バクテリア性髄膜炎を有する成人の内臓内膜炎
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
まとめ
腸内心炎 (心臓内膜の炎症) によって合併された細菌性髄膜炎は珍しいが,頻繁な合併症と悪い結果につながる. この研究では,バクテリア性髄膜炎症例の2%で内心炎が見つかりました.
科学分野:
- 感染症 感染症は感染症です.
- 心臓病学 心臓病学
- 神経学 神経学とは
背景:
- 細菌性髄膜炎は心内膜炎によって複雑化することがありますが,この共発生の頻度と影響は十分に確立されていません.
- 細菌性髄膜炎における内心炎の発生率と臨床的影響を理解することは,患者の管理に極めて重要です.
研究 の 目的:
- コミュニティで得られた細菌性髄膜炎を患っている成人の患者における内心炎の発生率と臨床的特徴を決定する.
- 併存する髄膜炎と内心炎に関連したアウトカムと合併症を調査する.
主な方法:
- 2006年から2012年までオランダで全国的なコホート研究が実施され,コミュニティで発症した細菌性髄膜炎の成人の患者を分析した.
- 心臓内膜炎は,心臓のうなり声,絶え間ない発熱,心臓弁疾患の歴,およびStaphylococcus aureus.のような特定の病原菌などの臨床的手がかりに基づいて特定されました.
主要な成果:
- 細菌性髄膜炎のエピソードの2% (24件中1025件) に内臓内膜炎が診断されました.
- 共通の原因となる病原体には,Streptococcus pneumoniaeとStaphylococcus aureusが含まれる.
- システミック (70%) と神経学的 (54%) 合併症の高い割合が観察され,患者の63%が不利な結果と29%の死亡率を経験しました.
結論:
- 内臓内膜炎は,細菌性髄膜炎のまれだが重大な合併症である.
- 細菌性髄膜炎と内心炎の同時発生は,重篤な合併症と不利な結果の高い発生率と関連しています.
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