Central Nervous System Infections in Denmark

  • STATUS
    Recruiting
  • End date
    Jan 1, 2025
  • participants needed
    1900
  • sponsor
    Aalborg University Hospital
Updated on 29 July 2021
antibiotics
fever
meningitis
headache
blood culture
bacterial meningitis
syphilis
encephalitis
neck stiffness
neurologic finding
serological tests
antigen tests

Summary

The Danish Study Group of Infections of the Brain is a collaboration between all departments of infectious diseases in Denmark. The investigators aim to monitor epidemiological trends in central nervous system (CNS) infections by a prospective registration of clinical characteristics and outcome of all adult (>17 years of age) patients with community-acquired CNS infections diagnosed and/or treated at departments of infectious diseases in Denmark since 1st of January 2015.

Description

The investigators include data on diagnosis at admission, symptoms and signs on admission, character and timing of diagnostic work-up and treatment and outcome assessed by the Glasgow Outcome Score (GOS).

Diagnostic work-up and treatment is left at the discretion of the local physician and therefore not standardised

In general any symptoms/deficits should only be listed if they are 'new' to the patient, e.g. a known palsy of the facial nerve should not be listed as a new relevant finding at admission. On the other hand, worsening of a known neurological deficit should be listed under signs in the given instrument (bacterial meningitis, encephalitis, neuroborreliosis etc). Likewise, for outcome only changes in pre-morbid conditions should be listed including place of residence, functional status, neurological deficits etc.

Time of admission is obtained in prioritized order from the ambulance charts or notifications of arrival by secretaries or nurses in the emergency departments. Timing of lumbar puncture and cranial imaging is extracted from the electronic records at the departments of biochemistry or radiology while timing of antibiotic therapy for meningitis is identified in electronic medication systems. Time to lumbar puncture, cranial imaging and antibiotic therapy is calculated as time from arrival at hospital to each of the above events.

Quality control of case enrollment is ensured by ad hoc case-to-case discussions and at study group meetings 2-3 times a year

To ensure completeness of reported CNS infections annual searches of selected International Classification of Diseases version 10 (ICD-10) codes are performed in local administrative databases at each department:

A17 A32.1 A32.7 A39.0 A52.1-52.3 A69.2 (neuroborreliosis) A83 A84 A85 A87 A89 B00.3-00.4 B01.0-01.1 B02.0-02.0 B582 B451 B375 G00 G01 G02 G03 G04 G05 G06 G07

Details
Condition Central Nervous System Infection, Viral meningitis, Aseptic Meningitis, Meningitis, Lyme Disease, Brain Abscess, Bacterial meningitis, Neurosyphilis, Lyme Disease Vaccine, Encephalitis, Neuroborreliosis, Tertiary Syphilis, cns infections, cns infection, infectious disease of central nervous system, meningitides, brain inflammation, inflammation of the brain
Treatment Community-acquired CNS infections
Clinical Study IdentifierNCT03418441
SponsorAalborg University Hospital
Last Modified on29 July 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

All patient have a clinical presentation consistent with brain abscess (e.g. headache, focal neurological deficit, mass lesion on cranial imaging)
and
Proven microbiological aetiology by culture/DNA-based technology from pus from brain abscess or blood or CSF
or
Aspiration of pus from the brain abscess
or
Response to antimicrobial treatment
or
Tumour ruled out
or
Tumour thought less probable than abscess on MRI using diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences
Lyme neuroborreliosis inclusion criteria
A clinical presentation consistent with neuroborreliosis (e.g. radiculopathy)
and
CSF pleocytosis>10 leukocytes/mL
and
Positive intrathecal B.burgdorferi antibody production index
Neurosyphilis inclusion criteria - A clinical presentation consistent with
neurosyphilis (e.g. 'encephalitis-like symptoms', dementia, ocular or otogenic
syphilis)
and either
Positive syphilis serology in serum combined with CSF leukocytes>10/mL
or
CSF syphilis antibodies

Exclusion Criteria

We exclude cases of proven or suspected autoimmune encephalitis
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