Delayed cerebral thrombosis in bacterial meningitis: a prospective cohort study

Abstract

Delayed cerebral thrombosis is a rare but devastating complication of bacterial meningitis. Adjunctive dexamethasone therapy seems to predispose patients with bacterial meningitis to this complication. We found some evidence that this thrombotic complication is associated with activation of the complement system.

Prediction of Outcome From Adult Bacterial Meningitis in a High-HIV-Seroprevalence, Resource-Poor Setting Using the Malawi Adult Meningitis Score (MAMS)

“…Physiological data are from the first recording to minimize both heterogeneity and biases associated with delays to antibiotic therapy, and increase applicability for clinical use in the region. Outcome was measured as death or survival at day 40 postadmission to account for additional acute postdischarge mortality, which has been reported to occur due to late complications in 5%–10% of initial survivors of ABM [9, 22]. Data on in-hospital delays and morbidity (principally deafness) were collected variably across the studies and were not included to minimize heterogeneity.…”

Repeat lumbar puncture in adults with bacterial meningitis

“…However, there are other indications for repeat lumbar puncture, e.g. to reduce intracranial pressure in patients with communicating hydrocephalus, or in those who deteriorate after initial recovery; for example in delayed cerebral thrombosis [5][6][7]. Complications of a lumbar puncture are uncommon, but include post-puncture headache, spinal or epidural bleeding, damage of the spinal nerve roots and cerebral herniation [8][9][10][11].…”

Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition

“…Analysis of a nationwide prospective Dutch cohort study of 1,032 cases of CSF culture-positive community-acquired bacterial meningitis demonstrated a 1.1 % incidence (11 cases) of delayed cerebral thrombosis [68]. All of the 11 patients had an initial response to treatment but deteriorated after 7-42 days, and the final outcome was poor in all but one of them.…”