Hydrocephalus in adults with community-acquired bacterial meningitis.

23:39 EDT 17th September 2014 | BioPortfolio

Summary of "Hydrocephalus in adults with community-acquired bacterial meningitis."


OBJECTIVE:
To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults.
METHODS:
Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009.
RESULTS:
Hydrocephalus was diagnosed in 26 of 577 episodes (5%) and was classified as communicating hydrocephalus in all but 1 patient. The majority of patients (69%) presented with hydrocephalus on admission. Most common causative bacteria were Streptococcus pneumoniae (in 14 patients, 54%) and Listeria monocytogenes (in 4 patients, 15%). Thirteen patients died (50%) and 18 had an unfavorable outcome (69%). Hydrocephalus was an independent predictor of death in a multivariate analysis (odds ratio 7.81, 95% confidence interval 2.91-20.8). Six patients underwent an intervention: 2 patients (8%) had serial lumbar punctures; 4 patients (15%) underwent external ventricular CSF catheter placement. Median time from diagnosis of hydrocephalus to CSF shunting was 12 hours (range 0-4 days). All patients who underwent CSF shunting died or had a poor outcome.
CONCLUSIONS:
Hydrocephalus complicates community-acquired bacterial meningitis in 5% of adult cases and is associated with high fatality rates. A minority of patients underwent neurosurgery and outcome was uniformly poor in these patients.

Affiliation

Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, PO Box 22660, 1100DD Amsterdam, the Netherlands d.vandebeek@amc.uva.nl.

Journal Details

This article was published in the following journal.

Name: Neurology
ISSN: 1526-632X
Pages: 918-23

Links

PubMed Articles [10263 Associated PubMed Articles listed on BioPortfolio]

Predictive performance of serum procalcitonin for the diagnosis of bacterial meningitis after neurosurgery.

Postoperative bacterial meningitis (PBM) is a serious potential complication after neurosurgery. Early diagnosis and introduction of antimicrobial therapy are necessary to reduce the rate of fatal out...

Stroke in community-acquired bacterial meningitis: a Danish population-based study.

Stroke is a serious complication in community-acquired bacterial meningitis (CABM), but the incidence, predispositions, and outcome need further clarification; this pertains in particular to the impac...

Economic cost of Streptococcus pneumoniae community-acquired pneumonia, meningitis and bacteremia in an adult population that required hospitalization in Bogotá, Colombia.

Introduction: Streptococcus pneumoniae infection in adults is related to pneumonia, meningitis and bacteremia. Its care costs in adults are not well documented in Colombia and it has a greater impact ...

A randomized study of ventriculoperitoneal shunt versus endoscopic third ventriculostomy for the management of tubercular meningitis with hydrocephalus.

This study aims at generating knowledge to understand the conditions in which either of the two procedures (endoscopic third ventriculostomy (ETV) and shunt) are better options and to develop good pra...

Acute bacterial meningitis in the intensive care unit and risk factors for adverse clinical outcomes: Retrospective study.

Bacterial meningitis constitutes a medical emergency. Its burden has driven from childhood to the elderly and the immunocompromised population. However, the admission of patients with bacterial mening...

Clinical Trials [2293 Associated Clinical Trials listed on BioPortfolio]

Community Acquired Pneumonia in Telemark and Ostfold

The aim of the study is to investigate the bacterial causes in community acquired pneumonia in adults admitted to hospital in two counties in Norway and to look at possible factors that ma...

A Global Active Surveillance for Community Acquired Pneumonia and Invasive Pneumococcal Disease in Adults

This study is an observational surveillance study to identify adults 50 years and older who present to a study healthcare facility with signs and symptoms of Community-Acquired Pneumonia ...

Comparative Study of Ceftaroline vs. Ceftriaxone in Adults With Community-Acquired Pneumonia

The purpose of the study is to determine if the antibiotic ceftaroline is safe and effective in the treatment of community-acquired pneumonia in adults.

Comparative Study of Ceftaroline vs. Ceftriaxone in Adult Subjects With Community-Acquired Pneumonia

The purpose of this study is to determine whether ceftaroline is effective and safe in the treatment of Community-Acquired Pneumonia

Usefulness of Microbiological Tests in Community-Acquired Pneumonia

The hypothesis is that community-acquired pneumonia is usually a monomicrobial infection. Therefore, early detection of the etiology allows to select the most active, narrow-spectrum, and ...

Medical and Biotech [MESH] Definitions

A fulminant infection of the meninges and subarachnoid fluid by the bacterium NEISSERIA MENINGITIDIS, producing diffuse inflammation and peri-meningeal venous thromboses. Clinical manifestations include FEVER, nuchal rigidity, SEIZURES, severe HEADACHE, petechial rash, stupor, focal neurologic deficits, HYDROCEPHALUS, and COMA. The organism is usually transmitted via nasopharyngeal secretions and is a leading cause of meningitis in children and young adults. Organisms from Neisseria meningitidis serogroups A, B, C, Y, and W-135 have been reported to cause meningitis. (From Adams et al., Principles of Neurology, 6th ed, pp689-701; Curr Opin Pediatr 1998 Feb;10(1):13-8)

A form of compensated hydrocephalus characterized clinically by a slowly progressive gait disorder (see GAIT DISORDERS, NEUROLOGIC), progressive intellectual decline, and URINARY INCONTINENCE. Spinal fluid pressure tends to be in the high normal range. This condition may result from processes which interfere with the absorption of CSF including SUBARACHNOID HEMORRHAGE, chronic MENINGITIS, and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp631-3)

Meningeal inflammation produced by CRYPTOCOCCUS NEOFORMANS, an encapsulated yeast that tends to infect individuals with ACQUIRED IMMUNODEFICIENCY SYNDROME and other immunocompromised states. The organism enters the body through the respiratory tract, but symptomatic infections are usually limited to the lungs and nervous system. The organism may also produce parenchymal brain lesions (torulomas). Clinically, the course is subacute and may feature HEADACHE; NAUSEA; PHOTOPHOBIA; focal neurologic deficits; SEIZURES; cranial neuropathies; and HYDROCEPHALUS. (From Adams et al., Principles of Neurology, 6th ed, pp721-2)

Inflammation of the coverings of the brain and/or spinal cord, which consist of the PIA MATER; ARACHNOID; and DURA MATER. Infections (viral, bacterial, and fungal) are the most common causes of this condition, but subarachnoid hemorrhage (HEMORRHAGES, SUBARACHNOID), chemical irritation (chemical MENINGITIS), granulomatous conditions, neoplastic conditions (CARCINOMATOUS MENINGITIS), and other inflammatory conditions may produce this syndrome. (From Joynt, Clinical Neurology, 1994, Ch24, p6)

Any infection acquired in the community, that is, contrasted with those acquired in a health care facility (CROSS INFECTION). An infection would be classified as community-acquired if the patient had not recently been in a health care facility or been in contact with someone who had been recently in a health care facility.

Search BioPortfolio:
Loading