TY - JOUR
T1 - Vertebral osteomyelitis in bacterial meningitis patients
AU - Sheybani, Fereshte
AU - Figueiredo, Ana Helena A.
AU - Brouwer, Matthijs C.
AU - van de Beek, Diederik
N1 - Funding Information: Financial support: This work was supported by the Netherlands Organization for Health Research and Development (ZonMw; NWO-Vidi Grant (grant number 917.17.308 to MB), NWO-Vici Grant (grant number 918.19.627 to DB)) and the European Research Council (ERC starting grant to DB; ERC consolidator grant to MB). The Netherlands Reference Laboratory for Bacterial Meningitis is supported by the National Institute of Public Health and the Environmental Protection, Bilthoven. Funding Information: Financial support: This work was supported by the Netherlands Organization for Health Research and Development (ZonMw; NWO-Vidi Grant (grant number 917.17.308 to MB), NWO-Vici Grant (grant number 918.19.627 to DB)) and the European Research Council (ERC starting grant to DB; ERC consolidator grant to MB). The Netherlands Reference Laboratory for Bacterial Meningitis is supported by the National Institute of Public Health and the Environmental Protection, Bilthoven. FS performed the research and analyzed the data. FS, AHAF, DvdB, and MCB designed the study. FS wrote the first draft of the paper; DvdB and MCB revised the paper. FS, AHAF, DvdB, and MCB have read and approved the final manuscript. Publisher Copyright: © 2021 The Authors
PY - 2021/10
Y1 - 2021/10
N2 - Objective: To analyze the clinical and laboratory characteristics of vertebral osteomyelitis in community-acquired bacterial meningitis patients. Methods: All episodes of vertebral osteomyelitis in a cohort study of adult patients with community-acquired bacterial meningitis in the Netherlands were analyzed. Subsequently, a systematic review of published cases was performed. Results: Between March 2006 and August 2018, 10 of 1974 (0.5%) meningitis patients were diagnosed with vertebral osteomyelitis. The median age was 70 years (interquartile range (IQR) 54–74 years); six (60%) were male and four (40%) were female. The median time between diagnosis of bacterial meningitis and vertebral osteomyelitis was 6 days (IQR 1–13 days). The most common presenting symptoms were back or neck pain, occurring in seven patients (70%); one patient presented with neurological deficits due to cauda equina compression. Streptococcus pneumoniae was the causative pathogen in five patients and Staphylococcus aureus in three. The literature review identified 32 additional cases, showing a similar distribution by age, sex, and pathogen. Seven (18%) of 40 patients from the series presented here and those reported in the literature died. Conclusions: Concomitant vertebral osteomyelitis is rare in community-acquired bacterial meningitis patients. Persisting back pain is a clue to the diagnosis and should prompt magnetic resonance imaging of the spine, because prolonged antibiotic treatment or surgical treatment may be indicated.
AB - Objective: To analyze the clinical and laboratory characteristics of vertebral osteomyelitis in community-acquired bacterial meningitis patients. Methods: All episodes of vertebral osteomyelitis in a cohort study of adult patients with community-acquired bacterial meningitis in the Netherlands were analyzed. Subsequently, a systematic review of published cases was performed. Results: Between March 2006 and August 2018, 10 of 1974 (0.5%) meningitis patients were diagnosed with vertebral osteomyelitis. The median age was 70 years (interquartile range (IQR) 54–74 years); six (60%) were male and four (40%) were female. The median time between diagnosis of bacterial meningitis and vertebral osteomyelitis was 6 days (IQR 1–13 days). The most common presenting symptoms were back or neck pain, occurring in seven patients (70%); one patient presented with neurological deficits due to cauda equina compression. Streptococcus pneumoniae was the causative pathogen in five patients and Staphylococcus aureus in three. The literature review identified 32 additional cases, showing a similar distribution by age, sex, and pathogen. Seven (18%) of 40 patients from the series presented here and those reported in the literature died. Conclusions: Concomitant vertebral osteomyelitis is rare in community-acquired bacterial meningitis patients. Persisting back pain is a clue to the diagnosis and should prompt magnetic resonance imaging of the spine, because prolonged antibiotic treatment or surgical treatment may be indicated.
KW - Bacterial meningitis
KW - Epidural abscess
KW - Vertebral osteomyelitis
UR - http://www.scopus.com/inward/record.url?scp=85115604051&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijid.2021.08.069
DO - https://doi.org/10.1016/j.ijid.2021.08.069
M3 - Article
C2 - 34487853
SN - 1201-9712
VL - 111
SP - 354
EP - 359
JO - International journal of infectious diseases : IJID
JF - International journal of infectious diseases : IJID
ER -