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Characteristics and outcome of spontaneous bacterial meningitis in patients with cancer compared to patients without cancer
Pomar, Virginia (Institut d'Investigació Biomèdica Sant Pau)
Benito, Natividad (Institut d'Investigació Biomèdica Sant Pau)
López-Contreras, Joaquín (Institut d'Investigació Biomèdica Sant Pau)
Coll Figa, Pedro (Institut d'Investigació Biomèdica Sant Pau)
Gurguí, Mercè (Red Española de Investigación en Patologías Infecciosas (REIPI))
Domingo, Pere (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Fecha: 2017
Resumen: Supplemental Digital Content is available in the text In cancer patients, who are frequently immunocompromised, bacterial meningitis (BM) can be a severe complication, with a different presentation, etiology, and course, compared to patients without cancer. Our objective is to compare the characteristics and outcomes of BM in patients with and without cancer. A single-center, prospective observational cohort study, conducted between 1982 and 2012, in a tertiary university hospital in Barcelona (Spain). The main outcome measure is in-hospital mortality. We evaluated 659 episodes of BM; 97 (15%) had active cancer. Patients with malignancies were older (median 63 (interquartile range [IQR] 24) vs 52 [IQR 42] years, P < . 001) and more often had a Charlson comorbidity score of ≥3 (51% vs 11%, P < . 001). The classic meningitis triad (35% vs 50%, P = . 05), fever (91% vs 96%, P = . 03), neck stiffness (58% vs 78%, P < . 001), headache (63% vs 77%) P = . 003), and rash (7% vs 30%, P < . 001) were less frequent. There was a longer interval between admission and antibiotic therapy (median 5 [IQR 14] vs 3 [IQR 6] hours, P < . 001). Listeria meningitis was the commonest cause of BM (29%) and was more frequent in cancer than noncancer (8%, P < . 001) patients, whereas meningococcal meningitis was much less frequent (4% vs 36%, P < . 001). Overall mortality was higher in patients with cancer (31% vs 16%, P < . 001), although cancer was not associated with an unfavorable outcome in the multivariate analysis (odds ratio 1. 825, P = . 07). Patients with meningitis and cancer are older and have more subtle clinical manifestations than patients without cancer. Listeria monocytogenes is the predominant pathogen and mortality is higher in cancer patients.
Derechos: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució i la comunicació pública de l'obra, sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. Creative Commons
Lengua: Anglès
Documento: Article ; recerca ; Versió publicada
Materia: Bacterial infection of the central nervous system ; Bacterial meningitis ; Cancer ; Spontaneous meningitis
Publicado en: Medicine, Vol. 96 (may 2017) , ISSN 1536-5964

DOI: 10.1097/MD.0000000000006899
PMID: 28489800


7 p, 219.3 KB

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 Registro creado el 2022-02-07, última modificación el 2023-11-30



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