ArticleIntensive care medicine2023
Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study.
Article in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 46 citations in OpenAlex.
- Determinants of neurologic causes and systemic causes of death in severe meningitis and encephalitis: insights from the international prospective multicenter EURECA study.Intensive care medicine · 2026Article
- Outcomes, prognostic factors, and the role of intracranial pressure monitoring in severe community-acquired bacterial meningitis: a multicenter retrospective cohort study.The Lancet regional health. Europe · 2026Article
- Infectious meningitis and encephalitis: A primer for acute care practitioners.Journal of the Intensive Care Society · 2026Review
- Herpes simplex virus type 2 encephalitis in critically ill adults: A retrospective analysis of EURECA and Herpetics cohort studies.Critical care (London, England) · 2026Article
- Nationwide Analysis of In-Hospital Mortality in Patients with Encephalitis-Related Diagnoses in Ecuador.Diseases (Basel, Switzerland) · 2026Article
- Characteristics of and risk factors for epilepsy after autoimmune and infectious encephalitis.BMC neurology · 2026Article
- Real-life impact of clinical metagenomics in the intensive care unit: a multicenter retrospective study in greater paris area hospitals.Critical care (London, England) · 2026Article
- Factors Predicting the Outcome in Patients With Acute Encephalitis Syndrome: A Retrospective Analysis of Surveillance Data in Bangladesh.Neurology research international · 2026Article
- Initial management and outcome of community-acquired bacterial meningitis in two French ICUs over a period of fifteen years.BMC infectious diseases · 2025Observational
- Outcomes of Critically Ill Adult Patients With Acute Encephalitis.JAMA network open · 2025Article
- Neuroimaging for prognosis of central nervous system infections: a systematic review and meta-analysis.Annals of intensive care · 2025Article
- Triggers of viral encephalitis: a brain teaser to be solved!Annals of intensive care · 2025Article
- Article
- Clinical features and factors associated with outcomes of antibody-negative autoimmune encephalitis in patients requiring intensive care.Critical care (London, England) · 2025Article
- [Focus neurological intensive care medicine 2023/2024 : Summary of selected studies in intensive medical care].Die Anaesthesiologie · 2025Article
- Community acquiredIDCases · 2025Article
- The role of rapid multiplex molecular syndromic panels in the clinical management of infections in critically ill patients: an experts-opinion document.Critical care (London, England) · 2024Review
- Should initial ICU admission become a standard of care for acute bacterial meningitis ?Annals of intensive care · 2024Article
- Clinical description and outcome of overall varicella-zoster virus-related organ dysfunctions admitted in intensive care units: the VAZOREA cohort study.Annals of intensive care · 2024Article
- Impact of direct ICU admission of pneumococcal meningitis in France: a retrospective analysis of a French medico-administrative (PMSI) database.Annals of intensive care · 2024Article
Corrections and comments
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Authors and funding
31 authors at 20 institutions in 8 countries.
Funding
Abstract
purposeWe aimed to characterize the outcomes of patients with severe meningoencephalitis requiring intensive care.
methodsWe conducted a prospective multicenter international cohort study (2017-2020) in 68 centers across 7 countries. Eligible patients were adults admitted to the intensive care unit (ICU) with meningoencephalitis, defined by an acute onset of encephalopathy (Glasgow coma scale (GCS) score [Formula: see text] 13), a cerebrospinal fluid pleocytosis [Formula: see text] 5 cells/mm
resultsAmong 599 patients enrolled, 589 (98.3%) completed the 3-month follow-up and were included. Overall, 591 etiologies were identified in those patients which were categorized into five groups: acute bacterial meningitis (n = 247, 41.9%); infectious encephalitis of viral, subacute bacterial, or fungal/parasitic origin (n = 140, 23.7%); autoimmune encephalitis (n = 38, 6.4%); neoplastic/toxic encephalitis (n = 11, 1.9%); and encephalitis of unknown origin (n = 155, 26.2%). Overall, 298 patients (50.5%, 95% CI 46.6-54.6%) had a poor functional outcome, including 152 deaths (25.8%). Variables independently associated with a poor functional outcome were age > 60 years (OR 1.75, 95% CI 1.22-2.51), immunodepression (OR 1.98, 95% CI 1.27-3.08), time between hospital and ICU admission > 1 day (OR 2.02, 95% CI 1.44-2.99), a motor component on the GCS [Formula: see text] 3 (OR 2.23, 95% CI 1.49-3.45), hemiparesis/hemiplegia (OR 2.48, 95% CI 1.47-4.18), respiratory failure (OR 1.76, 95% CI 1.05-2.94), and cardiovascular failure (OR 1.72, 95% CI 1.07-2.75). In contrast, administration of a third-generation cephalosporin (OR 0.54, 95% CI 0.37-0.78) and acyclovir (OR 0.55, 95% CI 0.38-0.80) on ICU admission were protective.
conclusionMeningoencephalitis is a severe neurologic syndrome associated with high mortality and disability rates at 3 months. Actionable factors for which improvement could be made include time from hospital to ICU admission, early antimicrobial therapy, and detection of respiratory and cardiovascular complications at admission.
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