Table 2.
Diagnostic Studies and Outcomes in 549 Adults with Community-Acquired Meningitis With or Without HIV Infection
| HIV infected, n = 138 | Non-HIV infected, n = 411 | pa | |
|---|---|---|---|
| Laboratory examinations | |||
| CSF gram stain positive, n (%) | 16/122 (13) | 4/346 (1.1) | <0.001 |
| CSF protein (≥100 mg/dL), n (%) | 77/112 (60) | 160/330 (48%) | 0.04 |
| CSF glucose (<45 mg/dL), n (%) | 46/112 (41) | 53/330 (16) | <0.001 |
| CSF WBC (median, range) | 45 (6–53,790) | 133 (6–22,900) | 0.77 |
| Leukocytosis (>12,000 cells/μL), n (%) | 12/112 (11) | 101/330 (31) | <0.001 |
| CD4+ cell count median (range, cells/mm3) | 89 (1–593) | — | |
| CD4 < 200 cells/μL, n (%) | 75/118 (64) | — | |
| Imaging studies, n (%) | |||
| Abnormal CT head | 25/128 (20) | 44/359 (12) | 0.05 |
| Abnormal brain MRI | 33/67 (49) | 82/172 (48) | 0.88 |
| Outcomes, n (%) | |||
| Urgent treatable etiologiesb | 61/138 (45) | 69/411 (16) | <0.001 |
| Empiric antibiotics | 90/120 (75) | 285/337 (85) | 0.02 |
| Glasgow outcome score ≤4 | 36/133 (27) | 90/371 (24) | 0.56 |
a
p Value comparing HIV-1-infected vs. non-HIV-infected adults.
b
Urgent treatable etiologies are expressed as a ratio of HIV-1 infected to non-HIV infected and include the following: Cryptococcus (41:3), Streptococcus pneumoniae (3:9), Mycobacterium tuberculosis (2:5), other bacteria (13:42), HSV encephalitis (2:6), VZV (5:4), toxoplasmosis (3:0), noninfectious (i.e., malignancy and bleeding; 2:6), others (1:2).
CSF, cerebrospinal fluid; CT, computerized tomography; HIV, human immunodeficiency virus; HSV, herpes simplex virus; MRI, magnetic resonance imaging; VZV, varicella-zoster virus; WBC, white blood cell count.