Table 3 Characteristics of patients with acute community-acquired Lm meningitis
Variable a | Patients | Immunocompromised | Immunocompetent | p * |
|---|---|---|---|---|
Number of patients | 43 | 29 | 14 | |
Age (median ± IQR) | 69 ± 30 | 69.5 ± 32 | 64.5 ± 23 | 1 |
Elderly (60 years or older) | 24 (56) | 16 (55) | 8 (58) | 0.903 |
Antibiotic therapy before admission b | 3/43 (7) | 2/29 (7) | 1/14 (7) | 0.950 |
Median time to admission (hours) | 48.5 | 48 | 49 | 0.500 |
Time to admission > 48 h | 22/43 (51) | 15/29 (52) | 7/14 (50) | 0.916 |
Symptoms at presentation | ||||
Seizures | 4/43 (9) | 3/29 (10) | 1/14 (7) | 0.735 |
Headache | 29/43 (67) | 17/29 (59) | 12/14 (85) | 0.076 |
Vomiting | 20/43 (46) | 12/29 (41) | 8/14 (57) | 0.331 |
Neck stiffness | 30/43 (70) | 17/29 (62) | 12/14 (86) | 0.114 |
Temperature ≥ 38°C | 39/43 (91) | 26/29 (90) | 13/14 (93) | 0.735 |
Glasgow Coma Scale at admission (median ± IQR) | 13 ± 3 | 13 ± 5 | 13 ± 1 | 0.279 |
Classic Triad c | 21/43 (49) | 11/29 (45) | 10/14 (71) | 0.039 |
Focal neurological deficit | ||||
Any | 14/43 (32) | 8/29 (28) | 6/14 (43) | 0.317 |
Cranial nerve palsies | 7/14 (50) | 4/8 (50) | 3/6 (50) | 1 |
Large nerve palsies | 2/14 (12) | 2/8 (25) | 0 | 0.186 |
Cerebellum dysfunction | 5/14 (38) | 2/8 (25) | 3/6 (50) | 0.334 |
Laboratory findings | ||||
Indexes of CSFd inflammation | ||||
WBC count (median ± IQR) | 550 ± 2400 | 936 ± 3610 | 310 ± 520 | 0.069 |
< 100 cells/mL | 5/40 (12) | 3/27 (11) | 2/13 (15) | 0.702 |
100-999 cells/mL | 20/40 (50) | 11/27 (40) | 9/13 (70) | 0.091 |
> 999 cells/mL | 15/40 (37) | 13/27 (49) | 2/13 (15) | 0.045 |
Protein level,g/L (median ± IQR) | 2.4 ± 2.7 | 2.39 ± 2.26 | 2.88 ± 3.16 | 0.357 |
Protein level > 2 g/L | 23/43 (53) | 17/29 (67) | 6/14 (32) | 0.331 |
% PMN (median ± IQR) | 70 ± 59 | 70 ± 62 | 65 ± 48 | 0.418 |
> 50% | 27/40 (67) | 19/27 (67) | 8/13 (61) | 0.576 |
CSF/blood glucose (median ± IQR) | 0.26 ± 0.23 | 0.27 ± 0.25 | 0.22 ± 0.23 | 0.243 |
CSF Gram stain | ||||
Gram-positive rods | 13/43 (30) | 9/29 (31) | 4/14 (29) | 0.869 |
Positive CSF culture e | 40/43 (93) | 26/29 (67) | 14/14 | 0.212 |
4b serotype | 23/28 (82) | 12/16 (75) | 11/12 (92) | 0.355 |
1/2b serotype | 5/28 (18) | 4/16 (25) | 1/12 (8) | 0.254 |
Positive blood cultures | 27/43 (63) | 18/29 (62) | 9/14 (63) | 0.643 |
Blood analytical findings | ||||
WBC count (109/L, (median ± IQR) | 12 ± 10 | 10 ± 11 | 15 ± 5 | 0.006 |
Platelets (109/L, median ± IQR) | 182 ± 75 | 161 ± 87 | 193 ± 70 | 0.492 |
Sodium (mEq/L, median ± IQR) | 135.1 ± 4.9 | 134.2 ± 5 | 136.9 ± 3.8 | 0.086 |
Hyponatremia | 19/43 (44) | 15/29 (51) | 4/14 (28) | 0.152 |
Outcome | ||||
Unfavorable outcome (GOSf<4) | 15/43 (35) | 8/29 (27) | 7/14 (50) | 0.184 |
Mortality | 12/43 (28) | 7/29 (24) | 5/14 (35) | 0.482 |