Community-acquired bacterial meningitis in adults: Categorization of causes and timing of death

The relationship between cause and timing of death in 294 adults who had be en hospitalized with community-acquired bacterial meningitis was investigat ed. For 74 patients with community-acquired bacterial meningitis who died d uring hospitalization, the underlying and immediate causes of death were id entified according to the criteria of the World Health Organization and Nat ional Center for Health Statistics. Patients were classified into 3 groups: category I, in which meningitis was the underlying and immediate cause of death (59% of patients; median duration of survival, 3 days); category II, in which meningitis was the underlying but not immediate cause of death (18 %; median duration of survival, 10 days); and category III, in which mening itis was neither the underlying nor immediate cause of death (23%; median d uration of survival, 32 days). In a substantial proportion of adults hospit alized with community-acquired bacterial meningitis, meningitis was neither the immediate nor the underlying cause of death. A 14-day survival end poi nt discriminated between deaths attributable to meningitis and those with a nother cause.