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Published on: February 14, 2020
Hyperglycemia in bacterial meningitis: a prospective cohort study
Ewout S Schut1, Willeke F Westendorp, Jan de Gans
1Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands. e.s.schut@amc.uva.nl
BMC Infectious Diseases
|May 12, 2009
Summary
Most bacterial meningitis patients exhibit hyperglycemia on admission. While not a robust predictor in multivariate analysis, hyperglycemia and diabetes significantly increase the risk of unfavorable outcomes in these patients.
Area of Science:
- Neurology
- Infectious Diseases
- Endocrinology
Background:
- Hyperglycemia is linked to poor outcomes in various conditions, but its role in bacterial meningitis is less understood.
- This study investigates the prevalence and impact of hyperglycemia in adult bacterial meningitis cases.
Purpose of the Study:
- To determine the incidence of hyperglycemia in adult bacterial meningitis patients.
- To assess the significance of hyperglycemia and diabetes on patient outcomes.
Main Methods:
- Prospective data collection from 696 adult community-acquired bacterial meningitis episodes (1998-2002).
- Patients categorized by blood glucose levels: hyperglycemia (≥7.8 mmol/L) and severe hyperglycemia (≥11.1 mmol/L).
- Unfavorable outcome defined as Glasgow outcome scale score <5; analysis included patients with and without known diabetes.
Main Results:
- 69% of patients had hyperglycemia, and 25% had severe hyperglycemia on admission.
- Hyperglycemia associated with older age, pre-existing diabetes, and pneumococcal meningitis.
- While hyperglycemia showed a univariate link to unfavorable outcomes, this was not sustained in multivariate analysis.
Conclusions:
- The majority of bacterial meningitis patients present with hyperglycemia, potentially due to stress response and CNS insult.
- Patients with diabetes and bacterial meningitis face a high risk of unfavorable outcomes.
- Neurologic compromise linked to higher glucose levels; systemic compromise to lower levels.
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