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Adults with spontaneous aerobic Gram-negative bacillary meningitis admitted to the intensive care unit

2006; Elsevier BV; Volume: 12; Issue: 3 Linguagem: Inglês

10.1111/j.1469-0691.2005.01346.x

1469-0691

Lila Bouadma, Frédérique Schortgen, R. Thomas, S. Wutke, François Lellouche, B. Régnier, Michel Wolff,

Infective Endocarditis Diagnosis and Management

The characteristics of spontaneous aerobic Gram-negative bacillary meningitis (AGNBM) were determined in 40 adults requiring admission to an intensive care unit (ICU) during a 16-year period in ten French ICUs. Eight infections were hospital-acquired and most patients had predisposing factors, mainly chronic alcoholism and an immunocompromised status. Three immunosuppressed patients had disseminated strongyloidiasis. Gram's stain, cerebrospinal fluid and blood cultures were positive for 85%, 98% and 80% of cases, respectively. Escherichia coli (57%) and Klebsiella pneumoniae (17%) were the most frequent pathogens. In-ICU mortality was 38%. Spontaneous AGNBM is a rare complication of bacteraemia in adults. The severity of predisposing underlying diseases might explain the poor prognosis despite appropriate antimicrobial therapy.