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Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults: a retrospective analysis
Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this field of resear...
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| Published in: | BMC infectious diseases 2013-07, Vol.13 (1), p.321-321, Article 321 |
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| description | Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region.
We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded according to the Glasgow Outcome Scale at discharge from the primary admission. Long-term sequelae were based upon any subsequent hospital contacts until the end of 2011.
Hydrocephalus was diagnosed in five of 165 episodes (3%) and all were classified as communicating. Only 120 patients had cranial imaging done and in this group the rate was 4.2%. In three cases hydrocephalus was present at admission, while two cases were diagnosed on days 44 and 99, respectively, due to altered mental status. The aetiology was either Eschericia coli (n = 2) or Streptococcus pneumoniae (n = 3). Case fatality was 60% among cases with hydrocephalus and 17% among other cases. Case fatality was similar irrespective of whether patients had a cranial CT or not.
Hydrocephalus was diagnosed in 3% of adolescent and adult cases with CABM and had a high case fatality rate in spite of specialised medical care and neurosurgical interventions. Our findings are comparable with a recent Dutch national prospective study. |
| doi_str_mv | 10.1186/1471-2334-13-321 |
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We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded according to the Glasgow Outcome Scale at discharge from the primary admission. Long-term sequelae were based upon any subsequent hospital contacts until the end of 2011.
Hydrocephalus was diagnosed in five of 165 episodes (3%) and all were classified as communicating. Only 120 patients had cranial imaging done and in this group the rate was 4.2%. In three cases hydrocephalus was present at admission, while two cases were diagnosed on days 44 and 99, respectively, due to altered mental status. The aetiology was either Eschericia coli (n = 2) or Streptococcus pneumoniae (n = 3). Case fatality was 60% among cases with hydrocephalus and 17% among other cases. Case fatality was similar irrespective of whether patients had a cranial CT or not.
Hydrocephalus was diagnosed in 3% of adolescent and adult cases with CABM and had a high case fatality rate in spite of specialised medical care and neurosurgical interventions. Our findings are comparable with a recent Dutch national prospective study.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/1471-2334-13-321</identifier><identifier>PMID: 23855442</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Aged ; Analysis ; Antibiotics ; Bacterial meningitis ; Coma ; Community-Acquired Infections - complications ; Community-Acquired Infections - epidemiology ; Community-Acquired Infections - microbiology ; Community-Acquired Infections - mortality ; Denmark - epidemiology ; Female ; Gene amplification ; Hospitalization ; Hospitals ; Humans ; Hydrocephalus ; Hydrocephalus - epidemiology ; Hydrocephalus - microbiology ; Hydrocephalus - mortality ; Incidence ; Male ; Medical research ; Meningitis ; Meningitis, Bacterial - complications ; Meningitis, Bacterial - epidemiology ; Meningitis, Bacterial - microbiology ; Middle Aged ; Patient outcomes ; Population ; Retrospective Studies ; Risk factors ; Streptococcus pneumoniae</subject><ispartof>BMC infectious diseases, 2013-07, Vol.13 (1), p.321-321, Article 321</ispartof><rights>COPYRIGHT 2013 BioMed Central Ltd.</rights><rights>2013 Bodilsen et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2013 Bodilsen et al.; licensee BioMed Central Ltd. 2013 Bodilsen et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b718t-21f94b7cec62d9aa7af7e06d4cc5d873e7252356a2099e73dfb476b34403fc173</citedby><cites>FETCH-LOGICAL-b718t-21f94b7cec62d9aa7af7e06d4cc5d873e7252356a2099e73dfb476b34403fc173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717123/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1412685314?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,25783,27957,27958,37047,37048,44625,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23855442$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bodilsen, Jacob</creatorcontrib><creatorcontrib>Schønheyder, Henrik Carl</creatorcontrib><creatorcontrib>Nielsen, Henrik</creatorcontrib><title>Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults: a retrospective analysis</title><title>BMC infectious diseases</title><addtitle>BMC Infect Dis</addtitle><description>Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region.
We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded according to the Glasgow Outcome Scale at discharge from the primary admission. Long-term sequelae were based upon any subsequent hospital contacts until the end of 2011.
Hydrocephalus was diagnosed in five of 165 episodes (3%) and all were classified as communicating. Only 120 patients had cranial imaging done and in this group the rate was 4.2%. In three cases hydrocephalus was present at admission, while two cases were diagnosed on days 44 and 99, respectively, due to altered mental status. The aetiology was either Eschericia coli (n = 2) or Streptococcus pneumoniae (n = 3). Case fatality was 60% among cases with hydrocephalus and 17% among other cases. Case fatality was similar irrespective of whether patients had a cranial CT or not.
Hydrocephalus was diagnosed in 3% of adolescent and adult cases with CABM and had a high case fatality rate in spite of specialised medical care and neurosurgical interventions. Our findings are comparable with a recent Dutch national prospective study.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Antibiotics</subject><subject>Bacterial meningitis</subject><subject>Coma</subject><subject>Community-Acquired Infections - complications</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Community-Acquired Infections - microbiology</subject><subject>Community-Acquired Infections - mortality</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>Gene amplification</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hydrocephalus</subject><subject>Hydrocephalus - epidemiology</subject><subject>Hydrocephalus - microbiology</subject><subject>Hydrocephalus - mortality</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical research</subject><subject>Meningitis</subject><subject>Meningitis, Bacterial - complications</subject><subject>Meningitis, Bacterial - epidemiology</subject><subject>Meningitis, Bacterial - microbiology</subject><subject>Middle Aged</subject><subject>Patient outcomes</subject><subject>Population</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Streptococcus pneumoniae</subject><issn>1471-2334</issn><issn>1471-2334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNqNkstr3DAQxk1padJt7z0VQy_twaletuQeCmFpm0Ag0NdVyPJ4o2BLGz1C97-vzKZLXFJadBgx85uP4ZspipcYnWAsmneYcVwRSlmFaUUJflQcH1KP7_2PimchXCOEuSDt0-KIUFHXjJHjwp7teu80bK_UmEJpQqlKrzyULkXtJiiNLXOckjVxVyl9k4yHvuyUjuCNGssJrLEbE3NnRlWfxhjezyIQvQtb0NHcQqmsGnfBhOfFk0GNAV7cxVXx_dPHb-uz6uLy8_n69KLqOBaxInhoWcc16Ib0rVJcDRxQ0zOt615wCpzUhNaNIqhtgdN-6BhvOsoYooPGnK6KD3vdbeom6DXY6NUot95Myu-kU0YuK9ZcyY27lZRjjrNlq2K9F-iM-4vAspJNkrPfcvZbYirzOrLKm7sxvLtJEKKcTNAwjsqCS0HimomGopaIf6OMIlEj0aKMvv4DvXbJZ4dnCpNG1DTTB2qjRpDGDi7PqWdReVpT1mQ1MWudPEDl18NktLMwmJxfNLxdNGQmws-4USkEef71y_-zlz-WLNqzOp9N8DAcvMZIzsf-kLuv7i_50PD7uukvLor4gw</recordid><startdate>20130715</startdate><enddate>20130715</enddate><creator>Bodilsen, Jacob</creator><creator>Schønheyder, Henrik Carl</creator><creator>Nielsen, Henrik</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QL</scope><scope>7T2</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130715</creationdate><title>Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults: a retrospective analysis</title><author>Bodilsen, Jacob ; 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Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region.
We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded according to the Glasgow Outcome Scale at discharge from the primary admission. Long-term sequelae were based upon any subsequent hospital contacts until the end of 2011.
Hydrocephalus was diagnosed in five of 165 episodes (3%) and all were classified as communicating. Only 120 patients had cranial imaging done and in this group the rate was 4.2%. In three cases hydrocephalus was present at admission, while two cases were diagnosed on days 44 and 99, respectively, due to altered mental status. The aetiology was either Eschericia coli (n = 2) or Streptococcus pneumoniae (n = 3). Case fatality was 60% among cases with hydrocephalus and 17% among other cases. Case fatality was similar irrespective of whether patients had a cranial CT or not.
Hydrocephalus was diagnosed in 3% of adolescent and adult cases with CABM and had a high case fatality rate in spite of specialised medical care and neurosurgical interventions. Our findings are comparable with a recent Dutch national prospective study.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>23855442</pmid><doi>10.1186/1471-2334-13-321</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC infectious diseases, 2013-07, Vol.13 (1), p.321-321, Article 321 |
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| language | eng |
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| source | Publicly Available Content Database; PubMed Central |
| subjects | Adult Aged Analysis Antibiotics Bacterial meningitis Coma Community-Acquired Infections - complications Community-Acquired Infections - epidemiology Community-Acquired Infections - microbiology Community-Acquired Infections - mortality Denmark - epidemiology Female Gene amplification Hospitalization Hospitals Humans Hydrocephalus Hydrocephalus - epidemiology Hydrocephalus - microbiology Hydrocephalus - mortality Incidence Male Medical research Meningitis Meningitis, Bacterial - complications Meningitis, Bacterial - epidemiology Meningitis, Bacterial - microbiology Middle Aged Patient outcomes Population Retrospective Studies Risk factors Streptococcus pneumoniae |
| title | Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults: a retrospective analysis |
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