Danish Study Group of Infections of the Brain: A Nationwide Prospective Observational Cohort Study of All Central Nervous System Infections in Adults at Departments of Infectious Diseases in Denmark
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.
⁃ \- All patients have to have a clinical presentation consistent with non-bacterial meningitis (e.g. headache, neck stiffness, photo- or phonophobia, fever)
⁃ and
⁃ Cerebrospinal fluid leukocytes\>10 cells/ml
⁃ Patients with viral meningitis with undetermined pathogen have to have:
• CSF leukocytes\> 10/mL and no other more probable diagnosis assessed by the local investigator.
⁃ In case of doubt, patients are discussed with the DASGIB secretary and chair or at meetings.
⁃ and
⁃ Proven bacterial aetiology (CSF or blood culture/DNA based technology or antigen tests)
⁃ Patients with bacterial meningitis in whom the bacteria cannot not be cultured or identified by DNA-based technologies have to have:
⁃ \- CSF leukocytes\> 10/mL and no other more probable diagnosis assessed by the local investigator.
⁃ In case of doubt, patients are discussed with the DASGIB secretary and chair or at meetings.
⁃ \- 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.
⁃ \- A clinical presentation consistent with neuroborreliosis (e.g. radiculopathy)
⁃ and
⁃ \- CSF pleocytosis\>10 leukocytes/mL
⁃ and
⁃ \- Positive intrathecal B.burgdorferi antibody production index.
⁃ and either
⁃ \- Positive syphilis serology in serum combined with CSF leukocytes\>10/mL
⁃ or
⁃ \- CSF syphilis antibodies.