title: Hyponatraemia in adults with community-acquired bacterial meningitis.
abstract: BACKGROUND
  Hyponatraemia in adults with bacterial meningitis has been described as a common complication, but its true prevalence and clinical importance are unknown.
  
  
  OBJECTIVE
  To investigate the prevalence, clinical characteristics and consequences of hyponatraemia in bacterial meningitis in adults.
  
  
  METHODS
  Nationwide observational cohort study.
  
  
  METHODS
  We prospectively assessed the prevalence and clinical characteristics of hyponatraemia among 696 adults with community-acquired bacterial meningitis. Symptoms and signs on admission, blood and CSF test results, radiological examinations and complications during admission were recorded.
  
  
  RESULTS
  Sodium levels were determined at admission in 685/696 episodes of bacterial meningitis (98%). Hyponatraemia (<135 mmol/l) was seen in 208/685 (30%) and was classified as severe (<130 mmol/l) in 38 (6%). Hyponatraemia developed during admission in an additional 53 episodes. Hyponatraemia was not associated with an increase in symptoms, with complications or with unfavourable outcome. Treatment for hyponatraemia was initiated in 16% of episodes, but did not influence its duration.
  
  
  CONCLUSIONS
  Hyponatraemia appears both common and benign in adults with bacterial meningitis. In cases of severe hyponatraemia, we suggest the use of fluid maintenance therapy.
authors.affiliation: Department of Neurology, The Netherlands Reference Laboratory for Bacterial Meningitis, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands. m.c.brouwer@amc.uva.nl
authors.forename: M C
authors.initials: MC
authors.lastname: Brouwer
authors.forename: D
authors.initials: D
authors.lastname: van de Beek
authors.forename: S G B
authors.initials: SG
authors.lastname: Heckenberg
authors.forename: L
authors.initials: L
authors.lastname: Spanjaard
authors.forename: J
authors.initials: J
authors.lastname: de Gans
mesh_terms: D000328:Adult; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000150:complications; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology*; D008089:Listeria monocytogenes / Q000302:isolation & purification; D016920:Meningitis, Bacterial / Q000150:complications*; D009345:Neisseria meningitidis / Q000302:isolation & purification; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000302:isolation & purification