title: Community-acquired spontaneous bacterial meningitis in adult diabetic patients: an analysis of clinical characteristics and prognostic factors.
abstract: BACKGROUND
  We analyzed the clinical characteristics and prognostic factors of community-acquired spontaneous bacterial meningitis (CASBM) in adult diabetic patients.
  
  
  METHODS
  Over a period of 15 years, 47 adult diabetic patients with CASBM were identified. The clinical characteristics, laboratory data and therapeutic outcome of these 47 patients were statistically analyzed.
  
  
  RESULTS
  The 47 patients were 31 men and 16 women, aged 22 to 79 years, and they accounted for 38.5% (47/122) of our adult patients with culture-proven CASBM. The most common causative pathogen was Klebsiella pneumoniae (n = 32), followed by pathogens of the streptococcal species (n = 6). Besides classic manifestations of bacterial meningitis, bacteremia and focal suppuration, especially liver abscess, were common features in this group of patients. Liver cirrhosis and/or alcoholism were the other frequent underlying conditions. 27 patients survived in the course of therapy. The prognostic factors with statistical significance were glucose ratio and cerebrospinal fluid (CSF) white blood cell (WBC) count.
  
  
  CONCLUSIONS
  This study showed the high incidence of diabetes mellitus (DM) among the adult patients with CASBM in Taiwan. K. pneumoniae was the most frequent causative pathogen. Bacteremia and focal suppuration, especially liver abscess, were common findings. The values of glucose ratio and CSF WBC count had a statistically significant influence on the prognosis of our patients.
authors.affiliation: Dept. of Neurology, Chang Gung Memorial Hospital-Kaohsiung, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
authors.forename: C R
authors.initials: CR
authors.lastname: Huang
authors.forename: C H
authors.initials: CH
authors.lastname: Lu
authors.forename: H W
authors.initials: HW
authors.lastname: Chang
authors.forename: P Y
authors.initials: PY
authors.lastname: Lee
authors.forename: M W
authors.initials: MW
authors.lastname: Lin
authors.forename: W N
authors.initials: WN
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D011379:Prognosis