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Table 1 Characteristics of episodes of spontaneous meningitis due to gram-negative bacilli and those due to other pathogens*

From: Spontaneous gram-negative bacillary meningitis in adult patients: characteristics and outcome

Characteristics Gram-negative bacillary meningitis (n = 40) Other causes of meningitis (n = 405) P value
Male sex 23/40 (57.5) 183/393 (46.6) 0.187
Age – years, median (IQR) 64 (17) 50 (41) < 0.001
Comorbid conditions 29/40 (72.5) 173/403 (42.9) <0.001
• Cancer 8/40 (20.0) 41/403 (10.2) 0.067
• Diabetes mellitus 7/40 (17.5) 45/403 (11.2) 0.298
• Alcoholism 6/40 (15.0) 43/403 (10.7) 0.425
• Liver cirrhosis 4/40 (10.0) 17/403 (4.2) 0.110
Charlson comorbidity index ≥ 3 10/39 (25.6) 50/399 (12.5) 0.023
Distant focus of infection 31/40 (77.5) 139/402 (34.6) <0.001
• Urinary tract infection 13/40 (32.5) 2/405 (0.5) <0.001
• Otitis or sinusitis 4/40 (10.0) 58/405 (14.3) 0.452
• Pneumonia 2/40 (5.0) 22/405 (5.4) 1.000
Route of acquisition    
• Hospital-acquired (vs. community-acquired) 9/40 (22.5) 8/405 (2) <0.001
Symptoms on presentation    
• Fever 37/40 (92.5) 387/402 (96.3) 0.217
• Change in mental status 29/40 (72.5) 278/402 (69.2) 0.661
• Neck stiffness 24/40 (60.0) 330/400 (82.5) 0.001
• Triad of fever, neck stiffness, and change in mental status 16/40 (40.0) 231/401 (57.6) 0.032
• Headache 22/40 (55.0) 323/402 (80.3) <0.001
• Nausea and/or vomiting 18/40 (45.0) 239/394 (60.7) 0.055
• Focal neurological deficits 12/40 (30.0) 74/402 (18.4) 0.093
• Coma 6/40 (15) 26/402 (6.5) 0.057
• Seizures 5/40 (12.5) 33/401 (8.2) 0.371
• Rash 1/40 (2.5) 148/402 (36.8) <0.001
• Systolic blood pressure – mm Hg (SD) 122 (31) 126 (31) 0.507
• Diastolic blood pressure – mm Hg (SD) 69 (22) 75 (21) 0.087
CSF examination    
• White-cell count, median (IQR) 1650 (2886) 1120 (2865) 0.248
 < 100/mm3 3/39 (7.7) 54/395 (13.7) 0.292
100–999/mm3 9/39 (23.1) 132/395 (33.4) 0.188
 > 999/mm3 27/39 (69.2) 209/395 (52.9) 0.051
• Protein – g/liter, median (IQR) 3.75 (4.32) 3.48 (5.03) 0.786
• CSF: blood glucose ratio, median (IQR) 0.13 (0.22) 0.20 (0.34) 0.448
Positive blood culture 27/40 (67.5) 218/401 (54.4) 0.111
Blood white-cell count, median (IQR) 17350 (13225) 16650 (10800) 0.258
Thrombocyte count- platelets/mm3, median (IQR) 175000 (173000) 185000 (125000) 0.196
Neurological complications 20/40 (50) 121/402 (30.1) 0.010
• Impaired mental status 16/40 (40) 70/401 (17.5) 0.001
• Seizures 9/40 (22.5) 50/403 (12.4) 0.073
• Focal neurological deficits 12/40 (30) 81/402 (20.1) 0.145
Systemic complications 24/40 (60) 123/395 (31.1) <0.001
• Septic shock 15/40 (37.5) 63/402 (15.7) 0.001
• Disseminated intravascular coagulation 7/40 (17.5) 40/399 (10) 0.174
• Acute respiratory failure 15/40 (37.5) 56/402 (13.9) <0.001
• Acute kidney injury 12/40 (30) 51/401 (12.7) 0.003
Outcome    
• Neurological sequelae 3/19 (15.8) 49/334 (14.7) 0.894
• In-hospital mortality 21/40 (52.5) 66/404 (16.3) <0.001
  1. CI = confidence interval; IQR = interquartile range; SD = standard deviation.
  2. *Values are reported as no./no. evaluated (%), unless otherwise noted.