The cause of death in bacterial meningitis

Abstract

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.

Sudden Death in Adults: A Practical Flow Chart for Pathologist Guidance

“…Other than stroke causes include: Bacterial meningitis: despite advances in clinical care, it remains a severe disease with a high risk of complications that may lead to SD [ 88 ]; Epilepsy: it is named sudden unexpected death in epilepsy (SUDEP), referring to the sudden and unexpected death of an epileptic patient with no other health issues during normal activity. The exact cause of SUDEP has not been established yet; however, it is assumed to be caused by multiple organ failure [ 89 ]; Brain tumor: even if it represents a rare event, an undiagnosed primary brain tumor may be considered a risk factor for SD.…”

“…Bacterial meningitis: despite advances in clinical care, it remains a severe disease with a high risk of complications that may lead to SD [ 88 ];…”

Determining the required level of care for patients with acute bacterial meningitis: case reports and literature review

“…The risk fac tors pre sented may have con trib uted to the rapid de te rio ra tion of the pa tient's con di tion. It is likely that the patient's con di tion and con scious ness may have de te ri o rated as a re sult of in creas ing intracranial pres sure (ICP) caused by ce re bral edema, which usu ally starts to worsen af ter a few hours to a cou ple of days af ter in fec tion [14]. The de teri o ra tion was spot ted in the morn ing, al though it likely occurred dur ing night-time hours and was not de tected as it is not al ways pos si ble to mon i tor pa tients in neu ro log i cal ward ev ery hour, es pe cially at night.…”

“…Ini tial phase of the dis ease is con sid ered to be the first week of the dis ease as AWMF con sid ers the first week of bac te rial men in gi tis to be most crit i cal. Although the guide line com mit tee did not give any data to back up its claims, there is some ev i dence that most bac terial men in gi tis cases de te ri o rate within the first week of infec tion [13,14]. How ever, it is worth not ing that the German guide line has not been up dated in over 5 years.…”

Post-Traumatic Meningitis Is a Diagnostic Challenging Time: A Systematic Review Focusing on Clinical and Pathological Features

“…Bacterial meningitis death is rarely attributed to the actual event that caused death. Fatal complications from primary infection, meningitis, present many differences in the complications that cause death, so that determining the clinical cause of death is essential for evaluating causal correlation and new therapeutic strategies [95].…”