title: Stroke in community-acquired bacterial meningitis: a Danish population-based study.
abstract: OBJECTIVE
  Stroke is a serious complication in community-acquired bacterial meningitis (CABM), but the incidence, predispositions, and outcome need further clarification; this pertains in particular to the impact of pre-existing atherosclerosis risk factors. Therefore, we aimed to assess these features in a retrospective population-based cohort study.
  
  
  METHODS
  We included all patients over 16 years of age with CABM in North Denmark Region, 1998-2010. All data were retrieved from the patient records. A Glasgow Outcome Scale score of 1-4 was defined as an unfavourable outcome and 5 as favourable.
  
  
  RESULTS
  We identified 152 episodes of CABM. In 22 (14%) of the episodes, the patient had a stroke; 15 strokes were ischaemic, three were haemorrhagic, and four were a combination of both. Age and atherosclerosis risk factors were not significantly associated with stroke. However, stroke was associated with a higher in-hospital mortality (27% vs. 16%; age adjusted risk ratio (age aj. RR) 1.43, 95% confidence interval (CI) 0.67-3.04), unfavourable outcome (86% vs. 37%; age adj. RR 2.09, 95% CI 1.59-2.75), and long-term sequelae among survivors (88% vs. 40%, age adj. RR 2.01, 95% CI 1.53-2.65) compared with patients without stroke.
  
  
  CONCLUSIONS
  Stroke is a common complication among adult CABM patients and is associated with long-term sequelae and possibly also death. However, stroke seemed not to be related to atherosclerosis risk factors.
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Mølleparkvej 4, PO Box 365, 9100 Aalborg, Denmark. Electronic address: jacob.bodilsen@rn.dk.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bodilsen
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Mølleparkvej 4, PO Box 365, 9100 Aalborg, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Dalager-Pedersen
authors.affiliation: Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Henrik Carl
authors.initials: HC
authors.lastname: Schønheyder
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Mølleparkvej 4, PO Box 365, 9100 Aalborg, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Nielsen
mesh_terms: D017714:Community-Acquired Infections; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D012189:Retrospective Studies; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D020521:Stroke / Q000453:epidemiology*
chemical_list: D003907:Dexamethasone
keywords: Cerebral infarction; Meningitis; Stroke