Clinical Course and Outcome of Community-Acquired Bacterial Meningitis in Cancer Patients.
Adv Exp Med Biol
; 1251: 49-56, 2020.
Article
em En
| MEDLINE
| ID: mdl-31792808
ABSTRACT
The aim of the study was to determine the course and outcome of bacterial meningitis (BM) in patients with cancer. We retrospectively reviewed files of patients with community-acquired BM, hospitalized in a single neuroinfection center between January 2010 and December 2017. There were 209 patients included in the analysis:
28 had cancer (9 women, 19 men; median age 76, IQR 67-80 years) and 181 were cancer-free (76 women, 105 men; median age 52, IQR 33-65 years) and constituted the control group. Cancer patients, compared with controls, were more likely to present with seizures (25% vs. 8%, p = 0.019), scored higher on the Sequential Organ Failure Assessment, and had a higher mortality rate (32% vs. 13%, p = 0.025). Further, cancer patients were less likely (64% vs. 83%, p = 0.033) to present with two or more out of four clinical manifestations of BM (pyrexia, neck stiffness, altered mental status, and headache) and had a lower white blood cell (WBC) count than non-cancer controls. In multiple regression analysis, the presence of bacterial meningitis in cancer patients was independently associated only with older age (p = 0.001) and lower WBC count (p = 0.007), while mortality was associated with lower Glasgow Coma Score (p = 0.003). In conclusion, bacterial meningitis in cancer patients is characterized by atypical symptoms and high mortality, which requires physicians' vigilance and a prompt investigation of cerebrospinal fluid in suspected cases. However, multiple regression analysis suggests that differences in clinical presentation and outcomes of bacterial meningitis between cancer and cancer-free patients may also be attributable to other factors, such as age differences.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Meningites Bacterianas
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Infecções Comunitárias Adquiridas
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Neoplasias
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article