1989a Neurological manifestations of acquired immunodeficiency syndrome in children. International Pediatrics 4: 161-171

300. Mintz M, Rapaport R, Oleske J et al 1989b Elevated serum levels of tumor necrosis factor are associated with progressive encephalopathy in children with acquired immunodeficiency syndrome. American Journal of Diseases in Children 143: 771-774

301. Modlin J F, Brandling-Bennett D, Witte J J et al 1975 A review of five years' experience wth rubella vaccine in the United States. Pediatrics 55: 20-29

302. Modlin J F, Halsey N A, Eddins D L et al 1979 Epidemiology of subacute sclerosing panencephalitis. Journal of Pediatrics 94: 231-236

303. Modlin J F 1990 In: Mandell G L, Douglas R G, Bennett J E (eds) Principles and practice of infectious diseases, 3rd edn. Churchill Livingstone, Edinburgh, pp 1359-1367

304. Monard-Krohn G H 1923 The neurological aspects of leprosy. Chicago Medical Book, Chicago

305. Monath T P 1988 Japanese encephalitis: a plaque of the Orient. New England Journal of Medicine 319: 641-643

306. Moxon E R, Zwahlen A, Rubin L G et al 1984 Pathogenesis of meningitis: experimental studies on the molecular basis of Haemophilus influenzae. Infection 12(8): 523-527

307. Muhlemann M F, Wright D J 1987 Emerging pattern of Lyme disease in the United Kingdom and Irish Republic. Lancet: 260-262

308. Mukhtar M Y 1987 Birth care practice and tetanus neonatorum a hospital-based study in Mosul. Public Health 101: 453-456

309. Mulder C J J, Van Alphen L, Zanen H C 1984 Neonatal meningitis caused by Escherichia coli in the Netherlands. Journal of Infectious Diseases 150: 935-940

310. Murphy E L 1993 HTLV II related disease. Lancet 341: 888

311. Mustafa M M, Ramilo 0, Syrogiannopoulos G A et al 1989 Induction of meningeal inflammation by outer membrane vesicles of Haemophilus influenzae type b. Journal of Infectious Diseases 159: 917-922

312. Myint T T 1980 Tuberculous meningitis and BCG vaccination in Burmese children. Journal of Tropical Pediatrics 26: 227-231

313. SFSF'`idel S, Levin M, Habibi P. 1995 Treatment of meningococcal disease.In: Cartwright K (ed.) Meningococcal disease. Wiley, Chichester, ch 9

314. Nicolaidou P, Iacovidou N, Youroukos S et al 1993 Relapse of herpes simplex encephalitis after acyclovir therapy. European Journal of Pediatrics 152: 737-738

315. Nielsen H 1983 Cerebral abscess in children. Neuropediatrics 14: 76-80

316. Niemoller V M, Tauber M G 1989 Brain edema and increased intracranial pressure in the pathophysiology of bacterial meningitis. European Journal of Clinical and Microbiological Infectious Diseases 8: 109-117

317. Nihill M R, Feigin R D, Gruber R et al 1987 Kawasaki disease. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, Philadelphia, pp 2137-2165

318. Noah N D 1987 Eidemiology of bacterial meningitis. In: Williams J D, Burnie J (eds) Bacterial meningitis. Academic Press, London, pp 93-115

319. Noorden S K, Lopez Bravo L, Sundaresan T K 1992 Estimated number of leprosy cases in the world. Bulletin of the World Health Organization 70: 7-10

320. Nottidge V A 1983 Pneumococcal meningitis in sickle cell disease in childhood. American Journal of Disease in Childhood 137: 29-31

321. Odio C M, Faingezicht I, Salas J L 1986 Cefotaxime versus conventional therapy for the treatment of bacterial meningitis of infants and children. Pediatric Infectious Disease journal 5: 402-407

322. Odio C M, Faingezicht I, Paris M et al 1991 The beneficial effects of early dexamethasone administration in infants and children with bacterial meningitis. New England Journal of Medicine 324:1525-1531

323. Offenbacher H, Fazekas F, Schmidt R et al 1991 MRI in tuberculous meningoencephalitis: report of four cases and review of the neuroimaging literature. Journal of Neurology 238: 340-344

324. Ogel J W, Toltzis P, Parker W D et al 1989 Oral ribavirin therapy for subacute sclerosing panencephalitis. Journal of Infectious Diseases 159(4): 748-750 Oh S 1968 Paragonimus meningitis. Journal of the Neurological Sciences 6:419-433

325. Olson L C 1975 Pertussis. Medicine 54: 427-469

326. Osterholm M T, Pierson L M, White K E et al 1987 The risk of subsequent tranmission of Hemophilus influenzae type B disease among children in day care. New England Journal of Medicine 316:5-10

327. Pahwa S 1988 Human immunodeficiency virus infection in children: nature of immunodeficiency, clinical spectrum and management. Pediatric Infectious Disease journal 7: 561-571

328. Pampiglione G 1964 Polymyographic studies of some involuntary movement in subacute sclerosing panencephalitis. Archives of Disease in Childhood 39: 558-563

329. Paredes A, Wong P, Mason E 0 et al 1977 Nosocomial transmission of group B streptococci in a nursery. Pediatrics 59: 679-682

330. arker P, Puck J, Fernandez F 1981 Cerebral infarction associated with Mycoplasma pneumoniae. Pediatrics 67: 373-375

331. Paryani S G, Arvin A M 1986 Intrauterine infection with varicella zoster virus after maternal varicella. New England Journal of Medicine 314:1542-1546

332. Pass R F, Stagno S, Myers G J et al 1980 Outcome of symptomatic congenital cytomegalovirus infection: results of long-term longitudinal follow-up. Pediatrics 66: 758-762

333. Patrick C C, Kaplan S L 1988 Current concepts in the pathogenesis and management of brain abscesses in children. Pediatric Clinics of North America 35: 625-636

334. Paul F M 1961 Tuberculosis in BCG vaccinated children in Singapore. Archives of Disease in Childhood 36: 530-536

335. Peckham C S 1972 A clinical and laboratory study of children exposed in utero to maternal rubella. Archives of Disease in Childhood 47: 571-577

336. Peltola H, Anttila M, Renkonen 0 1989 Randomized comparison of chloramphenicol, ampicillin, cefotaxime and ceftriaxone for childhood bacterial meningitis. Lancet 1: 1281-1286

337. Pearson J M H, Ross W X 1975 Nerve involvement in leprosy - pathology, differential diagnosis and principles of management. Leprosy Review 46:199-207

338. Pfaltzgraff R E, Bryceson A 1985 Clinical leprosy. In: Hastings R C (ed.) Leprosy. Churchill Livingstone, Edinburgh Phillips R E, Solomon T 1990 Cerebral malaria in children. Lancet 336(8727): 1355-1360

339. Picket J, Berg B, Chaplin E et al 1976 Syndrome of botulism in infancy: clinical and electrophysiologic study. New England Journal of Medicine 295: 770-772

340. Pike M G, Wong P K H, Bencivengo R et al 1990 Electrophysiological studies, computed tomography and neurological outcome in acute bacterial meningitis. Journal of Pediatrics 116: 703-706

341. Pippard M J, Dalgleish A, Gibson P et al 1986 Acquired immunodeficiency with disseminated cryptococcosis. Archives of Disease in Childhood 61: 289-291

342. Pizzo P A, Butler K, Balis F 1990 Dideoxycytidine alone and in an alternating schedule with zidovudine in children with symptomatic human immunodeficiency virus infection. Journal of Pediatrics 117:799-808

343. Pizzo P A, Eddy J, Falloon J et al 1988 Effect of continuous intravenous infusion of zidovudine (AZT) in children with symptomatic HIV infection. New England Journal of Medicine 319: 889-896

344. Poland G A 1996 Acellular pertussis vaccines: new vaccines for an old disease. Lancet 347: 209-210

345. Ponnighaus J M, Fine P E M, Sternae J A C et al 1992 Efficacy of BCG vaccine against leprosy and tuberculosis in Northern Malawi. Lancet 399:636-639

346. Porterfield J S 1987 Alphaviruses, flaviviruses and bunyaviridae. In: Zuckerman A J, Banatvala J E, Pattison J R (eds) Principles and practice of clinical virology. Wiley, Chichester, pp 419-431

347. Portnoy J M, Olson L 1985 Normal cerebrospinal fluid values in children: another look. Pediatrics 76: 485-487

348. Powderly W G, Saag M S, Cloud G A 1992 A controled trial of fluconazole or amphoteritic B to prevent relapse of cryptococcal meningitis in patients with the acquired immunodeficiency syndrome. New England Journal of Medicine 326: 793-798

349. Powell K R, Sugarman L I, Eskenazi A E et al 1990 Normalization of plasma arginine vasopressin concentrations when children with meningitis are given maintenance plus replacement fluid therapy. Journal of Pediatrics 117: 515-522

350. Preblud S R 1981 Age-specific attack rates of varicella complications. Pediatrics 68: 14-17

351. Preston N W 1988 Pertussis today. In: Wardlaw A C, Parton R (eds) Pathogenesis and immunity in pertussis. Wiley, Chichester

352. Prober C G, Hensleigh P A, Boucher F D et al 1988 Use of routine viral cultures at delivery to identify neonates exposed to herpes simplex virus. New England Journal of Medicine 318: 887-891

353. Prusiner S B 1982 Novel proteinaceous infectious particles cause scrapie. Science 216: 136-144

354. Prusiner S B 1987 Human slow infections: prion diseases. In: Zuckerman A J, Banatvala J E, Pattison J R (eds) Principles and practice of clinical virology. Wiley, Chichester, pp 545-565

355. Prusiner S B 1991 Molecular biology of prion diseases. Science 252:1515-1522

356. Pullan C R, Noble C T Scott D J et al 1976 Atypical measles infection in leukaemic children on immunosuppressive treatment. British Medical journal 1: 1562-1565

357. Quagliarello V, Scheld W M 1992 Bacterial meningitis: pathogenesis, pathophysiology and progress. New England Journal of Medicine 327:864-872

358. Radhakrishnan V V, Mathai A, Sehgal S 1990 Correlation between culture of Mycobacterium tuberculosis and IgG antibody to Mycobacterium tuberculosis antigen-5 in the cerebrospinal fluid of patients with tuberculous meningitis. Journal of Infection 21:271-277

359. Radhakrishnan V V, Mathai A 1991 Detection of Mycobacterium tuberculosis antigen-5 in cerebrospinal fluid by inhibition ELISA and its diagnostic potential in tuberculous meningitis. Journal of Infectious Diseases 163: 650-652

360. Rahal J, Simberkoff M S 1979 Bactericidal and bacteriostatic action of chloramphenicol against meningeal pathogens. Antimicrobial Agents and Chemotherapy 16: 13-18

361. Ramilo 0, Saez-Llorens X, Mertsola J et al 1990 Tumor necrosis factor alpha/cachectin and interleukin 1 beta initiates meningeal inflammation. Journal of Experimental Medicine 172: 497-507

362. Raphael S A, Price M L, Lishner H W et al 1991 Inflammatory demyelinating polyneuropathy in a child with symptomatic human immunodeficiency virus infection. Journal of Pediatrics 118: 242-245

363. Rawley A H, Shulman S T 1987 The search for the etiology of Kawasaki disease. Pediatric Infectious Disease journal 6: 506-508

364. Rea T H, Levan N E 1977 Current concepts in the immunology of leprosy. Archives of Dermatology 113: 345

365. Reik L, Steere A C, Bartenhagen N H, Sharpe R E et al 1979 Neurologic abnormalities of Lyme disease. Medicine 58: 281-294

366. Resnick L, Berger J R, Shapshak P et al 1988 Early penetration of blood- brain-barrier by HIV. Neurology 38: 9-14

367. Richardson E P 1961 Progressive multifocal leukoencephalopathy. New England Journal of Medicine 265: 815-823

368. Richardson E P 1988 Progressive multifocal leukoencephalopathy 30 years later. New England Journal of Medicine 318: 315-317

369. Ridley D S, Jopling W H 1966 Classification of leprosy according to immunity. International Journal of Leprosy 31: 255

370. Robb R M, Watters G V 1970 Ophthalmic manifestations of subacute sclerosing panencephalitis. Archives of Ophthalmology 83:426-435

371. Roberts R B, Romankiewicz J A 1986 Bacterial meningitis in adults. In: Kass E H, Platt R (eds) Current therapy in infectious disease, vol 2. Mosby, London, pp 205-212

372. Rodriguez W J, Puig J R, Khan W N 1986 Ceftazidime versus standard therapy for pediatric meningitis: therapeutic, pharmacologic and epidimiologic observations. Pediatric Infectious Disease journal 5:408-415

373. Roman G C 1987 Retrovirus-associated myelopathies. Archives of Neurology 44: 649-663

374. Roman G C, Spencer P S, Schoenber B S 1985 Tropical myeloneuropathies: the hidden endemias. Neurology 35: 1158-1170

375. Ronne T, Berthelsen L, Buhl L H et al 1993 Comparative studies on pharyngeal carriage of Neisseria meningitides during a localized outbreak of serogroup C meningococcal disease. Scandinavian Journal of Infectious Diseases 25: 331-339

376. Rosman N P, Peterson D B, Kaye E M et al 1985 Seizures in bacterial meningitis, prevalence, patterns, pathogenesis and prognosis. Pediatric Neurology 1: 278-285

377. Ross E M 1988 Reactions to whole cell pertussis vaccine. In: Wardlaw A C, Parton R (eds) Pathogenesis and immunity in pertussis. Wiley, Chichester, pp 375-398

378. Rouse D J, Goldenberg R L, Cliver S P et al 1994 Strategies for the prevention of early-onset neonatal group B streptococcal sepsis: a decision analysis. Obstetrics and Gynecology 83(4): 483-494

379. Saez-Llorens X, Romilo 0, Mustafa M M et al 1990a Molecular pathophysiology of bacterial meningitis: Current concepts and therapeutic implications. Journal of Pediatrics 116: 671-684

380. Saez-Llorens X, Romilo 0, Mustafa M M et al 1990b Pentoxifylline modulates meningeal inflammation in experimental bacterial meningitis. Antimicrobial Agents in Chemotherapy 34: 837-843

381. Saez-Llorens X, Jafari H S, Severien S et al 1991 Enhanced attenuation of meningeal inflammation and brain edema by concomitant administration of anti-CD 18 monoclonal antibodies and dexamethasone in experimental Haemophilus meningitis. Journal of Clinical Investigation 88: 2003-2011

382. Sarff L D, McCracken G H, Schiffner M S 1975 Epidemiology of Escherichia coli Kl in healthy and diseased newborns. Lancet 1:1099-1104

383. Saukkonen K, Sande S, Cioffe C et al 1990 The role of cytokines in the generation of inflammation and tissue damage in experimental gram-positive meningitis. Journal of Experimental Medicine 171:439-448

384. Schauseil-Zipf U, Harden A, Hoare R et al 1982 Early diagnosis of Herpes simplex encephalitis in childhood. European Journal of Pediatrics 138: 154-161

385. Schlech W F, Lavigne P M, Botolossi R A 1983 Epidemic listeriosis: evidence for tranmission by food. New England Journal of Medicine 308:203-206

386. Schlech W F, Ward J I, Band J D 1985 Bacterial meningitis in the United States 1978 through 1981: the National Bacterial Meningitis Surveillance Study. Journal of the American Medical Association 253:1749-1754

387. Schlievert P M 1989 Role of toxic shock syndrome. Toxin 1 in toxic shock syndrome. Reviews of Infectious Disease 11 (suppl): 107-109

388. Schoeman J F, Leroux D, Bezuidenhoot P B et al 1985 Intracranial pressure monitoring in tuberculous meningitis: clinical and computerized tomographic correlation. Developmental Medicine and Child Neurology 27: 644-653

389. Scott G, Hutto C, Majuch R W et al 1989 Survival in children with perinatally acquired human immunodeficiency virus type infection. New England Journal of Medicine 321: 1791-1796

390. Sell S H W 1983 Long term sequelae of bacterial meningitis in children. Pediatric Infectious Diseases 2: 90-93

391. Sells C J, Carpenter R L, Ray G C 1975 Sequelae of central nervous system enterovirus infections. New England Journal of Medicine 293:1-4

392. Selmaj K W, Raine C S 1988 T N F mediates myelin and oligodendrocyte damage in vitro. Annals of Neurology 23: 339-346

393. Shankar P, Manjunath N, Mohan K K et al 1991 Rapid diagnosis of tuberculous meningitis by polymerase chain reaction. Lancet 337:5-7

394. Shannon K M, Ammann A J 1985 Acquired immune deficiency syndrome in childhood. Journal of Pediatrics 106: 332-342

395. Shao J, Brubaker B, Levin A et al 1994 Population based study of HIV -1 infection in 4086 subjects in northwest Tanzania. Journal of AIDS 7: 397-402

396. Sharer L R, Epstein L G, Cho E-S et al 1986 Pathologic features of AIDS encephalopathy in children: evidence for LAV: HTLV III infection of brain. Human Pathology 17: 271-284

397. Shenep J L, Flynn P 1986 Infections associated with long term intravascular and cerebrospinal fluid shunt catheters. Advances in Pediatric Infectious Diseases 1: 145-162

398. Sherman F E, Michaels R H, Kenny F M 1965 Acute encephalopathy (encephalitis) complicating rubella. Journal of the American Medical Association 192: 675-681

399. Sheth K J, Swick H M, Hawarth N 1986 Neurological involvement in hemolytic uremic syndrome. Annals of Neurology 19: 90-93

400. Silverberg R, Brenner T, Abramsky 0 1979 Inosiplex in the treatment of subacute sclerosing panencephalitis. Archives of Neurology 36:374-475

401. Sippel J E, Hider P A, Controni G et al 1984 Use of the direct latex agglutination test for detection ofHaemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis antigens in cerebrospinal fluid from meningitis patients. Journal of Clinical Microbiology 20:884-886

402. Smith A 1 1987 Antibiotic resistance in bacteria causing meningitis. In: Williams J D, Burnie J (eds) Bacterial meningitis. Academic Press, London, pp 117-134

403. Smith A L 1975 Tuberculous meningitis in childhood. Medical journal of Australia 1: 57-60

404. Smith W C S 1992 The epidemiology of disability in leprosy including risk factors. Leprosy Review: 63 (suppl): 23-30

405. Smyth D, Tripp J H, Brett E M et al 1976 Atypical measles encephalitis in leukaemic children in remission. Lancet 1: 574-575

406. Seanjaard L, Bol P, Zanen H C 1986 Non-neonatal meningitis due toless common bacterial pathogens, The Netherlands, 1975-1983. Journal of Hygiene 97: 219-228

407. Spencer J A D 1987 Perinatal listeriosis. British Medical journal 295:349-351

408. Stagno S, Pass R F, Dworsky M E et al 1982 Congenital cytomegalovirus infection: the relative importance of primary and recurrent maternal infection. New England Journal of Medicine 306: 945-949

409. Starke J R 1988 Modern approach to the diagnosis and treatment of tuberculosis in children. Pediatric Clinics of North America 35: 441-464

410. Steele R W, McConnell J R, Jacobs R F et al 1985 Recurrent bacterial meningitis: coronal thin section cranial computed tomography to delineate anatomic defects. Pediatrics 76: 750-753

411. Steere A C, Grodzicki R L, Kornblatt A N et al 1983a The spirochetal etiology of Lyme disease. New England Journal of Medicine 308:733-740

412. Steere A C, Malawista S E, Snydman D R 1977 Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities. Arthritis and Rheumatology 20: 7-17

413. Steere A C, Pachner A R, Malawista S E 1983b Neurologic abnormalities of Lyme disease: successful treatment with high dose intravenous penicillin. Annals of Internal Medicine 99: 767-772

414. Stevens D L, Everett E D 1978 Sequential computerized axial tomography in tuberculous meningitis. Journal of the American Medical Association 239: 642-643

415. Sugimoto T, Sakawa Y, Koboyashi Y 1985 Early diagnosis of herpes simplex virus encephalitis in childhood by the enzyme-linked immunosorbent assay. Acta Neurologica Scandinavica 71: 359-366

416. Sunukawa K, Akita H, Iwata S et al 1984 The influence of cefotaxime on intestinal flora and bleeding diathesis in infants and neonates compared with other beta-lactams. Journal of Microbiology and Chemotherapy 14(S): 317-324

417. Swartz M N 1981 Intraventricular use of aminoglycosides in the treatment of gram-negative bacillary meningitis: conflicting views. Journal of Infectious Diseases 143: 293-296

418. Swedish Study Group 1982 Cefuroxime versus ampicillin and chloramphenicol for the treatment of bacterial meningitis. Lancet 1:295-298

419. Talan D A, Hoffman J R, Yoshikawa T T et al 1988 Role of empiric antibiotics prior to lumbar puncture in suspected bacterial meningitis: state of the art. Review of Infectious Diseases 10: 365-376

420. Tauber M G, Sande M A 1984 Pathogenesis of bacterial meningitis: contributions by experimental models in rabbits. Infection 12(S): 53-58

421. Taylor H G, Michaels R H, Mazur P M et al 1984 Intellectual, neuropsychological and achievement outcomes in children six to eight years after recovery from Haemophilus influenzae meningitis. Pediatrics 74:198-205

422. Tejani A, Dobias B, Sambursky J 1982 Long term prognosis after H. influenzae meningitis: prospective evaluation. Developmental Medicine and Child Neurology 24: 338-343

423. Tejani A, Mahadevan R, Dobias B 1981 Occurrence of HLA types in H. Influenzae type B disease. Tissue Antigens 17: 205-211

424. Todd J, Fishaut M, Kapral F et al 1978 Toxic shock syndrome associated with phage group 1 staphylococci. Lancet 2: 1116-1118

425. Townsend J J, Baringer J R, Wolinsky J S et al 1975 Progressive rubella panencephalitis: late onset after congenital rubella. New England Journal of Medicine 292: 990-993

426. Trollfors B, Claesson B A, Strangent K et al 1987 Haemophilus influenzae meningitis in Sweden 1981-1983. Archives of Disease in Childhood 62: 1220-1223

427. Tuomanen E, Liu H, Hengstler B et al 1985 The initiation of meningeal inflammation by components of the pneumococcal cell wall. Journal of Infectious Diseases 151: 859-868

428. Tuomanen E, Saukkonen K, Sande S et al 1989 Reduction of inflammation, tissue damage, and mortality in bacterial meningitis in rabbits treated with monoclonal antibodies against adhesion- promoting receptors of leukocytes. Journal of Experimental Medicine 170:959-969

429. Tureen j H, Dworkin R J, Kennedy S L et al 1990 Loss of cerebrovascular autoregulation in experimental meningitis in rabbits. Journal of Clinical Investigation 85: 577-581

430. Tureen J H, Tauber M G, Sande M A 1991 Effect of indomethacin on the pathophysiology of experimental meningitis in rabbits. Journal of Infectious Diseases 163: 647-649

431. Tureen J H, Tauber M G, Sande M A 1992 Effect of hydration on cerebral blood flow and cerebrospinal fluid lactic acidosis in rabbits with experimental meningitis. Journal of Infectious Diseases 89:947-953

432. Turk D C 1965 Distribution of Hemophilus influenzae in healthy communities. In: Turk D C, May J R (eds) Hemophilus influenzae: its clinical importance. English University Press, London

433. Udani P M, Parekh U C, Dastur D K 1971 Neurological and related syndromes in CNS tuberculosis: clinical features and pathogenesis. Journal of Neurological Science 14: 341-357

434. Upadhyaya K, Berwick K, Fishaut M 1980 The importance of non-renal involvement in hemolytic uremic syndrome. Pediatrics 65: 115-120

435. Upton A, Gumpert J 1970 Electroencephalography in herpes simplex encephalitis. Lancet 1: 650-652

436. Valmari P, Peltola H, Ruuskanen 0 et al 1987 Childhood bacterial meningitis - initial symptoms and signs related to age, and reasons for consulting a physician. European Journal of Pediatrics 146:515-518

437. Veterinary Public Health notes 1975 Mosquitoes carry Hansen's disease. Centers for Disease Control. Public Health Service. US Dept HEW 90: 183

438. Visudhiphan P, Chiemchanya S 1989. Tuberculous meningitis in children: Treatment with isoniazid and rifampicin for twelve months. Journal of Pediatrics 114: 875-879

439. von Asmuth E J U, Dentener M A, Bazil V et al 1993 Anti-CD 14 antibodies reduce responses of cultured endothelial cells to endotoxin. Immunology 80: 78-83

440. von Voorhis W C, Kaplan G, Saron E N et al 1982 The cutaneous infiltrates of leprosy. Cellular characteristics and the predominant T -cell phenotypes. New England Journal of Medicine 307:1593-1597

441. Waage A, Halstensen A, Shalaby R et al 1989 Local production of Tumor necrosis factor alpha interleukin 1 and interleukin 6 in meningococcal meningitis: relation to the inflammatory response. Journal of Experimental Medicine 170: 1859-1867

442. Waitkins S A 1985 An update on leptospirosis. British Medical journal 290:1502-1503

443. Wallach D, Cottenot F, Bach M 1982 Imbalance in T cell subpopulations in lepromatous leprosy. International Journal of Leprosy 50: 282-290

444. Walters M F, Rees R J, Sunderland 1 1967 Chemotherapeutic trials in leprosy. International Journal of Leprosy 35: 311

445. Wang D, Bortolussi R 1981 Acute viral infections of the central nervous system in children: an eight year review. Canadian Medical Association Journal 125: 585-589

446. Ward J I, Fraser D W, Baraff L J 1979 Hemophilus influenzae meningitis: a national study of secondary spread in household contacts. New England Journal of Medicine 19: 122-126

447. Warrell D A, Looareesuwan S, Warrell M J 1983 Dexamethasone proves deleterious in cerebral malaria. New England Journal of Medicine 306:313-319

448. Warrell D A, Warrell M J 1988 Human rabies and its prevention: an overview. Review of Infectious Diseases 10: S726-S731

449. Warrell D A 1989 Cerebral malaria [editorial]. Q Journal of Medicine 71(265): 369-371

450. Wasiewski W W, Fishman M A 1988 Herpes simplex encephalitis: the brain biopsy controversy. Journal of Pediatrics 113: 575-578

451. Watt G, Zaraspe G, Bautista S et al 1988 Rapid diagnosis of tuberculous meningitis by using an enzyme-linked immunosorbent assay to detect mycobacterial antigen and antibody in cerebrospinal fluid. Journal of Infectious Diseases 158: 681-686

452. Weil H L, Itabashi H H, Cremer N E et al 1975 Chronic progressive panencephalitis due to rubella virus simulating subacute sclerosing panencephalitis. New England Journal of Medicine 292: 994-998

453. Weinstein L 1987 Tetanus. In: Feigin R D, Cherry J D (eds) Pediatric infectious diseases, 2nd edn. Saunders, London, pp 1126-1134

454. Weiss J, Elsbach P, Shu C et al 1992 Human bactericidal/permeabilityincreasing protein and a recombinant NH2-terminal fragment cause killing of serum resistant gram-negative bacteria in whole blood and inhibit tumor necrosis factor release induced by the bacteria. Journal of Clinical Investigation 90: 1122-1130

455. Weissmann C 1991 A `unified theory' of prion propagation. Nature 353:679-683

456. White N J, Warrell D A, Looareesuwan S et al 1985 Pathophysiological and prognostic significance of cerebrospinal fluid lactate in cerebral malaria. Lancet 1: 776-778

457. Whitley R j, Nahmias A J, Visintine ARM 1983 Neonatal herpes simplex infection: follow-up evaluation of vidarabine therapy. Pediatrics 72:778-785

458. Whitley R j, Nahmias A J, Visintine ARM et al 1980 The natural history of herpes simplex virus infection of mother and newborn. Pediatrics 66:489-494

459. Whitley R, Alford C, Hirsch M S et al 1986 Vidarabine versus acyclovir in herpes simplex encephalitis. New England Journal of Medicine 314:144-149

460. Wiley A C, Schrier R D, Nelson J A et al 1986 Cellular localization of human immunodeficiency virus infection within the brains of acquired immunodeficiency syndrome patients. Proceedings of the National Academy of Science USA 83: 7089-7093

461. Wilfert C M, Thompson R J, Sunder J R 1981 Longitudinal assessment of children with enteroviral meningitis during the first three months of life. Pediatrics 67: 811-815

462. Will R G, Ironside J W, Zeidler M et al 1996 A new variant of Creutzfeldt- Jakob disease in the UK. Lancet 347: 921-925

463. Wilson C B, Remington J G, Stagno S S et al 1980 Development of adverse sequelae in children born with subclinical congenital toxoplasma infection. Pediatrics 66: 767-774

464. Wispelwey B, Hansen E J, Scheld W M 1989 Haemophilus influenzae outer-membrane vesicle-induced blood-brain barrier permeability during experimental meningitis. Infection and Immunology 57:2559-2562

465. Wispelwey B, Lesse A J, Hansen E J et al 1988 Haemophilus influenzae lipopolysaccharide-induced blood-brain barrier permeability during experimental meningitis in the rat. Journal of Clinical Investigation 82:1339-1346

466. Witrak B J, Ellis G T 1985 Intracranial tuberculosis: manifestations on computerized tomography. Southern Medical Journal 78: 386-392

467. Wolf S M 1973 The ocular manifestations of congenital rubella. Journal of Pediatric Ophthalmology 10: 107-141

468. Wolinsky J S, Berg B 0, Maitland C J 1976 Progressive rubella panencephalitis. Archives of Neurology 33: 722-723

469. Wong M, Kaplan S, Dunkle L M et al 1977 Leptospirosis: a childhood disease. Journal of Pediatrics 90: 525-537

470. Wong V, Yeung C Y 1987 Acute viral encephalitis in children. Australian Paediatric journal 23: 339-342

471. Wood M, Anderson M 1988 Neurological infections. Saunders, London, pp 135-168

472. Word B M, Klein J O 1988 Current therapy of bacterial sepsis and meningitis in infants and children: a poll of directors of programs in pediatric infectious diseases. Pediatric Infectious Disease journal 7:267-270

473. World Health Organization 1993 Veterinary Public Health Unit. World Survey of Rabies 27. World Health Organization, Geneva

474. World Health Organization Malaria Action Program 1986 Severe and complicated malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene 80: 1-50

475. Wright P F, Kaiser A B, Bowman C M et al 1981 Pharmacokinetics a .d efficacy of an aminoglycoside administered into the cerebral ventricles in neonates: implications for further evaluation of this route of therapy in meningitis. Journal of Infectious Diseases 143: 141-147

476. Yamamura M, Uyemura K, Deans R J et al 1991 Defining protective responses to pathogens: cytokine profiles in leprosy lesions. Science 254:277-279

477. Yii C 1976 Clinical observations on eosinophilic meningitis and meningoencephalitis caused by Angiostrongylus cantonensis in Taiwan. American Journal of Tropical Medicine and Hygiene 25:233-249

478. Zellweger H 1959 Pertussis encephalopathy. Archives of Pediatrics 76: 381-386

479. Zuger A, Lowy F D 1996 Tuberculosis of the brain, meninges, and spinal cord. In: Rom W N, Garay S (eds) Tuberculosis. Little, Brown, Boston, 541-556

Source:[480]

480. edited by Edward M. Brett. Paediatric neurology. New York: Churchill Livingstone, 1997. isbn:044305200X.

Contributors to this page

Admin