Table 2.
Blood cell counts and chemistry on day of diagnosis, neuroimaging, cerebrospinal fluid data, treatment characteristics, complications, and outcomes of patients with meningitis and/or encephalitis with and without identified infectious pathogens
| Total cohort (n = 372) | Patients with identified pathogens (n = 159) | Patients without identified pathogens (n = 213) | p-value | ||||
|---|---|---|---|---|---|---|---|
| Blood cell counts and chemistry on day of diagnosis | |||||||
| White blood cell count (× 109/l; median, IQR) | 8.4 | 6.6–12.0 | 9.1 | 7.0–13.7 | 8.2 | 6.7–11.6 | 0.060 |
| C-reactive protein (mg/l; median, IQR) | 7.8 | 1.7–48.3 | 16.8 | 3.5–97.5 | 5.9 | 1.3–34.2 | 0.002 |
| Albumin (g/l; median, IQR) | 34 | 30–38 | 33 | 29–38 | 34 | 30–38 | 0.245 |
| Lactate (mmol/l; median, IQR) | 1.2 | 0.9–1.7 | 1.3 | 0.9–1.9 | 1.2 | 0.9–1.6 | 0.136 |
| Neuroimaging | |||||||
| Neuroimaging performed (n, %) | 335 | 90.1 | 140 | 88.1 | 195 | 91.6 | 0.265 |
| Computed tomography performed (n, %) | 247 | 66.4 | 112 | 70.4 | 135 | 63.4 | 0.154 |
| Magnetic resonance imaging performed (n, %) | 237 | 63.7 | 84 | 52.8 | 153 | 71.8 | < 0.001 |
| Brain lesions on neuroimaging in patients with imaging (n, % patients with imaging) | 203 | 4.6 | 92 | 65.7 | 111 | 56.9 | 0.104 |
| Brain edema in patients with imaging (n, % patients with imaging) | 39 | 10.5 | 19 | 13.6 | 20 | 10.3 | 0.351 |
| Brain inflammation in patients with imaging (n, % patients with imaging) | 68 | 18.3 | 35 | 25.0 | 33 | 16.9 | 0.070 |
| Cerebrospinal fluid data | |||||||
| White blood cells (× 106/l; median, IQR) | 65 | 10–261 | 171 | 43–575 | 33 | 5–122 | < 0.001 |
| Polynuclear cells (×106/l; median, IQR) | 5 | 0.3–37.4 | 16 | 3–187 | 1 | 0–12 | |
| Mononuclear cells (×106/l; median, IQR) | 39 | 6–139 | 81 | 16–217 | 21 | 4–90 | |
| Protein (mg/l; median, IQR) | 807 | 497–1449 | 1650 | 629–2470 | 684 | 449–1111 | < 0.001 |
| Lactate (mmol/l; median, IQR) | 2.4 | 1.8–3.5 | 3 | 2.1–7.5 | 2.1 | 1.6–2.8 | < 0.001 |
| Glucose (mmol/l; median, IQR) | 3.2 | 2.6–3.8 | 2.9 | 1.9–3.5 | 3.3 | 2.9–3.9 | < 0.001 |
| Glucose ratio (CSF/serum; median, IQR) | 0.6 | 0.5–0.6 | 0.5 | 0.4–0.6 | 0.6 | 0.5–0.7 | < 0.001 |
| Treatment | |||||||
| Hospital stay (days; median, IQR) | 11 | 5–19 | 14 | 6–21 | 9 | 4–17 | 0.015 |
| Treatment on ICUs (n, %) | 141 | 37.9 | 69 | 43.4 | 72 | 33.8 | 0.059 |
| ICU stay of patients in ICUs (days; median, IQR) | 3 | 2–7 | 4 | 2–7 | 3 | 2–7 | 0.208 |
| Mechanical ventilation (n, %) | 43 | 11.6 | 29 | 18.2 | 14 | 6.6 | < 0.001 |
| Empiric antimicrobial treatment (n, %) | 323 | 86.8 | 151 | 95.0 | 172 | 80.8 | < 0.001 |
| Antiseizure drugs (n, %) | 121 | 32.5 | 51 | 32.1 | 70 | 32.9 | 0.872 |
| Vasopressors (n, %) | 4411.8 | 28 | 17.6 | 16 | 7.5 | 0.003 | |
| Complications | |||||||
| Arterial hypotension (n, %) | 44 | 11.8 | 28 | 17.6 | 16 | 7.5 | 0.003 |
| Epileptic seizures (n, %) | 25 | 6.7 | 14 | 8.8 | 11 | 5.2 | 0.165 |
| Status epilepticus (n, %) | 20 | 5.4 | 7 | 4.4 | 13 | 6.1 | 0.643 |
| Aspiration pneumonia (n, %) | 13 | 3.5 | 6 | 3.8 | 7 | 3.3 | 0.785 |
| Brain herniation (n, %) | 6 | 1.6 | 4 | 2.5 | 2 | 0.9 | 0.408 |
| In-hospital outcomes | |||||||
| Death (n, %) | 11 | 3.0 | 3 | 1.9 | 8 | 3.8 | 0.365 |
| Care withdrawal (n, %) | 7 | 1.9 | 3 | 1.9 | 4 | 1.9 | 1.000 |
| Return to premorbid baseline (n, %) | 236 | 63.4 | 102 | 64.2 | 134 | 62.9 | 0.806 |
IQR interquartile range, ICU intensive care unit; Boldp-values indicate significance set at ap-value of < 0.002 after correction for multiple comparisons (Bonferroni)
All continuous variables were analyzed using the Mann-Whitney U test