Abstract
Background
Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients’ quality of life.
Methods
In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed.
Results
Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54–4.90]; p < 0.001), pre-existing headaches before meningitis (OR: 2.38 [1.32–4.30]; p < 0.01), higher neutrophilic polynuclei percentage in the CSF of the initial lumbar puncture (OR: 1.02 [1.00–1.04]; p < 0.05), and brain abscess during the initial hospitalisation (OR: 8.32 [1.97–35.16]; p < 0.01) were associated with M12 persistent headaches. Neither the responsible microorganism, nor the corticoids use were associated with M12 persistent headaches. M12 neuro-functional disability (altered Glasgow Outcome Scale; p < 0.01), M12 physical handicap (altered modified Rankin score; p < 0.001), M12 depressive symptoms (p < 0.0001), and M12 altered physical (p < 0.05) and mental (p < 0.0001) qualities of life were associated with M12 headaches.
Conclusion
Persistent headaches are frequent one year after meningitis and are associated with quality of life alteration.
Clinical trial
NCT01730690.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The datasets generated and analysed during the current study are not publicly available since other investigations are ongoing for further publications. They are available from the corresponding author, should the manuscript be published.
References
Brouwer MC, van de Beek D (2018) Epidemiology of community-acquired bacterial meningitis. Curr Opin Infect Dis 31:78–84. https://doi.org/10.1097/QCO.0000000000000417
Bijlsma MW, Brouwer MC, Kasanmoentalib ES, Kloek AT, Lucas MJ, Tanck MW et al (2016) Community-acquired bacterial meningitis in adults in the Netherlands, 2006–14: a prospective cohort study. Lancet Infect Dis 16:339–347. https://doi.org/10.1016/S1473-3099(15)00430-2
Tubiana S, Varon E, Biron C, Ploy M-C, Mourvillier B, Taha M-K et al (2020) Community-acquired bacterial meningitis in adults: in-hospital prognosis, long-term disability and determinants of outcome in a multicentre prospective cohort. Clin Microbiol Infect 26:1192–1200. https://doi.org/10.1016/j.cmi.2019.12.020
Roed C, Omland LH, Skinhoj P, Rothman KJ, Sorensen HT, Obel N (2013) Educational Achievement and Economic Self-sufficiency in Adults After Childhood Bacterial Meningitis. JAMA 309:1714. https://doi.org/10.1001/jama.2013.3792
van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M (2004) Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 51:1849–59. https://doi.org/10.1056/NEJMoa040845
de Beek D van, Schmand B, de Gans J, Weisfelt M, Vaessen H, Dankert J, et al (2002) Cognitive Impairment in Adults with Good Recovery after Bacterial Meningitis. J Infect Dis 186:1047–52. https://doi.org/10.1086/344229
Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I (2010) Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis 10:317–328. https://doi.org/10.1016/S1473-3099(10)70048-7
Hoen B, Varon E, de Debroucker T, Fantin B, Grimprel E, Wolff M et al (2019) Management of acute community-acquired bacterial meningitis (excluding newborns). Long version with arguments. Médecine et Maladies Infectieuses 49:405–41. https://doi.org/10.1016/j.medmal.2019.03.009
Glimåker M, Sjölin J, Åkesson S, Naucler P (2018) Lumbar Puncture Performed Promptly or After Neuroimaging in Acute Bacterial Meningitis in Adults: A Prospective National Cohort Study Evaluating Different Guidelines. Clin Infect Dis 66:321–328. https://doi.org/10.1093/cid/cix806
(2018) Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38:1–211. https://doi.org/10.1177/0333102417738202
Banks JL, Marotta CA (2007) Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials: A Literature Review and Synthesis. Stroke 38:1091–1096. https://doi.org/10.1161/01.STR.0000258355.23810.c6
Fayol P, Carrière H, Habonimana D, Preux P-M, Dumond J-J (2004) Version française de l’entretien structuré pour l’échelle de devenir de Glasgow (GOS): recommandations et premières études de validation. Ann Readapt Med Phys 47:142–156. https://doi.org/10.1016/j.annrmp.2004.01.004
Vilagut G, Forero CG, Barbaglia G, Alonso J (2016) Screening for Depression in the General Population with the Center for Epidemiologic Studies Depression (CES-D): A Systematic Review with Meta-Analysis. PLoS One 11:e0155431. https://doi.org/10.1371/journal.pone.0155431
Fuhrer R., Rouillon F. La version française de l’échelle CES-D (Center for Epidemiologic Studies-Depression Scale) (1989) Description et traduction de l’échelle d’autoévaluation. Psychiatr Psychobiol 4:163–6. https://doi.org/10.1017/S0767399X00001590
Gandek B, Ware JE, Aaronson NK, Alonso J, Apolone G, Bjorner J et al (1998) Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51:1149–58. https://doi.org/10.1016/s0895-4356(98)00106-1
Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE et al (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51:1171–8. https://doi.org/10.1016/s0895-4356(98)00109-7
Bohr V, Hansen B, Kjersem H, Rasmussen N, Johnsen N, Kristensen HS et al (1983) Sequelae from bacterial meningitis and their relation to the clinical condition during acute illness, based on 667 questionnaire returns. Part II of a three part series. J Infect 7:102–10. https://doi.org/10.1016/S0163-4453(83)90443-7
Neufeld MY, Treves TA, Chistik V, Korczyn AD (1999) Postmeningitis Headache. Headache 39:132–134. https://doi.org/10.1046/j.1526-4610.1999.3902132.x
Hansen AP, Marcussen NS, Klit H, Kasch H, Jensen TS, Finnerup NB (2015) Development of persistent headache following stroke: A 3-year follow-up. Cephalalgia 35:399–409. https://doi.org/10.1177/0333102414545894
Schytz HW, Ashina M, Magyari M, Larsen VA, Olesen J, Iversen HK (2014) Acute headache and persistent headache attributed to cervical artery dissection: Field testing of ICHD-III beta. Cephalalgia 34:712–716. https://doi.org/10.1177/0333102414520767
Lanteri-Minet M, Valade D, Géraud G, Lucas C, Donnet A (2013) Prise en charge diagnostique et thérapeutique de la migraine chez l’adulte et chez l’enfant. Revue Neurologique 169:14–29. https://doi.org/10.1016/j.neurol.2012.07.022
Baraff LJ, Lee SI, Schriger DL (1993) Outcomes of bacterial meningitis in children: a meta-analysis. Pediatr Infect Dis J 12:389–394. https://doi.org/10.1097/00006454-199305000-00008
Kastenbauer S, Pfister H-W (2003) Pneumococcal meningitis in adults: Spectrum of complications and prognostic factors in a series of 87 cases. Brain 126:1015–1025. https://doi.org/10.1093/brain/awg113
de Portes V (2009) Quel suivi à long terme pour quels patients? Séquelles des méningites bactériennes chez l’enfant et chez l’adulte : incidence, types, modes d’évaluation. Médecine et Maladies Infectieuses 39:572–80. https://doi.org/10.1016/j.medmal.2009.02.019
Schmidt H (2006) Sleep disorders are long-term sequelae of both bacterial and viral meningitis. J Neurol Neurosurg Psychiatry 77:554–558. https://doi.org/10.1136/jnnp.2005.071142
Philipp J, Zeiler M, Wöber C, Wagner G, Karwautz AFK, Steiner TJ et al (2019) Prevalence and burden of headache in children and adolescents in Austria – a nationwide study in a representative sample of pupils aged 10–18 years. J Headache Pain 20:101. https://doi.org/10.1186/s10194-019-1050-8
Steiner TJ, Stovner LJ, Katsarava Z, Lainez JM, Lampl C, Lantéri-Minet M et al (2014) The impact of headache in Europe: principal results of the Eurolight project. J Headache Pain 15:31. https://doi.org/10.1186/1129-2377-15-31
Combat study group
Principal investigator: Xavier DUVAL.
Steering Committee: Bruno HOEN, Bruno MOURVILLIER, Marie-Cécile PLOY, Sarah TUBIANA, Emmanuelle VARON.
Scientific committee: steering committee and the following members François CARON, Pierre-Edouard BOLLAERT, Olivier GAILLOT, Muhamed-Kheir TAHA, Claire POYART, Stephane BONACORSI, François VANDENESCH, Emmanuelle CAMBAU, Marc LECUIT, Alain GRAVET, Bruno FRACHET, Thomas De BROUCKER, Daniel LEVY BRUHL, François RAFFI, Marie PREAU.
COMBAT Clinical Centers: Nadia ANGUEL, Laurent ARGAUD, Sophie ARISTA, Laurence ARMAND-LEFEVRE, Stéphanie BALAVOINE, Régine BARADUC, Guilène BARNAUD, Guillaume BERAUD, Louis BERNARD, Georges BERNARS, Dominique BERTEI, Emilie BESSEDE, Typhaine BILLARD POMARES, Charlotte BIRON, Stéphane BLAND, Julien BOILEAU, Patrice BOUBEAU, Sandra BOURDON, Aurore BOUSQUET, Sophie BOYER, Alexis BOZORG-GRAYELI, Laurent BRET, Cédric BRETONNIERE, François BRICAIRE, Elsa BROCAS, Michel BRUN, Jennifer BURET, Christophe BURUCOA, Jean CABALION, Mathieu CABON, Emmanuelle CAMBAU, Guillaume CAMUSET, Christophe CANEVET, Anne CARRICAJO, Bernard CASTAN, Eric CAUMES, Charles CAZANAVE, Amélie CHABROL, Thibaut CHALLAN-BELVAL, Vanessa CHANTEPERDRIX-MARILLIER, Chantal CHAPLAIN, Caroline CHARLIER-WOERTHER, Hélène CHAUSSADE Catherine CHIROUZE, Bernard CLAIR, Julien COLOT, Jean-Marie CONIL, Hugues CORDEL, Philippe CORMIER, Joël COUSSON, Pierrick CRONIER, Eric CUA, Anne DAO-DUBREMETZ, Sylvie DARGERE, Nicolas DEGAND, Sophie DEKEYSER, Deborah DELAUNE, Eric DENES, Pierre-Francois DEQUIN, Diane DESCAMPS, Elodie DESCLOUX, Jean-Luc DESMARETZ, Jean-Luc DIEHL, Jérôme DIMET, Aurélien DINH, Xavier DUVAL, Lelia ESCAUT, Claude FABE, Frédéric FAIBIS, Clara FLATEAU, Nathalie FONSALE, Emmanuel FORESTIER, Nicolas FORTINEAU, Amandine GAGNEUX-BRUNON, Caroline GARANDEAU, Magali GARCIA, Denis GAROT, Stéphane GAUDRY, François GOEHRINGER, Alain GRAVET, Valérie GREGOIRE-FAUCHER, Marine GROSSET, Camélia GUBAVU, Isabelle GUEIT, Dominique GUELON, Thomas GUIMARD, Jérôme GUINARD, Tahar HADOU, Jean-Pierre HELENE, Sandrine HENARD, Benoit HENRY, Anne-Cécile HOCHART, Bruno HOEN, Gabriela ILLES, Sylvain JAFFUEL, Irène JARRIN, Françoise JAUREGUY, Cédric JOSEPH, Marie-Emmanuelle JUVIN, Samer KAYAL, Solen KERNEIS, LACASSIN, Isabelle LAMAURY, Philippe LANOTTE, Etienne LAURENS, Henri LAURICHESSE, Cécile LE BRUN, Vincent LE MOING, Paul LE TURNIER, Hervé LECUYER, Sylvie LEDRU, Céline LEGRIX, Adrien LEMAIGNEN, Chantal LEMBLE, Ludovic LEMEE, Olivier LESENS, Marion LEVAST, Claire LHOMMET, Silvija MALES, Edith MALPOTE, Guillaume MARTIN-BLONDEL, Matthieu MARX, Raphael MASSON, Olivier MATRAY, Aurore MBADI, Frédéric MECHAI, Guillaume MELLON, Audrey MERENS, Marie Caroline MEYOHAS, Adrien MICHON, Joy MOOTIEN YOGANADEN, David MORQUIN, Stéphane MOULY, Natacha MROZEK, Sophie NGUYEN, Yohan NGUYEN, Maja OGIELSKA, Eric OZIOL, Bernard PAGE, Solène PATRAT-DELON, Isabelle PATRY, André PECHINOT, Sandrine PICOT, Denys PIERREJEAN, Lionel PIROTH, Claire PLASSART, Patrice PLESSIS, Marie-Cécile PLOY, Laurent PORTEL, Patrice POUBEAU, Marie POUPARD, Claire POYART, Thierry PRAZUCK, Luc QUAESAET, François RAFFI, Adriatsiferana RAMANANTSOA, Christophe RAPP, Laurent RASKINE, Josette RAYMOND, Matthieu REVEST, Agnès RICHE, Stéphanie ROBADAY-VOISIN, Frédéric ROBIN, Jean-Pierre ROMASZKO, Florence ROUSSEAU, Anne-Laure ROUX, Cécile ROYER, Matthieu SAADA, Dominique SALMON, Carlo SAROUFIM, Jean Luc SCHMIT, Manuela SEBIRE, Christine SEGONDS, Valérie SIVADON-TARDY, Nathalie SOISMIER, Olivia SON, Simon SUNDER, Florence SUY, Didier TANDE, Jacques TANKOVIC, Nadia VALIN, Nicolas VAN GRUNDERBEECK, François VANDENESCH, Emmanuelle VARON, Renaud VERDON, Michel VERGNAUD, Véronique VERNET-GARNIER, Magali VIDAL, Virginie VITRAT, Daniel VITTECOQ, Fanny VUOTTO.
Coordination and statistical analyses (Clinical trial unit, Hôpitaux Universitaires Paris Nord Val de Seine, AP-HP, Paris): Isabelle GORENNE, Cédric LAOUENAN, Estelle MARCAULT, France MENTRE, Blandine PASQUET, Carine ROY, Sarah TUBIANA.
Scientific partnership: SPLIF, CMIT, SRLF, SFM, REIVAC, SFORL, APNET, SPF.
Partners: ORP (Marie-Cécile PLOY), GPIP/ACTIV (Corinne Levy).
Sponsor: DRCI APHP.
Funding
The cohort was funded by the French ministry of health, the DRCI, the French society of infectious diseases and the Pfizer pharmaceutical company.
Author information
Authors and Affiliations
Consortia
Contributions
Data collection was performed by all authors. Data analysis were performed by Rémi Nguyen Van, Sarah Tubiana, Xavier Duval, Thomas De Broucker and Matthieu Revest. The first draft of the manuscript was written by Rémi Nguyen Van and Matthieu Revest and all authors commented on previous versions of manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval
The COMBAT study was registered with ClinicalTrials.gov (NCT02916732) and received ethics approval by the Comité de Protection des Personnes Ile de France CPP 4 (IRB 00003835) (2012-16NI) and the CNIL (commission nationale de l’informatique et des libertés) (EGY/FLR/AR128794).
Consent to participate
Informed consent was obtained from all individual participants included in the study.
Consent to publish
Not applicable.
Conflicts of interest/Competing interests
The authors have no relevant financial or non-financial interests to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Van, R.N., Tubiana, S., De Broucker, T. et al. Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life. Eur J Clin Microbiol Infect Dis 42, 1459–1467 (2023). https://doi.org/10.1007/s10096-023-04673-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-023-04673-y