Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study

Sonneville, Romain; Montmollin, Étienne de; Contou, Damien; Ferrer, Ricard; Gurjar, Mohan; Klouche, Kada; Sarton, Benjamine; Demeret, Sophie; Bailly, Pierre; Silva, Daniel da; Escudier, Étienne; Guennec, Loïc Le; Chabanne, Russel; Argaud, Laurent; Salem, Omar Ben Hadj; Thyrault, Martial; Frerou, Aurélien; Louis, Guillaume; Pascale, Gennaro De; Horn, Janneke; Helbok, Raimund; Géri, Guillaume; Bruneel, Fabrice; Martín‐Loeches, Ignacio; Taccone, Fabio Silvio; Waele, Jan J. De; Ruckly, Stéphane; Staiquly, Quentin; Citerio, Giuseppe; Timsit, Jean‐François; Santafe, Manuel; Smonig, Roland; Roux, Damien; Voiriot, Guillaume; Souweine, Bertrand; Razazi, Keyvan; Ducrocq, Thibault; Boronat, Patricia; Aïssaoui, Nadia; Reuter, Danielle; Cariou, Alain; Mateu, Philippe; Moreno, Barabara Balandin; Vera, Paula Valentina de Sousa; Jordan, Estela Val; Barbier, François; Landais, Mickaël; Bourenne, Jérémy; Marchalot, Antoine; Perrin, Mathilde; Sztrympf, Benjamin; Schwebel, Carole; Mishra, Shakti Bedanta; Chillet, Patrick; Martin, Maëlle; Georges, Hugues; Lachérade, Jean-Claude; Larcher, Romaric; Papin, G.; Schnell, David; Saxena, Shilpi; Chemouni, Frank; Audibert, J; Mariotte, Éric; Siami, Shidasp; Calamai, Italo; Bruel, Cédric; Massri, Alexandre; Priego, Jesus; Souloy, Xavier; Beuret, Pascal; Gupta, B. S.; Ritzenthaler, Thomas; Hraiech, Sami; Radjou, Aguila; Renuka, M

doi:10.1007/s00134-023-07032-9

Cited by 20 publications

(15 citation statements)

References 36 publications

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“…A recent international multicenter prospective study (the EURopean study on Encephalitis in intensive Care, EURECA) investigated the epidemiology and outcomes of 589 patients with meningoencephalitis requiring ICU admission from 68 centers across 7 countries between 2017 and 2020 [1 ▪▪ ]. Of note, bacterial meningitis accounted for 42% of cases, with Streptococcus pneumoniae being the most frequent identified pathogen representing 60% of causes of acute bacterial meningitis, and 25% of the whole cohort.…”

Section: Epidemiologymentioning

confidence: 99%

“…Main causes of meningoencephalitis, data from the EURopean study on Encephalitis in intensive Care study. Data from [1 ▪▪ ].…”

Section: Epidemiologymentioning

confidence: 99%

“…Severe meningoencephalitis requiring ICU admission is associated with a poor prognosis, including mortality rates of 11–25%, and severe functional disability in 15–25% of survivors [1 ▪▪ ,3 ▪ ]. Several indicators of poor outcomes available at ICU admission have been identified in patients with all-cause meningoencephalitis, including older age (>60 years old), immunocompromised status, focal signs (hemiparesis/hemiplegia), a motor component of Glasgow coma scale 3 or less, abnormal neuroimaging, cardiovascular and respiratory failures, a delay to ICU admission greater than 1 day.…”

Section: Epidemiologymentioning

confidence: 99%

“…Data from [1 ▪▪ ]. Immunodepression was defined by a history of HIV infection, solid organ transplant recipient, hematology/cancer, and long-term use of steroids and/or immunosuppressant drugs.…”

Section: Epidemiologymentioning

confidence: 99%

“…Despite recent advances, pneumococcal meningitis remains the most frequent cause (25%) and is associated with high residual rates of mortality and neurological sequelae [16 ▪▪ ], up to 47% of patients with a modified Rankin score at least 3 at 3 months [1 ▪▪ ] and 43% with a Glasgow outcome scale 4 or less in a Dutch cohort [16 ▪▪ ]. Meningococcal meningitis is also rare (3%) but with less morbidity and mortality, with up to 18% of patients with a modified Rankin score at least 3 at 3 months [1 ▪▪ ] and 14% with a Glasgow outcome scale 4 or less in a Dutch cohort, driven by an outbreak of serogroup W associated with higher rates of unfavorable outcome [17 ▪▪ ]. Neurological listeriosis is a rare cause (2%) but is associated with high morbidity and mortality, with up to 57% of patients with a modified Rankin score at least 3 at 3 months [1 ▪▪ ] and 56% with a Glasgow outcome scale 4 or less [18 ▪▪ ].…”

Section: Bacterial Causesmentioning

confidence: 99%

See 4 more Smart Citations

Severe meningoencephalitis: epidemiology and outcomes

Thy,

de Montmollin,

Bouadma

et al. 2023

Current Opinion in Critical Care

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Purpose of review This article aims to provide an updated review on the epidemiology and outcomes of severe meningoencephalitis. Recent findings Meningoencephalitis is a critical medical condition characterized by inflammation in both the meninges and brain parenchyma. Bacterial, viral, or fungal infections are common causes, although noninfectious factors, such as autoimmune causes, can also contribute. In patients requiring intensive care, meningoencephalitis is associated with a severe prognosis, including mortality rates ranging from 11 to 25% and functional disability in 15–25% of survivors. Recent multicenter studies have identified several parameters linked to poor outcomes, including older age, immunocompromised status, focal neurologic signs, abnormal brain imaging, and delayed administration of antimicrobials. The use of new multiplex PCR techniques for diagnosis has generated debate based on recent data. Investigation is still needed to determine the effectiveness of adjunctive therapies, including seizure prophylaxis, and adjunctive steroids for nonbacterial causes. Summary Recent multicenter studies have enhanced our understanding of the current epidemiology and outcomes of severe meningoencephalitis in adult patients.

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Section: Epidemiologymentioning

confidence: 99%

“…Main causes of meningoencephalitis, data from the EURopean study on Encephalitis in intensive Care study. Data from [1 ▪▪ ].…”

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%