Abstract
A retrospective study was conducted to examine the laboratory, clinical features and outcome of 206 adult acute bacterial meningitis patients (218 episodes) during the years 1985–1996. Pneumonia (8.7 per cent), head trauma (7.8 per cent) and chronic otitis media (6.0 per cent) were identified as the main predisposing factors for acute bacterial meningitis. Aetiology was described only in 61 episodes (28.0 per cent). Streptococcus pneumonia was the most commonly identified pathogen overall, causing 33 of the 218 episodes (15.2 per cent). Antibiotic treatment before admission was given to 48.4 per cent of patients. On admission, the following symptoms of meningitis were predominant: 83 per cent had neck stiffness, 81 per cent had a headache and 73 per cent had fever. Case fatality rate was 27.1 per cent (59 patients). The important factors in mortality were as follows: old age, a long duration of symptoms before admission, a lack of neck stiffness, obtunded mental state on admission, low glucose levels in first CSF, low CSF/blood glucose ratio, and abnormality in computerised tomography scanning.
Similar content being viewed by others
References
Tunkel, A. R., Wispelwey, B., Scheid, M. Bacterial meningitis: Recent advances in pathophysiology and treatment. An. Internal. Med. 1990; 112: 610–623.
Sangster, G., Murdoch, J. M., Gray, J. A. Bacterial meningitis 1940–79. J. Infect. 1982; 5: 245–255.
Girgis, N. I., Farid, Z., Mikhail, I. A., Farrag, I., Sultan, Y., Kilpatrick, M. E. Dexamethasone treatment for bacterial meningitis in children and adults. Pediatr. Infect. Dis. J. 1989; 8: 848–851.
Fortnum, H. M., Davis, A. C. Epidemiology of bacterial meningitis. Arch. Dis. Child. 1993; 68: 763–767.
Bryan, J. B., Rodriques, S., Tavares, A., Rocha, H., Scheid, M. Etiology and mortality of bacterial meningitis in northeastern Brazil. Rev. Infect. Dis. 1990; 12: 128–135.
Özyürek, S., Yayli, G., Kazgöl N, Selçuk, S. A retrospective evaluation of 311 Gases of meningitis. J. A. Turk. Microbiol. 1991; 21: 29–36.
Gonse, G. J., Thrupp, L. D., Nudleman, K. L., Wyle, F. A., Hawkins, B., Thomas, C. C. Bacterial meningitis in the elderly. Arch. Intern. Med. 1984; 144: 1603–1607.
Tunkel, A. R., Scheid, W. M. Pathogenesis and pathophysiology of bacterial meningitis. Clin. Microbiol. Rev. 1993; 6: 118–136.
Quagliarello, V. J., Scheid, W. M. New Perspectives on bacterial meningitis. Clin. Infect. Dis. 1993; 17: 603–610.
Pfister, H. W., Feiden, W., Einhaupl, K. M. Spectrum of complications during bacterial meningitis in adults. Arch. Neurol. 1993; 50: 575–581.
Durand, M. L., Calderwood, S. B., Weber, D. J., Miller, S. I., Southwick, F. S., Verne, S.C., Swartz, M. N. Acute bacterial meningitis in adults. N. Engl. J. Med. 1993; 328: 21–28.
Fraser, D. W., Henke, C. E., Feldman, R. A. Changing patterns of bacterial meningitis in Olmsted County, Minnesota, 1935–1972. J. Infect. Dis. 1972; 128: 300–307.
Schlech, W. F., Ward, J. I., Band, J. D., Hightower, A., Fraser, D. W., Broome, C. V. Bacterial meningitis in the United States, 1978 through 1981: The National Bacterial Meningitis Surveillance Study. J.A.M.A. 1985; 253: 1749–1754.
Wegner, J. D., Hightower, A. W., Faclam, F. R., Gaventa, S., Broome, C. V. Bacterial Meningitis Study Group. Bacterial meningitis in the United States, 1986: Report of a multi-state surveillance study. J. Infect. Dis. 1990; 162: 1316–1323.
Tunkel, A.R., Scheid, W. M. Acute meningitis. In: Mandell, G. L., Bennett, J. E., Dolin, R., eds. Principles and practice of infectious diseases (4th edition). New York: Churchill Livingstone. 1995: 831–865.
Cabrai, D. A., Flodmark, O., Farrell, K., Speert, D. P. Prospective study of computed tomograph in acute bacterial meningitis. J. Pediatr. 1987; 111: 201–205.
Snyder, R. D. Ventriculomegaly in childhood bacterial meningitis. Neuropediatrics 1984; 15: 136–138.
Andersen, J., Backer, V., Jensen, E., Voldsgaard, P., Wandall, J. H. Acute meningitis of unknown aetiology: Analysis of 219 cases admitted to hospital between 1977 and 1990. J. Infect. 1995; 31: 115–122.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hoşoğlu, S., Ayaz, C., Geyik, M.F. et al. Acute bacterial meningitis in adults: Analysis of 218 episodes. I.J.M.S. 166, 231–234 (1997). https://doi.org/10.1007/BF02944240
Issue Date:
DOI: https://doi.org/10.1007/BF02944240