1421. Hypoglycorrachia in Adults with Community-Acquired Meningitis
Session: Poster Abstract Session: CNS Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Hypoglycorrachia (CSF glucose <45mg/dl) has been identified as one of the prognostic factors in patients with meningitis. Methods: This is a retrospective study of 621 adults (age >17 years) with community-acquired meningitis [CSF WBC > 5 cells/mm3, absence of a CSF shunt or recent neurosurgery procedure (<1 mo.)] at 8 Memorial Hermann Hospitals in Houston, TX from January 2005 to December 2010. The study patients were divided into hypoglycorrachia (n=106) and non-hypoglycorrachia (n=515) groups. An adverse clinical outcome was defined as a Glasgow Outcome Scale score of 4 or less. Results: The most common causes of hypoglycorrachia in our study were Cryptococcus neoformans (n=36), unknown (n=29), bacterial (n=27), viral (n=9), tuberculous (n=4) and toxoplasmosis (n=1). There were no significant differences found in regards to the presence of fever, seizures, vesicular or petechial rash, or management decisions such as the use of cranial imaging, use of empiric antibiotic or antiviral therapy and admission to the hospital (p >0.05) between the two groups. We found that patients with hypoglycorrachia had significantly higher rates of comorbidities, immunosuppressive states such as HIV/AIDS, abnormal mental status, sinusitis, otitis, respiratory symptoms and nuchal rigidity. Patients in the hypoglycorrhachia group had significantly higher rates of known etiologies with more positive bacterial and fungal cultures, urgent treatable causes and abnormal cranial imaging (p <0.05). Furthermore, adverse clinical outcomes were seen more frequently in the hypoglycorrahcia group (26 out of 106 (24.5%) in comparison to 42 out of 515 (8.1%) the non-hypoglycorrachia group) (p <0.001). Conclusion: Hypoglycorrachia has important prognostic significance in the evaluation of patients with community-acquired meningitis.
Vandana Shrikanth, MD1, Lucrecia Salazar, MD2, Nabil Khoury, MD3, Susan Wootton, MD4 and Rodrigo Hasbun, MD3, (1)Infectious Diseases, UT Health, Houston, TX, (2)Infectious Disease, University of Texas (UT) Health, Houston, TX, Houston, TX, (3)Internal Medicine, University of Texas Health Science Center, Houston, TX, (4)Pediatrics, University of Texas Health Science Center, Houston, TX

Disclosures:

V. Shrikanth, None

L. Salazar, None

N. Khoury, None

S. Wootton, None

R. Hasbun, None

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