TY - JOUR AU - Engelen-Lee, Joo-Yeon AU - Brouwer, Matthijs C. AU - Aronica, Eleonora AU - van de Beek, Diederik PY - 2016 DA - 2016/03/22 TI - Pneumococcal meningitis: Clinical-pathological correlations (meningene-path) JO - Acta Neuropathologica Communications SP - 26 VL - 4 IS - 1 AB - Pneumococcal meningitis is associated with substantial mortality and morbidity. We systematically assessed brain histopathology of 31 patients who died of pneumococcal meningitis from a nationwide study (median age 67 years; 21 (67 %) were male) using a pathology score including inflammation and vascular damage. Of the 27 patients with known time from the admission to death, 14 patients died within 7 days of admission and 13 after 7 days of admission. Eleven of 25 (44 %) patients had been treated with adjunctive dexamethasone therapy. Observed pathological processes were inflammation of medium-large arteries in 30 brains (97 %), cerebral haemorrhage in 24 (77 %), cerebritis in 24 (77 %), thrombosis in 21 (68 %), infarction in 19 (61 %) and ventriculitis in 19 (of 28 cases, 68 %). Inflammation of medium-large arteries led to obstruction of the vascular lumen in 14 (of 31 cases, 45 %). Vascular inflammation was associated with infarction and thrombosis of brain parenchymal vessels. Hippocampal dentate gyrus apoptosis between patients treated with and without dexamethasone was similar (p = 0.66); however, dexamethasone treated patients had higher total pathology score than non-dexamethasone treated patients (p = 0.003). Our study shows that vascular damage is key in the process of brain damage in pneumococcal meningitis. Data and material of this study will be made open-access for translational research in pneumococcal meningitis (MeninGene-Path). SN - 2051-5960 UR - https://doi.org/10.1186/s40478-016-0297-4 DO - 10.1186/s40478-016-0297-4 ID - Engelen-Lee2016 ER -