Role of bacterial infection in exacerbation of multiple sclerosis.
One hundred consecutive patients admitted to the hospital with a diagnosis of exacerbation of multiple sclerosis were evaluated for an infectious process. All patients received a complete blood count, urinalysis, urine culture with susceptibility studies, blood cultures, and a chest x-ray at the time of admission. A control group of 55 patients carrying the diagnosis of multiple sclerosis but without symptoms of neurologic decline were also studied. Thirty-five percent of patients experiencing exacerbation of their disease were identified as having a significant bacterial infection compared with 11% in the control group with quiescent disease. These results were significant with a P value of < 0.001. When presumptive viral and bacterial infections diagnosed before admission were included, almost 50% of patients could have had an exacerbation of their disease in response to an infectious process. Bacterial infection might well play a role in precipitating relapse in multiple sclerosis as well as influencing treatment.
Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
N S
NS
Rapp
J
J
Gilroy
A M
AM
Lerner
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy; D016022:Case-Control Studies; D002408:Catheters, Indwelling / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy; D016017:Odds Ratio; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects; D012008:Recurrence; D012307:Risk Factors; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy; D014777:Virus Diseases / Q000150:complications
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents