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  1. AU="Wiese, Lothar"
  2. AU=Rackova Sylva AU=Rackova Sylva
  3. AU="Akala, Isiaka Olusola"
  4. AU="Nicolás Gonzalo Núñez"
  5. AU="Hernández Solis, Alejandro"
  6. AU="Jadad, Alejandro R"
  7. AU="Lastres, Palma Rico" AU="Lastres, Palma Rico"
  8. AU="Manes, K"
  9. AU="Baugh, Matthew"
  10. AU="Qu, C"
  11. AU="Flett, Heather"
  12. AU="Shueh Lin Lim"
  13. AU="Schröder, Johann"
  14. AU=Butler Taylor
  15. AU="Yang, Fan"
  16. AU="Giacomo Frati"
  17. AU=Kokhaei P
  18. AU="Charikleia Triantopoulou"
  19. AU="Salil Bhargava"
  20. AU="Jong-Eun Lee"
  21. AU="Vargas C, Laura"

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  1. Artikel ; Online: Point-of-care self-testing for measuring total white blood cells and C-reactive protein - a pilot study for future home-monitoring of patients during antibiotic treatment at home.

    Schousboe, Amalie / Wiese, Lothar

    Infectious diseases (London, England)

    2022  Band 55, Heft 4, Seite(n) 235–242

    Abstract: Background: During home treatment with antibiotics, patients' laboratory results of total white blood cell count (WBC) with neutrophil counts and C-reactive protein (CRP) are drawn and monitored at the hospital. The aim of the study was to examine the ... ...

    Abstract Background: During home treatment with antibiotics, patients' laboratory results of total white blood cell count (WBC) with neutrophil counts and C-reactive protein (CRP) are drawn and monitored at the hospital. The aim of the study was to examine the feasibility and analytical accuracy of hospitalized patients 18 years or older self-testing using two point-of-care tests (POCT).
    Methods: The pilot study included 41 hospitalized patients. A subjective judgment of the patients' ability to conduct the self-testing was made along with a comparison of the POCT measurements of WBC, neutrophil counts and CRP with standard laboratory measurements. Correlation between the POCTs and laboratorial values was assessed by coefficient of determination and the level of agreement between the means was assessed by Bland Altman test.
    Results: Of the 38 patients conducting self-testing, 78% were men and the mean age was 61.8 years. 28 patients (73.7%) successfully performed self-testing on the first try while, 10 (26.3%) 'HemoCue WBC DIFF' measurements showed an error code. All the patients successfully performed the 'QuickRead go CRP' self-test. Comparison of the 'HemoCue WBC DIFF' results with the laboratory results of WBC and neutrophil counts showed good agreement. On the other hand, 'QuickRead go CRP' results showed a small but significant systematic disagreement compared to the laboratory results.
    Conclusion: Our results showed that the POCTs can be used by some patients and factors influencing the patient participation included psychological and physical limitations. Both POCTs appeared to have an acceptable clinical level of accuracy.
    Mesh-Begriff(e) Male ; Humans ; Middle Aged ; Female ; C-Reactive Protein/analysis ; Point-of-Care Systems ; Self-Testing ; Pilot Projects ; Leukocyte Count ; Point-of-Care Testing ; Neutrophils ; Anti-Bacterial Agents/therapeutic use
    Chemische Substanzen C-Reactive Protein (9007-41-4) ; Anti-Bacterial Agents
    Sprache Englisch
    Erscheinungsdatum 2022-12-25
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2839775-7
    ISSN 2374-4243 ; 2374-4235
    ISSN (online) 2374-4243
    ISSN 2374-4235
    DOI 10.1080/23744235.2022.2152091
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Recurring episodes of bundle branch reentry ventricular tachycardia due to aortitis preceded by SARS-CoV-2 infection: a case report.

    Melchior, Simon E / Schoos, Mikkel M / Gang, Uffe / Jacobsen, Peter K / Wiese, Lothar / Melchior, Thomas Maria

    BMC cardiovascular disorders

    2023  Band 23, Heft 1, Seite(n) 46

    Abstract: Background: SARS-CoV-2 may trigger both vasculitis and arrhythmias as part of a multisystem inflammatory syndrome described in children as well as in adults following COVID-19 infection with only minor respiratory symptoms. The syndrome denotes a severe ...

    Abstract Background: SARS-CoV-2 may trigger both vasculitis and arrhythmias as part of a multisystem inflammatory syndrome described in children as well as in adults following COVID-19 infection with only minor respiratory symptoms. The syndrome denotes a severe dysfunction of one or more extra-pulmonary organ systems, with symptom onset approximately 2-5 weeks after the COVID-19 infection. In the present case, a seemingly intractable ventricular tachycardia preceded by SARS-CoV2 infection was only managed following the diagnosis and management of aortitis.
    Case presentation: A 69-year-old woman was hospitalized due to syncope, following a mild COVID-19 infection. She presented with paroxysmal atrial fibrillation and intermittent ventricular tachycardia interpreted as a septum-triggered bundle branch reentry ventricular tachycardia, unaffected by amiodaron, lidocaine and adenosine. A CT-scan revealed inflammation of the aortic arch, extending into the aortic root. In the following days, the tachycardia progressed to ventricular storm with intermittent third-degree AV block. A temporary pacemaker was implanted, and radiofrequency ablation was performed to both sides of the ventricular septum after which the ventricular tachycardia was non-inducible. Following supplemental prednisolone treatment, cardiac symptoms and arrythmia subsided, but recurred after tapering. Long-term prednisolone treatment was therefore initiated with no relapse in the following 14 months.
    Conclusion: We present a rare case of aortitis complicated with life-threatening ventricular tachycardia presided by Covid-19 infection without major respiratory symptoms. Given a known normal AV conduction prior to the COVID-19 infection, it seems likely that the ensuing aortitis in turn affected the septal myocardium, enabling the reentry tachycardia. Generally, bundle branch reentry tachycardia is best treated with radiofrequency ablation, but if it is due to aortitis with myocardial affection, long-term anti-inflammatory treatment is mandatory to prevent relapse and assure arrhythmia control. Our case highlights importance to recognize the existence of the multisystem inflammatory syndrome in adults (MIS-A) following COVID-19 infection in patients with alarming cardiovascular symptoms. The case shows that the early use of an CT-scan was crucial for both proper diagnosis and treatment option.
    Mesh-Begriff(e) Adult ; Aged ; Child ; Female ; Humans ; Aortitis/diagnosis ; Aortitis/therapy ; Aortitis/virology ; Catheter Ablation ; COVID-19/complications ; Electrocardiography ; RNA, Viral ; SARS-CoV-2 ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/etiology ; Tachycardia, Ventricular/therapy
    Chemische Substanzen RNA, Viral
    Sprache Englisch
    Erscheinungsdatum 2023-01-25
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 2059859-2
    ISSN 1471-2261 ; 1471-2261
    ISSN (online) 1471-2261
    ISSN 1471-2261
    DOI 10.1186/s12872-023-03080-7
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: COVID-19 severity in patients with chronic lymphocytic leukemia treated with venetoclax: a single-center observational cohort study.

    Thau, Sophie / Poulsen, Christian Bjørn / Brieghel, Christian / Larsen, Morten Kranker / Wiese, Lothar / Nielsen, Xiaohui Chen / Pedersen, Lars Møller

    Annals of hematology

    2024  

    Abstract: Patients with chronic lymphocytic leukemia (CLL) are at high risk of developing severe COVID-19. The present study was undertaken to elucidate COVID-19 related morbidity and mortality in CLL patients treated with venetoclax. We present a single-center ... ...

    Abstract Patients with chronic lymphocytic leukemia (CLL) are at high risk of developing severe COVID-19. The present study was undertaken to elucidate COVID-19 related morbidity and mortality in CLL patients treated with venetoclax. We present a single-center study of 108 patients with small lymphocytic lymphoma or CLL treated with venetoclax. Primary outcome was 30-day COVID-19 mortality. Secondary outcomes included COVID-19 severity and hospitalization rate. Forty-eight (44%) patients had PCR-verified SARS-COV-2 between March 2020 and January 2023. Thirty-six patients (75%) presented with asymptomatic/mild COVID-19 and 12 (25%) with severe/critical disease. The hospitalization rate was 46% with a 30-day mortality rate of only 4% and severe comorbidities as the primary cause of death. COVID-19 severity and mortality were similar before and during the Omicron era. High CIRS-scores (P < 0.02) and thrombocytopenia (P < 0.01) were more frequent in patients with severe/critical disease. In real-world data, most venetoclax treated patients presented with mild COVID-19. Hospitalization and mortality rates were low compared to data of general CLL populations. Our data indicate that venetoclax was a safe treatment option for CLL patients during the pandemic.
    Sprache Englisch
    Erscheinungsdatum 2024-04-18
    Erscheinungsland Germany
    Dokumenttyp Journal Article
    ZDB-ID 1064950-5
    ISSN 1432-0584 ; 0939-5555 ; 0945-8077
    ISSN (online) 1432-0584
    ISSN 0939-5555 ; 0945-8077
    DOI 10.1007/s00277-024-05738-4
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Group A Streptococcus Meningitis in Adults, Denmark.

    Nielsen, Henrik / Storgaard, Merete / Helweg-Larsen, Jannik / Larsen, Lykke / Jepsen, Micha P G / Hansen, Birgitte R / Wiese, Lothar / Bodilsen, Jacob

    Emerging infectious diseases

    2023  Band 29, Heft 9, Seite(n) 1937–1939

    Abstract: We report a 21-fold increase in group A Streptococcus meningitis in adults in Denmark during October 13, 2022-April 12, 2023, concurrent with an outbreak of invasive streptococcal disease. We describe clinical characteristics of the outbreak cases and ... ...

    Abstract We report a 21-fold increase in group A Streptococcus meningitis in adults in Denmark during October 13, 2022-April 12, 2023, concurrent with an outbreak of invasive streptococcal disease. We describe clinical characteristics of the outbreak cases and prognosis for patients in comparison to those for previous sporadic cases.
    Mesh-Begriff(e) Humans ; Adult ; Meningitis, Bacterial/epidemiology ; Streptococcal Infections/epidemiology ; Streptococcus pyogenes ; Disease Outbreaks ; Denmark/epidemiology
    Sprache Englisch
    Erscheinungsdatum 2023-07-21
    Erscheinungsland United States
    Dokumenttyp Letter
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2909.230627
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Exploration of the induced cytokine responses in European Lyme neuroborreliosis: A longitudinal cohort study

    Gynthersen, Rosa Maja Møhring / Ørbæk, Mathilde / Mens, Helene / Stenør, Christian / Wiese, Lothar / Ostrowski, Sisse Rye / Nielsen, Susanne Dam / Lebech, Anne-Mette

    Ticks and Tick-borne Diseases. 2023 Jan., v. 14, no. 1 p.102057-

    2023  

    Abstract: Lyme neuroborreliosis (LNB) is a prevalent tick-borne disease in Europe caused by Borrelia burgdorferi sensu lato complex. Slightly suppressed induced Th1- and Th17-responses are seen at diagnosis. The induced immune response following antibiotic therapy ...

    Abstract Lyme neuroborreliosis (LNB) is a prevalent tick-borne disease in Europe caused by Borrelia burgdorferi sensu lato complex. Slightly suppressed induced Th1- and Th17-responses are seen at diagnosis. The induced immune response following antibiotic therapy is unknown. We hypothesized that the immune responses normalize after completing antibiotic treatment. An observational longitudinal cohort study investigating the induced immune response in adult patients with LNB at diagnosis, three and six months after treatment. Whole blood was added to three TruCulture® (Myriad RBM, Austin, USA) tubes each containing one stimulation. An additional TruCulture® tube was without stimulation representing the in vivo activation of blood immune cells. Nine cytokines were measured using Luminex (LX200, R&D Systems, BIO-Teche LTD). Changes in immune response were analyzed with linear mixed model including follow-up as categorical fixed effect. A total of 21 patients with 55 samples were included. All had clinical improvement, but 5/21 patients reported residual symptoms after six months. The non-induced release of IL-17A and IL-1β increased significantly from diagnosis to six month follow-up. Six months after treatment only IFN-α and TNF-α were below the reference range. Minor variations in the induced immune responses were seen during the study period. Th1- and Th17-responses continued to be low with low IFN-γ, IL-12p40, and IL-17A in multiple stimulations. Overall little dynamic was observed. The changes in the cytokine responses are most likely not linked to LNB pathogenesis and our results do not support the implementation of TruCulture® in the diagnostics or follow-up of LNB.
    Schlagwörter Borrelia burgdorferi ; adults ; antibiotics ; blood ; cohort studies ; diagnostic techniques ; immune response ; interleukin-12 ; interleukin-17 ; pathogenesis ; statistical models ; therapeutics ; tick-borne diseases ; Europe ; Induced immune response ; TruCulture ; Lyme neuroborreliosis ; Borrelia burgdorferi sensu lato complex ; Cytokines
    Sprache Englisch
    Erscheinungsverlauf 2023-01
    Erscheinungsort Elsevier GmbH
    Dokumenttyp Artikel ; Online
    Anmerkung Use and reproduction
    ZDB-ID 2541872-5
    ISSN 1877-9603 ; 1877-959X
    ISSN (online) 1877-9603
    ISSN 1877-959X
    DOI 10.1016/j.ttbdis.2022.102057
    Datenquelle NAL Katalog (AGRICOLA)

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  6. Artikel: Disseminated

    Norredam, Marie / Knudsen, Andreas / Thomsen, Carsten / Wiese, Lothar

    Diagnostics (Basel, Switzerland)

    2019  Band 9, Heft 1

    Abstract: We describe the clinical course of a 24-year old male with Crohn's disease in immunosuppressive therapy admitted with a 6-week history of fever, weight loss, night sweat, and general malaise. The patient received extensive workup for a fever of unknown ... ...

    Abstract We describe the clinical course of a 24-year old male with Crohn's disease in immunosuppressive therapy admitted with a 6-week history of fever, weight loss, night sweat, and general malaise. The patient received extensive workup for a fever of unknown origin and received empiric antibiotics. Workup with Fluorine-18 fluoro-2-deoxy-d-glucose ([
    Sprache Englisch
    Erscheinungsdatum 2019-03-01
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics9010025
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  7. Artikel ; Online: Compression bandaging does not compromise peripheral microcirculation in patients with cellulitis of the lower leg.

    Bojesen, Sophie / Midttun, Mette / Wiese, Lothar

    European journal of dermatology : EJD

    2019  Band 29, Heft 4, Seite(n) 396–400

    Abstract: Cellulitis ranks among the most frequent infections, and antibiotic treatment is the accepted mainstay of therapy. There is disagreement on the guidelines for the use of compression bandaging as supplementary treatment, and the evidence within the field ... ...

    Abstract Cellulitis ranks among the most frequent infections, and antibiotic treatment is the accepted mainstay of therapy. There is disagreement on the guidelines for the use of compression bandaging as supplementary treatment, and the evidence within the field is scarce. To determine whether compression bandaging impairs microcirculation in patients with cellulitis of the lower leg, thereby having a negative impact on the supply of oxygen, nutritional components, and antibiotics. Adult patients were prospectively enrolled for compression bandaging in addition to antibiotic treatment. The peripheral blood flow rate was measured before and after application of the compression bandage and on the following day. For this, we applied the heat-washout method, which has previously been shown to provide an accurate estimate of peripheral microcirculation. Comparing the blood flow rate before and after application of the compression bandage showed no significant change and therefore no alteration in microcirculation (p = 0.61). Compression bandaging of the lower leg does not impair microcirculation in patients with cellulitis. This strongly indicates that compression bandaging can play a positive role as supportive treatment in addition to standard antibiotic therapy.
    Mesh-Begriff(e) Adult ; Anti-Bacterial Agents/therapeutic use ; Cellulitis/diagnosis ; Cellulitis/therapy ; Cohort Studies ; Compression Bandages/adverse effects ; Compression Bandages/statistics & numerical data ; Denmark ; Female ; Humans ; Lower Extremity/blood supply ; Lower Extremity/physiopathology ; Male ; Microcirculation/physiology ; Middle Aged ; Patient Safety ; Prognosis ; Prospective Studies ; Risk Assessment ; Treatment Outcome ; Wound Healing/physiology
    Chemische Substanzen Anti-Bacterial Agents
    Sprache Englisch
    Erscheinungsdatum 2019-09-11
    Erscheinungsland France
    Dokumenttyp Journal Article
    ZDB-ID 1128666-0
    ISSN 1952-4013 ; 1167-1122
    ISSN (online) 1952-4013
    ISSN 1167-1122
    DOI 10.1684/ejd.2019.3606
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Exploration of the induced cytokine responses in European Lyme neuroborreliosis: A longitudinal cohort study.

    Gynthersen, Rosa Maja Møhring / Ørbæk, Mathilde / Mens, Helene / Stenør, Christian / Wiese, Lothar / Ostrowski, Sisse Rye / Nielsen, Susanne Dam / Lebech, Anne-Mette

    Ticks and tick-borne diseases

    2022  Band 14, Heft 1, Seite(n) 102057

    Abstract: Lyme neuroborreliosis (LNB) is a prevalent tick-borne disease in Europe caused by Borrelia burgdorferi sensu lato complex. Slightly suppressed induced Th1- and Th17-responses are seen at diagnosis. The induced immune response following antibiotic therapy ...

    Abstract Lyme neuroborreliosis (LNB) is a prevalent tick-borne disease in Europe caused by Borrelia burgdorferi sensu lato complex. Slightly suppressed induced Th1- and Th17-responses are seen at diagnosis. The induced immune response following antibiotic therapy is unknown. We hypothesized that the immune responses normalize after completing antibiotic treatment. An observational longitudinal cohort study investigating the induced immune response in adult patients with LNB at diagnosis, three and six months after treatment. Whole blood was added to three TruCulture® (Myriad RBM, Austin, USA) tubes each containing one stimulation. An additional TruCulture® tube was without stimulation representing the in vivo activation of blood immune cells. Nine cytokines were measured using Luminex (LX200, R&D Systems, BIO-Teche LTD). Changes in immune response were analyzed with linear mixed model including follow-up as categorical fixed effect. A total of 21 patients with 55 samples were included. All had clinical improvement, but 5/21 patients reported residual symptoms after six months. The non-induced release of IL-17A and IL-1β increased significantly from diagnosis to six month follow-up. Six months after treatment only IFN-α and TNF-α were below the reference range. Minor variations in the induced immune responses were seen during the study period. Th1- and Th17-responses continued to be low with low IFN-γ, IL-12p40, and IL-17A in multiple stimulations. Overall little dynamic was observed. The changes in the cytokine responses are most likely not linked to LNB pathogenesis and our results do not support the implementation of TruCulture® in the diagnostics or follow-up of LNB.
    Mesh-Begriff(e) Humans ; Longitudinal Studies ; Interleukin-17 ; Cytokines ; Europe/epidemiology
    Chemische Substanzen Interleukin-17 ; Cytokines
    Sprache Englisch
    Erscheinungsdatum 2022-10-21
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2541872-5
    ISSN 1877-9603 ; 1877-959X
    ISSN (online) 1877-9603
    ISSN 1877-959X
    DOI 10.1016/j.ttbdis.2022.102057
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: Validation of a risk score to differentiate autoimmune and viral encephalitis: a Nationwide Cohort Study in Denmark.

    Fjordside, Lasse / Nissen, Mette Scheller / Florescu, Anna Maria / Storgaard, Merete / Larsen, Lykke / Wiese, Lothar / von Lüttichau, Hans Rudolf / Jepsen, Micha Phill Grønholm / Hansen, Birgitte Rønde / Andersen, Christian Østergaard / Bodilsen, Jacob / Nielsen, Henrik / Blaabjerg, Morten / Lebech, Anne-Mette / Mens, Helene

    Journal of neurology

    2024  

    Abstract: Background: A score to differentiate autoimmune (AE) and viral encephalitis (VE) early upon admission has recently been developed but needed external validation. The objective of this study was to evaluate the performance of the score in a larger and ... ...

    Abstract Background: A score to differentiate autoimmune (AE) and viral encephalitis (VE) early upon admission has recently been developed but needed external validation. The objective of this study was to evaluate the performance of the score in a larger and more diagnostically diverse patient cohort.
    Methods: We conducted a retrospective nationwide and population-based cohort study including all adults with encephalitis of definite viral (2015-2022) or autoimmune aetiology (2009-2022) in Denmark. Variables included in the score-model were extracted from patient records and individual risk scores were assessed. The performance of the score was assessed by receiver-operating characteristics (ROC) curve analyses and calculation of the area under the curve (AUC).
    Results: A total of 496 patients with encephalitis [AE n = 90, VE n = 287 and presumed infectious encephalitis (PIE) n = 119] were included in the study. The score was highly accurate in predicting cases of AE reaching an AUC of 0.94 (95% CI 0.92-0.97). Having a score ≥ 3 predicted AE with a PPV of 87% and an NPV of 91%. The risk score was found to perform well across aetiological subgroups and applied to the PIE cohort resulted in an AUC of 0.88 (95% CI 0.84-0.93).
    Conclusion: The excellent performance of the score as reported in the development study was confirmed in this significantly larger and more diverse cohort of patients with encephalitis in Denmark. These results should prompt further prospective testing with wider inclusion criteria.
    Sprache Englisch
    Erscheinungsdatum 2024-05-18
    Erscheinungsland Germany
    Dokumenttyp Journal Article
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-024-12392-3
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Clinical features and prognostic factors in adults with viral meningitis.

    Petersen, Pelle Trier / Bodilsen, Jacob / Jepsen, Micha Phill Grønholm / Larsen, Lykke / Storgaard, Merete / Hansen, Birgitte Rønde / Helweg-Larsen, Jannik / Wiese, Lothar / Lüttichau, Hans Rudolf / Andersen, Christian Østergaard / Nielsen, Henrik / Brandt, Christian Thomas

    Brain : a journal of neurology

    2023  Band 146, Heft 9, Seite(n) 3816–3825

    Abstract: Clinical features applicable to the entire spectrum of viral meningitis are limited, and prognostic factors for adverse outcomes are undetermined. This nationwide population-based prospective cohort study included all adults with presumed and ... ...

    Abstract Clinical features applicable to the entire spectrum of viral meningitis are limited, and prognostic factors for adverse outcomes are undetermined. This nationwide population-based prospective cohort study included all adults with presumed and microbiologically confirmed viral meningitis in Denmark from 2015 until 2020. Prognostic factors for an unfavourable outcome (Glasgow Outcome Scale score of 1-4) 30 days after discharge were examined by modified Poisson regression. In total, 1066 episodes of viral meningitis were included, yielding a mean annual incidence of 4.7 episodes per 100 000 persons. Pathogens were enteroviruses in 419/1066 (39%), herpes simplex virus type 2 in 171/1066 (16%), varicella-zoster virus in 162/1066 (15%), miscellaneous viruses in 31/1066 (3%) and remained unidentified in 283/1066 (27%). The median age was 33 years (IQR 27-44), and 576/1066 (54%) were females. In herpes simplex virus type 2 meningitis, 131/171 (77%) were females. Immunosuppression [32/162 (20%)] and shingles [90/149 (60%)] were frequent in varicella-zoster virus meningitis. The triad of headache, neck stiffness and hyperacusis or photophobia was present in 264/960 (28%). The median time until lumbar puncture was 3.0 h (IQR 1.3-7.1), and the median CSF leucocyte count was 160 cells/µl (IQR 60-358). The outcome was unfavourable in 216/1055 (20%) 30 days after discharge. Using unidentified pathogen as the reference, the adjusted relative risk of an unfavourable outcome was 1.34 (95% CI 0.95-1.88) for enteroviruses, 1.55 (95% CI 1.00-2.41) for herpes simplex virus type 2, 1.51 (95% CI 0.98-2.33) for varicella-zoster virus and 1.37 (95% CI 0.61-3.05) for miscellaneous viruses. The adjusted relative risk of an unfavourable outcome was 1.34 (95% CI 1.03-1.75) for females. Timing of acyclovir or valacyclovir was not associated with the outcome in meningitis caused by herpes simplex virus type 2 or varicella-zoster virus. In summary, the outcome of viral meningitis was similar among patients with different aetiologies, including those with presumed viral meningitis but without an identified pathogen. Females had an increased risk of an unfavourable outcome. Early antiviral treatment was not associated with an improved outcome in meningitis caused by herpes simplex virus type 2 or varicella-zoster virus.
    Mesh-Begriff(e) Female ; Humans ; Adult ; Male ; Prospective Studies ; Prognosis ; Meningitis, Viral/epidemiology ; Meningitis, Viral/drug therapy ; Herpesvirus 3, Human
    Sprache Englisch
    Erscheinungsdatum 2023-03-20
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80072-7
    ISSN 1460-2156 ; 0006-8950
    ISSN (online) 1460-2156
    ISSN 0006-8950
    DOI 10.1093/brain/awad089
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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