Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/173479
Title: Delayed Cerebral Vasculopathy in Pneumococcal Meningitis: Epidemiology and Clinical Outcome. A Cohort Study
Author: Boix Palop, Lucía
Fernández, Tamara
Pelegrin, Ivan
Obradors, Meritxell
García Roulston, Kevin
Xercavins, Mariona
García Somoza, Dolors
Ardanuy Tisaire, María Carmen
Garau, Javier
Calbo, Esther
Cabellos Mínguez, Ma. Carmen
Keywords: Meningitis cerebrospinal epidèmica
Vasculitis
Cerebrospinal meningitis
Vasculitis
Issue Date: 1-Aug-2020
Publisher: Elsevier Ltd.
Abstract: Background: To describe the prevalence, clinical characteristics, impact of systemic steroids exposure and outcomes of delayed cerebral vasculopathy (DCV) in a cohort of adult patients with pneumococcal meningitis (PM). Methods: Observational retrospective multicenter study including all episodes of PM from January 2002 to December 2015. DCV was defined as proven/probable/possible based upon clinical criteria and pathological-radiological findings. DCV-patients and non-DCV-patients were compared by univariate analysis. Results: 162 PM episodes were included. Seventeen (10.5%) DCV-patients were identified (15 possible, 2 probable). At admission, DCV-patients had a longer duration of symptoms (>2 days in 58% vs. 25.5% (p 0.04)), more coma (52.9% vs. 21.4% (p 0.03)), lower median CSF WBC-count (243 cells/uL vs. 2673 cells/uL (p 0.001)) and a higher proportion of positive CSF Gram stain (94.1% vs. 71% (p 0.07)). Median length of stay was 49 vs. 15 days (p 0.001), ICU admission was 85.7% vs. 49.5% (p 0.01) and unfavorable outcome was found in 70.6% vs. 23.8% (p 0.001). DCV appeared 1-8 days after having completed adjunctive dexamethasone treatment (median 2,5, IQR = 1.5-5). Conclusions: One tenth of the PM developed DCV. DCV-patients had a longer duration of illness, were more severely ill, had a higher bacterial load at admission and had a more complicated course. Less than one third of cases recovered without disabilities. The role of corticosteroids in DCV remains to be established. (c) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Note: Reproducció del document publicat a: https://doi.org/10.1016/j.ijid.2020.06.005
It is part of: International Journal of Infectious Diseases, 2020, vol. 97, p. 283-289
URI: http://hdl.handle.net/2445/173479
Related resource: https://doi.org/10.1016/j.ijid.2020.06.005
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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