Resumen
A pesar de su baja incidencia la meningitis bacteriana tiene una alta morbimortalidad. En la del adulto adquirida en la comunidad el pneumococo y meningococo son sus principales agentes etiológicos. Su desarrollo depende de la interacción compleja entre factores bacterianos y la respuesta inmunológica del huésped. Su diagnóstico requiere el reconocimiento del síndrome clínico, la confirmación del proceso inflamatorio meníngeo y la identificación del agente etiológico en el líquido cefalorraquídeo. El tratamiento temprano con cubrimiento antibiótico de amplio espectro y luego dirigido según resultados de laboratorio reduce los desenlaces adversos. En este resumen narrativo se describen aspectos clínicos, fisiopatológicos, diagnósticos, terapéuticos y pronóstico de la meningitis bacteriana aguda del adulto adquirida en la comunidad.
Citas
Van De Beek D, Brouwer M, Hasbun R, Koedel U, Whitney CG, Wijdicks E. Community-acquired bacterial meningitis. Nat Rev Dis Prim. 2016;2:1-21. doi: 10.1038/nrdp.2016.74.
Davis LE. Acute Bacterial meningitis. Contin Lifelong Learn Neurol. 2018;24(5, Neuroinfectious Disease):1264-83. doi: 10.1212/CON.0000000000000660.
Principi N, Esposito S. Bacterial meningitis: new treatment options to reduce the risk of brain damage. Expert Opin Pharmacother. 2020;21(1):97-105. doi: 10.1080/14656566.2019.1685497.
Brouwer MC, Van De Beek D. Epidemiology of community-acquired bacterial meningitis. Curr Opin Infect Dis. 2018;31(1):78-84. doi: 10.1097/QCO.0000000000000417.
Koopmans MM, Bijlsma MW, Brouwer MC, van de Beek D, van der Ende A. Listeria monocytogenes meningitis in the Netherlands, 1985-2014: A nationwide surveillance study. J Infect. 2017;75(1):12-19. doi: 10.1016/j.jinf.2017.04.004.
Prieto FE. Semana 16, del 12 al 18 de abril del año 2020. Instituto Nacional de Salud. doi: 10.33610/23576189.2020.16.
Figueiredo AHA, Brouwer MC, van de Beek D. Acute community-acquired bacterial meningitis. Neurol Clin. 2018;36(4):809-20. doi: 10.1016/j.ncl.2018.06.007.
McGill F, Heyderman RS, Panagiotou S, Tunkel AR, Solomon T. Acute bacterial meningitis in adults. Lancet 2016;388(10063):3036-47. doi: 10.1016/S0140-6736(16)30654-7.
Young N, Thomas M. Meningitis in adults: diagnosis and management. Intern Med J. 2018;48(11):1294-307. doi: 10.1111/imj.14102.
Runde TJ, Anjum FHJ. Bacterial meningitis. [Actualizado 2020 Ago 11]. En: StatPearls. StatPearls [Internet] Treasure Island: StatPearls; 2020.
Trivedi K, Tang CM, Exley RM. Mechanisms of meningo-coccal colonisation. Trends Microbiol. 2011;19(9):456-63. doi: 10.1016/j.tim.2011.06.006.
Takada S, Fujiwara S, Inoue T, Kataoka Y, Hadano Y, Matsumoto K, Morino K, Shimizu T. Meningococcemia in adults: A review of the literature. Intern Med. 2016;55(6):567-72. doi: 10.2169/internalmedicine.55.3272.
Pagliano P, Ascione T, Boccia G, De Caro F, Esposito S. Listeria monocytogenes meningitis in the elderly: Epidemiological, clinical and therapeutic findings. Infez Med. 2016;24(2):105-11.
Barichello T, Generoso JS, Simões LR, Elias SG, Quevedo J. Role of oxidative stress in the pathophysiology of pneumococcal meningitis. Oxid Med Cell Longev. 2013;2013. doi: 10.1155/2013/371465.
Viallon A, Botelho-Nevers E, Zeni F. Clinical decision rules for acute bacterial meningitis: Current insights. Open Access Emerg Med. 2016;8:7-16. doi: 10.2147/OAEM.S69975.
Hoen B, Varon E, de Debroucker T, Fantin B, Grimprel E, Wolff M, et al. Management of acute community-acquired bacterial meningitis (excluding newborns). Long version with arguments. Med Mal Infect. 2019;49(6):405-41. doi: 10.1016/j.medmal.2019.03.009.
van de Beek D, Cabellos C, Dzupova O, Esposito S, Klein M, Kloek AT, et al. ESCMID guideline: Diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect. 2016;22:537-62. doi: 10.1016/j.cmi.2016.01.007.
Julián-Jiménez A, Morales-Casado MI. Usefulness of blood and cerebrospinal fluid laboratory testing to predict bacterial meningitis in the emergency department. Neurologia. 2019;34(2):105-13. doi: 10.1016/j.nrl.2016.05.009.
van Ettekoven CN, van de Beek D, Brouwer MC. Update on community-acquired bacterial meningitis: guidance and challenges. Clin Microbiol Infect. 2017;23(9):601-6. doi: 10.1016/j.cmi.2017.04.019.
Mofidi M, Negaresh N, Farsi D, Rezai M, Mahshidfar B, Abbasi S, Hafezimoghadam P. Jolt accentuation and its value as a sign in diagnosis of meningitis in patients with fever and headache. Turkish J Emerg Med. 2017;17(1):29-31. doi: 10.1016/j.tjem.2016.11.001.
Costerus jM, Brouwer MC, Bijlsma MW, Van De Beek D. Community-acquired bacterial meningitis. Curr Opin Infect Dis. 2017;30(1):135-41. doi: 10.1097/QCO.0000000000000335.
Obaro S. Updating the diagnosis of bacterial meningitis. Lancet Infect Dis. 2019;19(11):1160-1. doi: 10.1016/51473-3099(19)30549-3.
Sakushima K, Hayashino Y, Kawaguchi T, Jackson JL, Fukuhara S. Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: A meta-analysis. J Infect. 2011;62(4):255-62. doi: 10.1016/j.jinf.2011.02.010.
Du B, Hua C, Xia Y, Tao Y, Cao Q, Mo X. Evaluation of the BioFire FilmArray meningitis/encephalitis panel for the detection of bacteria and yeast in Chinese children. Ann Transl Med. 2019;7(18):437. doi: 10.21037/atm.2019.08.103.
Domingues RB, Santos MVD, Leite FBVM, Senne C. FilmArray meningitis/encephalitis (ME) panel in the diagnosis of bacterial meningitis. Brazilian J Infect Dis. 2019;23(6):468-70. doi: 10.1016/j.bjid.2019.10.008.
Leber AL, Everhart K, Balada-Llasat JM, Cullison J, Daly J, Holt S, et al. Multicenter Evaluation of BioFire FilmArray Meningitis/Encephalitis Panel for Detection of Bacteria, Viruses, and Yeast in Cerebrospinal Fluid Specimens. J Clin Microbiol. 2015;54(9):2251-61. doi: 10.1128/JCM.00730-16.
Gu W, Miller S, Chiu CY Clinical metagenomic next-generation sequencing for pathogen detection. Annu Rev Pathol Mech Dis. 2019;14:319-38. doi: 10.1146/annurev-pathmech-dis-012418-012751.
Ramachandran PS, Wilson MR. Metagenomics for neurological infections - expanding our imagination. Nat Rev Neurol. 2020;16(10):547-56. doi: 10.1038/s41582-020-0374-y.
Wilson MR, Sample HA, Zorn KC, Arevalo S, Yu G, Neuhaus J, et al. Clinical metagenomic sequencing for diagnosis of meningitis and encephalitis. N Engl J Med. 2019;380(24):2327-40. doi: 10.1056/NEJMoa1803396.
Hughes DC, Raghavan A, Mordekar SR, Griffiths PD, Connolly DJA. Role of imaging in the diagnosis of acute bacterial meningitis and its complications. Postgrad Med J. 2010;86(1018):478-85. doi: 10.1136/pgmj.2010.097022.
Hasbun R. Update and advances in community acquired bacterial meningitis. Curr Opin Infect Dis. 2019;32(3):233-8. doi: 10.1097/QCO.0000000000000543.
Salazar L, Hasbun R. Cranial imaging before lumbar puncture in adults with community-acquired meningitis: Clinical utility and adherence to the infectious diseases society of America Guidelines. Clin Infect Dis. 2017;64(12):1657-62. doi: 10.1093/cid/cix240.
Thumher M. Meningitis and ventriculitis. Naidich TP, Castillo M, Cha C, Smirniotopoulos, Editores. En: Imaging of the Brain. Philadelphia: Elsevier Saunders ;2013.p.865-868.
Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lyn-field R, Hadler JL, et al. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011;364(21):2016-25. doi: 10.1056/NEJMoa1005384.
Departamento Administrativo Nacional de Estadística (DANE). Defunciones no fetales. 2019. Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/salud/nacimientos-y-defunciones/defunciones-no-fetales/ defunciones-no-fetales-2019
Lundbo LF, Benfield T. Risk factors for community-acquired bacterial meningitis. Infect Dis (Auckl). 2017;49(6):433-44. doi: 10.1080/23744235.2017.1285046.
Brouwer MC, de Gans J, Heckenberg SG, Zwinderman AH, van der Poll T, van de Beek D. Host genetic susceptibility to pneumococcal and meningococcal disease: a systematic review and meta-analysis. Lancet Infect Dis. 2009;9(1):31-44. doi: 10.1016/S1473-3099(08)70261-5.
Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, et al. Practice of for the management meningitis. Practice. 2012;39(9):1267-84. doi: 10.1086/425368.
McGill F, Heyderman RS, Michael BD, Defres S, Beeching NJ, Borrow R, et al. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. J Infect. 2016;72(4):405-38. doi:10.1016/j.jinf.2016.01.007
Lee EK, Lee EJ, Kim S, Lee YS. Importance of contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging in various intracranial pathologic conditions. Korean J Radiol. 2016;17(1):127-41. doi: 10.3348/kjr.2016.17.1.127.
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