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Community-acquired spontaneous bacterial meningitis in patients with alcoholic liver disease

Wen-Neng Chang1, Cheng-Hsien Lu, Chen-Sheng Chang

  • 1Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|November 20, 2003
PubMed
Abstract

Insights

Adults with alcoholic liver disease (ALD) and bacterial meningitis show a high incidence of Klebsiella pneumoniae infections, particularly when diabetes mellitus is also present. This highlights the need for targeted treatment strategies in this vulnerable patient group.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Neurology

Background:

  • Limited data exists on clinical characteristics of adult alcoholic liver disease (ALD) patients experiencing acute bacterial meningitis.
  • This study focuses on 14 male ALD patients treated over a 15-year period.

Purpose of the Study:

  • To analyze the clinical and laboratory data of adult ALD patients with bacterial meningitis.
  • To evaluate the therapeutic outcomes in this specific patient cohort.

Main Methods:

  • Retrospective analysis of medical records from adult bacterial meningitis patients (Jan 1986-Dec 2000).
  • Inclusion criteria: adult patients with bacterial meningitis admitted to Chang Gung Memorial Hospital-Kaohsiung.
  • Data collected included microbiological findings (CSF, blood cultures) and clinical records.

Main Results:

  • Klebsiella pneumoniae was the predominant pathogen (11/14 cases).
  • Diabetes mellitus (DM) was common (64%), with all DM patients infected by K. pneumoniae.
  • High rates of bacteremia (64%) and thrombocytopenia (50%) were observed. Focal suppurations occurred in 4 patients. Overall mortality was 14%.

Conclusions:

  • Adult meningitis patients with ALD exhibit a high incidence of K. pneumoniae infections.
  • Concomitant diabetes mellitus significantly increases the risk of K. pneumoniae meningitis in ALD patients.

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