The following are the most important diseases or complications that may be contributed to by bacterial meningitis (bacterial meningitis): Respiratory system (J00-J99)
Eyes and eye appendages (H00-H59).
- Amaurosis (blindness)
Blood, blood-forming organs – immune system (D50-D90).
- Disseminated intravascular coagulopathy (DIC)/consumptive coagulopathy – severe coagulopathy with bleeding and excessive clotting.
- Purpura fulminans – severe general symptoms; patchy to extensive skin hemorrhages (sugillations) that rapidly progress to hemorrhagic skin necrosis (death of the skin); occurrence in a symmetrical pattern on the face, extremities, and trunk
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Pituitary insufficiency (hypofunction of the pituitary gland; rare).
- Severe electrolyte imbalances such as hyponatremia (sodium deficiency) (in tuberculous meningitis: severe hyponatremia with < 120 mmol/L in 45% of adults and 11% of children)
Cardiovascular system (I00-I99).
- Apoplexy (stroke) – cerebral infarcts occur in 15-57% of patients with tuberculous meningitis
- Sinus thrombosis – occurrence of blood clots (thrombosis) in the large venous confluences of the brain in the hard meninges (dura mater).
- Thromboembolism – vascular occlusion (embolism) caused by an entrained thrombus (blood clot).
Infectious and parasitic diseases (A00-B99).
- Meningococcal sepsis (blood poisoning).
- Waterhouse-Friderichsen syndrome (synonyms: adrenal apoplexy; suprarenal apoplexy) in which, in addition to sepsis (blood poisoning), there is failure of the adrenal cortex (acute failure of the adrenal glands), consumption coagulopathy (resulting in mass consumption of clotting factors and platelets (thrombocytes)) and circulatory shock.
Liver, gallbladder, bile ducts – pancreas (pancreas) (K70-K77; K80-K87).
- Pancreatitis (inflammation of the pancreas).
Musculoskeletal system and connective tissue (M00-M99).
- Arthritis (inflammation of the joints)
- Rhabdomyolysis – dissolution of skeletal muscle.
Ears – mastoid process (H60-H95)
- Hearing disorders to hearing loss
- Vestibulopathy – disease of the organ of balance.
Psyche – nervous system (F00-F99; G00-G99)
- Ataxia (gait unsteadiness)
- Epileptic seizures (convulsive seizures)
- Memory disorders
- Brain edema (swelling of the brain)
- Hydrocephalus (hydrocephalus)
- Myelitis (inflammation of the spinal cord)
- Psychosis
- Decreased intellectual abilities
- Vertigo (dizziness)
- Cerebral palsy (spastic paralysis as a result of brain damage).
Prognostic factors
- Age of the patient (the younger, the better the outcome).
- Prematurity
- Risk factors in children aged three days to 15 years for severe courses:
- Streptococcus pneumoniae as the causative agent (odds ratio, OR 5.2).
- Leukopenia (decreased white blood cell count compared with the norm) at the start of therapy (OR 5.6)
- CSF/serum glucose ratio <0.25 (OR 4.5).
- Risk factors in children aged three days to 15 years for prognosis of impending late complications:
- Haemophilus influenzae type b (Hib) as a cause (OR 29.5).
- Epileptic seizures (convulsive seizure) during hospitalization that required therapy with antiepileptic drugs (OR 10.6)
- Septic shock (OR 8.4).
- Type of pathogen
- Hypoglycemia (low blood sugar), severe.
- Arterial hypotension/shock on admission (septic shock).
- Duration until the start of antibiotic therapy.
