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Bacterial meningitis in alcoholic patients: A population-based prospective study
Kiril E B van Veen1, Matthijs C Brouwer2, Arie van der Ende3
1Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands.
The Journal of Infection
|January 10, 2017
Summary
Community-acquired bacterial meningitis in alcoholic patients often leads to poor outcomes due to systemic complications like respiratory failure. Seizures are common, signaling potential alcohol withdrawal syndrome.
Area of Science:
- Infectious Diseases
- Neurology
- Critical Care Medicine
Background:
- Community-acquired bacterial meningitis (CABM) poses significant health risks.
- Alcoholism is a known risk factor for various infections and complications.
- The specific clinical features and outcomes of CABM in alcoholic patients require detailed investigation.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of community-acquired bacterial meningitis (CABM) specifically in patients with a history of alcoholism.
- To identify factors associated with unfavorable outcomes in alcoholic patients diagnosed with CABM.
Main Methods:
- A nationwide prospective cohort study was conducted from March 2006 to October 2014.
- Data were collected on 1359 episodes of CABM, including 88 episodes in alcoholic patients.
- Information gathered included patient history, admission symptoms/signs, treatment, and patient outcomes.
Main Results:
- Alcoholic patients constituted 6% (88/1359) of the CABM cohort.
- Presenting symptoms included seizures (18%) and pneumonia (23%).
- Common causative organisms were Streptococcus pneumoniae (76%). Systemic complications were frequent, with respiratory failure (40%) and endocarditis (9%). Unfavorable outcomes occurred in 58% of alcoholic patients, with a 25% mortality rate. Alcoholism was linked to unfavorable outcomes (OR 1.96).
Conclusions:
- Alcoholic patients with CABM frequently experience unfavorable outcomes, primarily due to a high incidence of systemic complications, notably respiratory failure.
- The occurrence of seizures in this population necessitates vigilance for alcohol withdrawal syndrome.
- Early recognition and management of complications are crucial for improving patient prognosis.
