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Clinical Presentation and Outcome of Bacterial Meningitis in University Hospital

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DOI: 10.4236/aid.2014.43019    3,748 Downloads   5,285 Views   Citations

ABSTRACT

Purpose: To determine the clinical characteristics and outcome of bacterial meningitis in adult patients using CT, MRI and CSF culture. Methods: Patients admitted to the university hospital with clinical diagnosis of meningitis were included in the present study. All patients were subjected to clinical examination as well as CT, MRI scanning and CSF-bacteriological culture. Results: The age distribution of the patients shows that there is high frequency of symptoms found in the age group between ages 40 - 45. CSF in the present study included WBS, RBC, glucose and protein, which is associated with the adverse outcome. Meningitis can be confirmed by many methods, in the present study three different methods were used, which included CT scan, MRI and CSF analysis and bacterial culture. In CT scan, among the predictors of meningitis, persons with TB (P = 0.037), patients with HIV (P = 0.036) and stroke (P = 0.036) showed significant association. Whereas MRI findings were significantly associated with TB meningitis (P = 0.015). Meningitis was prevalent in the age group of <45. Conclusion: This study highlights the importance of several modalities for diagnosing and predicting the outcome of meningitis in adults.

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The authors declare no conflicts of interest.

Cite this paper

Ahmed, M. (2014) Clinical Presentation and Outcome of Bacterial Meningitis in University Hospital. Advances in Infectious Diseases, 4, 124-131. doi: 10.4236/aid.2014.43019.

References

[1] Farag, H.F.M., Abdel-Fattah, M.M. and Youssri, A.M. (2005) Epidemiological, Clinical and Prognostic Profile of Acute Bacterial Meningitis among Children in Alexandria, Egypt. Indian Journal of Medical Mi-
crobiology, 23, 95-101. http://www.ncbi.nlm.nih.gov/pubmed/15928437 http://dx.doi.org/10.4103/
0255-0857.16047
[2] Abdulrab, A., Algobaty, F., Salem, A.K. and Mohammed, Y.A. (2010) Acute Bacterial Meningitis in Adults: A Hospital Based Study in Yemen. Japanese Journal of Infectious Diseases, 63, 128-131. http://www.ncbi.nlm.nih.gov/pubmed/20332577
[3] van de Beek, D., de Gans, J., Spanjaard, L., et al. (2004) Clinical Features and Prognostic Factors in Adults with Bacterial Meningitis. The New England Journal of Medicine, 351, 1849-1859. http://www.nejm.org/doi/full/10.1056/NEJMoa040845#t=articleBackground http://dx.doi.org/10.1056/NEJMoa040845
[4] Zaidi, A., Awasthi, S. and DeSilva, H. (2004) Burden of Infectious Diseases in South Asia. BMJ, 328, 811-815. http://dx.doi.org/10.1136/bmj.328.7443.811
[5] Al-Binali, A.M. and Al-Fifi, S.H. (2002) Profile of Childhood Meningitis in a Hospital in South West Saudi Arabia. Saudi Medical Journal, 23, 793-796. http://www.ncbi.nlm.nih.gov/pubmed/12174227
[6] McGee, Z. and Baringer, J. (1990) Acute Meningitis. In: Mandell, G.L., Bennett, J. and Dolin, R., Eds., Principles and Practice of Infectious Diseases, Churchill Livingstone, New York, 741-755.
[7] Wallace Jr., R.J., Musher, D.M., Septimus, E.J., McGowan Jr., J.E., Quinones, F.J., et al. (1981) Haemophilus influenzae Infections in Adults: Characterization of Strains by Serotypes, Biotypes and
β-Lactamase Production. The Journal of Infectious Diseases, 144, 101-106. http://dx.doi.org/10.1093
/infdis/144.2.101
[8] Sigurdardottir, B., Bjornsson, O.M., Jonsdottir, K.E., Erlendsdóttir, H. and Gudmundsson, S. (1997) Acute Bacterial Meningitis in Adults. A 20-Year Overview. Archives of Internal Medicine, 158, 425-430. http://dx.doi.org/10.1001/archinte.1997.00440250077009
[9] Holmes, S.J., Lucas, A.H., Osterholm, M.T., Froeschle, J.E. and Granoff, D.M. (1991) Immunoglobulin Deficiency and Idiotype Expression in Children Developing Haemophilus influenzae Type b Disease after Vaccination with Conjugate Vaccine. The Collaborative Study Group. JAMA, 266, 1960-1965. http://dx.doi.org/10.1001/jama.1991.03470140072027
[10] Azubuike, J.C. (1990) Childhood Bacterial Meningitis in Tabuk, Saudia Arabia. Annals of Saudi Medicine, 10, 145-148.
[11] AL-Jurayyan, N. (1992) Childhood Bacterial Meningitis in AL-Baha Provience, Saudia Arabia. The Journal of Tropical Medicine and Hygiene, 95, 180-185.
[12] Srair, H. (1992) Bacterial Meningitis in Saudi Children. Indian Journal of Pediatrics, 59, 719-721. http://dx.doi.org/10.1007/BF02859407
[13] Rabay, H.A., Al Anazy, A.R. and Saidu, A.B. (2003) Case Reports Meningitis in an Adult Immunocompetent Patient. SAUDI Medical Journal, 24, 783-785.
[14] Crawford, C., Kennedy, N. and Weir, W. (1994) Cerebrospinal Fluid Rhinorrhoea and Haemophilus influenzae Meningitis 37 Years after Head Injury. Journal of Infection, 28, 93-97.
http://dx.doi.org/10.1016/S0163-4453(94)94378-8
[15] Durand, M.L., Calderwood, S.B., Weber, D.J., Miller, S.I., Southwick, F.S., Caviness Jr., V.S. and Swartz, M.N. (1993) Acute Bacterial Meningitis in Adults—A Review of 493 Episodes. The New England Journal of Medicine, 328, 21-28. http://dx.doi.org/10.1056/NEJM199301073280104
[16] Paul, R., Kastenbauer, S., Koedel, U. and Grosshadern, K. (2003) Complications and Treatment of Bacterial Meningitis. Schweizer Archiv fur Neurologie und Psyshiatrie, 154, 169-173.
[17] Wolf, S. (1978) Laboratory Evaluation of the Child with a Febrile Convulsion. Pediatrics, 62, 1074-1076.
[18] Berkley, J.A., Mwangi, I., Ngetsd, C.J., et al. (2001) Diagnosis of Acute Bacterial Meningitis at a Distant Hospital in Sub-Saharan Africa. The Lancet, 357, 1753-1757.
http://dx.doi.org/10.1016/S0140-6736(00)04897-2
[19] Khalfan, S., Ayhmard, M. and Lina, B. (1998) Epidemics of Aseptic Meningitis Due to Enteroviruses Following National Immunization Days in Bahrain. Annals of Tropical Paediatrics, 18, 101-109.
[20] Quagliarello, V. and Scheld, W.M. (1992) Bacterial Meningitis: Pathogenisis, Pathophysiology and Progress. The New England Journal of Medicine, 327, 864-872.
http://dx.doi.org/10.1056/NEJM199209173271208
[21] Ahmad, I., Haq, H., Rehman, A., Khattak, A. and Khan, F.M. (2004) Bacterial Meningitis in Children. Journal of Postgraduate Medical Institute, 18, 523-528.
[22] Yost, G.C., Kaplan, A.M. and Bustmante, R. (1986) Bascterial Meningitis in Arizona American Indian Children. American Journal of Diseases of Children, 6, 943-946.
[23] Muhe, L. and Tilahun, M.L.S. (1999) Etiology of Pneumonia, Sepsis and Meningitis in Infants Younger than 3 Months of Age in Ethiopia. Pediatric Infectious Disease Journal, 18, S56-S61.
[24] Tikhomirov, E., Santamaria, M. and Esteves, K. (1997) Meningococcal Diseases: Public Health Burden and Control. World Health Statistics Quarterly, 50, 170-177.
[25] Salih, M.A., Ahmed, H.S., Karrar, Z.A., Kamil, I., Osman, K.A., Palmgren, H., Hofvander, Y. and Olcén, P. (1990) Features of Large Epidemic Group of Meningococcal Meningitis in Khartoum. Scandinavian Journal of Infectious Diseases, 22, 161-170.
[26] Kastenbauer, S. and Pfister, H. (2003) Pneumococcal Meningitis in Adults: Spectrum of Complications and Prognostic Factors in a Series of 87 Cases. Brain, 126, 1015-1025.
http://dx.doi.org/10.1093/brain/awg113
[27] McMillan, D., Lin, C., Aronin, S. and Quagliarello, V. (2001) Community-Acquired Bacterial Meningitis in Adults: Categorization of Causes and Timing of Death. Clinical Infectious Diseases, 33, 969-975. http://dx.doi.org/10.1086/322612
[28] Schaad, U.B., Suter, M.D., Borradori, A.G., Pfenninger, J., Auckenthaler, R., Bernath, O., Cheseaux, J.J. and Wedgwood, J. (1990) Comparison of Ceftriaxone and Cefuroxime for the Treatment of Bacterial Meningitis in Children. The New England Journal of Medicine, 322, 142-147.
http://dx.doi.org/10.1056/NEJM199001183220301
[29] Samiullah, S., Humaira, M., Hanif, G., Ghouri, A.A. and Shaikh, K. (2010) Etiological Patterns of Stroke in Young Patients at a Tertiary Care Hospital. Journal of Pakistan Medical Association, 60, 201-204.
[30] Incesu, L., Khosla, A. and Aiello, M. (2009) Imaging in Chiari II Malformation: Imaging eMedicine. http://emedicine.medscape.com/article/406975-overview.
[31] Vaswani, A.K., Nizamani, W.M., Ali, M., Aneel, G., Shahani, B. and Hussain, S. (2014) Diagnostic Accuracy of Contrast-Enhanced FLAIR Magnetic Resonance Imaging in Diagnosis of Meningitis Corre-
lated with CSF Analysis. Radiology, 2014, Article ID: 578986.
http://dx.doi.org/10.1155/2014/578986.
[32] Carol, K. and Carrol, C. (1994) A Prospective Investigation of the Long-Term Auditory-Neurological Sequelae Associated with Bacterial Meningitis: A Study from Vanuatu. The Journal of tropical medicine and hygiene, 97, 145-150.
[33] Liu, C.C., Chen, J.S., Lin C.H., et al. (1993) Bacterial Meningitis in Infants and Children in Southern Taiwan Emphasis on H. influenza Type B Infection. Journal of the Formosan Medical Association, 92, 884-888.
[34] Muhe, L. and Tilahun, M.L.S. (1994) Clinical Signs and Etiological Agents of Pneumonia. Clinical Outcome Predictors. Ethiopian Medical Journal, 32, 206.

  
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