McGill F, et al. - In this multicenter, prospective, observational cohort study, researchers determined the incidence, causes, and sequelae of viral meningitis in UK adults to improve patient management and help with health service planning. Study results showed that the most commonly identified cause of meningitis in UK adults are viruses, which lead to substantial long-term morbidity. Findings suggested an association of delays in getting a lumbar puncture and unnecessary treatment with antivirals with longer hospital stays. Results of this study suggested that rapid diagnostics and rationalizing treatments might lessen the burden of meningitis on health services.

Methods

• Participants in the study were adults with suspected meningitis at 42 hospitals across England.
• Eligibility criteria included being aged 16 years or older, having clinically suspected meningitis, and either underwent a lumbar puncture or, if lumbar puncture was contraindicated, had clinically suspected meningitis and an appropriate pathogen identified either in blood culture or on blood PCR.
• People with ventricular devices were excluded.
• The incidence of viral meningitis was calculated using data from patients from the northwest region only and used these data to estimate the population-standardized number of cases in the UK.
• Patients self-reported quality-of-life and neuropsychological outcomes, utilizing the EuroQol EQ-5D-3L, the 36-Item Short Form Health Survey (SF-36), and the Aldenkamp and Baker neuropsychological assessment schedule, for 1 year after admission.

Results

• Between September 30, 2011 and September 30, 2014, 1,126 patients were enlisted.
• Researchers found that 638 (57%) patients had meningitis: 231 (36%) cases were viral, 99 (16%) were bacterial, and 267 (42%) had an unknown cause.
• It was noted that 41 (6%) cases had other causes.
• Findings revealed that the estimated annual incidence of viral meningitis was 2.73 per 100,000 and that of bacterial meningitis was 1.24 per 100,000.
• It was observed that the median length of hospital stay for patients with viral meningitis was 4 days (IQR 3–7), increasing to 9 days (6–12) in those treated with antivirals.
• As per data, earlier lumbar puncture resulted in more patients having a specific cause identified than did those who had a delayed lumbar puncture.