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Severe meningoencephalitis: epidemiology and outcomes

Michael Thy1,2,3, Etienne de Montmollin1,4, Lila Bouadma1,4

  • 1Department of Intensive Care Medicine.

Current Opinion in Critical Care
|August 29, 2023
PubMed
Abstract

Insights

Severe meningoencephalitis has a poor prognosis, with high mortality and disability rates. Factors like older age and delayed treatment worsen outcomes, necessitating further research into effective therapies.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Meningoencephalitis involves inflammation of the meninges and brain parenchyma, often caused by infections (bacterial, viral, fungal) or autoimmune conditions.
  • This critical condition carries a severe prognosis, with mortality rates of 11-25% and functional disability in 15-25% of survivors requiring intensive care.
  • Recent multicenter studies have improved understanding of severe meningoencephalitis epidemiology and outcomes in adults.

Approach:

  • Review of recent multicenter studies on severe meningoencephalitis.
  • Identification of epidemiological trends and prognostic factors.
  • Evaluation of diagnostic techniques and therapeutic interventions.

Key Points:

  • Poor prognostic indicators include older age, immunocompromised status, focal neurologic signs, abnormal brain imaging, and delayed antimicrobial administration.
  • The diagnostic utility of multiplex PCR techniques is under ongoing investigation.
  • Further research is required to establish the efficacy of adjunctive therapies such as seizure prophylaxis and steroids for nonbacterial cases.

Conclusions:

  • Severe meningoencephalitis remains a critical condition with significant mortality and morbidity.
  • Understanding prognostic factors aids in risk stratification and management.
  • Continued research is essential for optimizing diagnostic and therapeutic strategies.

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