Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance
Objectives: Hypoglycorrhachia (cerebrospinal fluid (CSF) glucose <45 mg/dl) has been identified as a prognostic factor in patients with meningitis. The differential diagnosis of hypoglycorrhachia and its clinical significance was analyzed in the present study. Methods: This was a retrospective st...
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doaj-42ee4135dc22447b93425861b08871b12020-11-24T23:04:19ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112015-10-0139C394310.1016/j.ijid.2015.08.001Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significanceVandana Shrikanth0Lucrecia Salazar1Nabil Khoury2Susan Wootton3Rodrigo Hasbun4Department of Internal Medicine, University of Texas Health Science Center, 6431 Fannin St., 2.112 MSB, Houston, TX 77030, USADepartment of Internal Medicine, University of Texas Health Science Center, 6431 Fannin St., 2.112 MSB, Houston, TX 77030, USADepartment of Internal Medicine, University of Texas Health Science Center, 6431 Fannin St., 2.112 MSB, Houston, TX 77030, USADepartment of Pediatrics, University of Texas Health Science Center, Houston, Texas, USADepartment of Internal Medicine, University of Texas Health Science Center, 6431 Fannin St., 2.112 MSB, Houston, TX 77030, USAObjectives: Hypoglycorrhachia (cerebrospinal fluid (CSF) glucose <45 mg/dl) has been identified as a prognostic factor in patients with meningitis. The differential diagnosis of hypoglycorrhachia and its clinical significance was analyzed in the present study. Methods: This was a retrospective study of 620 adult patients with community-acquired meningitis (CSF white blood cell count >5 × 106 cells/l and absence of a CSF shunt or recent neurosurgical procedure (<1 month)) at eight Memorial Hermann hospitals in Houston, Texas, from January 2005 to December 2010. An adverse clinical outcome was defined as a Glasgow outcome scale score of ≤4. Results: Out of 620 patients with meningitis, 116 (19%) had hypoglycorrhachia. Etiologies of hypoglycorrhachia were idiopathic (n = 40), bacterial (n = 27), cryptococcal (n = 26), viral (n = 15), and tuberculous (n = 4). Patients with hypoglycorrhachia were more likely to be immunosuppressed, have a history of intravenous drug use, and present with a vesicular or petechial rash, nausea or vomiting, nuchal rigidity, sinusitis/otitis, abnormal mental status, and focal neurological deficits compared to those patients without hypoglycorrhachia (p < 0.05). Additionally, patients in the hypoglycorrhachia group had significantly higher rates of positive CSF and blood cultures, urgent treatable conditions, and abnormal cranial imaging (p < 0.05). Furthermore, patients with hypoglycorrhachia had more adverse clinical outcomes (26/116 (22.4%) vs. 45/504 (8.9%); p < 0.001). Conclusion: Hypoglycorrhachia has significant clinical and prognostic value in the evaluation of adult patients with community-acquired meningitis.http://www.sciencedirect.com/science/article/pii/S1201971215001964HypoglycorrhachiaMeningitisPrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vandana Shrikanth Lucrecia Salazar Nabil Khoury Susan Wootton Rodrigo Hasbun |
spellingShingle |
Vandana Shrikanth Lucrecia Salazar Nabil Khoury Susan Wootton Rodrigo Hasbun Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance International Journal of Infectious Diseases Hypoglycorrhachia Meningitis Prognosis |
author_facet |
Vandana Shrikanth Lucrecia Salazar Nabil Khoury Susan Wootton Rodrigo Hasbun |
author_sort |
Vandana Shrikanth |
title |
Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance |
title_short |
Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance |
title_full |
Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance |
title_fullStr |
Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance |
title_full_unstemmed |
Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance |
title_sort |
hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 1878-3511 |
publishDate |
2015-10-01 |
description |
Objectives: Hypoglycorrhachia (cerebrospinal fluid (CSF) glucose <45 mg/dl) has been identified as a prognostic factor in patients with meningitis. The differential diagnosis of hypoglycorrhachia and its clinical significance was analyzed in the present study.
Methods: This was a retrospective study of 620 adult patients with community-acquired meningitis (CSF white blood cell count >5 × 106 cells/l and absence of a CSF shunt or recent neurosurgical procedure (<1 month)) at eight Memorial Hermann hospitals in Houston, Texas, from January 2005 to December 2010. An adverse clinical outcome was defined as a Glasgow outcome scale score of ≤4.
Results: Out of 620 patients with meningitis, 116 (19%) had hypoglycorrhachia. Etiologies of hypoglycorrhachia were idiopathic (n = 40), bacterial (n = 27), cryptococcal (n = 26), viral (n = 15), and tuberculous (n = 4). Patients with hypoglycorrhachia were more likely to be immunosuppressed, have a history of intravenous drug use, and present with a vesicular or petechial rash, nausea or vomiting, nuchal rigidity, sinusitis/otitis, abnormal mental status, and focal neurological deficits compared to those patients without hypoglycorrhachia (p < 0.05). Additionally, patients in the hypoglycorrhachia group had significantly higher rates of positive CSF and blood cultures, urgent treatable conditions, and abnormal cranial imaging (p < 0.05). Furthermore, patients with hypoglycorrhachia had more adverse clinical outcomes (26/116 (22.4%) vs. 45/504 (8.9%); p < 0.001).
Conclusion: Hypoglycorrhachia has significant clinical and prognostic value in the evaluation of adult patients with community-acquired meningitis. |
topic |
Hypoglycorrhachia Meningitis Prognosis |
url |
http://www.sciencedirect.com/science/article/pii/S1201971215001964 |
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