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Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients
BACKGROUND: Depending on geographic location, causes of encephalitis, meningoencephalitis and meningitis vary substantially. We aimed to identify the most frequent causes, clinical presentation and long-term outcome of encephalitis, meningoencephalitis and meningitis cases treated in the Inselspital...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647376/ https://www.ncbi.nlm.nih.gov/pubmed/34872509 http://dx.doi.org/10.1186/s12883-021-02502-3 |
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author | Ungureanu, Anamaria van der Meer, Julia Bicvic, Antonela Abbuehl, Lena Chiffi, Gabriele Jaques, Léonore Suter-Riniker, Franziska Leib, Stephen L. Bassetti, Claudio L. A. Dietmann, Anelia |
author_facet | Ungureanu, Anamaria van der Meer, Julia Bicvic, Antonela Abbuehl, Lena Chiffi, Gabriele Jaques, Léonore Suter-Riniker, Franziska Leib, Stephen L. Bassetti, Claudio L. A. Dietmann, Anelia |
author_sort | Ungureanu, Anamaria |
collection | PubMed |
description | BACKGROUND: Depending on geographic location, causes of encephalitis, meningoencephalitis and meningitis vary substantially. We aimed to identify the most frequent causes, clinical presentation and long-term outcome of encephalitis, meningoencephalitis and meningitis cases treated in the Inselspital University Hospital Bern, Switzerland. METHODS: In this monocentric, observational study, we performed a retrospective review of clinical patient records for all patients treated within a 3-year period. Patients were contacted for a telephone follow-up interview and to fill out questionnaires, especially related to disturbances of sleep and wakefulness. RESULTS: We included 258 patients with the following conditions: encephalitis (18%), nonbacterial meningoencephalitis (42%), nonbacterial meningitis (27%) and bacterial meningoencephalitis/meningitis (13%). Herpes simplex virus (HSV) was the most common cause of encephalitis (18%); tick-borne encephalitis virus (TBEV) was the most common cause of nonbacterial meningoencephalitis (46%), enterovirus was the most common cause of nonbacterial meningitis (21%) and Streptococcus pneumoniae was the most common cause of bacterial meningoencephalitis/meningitis (49%). Overall, 35% patients remained without a known cause. After a median time of 16 months, 162 patients participated in the follow-up interview; 56% reported suffering from neurological long-term sequelae such as fatigue and/or excessive daytime sleepiness (34%), cognitive impairment and memory deficits (22%), headache (14%) and epileptic seizures (11%). CONCLUSIONS: In the Bern region, Switzerland, TBEV was the overall most frequently detected infectious cause, with a clinical manifestation of meningoencephalitis in the majority of cases. Long-term neurological sequelae, most importantly cognitive impairment, fatigue and headache, were frequently self-reported not only in encephalitis and meningoencephalitis survivors but also in viral meningitis survivors up to 40 months after acute infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02502-3. |
format | Online Article Text |
id | pubmed-8647376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86473762021-12-07 Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients Ungureanu, Anamaria van der Meer, Julia Bicvic, Antonela Abbuehl, Lena Chiffi, Gabriele Jaques, Léonore Suter-Riniker, Franziska Leib, Stephen L. Bassetti, Claudio L. A. Dietmann, Anelia BMC Neurol Research Article BACKGROUND: Depending on geographic location, causes of encephalitis, meningoencephalitis and meningitis vary substantially. We aimed to identify the most frequent causes, clinical presentation and long-term outcome of encephalitis, meningoencephalitis and meningitis cases treated in the Inselspital University Hospital Bern, Switzerland. METHODS: In this monocentric, observational study, we performed a retrospective review of clinical patient records for all patients treated within a 3-year period. Patients were contacted for a telephone follow-up interview and to fill out questionnaires, especially related to disturbances of sleep and wakefulness. RESULTS: We included 258 patients with the following conditions: encephalitis (18%), nonbacterial meningoencephalitis (42%), nonbacterial meningitis (27%) and bacterial meningoencephalitis/meningitis (13%). Herpes simplex virus (HSV) was the most common cause of encephalitis (18%); tick-borne encephalitis virus (TBEV) was the most common cause of nonbacterial meningoencephalitis (46%), enterovirus was the most common cause of nonbacterial meningitis (21%) and Streptococcus pneumoniae was the most common cause of bacterial meningoencephalitis/meningitis (49%). Overall, 35% patients remained without a known cause. After a median time of 16 months, 162 patients participated in the follow-up interview; 56% reported suffering from neurological long-term sequelae such as fatigue and/or excessive daytime sleepiness (34%), cognitive impairment and memory deficits (22%), headache (14%) and epileptic seizures (11%). CONCLUSIONS: In the Bern region, Switzerland, TBEV was the overall most frequently detected infectious cause, with a clinical manifestation of meningoencephalitis in the majority of cases. Long-term neurological sequelae, most importantly cognitive impairment, fatigue and headache, were frequently self-reported not only in encephalitis and meningoencephalitis survivors but also in viral meningitis survivors up to 40 months after acute infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02502-3. BioMed Central 2021-12-06 /pmc/articles/PMC8647376/ /pubmed/34872509 http://dx.doi.org/10.1186/s12883-021-02502-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Ungureanu, Anamaria van der Meer, Julia Bicvic, Antonela Abbuehl, Lena Chiffi, Gabriele Jaques, Léonore Suter-Riniker, Franziska Leib, Stephen L. Bassetti, Claudio L. A. Dietmann, Anelia Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients |
title | Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients |
title_full | Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients |
title_fullStr | Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients |
title_full_unstemmed | Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients |
title_short | Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients |
title_sort | meningitis, meningoencephalitis and encephalitis in bern: an observational study of 258 patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647376/ https://www.ncbi.nlm.nih.gov/pubmed/34872509 http://dx.doi.org/10.1186/s12883-021-02502-3 |
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