Infectious meningitis and encephalitis in adults in Denmark: a prospective nationwide observational cohort study (DASGIB)

Bodilsen, Jacob; Storgaard, Merete; Larsen, Lasse Juel; Wiese, Lothar; Helweg‐Larsen, Jannik; Lebech, Anne‐Mette; Brandt, Christian; Østergaard, Christian Richter; Nielsen, Henrik

doi:10.1016/j.cmi.2018.01.016

Cited by 57 publications

(51 citation statements)

References 15 publications

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“…Patients were eligible to be included if the following inclusion criteria were fulfilled: Patients were older than 15 years of age, had a clinical presentation strongly suggesting bacterial meningitis (headache, fever, stiffness of the neck, petechiae, confusion or impaired level of consciousness) and ≥ 1 of the following inclusion criteria [7][8][9]:…”

Section: Introductionmentioning

confidence: 99%

The cause of death in bacterial meningitis

et al. 2020

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Background: Death from bacterial meningitis is rarely attributed to the actual event causing death. The present study therefore categorized and characterized the cause and time of death due to bacterial meningitis. Methods: In a cohort of patients > 15 years of age with community acquired bacterial meningitis the medical records were reviewed, and a clinical cause of death categorized into six main categories: 1) CNS complications, 2) Systemic complications, 3) Combination of systemic and CNS complications, 4) Sudden death, 5) Withdrawal of care, or 6) Unknown. Results: We identified 358 patients of which 84 (23%) died in-hospital. Causes of death were ascribed to CNS complications in 43%, Systemic complications in 39%, Combined CNS and systemic complications in 4%, Sudden death in 7% and withdrawal of care in 5%. Brain herniation, circulatory failure, intractable seizures and other brain injury were the most common specific causes of death within 14 days from admission (55%). Conclusion: Fatal complications due to the primary infectionmeningitis-is most common within 14 days of admission. The diversity of complications causing death in meningitis suggest that determining the clinical cause of death is essential to the evaluation of novel treatment strategies.

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Section: Introductionmentioning

confidence: 99%

The cause of death in bacterial meningitis

et al. 2020

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“…Лихорадка как начальный признак нейроинфекций, согласно данным литературы, отмечается в 50 % случаев с интервалом 38,5-39,5 °С [5,7,15,22]. Лихорадка у пациентов группы вирусных нейроинфекций в нашем случае достигала фебрильных цифр (38,6 ± 0,6 °С), средняя продолжительность составила 3 ± 1,2 суток.…”

Section: таблица 1 клиническая характеристика групп (ме ± Sd)unclassified

“…При этом в 60 % случаев судороги у детей развивалась на фоне нормальной температуры тела как проявление тяжёлого поражения вещества головного мозга в группе пациентов с менингоэнцефалитом и отёком головного мозга. Однако даже при молниеносной форме менингококковой инфекции судороги могут регистрироваться у трети больных детей [5,15,22].…”

Section: Infectious Diseasesunclassified

Peculiarities of Clinical Manifestations of CNS Infections in Children

Berezovskaya

Miromanova

Мироманов

2018

Acta biomedica scientifica

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At present, the neuroinfections in children are a socially significant problem, as they can lead to disability and death.Aim. To reveal the patterns of clinical manifestations of neuroinfections in the children’s central nervous system.Materials and methods. We investigated 91 cases of neuroinfections in children. The children underwent treatment in the Regional Infectious Diseases Hospital (Chita) between 2007 and 2014. Among 91 cases, 32 patients had viral neuroinfections and 59 had bacterial infections.Results. The young boys have bacterial neuroinfections more often. Headaches were found in 73.6 % of children; more often in children with viral neuroinfections – in 87.5 %, and less frequent in children with bacterial neuroinfections – in 66.1 %, p ˂ 0.01 The disease often starts with fever and vomiting. The neck stiffness and the Kernig symptom were often found in patients with bacterial neuroinfections persisting for 5 ± 1.7 days and 4 ± 1.9 days correspondingly, in children with viral neuroinfections – for 3 ± 1.4 and 3 ± 1.2 days, p ˂ 0.05. Pneumococcal etiology of the disease underlies the most severe and protracted cases in the course of neuroinfections. Pneumococcus causes the most severe and protracted diseases of the nervous system. Most often the bacterial neuroinfections cause cerebral edema and septic shock.Conclusions. Neuroinfections have typical clinical signs that need to be properly interpreted and evaluated by physicians to reduce adverse outcomes.

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“…Interestingly, in previous studies, adults were more likely to be tested positive for herpes simplex virus and West Nile virus while children were more likely to be tested positive for enterovirus (EV) 5 . Therefore, multiple studies have been conducted in order to better understand this phenomenon: In a Danish nation-wide prospective observational study between 1 st of January 2015 to 30 th of June 2016 an unfavorable outcome of viral meningitis was documented in 17% of all patients 6 . According to a UK study, the infection rates of viral meningitis are mainly driven by an EV predominance of echovirus 30 7 .…”

Section: Introductionmentioning

confidence: 99%

Meningitis gone viral: Description of the Echovirus Wave 2013 in Germany

Graf

Hartmann

Lehmann

et al. 2019

Preprint

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BACKGROUND: Aseptic meningitis epidemics may pose various health care challenges. OBJECTIVE: We describe the German enterovirus meningitis epidemics in the university hospital centers of Düsseldorf, Cologne and Berlin between January 1 st and December 31 st , 2013 in order to scrutinize clinical differences from other aseptic meningitis cases. RESULTS: A total of 72 enterovirus (EV-positive) meningitis cases were detected in our multicenter cohort, corresponding to 5.8% of all EV-positive cases which were voluntarily reported within the National Enterovirus surveillance (EVSurv, based on investigation of patients with suspected aseptic meningitis/encephalitis and/or acute flaccid paralysis) by physicians within this period of time. Among these 72 patients, 38 (52.8%) were enterovirus positive and typed as echovirus (18 pediatric and 20 adult cases, median age 18.5 years; echovirus 18 (1), echovirus 2 (1), echovirus 30 (31), echovirus 33 (1), echovirus 9 (4)). At the same time, 45 aseptic meningitis cases in our cohort were excluded to be due to enteroviral infection (EV-negative). Three EV-negative patients were tested positive for varicella zoster virus (VZV) and one EV-negative patient for herpes simplex virus 2. Hospitalization was significantly longer in EV-negative cases. Cerebrospinal fluid analysis did not reveal significant differences between the two groups. After discharge, EV-meningitis resulted in significant burden of sick leave in our pediatric cohort as parents had to care for the children at home. CONCLUSION: Voluntary syndromic surveillance, such as provided by the EVSurv in our study may be a valuable tool for epidemiological research. Our analyses suggest that EV-positive meningitis predominantly affects younger patients and may be associated with a rather benign clinical course, compared to EV-negative cases.

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Infectious meningitis and encephalitis in adults in Denmark: a prospective nationwide observational cohort study (DASGIB)

Cited by 57 publications

References 15 publications

The cause of death in bacterial meningitis

The cause of death in bacterial meningitis

Peculiarities of Clinical Manifestations of CNS Infections in Children

Meningitis gone viral: Description of the Echovirus Wave 2013 in Germany

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