Community-acquired recurrent bacterial meningitis in adults.
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 meningitis were identified among 31 patients; 3 patients experienced 2 episodes during the study period. The mean age was 43 years, and 25 (74%) of 34 episodes occurred in men. Predisposing conditions were involved in 26 (77%) of 34 episodes; the most common predisposing conditions were remote head injury (17 [53%] of 32 episodes) and cerebrospinal fluid (CSF) leakage (9 [32%] of 28 episodes). Lumbar puncture revealed an individual CSF indicator of bacterial meningitis for almost all episodes (88%). The outcome was death for 5 (15%) of 34 episodes; 1 additional patient had a suboptimal score on the Glasgow Outcome Scale.


CONCLUSIONS
We conclude that most patients with recurrent meningitis are male and have predisposing conditions, which, in most cases, are remote head injury or CSF leakage.
Department of Neurology, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. k.s.adriani@amc.uva.nl
Kirsten S
KS
Adriani
Diederik
D
van de Beek
Matthijs C
MC
Brouwer
Lodewijk
L
Spanjaard
Jan
J
de Gans
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D017714:Community-Acquired Infections / Q000453:epidemiology; D006259:Craniocerebral Trauma / Q000150:complications*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015994:Incidence; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000382:microbiology / Q000401:mortality*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D013353:Subdural Effusion / Q000150:complications*