Abstract
The aim of the study was to determine the course and outcome of bacterial meningitis (BM) in patients with cancer. We retrospectively reviewed files of patients with community-acquired BM, hospitalized in a single neuroinfection center between January 2010 and December 2017. There were 209 patients included in the analysis: 28 had cancer (9 women, 19 men; median age 76, IQR 67–80 years) and 181 were cancer-free (76 women, 105 men; median age 52, IQR 33–65 years) and constituted the control group. Cancer patients, compared with controls, were more likely to present with seizures (25% vs. 8%, p = 0.019), scored higher on the Sequential Organ Failure Assessment, and had a higher mortality rate (32% vs. 13%, p = 0.025). Further, cancer patients were less likely (64% vs. 83%, p = 0.033) to present with two or more out of four clinical manifestations of BM (pyrexia, neck stiffness, altered mental status, and headache) and had a lower white blood cell (WBC) count than non-cancer controls. In multiple regression analysis, the presence of bacterial meningitis in cancer patients was independently associated only with older age (p = 0.001) and lower WBC count (p = 0.007), while mortality was associated with lower Glasgow Coma Score (p = 0.003). In conclusion, bacterial meningitis in cancer patients is characterized by atypical symptoms and high mortality, which requires physicians’ vigilance and a prompt investigation of cerebrospinal fluid in suspected cases. However, multiple regression analysis suggests that differences in clinical presentation and outcomes of bacterial meningitis between cancer and cancer-free patients may also be attributable to other factors, such as age differences.
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References
Adriani KS, Brouwer MC, van de Beek D (2015) Risk factors for community-acquired bacterial meningitis in adults. Neth J Med 73(2):53–60
Albrecht P, Hryniewicz W, Kuch A, Przyjałkowski W, Skoczyńska A, Szenborn L (2011) Recommendations in bacterial infections of the central nervous system. https://koroun.edu.pl/wp-content/uploads/2017/10/Rekomendacje-ukl-nerwowy_2011.pdf. Accessed on 25 August 2019 (Article in Polish)
Bellizzi KM, Gosley MA (2012) Cancer and aging handbook: research and practice, 1st edn. Wiley–Blackwell, Hoboken
Bijlsma MW, Brouwer MC, Kasanmoentalib ES, Kloek AT, Lucas MJ, Tanck MW, van der Ende A, van de Beek D (2016) Community-acquired bacterial meningitis in adults in the Netherlands, 2006–14: a prospective cohort study. Lancet Infect Dis 16(3):339–347
Cabellos C, Verdaguer R, Olmo M, Fernandez-Sabe N, Cisnal M, Ariza J, Gudiol F, Viladrich PF (2009) Community-acquired bacterial meningitis in elderly patients: experience over 30 years. Medicine (Baltimore) 88(2):115–119
Costerus JM, Brouwer MC, van der Ende A, van de Beek D (2016) Community-acquired bacterial meningitis in adults with cancer or a history of cancer. Neurology 86(9):860–866
Domingo P, Pomar V, Benito N, Coll P (2013) The changing pattern of bacterial meningitis in adult patients at a large tertiary university hospital in Barcelona, Spain (1982–2010). J Infect 66(2):147–154
Guven GS, Uzun O, Cakir B, Akova M, Unal S (2006) Infectious complications in patients with hematological malignancies consulted by the infectious diseases team: a retrospective cohort study (1997–2001). Support Care Cancer 14(1):52–55
Harding C, Pompei F, Wilson R (2012) Peak and decline in cancer incidence, mortality, and prevalence at old ages. Cancer 118(5):1371–1386
Hoffman O, Weber RJ (2009) Pathophysiology and treatment of bacterial meningitis. Ther Adv Neurol Disord 2(6):1–7
Maschmeyer G, Haas A (2008) The epidemiology and treatment of infections in cancer patients. Int J Antimicrob Agents 31(3):193–197
Mook P, O’Brien SJ, Gillespie IA (2011) Concurrent conditions and human listeriosis, England, 1999–2009. Emerg Infect Dis 17(1):38–43
Paradowska–Stankiewicz I, Piotrowska A (2016) Meningitis and encephalitis in Poland in 2014. Przegl Epidemiol 70(3):349–357
Paradowska–Stankiewicz I, Piotrowska A (2017) Meningitis and encephalitis in Poland in 2015. Przegl Epidemiol 71(4):493–500
Pietraszek–Grzywaczewska I, Bernas S, Lojko P, Piechota A, Piechota M (2016) Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis. Anaesthesiol Intensive Ther 48(3):175–179
Polkowska A, Toropainen M, Ollgren J, Lyytikainen O, Nuorti JP (2017) Bacterial meningitis in Finland, 1995–2014: a population–based observational study. BMJ Open 7(5):e015080
Pomar V, Benito N, Lopez–Contreras J, Coll P, Gurgui M, Domingo P (2017) Characteristics and outcome of spontaneous bacterial meningitis in patients with cancer compared with patients without cancer. Medicine (Baltimore) 96(19):e6899
Pruitt AA (2012) CNS infections in patients with cancer. Continuum (Minneap Minn) 18(2):384–405
Singer M, Deutschman CS, Seymour CW, Shankar–Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC (2016) The third international consensus definitions for Sepsis and septic shock (Sepsis–3). JAMA 315(8):801–810
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 351(18):1849–1859
Van de Beek D, Cabellos C, Dzupova O, Esposito S, Klein M, Kloek AT, Leib SL, Mourvillier B, Ostergaard C, Pagliano P, Pfister HW, Read RC, Sipahi OR, Brouwer MC (2016) ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect 22:S37–S62
van Veen KE, Brouwer MC, van der Ende A, van de Beek D (2017) Bacterial meningitis in alcoholic patients: a population-based prospective study. J Infect 74(4):352–357
Vento S, Cainelli F (2003) Infections in patients with cancer undergoing chemotherapy: aetiology, prevention, and treatment. Lancet Oncol 4(10):595–604
Wang KW, Chang WN, Chang HW, Chuang YC, Tsai NW, Wang HC, Lu CH (2005) The significance of seizures and other predictive factors during the acute illness for the long-term outcome after bacterial meningitis. Seizure 14(8):586–592
Weisfelt M, de Gans J, van der Ende A, van de Beek D (2010) Community-acquired bacterial meningitis in alcoholic patients. PLoS One 5(2):e9102
Zhao S, Wu D, Wu P, Wang Z, Huang J (2015) Serum IL-10 predicts worse outcome in cancer patients: a meta-analysis. PLoS One 10(10):e0139598
Zoons E, Weisfelt M, de Gans J, Spanjaard L, Koelman JH, Reitsma JB, van de Beek D (2008) Seizures in adults with bacterial meningitis. Neurology 70(22 Pt 2):2109–2115
Acknowledgments
MP was supported by grant FRN 004/2019 from the Research Development Foundation of the Hospital for Infectious Diseases in Warsaw and TL by grant 2017/25/B/NZ6/01463 from the National Science Center.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
This study had a retrospective nature consisting of reviewing medical files, with no direct contact with patients; therefore, the requirement of obtaining individual patient consent did not apply.
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Paciorek, M. et al. (2019). Clinical Course and Outcome of Community-Acquired Bacterial Meningitis in Cancer Patients. In: Pokorski, M. (eds) Trends in Biomedical Research. Advances in Experimental Medicine and Biology(), vol 1251. Springer, Cham. https://doi.org/10.1007/5584_2019_438
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DOI: https://doi.org/10.1007/5584_2019_438
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