Related Experiment Video

Updated: Aug 9, 2026

Knee Arthrocentesis in Adults
04:41

Knee Arthrocentesis in Adults

Published on: February 25, 2022

Arthritis in adults with community-acquired bacterial meningitis: a prospective cohort study

Martijn Weisfelt1, Diederik van de Beek, Lodewijk Spanjaard

  • 1Department of Neurology, Centre of Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. m.weisfelt@amc.uva.nl

BMC Infectious Diseases
|March 31, 2006
PubMed
Abstract

Insights

Bacterial meningitis co-occurs with arthritis in 7% of adult cases. While often immune-mediated and generally having good outcomes, prolonged antibiotic therapy is crucial for infectious arthritis in bacterial meningitis.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Clinical Microbiology

Background:

  • The simultaneous occurrence of bacterial meningitis and arthritis is recognized but not well-quantified.
  • Understanding the frequency and characteristics of this dual condition is important for patient management.

Purpose of the Study:

  • To determine the incidence of arthritis in adult patients with community-acquired bacterial meningitis.
  • To analyze the clinical features and outcomes of bacterial meningitis with coexisting arthritis.

Main Methods:

  • A prospective nationwide cohort study of 696 adult patients with culture-confirmed bacterial meningitis.
  • Arthritis diagnosis was based on physician judgment; statistical analysis included Fisher exact test and Mann-Whitney U test.

Main Results:

  • Arthritis was present in 7% of bacterial meningitis episodes (48/696).
  • Meningococcal meningitis had the highest arthritis incidence (12%).
  • Of those with arthritis, 48% underwent joint fluid aspiration, with 26% yielding positive bacterial cultures. Mortality was 8%, and 23% experienced residual joint symptoms.

Conclusions:

  • Arthritis is a common complication of community-acquired bacterial meningitis.
  • Outcomes vary by causative agent; meningococcal arthritis is typically immune-mediated and less deforming than staphylococcal arthritis.
  • Consideration of additional therapies and mandatory prolonged antibiotic treatment for infectious arthritis are recommended.

Related Concept Videos

Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Bacterial Meningitis01:24

Bacterial Meningitis

Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Genome-wide Association Studies-GWAS01:11

Genome-wide Association Studies-GWAS

Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...