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Endocarditis in adults with bacterial meningitis
Marjolein J Lucas1, Matthijs C Brouwer, Arie van der Ende
1Academic Medical Center, Center of Infection and Immunity Amsterdam, Department of Neurology.
Circulation
|April 19, 2013
Summary
Bacterial meningitis complicated by endocarditis (inflammation of the heart lining) is uncommon but leads to frequent complications and poor outcomes. This study found endocarditis in 2% of bacterial meningitis cases.
Area of Science:
- Infectious Diseases
- Cardiology
- Neurology
Background:
- Bacterial meningitis can be complicated by endocarditis, but the frequency and impact of this co-occurrence are not well-established.
- Understanding the incidence and clinical implications of endocarditis in bacterial meningitis is crucial for patient management.
Purpose of the Study:
- To determine the incidence and clinical characteristics of endocarditis in adult patients with community-acquired bacterial meningitis.
- To investigate the outcomes and complications associated with coexisting meningitis and endocarditis.
Main Methods:
- A nationwide cohort study was conducted in the Netherlands from 2006 to 2012, analyzing adult patients with community-acquired bacterial meningitis.
- Endocarditis was identified based on clinical clues, including cardiac murmurs, persistent fever, history of heart valve disease, and specific causative pathogens like Staphylococcus aureus.
Main Results:
- Endocarditis was diagnosed in 2% (24 of 1025) of bacterial meningitis episodes.
- Common causative pathogens included Streptococcus pneumoniae and Staphylococcus aureus.
- High rates of systemic (70%) and neurological (54%) complications were observed, with 63% of patients experiencing an unfavorable outcome and 29% mortality.
Conclusions:
- Endocarditis is an infrequent but significant complication of bacterial meningitis.
- The co-occurrence of bacterial meningitis and endocarditis is associated with a high incidence of severe complications and unfavorable outcomes.
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