Community-acquired Haemophilus influenzae meningitis in adults - 25/04/21
, Arie van der Ende b, c, Diederik van de Beek a, ⁎ Highlights |
• | H. influenzae causes 4% of community-acquired bacterial meningitis cases in adults. |
• | Majority of adult H. influenzae meningitis cases are caused by non-typeable serotypes. |
• | Predisposing conditions are ENT infections, CSF leakage or immunocompromised state. |
• | Unfavourable outcome in H. influenzae meningitis in adults occurs in 17%. |
Summary |
Background |
Haemophilus influenzae is an uncommon cause of meningitis in adults.
Methods |
We analyzed episodes of community-acquired H. influenzae meningitis in adults included in a prospective nationwide cohort study in the Netherlands.
Results |
From 2006 to July 2018, 82 of 2272 (4%) bacterial meningitis episodes were caused by H. influenzae (mean annual incidence 0.5 patients per 1,000,000). Median age was 61 years (IQR 46–68), and 48 episodes (59%) occurred in woman. Predisposing factors were otitis and/or sinusitis in 33 of 76 patients (49%), immunocompromising conditions in 19 of 75 patients (25%) and cerebrospinal fluid leak in 13 of 79 patients (17%). Serotyping showed 63 of 80 isolates (79%) were non-typeable (NTHi). Three patients (4%) died and 14 patients (17%) had an unfavorable outcome (Glasgow Outcome Scale score < 5 at discharge). Pneumonia (odds ratio [OR] 5.8, 95% confidence interval [95%CI] 1.1–30.8), presence of immunocompromising conditions (OR 6.0, 95%CI 1.5–24.4), and seizures on admission (OR 10.7, 95%CI 1.6–72.8) were associated with an unfavorable outcome, while NTHi was associated with a favorable outcome (OR 5.6, 95%CI 1.6–19.5).
Conclusion |
H. influenzae is an uncommon cause of adult bacterial meningitis patients mainly causing disease in those with predisposing factors, such as CSF leakage, ENT infections, and immunocompromised state. In adult patients the majority of H. influenzae meningitis is caused by non-typeable strains.
Le texte complet de cet article est disponible en PDF.Keywords : Community-acquired bacterial meningitis, Haemophilus influenzae, Prospective cohort study, Clinical characteristics, Capsular serotype
Plan
Vol 82 - N° 5
P. 145-150 - mai 2021 Retour au numéro
Article précédent
- Tobacco smoking and meningococcal disease in adolescents and young adults: a systematic review and meta-analysis
- Ellie K Pilat, James M Stuart, Clare E French
- Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers
- Ranya Mulchandani, Sian Taylor-Philips, Hayley E. Jones, A.E. Ades, Ray Borrow, Ezra Linley, Peter D Kirwan, Richard Stewart, Philippa Moore, John Boyes, Anil Hormis, Neil Todd, Antoanela Colda, Ian Reckless, Tim Brooks, Andre Charlett, Matthew Hickman, Isabel Oliver, David Wyllie
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?