Concomitant infectious foci in community-acquired bacterial meningitis: the clinical impact of concomitant spondylitis and endocarditis

社区获得性细菌性脑膜炎合并感染灶:合并脊柱炎和心内膜炎的临床影响

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Abstract

BACKGROUND: Community-acquired bacterial meningitis has been linked to concurrent infectious foci in certain cases. However, reports specifically addressing concomitant infectious foci in patients with community-acquired bacterial meningitis, particularly in recent years, remain scarce. Moreover, the distinct characteristics of various types of concomitant infectious foci in bacterial meningitis cases have yet to be fully elucidated. METHODS: We conducted a retrospective analysis of 35 consecutive patients diagnosed with community-acquired bacterial meningitis. We assessed the presence, distribution, and frequency of concomitant infectious foci, followed by an evaluation of the clinical characteristics of patients with these infections. Patients were categorized into two groups based on the period of onset: the early-period group (2004–2013) and the late-period group (2014–2024). RESULTS: Among the 35 patients, 20 (57%) presented with concomitant infections. Based on the site of infection, 7 patients (20%) had sinusitis, 4 (11%) had otitis, 3 (9%) had pneumonia, 8 (24%) had spondylitis, and 4 (12%) had endocarditis. The total number of patients with spondylitis and/or endocarditis was 11 (31%). A higher proportion of patients with concomitant spondylitis and/or endocarditis belonged to the late-period group (9 of 11, 82%) compared to those without these infections (9 of 24 38%). CONCLUSIONS: Spondylitis and endocarditis were observed as concomitant infectious foci in patients with community-acquired bacterial meningitis, and their occurrence appeared more frequent than in earlier reports. In addition, the data from our cohort indicate a possible increasing trend in recent years, although this finding should be interpreted cautiously. CLINICAL TRIAL NUMBER: Not applicable.

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