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Characteristics and outcome of spontaneous bacterial meningitis in patients with diabetes mellitus.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2020 Apr 20; Vol. 20 (1), pp. 292. Date of Electronic Publication: 2020 Apr 20. - Publication Year :
- 2020
-
Abstract
- Background: Studies on bacterial meningitis in diabetics patients versus non-diabetics are scarce. In patients with diabetes, bacterial meningitis may have a different presentation, etiology and course. We analyzed and compared the characteristics and outcome of spontaneous BM in adult patients with and without diabetes mellitus (DM).<br />Methods: We performed a single-center, prospective observational cohort study, conducted between 1982 and 2017, in a tertiary university hospital in Barcelona (Spain). The primary outcome measure was in-hospital mortality.<br />Results: We evaluated 715 episodes of bacterial meningitis; 106 patients (15%) had diabetes mellitus. Patients with diabetes were older (median 67 [IQR 17] vs 49 [IQR 40] years, p <  0.001) and more often had a Charlson comorbidity score of ≥3 (40% vs 15%, p <  0.001). Neck stiffness (56% vs 75%, p <  0.001), headache (41% vs 78%) p <  0.001), nausea and/or vomiting (32% vs 56% p < 0.001), and rash (12% vs 26%, p = 0.007) were less frequent in diabetics, whereas altered mental status was more common. Streptococcus pneumoniae and Listeria meningitis were the most common etiologic agents (24 and 18%, respectively). Listeria was more frequent (18% vs. 10%, p = 0.033), whereas meningococcal meningitis was less frequent (10% vs 32%, p < 0.001). Overall mortality was higher in patients with diabetes (26% vs 16%, p = 0.025) concerning non-diabetics.<br />Conclusions: Patients with bacterial meningitis and diabetes mellitus are older, have more comorbidities, and higher mortality. S. pneumoniae and L. monocytogenes are the predominant pathogens, Listeria being more common, whereas Neisseria meningitidis is significantly less frequent than in non-diabetics.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Comorbidity
Diabetes Complications microbiology
Diabetes Complications mortality
Female
Hospital Mortality
Hospitals, University
Humans
Male
Meningitis, Bacterial microbiology
Meningitis, Bacterial mortality
Middle Aged
Prospective Studies
Risk Factors
Spain epidemiology
Tertiary Care Centers
Young Adult
Diabetes Complications epidemiology
Meningitis, Bacterial epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 32312231
- Full Text :
- https://doi.org/10.1186/s12879-020-05023-5