| Bacterial meningitis in cirrhotic patients: case series and description of the prognostic role of acute renal failure. | |
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MedLine Citation:
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PMID: 20453662 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To analyze the mortality risk factors in cirrhotic patients with bacterial meningitis (BM). BACKGROUND: Cirrhotic patients are susceptible to infections. Despite its high mortality rate, BM has not been extensively studied in this group of patients. STUDY: BM patients diagnosed with cirrhosis, between 1987 and 2008, were studied. BM was defined as the presence of signs or symptoms of meningitis and a cerebrospinal fluid (CSF) leukocyte count >100/mm3 or the presence of bacteria in CSF. RESULTS: We identified 4955 infections among 7591 cirrhotic patients; 12 (0.2%) had BM. The mean age at diagnosis was 60±16 years. Abnormal mental status (83%), fever (67%), and neck stiffness (67%) were the most frequent clinical presentations. The sensitivity of CSF culture was 75% (Streptococcus pneumoniae, 2; Staphylococcus aureus, 2; Listeria monocytogenes, 1; Group B Streptococcus, 1; Streptococcus agalactiae, 1; Streptococcus bovis, 1; and Escherichia coli, 1), and its correlation with blood culture was 78%. Five patients died. On admission, the serum creatinine level was 1.63±0.93 mg/dL. A serum creatinine level ≥1.3 mg/dL was associated with increased mortality (P=0.028). The model for end-stage liver disease score, gastrointestinal bleeding, bilirubin level >3.5 mg/dL, hepatic encephalopathy, diabetes mellitus, and results of cytology and biochemistry tests of CSF were not associated with mortality. CONCLUSIONS: BM in cirrhotic patients is associated with a high mortality rate. The clinical and microbiologic features of BM in cirrhotic patients differ from those in the general population. A serum creatinine level ≥1.3 mg/dL on admission is associated with a higher risk of mortality. |
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Authors:
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Josué Barahona-Garrido; Jorge Hernández-Calleros; Félix I Téllez-Avila; Norberto C Chávez-Tapia; José M Remes-Troche; Aldo Torre |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 44 ISSN: 1539-2031 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-17 Completed Date: 2011-01-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: e218-23 Citation Subset: IM |
Affiliation:
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Instituto de Enfermedades Digestivas y Nutricionales, Hospital General San Juan de Dios, Guatemala City, Guatemala. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Kidney Injury
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complications* Adult Aged Aged, 80 and over Creatinine / blood Female Humans Liver Cirrhosis / complications* Male Meningitis, Bacterial / etiology, microbiology, mortality* Middle Aged Prognosis Risk Factors |
| Chemical | |
Reg. No./Substance:
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60-27-5/Creatinine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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