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Volume 29, Number 9—September 2023
Research Letter

Group A Streptococcus Meningitis in Adults, Denmark

Henrik NielsenComments to Author , Merete Storgaard, Jannik Helweg-Larsen, Lykke Larsen, Micha P.G. Jepsen, Birgitte R. Hansen, Lothar Wiese, and Jacob Bodilsen
Author affiliations: Aalborg University Hospital, Aalborg, Denmark (H. Nielsen, J. Bodilsen); Aalborg University, Aalborg (H. Nielsen, J. Bodilsen); Aarhus University Hospital, Aarhus, Denmark (M. Storgaard); Rigshospitalet, Copenhagen, Denmark (J. Helweg-Larsen); Odense University Hospital, Odense, Denmark (L. Larsen); Nordsjællands Hospital, Hillerød, Denmark (M.P.G. Jepsen); Hvidovre University Hospital, Hvidovre, Denmark (B.R. Hansen); Zealand University Hospital, Roskilde, Denmark (L. Wiese)

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Table

Characteristics of adults with community-acquired group A streptococcal meningitis, Denmark, 2015–2023

Characteristic Jan 1, 2015–Oct 12, 2022 Oct 13, 2022–Apr 13, 2023 p value†
Total no. cases
 8
 11
Age
 57 (35–66)
 58 (40–69)
 0.53
Sex, no. (%)
M 5 (62) 7 (64)
F
 3 (38)
 4 (36)
 1.0
Comorbidity, no. (%)
 0
 4 (36)
 0.09
Duration of symptoms, d
 5.5 (1–7)
 2 (1–4)
 0.35
Glasgow Coma Score‡
15 (15–15)
 13 (11–15)
 0.01
Temperature 37.7 (37.0–39.0) 39.1 (37.7–39.4) 0.23
Systolic blood pressure 131 (113–136) 125 (119–125) 0.25
Ear-nose-throat focus, no. (%) 7 (88) 9 (82) 1.0
C-reactive protein, mg/L 305 (228–367) 216 (105–313) 0.46
Time until lumbar puncture, h
 3.0 (1.8–3.6)
 2.2 (1.6–7.8)
 0.85
CSF leukocytes, 106 cells/L 111 (40–385) 1,726 (534–3,990) 0.03
CSF protein, g/L 1.7 (0.7–3.2) 1.6 (0.9–2.6) 0.79
CSF culture positive, no. (%)
 3 (38)
 3 (27)
 1.0
Bacteremia, no. (%)
 5 (63)
 7 (64)
 1.0
Time until antimicrobial drugs, h 3.7 (1.7–7.0) 4.4 (0.3–12.3) 0.95
Dexamethasone, no. (%)
 8 (100)
 8 (73)
 0.23
Intensive care unit stay, no. (%)
 4 (50)
 7 (64)
 0.66
Progressive or new neurologic deficits, no. (%) 3 (38) 1 (9) 0.26
Seizures, no. (%) 2 (25) 1 (9) 0.55
Septic shock, no. (%)
 3 (38)
 1 (9)
 0.26
Death, no. (%) 1 (13) 1 (9) 1.0

*Values are median (IQR) except as indicated. CSF, cerebrospinal fluid; IQR, interquartile range. †p value determined by Fisher exact test for categorial variables and Mann-Whitney rank sum test for continuous variables. ‡Glasgow Coma Score based on eye opening (1–4), verbal response (1–5) and motor response (1–6), maximum 15 points.

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References
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Page created: July 18, 2023
Page updated: August 20, 2023
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