Bichat Hospital, Paris, France.
Bichat Hospital, Paris, France
Clin Med (Lond). 2018 Mar;18(2):132-137. doi: 10.7861/clinmedicine.18-2-132.
Acute meningitis can be the first manifestation of an underlying systemic inflammatory disorder (SID). In the current study, we aimed to identify clinical indicators for SIDs in patients admitted for acute aseptic meningitis. All patients hospitalised for acute aseptic meningitis over a 4-year period in a department of internal medicine were included retrospectively. Patients with neoplastic meningitis were excluded. Extraneurological signs were recorded using a systematic panel. Systemic inflammatory disorder diagnosis was made according to current international criteria. Forty-three (average age 46 years [range 19-82 years], 60% females) consecutive patients were analysed retrospectively. Of these, 23 patients had an SID (mostly sarcoidosis and Behçet's disease). -Multiple logistic regression analysis showed that the probability of an SID was 93.7% in patients with both neurological and extraneurological signs, but 14.9% in patients with neither neurological nor extraneurological signs. In conclusion, clinical sorting according to both neurological and extraneurological signs could help to identify patients with acute aseptic meningitis caused by an SID.
急性脑膜炎可能是潜在系统性炎症性疾病(SIDs)的首发表现。在本研究中,我们旨在确定因急性无菌性脑膜炎住院患者中 SIDs 的临床指标。回顾性纳入了内科 4 年内因急性无菌性脑膜炎住院的所有患者。排除了癌性脑膜炎患者。使用系统面板记录了神经外表现。根据当前国际标准诊断 SID。回顾性分析了 43 例(平均年龄 46 岁[19-82 岁],60%为女性)连续患者。其中,23 例患者存在 SID(主要为结节病和贝赫切特病)。多变量逻辑回归分析显示,同时存在神经和神经外表现的患者 SID 的可能性为 93.7%,而无神经和神经外表现的患者则为 14.9%。总之,根据神经和神经外表现进行临床分类有助于识别因 SIDs 引起的急性无菌性脑膜炎患者。