{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:29:51Z","timestamp":1760711391384,"version":"3.44.0"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["917.17.308","918.19.627"],"award-info":[{"award-number":["917.17.308","918.19.627"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Bacterial meningitis is a severe disease with high rates of complications and unfavorable outcome. Complications involving the spinal cord are rarely reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases of noncompressive myelopathy were identified from a nationwide cohort study of adults with community\u2010acquired bacterial meningitis in the Netherlands. The American Spinal Injury Association Impairment Scale was used to classify the severity of spinal cord dysfunction. Subsequently, we reviewed the literature on noncompressive myelopathy as a complication of bacterial meningitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Noncompressive myelopathy was reported in seven of 3047 episodes of community\u2010acquired bacterial meningitis (0.2%). The median age of these patients was 51\u2009years (range\u2009=\u200917\u201377). Causative pathogens were <jats:italic>Streptococcus pneumoniae<\/jats:italic> in three, <jats:italic>Streptococcus agalactiae<\/jats:italic> in two, and <jats:italic>Neisseria meningitidis<\/jats:italic> and <jats:italic>Haemophilus influenzae<\/jats:italic> both in one. Paresis of legs (<jats:italic>n<\/jats:italic>\u2009=\u20096) or arms and legs (<jats:italic>n<\/jats:italic>\u2009=\u20091) was the presenting symptom, occurring after a median duration of 9\u2009days after admission (range\u2009=\u20092\u201328). Spinal magnetic resonance imaging showed T2\u2010weighted abnormalities of the spinal cord in six of seven patients. Improvement of spinal cord function during admission was noted in four of seven patients. The literature review yielded 15 additional cases. Among patients from our cohort and the literature, there was no significant association between immunosuppressive therapy and subsequent improvement of spinal cord function (5\/8 patients with immunosuppressive therapy [63%] vs. 5\/14 without immunosuppressive therapy [36%], <jats:italic>p<\/jats:italic>\u2009=\u20090.44).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Noncompressive myelopathy is an uncommon but severe complication of bacterial meningitis. Improvement after diagnosis is expected, but all patients had persistent neurological deficits.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16447","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T10:34:23Z","timestamp":1725273263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Noncompressive myelopathy in acute community\u2010acquired bacterial meningitis: Report of seven cases and review of literature"],"prefix":"10.1111","volume":"31","author":[{"given":"Evelien H. G. 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