Amsterdam UMC, Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, PO Box 22660, Amsterdam 1100DD, Netherlands.
Amsterdam UMC, Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, PO Box 22660, Amsterdam 1100DD, Netherlands.
J Infect. 2022 Sep;85(3):301-305. doi: 10.1016/j.jinf.2022.06.013. Epub 2022 Jun 18.
To determine the incidence, clinical course, radiological patterns, and clinical outcome of intracerebral haemorrhage (ICH) complicating community-acquired bacterial meningitis.
The clinical characteristics and outcome of patients with ICH complicating bacterial meningitis were studied in a prospectively nationwide cohort in the Netherlands performed from 2006 to 2018.
ICH was identified in 44 of 2306 episodes of bacterial meningitis (1.9%). Nine of these patients (20%) were diagnosed with ICH on admission and 35 (80%) during clinical course after a median of 5 days (1-9). ICH occurred in 4 patients with endocarditis (9%), 9 patients on anticoagulation (vitamin K antagonists and heparin; 20%), and 10 patients with cerebral infarctions (23%). In 31 patients (70%) ICH was a lobar haematoma. ICH in bacterial meningitis was associated with high rates of death (24 of 44 [55%] vs. 346 of 2200 [16%]; P < 0.001) and unfavourable outcome compared to non-ICH patients (39 of 44 [89%] vs. 798 of 2200 [36%]; P < 0.001). Neurological sequelae on discharge occurred frequently in ICH survivors compared to non-ICH patients (15 of 20 [75%] vs. 203 of 1669 [12%]; P < 0.001).
ICH is a rare but severe complication in patients with bacterial meningitis occurring in those with endocarditis, cerebral infarction, and anticoagulant use. ICH complicating bacterial meningitis is associated with high rates of death and morbidity.
确定社区获得性细菌性脑膜炎并发脑出血（ICH）的发病率、临床病程、影像学模式和临床转归。
在 2006 年至 2018 年期间，在荷兰进行了一项前瞻性全国性队列研究，研究了并发细菌性脑膜炎的 ICH 患者的临床特征和结局。
在 2306 例细菌性脑膜炎病例中发现了 44 例 ICH（1.9%）。其中 9 例（20%）患者在入院时被诊断为 ICH，35 例（80%）在中位时间为 5 天（1-9 天）的临床病程中被诊断。ICH 发生于 4 例心内膜炎患者（9%）、9 例抗凝治疗患者（维生素 K 拮抗剂和肝素；20%）和 10 例脑梗死患者（23%）。31 例（70%）ICH 为脑叶血肿。与非 ICH 患者相比，细菌性脑膜炎并发 ICH 患者的死亡率（24 例[55%]与 2200 例[16%]；P<0.001）和不良结局发生率（39 例[89%]与 2200 例[36%]；P<0.001）均较高。ICH 幸存者出院时经常出现神经后遗症，与非 ICH 患者相比（15 例[75%]与 1669 例[12%]；P<0.001）。
ICH 是细菌性脑膜炎患者的一种罕见但严重的并发症，发生于心内膜炎、脑梗死和抗凝治疗患者。并发细菌性脑膜炎的 ICH 与高死亡率和发病率相关。
