Risk and case fatality rate of meningitis in patients with liver cirrhosis

Bacterial infections are major causes of morbidity and death in patients wi th liver cirrhosis. The risk of bacterial meningitis in these patients is u nknown. however. In this study on a nationwide cohort of 22,743 patients wi th liver cirrhosis in Denmark an incidence rate of bacterial meningitis of 54.4 per 100,000 was found [195% confidence interval (CT) 40,3-71,9]. The h ighest incidence rate was found in patients with alcoholic cirrhosis, 65.3 per 100,000 person-years (95% CI46.2-89.6), compared with 33.6 per 100,000 person-years (95% CI 17.3-61.9) in patients with non-alcoholic cirrhosis. T he 30-d case fatality rate,Fas 53.1% (95% CI38.3-67.5), and high age and al coholic cirrhosis were associated with the highest case fatality rates. The main bacterial pathogens were pneumococci and unspecified bacteria. These findings suggest that patients with liver cirrhosis are at increased risk o f bacterial meningitis with a poor prognosis.