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Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study

BACKGROUND: To monitor emerging infectious diseases, the Centers for Disease Control and Prevention and the Infectious Disease Society of America established the Emerging Infections Network (EIN), allowing infectious disease specialists to post inquiries about clinical cases. We describe the frequen...

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Autores principales: Matthews, Elizabeth, Diaz-Arias, Luisa A, Beekmann, Susan E, Polgreen, Philip, Waldrop, Greer, Yang, Vivian, Rimmer, Kathryn, Venkatesan, Arun, Thakur, Kiran T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292246/
https://www.ncbi.nlm.nih.gov/pubmed/32550236
http://dx.doi.org/10.1093/ofid/ofaa163
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author Matthews, Elizabeth
Diaz-Arias, Luisa A
Beekmann, Susan E
Polgreen, Philip
Waldrop, Greer
Yang, Vivian
Rimmer, Kathryn
Venkatesan, Arun
Thakur, Kiran T
author_facet Matthews, Elizabeth
Diaz-Arias, Luisa A
Beekmann, Susan E
Polgreen, Philip
Waldrop, Greer
Yang, Vivian
Rimmer, Kathryn
Venkatesan, Arun
Thakur, Kiran T
author_sort Matthews, Elizabeth
collection PubMed
description BACKGROUND: To monitor emerging infectious diseases, the Centers for Disease Control and Prevention and the Infectious Disease Society of America established the Emerging Infections Network (EIN), allowing infectious disease specialists to post inquiries about clinical cases. We describe the frequency and characteristics of neuroinfectious disease-related inquiries. METHODS: The EIN listserv was retrospectively reviewed from February 1997 to December 2019 using search terms associated with neurologic diseases. We recorded case summaries, disease type (ie, meningitis, encephalitis), inquiry type (diagnostic approach, result interpretation, management decisions), unique patient populations, exposures, pathogens, ultimate diagnosis, and change in clinical care based on responses. RESULTS: Of 2348 total inquiries, 285 (12.1%) related to neuroinfectious diseases. The majority involved meningitis (99, 34.7%) or encephalitis (56, 19.6%). One hundred fifteen inquiries (40%) related to management, 34 (12%) related to diagnostic workup, and 22 (8%) related to result interpretation. Eight (2.8%) specifically involved results of cerebrospinal fluid polymerase chain reaction testing. Sixty-three (22.1%) involved immunosuppressed patients (29 human immunodeficiency virus-positive cases [46%]). The most common pathogens were Treponema pallidum (19, 6.7%) and Cryptococcus neoformans (18, 6.3%). In 74 (25%) inquiries, patients had neurologic symptoms without a clear infection, 38 (51.3%) of which included noninfectious neurologic etiologies in the differential diagnosis. CONCLUSIONS: This study demonstrates the significant challenges of diagnosis and management of neuroinfectious diseases within the field of infectious diseases. It also highlights the importance of curated forums to guide the approach of difficult cases, in particular instances that mimic infectious diseases. Finally, the EIN listserv may assist in identifying areas for research and training to address these complexities.
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spelling pubmed-72922462020-06-16 Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study Matthews, Elizabeth Diaz-Arias, Luisa A Beekmann, Susan E Polgreen, Philip Waldrop, Greer Yang, Vivian Rimmer, Kathryn Venkatesan, Arun Thakur, Kiran T Open Forum Infect Dis Major Article BACKGROUND: To monitor emerging infectious diseases, the Centers for Disease Control and Prevention and the Infectious Disease Society of America established the Emerging Infections Network (EIN), allowing infectious disease specialists to post inquiries about clinical cases. We describe the frequency and characteristics of neuroinfectious disease-related inquiries. METHODS: The EIN listserv was retrospectively reviewed from February 1997 to December 2019 using search terms associated with neurologic diseases. We recorded case summaries, disease type (ie, meningitis, encephalitis), inquiry type (diagnostic approach, result interpretation, management decisions), unique patient populations, exposures, pathogens, ultimate diagnosis, and change in clinical care based on responses. RESULTS: Of 2348 total inquiries, 285 (12.1%) related to neuroinfectious diseases. The majority involved meningitis (99, 34.7%) or encephalitis (56, 19.6%). One hundred fifteen inquiries (40%) related to management, 34 (12%) related to diagnostic workup, and 22 (8%) related to result interpretation. Eight (2.8%) specifically involved results of cerebrospinal fluid polymerase chain reaction testing. Sixty-three (22.1%) involved immunosuppressed patients (29 human immunodeficiency virus-positive cases [46%]). The most common pathogens were Treponema pallidum (19, 6.7%) and Cryptococcus neoformans (18, 6.3%). In 74 (25%) inquiries, patients had neurologic symptoms without a clear infection, 38 (51.3%) of which included noninfectious neurologic etiologies in the differential diagnosis. CONCLUSIONS: This study demonstrates the significant challenges of diagnosis and management of neuroinfectious diseases within the field of infectious diseases. It also highlights the importance of curated forums to guide the approach of difficult cases, in particular instances that mimic infectious diseases. Finally, the EIN listserv may assist in identifying areas for research and training to address these complexities. Oxford University Press 2020-05-09 /pmc/articles/PMC7292246/ /pubmed/32550236 http://dx.doi.org/10.1093/ofid/ofaa163 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Matthews, Elizabeth
Diaz-Arias, Luisa A
Beekmann, Susan E
Polgreen, Philip
Waldrop, Greer
Yang, Vivian
Rimmer, Kathryn
Venkatesan, Arun
Thakur, Kiran T
Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
title Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
title_full Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
title_fullStr Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
title_full_unstemmed Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
title_short Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
title_sort prevalence and characteristics of neuroinfectious disease inquiries within the emerging infections network: a 22-year retrospective study
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292246/
https://www.ncbi.nlm.nih.gov/pubmed/32550236
http://dx.doi.org/10.1093/ofid/ofaa163
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