From: Spontaneous gram-negative bacillary meningitis in adult patients: characteristics and outcome
Characteristics | Gram-negative bacillary meningitis (n = 40) | Other causes of meningitis (n = 405) | P value |
---|---|---|---|
Male sex | 23/40 (57.5) | 183/393 (46.6) | 0.187 |
Age – years, median (IQR) | 64 (17) | 50 (41) | < 0.001 |
Comorbid conditions | 29/40 (72.5) | 173/403 (42.9) | <0.001 |
• Cancer | 8/40 (20.0) | 41/403 (10.2) | 0.067 |
• Diabetes mellitus | 7/40 (17.5) | 45/403 (11.2) | 0.298 |
• Alcoholism | 6/40 (15.0) | 43/403 (10.7) | 0.425 |
• Liver cirrhosis | 4/40 (10.0) | 17/403 (4.2) | 0.110 |
Charlson comorbidity index ≥ 3 | 10/39 (25.6) | 50/399 (12.5) | 0.023 |
Distant focus of infection | 31/40 (77.5) | 139/402 (34.6) | <0.001 |
• Urinary tract infection | 13/40 (32.5) | 2/405 (0.5) | <0.001 |
• Otitis or sinusitis | 4/40 (10.0) | 58/405 (14.3) | 0.452 |
• Pneumonia | 2/40 (5.0) | 22/405 (5.4) | 1.000 |
Route of acquisition | |||
• Hospital-acquired (vs. community-acquired) | 9/40 (22.5) | 8/405 (2) | <0.001 |
Symptoms on presentation | |||
• Fever | 37/40 (92.5) | 387/402 (96.3) | 0.217 |
• Change in mental status | 29/40 (72.5) | 278/402 (69.2) | 0.661 |
• Neck stiffness | 24/40 (60.0) | 330/400 (82.5) | 0.001 |
• Triad of fever, neck stiffness, and change in mental status | 16/40 (40.0) | 231/401 (57.6) | 0.032 |
• Headache | 22/40 (55.0) | 323/402 (80.3) | <0.001 |
• Nausea and/or vomiting | 18/40 (45.0) | 239/394 (60.7) | 0.055 |
• Focal neurological deficits | 12/40 (30.0) | 74/402 (18.4) | 0.093 |
• Coma | 6/40 (15) | 26/402 (6.5) | 0.057 |
• Seizures | 5/40 (12.5) | 33/401 (8.2) | 0.371 |
• Rash | 1/40 (2.5) | 148/402 (36.8) | <0.001 |
• Systolic blood pressure – mm Hg (SD) | 122 (31) | 126 (31) | 0.507 |
• Diastolic blood pressure – mm Hg (SD) | 69 (22) | 75 (21) | 0.087 |
CSF examination | |||
• White-cell count, median (IQR) | 1650 (2886) | 1120 (2865) | 0.248 |
○ < 100/mm3 | 3/39 (7.7) | 54/395 (13.7) | 0.292 |
○ 100–999/mm3 | 9/39 (23.1) | 132/395 (33.4) | 0.188 |
○ > 999/mm3 | 27/39 (69.2) | 209/395 (52.9) | 0.051 |
• Protein – g/liter, median (IQR) | 3.75 (4.32) | 3.48 (5.03) | 0.786 |
• CSF: blood glucose ratio, median (IQR) | 0.13 (0.22) | 0.20 (0.34) | 0.448 |
Positive blood culture | 27/40 (67.5) | 218/401 (54.4) | 0.111 |
Blood white-cell count, median (IQR) | 17350 (13225) | 16650 (10800) | 0.258 |
Thrombocyte count- platelets/mm3, median (IQR) | 175000 (173000) | 185000 (125000) | 0.196 |
Neurological complications | 20/40 (50) | 121/402 (30.1) | 0.010 |
• Impaired mental status | 16/40 (40) | 70/401 (17.5) | 0.001 |
• Seizures | 9/40 (22.5) | 50/403 (12.4) | 0.073 |
• Focal neurological deficits | 12/40 (30) | 81/402 (20.1) | 0.145 |
Systemic complications | 24/40 (60) | 123/395 (31.1) | <0.001 |
• Septic shock | 15/40 (37.5) | 63/402 (15.7) | 0.001 |
• Disseminated intravascular coagulation | 7/40 (17.5) | 40/399 (10) | 0.174 |
• Acute respiratory failure | 15/40 (37.5) | 56/402 (13.9) | <0.001 |
• Acute kidney injury | 12/40 (30) | 51/401 (12.7) | 0.003 |
Outcome | |||
• Neurological sequelae | 3/19 (15.8) | 49/334 (14.7) | 0.894 |
• In-hospital mortality | 21/40 (52.5) | 66/404 (16.3) | <0.001 |