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Endocarditis en adultos con meningitis bacteriana en el cerebro
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
Resumen
La meningitis bacteriana complicada por endocarditis (inflamación del revestimiento del corazón) es poco común, pero conduce a complicaciones frecuentes y resultados pobres. Este estudio encontró endocarditis en el 2% de los casos de meningitis bacteriana.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Cardiología Cardiología.
- Neurología Neurología.
Sus antecedentes:
- La meningitis bacteriana puede ser complicada por la endocarditis, pero la frecuencia y el impacto de esta coincidencia no están bien establecidos.
- Comprender la incidencia y las implicaciones clínicas de la endocarditis en la meningitis bacteriana es crucial para el manejo del paciente.
Objetivo del estudio:
- Determinar la incidencia y las características clínicas de la endocarditis en pacientes adultos con meningitis bacteriana adquirida en la comunidad.
- Investigar los resultados y las complicaciones asociadas con la meningitis y la endocarditis coexistentes.
Principales métodos:
- Un estudio de cohorte a nivel nacional se llevó a cabo en los Países Bajos desde 2006 hasta 2012, analizando a pacientes adultos con meningitis bacteriana adquirida en la comunidad.
- La endocarditis se identificó en base a pistas clínicas, incluidos soplos cardíacos, fiebre persistente, antecedentes de enfermedad de las válvulas cardíacas y patógenos causantes específicos como Staphylococcus aureus.
Principales resultados:
- La endocarditis fue diagnosticada en el 2% (24 de 1025) de los episodios de meningitis bacteriana.
- Los patógenos causantes comunes incluyen Streptococcus pneumoniae y Staphylococcus aureus.
- Se observaron altas tasas de complicaciones sistémicas (70%) y neurológicas (54%), con un 63% de pacientes que experimentaron un resultado desfavorable y una mortalidad del 29%.
Conclusiones:
- La endocarditis es una complicación poco frecuente pero significativa de la meningitis bacteriana.
- La coocurrencia de meningitis bacteriana y endocarditis se asocia con una alta incidencia de complicaciones graves y resultados desfavorables.
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