title: Bacterial meningitis during sepsis in diabetic patient.
abstract: The aim of the study was to evaluate the etiology, clinical features and outcome in diabetic patients with bacterial meningitis, as a nervous system determination during invasive infections.
  
  
  METHODS
  In a retrospective study, conducted over a period of three years, we have analyzed clinical and etiological aspects of 445 patients over 18 years old, diagnosed with sepsis of known (positive cultures from normally sterile sites) or suspected etiology (positive cultures from pus), 95 of them being included in the diabetic group.
  
  
  RESULTS
  Bacterial meningitis was diagnosed in 16 of 95 diabetic patients (16.8%) and 43 of 350 (12.3%) non-diabetic patients (chi2 = 0.98; GL = 1; p = 0.322). Among the multiple co morbidities associated in diabetic patients, as suggested by a higher Charlson score (5.44 vs. 3.25) (p = 0.001), the most common underlying condition was chronic liver disease (31.3% vs. 25.6%) (p = 0.916). The isolation of the microorganism concurrently from cerebro-spinal fluid and other sites (blood cultures and pus) was more frequently encountered in diabetics. The clinical picture was dominated by altered consciousness (68.8% vs. 23.3%) (p = 0.003), while fever was less present (37.5% vs. 88.4%) (p = 0.0003). The most frequently involved microorganism in the etiology of meningitis was S. aureus (31.3 vs. 23.3%) (p = 0.771) and Gram negative bacilli: E. coli (12.5% vs. 4.7%) (p = 0.629) and Klebsiella spp. (12.5% vs. 9.3%) (p = 0.902).
  
  
  CONCLUSIONS
  Altered consciousness was more frequent in diabetic patients group (68.8% vs. 23.3%) (p = 0.003) where the absence of fever at admission was a more common finding than in non-diabetic septic patients with meningitis (37.5% vs. 88.4%) (p = 0.0003).
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Infectious Diseases.
authors: Cristina G
authors: CG
authors: Petrovici
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Infectious Diseases.
authors: Daniela
authors: D
authors: Leca
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Infectious Diseases.
authors: Andra
authors: A
authors: Teodor
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Microbiology.
authors: Olivia
authors: O
authors: Dorneanu
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Infectious Diseases.
authors: Gabriela
authors: G
authors: Juganariu
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Infectious Diseases.
authors: Carmen
authors: C
authors: Dorobăţ
authors: University of Medicine and Farmacy Grigore T. Popa-Iaşi, Faculty of Medicine, Discipline of Infectious Diseases.
authors: Miftode
authors: M
authors: Egidia
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D048909:Diabetes Complications / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification