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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Main Authors: Barry B Mook-Kanamori, Daan Fritz, Matthijs C Brouwer, Arie van der Ende, Diederik van de Beek
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
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.
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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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AT matthijscbrouwer intracerebralhemorrhagesinadultswithcommunityassociatedbacterialmeningitisinadultsshouldwereconsideranticoagulanttherapy
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