Risk and case fatality rate of meningitis in patients with liver cirrhosis.

Bacterial infections are major causes of morbidity and death in patients with liver cirrhosis. The risk of bacterial meningitis in these patients is unknown, however. In this study on a nation-wide cohort of 22,743 patients with liver cirrhosis in Denmark an incidence rate of bacterial meningitis of 54.4 per 100,000 was found [95% confidence interval (CI) 40.3-71.9]. The highest incidence rate was found in patients with alcoholic cirrhosis, 65.3 per 100,000 person-years (95% CI 46.2-89.6), compared with 34.6 per 100,000 person-years (95% CI 17.3-61.9) in patients with non-alcoholic cirrhosis. The 30-d case fatality rate was 53.1% (95% CI 38.3-67.5), and high age and alcoholic cirrhosis were associated with the highest case fatality rates. The main bacterial pathogens were pneumococci and unspecified bacteria. These findings suggest that patients with liver cirrhosis are at increased risk of bacterial meningitis with a poor prognosis.