Intracranial Complications in Severe Pneumococcal Meningitis
Author Information
Author(s): Legouy Camille, Cornic Renaud, Razazi Keyvan, Contou Damien, Legriel Stéphane, Garrigues Eve, Buiche Pauline, Decavèle Maxens, Benghanem Sarah, Rambaud Thomas, Aboab Jérôme, Esposito-Farèse Marina, Timsit Jean-François, Couffignal Camille, Sonneville Romain
Primary Institution: GHU Paris Psychiatrie & Neurosciences, Paris, France
Hypothesis
We aimed to investigate the association of intracranial complications diagnosed on neuroimaging with neurological outcomes of adults with severe pneumococcal meningitis.
Conclusion
Intracranial complications were independently associated with a higher risk of poor functional outcome, in the form of persistent disability or death.
Supporting Evidence
- Intracranial complications were diagnosed in 68/220 patients (31%) who underwent neuroimaging at ICU admission.
- At 90 days, 103 patients (44%) had unfavorable outcomes, including 71 (30%) deaths.
- The most frequent intracranial complications were ischemic lesion (29%), diffuse cerebral oedema (18%), and ventriculitis (15%).
- Chronic alcohol consumption was associated with persistent disability at 90 days.
- Intracranial complications were detected in 57% of cases during the entire hospitalization.
- Neuroimaging studies are valuable for prognostication in this population.
Takeaway
This study found that many adults with severe pneumococcal meningitis have brain problems that can lead to worse health outcomes, like disability or death.
Methodology
A retrospective multicenter study on consecutive adults diagnosed with pneumococcal meningitis requiring at least 48 hours of ICU stay and undergoing neuroimaging.
Potential Biases
Potential immortality bias may have been introduced with complications on admission being missed.
Limitations
The study is retrospective, and the timing and technique of neuroimaging were not standardized between centers.
Participant Demographics
Median age of 60 years, 54% male, with various comorbidities including diabetes and chronic alcohol consumption.
Statistical Information
Confidence Interval
95%CI 0.25–0.37
Digital Object Identifier (DOI)
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