Acute bacterial meningitis in adults: Predictors of outcome

Autor:	Jiri Benes, Bohumir Prochazka, Olga Dzupova, Hanus Rozsypal
Rok vydání:	2009
Předmět:	Adult Blood Glucose Male Microbiology (medical) medicine.medical_specialty Comorbidity Neisseria meningitidis medicine.disease_cause Meningitis Bacterial Risk Factors Internal medicine Case fatality rate Streptococcus pneumoniae Humans Medicine Longitudinal Studies Coma Intensive care medicine CSF albumin Czech Republic General Immunology and Microbiology business.industry Cerebrospinal Fluid Proteins General Medicine Middle Aged Prognosis medicine.disease Anti-Bacterial Agents Glucose Infectious Diseases Acute Disease Etiology Female Hypotension medicine.symptom business Meningitis
Zdroj:	Scandinavian Journal of Infectious Diseases. 41:348-354
ISSN:	1651-1980 0036-5548
DOI:	10.1080/00365540902849391
Popis:	Case fatality ratio and permanent sequelae of acute bacterial meningitis remain high in recent decades. A prospective longitudinal study of adult patients admitted with community acquired acute bacterial meningitis at a tertiary infectious diseases unit aimed to identify predictors of unfavourable outcome - death and sequelae. Anamnestic, clinical and laboratory data and clinical outcome were recorded. From 1997 to 2006, 279 adults (122F, 157M) with a median age of 51 y were admitted with acute bacterial meningitis. Predisposing condition and comorbidity were recorded in 42% and 38% of patients, respectively. Time between symptoms onset and antibiotic treatment ranged from 6 to 160 h. An aetiological agent was identified in 77% of patients: Streptococcus pneumoniae (29%) and Neisseria meningitidis (27%) were the most frequent. 55 patients (20%) died and 63 (23%) had neurological sequelae 6 months after discharge. In multivariate analysis, 7 independent predictors of unfavourable outcome were identified: internal comorbidity, time to treatment >48 h, coma, hypotension, high CSF protein, low glucose ratio, and non-meningococcal aetiology. The results suggest that acute bacterial meningitis remains associated with significant morbidity and mortality. Maintaining a high clinical suspicion and initiating appropriate diagnostic testing and therapeutic interventions promptly are essential for an optimal clinical outcome.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d3bde28004e6b3c4fed95d1c002dcda4 https://doi.org/10.1080/00365540902849391 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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