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Table 1 Comparison between bacterial and aseptic meningitis

From: Point-of-care cerebrospinal fluid Gram stain for the management of acute meningitis in adults: a retrospective observational study

 

Bacterial meningitis

 

Aseptic meningitis

 

p value

 

N = 34

 

N = 97

  

Median age (IQR)

60 (44–68)

 

30 (23–34)

 

 < 0.0001*

Male sex

19/34 (55.9%)

 

51/97 (52.6%)

 

0.74

Medical histories

 Symptom duration days (IQR)

2.5 (0–5)

 

3 (1–4)

 

0.71

 Shaking chills

9/34 (26.5%)

 

6/97 (6.2%)

 

0.001*

 Previous antibiotic exposure within 48 h

12/34 (35.3%)

 

9/97 (9.2%)

 

 < 0.001*

 Immunocompromised host

17/34 (50.0%)

 

8/97 (8.2%)

 

 < 0.001*

Vital signs and physical examinations

 Systolic blood pressure (mmHg) (IQR)

136 (120–150)

 

112 (100–120)

 

 < 0.0001*

 Pulse rate (/min) (IQR)

113 (100–126)

 

88 (80–96)

 

 < 0.0001*

 Respiratory rate (/min) (IQR)

24 (20–30)

 

20 (18–22)

 

0.0002*

 Body temperature (℃) (IQR)

38.6 (37.9–39.3)

 

37.7 (37.1–38.4)

 

 < 0.0001*

 Glasgow Coma Scale (IQR)

11 (9–14)

 

15 (15–15)

 

 < 0.0001*

 Neck stiffness

28/33 (84.9%)

 

47/95 (49.5%)

 

0.002*

 Jolt accentuation

5/6 (83.3%)

 

53/64 (82.8%)

 

0.97

Laboratory data

 White blood cell counts (/μL) (IQR)

13,800 (11,000–16,200)

 

7800 (5900–9900)

 

 < 0.0001*

 C-reactive protein (mg/dL) (IQR)

6.7 (1.3–19.4)

 

0.18 (0.02–0.9)

 

 < 0.0001*

 CSF cell counts (/μL) (IQR)

1116 (140–4200)

 

80 (37–156)

 

 < 0.0001*

 CSF monocytes (%) (IQR)

5 (3–17)

 

74 (27–95)

 

 < 0.0001*

 CSF protein (mg/dL) (IQR)

287 (100–420)

 

66 (51–94)

 

 < 0.0001*

 CSF glucose (mg/dL) (IQR)

37 (1–59)

 

57 (53–63)

 

0.0001*

 CSF glucose/blood glucose ratio (IQR)

0.17 (0.006–0.43)

 

0.55 (0.50–0.60)

 

 < 0.0001*

 CSF bacteria confirmed with PCGS

31/34 (91.2%)

 

1/97 (1.0%)

 

 < 0.001*

 CSF culture positivity

34/34 (100%)

 

0

 

 < 0.001*

 Blood culture positivity

29/34 (85.3%)

 

0

 

 < 0.001*

Etiologic agent

Streptococcus pneumoniae

20

Mumps virus

8

 
 

Klebsiella pneumoniae

5

Varicella zoster

5

 
 

Streptococcus bovis

4

Cytomegalovirus

2

 
 

Bacteroides fragilis

1

Herpes simplex

2

 
 

Escherichia coli

1

Unknown

80

 
 

Haemophilus influenzae

1

   
 

Lactococcus lactis cremoris

1

   
 

Listeria monocytogenes

1

   

Complications

 Infection sites other than meningitis

9/34 (26.7%)

 

13/97 (13.4%)

 

0.079

 Strongyloides coinfection

10/34 (29.4%)

 

0

 

 < 0.001*

Treatment

 Antibiotics other than acyclovir

34/34 (100%)

 

38/97 (39.2%)

 

 < 0.001*

 Steroid use

4/34 (11.8%)

 

0

 

0.005*

 Antimicrobial treatment days (IQR)

14 (12–14)

 

3 (3–5)

 

0.0001*

Outcome

 Death

4/34 (11.8%)

 

0

 

0.004*

 Neurological sequelae

4/30 (13.3%)

 

0

 

0.004*

  1. CSF cerebrospinal fluid, IQR interquartile range, PCGS point-of-care Gram stain
  2. * p < 0.05
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Annals of Clinical Microbiology and Antimicrobials

ISSN: 1476-0711

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