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Zoonotic Bacterial Meningitis in Adults: Clinical Characteristics, Etiology, Treatment and Outcome Van Samkar, A UvA-DARE (Digital Academic Repository) Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome van Samkar, A. Publication date 2016 Document Version Final published version Link to publication Citation for published version (APA): van Samkar, A. (2016). Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. 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UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl) Download date:04 Oct 2021 Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome Anusha van Samkar van Anusha and outcome treatment etiology, bacterial in adults: clinical characteristics, meningitis Zoonotic Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome Anusha van Samkar 41586 Samkar, Anusha Cover en uitn kaart.indd 1 24-08-16 15:59 Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome Anusha van Samkar 41586 Samkar, Anusha van.indd 1 31-08-16 21:29 Design Ferdinand van Nispen, my-thesis.nl, The Netherlands Print: GVO drukkers & vormgevers B.V., Ede, The Netherlands ISBN: 978-94-6332-068-9 The printing of this thesis was financially supported by the Neurology department of the Academic Medical Center, University of Amsterdam, Pfizer BV, and ChipSoft. ©Anusha van Samkar, 2016 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means, without permission of the author, or, when appropriate, of the Publisher of the publication or illustration material. 41586 Samkar, Anusha van.indd 2 31-08-16 21:29 Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome ACADEMISCH PROEFSCHRIFT ter verkrijging van de graad van doctor aan de Universiteit van Amsterdam op gezag van de Rector Magnificus prof. dr. ir. K.I.J. Maex ten overstaan van een door het College voor Promoties ingestelde commissie, in het openbaar te verdedigen in de Agnietenkapel op dinsdag 11 oktober 2016, te 10:00 uur door Anusha van Samkar geboren te Leiden 41586 Samkar, Anusha van.indd 3 31-08-16 21:29 PROMOTIECOMMISSIE Promotor: Prof. dr. D. van de Beek Universiteit van Amsterdam Copromotores: Dr. M.C. Brouwer Universiteit van Amsterdam Dr. A. van der Ende Universiteit van Amsterdam Overige leden: Prof. dr. P. Portegies Universiteit van Amsterdam Prof. dr. M.P. Grobusch Universiteit van Amsterdam Prof. dr. I.N. van Schaik Universiteit van Amsterdam Prof. dr. E.A.M. Sanders Universiteit Utrecht Prof. dr. E.J. Kuijper Universiteit Leiden Prof. dr. Y.B.W.E.M. Roos Universiteit van Amsterdam Faculteit der Geneeskunde 41586 Samkar, Anusha van.indd 4 31-08-16 21:29 CONTENTS Chapter 1 Introduction 7 Chapter 2 Streptococcus equi meningitis 13 Clinical Microbiology and Infection 2016; 22: e3-4. Chapter 3 Streptococcus suis meningitis in the Netherlands 25 Journal of Infection 2015; 71: 602-4. Chapter 4 Streptococcus suis meningitis: 33 a systematic review and meta-analysis PLoS Neglected Tropical Diseases 2015; 9: e0004191. Chapter 5 Capnocytophaga canimorsus meningitis: 47 three cases and review of the literature Zoonoses and Public Health 2016; 63: 442-8. Chapter 6 Campylobacter fetus meningitis in adults: 63 report of two cases and review of the literature Medicine (Baltimore) 2016; 95: e2858. Chapter 7 Suspected leptospiral meningitis in adults: 79 report of four cases and review of the literature The Netherlands Journal of Medicine 2015; 73: 464-70. Chapter 8 Streptococcus gallolyticus meningitis in adults: 97 report of five cases and review of the literature Clinical Microbiology and Infection 2015; 21: 1077-83. Chapter 9 General discussion: zoonotic bacterial meningitis in adults 115 Neurology 2016, published online. Summary 135 Samenvatting 139 Dankwoord 143 Portfolio 147 41586 Samkar, Anusha van.indd 5 31-08-16 21:29 41586 Samkar, Anusha van.indd 6 31-08-16 21:29 CHAPTER 1 INTRODUCTION 41586 Samkar, Anusha van.indd 7 31-08-16 21:29 Chapter 1 Since the early days of history, it has been known that diseases can be transmitted from animals to humans. Around 2300 BC, the Mesopotamian laws of Eshnunna stated: “If a dog is vicious and the authorities have brought the fact to the knowledge of its owner, [if nevertheless] he does not keep it in, it bites a man and causes [his] death, then the owner of the dog shall pay two-thirds of a mina of silver.”1 In 380 BC, Aristotle described this zoonotic disease, now known as rabies, as “fatal to the dog itself and to any animal that it may bite”.1 Since then, more than 200 zoonotic diseases have been described. Some of these diseases have had a major impact on human civilization. For instance, the bubonic plague, that is transmitted to humans from infected rodents, wiped out 25% of Europe’s population in the 14th century and is therefore considered one of the most devastating pandemics in human history.2 Bovine tuberculosis, transmitted to humans through consumption of unpasteurized dairy products and contact with infected animals, was a significant cause of death in Europe in the 19th century.3 Due to modern sanitation and public health practice, the spread and mortality of many infectious diseases has decreased markedly. However, due to socio- economic and ecological changes, such as human population growth and loss of biodiversity, the incidence of emerging infectious diseases events has increased since 1940.4,5 More than 60% of the roughly 400 emerging infectious diseases that have been identified are zoonotic.4,6 In addition, the most recent pandemics and epidemics, e.g. Q-fever, severe acute respiratory syndrome (SARS) and avian influenza, are caused by zoonotic pathogens.6 Zoonotic diseases are thus an increasing public health problem.6 Zoonotic pathogens may cause a variety of symptoms and diseases. One of the possible clinical manifestations of a zoonotic bacterial infection is meningitis. Bacterial meningitis is a neurologic emergency requiring prompt recognition and treatment. Despite fast initiation of antibiotic treatment, the mortality of bacterial meningitis remains high at 17%, and half of the patients surviving bacterial meningitis end up with neurological sequelae.7 In patients presenting with bacterial meningitis, rapid identification of the bacteria causing the infection is essential for choice of treatment and for prediction of outcome. While meningitis caused by pathogens originating 8 41586 Samkar, Anusha van.indd 8 31-08-16 21:29 Introduction from humans has been studied extensively, little is known about meningitis caused by zoonotic bacteria. 1 Aims and outline of this thesis The aim was to investigate the epidemiology, etiology, clinical characteristics, treatment, outcome and prevention of zoonotic bacterial meningitis. In the following chapters, we will describe cases of meningitis caused by several zoonotic pathogens. In general, one zoonotic pathogen is described per chapter, combining cases identified in a nationwide cohort study of bacterial meningitis patients7 and a review of the literature on meningitis caused by the described zoonotic pathogen. In Chapter 2, we describe cases of Streptococcus equi meningitis and perform a literature review on S. equi meningitis. In Chapter 3, we describe cases of Streptococcus suis meningitis identified in a nationwide cohort study of bacterial meningitis patients in the Netherlands. In Chapter 4, we perform a systematic review and meta-analysis on the clinical characteristics, adjunctive treatment and outcome of S. suis meningitis. In Chapter 5, we describe the clinical characteristics, complications and outcome of meningitis caused by Capnocytophaga canimorsus. In Chapter 6, we describe cases of Campylobacter fetus meningitis and perform a review of the literature on C. fetus meningitis. In Chapter 7, we describe cases of Streptococcus gallolyticus meningitis. S. gallolyticus, formerly known as a member of the Streptococcus bovis group, is not a zoonotic pathogen, as it occasionally occurs as a commensal in the human gastro-intestinal tract.6 Nevertheless, S. gallolyticus meningitis is described in this thesis, as the pathogen was first discovered in cattle and is commonly found in the gastro-intestinal tract of ruminants.7 In Chapter 8, we describe leptospiral meningitis and report four cases of leptospiral meningitis in the Netherlands. Finally, the thesis concludes with a general discussion in Chapter 9, in which we give an overview of the clinical characteristics, treatment and outcome of zoonotic bacterial meningitis. In this chapter, meningitis caused by the formerly mentioned zoonotic pathogens is described with addition of rare zoonotic pathogens not identified in our cohort study, such asBacillus anthracis and Francisella tularensis. 9 41586 Samkar, Anusha van.indd 9 31-08-16 21:29 Chapter 1 References 1. Hagan WA, Bruner DW, Timoney JF. Hagan and Bruner’s microbiology and infectious diseases of domestic animals: with reference to etiology, epizootiology, pathogenesis, immunity, diagnosis, and antimicrobial susceptibility. 8th ed: Cornell University Press; 1981. 2. Griffin JP. Bubonic plague in biblical times. J R Soc Med 2000; 93: 449. 3. Centers for Disease Control and Prevention. Mycobacterium bovis (bovine tuberculosis) in humans. Center for Disease Control and Prevention factsheets 2012.
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