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Cognitive outcome in adults after bacterial meningitis
  1. Martine Hoogman (m.hoogman{at}psy.umcn.nl)
  1. Academic Medical Center, Netherlands
    1. Diederik van de Beek (d.vandebeek{at}amc.uva.nl)
    1. Academic Med Center/Univ of Amsterdam, Netherlands
      1. Martijn Weisfelt (m.weisfelt{at}amc.uva.nl)
      1. academic medical center, Netherlands
        1. Jan de Gans (j.degans{at}amc.uva.nl)
        1. Academic Medical Center, Netherlands
          1. Ben Schmand (b.schmand{at}amc.uva.nl)
          1. Academic Med Center/Univ of Amsterdam, Netherlands

            Abstract

            Objective: To evaluate cognitive outcome in adult survivors of bacterial meningitis

            Methods: Data from three prospective multi-center studies were pooled and re-analyzed, involving 155 adults surviving bacterial meningitis (79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls.

            Results: Cognitive impairment was found in 32% of the patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Patients after pneumococcal meningitis performed worse on memory tasks (P < 0.001) and tended to be cognitively slower than patients after meningococcal meningitis (P = 0.08). We found a diffuse pattern of cognitive impairment, in which cognitive speed played the most important role. Cognitive performance was not related to time since meningitis; however, there was a positive association between time since meningitis and self-reported physical impairment (P <0.01). The frequency of cognitive impairment and the numbers of abnormal test results for patients with and without adjunctive dexamethasone were similar.

            Conclusions: Adult survivors of bacterial meningitis are at risk for cognitive impairment, which consist mainly of cognitive slowness. The loss of cognitive speed is stable over time after bacterial meningitis; however, there is a significant improvement of subjective physical impairment in the years after bacterial meningitis. The use of dexamethasone was not associated with cognitive impairment.

            • adults
            • bacterial meningitis
            • neisseria meningitidis
            • neuropsychological tests
            • streptococcus pneumoniae

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