Intracerebral haemorrhage in bacterial meningitis - 30/07/22
Abstract |
Objective |
To determine the incidence, clinical course, radiological patterns, and clinical outcome of intracerebral haemorrhage (ICH) complicating community-acquired bacterial meningitis.
Methods |
The clinical characteristics and outcome of patients with ICH complicating bacterial meningitis were studied in a prospectively nationwide cohort in the Netherlands performed from 2006 to 2018.
Results |
ICH was identified in 44 of 2306 episodes of bacterial meningitis (1.9%). Nine of these patients (20%) were diagnosed with ICH on admission and 35 (80%) during clinical course after a median of 5 days (1–9). ICH occurred in 4 patients with endocarditis (9%), 9 patients on anticoagulation (vitamin K antagonists and heparin; 20%), and 10 patients with cerebral infarctions (23%). In 31 patients (70%) ICH was a lobar haematoma. ICH in bacterial meningitis was associated with high rates of death (24 of 44 [55%] vs. 346 of 2200 [16%]; P < 0.001) and unfavourable outcome compared to non-ICH patients (39 of 44 [89%] vs. 798 of 2200 [36%]; P < 0.001). Neurological sequelae on discharge occurred frequently in ICH survivors compared to non-ICH patients (15 of 20 [75%] vs. 203 of 1669 [12%]; P < 0.001).
Conclusions |
ICH is a rare but severe complication in patients with bacterial meningitis occurring in those with endocarditis, cerebral infarction, and anticoagulant use. ICH complicating bacterial meningitis is associated with high rates of death and morbidity.
Le texte complet de cet article est disponible en PDF.Keywords : Bacterial meningitis, Intracerebral haemorrhage, Cerebrovascular complication, Stroke, Streptococcus pneumoniae
Abbreviations : ICH, CSF
Plan
| ☆ | Edited by: R. Read |
| Funding |
|
| This study is supported by the Netherlands Organization for Health Research and Development (ZonMw; NWO-Vici-Grant [91,819,627] to D.v.d.B., NWO-Vidi-Grant [916.13.078] to M.C.B.), and the European Research Council (ERC Consolidator Grant to M.C.B.). |
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| Financial Disclosure Statement |
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| Dr. Deliran, reports no disclosures. Dr. Brouwer, reports no disclosures. Prof. Dr. van de Beek, reports no disclosures. |
Vol 85 - N° 3
P. 301-305 - septembre 2022 Retour au numéro
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