Abstract
BackgroundInfection is a common complication in acute phase after stroke, and even in specialized stroke units, it remains one of the major complications. The relationship between infections and acute ischemic stroke is complex and bidirectional. Infections can result in ischemic stroke, and the rate of infection is increased after ischemic stroke.Aim of workThe aim of this study is to estimate the incidence of post-stroke infections in the Egyptian patients, with determination of the most common infections, possible risk factors, and their clinical implications.MethodsThe study was conducted on one hundred adult patients with acute ischemic stroke, full medical history, thorough clinical examination, routine laboratory investigations, estimation of erythrocyte sedimentation rate and C-reactive protein, abdominal ultrasound, plain X-ray of the chest, culture and sensitivity, non-contrast computed tomography, magnetic resonance imaging for patients with normal CT studies of the brain, duplex study of both carotids and vertebral, ECG, and echocardiography, any further investigations needed and lastly collected data statistically analyzed.ResultsThe results of our study showed that 32 patients (32%) developed post-stroke infection. Post-stroke infections increased with higher age and female gender. Post-stroke infections were strongly correlated to the presence of atrial fibrillation, previous stroke, or transient ischemic attacks. The occurrence of post-stroke infection was significantly correlated to stroke severity, size of infarction, and carotid stenosis. Post-stroke infection was also correlated with the occurrence of multiple post-stroke neurological complications. Infections that occurred post-stroke were pneumonia (21%) and urinary tract infection (15%), blood (5%), and subcutaneous infection (3%).ConclusionStroke is a major health problem, and infection is one of the commonest post-stroke complications. Post-stroke infection significantly affects clinical outcome and being strongly associated with occurrence of neurological complications.: study was conducted on one hundred adult patients with acute ischemic stroke, full medical history, thorough clinical examination, routine laboratory investigations, estimation of erythrocyte sedimentation rate and C-reactive protein, abdominal ultrasound, plain X-ray of the chest, culture and sensitivity, non-contrast computed tomography (CT), magnetic resonance imaging (MRI) for patients with normal CT studies of the brain, duplex study of both carotids and vertebral, electrocardiography (ECG), and echocardiography, any further investigations needed and lastly collected data statistically analyzed.
Highlights
Infection is a common complication in acute phase after stroke, and even in specialized stroke units, it remains one of the major complications
The study was conducted on one hundred adult patients with acute ischemic stroke, full medical history, thorough clinical examination, routine laboratory investigations, estimation of erythrocyte sedimentation rate and C-reactive protein, abdominal ultrasound, plain X-ray of the chest, culture and sensitivity, non-contrast computed tomography, magnetic resonance imaging for patients with normal CT studies of the brain, duplex study of both carotids and vertebral, ECG, and echocardiography, any further investigations needed and lastly collected data statistically analyzed
The occurrence of post-stroke infection was significantly correlated to stroke severity, size of infarction, and carotid stenosis
Summary
Infection is a common complication in acute phase after stroke, and even in specialized stroke units, it remains one of the major complications. Infection is a common complication in acute phase after stroke (Vermeij et al 2009), and even in specialized stroke units, it remains one of the major complications (Meisel et al 2005). Post-stroke infections were typically explained as a result of neurological deficits such as impaired protective reflexes, dysphagia, and decreased consciousness, or as treatment associated complications related to mechanical ventilation or indwelling urinary catheters (Ersoz et al 2007); Tables 4 and 5 showed risk factors of postischemic stroke UTI and pathogen responsible for UTI. More recent evidence suggests that brain injury itself induces a disturbance of the normally well balanced brainimmune interactions resulting in an immune depressive status with subsequent infections (Dirnagl et al 2007)
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