title: Zoonotic bacterial meningitis in human adults.
abstract: OBJECTIVE
  To describe the epidemiology, etiology, clinical characteristics, treatment, outcome, and prevention of zoonotic bacterial meningitis in human adults.
  
  
  METHODS
  We identified 16 zoonotic bacteria causing meningitis in adults.
  
  
  RESULTS
  Zoonotic bacterial meningitis is uncommon compared to bacterial meningitis caused by human pathogens, and the incidence has a strong regional distribution. Zoonotic bacterial meningitis is mainly associated with animal contact, consumption of animal products, and an immunocompromised state of the patient. In a high proportion of zoonotic bacterial meningitis cases, CSF analysis showed only a mildly elevated leukocyte count. The recommended antibiotic therapy differs per pathogen, and the overall mortality is low.
  
  
  CONCLUSIONS
  Zoonotic bacterial meningitis is uncommon but is associated with specific complications. The suspicion should be raised in patients with bacterial meningitis who have recreational or professional contact with animals and in patients living in regions endemic for specific zoonotic pathogens. An immunocompromised state is associated with a worse prognosis. Identification of risk factors and underlying disease is necessary to improve treatment.
authors.affiliation: From the Departments of Neurology (A.v.S., M.C.B., D.v.d.B.) and Medical Microbiology (A.v.d.E.), Academic Medical Centre, Centre of Infection and Immunity Amsterdam; and Academic Medical Centre (A.v.d.E.), Netherlands Reference Laboratory for Bacterial Meningitis.
authors.forename: Anusha
authors.initials: A
authors.lastname: van Samkar
authors.affiliation: From the Departments of Neurology (A.v.S., M.C.B., D.v.d.B.) and Medical Microbiology (A.v.d.E.), Academic Medical Centre, Centre of Infection and Immunity Amsterdam; and Academic Medical Centre (A.v.d.E.), Netherlands Reference Laboratory for Bacterial Meningitis.
authors.forename: Matthijs C
authors.initials: MC
authors.lastname: Brouwer
authors.affiliation: From the Departments of Neurology (A.v.S., M.C.B., D.v.d.B.) and Medical Microbiology (A.v.d.E.), Academic Medical Centre, Centre of Infection and Immunity Amsterdam; and Academic Medical Centre (A.v.d.E.), Netherlands Reference Laboratory for Bacterial Meningitis.
authors.forename: Arie
authors.initials: A
authors.lastname: van der Ende
authors.affiliation: From the Departments of Neurology (A.v.S., M.C.B., D.v.d.B.) and Medical Microbiology (A.v.d.E.), Academic Medical Centre, Centre of Infection and Immunity Amsterdam; and Academic Medical Centre (A.v.d.E.), Netherlands Reference Laboratory for Bacterial Meningitis. d.vandebeek@amc.uva.nl.
authors.forename: Diederik
authors.initials: D
authors.lastname: van de Beek
mesh_terms: D000818:Animals; D006801:Humans; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D015047:Zoonoses / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*