Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy?
<h4>Objective</h4>To study the incidence, clinical presentation and outcome of intracranial hemorrhagic complications in adult patients with community associated bacterial meningitis.<h4>Methods</h4>Nationwide prospective cohort study from all hospitals in the Netherlands, fr...
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0045271&type=printable |
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| author | Barry B Mook-Kanamori Daan Fritz Matthijs C Brouwer Arie van der Ende Diederik van de Beek |
| author_facet | Barry B Mook-Kanamori Daan Fritz Matthijs C Brouwer Arie van der Ende Diederik van de Beek |
| author_sort | Barry B Mook-Kanamori |
| collection | DOAJ |
| description | <h4>Objective</h4>To study the incidence, clinical presentation and outcome of intracranial hemorrhagic complications in adult patients with community associated bacterial meningitis.<h4>Methods</h4>Nationwide prospective cohort study from all hospitals in the Netherlands, from 1 March 2006, through 31 December 2010.<h4>Results</h4>Of the 860 episodes of bacterial meningitis that were included, 24 were diagnosed with intracranial hemorrhagic complications: 8 upon presentation and 16 during clinical course. Clinical presentation between patients with or without intracranial hemorrhage was similar. Causative bacteria were Streptococcus pneumoniae in 16 patients (67%), Staphylococcus aureus in 5 (21%), Pseudomonas aeruginosa and Listeria monocytogenes both in 1 patient (4%). Occurrence of intracranial hemorrhage was associated with death (63% vs. 15%, P<0.001) and unfavorable outcome (94% vs. 34%, P<0.001). The use of anticoagulants on admission was associated with a higher incidence of intracranial hemorrhages (odds ratio 5.84, 95% confidence interval 2.17-15.76).<h4>Conclusion</h4>Intracranial hemorrhage is a rare but devastating complication in patients with community-associated bacterial meningitis. Since anticoagulant therapy use is associated with increased risk for intracranial hemorrhage, physicians may consider reversing or temporarily discontinuing anticoagulation in patients with bacterial meningitis. |
| format | Article |
| id | doaj-art-b7eb7301d2974c71a33ecbb7c36ed6c0 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-b7eb7301d2974c71a33ecbb7c36ed6c02025-08-20T03:10:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4527110.1371/journal.pone.0045271Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy?Barry B Mook-KanamoriDaan FritzMatthijs C BrouwerArie van der EndeDiederik van de Beek<h4>Objective</h4>To study the incidence, clinical presentation and outcome of intracranial hemorrhagic complications in adult patients with community associated bacterial meningitis.<h4>Methods</h4>Nationwide prospective cohort study from all hospitals in the Netherlands, from 1 March 2006, through 31 December 2010.<h4>Results</h4>Of the 860 episodes of bacterial meningitis that were included, 24 were diagnosed with intracranial hemorrhagic complications: 8 upon presentation and 16 during clinical course. Clinical presentation between patients with or without intracranial hemorrhage was similar. Causative bacteria were Streptococcus pneumoniae in 16 patients (67%), Staphylococcus aureus in 5 (21%), Pseudomonas aeruginosa and Listeria monocytogenes both in 1 patient (4%). Occurrence of intracranial hemorrhage was associated with death (63% vs. 15%, P<0.001) and unfavorable outcome (94% vs. 34%, P<0.001). The use of anticoagulants on admission was associated with a higher incidence of intracranial hemorrhages (odds ratio 5.84, 95% confidence interval 2.17-15.76).<h4>Conclusion</h4>Intracranial hemorrhage is a rare but devastating complication in patients with community-associated bacterial meningitis. Since anticoagulant therapy use is associated with increased risk for intracranial hemorrhage, physicians may consider reversing or temporarily discontinuing anticoagulation in patients with bacterial meningitis.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0045271&type=printable |
| spellingShingle | Barry B Mook-Kanamori Daan Fritz Matthijs C Brouwer Arie van der Ende Diederik van de Beek Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy? PLoS ONE |
| title | Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy? |
| title_full | Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy? |
| title_fullStr | Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy? |
| title_full_unstemmed | Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy? |
| title_short | Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: should we reconsider anticoagulant therapy? |
| title_sort | intracerebral hemorrhages in adults with community associated bacterial meningitis in adults should we reconsider anticoagulant therapy |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0045271&type=printable |
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