Volume 20, Number 7—July 2014
Synopsis
Epidemiology, Clinical Manifestations, and Outcomes of Streptococcus suis Infection in Humans
Table 3
Main clinical and laboratory parameters at admission of the patients with Streptococcussuis infection in a systematic review
| Variable | Single-case dataset | Large studies, median value (range) | Meta-analysis, pooled mean (95% CI)† | No. studies meta-analyzed‡ |
|---|---|---|---|---|
| Clinical syndrome, %§ | ||||
| Meningitis | 69.5 | 64.5 (30.2–100) | 68.0 (58.9–75.8) | 26 |
| Sepsis¶ | 19.5 | 23.8 (11.8–39.4) | 25.0 (20.5–30.2) | 12 |
| Arthritis | 2.87 | 16.7 (1.5–50.0) | 12.9 (6.0–25.6) | 12 |
| Endocarditis | 8.6 | 14.3 (1.9–39.0) | 12.4 (6.7–21.9) | 10 |
| Endophthamiltis | 2.9 | 4.5(1.5–28.6) | 4.6 (2.8–7.4)# | 9 |
| Spondylodiscitis | 4.6 | 1.9 (1.5-2.4) | 3.7 (2.1-6.6) | 4 |
| Toxic shock syndrome | 2.9** | 37.7 (28.9–64.0) | 25.7 (9.8-52.6) | 4†† |
| Mean duration, d | ||||
| Onset to admission, n = 90 | 7.3 | 3.5 (2.0–11.4) | 4.1 (2.7–5.4) | 7 |
| Hospitalization, n = 68 | 20.5 | 17.4 (13.0–19.2) | 17.2 (15.6–18.9)# | 5 |
| Symptoms, % | ||||
| Meningeal sign‡‡ | 49.4 | 66.7 (12.5–95.1) | 67.1 (54.9–77.4) | 18 |
| Skin rash | 10.9 | 12.5 (0–52.0) | 15.4 (8.6–25.9) | 10 |
| Shock | 8.6 | 11.8 (1.3–64.0) | 11.9 (6.3–21.5) | 12 |
| Respiratory failure | 5.2 | 20.0 (8.3–35.8) | 16.7 (8.6–29.9) | 6 |
| Acute renal failure | 5.2 | 8.3 (1.3–28.0) | 7.1 (2.2–20.5) | 5 |
| Disseminated intravascular coagulation | 10.3 | 6.0 (2.4–57.1) | 10.3 (5.4–18.8) | 9 |
| Relapse | 2.9 | 7.3 (2.9–8.3) | 4.4 (2.4–7.8)# | 5 |
| Laboratory values (mean)§§ | ||||
| Leukocytes, 109 cells/L, n = 98 | 17.4 | 15.1 (13.9–18.2) | 15.8 (14.6–16.9) | 9 |
| Hemoglobin, g/L, n = 22 | 106.7 | – | – | – |
| Platelets, 109/L, n = 41 | 121.0 | 182.4 (115–241.5) | 164.9 (132.9–197) | 7 |
| Blood glucose, mg/dL, n = 32 | 147.8 | – | – | – |
| C-reactive protein, mg/L, n = 36 | 349.7 | – | – | – |
| Cerebrospinal fluid | ||||
| Leukocytes, cells/mm3, n = 88 | 3,166 | 2029 (450–3253) | 2330 (1721–2939)# | 7 |
| Protein, g/L, n = 74 | 3.20 | 2.35 (1.7–4.18) | 2.45 (1.91–2.99) | 7 |
| Glucose, mg/dL, n = 70 | 20.9 | 8.60 (1.7–25.6) | 12.6 (3.5–21.7) | 6 |
*N = 174 unless otherwise indicated. –, not applicable because no large study reported these data.
†Random-effects model unless otherwise indicated.
‡Includes the single-case dataset and the large studies (Technical Appendix Table 2.
§Other less common syndromes included peritonitis, myositis, pneumonia, sacroiliitis, abdominal aortic aneurysm, hemorrhagic labyrinthitis, gastroenteritis, vertebral osteomyelitis, lymphadenopathy, cellulitis, and vertigo.
¶Case-patients with toxic shock syndrome in China and in Thailand not included in this sepsis category.
#Mixed-effects model.
**Counted if the author described the case as toxic shock syndrome.
††Include 3 large studies reporting toxic shock syndrome, including 2 outbreaks in China (2,30) and 1 prospective study in Thailand (24).
‡‡Mainly reported with neck stiffness.
§§Reference values may differ among laboratories. Commonly used reference values for presented laboratory blood tests are as follows: leukocytes 4.0–10 × 109 cells/L; hemoglobin 140–170 g/L (for male patients) and 120–160 g/L (for female patients); platelets 150–350 × 109/L; blood glucose (fasting) 70–100 mg/dL; C-reactive protein 0–8.0 mg/L. Reference ranges for cerebrospinal fluid are as follows: leucocytes 0–5 cells/mm3; protein 0.15–0.60 g/L; glucose 40–80 mg/dL. (Source: http://im2014.acponline.org/for-meeting-attendees/normal-lab-values-reference-table/)
1These authors contributed equally to this article.