ArticleJournal of the American Geriatrics Society2014
Community-acquired meningitis in older adults: clinical features, etiology, and prognostic factors.
Article in Journal of the American Geriatrics Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 42 citations in OpenAlex.
- Mid-term health-related quality of life in community-acquired bacterial meningitis survivors; the COMBAT study.PloS one · 2023Trial
- Meningitis Mortality in U.S. Adults Aged ≥25 Years: Demographic and Geographic Insights from the CDC WONDER Database (1999-2024).Pathogens (Basel, Switzerland) · 2026Article
- Trends in laboratory-confirmed bacterial meningitis (2012-2019): national observational study, England.The Lancet regional health. Europe · 2023Article
- Role of cerebrospinal fluid lactate in diagnosing meningitis in critically ill patients.World journal of critical care medicine · 2023Article
- Tuberculous Meningitis: Pathogenesis, Immune Responses, Diagnostic Challenges, and the Potential of Biomarker-Based Approaches.Journal of clinical microbiology · 2021Review
- The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients.BMC infectious diseases · 2020Article
- Readmissions after hospital care for meningitis in the United States.American journal of infection control · 2020Article
- Unusual presentation of meningococcal meningitis in the elderly and utility of CSF PCR testing.Access microbiology · 2020Article
- Comparison of Clinical Features and Prognostic Factors of Cryptococcal Meningitis Caused by Cryptococcus neoformans in Patients With and Without Pulmonary Nodules.Mycopathologia · 2019Article
- Aseptic meningitis in adults and children: Diagnostic and management challenges.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2017Article
- Article
- Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Hematologic parameters to predict negative cerebrospinal fluid examination results among neurologically intact patients who underwent lumbar puncture on suspicion of central nervous system infection.Clinical and experimental emergency medicine · 2017Article
- Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department.Emergency medicine clinics of North America · 2016Review
- Sepsis and Other Infectious Disease Emergencies in the Elderly.Emergency medicine clinics of North America · 2016Review
- Proposal for a New Score-Based Approach To Improve Efficiency of Diagnostic Laboratory Workflow for Acute Bacterial Meningitis in Adults.Journal of clinical microbiology · 2016Article
- Gender Differences in Community-acquired Meningitis in Adults: Clinical Presentations and Prognostic Factors.Journal of meningitis · 2016Article
- Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis.BMC infectious diseases · 2015Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo investigate the epidemiology and outcomes of community-acquired meningitis in older adults.
designRetrospective study.
settingParticipants adults in Houston, Texas, with community-acquired meningitis hospitalized between January 1, 2005, and January 1, 2010 (N = 619; n = 54, 8.7%, aged ≥65; n = 565 aged <65).
methodsAn adverse clinical outcome was defined as a Glasgow Outcome Scale score of 4 or less.
resultsOlder adults had higher rates of comorbidities, abnormal neurological and laboratory (serum white blood cell count >12,000/μL, and cerebrospinal fluid protein >100 mg/dL) findings (P < .001), abnormalities on computed tomography and magnetic resonance imaging of the head (P = .002), and adverse clinical outcomes (ACOs) (P < .001). The majority of participants (65.8%) had meningitis of unknown etiology. Bacterial meningitis was an infrequent cause of community-acquired meningitis (7.4%). Of the known causes, bacterial meningitis and West Nile virus were more common in older than younger adults; younger participants more frequently had cryptococcal and viral meningitis. On logistic regression, female sex was predictive of a poor outcome in the older participants (P = .002), whereas abnormal neurological examination (P < .001), fever (P = .01), and a cerebrospinal fluid glucose level less than 45 mg/dL (P = .002) were significant poor prognostic factors in younger participants.
conclusionMost cases of community-acquired meningitis are of unknown origin. Older adults are more likely than younger adults to have bacterial meningitis and West Nile virus infection when a cause can be identified. They also have more neurological abnormalities, laboratory and imaging abnormalities, and adverse clinical outcomes.
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