Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

被引：54

作者：

Erdem, Hakan ^{[1
]}

Cag, Yasemin ^{[2
]}

Ozturk-Engin, Derya ^{[3
]}

Defres, Sylviane ^{[4
,5
]}

Kaya, Selcuk ^{[6
]}

Larsen, Lykke ^{[7
]}

Poljak, Mario ^{[8
]}

Barsic, Bruno ^{[9
]}

Argemi, Xavier ^{[10
]}

Sorensen, Signe Maj ^{[11
]}

Bohr, Anne Lisbeth ^{[12
]}

Tattevin, Pierre ^{[13
]}

Gunst, Jesper Damsgaard ^{[14
]}

Bastakova, Lenka ^{[15
,16
]}

Jereb, Matjaz ^{[17
]}

Johansen, Isik Somuncu ^{[7
]}

Karabay, Oguz ^{[18
]}

Pekok, Abdullah Umut ^{[19
]}

Sipahi, Oguz Resat ^{[20
]}

Chehri, Mahtab ^{[21
]}

Beraud, Guillaume ^{[22
]}

Shehata, Ghaydaa ^{[23
]}

Del Vecchio, Rosa Fontana ^{[24
]}

Maresca, Mauro ^{[24
]}

Karsen, Hasan ^{[25
]}

Sengoz, Gonul ^{[26
]}

Sunbul, Mustafa ^{[27
]}

Yilmaz, Gulden ^{[28
]}

Yilmaz, Hava ^{[27
]}

Sharif-Yakan, Ahmad ^{[29
]}

Kanj, Souha Shararah ^{[29
]}

Parlak, Emine ^{[30
]}

Pehlivanoglu, Filiz ^{[26
]}

Korkmaz, Fatime ^{[31
]}

Komur, Suheyla ^{[32
]}

Kose, Sukran ^{[33
]}

Ulug, Mehmet ^{[34
]}

Bolukcu, Sibel ^{[3
]}

Coskuner, Seher Ayten ^{[35
]}

Ince, Nevin ^{[36
]}

Akkoyunlu, Yasemin ^{[37
]}

Halac, Gulistan ^{[38
]}

Sahin-Horasan, Elif ^{[39
]}

Tireli, Hulya ^{[40
]}

Kilicoglu, Gamze ^{[41
]}

Al-Mandawi, Akram ^{[42
]}

Nemli, Salih Atakan ^{[43
]}

Inan, Asuman ^{[3
]}

Senbayrak, Seniha ^{[3
]}

Stahl, Jean Paul ^{[44
,45
]}

机构：

[1] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[2] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[3] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[4] Univ Liverpool, Inst Infect & Global Hlth, Liverpool L69 3BX, Merseyside, England

[5] Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Trop Infect Dis Unit, Liverpool, Merseyside, England

[6] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey

[7] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark

[8] Univ Ljubljana, Fac Med, Inst Microbiol & Immunol, Ljubljana, Slovenia

[9] Univ Zagreb, Sch Med, Dr Fran Mihaljevic Univ Hosp Infect Dis, Dept Infect Dis, Zagreb 41001, Croatia

[10] Nouve Hop Civil, Dept Infect Dis, Strasbourg, France

[11] Alaborg Univ Hosp, Dept Infect Dis, Aalborg, Denmark

[12] Rigshosp, Copenhagen Univ Hosp, Inst Inflammat Res, Dept Infect Dis & Rheumatol, DK-2100 Copenhagen, Denmark

[13] Pontchailou Univ Hosp, Infect Dis & Intens Care Unit, Rennes, France

[14] Aarhus Univ Hosp, Dept Infect Dis, DK-8000 Aarhus, Denmark

[15] Fac Hosp Brno, Dept Infect Dis, Brno, Czech Republic

[16] Masaryk Univ, Fac Med, Brno, Czech Republic

[17] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia

[18] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey

[19] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey

[20] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[21] Hvidovre Univ Hosp, Dept Infect Dis & Clin Microbiol, Copenhagen, Denmark

[22] Poitiers Hosp Univ, Dept Infect Dis, Poitiers, France

[23] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt

[24] Univ Catania, Dept Clin & Mol Biomed, Sect Infect Dis, Catania, Italy

[25] Arran Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sanliurfa, Turkey

[26] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[27] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey

[28] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey

[29] Amer Univ Beirut, Med Ctr, Beirut, Lebanon

[30] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey

[31] Konya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Konya, Turkey

[32] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey

[33] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[34] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey

[35] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[36] Duzce Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konuralp, Duzce, Turkey

[37] Bezmi Alern Vakf Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[38] Bezmi Alern Vakf Univ, Sch Med, Dept Neurol, Istanbul, Turkey

[39] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey

[40] Haydarpasa Numune Training Hosp, Dept Neurol, Istanbul, Turkey

[41] Haydarpasa Numune Training Hosp, Dept Radiol, Istanbul, Turkey

[42] Baghdad Teaching Hosp, Dept Neurol, Baghdad, Iraq

[43] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey

[44] Univ Grenoble 1, Grenoble, France

[45] Univ Hosp Grenoble, Dept Infect Dis, Grenoble, France

[46] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

来源：

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY | 2015年 / 59卷 / 06期

关键词：

CENTRAL-NERVOUS-SYSTEM; SIMPLEX ENCEPHALITIS; BACTERIAL-MENINGITIS; PRACTICE GUIDELINES; ADULT PATIENTS; ACYCLOVIR; MANAGEMENT; INFECTIONS; MANIFESTATIONS; MULTICENTER;

D O I：

10.1128/AAC.05016-14

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.

引用

页码：3084 / 3089

页数：6

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