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Long-term outcome in adults with acute bacterial meningitis and the impact of dexamethasone treatment.

  • Researchers:
    Dr Ben Schmand, Dr Diederik Van de Beek, Dr Jan De Gans
  • Start Date:
    01 January 2005
  • Category:
    Treatment
  • Location:
    University of Amsterdam, Amsterdam, The Netherlands

Bacterial meningitis remains a disease with high mortality and morbidity rates. Recently, adjunctive use of dexamethasone showed to be beneficial for both children and adults with bacterial meningitis. In experimental meningitis the use of dexamethasone can lead to damage in the hippocampal formation. Although lower mortality rates in patients treated with dexamethasone did not result in an increase of patients with neurological sequelae, it is important to know whether dexamethasone prevents death but worsens cerebral functioning. Therefore cognitive evaluation of patients treated with and without dexamethasone is needed. This project is a follow-up study of the European Dexamethasone in Adulthood Bacterial Meningitis Study. All Dutch patients included in this study who survived a pneumococcal or meningococcal meningitis (n=135) will be contacted for participation. All included patients will undergo a full neurological and neuropsychological examination. The aim of this study is to determine long term outcome in patients after bacterial meningitis, and the effect of adjunctive treatment with dexamethasone on long term neuropsychological outcome and quality of life.

Results from this study have been published in scientific journals as follows:

Weisfelt M, Van de Beek D, Hoogman M, Hardeman C, de Gans J, Schmand B.
Cognitive outcome in adults with moderate disability after pneumococcal meningitis.
J Infect 2006 Jun;52(6):433-9.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJT-4H98SWB-4&_coverDate=06%2F30%2F2006&_alid=441381671&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6887&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=30194190362c53ea8deaba1ee

Van de Beek D, de Gans J, Tunkel AR, Wijdicks EF.
Community-acquired bacterial meningitis in adults.
N Engl J Med 2006 Jan 5;354(1):44-53.
http://content.nejm.org/cgi/reprint/354/1/44.pdf

Weisfelt M, Van de Beek D, Spanjaard L, Reitsma JB, de Gans J.
Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series.
Lancet Neurol 2006 Feb;5(2):123-9.
http://linkinghub.elsevier.com/retrieve/pii/S1474-4422(05)70288-X

Van de Beek D, Weisfelt M, Hoogman M, de Gans J, Schmand B.
Neuropsychological sequelae of bacterial meningitis: the influence of alcoholism and adjunctive dexamethasone therapy.
Brain 2006 May;129(Pt 5):E46.
http://brain.oxfordjournals.org/cgi/reprint/129/5/E46

Van de Beek D, de Gans J.
Dexamethasone in adults with community-acquired bacterial meningitis.
Drugs 2006;66(4):415-27.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16597160&query_hl=124&itool=pubmed_docsum

Van de Beek D.
Brain teasing effect of dexamethasone
Lancet Neurol 2007 Mar;6(3):203-4.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X3F-4N21KCT-4&_user=10&_coverDate=03%2F31%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=37774523a88ce0f81fe0c5d9337eb655

Weisfelt M, Determann RM, de Gans J, van der Ende A, Van de Beek D, Schultz MJ.
Procoagulant and fibrinolytic activity in cerebrospinal fluid from adults with bacterial meningitis.
J Infect 2007 Jan;3 Epub.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJT-4MRFC46-3&_user=10&_coverDate=01%2F04%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=976122bfaf9e3b6d2e54fcfcfa539b78

Brouwer MC, Van de Beek D, Heckenberg SG, Spanjaard L, de Gans J.
Hyponatraemia in adults with community-acquired bacterial meningitis.
QJM 2007 Jan;100(1):37-40. Epub 2006 Dec 17.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17178734&query_hl=13&itool=pubmed_docsum

WeisfeMlt, Van de Beek D, Spanjaard L, Reitsma JB, de Gans J.
Attenuated cerebrospinal fluid leukocyte count and sepsis in adults with pneumococcal meningitis: a prospective cohort study.
BMC Infect Dis. 2006 Oct 12;6:149.
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1618396&blobtype=pdf

Fitch MT, Van de Beek D.
Emergency diagnosis and treatment of adult meningitis
Lancet 2007 Mar;7(3):191-200.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17317600&query_hl=2&itool=pubmed_docsum

Hoogman M, Van de Beek D, Weisfelt M, de Gans J, Schmand B.
Cognitive outcome in adults after bacterial meningitis.
J Neurol Neurosurg Psychiatry 2007 Mar 12; [Epub ahead of print].
http://jnnp.bmj.com/cgi/rapidpdf/jnnp.2006.110023v1

Brouwer MC, van de Beek D, Heckenberg SG, Spanjaard L, de Gans J. 
Community-acquired Listeria monocytogenes meningitis in adults.
Clin Infect Dis. 2006 Nov 15;43(10):1233-8. Epub 2006 Oct 10. 
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17051485&ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

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