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The cause of death in bacterial meningitis
A Sharew1, J Bodilsen2, B R Hansen3
1Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark.
Background:
Death from bacterial meningitis is rarely attributed to the actual event causing death. The present study therefore categorized and characterized the cause and time of death due to bacterial meningitis.
Methods:
In a cohort of patients > 15 years of age with community acquired bacterial meningitis the medical records were reviewed, and a clinical cause of death categorized into six main categories: 1) CNS complications, 2) Systemic complications, 3) Combination of systemic and CNS complications, 4) Sudden death, 5) Withdrawal of care, or 6) Unknown.
Results:
We identified 358 patients of which 84 (23%) died in-hospital. Causes of death were ascribed to CNS complications in 43%, Systemic complications in 39%, Combined CNS and systemic complications in 4%, Sudden death in 7% and withdrawal of care in 5%. Brain herniation, circulatory failure, intractable seizures and other brain injury were the most common specific causes of death within 14 days from admission (55%).
Conclusion:
Fatal complications due to the primary infection - meningitis - is most common within 14 days of admission. The diversity of complications causing death in meningitis suggest that determining the clinical cause of death is essential to the evaluation of novel treatment strategies.
Insights
Bacterial meningitis deaths are often due to complications, not the infection itself. Understanding these complications, particularly central nervous system (CNS) issues within 14 days, is crucial for developing new treatments.
Area of Science:
- Infectious Diseases
- Neurology
- Critical Care Medicine
Background:
- Bacterial meningitis mortality is rarely attributed to the primary infection.
- The specific causes and timing of death in bacterial meningitis require detailed characterization.
Purpose of the Study:
- To categorize and characterize the causes and timing of death in adult community-acquired bacterial meningitis.
Main Methods:
- Retrospective review of medical records for patients aged >15 years with community-acquired bacterial meningitis.
- Classification of death into six categories: CNS complications, systemic complications, combined complications, sudden death, withdrawal of care, or unknown.
Main Results:
- Of 358 patients, 84 (23%) died in-hospital.
- Causes of death included CNS complications (43%), systemic complications (39%), combined (4%), sudden death (7%), and withdrawal of care (5%).
- Within 14 days of admission, brain herniation, circulatory failure, and intractable seizures were common specific causes (55%).
Conclusions:
- Fatal complications of bacterial meningitis predominantly occur within 14 days of admission.
- The wide range of complications leading to death highlights the need for precise clinical cause-of-death determination.
- Accurate classification is essential for evaluating and advancing novel therapeutic strategies for bacterial meningitis.
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