| Title |
Delayed cerebral thrombosis complicating pneumococcal meningitis: an autopsy study
|
|---|---|
| Published in |
Annals of Intensive Care, February 2018
|
| DOI | 10.1186/s13613-018-0368-8 |
| Pubmed ID | |
| Authors |
Joo-Yeon Engelen-Lee, Matthijs C. Brouwer, Eleonora Aronica, Diederik van de Beek |
| Abstract |
Delayed cerebral thrombosis (DCT) is a devastating cerebrovascular complication in patients with excellent initial recovery of pneumococcal meningitis. The aetiology is unknown, but direct bacterial invasion, activation of coagulation or post-infectious immunoglobulin deposition has been suggested. We studied histopathology of 4 patients with pneumococcal meningitis complicated by DCT. Results were compared with 8 patients who died of pneumococcal meningitis without DCT and 3 non-meningitis control cases. Furthermore, we evaluated vascular immunoglobulin depositions (IgA, IgG and IgM) and the presence of pneumococcal capsules by immunofluorescence. Patients who died after pneumococcal meningitis showed inflammation in the meninges and blood vessels with extensive infarction and thrombosis. We did not observe gross differences between DCT and non-DCT patients, except that 2 of 4 DCT patients had a basilar artery aneurysm compared to none of the non-DCT patients. We observed high density of IgM and IgG deposition in meningitis cases as compared to controls, but no difference between DCT and non-DCT patients. Immunofluorescence staining of pneumococci demonstrated the presence of bacterial capsules in the meninges of all meningitis patients, even 35 days after the initiation of antibiotic treatment. The aetiology of DCT complicating pneumococcal meningitis seems to be of multifactorial aetiology and includes vascular inflammation, thromboembolism of large arteries and infectious intracranial aneurysms. Pneumococcal cell wall components can be observed for weeks after pneumococcal meningitis and may be a source of resurging inflammation after the initial immunosuppression by dexamethasone. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 30 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 4 | 13% |
| Student > Bachelor | 4 | 13% |
| Student > Doctoral Student | 3 | 10% |
| Researcher | 3 | 10% |
| Student > Postgraduate | 2 | 7% |
| Other | 5 | 17% |
| Unknown | 9 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 20% |
| Biochemistry, Genetics and Molecular Biology | 3 | 10% |
| Neuroscience | 2 | 7% |
| Nursing and Health Professions | 2 | 7% |
| Unspecified | 1 | 3% |
| Other | 2 | 7% |
| Unknown | 14 | 47% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 August 2018.
All research outputs
#15,699,189
of 23,931,222 outputs
Outputs from Annals of Intensive Care
#836
of 1,089 outputs
Outputs of similar age
#264,838
of 448,796 outputs
Outputs of similar age from Annals of Intensive Care
#25
of 32 outputs
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