Related Experiment Video
Updated: Aug 2, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Community-acquired bacterial meningitis in adults: categorization of causes and timing of death
D A McMillan1, C Y Lin, S I Aronin
1Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Abstract:
The relationship between cause and timing of death in 294 adults who had been hospitalized with community-acquired bacterial meningitis was investigated. For 74 patients with community-acquired bacterial meningitis who died during hospitalization, the underlying and immediate causes of death were identified according to the criteria of the World Health Organization and National Center for Health Statistics. Patients were classified into 3 groups: category I, in which meningitis was the underlying and immediate cause of death (59% of patients; median duration of survival, 5 days); category II, in which meningitis was the underlying but not immediate cause of death (18%; median duration of survival, 10 days); and category III, in which meningitis was neither the underlying nor immediate cause of death (23%; median duration of survival, 32 days). In a substantial proportion of adults hospitalized with community-acquired bacterial meningitis, meningitis was neither the immediate nor the underlying cause of death. A 14-day survival end point discriminated between deaths attributable to meningitis and those with another cause.
Insights
In adults hospitalized with community-acquired bacterial meningitis, the cause of death varied. Meningitis was the primary cause for 59% of fatalities, but other factors contributed significantly in many cases.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Public Health
Background:
- Community-acquired bacterial meningitis is a serious infection with significant mortality.
- Understanding the precise cause of death is crucial for improving patient outcomes and public health strategies.
Purpose of the Study:
- To investigate the relationship between the cause of death and its timing in adults hospitalized with community-acquired bacterial meningitis.
- To classify deaths based on whether bacterial meningitis was the underlying or immediate cause.
Main Methods:
- Retrospective analysis of 294 adult patients hospitalized with community-acquired bacterial meningitis.
- Detailed review of underlying and immediate causes of death for 74 deceased patients, using WHO and NCHS criteria.
- Classification of patients into three groups based on the role of meningitis in mortality.
Main Results:
- Category I (meningitis as underlying and immediate cause): 59% of deaths, median survival 5 days.
- Category II (meningitis as underlying, not immediate cause): 18% of deaths, median survival 10 days.
- Category III (meningitis not underlying nor immediate cause): 23% of deaths, median survival 32 days.
- A significant proportion of deaths were not directly attributable to meningitis as the primary cause.
Conclusions:
- In a substantial number of adult hospitalizations for community-acquired bacterial meningitis, the infection was not the primary driver of mortality.
- A 14-day survival endpoint effectively differentiated deaths directly caused by meningitis from those with other underlying causes.
Related Concept Videos
01:24Bacterial Meningitis
01:18Viral Meningitis
01:27Cryptococcal Meningitis
01:22Bacterial Meningitis I: Introduction
01:26Bacterial Meningitis II: Pathophysiology
01:19Encephalitis l: Introduction