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The epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to(More)
BACKGROUND In experimental studies, the outcome of bacterial meningitis has been related to the severity of inflammation in the subarachnoid space. Corticosteroids reduce this inflammatory response. OBJECTIVES To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages(More)
OBJECTIVE To evaluate the occurrence, treatment, and outcome of subdural empyema complicating community-acquired bacterial meningitis in adults. METHODS Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2011. RESULTS Subdural empyema was diagnosed in 28 of 1,034 episodes (2.7%), and was present on admission in 10(More)
We present 9 patients with community acquired Staphylococcus aureus meningitis. Foci of infection outside the central nervous system were present in 8 (89%) patients, mostly endocarditis and pneumonia. Cardiorespiratory complications occurred frequently and 6 patients died (67%). Identification and treatment of the primary focus of infection should be a(More)
BACKGROUND In this nationwide prospective cohort study, we evaluated the implementation of adjunctive dexamethasone therapy in Dutch adults with pneumococcal meningitis. METHODS From March 2006 through January 2009, all Dutch patients over 16 years old with community-acquired pneumococcal meningitis were prospectively evaluated. Outcome was classified as(More)
Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Disease outcome has been related to the severity of the proinflammatory response in the subarachnoid space. The complement system, which mediates key inflammatory processes, has been(More)
OBJECTIVE To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults. METHODS Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009. RESULTS Hydrocephalus was diagnosed in 26 of 577 episodes (5%) and was classified as communicating(More)
BACKGROUND Community-acquired recurrent bacterial meningitis in adults is a relatively rare disease. All previous data were derived from small retrospective case series. METHODS We prospectively evaluated episodes of recurrent bacterial meningitis in a nationwide cohort study in The Netherlands. RESULTS Thirty-four episodes of recurrent bacterial(More)
BACKGROUND We analyzed clinical characteristics, treatment, genetic diversity, and outcome of 92 adults with Listeria monocytogenes meningitis included in 2 prospective nationwide cohort studies. METHODS Episodes of community-acquired listerial meningitis confirmed by cerebrospinal fluid culture were included from 1998 to 2002 and 2006 to 2012. We(More)